Linking cognitive flexibility to entrepreneurial alertness and entrepreneurial intention among medical students with the moderating role of entrepreneurial self-efficacy: A second-order moderated mediation model.

This study extended the research on the association between cognitive flexibility and entrepreneurial intention by developing a moderated mediation model. This research examined whether entrepreneurial alertness mediates this association. This study also investigated whether entrepreneurial self-efficacy moderates this mediation model by conducting a moderated mediation model. The sample of this study comprised 486 medical university students of Pakistan. Data gathered using a self-report administered questionnaire and hypotheses were tested with SEM structural equation modeling technique through AMOS user-defined estimates and developed a syntax based on Hayes model 15 of process macro. The results revealed that cognitive flexibility is positively related to entrepreneurial alertness and entrepreneurial intentions. Furthermore, findings showed that the indirect relationship of entrepreneurial alertness via entrepreneurial self-efficacy on cognitive flexibility and the entrepreneurial intention was also significant. This study contributes to the emerging research on psychology and entrepreneurship as well as concludes that individuals with a high level of cognitive flexibility, entrepreneurial alertness, and entrepreneurial self-efficacy are more inclined to pursue a career in entrepreneurship.

An Individual Development Plan for Pharmacy Students for Career Planning and Tracking Accreditation Standards.

Objective. To create and implement individual development plans (IDPs) to assist pharmacy students in career planning and tracking their achievement of ACPE Standards 2016, Standard 4, for Personal and Professional Development. Methods. First-year Doctor of Pharmacy students completed IDPs, which were subsequently reviewed to ensure they addressed components of the ACPE Standard 4 key elements: self-awareness, leadership, innovation and entrepreneurship, and professionalism. Faculty advisors were surveyed regarding the utility of IDPs. Descriptive statistics were used to evaluate the results. Results. Self-awareness (100%) and professionalism (100%) were the key elements most commonly documented by pharmacy students, followed by leadership (51%), and innovation and entrepreneurship (22%). Faculty advisors reported IDPs as beneficial for stimulating individualized career planning and tracking achievement of ACPE Standard 4. Conclusion. Most students enter pharmacy school recognizing the importance of self-awareness and professionalism, but require additional training to instill leadership and innovation/entrepreneurship skills. Individual development plans can be implemented in pharmacy education as a cornerstone of personal and professional development planning, as well as a means of tracking a school's progress toward meeting accreditation standards.

Moral entrepreneurship, the power-knowledge nexus, and the Cochrane "crisis".

BACKGROUND: In 2018, a so-called crisis developed in the international network of systematic reviewers known as Cochrane. It was widely depicted in terms of two competing narratives-"bad behaviour" by one member of Cochrane's Governing Board and scientific and moral decline within Cochrane. OBJECTIVE: Our goal was to distil insights on the structural issues underpinning the crisis, without taking a definitive position on the accuracy of either narrative. APPROACH AND DATASET: In this paper, we draw on (among other theories) Becker's notion of moral entrepreneurship and Foucault's conceptualisation of power to analyse the claims and counterclaims made by different parties. Our dataset consisted of publicly available materials (blogs, journal articles, newspaper articles) to end 2018, notably those relating to the expulsion of one Governing Board member. MAIN FINDINGS: Both narratives include strong moral claims about the science of systematic review and the governance of scientific organizations. The expelled individual and his supporters defined good systematic reviews in terms of a particular kind of methodological rigour and elimination of bias, and good governance largely in terms of measures to achieve independence from industry influence. Most of Cochrane's Governing Board and their sympathizers evaluated systematic reviews according to a broader range of criteria, incorporating factors such as attention to relationships among reviewers and reflexivity and dialogue around scientific and other judgements. They viewed governance partly in terms of accountability to an external advisory group. Power-knowledge alignments in Cochrane have emerged from, and contributed to, a particular system of meaning which is now undergoing evolution and challenge. CONCLUSION: Polarizing Cochrane's "crisis" into two narratives, only one of which is true, is less fruitful than viewing it in terms of a duality consisting of tensions between the two positions, each of which has some validity. Having framed the conflict as primarily philosophical and political rather than methodological and procedural, we suggest how Cochrane and its supporters and critics might harness their tensions productively.

Studying entrepreneurial occupations in the Terman women.

To achieve a better understanding of entrepreneurship development in women, longitudinal data on 672 individuals collected from 1922 to 1959 were analysed in a secondary investigation of the Terman Longitudinal Study. Women's reports on their occupations during 10 different years were assigned to one of two categories: work for pay (0/1), and work allowing for self-employment (0/1) in the respective year. Structural equation modelling supported earlier results concerning male entrepreneurial activity. Personality and aspects of the parenting context the women had experienced by the average age of 12 predicted early entrepreneurial competencies (inventions, leadership) and occupational interests by age 13, which related to an entrepreneurship-related career goal in 1936, when the participants were about 27 years of age on average. Such a career goal in turn predicted a higher number of occasions of entrepreneurship-prone work. Surprisingly, we also found a relationship to divorce. Women who had experienced the failure of a marriage were in occupations with a potential for entrepreneurship more often. Reasons are discussed against a backdrop of historical timing and current findings to identify general aspects of entrepreneurship development.

Pharmapreneur - Defining a Framework for Entrepreneurship in Pharmacy Education.

Objective. To determine the role of entrepreneurism within the broader missions of schools of pharmacy and develop an educational framework to produce pharmacist entrepreneurs. Methods. Following a systematic review and six semi-structured interviews, a three-round Delphi process was conducted with an expert panel comprised of successful entrepreneurs, pharmacy faculty members and administrators, students, and community members. Participants were asked about the role of entrepreneurship in a pharmacy school's mission, how they would define a pharmacist entrepreneur, and to identify the knowledge, skills, and attitudes (KSAs) expected to be successful as a pharmacist entrepreneur. A model for entrepreneur education was also developed in accordance with Bloom's taxonomy. Participant agreement and rankings were reported. Results. Based on the semi-structured interviews and the results from the Delphi process, the following framework for a pharmacist entrepreneur was proposed along with a list of KSAs: identifies, creates, and pursues new opportunities; successfully implements new ideas into practice; is willing to take risks; fills unmet needs; creates new value through innovation; is responsive to change; makes sacrifices; includes social and intrapreneurship; leverages existing knowledge, skills, and resources; goes beyond traditional roles for pharmacists; and improves patient care. Recommendations for entrepreneurship instruction, guided by Bloom's taxonomy of cognitive processes, were created. Conclusion. According to our expert panel, a pharmacist entrepreneur combines several characteristics identified with a more traditional entrepreneur construct with the characteristics of an individual devoted to achieving outcomes beyond one's personal gain. Additional research to inform implementation and assessment of entrepreneurship within pharmacy curricula would provide more specific guidance for instructional design and accreditation evaluations.

Policy entrepreneurship and policy networks in healthcare systems - the case of Israel's pediatric dentistry reform.

BACKGROUND: Can the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel's dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel. We demonstrate how a policy entrepreneur navigated within a policy network and managed to promote a reform that, until his appearance, no one else in that network had succeeded in enacting. METHODS: Our goals are advanced through a case study of a reform in pediatric dentistry implemented in Israel in 2010. It rests on textual analyses of the literature, reports, committee minutes, parliamentary proceedings, print and online media, and updates in relevant legislation and case law between 2009 and 2015. In addition, the case study draws on the insights of one of the authors (TH), who played a role in the reform process. RESULTS: Historical circumstances and the Israeli public's longstanding lack of interest in changing the existing model as well as interest groups that preferred the dominance of the private sector in the dental healthcare system kept that area out of the services supplied, universally, under the National Health Insurance Law. This situation changed significantly following the publication in 2007 of a policy analysis that contributed to shifts in the motivations and balance of power within the policy network, which in turn prepared the ground for a policy change. In this environment a determined policy entrepreneur, who identified a window of opportunity, took the lead and instituted an innovative and far-reaching reform. CONCLUSIONS: A policy entrepreneur can leverage external factors as well as the previous activities of a policy network that has already matured to create a policy change. Such entrepreneurial activity includes maneuvering around opponents and overcoming resistance from various stakeholders.

Role of institutional entrepreneurship in building adaptive capacity in community-based healthcare organisations: realist review protocol.

INTRODUCTION: Over the past 3 decades, there has been a substantial shift to the marketisation of government-funded health services. For organisations traditionally buffered from the competitive pressures of for-profit enterprises, such as community-based organisations, this means developing the capacity to adapt to competitive tendering processes, shifting client expectations, and increasing demands for greater accountability. Drawing on ideas of institutional entrepreneurship, we believe that attempts to build adaptive capacity require the transformation of existing institutional arrangements. Key in this may be identifying and fostering institutional entrepreneurs--actors who take the lead in being the impetus for, and giving direction to, structural change. This study focuses on the strategies used by institutional entrepreneurs to build adaptive capacity in the community-based healthcare sector. METHODS AND ANALYSIS: The research will use an adapted rapid realist review. The review will find underlying theories that explain the circumstances surrounding the implementation of capacity-building strategies that shape organisational response and generate outcomes by activating causal mechanisms. An early scoping of the literature, and consultations with key stakeholders, will be undertaken to identify an initial programme theory. We will search for relevant journal articles and grey literature. Data will be extracted based on contextual factors, mechanisms and outcomes, and their configurations. The analysis will seek patterns and regularities in these configurations and will focus on confirming, refuting or refining our programme theory. ETHICS AND DISSEMINATION: The study does not involve primary research and, therefore, does not require formal ethical approval. However, ethical standards of utility, usefulness, feasibility, propriety, accuracy and accountability will be followed. The results will be written up according to the Realist and Meta-Review Evidence Synthesis: Evolving Standards guidelines. Once completed, findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: CRD42015026487.

Core competencies of the entrepreneurial leader in health care organizations.

The purpose of this article is to discuss core competencies that entrepreneurial health care leaders should acquire to ensure the survival and growth of US health care organizations. Three overlapping areas of core competencies are described: (1) health care system and environment competencies, (2) organization competencies, and (3) interpersonal competencies. This study offers insight into the relationship between leaders and entrepreneurship in health care organizations and establishes the foundation for more in-depth studies on leadership competencies in health care settings. The approach for identifying core competencies and designing a competency model is useful for practitioners in leadership positions in complex health care organizations, so that through the understanding and practice of these 3 areas of core competencies, they can enhance their entrepreneurial leadership skills to become more effective health care entrepreneurial leaders. This study can also be used as a tool by health care organizations to better understand leadership performance, and competencies can be used to further the organization's strategic vision and for individual improvement purposes.

An empirical analysis of health care IPOs and SEOs.

This article reviews the extant literature regarding the three new issues phenomena: hot issue markets, first-day underpricing, and poor long-run performance as they apply to the heath care industry. Given the "creeping corporatization" of the heath care industry and the unique influence of nonmarket forces on it, we examine whether the three IPO phenomena exist within the industry. We find that hot issue markets, initial underpricing, and negative long-run abnormal returns and sales growth occur among both heath care IPOs and SEOs. Of particular interest, we find that firms are able to issue during times of excess heath care spending and subsequently underperform the market, apparently exploiting windows of opportunity.

Medical entrepreneurism: the current opportunity in America.

This article discusses both the current climate for entrepreneurial activity in the fields of biotechnology, health care services, and medical devices as well as key ideas in the process of successful innovation. Basic issues related to the nature of new medical ventures and its importance in the U.S. economy are discussed. A stepwise overview of the process of innovation is provided, starting from the initial idea, through the early and middle stages of growth, and on to an initial public offering or other alternative harvest strategy. The roles of financing sources in generating health care entrepreneurial activity are explored, and the advantages and disadvantages of each are discussed. The article focuses on venture capital investment because of its pivotal role in high-profile successes; however, alternative forms of financing are also covered as appropriate to each stage. In addition, critical nonfinancial issues that affect the success of new enterprises, such as intellectual property protection and the creation of management teams for young companies, are also covered. The magnitude of current investment in the domestic biomedical field is addressed, and future prospects for American medical innovation are briefly discussed.

From patenting genes to proteins: the search for utility via function.

The debate regarding the patenting of genes has extended into the post-genome era. With only approximately 35000 genes deduced from the draft sequence of the human genome, there are fears that a few companies have already gained monopoly on the potential benefits from this knowledge. Nevertheless, it is accepted that proteins determine gene function and function is not readily predicted from gene sequence. Furthermore, genes can encode multiple proteins and a single protein can have multiple functions. Here, we argue that unraveling the intrinsic complexity of proteins and their functions is the key towards determining the utility requirement for patenting protein inventions and consider the possible socioeconomic impact.