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Debets M, Jansen I, Lombarts K, Kuijer-Siebelink W, Kruijthof K, Steinert Y, Daams J, Silkens M. Linking leadership development programs for physicians with organization-level outcomes: a realist review. BMC Health Serv Res 2023; 23:783. [PMID: 37480101 PMCID: PMC10362722 DOI: 10.1186/s12913-023-09811-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization's performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing. OBJECTIVE To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes. METHODS We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O). RESULTS In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories 'culture', 'quality improvement', and 'the leadership pipeline': 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes. CONCLUSIONS LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes.
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Affiliation(s)
- Maarten Debets
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands.
| | - Iris Jansen
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Kiki Lombarts
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, Research On Responsive Vocational and Professional Education, HAN University of Applied Sciences, Nijmegen, Netherlands
- Research On Learning and Education, Radboud University Medical Centre, Radboudumc Health Academy, Nijmegen, Netherlands
| | - Karen Kruijthof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Yvonne Steinert
- Faculty of Medicine and Health Sciences, Institute of Health Sciences Education, McGill University, Montreal, Canada
| | - Joost Daams
- Medical Library, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, Netherlands
| | - Milou Silkens
- Department of Health Services Research & Management, City University of London, London, UK
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
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Gilbert S, Irvine R, D'or M, Adam MTP, Collins CE, Marriott R, Rollo ME, Walker R, Rae KM. Indigenous women and their nutrition during pregnancy: Study Protocol for co-designed m-health resource for the 'Mums and Bubs Deadly Diets' project. JMIR Res Protoc 2023. [PMID: 37147188 PMCID: PMC10360010 DOI: 10.2196/45983] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Nutrition in pregnancy is pivotal to optimising infant growth and maternal wellbeing. The factors affecting Indigenous people's food and nutrition intake are complex, with a history of colonisation impacting the disproportionate effect of social determinants to this day. Literature regarding the dietary intake or priorities of Indigenous women in Australia is scarce with supportive, culturally appropriate resources developing for and with this group rare. Research suggests mHealth tools are effective in supporting health knowledge of Indigenous people and positive health behaviour changes when designed and developed with the expertise of Indigenous communities. OBJECTIVE This study seeks to build the body of knowledge related to nutrition needs and priorities for Indigenous women in Australia during pregnancy. Further this project team and its participants will co-design an mHealth digital tool to support these nutrition needs. METHODS The Mums and Bubs Deadly Diets study recruits Indigenous women and healthcare professionals who support Indigenous women during pregnancy into two phases. Phase One (pre-design) utilises a mixed methods convergent design utilising a biographical questionnaire and social/focus groups to inform Phase Two (generative). Phase Two will use a participatory action research process during co-design workshops to iteratively develop the digital tool, the exact actions within a workshop will evolve according to the participant group decisions. RESULTS To date, this project has undertaken Phase One focus groups at all Queensland sites with New South Wales and Western Australia to begin in early to mid 2023. We have recruited 12 participants from Galangoor Duwalami, 18 participants from Carbal in Toowoomba and 18 participants from Carbal in Warwick. We are expecting similar numbers of recruits in Western Australia and New South Wales. Participants have been both community members and health care professionals. CONCLUSIONS This study is an iterative and adaptive research program that endeavours to develop real world, impactful resources to support the nutrition needs and priorities of pregnant Indigenous women in Australia. This comprehensive project requires a combination of methods and methodologies to ensure Indigenous voices are heard at each stage and in all aspects of research output. The development of an mHealth resource for this cohort will provide a necessary bridge where there is often a gap in access to nutrition resources for women in pregnancy in Indigenous communities. CLINICALTRIAL Not applicable.
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Affiliation(s)
- Stephanie Gilbert
- Faculty of Humanities and Social Sciences, University of Queensland, Brisbane, AU
- Aboriginal and Torres Strait Islander Studies Unit,, University of Queensland, St Lucia, Brisbane, AU
| | - Rachel Irvine
- Aboriginal and Torres Strait Islander Studies Unit,, University of Queensland, St Lucia, Brisbane, AU
| | - Melissa D'or
- Mater Research Institute, Aubigny Place, South Brisbane, Brisbane, AU
| | - Marc T P Adam
- School of Information and Physical Science,, The University of Newcastle, Callaghan, Newcastle, AU
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing,, The University of Newcastle, Callaghan, Newcastle, AU
- Food and Nutrition Research Program,, Hunter Medical Research Institute, Rankin Park, Newcastle, AU
| | - Rhonda Marriott
- Ngangk Yira Institute for Change,, Murdoch University, Perth, AU
| | - Megan E Rollo
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Perth, AU
| | - Roz Walker
- Ngangk Yira Institute for Change,, Murdoch University, Perth, AU
- School of Indigenous Studies, University of Western Australia, Nedlands, Perth, AU
- School of Population and Global Health, University of Western Australia, Nedlands, Perth, AU
| | - Kym M Rae
- Mater Research Institute, Aubigny Place, Raymond Terrace, Brisbane, AU
- Faculty of Medicine,, The University of Queensland, Herston, AU
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Schleiff M, Hahn E, Dolive C, James L, Atwell M, Hansoti B. Defining and utilizing individualized learning objectives to achieve learning priorities for global health leaders. PLoS One 2022; 17:e0270465. [PMID: 35763536 PMCID: PMC9239444 DOI: 10.1371/journal.pone.0270465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/10/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Learning objectives (LOs) are a common tool used to define learning goals and guide curricula. As the field of global health has expanded, more rigorous and tailored approaches to effectively teach the next generation of the workforce are needed. The STAR project developed and utilized individualized LOs as the basis for on-the-job learning plans for senior global health leaders from low- and middle-income countries and from the US. METHODS We analyzed basic demographic information and LOs from 36 STAR fellows. Descriptive statistics provided an overview of the STAR fellows, competency areas and planned outputs of their LOs. We utilized qualitative thematic analysis to further explore the LOs themselves. RESULTS STAR fellows were based in the US and in low- and middle-income countries (LMICs). The majority had over 10 years of experience and at least one advanced degree. Fellows commonly worked on LOs related to capacity strengthening, communications, and development practice. Capacity strengthening LOs focused on mentorship, decision-making, and technical skills such as data analysis. Communications LOs focused on language skills, dissemination of information, and writing. Development practice LOs included gaining understanding of key stakeholders in global health and building effective partnerships and teams. DISCUSSION Our experience developing tailored LOs provided deeper understanding of diverse learning needs of global health leaders. While not representative of all global health learners, we captured priorities of senior US- and LMIC-based leaders and identified common themes for learning. Despite the labor required to tailor curricula in this way, more global health education programs can benefit by integrating similar processes.
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Affiliation(s)
- Meike Schleiff
- Department of International Health, Johns Hopkins Bloomberg School of Public, Baltimore, Maryland, United States of America
| | - Elizabeth Hahn
- Department of International Health, Johns Hopkins Bloomberg School of Public, Baltimore, Maryland, United States of America
| | - Caroline Dolive
- Sustaining Technical and Analytical Resources (STAR) project, Public Health Institute, Washington, DC, United States of America
| | - Lillian James
- Sustaining Technical and Analytical Resources (STAR) project, Public Health Institute, Washington, DC, United States of America
| | - Melanie Atwell
- Sustaining Technical and Analytical Resources (STAR) project, Public Health Institute, Washington, DC, United States of America
| | - Bhakti Hansoti
- Department of International Health, Johns Hopkins Bloomberg School of Public, Baltimore, Maryland, United States of America
- Sustaining Technical and Analytical Resources (STAR) project, Public Health Institute, Washington, DC, United States of America
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
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Ssekamatte T, Isunju JB, Nalugya A, Mugambe RK, Kalibala P, Musewa A, Bikaako W, Nattimba M, Tigaiza A, Nakalembe D, Osuret J, Wafula ST, Buregyeya E, Tsiouris F, Michaels-Strasser S, Kabasa JD, Bazeyo W. Using the Kolb's experiential learning cycle to explore the extent of application of one health competencies to solving global health challenges; a tracer study among AFROHUN-Uganda alumni. Global Health 2022; 18:49. [PMID: 35550588 PMCID: PMC9096757 DOI: 10.1186/s12992-022-00841-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/02/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The Africa One Health University Network (AFROHUN) with support from the United States Agency for International Development (USAID), has since 2012 conducted pre and in-service One health (OH) trainings with the objective of improving global health security. These trainings aim to build competencies that, enhance a multidisciplinary approach to solving global health challenges. Despite the investment in OH trainings, there is limited documentation of the extent of acquisition and application of the OH competencies at workplaces. This tracer study explored the extent of acquisition and application of the OH competencies by the AFROHUN-Uganda alumni. METHODS A cross-sectional study was conducted among a random sample of 182 AFROHUN-Uganda alumni of 2013-2018 cohorts. A blended approach of interviewer-administered and self-administered questionnaires was used. Virtual platforms such as Zoom, Microsoft teams, and Skype, and phone interviews were used to collect data when face-to-face interactions with alumni were not possible. Data were collected electronically, either through a link or with the aid of the KoboCollect mobile application, pre-installed on android enabled devices, and analysed using STATA14.0. RESULTS The majority of respondents, 78.6% (143/182) had jobs that required application of OH knowledge and skills, 95.6% (174/182) had learned employable skills from OH activities and 89.6% (163/182) had applied such skills when searching for employment. About 21.7% (34/180) to a very high extent required OH field-specific theoretical knowledge at their workplaces, 27.4% (43/80) to a very high extent required OH field-specific practical knowledge/skills, 42.7% (67/180) to a high extent required a change in attitude and perceptions towards working with people from different disciplines, 49.0% (77/180) required collaboration and networking skills, and more than half, 51.0% (80/180) required team building skills. CONCLUSIONS The majority of OH alumni to a very high extent acquired and applied OH competences such as teamwork, effective communication, community entry and engagement, report writing and problem-solving skills. This study revealed the significant contribution of the AFROHUN Uganda OH activities towards supportive work environments, and highlights areas of improvement such as supporting the trainees to acquire people-management skills, innovation, and an entrepreneurial mind set.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda. .,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Patrick Kalibala
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Angella Musewa
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Winnie Bikaako
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Milly Nattimba
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Arnold Tigaiza
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Doreen Nakalembe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Fatima Tsiouris
- Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - John David Kabasa
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - William Bazeyo
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
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Cassell HM, Rose ES, Moon TD, Bello-Manga H, Aliyu MH, Mutale W. Strengthening research capacity through an intensive training program for biomedical investigators from low- and middle-income countries: the Vanderbilt Institute for Research Development and Ethics (VIRDE). BMC MEDICAL EDUCATION 2022; 22:97. [PMID: 35164739 PMCID: PMC8842898 DOI: 10.1186/s12909-022-03162-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Capacity strengthening initiatives aimed at increasing research knowledge and skills of investigators in low- and middle-income countries (LMICs) have been implemented over the last several decades. With increased capacity, local investigators will have greater leadership in defining research priorities and impact policy change to help improve health outcomes. Evaluations of models of capacity strengthening programs are often limited to short-term impact. Noting the limitations of traditional output-based evaluations, we utilized a broader framework to evaluate the long-term impact of the Vanderbilt Institute in Research Development and Ethics (VIRDE), a decade-old intensive grant development practicum specifically tailored for investigators from LMICs. METHODS To assess the impact of VIRDE on the research careers of alumni over the past 10 years, we surveyed alumni on research engagement, grant productivity, career trajectory, and knowledge gained in grant writing. Descriptive statistics, including means and total counts, and paired sample t-tests were used to analyze the data. RESULTS Forty-six of 58 alumni completed the survey. All respondents returned to their home countries and are currently engaged in research. Post-VIRDE grant writing knowledge ratings were significantly greater than pre-VIRDE. The number of respondents submitting grants post-VIRDE was 2.6 times higher than before the program. Eighty-three percent of respondents submitted a total of 147 grants post-VIRDE, of which 45.6% were awarded. Respondents acknowledged VIRDE's positive impact on career growth and leadership, with 88% advancing in career stage. CONCLUSIONS Gains in grant writing knowledge and grant productivity suggest that VIRDE scholars built skills and confidence in grant writing during the program. A substantial proportion of respondents have advanced in their careers and continue to work in academia in their country of origin. Results show a sustained impact on the research careers of VIRDE alumni. The broader framework for research capacity strengthening resulted in an expansive assessment of the VIRDE program and alumni, illuminating successful program elements and implications that can inform similar capacity strengthening programs.
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Affiliation(s)
- Holly M Cassell
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Avenue Suite 750, Nashville, TN, 37203, USA.
| | - Elizabeth S Rose
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Avenue Suite 750, Nashville, TN, 37203, USA
- Departments of Pediatrics, Health Policy, and Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Troy D Moon
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Avenue Suite 750, Nashville, TN, 37203, USA
- Departments of Pediatrics, Health Policy, and Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Halima Bello-Manga
- Department of Hematology and Blood Transfusion, Barau Dikko Teaching Hospital/Kaduna State University, Kaduna, Nigeria
| | - Muktar H Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Avenue Suite 750, Nashville, TN, 37203, USA
- Departments of Pediatrics, Health Policy, and Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wilbroad Mutale
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Avenue Suite 750, Nashville, TN, 37203, USA
- Departments of Pediatrics, Health Policy, and Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
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Developing Public Health Emergency Response Leaders in Incident Management: A Scoping Review of Educational Interventions. Disaster Med Public Health Prep 2021; 16:2149-2178. [PMID: 34462032 DOI: 10.1017/dmp.2021.164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
During emergency responses, public health leaders frequently serve in incident management roles that differ from their routine job functions. Leaders' familiarity with incident management principles and functions can influence response outcomes. Therefore, training and exercises in incident management are often required for public health leaders. To describe existing methods of incident management training and exercises in the literature, we queried 6 English language databases and found 786 relevant articles. Five themes emerged: (1) experiential learning as an established approach to foster engaging and interactive learning environments and optimize training design; (2) technology-aided decision support tools are increasingly common for crisis decision-making; (3) integration of leadership training in the education continuum is needed for developing public health response leaders; (4) equal emphasis on competency and character is needed for developing capable and adaptable leaders; and (5) consistent evaluation methodologies and metrics are needed to assess the effectiveness of educational interventions.These findings offer important strategic and practical considerations for improving the design and delivery of educational interventions to develop public health emergency response leaders. This review and ongoing real-world events could facilitate further exploration of current practices, emerging trends, and challenges for continuous improvements in developing public health emergency response leaders.
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Training Curriculum, Skills, and Competencies for Global Health Leaders: Good Practices and Lessons Learned. Ann Glob Health 2021; 87:64. [PMID: 34307067 PMCID: PMC8284497 DOI: 10.5334/aogh.3212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objectives: This paper aims to depict unique perspectives and to compare and contrast three leadership programs for global health in order to enable other training institutions to design impactful curricula. Methods: We purposively selected three global health training programs. We used a six-step curriculum development framework to systematically compare the curriculum process across programs and to identify best practices and factors contributing to the impact of each of these programs. Findings: All three fellowship programs undertook an intentional and in-depth approach to curriculum development. Each identified competencies related to leadership and technical skills. Each defined goals, though the goals differed to align with the desired impact of the program, ranging from improving the impact of HIV programming, supporting stronger global health program implementation, and supporting the next generation of global health leaders. All programs implemented the curriculum through an onboarding phase, a delivery of core content in different formats, and a wrap-up or endline phase. During implementation, each program also utilized networking and mentoring to enhance connections and to support application of learning in work roles. Programs faced overlapping challenges and opportunities including funding, strengthening partnerships, and finding ways to engage and support alumni. Conclusions: Local ownership of programs is critical, including tailoring curricula to the needs of specific contexts. Strong partnerships and resources are needed to ensure program sustainability and impact. Key Takeaways
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Liu V, Whitford R, Damji KF. Leadership development facilitated by the "sandwich" and related glaucoma fellowship programs. Leadersh Health Serv (Bradf Engl) 2021; ahead-of-print. [PMID: 34106557 DOI: 10.1108/lhs-10-2020-0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to evaluate leadership training in the Sandwich Glaucoma Fellowship (SGF), a program in which fellows learn skills in a developed world institution and their home country to become leaders in glaucoma care. DESIGN/METHODOLOGY/APPROACH This paper is a retrospective, qualitative and quantitative evaluation. Participants of the SGF between 2007 and 2019 were provided a survey eliciting demographic information, leadership training exposure, development of leadership competencies and feedback for the fellowship program. FINDINGS Seven of nine alumni responded. The fellowship strongly impacted leadership competencies including integrity (8.8, 95% CI 7.8-9.8), work ethic (8.64, 95% CI 7.7-9.6) and empathy (8.6, 95% CI 7.7-9.5). A total of 85% of alumni indicated positive changes in their professional status and described an increasing role in mentorship of colleagues or residents as a result of new skills. Lack of formal leadership training was noted by three respondents. Informal mentorship equipped fellows practicing in regions of Sub Saharan Africa with competencies to rise in their own leadership and mentoring roles related to enhancing glaucoma management. Suggested higher-order learning objectives and a formal curriculum can be included to optimize leadership training catered to the individual fellow experience. ORIGINALITY/VALUE Leadership is necessary in health care and specifically in the context of low- and middle-income countries to bring about sustainable developments. The SGF contains a unique "Sandwich" design, focusing on the acquisition of medical and leadership skills. This evaluation outlines successes and challenges of this, and similar fellowship programs. Other programs can use a similar model to promote the development of skills in partnership with the fellows' home country to strengthen health-care leaders.
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Affiliation(s)
| | - Rita Whitford
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Canada
| | - Karim F Damji
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Canada
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Middleton R, Jones K, Martin M. The impact and translation of postgraduate leadership education on practice in healthcare. Collegian 2021. [DOI: 10.1016/j.colegn.2020.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Kimball AM, Harper D, Creamer K, Adeyemi A, Yates R, Lillywhite L, Told M, Heymann DL. Strengthening Public Health Leadership in Africa: An Innovative Fellowship Program. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1146-1149. [PMID: 30870155 DOI: 10.1097/acm.0000000000002707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PROBLEM The Ebola virus disease crisis in West Africa revealed critical weaknesses in health policy and systems in the region, including the poor development and retention of policy leaders able to set sound policy to improve health. Innovative models for enhancing the capabilities of emerging leaders while retaining their talent in their countries are vital. APPROACH Chatham House (London, United Kingdom) established the West African Global Health Leaders Fellowship to help develop the next generation of West African public health leaders. The innovative program took a unique approach: Six weeks of intensive practical leadership and policy training in London and Geneva bookended a 10-month policy project conceived and carried out by each fellow in their home country. The program emphasized practice, site visits and observation of U.K. public health organizations, identifying resources, and networking. Strong mentorship throughout the fieldwork was a central focus. Work on the pilot phase began in June 2016; the fellows completed their program in September 2017. OUTCOMES The pilot phase of the fellowship was successful, demonstrating that this "sandwich" model for fellowships-whereby participants receive focused leadership training at the start and end of the program, minimally disrupting their lives in-country-offers exciting possibilities for enhancing leadership skills while retaining talent within Africa. NEXT STEPS On the basis of this successful pilot, a second cohort of eight fellows began the program in October 2018. The expanded African Public Health Leaders Fellowship has become a central activity of Chatham House's Centre on Global Health Security.
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Affiliation(s)
- Ann Marie Kimball
- A.M. Kimball is senior consulting fellow and director, pilot phase, Fellows Program, Chatham House, London, United Kingdom, and professor emerita, University of Washington School of Public Health, Seattle, Washington. D. Harper is senior consulting fellow, Chatham House, and honorary professor, London School of Tropical Medicine and Hygiene, London, United Kingdom, and honorary professor, University of Dundee, Dundee, United Kingdom. K. Creamer is former program manager, Chatham House, London, United Kingdom. A. Adeyemi is assistant director, Fellows Program, Chatham House, London, United Kingdom. R. Yates is programme director, Universal Health Care Policy Forum, Chatham House, London, United Kingdom. L. Lillywhite is senior consulting fellow, Chatham House, London, United Kingdom; ORCID: https://orcid.org/0000-0001-5328-6805. M. Told is executive director, Global Health Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland. D.L. Heymann is director, Centre on Global Health Security, director, African Fellows Programme, Chatham House, and professor, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Bowsher G, Papamichail A, El Achi N, Ekzayez A, Roberts B, Sullivan R, Patel P. A narrative review of health research capacity strengthening in low and middle-income countries: lessons for conflict-affected areas. Global Health 2019; 15:23. [PMID: 30914049 PMCID: PMC6434620 DOI: 10.1186/s12992-019-0465-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/07/2019] [Indexed: 11/10/2022] Open
Abstract
Conducting health research in conflict-affected areas and other complex environments is difficult, yet vital. However, the capacity to undertake such research is often limited and with little translation into practice, particularly in poorer countries. There is therefore a need to strengthen health research capacity in conflict-affected countries and regions.In this narrative review, we draw together evidence from low and middle-income countries to highlight challenges to research capacity strengthening in conflict, as well as examples of good practice. We find that authorship trends in health research indicate global imbalances in research capacity, with implications for the type and priorities of research produced, equity within epistemic communities and the development of sustainable research capacity in low and middle-income countries. Yet, there is little evidence on what constitutes effective health research capacity strengthening in conflict-affected areas. There is more evidence on health research capacity strengthening in general, from which several key enablers emerge: adequate and sustained financing; effective stewardship and equitable research partnerships; mentorship of researchers of all levels; and effective linkages of research to policy and practice.Strengthening health research capacity in conflict-affected areas needs to occur at multiple levels to ensure sustainability and equity. Capacity strengthening interventions need to take into consideration the dynamics of conflict, power dynamics within research collaborations, the potential impact of technology, and the wider political environment in which they take place.
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Affiliation(s)
- Gemma Bowsher
- Conflict and Health Research Group, Department of War Studies, King’s College London, London, UK
| | | | - Nassim El Achi
- R4HC-MENA, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | | | - Bayard Roberts
- RECAP, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard Sullivan
- R4HC-MENA, Institute of Cancer Policy, Conflict and Health Research Group, King’s College London, London, UK
| | - Preeti Patel
- R4HC-MENA, Department of War Studies, King’s College London, London, UK
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Daniels J. Building Global Health Capacity at a Minority-Serving Institution in the Bronx: The Potential Role of PhotoVoice and the Geo-Social Pathway Framework in This Endeavor. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 39:19-30. [PMID: 30479193 DOI: 10.1177/0272684x18809508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Global health training programs for undergraduate students are expanding in the United States, which includes Minority-Serving Institutions (MSIs), but capacity building is needed at MSIs to develop career pathways into the field, especially for those institutions that serve low-income students who live in communities with high health disparities. Often, global health pathways begin by building a global lens through the examination of local health issues coupled with international educational experiences. This approach is limited for students who come from low-income settings with limited funding for international experiences, and as a result, may not see the feasibility of a global health career. However, there may be opportunity in harnessing student motivations and participatory research methods to build interest in a global health career. This article outlines the course, Fundamentals of Global Health, offered at a public MSI in the Bronx. The course was grounded in the Geo-Social Pathway Framework and utilized PhotoVoice to engage students in individual research projects. A constant comparison method was used to analyze papers, photos, reflections, and presentations in order to identify themes. Analysis of course materials submitted by students suggests that they were motivated to examine health disparities using PhotoVoice and that they focused their research projects on their family and community health disparities, or aligned with educational or professional goals to address their community health needs. This course model may inform future training in global health for students at MSIs, but community-based participatory research priority funding is needed to sustain global health at these key institutions.
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Affiliation(s)
- Joseph Daniels
- 1 Lehman College, City University of New York, Bronx, NY, USA
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Monroe-Wise A, Mashalla Y, O’Malley G, Nathanson N, Seloilwe E, Gachuno O, Odero T, Nakanjako D, Sewankambo N, Tarimo E, Urassa D, Manabe YC, Chapman S, Voss JG, Wasserheit J, Farquhar C. Training tomorrow's leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni. BMC MEDICAL EDUCATION 2016; 16:241. [PMID: 27643589 PMCID: PMC5028919 DOI: 10.1186/s12909-016-0750-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 08/19/2016] [Indexed: 05/30/2023]
Abstract
BACKGROUND Effective leadership is a cornerstone of successful healthcare delivery in resource limited settings throughout the world. However, few programs in Africa prepare healthcare professionals with the leadership skills vital to the success of the healthcare systems in which they work. One such program, the Afya Bora Consortium Fellowship in Global Health Leadership, has been training health professionals since 2011. The purpose of this study was to assess what career changes, if any, the Afya Bora Fellowship's alumni have experienced since completing the fellowship, and to describe those changes. METHODS The Afya Bora Fellowship is a multidisciplinary, one-year training program that teaches health professionals leadership skills through didactic and experiential learning in four African countries. Between January 2011 and June 2013 the consortium trained 42 nurses and doctors. In November 2013, an electronic survey was sent to all alumni to assess their performance in the workplace post-fellowship. RESULTS Thirty-one (74 %) of 42 alumni completed surveys. Twenty-one (68 %) reported changes to their position at work; of those, sixteen (76 %) believed the change was due to participation in the fellowship. All alumni reported improved performance at work, and cited the application of a wide range of fellowship skills, including leadership, research, communication, and mentoring. Twenty-six (84 %) alumni spearheaded improvements in their workplaces and almost all (97 %) remained in contact with colleagues from the fellowship. Among the respondents there were five publications, nine manuscripts in preparation, and three international conference presentations. CONCLUSIONS Afya Bora alumni overwhelmingly reported that the one year fellowship positively influenced both their work and career trajectory. Training health professionals in leadership skills through didactic modules with the opportunity to apply learned skills at attachment sites in the Afya Bora Fellowship has an impact on performance in the workplace and the potential to improve long-term institutional capacity.
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Affiliation(s)
- Aliza Monroe-Wise
- Departments of Medicine and Global Health, University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA 98104-2499 USA
| | - Yohana Mashalla
- Department of Medicine, University of Botswana, Gaborone, Botswana
| | | | - Neal Nathanson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Esther Seloilwe
- School of Nursing, University of Botswana, Gaborone, Botswana
| | - Onesmus Gachuno
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - Theresa Odero
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Damalie Nakanjako
- Department of Internal Medicine, Makerere University, Kampala, Uganda
| | | | - Edith Tarimo
- Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - David Urassa
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Yukari C. Manabe
- Department of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Susan Chapman
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, CA USA
| | - Joachim G. Voss
- School of Nursing, University of Washington, Seattle, WA USA
| | - Judith Wasserheit
- Departments of Medicine and Global Health, University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA 98104-2499 USA
| | - Carey Farquhar
- Departments of Medicine, Global Health, and Epidemiology, University of Washington, Seattle, WA USA
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Ousman K, Polomano RC, Seloilwe E, Odero T, Tarimo E, Mashalla YJ, Voss JG, O’Malley G, Chapman SA, Gachuno O, Manabe Y, Nakanjako D, Sewankambo N, Urassa D, Wasserheit JN, Wiebe DJ, Green W, Farquhar C. Interprofessional Fellowship Training for Emerging Global Health Leaders in Africa to Improve HIV Prevention and Care: The Afya Bora Consortium. J Assoc Nurses AIDS Care 2016; 27:331-43. [PMID: 27086192 PMCID: PMC4834555 DOI: 10.1016/j.jana.2016.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/29/2016] [Indexed: 02/03/2023]
Abstract
HIV continues to challenge health systems, especially in low- and middle-income countries in Sub-Saharan Africa. A qualified workforce of transformational leaders is required to strengthen health systems and introduce policy reforms to address the barriers to HIV testing, treatment, and other HIV services. The 1-year Afya Bora Consortium Fellowship in Global Health capitalizes on academic partnerships between African and U.S. universities to provide interprofessional leadership training through classroom, online, and service-oriented learning in 5 countries in Africa. This fellowship program prepares health professionals to design, implement, scale-up, evaluate, and lead health programs that are population-based and focused on prevention and control of HIV and other public health issues of greatest importance to African communities and health service settings. Afya Bora nurse fellows acquire leadership attributes and competencies that are continuously and systematically tested during the entire program. This multinational training platform promotes interprofessional networks and career opportunities for nurses.
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Affiliation(s)
- Kevin Ousman
- Principal Partner, African Health Resource Group, Baltimore, Maryland, USA
| | - Rosemary C. Polomano
- Professor of Pain Practice, University of Pennsylvania School of Nursing, and Professor of Anesthesiology and Critical Care (Secondary), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Esther Seloilwe
- Associate Professor, School of Nursing University of Botswana, Gaborone, Botswana
| | - Theresa Odero
- Senior Lecturer, School of Nursing Sciences, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Edith Tarimo
- Senior Lecturer, Department of Nursing Management, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Yohana J. Mashalla
- Dean, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Joachim G. Voss
- Professor and Director, Sarah Cole Hirsh Center for Evidence Based Practice, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA
| | - Gabrielle O’Malley
- Assistant Professor, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, Washington, USA
| | - Susan A. Chapman
- Associate Professor, Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, California, USA
| | - Onesmus Gachuno
- Senior Lecturer, Department of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Yukari Manabe
- Associate Professor, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Damalie Nakanjako
- Associate Professor, Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nelson Sewankambo
- Principal, College of Health Sciences, Makerere University, Kampala, Uganda
| | - David Urassa
- Associate Dean, Department of Community Health, College of Health Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Judith N. Wasserheit
- Chair, Department of Global Health, and Professor of Global Health & Medicine, University of Washington, Seattle, Washington, USA
| | - Douglas J. Wiebe
- Associate Professor, Departments of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Wendy Green
- Assistant Professor, Counseling, Administration, Supervision & Adult Learning, Cleveland State University, Cleveland, Ohio, USA
| | - Carey Farquhar
- Director and Professor, Departments of Medicine, Epidemiology, and Global Health, School of Medicine, University of Washington, Seattle, Washington, USA
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