Surveys on the competencies of specialist occupational physicians and effective methods for acquisition of competencies in Japan

[Competencies required for occupational health professionals in disaster management based on their personal experiences of workplaces damaged by the Kumamoto earthquakes]

OBJECTIVES

This study aimed to clarify the competencies required for occupational health professionals in disaster management based on their personal experiences of workplaces damaged by the Kumamoto earthquakes.

METHODS

This study adopted a qualitative descriptive design using semi-structured interviews. The study participants included eight occupational health professionals who had been engaged in occupational health practice at workplaces affected by the Kumamoto earthquakes and subsequently employed at the same workplace. Data analyses were performed using a qualitative data analysis method. The researcher read transcripts of the interviews verbatim and extracted subcategories and categories, seeking points of commonality among homogeneous and heterogeneous elements while identifying content related to the competencies of the professionals during a disaster.

RESULTS

Nine categories and 29 subcategories were extracted. The following competencies were identified as skills required for occupational health professionals when a disaster occurred: "perceiving the essentials of the situation through a comprehensive understanding of the health impacts caused by disasters," "prioritizing tasks while appropriately understanding a situation that is changing over time," "starting from what one can do while ensuring one's own health and safety," "continuing occupational health practice by devising efficient approaches while flexibly responding to the situation," "creating an environment that enables each occupational health team member to fulfill their role," and "adjusting the positions of occupational health departments within organizations to utilize networks." The following competencies were identified as skills required for occupational health professionals' disaster response and preparedness: "having the essential personal qualities of occupational health professionals," "establishing relationships of trust with employees and companies," and "linking one's experience of a disaster to future occupational health practice."

CONCLUSIONS

The competencies required for occupational health professionals in disaster management are disaster response and preparedness. Moreover, these aspects in disaster response and preparedness suggest that occupational health professionals are required to have strategic and creative thinking skills including organizational approaches such as boosting networking in the workplace and establishing employer-employee relationships based on multifaceted assessment and situational flexibility.

Survey of the necessary competencies and proficiency of safety officers in Thailand

Competency is important for professionals' effective performance and career development. However, little is known about the necessary competencies and proficiency in these for Thai safety officers. Therefore, this study aimed to identify the necessary competencies for this group and to compare proficiency in each competency between senior and junior safety officers. A descriptive, cross-sectional study was conducted among 73 safety officers using a self-administered questionnaire. Twenty-five competencies were classified as necessary. Mean proficiency scores were higher for senior safety officers than for more junior safety officers for all examined competencies; however, this difference was not statistically significant for 'first aid' or for 'air sampling and analytical methods'. Regulatory compliance was assessed as the most important competency. Gaps between necessity and proficiency were observed in managing safety programs for the junior group. In both groups, proficiency was lowest in the competency of mental health. The results indicate that Thai safety officers' training needs may be particularly high for regulatory compliance, managing safety programs, and mental health. Lifelong learning is important for enabling occupational safety and health practitioners to fulfill current requirements in Thailand and elsewhere. Multiple training approaches and a specialist qualification program may encourage competency development, especially for junior practitioners.

[Types of Methods of Occupational Physician's Actions in the Health Committee]

OBJECTIVES

In this study, we aimed to categorize the actions of occupational physicians in health committees leading to solutions of occupational health problems.

METHODS

We conducted two focus group discussions among experienced occupational physicians. The discussions addressed the following question: what had they and others said and done that had led to the development of solutions to occupational health problems. We used a qualitative content analysis approach developed by Berelson, and created a draft of the categories of actions. Subsequently, an online questionnaire survey was then used to evaluate the external validity of the draft. The questionnaire asked physicians whether they had experience of each item in the draft. They were also asked whether they had experienced any other items not included in the draft. If so, they were asked to provide a description of their experience. These descriptions were discussed by three researchers. Any suggested new items considered to fall under any of the original items in the draft were excluded, and any new items proposed by two or more participants were added as additional items. Finally, we corrected words and phrases and reviewed the items to ensure that they clearly conveyed the required meaning, and described actions leading to solutions to occupational health problems.

RESULTS

The content analysis revealed six basic actions, and 32 items were categorized in the draft. The six basic actions were "participate", "gather information", "make a place that allows communication with key people and health committee members", "make arrangements", "speak at a health committee", and "pay attention". In total, 67 physicians responded to the questionnaire survey. At least 40% of participants answered that they had experience of the draft items. All items in the draft had also been experienced by groups of occupational physicians other than those involved in the focus groups. Three additional items proposed by two or more participants were added. "Pay attention" was deleted following the final review.

CONCLUSIONS

We categorized the actions of occupational physicians in health committees into five basic actions, and 32 items. Being aware of types of actions used in groups may encourage occupational physicians to be more involved in workplace health committees and contribute to the promotion of occupational health activities in the workplace.

Current Status and Issues for the Role of Occupational Health Physicians in Japan

This paper reviews the circumstances, current situation, and issues for Japanese occupational health physicians and discusses future developments. The Industrial Safety and Health Act requires workplaces that regularly employ 50 or more workers to appoint one occupational health physician. Their duties have been expanded by amendments to the Act, and they now have increased authority. Under these conditions, the occupational health physicians not only comply with laws and regulations but also follow a professional code of ethics. After the Act was amended in 1996, occupational health physicians had to complete additional training requirements. Basic training courses are provided by the Japan Medical Association (JMA) and the University of Occupational and Environmental Health, Japan. Most of the occupational health physicians certified by the JMA do not spend enough time on occupational health. Many Japanese occupational health work issues can be separated into issues of exposure, labor, and the occupational health system. Occupational health is characterized by changing needs because of new industrial structures and technological innovations. Given occupational health physicians’ expanding duties and professional development, they need to collaborate with one other and other occupational health staff to meet society’s expectations.

Perception of and attitude toward ethical issues among Korean occupational physicians

Background

Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs.

Methods

An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community ‘oem-doctors’ in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher’s exact test.

Results

Responses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought ‘consideration of worker’s health and safety’ (26.0%) and ‘neutrality’ (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations.

Conclusions

This study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-017-0182-z) contains supplementary material, which is available to authorized users.

[Development of a Tool for Training and Evaluation of the Competencies in Occupational Mental Health Necessary for Labor and Social Security Attorneys]

Labor and Social Security Attorneys (LSSAs) advise their clients about occupational mental health, but the competencies necessary in this field are not clear to them. We standardized the necessary competencies as a counseling guide for LSSAs, and we also designed a related discussion training program. These competencies were summarized in a brainstorming session at a research conference comprised of physicians, an occupational health nurse, LSSAs, an instructional design expert, and a management consultant, and then a training program (lasting 9 hours 30 minutes) was developed. Nineteen trainees who were introduced by members of the research conference collectively completed a seven-question written test, both before and after the training, in order to assess its effectiveness. Sixteen trainees who completed the training were surveyed, with a recovery rate of 100%. The necessary competencies that they identified were: information about circular notices from the Ministry of Health, Labor and Welfare; behavior such as the gathering of information; and dealing with the reinstatement of employees. The scores were subjected to the Wilcoxon signed-rank test in order to evaluate the training, and the answers from the pre-training were compared with those from the post-training. A significant difference (P < 0.05) was seen for each question. These results show the effectiveness of the developed training program for the learning of the competencies necessary for LSSAs.