Ten principles for data sharing and commercialization.

Digital medical records have enabled us to employ clinical data in many new and innovative ways. However, these advances have brought with them a complex set of demands for healthcare institutions regarding data sharing with topics such as data ownership, the loss of privacy, and the protection of the intellectual property. The lack of clear guidance from government entities often creates conflicting messages about data policy, leaving institutions to develop guidelines themselves. Through discussions with multiple stakeholders at various institutions, we have generated a set of guidelines with 10 key principles to guide the responsible and appropriate use and sharing of clinical data for the purposes of care and discovery. Industry, universities, and healthcare institutions can build upon these guidelines toward creating a responsible, ethical, and practical response to data sharing.

Examination Innovation: Transforming the National Board of Examiners in Optometry's Clinical Skills Examination.

SIGNIFICANCE: The National Board of Examiners in Optometry recognizes the need for innovation and is creating a multidimensional clinical examination to parallel advancements within optometry. As optometry evolves, so must the assessments which form the path to optometric licensure. The current performance-based Part III, Clinical Skills Examination, is undergoing a transformation to best assess the diversity of knowledge, skills, and abilities needed to practice contemporary optometry. The objectives for the new clinical examination include increasing clinical authenticity, prioritizing the most essential and relevant skills, and emphasizing patient-centered care. This initiative is evidence based and consistent with best practices within the larger assessment community.

Research Success in Schools of Allied Health Professions.

Although the value of research within schools of allied health professions is widely accepted, its practice is limited, and the means of achieving success is poorly understood. This project aimed to characterize schools that have achieved research success, to explore the activities that allow schools to become successful, and to evaluate the metrics by which research success may be monitored. Using data from the 2016 ASAHP Institutional Survey (n=83 schools) and interviews with leadership at top-funded schools, we examined the relationships between external research funding, publications, and program rank for ASAHP member schools and explored the characteristics of well-funded schools. The hallmarks of success include high and clear expectations of faculty, significant levels of institutional investment in research infrastructure, and protected time for faculty research. Institutional support for publishing, including support for pilot studies, statistical analysis, and writing, may be important first steps in achieving research success. While average program rank is higher among schools with research funding than schools without it, program standing alone is not highly correlated with overall research success among ASAHP member institutions.

Citation and Characteristic Analysis of Physician Assistant Programs Placed on Accreditation-Probation, 2015-2017.

PURPOSE: The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) is responsible for accrediting the current 236 entry-level physician assistant (PA) programs in the United States. This study analyzes citations levied against PA programs by the ARC-PA and how those citations relate to the commission's ultimate accreditation decisions; in addition, this study compares PA program characteristics and assesses those characteristics as they relate to recent accreditation outcomes. METHODS: This study used citations for specific violations of ARC-PA Standards to analyze the ARC-PA's accreditation decisions from September 2015 through September 2017. The institutional characteristics of programs that received an accreditation-probation decision were compared with those that received an accreditation-continued or accreditation-provisional decision. Where possible, outcome decisions were benchmarked using national data obtained from publications distributed by the Physician Assistant Education Association. RESULTS: On average, programs that were placed on accreditation-probation during the time frame of this study had received their initial accreditation 16 years before being placed on probation. Altogether, 393 citations were levied against those programs (range: 2-60 citations; median: 13.5 citations). Physician assistant programs that were awarded provisional or continued accreditation were cited for slightly different Standards violations than PA programs that were placed on probation. The average 5-year pass rate for students taking the Physician Assistant National Certifying Examination for the first time was not very different for students from PA programs that were placed on probation and all other programs. CONCLUSIONS: Faculty members, institutions, and entities that support PA program development can use this information to compare PA programs. The results of this study can help PA programs identify areas of frequent noncompliance with the ARC-PA's Standards; provide context that PA programs can use to assess their performance against other programs in the accreditation process; and help PA programs identify areas in need of priority attention nationwide.

Similarities and Differences Between Physician Assistant Program and Medical School Mission Statement Themes.

PURPOSE: The purpose of this study was to examine the concordance of US physician assistant (PA) program mission statements with those of US public- and private-sponsored medical schools. With the exception of a broader medical school focus on research, the authors hypothesized that little difference in mission statement congruence would be found in a comparison of medical schools and PA programs. METHODS: Mission statements of 209 of the 210 accredited US PA programs as of May 2016 were obtained and analyzed. Keywords and phrases were identified, coded, and analyzed using NVivo. Themes that previously reported medical school mission statement analyses (including education, research, service, primary care, diversity, prevention, provider distribution, and cost control) were examined. Additional themes of evidence-based medicine (EBM), interprofessional care, patient safety, and quality improvement were included in the analyses. RESULTS: Analyses revealed similar emphasis in both PA programs and medical schools on themes of education, prevention, and cost control, with dissimilar emphases on themes of research, service, primary care, diversity, and provider distribution. Physician assistant programs were more likely to emphasize interprofessional care than EBM, patient safety, or quality improvement. CONCLUSIONS: In the comparison of mission statements of medical schools and PA programs, much less congruence was found than had been hypothesized. Although this study examined the similarities and differences between the mission statements of US medical schools and PA programs, it did not examine the extent to which programs succeeded in meeting the stated missions. Additional research is necessary to understand the factors that determine whether mission statements are actualized in measurable deliverables.

Key Factors Leading to Program Selection: A Survey of Physician Assistant Program Interviewees.

PURPOSE: The purpose of this study was to determine which factors had the greatest influence on physician assistant (PA) interviewees' decision to choose a PA program to attend. The information in this article may assist PA programs in making their program more attractive to potential applicants and also may help applicants identify programs that will best fit their needs. METHODS: Applicants who interviewed with a PA program were asked to rate 33 different influential factors when choosing a program to attend. RESULTS: Respondents most highly endorsed quality of faculty and staff, first-time Physician Assistant National Certifying Examination pass rates, and morale of faculty and staff. Results varied by demographics, including marital status, age, and sex of respondent. Results also varied from pre-PA students. CONCLUSIONS: Although there are numerous factors involved in program selection, PA programs may want to focus on the quality and morale of their faculty and staff to help improve the likelihood of attracting and retaining the highest quality applicants.

Time for action: key considerations for implementing social accountability in the education of health professionals.

Within health professional education around the world, there exists a growing awareness of the professional duty to be socially responsible, being attentive to the needs of all members of communities, regions, and nations, especially those who disproportionately suffer from the adverse influence of social determinants. However, much work still remains to progress beyond such good intentions. Moving from contemplation to action means embracing social accountability as a key guiding principle for change. Social accountability means that health institutions attend to improving the performance of individual practitioners and health systems by directing educational and practice interventions to promote the health of all the public and assessing the systemic effects of these interventions. In this Reflection, the authors (1) review the reasons why health professional schools and their governing bodies should codify, in both curricular and accreditation standards, norms of excellence in social accountability, (2) present four considerations crucial to successfully implementing this codification, and (3) discuss the challenges such changes might entail. The authors conclude by noting that in adopting socially accountable criteria, schools will need to expand their philosophical scope to recognize social accountability as a vitally important part of their institutional professional identity.

Crafting a Profession: Moving From Innovative Model Programs to a Successful National Profession.

The authors review the historical underpinnings of the physician assistant (PA) profession and the tumultuous social context at the time the PA profession was born. They explore the creation of "model" PA programs and the subsequent crafting of the PA profession through 2 distinct "quality control" procedures: the credentialing of PA programs (accreditation) and the credentialing of PA graduates (certification). These pillars of PA education and PA practice brought credibility to a fledgling profession in its early years and stand today as examples of the creative thinking and courage of the architects of a profession that, for the first time in American medical history, allowed someone, other than physicians, to practice medicine.

The Future of Clinical Education: Using Futuristic Scenarios to Explore Allied Health Deans' Perspectives on Clinical Education.

ISSUE: There is limited information and consensus on the future of clinical education. The Delphi technique was selected to identify agreement among Association of Schools of Allied Health Professions' (ASAHP) allied health deans on the future (2018-2023) of allied health (AH) clinical education. METHODS: Sixty-one AH deans, 54.9% (61 of 111) of the ASAHP membership, expressed opinions about clinical education through a three-round Delphi study. In conjunction with a conceptual model, four futuristic scenarios were used to encourage deans' feedback on the key factors impacting the future of clinical education. RESULTS: The responses to the four scenarios showed ways the external environment influences which activities the deans recommend. The results presented, by individual scenario and in totality, provide relevant and timely information on the importance and transformation of AH clinical education and its future. DISCUSSION: Futuristic scenarios, in combination with the Delphi technique, generated information where little exists specific to AH deans' perspectives on AH clinical education. The results offer deans opportunities for future strategic improvements. CONCLUSION: The use of the futuristic scenarios was suitable for guiding deans' responses and reaching agreement on the future of AH clinical education. These contributions reflect the imminent conditions and healthcare environment identified in the various scenarios and provide additional insight on key factors impacting the future for AH clinical education.

Profesionalismo: valores y competencias en formación sanitaria especializada / Professionalism: values and competences in specialized medical training

Objetivo. Conocer la percepción de los profesionales sanitarios implicados en la docencia de la formación sanitaria especializada (tutores, residentes y colaboradores docentes) sobre los principales valores y competencias que desarrollan habitualmente en su trabajo. Métodos. Se diseñó un cuestionario para ser autocumplimentado, con 4 secciones y 51 variables (escala 1-10). Se distribuyó entre los profesionales de un hospital universitario y 9 centros de salud. Resultados. Respondieron 287 profesionales. Participación: 97% de los tutores (n=59), 38% de los residentes (n=61) y 56% de otros profesionales sanitarios (97 con faceta docente y 70 sin ella). El coeficiente alfa de Cronbach fue de 0,945. Los 3valores mejor puntuados fueron la responsabilidad por cumplir con el propio trabajo (8,7 puntos), la integridad ética (8,6 puntos) y el respeto hacia el equipo de profesionales con el que trabajan (8,3 puntos). Las 3competencias mejor puntuadas fueron la comunicación con pacientes y familiares (8,16 puntos), el liderazgo para motivarse a uno mismo (7,9 puntos) y el trabajo en equipo (7,8 puntos). Los valores recibieron, de media, 0,7 puntos más que las competencias (IC 95%: 0,5-0,9). No se observaron diferencias entre tutores y residentes, aunque sí entre médicos y enfermeras, y entre hombres y mujeres. Conclusiones. La percepción sobre los valores y las competencias es compartida por tutores, residentes y colaboradores docentes. Sobre esta percepción influyó la categoría profesional y el sexo, pero no la edad ni trabajar en el hospital o en atención primaria (AU)

Objective. To determine the perception of healthcare professionals (tutors, residents and teaching collaborators) involved in specialist medical training on the core values and skills to develop their tasks. Methods. A tailor-made questionnaire aimed at healthcare professionals in 9health care centres and a referral hospital. Questionnaire: 4 sections and 51 variables (scale 1-10). Results. A total of 287 professionals participated, which included 97% tutors (n=59), 38% residents (n=61), and 56% others (97 teaching collaborators and 70 not associated with teaching). The alfa Cronbach coefficient was 0.945. Best rated values were work compliance (8.7 points), ethics in professional practice (8.6 points), and respect for their team (8.3 points). The best rated competence was communication with patients and families (8.1 points), followed by self-motivating leadership (7.9 points), and the practical application of medical and healthcare theoretical knowledge (7.8 points). The values received, on average, 0.7 points above competences (95% CI: 0.5-0.9). There were no differences between tutors and residents, although differences were found between doctors and nurses, and between males and females. Conclusion. Most of the professionals (tutors, residents, and teaching collaborators) share the same perception of the values and competencies that influence their professional development. This perception was influenced by the professional category and gender, but not age or working in a hospital or primary health care (AU)

The Future of Clinical Education: Opportunities and Challenges from Allied Health Deans' Perspective.

ISSUE: There is limited information and consensus on the future of clinical education and the key factors impacting allied health (AH) clinical training. AH deans identified both opportunities and challenges impacting clinical education based on a proposed educational model. METHODS: From July 2013 to March 2014, 61 deans whose institutions were 2013 members of the Association of Schools of Allied Health Professions (ASAHP) participated in a three-round Delphi survey. Agreement on the relative importance of and the ability to impact the key factors was analyzed. Impact was evaluated for three groups: individual, collective, and both individual and collective deans. AH deans' responses were summarized and refined; individual items were accepted or rerated until agreement was achieved or study conclusion. RESULTS: Based on the deans' ratings of importance and impact, 159 key factors within 13 clinical education categories emerged as important for the future of clinical education. Agreement was achieved on 107 opportunities and 52 challenges. CONCLUSIONS: The Delphi technique generated new information where little existed specific to AH deans' perspectives on AH clinical education. This research supports the Key Factors Impacting Allied Health Clinical Education conceptual model proposed earlier and provides a foundation for AH deans to evaluate opportunities and challenges impacting AH clinical education and to design action plans based on this research.

Paediatric concussion: Knowledge and practices of school speech-language pathologists.

PRIMARY OBJECTIVE: To characterize paediatric concussion knowledge and the management practices of school-based speech-language pathologists (SLPs) in the US to establish a baseline upon which changes in SLP training, knowledge and best practices can be measured. RESEARCH DESIGN: A survey was developed to assess current knowledge and management of paediatric concussion allowing for comparison to previous and future surveys on SLP knowledge and practice in other areas of brain injury. METHODS AND PROCEDURES: One thousand surveys were distributed to school-based SLPs from 10 states. Two hundred and eighty SLPs from Minnesota, Wisconsin, New York, Massachusetts, Georgia, Florida, Texas, Tennessee, California and Arizona responded to the survey. MAIN OUTCOMES AND RESULTS: Compared to previous survey results, SLPs from the current sample indicate an increase in general brain injury training, but confidence in providing clinical services to brain-injured students remains low. SLPs have a mix of accurate and inaccurate concussion knowledge and uncertainty about their role in concussion management. CONCLUSIONS: Findings suggest that increasing communication with other school personnel about concussion, increased training in paediatric TBI and concussion improved access to appropriate assessments tools and implementation of long-term concussion management will improve service delivery to school-aged children with concussion.

Failure to fail: the institutional perspective.

PURPOSE: To determine institutional barriers to placing failing students on probation, dismissing students. METHODS: An online survey study was distributed to Student Affairs Deans or the equivalent at allopathic (MD) and osteopathic (DO) medical schools, and physician assistant (PA) and nurse practitioner (NP) schools across the United States. Nineteen (40%) of the 48 schools responded: six MD, four DO, five PA and four NP. The survey contained demographic questions and questions regarding probation and dismissal. Themes were independently coded and combined via consensus based on grounded theory. The survey was distributed until saturation of qualitative responses were achieved. RESULTS: Respondents identified variations in the use of probation and dismissal and a wide range of barriers, with the greatest emphasis on legal concerns. Respondents felt that students were graduating who should not be allowed to graduate, and that the likelihood of a student being placed on probation or being terminated was highly variable. DISCUSSION: Our results suggest that institution culture at heath professions schools across the United States may represent an obstacle in placing failing learners on probation and dismissing learners who should not graduate. Additional studies are needed to prove if these concerns are founded or merely fears.

Student vaccination requirements of U.S. health professional schools: a national survey.

UNLABELLED: To help protect healthcare personnel (HCP) from infection and to prevent possible disease transmission to their patients, the Advisory Committee on Immunization Practices (ACIP) recommends vaccination of all HCP, including students. We sought to gather information on the vaccination policies of U.S. health professional (i.e., non-physician HCP) programs and to compare those requirements to current ACIP recommendations. METHODS: A self-administered, internet-based survey sent to 2,779 U.S. health professional programs was used to collect data on program demographics; student vaccination requirements; deadlines for adherence, consequences for non-adherence, and permitted exemptions to these requirements; and factors influencing the program's vaccination policy. RESULT: The response rate was 75%. Among 2,077 responding programs, 19% required all ACIP-recommended vaccines for HCP--87% required measles, mumps, and rubella; 84% required hepatitis B; 75% required varicella; 48% required tetanus, diphtheria, and acellular pertussis (Tdap); and 32% required influenza. Programs reviewing requirements at least annually and those that reported the ACIP influenced requirements were significantly more likely to require varicella, Tdap, and influenza vaccine. During the 2009-2010 influenza season, only 59% of programs offered influenza vaccine to students. CONCLUSION: Health professional schools should update their vaccination requirements annually to be consistent with ACIP recommendations.