The core competencies in disaster nursing of new graduate nurses in Guangdong, China: A cross-sectional study

AIM

This study aimed to assess the level of core competencies in disaster nursing of New Graduate Nurses (NGNs) and explore its influencing factors.

BACKGROUND

In recent years, the overall frequency of disasters around the world has been on the rise. As the emerging workforce in clinical settings, NGNs play an integral role in future disaster relief efforts. NGNs' level and influencing impact of core competencies in disaster nursing need to be understood.

DESIGN

A cross-sectional design.

METHODS

From June to September 2023, the Core Competencies in Disaster Nursing Scale - General Professional Nurse (CCDNS-GPN), designed according to the CCDN V2.0, was used to collect data from NGNs of six nursing schools and 15 hospitals in Guangdong, China. Descriptive analysis was conducted to examine the scores of core competencies in disaster nursing. Furthermore, one-way analysis of variance and multivariate linear regression analysis were used to explore the influencing factors.

RESULTS

A total of 607 NGNs participated in this study. The scores of CCDNS-GPN of NGNs were 90.23 (SD 15.09) (score ratio: 51.56%), indicating a low level of core competencies in disaster nursing. The highest competency was the recovery (score ratio: 55.00%), while the lowest competency was the communication (score ratio: 45.44%). The predictor for core competencies in disaster nursing of NGNs were male (β = 0.091, p < 0.05), below bachelor's degree (β = -0.109, p < 0.05), had received disaster nursing education at school (β = 0.087, p < 0.05), had participated in a disaster rescue drill at school (β = 0.140, p < 0.05), had been to the ICU during internship (β = 0.135, p < 0.05) and had the intention to be a disaster specialized nurse (β = 0.114, p < 0.05).

CONCLUSIONS

The NGNs exhibited insufficient core competencies in disaster nursing in Guangdong, China. Nursing schools and clinical institutions should collaborate and play their respective roles to enhance nurses' core competencies in disaster nursing, ensuring they can timely, safely and efficiently participate in disaster medical relief efforts.

Exploring variations in IPC competencies: a cross-sectional study among healthcare professionals in Northwest China

BACKGROUND

This cross-sectional study investigates infection prevention and control (IPC) competencies among healthcare professionals in northwest China, examining the influence of demographic factors, job titles, education, work experience, and hospital levels.

METHODS

Data from 874 respondents across 47 hospitals were collected through surveys assessing 16 major IPC domains. Statistical analyses, including Mann-Whitney tests, were employed to compare competencies across variables.

RESULTS

Significant differences were identified based on gender, job titles, education, work experience, and hospital levels. Females demonstrated higher IPC competencies, while senior positions exhibited superior performance. Higher educational attainment and prolonged work experience positively correlated with enhanced competencies. Variances across hospital levels underscored context-specific competencies.

CONCLUSION

Demographic factors and professional variables significantly shape IPC competencies. Tailored training, considering gender differences and job roles, is crucial. Higher education and prolonged work experience positively impact proficiency. Context-specific interventions are essential for diverse hospital settings, informing strategies to enhance IPC skills and mitigate healthcare-associated infections effectively.

Global One Health post-graduate programmes: a review

BACKGROUND

The One Health (OH) approach recognises that humans, animals, plants, and the environment are interrelated, and therefore seeks to facilitate collaboration, communication, coordination, and capacity building between relevant stakeholders to achieve a healthier ecosystem. This calls for integrating OH into established governance, policy, health, education, and community structures, and requires OH professionals equipped with the necessary inter and trans-disciplinary skillset. Therefore, numerous OH training programmes are currently being offered globally. However, the coordination and contents of some of these trainings have been criticised as inconsistent and inadequately standardised, and therefore could serve as a barrier to OH implementation. In this study, an up-to-date repository of a subset of OH academic programmes offered globally was provided, and their curricula contents was critically assessed.

METHODS

Between December 2022 and April 2023, an online search for key terms 'ONE HEALTH MASTERS COURSES', and 'ONE HEALTH MASTERS PROGRAMMES' together with variations of 'AFRICA', 'NORTH AMERICA', 'ASIA', 'AUSTRALIA', 'EUROPE', 'GLOBAL' was conducted. Details about course title, delivery mode, joint administration status, curricula contents, language of instruction, years to completion, host university, country, and continent were collected.

RESULTS

Forty-three programmes met inclusion criteria of the study, and almost all (n = 36, 83.7%) were tailored towards infectious diseases and population/global health, compared to the environmental and conservation perspectives. Compiled curricula contents clustered into one of these 12 sub-headings: 'principles and concepts of OH', 'epidemiology and biostatistics', 'major branches of OH', 'internship/externship/research project', 'infectious diseases, zoonoses, and surveillance', 'risk analysis and crises management', 'food safety, microbiology, immunology, and allied', 'communication', 'ethics', 'economics, policy, and management' and 'others. Of these, infectious disease themes were the most common. Regarding geography and organising institutions, North America and Europe, and veterinary institutions, respectively, were the most represented.

CONCLUSION

Despite the multi-level diversity observed, uniformity still exists across the programmes which favours interdisciplinary cross-talks. Future pedagogical studies that objectively assess the alignment of module contents with the OH core competencies and the impacts of these OH programmes is recommended. With this study, a critical information gap that has existed for long in the OH field has been bridged.

AONN+ Navigation Metrics That Support the Oncology Navigation Standards of Professional Practice

OBJECTIVES

To offer a comprehensive overview of the critical elements contributing to the achievements of oncology navigation, address challenges in standardized implementation, and examine recent advancements influencing the acknowledgment and reimbursement of navigation services. Lastly, the AONN+ 35 evidence-based navigation metrics will be shared, emphasizing the five core metrics that should be utilized by all navigation models in all settings.

METHODS

Employed in this review involves synthesizing information from established oncology organizations, documenting the development of navigator professional standards of practice and navigation metrics that measure patient experience, clinical outcomes, and return on investment, and analyzing outcomes from national studies and collaborations to present a summary of advancements in oncology navigation.

RESULTS

The key components vital for ensuring the enduring success of programs encompass the core competencies of navigators, adherence to standards of navigation practice set by the Professional Oncology Navigation Taskforce, and the establishment of well-defined metrics specific to oncology navigation.

CONCLUSIONS

Despite these advancements, challenges persist in implementing and recognizing the newly defined standards and metrics. Effective solutions involve aligning navigation programs with leadership, integrating standards into daily practice, defining navigator roles, measuring navigation program outcomes through defined metrics, and leveraging certifications. Standardized measurement and practice are imperative for national policy development and reimbursement models, aligning with the Cancer Moonshot's goal of high-quality, patient-centered, and cost-effective cancer care.

IMPLICATIONS FOR NURSING PRACTICE

To contribute to standardizing measurement and practice in oncology navigation for national policy development and reimbursement models.

2022 Shandong Province university medical technical skills competition nursing track: An effective project to improve core competencies of nursing students

Background

The core competencies of nursing students have gradually become the focus of attention of nursing educators. Nursing skills competitions are an important form of educational and teaching activity in universities and the nursing track at the Shandong Provincial University Students' Medical Technical Skills Competition gives nursing students an opportunity to demonstrate their clinical skills and knowledge. This study aims to describe the organisation and procedures of the nursing track, analyse the competition results and explore the impact the competition has on the core competencies of the nursing students. This will provide new ideas for future nursing professional education.

Methods

Statistical analysis of the competition results was performed as a means of understanding the current status of theoretical knowledge and clinical skills of nursing students in Shandong Province. The impact of the competition on the core competencies of participating students was analysed by distributing questionnaires to universities in Shandong Province that participated in the competition.

Results

14 universities with nursing programmes participated in the competition, including eight public universities and six private universities. 220 questionnaires were distributed to nursing students at the participating universities and 218 were ultimately included, demonstrating an efficiency rate of 99.09%.

Conclusions

The 2022 nursing track included the addition of a comprehensive written examination as a means of judging the competencies of nursing students in Shandong Province from a variety of aspects. Skills competitions are effective for improving the core competencies of nursing students and they will become an important means for nursing educators to reform education and improve the core competencies of nursing students in the future.

Infection prevention and control continuous education and training in pre-registration nursing programmes

BACKGROUND

Infection prevention and control (IPC) education and training in pre-registration nursing programmes are imperative in developing student nurses' clinical aptitudes. The IPC core competencies must be consistent amongst student nurses across different settings, asserting the need for education and training providers to respond. Continuous education and training can improve IPC core competencies through enhanced knowledge, compliance, and attitude in the academic and clinical contexts, impacting future nursing practice and patient safety.

OBJECTIVE

This integrative review critically examines the reported IPC core competencies in pre-registration nursing programmes to contribute to future continuous IPC education and training.

REVIEW METHODS

An integrative literature review methodology was utilised to conduct a structured literature search within the last five years using CINAHL Plus, EMBASE, ERIC, MEDLINE, and PubMed databases. The following keywords were used: infection prevention and control; pre-registration nursing; higher education; core competencies in the databases. A total of 15 articles were identified under the inclusion criteria of peer-reviewed primary research in English on the pre-registration nurse population and their nursing programmes.

RESULTS

The final review of the 15 reports yielded continuous IPC education and training, knowledge, skills, and attitudes, and clinical placements as key components to develop and elevate student nurses' IPC core competencies.

CONCLUSION

All reports acknowledged the challenges of maintaining IPC core competencies and seeking diversified strategies to support continuous education and training utilising interactive tools embedded with simulated scenarios and quizzes, translating knowledge and skills to exemplary professional behaviours, and consistent academic and clinical support as the IPC demand intensifies.

Status and influencing factors of undergraduate midwifery students' core competencies: A cross sectional study

INTRODUCTION

Midwifery undergraduate students' core competencies directly affect the quality of midwifery services and overall quality of midwifery teams. However, limited research has explored the core competencies of undergraduate midwifery students in China.

OBJECTIVES

This study aimed to describe the level of core competencies among undergraduate midwifery students in China and investigated possible associated factors.

DESIGN

This was a cross-sectional descriptive study.

SETTINGS AND PARTICIPANTS

The study population comprised third- and fourth-year undergraduate midwifery students at Zunyi Medical University in Guizhou Province in southwest China (n = 207, response rate 94.1 %).

METHODS

Data were collected using an online survey that included a general information questionnaire, a general self-efficacy scale, and a core competencies self-assessment questionnaire for midwifery undergraduates. Data were statistically analyzed using SPSS 18.0. Pearson's correlation analysis was used to explore the relationship between self-efficacy and the core competencies. Stepwise multiple linear regression was used to explore influencing factors.

RESULTS

The total score for the core competencies among midwifery undergraduates was 118.46 (8.97). The highest mean score was for professional attitude, 4.21 (0.43), and the lowest was for professional skills, 3.70 (0.30). We found a positive association between self-efficacy and core competencies (r = 0.251, P < 0.01). Grade (β = 0.261, P < 0.01), scholarship (β = -0.231, P < 0.01), work intention (β = -0.135, P < 0.05), and self-efficacy (β = 0.207, P < 0.01) significantly influenced undergraduate midwifery students' core competencies (R2 = 0.189, adjusted R2 = 0.173, F = 11.775, P < 0.001).

CONCLUSIONS

Undergraduate midwifery students showed moderate core competencies, indicating room for improvement. Fourth-grade midwifery students had higher core competencies than third-grade students. Additionally, scholarship, work intention, and self-efficacy were significant influencing factors. Midwifery educators should examine students' core competencies and explore targeted interventions, particularly for those with low self-efficacy and core competencies.

The effect of scenario-based training on the Core competencies of nursing students: a semi-experimental study

INTRODUCTION

Competency is defined as the variety of skills and knowledge required to perform a specific task. Due to the specificity of pediatric nursing, students face some challenges in acquiring core competencies. Therefore, the use of new training methods in pediatric nursing is necessary. One of the modern learning methods is learning based on clinical scenarios. Thus, this study aimed to investigate the effect of scenario-based education on the core competencies of nursing students.

METHOD

This quasi-experimental study employed a pre-test and post-test design. All participants (n = 72) were selected via the census method and randomly divided into intervention (N = 33) and control groups (N = 40). The data were collected using a demographic information questionnaire and the Nursing Students' Clinical Competencies Questionnaire. Before the intervention, both groups completed the pre-tests. After one month, the students in both groups completed post-tests.

RESULTS

The average score of core competencies for the students in the intervention group after the training (247.05, SD = 36.48) increased compared to before the intervention (229.05, SD = 36.58) (P > 0.05). The average score of the core competencies for the students in the control group after the training was 240.76 (SD = 35.36) compared to 235.56 (SD = 27.94) before the intervention, with no significant difference (P < 0.05). The independent t-test did not show a significant difference between the control and intervention groups before and after the intervention (P > 0.05).

CONCLUSION

The results indicated the effectiveness of scenario-based training on the core competencies of students in the intervention group. Accordingly, nursing administrators and professors are recommended to incorporate new scenario-based teaching and learning methods in educational programs of universities. It is also necessary to conduct more research into the effectiveness of this method in combination with other training methods like team-based and problem-based training.

Core competencies in critical care for general medical practitioners in South Africa: A Delphi study

Background

Despite a high burden of disease that requires critical care services, there are a limited number of intensivists in South Africa (SA). Medical practitioners at district and regional public sector hospitals frequently manage critically ill patients in the absence of intensivists, despite these medical practitioners having had minimal exposure to critical care during their undergraduate training.

Objectives

To identify core competencies in critical care for medical practitioners who provide critical care services at public sector hospitals in SA where intensivists are not available to direct patient management.

Methods

A preliminary list of core competencies in critical care was compiled. Thereafter, 13 national and international experts were requested to achieve consensus on a final list of core competencies that are required for critical care by medical practitioners, using a modified Delphi process.

Results

A final list of 153 core competencies in critical care was identified.

Conclusion

The core competencies identified by this study could assist in developing training programmes for medical practitioners to improve the quality of critical care services provided at district and regional hospitals in SA.

Contribution of the study

The study provides consensus on a list of core competencies in critical care that non-intensivist medical practitioners managing critically ill patients in healthcare settings in South Africa, especially where intensivists are not readily available, should have. The list can form the core content of training programmes aimed at improving critical care competence of general medical practitioners, and in this way hopefully improve the overall outcomes of critically ill patients in South Africa.

Construction of an index system of core competence assessment for otolaryngology nurse specialists in China: A Delphi study

BACKGROUND

Clinical nurse specialists play a vital role in the work quality, patient safety and team development of nurses. However, there is currently no prior study constructing the index of core competence assessment for otolaryngology Nurse Specialists.

OBJECTIVES

To establish an index system for the evaluation of Chinese otolaryngology Nurse Specialists' core competence.

DESIGN

A Delphi study.

SETTINGS

The study was mainly conducted in a university-affiliated hospital in China.

PARTICIPANTS

Twenty-two experts with otolaryngology knowledge and practical experience from different regions and organizations in China.

METHODS

We used literature reviews and expert meetings to establish a draft index system . Subsequently, a two-round Delphi survey was utilized to consult opinions from 22 experts about the index for the evaluation of otolaryngology nurse specialists' core competence and provide qualitative comments on their ratings. Consensus was predefined as a mean important score of 4.0 or above and a coefficient of variation is not above 0.25 among the participants.

RESULTS

The final evaluation indexes of the core competencies for otolaryngology Nurse Specialists included 5 first-level indexes (clinical competence, critical thinking competence, leadership, professional development competence, professionalism), 19 second-level indexes, and 85 third-level indexes. The effective response rates of the two expert consultation rounds were 100 %. The expert authority coefficients were 0.864 and 0.859 in the first and second rounds of consultation, respectively. In the second round of consultation, the first, second and third indexes of Kendall's coefficient of concordance were 0.357, 0.330, and 0.232, respectively (P < 0.001).

CONCLUSIONS

The constructed evaluation indexes of the core competencies of otolaryngology Nurse Specialists are scientific, reasonable, comprehensive, and specific and may provide references for the training and evaluation of otolaryngology Nurse Specialists.

Refining core competencies of first-line nurse managers in the hospital context: A qualitative study

Objectives

As the world moves towards a new normal, challenges continue to emerge while simultaneously inspiring us with new solutions. Strengthening the skills of first-line nurse managers (FLNMs) to fulfill a wide range of complex roles and responsibilities effectively necessitates refining core competency guidelines or standards. This study aimed to explore the perceived core competencies of Indonesian FLNMs within the context of the post-pandemic era.

Methods

The study employed a qualitative descriptive design. Face-to-face interviews were conducted in a public hospital in Indonesia from January 2022 through August 2022. Seven head nurses with direct experience managing a unit during the COVID-19 pandemic were selected. The interviews were audio-recorded, transcribed verbatim, and validated by re-listening. Data were analyzed using thematic analysis.

Results

Four main themes of the core competencies developed, including 1) managerial core competencies, 2) clinical core competencies, 3) technological core competencies, and 4) socio-emotional skills/personal traits consisting of the following: be brave, fast, patient, optimistic, consistent, and responsible.

Conclusions

The findings demonstrate that the managerial and clinical core competencies of the FLNMs must be aligned, while technological core competencies are the mediating component of both. Personal traits are essential for FLNMs as they undergird the other three core competencies and the success of the FLNMs.

Effectiveness of an online training program for improving nurses' competencies in disaster risk management

BACKGROUND

Nurses' incompetency in disaster risk management can have many negative consequences during disasters, so it is important to prepare nurses and improve their competencies in disaster risk management. This study was conducted with the aim of investigating the effectiveness of an online training program to improve competencies in disaster risk management.

METHOD

This interventional study was conducted on nurses working in a specialized trauma hospital affiliated with the Kerman University of Medical Sciences in southeastern Iran in 2023. Eighty-one nurses were randomly assigned into two interventions (n = 42) and control groups (n = 39). The intervention group received an online training program in four sessions, and both groups electronically completed the demographic questionnaire and the nurses' perceptions of disaster core competencies scale (NPDCC) before and one month after the intervention.

RESULTS

The study results showed no significant difference in disaster competency scores between the two groups before the intervention (p < 0.51), but the NPDCC score in the intervention group was statistically significant after the intervention compared to before the intervention (p < 0.02) and no statistically significant difference was observed between the two groups after the intervention (p < 0.16).

CONCLUSION

While the online training program was found to significantly improve the NPDCC score of nurses in the intervention group, this increase was not significant when compared to the control group. Therefore, we suggest continuous practical exercises and maneuvers to improve nurses' perception of the competencies required for effective disaster management.

Foundational Curriculum and Core Guidelines for Training in Latinx/a/o-Hispanic Cultural Neuropsychology Across the Lifespan

OBJECTIVE

The training competency of individual and cultural diversity is an advanced, fundamental competency to health service psychology since 2015. However, there is minimal instruction on how to integrate it into training curricula in neuropsychology, especially at the postdoctoral fellowship level. Our objective was to operationalize the individual and cultural diversity standard to provide a tangible application for educational programs on how to develop a competency-based training model for Latinx/a/o-Hispanic (L/H) cultural neuropsychology across the lifespan.

METHOD

The knowledge-based and applied-based competencies necessary to train to be a cultural neuropsychologist delivering services to L/H patients and families are defined. For learners to complete these competencies, training programs need to implement clinical, didactic, research, and professional development core guidelines grounded in cultural neuropsychology. We provide a framework on how to transform each core guideline, including a Didactics Core with foundational readings across a range of L/H topics, and a Report Template to guide the documentation of sociocultural information, language usage, normative data, and other relevant factors in a neuropsychological report.

CONCLUSIONS

These cultural neuropsychology competencies and core guidelines need to become a basic core requirement for all neuropsychologists in training. With focused education in culturally based competencies, training programs can cultivate a sense of responsibility, inclusion, justice, and equity to train a generation of neuropsychologists, who intentionally and consistently practice socially responsible neuropsychology.

Self-Assessment of Addiction Medicine Core Competencies in Four Year Groups of Psychiatrists in Training: Efficacy of the Addiction Medicine Training Needs Assessment Scale in a Local Training Context

BACKGROUND

In addiction medicine training, self-assessment is increasingly used to support self-regulation learning by identifying standards of excellence, competence gaps, and training needs. To ensure psychiatrists in Lithuania also develop specific addiction competencies, the Lithuanian Health Sciences University faculty in Kaunas developed an addiction psychiatry curriculum.

OBJECTIVES

The aim of this research is to explore the efficacy of the AM-TNA scale to measure individual and group differences in proficiency in the core competencies of addiction medicine. A cross-sectional study and a convenience sample were used.

METHOD

We studied the differences in performance in addiction medicine competencies between 4 successive year groups and analysed the variance to determine the statistical differences between the means of 4 year groups with biases, resulting from repeated measurement statistically corrected-for.

RESULTS

Of the psychiatrists in training, 41% or 59% completed the scale. The assessment of competencies suggested that all but 2 competencies differ significantly (p < 0.05) between the 4 groups. The post hoc analyses indicated that mean scores for 24 of the 30 core competencies differed significantly between the year groups (p < 0.05) and showed a gradual increase in scores of self-assessed competencies over the 4 year groups. We found adequate scale variance and a gradual increase in self-assessed competencies between the 4 year groups, suggesting a positive association between the results of incremental professional training and improved self-assessed substance use disorders (SUD) competency scores.

CONCLUSIONS

This study illustrates the efficacy of the AM-TNA scale as an assessment instrument in a local training context. Future research should aim to have larger sample sizes, be longitudinal in design, assess individual progress, and focus on comparing and combining self-reported competencies with validated objective external assessment and feedback.

Residency Education in Oral and Maxillofacial Surgery: A New Curriculum Framework

Residency education in oral and maxillofacial surgery (OMS) exists in an environment of transformation unlike anything seen in the past. Changes in American society accelerated by the COVID-19 pandemic are impacting all of health-care education and demand a comprehensive response by OMS programs and in standards for education. The oral health in America report of the National Institutes of Health and actions of the American Council on Graduate Medical Education provides a new framework for structuring and adapting OMS programs. These include incorporating the Quadruple Aims and ACGME core competencies into OMS education. The evolution of clinical education is being adapted to changes in technology and the American higher education environment. A changing workforce and practice model combined with today's technology revolution are being incorporated into OMS residency education.

Core competencies for a biomedical laboratory scientist - a Delphi study

BACKGROUND

After completing university education, biomedical laboratory scientists work in clinical laboratories, in biomedical research laboratories, in biotech, and in pharmaceutical companies. Laboratory diagnostics have undergone rapid development over the recent years, with the pace showing no signs of abatement. This rapid development challenges the competence of the staff and will most certainly influence the education of future staff. This study aimed to examine what was considered the necessary competencies needed to pursue a career as a biomedical laboratory scientist.

METHODS

A modified Delphi technique was used, with the panel of experts expressing their views in a series of three questionnaire. Consensus was defined as the point which 75 % or more of the panel participants agreed that a particular competency was necessary.

RESULTS

The study highlights the perceived importance of mostly generic competencies that relate to quality, quality assurance, and accuracy, as well as different aspects of safety, respect, trustworthiness (towards patients/clients and colleagues), and communication skills. The results also stress the significance of self-awareness and professionality.

CONCLUSIONS

We identified important competencies for biomedical laboratory scientists. Together with complementary information from other sources, i.e., guidelines, laws, and scientific publications, the competencies identified can be used as learning outcomes in a competency-based education to provide students with all the competencies needed to work as professional biomedical laboratory scientists.

Education Competencies for Integrative Oncology-Results of a Systematic Review and an International and Interprofessional Consensus Procedure

Integrative oncology is a burgeoning field and typically provided by a multiprofessional team. To ensure cancer patients receive effective, appropriate, and safe care, health professionals providing integrative cancer care should have a certain set of competencies. The aim of this project was to define core competencies for different health professions involved in integrative oncology. The project consisted of two phases. A systematic literature review on published competencies was performed, and the results informed an international and interprofessional consensus procedure. The second phase consisted of three rounds of consensus procedure and included 28 experts representing 7 different professions (medical doctors, psychologists, nurses, naturopathic doctors, traditional Chinese medicine practitioners, yoga practitioners, patient navigators) as well as patient advocates, public health experts, and members of the Society for Integrative Oncology. A total of 40 integrative medicine competencies were identified in the literature review. These were further complemented by 18 core oncology competencies. The final round of the consensus procedure yielded 37 core competencies in the following categories: knowledge (n = 11), skills (n = 17), and abilities (n = 9). There was an agreement that these competencies are relevant for all participating professions. The integrative oncology core competencies combine both fundamental oncology knowledge and integrative medicine competencies that are necessary to provide effective and safe integrative oncology care for cancer patients. They can be used as a starting point for developing profession-specific learning objectives and to establish integrative oncology education and training programs to meet the needs of cancer patients and health professionals.

Development and Pilot Test of the Competency Assessment for Sexual Assault Prevention Practitioners

Sexual assault is a preventable problem that is widespread and particularly prevalent for certain populations (e.g., female college students, Native American women). Despite the gravity of this public health priority, most individuals tasked with the primary prevention of sexual assault are not adequately trained for the job (e.g., professionals often trained solely in sexual assault response). To achieve optimal outcomes, professionals responsible for implementing sexual assault prevention must possess certain core competencies, or knowledge and skills essential for job performance, which include those needed for any primary prevention effort in addition to those specific to sexual assault prevention. The purpose of this study was to develop and assess the construct validity of a competency assessment tool for sexual assault prevention practitioners. An existing assessment tool, which was designed for injury and violence prevention practitioners, was tailored to reflect competencies needed by sexual assault prevention practitioners as informed by the literature. The newly tailored measure was pilot tested with 33 individuals with varying levels of expertise with sexual assault prevention. These individuals were categorized into three groups based on self-rated sexual assault prevention expertise (low, medium, or high) to assess group differences. As expected, the high expertise group rated higher knowledge in all the competencies than the medium and low expertise groups (except for the competency pertaining to developing and maintaining competency). Data collection and analyses were conducted in 2020. Implications for how the assessment tool can be used to identify gaps among individual practitioners and teams of practitioners are discussed.

Evaluating the association of state regulation of community health workers on adoption of standard roles, skills, and qualities by employers in select states: a mixed methods study

BACKGROUND

The occupation of community health worker (CHW) has evolved to support community member navigation of complex health and social systems. The U.S. Bureau of Labor Statistics formally recognized the occupation of community health worker (CHW) in 2009. Since then, various national and state efforts to professionalize the occupation have been undertaken. The Community Health Workers Core Consensus (C3) project released a set of CHW roles and competency recommendations meant to provide evidence-based standards for CHW roles across work settings. Some states have adopted the recommendations; however, there are a variety of approaches regarding the regulation of the occupation. As of 2020, 19 U.S. states have implemented voluntary statewide CHW certification programs. The purpose of this study was to explore the relationship between state regulation of CHWs and adoption of standard roles, skills, and qualities by employers in select states.

METHODS

This mixed methods study used purposive sampling of job ads for CHWs posted by employers from 2017 to 2020 in select states. Natural language processing was used to extract content from job ads and preprocess the data for statistical analysis. ANOVA, chi-square analysis, and MANOVA was used to test hypotheses related to the relationship between state regulation of CHWs and differences in skills, roles, and qualities employers seek based on seniority of state regulatory processes and employer types.

RESULTS

The mean job ads with nationally identified roles, skills, and qualities varies significantly by state policy type (F(2, 4801) = 26.21) and by employer type (F(4, 4799) = 69.08, p = 0.000).

CONCLUSIONS

Employment of CHWs is increasing to provide culturally competent care, address the social determinants of health, and improve access to health and social services for members of traditionally underserved communities. Employers in states with CHW certification programs were associated with greater adoption of occupational standards set by state and professional organizations. Wide adoption of such standards may improve recognition of the CHW workforce as a valuable resource in addressing the needs of high-need and marginalized groups.

Public health moves to innocence and evasion? Graduate training programs' engagement in truth and reconciliation for Indigenous health

OBJECTIVES

Indigenous peoples are the first peoples of what is now called Canada. Canadians have benefitted from their largesse and contributions in a myriad of ways that remain unacknowledged. Indeed, ongoing colonization and systemic anti-Indigenous racism in all quarters of our society have had heinous impacts on their health and well-being. Despite this reality and multiple calls for redress, Indigenous health is still missing from the Core Competencies for Public Health in Canada, having obvious implications for public health training programs and subsequent practice. Our objective in this paper is to critically explore the reasons behind institutional apathy for reconciliation in Indigenous health.

METHODS

Interviews were conducted with 19 leaders in Canadian Graduate Public Health Programs (CGPHPs) at 15 universities to explore the extent to which CGPHPs engage with Canada's 2015 Truth and Reconciliation Commission's Calls to Action to address Indigenous health. We used thematic discourse analysis to illuminate the landscape and make recommendations.

RESULTS

Participants agree that Indigenous health is important, but our data reveal an uneven landscape for addressing the Calls to Action. Curriculum was limited though we noted modest positive change. On the whole, the non-Indigenous (white) professoriate still needs to educate themselves while not all see the need to do so. Many deflected responsibility. Yet anecdotally, there is desire among CGPHP students who are already unsettling themselves to see such competency in their training.

CONCLUSION

It is a settler evasion to claim lack of expertise, to express a desire to limit the burden on Indigenous academics, and to stand on the sidelines of institutional inertia. Our findings are a call to CGPHPs to do better.

Mapping a postgraduate curriculum in disaster nursing with the International Council of Nursing's Core Competencies in Disaster Nursing V2.0: The extent of the program in addressing the core competencies

BACKGROUND

The increasing frequency and magnitude of disasters call for enhancing the preparation of nurses with advanced knowledge and skills in disaster management.

OBJECTIVES

With the release in December 2019 of the updated version 2.0 of the ICN's Core Competencies in Disaster Nursing (ICN CCDN V2.0), the aims of this study were to examine the extent to which the selected disaster nursing postgraduate program curriculum and the dissertation projects address the updated core competencies and to determine whether the syllabus requires revision.

METHODS

A data mapping analysis approach was used to review the syllabus of the studied program for coverage of the ICN V2.0 core competencies for general professional (Level I) and advanced/specialized nurses (Level II). The dissertation projects of the students were also included in the mapping analysis.

RESULTS

It found that 83% of the core competencies were addressed at Level I for general professional nurses and 69% at Level II for advanced/specialized nurses in the curriculum. Out of the 35 core competencies at Level I under the eight domains, six items (17.1%) were not covered under the domains of Intervention and Recovery. Out of the 32 core competencies at Level II, ten items (31.3%) were not covered under the domains of Communication, Incident Management, Safety and Security, Assessment, Intervention, and Law and Ethics. Students' dissertations could complement some of the competencies not covered in the syllabus.

CONCLUSIONS

The studied curriculum covered the majority of the core competencies proposed by ICN CCDN V2.0, but subjects were required to be revised to address the competencies missing from the syllabus. Moreover, it is critically important for educators to review their curriculum to prepare nurses for disasters, to ensure that they are equipped with the competencies required to meet the demands arising from the increasingly frequent occurrences of global disaster.

Evaluating the specialist palliative care clinical nurse specialist role in an acute hospital setting: a mixed methods sequential explanatory study

Background

Special palliative care is provided in a range of settings including a patient’s home (their primary place of dwelling), a hospice in-patient unit, or an acute hospital. The aim of the study was to evaluate the role of the specialist in palliative care clinical nurse specialist (SPC CNS) role in an acute hospital setting.

Methods

This study was conducted using a mixed methods sequential explanatory approach in two phases; phase 1 involved completion of a study questionnaire (n = 121) and phase 2 involved part-taking in a focus group (n = 6) or individual interview (n = 4).

Results

Phase 1 results indicated that respondents held positive attitudes towards the Specialist Palliative Care Clinical Nurses Specialist (SPC CNS) in relation to clinical care, education and patient advocacy. Phase 2 qualitative findings identified the importance of the role in terms of symptom management, education and support.

Conclusions

This study provides an evaluation of a SPC CNS role since it was established in an acute hospital setting. The evidence indicates that there is a varied understanding of the role of the SPC CNS. The role was seen as an important one particularly in terms of referrals to and support provided by the SPC CNS, as well as recognition of the importance of the role is providing ongoing education to staff.

A Proposed Model of Core Competencies for Research Ethics Consultants

Research ethics consultation services (RECS), which function as an advisory service to facilitate the resolution of complex ethical issues in clinical research, have been proliferating over the last decade. However, the qualification of an individual who provides RECS, or “a research ethics consultant,” has not been thoroughly investigated, in contrast to healthcare ethics consultants, whose core competencies have been discussed and clarified to a great extent. In this study, we investigated core competencies necessary for research ethics consultants, referring to the core competency models of ethics consultants developed in the healthcare practice context, and propose a competency model for research ethics consultants.

What influences new graduate nurses' core competencies transformation to clinical in China? A cross-sectional study

BACKGROUND

The core competencies of new graduate nurses (NGNs) have significant health outcomes in the clinical environment. However, these nurses experience a theory-practice gap, which creates a barrier in the transition process when they first enter the clinical workplace.

OBJECTIVE

To understand the general overview of the transition of the core competencies of NGNs to clinical practice in China and the influencing factors.

DESIGN AND SETTING

A cross-sectional study design consisting of a multi-stratified grounded random sample from 31 hospitals in seven regions nationwide.

PARTICIPANTS

2400 NGNs were recruited by email.

METHODS

The Competencies Inventory for Registered Nurse (CIRN) was applied to evaluate NGNs' core competencies.

RESULTS

NGNs performed best on leadership and worst on critical thinking or research aptitude. Core competencies were predicted by depressive symptoms, worked for two-three years, having a nurse-in-charge title, professional values, department, happiness, etc. Besides, the preceptor program also has significant to core competencies.

CONCLUSION

The average level of Chinese NGNs' core competencies was at a moderate level, which wasn't well optimized. It is recommended to adopt appropriate interventions to support NGNs. With an increase in work years and the accumulation of more work experience, the corresponding core competencies of NGNs will also improve. Preceptor institutions, limiting first-degree recruitment, and early ICU or operating room department rotations can be carried out by nursing educators to improve core competencies.

Core competencies required by toxicology graduates in order to function effectively in a Poisons Information Centre: A Delphi study

INTRODUCTION

The availability of trained Medical Toxicologists in developing countries is limited and education in Medical Toxicology remains inadequate. The lack of toxicology services contributes to a knowledge gap in the management of poisonings. A need existed to investigate the core competencies required by toxicology graduates to effectively operate in a Poisons Information Centre. The aim of this study was to obtain consensus from an expert group of health care workers on these core competencies. This was done by making use of the Delphi technique.

METHODOLOGY

The Delphi survey started with a set of carefully selected questions drawn from various sources including a literature review and exploration of existing curricula. To capture the collective opinion of experts in South Africa, Africa and also globally, three different groups were invited to participate in the study. To build and manage the questionnaire, the secure Research Electronic Data Capture (REDCap) web platform was used.

RESULTS

A total of 134 competencies were selected for the three rounds and in the end consensus was reached on 118 (88%) items. Panel members agreed that 113 (96%) of these items should be incorporated in a Medical Toxicology curriculum and five (4%) should be excluded.

DISCUSSION

All participants agreed that effective communication is an essential skill for toxicology graduates. The curriculum can address this problem by including effective pedagogy to enhance oral and written communication skills.Feedback from panellists indicated that the questionnaires were country-specific and not necessarily representative of all geographical locations. This is an example of the 'battle of curriculum design' where the context in which the curriculum will be used, will determine the content.

CONCLUSION

The Delphi method, based on three iterative rounds and feedback from experts, was effective in reaching consensus on the learning outcomes of a Medical Toxicology curriculum. The study results will ultimately improve education in Medical Toxicology.

Professionalism and inter-communication skills (ICS): a multi-site validity study assessing proficiency in core competencies and milestones in medical learners

BACKGROUND

Interpersonal and Communication Skills (ICS) and Professionalism milestones are challenging to evaluate during medical training. Paucity in proficiency, direction and validity evidence of assessment tools of these milestones warrants further research. We validated the reliability of the previously-piloted Instrument for Communication skills and Professionalism Assessment (InCoPrA) in medical learners.

METHODS

This validity approach was guided by the rigorous Kane's Framework. Faculty-raters and standardized patients (SPs) used their respective InCoPrA sub-component to assess distinctive domains pertinent to ICS and Professionalism through multiple expert-built simulated-scenarios comparable to usual care. Evaluations included; inter-rater reliability of the faculty total score; the correlation between the total score by the SPs; and the average of the total score by two-faculty members. Participants were surveyed regarding acceptability, realism, and applicability of this experience.

RESULTS

Eighty trainees and 25 faculty-raters from five medical residency training sites participated. ICC of the total score between faculty-raters was generally moderate (ICC range 0.44-0.58). There was on average a moderate linear relationship between the SPs and faculty total scores (Pearson correlations range 0.23-0.44). Majority of participants ascertained receiving a meaningful, immediate, and comprehensive patient-faculty feedback.

CONCLUSIONS

This work substantiated that InCoPrA was a reliable, standardized, evidence-based, and user-friendly assessment tool for ICS and Professionalism milestones. Validating InCoPrA showed generally-moderate agreeability and high acceptability. Using InCoPrA also promoted engaging all stakeholders in medical education and training-faculty, learners, and SPs-using simulation-media as pathway for comprehensive feedback of milestones growth.

Selection of New Psychiatry Residents Within a National Program: a Qualitative Study of Faculty Perspectives on Competencies and Attributes

OBJECTIVE

Admission committees use multiple sources of information to select residents. However, the way in which faculty members use each data source remains unclear and highly context-specific. The present study seeks to understand how faculty members use various sources of information about candidates to make admission decisions to a National Psychiatry Residency Program.

METHODS

The theory of core competencies was used as a foundation for this qualitative study. Framework analysis was used to structure the project and data presentation. Twenty key informants from the faculty were purposefully sampled in accordance with the initial theory. Open-ended semi-structured interviews were conducted to obtain their views about the essential competencies of psychiatrists and the ways in which these competencies could be reliably gauged.

RESULTS

Participants described numerous competencies that they believed were essential to becoming competent psychiatrists. These competencies fell within the six core competencies of the Accreditation Council for Graduate Medical Education framework. However, several non-competency attributes (such as perseverance, empathy, and compassion) were also relevant in the selection process. To reduce the impact of self-presentation bias, to which these attributes were vulnerable, the faculty relied heavily on sources of information obtained from third parties, such as feedback from co-workers with first-hand experience of the candidate during their clinical placements.

CONCLUSION

Faculty members place importance on informal informant-derived information about a candidate's non-competency attributes in addition to core competencies when deciding whether or not to select a candidate for admission into a residency training program.

Sustaining a national surgical training programme during the COVID-19 pandemic

The COVID-19 pandemic has disrupted all segments of daily life, with the healthcare sector being at the forefront of this upheaval. Unprecedented efforts have been taken worldwide to curb this ongoing global catastrophe that has already resulted in many fatalities. One of the areas that has received little attention amid this turmoil is the disruption to trainee education, particularly in specialties that involve acquisition of procedural skills. Hand surgery in Singapore is a standalone combined programme that relies heavily on dedicated cross-hospital rotations, an extensive didactic curriculum and supervised hands-on training of increasing complexity. All aspects of this training programme have been affected because of the cancellation of elective surgical procedures, suspension of cross-hospital rotations, redeployment of residents, and an unsustainable duty roster. There is a real concern that trainees will not be able to meet their training requirements and suffer serious issues like burnout and depression. The long-term impact of suspending training indefinitely is a severe disruption of essential medical services. This article examines the impact of a global pandemic on trainee education in a demanding surgical speciality. We have outlined strategies to maintain trainee competencies based on the following considerations: 1) the safety and wellbeing of trainees is paramount; 2) resource utilization must be thoroughly rationalized; 3) technology and innovative learning methods must supplant traditional teaching methods; and 4) the changes implemented must be sustainable. We hope that these lessons will be valuable to other training programs struggling to deliver quality education to their trainees, even as we work together to battle this global catastrophe.

Immediate knowledge improvement and long-term teaching confidence after general medicine faculty training program

BACKGROUND/PURPOSE

This study analyzed the effects of the General Medicine Faculty Training Program (GMFTP), which was implemented in 2009. The training program includes a 7-hour basic training (BT) to introduce ways of teaching and assessing the 6 core competencies identified by the Accreditation Council for Graduate Medical Education, and a 40-hour clinical training program.

METHODS

Physicians from different hospitals attended the GMFTPs. Since 2010, we have been using quick tests to assess trainees' familiarity of core competencies. Knowledge improvement (KI) was defined as the difference between post-BT and pre-BT test scores. Since 2013, we have been annually mailing questionnaires to assess trainees' teaching confidence (TC) of core competencies. We analyzed the correlations between trainees' characteristics, KIs, and TCs.

RESULTS

Between year 2009 and 2017, a total of 319 attending physicians (257 male, 62 female), with a mean age of 39.1 ± 6.2 years, completed the GMFTPs. Significant KI (32.6-55.4) was noted. There were no correlations between trainees' characteristics and KIs. The mean TCs for the 6 core competences were all above 4.0 (based on a 5-point Likert scale). TCs were positively correlated with age during GMFTP training, age when responding to the questionnaire, and duration between training and the last time responding to the questionnaire. TC showed no correlation with sex, hospitals, departments, or KI.

CONCLUSION

Knowledge of teaching core competencies improved immediately after BT, but KIs did not correlate with TCs in long-term follow-up. After the training program, physicians' teaching confidence increased over time.

Practicing Histotechnologists Identify the Core Competencies Needed by Newly Graduated Biomedical Laboratory Scientists in Histotechnology and Histology

The universities of applied sciences in Finland offer 3.5-year courses for histotechnologists and they graduate as biomedical laboratory scientist with 12 credits in histology and histotechnology. The aim of this study was to survey practicing histotechnologists about the core competencies needed by newly graduated biomedical scientists in histology and histotechnology. The data were collected in Finland in 2015. We asked 43 participants to complete a questionnaire that comprised two background questions, five open-ended questions and 38 Likert scale questions, with the responses ranging from five (strongly agree) to one (strongly disagree), and 22 (51%) responded. They stated that the most important competencies were the principles of tissue processing (mean 4.77), embedding (4.64), laboratory safety (4.57), fixation methods (4.55), cutting by microtomy (4.55), quality control of sections (4.55), fixation methods (4.55), and principles of stains (4.36). The least important competencies were quality control of molecular pathology (2.56), interpretation of immunohistological stains (2.71), use of molecular pathology (2.89), and independent dissection (2.91). The respondents stated that there were 20 stains that newly graduated biomedical laboratory scientists needed to know. The practices involving staining emerged in the open responses and four were considered to be important: Hematoxylin-Eosin (n = 18), Periodic Acid Schiff (n = 11), Alcian Blue-Periodic Acid Schiff (n = 9), and Giemsa (n = 9). The most essential tissues to identify were the histology of the alimentary track (n = 9), skin (n = 6), and liver (n = 5). The core competencies that histotechnologists felt were important for newly graduated biomedical laboratory scientists seemed to be consistent with the current curriculum.

Ability of Ophthalmology Residents to Self-Assess Their Performance Through Established Milestones

OBJECTIVES

Accurate self-assessment is an important aspect of practice-based learning and improvement and a critical skill for resident growth. The Accreditation Council for Graduate Medical Education mandates semiannual milestones assessments by a clinical competency committee (CCC) for all ophthalmology residents. There are six core competencies: patient care (PC), medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal communication skills. These competencies are assessed by the milestones rubric, which has detailed behavioral anchors and are also used for trainee self-assessments. This study compares resident self-assessed (SA) and faculty CCC milestones scores.

DESIGN

Residents completed milestones self-assessments prior to receiving individual score reports from the CCC. Correlation coefficients were calculated comparing the SA and CCC scores. In addition, statistical models were used to determine predictors of disparities and differences between the SA and CCC scores.

SETTING

Wilmer Eye Institute, Johns Hopkins Hospital.

PARTICIPANTS

Twenty-one residents in the Wilmer Ophthalmology Residency program from July 2014 to June 2016.

RESULTS

Fifty-seven self-assessments were available for the analysis. For each resident's first assessment, SA and CCC scores were strongly correlated (r ≥ 0.6 and p < 0.05) for four milestones, and not correlated for the remaining 20 milestones. In multivariable models, the SA and CCC scores are less disparate for medical knowledge and systems-based practice competencies compared to practice-based learning and improvement. Higher year of training, PC and professionalism competencies were predictive of statistically significant resident overestimation of scores relative to the CCC. In addition, higher CCC scores predicted statistically significant lower SA-CCC disparities and differences. SA-CCC differences did not lower to a significant extent with repeated assessments or modification to the end-of-rotation evaluation forms.

CONCLUSIONS

Self-assessments by ophthalmology residents are not well-correlated with faculty assessments, emphasizing the need for improved and frequent timely feedback. Residents have the greatest difficulty self-assessing their professionalism and PC competency. In general, senior residents and underperforming residents have more inaccurate self-assessments.

Core competencies for diabetes educators: A scoping review

AIMS

Diabetes educators (DEs) play a major role in diabetes education and management. The aims of this scoping review were to compile the currently identified core competencies for DEs and, to review the currently used criteria to assess DEs' core competencies.

METHODS

A scoping review was conducted using the methodology of the Joanna Briggs Institute. Five databases (Ovid, CINAHL, Scopus, Web of Science and PubMed) were searched. Keywords as well as inclusion and exclusion criteria were identified as search strategies and study selection for this review.

RESULTS

A total of (n = 22) publications comprising sixteen peer-reviewed studies and six professional-organisations (grey literature) were selected for review, as they listed the core competencies of DEs. The most common core competencies were related to knowledge and skills in diabetes self-management education, knowledge of pathophysiology and epidemiology, teaching skills, clinical skills and cultural competency. Evidently, an appropriate tool for assessing DEs' competencies is currently unavailable.

CONCLUSIONS

Given the importance of diabetes education in the care of people living with diabetes, it is imperative that DEs possess competencies in diabetes education and management. The review also identified the need to develop a globally applicable core competency assessment tool for DEs.

Medicolegal Expert Core Competencies and Professionalism

Medicolegal expert opinions can be the source of long and senseless acrimonious debates when they lack the necessary qualities to be considered good evidence. In contrast, quality medicolegal expert reports contribute significantly to the proper and prompt resolution of personal injury claims in civil litigation. To this end, expert physiatrists must develop the medicolegal mindset necessary to survive and thrive in the civil litigation arena. Medicolegal core competencies needed for this endeavor are identified and addressed for what is a lifelong learning project.

A Delphi Study to Determine Leveling of the Interprofessional Core Competencies for Four Levels of Interprofessional Practice

INTRODUCTION

Although the Core Competencies for Interprofessional Education (IPE) provide guidance in developing interprofessional learning experiences, the literature is sparse in how to incorporate them across varying levels of learning activities. Thus, the purpose of this study was to explore consensus for leveling the IPEC Core Competencies for use across four levels of interprofessional practice. Initially, Benner's novice to expert theory was used to develop a leveling document for planning educational experiences appropriate for pre-licensure through practice learners. Using this document, a Delphi study was conducted to gain consensus on leveling the Core Competencies.

METHODS

A modified Delphi technique was employed using an expert panel of 48 healthcare faculty experienced in interprofessional education. Participants were asked to select their opinion of the level of learner for which each of the competencies were most appropriate.

RESULTS

After three rounds of questionnaires, 34 of the 38 competencies achieved consensus at a 70% agreement. Four competencies did not reach consensus.

CONCLUSIONS

Using a developmental approach, this study provides a foundational point for establishing guidelines for progressive organization and consistency in interprofessional learning activities. Although four competencies did not reach consensus, the results suggest that leveling is possible. Ongoing research is needed to further validate or revise the findings from this study.

Utilizing public health core competencies to share data effectively with community organizations to promote health equity

OBJECTIVES

This article utilizes an adapted model for research transfer to highlight the important role of Local Public Health Agencies (LPHAs) to share data more effectively with local community organizations to advance health equity.

METHODS

A literature review related to public health data sharing with local community partners was conducted using Medline, Embase, and CINAHL databases and grey literature sources with 12 articles included for analysis. Six LPHAs distributed an online survey to 405 local community organizations to define their current data uses and needs. Survey and literature review findings informed a one-day deliberative dialogue event with 19 participants who brought multiple perspectives together on the barriers and potential solutions for data sharing.

RESULTS

Results are discussed utilizing the three stages of data sharing: awareness, communication, and collaboration. Awareness of the barriers and needs of community partners related to data, and the public health core competency of assessment and analysis is the first stage. More effective is the second stage, where LPHAs proactively communicate to understand and meet the needs of community partners. Data sharing is the most effective when LPHAs use the third stage of collaboration to work with community partners to mutually benefit from data sharing.

CONCLUSION

When LPHAs utilize their core competencies of assessment and analysis, communication, and collaboration to share data with community partners, they are able to share data more effectively. This allows community partners to modify programs to better serve priority populations and improve population health.

Core competencies for nurses in Chinese intensive care units: a cross-sectional study

BACKGROUND

Core competencies of intensive care unit (ICU) nurses were defined as the essential capability to influence patient safety and interdisciplinary collaboration; however, there has been no research conducted that relates to core competencies of ICU nurses at Chinese tertiary-A hospitals in Shanghai.

AIMS AND OBJECTIVES

To investigate the current state of core competencies and the factors that influence this key capability in ICU nurses in Chinese tertiary-A hospitals.

DESIGN

This was a multicentre, cross-sectional study.

METHODS

A convenient sampling method was used to investigate 451 ICU nurses at five tertiary-A hospitals in Shanghai. Data were collected using self-administered questionnaires.

RESULTS

The core competencies of ICU nurses were above average, and the scores of seven dimensions, ranked from first to last, were medical ethics, clinical practice, nurse-nurse co-operation, assessment and decision-making, personal and professional development, teaching and research and nurse-physician co-operation. Multivariate linear regression analysis showed that the factors exerting an influence on the core competencies of ICU nurses were title, role incumbent and ICU department.

CONCLUSION

This study showed an above-average level of core competencies among ICU nurses in tertiary-A hospitals in Shanghai; however, competencies related to nurse-physician co-operation and the translation of research into practice were underdeveloped.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers should implement targeted interventions to improve nurse-physician co-operation and translate research into practice competencies, such as high-fidelity simulation, inter-professional education, scientific research training and innovative skills tutorials. Moreover, this study demonstrated the influencing factors that can be used to improve core competences of ICU nurses.

Creation of a competency-based professional development program for infection preventionists guided by the APIC Competency Model: steps in the process

BACKGROUND

Infection Preventionists have varying levels of educational preparation. Many have no prior experience in IP. The diversity makes design of professional development programs challenging. Recent surveys suggest that only about half of practicing IPs are board certified. There is an urgent need to employ competent IP's to drive improvement in patient outcomes.

METHODS

This is a project that utilized the APIC Competency Model to create a professional development program characterizing three career stages. Methods included a review of literature on professional development; a survey of IP competence; an assessment of job descriptions and performance evaluations; and a crosswalk of IP competencies.

RESULTS

The professional development program includes competency - based IP job descriptions and performance evaluations for each career stage; a professional portfolio; and a toolkit for supervisors.

DISCUSSION

Participants agreed that application of the model resulted in tools which are more closely aligned with current roles for IPs; and increased satisfaction and motivation with the new program.

CONCLUSION

Competent and knowledgeable IP's are crucial to optimizing efficacy of IPC programs. A professional development program has the potential to guide staff orientation, improve satisfaction and retention, improve patient outcomes and promote a positive trajectory in advancing practice.

What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa

BACKGROUND

As part of efforts to implement the human resources capacity building component of the African Regional Strategy on Disaster Risk Management (DRM) for the health sector, the African Regional Office of the World Health Organization, in collaboration with selected African public health training institutions, followed a multistage process to develop core competencies and curricula for training the African health workforce in public health DRM. In this article, we describe the methods used to develop the competencies, present the identified competencies and training curricula, and propose recommendations for their integration into the public health education curricula of African member states.

METHODS

We conducted a pilot research using mixed methods approaches to develop and test the applicability and feasibility of a public health disaster risk management curriculum for training the African health workforce.

RESULTS

We identified 14 core competencies and 45 sub-competencies/training units grouped into six thematic areas: 1) introduction to DRM; 2) operational effectiveness; 3) effective leadership; 4) preparedness and risk reduction; 5) emergency response and 6) post-disaster health system recovery. These were defined as the skills and knowledge that African health care workers should possess to effectively participate in health DRM activities. To suit the needs of various categories of African health care workers, three levels of training courses are proposed: basic, intermediate, and advanced. The pilot test of the basic course among a cohort of public health practitioners in South Africa demonstrated their relevance.

CONCLUSIONS

These competencies compare favourably to the findings of other studies that have assessed public health DRM competencies. They could provide a framework for scaling up the capacity development of African healthcare workers in the area of public health DRM; however further validation of the competencies is required through additional pilot courses and follow up of the trainees to demonstrate outcome and impact of the competencies and curriculum.

Improving the biomedical research literature: insights from authors' editors can help journal editors define and refine their core competencies

A team of stakeholders in biomedical publishing recently proposed a set of core competencies for journal editors, as a resource that can inform training programs for editors and ultimately improve the quality of the biomedical research literature. This initiative, still in its early stages, would benefit from additional sources of expert information. Based on our experiences as authors’ editors, we offer two suggestions on how to strengthen these competencies so that they better respond to the needs of readers and authors – the main users of and contributors to research journals. First, journal editors should be able to ensure that authors are given useful feedback on the language and writing in submitted manuscripts, beyond a (possibly incorrect) blanket judgement of whether the English is “acceptable” or not. Second, journal editors should be able to deal effectively with inappropriate text re-use and plagiarism. These additional competencies would, we believe, be valued by other stakeholders in biomedical research publication as markers of editorial quality.

What are patient navigators doing, for whom, and where? A national survey evaluating the types of services provided by patient navigators

OBJECTIVE

A nationwide cross-sectional study was conducted to assess patient navigator, patient population, and work setting characteristics associated with performance of various patient navigation (PN) tasks.

METHODS

Using respondent-driven sampling, 819 navigators completed a survey assessing frequency of providing 83 PN services, along with information about themselves, populations they serve, and setting in which they worked. Analyses of variance and Pearson correlations were conducted to determine differences and associations in frequency of PN services provided by various patient, navigator, and work setting characteristics.

RESULTS

Nurse navigators and navigators with lower education provide basic navigation; social workers typically made arrangements and referrals; and individuals with higher education, social workers, and nurses provide treatment support and clinical trials/peer support. Treatment support and clinical trials/peer support are provided to individuals with private insurance. Basic navigation, arrangements and referrals, and care coordination are provided to individuals with Medicaid or no insurance.

CONCLUSION

Providing basic navigation is a core competency for patient navigators. There may be two different specialties of PN, one which seeks to reduce health disparities and a second which focuses on treatment and emotional support.

PRACTICE IMPLICATIONS

The selection and training of patient navigators should reflect the specialization required for a position.

Core competencies in clinical neuropsychology training across the world

OBJECTIVE

This work aimed to review main competency requirements from training models in countries with well-established specialties in clinical neuropsychology and to extract core competencies that likely will apply to clinical neuropsychologists regardless of regional and cultural context.

METHOD

We reviewed standards for post-graduate training in clinical neuropsychology from countries in Europe, Australia, and North America based on existing literature, presentations at international conferences, and from description of the training models from national psychological or neuropsychological associations.

RESULTS

Despite differences, the reviewed models share similar core competencies considered necessary for a specialty in clinical neuropsychology: (1) In-depth knowledge of general psychology including clinical psychology (post-graduate level), ethical, and legal standards. (2) Expert knowledge about clinically relevant brain-behavioral relationships. (3) Comprehensive knowledge about, and skills in, related clinical disciplines. (4) In-depth knowledge about and skills in neuropsychological assessment, including decision-making and diagnostic competency according to current classification of diseases. (5) Competencies in the area of diversity and culture in relation to clinical neuropsychology. (6) Communication competency of neuropsychological findings and test results to relevant and diverse audiences. (7) Knowledge about and skills in psychological and neuropsychological intervention, including treatment and rehabilitation.

CONCLUSIONS

All the models have undergone years of development in accordance with requirements of national health care systems in different parts of the world. Despite differences, the common core competency requirements across different regions of the world suggest generalizability of these competencies. We hope this summary can be useful as countries with less established neuropsychology training programs develop their models.

Core competencies for scientific editors of biomedical journals: consensus statement

BACKGROUND

Scientific editors are responsible for deciding which articles to publish in their journals. However, we have not found documentation of their required knowledge, skills, and characteristics, or the existence of any formal core competencies for this role.

METHODS

We describe the development of a minimum set of core competencies for scientific editors of biomedical journals.

RESULTS

The 14 key core competencies are divided into three major areas, and each competency has a list of associated elements or descriptions of more specific knowledge, skills, and characteristics that contribute to its fulfillment.

CONCLUSIONS

We believe that these core competencies are a baseline of the knowledge, skills, and characteristics needed to perform competently the duties of a scientific editor at a biomedical journal.

Perceptions of mistreatment among trainees vary at different stages of clinical training

BACKGROUND

Mistreatment of trainees remains a frequently reported phenomenon in medical education. One barrier to creating an educational culture of respect and professionalism may be a lack of alignment in the perceptions of mistreatment among different learners. Through the use of clinical vignettes, our aim was to assess the perceptions of trainees toward themes of potential mistreatment at different stages of training.

METHODS

Based on observations from external experts embedded in the clinical learning environment, six thematic areas of potential mistreatment were identified: verbal abuse, specialty-choice discrimination, non-educational tasks, withholding/denying learning opportunities, neglect and gender/racial insensitivity. Corresponding clinical vignettes were created and distributed to 1) medical students, 2) incoming interns, 3) residents/fellows. Perceptions of the appropriateness of the interactions depicted in the vignettes were measured on a 5-point Likert scale. Scores were categorized into neutral or appropriate (≤3) or inappropriate (i.e. mistreatment) (>3) and compared using chi-squared tests.

RESULTS

Four hundred twenty seven trainees participated (182 students, 120 interns, 125 residents/fellows). Proportions of students perceiving mistreatment differed significantly from those of interns and residents/fellows in domains of verbal abuse, specialty discrimination and gender/racial insensitivity (p < 0.05). In scenarios comparing interns to residents/fellows, no significant differences were noted in perceptions of mistreatment in the domains of non-educational tasks, withholding learning and neglect.

CONCLUSIONS

Perceptions of mistreatment differ at different developmental stages of medical training. After exposure to the clinical learning environment, perceptions of incoming interns did not differ from those of residents/fellows, implicating clinical rotations as a key period in indoctrinating students into the prevailing culture. More longitudinal studies are needed to confirm or better examine this phenomenon.

Aligning perceptions of mistreatment among incoming medical trainees

BACKGROUND

Learner mistreatment has been a long-standing example of unprofessional behavior in medical training. Alignment of perceptions of professional behavior is a critical component of developing a defined organizational culture. Clinical vignettes addressing learner mistreatment can help to achieve this goal. Our aim was to determine whether using clinical vignettes to address learner mistreatment during onboarding can reduce variability in the perceptions of mistreatment.

MATERIALS AND METHODS

External experts in the field of labor and employment relations embedded in the clinical learning environment identified six thematic areas of potential mistreatment. Corresponding clinical case vignettes were developed and presented to incoming trainees during the onboarding process, followed by facilitated discussion. Perceptions of mistreatment before and after discussion were assessed on a Likert scale, with results compared using F-test and t-test.

RESULTS

There were 145 participants. Most participants reported previously witnessing or experiencing episodes of mistreatment before matriculation (84%), with the majority reporting multiple events. The most common offenders were faculty (57%), residents/fellows (49%), and nurses (33%). Only 10% of incoming trainees reported a previous incident of mistreatment. Postintervention scores demonstrated decreased variability (P < 0.05) in perceptions of mistreatment in all but one vignette (withholding learning opportunities). Two vignettes demonstrated higher perception of mistreatment after intervention (noneducational tasks and gender or racial discrimination, P < 0.05).

CONCLUSIONS

Mistreatment remains a prevalent phenomenon in medical training involving a wide cross-section of healthcare providers. Trainees arrive with discordant definitions of mistreatment. Alignment of individuals' definitions can be achieved through the use of carefully crafted clinical vignettes and facilitated discussion.

Proficiency in identifying, managing and communicating medical errors: feasibility and validity study assessing two core competencies

BACKGROUND

Communication skills and professionalism are two competencies in graduate medical education that are challenging to evaluate. We aimed to develop, test and validate a de novo instrument to evaluate these two competencies.

METHODS

Using an Objective Standardized Clinical Examination (OSCE) based on a medication error scenario, we developed an assessment instrument that focuses on distinctive domains [context of discussion, communication and detection of error, management of error, empathy, use of electronic medical record (EMR) and electronic medical information resources (EMIR), and global rating]. The aim was to test feasibility, acceptability, and reliability of the method.

RESULTS

Faculty and standardized patients (SPs) evaluated 56 trainees using the instrument. The inter-rater reliability of agreement between faculty was substantial (Fleiss k = 0.71) and intraclass correlation efficient was excellent (ICC = 0.80). The measured agreement between faculty and SPs evaluation of resident was lower (Fleiss k = 0.36). The instrument showed good conformity (ICC = 0.74). The majority of the trainees (75 %) had satisfactory or higher performance in all six assessed domains and 86 % found the OSCE to be realistic. Sixty percent reported not receiving feedback on EMR use and asked for subsequent training.

CONCLUSION

An OSCE-based instrument using a medical error scenario can be used to assess competency in professionalism, communication, using EMRs and managing medical errors.

Global health education in the United Kingdom: a review of university undergraduate and postgraduate programmes and courses

OBJECTIVES

This study reviews the current state of global health education (GHE) in the United Kingdom (UK) through the collation and synthesis of data on undergraduate and postgraduate global health degree programmes. It examines both the curriculum provided and profile of the student currently studying global health in the UK.

STUDY DESIGN

Descriptive, case study design.

METHODS

A systematic review of the literature identified a set of global health 'core competencies' that students could acquire through their chosen programme of study. Those competencies were synthesized and then compared to core and elective courses currently offered by global health degree programmes at UK universities. A questionnaire was designed and sent electronically to all global health Programme Directors requesting generic information regarding the profile of their global health students.

RESULTS

Fifteen universities in the UK, based in England and Scotland, offered twenty-five postgraduate and six undergraduate global health degree programmes in 2012-13. Two Universities were developing a full, three-year, undergraduate degree programme in global health. Sixteen core competencies for a medical and non-medical student constituency were identified. Of these, just three 'core competencies' - epidemiology of tropical diseases, health systems (including health system management), and health care services - corresponded directly to core and elective courses offered by >50% of UK universities. The five most frequently offered subjects were: health systems (including health system management), research methods, public health (including specialisations in prevention, treatment and care), epidemiology, and health economics.

CONCLUSIONS

GHE in UK universities has seen comparable growth to North American institutions, becoming Europe's regional hub for undergraduate and postgraduate courses and programmes. As with the US and Canadian experience, GHE at the undergraduate level is offered primarily to medical students through intercalated degree programmes. At the postgraduate level, there is more innovation in content and mode of delivery, with a small number of UK universities providing students from a diversity of backgrounds the opportunity to study global health from multidisciplinary perspectives. Distance learning is also seeking to make the delivery of GHE truly global, with a growing number of universities recognizing its potential to further innovate in global health pedagogy. While demand for GHE is predicted to remain robust, to ensure the needs of students and practitioners are met, more critical reflection on global health curricula, the desired profile of graduates, and equity of access is required.

Harmonizing and supporting infection control training in Europe

Healthcare-associated infection (HCAI), patient safety, and the harmonization of related policies and programmes are the focus of increasing attention and activity in Europe. Infection control training for healthcare workers (HCWs) is a cornerstone of all patient safety and HCAI prevention and control programmes. In 2009 the European Centre for Disease Prevention and Control (ECDC) commissioned an assessment of needs for training in infection control in Europe (TRICE), which showed a substantial increase in commitment to HCAI prevention. On the other hand, it also identified obstacles to the harmonization and promotion of training in infection control and hospital hygiene (IC/HH), mostly due to differences between countries in: (i) the required qualifications of HCWs, particularly nurses; (ii) the available resources; and (iii) the sustainability of IC/HH programmes. In 2013, ECDC published core competencies for infection control and hospital hygiene professionals in the European Union and a new project was launched ['Implementation of a training strategy for infection control in the European Union' (TRICE-IS)] that aimed to: define an agreed methodology and standards for the evaluation of IC/HH courses and training programmes; develop a flexible IC/HH taxonomy; and implement an easily accessible web tool in 'Wiki' format for IC/HH professionals. This paper reviews several aspects of the TRICE and the TRICE-IS projects.

A randomized, controlled crossover study to discern the value of 360-degree versus traditional, faculty-only evaluation for performance improvement of anesthesiology residents

BACKGROUND

360-degree evaluation, or multi-rater feedback, is a means of providing evaluation from a variety of stakeholders. The Accreditation Council for Graduate Medical Education (ACGME) lists 360-degree feedback as a recommended method for evaluating residents. Our study determines if 360-degree evaluation, as compared to traditional evaluation, affords anesthesiology residents greater potential for performance improvement.

METHODS

After IRB exemption and resident consent to participate, sixteen anesthesiology residents of various training levels at The George Washington University Medical Center were randomly assigned to receive either 360-degree evaluation or traditional evaluation. Mid-way through the study, the groups were crossed over. Three faculty members blinded to which type of evaluation each resident received evaluated all residents pre-study, midway, and at the conclusion of the study according the six core competencies set forth by the ACGME. The 360-degree study included evaluations by faculty (traditional), self, medical students, nursing staff and patients.

RESULTS

Performance improvement in all core competencies demonstrated a trend toward greater scoring for residents who received early exposure to 360-degree evaluation compared to later exposure. Paired t-Tests demonstrated significance for resident performance improvement with early 360-degree evaluation versus early traditional evaluation for the Interpersonal and Communication Skills core competency over the entire study. Systems-based Practice and Practice-Based Learning and Improvement suggested improvements, but failed to reach statistical significance (P = 0.09, 0.07 respectively).

SUMMARY

Does a 360-degree evaluation, as compared to traditional, faculty-only evaluation afford anesthesiology residents greater potential for performance improvement? Sixteen residents were exposed to a prospective, single-blinded, crossover design study to determine the answer. For 360-degree evaluations, residents were rated according to the ACGME core competencies after adjusting to Program Director review of evaluations from self, faculty, nursing staff, medical students and patients.