Twelve tips for addressing ethical concerns in the implementation of artificial intelligence in medical education

Artificial Intelligence (AI) holds immense potential for revolutionizing medical education and healthcare. Despite its proven benefits, the full integration of AI faces hurdles, with ethical concerns standing out as a key obstacle. Thus, educators should be equipped to address the ethical issues that arise and ensure the seamless integration and sustainability of AI-based interventions. This article presents twelve essential tips for addressing the major ethical concerns in the use of AI in medical education. These include emphasizing transparency, addressing bias, validating content, prioritizing data protection, obtaining informed consent, fostering collaboration, training educators, empowering students, regularly monitoring, establishing accountability, adhering to standard guidelines, and forming an ethics committee to address the issues that arise in the implementation of AI. By adhering to these tips, medical educators and other stakeholders can foster a responsible and ethical integration of AI in medical education, ensuring its long-term success and positive impact.

The ESG performance influence mechanism analysis-based on empirical analysis

ESG has emerged as a prominent method for evaluating enterprises, gaining increasing importance in recent years. It assesses a company's ability to promote sustainable economic development and fulfill its social responsibilities, encompassing three non-financial dimensions: environmental, social, and corporate governance. Regulatory authorities, industry associations, and investment institutions worldwide have placed growing emphasis on a company's ESG performance. From the perspective of career concern, this study conducted a multiple regression analysis using data from Chinese A-share companies listed in Shanghai and Shenzhen from 2011 to 2020. It used CEO shareholding and CEO political affiliation as moderating variables to examine the impact of CEO career concerns on the corporate environment, society, and corporate governance performance. Empirical testing of whether CEO career concerns promote or suppress the ESG performance in enterprises. The findings of this study reveal that CEOs with heightened career concerns tend to impede the ESG performance of their respective enterprises. Additionally, CEO shareholding and political affiliations exert a negative moderating influence on the relationship between CEO career concerns and ESG performance. This research significantly extends the investigation into factors influencing ESG performance, offering fresh perspectives that could inform improved CEO oversight, foster corporate transformation, and enhance ESG performance.

Social accountability in a medical school: is it sufficient? A regional medical school curriculum and approaches to equip graduates for rural and remote medical services

BACKGROUND

Social accountability is increasingly integral to medical education, aligning health systems with community needs. Universitas Pattimura's Faculty of Medicine (FMUP) enhances this through a curriculum that prepares graduates for rural and remote (RR) medical practice, exceeding national standards. The impact of this curriculum on graduate readiness in actual work settings remains unassessed.

OBJECTIVE

This study was conducted to capture the perspectives of FMUP medical graduates in a rural-centric curriculum, focusing on the teaching and learning opportunities afforded to them during their medical education. These insights are crucial for evaluating the accountability of regional medical schools in delivering quality service, particularly in underserved areas.

METHODS

Semistructured interviews were conducted with nine FMUP graduates employed in the RR areas of Maluku Province. A qualitative analysis was employed to examine graduates' views on the curriculum concerning medical school accountability.

RESULTS

The FMUP curriculum, informed by social accountability principles, partially prepares graduates to work under Maluku's RR conditions. However, it was reported by participants that their skills and preparedness often fall short in the face of substandard working environments.

CONCLUSIONS

The FMUP curriculum supports the government's aim to develop an RR medical workforce. However, the curriculum's social accountability and rural emphasis fall short of addressing community health needs amid inadequate practice conditions. Political investment in standardizing medical facilities and equipment is essential for enhancing graduates' effectiveness and health outcomes in RR communities.

The role of governance in shaping health system reform: a case study of the design and implementation of new health regions in Ireland, 2018-2023

BACKGROUND

Effective governance arrangements are central to the successful functioning of health systems. While the significance of governance as a concept is acknowledged within health systems research, its interplay with health system reform initiatives remains underexplored in the literature. This study focuses on the development of new regional health structures in Ireland in the period 2018-2023, one part of a broader health system reform programme aimed at greater universalism, in order to scrutinise how aspects of governance impact on the reform process, from policy design through to implementation.

METHODS

This qualitative, multi-method study draws on document analysis of official documents relevant to the reform process, as well as twelve semi-structured interviews with key informants from across the health sector. Interviews were analysed according to thematic analysis methodology. Conceiving governance as comprising five domains (Transparency, Accountability, Participation, Integrity, Capacity) the research uses the TAPIC framework for health governance as a conceptual starting point and as initial, deductive analytic categories for data analysis.

RESULTS

The analysis reveals important lessons for policymakers across the five TAPIC domains of governance. These include deficiencies in accountability arrangements, poor transparency within the system and vis-à-vis external stakeholders and the public, and periods during which a lack of clarity in terms of roles and responsibilities for various process and key decisions related to the reform were identified. Inadequate resourcing of implementation capacity, competing policy visions and changing decision-making arrangements, among others, were found to have originated in and continuously reproduced a lack of trust between key institutional actors. The findings highlight how these challenges can be addressed through strengthening governance arrangements and processes. Importantly, the research reveals the interwoven nature of the five TAPIC dimensions of governance and the need to engage with the complexity and relationality of health system reform processes.

CONCLUSIONS

Large scale health system reform is a complex process and its governance presents distinct challenges and opportunities for stakeholders. To understand and be able to address these, and to move beyond formulaic prescriptions, critical analysis of the historical context surrounding the policy reform and the institutional relationships at its core are needed.

Accountability for maternal and newborn health: Why measuring and monitoring broader social, political, and health system determinants matters

This article offers four key lessons learned from a set of seven studies undertaken as part of the collection entitled, "Improving Maternal Health Measurement to Support Efforts toward Ending Preventable Maternal Mortality". These papers were aimed at validating ten of the Ending Preventable Maternal Mortality initiative indicators that capture information on distal causes of maternal mortality. These ten indicators were selected through an inclusive consultative process, and the research designs adhere to global recommendations on conducting indicator validation studies. The findings of these papers are timely and relevant given growing recognition of the role of macro-level social, political, and economic factors in maternal and newborn survival. The four key lessons include: 1) Strengthen efforts to capture maternal and newborn health policies to enable global progress assessments while reducing multiple requests to countries for similar data; 2) Monitor indicator "bundles" to understand degree of policy implementation, inconsistencies between laws and practices, and responsiveness of policies to individual and community needs; 3) Promote regular monitoring of a holistic set of human resource metrics to understand how to effectively strengthen the maternal and newborn health workforce; and 4) Develop and disseminate clear guidance for countries on how to assess health system as well as broader social and political determinants of maternal and newborn health. These lessons are consistent with the Kirkland principles of focus, relevance, innovation, equity, global leadership, and country ownership. They stress the value of indicator sets to understand complex phenomenon related to maternal and newborn health, including small groupings of complementary indicators for measuring policy implementation and health workforce issues. They also stress the fundamental ethos that maternal and newborn health indicators should only be tracked if they can drive actions at global, regional, national, or sub-national levels that improve lives.

Pathways, journeys and experiences: Integrating curricular activities related to social accountability within an undergraduate medical curriculum

BACKGROUND

Health professions education curricula are undergoing reform towards social accountability (SA), defined as an academic institution's obligation to orient its education, service and research to respond to societal needs. However, little is known about how or which educational experiences transform learners and the processes behind such action. For example, those responsible for the development and implementation of undergraduate medical education (UGME) programs can benefit from a deeper understanding of educational approaches that foster the development of competencies related to SA. The purpose of this paper was to learn from the perspectives of the various partners involved in a program's delivery about what curricular aspects related to SA are expressed in a UGME program.

METHODS

We undertook a qualitative descriptive study at a francophone Canadian university. Through purposive convenience and snowball sampling, we conducted 16 focus groups (virtual) with the following partners: (a) third- and fourth-year medical students, (b) medical teachers, (c) program administrators (e.g., program leadership), (d) community members (e.g., community organisations) and (e) patient partners. We used inductive thematic analysis to interpret the data.

RESULTS

The participants' perspectives organised around four key themes including (a) the definition of a future socially accountable physician, (b) socially accountable educational activities and experiences, (c) characteristics of a socially accountable MD program and (d) suggestions for curriculum improvement and implementation.

CONCLUSIONS

We extend scholarship about curricular activities related to SA from the perspectives of those involved in teaching and learning. We highlight the relevance of experiential learning, engagement with community members and patient partners and collaborative approaches to curriculum development. Our study provides a snapshot of what are the sequential pathways in fostering SA among medical students and therefore addresses a gap between knowledge and practice regarding what contributes to the implementation of educational approaches related to SA. We emphasise the need for educational innovation and research to develop and align assessment methods with teaching and learning related to SA.

Bringing social accountability education into hospital-based clinical practice

How can social accountability education be made relevant for hospital‐based practice? Shah et al. address this question by exploring the dichotomy between primary/community and secondary care.

Measuring social responsibility towards employees in healthcare settings in Egypt and its interrelation to their job satisfaction

OBJECTIVES

Developing a valid tool to measure perceived social responsibility (SR) practices towards employees and examining the impact of employee-centered SR considerations on the employees' job satisfaction.

METHODS

A cross sectional survey of employees at three private hospitals was conducted. Data was collected using a self-administered questionnaire. It consists of baseline characteristics, structured SR measuring scale, job satisfaction questionnaire and Perception of Empowerment Instrument (PEI).

RESULTS

The questionnaire developed to measure SR towards employees showed excellent internal consistency reliability (Cronbach's alpha is > 0.7). A considerable number of SR criteria were perceived as partially or fully met by the majority of studied employees except for rewarding, training activities, salary satisfaction and enhancement activities. Significant correlation was found between employees' job satisfaction and all domains of SR as well as employees' empowerment. Multiple linear regression analysis showed that significant predictors of employee's satisfaction are fulfillment of economic and social responsibility criteria as well as the level of perceived empowerment.

CONCLUSIONS

In healthcare industry in Egypt, fulfillment of the basis for SR is one of the predictors of achieving high job satisfaction. Extra-performance rewarding and career development should be looked at while managing human resources.

How does analyst coverage influence corporate social responsibility (CSR)? The governance- and information-based perspectives

Based on a sample of Chinese public manufacturing firms, this study empirically investigates whether and how analyst coverage drives corporate social responsibility (CSR) under different governance or information conditions. The results show that firms with greater analyst coverage take more social responsibility, representing magnified concerns and better CSR visibility for legitimacy and reputation. This relationship could be strengthened under high governance condition (high institutional ownership ratio, none CEO duality, low executive ownership) or low information situation (high earnings management and low accounting conservatism). These findings provide new evidence of information-based mechanism underlying the promotions of CSR in imperfect information environments.

Research on differential game of platform corporate social responsibility governance strategy considering user and public scrutiny

The development of digital technology and the sharing economy has extended corporations' innovative activities beyond the corporation's boundaries, so it has become more urgent to govern the lack of social responsibility and alienation of platform corporations from the perspective of social agents. First, the platform's CSR classification and social responsibility governance's main content are analyzed in this research. Then, this study uses government agencies, platform corporations, users, and the public as governance subjects and compares governance decisions with and without public and user oversight. Finally, the optimal balance strategy for each governing subject, the optimal trajectory of governance volume, and the trajectory of total revenue are obtained. The study found that: 1) Public and user supervision can improve the governance volume while encourage the governance motivation of government agencies and platform corporations. 2) The level of user supervision effort has a greater impact on the total governance revenue than public supervision. 3) The revenue of the system and the governance volume are greater in a centralized decision-making process, indicating that those involved should co-operate in governance based on the principle of mutual benefit. 4) The platform corporation has an incompatible but unified relationship between its social duty and financial success.

Corporate ESG and total factor productivity: Will the fulfillment of social responsibility sacrifice productivity?

With the increasing prominence of climate and energy issues, enterprises, as the micro-subjects of economic activities, need to pay attention to environmental responsibility to promote sustainable and high-quality economic development. However, one of the crucial controversies is whether enterprises will sacrifice efficiency to fulfill their environmental responsibilities. To try our best to answer the controversy, this paper explores the impact of ESG on total factor productivity and its mechanism. The research conclusion shows that Chinese enterprises fulfilling ESG responsibilities can improve staff efficiency, reduce financing costs, ease financing constraints, and increase innovation investment, thus effectively improving total factor productivity. Compared to non-state-owned enterprises, this effect is more significant in state-owned enterprises. In addition, the promotion of ESG construction on the total factor productivity of enterprises also presents specific acceleration characteristics. This shows that in the socialist market economy environment, there is an obvious "social responsibility dividend" in the implementation of the ESG concept by Chinese enterprises, which is helpful to enhance their long-term value and realize a win-win of social value and commercial value. The conclusions of this study help deal correctly with the relationship between business value and social value of enterprises and provide inspiration for promoting healthy and sustainable economic development.

[State of commitment to universal health coverage and associated challenges]

Purpose　Since 2020, UHC2030 has undertaken a project to review the progress of UN member states in fulfilling their commitments toward achieving universal health coverage (UHC) as outlined in the 2019 UHC Political Declaration. This involves identifying countries where UHC progress is of particular concern and engaging with multi-stakeholders. This article aims to provide a concise overview and widespread introduction to the State of UHC Commitment project for public health experts in Japan, with particular emphasis on the key findings from a pilot project on voluntary national reviews.Method　In order to gauge the evidence-based accountability actions of governments toward UHC, we conducted a comprehensive review of initial five-year Voluntary National Review (VNR) reports (2016-2020, 187 reports) published at the United Nations High-level Political Forum (HLPF). This included all descriptions (quantitative and qualitative information) regarding UHC and health systems. We also compared the descriptions in the latest VNR reports (40 reports) available as of February 2021. We checked whether there have been any improvements in the evidence-based accountability of each country.Research Results　We compared the 2021 VNR reports and the first five-year VNR reports and observed an improvement in evidence-based accountability. However, considering the wealth of data released by the United Nations Statistics on UHC and health systems, these indicators have not yet been fully utilized for accountability purposes.Conclusion　Despite the UHC Political Declaration follow-up meeting and the SDGs Mid-term Review held at the United Nations General Assembly in September 2023, some UHC targets set in 2019 have been postponed to 2025. The current status of UHC progress poses challenges to achieving the 2030 goal. There is an urgent need to strengthen governments' evidence-based accountability using UN statistics and promote UHC progress by implementing the agreed Political Declaration.

The model of norm-regulated responsibility for proenvironmental behavior in the context of littering prevention

Previous research suggests that descriptive norms positively influence proenvironmental behavior, including littering prevention. However, in some behavioral contexts, a weak descriptive norm may increase individuals' feelings of responsibility by signaling a need for action. We examined this effect in the context of litter prevention by conducting structural equation modeling of survey data from 1400 Singapore residents. The results showed that descriptive norms negatively predicted ascription of responsibility and were negatively related to littering prevention behavior via ascription of responsibility and personal norms. It also showed that strong injunctive norms can reduce the inhibitory effect of descriptive norms on ascription of responsibility. These findings were consistent with several hypotheses constituting the model of norm-regulated responsibility, a novel explanatory framework offering new insights and a more nuanced and comprehensive understanding of social norms' influence on proenvironmental behavior.

The influence of digital platform on the implementation of corporate social responsibility: from the perspective of environmental science development to explore its potential role in public health

Introduction

This paper aims to explore the intersection of corporate social responsibility (CSR) and public health within the context of digital platforms. Specifically, the paper explores the impact of digital platforms on the sustainable development practices of enterprises, seeking to comprehend how these platforms influence the implementation of environmental protection policies, resource management, and social responsibility initiatives.

Methods

To assess the impact of digital platforms on corporate environmental behavior, we conducted a questionnaire survey targeting employees in private enterprises. This survey aimed to evaluate the relationship between the adoption of digital platforms and the implementation of environmental protection policies and practices.

Results

Analysis of the survey responses revealed a significant positive correlation between the use of digital platforms and the environmental protection behavior of enterprises (r = 0.523 ; p < 0.001 ), Moreover, the presence of innovative environmental protection technologies on these platforms was found to positively influence the enforcement of environmental policies, with a calculated impact ratio of (a ∗ b / c = 55.31 % ). An intermediary analysis highlighted that environmental innovation technology plays a mediating role in this process. Additionally, adjustment analysis showed that enterprises of various sizes and industries respond differently to digital platforms, indicating the need for tailored environmental policies.

Discussion

These findings underscore the pivotal role of digital platforms in enhancing CSR efforts and public health by fostering improved environmental practices among corporations. The mediating effect of environmental innovation technologies suggests that digital platforms not only facilitate direct environmental actions but also enhance the efficiency and effectiveness of such initiatives through technological advances. The variability in response by different enterprises points to the importance of customizable strategies in policy formulation. By offering empirical evidence of digital platforms' potential to advance CSR and public health through environmental initiatives, this paper contributes to the ongoing dialogue on sustainable development goals. It provides practical insights for enterprises and policy implications for governments striving to craft more effective environmental policies and strategies.

From crisis to responsibility: The role of industry type, leadership style, and regulatory environment in shaping post-COVID-19 CSR initiative

Corporate social responsibility (CSR) is a major concern in modern industries. Chinese industries are growing rapidly and delivering products and services to the market. The Covid-19 pandemic has changed the working style of every type of industry. The objective of this research was to determine the influence of leadership style and industry type on the regulatory environment. This research also aims to determine the impact of the regulatory environment on CSR from the perspective of Chinese industries. Data based on a sample size of 599 was used for data analysis, and Smart PLS 3.0 was used for the results of measurement model assessment and structural model assessment. This study highlighted that industry type and leadership style have a significant positive impact on the regulatory environment and CSR. The framework of this research is based on the identified research gap, and the findings of this study are significant for Chinese policymakers. Furthermore, the research also asserted practical implications that are reliable to advance practices in the regulatory environment and achieve CSR by Chinese firms. This study has several limitations that are required to be significantly addressed for the sustainability of organizations.

Perceptions and experiences of undergraduate medical students regarding social accountability: a cross-sectional study at a Subsaharan African medical school

BACKGROUND

Medical schools are called to be socially accountable by medical education and healthcare system stakeholders. Social accountability is a feature of excellent medical education. Medical students are essential to the development of socially accountable medical schools. Therefore, understanding the perceptions and experiences of medical students regarding social accountability is critical for efforts to improve social accountability practices and outcomes.

METHODS

This cross-sectional online questionnaire-based survey used Google Forms and involved medical students in their fourth and fifth years of study at the Makerere University School of Medicine. The survey was conducted between September 2022 and October 2023. We used a study questionnaire and a validated toolkit designed by students as part of The Training for Health Equity Collaborative to gauge a school's progress towards social accountability in medical schools to collect data on demographics, perceptions and experiences and evaluate social accountability.

RESULTS

Out of 555 eligible medical students, 426 responded to the online questionnaire. The response rate was 77%. The mean age of the students was 25.24 ± 4.4 years. Almost three fourths of the students were male (71.3%), and slightly less than two thirds were in their fourth year of study (65%). Almost half of the students (48.1%%) evaluated the school as doing well with regard to social accountability. The evaluation items referring to community-based research and positive impact on the community had the highest mean scores. Only 6 (3.6%) students who reported hearing of social accountability had a clear understanding of social accountability. Students receiving career guidance in secondary school was associated with evaluating social accountability in the medical school as strong (p-0.003).

CONCLUSIONS

Medical students evaluated the medical school favorably forsocial accountability despite lacking a clear understanding of social accountability. Receiving career guidance in secondary school was significantly associated with a positive evaluation of social accountability.

Earnings management and readability of CSR report: Evidence from China

The literature has confirmed that when managers increase profits through earnings management, the readability of annual reports may be reduced Lo (2017), Ye (2018). Whether this conclusion is suitable for Chinese corporate social responsibility (CSR) reports, however, is still unclear. Based on the panel data of 5083 Chinese non-financial listed companies from 2010 to 2019, this paper adopts multiple linear regression to investigate the impact of earnings management on the readability of Chinese CSR reports. The results show that: (1) There is a significant negative correlation between earnings management and the readability of Chinese CSR reports, with the readability of Chinese annual reports as a mediating variable. (2) The negative effect is more significant when companies are not punished for violations, when the internal control index is low, when companies lack ISO14001 certification and when companies do not have independent third-party authentication for Chinese CSR reports. (3) When earnings management just exceeds zero, the readability of Chinese CSR reports decreases. (4) The economic consequences of reducing the readability of Chinese CSR reports are that financing costs are increased and environmental performance is decreased. To improve the quality of information disclosure of listed companies, the recommendations are as follows: First, the government should issue CSR reporting standards to reduce the manipulation of Chinese CSR reports. Second, Chinese CSR reports disclosed by listed companies must be audited by independent third parties to enhance the credibility of the information. Third, the company needs to strengthen its external and internal supervision to reduce the manipulation space for the readability of Chinese CSR reports. This study extends the negative relationship between earnings management and the readability from annual reports to Chinese CSR reports. To prevent investors from detecting earnings management, the readability of Chinese CSR reports may be reduced. At the same time, the study has definitely added value to the existing literature in the domain of CSR.

Measures that matter should define accountability and governance frameworks

While the Royal Commission into Aged Care Quality and Safety has clearly identified the issues with our Australian residential aged care system, its recommendations-so far-have not been translated into policies that will ensure a framework in which nursing home operators and care staff are empowered to focus on what matters-ensuring vulnerable residents receive care that meets their needs and preserves their dignity. For this to be achievable the system requires measures that in the first instance reflect the system's purpose, and that all stakeholders can use to improve care. Such measures need to be easy to understand and implement, and most importantly reduce bureaucratic burden.

Diversity of returnee executives' foreign experience and corporate social responsibility performance

Top managers' past experiences (e.g., foreign experience) significantly impact their decision-making behavior, which may influence firms' sustainable development. The available literature, focusing on the role of the increase in the number of top executives with foreign experience in corporate social responsibility (CSR), yields mixed results. In order to clarify the ambiguous relationship between executive foreign experience and CSR, we empirically examine the effect of the geographic diversity of top executives' foreign experience on CSR. Based on a hand-collected dataset of the top management team's (TMT's) foreign experience, we demonstrate the positive impact of the geographic diversity of returnee executives' foreign experience on firms' CSR using Chinese A-share listed firms from 2009 to 2018. Moreover, this impact is stronger in firms with political connections with the central government and in regions with good market development. Furthermore, the mechanism analysis shows that returnee executives drive firms' CSR by promoting corporate donations and green innovation. This paper offers clear policy implications by suggesting that hiring returnees with a broad geographic scope of foreign experience as corporate executives is an efficient way to enhance firms' CSR.

Suicide-Related Stigma and Social Responsibility Moderate the Effects of an Online Suicide Prevention Gatekeeper Training Program

AIM

Gatekeeper interventions are universal programs designed for use by the general public that provide brief training sessions in responding to suicidal risk. To date, the evidence base for the efficacy of gatekeeper intervention training programs has been mixed. However, little attention has been paid to potential psychological moderators of the efficacy of suicide gatekeeper interventions. We explore the potential moderating effects of suicide-related stigma and social responsibility on the efficacy of a suicide prevention gatekeeper training program.

METHODS

Participants were 179 college students with a mean age of 19.05 years (SD = 1.82, range 18-31). Participants were 71.5% women, 48.6% Hispanic, and 19.6% non-Hispanic White.

RESULTS

Results indicated that higher scores on suicide-related stigma were associated with smaller intervention effects on gatekeeper self-efficacy. In contrast, higher scores on social responsibility were associated with greater intervention effects with regard to gatekeeper preparedness and gatekeeper likelihood.

CONCLUSION

An improved understanding of the factors associated with efficacy of gatekeeper intervention programs may lead to the development of improved gatekeeper interventions. These findings may also contribute to the development of targeted gatekeeper interventions for specific cultural or occupational groups.

Ethics and accountability for clinical trials

In May 2023, a disclaimer posted on ClinicalTrials.gov dismisses accountability for the accuracy of registered information. For spinal cord injury, inconsistencies in intervention classification, phase designation, and lack of study protocols and results threaten the integrity of the database and put users at risk. An investment in what the resource should be rather than what it is not will give it the authority commensurate with the requirements for its regulatory use and informed decision-making for prospective trial participants.

Justice at the Forefront: Cultivating felt accountability towards Artificial Intelligence among healthcare professionals

The advent of AI has ushered in a new era of patient care, but with it emerges a contentious debate surrounding accountability for algorithmic medical decisions. Within this discourse, a spectrum of views prevails, ranging from placing accountability on AI solution providers to laying it squarely on the shoulders of healthcare professionals. In response to this debate, this study, grounded in the mutualistic partner choice (MPC) model of the evolution of morality, seeks to establish a configurational framework for cultivating felt accountability towards AI among healthcare professionals. This framework underscores two pivotal conditions: AI ethics enactment and trusting belief in AI and considers the influence of organizational complexity in the implementation of this framework. Drawing on Fuzzy-set Qualitative Comparative Analysis (fsQCA) of a sample of 401 healthcare professionals, this study reveals that a) focusing justice and autonomy in AI ethics enactment along with building trusting belief in AI reliability and functionality reinforces healthcare professionals' sense of felt accountability towards AI, b) fostering felt accountability towards AI necessitates ensuring the establishment of trust in its functionality for high complexity hospitals, and c) prioritizing justice in AI ethics enactment and trust in AI reliability is essential for low complexity hospitals.

Impact of corporate social responsibility on employee loyalty: Mediating role of person-organization fit and employee trust

The study explores the impact of employee perceptions of corporate social responsibility (CSR) in improving employee loyalty by examining the direct and indirect role of person-organization fit and employee trust. A convenient sampling technique was employed to collect the data sample. A total of 338 questionnaires were collected at three different China-Pakistan Economic Corridor (CPEC) projects in Pakistan. The SmartPLS-3 was used to test the study hypotheses. The results revealed that CSR positively and significantly influenced employee loyalty. The findings indicated a partial mediating impact of P-O fit and employee trust in the relationship between CSR and employee loyalty. Discussions, implications, limitations, and future research direction are also given.

Leaders' Perspectives on Resources for Academic Success: Defining Clinical Effort, Academic Time, and Faculty Support

INTRODUCTION

For academic promotion, clinical faculty are expected to excel in clinical care, teaching, and scholarship. Ensuring adequate protected time and resources to engage in scholarly work in the face of competing clinical responsibilities is critical. The authors examined academic leaders' perspectives across affiliate hospitals of a large medical school regarding the definition of clinical full-time effort and academic time, best practices to enable academic success, and barriers to faculty advancement.

METHODS

Open-ended, semistructured, individual interviews were conducted with a purposive sample of clinical department and division heads. Interview data were examined to illuminate the range and commonalities in practices and to identify successful approaches.

RESULTS

Interviews were conducted with 17 academic leaders across 6 affiliate hospitals. There was considerable variability in clinical full-time effort definition. "Academic time," more accurately characterized as "nonclinical time," was typically 1 day a week for nonshift specialties and mostly used for administrative work or completing clinical documentation. Certain departments were more explicit in designating and protecting time for academic pursuits; some had invested resources in intensive programs for academic advancement with built-in expectations for accountability. The impact of documentation burden was considerable in certain departments.

DISCUSSION AND CONCLUSION

Marked variability exists in time allocations for clinical and academic work, as well as in resources for academic success. This supports the potential value of establishing standards for defining and protecting academic time, motivating clinical faculty to engage in academic work, and building accountability expectations. Sharing best practices and setting standards may enhance academic advancement. Strategies to reduce documentation burden may enhance wellness.

Consent as a compositional act - a framework that provides clarity for the retention and use of data

BACKGROUND

Informed consent is one of the key principles of conducting research involving humans. When research participants give consent, they perform an act in which they utter, write or otherwise provide an authorisation to somebody to do something. This paper proposes a new understanding of the informed consent as a compositional act. This conceptualisation departs from a modular conceptualisation of informed consent procedures.

METHODS

This paper is a conceptual analysis that explores what consent is and what it does or does not do. It presents a framework that explores the basic elements of consent and breaks it down into its component parts. It analyses the consent act by first identifying its basic elements, namely: a) data subjects or legal representative that provides the authorisation of consent; b) a specific thing that is being consented to; and c) specific agent(s) to whom the consent is given.

RESULTS

This paper presents a framework that explores the basic elements of consent and breaks it down into its component parts. It goes beyond only providing choices to potential research participants; it explains the rationale of those choices or consenting acts that are taking place when speaking or writing an authorisation to do something to somebody.

CONCLUSIONS

We argue that by clearly differentiating the goals, the procedures of implementation, and what is being done or undone when one consent, one can better face the challenges of contemporary data-intensive biomedical research, particularly regarding the retention and use of data. Conceptualising consent as a compositional act enhances more efficient communication and accountability and, therefore, could enable more trustworthy acts of consent in biomedical science.

Educational challenges and opportunities for the future generation of surgeons: a scoping review

PURPOSE

Surgery offers exciting opportunities but comes with demanding challenges that require attention from both surgical program administrators and aspiring surgeons. The hashtag #NoTrainingTodayNoSurgeonsTomorrow on 𝕏 (previously Twitter) underscores the importance of ongoing training. Our scoping review identifies educational challenges and opportunities for the next generation of surgeons, analyzing existing studies and filling gaps in the literature.

METHODS

Following the PRISMA guidelines, MEDLINE/PubMed was searched in February 2022, using the MeSH terms "surgeons/education," for articles in English or German on general, abdominal, thoracic, vascular, and hand surgery and traumatology targeting medical students, surgical residents, future surgeons, and fellows.

RESULTS

The initial search yielded 1448 results. After a step-by-step evaluation process, 32 publications remained for complete review. Three main topics emerged: surgical innovations and training (n = 7), surgical culture and environment (n = 19), and mentoring (n = 6). The articles focusing on surgical innovations and training mainly described the incorporation of structured surgical training methods and program initiatives. Articles on surgical culture examined residents' burnout, well-being, and gender issues. Challenges faced by women, including implicit bias and sexual harassment, were highlighted. Regarding mentoring, mentees' needs, training challenges, and the qualities expected of both mentors and mentees were addressed.

CONCLUSION

At a time of COVID-19-driven surgical innovations, the educational and working environment of the new generation of surgeons is changing. Robotic technology and other innovations require future surgeons to acquire additional technological and digital expertise. With regard to the cultural aspects of training, surgery needs to adapt curricula to meet the demands of the new generation of surgeons, but even more it has to transform its culture.

Accountability focus and nurses' performance: A moderated-mediation model by using experiment design simulations

AIM

The aim of this study was to test a moderated-mediation model, explaining how and under which circumstances a process- or an outcome-accountability focus affects performance.

DESIGN

Randomized controlled design, using screen-based simulations.

METHODS

Data were collected during 2021. Two screen-based simulations of medication administration (for low- and high-complexity tasks) were used. Each participant was randomly assigned to one of the six experimental conditions. Nurses completed validated questionnaires on strain levels and their perceptions of the simulated task complexity and accountability focus. Performance was assessed via validated checklists assessing nurses' performance of the simulation.

RESULTS

Task complexity significantly moderated the relationship between accountability-focus conditions and strain. For the process-accountability-focus condition, strain levels were lower during high-complexity tasks compared with low-complexity tasks, while for the outcome-accountability-focus condition, strain levels were lower during low-complexity tasks compared with high-complexity tasks. The highest strain levels were observed under the no accountability-focus condition. Additionally, this interaction had an impact on performance, with nurses' strain playing a mediating role.

CONCLUSIONS

Any accountability focus reduces strain levels and enhances performance compared with having no accountability focus. The choice of accountability focus should be based on task-complexity considerations.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

Managers can effectively reduce nurses' strain and improve performance by prioritizing outcome accountability focus for simpler tasks and process accountability focus for complex tasks.

IMPACT

The study addressed previous ambiguous findings regarding the type of accountability focus that better motivates nurses' performance. By considering accountability focus, nurse managers can balance nurses' strain levels with improved performance.

REPORTING METHOD

We have adhered to the relevant EQUATOR guidelines: CONSORT.

PATIENT OR PUBLIC CONTRIBUTION

There is no patient or public contribution, as the study only concerns the providers of the service, that is the nurses themselves.

Exploring the ethical dimensions in forensic entomology: From codes of conduct to professional accountability

This article investigates a critical part of professional careers: adhering to a code of ethics that defines proper behavior within the context of one's specialized practice. It aims to improve the setting of forensic entomology work by highlighting the ethical issues that frequently emerge. The primary goal is to uncover common ethical issues involved in this field's everyday activities and provide informed advice on appropriate resolution options. This investigation dives into the complex interaction of religious beliefs, cultural aspects, and issues of ethics, evaluating their relevance in forensic entomology. It examines a wide range of ethical issues, from the ethics involved in collecting samples at crime scenes and morguesto the ethics created into scientific investigations, report writing, and court testimony. These guiding principles are critical in setting scientific standards and building public trust in forensic entomology's ability to provide exceptional services. Notably, regardless of whether the forensic entomology service provider is accredited by any validating organization, these ethical requirements remain critical, emphasizing their global application.

Accountability in healthcare in the Netherlands: A scoping review

For better serving people's complex needs the subsequent movement to person-centred integrated care, requires inter-organisational cooperation and service provision by domain-overarching networks and alliances. In the development to these networks, it is relevant to explore which accountability approaches are appropriate for local inter-organisational healthcare governance. Therefore, in a scoping review we studied the current state of knowledge and practice of accountability in healthcare in the Netherlands. We found that two of the included 41 studies show characteristics of accountability towards healthcare with characteristics of integration care components, such as integration of services with accompanying accountability arrangements and development of networked accountability. The first studies are found in the literature which report on accountability in integrated care. With this we add to the international discussion about accountability as an aspect of integrated care governance, by providing insight into the current state of art of accountability in Dutch healthcare.

Graduate anatomy education: How are we training the future generations of anatomy educators?

The teaching of anatomy is relevant to many fields and anatomy teachers are in demand. Individuals with a graduate anatomy education are some of the most sought-after candidates to fill open teaching positions, but it is unclear as to what constitutes a graduate anatomy education. The purpose of this study was to investigate the components of a graduate anatomy education in the United States. A survey regarding the components of doctoral, master's, and graduate certificate programs was distributed to program directors and department chairs at 71 US institutions. Respondents indicated that there were 17 doctoral, 28 master's, and 9 graduate certificate programs. Students completed coursework in all the traditional anatomical subdisciplines in approximately half of doctoral (53%) and master's (57%) programs, though the number was lower in graduate certificate programs (22%). In comparison, within 12 programs (5 doctoral, 4 master's, and 3 graduate certificate) students were required to complete coursework in less than 2 anatomical subdisciplines. Required coursework outside the subdisciplines usually involved educational theories and practices (61% of programs), research methods (52% of programs), and/or physiology (37% of programs). Respondents indicated that most programs (81%) were designed to prepare their students to teach. It appears that graduate anatomy training likely involves gross anatomy coursework, coursework in another anatomical subdiscipline, and coursework in educational theories and practices. Given the likely decline in the number of doctoral-level anatomy programs from 21 to 19, serious consideration should be given to hiring teaching candidates with master's or graduate certificate training in anatomy.

The confluence of legacy, corporate social responsibility, and public health: The case of Migros and alcohol-free retailing in Switzerland

BACKGROUND

Alcohol policy studies have traditionally focused on formal policymaking processes. Retail cooperatives, however, have rarely been studied as sites of public health interventions. Migros, a cooperatively owned chain of supermarkets in Switzerland, has long forbidden alcohol sales in its supermarkets. Focusing on processes of framing, this study explores a recent unsuccessful attempt to reverse the long-standing ban via membership vote in 2022.

METHODS

The study draws on a range of data sources, including company documents, a televised debate, and the results of a large online survey among the general population conducted ahead of the referendum. Using thematic analysis, it investigates various campaign-related arguments, including those made by Migros management, NGOs, and other key campaign participants.

RESULTS

Proponents and opponents used a combination of public health, economic/market-oriented, and corporate social responsibility (CSR) frames. Migros's longstanding dedication to CSR, its participatory governance structure, and the regional political dynamics in the Swiss context are essential in understanding the nature and impact of framing.

CONCLUSIONS

Alcohol-related harm arises from a complex interaction between different social, political, and economic factors. Reducing harm requires approaches that consider the range of contexts and measures that can shape alcohol availability.

Validity evidence and psychometric evaluation of a socially accountable health index for health professions schools

There is an expectation that health professions schools respond to priority societal health needs. This expectation is largely based on the underlying assumption that schools are aware of the priority needs in their communities. This paper demonstrates how open-access, pan-national health data can be used to create a reliable health index to assist schools in identifying societal needs and advance social accountability in health professions education. Using open-access data, a psychometric evaluation was conducted to examine the reliability and validity of the Canadian Health Indicators Framework (CHIF) conceptual model. A non-linear confirmatory factor analysis (CFA) on 67 health indicators, at the health-region level (n = 97) was used to assess the model fit of the hypothesized 10-factor model. Reliability analysis using McDonald's Omega were conducted, followed by Pearson's correlation coefficients. Findings from the non-linear CFA rejected the original conceptual model structure of the CHIF. Exploratory post hoc analyses were conducted using modification indices and parameter constraints to improve model fit. A final 5-factor multidimensional model demonstrated superior fit, reducing the number of indicators from 67 to 32. The 5-factors included: Health Conditions (8-indicators); Health Functions (6-indicators); Deaths (5-indicators); Non-Medical Health Determinants (7-indicators); and Community & Health System Characteristics (6-indicators). All factor loadings were statistically significant (p < 0.001) and demonstrated excellent internal consistency ( ω >0.95). Many schools struggle to identify and measure socially accountable outcomes. The process highlighted in this paper and the indices developed serve as starting points to allow schools to leverage open-access data as an initial step in identifying societal needs.

How do roles impact suicidal agents' obligations?

In this paper, I assess the role responsibility argument that claims suicidal agents have obligations to specific people not to kill themselves due to their roles. Since the plausibility of the role responsibility argument is clearest in the parent-child relationship, I assess parental obligations. I defend a view that says that normative roles, such as those of a parent, are contractual and voluntary. I then suggest that the normative parameters for some roles preclude permissible suicide because the role-related contract includes a promise to provide continuing care and emotional support. I propose that as we have established criteria for morally acceptable reasons for cancelling, voiding, or amending a contract, we can apply these to the role responsibility argument to establish grounds for releasing a parent from his role-related and contractual obligations. Failure to fulfil one's contractual roles may not be blameworthy, depending upon the circumstances. I propose the factors determining culpability in failure to fulfil one's role-related obligations are: intention, voluntariness, diminished responsibility, mental capacity, and foreseeability.