Adaptive leadership during challenging times: Effective strategies for health professions educators: AMEE Guide No. 148.

Leadership and management are becoming increasingly recognised as vital for high-performing organisations and teams in health professions education. It is often difficult for those embarking on leadership activities (as well as more experienced leaders) to find their way through the volume of literature and generic information on the topic. This guide aims to provide a framework for developing educators' understanding of leadership, management, and followership in the context of health professions education. It explains many relevant approaches to leadership and suggests various strategies through which educators can develop their practice to become more effective.

Co-creating scholarship through collaborative writing in health professions education: AMEE Guide No. 143.

This AMEE guide provides a robust framework and practical strategies for health professions educators to enhance their writing skills and engage in successful scholarship within a collaborative writing team. Whether scholarly output involves peer-reviewed articles, book chapters, blogs and online posts, online educational resources, collaborative writing requires more than the usual core writing skills, it requires teamwork, leadership and followership, negotiation, and conflict resolution, mentoring and more. Whilst educators can attend workshops or courses to enhance their writing skills, there may be fewer opportunities to join a community of scholars and engage in successful collaborative writing. There is very little guidance on how to find, join, position oneself and contribute to a writing group. Once individuals join a group, further questions arise as to how to contribute, when and whom to ask for help, whether their contribution is significant, and how to move from the periphery to the centre of the group. The most important question of all is how to translate disparate ideas into a shared key message and articulate it clearly. In this guide, we describe the value of working within a collaborative writing group; reflect on principles that anchor the concept of writing as a team and guide team behaviours; suggest explicit strategies to overcome challenges and promote successful writing that contributes to and advances the field; and review challenges to starting, maintaining, and completing writing tasks. We approach writing through three lenses: that of the individual writer, the writing team, and the scholarly product, the ultimate goal being meaningful contributions to the field of Health Professions Education.

Workplace programmes for supporting breast-feeding: a systematic review and meta-analysis.

OBJECTIVE: To critically review the literature regarding workplace breast-feeding interventions and to assess their impact on breast-feeding indicators. DESIGN: A systematic review and meta-analysis was conducted. Electronic searches for workplace intervention studies to support breast-feeding, without restriction on language or study design, were performed in PubMed, CENTRAL, CINAHL, Embase, Web of Science, Business Source Complete, ProQuest-Sociology and ProQuest-Social Science to 13 April 2020. A meta-analysis of the pooled effect of the programmes on breast-feeding indicators was conducted. RESULTS: The search identified 10 215 articles; fourteen studies across eighteen publications met eligibility criteria. Programmes were delivered in the USA (n 10), Turkey (n 2), Thailand (n 1) or Taiwan (n 1). There were no randomised controlled trials. The pooled OR for exclusive breast-feeding at 3 or 6 months for participants v. non-participants of three non-randomised controlled studies was 3·21 (95 % CI 1·70, 6·06, I2 = 22 %). Despite high heterogeneity, other pooled outcomes were consistently in a positive direction with acceptable CI. Pooled mean duration of breast-feeding for five single-arm studies was 9·16 months (95 % CI 8·25, 10·07). Pooled proportion of breast-feeding at 6 months for six single-arm studies was 0·76 (95 % CI 0·66, 0·84) and breast-feeding at 12 months for three single-arm studies was 0·41 (95 % CI 0·22, 0·62). Most programmes were targeted at mothers; two were targeted at expectant fathers. CONCLUSIONS: Workplace programmes may be effective in promoting breast-feeding among employed mothers and partners of employed fathers. However, no randomised controlled trials were identified, and better-quality research on workplace interventions to improve breast-feeding is needed.

Physiotherapy students' DiSC behaviour styles can be used to predict the likelihood of success in clinical placements.

BACKGROUND: Behaviour can be defined as the internally coordinated responses (actions or inactions) of whole living organisms (individuals or groups) to internal and/or external stimuli, excluding responses more easily understood as developmental changes. Unlike personality traits, that are thought to be biologically consistent, behaviour, through the application of cognition and reasoning is open to change across time and circumstance, although most humans will display preferred ways of behaving. The objective of this study was to: i) identify the behaviour styles of physiotherapy students and investigate if there is a relationship (predictive or otherwise) between students' unique behaviour patterns and their clinical placement grades and; ii) examine if this relationship differs when student's in a Master's level program as well as student's in a Bachelor's level program are explored separately. METHODS: This cross-sectional study with 132 (F = 78, M = 54) physiotherapy students was conducted across two Australian university settings. Measures included Everything DiSC Workplace profile, Assessment of Physiotherapy Practice (APP). RESULTS: Physiotherapy students (n = 133) profiled the following ways: Dominance (D) style n = 20 (15%), Influence (i) style n = 33 (25%), Steadiness (S) style n = 36 (27%) and Conscientiousness (C) n = 44 (33%). Students with the individual DiSC styles of i and Conscientiousness / Steadiness (CS) were in the lowest APP quartile for clinical grades and the D style was in the highest quartile. Binary logistic regressions revealed students with an i DiSC style had 3.96 times higher odds, and students with a CS DiSC style had 4.34 times higher odds, of failing a clinical placement. When explored independently, the same trend remained for Master's level students. Bachelor's level students with DiSC styles of S and C had failed placements, however these styles were not significantly associated with failure (DiSC S Style: Exp(B) 1.667, p = 0.713 (CI: 0.109 to 25.433), DiSC C Style: Exp(B) 11.00, p = 0.097 (CI: 0.646 to 187.166)). CONCLUSION: Physiotherapy students with DiSC styles i and CS appear to be more likely to fail physiotherapy clinical placements. Further research with larger undergraduate samples is required to establish if relations differ for undergraduate versus postgraduate students.

Medical student wellbeing - a consensus statement from Australia and New Zealand.

BACKGROUND: Medical student wellbeing - a consensus statement from Australia and New Zealand outlines recommendations for optimising medical student wellbeing within medical schools in our region. Worldwide, medical schools have responsibilities to respond to concerns about student psychological, social and physical wellbeing, but guidance for medical schools is limited. To address this gap, this statement clarifies key concepts and issues related to wellbeing and provides recommendations for educational program design to promote both learning and student wellbeing. The recommendations focus on student selection; learning, teaching and assessment; learning environment; and staff development. Examples of educational initiatives from the evidence-base are provided, emphasising proactive and preventive approaches to student wellbeing. MAIN RECOMMENDATIONS: The consensus statement provides specific recommendations for medical schools to consider at all stages of program design and implementation. These are: Design curricula that promote peer support and progressive levels of challenge to students. Employ strategies to promote positive outcomes from stress and to help others in need. Design assessment tasks to foster wellbeing as well as learning. Provide mental health promotion and suicide prevention initiatives. Provide physical health promotion initiatives. Ensure safe and health-promoting cultures for learning in on-campus and clinical settings. Train staff on student wellbeing and how to manage wellbeing concerns. CONCLUSION: A broad integrated approach to improving student wellbeing within medical school programs is recommended. Medical schools should work cooperatively with student and trainee groups, and partner with clinical services and other training bodies to foster safe practices and cultures. Initiatives should aim to assist students to develop adaptive responses to stressful situations so that graduates are prepared for the realities of the workplace. Multi-institutional, longitudinal collaborative research in Australia and New Zealand is needed to close critical gaps in the evidence needed by medical schools in our region.

Internal evaluation of medical programs is more than housework: A scoping review.

PURPOSE: The aim of this scoping review was to explore current program evaluation practices across various medical schools. METHODS: We conducted searches in MEDLINE (Ovid), Embase (Elsevier) and ERIC (ed.gov) for original research and review articles related to medical education evaluation with key words evaluation, program, medical education, pre-registration, framework, curriculum, outcomes, evaluation, quality. We followed Arksey and O'Malley's (2005) process for scoping reviews. RESULTS: Thirty-two articles were included. Studies were primarily concerned with either proving (n = 21) or improving efficacy of their programs (n = 11). No studies aimed at comparing programs. Nine were literature reviews. Others aimed to develop a new evaluation model (n = 7) or apply (n = 12) or validate (n = 4) an existing model (or part thereof). Twenty-two studies explicitly identified an evaluation model they had used or would recommend. Most frequently used models for evaluation were: Context-Input-Process-Product, Kirkpatrick, World Federation Medical Education, and the Standards by Joint Committee on Standards for Educational Evaluation. Overall, evaluations were learner-focused and accreditation driven with a minority considering the broader influences of program success. CONCLUSION: Program evaluation is fundamental to driving the quality of education delivered to produce workforce-ready healthcare professionals. The focus of current evaluations is on student experience and content delivery with a significant gap in the existing literature on evaluation related to staff, learner/staff well-being, equity, diversity, and meta evaluation.

Health Professions' Educators' Adaptation to Rapidly Changing Circumstances: The Ottawa 2020 Conference Experience.

This article was migrated. The article was marked as recommended. Most health professions' educators (HPEs) are used to responding to change, whether these are longer term organisational changes or short term crises, e.g. staff or student sickness or technical systems' failures. Most of these changes, whilst they can be frustrating, typically have fairly straightforward and routine solutions. Other wider, environmental changes are also starting to affect educators, learners and the complex education and healthcare systems in which they operate, and these will have great impact in the relatively near future. However, it is the current crisis stemming from the global transmission of the coronavirus COVID-19 which has most recently impacted on HPE on a global scale. Whilst many of us are very used to working virtually and using social media and other activities to work collaboratively, we still tend to rely on regular meetings with friends and colleagues (old and new) around the world at conferences and meetings. Similarly, most universities rely primarily on face to face teaching to provide their programmes, particularly in the early years. The COVID-19 pandemic has put all that into sharp relief, and many of us are having to make quick and sometimes reactive adaptations to our best-laid plans. In this article, we discuss some of our experiences from the recent Ottawa 2020 conference held in Kuala Lumpur from 1-5 March 2020, identifying some of the lessons learned that educators around the world will need to keep in mind as we move into what is currently unchartered territory. The learning lessons from our experience are that safety is paramount, communication and transparency is key; flexibility is needed from all stakeholders; technologies can help, but be realistic; acknowledge the need for psychological adaptation to change and crisis and tap into the wisdom and collegiality of the community. This paper specifically refers to Covid-19 but the learning lessons are applicable to other major challenges and the ideas described transferable to other situations.