Qualities of Role Models of Internal Medicine Residents in a Tertiary National University Hospital in the Philippines.

Background: Teachers in medicine do not only teach scientific facts about health and disease to their learners but they are also looked up to as role models. Little is known about the qualities of consultant-faculty members who are regarded as role models by Filipino internal medicine residents. Objective: This study aimed to determine the reasons why consultant-faculty members are considered role models by Filipino internal medicine residents. Methods: A cross-sectional survey was conducted among internal medicine residents at a tertiary national university hospital in the Philippines. Participants were asked to give the reasons for citing consultant-faculty members who they consider as role models. Results: There were 81 residents who participated (93% response rate) who gave a total of 332 qualities as reasons for citing them as role models. The most commonly cited quality category was those of personal qualities (35.84% of all responses). This was followed by academic, clinical, teaching, leadership and research qualities. Physical qualities were the least cited (0.30% of all responses). Across the four batches of residents, personal qualities were consistently cited the most number of times, while physical qualities were consistently cited the least. Conclusion: Filipino internal medicine residents identified personal qualities as the most frequent reason for considering their consultant-faculty as role models.

Insights into discrepancies in professional identities and role models in undergraduate medical education in the context of affective burden.

Introduction: International evidence strongly suggests that medical students are at high risk of mental health problems. This distress, which can be mediated by a variety of individual, interpersonal and contextual factors within the curriculum, can be mitigated by effective coping strategies and interventions. Central to this discourse is the recognition that the challenges of professional identity formation can contribute significantly to medical students' distress. The focus of our study is therefore to examine discrepancies in professional identities and role models in undergraduate medical education in relation to affective burden. Methods: Medical students at different stages of university education and high school graduates intending to study medicine were surveyed in a cross-sectional study. The study employed Osgood and Hofstätter's polarity profile to evaluate the self-image of participants, the image of an ideal and real physician, and their correlation with depression (PHQ-9) and anxiety (GAD-7). Results: Out of the 1535 students recruited, 1169 (76.2%) participated in the study. Students rated their self-image as somewhere between a more critical real image of physicians and a more positive ideal image. Medical students at all training levels consistently rated the ideal image as remaining constant. Significant correlations were found between the professional role models of medical students and affective symptoms, particularly for the discrepancy between the ideal image of a physician and their self-image. Furthermore, 17% and nearly 15% reported significant symptoms of depression and anxiety, respectively. Discussion: Our study adds to the growing body of knowledge on professional identity formation in medicine and socialisation in the medical environment. The study highlights the importance of discrepancies between self-image and ideal image in the experience of depressive and anxiety symptoms. Primary prevention-oriented approaches should incorporate these findings to promote reflective competence in relation to professional role models and strengthen the resilience of upcoming physicians in medical training.

Lessons Learned From Early Undergraduate Exposure to the Medical School Curriculum: A Qualitative Analysis.

BACKGROUND:  Students considering the health profession as a career rarely have an opportunity to explore medical school experiences. Pathway programs and "mini-medical school" programs exist but rarely involve integrating participants into the medical school experience. A novel for-credit undergraduate course was developed to embed students into a clinical skills course for medical students beginning in 2013. To better understand the impact of these experiences, this study explored former students' perceptions and career trajectories. METHODS: Participants were contacted via email to participate in a virtual, semi-structured interview. Virtual interviews were recorded and transcribed verbatim. Three investigators analyzed 17 interview transcripts independently and developed a codebook. Investigators met to discuss common themes and outcomes. RESULTS: Participants received early education on patient interviewing and physical examination skills, health policy, and ultrasound. They noted their course experience was a productive way to gain insight into medical school and often cited it when applying for their chosen professional school. Although not a formal part of the course curriculum, many received guidance on the medical school application process, and some obtained letters of recommendation from physician facilitators. Participants emphasized the sense of belonging within the medical school community and affirmation of pursuing a health professional degree. CONCLUSION: Participants found their experience to be meaningful and cited it as an influential factor in deciding to pursue a health professional degree. The course could be adopted by other institutions to enhance the variety of pre-health experiences for future medical students or health profession students.

Professional nurses supporting learners during professional socialisation in Limpopo province.

Background: Professional nurses play a significant role in the professional socialisation of learner nurses during clinical placement. Clinical placements are areas of experiential learning as learner nurses come in contact with real-life experiences. Professional nurses are custodians of learners and need to offer them support. Aim: The study sought to explore the role of professional nurses in supporting learner nurses during professional socialisation. Setting: Four clinical health facilities in Limpopo province at different levels of care were purposely sampled to obtain information from different levels of care. Methods: An ethnonursing approach and qualitative, explorative design was used. Non-probability purposive sampling was used to select 25 professional nurses. The criteria were professional nurses with 3 years of experience in professional socialisation and working in institutions accredited for clinical placement of learner nurses registered in the undergraduate programme. Data were collected through a face-to-face interview until data saturation was reached. Tesch's open coding system was used to analyse data. Results: Professional nurses acknowledged that their responsibilities in supporting learners during professional socialisation are mentoring, teaching and being competent practitioners. Professional nurses were aware of their role in transferring ethical skills and knowledge to learners through professional socialisation. Conclusion: The effectiveness of professional socialisation of learner nurses depends on the support offered during clinical placements. Contribution: The study adds to the body of knowledge in nursing education and practice because when learners are offered support in the clinical areas, their learning journey will be of positive experience leading to competent practitioners.

Meta-synthesis of qualitative studies to explore fathers' perspectives of their influence on children's obesity-related health behaviors.

BACKGROUND: In nursing research and practice, there is a paucity of information about how fathers perceive their role in shaping their children's health behaviors. Most studies on the parental factors affecting children's health behaviors have focused on the role of mothers. However, recent studies showed that fathers' health behaviors can influence those of their children. Therefore, the aim of this study was to synthesize existing qualitative studies to explore fathers' perspectives regarding how they influence children's obesity-related health behaviors. METHODS: We conducted a descriptive meta-synthesis. To retrieve relevant articles, we used databases including PubMed, CINAHL, and Web of Science. Only qualitative studies published in English-language peer-reviewed journals, targeting fathers of children aged 2-18 years, and focusing on fathers' perspectives were included. All the quotes collected from the studies were reviewed and coded, and thematic analysis was used to derive themes. RESULTS: Article screening and review yielded a total of 13 qualitative studies, from which the following themes emerged: (1) fathers' parenting practices and role-modeling behaviors, (2) fathers' roles in their relationships with their family members, and (3) fathers' resource-seeking behaviors and contributions to their home food environment. Fathers were aware that their parenting practices and role-modeling behaviors could influence their children's health behaviors. Furthermore, fathers recognized the importance of their relationships with family members, which was reflected in their family roles; that is, whether they took responsibility for childcare and household work, whether their parenting practices were similar to those of their spouses, and whether they involved their children in their activities. Fathers also reported their resource-seeking behaviors as well as their contribution to the home food environment, which affected their children's health behaviors. CONCLUSION: Fathers' perspectives on their influence on children's health behaviors reveal their unique paternal role in influencing children's health behaviors. Fathers' perspectives could be incorporated into future nursing research to examine the relationship between fathers' roles and children's health behaviors to develop better health intervention programs.

Exploration of the representation of the allied health professions in senior leadership positions in the UK National Health Service.

BACKGROUND: Allied health professionals (AHPs) are an important group within the National Health Service (NHS) in the UK and make up a large portion of the workforce. Investment in AHP leadership is believed to lead to improvements in patient care, resource use, collaboration and innovation. This study aims to assess the current state of AHP strategic leadership within the NHS. METHODS: A freedom of information (FOI) request was sent to all NHS Trusts and health boards (HBs) within the UK NHS. The questions focused on the AHP workforce, with a particular interest in the chief AHPs (or equivalent roles) working in an NHS setting. Analysis of the FOI used a range of descriptive statistics. RESULTS: Of the 217 Trusts/HBs contacted, responses were received from 160 (74%). The majority (81%) reported that they employed a Chief AHP or equivalent role, with only 14% of these having a position on the Trust/HB executive board. There were 50 different job titles reported as the titles for the chief AHP or equivalent roles: with director of AHPs (18.6%), lead AHP (13.9%) and chief AHP (11.6%) being the most reported titles. The results identified an inequity of representation of AHP professions within senior AHP leadership; with most of these roles (70%) held by physiotherapists and occupational therapists. CONCLUSION: Changes in AHP strategic leadership are needed to address the inequities identified in this study. Addressing these issues is required to enable inclusive leadership, which is crucial to improve the contribution of AHPs to healthcare.

Prevention of tobacco use in an adolescent population through a multi-personal intervention model.

INTRODUCTION: The study aimed to assess the impact of a new intervention proposal involving students, teachers, and parents on smoking prevalence in secondary school adolescents. METHODS: A quasi-experimental study was conducted, in which the response to a preventive multi-personal intervention model (intervention) against tobacco consumption was compared with a standard anti-smoking activity carried out by the local government administration (control). The study was carried out during the 2017-2018 academic year. The study population included 306 students (intervention 151, control 155) with a mean age of 13.4 years. The model involved the parents, the students (aged 15-17 years), and the teachers. The primary outcome was the change in smoking status one year after the intervention. RESULTS: The percentage of non-smokers increased from 84.1% to 88.7% in the intervention group and remained almost unchanged among controls (89.3% vs 89.9%). After one year, there was an increase in the prevalence of non-smokers of 4.6% and a decrease in the prevalence of smokers of 4.7% among students who received the multi-personal intervention, whereas changes among controls were almost negligible (there was in fact a slight increase in the prevalence of smokers of 0.9%). The students who received the intervention smoked less or quit smoking more than those in the control group (OR=0.135; 95% CI: 0.019-0.973, p=0.047). CONCLUSIONS: The multi-personal model developed in the study with the participation of teachers and parents focused on students was feasible, and effectively reduced the prevalence of smoking among high school adolescents.

How can peer teaching influence the development of medical students? a descriptive, longitudinal interview study.

BACKGROUND: Peer-assisted learning (PAL) - where students take up a teaching role at an early stage of their training-is widely used in medical curricula. Many qualitative studies have investigated the perceptions and benefits of PAL, but no studies have longitudinally explored how peer teachers experienced their development. This could allow for a better understanding of PAL. In this study, we explored the perceived impact of being a peer teacher on the development of personal and professional competencies as a medical student. METHODS: We longitudinally conducted semi-structured interviews with peer teachers, during their 2-year teaching period in the skills lab at the University of Antwerp and applied descriptive thematic analysis. RESULTS: In total we gathered 47 interviews in 13 peer teachers (9 female, 4 male,. 1-7 interviews each). Peer teachers reported an increase in self-confidence, which gradually transformed into self-efficacy in clinical and teaching skills., Participants told us to be inspired by the previous generation of peer teachers. Their motivation shifted from personal benefits to benefiting others while becoming a role model themselves. The peer teachers illustrated how they developed maturity by integrating different CanMEDS roles. They grew in reflection, changed/transformed an initial mark-driven study drive into more patient-centered ambitions, and started developing a personal style. CONCLUSIONS: Our study suggests that being a peer teacher leads to more self-efficacy, in clinical and teaching skills, to become a role model with as motivation to benefit others and to grow towards a good doctor maturity. Although the task is to teach peers, this opportunity nurtures the practice and integration of various CanMEDS roles, not only that of scholar but also communicator, collaborator and leader, thereby positively influencing their personal and professional development and their identity as a doctor (professional role).

Gender and ethnicity intersect to reduce participation at a large European hybrid HIV conference.

OBJECTIVE: To evaluate how gender and ethnicity of panel members intersect to effect audience participation at a large European hybrid conference. DESIGN: An observational cross-sectional study design was used to collect data at the conference and descriptive survey was used to collect data retrospectively from the participants. SETTING: European AIDS Clinical Society 18th Conference; a 3223-delegate, hybrid conference held online and in London over 4 days in October 2021. MAIN OUTCOME MEASURES: We observed the number and type of questions asked at 12 of 69 sessions and described characteristics of the panel composition by ethnicity, gender and seniority. A postconference survey of conference attendees collated demographic information, number of questions asked during the conference and the reasons for not asking questions. RESULTS: Men asked the most questions and were more likely to ask multiple questions in the observed sessions (61.5%). People from white ethnic groups asked >95% of the questions in the observed sessions. The fewest questions were asked in the sessions with the least diverse panels in terms of both ethnicity and gender. Barriers to asking questions differed between genders and ethnicities. CONCLUSIONS: Our study aims to provide evidence to help conference organisers improve leadership, equality, diversity and inclusion in the professional medical conference setting. This will support equitable dissemination of knowledge and improve education and engagement of delegates. To our knowledge, this is the first study describing conference participation by both ethnicity and gender in panellists and delegates within a hybrid conference setting.

The Presence of a Physician Role Model and the Career Preference of Medical Students Are Associated With Rural Self-efficacy.

Rural career preference is known to be affected by rural self-efficacy. This study aims to explore whether the presence of a physician role model and having a medical department of interest influence rural self-efficacy among medical students. The study sample comprised 813 students (464 male and 349 female). We assessed rural self-efficacy using a validated scale that comprised 15 questions. The effect of the presence of a physician role model and the choice of medical department on rural self-efficacy score was examined. Multivariable-adjusted regression analysis showed that the presence of a physician role model was significantly associated with the rural self-efficacy score (ß = 0.236, p < 0.001), as were gender (ß = -0.096, p = 0.004), admission while living in hometown (ß = 0.077, p = 0.041), receiving a scholarship for regional duty (ß = 0.079, p = 0.025), admission based on school recommendation (ß = 0.077, p = 0.031), and subjective difficulty with living in a rural area (ß = -0.201, p < 0.001). Moreover, a higher rural self-efficacy score was significantly associated with students who listed general medicine/family medicine (ß = 0.204, p < 0.001), pediatrics (ß = 0.098, p = 0.004), or obstetrics and gynecology (ß = 0.108, p = 0.002) as their department of choice, while anesthesiology (ß = -0.075, p = 0.023) was significantly associated with a lower rural self-efficacy score. These relationships were consistent for both males and females. The presence of a physician role model and the choice of medical department are important factors for higher rural self-efficacy scores.

Perception of Current and Future Commitment of Medical Teachers to the Varied Roles of a Teacher: An Observational Study.

Background Medical education is gradually moving towards self-directed learning, thus the roles of a teacher have assumed wider dimensions than before. The awareness of these roles among medical teachers has been studied in several countries, but no study on the awareness of these roles among Indian medical faculty has been found. The aim of this research was to assess the current and future commitment perception of the roles of a teacher among Indian medical faculty. Methods A cross-sectional questionnaire-based survey regarding the 12 roles of a teacher, as defined by Harden and Crosby, was conducted among medical teachers in a tertiary-level hospital and medical college. The questionnaire consisted of three categories: importance in medical teaching, current commitment, and preferred future commitment to these roles, all measured on a five-point Likert scale. Results The highest mean scores were given to the roles of learning facilitator and on-the-job role model. In contrast, the lowest scores were designated to the production of study guides. Interestingly, the teachers' current commitment to roles such as curriculum planner and course organizer was found to be low. A significant difference was observed between the three categories for the majority of the roles. Younger faculties showed significant difference among categories, while the senior professors did not show significant variations across the roles. Conclusion This study of Indian medical teachers emphasizes the decreased importance attributed to roles like curriculum planning and course organization. Further studies in other developing countries are essential to understand this issue more comprehensively.

The quest for leadership qualities in cooperative societies: An exploratory analysis.

Successful leadership is imperative for a cooperative to flourish. However, there is limited literature concerning leadership qualities in the context of cooperatives, most particularly in cooperatives in the global south. This study applied the participatory Delphi research technique to identify effective leadership qualities in the context of community-based cooperative societies in rural Nepal. A survey of 1255 leaders and team members from 210 cooperatives was undertaken and the qualities of leadership were obtained by using explorative factor analysis. The results identified four dimensions of effective leadership: Role Model, Empowering the Team, Performance-based Rewards, and Skills of the Sector. These four dimensions, unified in the 'REPS' Model of leadership, are presented as a contextualized model of cooperative leadership that can serve to inform both further research and cooperative development practice.

The Mentor's Role in Fostering Research Integrity Standards Among New Generations of Researchers: A Review of Empirical Studies.

Promoting research integrity practices among doctoral candidates and early career researchers is important for creating a stable and healthy research environment. In addition to teaching specific technical skills and knowledge, research supervisors and mentors inevitably convey research practices, both directly and indirectly. We conducted a scoping review to summarise the role of mentors in fostering research integrity practices, mentors' responsibilities and the role that institutions have in supporting good mentorship. We searched five different databases and included studies that used an empirical methodology. After searching, a total of 1199 articles were retrieved, of which 24 were eligible for analysis. After snowballing, a total of 35 empirical articles were selected. The review discusses various themes such as the importance of good mentorship, poor mentorship practices, virtues and qualities of mentors, responsibilities and activities of mentors, group mentoring and responsibilities of the institution in supporting good mentorship. This review demonstrates the importance of mentors instilling responsible research practices and attitudes, and promoting research integrity among their mentees. Mentors are responsible for providing explicit guidance and for acting as good role models. The review highlights how poor mentorship can have a bad impact on the research climate. In addition, the review highlights the important influence that institutions can have in supporting mentorship.

Teacher as role model in developing professional behavior of medical students: a qualitative study.

Objectives: This study aimed to explore students' perspectives on the attributes of medical teachers as role models to students' professional behaviour in the educational process. Methods: A phenomenological study was conducted to obtain participants' perceptions concerning the professional attributes of medical teachers. The participants were 21 final-year medical students in the School of Medicine, Universitas Gadjah Mada, who had completed and passed the national examination. The participants were recruited purposively to represent genders and performance (i.e., high-performing and average-performing students). The participants were divided into two focus groups based on their performance, each facilitated by non-teaching faculty members to avoid bias. Thematic analysis was conducted to analyze focus group transcripts by two independent coders. Codes were synthesized into themes related to the study aims. Results: Seven themes were identified related to observed role model attributes, for instance, passionate lecturers, caring and empathetic, supportive and involving, objectivity, incompetence and compromising, poor communication and conflict, and time management. Subsequently, five themes were identified in participants' responses towards the observed role model, for instance, exemplary models, respect and motivating, confusion and inconvenience, avoiding and hate, and value collision and harmonization. Conclusions: This study revealed a range of role model attributes and responded positively and negatively during learning encounters. As negative attributes are also prominent and observed by students, there is a need for medical schools to perform faculty development for the professional enhancement of medical teachers. Further study should be conducted to investigate the impact of role modelling on learning achievement and future medical practice.

Motives of Online Hate Speech: Results from a Quota Sample Online Survey.

Online hate speech (OHS) is a prevalent societal problem, but most studies investigating the reasons and causes of OHS focus on the perpetrators' side while ignoring the bystanders' and the victims' side. This is also true for the underlying theories. Therefore, we proposed a new Action-Theoretical Model of Online Hate Speech (ATMOHS), which assumes that OHS is a product of environmental, situational, and personal variables with three groups involved (perpetrators, bystanders, and victims) that each have their own set of motives, attitudes, traits, and norm beliefs that are impacting their behavior. The model was put to a first test with an online survey using a quota sample of the German online population (N = 1,791). The study at hand is a first analysis of these data that focus on the motives of OHS. Results show that wanting to be a role model for others is an important motive on the active bystanders' side. However, it could not be confirmed that any aggression motive is important on the perpetrators' side or that undeservingness is an important motive on the victims' side. Future studies could investigate if there are other motives for the victims' side that are in-line with the underlying theory of learned helplessness, or if there is a better theory for modeling the victims' side. Future studies could also develop a better scale for aggression motives. In practice, prevention programs could focus on being a role model for others as a relevant motive for becoming an active bystander.

How to Become a Mentor and Be Good at It.

Mentoring skills are key assets for academic medicine and allied health faculty. Mentors can influence and help to shape the careers of the next generation of health-care providers. Mentors are not only role models but they can also teach the intricacies of professionalism, ethics, values, and the art of medicine. A mentor can be a teacher, a counselor, or an advocate. Mentors can enhance their own leadership skills, improve self-awareness, and increase professional credibility. This article will review the types of mentoring models, the benefits of mentoring, and the core and critical skills of mentoring.

Role modelling in professional identity formation: a systematic scoping review.

BACKGROUND: Role modelling's pivotal part in the nurturing of a physician's professional identity remains poorly understood. To overcome these gaps, this review posits that as part of the mentoring spectrum, role modelling should be considered in tandem with mentoring, supervision, coaching, tutoring and advising. This provides a clinically relevant notion of role modelling whilst its effects upon a physician's thinking, practice and conduct may be visualised using the Ring Theory of Personhood (RToP). METHODS: A Systematic Evidence Based Approach guided systematic scoping review was conducted on articles published between 1 January 2000 to 31 December 2021 in the PubMed, Scopus, Cochrane, and ERIC databases. This review focused on the experiences of medical students and physicians in training (learners) given their similar exposure to training environments and practices. RESULTS: 12,201 articles were identified, 271 articles were evaluated, and 145 articles were included. Concurrent independent thematic and content analysis revealed five domains: existing theories, definitions, indications, characteristics, and the impact of role modelling upon the four rings of the RToP. This highlights dissonance between the introduced and regnant beliefs and spotlights the influence of the learner's narratives, cognitive base, clinical insight, contextual considerations and belief system on their ability to detect, address and adapt to role modelling experiences. CONCLUSION: Role modelling's ability to introduce and integrate beliefs, values and principles into a physician's belief system underscores its effects upon professional identity formation. Yet, these effects depend on contextual, structural, cultural and organisational influences as well as tutor and learner characteristics and the nature of their learner-tutor relationship. The RToP allows appreciation of these variations on the efficacy of role modelling and may help direct personalised and longitudinal support for learners.

Unique Device Identification-Based Linkage of Hierarchically Accessible Data Domains in Prospective Surgical Hospital Data Ecosystems: User-Centered Design Approach.

BACKGROUND: The electronic health record (EHR) targets systematized collection of patient-specific, electronically stored health data. The EHR is an evolving concept driven by ongoing developments and open or unclear legal issues concerning medical technologies, cross-domain data integration, and unclear access roles. Consequently, an interdisciplinary discourse based on representative pilot scenarios is required to connect previously unconnected domains. OBJECTIVE: We address cross-domain data integration including access control using the specific example of a unique device identification (UDI)-expanded hip implant. In fact, the integration of technical focus data into the hospital information system (HIS) is considered based on surgically relevant information. Moreover, the acquisition of social focus data based on mobile health (mHealth) is addressed, covering data integration and networking with therapeutic intervention and acute diagnostics data. METHODS: In addition to the additive manufacturing of a hip implant with the integration of a UDI, we built a database that combines database technology and a wrapper layer known from extract, transform, load systems and brings it into a SQL database, WEB application programming interface (API) layer (back end), interface layer (rest API), and front end. It also provides semantic integration through connection mechanisms between data elements. RESULTS: A hip implant is approached by design, production, and verification while linking operation-relevant specifics like implant-bone fit by merging patient-specific image material (computed tomography, magnetic resonance imaging, or a biomodel) and the digital implant twin for well-founded selection pairing. This decision-facilitating linkage, which improves surgical planning, relates to patient-specific postoperative influencing factors during the healing phase. A unique product identification approach is presented, allowing a postoperative read-out with state-of-the-art hospital technology while enabling future access scenarios for patient and implant data. The latter was considered from the manufacturing perspective using the process manufacturing chain for a (patient-specific) implant to identify quality-relevant data for later access. In addition, sensor concepts were identified to use to monitor the patient-implant interaction during the healing phase using wearables, for example. A data aggregation and integration concept for heterogeneous data sources from the considered focus domains is also presented. Finally, a hierarchical data access concept is shown, protecting sensitive patient data from misuse using existing scenarios. CONCLUSIONS: Personalized medicine requires cross-domain linkage of data, which, in turn, require an appropriate data infrastructure and adequate hierarchical data access solutions in a shared and federated data space. The hip implant is used as an example for the usefulness of cross-domain data linkage since it bundles social, medical, and technical aspects of the implantation. It is necessary to open existing databases using interfaces for secure integration of data from end devices and to assure availability through suitable access models while guaranteeing long-term, independent data persistence. A suitable strategy requires the combination of technical solutions from the areas of identity and trust, federated data storage, cryptographic procedures, and software engineering as well as organizational changes.