Health professional education at global scale: The inaugural Lincoln Chen lecture.

This inaugural Lincoln Chen Lecture comments on five themes raised in the International Conference on the Future of Health Professional Education (University of Miami, November 2022), identifies challenges for the future of health professional education, and highlights the contributions and legacy of Lincoln Chen.

Challenges and opportunities for educating health professionals after the COVID-19 pandemic.

The education of health professionals substantially changed before, during, and after the COVID-19 pandemic. A 2010 Lancet Commission examined the 100-year history of health-professional education, beginning with the 1910 Flexner report. Since the publication of the Lancet Commission, several transformative developments have happened, including in competency-based education, interprofessional education, and the large-scale application of information technology to education. Although the COVID-19 pandemic did not initiate these developments, it increased their implementation, and they are likely to have a long-term effect on health-professional education. They converge with other societal changes, such as globalisation of health care and increasing concerns of health disparities across the world, that were exacerbated by the pandemic. In this Health Policy, we list institutional and instructional reforms to assess what has happened to health-professional education since the publication of the Lancet Commission and how the COVID-19 pandemic altered the education process.

How Hospitals Can Save Lives and Themselves: Lessons on Patient Flow From the COVID-19 Pandemic.

COVID-19 has strained hospital capacity, detracted from patient care, and reduced hospital income. This article lays out a tested strategy that surgical and hospital leaders can use to overcome clinical and financial strain, emphasizing the experience at 2 leading North American medical centers. By classifying the time and resource needs of surgical patients and smoothing the flow of surgical admissions over all days of the week, hospitals can dramatically improve hospital efficiency, the quality of care and timely access to care for emergent and urgent surgeries. Through and beyond the time of COVID, smoothing the flow of surgical patients is a key means to restore hospital vitality and improve the care of all patients.

Assessing Diagnostic Performance.

Assessing Diagnostic PerformanceDiagnosis is an action and a goal in medicine. This article is the introduction to a series of review articles on varying facets of diagnosis. Clinical diagnosis is an exercise in classification; that is, placing the patient's condition in the correct diagnostic category. However, consideration must also be given to the performance objective, whether it is technical performance of a test, acquiring diagnostic information with respect to clinical management for an individual or a population's health outcomes, or cost-effectiveness and equity of care.

The paradox of disease prevention: celebrated in principle, resisted in practice.

Prevention of disease is often difficult to put into practice. Among the obstacles: the success of prevention is invisible, lacks drama, often requires persistent behavior change, and may be long delayed; statistical lives have little emotional effect, and benefits often do not accrue to the payer; avoidable harm is accepted as normal, preventive advice may be inconsistent, and bias against errors of commission may deter action; prevention is expected to produce a net financial return, whereas treatment is expected only to be worth its cost; and commercial interests as well as personal, religious, or cultural beliefs may conflict with disease prevention. Six strategies can help overcome these obstacles: (1) Pay for preventive services. (2) Make prevention financially rewarding for individuals and families. (3) Involve employers to promote health in the workplace and provide incentives to employees to maintain healthy practices. (4) Reengineer products and systems to make prevention simpler, lower in cost, and less dependent on individual action. (5) Use policy to reinforce choices that favor prevention. (6) Use multiple media channels to educate, elicit health-promoting behavior, and strengthen healthy habits. Prevention of disease will succeed over time insofar as it can be embedded in a culture of health.

The impact of nontransparent health communication during the COVID-19 pandemic on vaccine-hesitant people's perception of vaccines.

Background: Although transparency is crucial for building public trust, public health communication during the COVID-19 pandemic was often nontransparent. Methods: In a cross-sectional online study with COVID-19 vaccine-hesitant German residents (N = 763), we explored the impact of COVID-19 public health communication on the attitudes of vaccine-hesitant individuals toward vaccines as well as their perceptions of incomprehensible and incomplete information. We also investigated whether specific formats of public health messaging were perceived as more trustworthy. Results: Of the 763 participants, 90 (11.8%) said they had become more open-minded toward vaccines in general, 408 (53.5%) reported no change, and 265 (34.7%) said they had become more skeptical as a result of public health communication on COVID-19 vaccines. These subgroups differed in how incomprehensible they found public health communication and whether they thought information had been missing. Participants' ranking of trustworthy public health messaging did not provide clear-cut results: the fully transparent message, which reported the benefit and harms in terms of absolute risk, and the nontransparent message, which reported only the benefit in terms of relative risk were both considered equally trustworthy (p = 0.848). Discussion: Increased skepticism about vaccines during the COVID-19 pandemic may have partly been fueled by subpar public health communication. Given the importance of public trust for coping with future health crises, public health communicators should ensure that their messaging is clear and transparent.