Working Definitions of the Roles and an Organizational Structure in Health Professions Education Scholarship: Initiating an International Conversation.

PROBLEM: Health professions education scholarship (HPES) is an important and growing field of inquiry. Problematically, consistent use of terminology regarding the individual roles and organizational structures that are active in this field are lacking. This inconsistency impedes the transferability of current and future findings related to the roles and organizational structures of HPES. APPROACH: Based on data collected during interviews with HPES leaders in Canada, Australia, New Zealand, the United States, and the Netherlands, the authors constructed working definitions for some of the professional roles and an organizational structure that support HPES. All authors reviewed the definitions to ensure relevance across multiple countries. OUTCOMES: The authors define and offer illustrative examples of three professional roles in HPES (clinician educator, HPES research scientist, and HPES administrative leader) and an organizational structure that can support HPES participation (HPES unit). These working definitions are foundational and not all-encompassing and, thus, are offered as stimulus for international dialogue and understanding. NEXT STEPS: With these working definitions, scholars and administrative leaders can examine HPES roles and organizational structures across and between national contexts to decide how lessons learned in other contexts can be applied to their local contexts. Although rigorously constructed, these definitions need to be vetted by the international HPES community. The authors argue that these definitions are sufficiently transferable to support such scholarly investigation and debate.

Relationships Between Self-Reported Leadership Practices, Job Satisfaction, and Demographics of Radiology Administrators.

PURPOSE: To evaluate the self-reported leadership practices of radiology administrators and the demographic characteristics associated with those leadership practices. The effect of these demographic characteristics and leadership practices on job satisfaction also was studied. METHODS: One-hundred forty-nine American Society of Radiologic Technologists members who indicated they have a position of administrator/manager, chief technologist, or supervisor completed a demographic survey and the Leadership Practices Inventory (LPI) self-survey tool. The LPI divides successful leadership into 5 practices: Challenge the Process, Inspire a Shared Vision, Enable Others to Act, Encourage the Heart, and Model the Way. RESULTS: The categories Challenge the Process and Inspire a Shared Vision had the lowest mean scores and the widest variation. Having had formal leadership training and being older were demographic characteristics associated with higher LPI scores. Having a higher LPI score and having had formal leadership training were associated with higher job satisfaction. DISCUSSION: Formal leadership training was the only statistically significant variable when using LPI score as the response variable. CONCLUSION: The results of this study show that radiology administrators would benefit from formal leadership training that focuses on challenging the process and inspiring a shared vision.

Regulators extend their reign.

As the cogs begin turning to make health reform a reality, who wields the most power? Our readers put policymakers in Washington at the top of our ranking S of the 100 Most Powerful People in Healthcare. The Patient Protection and Affordable Care Act is a "great first step...but it really is only a first step. It sets us up to get into a whole body of work on changing the care delivery system", says Scott Armstrong of Group Health Cooperative in Seattle, who debuted at No. 38.

Trying to compensate. Latest ranking of CEO compensation finds stock options still key to pay as experts monitor for effects of SEC rule changes.

Despite past outcries from critics, stock options continue to play a starring, albeit smaller, role in compensation for CEOs at top companies, based on research by accounting professor Steven Balsam, left. Read about the 30 healthcare executives who brought home the biggest pay packages in our annual ranking of CEOs' compensation.

Diversity in the executive suite. Modern Healthcare salutes the Top 25 Minority Executives in Healthcare, who say their colleagues still face numerous obstacles.

With minorities expected to swell to half of all U.S. residents by 2050, the healthcare C-suite needs to reflect that diversity to better meet patients' needs. We honor the Top 25 Minority Executives in Healthcare, who have found ways to help others along the way. "I've learned to navigate within a system and work with people for the greater good, says Christopher Mosley, left, who made the Top 25.

The impact of employee level and work stress on mental health and GP service use: an analysis of a sample of Australian government employees.

BACKGROUND: This study sought to identify the extent to which employee level and work stressors were associated with mental health problems experienced by Australian government employees, and with their use of primary care services. METHODS: 806 government employees aged between 40 and 44 years were surveyed as part of an epidemiological study conducted in Australia. Data collected from participants included sociodemographic attributes, physical health, psychological measures and work stressors relating to job control, job demands, job security and skills discretion at work. For 88% of these participants, information on visits made to general practitioners (GPs) for the six months before and after their survey interview was obtained from health insurance records. RESULTS: When work stress and personal factors were taken into account, men at more junior levels reported better mental health, more positive affect and used fewer GP services. Women at middle-management levels obtained less GP care than their more senior counterparts. Both men and women who reported higher levels of work stress were found to have poorer mental health and well-being. The impact of such stressors on GP service use, however, differed for men and women. CONCLUSION: Measures of work stress and not employee level affect the mental health and well-being of government employees. For governments with responsibility for funding health care services, reducing work stress experienced by their own employees offers potential benefits by improving the health of their workforce and reducing outlays for such services.

State legislator gender and other characteristics associated with sponsorship of child health bills.

OBJECTIVE: To examine the characteristics of state legislators who introduce child health bills. METHODS: We conducted a cross-sectional analysis of all bills introduced in Colorado, Louisiana, and Michigan during the 1997-1998 legislative session. We identified the topic for each bill while blinded to legislator characteristics. The primary study outcome was whether the bill topic related to child health. We also categorized whether the bill was signed into law. We examined associations between the outcomes and characteristics of the sponsoring legislators (gender, political party, terms served, chairpersonship of committees, legislative chamber, membership in the legislature's Black Caucus). RESULTS: During 1997 and 1998, legislators in the 3 study states introduced 9833 bills (1234 in Colorado, 4905 in Louisiana, and 3694 in Michigan). Sixty-five bills (0.66%) related to child health issues. Child health bills comprised a significantly higher proportion of all legislation introduced by female legislators compared with male legislators (1.5% vs 0.5%, P <.001). Of bills introduced by Black Caucus members, 1.4% pertained to child health compared with 0.59% of bills introduced by nonmembers (P <.01). In contrast, 0.23% of bills introduced by committee chairpersons pertained to child health versus 0.96% of bills introduced by nonchair legislators (P <.001). These associations remained statistically significant in multivariate analyses controlling for state effects. Whether child health bills were signed into law was not associated with other legislator characteristics. CONCLUSIONS: This study offers valuable insights about the different roles of women, Black Caucus members, and committee chairpersons in the state legislative process regarding children's health.

Gender stratification in management. The World Health Organization 2000.

The World Health Organization (WHO) is a global organization that nowadays has integrated gender issues into its policy, programmes and budget. How then is the state of affairs in the area of gender equity at the ultimate governing bodies of the modern WHO? This study aims to assess the representation of women and men and their promotion within the supreme decision-making bodies of the WHO during the year 2000. Information sources used are the official and confirmed protocols of the 53rd World Health Assembly (WHA) in 2000 and of the two Executive Board (EB) meetings of the corresponding year. A descriptive quantitative content analysis approach is used exclusively. The present study demonstrates strikingly skewed gender distribution, with men substantially at an advantage numerically in the prominent positions at the WHA 2000. Additionally, men also hold an advantage in terms of being promoted to leading positions within the bodies examined, notably all upgraded chairs of the EB during 2000. However, the formerly male-dominated supervisory positions of the WHO are, these days, challenged by women having been elected at the very top of the WHO. The present study stresses the need to elaborate a qualitative research design to advance the understanding of the social construction of gender in supreme governing positions of the modern WHO.

100 most powerful. Familiar legislators and policymakers dominate the top of Modern Healthcare's second annual ranking of the most influential people in healthcare, but plenty of new names fill out the list. See who's in and who's out.

Our second annual ranking of the 100 Most Powerful People in Healthcare has quite a few surprises. Readers nominated and voted for the people who move and shake the healthcare industry. The 2003 list of the Most Powerful has 52 names absent from last year's ranking, including a new No. 1. Who are they and who are the repeat winners?

A lay person versus a trained endoscopist: can the preop endoscopy simulator detect a difference?

The purpose of this study was to establish construct validation of a flexible sigmoidoscopy simulator by comparing training-level grouped subjects. These included clerical staff (n = 10), residents (n = 19), and experts (n = 5). Each participant performed 3 scopes. The ANOVA group-based results for trainer-measured variables are shown in Table 1. These results demonstrate that the flexible sigmoidoscopy simulator distinguished the trained from the untrained and the resident from the expert. Although there was no statistically significant differences between the senior residents and the experts, the expert commonly outperformed the residents. Establishing the transferability of simulator training to real life is next. If the transfer of skill can be established, it may give rise to a new skills training approach.