Why the Indian Health Care Improvement Act Has Failed to Effectively Fund Workforce Development for the Indian Health Service.

The Indian Health Service (IHS) faces severe workforce shortages due to underfunding and underdevelopment of clinical training programs. Unlike other direct federal health care systems that have implemented clinical training paradigms as central parts of their success, the IHS has no formalized process for developing such programs internally or in partnership with academic institutions. While the Indian Health Care Improvement Act (IHCIA) authorizes mechanisms by which the IHS can support overall workforce development, a critical portion of the act (U.S. Code 1616p) intended for developing clinical training programs within the agency remains unfunded. Here, we review the funding challenges of the IHCIA, as well as its authorized and funded workforce development programs that have only partially addressed workforce shortages. We propose that through additional funding to 1616p, the IHS could implement clinical training programs needed to prepare a larger workforce more capable of meeting the needs of American Indian/Alaska Native communities.

A practical model of faculty development in medical education: make it accessible, versatile, and easy to use!

Faculty development programs should offer transformative resources and prioritize the needs of the faculty. If faculty face difficulty in accessing such programs, the potential impact of the resources may be limited. To alleviate such issues, we designed a faculty development program that is available to anyone at any time in any configuration. By allowing faculty to choose from a diverse range of medical education topics based on their interests and needs, they may promptly apply crucial concepts in their teaching and education leadership roles. Faculty members can engage in personalized professional development, enhance their teaching practices, and ultimately foster their professional growth. Also, program coordinators and administrators can seamlessly integrate our resources into any existing faculty development program, serving as self-study materials, resources for existing programs, or a stand-alone curriculum with high accessibility, versatility, and ease of use.

Les programmes de développement du corps professoral doivent offrir des ressources transformatrices et donner la priorité aux besoins des enseignants. Si ces derniers ont des difficultés à accéder à ces programmes, l'impact potentiel des ressources peut être limité. Pour y remédier, nous avons conçu un programme de développement du corps professoral accessible à tous, à tout moment et dans n'importe quelle configuration. En permettant aux enseignants de choisir parmi une gamme variée de sujets relatifs à l'enseignement médical en fonction de leurs intérêts et de leurs besoins, ils peuvent rapidement mettre en pratique des concepts cruciaux dans leur rôle d'enseignant et de responsable de l'enseignement. Les membres du corps enseignant peuvent s'engager dans un développement professionnel personnalisé, améliorer leurs pratiques d'enseignement et, en fin de compte, favoriser leur croissance professionnelle. En outre, les coordonnateurs et administrateurs de programmes peuvent aisément intégrer nos ressources dans n'importe quel programme existant de formation du corps enseignant, en tant qu'outil d'auto-apprentissage, de ressources pour les programmes existants, ou de programme autonome avec une grande accessibilité, polyvalence et facilité d'utilisation.

A Renaissance in Academic Medicine-Using a Coach Approach to Develop Early-Career Faculty.

This Viewpoint discusses contemporary approaches to mentoring and coaching new physicians.

Attending to the complexities of leadership learning and practice: Emergent-based assessment and evaluation strategies.

In emergence-based leadership education, the knowledge and experiences co-created in the classroom may violate some of the assumptions behind traditional teaching and learning assessment methods. Thus, traditional assessment, evaluation, and outcomes for courses utilizing emergence-based methods, such as intentional emergence, case-in-point, dialogic group process consultations, and group relations/dynamics, are counterintuitive and must be reconsidered. We provide recommendations regarding how to conduct assessment when utilizing emergence-based teaching methods in leadership education. We review the use of inductive forms of assessment and provide recommendations for broadening learning outcomes and engaging in learning outcomes beyond the knowledge domain.

Efectividad de la formación teórico-práctica en soporte vital básico a monitoras de comedores escolares desde Atención Primaria / Effectiveness of theoretical-practical training in basic life support for school canteen monitors from Primary Care

Introducción: las enfermedades cardiovasculares constituyen un problema de salud pública a nivel mundial y dentro de ellas destaca la parada cardiorrespiratoria (PCR). Los comedores escolares son espacios con potencial riesgo de presenciar una PCR. Materiales y métodos: estudio analítico cuasiexperimental de intervención. Las participantes recibieron formación mediante una plataforma virtual interactiva y una sesión de simulación clínica presencial sobre maniobra de Heimlich, reanimación cardiopulmonar (RCP) básica y uso del desfibrilador externo semiautomático (DESA). Se realizó un análisis descriptivo de la población a estudio y un análisis estadístico comparativo entre el resultado obtenido en un test previo y otro posterior a la formación virtual. Se creó una variable restando la puntuación obtenida antes de la formación a la obtenida después de la misma. Se analizó mediante observación directa la simulación clínica. Se definió la significación estadística con una p <0,05. Análisis estadístico con SPSS versión 19.0. Se siguieron los principios de la Declaración de Helsinki y las directrices sobre buenas prácticas clínicas. Resultados: la totalidad de la muestra eran mujeres con edad mediana de 48,50 años. La nota mediana del test previo fue de 6,7/10 y el test posterior tuvo un resultado constante de 10/10. La diferencia entre el test posterior y el previo tuvo una mediana de 3,3 (p 0,01) y se constató en la simulación que el aprendizaje fue óptimo. Conclusiones: la formación en RCP es una estrategia de impacto social, relacionada con una mejora en la respuesta ante un caso de PCR, disminuyendo la morbimortalidad que esta implica. (AU)

Introduction: cardiovascular diseases constitute a public health problem worldwide, among which cardiopumonary arrest (CPA) stands out. School canteens are spaces where there is a possibility of witnessing CPA. Materials and methods: quasi-experimental interventional and analytical study. Participants received training through an interactive virtual platform and a face-to-face clinical simulation session on the Heimlich manoeuvre, basic cardiopulmonary resuscitation (CPR) and the use of the semiautomatic external defibrillator (SAED). We carried out a descriptive analysis of the study population and a comparative statistical analysis of the results obtained in the tests conducted before and after the virtual training. We created variable corresponding to the subtraction of the pre-training score from the post-training score. Clinical simulation was analysed by direct observation. Statistical significance was defined as p < 0.05. The statistical analysis was carried out with SPSS version 19.0. The study adhered to the principles of the Declaration of Helsinki and the guidelines on good clinical practice. Results: the entire sample consisted of women with a median age of 48.50 years. The median score in the pre-test was 6.7/10, and the score in the post-test was uniformly 10/10. The median difference between the pre- and post-training tests was of 3.3 points (p 0.01) and the simulation evinced that the learning was optimal. Conclusions: training in CPR is a strategy that has social impact in terms of the improvement in the response to a CPA events, achieving a reduction in the associated morbidity and mortality. (AU)

Evaluating the Impact of an Evidence-Based Practice Education Program in a Nurse Residency Program on Evidence-Based Practice Beliefs, Implementation, and Competency.

This quality improvement project examined implementation of the John Hopkins Nursing evidence-based practice (EBP) model, a standardized EBP education curriculum, in a hospital-based nurse residency program. We found that EBP education increased nurse residents' EBP beliefs, implementation frequency, and competencies. Our findings suggest that adopting existing EBP curricula is a convenient and effective approach to EBP education. Staff development professionals should continue to support and advocate for the adoption of EBP education within their organizations.

Moderated Mediation between High Performance Work Systems (HPWS) and Employee Voice Behavior: The Role of Psychological Safety and Supportive Leadership / [La mediación moderada entre los sistemas laborales de alto rendimiento y la opinión constructiva de los empleados: el papel que juega la seguridad psicológica y el liderazgo de apoyo]

The objective of this study was to examine the mediating role of psychological safety in the relationship between high performance work systems (HPWS) and employee voice behavior. Moreover, this study examined the moderating effect of supportive leadership on the indirect effect of HPWS on voice behavior through psychological safety. Data were gathered in a survey of middle and lower level bank employees (N = 261). Data validity/reliability and estimations were performed by applying the principles of partial least squares structural equation modeling (PLS-SEM). The findings indicate that psychological safety mediates the link between HPWS and voice behavior, and supportive leadership enhances voice behavior by strengthening the effect of HPWS on psychological safety. This study contributes to organizational psychology literature by explaining how supportive leadership affects the indirect effect of HPWS on voice behavior through psychological safety. Study limitations are related to external validity and cross-sectional testing of data.(AU)

Este estudio tiene como objetivo analizar el papel mediador que juega la seguridad psicológica en la relación entre los sistemas laborales de alto rendimiento (SLAR) y la opinión constructiva de los empleados. Además, se analiza el efecto moderador del liderazgo de apoyo en el efecto indirecto de los SLAR en la opinión constructiva a través de la seguridad psicológica. Se recogieron datos en una encuesta a empleados de banca de nivel medio y bajo (N = 261). Se llevó a cabo la validez/fiabilidad de los datos y las estimaciones aplicando los principios de modelación de ecuaciones estructurales de mínimos cuadrados parciales. Los resultados indican que la seguridad psicológica es mediadora del nexo entre los SLAR y la opinión constructiva, a la par que el liderazgo de apoyo potencia la opinión constructiva al reforzar el efecto de los SLAR en la seguridad psicológica. El estudio supone una contribución a la investigación en psicología organizacional al explicar de qué modo el liderazgo de apoyo contribuye al efecto indirecto de los SLAR en la opinión constructiva a través de la seguridad psicológica. El estudio tiene algunas limitaciones en cuanto a la validez externa y a la comprobación transversal de los datos.(AU)

Factores psicosocioculturales relacionados con la formación técnica o profesional del personal de enfermería en Tlaxcala, México / Psychosociocultural factors related to the technical or professional training of nursing staff in Tlaxcala, México

Introducción: las demandas actuales en el cuidado de los pacientes ameritan cambios curriculares en la formación del personal de enfermería y su relación con los factores socioculturales. Objetivo: identificar y describir los factores psico-socioculturales que se relacionan con la formación técnica o profesional del personal de enfermería en Tlaxcala. Metodología: se realizó un estudio transversal descriptivo en el Hospital General de Zona No. 1, con personal de enfermería en cursos de formación técnico o profesional, seleccionados de manera no probabilística. Variables: edad, sexo, factores psico-socioculturales. Análisis con frecuencias, porcentajes y medidas de dispersión. Resultados: de un total de 51 enfermeras, la edad promedio es de 46.4 ± 8.9 años y 44% son enfermeras generales. Los factores referidos por el personal son: nivel de preparatoria (98%), nivel técnico (46%), estudios de licenciatura (84%), problemas económicos (48%), apoyo familiar (82%), enfermedad (8%), trabajo y estudio (20%), cambio de residencia (10%), interés (94%), vocación (100%), escuela de procedencia (94%), rendimiento escolar (8%), programa académico (88%), forma de trabajo (10%), técnicas docentes (10%), carga académica (14%), ambiente académico (84%), reglamento escolar (2%) y prácticas (4%). Conclusiones: el género se relaciona con la formación de nivel licenciatura y la edad con el nivel técnico, nivel licenciatura, trabajo y estudio, y carga académica; el estado civil con el interés por estudiar; y la religión con el apoyo docente.

Abstract Introduction: Current demands in patient care warrant curricular changes in the training of nursing personnel and their relationship with sociocultural factors. Objective: Identify and describe the Psychosocial Cultural factors that are related to the technical or professional training of nursing staff in Tlaxcala. Methodology: A descriptive cross-sectional study was carried out at the General Hospital of Zone No. 1, with nursing staff in technical or professional training courses, selected in a non-probabilistic manner. Variables: age, sex, Psychosociocultural factors. Analysis with frequencies, percentages and dispersion measures. Results: Of a total of 51 nurses, the average age is 46.4 ± 8.9 years and 44% are general nurses. The factors referred to by the staff are: high school level (98%), technical level (46%), bachelor's studies (84%), economic problems (48%), family support (82%), illness (8%), work and study (20%), change of residence (10%), interest (94%), vocation (100%), school of origin (94%), school performance (8%), academic program (88%), form of work (10%), teaching techniques (10%), academic load (14%), academic environment (84%), school regulations (2%) and practices (4%). Conclusions: Gender is related to bachelor's level training and age to technical level, bachelor's level, work and study, and academic load; marital status with interest in studying; and religion with teaching support.

Strengthening human resources for health in the Caribbean: Report on HRH core indicators

The Caribbean has a serious need to improve the health information system, and in particular related to human resources for health. PAHO has been working with country focal points to report on the HRH indicators included in the WHO National Health Workforce Accounts (NHWA) platform. However, not all indicators in the NHWA are relevant to the Caribbean or can be reported due to limitations in data collection and available information. The HRH Action Task Force (now HRH Caribbean Commission), with support from PAHO identified a set of 30 core indicators and sub-indicators for the Caribbean, classified in three levels of importance and complexity. This publication systematizes the process and includes the chosen core indicators and sub-indicators.

Team Building and Employee Behaviour: The Role of Employees Sports Involvement, Work Environment, and Participated Leadership / Formación de equipos y comportamiento de los empleados: el papel de los empleados Participación deportiva, entorno laboral y liderazgo participativo

The cultivation of healthy Work Environments, coupled with the enhancement of Employee Behaviour through effective team building, holds significant importance. There is an increasing scholarly focus on examining the impact of employees' participation in sports on team dynamics and interpersonal relationships within the workplace. The behaviour of employees is significantly impacted by the Work Environment, encompassing both the physical setting and the organisational culture. Furthermore, the implementation of participatory leadership fosters a sense of unity within the team and enhances overall performance through the engagement of team members in the decision-making process. Hence, the objective of this research is to examine the correlation among engagement in sports, the Work Environment, and participative leadership, thereby illustrating their collective impact on team cohesion and Employee Behaviour within contemporary organisational settings. The study was conducted by the researcher using a deductive approach grounded in quantitative research methodology. Research findings indicate a positive correlation between employees' engagement in sports activities, enhanced teamwork, and overall workplace conduct. Moreover, empirical evidence suggests that the presence of a conducive Work Environment, coupled with the implementation of participative leadership practices, significantly contributes to the development of a positive organisational culture and the promotion of desirable employee conduct. Nevertheless, the research has predominantly utilised quantitative data, thereby excluding qualitative perspectives that could provide a more comprehensive understanding of the underlying concepts driving the observed correlations.(AU)

Medicina Familiar y Comunitaria. Profesionales polivalentes / Family and Community Medicine. Versatile professionals

Una de las competencias en la Medicina Familiar y Comunitaria es la atención a la patología urgente, ya sea en el ámbito hospitalario o extrahospitalario. El programa de la especialidad así lo recoge y la formación de los profesionales de Medicina Familiar y Comunitaria se establece de forma muy polivalente y capacita para la atención en todas las etapas de la vida. Es muy relevante la necesidad de formación cualificada y polivalente en el ámbito rural por la intensa variabilidad de situaciones que hay que resolver. Para analizar esa polivalencia en el ámbito de la Atención Primaria frente a la urgencia, se diseñó un cuestionario, que se difundió entre nuestros socios y socias a través de internet, mediante el que se pretendía recoger las diferencias y las oportunidades de mejora para las/los profesionales. La encuesta de este estudio transversal se difundió a través de las sociedades federadas de la Sociedad Española de Medicina Familiar y Comunitaria (semFYC) y se obtuvieron datos del 88% del territorio. Aunque la muestra evaluada es pequeña, se concluye que el 92% cree que es positivo poder trabajar en ambos ámbitos, ya que aporta seguridad y mejor manejo del paciente más allá del entorno donde se desarrolle la atención.(AU)

One of the skills in family and community medicine is care of emergency pathology, whether in the hospital or out-of-hospital setting. The specialty programme includes this and family and community medicine professional training is set out in a very versatile way and enables care at all stages of life. The need for qualified and versatile training in rural areas is especially relevant due to the intense variability of situations to be tackled. To analyze this versatility in the field of primary versus emergency care, an online questionnaire was devised to be disseminated among our members over the Internet. By means of this questionnaire it was intended to collate the differences and opportunities for professional improvement. The survey of this cross-sectional study was disseminated by means of the Federated Societies of the Spanish Society of Family and Community Medicine and data were obtained from 88% of Spain. Although the sample evaluated is small, it is concluded that 92% believe that it is positive to be able to work in both areas, since it provides security and better management of the patient beyond the setting where she was treated.(AU)

Understanding professional development challenges of Chinese public health professionals: association and prediction analyses with data validity screening.

Background: Little is known about the public health professionals engaged in educating and training new or future researchers in public health. Research in this direction identifies their issues, concerns, challenges, and needs. This study focused on the professional development challenges of Chinese public health professionals. Methods: Snowball sampling was utilized. A total of 265 public health professionals participated. An instrument of 6 dimensions (burnout, sleep issue, mood issue, friends' support, exercise, and challenges) was developed, revised, and administered online. Two different approaches, the conventional and data screening approaches, were applied. The former started with item quality analyses, whereas the latter began with data quality checks. The chi-square tests of associations and logistic regressions were performed on both approaches. Results and discussion: 19.25% of the participants were detected and deleted as careless respondents. Using both approaches, six professional development challenges except one ("Multidisciplinary learning") were significantly associated with various demographic features. The two approaches produced different models though they converged sometimes. The latent variables of exercise predicted professional development challenges more frequently than other latent variables. Regarding correct classification rates, results from the data screening approach were comparable to those from the conventional approach. Conclusion: The latent variables of exercise, such as "Exercise effects," "Expectations of exercise," and "Belief in exercise," might be understudied. More research is necessary for professional development challenges using exercise as a multidimensional construct. Based on the current study, screening and deleting careless responses in survey research is necessary.