Overcoming Barriers to Research Competency: a nationwide mixed-method study on residency training in the field of Korean medicine.

Objectives: This study aimed to analyze the educational needs of interns and residents in Korean medicine as the first step in developing an education program to improve their research competencies. Methods: A mixed-method design, incorporating both quantitative and qualitative data collection methods, was used to investigate the educational needs for research competencies among interns and residents working in Korean medicine hospitals nationwide. Data were collected through online surveys and online focus group discussions (FGDs), and processed using descriptive statistical analysis and thematic analysis. The study results were derived by integrating survey data and FGD outcomes. Results: In total, 209 interns and residents participated in the survey, and 11 individuals participated in two rounds of FGDs. The majority of participants felt a lack of systematic education in research and academic writing in postgraduate medical education and highlighted the need for nationally accessible education due to significant disparities in the educational environment across hospitals and specialties. The primary barrier to learning research and academic writing identified by learners was the lack of knowledge, leading to time constraints. Improving learners' research competencies, relationship building, autonomy, and motivation through a support system was deemed crucial. The study also identified diverse learner types and preferred educational topics, indicating a demand for learner-centered education and coaching. Conclusion: This study provides foundational data for designing and developing a program on education on research competencies for interns and residents in Korean medicine and suggests the need for initiatives to strengthen these competencies.

General nurse competencies in disaster: A delphi study.

AIM: The aim of this study is to understand the significance of a disaster-related competence framework for Portuguese general nurses and identify from ICN - Core Competencies in Disaster Nursing version 2.0 core competencies description, those that are considered crucial for a competent preparedness and response in disaster scenarios. BACKGROUND: Research suggests that the occurrence of disasters will be more recurrent, requiring that nurses, pillars of any health system, have knowledge, skills and preparedness to face these events. DESIGN: An exploratory, cross-sectional qualitative study was carried out. Delphi method was used for data collection. METHODS: The study group consisted of technical-scientific council's presidents or coordinators/directors of nursing courses, nurses integrated in the Portuguese Council of Nurses and National Nursing Specialty Colleges and nurses with experience in the field of disasters. RESULTS: Findings revealed that there is consensus on sixteen competencies, considered relevant for developing general nurse knowledge and competence, both at a national or international level, in the field of disasters. CONCLUSIONS: The development of these competencies which establishes practice standards, building nurses skills and knowledge and ultimately, influencing nursing level-entry curricula's, conferring professional autonomy and self-regulation, in the field of disaster are fundamental. Furthermore, this study may serve as a reference for future alignment of competency frameworks between European Union countries or others.

Changing the Clock in Medical Education: Addressing Physician Shortages and Patient Outcomes.

Despite the shortage of physicians in the United States, there is no consensus among medical educators as to how to address the nation's unmet needs. A growing but unfulfilled argument is to revisit the configuration of medical education and the time required to complete medical training. Pilot programs, such as shortened programs or advancement-in-place structures to accelerate the practice capability of trainees, have been attempted. This manuscript addresses underlying economic and human considerations that medical educators must reconcile, drawing on lessons from international educational structures, as we advance toward a system that supports the needs of the communities that our graduates will serve.

Challenges and opportunities for competency-based health professional education in Bangladesh: an interview, observation and mapping study.

BACKGROUND: Bangladesh has a shortfall of health professionals. The World Health Organization states that improving education will increase recruitment and retention of health workers. Traditional learning approaches, in medical education particularly, focus on didactic teaching, teaching of subjects and knowledge testing. These approaches have been superseded in some programmes, with a greater focus on active learning, integrated teaching and learning of knowledge, application, skills and attitudes or values and associated testing of competencies as educational outcomes. In addition, some regions do not have continuous professional development or clinical placements for health worker students, contributing to difficulties in retention of health workers. This study aims to explore the experiences of health professional education in Bangladesh, focusing on what is through observation of health professional education sessions and experiences of educators. METHODS: This mixed method study included 22 observations of teaching sessions in clinical and educational settings, detailed analysis of 8 national curricula documents mapped to Global Competency and Outcomes Framework for Universal Health Coverage and 15 interviews of professionals responsible for health education. An observational checklist was created based on previous literature which assessed training of within dimensions of basic clinical skills; diagnosis and management; professionalism; professional development; and effective communication. Interviews explored current practices within health education in Bangladesh, as well as barriers and facilitators to incorporating different approaches to learning. RESULTS: Observations revealed a variety of approaches and frameworks followed across institutions. Only one observation included all sub-competencies of the checklist. National curricula documents varied in their coverage of the Global Competency and Outcomes Framework domains. Three key themes were generated from a thematic analysis of interview transcripts: (1) education across the career span; (2) challenges for health professional education; (3) contextual factors and health professional education. Opportunities for progression and development post qualification are limited and certain professions are favoured over others. CONCLUSION: Traditional approaches seem to predominate but there is some enthusiasm for a more clinical focus to education and for more competency based approaches to teaching, learning and assessment.

Acceptability and feasibility of an evaluation table to assess the competency of general medicine interns during ambulatory rotations in Brest.

BACKGROUND: General practitioner interns need to acquire the expected clinical, communication, personal and professional competencies. Internship evaluations use qualitative evaluation tables to assess competency acquisition. However, there is no standardised evaluation table used in France. Some faculties use the exhaustive, precise, and manageable Exceler evaluation tool. We aim to evaluate opinions of General practice interns in Brest about the acceptability and feasibility of using the Exceler evaluation tool to monitor competency acquisition during internships. METHODS: This qualitative study used intern focus groups. Six-open ended questions with optional follow-up questions were asked. Cards from the Dixit® game were used to guide and facilitate discussion. Open, axial, then integrative analysis of the verbatim was performed. RESULTS: This is the first study to evaluate intern opinions about GP internship evaluations using focus groups. Participants felt that the quality of existing evaluations was insufficient, and it was difficult to monitor their progress. Adapting evaluations to individual profiles and backgrounds seemed necessary. Exceler appeared to be a possible solution due to its content validity, flexibility of use and accessibility. However, there were comments about possible modifications. CONCLUSIONS: Analysing opinions of tutors, supervisors and other practice centers could help identify potential barriers and reveal solutions to facilitate its implementation and use. TRIAL REGISTRATION: Not applicable.

Clinical competency of nurses trained in competency-based versus objective-based education in the Democratic Republic of the Congo: a qualitative study.

BACKGROUND: Designing competency-based education (CBE) programmes is a priority in global nursing education for better nursing care for the population. In the Democratic Republic of the Congo (DRC), object-based education (OBE) remains mainstream in pre-service nursing education programmes. Recently, the Ministry of Health developed a self-assessment tool and quantitatively compared the clinical competency of CBE- and OBE-trained nurses. This study aimed to qualitatively triangulate the results of self-evaluation by exploring perception of supervisors, incumbent CBE-, and OBE-trained nurses in comparison with the competence of the two types of nurses, and to identify influential factors or barriers to their competence in clinical settings. METHODS: A qualitative descriptive approach with conventional content analysis was applied. Twenty interviews with clinical supervisors who oversaw both CBE- and OBE-trained nurses, 22 focus group discussions (FGDs) with CBE-trained nurses, and 21 FGDs with OBA-trained nurses currently working in health facilities were conducted. Participants of the FGDs were selected from the participants of the DRC self-assessment competency comparison study where there was no statistically significance between CBE- and OBE-trained nurses in the demographic characteristics. Data were analysed in terms of the competencies identified by the Ministry of Health. RESULTS: The supervisors recognised that the CBE-trained nurses had stronger competencies in professional communication, making decisions about health problems, and engaging in professional development, but were weak in clinical skills. This study identified challenges for supervisors in assuring standardised care in health facilities with OBE- and CBE-trained nurses, as well as barriers for CBE-trained nurses as a minority in the workplace in demonstrating their competencies. CONCLUSIONS: The study results support the Ministry of Health's policy to expand CBE in pre-service education programmes but reveal that its slow implementation impedes full utilisation of the acquired competencies at health facilities. Implementation could be accelerated by strengthening cooperation among the Ministry of Health's three human resource departments, and developing and implementing a well-planned, legally binding, long-term CBE reform strategy, including an approach to the Continuing Professional Development system.

Preclinical obesity curriculum: audit, implementation, and evaluation.

BACKGROUND: This study aimed to (1) evaluate the current status of obesity education at Case Western Reserve University School of Medicine (CWRU) (2), introduce a comprehensive first-year curriculum on obesity, and (3) assess the impact of the curriculum on self-reported attitudes and knowledge regarding obesity among first-year medical students. METHODS: The preclinical curriculum at CWRU was reviewed to determine the degree of coverage of Obesity Medicine Education Collaborative (OMEC) competencies for healthcare professionals, and recommendations were provided for revising the curriculum to better adhere to these evidence-based competencies. A survey on obesity attitudes and knowledge was given before and after the implementation of the new curriculum to measure intervention-related changes. Changes in obesity attitudes and knowledge were compared (1) before and after the intervention for the class of 2025 and (2) after the intervention for the class of 2025 to a historical cohort that did not receive the intervention. RESULTS: Among the 27 competencies examined in the audit, 55% were unmet and 41% were partially met. Of 186 first-year medical students (M1s), 29 (16%) completed the baseline survey and 26 (14%) completed the post-intervention survey. Following the intervention, there was a notable improvement in attitudes and knowledge regarding obesity. Specifically, there was a significant decrease in the belief that obesity is caused by poor personal choices, and knowledge of obesity in fourteen out of fifteen areas showed significant improvement from pre- to post-intervention. Additionally, obesity attitudes and knowledge were significantly better post-intervention when compared to the historical cohort. CONCLUSIONS: The improvements made to the preclinical curriculum through this project improved obesity attitudes and knowledge among first-year medical students. This method provides a practical approach for evaluating and enhancing obesity education in medical school curricula.

A Pharmacist Clinician Model as part of a collaborative clinical workforce: A philosophical critique.

The term 'clinician' is not reserved for any healthcare professional group. However, there is a general acceptance that a clinician would have the knowledge, skills and behaviours to enable them to clinically assess and manage a patient autonomously. The expectation, in a modern collaborative healthcare system, is that this work would be completed as a part of a planned and integrated multi-disciplinary care delivery structure, where any given clinician delivers a devolved element of that patient's care. Forthcoming changes to regulation and professional development pathways in the UK will have a profound impact on pharmacist professional identity and practice. From 2026, all new UK pharmacist registrants will have full independent prescribing rights. A paradigm shift is expected to enable the development of a Pharmacist Clinician Model, incorporating pharmaceutical care needs with wider clinical assessment, diagnostic, and clinical management responsibilities. Consideration is given to this model and its implications. Changes to regulation, policy, education, and the governance required to deliver safe and effective pharmacist clinicians are outlined. A philosophical critique on the nature of being a clinician, and the differentiation of pharmacist clinician roles compared to other healthcare professions, is given. A further examination of the projected risks and expected benefits of this transformative practice model are then explored.

Core Competencies for Gerontogeriatric Nursing: A Validation Study.

BACKGROUND: As the aging population grows, facing multifaceted health challenges and escalating care costs, equipping newly graduated nurses with the requisite skills for high-quality gerontogeriatric care becomes crucial. This study assesses the psychometric properties of a Gerontogeriatric Competency (GGC) scale to evaluate the competencies of newly graduated registered nurses (RNs). METHODS: Using a convenience sampling approach, a nationwide, observational prospective cohort study was conducted among 272 newly graduated RNs. The evaluation framework included a sociodemographic questionnaire, three groups of questions targeting gerontogeriatric nursing education aspects, and the GGC scale, with 64 competencies. Construct validity (via confirmatory factor analysis), known-group validity and reliability (assessed by Cronbach's α) were examined. RESULTS: The confirmatory factor analysis (CFA) showed an adequate index fit: the ratio of chi-square to degrees of freedom (χ2/df) = 2.785, the goodness-of-fit index (GFI) = 0.579, confirmatory fit index (CFI) = 0.864, the parsimony goodness-of-fit index (PGFI) = 0.526, the parsimony confirmatory-of-fit index (PCFI) = 0.809, the root mean square error of approximation (RMSEA) = 0.087, and the modified expected cross-validation index (MECVI) = 24.418. Differences were observed in gerontogeriatric competencies based on curriculum inclusion, self-confidence, knowledge in caring for older adults, and satisfaction with the nursing program content. The Cronbach's α coefficient was 0.992 for the overall scale and ranged from 0.935 to 0.983 for the GGC dimensions. CONCLUSIONS: The GGC scale is a valid and reliable tool for assessing the gerontogeriatric competencies of new graduate RNs, highlighting its potential to enhance education, training, and, ultimately, the quality of care provided to the older population.

Exploring the adoption of concept-based curricula: insights from educators and implications for change.

Concept-based approaches to curriculum design have been proposed to solve content and curricula overload and promote conceptual learning. Few health professions have adopted this approach and little is known about how to support this educational change. We aimed to understand how nutrition and dietetics educators may navigate proposed education change towards concept-based curricula. We employed an interpretivist approach and in-depth interviews that explored the views of nutrition and dietetic educators towards using a concept-based approach to curriculum. Employing deductive thematic analysis based on the diffusion of innovation theory, data from twenty experienced dietetics educators were analysed. Three main themes were identified; the need for change champions, concerns about change, and the complexity of the education system. Diffusion of innovation theory highlighted that to enact change, the relative advantage and compatibility of the approach with current structures and systems, with evidence from trialling and observing the new approach in action, were needed. Developing education leaders and infiltrating the social system of education through existing communities of practice is critical to enacting educational change.

Corrigendum: Merging Academy and Healthcare in the Public Health Training of Medical Students.

[This corrects the article DOI: 10.1186/s40985-020-00146-1.].

Evaluating the Need for Competency-Based Pharmacy Education (CBPE): The Report of the 2023-2024 Academic Affairs Standing Committee.

The 2023-2024 Academic Affairs Committee was charged to create a sense of urgency around the concept of Competency-Based Pharmacy Education and develop a "readiness for change" instrument that is based on the 5 essential elements that make up the definition of Competency-Based Pharmacy Education. This report describes the process undertaken by the committee to determine the societal needs of pharmacists and current state of pharmacy practice and pharmacy education. The practice gaps in pharmacy education and the key drivers needed to close these gaps are evaluated. To complete the charges, the committee conducted evidence-based literature reviews and completed a series of focus groups with stakeholders and thought leaders with experience in competency-based education.

Study of mindset among learners and educators in an Indian medical school-A questionnaire-based survey.

BACKGROUND: Mindset varies along a spectrum of two extremes- fixed and growth. Individuals with growth mindset embrace new challenges readily and believe that intelligence is malleable. Mindset theory has gained focus as a principal underpinning value of health professions education, as it is aligned with the goals of competency-based education. The study aims to assess the mindset of health professional educators and learners. MATERIALS AND METHODS: A cross-sectional questionnaire-based survey was conducted in a private medical college in South India. A pre-validated modified version of Dweck's (2000) Implicit Theories of Intelligence Questionnaire was administered to the study participants. Participants responded to 10 items using a four-point Likert scale, rating the degree to which they agreed or disagreed with each statement. The quantitative data were expressed in means and percentages. RESULTS: A total of192 students and 25 faculty participated in the study. Among students, 45.8% (n = 88) had strong growth mindset, 42.1% (n = 81) had growth mindset with some fixed ideas, 10.9% (n = 21) had fixed mindset with some growth ideas, and 1% (n = 2) had strong fixed mindset. Among faculty 4% (n = 1) had fixed mindset with growth ideas, 44% (n = 11) had growth mindset with fixed ideas, and 52% (n = 13) had strong growth mindset. DISCUSSION: In this study, educators and learners of a medical school were found to have predominantly growth mindset. Fostering growth mindset among stakeholders of health professions education is essential for effective teaching and learning in competency-based education.

Evaluating the Strengths and Barriers of Competency-Based Education in the Health Professions.

OBJECTIVE: This study aimed to define competency-based education (CBE) for pharmacy education and describe how strengths and barriers of CBE can support or hinder implementation. FINDINGS: Sixty-five studies were included from a variety of health professions in order to define competency based pharmacy education (CBPE) and identify barriers and benefits from the learner, faculty, institution, and society perspectives. From the 7 identified thematic categories, a CBPE definition was developed: "Competency-based pharmacy education is an outcomes-based curricular model of an organized framework of competencies (knowledge, skills, attitudes) for pharmacists to meet health care and societal needs. This learner-centered curricular model aligns authentic teaching and learning strategies and assessment (emphasizing workplace assessment and quality feedback) while deemphasizing time." SUMMARY: This article provides a definition of CBE for its application within pharmacy education. The strengths and barriers for CBE were elucidated from other health professions' education literature. Identified implementation strengths and barriers aid in the discussions on what will support or hinder the implementation of CBE in pharmacy education.

The Need for Competency-Based Education.

OBJECTIVES: While pharmacy education updates learning as new information arises, changes to learning experiences can trail behind current practices and technology. There have been multiple calls for radical changes in how health professions education is delivered to ensure patients are receiving high-quality care. Competency-based education has been one way discussed in the literature for how to handle this need to develop students who have a willingness to learn and can problem-solve. The goal of this review is to examine whether competency-based education is needed to drive the profession of pharmacy forward. FINDINGS: To address, we collaboratively identified stakeholder perspectives to evaluate the need. The following stakeholders achieved consensus among the committee members: patients/society, learners, workplace/profession, and academic institutions. SUMMARY: Based on those perspectives, needs, and gaps to address those needs were identified and are presented in this review.

Usability, Acceptability, and Implementation of Artificial Intelligence (AI) and Machine Learning (ML) Techniques in Surgical Coaching and Training: A Scoping Review.

OBJECTIVE: To define the current state of peer-reviewed literature demonstrating the usability, acceptability, and implementation of artificial intelligence (AI) and machine learning (ML) techniques in surgical coaching and training. DESIGN: We conducted a literature search with defined inclusion and exclusion criteria. We searched five scholarly databases: MEDLINE via PubMed, Embase via Elsevier, Scopus via Elsevier, Cochrane Central Register of Controlled Trials, and the Healthcare Administration Database via ProQuest. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. RESULTS: Only 4 articles met the inclusion criteria and used standardized methods for performance evaluation with expert observation. We found no literature examining the impact on performance, user acceptance, or implementation of AI/ML techniques used for surgical coaching and training. We highlight the need for qualitative and quantitative research demonstrating these techniques' effectiveness before broad implementation. CONCLUSION AND RELEVANCE: We emphasize the need for research to specifically evaluate performance, impact, user acceptance, and implementation of AI/ML techniques. Incorporating these facets of research when developing AI/ML techniques for surgical training is crucial to ensure emerging technology meets user needs without increasing cognitive burden or frustrating users.