Enhancing Digital Health Awareness and mHealth Competencies in Medical Education: Proof-of-Concept Study and Summative Process Evaluation of a Quality Improvement Project.

BACKGROUND: Currently, there is a need to optimize knowledge on digital transformation in mental health care, including digital therapeutics (eg, prescription apps), in medical education. However, in Germany, digital health has not yet been systematically integrated into medical curricula and is taught in a relatively small number of electives. Challenges for lecturers include the dynamic field as well as lacking guidance on how to efficiently apply innovative teaching formats for these new digital competencies. Quality improvement projects provide options to pilot-test novel educational offerings, as little is known about the acceptability of participatory approaches in conventional medical education. OBJECTIVE: This quality improvement project addressed the gap in medical school electives on digital health literacy by introducing and evaluating an elective scoping study on the systematic development of different health app concepts designed by students to cultivate essential skills for future health care professionals (ie, mobile health [mHealth] competencies). METHODS: This proof-of-concept study describes the development, optimization, implementation, and evaluation of a web-based elective on digital (mental) health competencies in medical education. Implemented as part of a quality improvement project, the elective aimed to guide medical students in developing app concepts applying a design thinking approach at a German medical school from January 2021 to January 2024. Topics included defining digital (mental) health, quality criteria for health apps, user perspective, persuasive design, and critical reflection on digitization in medical practice. The elective was offered 6 times within 36 months, with continuous evaluation and iterative optimization using both process and outcome measures, such as web-based questionnaires. We present examples of app concepts designed by students and summarize the quantitative and qualitative evaluation results. RESULTS: In total, 60 students completed the elective and developed 25 health app concepts, most commonly targeting stress management and depression. In addition, disease management and prevention apps were designed for various somatic conditions such as diabetes and chronic pain. The results indicated high overall satisfaction across the 6 courses according to the evaluation questionnaire, with lower scores indicating higher satisfaction on a scale ranging from 1 to 6 (mean 1.70, SD 0.68). Students particularly valued the content, flexibility, support, and structure. While improvements in group work, submissions, and information transfer were suggested, the results underscore the usefulness of the web-based elective. CONCLUSIONS: This quality improvement project provides insights into relevant features for the successful user-centered and creative integration of mHealth competencies into medical education. Key factors for the satisfaction of students involved the participatory mindset, focus on competencies, discussions with app providers, and flexibility. Future efforts should define important learning objectives for digital health literacy and provide recommendations for integration rather than debating the need for digital health integration.

Competencies for Training Juvenile Services on Justice-Involved Youth with Traumatic Brain Injury.

Research indicates young individuals with traumatic brain injuries (TBI) in juvenile justice settings lack essential support, mainly due to staff members' insufficient knowledge and skills in TBI-related areas stemming from a lack of relevant professional development. This study aimed to improve services for justice-involved youths with TBI in juvenile correction facilities by establishing empirically validated core competencies tailored to their needs. Through a Delphi study involving experts in juvenile services, juvenile corrections, TBI, transition services, and professional development, we identified and refined a set of 44 competencies distributed across six domains: knowledge (12 competencies), screening (6 competencies), eligibility (3 competencies), assessment (4 competencies), intervention (10 competencies), and community reentry (9 competencies).

Developing Interdisciplinary Competency in Voice Performance: A Phenomenological Study of Higher Education in China.

This phenomenological study investigates the experiences and perceptions of interdisciplinary competencies for voice performance in higher education in China through semistructured interviews with four vocal education experts. Participants were selected via selective sampling based on their teaching experience, theoretical research, location, and professional development contributions. Coding and thematic analyses identify key interdisciplinary domains crucial for voice performers. Physiological and anatomical principles, informed by life sciences, are fundamental for vocal health and technique. Incorporating historical and cultural knowledge enriches performers' interpretive depth and emotional expression. Digital technologies further modernize vocal training and prepare students for contemporary performance environments. The findings illuminate that Chinese interdisciplinary competency in vocal performance has unique characteristics, emphasizing cultural literacy and the fusion of Italian bel canto with Chinese Indigenous vocalization methods, but it has its limitations. This study contributes to the global discourse on higher education voice performance studies by presenting the lived experiences of Chinese voice professors in higher education, which can inspire and inform educational initiatives worldwide.

Impact of Health Informatics Analyst Education on Job Role, Career Transition, and Skill Development: Survey Study.

Background: Professionals with expertise in health informatics play a crucial role in the digital health sector. Despite efforts to train experts in this field, the specific impact of such training, especially for individuals from diverse academic backgrounds, remains undetermined. Objective: This study therefore aims to evaluate the effectiveness of an intensive health informatics training program on graduates with respect to their job roles, transitions, and competencies and to provide insights for curriculum design and future research. Methods: A survey was conducted among 206 students who completed the Advanced Health Informatics Analyst program between 2018 and 2022. The questionnaire comprised four categories: (1) general information about the respondent, (2) changes before and after program completion, (3) the impact of the program on professional practice, and (4) continuing education requirements. Results: The study received 161 (78.2%) responses from the 206 students. Graduates of the program had diverse academic backgrounds and consequently undertook various informatics tasks after their training. Most graduates (117/161, 72.7%) are now involved in tasks such as data preprocessing, visualizing results for better understanding, and report writing for data processing and analysis. Program participation significantly improved job performance (P=.03), especially for those with a master's degree or higher (odds ratio 2.74, 95% CI 1.08-6.95) and those from regions other than Seoul or Gyeonggi-do (odds ratio 10.95, 95% CI 1.08-6.95). A substantial number of respondents indicated that the training had a substantial influence on their career transitions, primarily by providing a better understanding of job roles and generating intrinsic interest in the field. Conclusions: The integrated practical education program was effective in addressing the diverse needs of trainees from various fields, enhancing their capabilities, and preparing them for the evolving industry demands. This study emphasizes the value of providing specialized training in health informatics for graduates regardless of their discipline.

Characteristics of nursing educators' professional competency standards: A scoping review.

AIM: To map the characteristics of nursing educators' competency standards for practice from the existing literature, examine the evidence and identify commonalities and differences. BACKGROUND: Many countries or regions have produced nursing educator standards, however, there is no common set of standards or competencies used globally. Mapping these nursing educator standards should identify a common set of standards that can be applied across any nursing educator practice setting. DESIGN: The review was conducted using the JBI methodology for scoping reviews and followed an a priori protocol. METHODS: A comprehensive search of studies or guidelines (2001-2022) was undertaken to identify specific nursing educator competencies from any practice setting and in any language. Preceptorship and mentorship studies were excluded from the search terms. Databases searched for relevant records and guidelines were CINAHL, ERIC, Medline (Ovid), Pubmed, Scopus, Google and targeted websites. After screening and selection, relevant data were extracted and summarized using an extraction guide. Characteristics of the reports were identified and all three levels of competency statements were mapped against commonly occurring categories derived from the data. RESULTS: 1145 evidence records were screened after removal of duplicates with 14 records included in the review. The included evidence sources were from various nursing educator practice settings and educator roles. All evidence sources had at least two levels of competency statements and 16 competency categories were identified. Common categories in the first two competency levels were: leadership and management; research and scholarship; professional values and professional development; and facilitating learning. Statements related to learner evaluation were also common in the level 2 competencies. Level 3 competencies were included in seven evidence sources and most of the sources included almost all categories. Low-occurring statements at all levels were in the 'Nursing skills' and 'Decision-making/strategic planning" categories. CONCLUSIONS: Common characteristics and categories were found between different evidence sources in this review. The most common competency review categories included leadership and management, professional development and facilitating learning. Few decision-making competencies were identified from the evidence sources. These results can inform educators and managers in developing globally-based nursing educator competencies, performance management tools and job descriptions.

Twenty-five years of Medical Library Association competencies and communities.

Professional associations provide resources to support members' career development and facilitate ways for members to engage with and learn from one another. This article describes Medical Library Association (MLA) activities related to the revision of professional competencies and the restructuring of the organization's communities during the past twenty-five years. Grounded in MLA's Platform for Change, the MLA competency statement underwent two revisions with core themes remaining consistent. Major efforts went into rethinking the structure of MLA communities, and it became a strategic goal of the association. Numerous groups spent considerable time guiding the changes in MLA's community structure. Sections and special interest groups were transformed into caucuses. Domain hubs were established to facilitate project coordination across caucuses and create more leadership opportunities for MLA members, but their implementation did not meet expectations. Member engagement and leadership are ongoing challenges for MLA. The next twenty-five years will undoubtedly see additional revisions to the competencies and continued iterations of the community structure.

ASPEN international survey on ethical competencies dealing with decision-making in the use of artificially administered nutrition and hydration and competency application in clinical practice.

BACKGROUND: Ethical competencies dealing with decision-making for clinicians involved in artificially administered nutrition and hydration (AANH) have not been defined in the literature. Although clinical assessments identify nutrition needs and appropriate routes of nutrition administration, an assessment of the ethical, cultural, and spiritual implications of the medical nutrition therapy may be overlooked. METHODS: Eleven competency statements were developed by members of two international sections of the American Society for Parenteral and Enteral Nutrition. This descriptive cross-sectional survey study was conducted to measure the importance of the competency statements to the membership of two sections using a five-point Likert scale of 1-5 (1-low to 5-high). RESULTS: A total of 113 responses (12.5% response rate) were obtained predominantly from physicians and dietitians from 25 countries. There was a wide range of world regions of the 49% respondents outside of the United States. Means and SDs were calculated for agreement with the 11 competency statements with overall means ranging from 4.32 to 4.67. Most of the participants cared for adult/older adult patients (63.7%) exclusively, and 12.4% cared for pediatric/neonate patients exclusively; the remainder (23.9%) cared for both populations. Respondents reported they were either experienced, competent, or expert (88.6%) in dealing with ethical issues related to AANH. CONCLUSION: This international interdisciplinary group agreed that the integration of ethical, cultural, and spiritual competencies into clinical decision-making regarding artificially AANH is important.

A landscape analysis of digital health technology in medical schools: preparing students for the future of health care.

Although Digital Health Technology is increasingly implemented in hospitals and clinics, physicians are not sufficiently equipped with the competencies needed to optimize technology utilization. Medical schools seem to be the most appropriate channel to better prepare future physicians for this development. The purpose of this research study is to investigate the extent to which top-ranked medical schools equip future physicians with the competencies necessary for them to leverage Digital Health Technology in the provision of care. This research work relied on a descriptive landscape analysis, and was composed of two phases: Phase I aimed at investigating the articulation of the direction of the selected universities and medical schools to identify any expressed inclination towards teaching innovation or Digital Health Technology. In phase II, medical schools' websites were analyzed to discover how innovation and Digital Health Technology are integrated in their curricula. Among the 60 medical schools that were analyzed, none mentioned any type of Digital Health Technology in their mission statements (that of the universities, in general, and medical schools, specifically). When investigating the medical schools' curricula to determine how universities nurture their learners in relation to Digital Health Technology, four universities covering different Digital Health Technology areas were identified. The results of the current study shed light on the untapped potential of working towards better equipping medical students with competencies that will enable them to leverage Digital Health Technology in their future practice and in turn enhance the quality of care.

Development and validation of the Telehealth Etiquette Competency Checklist: A Delphi study.

BACKGROUND: Providing telehealth care requires unique professionalism skills (i.e. telehealth etiquette) to ensure patients have a positive experience. Given the effect of patient-provider relationships on healthcare outcomes and the limited evidence for healthcare professionals to learn and practice these skills, developing a telehealth etiquette competency tool is necessary. METHODS: This multiround Delphi study utilized subject matter experts' opinions to validate a telehealth etiquette competency checklist, using Lawshe's content validity measurements. Panelists were diverse in professional backgrounds, years of experience, telehealth teaching, clinical experience, and involvement in telehealth professional society and governmental policy making. RESULTS: Consensus and validation were achieved on the checklist by the 17 panelists in Round 1 for 19 of 20 competencies. Following revisions based on their expert opinions, consensus was achieved by all 16 panelists in Round 2 for 20 competencies. DISCUSSION: The Telehealth Etiquette Competency Checklist (TECC) provides a validated telehealth etiquette tool that can be used by health professionals to improve their telehealth videoconsultations, thus enhancing patient satisfaction.

Delineation of core roles of oncology social workers in inpatient settings: a secondary data analysis.

There is limited literature on the roles and tasks conducted by oncology social workers (OSW) who work with cancer patients in inpatient units. The purpose of this study was to delineate the roles reported to be significant to practice among OSWs who practice in inpatient settings and to identify the domains into which these roles fall. The data used in this secondary data analysis were collected in a large national study of OSWs to delineate the roles and tasks across all cancer settings. The sample extracted for this study were 240 OSWs who endorsed providing direct care to cancer patients in inpatient settings. Exploratory factor analysis revealed eight factors made up of 34 tasks. The roles were aligned with three of the four service areas in the Association of Oncology Social Scope of Practice and seven of the nine competencies set forth by the Council of Social Work Education. The findings can be used to enhance communications about the roles of inpatient OSWs across OSW constituencies, increase awareness of the role supervision and consultation to ensure equitable and just practice, enhance social work coursework to prepare students to work in healthcare inpatient settings, and in future research.

Clinical decision making in the assessment and treatment of closed hand fractures: A scoping review.

Introduction: Closed hand fractures represent a significant proportion of emergency department attendances, result in substantial health service utilisation and have a detrimental effect on quality of life. Increasingly, hand therapists in the United Kingdom provide first line fracture treatment. However, the knowledge and skills required to work in such an extended scope capacity have not been elucidated or standardised. This literature review synthesises and reports evidence for the knowledge requisite of clinicians to make evidence-based treatment decisions for patients with hand fractures. Methods: A systematic search was undertaken, using Embase, MEDLINE, PsychInfo and CINAHL electronic databases. Inclusion criteria were English language, full research reports of studies assessing of the reliability or validity of the decision-making process in hand fracture treatment published between 2013 and 2023. Data were summarised narratively. Results: 15 studies met inclusion criteria; most assessed decision making for metacarpal fractures. Studies on imaging (n = 4) suggested the reliability of plain radiograph interpretation of hand fracture characteristics such as angulation is good and similar across various levels of experience. Agreement between surgeons and therapists in choosing surgical or nonsurgical treatment was generally good, but factors influencing decision making remained unclear. No evidence was identified that explored clinical assessment knowledge (subjective or objective patient factors) or the specific competencies required to treat hand fractures. Conclusions: There is limited evidence for the knowledge and skills required of clinicians for the competent assessment and treatment of hand fractures. Stakeholder consensus work is required to develop robust competencies and standardise practice.

Essential competencies for healthcare chaplains: insights from hiring managers and implications for chaplaincy education.

This first-of-its-kind study explored the essential competencies healthcare chaplaincy hiring managers (HCHMs) sought for entry-level healthcare chaplains (HCCs). We conducted qualitative interviews with 16 HCHMs and using reflexive thematic analysis (RTA), developed nine key themes: interpersonal skills, teamwork, knowledge of family and group dynamics, understanding of the healthcare system, professionalism, proficiency in spiritual assessment, effective communication, commitment to lifelong learning, and knowledge of various religious and spiritual beliefs, extending beyond one's own faith tradition. These themes reflected HCCs roles as healthcare professionals who contribute to patient care, interdisciplinary collaboration, and spiritual leadership responsibilities. The study underscored the need for chaplaincy education to integrate healthcare-specific coursework, interprofessional training, cultural and religious humility, and deeper knowledge of diverse belief systems. Developing and incorporating curriculum standards based on these themes could enhance the readiness of HCCs to deliver comprehensive care and meet the dynamic demands of diverse patient populations within today's healthcare landscape.

Mapping competency profiles of schools of public health: implications for public health workforce education and training in Israel.

Aim: Competency frameworks are essential for analyzing capabilities of Schools of Public Health to adequately prepare public health (PH) professionals to address contemporary challenges. This study maps the competency profiles of PH training programs in Israel using a novel curriculum mapping tool. Methods: This study assessed all five Israeli Health Education Institutions (HEIs) offering MPH or Bachelors in Public Health (BPH) degrees across 57 competencies in six domains to determine the extent to which competencies were addressed in the curriculum. The competencies list was based on the Association of Schools of Public Health in the European Region (ASPHER) List of Core Competences for the Public Health Professional, adapted for Israeli HEIs. Results: The core curricula in the four MPH programs addressed 45-84% of all competencies. The BPH program addressed 79% of competencies. In MPH programs, the core curricula addressed most or all competencies in the Methods and the Socioeconomic Determinants of Health domains. Competencies in the domains of Environmental Determinants of Health, Health Policy, Economics & Organization, and Health Promotion and Prevention were less comprehensively addressed in most core curricula. Students' opportunities to broaden their exposure to competencies outside the core curricula were context dependent. Discussion: The curriculum competencies mapping tool that was developed served to assess both strengths and shortcomings in PH education in Israel. The findings demonstrate a highly variable array of PH curriculum models in Israeli HEIs, as well as overall shortcomings in the Environmental, Health Policy Economics and Organization, and Health Promotion and Prevention domains. This analysis has already led to reassessment of the curriculum, and will continue to guide the next steps to increase the harmonization of PH training curricula and to better meet PH challenges in Israel.

The scholarly and practice profile of respiratory therapists in Canada: A cross-sectional survey.

Introduction: Respiratory therapists (RTs) are expected to provide high-quality care for patients with chronic and acute cardiopulmonary conditions across the lifespan by staying abreast of emerging scientific evidence and effectively integrating it into clinical practice. This integration of evidence is encompassed within the competency of scholarly practice. However, there is currently a limited understanding of RTs' scholarly practice. Furthermore, despite RTs' widespread presence in the Canadian healthcare system, comprehensive studies describing the profiles of RTs are lacking. This study aimed to describe the demographic characteristics, scholarly and practice profiles of the respiratory therapy profession in Canada. Methods: A cross-sectional survey was distributed via the national professional association and regulatory bodies. The survey contained seven sections with 52 items. We calculated means and standard deviations, or medians and interquartile ranges for continuous variables and frequencies and proportions for categorical variables. Open-ended questions were analyzed using summative content analysis. Results: We analyzed data from 832 participants (6.8% response rate) from Ontario (17.8%), Québec (15.7%), and Alberta (13.3%), and across other provinces. Nearly 40% had completed an undergraduate degree beyond their respiratory therapy diploma. Few participants had authored or co-authored peer-reviewed publications. RTs reported reading approximately 2.2 peer-reviewed publications monthly. Most participants agreed on the importance of critical reflection in practice (93.1%) and that having a supportive work environment was vital. Almost three-quarters of participants (73.4%) reported that they believe that RTs are valued members of interprofessional teams, and 78% agreed that understanding research enables them to engage in patient advocacy. Conclusion: This survey provides a portrait of the practice and scholarly profile of the respiratory therapy profession in Canada. While the profession shows potential for growth, concerns persist regarding limited engagement in activities related to scholarly practice. Addressing these challenges and nurturing a culture of scholarly practice are likely necessary to support the development of scholarly practice in the profession. Creating supportive environments, providing access to resources, and encouraging professional development activities may advance the scholarly practice of RTs. Future national surveys could employ random sampling strategies to achieve a more representative sample of the profession.

Undergraduate acute care clinical competencies for managing acute care cases in adult patients within a South African in-hospital environment: A modified Delphi Study.

Introduction: With the increase of global population, there has been an increased demand for acute care services both locally and globally. In the absence of an acute care competency-based curriculum in South Africa, this study sought to identify the core competencies required by undergraduate medical students to safely manage adult patients within an acute care setting in a South African hospital environment. Methodology: The modified Delphi study comprised of three rounds. The traditional Delphi method, which uses the same participants across various rounds, was modified by using different stakeholders across the three rounds. Emergency Medicine (EM) specialist trainees (registrars) generated competencies in round one, which were provided to a multi-disciplinary team with expertise in undergraduate curriculum development in round two, using a 5-point Likert scale for rating their agreement-disagreement. Round three entailed inviting the round one contributors to anonymously comment, via online survey, on the competencies generated in round two. Results: A total of 34 EM registrars participated during round one and 7 curriculum development experts participated during round two. A total of 120 competencies were identified from the 3-round Delphi study; of these 103 (85.8%) were reached by "Strong Agreement"; 16 (13.3%) reached by "Agreement"; and 1 (0.8%) was undecided. Discussion: The results of the modified Delphi study contributed to developing a comprehensive list of undergraduate acute care clinical competencies set in a South African context. The value of engaging with medical practitioners at the forefront of delivering acute care in a South African healthcare environment who are exposed on a daily basis to the healthcare needs of society, became evident. The findings of this study highlight and reinforce the importance of contextual relevance during the curriculum development process. Conclusion: The modified Delphi method, based on three iterative rounds and feedback from experts, was effective in reaching consensus on the competencies required by undergraduate medical students to manage acute care adult patients safely within a South African hospital environment.

Mentoring as a Buffer for the Impact of Social Unrest due to Systemic Racism and Ambient Discrimination.

Mentoring may act as a buffer for the negative impacts of racial trauma. Building Up (conducted 2020-2024) is a cluster-randomized trial at 25 institutions of postdoctoral fellows and early-career faculty from underrepresented backgrounds. Generalized linear mixed models were used to identify mentoring competencies associated with the impact of social unrest due to systemic racism. Eighty-two percent of participants (n=143) identified as female, 33% as non-Hispanic Black, and 36% as Hispanic. Mentoring that aligns expectations and mentoring that assesses understanding were significantly associated with social unrest due to systemic racism impacting ability to work (OR=2.84 and OR=0.52, respectively) and conduct research (OR=4.21 and OR=0.41, respectively). Future research should elucidate specific aspects of mentoring relationships that serve as a buffer during times of social unrest.

A Survey of Post-Graduate Satisfaction With Orthopaedic Residency Training at a Single Institution.

Background: The Accreditation Council for Graduate Medical Education (ACGME) has called for self-study within residency programs. Post-graduate surveys allow the graduate to reflect upon their residency experience after years of autonomous practice. Despite their potential utility, a standardized assessment of residency training from the perspective of orthopaedic alumni does not exist. In this study, we aimed to create, analyze, and share with our alumni a post-graduate survey based on ACGME core competencies. Methods: The survey was developed by full-time orthopaedic faculty and reviewed by a survey methodologist to ensure clarity and an ideal survey format. In May 2020, the survey was emailed to all 90 graduates from 2000 to 2019. Respondents were polled on current clinical practice and satisfaction with program-specific initiatives, residency requirements, and learning environment issues based on a 7-point Likert scale. Respondents were also given the opportunity to provide open-ended responses. Data were collected within the survey platform and subdivided into 3 cohorts based on years since graduation. Results: The response rate was 71% (64/90). The likelihood of fellowship training increased with recency since graduation. Most respondents are in either private or health-system-owned practice but 23% work in an academic center.The oldest cohort had greater variability in clinical practice. Most program-specific initiatives received high satisfaction scores, but graduates within the past 5 years had the lowest satisfaction scores. Instruction of skills included in ACGME competencies received generally favorable reviews, but professional development skills, such as starting a practice and evaluating job opportunities, received low marks.The overall satisfaction with the program was high (86%) but was lowest among most recent graduates. Conclusion: The post-graduate survey demonstrates areas of strength and weakness and highlights dissatisfaction among recent graduates. The data will drive specific curricular changes within our program. The survey will be shared to promote self-study within other programs.