Clinical Leadership as an Agent for Change: A Health System Improvement Intervention in Curaçao.

INTRODUCTION: The healthcare system in Curaçao is complex, fragmented, and poorly organized and typifies a system in a resource-limited environment. Deficits in competencies and local cultural barriers are factors that hinder sustainable healthcare in such settings and a failure to meet WHO sustainable development goals. This study reports the potential cost-effectiveness and improved health outcomes of the first stage of a healthcare improvement project. The intervention, which is a multidisciplinary team-based leadership training program (MLP), reflects a promising strategy to tackle local healthcare needs. METHODS: A Multidisciplinary group of healthcare professionals in St. Elisabeth hospital, Curaçao, was selected to 1) participate in the MLP and 2) co-design a healthcare pathway on the management of decubitus ulcers. Using a qualitative research methodology, we conducted interviews to assess the perceived leadership growth, teamwork, and the barriers to the introduction of the new care pathway in their setting. Six themes were identified that explained the perceived leadership development and interprofessional collaboration. These included 1) Professional background, 2) Healthcare pathway design, 3) Resources, 4) Personal development, 5) Collaboration 6) Execution. CONCLUSION/IMPLICATION: The participants valued the interdisciplinary approach of this health improvement project and acknowledged the added value of a training program that also addressed personal growth. This study shows how MLPs for health professionals can also serve as catalysts for health improvement efforts in resource-limited environments.

Corrigendum: Social Tobacco Warnings Can Influence Implicit Associations and Explicit Cognitions.

[This corrects the article DOI: 10.3389/fpsyg.2019.00324.].

Social Tobacco Warnings Can Influence Implicit Associations and Explicit Cognitions.

Previous research showed that fear-inducing graphic warning labels can lead to cognitive dissonance and defensive responses. Less threatening, social-related warning labels do not elicit these defensive responses, making them more effective in preventing smoking in adults. Given that smoking numbers are still too high among youngsters, it is crucial to investigate how warning labels should be designed to prevent teenagers from starting smoking in the first place. In two studies, we investigated whether comparable effects of social-related warning labels could be observed in a group of teenagers (14-17 years) who are not yet legally allowed to smoke. In addition, we tried to replicate earlier findings with smoking and non-smoking adults. Participants were presented with either health warning labels, social warning labels, or no warning labels. Subsequently, their explicit cognitions (i.e., risk perception, attitude toward smoking) and their implicit associations of smoking with healthiness/unhealthiness (Study 1a and Study 1b) and with positivity/negativity (Study 2a and Study 2b) were assessed. Results showed that in both studies, adult smokers had a higher risk perception and a more positive attitude toward smoking than adult non-smokers. Additionally, social warning labels lead to stronger implicit associations between smoking and negativity in Study 2 in the adult groups. In the teenage group, social warning labels lead to more positive attitudes than health warning labels in Study 2. No further effects on risk perception or implicit associations were found in the teenage group. Possible explanations are discussed.

Serious games as an educational strategy for management and leadership development in postgraduate medical education - an exploratory inquiry.

BACKGROUND: Previous research has shown that medical residents are in need of additional training in management and leadership skills. One of the possible ways of teaching this competency is the use of a serious game. This study explores residents' views of the potential use of a serious game to teach a module on negotiation in practice management and leadership curriculum. METHOD: The aim of this study was to identify the features required to design a serious game for management and leadership education, including potential scenarios for such a game. Qualitative interviews were conducted with six medical residents. After transcription and coding of data, thematic analysis was used to group the data into four themes, namely: 1) CanMEDS leader competency, 2) personal views about negotiation, 3) views about serious games, and 4) educational needs in a serious game. RESULTS: Our findings revealed that leadership and negotiation were two domains where residents felt they needed additional training. Those who were already familiar with medical applications and had them installed on their smartphones or tablets had a more positive attitude toward gaming than those who did not. The residents were mostly interested in how realistic the content of a serious game was and its ability to combine management and leadership skills with medical knowledge and clinical expertise. CONCLUSIONS: The findings in this study demonstrate that serious games have the potential to teach certain aspects of management and leadership. The study shows that residents are receptive to the use of serious games and, if well designed, believe that it can be used to improve their management and leadership competencies.