Evidence-based teaching: a course in health services management

This article traces the development of a course in health services management over 40 years and presents the course within a context of teaching evidence-based management. One emphasis of the course is on teaching through storytelling--students developing learning capability to listen to what each stakeholder has to say, and then figuring what to do about it. Students share evidence from the professor's own work experience, the student's own work experience, peer-reviewed published articles, and case studies.

Teaching evidence-based management: where do we go from here?

Recently we talked with executive directors of healthcare organizations about the sources of information they use when conducting research. The responses were very similar. They preferred "googling," reading trusted trade journals, and reading more generic business literature such as Harvard Business Review. When asked if they ever read and used healthcare management research, they said the articles were often inaccessible. First, as CEOs faced with the responsibility for their organization's performance, they want to know whether there is anything in the research that will help them run their organizations better. Unfortunately, as observed by Gary Mecklenburg in this issue, the focus in healthcare research is too frequently on research implications, not on what a CEO wants and needs to know. As a result, the research is not always relevant. Further, by the time the research is conducted and published (it is not infrequent for more than a year to elapse from submission to actual publication in a journal, and by then the data may be two or more years old), executives have moved on to other decisions. As one of the CEOs observed, there is a gap between what she needs to know and what the health management literature has to say. Second, managers have limited time, and information needs to be succinct and to the point if it is to be useful. Research articles are very time consuming to read, and as the CEOs commented, time is a precious resource. Research articles frequently devote considerable space to conceptual development and methods, and even when managerial implications are addressed, managers

The impact of evidence on teaching healthcare management

As healthcare management becomes more responsive to market demands, healthcare management education must prepare a more sophisticated and effective product. The author reviews the barriers to change in education and suggests that education will evolve to a new business model emphasizing "small bites" that are directly related to work needs and often learnable at the worksite, as well as integrative materialbest learned in a university environment. The ultimate model will have the following characteristics: 1. Managers' learning will be continuous, and will be recorded in individual certified "life transcripts" of mastery. 2. Learning will be performance driven, where performance is measured as contribution to the employer's goals and the patients' needs. 3. Learning will be flexible as to site, medium, and timing. 4. Managers' learning programs will emphasize recurring evaluation, celebration, and goal-setting.

Use of evidence in implementing competency-based healthcare management teaching

Current efforts to develop a coherent list of health management competency domains supported by a set of sub-competencies and mapped to behavioral abilities are laudable. If we wanted to be evidence-based in our implementation of competency-based teaching in our educational programs, however, then as a minimum we must demonstrate the empirical association between individual's competency attainment and subsequent job performance and other desired outcomes. Assuming the association is positive and significant, we then need to demonstrate the association between the educational programming and individuals' competency attainment, in order to identify the approach to educational programming that best develops competencies. Inherent in conducting this research is articulating credible measures of complex and multifaceted concepts: educational programming, competency attainment, and job performance. Nevertheless, more rigorous evidence regarding the links between our educational approaches, our graduates' competencies, and their subsequent job performance would benefit us and move us closer to having evidence guide our educational system in health management.

Grooming future execs. War of words erupts over whose job it is

Several of healthcare's professional organizations have squared off against a newcomer--the National Center for Healthcare Leadership--over how best to train the next generation of healthcare leaders. Backed by industry icons, including Gail Warden and Gary Mecklenburg, the NCHL says its brand of educational programming is needed. What's needed, critics say, is more collaboration among existing organizations.

Improvement in undergraduate medical education: a 10-year follow-up in Finland

Several studies have revealed that undergraduate medical education does not adequately prepare students for their work as physicians. There have been attempts to solve this problem in curriculum reforms in medical faculties. In this article, Finnish physicians' opinions on their undergraduate medical education are analysed. In 1988, a postal questionnaire was mailed to 2632 physicians registered during 1977-86, and altogether 1745 questionnaires were returned (66.3%). A follow-up study was done in 1998, and a questionnaire was sent to 2529 physicians who graduated between 1987 and 1996; 1822 questionnaires were returned (73.1%). Half of the respondents considered undergraduate education to correspond well with the requisite diagnostic skills and hospital doctors' work in general. In older and more traditional medical faculties (Helsinki, Oulu and Turku) education in primary healthcare work was considered insufficient. Also, more than 80% of the respondents felt they received too little teaching in administrative work. They reported that both traditional and younger, community-oriented faculties (Kuopio and Tampere) had considerably improved their education, especially in primary healthcare, during the 10-year follow-up. However, there were still clear differences between the education in the respective types of faculty as evaluated by their graduates. There is still room for improvements in undergraduate medical education, the better to meet the real needs of practising physicians in different fields of health care.

[Evaluation of a leadership education at the Rigshospitalet. How an evaluation design can support organizational learning]

INTRODUCTION

The aim of the present study was to evaluate a Management & Leadership Education and Training Programme at the hospital before, during, and after implementation, allowing stakeholders to qualify alteration of the Programme as a process by using for instance formative evaluation.

MATERIAL AND METHODS

The Delphi method is used for pre-evaluation of the concept of the Programme. Pre- and post-questionnaires were employed to measure the participants' adaptation of the hospital's "Management Fundamentals" before and after the Programme.

RESULTS

The Expert panel stated that the Programme concept was pertinent and applicable. One hundred per cent recommended the Programme to be interdisciplinary. Eighty-two per cent stated that it would probably be difficult to acquire organisational learning. The results of the pre- and post-questionnaires showed that the participants and their superiors found that they adapted the hospital's "Management Fundamentals" better after having followed the Programme.

DISCUSSION

With the use of the Delphi method (formative evaluation), the Programme concept could be altered already before implementation. The experts stated that they were not sure that the Programme would support organisational learning. Having this knowledge, it has been possible to work with activities supporting organisational learning already during implementation. In future, the experience with pre- and post-measurements will be used in a concrete way to support the learning environment in the organisation.