Unveiling the paradoxes of implementing post graduate competency based medical education programs.

PURPOSE: Competency-based medical education (CBME) has gained prominence as an innovative model for post-graduate medical education, yet its implementation poses significant challenges, especially with regard to its sustainability. Drawing on paradox theory, we suggest that revealing the paradoxes underlying these challenges may contribute to our understanding of post graduate competency-based medical education (PGCBME) implementation processes and serve as a first-step in enhancing better implementation. Thus, the purpose of the current study is to identify the paradoxes associated with PGCBME implementation. METHOD: A qualitative study was conducted, as part of a larger action research, using in-depth semi-structured interviews with fellows and educators in eight Neonatal wards. RESULTS: Analysis revealed that the PGCBME program examined in this study involves three different levels of standardization, each serving as one side of paradoxical tensions; (1) a paradox between the need for standardized assessment tools and for free-flow flexible assessment tools, (2) a paradox between the need for a standardized implementation process across all wards and the need for unique implementation protocols in each ward; and 3) a paradox between the need for a standardized meaning of competency proficiency and the need for flexible and personal competency achievement indicators. CONCLUSIONS: Implementing PGCBME programs involves many challenges, some of which are paradoxical, i.e. two contradictory challenges in which solving one challenge exacerbates another. Revealing these paradoxes is important in navigating them successfully.

Count on trust: the indirect effect of trust in government on policy compliance with health behavior instructions.

Trust in government is considered a prominent factor for enhancing public compliance with government policies and instructions. The Coronavirus pandemic demonstrates the crucial role public compliance with governmentally issued health guidelines has in mitigating the pandemic. However, the mechanism explaining the trust-compliance association, particularly in regard to health-behavior compliance, is unclear. This article develops a new theoretical model, the Mediated Trust Model (MTM), for explaining the relationship between trust in government and public compliance with health instructions. The model extends the classic Health Belief Model for predicting health behavior by claiming that the perceptions regarding the instructions' costs, benefits and one's ability to perform them are affected by trust in government and mediate the trust-compliance association. The MTM was tested in four cross-sectional studies performed during the first 20 months of the Coronavirus pandemic in Israel on 3732 participants, for various health instructions. Implications for public health literature, policy compliance theory and policy makers are discussed.

The publicness enigma: Can perceived publicness predict employees' formal and prosocial behavior across sectors?

The meaning of Publicness for organizations and for individuals has received growing attention in the public administration literature in recent years. We adopt a perceived publicness perspective to expand our understanding of the publicness concept and operationalize this perception as a means to predict employees' formal and prosocial behaviors across sectors. Using a recently developed Publicness Perceptions Scale (PPS), we present and empirically examine a model regarding the direct and indirect relationships among perceived publicness, employees' engagement, and their performance in public and hybrid organizations. Findings based on a field study of 340 employees from governmental (i.e. public) and non-governmental (i.e. hybrid) organizations reveal that perceived publicness has a positive relationship with Organizational Citizenship Behaviors (OCB) and that this relationship is largely mediated by employees' engagement. In addition, in non-government organizations perceived publicness is negatively related to employees' in-role performance. We thus contribute to the theoretical knowledge on publicness at the perceptual level and point to its role in formal and informal performance across sectors. Other theoretical, methodological, and practical implications are discussed, and directions for future studies are suggested.

Bright sparks and enquiring minds: Differential effects of goal orientation on the creativity trajectory.

Why are some employees better than others at improving and maintaining their creativity over time? Despite decades of empirical study and theory on employee creativity, the temporal and developmental aspects of creativity are far from being fully understood. Emphasizing the dynamic nature of creativity, we propose that creativity trajectories are nonmonotonic, and that goal orientations explain individual variations in the ability to improve and sustain the productivity (number) and quality (novelty and usefulness) of ideas over time. Our findings from a longitudinal study at a manufacturing company suggest that employees with a learning orientation strive to develop their skills and thus improve the quality of their ideas at a faster rate and maintain it over time. Those with a performance orientation seek to demonstrate their skills, relying on existing frameworks that enable a larger number of ideas initially, yet ultimately undermine their creativity in the long term. We discuss the theoretical and practical implications for fueling creativity over time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"Apples and Oranges": Examining Different Social Groups' Compliance With Government Health Instructions During the COVID-19 Pandemic.

BACKGROUND: The coronavirus outbreak has demonstrated the crucial effect of the public's compliance with the government's health instructions on the population's health. However, evidence shows that some communities are less likely to comply with such instructions than others. This study highlights the factors related to intentions to comply with newly issued health directives during an ongoing extreme crisis, such as the current pandemic. In addition, it compares the impact of these factors on different minority groups and the general population in Israel. METHODS: Using an online survey (N=1005), we examined the impact of compliance-related factors on compliance intentions with newly issued health directives in two minority groups in Israel: the ultra-Orthodox Jewish community (N=323) and the Arab community (N=361), as well as in the general population (N=321), during the first outbreak of coronavirus disease 2019 (COVID-19). Participants were presented with a new made-up COVID-19-related instruction simulated to be issued by the Israeli Ministry of Health. Compliance intentions and compliance-related factors were measured. RESULTS: The Arab minority expressed greater intentions of complying with the instructions than the other groups. Perceptions on risk and the effectiveness of the instruction were the only two significantly associated factors with compliance intentions in all of the social groups. Additional factors affected different groups to different extents. Trust in government was related to compliance intentions only in the Arab minority. CONCLUSION: Intentions to comply with health instructions during a crisis differ in various minority groups and in comparison to the general population, both in their levels and in the factors related to them. Policy-makers and health authorities should consider providing information about the risks and negative outcomes of the crisis as well as the expected effectiveness of the recommended behaviors. Future research should examine other minority groups and other types of instructions in different stages of a crisis.

[COMPETENCY-BASED TRAINING AS A WAY TO CREATE ORGANIZATIONAL CHANGE AND IMPROVE PROFESSIONALISM: A REVIEW OF THE PROCESS OF IMPLEMENTING A COMPETENCY-BASED MEDICAL EDUCATION (CBME) TRAINING PROGRAM IN NEONATOLOGY FELLOWSHIP IN ISRAEL].

INTRODUCTION: Competency-based medical education (CBME) is a model aimed to address certain challenges and shortcomings attributed to the contemporary models of medical education and the medical profession in general. The CBME model has been used mainly in the education of undergraduate medical students with no continuation to residency, fellowship, or independent practice. In this review, we present a program based on the CBME model for the design and implementation of a new fellowship program in neonatology in Israel. As part of the program, we propose a mentorship program as a means to facilitate the implementation and acceptance of the program in the different wards. We designed assessment tools that can help the mentor track the fellow's development over time as well as to examine the impact of the proposed program on performance and on all stakeholders' satisfaction over time. We aim to evaluate the benefits and effectiveness of this CBME training not only on the fellows' abilities and performance outcomes, but also on the accompanying general organizational changes that can lead to general improvement in the neonatal profession in Israel.

Political Efficacy as a Buffer of the Heightened Risk of Posttraumatic Stress in Disadvantaged Communities.

External collective political efficacy (PE) is an individual's perception of the extent to which the government is responsive to the needs of his or her group or community or to its collective actions. Does PE play a role in the association between exposure to political violence and posttraumatic stress? The current study aimed to examine whether such PE may help explain why exposure to political violence results in posttraumatic stress for some people but not others. Based on the conservation of resource theory, research has found that residents of some types of communities are less likely to suffer from posttraumatic stress when exposed to political violence, due to the economic and psychological resources these communities provide. Political efficacy, as an individual-level factor that relates to the community, may help predict who will suffer more or less posttraumatic stress from exposure to political violence within a given community. Based on a panel study conducted immediately before and after the 2008-2009 Gaza conflict (N = 650) and hierarchical linear modeling analyses, we found that type of community indeed moderated the association between exposure to political violence and posttraumatic stress, Δ-2 log likelihood = 30.4, p < .001. In addition, we found that PE mitigated the psychological distress resulting from exposure to political conflict in disadvantaged communities, Δ-2 log likelihood = 22.8, p < .001. This study not only further untangled the association between exposure and distress during times of war but also identified the role that governments can play in preventing conflict-induced distress beyond offering physical protection.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) ¿La eficacia política amortigua el mayor riesgo de estrés postraumático en las comunidades desfavorecidas? EL EFECTO AMORTIGUADOR DE LA EFICACIA POLÍTICA La eficacia política colectiva externa (EP) es la percepción que tiene un individuo de la medida en que el gobierno responde a las necesidades de su grupo o comunidad o a sus acciones colectivas. ¿La EP juega un papel en la asociación entre la exposición a la violencia política y el estrés postraumático? El estudio actual tuvo como objetivo examinar si tal EP puede ayudar a explicar por qué la exposición a la violencia política produce estrés postraumático para algunas personas, pero no para otras. Sobre la base de la teoría de la conservación de los recursos, la investigación ha encontrado que los residentes de algunos tipos de comunidades tienen menos probabilidades de sufrir estrés postraumático cuando están expuestos a la violencia política, debido a los recursos económicos y psicológicos que estas comunidades proporcionan. La EP, como un factor a nivel individual que se relaciona con la comunidad, puede ayudar a predecir quién sufrirá más o menos estrés postraumático por la exposición a la violencia política dentro de una comunidad determinada. Sobre la base de un estudio de panel realizado inmediatamente antes y después del conflicto de Gaza de 2008-2009 (N = 650) y los análisis de modelos lineales jerárquicos, encontramos que el tipo de comunidad efectivamente moderó la asociación entre la exposición a la violencia política y el estrés postraumático Δ-2loglikelihood = 30.4, p <.001. Además, encontramos que la EP mitigó el malestar psicológico resultante de la exposición al conflicto político en comunidades desfavorecidas, Δ-2loglikelihood = 22.8, p <.001. Este estudio no solo desenredó más la asociación entre la exposición y malestar en tiempos de guerra, sino que también identificó el papel que los gobiernos pueden desempeñar en la prevención del malestar provocado por el conflicto más allá de ofrecer protección física.

The effects of team reflexivity on psychological well-being in manufacturing teams.

While the impact of team reflexivity (a.k.a. after-event-reviews, team debriefs) on team performance has been widely examined, we know little about its implications on other team outcomes such as member well-being. Drawing from prior team reflexivity research, we propose that reflexivity-related team processes reduce demands, and enhance control and support. Given the centrality of these factors to work-based strain, we posit that team reflexivity, by affecting these factors, may have beneficial implications on 3 core dimensions of employee burnout, namely exhaustion, cynicism, and inefficacy (reduced personal accomplishment). Using a sample of 469 unskilled manufacturing workers employed in 73 production teams in a Southern Chinese factory, we implemented a time lagged, quasi-field experiment, with half of the teams trained in and executing an end-of-shift team debriefing, and the other half assigned to a control condition and undergoing periodic postshift team-building exercises. Our findings largely supported our hypotheses, demonstrating that relative to team members assigned to the control condition, those assigned to the reflexivity condition experienced a significant improvement in all 3 burnout dimensions over time. These effects were mediated by control and support (but not demands) and amplified as a function of team longevity. (PsycINFO Database Record

The psychological effects of cyber terrorism.

When ordinary citizens think of cyber threats, most are probably worried about their passwords and banking details, not a terrorist attack. The thought of a shooting in a mall or a bombing at an airport is probably more frightening than a cyber breach. Yet terrorists aim for mental as well as physical destruction, and our research has found that, depending on who the attackers and the victims are, the psychological effects of cyber threats can rival those of traditional terrorism.

The relationship between socio-economic factors and responsiveness gaps in primary, preventative and health promotion services.

OBJECTIVE: To examine whether there are individual level factors such as socio-economic status that may predict disparities in the public's experiences with and expectations of their health-care providers. DATA SOURCES/STUDY SETTING: Primary data were collected in 2010. The sample comprised of 1211 Israeli citizens above the age of 18. STUDY DESIGN: Participants were randomly approached at one points in time and presented with statements regarding practices they experience and practices that are important to them related to primary care, preventive care and health promotion. We calculated a difference scores for each health-care area. We measured socio-economic status (SES) with three separate variables relating to income, education and living location. DATA COLLECTION/EXTRACTION METHODS: Employees of a professional telephone survey firm conducted the survey. Multiple regression was used with the responsiveness gap in each of three health-care areas as the dependent variables. PRINCIPAL FINDINGS: We found that level of education is negatively related to the extent of the responsiveness gap in both primary and preventive health care and that income is negatively related to the responsiveness gap in health promotion. CONCLUSIONS: Personal characteristics such as SES are related to people's perceptions about the extent of the responsiveness gap. Policy makers can now expend efforts and resources in minimizing such responsiveness gaps among specific populations.

Evidence-based disparities: examining the gap between health expectations and experiences.

CONTEXT: In a time of economic austerity, one of the most daunting questions is who decides on healthcare rationing? In the current study, we sought to examine if the public can in fact provide meaningful information regarding healthcare policy issues. Based on theories of public policy, this paper tries to find out if patients behave akin to 'responsible citizens' and can provide differentiated expectations between three healthcare dimensions. METHODS: One thousand two-hundred eleven individuals participated in a telephone interview. Participants were asked two series of questions, one regarding their views on the primary care, prevention and promotion practices they experience with their healthcare provider and one regarding the importance of these practices to them. We calculated a difference score representing the gap in each healthcare dimension. FINDINGS: In all three healthcare dimensions, the mean gap is in the positive side of the axis indicating that the public does not receive what it expects to receive, or in policy terms there is 'a responsiveness deficit'. The mean gap in relation to primary care is significantly lower than the mean gap in both preventive care and health promotion. CONCLUSIONS: The public can provide meaningful information even in areas of endless demand and can provide an addition point of view to be considered by policy makers in complicated healthcare rationing decisions.

Effects of job control and situational severity on the timing of help-seeking.

Studies suggest that the psychopathological effects of involvement in critical incidents among emergency service workers failing to seek help in a timely manner may be detrimental both for the individual and for the organization. However, little is known as to the factors governing when individuals seek such help. Consequently, drawing from the help-seeking and coping literatures, we generate a theory explicating how job characteristics (namely, job control) and situational factors (namely, the severity of incident involvement) combine to influence help-seeking delay or, in other words, the amount of time that passes before employees seek help for incident-related distress. Using data collected from firefighters who were involved at varying degrees of intensity in the events in and around the World Trade Center on September 11, 2001, we demonstrate that increasing levels of situational severity influence the relationship between job-control and help-seeking delay with job control having a curvilinear association with help-seeking delay under conditions of high situational severity.

Retirement and drug abuse: the conditioning role of age and retirement trajectory.

Although recent research on the link between retirement and drinking behavior among older adults suggests that retirement may also serve as a risk factor for drug abuse, the latter association has yet to be subject to rigorous research. We examined this association, as well as the possible conditioning effects of age and retirement trajectory, using a sample of 978 retirement-eligible workers (some having retired, others deferring their retirement) from 3 blue-collar employment sectors: (e.g., construction, manufacturing, and transportation). The findings indicate a weak but significant positive association between retirement and the severity of drug abuse. Age moderated the retirement-drug abuse relationship with - among older workers - higher rates of drug abuse found among those deferring retirement and lower rates among those actually retiring, and the exact opposite pattern found among younger retirement-eligible workers. Also, as hypothesized, the moderating effects of age on the association between retirement and drug abuse were weaker among those opting to return to work post-retirement as opposed to those fully retiring.