Development and Implementation of a Hospitalist Faculty Development Program in a University- and Community-Based Multihospital System.

OBJECTIVES: Robust faculty development (FD) is an emerging area of focus within hospital medicine, a relatively new specialty with limited mentorship infrastructure to find and develop a professional niche. There are few descriptions in the literature of establishing and evaluating an FD program with strategies to evaluate success, invite collaboration, and achieve feasible, useful metrics. METHODS: We created our University Division of Hospital Medicine's FD Program to help community and academic hospitalist faculty fulfill professional goals in (and beyond) quality improvement, leadership, education, and clinical skills. We describe program development, initial implementation, and early evaluation results. We outline program roles and offerings such as professional development awards, lectures, and mentorship structures. RESULTS: Our program was successfully implemented, measured by engagement and participation via preliminary indicators suggesting programmatic effectiveness: faculty who applied for (and continued participation in) mentorship and faculty development awards and faculty who attended our lecture series. Since program implementation, faculty retention has increased, and percentages of faculty reporting they were likely to remain were stable, even during the coronavirus disease 2019 pandemic. Scholarly production increased and the number of division associate professors/professors grew from 2 in 2015 to 19 in 2024. CONCLUSIONS: Our experience can guide institutions seeking to support and encourage faculty professional development. Lessons learned include the importance of needs assessment and leadership commitment to meeting identified needs; how a steering committee can amplify the effectiveness and relevance of FD efforts; and the utility of multiple recognition strategies-quarterly newsletters, monthly clinical recognition, mentions on social media-to support and encourage faculty.

Design and development of an arena blended connected learning model for faculty development in health professions education: A step forward.

Current medical education and clinical practice has led to a need for advanced faculty development for medical teachers to effectively play the role of educators, researchers and administrators. There is large variability in the teaching programmes across countries, which range from a one-time activity to regularly scheduled workshops and seminars, to a highly advanced course spanning a few months to a year. Several healthcare institutes around the world offer faculty training programmes in health professions education, where the curriculum varies in design as they are developed and implemented by their own institutional body or education unit. Following a discussion of arena blended connected (ABC) learning design during a faculty training programme (Postgraduate Diploma in Health Professions Education) and the subsequent move towards an online approach to education due to the pandemic in 2019, the advisory faculty and students started to envision designing the already existing Postgraduate Diploma in Health Professions Education curriculum along the ABC model favouring blended and outcome-based education. Criteria were set for each topic with clearly defined learning levels to be implemented and the frequency of implementation. We describe the design and development of a curriculum for faculty development of health professions education using the ABC model.

Using Debriefing in Professional Development Courses.

Debriefing is a valuable tool to use when developing teamwork skills. The skill set can be either a specific outcome talent, such as a class on building teams, or a team skill set needed to successfully complete a team project. Professional development faculty can work to acquire and expand the skills described in this column. [J Contin Educ Nurs. 2024;55(8):375-377.].

Leadership Succession Planning for ANCC Accredited Providers in Nursing Continuing Professional Development.

Succession planning in leadership is a strategic process used to identify and develop future leaders to fill key organizational positions. This process ensures continuity of leadership and helps maintain the organization's performance over time. Succession planning is essential for critical roles and can be part of a broader strategic plan for talent management. Organizations that are accredited by the American Nurses Credentialing Center (ANCC) in Nursing Continuing Professional Development (NCPD) can benefit from implementing succession planning to drive the stability of its work as an Accredited Provider and confirm that the organization maintains its commitment to quality in providing NCPD. This column describes how the Accredited Provider Program Director (AP-PD) role can benefit from implementing succession planning into the structure of the Accredited Provider processes. [J Contin Educ Nurs. 2024;55(7):321-325.].

Understanding the capacity development of faculty development programs: a sequential explanatory mixed methods study.

BACKGROUND: Faculty development programs can bring about both individual and organizational capacity development by enhancing individuals' attitudes, values, and skillsto enable them to implement organizational change. Understanding how faculty development programs produce capacity development, and the influencing factors, requires further understanding. This study aimed to explore the perceptions of the participants of a faculty development program about the capacity development features of the program and the influencing factors. METHODS: A sequential explanatory mixed methods design was used. Faculty members were surveyed about their perspectives on capacity development of faculty development. Subsequently, 22 interviews were conducted with the respondents to deepem understanding of the survey results. Interview transcripts underwent conventional content analysis. RESULTS: A total of 203 completed the questionnaire. Most of the faculty highly agreed that the faculty development programs had produced capacity development. The combined data identified (a) "quality of faculty development programs", underscoring the significance of robust and comprehensive initiatives, (b) "development in instruction", emphasizing the importance of continuous improvement in pedagogical approaches (c) "development in professionalism", highlighting the necessity for cultivating a culture of professionalism among faculty members, (d) "development in attitude towards education", emphasizing the role of mindset in fostering effective teaching practices, and (e) "supporting faculty development programs", with fostering organizational growth and innovation. Important barriers and facilitators of the capacity development process included several organizational, interpersonal, and individual factors. CONCLUSION: The study identified specific features of the capacity development process in the context of a faculty development program and highlighted the importance of these programs in producing changes in both individuals and within the wider organizational system. Several factors that enabled and constrained the capacity development process were also identified. The findings of the study can inform future implementation of faculty development programs for capacity development.

Radiologist preferences for faculty development initiatives to improve resident feedback in the era of competency-based medical education.

INTRODUCTION: Since 2022, all Canadian post-graduate medical programs have transitioned to a Competence by Design (CBD) model within a Competency-Based Medical Education (CBME) framework. The CBME model emphasized more frequent, formative assessment of residents to evaluate their progress towards predefined competencies in comparison to traditional medical education models. Faculty members therefore have increased responsibility for providing assessments to residents on a more regular basis, which has associated challenges. Our study explores faculty assessment behaviours within the CBD framework and assesses their openness to opportunities aimed at improving the quality of written feedback. Specifically, we explore faculty's receptiveness to routine metric performance reports that offer comprehensive feedback on their assessment patterns. METHODS: Online surveys were distributed to all 28 radiology faculty at Queen's University. Data were collected on demographics, feedback practices, motivations for improving the teacher-learner feedback exchange, and openness to metric performance reports and quality improvement measures. Following descriptive statistics, unpaired t-tests and one-way analysis of variance were conducted to compare groups based on experience and subspecialty. RESULTS: The response rate was 89% (25/28 faculty). 56% of faculty were likely to complete evaluations after working with a resident. Regarding the degree to which faculty felt written feedback is important, 62% found it at least moderately important. A majority (67%) believed that performance reports could influence their evaluation approach, with volume of written feedback being the most likely to change. Faculty expressed interest in feedback-focused development opportunities (67%), favouring Grand Rounds and workshops. CONCLUSION: Assessment of preceptor perceptions reveals that faculty recognize the importance of offering high-quality written feedback to learners. Faculty openness to quality improvement interventions for curricular reform relies on having sufficient time, knowledge, and skills for effective assessments. This suggests that integrating routine performance metrics into faculty assessments could serve as a catalyst for enhancing future feedback quality.

Public health communication professional development opportunities and alignment with core competencies: an environmental scan and content analysis. / Offres de perfectionnement professionnel en communication en santé publique et correspondance avec les compétences essentielles : analyse contextuelle et analyse de contenu.

INTRODUCTION: Communication is vital for effective and precise public health practice. The limited formal educational opportunities in health communication render professional development opportunities especially important. Competencies for public health communication describe the integrated knowledge, values, skills and behaviours required for practitioner and organizational performance. Many countries consider communication a core public health competency and use communication competencies in workforce planning and development. METHODS: We conducted an environmental scan and content analysis to determine the availability of public health communication professional development opportunities in Canada and the extent to which they support communication-related core competencies. Three relevant competency frameworks were used to assess the degree to which professional development offerings supported communication competency development. RESULTS: Overall, 45 professional development offerings were included: 16 "formalized offerings" (training opportunities such as courses, webinars, certificate programs) and 29 "materials and tools" (resources such as toolkits, guidebooks). The formalized offerings addressed 25% to 100% of the communication competencies, and the materials and tools addressed 67% to 100%. Addressing misinformation and disinformation, using current technology and communicating with diverse populations are areas in need of improved professional development. CONCLUSION: There is a significant gap in public health communication formalized offerings in Canada and many of the materials and tools are outdated. Public health communication professional development offerings lack coordination and do not provide comprehensive coverage across the communication competencies, limiting their utility to strengthen the public health workforce. More, and more comprehensive, professional development offerings are needed.

Preceptor Development: Using the American Nurses Credentialing Center Outcome-Based Continuing Education Model©.

Preceptors play a vital role in shaping the growth of every nurse. Effective preceptors lead to better patient outcomes as new nurses are better equipped to deliver high-quality care under the guidance of experienced mentors. Providing a supportive preceptor experience increases job satisfaction and retention rates among new and tenured nurses, ultimately benefiting health care organizations. When designing preceptor development programs, health care institutions should incorporate the Outcome-Based Continuing Education Model© (OB-CE Model©) from the American Nurses Credentialing Center. This column explores how to use the OB-CE Model© to enhance the competency and human skills of preceptors as learners, thereby fostering their development effectively. [J Contin Educ Nurs. 2024;55(5):212-216.].

The Role of Faculty Development in Advancing Change at the Organizational Level.

ABSTRACT: Although the traditional goal of faculty development (FD) has been to enhance individual growth and development, this goal may no longer suffice to address the compelling challenges faculty members are facing, such as increasing workloads, emotional well-being, and institutional support for education. Addressing these challenges will require change at the organizational level. The purpose of this perspective is to articulate a vision for FD programming that describes ways in which FD leaders, together with other educational leaders, can bring about change at the organizational level to support excellence and innovation in health professions education. To impact the organization at large, the authors propose a model that includes 4 major goals: (1) promoting individual and group development, through educational and leadership development programs, coaching and mentoring, and advanced degrees; (2) advocating for infrastructure and resources, including academies of medical educators, educational scholarship units, educational awards, and intramural funding for educational innovation and scholarship; (3) influencing policies and procedures, by engaging educators on key committees, reviewing appointment and promotion criteria, defining educator roles and portfolios, and valuing diversity, equity, and inclusion; and (4) contributing to organization-wide initiatives, such as addressing "hot button" issues, identifying value factors that support investments in FD and medical education, and enhancing the visibility of educators. In this model, the 4 goals are dynamically interconnected and can impact the culture of the organization. For each goal, the authors offer evidence-informed actions that FD leaders, along with other educational leaders, can adopt to improve the organizational culture and inspire institutionally relevant actions. Because each institution is unique, the options are illustrative and not prescriptive. The intent is to provide examples of how FD leaders and programs can enhance the educational mission through broader engagement with their institutions.

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

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

Supporting Nurse Professional Development Practitioners Through an Academic-Practice Pilot Initiative.

BACKGROUND: Nurse professional development practitioners (NPDPs) support licensed nurses as they transition into practice. The NPDPs themselves benefit from opportunities to grow professionally in their role as educators. METHOD: A nursing school and hospital leadership pilot initiative was conducted to support staff development for NPDPs at a Midwestern health system. Four sessions were developed by academic educators and presented to NPDPs: educational theory, backward curricular design, active learning strategies, and assessment and evaluation principles. RESULTS: The NPDPs who attended the seminar indicated that the program objectives were met and identified at least one change they planned to make in planning, course design, or evaluation. In addition, they requested future professional development opportunities. Planning and implementation of this pilot educational seminar provided valuable content for NPDPs. CONCLUSION: This pilot model can strengthen academic-practice partnerships and support ongoing staff development. [J Contin Educ Nurs. 2024;55(5):253-256.].

Global Health Training Collaborations: Lessons Learned and Best Practices.

Interest in global health training experiences among trainees from higher income countries has grown. The Working Group on Ethics Guidelines for Global Health Training (WEIGHT) clarified best practices in 2010 based on expert consensus. These guidelines address both balancing priorities in international partnerships and local sustainability concerns related to short-term experiences. However, the guidelines can be difficult to implement in actual practice. Because our organization predated the availability of these consensus guidelines, we reviewed our current set of practices for hosting service-learning programs at our rural Ugandan clinic for adherence to the WEIGHT guidelines. The discrete activities and standardized processes developed over 10 years of hosting experiences were grouped into broader hosting categories, with consensus among the hosting and sending volunteer coordinators of our non-governmental organization partnership. These practices were then mapped to the WEIGHT guidelines. We found our implementation strategies map these guidelines into a clear checklist of actions that can be used by coordinators involved in global health training programs. We include some of the historical reasons that led to our current processes, which may help other partnerships identify similar practice gaps. We anticipate that this action-oriented checklist with historical context will help accomplish the difficult implementation of best practices in global health training collaborations.

A cross-institutional analysis of the effects of broadening trainee professional development on research productivity.

PhD-trained scientists are essential contributors to the workforce in diverse employment sectors that include academia, industry, government, and nonprofit organizations. Hence, best practices for training the future biomedical workforce are of national concern. Complementing coursework and laboratory research training, many institutions now offer professional training that enables career exploration and develops a broad set of skills critical to various career paths. The National Institutes of Health (NIH) funded academic institutions to design innovative programming to enable this professional development through a mechanism known as Broadening Experiences in Scientific Training (BEST). Programming at the NIH BEST awardee institutions included career panels, skill-building workshops, job search workshops, site visits, and internships. Because doctoral training is lengthy and requires focused attention on dissertation research, an initial concern was that students participating in additional complementary training activities might exhibit an increased time to degree or diminished research productivity. Metrics were analyzed from 10 NIH BEST awardee institutions to address this concern, using time to degree and publication records as measures of efficiency and productivity. Comparing doctoral students who participated to those who did not, results revealed that across these diverse academic institutions, there were no differences in time to degree or manuscript output. Our findings support the policy that doctoral students should participate in career and professional development opportunities that are intended to prepare them for a variety of diverse and important careers in the workforce.

Systems controls are needed to reduce mistaken tests for hemophagocytic lymphohistiocytosis, results of a prospective quality-improvement cohort study.

ABSTRACT: Medical diagnosis and therapy often rely on laboratory testing. We observed mistaken testing in evaluations for hemophagocytic lymphohistiocytosis (HLH) that led to delays and adverse outcomes. Physicians were mistakenly ordering interleukin-2 and quantitative natural killer cell flow cytometry, rather than soluble interleukin 2 receptor (sIL2R) or qualitative natural killer functional tests in the evaluation of patients suspected to have HLH.We initiated a prospective quality improvement project to reduce mistaken testing, reduce delays in correct testing due to mistaken ordering, and improve HLH evaluations. This consisted of provider education, developing an evaluation algorithm, and ultimately required systems interventions such as pop-ups and removal of the mistaken tests from the electronic ordering catalog.Active education reduced mistaken testing significantly in HLH evaluations from baseline (73.3% vs 33.3%, P = .003, relative risk reduction (RRR) 54.5%), but failed to meet the pre-specified RRR cutoff for success (70%). Education alone did not significantly reduce the proportion of HLH evaluations with delays in sIL2R testing (23.3% vs 7.4%, P = .096). Mistaken testing increased after the active intervention ended (33.3% vs 43.5%, P = .390, with RRR 40.7% from baseline. Mistaken test removal was successful: mistaken testing dropped to 0% (P < .001, RRR 100%), saved $14,235 yearly, eliminated delays in sIL2R testing from mistaken testing (23.3% vs 0%, P = .008), and expedited sIL2R testing after admission for HLH symptoms (14.6 days vs 3.8 days, P = .0012). These data show systems controls are highly effective in quality improvement while education has moderate efficacy.

Testing telediagnostic obstetric ultrasound in Peru: a new horizon in expanding access to prenatal ultrasound.

BACKGROUND: Ninety-four percent of all maternal deaths occur in low- and middle-income countries, and the majority are preventable. Access to quality Obstetric ultrasound can identify some complications leading to maternal and neonatal/perinatal mortality or morbidity and may allow timely referral to higher-resource centers. However, there are significant global inequalities in access to imaging and many challenges to deploying ultrasound to rural areas. In this study, we tested a novel, innovative Obstetric telediagnostic ultrasound system in which the imaging acquisitions are obtained by an operator without prior ultrasound experience using simple scan protocols based only on external body landmarks and uploaded using low-bandwidth internet for asynchronous remote interpretation by an off-site specialist. METHODS: This is a single-center pilot study. A nurse and care technician underwent 8 h of training on the telediagnostic system. Subsequently, 126 patients (68 second trimester and 58 third trimester) were recruited at a health center in Lima, Peru and scanned by these ultrasound-naïve operators. The imaging acquisitions were uploaded by the telemedicine platform and interpreted remotely in the United States. Comparison of telediagnostic imaging was made to a concurrently performed standard of care ultrasound obtained and interpreted by an experienced attending radiologist. Cohen's Kappa was used to test agreement between categorical variables. Intraclass correlation and Bland-Altman plots were used to test agreement between continuous variables. RESULTS: Obstetric ultrasound telediagnosis showed excellent agreement with standard of care ultrasound allowing the identification of number of fetuses (100% agreement), fetal presentation (95.8% agreement, κ =0.78 (p < 0.0001)), placental location (85.6% agreement, κ =0.74 (p < 0.0001)), and assessment of normal/abnormal amniotic fluid volume (99.2% agreement) with sensitivity and specificity > 95% for all variables. Intraclass correlation was good or excellent for all fetal biometric measurements (0.81-0.95). The majority (88.5%) of second trimester ultrasound exam biometry measurements produced dating within 14 days of standard of care ultrasound. CONCLUSION: This Obstetric ultrasound telediagnostic system is a promising means to increase access to diagnostic Obstetric ultrasound in low-resource settings. The telediagnostic system demonstrated excellent agreement with standard of care ultrasound. Fetal biometric measurements were acceptable for use in the detection of gross discrepancies in fetal size requiring further follow up.

An Integrative Review of Organizational Factors Influencing Successful Large-Scale Changes in Healthcare.

OBJECTIVE: The aim of this study was to review organizational factors influencing successful large-scale change (LSC) in healthcare. BACKGROUND: LSC is necessary to achieve sustained and meaningful healthcare improvement. However, organizational readiness needs to be considered to promote successful LSC. METHODS: Four databases were searched for articles published between 2009 and 2018. Thematic analysis was used to identify enabling or hindering factors to LSC. RESULTS: Seven organizational factors were consistently described as facilitators of or barriers to successful LSC in healthcare: infrastructure support, organizational culture, leadership, change management approach, roles and responsibilities, networks, and measurement and feedback. CONCLUSION: The factors that emerged from this review are consistent with concepts of implementation but broadened and highlight learning organizations in successful LSC. The results of this review informed the development of a reflective tool on LSC for nurse leaders.

Effect of Shared Governance on Nurse-Sensitive Indicator and Satisfaction Outcomes: An International Comparison.

OBJECTIVE: Researchers examined associations between Index for Professional Nursing Governance (IPNG) scores and outcomes, by US and international hospitals. BACKGROUND: Nursing governance and effects on nurse-related outcomes are not well studied. METHODS: Associations were evaluated using average IPNG scores from 2170 RNs and nurse-sensitive indicators (NSIs) and patient and RN satisfaction outcomes (n = 205 study units, 20 hospitals, 4 countries). RESULTS: International units had better IPNG shared governance scores (113.5; US = 100.6; P < 0.001), and outcomes outperforming unit benchmarks (6 of 15, 40.0%; US = 2 of 15, 13.3%). Shared governance significantly outperformed traditional governance for 5 of 20 (25.0%) US outcomes (patient satisfaction = 1, RN satisfaction = 4) and for 3 of 11 (27.3%) international (patient satisfaction = 1, RN satisfaction = 2). Internationally, self-governance significantly outperformed traditional governance and shared governance for 5 of 12 (41.7%) outcomes (NSI = 2, patient satisfaction = 3). CONCLUSIONS: Shared governance is a strategy that can be considered by nurse leaders for improving select outcomes.