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Falandry C, Bacchetta J, Doret-Dion M, Ferraro-Peyret C, Confavreux CB, Douplat M, Feugier P, Friggeri A, Bolze PA, Dargaud Y, Messager A, Wallon M, Geffroy L, Matillon Y, Bradwejn J. Tailoring a specific medical leadership development program for faculty members: the Lyon-Ottawa experience. Med Educ Online 2024; 29:2308955. [PMID: 38290044 PMCID: PMC10829808 DOI: 10.1080/10872981.2024.2308955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024]
Abstract
The development of leadership skills has been the topic of several position statements over recent decades, and the need of medical leaders for a specific training was emphasized during the COVID-19 crisis, to enable them to adequately collaborate with governments, populations, civic society, organizations, and universities. However, differences persist as to the way such skills are taught, at which step of training, and to whom. From these observations and building on previous experience at the University of Ottawa, a team of medical professors from Lyon (France), Ottawa, and Montreal (Canada) universities decided to develop a specific medical leadership training program dedicated to faculty members taking on leadership responsibilities. This pilot training program was based on a holistic vision of a transformation model for leadership development, the underlying principle of which is that leaders are trained by leaders. All contributors were eminent French and Canadian stakeholders. The model was adapted to French faculty members, following an inner and outer analysis of their specific needs, both contextual and related to their time constraints. This pilot program, which included 10 faculty members from Lyon, was selected to favor interactivity and confidence in older to favor long-term collaborations between them and contribute to institutional changes from the inner; it combined several educational methods mixing interactive plenary sessions and simulation exercises during onescholar year. All the participants completed the program and expressed global satisfaction with it, validating its acceptability by the target. Future work will aim to develop the program, integrate evaluation criteria, and transform it into a graduating training.
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Affiliation(s)
- Claire Falandry
- Service de Gériatrie, Centre Hospitalier de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Laboratoire CarMeN de l’Université de Lyon, INSERM U.1060/Université Lyon1/INRA U. 1397/INSA Lyon/Hospices Civils Lyon, Pierre-Bénite, France
| | - Justine Bacchetta
- Néphrologie Rhumatologie Dermatologie Pédiatrique, Hopital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
- UMR 1033, INSERM, Lyon, France
| | - Muriel Doret-Dion
- Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Faculté De Médecine Et De Maïeutique Lyon Sud - Charles Mérieux, Université Lyon 1, Oullins, France
| | - Carole Ferraro-Peyret
- Centre de biopathologie des tumeurs, Hôpitaux Est, Hospices Civils de Lyon, Bron, France
- ISPB Faculté de pharmacie, INSERM 1052, CNRS5286, Centre de Recherche sur le Cancer de Lyon, Université de Lyon, Lyon, France
| | - Cyrille B. Confavreux
- Service de Rhumatologie Sud, Hôpital Lyon Sud, Hospices Civils de LyonPierre-Bénite, France
- Université Lyon 1, UFR médecine Lyon Est, INSERM UMR 1033, Lyon, France
| | - Marion Douplat
- Service des Urgences, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université de Lyon, Laboratoire RESHAPE - Research on Healthcare Performance, Université Lyon 1, Lyon, France
| | - Patrick Feugier
- Service de Chirurgie Vasculaire et Endovasculaire, Centre Hospitalier Lyon Sud, Hospices Civils de LyonPierre-Bénite, France
- Université de Lyon, UFR médecine Lyon Est, Université Lyon1, Pierre-Bénite, France
| | - Arnaud Friggeri
- Service d’Anesthésie-Réanimation, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université de Lyon, Faculté De Médecine Et De Maïeutique Lyon Sud - Charles Mérieux, Université Lyon 1, Oullins, France
| | - Pierre-Adrien Bolze
- Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hôpital Lyon Sud, Hospices Civils de LyonPierre-Bénite, France
- Centre pour l’Innovation en Cancérologie de Lyon (CICLY EA3738), Université Lyon 1, Oullins, France
| | - Yesim Dargaud
- Centre d’Hémophilie de Lyon, Unité d’Hémostase clinique, Hôpital Louis Pradel, Bron, France
- Université de Lyon, Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
| | - Alexandre Messager
- Human Resources and Faculty/Clinical Leadership Development, Ottawa University, Ottawa, Canada
| | - Martine Wallon
- Service de Parasitologie et de Mycologie Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Waking Team, Centre de Recherche en Neurosciences de Lyon, Bron, France
| | - Loïc Geffroy
- Stratégie et management des organisations, Université Lyon 1, Lyon, France
| | - Yves Matillon
- Laboratoire Parcours Santé Systémique, Université Lyon 1, Lyon, France
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Pizzolato D, Labib K, Skoulikaris N, Evans N, Roje R, Kavouras P, Aubert Bonn N, Dierickx K, Tijdink J. How can research institutions support responsible supervision and leadership? Account Res 2024; 31:173-195. [PMID: 35975399 DOI: 10.1080/08989621.2022.2112033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Supervisors, PhD candidates and research leaders are expected to be the primary persons responsible for maintaining a high research integrity standards. However, research institutions should support them in this effort, by promoting responsible supervision and leadership practices. Although it is clear that institutions play a crucial role in this, there is a lack of institutional guidelines focusing on these topics. The development of the experience-based guidelines presented in this article consisted of a multi-step, iterative approach. We engaged 16 experts in supervision and research integrity in four workshops to co-create institutional guidelines for responsible supervision and leadership. To revise the guidelines and make them operational, we formed a dedicated working group and consulted experts in the field of supervision. This resulted in three guidelines focusing on what institutions can do to support: responsible supervision, PhD candidates during their PhD trajectory, and responsible leadership. The recommendations focus on the rights and responsibilities of the three targeted stakeholder groups, and institutions' responsibilities for the personal development and well-being of supervisors, PhD candidates and research leaders. The three guidelines can be used by institutions to foster responsible supervision and leadership by supporting researchers to conduct research with integrity.
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Affiliation(s)
- Daniel Pizzolato
- KU Leuven, Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, Leuven, Belgium
| | - Krishma Labib
- Amsterdam UMC, VrijeUniversiteit Amsterdam, Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam, The Netherland
| | - Niko Skoulikaris
- Amsterdam UMC, VrijeUniversiteit Amsterdam, Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam, The Netherland
| | - Natalie Evans
- Amsterdam UMC, VrijeUniversiteit Amsterdam, Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam, The Netherland
| | - Rea Roje
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Panagiotis Kavouras
- RNanoLab, Department of Materials Science and Engineering, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - Noémie Aubert Bonn
- Amsterdam UMC, VrijeUniversiteit Amsterdam, Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam, The Netherland
| | - Kris Dierickx
- KU Leuven, Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, Leuven, Belgium
| | - Joeri Tijdink
- Amsterdam UMC, VrijeUniversiteit Amsterdam, Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam, The Netherland
- Department of Philosophy, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Abraham P, Dubois N, Rimmelé T, Lilot M, Balança B. Enhancing perioperative care through decontextualized simulation: A game-changer for non-technical skills training. J Clin Anesth 2024; 94:111428. [PMID: 38422954 DOI: 10.1016/j.jclinane.2024.111428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/11/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Paul Abraham
- Department of Anesthesiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France.
| | - Nadège Dubois
- Medical Simulation Center, Public Health Department, Liège University, Liège, Belgium
| | - Thomas Rimmelé
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; EA 7426, PI3 (Pathophysiology of Injury-Induced Immunosuppression), Claude Bernard University Lyon 1-Biomérieux-Hospices Civils de Lyon, Lyon, France
| | - Marc Lilot
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; Unit of Pediatric and Congenital Cardio-thoracic Anesthesia and Intensive Care, Medical-Surgical Department of Congenital Cardiology of the Fœtus, Child and Adult. Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Baptiste Balança
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; Neurologic Intensive care and Anesthesiology, Hospices Civils de Lyon, Pierre Wertheimer Hospital and Claude Bernard University Lyon 1 - Neuroscience Research Center, Lyon, France
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Bigby C, Humphreys L. The strength of Frontline Practice Leadership in Australian supported accommodation services: Challenges confronting service providers. J Appl Res Intellect Disabil 2024; 37:e13227. [PMID: 38520280 DOI: 10.1111/jar.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The strength of practice leadership predicts the quality of Active Support but it can be compromised by other demands on frontline managers. The study aimed to identify and understand differences in practice leadership over time and between organisations. METHOD Data collected in 2022 in 96 services from 11 organisations using the Observed Measure of Practice Leadership were compared to similar data from 2013 and 2018. Qualitative fieldnotes were analysed thematically. FINDINGS Practice leadership scores increased significantly between 2013 and 2018 but declined significantly between 2018 and 2022. Scores were significantly higher in organisations that had implemented Active Support since 2013 compared to later adopters. Higher scoring organisations had structures that supported frontline managers with practice leadership and that countered increasing administrative demands. CONCLUSIONS Establishment of support structures for practice leadership by organisations warrants further investigation together with the relative importance of each task of practice leadership.
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Affiliation(s)
- Christine Bigby
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Lincoln Humphreys
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Abstract
This study explored the underlying mechanisms and boundary conditions of the relationship between transformational leadership and teacher burnout. Specifically, it investigated the mediating role of teacher self-efficacy and the moderating role of teacher emotional intelligence (EI) in this relationship. Data from 539 primary and secondary school teachers were analyzed using Structural Equation Model and hierarchical regression. The results indicate that transformational leadership predicted teacher burnout negatively, self-efficacy mediated the association of transformational leadership with burnout partially, and EI strengthened the association between transformational leadership and burnout. This study has important theoretical and managerial implications as it deepens the understanding of the association between transformational leadership and burnout in the educational field and provides practical suggestions on how to relieve teacher burnout in the school context.
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Affiliation(s)
- Ye Tian
- School of Public Administration, China University of Geosciences, Wuhan, China
| | - Yungui Guo
- School of Business, Hunan University of Science and Technology, Xiangtan, China
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Loftus TJ, McDowell LD, Upchurch GR. Surgical leadership: Ensuring financial stability through growth. Surgery 2024; 175:1218-1223. [PMID: 37839969 DOI: 10.1016/j.surg.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023]
Abstract
Maintaining financial stability is important for leaders in surgery because it (1) allows consistent, fair (market value) reimbursement for employees, which conveys that they are valued; (2) enables strategic investment in new programs that may not generate direct financial gains but are required; and (3) builds trust with stakeholders outside the department while strengthening the department's position in negotiations. Key strategies that we have used to increase revenue (income) over the past 6 years have been hiring more faculty, advocating for greater operating room and staffing capacity, staffing surgeons at other institutions using affiliation agreements, attempting to shift grant-funded efforts to non-clinical (research) faculty to mitigate National Institutes of Health salary cap penalties, and increasing efforts to identify external funding for educational and administrative tasks performed by surgeons (eg, increasing contact hours with medical students to secure a greater proportion of state general revenue). Using these strategies, our total revenue has increased 66% over the past 6 years, whereas Academic Support Agreement funds from the College of Medicine concurrently have decreased by 75%. Key strategies that we have used for curtailing expenses have been increasing clinic workflow efficiency; shifting advance practice provider contractual expenses and trainee indirect costs to the hospital; focusing on driving down delayed accounts receivable over time; and using net collections to preferentially invest in research likely to receive future external funding, for which indirect costs return to the department. Despite using these strategies, the total expenses of our department have increased 74% over the past 6 years, driven primarily by the doubling of clinic costs and contractual expenses for advance practice providers. These losses could theoretically be offset by (1) increasing billing by advance practice providers who can also facilitate excellent continuity of surgical care while allowing residents and fellows to shift their effort from service toward education and (2) increasing clinic capacity to generate increasing operative volumes. A department's financial stability is affected by complex interactions among several stakeholders, including the College of Medicine, faculty group practices, and hospitals, with competing interests. Leaders in surgery must understand and manage major categories of revenue and expenses to create a financially stable environment in which they can fulfill their multi-prong missions.
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Affiliation(s)
- Tyler J Loftus
- Department of Surgery, University of Florida Health, Gainesville, FL. https://twitter.com/_TylerLoftus
| | - Lonn D McDowell
- Department of Surgery, University of Florida Health, Gainesville, FL
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Dolinta J, Freysteinson WM, Nava A, Clutter P. The Journey and Experiences of Female Hispanic Nurse Leaders. J Nurs Adm 2024; 54:201-207. [PMID: 38501804 DOI: 10.1097/nna.0000000000001410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVE This study aimed to understand the experience of female Hispanic nurses in formal leadership roles. BACKGROUND Research has identified that a diverse nursing leadership workforce is essential to providing optimal patient care. Little is known about the phenomenon of minority nurse leaders, particularly female Hispanic nurses in leadership roles. METHODS Ricoeur's hermeneutic phenomenology guided the interviews of 15 female Hispanic nurses in leadership roles. RESULTS Three themes were generated that described the environment in which leaders lived: family, culture, and healthcare organization. Four phenomenological themes were identified: weaving my life fabric, my inner dialogue, weight on my shoulders, and paving the way. CONCLUSION The study findings highlight the importance of a diverse and inclusive nursing leadership workforce. By proactively addressing equal opportunities, reducing barriers to career advancement, and developing strategies to support and encourage minority nurses, organizations and communities can recruit and retain qualified underrepresented minority nurse leaders.
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Affiliation(s)
- Jeniffer Dolinta
- Author Affiliation: Visiting Visiting Assistant Clinical Professor (Dr Dolinta), Professor (Dr Freysteinson), Assistant Professor (Dr Nava), and Interim Dean and Professor (Dr Clutter), Nelda C. Stark College of Nursing, Texas Woman's University, Houston
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Wimelius ME, Strandh V. Organised crisis volunteers, COVID-19, and the political steering of crisis management in Sweden. Disasters 2024; 48:e12604. [PMID: 37450584 DOI: 10.1111/disa.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
This paper explores and analyses the activities of Swedish organised crisis volunteers during the COVID-19 pandemic. Based on a questionnaire and interviews, it sets out to answer two research questions on what characterised organised volunteerism during the pandemic, how organised volunteers experienced cooperation with local public actors, and how they viewed political steering. The paper contributes to a growing literature on the role of volunteers and links that role to views on political steering, something that is rarely done in disaster research. Sweden is a useful case study because of how COVID-19 was managed, as well as because there are organised crisis volunteers and a debate is occurring on how the national system is steered. The paper shows how organised volunteers adapted to changing needs and adopted new roles, that experiences of cooperation with local authorities varied, and that calls were made for a stronger national leadership and for more explicit central political steering.
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Affiliation(s)
- Malin E Wimelius
- Associate Professor, Department of Political Science, Umeå University, Sweden
| | - Veronica Strandh
- Associate Professor, Department of Political Science, Umeå University, Sweden
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Rajamohan S, Crotser C, Fleming W. Applying Biblical Wisdom to Trying Times: 10 Leadership Lessons for Nurses. J Christ Nurs 2024; 41:88-95. [PMID: 38436338 DOI: 10.1097/cnj.0000000000001149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
ABSTRACT In the post-COVID era, examining nursing and pastoral leadership experiences with biblical examples offers helpful perspectives on how to lead in times of crisis and adversity. Reflecting on men and women of the Bible who led during crisis can encourage nurses to view our ministries through God's lens and motivate us to become stronger leaders.
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Parks MA, Gaskins JT, Jin A, Galandiuk S, Kavalukas SL. You Want to be a Surgical Leader? Consider Training Elsewhere - An Observation of How Training Background May Impact Leadership Selection. J Surg Educ 2024; 81:564-569. [PMID: 38388306 DOI: 10.1016/j.jsurg.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/15/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVE The significance of thought differences has always held importance in medicine, but it could be considered as increasingly acknowledged and valued to a greater extent in recent times as more emphasis is placed on diversity, equity, and inclusion. These unique perspectives have been examined according to race, gender, and ethnicity, but there is limited published data examining the prevalence of leadership roles within surgical departments in terms of training background. Our main objective is to identify trends in surgical leaders' education, and emphasize training diversity in surgical leadership. DESIGN A descriptive study of the training background of all surgical academic leaders. SETTING This internet search was performed at a tertiary care, academic medical center. PARTICIPANTS Academic chairpersons, division directors, and program directors. RESULTS 124 programs had pertinent information available. There was a mean of 7.6 leaders per institute examined: total 939 positions (119 chairs, 704 division directors, 116 program directors). 90/119 (76%) of the Chairs led at institutions outside of the places they completed their training. 4/119 (3%) did all their training at the same institution they chaired. 25/119 (21%) completed at least some but not all their training there, and later rose to the role of Chair. Among division directors, 217/704 (31%) did some training at that institution, and program directors were significantly more likely to have completed some training at their current institute (53/116, 46%; p = 0.001). There were no statistically significant differences when examined geographically. Women made up 18% of the leaders and were significantly more likely to lead as program director rather than a chair or division director (p < 0.001). CONCLUSION A majority of surgery chairs hold positions at institutions where they did not complete their medical training. This suggests that outside perspective could be a contributing factor when searching for this position.
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Affiliation(s)
- Mary Alex Parks
- University of Louisville, Department of Surgery, Louisville, Kentucky
| | - Jeremy T Gaskins
- University of Louisville, Department of Bioinformatics & Biostatistics, Louisville, Kentucky
| | - Allie Jin
- University of Louisville, Department of Surgery, Louisville, Kentucky
| | - Susan Galandiuk
- University of Louisville, Department of Surgery, Louisville, Kentucky
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Bartone PT. Hardiness, leadership style and gender as predictors of leader performance in military academy cadets. Scand J Psychol 2024; 65:223-230. [PMID: 37747043 DOI: 10.1111/sjop.12969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023]
Abstract
The U.S. Military Academy at West Point is widely considered the premier leader development institution in the United States. Since first admitting women in 1976, few studies have examined factors that may influence female cadets to perform as leaders in this environment. The present study analyzed archival data collected during a unique longitudinal study of leader development conducted at West Point during the years 1993-2000, the Baseline Officer Leader Development Study (BOLDS). Personality hardiness, transformational and transactional leadership styles were evaluated as potential predictors of performance as leaders, according to supervisor ratings. Regression results showed that female cadets excel as leaders, outperforming male cadets as a group. Hardiness and transformational leadership style predicted leader performance for both male and female cadets. Additional analyses indicated it is the transformational leadership element of "charismatic" (or idealized influence) leadership that accounts for this finding. The transactional component "management by exception-active" also predicted leader performance, but for male cadets only. This study confirms that hardiness and charismatic leadership style are important for leadership performance of both male and female cadets. For male cadets, leader performance was also tied to actively identifying and addressing failures in subordinates. Leader development programs for both men and women may thus be enhanced by including programs to develop personality hardiness and transformational leadership qualities.
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Affiliation(s)
- Paul T Bartone
- National Defense University, Washington, DC, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Janke N, Gohar B, Blokland K, Coe JB. Workplace psychosocial factors are associated with veterinary employees' organizational commitment to their current veterinary hospital. J Am Vet Med Assoc 2024; 262:1-10. [PMID: 38183765 DOI: 10.2460/javma.23.10.0601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/06/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE To classify a sample of veterinary professionals into distinct organizational-commitment profiles and to identify associations between psychosocial aspects of the workplace and organizational-commitment profile membership. SAMPLE 487 veterinary employees who worked for a corporate veterinary organization in Canada. METHODS Survey components measured for this study included the Three-Component Model (TCM) Employee Commitment Survey-Revised, the Copenhagen Psychosocial Questionnaire, and participant demographics. First, latent profile analysis was used to identify distinct organizational-commitment profiles based on 3 components of commitment (affective, continuance, and normative). Next, the Mann-Whitney U test was used to compare participants' intention to leave their hospital on the basis of organizational-commitment profile. Finally, logistic regression was performed to assess the association between perceived psychosocial workplace characteristics and organizational-commitment profile membership. RESULTS 2 organizational-commitment profiles were identified: Affective/Normative (AC/NC) Dominant (n = 388) and Mid-Low Commitment (99). Participants in the Mid-Low Commitment Profile had a significantly higher intention-to-leave score (median, 3.0) than participants in the AC/NC Dominant Profile (median, 2.0; P < .001). Psychosocial factors found to predict membership in the AC/NC Dominant Profile included the following: influence at work (OR, 2.08; P < .001), meaning of work (OR, 1.38; P = .067), rewards/recognition (OR, 1.63; P = .007), and quality of leadership (OR, 1.85; P = .0003). Members of the AC/NC Dominant Profile also experienced greater work-life conflict (OR, 1.65; P = .003) compared to the Mid-Low Commitment Profile. CLINICAL RELEVANCE Findings identified potential psychosocial aspects of the workplace that can be considered to support more desirable organizational-commitment profiles that are likely to lead to favorable outcomes for veterinary practices and their employees.
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Affiliation(s)
- Natasha Janke
- 1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Basem Gohar
- 1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- 2Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, ON, Canada
| | - Kirsten Blokland
- 1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jason B Coe
- 1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Mitchell R, Gu J, Boyle B. The impact of leader member exchange quality and differentiation on counterproductive and citizenship behavior in health care teams. Health Care Manage Rev 2024; 49:86-93. [PMID: 38393981 DOI: 10.1097/hmr.0000000000000394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND Organizational citizenship behavior (OCB) may increase service quality. In contrast, counterproductive work behavior (CWB) may undermine patient safety. Efforts to increase OCB and reduce CWB rely on a good understanding of their antecedents, yet there is a lack of research in health care to inform such endeavors. PURPOSE The aim of this study was to investigate the role of leadership, specifically leader-member exchange (LMX), in reducing CWB and increasing OCB in health care teams. METHODOLOGY/APPROACH Team survey data were collected from 75 teams in U.S. health services organizations. Polynomial regression and response surface analysis was used to investigate our hypotheses. RESULTS For OCB, the response surface along the line of incongruence (a3) was positive and significant, and for CWB, a3 was negative and significant. CONCLUSION The results of polynomial regression and response surface analysis indicate that OCB increases when LMX quality is high and that LMX differentiation is comparatively lower. In contrast, CWB increases when LMX differentiation is high, whereas LMX quality is lower. PRACTICE IMPLICATIONS These findings provide useful suggestions to promote valuable extra-role behaviors in health care teams. Health care team leaders should aim to develop strong exchange relationships with all members if they wish to increase citizenship behavior and decrease counterproductive behavior. Building positive exchange relationships with only a few team members is likely to undermine citizenship behavior and increase counterproductive behavior.
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Xiao Q, Iftikhar Q, Spaeth K, Zhang C, Liang XC, Klarin A, Liu L. The relationship between servant leadership and nurses' in-role performance: The sequential mediating effects of job autonomy and emotional exhaustion. J Adv Nurs 2024; 80:1440-1451. [PMID: 37962237 DOI: 10.1111/jan.15930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023]
Abstract
AIMS Drawing on the conservation of resources theory, this study examines the underlying process through which servant leadership is associated with nurses' in-role performance. Specifically, we test the indirect effect of servant leadership on in-role performance via a sequential mediating mechanism of job autonomy and emotional exhaustion. DESIGN A time-lagged design was implemented using data gathered from two-wave online surveys (1 week apart) of registered nurses from Jiangsu Province, China. METHODS Between September 2022 and February 2023, we used Wenjuanxing and Credma, which are two powerful and user-friendly data collection platforms, to distribute online surveys to potential participants. We received a total of 220 usable responses and employed the PROCESS Model 4 and Model 6 to assess our proposed hypotheses. RESULTS Our proposed model was supported. Servant leadership has a positive indirect effect on nurses' in-role performance through job autonomy and emotional exhaustion. Job autonomy has a negative effect on emotional exhaustion. Additionally, job autonomy mediates the negative relationship between servant leadership and emotional exhaustion. CONCLUSION The present research extends existing nursing studies by unravelling the complex mechanisms underlying the relationship between servant leadership and nurses' in-role performance. Our study also identifies the underlying mechanism of how servant leadership mitigates emotional exhaustion by supporting nurses' job autonomy. IMPACT The sequential mediation results provide us with a more fine-grained understanding of the relationship between servant leadership and nurses' in-role performance. It further promotes job autonomy and decreases emotional exhaustion, which supports the UN Sustainable Development Goal #3 (Good Health and Well-being). PATIENT OR PUBLIC CONTRIBUTION This study addresses the UN Sustainable Development Goal #3: 'To ensure healthy lives and promote well-being for all at all ages' and the healthcare providers will benefit from our study. Therefore, the study contributes to a more sustainable organization and society.
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Affiliation(s)
- Qijie Xiao
- Department of Management, Monash Business School, Monash University, Melbourne, Victoria, Australia
- Suzhou lndustrial Park Monash Research Institute of Science and Technology, Suzhou, China
| | - Qudsia Iftikhar
- Department of Management, Monash Business School, Monash University, Melbourne, Victoria, Australia
- Department of Management, Deakin University, Melbourne, Victoria, Australia
| | - Katharina Spaeth
- Department of Management, Melbourne University, Melbourne, Victoria, Australia
| | - Chunyu Zhang
- School of Economics and Management, Guangxi Normal University, Guilin, China
| | | | - Anton Klarin
- School of Management and Marketing, Curtin University, Bentley, Western Australia, Australia
| | - Liping Liu
- School of Economics and Management, Guangxi Normal University, Guilin, China
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Eminoğlu A, Çelikkanat Ş. Assessment of the relationship between executive Nurses' leadership Self-Efficacy and medical artificial intelligence readiness. Int J Med Inform 2024; 184:105386. [PMID: 38387197 DOI: 10.1016/j.ijmedinf.2024.105386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/22/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
AIMS This study aims to assess the relationship between management nurses' leadership self-efficacy and medical artificial intelligence readiness. METHODS The research was conducted using a descriptive-correlational design. The sample of the study consisted of 196 management nurses working in public, private, and educational research hospitals in Gaziantep, Turkey. The data collection tools included the Personal Information Form, the Leadership Self-Efficacy Scale, and the Medical Artificial Intelligence Readiness Scale. RESULTS The majority of the participants in the research were female (71.4 %), married (80.1 %) and graduates of a bachelor's or higher degree in nursing (74.5 %), had 16 years or more of work experience in the profession (39.3 %), and worked during the day shift (75.5 %). Among the participating management nurses, those who were single had a significantly higher mean score in the cognition subscale and the total score of medical artificial intelligence readiness (p < 0.05). The management nurses working in shifts had significantly higher mean scores in the cognition and ability subscales, as well as the total score of medical artificial intelligence readiness (p < 0.05). The management nurses who received leadership/management-related training after their undergraduate education had a significantly higher mean score in the cognition subscale (p < 0.05). Furthermore, there was a significant relationship (p < 0.05) between leadership self-efficacy, medical artificial intelligence readiness, and their subscales, concerning following and finding artificial intelligence applications useful, as well as informing team members about artificial intelligence applications. CONCLUSIONS In the research, it was determined that the leadership self-efficacy of the manager nurses was at a good level and that their artificial intelligence readiness was at a medium level in terms of cognition, skill, foresight and ethics while presenting their professional knowledge. A positive and significant relationship was found between leadership self-efficacy and medical artificial intelligence readiness.
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Affiliation(s)
- Ayşe Eminoğlu
- Gaziantep Islam Science and Technology University of Health Sciences Department of Nursing, Gaziantep, Turkey.
| | - Şirin Çelikkanat
- Gaziantep Islam Science and Technology University of Health Sciences Department of Nursing, Gaziantep, Turkey.
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16
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Clark TA. Perceived Barriers and Strategies to Increasing the BSN-Prepared Nursing Workforce. J Christ Nurs 2024; 41:112-119. [PMID: 38436342 DOI: 10.1097/cnj.0000000000001153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
ABSTRACT Care provided by Bachelor of Science in Nursing (BSN)-prepared Registered Nurses (RNs) has been shown to lead to more positive patient outcomes compared to care provided by non-BSN-prepared RNs. A Fall 2021 study explored barriers of requiring a BSN degree of staff nurses from the perspective of hospital and long-term care facility nurse leaders in Tennessee (N = 89), strategies to increase the number of nurses with BSNs, and association between leadership goals and the number of BSN-prepared nurses in the facilities. Seven barriers to requiring the BSN and nine strategies to increase BSNs were identified. Significant association was found between having plans to increase the number of BSN nurses and the percentage of nurses in the facility with BSN degrees.
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Affiliation(s)
- Terri A Clark
- Terri A. Clark, EdD, MSN, RN, serves as an associate professor of nursing and RN-to-BSN facilitator at Austin Peay State University, Clarksville, TN. She is passionate about the education of nurses
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Duprez V, Dhont L, van der Cingel M, Hafsteinsdóttir TB, Malfait S. Understanding strategies that foster nurses to act as clinical leaders in hospitals: A realist review. J Adv Nurs 2024; 80:1248-1261. [PMID: 37849078 DOI: 10.1111/jan.15902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/23/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023]
Abstract
AIM To identify strategies that develop clinical nursing leadership competencies among staff nurses, and to explain the contextual elements and mechanisms that underpin the development of clinical nursing leadership competencies. DESIGN Realist review according to the Realist and Meta-narrative Evidence Syntheses-Evolving Standards (RAMESES). DATA SOURCES PubMed, Embase, CINAHL, Web of Science, Wiley Online Library, PsycInfo and ProQuest were searched from January 2000 until October 2022. REVIEW METHODS Three iterative phases: (1) development of initial programme theory, (2) structured searches for relevant published and grey literature and (3) data synthesis and interpretation by researchers and theory triangulation, and discussions within the research group. RESULTS Multiple context-mechanism-outcome configurations were extracted from 10 reports that explain how, under what circumstances and why strategies can facilitate (or discourage) staff nurses to act as clinical leaders. Reports were both quantitative and qualitative in design, originating from English-speaking countries only. CONCLUSIONS A logic model was developed and suggests four contexts and five mechanisms underlying the development of clinical nursing leadership. Growth in clinical nursing leadership was mainly experienced through experiential learning, which was enhanced by a supportive relationship with a coach or mentor, the use of reflective practices and modelling from other leaders. Furthermore, a supportive work environment triggers ownership, confidence and motivation, and thereby growth in clinical nursing leadership competencies. IMPACT Fostering competencies for clinical leadership among staff nurses requires multifaceted strategies. Strategies are successful if, and only if, they combine learning by doing, by knowing and by observing, and establish a responsive work environment. Hospital policy should ensure that staff nurses have access to reciprocal relationships with role models or a coach. In order to grow as clinical nurse leader, ownership and self-reflection on own leadership behaviour need to be facilitated. NO PATIENT OR PUBLIC CONTRIBUTION Prospero ID CRD42021292290.
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Affiliation(s)
- Veerle Duprez
- Department of Nursing, Ghent University Hospital, Ghent, Belgium
| | - Laure Dhont
- Department of Nursing, Ghent University Hospital, Ghent, Belgium
| | - Margreet van der Cingel
- Professorship Nursing Leadership and Research, NHL-Stenden University of Applied Sciences and Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | - Thóra B Hafsteinsdóttir
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Simon Malfait
- Department of Nursing, Ghent University Hospital, Ghent, Belgium
- Faculty of Medicine and health sciences, Ghent University, Ghent, Belgium
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18
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Lui JNM, Andres EB, Johnston JM. How do organizational culture and leadership style affect nurse presenteeism and productivity?: A cross sectional study of Hong Kong acute public hospitals. Int J Nurs Stud 2024; 152:104675. [PMID: 38277926 DOI: 10.1016/j.ijnurstu.2023.104675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Presenteeism is defined as a type of work behavior in which employees are physically present at work when ill, often with reduced performance. While organizational culture and leadership style are known to impact the organizational behavior of hospital staff, as indicated by increased burnout and decreased work engagement, their impact on nurse presenteeism and productivity has not been explored. Moreover, nursing studies often neglect the importance of using multi-level analysis, adopting aggregated unit-level scores to account for collective perceptions to evaluate culture and leadership. OBJECTIVE This study aims to evaluate the impact of unit-level organizational culture and leadership style on individual-level nurse presenteeism and productivity in acute care hospitals using multilevel analysis. DESIGN Cross-sectional study. SETTING(S) Three major acute care public hospitals in Hong Kong, where public hospitals provide over 90 % of inpatient services. PARTICIPANTS All full-time nurses (N = 4657) in the three study hospitals were invited to participate in this study. A total of 2339 nurses responded to the survey for a 65 % response rate. METHODS Organizational culture and leadership style are characterized using the competing values framework and a two-factor leadership style typology, respectively. Multilevel hierarchical linear modeling was applied with unit-level clustering in each hospital. RESULTS Hierarchical culture was the dominant culture (M = 3.64, SD = 0.74) in our nurse sample. None of the unit-level organizational culture and leadership styles were associated with nurse presenteeism, however, rational organizational culture at the unit-level was significantly associated with increased productivity (regression coefficient: 0.17, 95 % CI: 0.04-0.31). CONCLUSIONS This study provides hospital managers with improved understanding of the differential impact of unit-level organizational culture and leadership style on nurse presenteeism and productivity. Unit-level leadership style did not have a direct impact on nurse presenteeism and productivity in this study, while the externally focused rational organizational culture increased nurse productivity. Further research is needed to understand the impacts of modifiable work factors and nurse psychosocial emotions on presenteeism and productivity.
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Affiliation(s)
- Juliana Nga Man Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
| | | | - Janice Mary Johnston
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pokfulam, Hong Kong, China
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Mitchell C, Parchment J, Taylor A. Weaving Diversity, Equity, Inclusion, and Belonging for Organizational Sustainability. J Nurs Adm 2024; 54:193-195. [PMID: 38512080 DOI: 10.1097/nna.0000000000001407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Within the intricate tapestry of healthcare, the threads of diversity, equity, inclusion, and belonging (DEIB) are paramount. These elements enrich the fabric and strengthen its resilience, ensuring it stands the test of time. This article describes the origins of the American Organization for Nursing Leadership (AONL) DEIB Toolkit, its DEIB Guiding Principles, its significance in nursing leadership, and the broader implications for the evolution of nursing practice. AONL aims to transform healthcare throughout various levels of nursing practice, ensuring diverse, equitable, inclusive, and belonging-centric care environments.
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Affiliation(s)
- Crystal Mitchell
- Author Affiliations: Chief Clinical Officer, Vice President of Growth & Development (Mitchell), Southern EVALS, Alexandria, Louisiana; Assistant Professor (Dr Parchment), Nursing Systems, College of Nursing, University of Central Florida, Orlando; Senior Director (Taylor), Marketing Communications & Membership, American Organization for Nursing Leadership, Chicago, Illinois
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20
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Taylor E. Diversity, Equity, and Inclusion Leadership: A True Team Sport. Clin Sports Med 2024; 43:299-309. [PMID: 38383112 DOI: 10.1016/j.csm.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
The diversity, equity, and inclusion (DEI) leadership and team experience has evolved in response to a very dynamic state of change in our society and profession. In this review, the author has outlined 4 necessary components of empowering leaders and teams, including solidifying a common mission, creating value around the team and its purpose, measuring relevant and inclusive outputs, and cocreating a strategy that is meaningful and effectively achieves the true north. The author uses parallels from sports to define these pragmatic steps of a "DEI leaders' playbook" to move forward in the creation of healthy, inclusive environments.
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Affiliation(s)
- Erica Taylor
- Duke Department of Orthopaedics Vice Chair of Equity, Diversity, and Inclusion & Orthopaedic Surgeon, Duke Health Integrated Practice CMO of Diversity, Equity, and Inclusion, Duke University School of Medicine, Duke Fuqua School of Business Executive in Residence Faculty, Orthopaedic Diversity Leadership Consortium, PO Box 1726, Wake Forest, NC 27587, USA.
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21
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Gauthier C, Kung J, Guy J. The Intrinsic Value of Diversity in Team Leadership. Clin Sports Med 2024; 43:293-297. [PMID: 38383111 DOI: 10.1016/j.csm.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Despite the demonstrated benefit of diversity within a team structure, there is a lack of diversity among leadership in professional organizations. An increase in diversity among leadership teams would allow for more effective communication with team members, better problem-solving skills, increased trust within a team environment, and greater inspiration for future generations. Therefore, diversity should be a core concept within a leadership team.
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Affiliation(s)
- Chase Gauthier
- Department of Orthopedic Surgery, Prisma Health, 2 Medical Park Road, Suite 404, Columbia, SC 29203, USA
| | - Justin Kung
- Department of Orthopedic Surgery, Prisma Health, 2 Medical Park Road, Suite 404, Columbia, SC 29203, USA
| | - Jeffrey Guy
- Department of Orthopedic Surgery, Prisma Health, 2 Medical Park Road, Suite 404, Columbia, SC 29203, USA.
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22
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Tillman F, Liu I, Lovince J, Mays E, Musick K, Sato J, Rao KV. Healthcare Equity and Leadership: Implementation of Diversity, Equity, and Inclusion Training for Pharmacy Residents. J Pharm Pract 2024; 37:422-428. [PMID: 36446745 DOI: 10.1177/08971900221142684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BackgroundPharmacy training programs infrequently include formal training in the areas of diversity, equity, and inclusion (DEI). Hence, the purpose of this report is to offer perspectives gained from the delivery of a DEI curriculum within a pharmacy residency program aimed at expanding experiential learning focused on DEI and health equity. Program Implementation: Pharmacy residents at an academic medical center were invited to participate in a longitudinal DEI/equity seminar series that was thoughtfully and strategically developed by a team of residents and program leadership based on a six-step process. Residents were offered 9 individual seminars covering 4 major focus areas to facilitate enhanced awareness, learning, and vulnerability. Participants were invited to provide evaluations of each seminar and the overall series. Program Assessment: A total of 41 residents (100%) participated in at least one of the 9 seminars that were offered and approximately 50% completed the post-series survey. Resident-perceived benefit of each individual session was consistently favorable. Additionally, greater than 70% of participants responded favorably when asked about the impact of each session on their awareness, resources provided, and ability to apply the learnings to their practice. Conclusion: Our inaugural experience with the integration of a DEI seminar series into a pharmacy residency program suggests that there is a clear benefit to including DEI/health equity into pharmacy residency training. This data may suggest that adoption of DEI-focused experiential training may increase cultural awareness and the availability of resources to better equip pharmacy residents in applying concepts of DEI into their practice.
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Affiliation(s)
- Frank Tillman
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- University of North Carolina Healthcare System, Chapel Hill, NC, USA
| | - Ina Liu
- University of North Carolina Healthcare System, Chapel Hill, NC, USA
| | | | - Erin Mays
- Duke University Healthcare System, Durham, NC, USA
| | - Kaitlin Musick
- University of Kentucky Healthcare System, Lexington, KY, USA
| | - Jennifer Sato
- University of North Carolina Healthcare System, Chapel Hill, NC, USA
| | - Kamakshi V Rao
- University of North Carolina Healthcare System, Chapel Hill, NC, USA
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Williams MJ, Wade JB, Nwadei T, Swaminathan A, Harrison CK, Bukstein S. Looking the Part: Stereotypicality in Appearance Among White Professionals Predicts Leadership Attainment and Perceived Leadership Suitability. Pers Soc Psychol Bull 2024; 50:613-628. [PMID: 36575969 DOI: 10.1177/01461672221143756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This project explores the effects of racial phenotypic stereotypicality, or the degree to which a person's appearance is perceived as typical of their racial group, on leadership outcomes. Building on research showing that people hold an image of the ideal leader as a White person, we propose that looking more typically White may facilitate leadership attainment. In Study 1, which used a sample of American college football coaches (N = 1,106), White (vs. Black) coaches were more likely to occupy leadership roles. Furthermore, within race, stereotypicality positively predicted occupying a leadership or head-coach role among White professionals (and negatively predicted occupying a head-coach role among Black professionals). Study 2 elucidated a possible mechanism by showing a causal effect of stereotypicality on perceived suitability for leadership among Whites. These findings advance theorizing on the White-leader link and have implications for the ability of people of color to access lucrative professional roles.
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Affiliation(s)
| | - James B Wade
- The George Washington University, Washington, DC, USA
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Abstract
ABSTRACT Organizations that foster psychologically safe environments create space for innovative cultures to emerge. The prioritization of nurse-led innovation signals broader cultural values around learning, a willingness to invest in people and their ideas, and an organizational focus around growth and operational excellence. Embracing innovative behaviors can propel emerging areas of nursing science, practice, and workforce solutions. This month's Magnet® Perspectives explores innovation and the critical role of nurse leadership in shaping today's healthcare environment, and the future of nursing.
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Affiliation(s)
- Oriana Beaudet
- Author Affiliation: Vice President, Nursing Innovation, American Nurses Association, Silver Spring, Maryland
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Leeper WR, James N. Trauma Bay Evaluation and Resuscitative Decision-Making. Surg Clin North Am 2024; 104:293-309. [PMID: 38453303 DOI: 10.1016/j.suc.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
The reader of this article will now have the ability to reflect on all aspects of high-quality trauma bay care, from resuscitation to diagnosis and leadership to debriefing. Although there is no replacement for experience, both clinically and in a simulation environment, trauma clinicians are encouraged to make use of this article both as a primer at the beginning of a trauma rotation and a reference text to revisit after difficult cases in the trauma bay. Also, periods of reflection seem appropriate in the busy but, of course, rewarding career in trauma care.
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Affiliation(s)
- William Robert Leeper
- Department of Surgery, Western University, Victoria Campus, London Health Sciences Center, Room E2-215, 800 Commissioners Road East, London, Ontario N6A 5W9, Canada; Trauma Program at London Health Sciences Center, Division of Critical Care, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
| | - Nicholas James
- London Health Sciences Center, Victoria Campus, Room E2-214, 800 Commissioners Road East, London, Ontario N6A 5W9, Canada; Trauma Program at London Health Sciences Center, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Crowder V, Brady V, Johnson C, Whisenant M. Patient competence in chronic illness: A concept derivation. J Clin Nurs 2024; 33:1575-1581. [PMID: 38178571 DOI: 10.1111/jocn.16984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Abstract
AIMS AND OBJECTIVES This paper aims to inform nursing and other healthcare disciplines by clearly defining patient competence and the skills required to improve self-care behaviours. BACKGROUND Competence has been defined in education and leadership. However, competence in persons with chronic disease has not been expanded upon since one publication in 1983. Patient competence needs to be developed and defined so that healthcare disciplines can understand the attributes necessary for a patient to be deemed competent to promote self-care behaviours. DESIGN A concept derivation. METHODS Walker and Avant's approach to concept derivation was used to identify a base concept (competence) that is well-defined in another field, define the concepts associated with the parent field, and transpose that definition to a new field to formulate a redefined concept. PsycINFO, Scopus, Web of Science and Medline were searched, and 21 articles were included. RESULTS Patient competence is defined as the ability of a person with a chronic illness to reach skill mastery, achieve knowledge, maintain a positive attitude and develop trust in themselves and in healthcare providers that will facilitate active engagement to improve self-care behaviours. CONCLUSIONS Defining patient competence is important in assisting nurses and other healthcare providers in understanding the attributes needed to deem a patient competent, especially those living with chronic illnesses requiring lifelong self-care behaviours. More research is needed to aid in the designing of a precise instrument for measuring this phenomenon. RELEVANCE TO CLINICAL PRACTICE Concept derivation of patient competence provides a framework for nurses and other members of the healthcare profession to understand the attributes needed to determine patient competence.
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Affiliation(s)
- Vivian Crowder
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Veronica Brady
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Constance Johnson
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Meagan Whisenant
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Cho SM, Choi J. Integral leadership in nursing: Development and psychometric validation of a Korean version of the Integral Nursing Leadership Scale. Int J Nurs Stud 2024; 152:104697. [PMID: 38295669 DOI: 10.1016/j.ijnurstu.2024.104697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/13/2023] [Accepted: 01/10/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND With the importance of nursing leadership roles, there is a need for a more integrated approach to nursing leadership that can adapt quickly to many challenges in today's healthcare environments. In recent years, integral leadership that can apply a more holistic and inclusive approach to leadership has gained growing attention in other disciplines. However, research on integral leadership in nursing is sparse since no instrument specifically measuring integral leadership in nursing contexts is available. OBJECTIVE The study aimed to develop an integral nursing leadership scale and evaluate its psychometric properties. METHODS The scale was developed in two phases. In the first phase, items were generated to reflect the attributes of integral leadership in the nursing context. These attributes were identified through a conceptualization process using a literature review and semi-structured interviews. The process was based on the four dimensions of the integral leadership framework, adopting Wilber's four quadrants of integral theory. Then, the psychometric properties of the scale, including content validity, structural validity, and internal consistency reliability, were evaluated. Data were collected from a convenience sample of 806 Korean nurses and were analyzed using both exploratory factor analysis and second-order confirmatory factor analysis, using two separate random halves of the sample. RESULTS The newly developed scale consisted of 30 items across four dimensions: individual leadership qualities, individual performance, influencing organizational culture, and organizational excellence. Content validity for the 30 items was calculated to be 0.84 for item-level content validity and 0.96 for the scale's content validity averaging method, indicating adequate content validity. The four-factor structure of integral nursing leadership was cross-validated by exploratory factor analysis and second-order confirmatory factor analysis. The internal consistency reliability was also found to be acceptable, as indicated by a Cronbach's alpha of 0.97 and a McDonald's ω estimate of 0.98. CONCLUSION Findings demonstrate that the Integral Nursing Leadership Scale has acceptable content validity, structural validity, and reliability in measuring integral leadership, specifically in the context of nursing. More research is needed to further refine and establish strong validity of the scale.
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Affiliation(s)
- Seon Mi Cho
- Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - JiSun Choi
- College of Nursing Science, Kyung Hee University, Seoul, South Korea.
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Dirik HF, Seren Intepeler S. An authentic leadership training programme to increase nurse empowerment and patient safety: A quasi-experimental study. J Adv Nurs 2024; 80:1417-1428. [PMID: 37921089 DOI: 10.1111/jan.15926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/20/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Authentic leadership and empowered nurses are necessary if a healthy work environment is to be created and patient safety maintained; however, few studies have examined the impact of authentic leadership, on nurse empowerment and the patient safety climate. PURPOSE The aim of the study was to investigate the impact of an educational intervention delivered through a multi-faceted training programme on nurses' perceptions of authentic leadership, nurse empowerment (both structural and psychological) and the patient safety climate. DESIGN A quasi-experimental study using a one-group pretest-posttest design consistent with TREND guidelines. METHODS The study was conducted in a university hospital between December 2018 and January 2020. Participants were followed for 6 months. The programme involved 36 head nurses (leaders) and 153 nurses (followers). The effectiveness of the programme was evaluated using repeated measures of analysis of variance, dependent sample t-tests and hierarchical regression analysis. RESULTS Following the intervention, safety climate and authentic leadership scores increased among both leaders and followers. Structural and psychological empowerment scores also increased among followers. We found that authentic leadership and structural empowerment were predictors of safety climate. CONCLUSION The implementation of the education programme resulted in positive changes in participants' perceptions of authentic leadership and empowerment, which can enhance patient safety. IMPLICATIONS Healthcare organizations can implement similar multi-faceted training programmes focused on authentic leadership, and nurse empowerment to increase patient safety. Achieving effective results in such programmes can be facilitated by motivating participants with the support of the top management. PATIENT OR PUBLIC CONTRIBUTION The study included nurses in the intervention and the data collection processes. IMPACT Patient safety is a global concern, and improving patient safety culture/climate is a key strategy in preventing harm. Authentic leadership and nurse empowerment are essential in creating healthy work environments and delivering safe, high-quality care. Training programmes addressing these issues can help bring about improvements in healthcare organizations.
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He Y, Hu L, Wu S, Li L, Zhong K, Li J, Liu N, Sun X, Wang Q, Sun C, Wu L. Nutritional screening and assessment tools for patients with cirrhosis based on the Global Leadership Initiative on Malnutrition criteria. J Hum Nutr Diet 2024; 37:430-439. [PMID: 37932103 DOI: 10.1111/jhn.13265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/03/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Malnutrition is highly prevalent and associated with complications and mortality in patients with cirrhosis. METHODS This was a prospective observational study. Patients with cirrhosis were screened using the Nutritional Risk Screening 2002, the Royal Free Hospital-Nutritional Prioritizing Tool and the Skeletal Muscle Index. Then, the sensitivity, specificity, positive and negative predictive values, and consistency with the Global Leadership Initiative on Malnutrition criteria results were calculated. We also analysed the association between nutritional status and short-term prognosis. RESULTS We enrolled 125 patients with cirrhosis, of whom 59.20% and 60.00% were malnourished based on the Global Leadership Initiative on Malnutrition criteria and Skeletal Muscle Index. Some 53.60% and 65.60%, respectively, were classified medium-to-high nutritional risk by Nutritional Risk Screening 2002 and the Royal Free Hospital-Nutritional Prioritizing Tool. The Royal Free Hospital-Nutritional Prioritizing Tool had the best predictive value, and it was more sensitive and had a better negative predictive value than the Nutritional Risk Screening 2002 Tool. The Skeletal Muscle Index also had good sensitivity and predictive value. The Royal Free Hospital-Nutritional Prioritizing Tool, Skeletal Muscle Index and Global Leadership Initiative on Malnutrition criteria showed high concordance. The 3- and 6-month mortality rates were significantly higher for patients with moderate-to-high nutritional risk or malnutrition, regardless of the tool. CONCLUSIONS When assessing cirrhosis with the Global Leadership Initiative on Malnutrition criteria, the Royal Free Hospital-Nutritional Prioritizing Tool is best for nutritional screening and the Skeletal Muscle Index is also a good nutritional assessment tool.
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Affiliation(s)
- Yumei He
- North Sichuan Medical College, Nanchong, China
- Department of Gastroenterology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Ling Hu
- Department of Gastroenterology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Shiyan Wu
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lu Li
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ke Zhong
- Department of Gastroenterology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Jiazhen Li
- Department of Clinical Nutrition, The Third People's Hospital of Chengdu, Chengdu, China
| | - Na Liu
- Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Xiaobin Sun
- Department of Gastroenterology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Qiong Wang
- Department of Gastroenterology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Liping Wu
- Department of Gastroenterology, The Third People's Hospital of Chengdu, Chengdu, China
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Weller JM, Mahajan R, Fahey-Williams K, Webster CS. Teamwork matters: team situation awareness to build high-performing healthcare teams, a narrative review. Br J Anaesth 2024; 132:771-778. [PMID: 38310070 DOI: 10.1016/j.bja.2023.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 02/05/2024] Open
Abstract
Healthcare today is the prerogative of teams rather than of individuals. In acute care domains such as anaesthesia, intensive care, and emergency medicine, the work is complex and fast-paced, and the team members are diverse and interdependent. Three decades of research into the behaviours of high-performing teams provides us with clear guidance on team training, demonstrating positive effects on patient safety and staff wellbeing. Here we consider team performance through the lens of situation awareness. Maintaining situation awareness is an absolute requirement for safe and effective patient management. Situation awareness is a dynamic process of perceiving cues in the environment, understanding what they mean, and predicting how the situation may evolve. In the context of acute clinical care, situation awareness can be improved if the whole team actively contributes to monitoring the environment, processing information, and planning next steps. In this narrative review, we explore the concept of situation awareness at the level of the team, the conditions required to maintain team situation awareness, and the relationship between team situation awareness, shared mental models, and team performance. Our ultimate goal is to help clinicians create the conditions required for high-functioning teams, and ultimately improve the safety of clinical care.
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Affiliation(s)
- Jennifer M Weller
- Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand; Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand.
| | - Ravi Mahajan
- Centre of Excellence in Critical Care, Apollo Hospitals Group, Chennai, India; Department of Anaesthesia and Intensive Care, University of Nottingham, Nottingham, UK
| | - Kathryn Fahey-Williams
- Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Craig S Webster
- Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand; Department of Anaesthesiology, School of Medicine, University of Auckland, Auckland, New Zealand
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Lee GS, Vervoort D, Lia H, Ouzounian M, Fremes SE, Yanagawa B. Representation of women in cardiothoracic surgery commentaries: An opportunity for gender equity. J Thorac Cardiovasc Surg 2024; 167:1381-1384.e2. [PMID: 37714371 DOI: 10.1016/j.jtcvs.2023.08.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/16/2023] [Accepted: 08/30/2023] [Indexed: 09/17/2023]
Affiliation(s)
- Grace S Lee
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Cardiovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Dominique Vervoort
- Division of Cardiovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hillary Lia
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Cardiovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Maral Ouzounian
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Cardiac Surgery, Department of Surgery, Peter Munk Cardiac Centre, University of Toronto, Toronto, Ontario, Canada
| | - Stephen E Fremes
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Bobby Yanagawa
- Division of Cardiovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
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DuCoin C, Kuo PC. Creating an integrated strategic plan. Surgery 2024; 175:1240-1243. [PMID: 38049360 DOI: 10.1016/j.surg.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 12/06/2023]
Abstract
The modern surgical leader now requires many tools for successful leadership. One critical tool is developing an integrated strategic plan where team and culture are developed with a directed common mission. This mission or strategic plan must fit within certain constraints, such as the larger institutional goals and constrained resources. To help develop this strategic plan, the surgical leader has many resources to use. The most common strategic planning tool is the Strengths, Weaknesses, Opportunities, and Threats analysis. Here, both internal and external factors are evaluated. From here, the contribution will review the Political, Economic, Social, Technological, Legal, and Environmental analysis (ideal for external factors) and Mission, Objectives, Strategies and Tactics analysis (ideal for internal factors), along with the Blue Ocean Strategy, Scenario Planning, and Ansoff Matrix, all of which are excellent for future planning. Porter's Five Forces will review standard competing forces, whereas Six Sigma reviews measurable process development, and Balanced Scorecard provides the framework for measurable advancements. After the paper, the reader will better understand the various tools that can be used to develop an integrated strategic plan.
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Affiliation(s)
- Christopher DuCoin
- Department of Surgery, University of South Florida, Tampa, FL. http://www.twitter.com/chrisducoin
| | - Paul C Kuo
- Department of Surgery, University of South Florida, Tampa, FL.
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Lee MCC, Ding AYL. The Relationship Between Market Culture, Clan Culture, Benevolent Leadership, Work Engagement, and Job Performance: Leader's Dark Triad as a Moderator. Psychol Rep 2024; 127:887-911. [PMID: 35981716 DOI: 10.1177/00332941221121564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Benevolent leadership is one of the leadership styles which provides a positive influence on employees. However, the current leadership literature has yet to investigate how benevolent leadership leads to job performance, the processes involved, the relationship between organizational culture and benevolent leadership, and the role of dark side of leaders in affecting this relationship. Using the leader-culture fit framework within an Eastern context, the current study first investigates the relationship between benevolent leadership and job performance through work engagement. The study then compares two contrasting organizational culture (i.e., market culture and clan culture) on benevolent leadership. Finally, the study investigates how leaders' dark triad affects the relationship between organizational culture and benevolent leadership. 374 full-time white-collar employees (Males = 54.01%; Mean age: 32.7 years) from various private organizations within the service industry participated in this study. The results showed that work engagement mediated benevolent leadership and job performance. Market culture showed a negative relationship with benevolent leadership while clan culture showed a positive relationship with benevolent leadership. Benevolent leadership mediated clan culture (but not market culture) and work engagement. Under a high market culture with a high dark triad leader, benevolent leadership is at its lowest level. Under a high clan culture with a low dark triad leader, benevolent leadership is at its highest level. The findings suggest the importance of benevolent leadership within a clan culture (rather than market culture), in aligning with the leader-culture fit framework in increasing employees' work engagement and job performance.
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Affiliation(s)
| | - Alyssa Y L Ding
- Department of Psychology, Sunway University, Petaling Jaya, Malaysia
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Enge M, Peelen FO, Nielsen RL, Beck AM, Olin AÖ, Cederholm T, Boström AM, Paur I. Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study. Eur J Nutr 2024; 63:927-938. [PMID: 38240774 PMCID: PMC10948466 DOI: 10.1007/s00394-023-03323-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/29/2023] [Indexed: 03/19/2024]
Abstract
PURPOSE In 2019, the Global Leadership Initiative on Malnutrition (GLIM) suggested a 2-step diagnostic format for malnutrition including screening and diagnosis. Prospective validation and feasibility studies, using the complete set of the five GLIM criteria, are needed. The aims of this study were to determine the prevalence of malnutrition, and investigate how the prevalence varied with mode of screening. Furthermore, we assessed the feasibility of GLIM in geriatric patients. METHODS Consecutive patients from two acute geriatric wards were included. For screening risk of malnutrition, the Mini Nutritional Assessment-Short Form (MNA-SF) or Malnutrition Screening Tool (MST) were used. In accordance with GLIM, a combination of phenotypic and etiologic criteria were required for the diagnosis of malnutrition. Feasibility was determined based on % data completeness, and above 80% completeness was considered feasible. RESULTS One hundred patients (mean age 82 years, 58% women) were included. After screening with MNA-SF malnutrition was confirmed by GLIM in 51%, as compared with 35% after screening with MST (p = 0.039). Corresponding prevalence was 58% with no prior screening. Using hand grip strength as a supportive measure for reduced muscle mass, 69% of the patients were malnourished. Feasibility varied between 70 and 100% for the different GLIM criteria, with calf circumference as a proxy for reduced muscle mass having the lowest feasibility. CONCLUSION In acute geriatric patients, the prevalence of malnutrition according to GLIM varied depending on the screening tool used. In this setting, GLIM appears feasible, besides for the criterion of reduced muscle mass.
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Affiliation(s)
- Maria Enge
- Department of Geriatric Medicine, Jakobsbergsgeriatriken, Stockholm, Sweden
| | - Frida Ostonen Peelen
- Theme Inflammation and Aging, Nursing Unit Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Rikke Lundsgaard Nielsen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Anne Marie Beck
- Dietetic and Nutritional Research Unit EATEN, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Ann Ödlund Olin
- Department of Quality and Patient Safety, Karolinska University Hospital Stockholm, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Tommy Cederholm
- Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Huddinge, Sweden
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anne-Marie Boström
- Theme Inflammation and Aging, Nursing Unit Aging, Karolinska University Hospital, Huddinge, Sweden
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Stockholms Sjukhem, Research and Development Unit, Stockholm, Sweden
| | - Ingvild Paur
- Norwegian Advisory Unit On Disease-Related Undernutrition, Oslo, Norway.
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Nydalen, Postbox 4950, 0424, Oslo, Norway.
- Institute for Clinical Medicine, Clinical Nutrition Research Group, UiT the Arctic University of Norway, Tromsø, Norway.
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Schmidt A, Marshall D, Raso R, Sintich M, Poch N, Joseph ML. A Culture of Inquiry: Practice-Based Knowledge for Nurse Leaders. J Nurs Adm 2024; 54:240-246. [PMID: 38512085 DOI: 10.1097/nna.0000000000001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
A culture of inquiry has not traditionally been associated with nursing leadership. As healthcare evolves, leaders must reevaluate barriers to improving healthcare outcomes. One noted barrier has been a need for more inquisitiveness to innovate. Through an American Organization for Nursing Leadership workgroup, the authors advanced the understanding of a "culture of inquiry," applying a practice-based learning approach for knowledge development. Three recommended foundational elements are psychological safety, building connections, and using design thinking at all organizational levels.
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Affiliation(s)
- Anne Schmidt
- Author Affiliations: Director (Dr Schmidt), Optum Advisory, Eden Prairie, Minnesota; Senior Vice President and Chief Nursing Executive (Dr Marshall), Cedars-Sinai, Los Angeles, California; Editor in Chief (Dr Raso), Nursing Management, Wolters Kluwer, Philadelphia, Pennsylvania; Executive Vice President and Chief Nursing Executive (Dr Sintich) Inova Health System, Fairfax, Virginia; Interim Director of Centralized Functions and Associate Chief Quality Officer (Dr Poch), The University of Iowa Health Care, Iowa City; and Distinguished Scholar in Nursing, Clinical Professor, and Director (Dr Joseph), Health Systems/Administration Program, The University of Iowa, Iowa City
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Zhu X, Carpenter CJ, Smith RA, Myrick JG, Martin MA, Lennon RP, Small ML, Van Scoy LJ. Extending the Theory of Normative Social Behavior: Collective Norms, Opinion Leadership, and Masking During the COVID-19 Pandemic. Health Commun 2024; 39:49-61. [PMID: 36476292 DOI: 10.1080/10410236.2022.2152964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Novel, public behaviors, such as masking, should be susceptible to normative influence. This paper advances the theory of normative social behavior by considering a new set of moderators of normative influence - superdiffuser traits - and by clarifying the antecedents and consequences of exposure to collective norms. We use data from a two-wave survey of a cohort living in one U.S. county during the pandemic (N = 913) to assess normative effects on masking. We also used a bipartite network (based on people shopping for food in the same stores) to examine exposure to collective norms. The results show different superdiffuser traits have distinct effects on the relationship between perceived injunctive norms and masking intentions. Exposure to collective norms influences masking, but this influence depends on how people interact with their social environments. Network analysis shows that behavioral homophily is a significant predictor of selective exposure to collective norms earlier (but not later) in the pandemic. Implications for understanding normative influence in a context where opinion leadership matters are discussed.
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Affiliation(s)
- Xun Zhu
- Department of Communication, University of North Dakota
| | | | - Rachel A Smith
- Department of Communication Arts and Sciences, Pennsylvania State University
| | - Jessica Gall Myrick
- Donald P. Bellisario College of Communications, Pennsylvania State University
| | - Molly A Martin
- Department of Sociology and Criminology, Pennsylvania State University
| | - Robert P Lennon
- Department of Family and Community Medicine, Pennsylvania State College of Medicine
| | - Meg L Small
- College of Health and Human Development, Pennsylvania State University
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George JF, Chen H. Developing research programs that align with the clinical mission. Surgery 2024; 175:1244-1246. [PMID: 38123371 DOI: 10.1016/j.surg.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023]
Abstract
Building a competitive research program within a department of surgery requires a significant commitment by the department and the institution to provide the necessary resources for faculty recruitment, retention of current faculty, and physical space/infrastructure to support research activities. We expanded the academic footprint of our department as demonstrated by the expansion of the department of surgery research funding by 13-fold over a period of 7 years, resulting in an increase in national ranking from 55th place to 10th place in the National Institutes of Health extramural funding. This required attention to multiple factors that affect the ability of faculty to establish and maintain competitive research programs. We executed a plan that established a leadership structure that coordinates resources and provides mentorship to faculty. The department invested heavily in the recruitment of new faculty, especially junior faculty, but also some mid-career and senior investigators to develop a critical mass in specific areas for competitive large grant and program project applications. The pipeline of new trainees interested in research was augmented by successful training grant applications that created a mechanism by which residents and fellows can pursue research for periods ranging from a few weeks to 2 years. Administrative infrastructure was created to assist faculty in grant submissions as well as post-award management. Finally, in partnership with institutional leadership, the department acquired the physical space necessary to support both dry-lab and wet-lab research activities. To achieve true excellence, an academic surgery department must maintain excellence in both the clinical and research areas, which, in the context of an academic medical center, are not separate goals.
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Affiliation(s)
- James F George
- Department of Surgery, University of Alabama at Birmingham, AL
| | - Herbert Chen
- Department of Surgery, University of Alabama at Birmingham, AL.
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Rixon A, Wong LY, Wilson S. Are emergency departments leader identity workspaces? A qualitative study of emergency physicians. Emerg Med Australas 2024; 36:266-276. [PMID: 37963578 DOI: 10.1111/1742-6723.14346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE Emergency medicine is a discipline with complex leadership demands, which are experienced by junior and senior emergency physicians alike. In this environment, emergency physicians can struggle to work out what it means to be a leader and develop professional identities as leaders, necessitating a leader identity workspace. The aim of the present study is to explore whether emergency physicians view their work environment as leader identity workspaces. METHODS An online qualitative survey was used that included open-ended questions about emergency physicians' experience of their workplace as a 'space' to craft their leadership identity. Participants' responses were analysed using reflexive thematic analysis. RESULTS Three themes, comprising several subthemes, were identified that related to emergency physicians' ideal leader selves (leader dreams and desired leader selves), their experience of the community of clinicians in hospitals (confrontational sentient communities) and the types of rituals emergency physicians yearn for to support and legitimate their leadership (seeking vital leadership rites of passage). CONCLUSION Our results suggest that neither EDs nor hospitals more generally exhibit the properties of, or are experienced by emergency physicians, as leader identity workspaces.
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Affiliation(s)
- Andrew Rixon
- Griffith Business School, Griffith University, Gold Coast, Queensland, Australia
| | - Lee Yung Wong
- Swinburne Business School, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Samuel Wilson
- Swinburne Business School, Swinburne University of Technology, Melbourne, Victoria, Australia
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Reinke LF. HPNA and HPNF President's Message: My Path to Leadership. J Hosp Palliat Nurs 2024; 26:58-59. [PMID: 38441664 DOI: 10.1097/njh.0000000000001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Affiliation(s)
- Lynn F Reinke
- Lynn F. Reinke, PhD, ARNP, FAAN, FPCN, ATSF, is the Claire Dumke Ryberg, RN, Presidential Endowed Chair for Palliative and End of Life Care, and Associate Professor, University of Utah College of Nursing, Salt Lake City
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Czelusta KLT, Appelbaum NP. Psychiatry Vice Chairs of Education: Expected and Actual Responsibilities, Satisfaction, and Work Barriers. Acad Psychiatry 2024; 48:163-167. [PMID: 38279072 DOI: 10.1007/s40596-024-01938-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/17/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVES The current study investigated the gap between actual and expected work responsibilities of psychiatry vice chairs of education (VCEs), their work satisfaction, and perceived work barriers. METHODS Psychiatry VCEs were identified through professional memberships and school websites within the USA. In 2021, identified VCEs were emailed an anonymous survey that was based on past research on roles and responsibilities of VCEs. Through qualitative and quantitative questions, the survey assessed demographic characteristics, actual and expected work responsibilities, work satisfaction, and work barriers during time spent in the VCE role. RESULTS Of 57 identified psychiatry VCEs, 32 (56.1%) completed the survey. Most respondents (59.4%) said their department/institution did not have a written VCE job description. There were gaps between actual and expected VCE responsibilities, especially with the performance review of education leaders (Δ - 11; actual n = 20 vs. expected n = 31). The greatest satisfaction came from mentoring trainees/faculty (respectively 4.88 ± 0.33 and 4.85 ± 0.37 on a 5-point scale) and overseeing/supporting educational programs (4.66 ± 0.48). Comments on work barriers included limited protected time (n = 11), education budget constraints (n = 6), and having multiple leadership roles (n = 5). The actual full-time equivalent in the VCE role was significantly lower than expected (p < .001). CONCLUSION Considering the role of psychiatry VCEs remains relatively new and is evolving, adequate allocation of resources and improved job descriptions may help close the gap between expected and actual responsibilities. The current findings can assist in developing such job descriptions to attract and define the work of a VCE based on specific responsibilities and associated work satisfaction.
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Khanam Z, Khan Z, Arwab M, Khan A. Assessing the mediating role of organizational justice between the responsible leadership and employee turnover intention in health-care sector. Leadersh Health Serv (Bradf Engl) 2024; ahead-of-print. [PMID: 38520672 DOI: 10.1108/lhs-06-2023-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
PURPOSE The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI). DESIGN/METHODOLOGY/APPROACH Both online and offline questionnaire was used to collect the data from 387 Indian health-care employees, and the data were analyzed using partial least squares structural equation modeling (PLS-SEM) with the help of SmartPLS 4. FINDINGS The study's findings demonstrated a significant positive association between RL and OJ and a negative association between OJ and employee TI. Furthermore, results also confirmed the mediating role of OJ between RI and TI. RESEARCH LIMITATIONS/IMPLICATIONS The generalizability of the study's data collection is limited because it is based on the responses of Indian health-care sector employees to an online and offline survey. The authors propose that the health-care sector uses RL as an approach that takes a broad view of the parties with a stake and focuses on creating fairness in acts and justice at the workplace to address the major issue of employee turnover. ORIGINALITY/VALUE This study expanded on previous research by demonstrating that the influence of responsible leadership on employee TI is mediated by OJ in the context of India's health-care sector. It also contributes to the literature regarding RI, OJ and TI. The study also enriched the body of knowledge about using the PLS-SEM approach to predict employee TI.
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Affiliation(s)
- Zeba Khanam
- Department of Commerce, Aligarh Muslim University, Aligarh, India
| | - Zebran Khan
- Department of Commerce and Business Studies, Jamia Millia Islamia Central University, New Delhi, India
| | - Mohd Arwab
- Department of Management, Institute of Professional Excellence and Management (IP EM), Ghaziabad, India
| | - Ariba Khan
- Department of Commerce and Business Studies, Jamia Millia Islamia Central University, New Delhi, India
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Barshay M, Richardson CR. Friend or Foe? Helping Health Care Leadership Reimagine a Healthy EHR Relationship. Ann Fam Med 2024; 22:79-80. [PMID: 38383046 DOI: 10.1370/afm.3091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 02/23/2024] Open
Affiliation(s)
- Meylakh Barshay
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
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Mahboubi M, Ahmady S, Mirzazadeh A, Zarei A, Hamidi H, Kohan N. Medical school department chair performance improvement: A qualitative study. PLoS One 2024; 19:e0294927. [PMID: 38527089 PMCID: PMC10962818 DOI: 10.1371/journal.pone.0294927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/11/2023] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION In medical education, department chairs should play a significant role. The present qualitative study was conducted to identify factors that influence the performance improvement of department chairs at medical schools in Iran. METHODS The study was conducted in Iran in 2022 and used a thematic analysis method. Using a purposeful sampling method, 20 participants were invited to participate, including medical school deans and department chairs. Focus group discussion (FGD) was used for qualitative data gathering. Braun and Clarke's thematic analysis was used to analyze data. RESULTS There were 18 males and 2 females among the participants. The mean age of the participants was 45±4 years. Five overarching themes were formulated: human resource management, organizational behavior management, performance support system, leadership, and financial resources. Also, nine subthemes emerged, including performance evaluation, job and work design, educational and non-educational support, motivational efforts, organization culture, organizational knowledge management, planning for change, and financing. CONCLUSIONS In this study, we found factors influencing DC performance improvement. Department chairs' effective performance may have a positive impact on department operations, processes, or outcomes.
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Affiliation(s)
- Mohammad Mahboubi
- Department of Medical Education, Smart University of Medical Sciences, Tehran, Iran
- Abadan University of Medical Sciences, Abadan, Iran
| | - Soleiman Ahmady
- School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azim Mirzazadeh
- Faculty of Medicine, Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Afagh Zarei
- Faculty of Medicine, Department of Medical Education, Birjand University of Medical Sciences, Birjand, Iran
| | - Hadi Hamidi
- Department of English Language, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Noushin Kohan
- Department of Medical Education, Smart University of Medical Sciences, Tehran, Iran
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Abbas S, Mitchell L. Australian medical leadership's silence on Gaza is a moral failure. Lancet 2024; 403:1138-1139. [PMID: 38458219 DOI: 10.1016/s0140-6736(24)00401-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Safiyyah Abbas
- The Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
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Bani Odeh AA, Wallis LA, Hamdan M, Stassen W. Consensus-based quality standards for emergency departments in Palestine. BMJ Open Qual 2024; 13:e002598. [PMID: 38519089 PMCID: PMC10961511 DOI: 10.1136/bmjoq-2023-002598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/29/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVES The present study aimed to establish appropriate quality standards for emergency departments (EDQS) in Palestine. METHODS The study comprised four phases. First, a comprehensive literature review was conducted to develop a framework for assessing healthcare services in EDs. Second, the initial set of EDQS was developed based on the review findings. Third, local experts provided feedback on the EDQS, suggesting additional standards, and giving recommendations. This feedback was analysed to create a preliminary set of EDQS. Finally, an expanded group of local emergency care experts evaluated the preliminary set, providing feedback on content and structure to contribute to the final set of EDQS. FINDINGS We identified quality domains in EDs and categorised them into clinical and administrative pathways. The clinical pathway comprises 39 standards across 7 subdomains: triage, treatment, transportation, medication safety, patient flow and medical diagnostic services. Expert consensus was achieved on 87.5% of these standards. The administrative domain includes 64 consensus-based standards across 9 subdomains: documentation, information management systems, access-location, design, leadership, management, workforce staffing, training, equipment, supplies, capacity-resuscitation rooms, resources for a safe working environment, performance indicators and patient safety-infection prevention and control programmes. CONCLUSION This study employed a rigorous approach to identify QS for EDs in Palestine. The multiphase consensus process ensured the appropriateness of the developed EDQS. Inclusion of diverse perspectives enriched the content. Future studies will validate and refine the standards based on feedback. The EDQS has potential to enhance emergency care in Palestine and serve as a model for other regions facing similar challenges.
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Affiliation(s)
| | - Lee A Wallis
- Emergency Medicince, University of Cape Town, Cape Town, Western Cape, South Africa
| | | | - Willem Stassen
- University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South Africa
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Clarke E, Näswall K, Wong J, Pawsey F, Malinen S. Enabling successful change in a high-demand working environment: a case study in a health care organization. J Health Organ Manag 2024; ahead-of-print. [PMID: 38509014 DOI: 10.1108/jhom-02-2023-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
PURPOSE The anticipation of organizational change and the transition process often creates uncertainty for employees and can lead to stress and anxiety. It is therefore essential for all organizations, especially those that operate in high-demand working environments, to support the well-being of staff throughout the change process. DESIGN/METHODOLOGY/APPROACH Research on how employees respond to the organizational change of relocating to a new work space is limited. To fill this gap in the research, we present a case study examining the well-being of clinical and health care employees before and after a disruptive change: relocation in workplace facilities. In addition, factors that enabled successful change in this high-stress, high-demand working environment were investigated. Interviews were conducted with 20 participants before the relocation and 11 participants after relocation. Following an inductive approach, data were analyzed using thematic analysis to identify key themes. FINDINGS Our findings suggest that a supportive team, inclusive leadership and a psychologically safe environment, may buffer negative employee well-being outcomes during disruptive organizational change. ORIGINALITY/VALUE This research contributes to the literature on successful organizational change in health care by highlighting the resources which support well-being throughout the change process and enabling the successful transition to a new facility.
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Affiliation(s)
- Emma Clarke
- University of Canterbury, Christchurch, New Zealand
| | | | | | - Fleur Pawsey
- University of Canterbury, Christchurch, New Zealand
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Daniels J, Robinson E, Jenkinson E, Carlton E. Perceived barriers and opportunities to improve working conditions and staff retention in emergency departments: a qualitative study. Emerg Med J 2024; 41:257-265. [PMID: 38195524 DOI: 10.1136/emermed-2023-213189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Staff retention in Emergency Medicine (EM) is at crisis level and could be attributed in some part to adverse working conditions. This study aimed to better understand current concerns relating to working conditions and working practices in Emergency Departments (EDs). METHODS A qualitative approach was taken, using focus groups with ED staff (doctors, nurses, advanced care practitioners) of all grades, seniority and professional backgrounds from across the UK. Snowball recruitment was undertaken using social media and Royal College of Emergency Medicine communication channels. Focus group interviews were conducted online and organised by profession. A semi-structured topic guide was used to explore difficulties in the work environment, impact of these difficulties, barriers and priorities for change. Data were analysed using a directive content analysis to identify common themes. RESULTS Of the 116 clinical staff who completed the eligibility and consent forms, 46 met criteria and consented, of those, 33 participants took part. Participants were predominantly white British (85%), females (73%) and doctors (61%). Four key themes were generated: 'culture of blame and negativity', 'untenable working environments', 'compromised leadership' and 'striving for support'. Data pertaining to barriers and opportunities for change were identified as sub-themes. In particular, strong leadership emerged as a key driver of change across all aspects of working practices. CONCLUSION This study identified four key themes related to workplace concerns and their associated barriers and opportunities for change. Culture, working environment and need for support echoed current narratives across healthcare settings. Leadership emerged more prominently than in prior studies as both a barrier and opportunity for well-being and retention in the EM workplace. Further work is needed to develop leadership skills early on in clinical training, ensure protected time to deliver the role, ongoing opportunities to refine leadership skills and a clear pathway to address higher levels of management.
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Affiliation(s)
- Jo Daniels
- Department of Psychology, University of Bath, Bath, UK
- Psychology, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
| | | | - Elizabeth Jenkinson
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
| | - Edward Carlton
- Emergency Department, Southmead Hospital, North Bristol NHS Trust, Westbury on Trym, UK
- Bristol Medical School, University of Bristol, Bristol, UK
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Alhajahjeh A, Abdulelah AA, Hmeidan M, Kakish D, Sukerji R, Qtaishat L, Awamlh B, Dobbs RW, Al Sukhun S, Laguna P, Shahait M. Gender inequality in genitourinary malignancies clinical trials leadership. World J Urol 2024; 42:174. [PMID: 38506931 DOI: 10.1007/s00345-024-04893-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Over the past 2 decades, there has been a growing interest in the significance of gender roles in healthcare and several efforts and initiatives have focused on increasing female representation in the medical field. Clinical trials play a very important role in shaping medical practice; moreover, the leaders of clinical trials often represent the upper echelon of researchers in any designated field. Presently, there is no data regarding women's representation in urological oncology clinical trials leadership. Therefore, the aim of this study is to examine the extent of female representation in leading urological clinical trials. METHODOLOGY To thoroughly examine the representation of females as principal investigators (PIs) in urological cancer clinical trials between 2000 and 2020, we conducted a comprehensive search of completed trials focused on kidney, prostate, and bladder cancer on ClinicalTrials.gov. We extracted relevant information regarding the PIs and analyzed the data using univariate analyses to identify any significant differences between male and female PIs. RESULTS A total of 9145 cancer clinical trials were conducted over the last 2 decades, and 11.3% (n = 1033) of them were urological cancer clinical trials. We were able to obtain detailed information about the principal investigators (PI) in 79.0% (n = 816) of the clinical trials, and we found that 16.8% (n = 137) of them were led by female investigators. Upon evaluating the characteristics of the PIs, female PIs had a significantly lower median age and median total citations as compared to male PIs (55.0 vs 59.0 and 5333 vs 7902; p-value < 0.001 and 0.006, respectively). However, there was no statistically significant difference between the termination rate, publication rate, funding source, cancer type, and the subject of conducting the clinical trials between male and female PIs. CONCLUSION Between 2000 and 2020, only 16.8% of urological cancer clinical trials were led by a female PI, perhaps reflective of a low percentage of senior female researchers in the fields of urology, oncology and radiation oncology. Universities, research institutes and funding agencies should work to improve mentorship, representation and opportunities for female investigators to encourage more involvement for female researchers in these clinical trials.
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Affiliation(s)
- Abdulrahman Alhajahjeh
- Department of Internal Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
- University of Jordan; School of Medicine, Amman, Jordan
| | - Ahmed A Abdulelah
- Department of Internal Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | | | - Diala Kakish
- Department of Urology, Vanderbilt University Medical Center, A-1302 Medical Center Drive, Nashville, TN, 37232, USA
| | - Razan Sukerji
- Department of Urology, Vanderbilt University Medical Center, A-1302 Medical Center Drive, Nashville, TN, 37232, USA
| | - Leen Qtaishat
- University of Jordan; School of Medicine, Amman, Jordan
| | - Bashir Awamlh
- Department of Urology, Vanderbilt University Medical Center, A-1302 Medical Center Drive, Nashville, TN, 37232, USA
| | - Ryan W Dobbs
- Cook County Health & Hospitals System Chicago, Chicago, IL, 60612, USA
| | - Sana Al Sukhun
- Al Hyatt Oncology Practice, 40 Ibn Khaldoon St., Amman, 11183, Jordan
| | - Pilar Laguna
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
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Skouteris H, Ananda-Rajah M, Blewitt C, Ayton D. 'No one can actually see us in positions of power': the intersectionality between gender and culture for women in leadership. BMJ Lead 2024; 8:63-66. [PMID: 37704368 DOI: 10.1136/leader-2023-000794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/23/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Warwick Business School, Warwick University, Coventry, UK
| | | | - Claire Blewitt
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini Ayton
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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