Toward a common understanding of competencies for health technology assessment: enhancing educational and training programs around the globe.

BACKGROUND: Depending on the health system context and the demands of relevant stakeholders in countries, the need, organizational structure, and prerequisites for enabling capacity building and development in health technology assessment (HTA) will vary. Core competencies are instrumental in this and include essential knowledge, skills, and attitudes (KSAs). They provide building blocks for delivering high-quality and effective practices of HTA. We aimed to systematically explore and develop an overview of the core competencies necessary for HTA. METHODS: This study was conducted during 2016-19 using different methods in a structured manner. We drew concepts of KSAs from various literature sources, surveyed universities and HTA professionals, and conducted expert workshops to arrive at a common understanding of the required competencies. RESULTS: The terminology for KSAs defining competencies in HTA programs has been clarified. In addition, a list of competencies offered through different educational and training programs has been created. The surveys provided clarity on a common understanding of KSAs among HTA stakeholders. Thereafter, a set of competencies was described and classified according to the HTA domains. CONCLUSIONS: Our study shows that there is diversity in HTA programs offered by educational institutions. The content of the programs varies due to differences between countries regarding the level of HTA development and the need for HTA, including the understanding of what HTA is. The preparation of a competency checklist or a "menu" of options mirroring the diversity of HTA will ensure that the specific needs of the HTA community will be covered.

Understanding Student Preferences in the Selection of a Graduate Allied Health Program: A Conjoint Analysis Study.

ISSUE: As the healthcare landscape rapidly changes, graduate allied health programs must position themselves to educate the next generation of healthcare professionals in a highly competitive landscape. No studies have directly measured the relative importance of attributes in program selection by prospective healthcare students. METHODS: We surveyed graduate healthcare management program applicants in the 2018 admissions cycle (n=512) to determine which attributes were most important in program choice. We utilized conjoint analysis to estimate utilities and importance scores of six attributes: program ranking, cost, work experience, geography, distance to home, and salary. We then conducted a market simulation to predict relative market share of academic programs. OUTCOMES: The most important attribute to prospective students was the projected starting salary, with US News and World Report ranking and tuition cost the second and third most important attributes, respectively. Each attribute was relatively inelastic respective to tuition cost. CONCLUSION: While future leaders placed the most value on earnings when selecting a program, they also valued rankings and cost. By focusing on these factors, programs can target their marketing efforts to recruit the best potential future healthcare leaders, while this method can be replicated to gauge the most important relative attributes for a variety of healthcare professions.

Creative Strengths-Based Approaches to Health Promotion: Perspectives From Graduate Training Experiences.

The authors met during a career development experience where they discussed the commonalities of their successes and challenges conducting creative strengths-based health promotion research with underserved communities during their graduate and postgraduate training. They identified changes to health promotion pedagogy that they would like to see in the future. These include understanding both the strengths and the challenges of creative strengths-based health promotion research conducted with underserved communities, ensuring that reflexivity and flexibility is a component of the process, developing support networks for trainees, understanding personal limitations to effect change, and supporting self-care. They hope that trainees and health education programs will learn from their experiences.

Teaching on the Continuum: Epidemiology Education From High School Through Graduate School.

Epidemiology education is increasingly recognized as a core science necessary for career preparation throughout the health sector, and graduate epidemiology instruction is continually being reevaluated to ensure students receive appropriate training. Recent work has also focused on the potential for epidemiology to be formally incorporated as a stand-alone discipline in undergraduate education and even integrated into wide-scale high-school science learning. As epidemiology educators, however, we face a tremendous challenge in that we should appreciate differences in students' instructional needs and goals (e.g., concepts and skills) at each educational level. In this article we propose an epidemiology learning continuum for students from high school through graduate school. We call for a student-centered instructional approach to best hone learners' grasp of concepts and skills. Furthermore, we propose scaffolded learning to help epidemiology students to develop more advanced insights and abilities as they progress in the field. This approach will not only best serve the discipline but also is well-aligned with the Association of Schools and Programs of Public Health's "Framing the Future" initiative for public health education for the 21st century.

Strategic leadership capacity building for Sub-Saharan African health systems and public health governance: a multi-country assessment of essential competencies and optimal design for a Pan African DrPH.

Leadership capacity needs development and nurturing at all levels for strong health systems governance and improved outcomes. The Doctor of Public Health (DrPH) is a professional, interdisciplinary terminal degree focused on strategic leadership capacity building. The concept is not new and there are several programmes globally-but none within Africa, despite its urgent need for strong strategic leadership in health. To address this gap, a consortium of institutions in Sub-Saharan Africa, UK and North America have embarked on a collaboration to develop and implement a pan-African DrPH with support from the Rockefeller Foundation. This paper presents findings of research to verify relevance, identify competencies and support programme design and customization. A mixed methods cross sectional multi-country study was conducted in Ghana, South Africa and Uganda. Data collection involved a non-exhaustive desk review, 34 key informant (KI) interviews with past and present health sector leaders and a questionnaire with closed and open ended items administered to 271 potential DrPH trainees. Most study participants saw the concept of a pan-African DrPH as relevant and timely. Strategic leadership competencies identified by KI included providing vision and inspiration for the organization, core personal values and character qualities such as integrity and trustworthiness, skills in adapting to situations and context and creating and maintaining effective change and systems. There was consensus that programme design should emphasize learning by doing and application of theory to professional practice. Short residential periods for peer-to-peer and peer-to-facilitator engagement and learning, interspaced with facilitated workplace based learning, including coaching and mentoring, was the preferred model for programme implementation. The introduction of a pan-African DrPH with a focus on strategic leadership is relevant and timely. Core competencies, optimal design and customization for the sub-Saharan African context has broad consensus in the study setting.

Preparing Future Healthcare Leaders through Graduate Education: Impact of Program Accreditation on Quality Improvement.

Accreditation is used by many health professions to ensure the adequacy of their training programs in preparing future leaders and practitioners. The impact of program accreditation, however, has not historically been the subject of systematic study, meaning the case for program accreditation has been more philosophical than empirical. We hypothesized that a healthcare management program's length of continuous accreditation (accreditation tenure) would be associated with factors related to applicant quality, program selectivity, and starting salaries of students upon graduation. We conducted a retrospective, correlational analysis to investigate the relationship between accreditation tenure and program quality and outcome metrics. The sample included all graduate programs (n=72) that were accredited in the 2013-2014 academic year and had completed a full annual report to the Commission on Accreditation of Healthcare Management Education (CAHME). As hypothesized, we found factors within each of our three areas of interest to be associated with accreditation tenure, providing at least preliminary evidence of an association between program-level accreditation and continuous quality improvement in programmatic outcomes.

Effectiveness of a Retention Program to Improve Performance During the First Semester of a Doctor of Physical Therapy Program.

BACKGROUND: To meet the expanding need for physical therapists universities are under increasing pressure to enroll, educate, and train physical therapists. Poor academic performance can result in student dismissal from a physical therapy program. The purpose of this study is to determine if implementation of a retention program would improve student academic performance in the foundational science curriculum in a physical therapy program. METHODS: A prospective observational cohort design was used. The retention program centered on three approaches: 1. Early identification of at-risk students. 2. Supplemental instruction in Human Anatomy. 3. Offering peer tutoring for the foundational science courses. RESULTS: A significant association existed between the implementation of the retention program and the reduction of dismissals from the Fall Semester of 2012 to the fall 2013 semesters. CONCLUSION: Implementation of a retention program had a beneficial effect on decreasing student dismissals in a physical therapy program.

Facilitators and barriers to students' learning in an obesity prevention graduate program.

Childhood obesity is a major public health concern with underpinnings at the individual, family, community and societal levels. The Transdisciplinary Childhood Obesity Prevention Graduate Certificate Program (TOP) is an innovative graduate-level certificate program developed to train professionals to understand and address obesity from multiple perspectives using an interprofessional education (IPE) approach. Currently, there is limited knowledge on what promotes or hinders learning in IPE approaches dealing with obesity prevention. The goal of this report is to address this gap by describing facilitators and barriers to learning in a graduate-level training program. Using a qualitative research design, semi-structured interviews were collected from 23 professional students, as part of a larger program evaluation project for TOP. Thematic analysis revealed the challenges and strengths of the program that relate specifically to: its interprofessional approach, its structure, and its activities. Interprofessional exchanges were reported to expand students' learning, but adequate interprofessional representation must be maintained, and the complexity of interprofessional collaborations must also be well-coordinated. Standardising the program structure and courses for consistency across professions, and clear communication are critical to program success. Findings add to the existing literature on what promotes effective learning in a professional obesity prevention program using an IPE approach.

Competitive Advantage of MBA for Physician Executives: A Systematic Literature Review.

In response to systemic challenges facing the US healthcare system, many medical students, residents and practicing physicians are pursuing a Master in Business Administration (MBA) degree. The value of such proposition remains poorly defined. The aim of this review is to analyze current literature pertaining to the added value of MBA training for physician executives (PEs). We hypothesized that physicians who supplement their clinical expertise with business education gain a significant competitive advantage. A detailed literature search of four electronic databases (PubMed, SCOPUS, Embase and ERIC) was performed. Included were studies published between Jan 2000 and June 2017, focusing specifically on PEs. Among 1580 non-duplicative titles, we identified 23 relevant articles. Attributes which were found to add value to one's competitiveness as PE were recorded. A quality index score was assigned to each article in order to minimize bias. Results were tabulated by attributes and by publication. We found that competitive domains deemed to be most important for PEs in the context of MBA training were leadership (n = 17), career advancement opportunities (n = 12), understanding of financial aspects of medicine (n = 9) and team-building skills (n = 10). Among other prominent factors associated with the desire to engage in an MBA were higher compensation, awareness of public health issues/strategy, increased negotiation skills and enhanced work-life balance. Of interest, the learning of strategies for reducing malpractice litigation was less important than the other drivers. This comprehensive systemic review supports our hypothesis that a business degree confers a competitive advantage for PEs. Physician executives equipped with an MBA degree appear to be better equipped to face the challenge of the dynamically evolving healthcare landscape. This information may be beneficial to medical schools designing or implementing combined dual-degree curricula.

Physician Assistant Student Training for the Inpatient Setting: A Needs Assessment.

PURPOSE: The number of physician assistants (PAs) practicing hospital medicine is rapidly expanding. Little research has been done to determine which inpatient medicine rotation experiences are most helpful to prepare PA students for a career in inpatient medicine. We aimed to determine those skills that practicing hospitalists believe are most critical for PA students to master and to describe hospitalists' current understanding of PA training. We also sought to evaluate the current performance of our own inpatient medicine rotation for PA students. METHODS: We surveyed 85 practicing hospitalists, including physicians and advanced-practice providers, from 3 hospitals in the Duke University Health System to identify (1) the clinical topics and skills deemed most essential for PA students on an inpatient medicine rotation, (2) the percentage of hospitalists able to correctly answer basic questions about PA training, and (3) current rotation performance. Descriptive statistics were used to summarize responses. RESULTS: Hospitalists identified the clinical conditions and health care systems with the most educational value for PA students. Hospitalists were found to have variable levels of understanding of the PA training pathway, with more than 20% incorrectly answering questions about the training process. According to mean responses, the rotation performed positively for 15 of 19 medical conditions. The majority of survey respondents suggested that a formal curriculum would help faculty teach and improve the learning experience for PA students. CONCLUSIONS: Identifying the most essential content can facilitate curriculum development. Hospitalists have a knowledge gap about the training of PA students. The inpatient medicine rotation was rated positively, but survey responses suggested that a formal curriculum could have a positive effect and would be well received.

National Survey on Doctoral-Level Education in Health Information Management: Perceptions and Rationale.

Objective: The purpose of this survey was to understand the perceptions and educational goals of the health information management (HIM) workforce in regard to pursuing doctoral-level degrees. Method: Survey data were collected from members of the American Health Information Management Association (AHIMA) to gain further insight into their interest in pursuing a doctoral degree, their reasons for obtaining such a degree, their methods of learning, and their financial support for an advanced degree. Descriptive characteristics were collected from AHIMA profile information. Results: A total of 13,020 surveys were electronically sent to selected AHIMA members, of which 1,453 were returned, for an 11 percent response rate. Of the 651 respondents who indicated that they were interested in obtaining a doctoral-level degree, close to half would like to start their doctoral-level study in the next one to five years. Discussion: This research points to recommendations for efforts to increase student funding opportunities, to increase the number of accredited HIM schools/programs, to create opportunities for doctoral-level study in HIM, to offer options for blended online learning, and to increase the number of doctorally prepared and qualified HIM faculty.

Designing programmes of assessment: A participatory approach.

Programmatic approaches to assessment provide purposeful and meaningful assessment yet few examples of their development exist. The aim of this study was to describe the development of a programme of assessment using a participatory action research (PAR) approach. Nine work-based assessors together with three academics met on six occasions to explore the current approach to competency-based assessment in the placement component of a dietetics university course, the findings of which were used to design a programme of assessment. Findings revealed disconnect between current assessment approaches and best practice. The PAR methodology fostered a shared vision for the design of a programmatic approach to assessment and strong leadership was essential. Participants experienced a philosophical shift in their views towards assessment, supporting the implementation of a new assessment programme. This paper is the first to describe a PAR approach as a feasible and effective way forward in the design of programmatic assessment. The approach engaged stakeholders to strengthen their abilities as work-based assessors and produced champions for best practice assessment.

Broadening measures of success: results of a behavioral health translational research training program.

BACKGROUND: While some research training programs have considered the importance of mentoring in inspiring professionals to engage in translational research, most evaluations emphasize outcomes specific to academic productivity as primary measures of training program success. The impact of such training or mentoring programs on stakeholders and local community organizations engaged in translational research efforts has received little attention. The purpose of this evaluation is to explore outcomes other than traditional academic productivity in a translational research graduate certificate program designed to pair graduate students and behavioral health professionals in collaborative service-learning projects. METHODS: Semi-structured qualitative interviews with scholars, community mentors, and academic mentors were conducted regarding a translational research program to identify programmatic impacts. Interviews were transcribed and coded by the research team to identify salient themes related to programmatic outcomes. RESULTS: Results are framed using the Translational Research Impact Scale which is organized into three overarching domains of potential impact: (1) research-related impacts, (2) translational impacts, and (3) societal impacts. This evaluation demonstrates the program's impact in all three domains of the TRIS evaluation framework. Graduate certificate participants (scholars) reported that gaining experience in applied behavioral health settings added useful skills and expertise to their present careers and increased their interest in pursuing translational research. Scholars also described benefits resulting from networks gained through participation in the program, including valuable ties between the university and community behavioral health organizations. CONCLUSIONS: This evaluation of the outcomes of a graduate certificate program providing training in translational research highlights the need for more community-oriented and practice-based measures of success. Encouraging practitioner involvement in translational research is vital to translate knowledge into practice and to enable practice-based needs to inform research and policy. A more flexible approach to measuring programmatic success in research training programs can help bridge the knowledge translation gap.

Integrated approaches to physical Therapy education: a new comprehensive model from the University of Illinois Chicago.

Demand for physical therapists in the United States (U.S.) is currently robust and expected to grow further. There are currently 228 physical therapy programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE), and 30 more are in development in the U.S.; 29,246 students are currently enrolled in these programs (2014-2015 data). A shortage of physical therapy faculty with an advanced doctoral degree (i.e., PhD, EdD, DSc) is a primary concern for these programs. Specialized residency and fellowship training in physical therapy continue to expand, preparing professionals to deliver advanced clinical care. The American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) reports that there are currently 179 accredited residency programs and 35 accredited fellowship programs in the U.S. A number of academic physical therapy programs also currently operate a clinical faculty practice. Currently, these aspects and trends in physical therapy education, advanced training, and clinical practice, for the most part, lack synergy and connectivity, in both planning and implementation amongst the various components. This professional theoretical article describes a novel model for academic physical therapy, with potential transformative implications for entry-level physical therapy education, advanced clinical training, and academic preparation.

Higher education in gerontology: A comparison of master's programs in Japan, Taiwan, and Turkey.

As of 2015, there is only one master's program of gerontology acknowledged by each of the following countries: Japan, Taiwan, and Turkey. All three programs have fewer than 15 years of history. These three countries differ in society types based on the proportion of older adults, rate of population aging, and population size. However, in terms of gerontological education, they seem to share great commonalities. Common challenges are a lack of awareness of the field of gerontology, insufficient numbers of gerontology programs and faculty members to produce trained gerontologists within society, and the inadequacy of opportunities for trained gerontologists to play an active role in various fields. This study intends not only to compare the differences and similarities among three countries and programs, but also to elucidate characteristics of a unique gerontology program in each country and identify challenges and possibilities from the perspective of gerontological educators.

Applied Grant Writing Training for Future Health Communication Researchers: The Health Communication Scholars Program.

Health communication faculty face increasing expectations regarding their academic productivity, including the expectation to seek and secure external funding. Doctoral training in health communication that does not fully prepare students for the challenges of securing external funding is doing them a disservice that will make them less competitive for academic positions and less likely to succeed in the academic positions they assume. The purpose of this study is to share the evaluation of a program, the Health Communication Scholars Program (HCSP), designed to train future health communication researchers in the pursuit of external funding. The HCSP includes a grant-writing workshop, requires interdisciplinary graduate student teams to submit applications, and awards funding to top proposals. HCSP participants responding to an evaluation survey (N = 25) had overwhelmingly positive experiences; respondents felt the program provided great value, improved their writing skills, gave them skills to pursue funding in the future, and helped them secure tenure-track faculty positions. The results of this formal evaluation suggest the HCSP is an experience that builds crucial skills and prepares graduate students for the demands they will face as faculty. It is a relatively low-cost, replicable model that merits consideration and adoption at other institutions that hope to provide professional development for doctoral students interested in health communication.

Building the capacity to solve complex health challenges in sub-Saharan Africa: CARTA's multidisciplinary PhD training.

OBJECTIVES: To develop a curriculum (Joint Advanced Seminars [JASs]) that produced PhD fellows who understood that health is an outcome of multiple determinants within complex environments and that approaches from a range of disciplines is required to address health and development within the Consortium for Advanced Research Training in Africa (CARTA). We sought to attract PhD fellows, supervisors and teaching faculty from a range of disciplines into the program. METHODS: Multidisciplinary teams developed the JAS curriculum. CARTA PhD fellowships were open to academics in consortium member institutions, irrespective of primary discipline, interested in doing a PhD in public and population health. Supervisors and JAS faculty were recruited from CARTA institutions. We use routine JAS evaluation data (closed and open-ended questions) collected from PhD fellows at every JAS, a survey of one CARTA cohort, and an external evaluation of CARTA to assess the impact of the JAS curriculum on learning. RESULTS: We describe our pedagogic approach, arguing its centrality to an appreciation of multiple disciplines, and illustrate how it promotes working in multidisciplinary ways. CARTA has attracted PhD fellows, supervisors and JAS teaching faculty from across a range of disciplines. Evaluations indicate PhD fellows have a greater appreciation of how disciplines other than their own are important to understanding health and its determinants and an appreciation and capacity to employ mixed methods research. CONCLUSIONS: In the short term, we have been effective in promoting an understanding of multidisciplinarity, resulting in fellows using methods from beyond their discipline of origin. This curriculum has international application.

Recruitment and retention of Native American graduate students in school psychology.

There is a clear underrepresentation of Native Americans in the field of school psychology. There are a number of factors that have led to this underrepresentation, including cultural and historical variables, barriers to accessing higher educational opportunities, and lack of financial support. Given the importance of having diverse perspectives in the field, as well as the need for mental health services and academic supports for Native American children and their families, school psychology trainers should consider actively recruiting and retaining Native American graduate students to doctoral and specialist programs. This article provides specific research-based recommendations for recruiting Native American students and strategies for supporting their success and matriculation in the program. (PsycINFO Database Record

Promoting diversity through program websites: A multicultural content analysis of school psychology program websites.

The recruitment of culturally and linguistically diverse students to graduate programs is critical to the overall growth and development of school psychology as a field. Program websites serve as an effective recruitment tool for attracting prospective students, yet there is limited research on how school psychology programs use their websites to recruit diverse students. The purpose of this study was to evaluate whether school psychology program websites include sufficient levels of diversity-related content critical for attracting diverse applicants. The website content of 250 professional psychology programs (165 school psychology training programs and 85 clinical and counseling psychology programs) were examined for the presence of themes of diversity and multiculturalism that prospective racially/ethnically and linguistically diverse students deem important for selecting a graduate program. Results indicated that school psychology programs had less diversity-related content on their program's website relative to clinical and counseling psychology programs.' Implications for improving recruitment of racially/ethnically and linguistically diverse students through websites are discussed. (PsycINFO Database Record