Patient-resident physician communication - a qualitative study to assess the current state, challenges and possible solutions.

BACKGROUND: Patients perceive effective patient-doctor communication as an important metric when evaluating their satisfaction with health systems. Hence, optimal patient-physician communication is fundamental for quality healthcare. High-income countries (HICs) have extensively studied patient-resident communication. However, there is a dearth of similar studies in low- and middle-income countries (LMICs). Therefore, we aimed to explore the current state of and barriers to practicing good patient-resident communication and explore possible solutions to mitigate these challenges at one of the largest Academic Medical Centers in an LMIC. METHODS: This study employed an exploratory qualitative study design and was conducted at the Aga Khan University Hospital in Pakistan. Through purposive maximum variation sampling, 60 healthcare workers from diverse cohorts, including attendings, fellows, residents, and medical students, participated in eight focus group discussions. RESULTS: We identified three key themes from the data: Status-quo of residents' communication skills and learning (Poor verbal and non-verbal communication, inadequate training programs, and variable sources of learning), Barriers to effective communication (Institutional barriers such as lack of designated counselling spaces, lack of resident insight regarding effective communication and deficits in intra-team communication), and the need for developing a communication skills curriculum (Design, implementation and scaling to other cohorts of healthcare workers). CONCLUSIONS: Findings from this study show that multifaceted factors are responsible for inadequate patient resident-physician communication, highlighting the need for and importance of developing a formal communication skills training curriculum for residents. These insights can be used to create standardized training for equipping residents with adequate skills for effectively communicating with patients which can improve healthcare service delivery and patient outcomes.

Core competencies among nurses engaged in pallative care: A scoping review.

AIM: To synthesize available evidence about core competencies for nurses engaged in palliative care. DESIGN: A scoping review conducted according to the framework from Joanna Briggs Institute. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist was adopted to report this scoping review. The PubMed, Web of Science, Embase, ScienceDriect, CNKI, WangFang, VIP and Sinomed databases were used to systematically search for published studies from their inception to December 2023. Two researchers independently screened and selected relevant studies and performed the data charting. RESULTS: Twenty-six studies were included in this scoping review. Among these, 14 studies identified core competency assessment instruments among nurses engaged in palliative care, with the Palliative Care Core Competence Questionnaire was used most frequently; 13 studies investigated the status of core competencies of nurses engaged in palliative care, the majority of included studies indicated that nurse's core competencies were at moderate levels; 11 studies explored the factors influencing the core competencies of the nurses engaged in palliative care, which were classified as sociodemographic-related factors, palliative care education-related factors, death attitude, palliative care practice-related experience and others. CONCLUSION: This scoping review offers a comprehensive overview of the current landscape of core competencies among nurses in palliative care. Findings suggested that the clinical nursing leaders need to develop tailored strategies and interventions to address specific factors and promote the continuous development of nurses' competencies in palliative care. RELEVANCE TO CLINICAL PRACTICE: Core competency assessment instruments equip nurses and healthcare organizations with a range of validated tools for evaluating their proficiency in palliative care. Targeted core competency enhancement programmes need to be developed to foster a nursing workforce better equipped to improve the quality of life of end-of-life patients and their families. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

A core competency evaluation index system for the graded use of clinical nurse specialists: A Delphi study.

AIMS AND OBJECTIVES: To describe a grading system that can be used to evaluate core competency of clinical nurse specialists (CNSs) at different levels. BACKGROUND: Evaluate core competence of CNSs at different levels reflects the quality of nursing and the development of the nursing profession. DESIGN: This research employed the Delphi method. METHODS: The STROBE checklist for observational cross-sectional studies was followed to report this research study. This study consisted of two main phases: a literature review and semistructured interviews. Individual semistructured interviews were conducted with 11 healthcare experts and two patients. Two rounds of questionnaire surveys were administered to 21 nursing experts using the Delphi method. The CNSs were classified as primary, intermediate or advanced based on their years of work, professional titles and educational qualifications. RESULTS: The graded competency evaluation system consisted of five first-level indicators (clinical practice, consulting guidance and teaching, scientific research innovation, management and discipline development, and ethical decision-making), 15 second level indicators, and 40 third-level indicators. The authority coefficients (Cr) of the experts were .865 and .901. The Kendall's concordance coefficients of the three-level indicators were .417, .289 and .316 for primary CNSs; .384, .294 and .337 for intermediate CNSs; and .489, .289 and .239 for advanced CNSs. CONCLUSION: The graded use evaluation system in clinical practice initially involves a comprehensive evaluation of the core abilities of CNSs. This is a tool for cultivating and grading the abilities of specialised nurses that can promote a practical upwards spiral. RELEVANCE TO CLINICAL PRACTICE: The evaluation system can promote the scientific management and continuous improvement of CNSs in clinical nursing and can serve as a practical and objective reference for the effective management and development of CNSs. PATIENT OR PUBLIC CONTRIBUTION: Patients participated in the data collection process, during which they shared their health-seeking experience with our research team.

Status and associated factors of gerontological nurse specialists' core competency: a national cross-sectional study.

BACKGROUND: Nurses' core competency directly affects patients' safety and health outcomes. Gerontological nurse specialists play an essential role in improving older adults' health status. However, little is known about their core competency level and the factors influencing core competency. Therefore, this study aimed to investigate the status of core competency and factors influencing the core competency of gerontological nurse specialists in China. METHODS: A multicenter cross-sectional study was conducted on gerontological nurse specialists certified by province-level or above organizations across China between March 2019 and January 2020. The Revised Core Competency Evaluation Instrument for Gerontological Nurse Specialists was used to measure participants' core competency. The median, frequencies, and percentages were used to describe participants' characteristics and level of core competency. Multivariate stepwise regression analysis was applied to analyze the factors influencing core competency. RESULTS: The median score of gerontological nurse specialists' core competency was 3.84, and professional development skills and research and analysis decision-making skills had the lowest scores among the dimensions. The multivariate stepwise regression analysis showed that individual-level factors (i.e., working experience length of geriatric nursing and attitudes toward caring for older adults), employer-level factors (i.e., departments, job responsibilities, the degree of satisfaction toward the attention and support and the promotion rules provided by the hospital or department), and training-associated factors (i.e., economic zone where training organizations are located and the degree to which the training content met clinical needs) are independently associated with gerontological nurse specialists' core competency level (P < 0.05). CONCLUSIONS: This study showed that gerontological nurse specialists' core competency needs further improvements, especially regarding professional development skills and research and analysis decision-making skills. Additionally, individual-, training-, and employer-level factors could influence their core competency level, indicating that interventions targeting these factors could be applied to improve the core competency of gerontological nurse specialists.

Exploring the core competencies of clinical nurses in chinese tertiary hospitals: a qualitative content analysis.

BACKGROUND: With the changes in social and medical environments and people's health needs, the nursing core competency should be updated and developed promptly. This study aimed to explore the core competencies of nurses in Chinese tertiary hospitals under the new health development strategy. METHODS: Descriptive qualitative research was conducted using qualitative content analysis. 20 clinical nurses and nursing managers from 11 different provinces and cities were interviewed via purposive sampling. RESULTS: Data analysis revealed 27 competencies, which were grouped into three major categories according to the onion model. These categories were motivation and traits (responsibility, enterprise, etc.), professional philosophy and values (professionalism, career perception, etc.), and knowledge and skills (clinical nursing competency, leadership and management competency, etc.). CONCLUSION: Based on the onion model, core competencies for nurses in Chinese tertiary hospitals were established, revealing three layers of core competencies and giving a theoretical reference for nursing managers to conduct competency training courses based on the competency levels.

Development of billing post competency evaluation index system for nurses in China: a Delphi study.

AIM: This study developed a set of competency evaluation indicators for billing nurses in China. BACKGROUND: In clinical practice, nurses often take up billing responsibilities that are accompanied by certain risks. However, the competency evaluation index system for billing nurses has not been established in China. METHODS: This study consisted of two main phases of research design: the first phase included a literature review and semi-structured interviews. Individual semi-structured interviews were conducted with 12 nurses in billing departments and 15 nurse managers in related departments. Concepts distilled from the literature review were linked to the results of the semi-structured interviews; this phase produced the first draft of indicators for assessing the professional competence of nurses in billing departments. In the second phase, two rounds of correspondence were conducted with 20 Chinese nursing experts using the Delphi method to test and evaluate the content of the index. The consensus was defined in advance as a mean score of 4.0 or above, with at least 75% agreement among participants. In this way, the final indicator framework was determined. RESULTS: Using the iceberg model as a theoretical foundation, the literature review identified four main dimensions and associated themes. The semi-structured interviews confirmed all of the themes from the literature review while generating new themes, both of which were incorporated into the first draft of the index. Then two rounds of the Delphi survey were conducted. The positive coefficients of experts in the two rounds were 100% and 95%, respectively, while the authority coefficients were 0.963 and 0.961, respectively. The coefficients of variation were 0.00-0.33 and 0.05-0.24, respectively. The competency evaluation index system for billing nurses consisted of 4 first-level indicators, 16 s-level indicators, and 53 third-level indicators. CONCLUSION: The competency evaluation index system for billing nurses, which was developed on the basis of the iceberg model, was scientific and applicable. IMPLICATIONS FOR NURSING MANAGEMENT: The competency assessment index system for billing nurses may provide an effective practical framework for nursing administration to evaluate, train, and assess the competency of billing nurses.

[Establishment of Role and Core Competencies of Geriatric Case Managers in Taiwan].

BACKGROUND: Older adults have unique and complex care needs that are multifaceted, continuous, and integrated and that span prevention and treatment to long-term rehabilitation. Case managers are able to integrate healthcare and social resources to help older adults and their caregivers manage the needs of daily life. Therefore, identifying the role and core competencies of geriatric case managers in Taiwan is crucial. PURPOSE: To develop the role and core competencies of geriatric case managers in Taiwan. METHODS: Based on a review of the literature, a two-round modified Delphi technique was used to evaluate the framework of the geriatric case manager role and core competencies. Experts were invited to join a panel to review and rank the importance of each role and competency within the context of the Delphi technique. RESULTS: Four roles and 36 core competencies of geriatric case managers were identified, and 94.4% consensus was reached in round two. The roles and core competencies included care expert (18 competencies), coordinator (6 competencies), consultant (6 competencies), and evidence-based practitioner (6 competencies). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Training programs may be developed for geriatric case managers based on the results of this study to further promote the quality of provided geriatric care.

[Application and Recommendation of Entrustable Professional Activities (EPAs) in Nursing Education].

The competency-based approach has been advocated in medical education in recent years to strengthen the professional competencies and skills of medical professionals entering their residency. Entrustable professional activity (EPA), which consists of clinical tasks, core competencies, and milestones, is a recommended competency-based training program focused on the learning process of trainees. EPA emphasizes that trainers evaluate their trainees' learning repeatedly and provide feedback so that these trainees have an opportunity to correct their behaviors. However, EPAs have not yet been widely implemented in school-based nursing education. The purpose of this essay was to introduce the concept, connotations, development stage, and application of EPAs. The dilemmas and recommendations of EPA development in Taiwan are also presented.

[Metamorphosis of Nurses: The Development and Breakthroughs of Advanced Practice Registered Nurses].

BACKGROUND: The introduction and development of the advanced practice registered nurse (APRN) is a global trend in nursing. However, the development of APRNs in Taiwan remains uncertain and lacks necessary consensus. PURPOSE: This research study aimed to explore the views and suggestions of nursing experts in industry, government, and academia regarding the development of APRNs (clinical nurse specialists, case managers, certified clinical registered nurse anesthetists, and certified nurse-midwives) in Taiwan. METHODS: Data were collected from March to August 2017. Sixty-four experts participated in one of six focus group discussions held in northern, central, and southern Taiwan. These group discussions were recorded and transcribed verbatim with the consent of the participants. Content analysis was used to analyze the transcribed data. RESULTS: The comments and suggestions raised during the discussions were categorized into four major themes: professional development of necessity, core competencies, accreditation, and future promotion-related issues. Each theme was further divided into several subthemes. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The opinions of relevant experts regarding the current status of development of the roles, practical scope, and management and suggestions for APRNs were summarized to facilitate the future development of APRNs in Taiwan in terms of education, core competencies, certification, and practical scope. Furthermore, the results may be referenced in the establishment of a nursing consensus model and as a basis for promoting APRNs.

Perceptions of Home Dialysis Training and Experience Among US Nephrology Fellows.

RATIONALE & OBJECTIVE: Prior research suggests a lack of confidence among graduating US nephrology trainees in implementing both peritoneal dialysis (PD) and home hemodialysis (HHD). Gaps in fellowship training may represent an obstacle to achieving the Advancing American Kidney Health Initiative's goal of increasing the use of home dialysis. We sought to identify the strengths of and limitations in home dialysis training. DESIGN: A cross-sectional study surveying nephrology trainees regarding their confidence with home dialysis management and perceptions of home dialysis educational resources provided by their training program. SETTING & PARTICIPANTS: A paper survey was distributed to 110 nephrology trainees with at least 1 year of nephrology fellowship training who attended any 1 of 3 home dialysis conferences. ANALYTICAL APPROACH: Data were summarized as percentages. χ2, Fisher exact, and Kruskal-Wallis rank sum tests were used for statistical analysis. OUTCOME: Self-perception of readiness to manage PD and HHD patients. RESULTS: 76 of 110 (66%) attendees completed the survey. Most respondents were moderately confident regarding principles of PD. However, only 3% had initiated patients on "urgent-start PD" and 11% observed a PD catheter insertion. The level of confidence for HHD was low. Most trainees attended a home dialysis continuity clinic with mentorship from faculty. LIMITATIONS: A small number of participants and the inability to verify respondent-provided data for the number of PD and HHD patients seen and clinics attended. Potential lack of generalizability owing to inclusion of only trainees who attended a home dialysis conference. CONCLUSIONS: Nephrology trainees perceive low and moderate levels of preparedness for managing HHD and PD, respectively. Educational innovation and optimization of resources at both the institutional and national levels may improve confidence and promote public policy goals regarding home dialysis therapies.

Core Competency Self-Assessment Enhances Critical Review of Complications and Entrustable Activities.

BACKGROUND: The Accreditation Council for Graduate Medical Education has defined six core competencies (CCs) that every successful physician should possess. However, the assessment of CC achievement among trainees is difficult. This project was designed to prospectively evaluate the impact of resident identification of CC as a component of morbidity review on error identification and standard of care (SOC) assessments. The platform was assessed for its reliability as a measure of resident critical analysis of complication causality across postgraduate year (PGY). MATERIALS AND METHODS: A total of 1945 general surgery cases with complications were assessed for error identification and SOC management between January 1, 2016, and December 31, 2018. CC identification was additionally assessed between January 1, 2019, and December 31, 2019, and included 708 general surgery cases. Data were evaluated for error assessments and overall SOC management. PGY4 and 5 residents were compared for number of cases and complications reviewed, severity, error causation, and CC relevance. RESULTS: Study groups were equivalent by Clavien-Dindo scores. Error identification significantly increased in all categories: diagnostic (P < 0.001), technical (P < 0.05), judgment (P < 0.001), system (P < 0.001), and communication (P < 0.001). Overall SOC assessments validated by a supervising surgical quality officer were unchanged. An increased exposure to cases with severe complications, error causation, and CC relevance was noted across PGY. CONCLUSIONS: The addition of CC assessment into morbidity review appears to improve the critical thinking of evaluating residents by increasing the identification of management errors. Used as an element of prospective self-assessment, teaching residents to identify CC principles in cases with complications may assist in learner progression toward clinical competence and critical thinking.

Are they ready yet?: A theory-driven evaluation of suicide risk assessment trainings in psychology graduate programs.

OBJECTIVES: The present study sought to understand the state of suicide risk assessment trainings in clinical psychology graduate programs. METHODS: We surveyed 167 clinical psychology doctoral students' behavioral competency in responding to suicidal clients and their attitudes, perceived behavioral control, subjective norms, and intentions related to suicide risk assessment. Hypotheses were tested using path analysis. RESULTS: Ninety six percent of participants reported receiving some type of suicide risk assessment training at their program. Results provided partial support for significant relationships between attitudes, perceived behavioral control, subjective norms, and intentions. Unexpectedly, amount of training in suicide risk assessments was not related to theory of planned behavior variables including behavioral competency. CONCLUSION: These findings have implications regarding the effectiveness of current suicide risk assessment training practices and ways to improve trainings to help increase the number of clinical psychologists competent in suicide risk assessment and management.

A systematic review of healthcare professionals' core competency instruments.

While technical and profession-specific competencies are paramount in the delivery of healthcare services, the cross-cutting core competencies of healthcare professionals play an important role in healthcare transformation, innovation, and the integration of roles. This systematic review describes the characteristics and psychometric properties of existing instruments for assessing healthcare professionals' core competencies in clinical settings. It was guided by the JBI methodology and used the COSMIN checklist (Mokkink et al., User manual, 2018, 78, 1) to evaluate the methodological quality of the included studies. A database search (CINAHL, Scopus, and PubMed) and additional manual search were undertaken for peer-reviewed papers with abstracts, published in English between 2008 and 2019. The search identified nine studies that were included in the synthesis demonstrating core competencies in professionalism, ethical and legal issues, research and evidence-based practice, personal and professional development, teamwork and collaboration, leadership and management, and patient-centered care. Few instruments addressed competencies in quality improvement, safety, communication, or health information technology. The findings demonstrate the reviewed tools' validity and reliability and pave the way for a comprehensive evaluation and assessment of core competencies into clinical practice.

Impact of faculty development programme on self-efficacy, competency and attitude towards medical education in Bhutan: a mixed-methods study.

BACKGROUND: Soon after Bhutan's first medical university was established in 2012, Faculty Development Programmes (FDPs) were adopted for efficient delivery of postgraduate medical curriculum. Medical education was an additional responsibility for the clinicians who already had multi-dimensional roles in the healthcare system where there is acute shortage of healthcare professionals. We studied the impact of FDPs on postgraduate medical education in Bhutan. METHODS: This was a mixed-methods study with a quantitative (cohort study - quasi-experimental with 18 participants) and concurrent explanatory qualitative component (focused group discussion (FGD) with 11 teaching faculty members). The 18 participants were given a structured FDP designed by the University. The FGD assessed teacher self-efficacy and competency using standard tools before and after the FDP. Thematic analysis of the FGD explored the impact of FDPs in the delivery of postgraduate residency programmes. RESULTS: There were significant increase in the teacher self-efficacy (31 vs 34, p = 0.009) and competency scores (56 vs 64, p = 0.011). There were significant improvements in self-efficacy in the domain of the teaching relevant subject contents and developing creative ways to cope with system constraints. In teaching-learning assessments, there was a significant appreciation of the effectiveness of lectures and tutorials and the use of essay questions. The FGD demonstrated the acceptance of FDPs and its importance in quality improvement of postgraduate medical education, professional development of teachers and improvement of their communication skills. The teachers have now migrated from the conventional methods of teaching to workplace-based teaching and assessment. The FDPs also resulted in review and revision of postgraduate medical curriculum soon after the first batch graduated in 2018. Lack of adequate support from relevant stakeholders and lack of a medical education centre in the University were seen as major challenges. CONCLUSIONS: The FDPs have brought tangible professionalization of postgraduate medical education at an early stage of the medical university. There is a need for continued efforts to strengthen, sustain and consolidate the gains made thus far.

Assessment of the core competencies of veterinarians: implications for policy decisions in India.

he objectives of this study were two-fold - to assess the technical competencies of veterinarians and their application, and to investigate veterinarians' activities and appropriate ways for them to acquire and enhance competencies. The studywas undertaken in three South Indian states: Andhra Pradesh, Karnataka and Telangana. The survey data, collected in 2015-2016 from nine districts in the three states, came from in-depth questionnaires completed by 270 veterinary assistant surgeons (VASs). The key survey questions were related to: specific technical competencies and their application, appropriate ways to acquirethem, additional competencies needed and recommended activities to enhancethem. Each respondent's rating was obtained on a) how important are thesecompetencies and b) what is their current level of knowledge and/or skills toperform them? The findings revealed that the current level of knowledge and/orskills was inadequate in production, para-clinical and clinical areas in the day-todaywork of VASs. The findings suggested that pre-service, in-service and basic induction training, and attending national and international seminars, workshopsand Webinars, are appropriate ways to acquire competencies. Additional skillsperceived as necessary by respondents include: time and stress managementskills, motivational techniques, digital communication technologies, and writing and presentation skills. Specific policy interventions suggested and discussed include: adequate hands-on pre-service instruction in veterinary colleges and assessment of competencies before certification, introducing a veterinary licensing examination, reinforcing competencies through induction training,in-service or continuing veterinary education programmes, and improving theinstitutional mechanisms to assess competencies at regular intervals.

Les objectifs de cette étude sont doubles : d'une part une évaluation des compétences techniques des vétérinaires et leur mise en oeuvre et d'autre part une enquête sur les activités vétérinaires et les moyens appropriés pour permettre aux vétérinaires d'acquérir des compétences et de les améliorer. Cette étude a été réalisée dans trois états du sud de l'Inde : Andhra Pradesh, Karnataka et Telangana. Des questionnaires détaillés ont été remplis par 270 auxiliaires vétérinaires dans neuf districts de ces trois états en 2015 et 2016. Les questions posées concernaient principalement les compétences techniques spécifiques et leur mise en oeuvre, les moyens appropriés pour apprendre des techniques spécifiques, les compétences complémentaires nécessaires, et les moyens permettant d'améliorer les compétences techniques. Les scores attribués aux participants ont été pondérés en fonction de (a) l'importance de chaque compétence et (b) le niveau actuel de connaissance/capacité technique et exécutoire. Les résultats montrent que le niveau actuel de connaissance/ capacité technique et exécutoire des auxiliaires vétérinaires est insuffisant, ne permettant pas la réalisation des activités vétérinaires quotidiennes dans les domaines clinique, paraclinique et de production. D'après les observations des participants, les moyens appropriés pour acquérir les compétences nécessaires sont la formation initiale, la formation d'initiation, la formation continue et la participation aux séminaires nationaux et internationaux ainsi qu'aux ateliers de formation et webinaires. Selon les participants, les compétences complémentaires à acquérir sont la gestion du temps et du stress, les techniques de motivation, les technologies numériques de communication et les compétences orales et écrites. Parmi les interventions spécifiques à envisager pour une politique de formation, on peut citer : des apprentissages pratiques dès l'école vétérinaire, une évaluation avant l'octroi du certificat, la création d'un examen diplômant de fin d'études, le renforcement des capacités à travers des programmes d'initiation et de formation continue et une amélioration des mécanismes institutionnels d'évaluation régulière des compétences.

Los autores describen un estudio que respondía a un doble objetivo: evaluar las competencias técnicas de los veterinarios y su aplicación práctica; y analizar las actividades de estos profesionales y los cauces adecuados para que adquieran competencias y las perfeccionen. El estudio discurrió en tres estados del sur de la India: Andhra Pradesh, Karnataka y Telangana. Empleando un detallado cuestionario que cumplimentaron 270 veterinarios, entre 2015 y se reunieron datos de nueve distritos de esos tres estados. Las principales preguntas del cuestionario guardaban relación con lo siguiente: competencias técnicas específicas y su aplicación, cauces adecuados para adquirirlas, otras competencias necesarias, y actividades recomendadas para perfeccionarlas. Después se obtuvo la clasificación establecida por cada persona interrogada respecto de: (a) cuán importantes son esas competencias; y (b) cuál es actualmente su nivel de conocimientos y/o aptitudes para ponerlas en práctica. Los resultados pusieron de relieve que el actual nivel de conocimientos y/o aptitudes era insuficiente en tres ámbitos del trabajo cotidiano de un veterinario: la producción, la labor paraclínica y la clínica. Del estudio se desprende que la formación previa, la formación continua y la formación básica introductoria, así como la asistencia a seminarios, talleres y seminarios interactivos por Internet de ámbito nacional e internacional, son cauces adecuados para adquirir competencias. De las demás competencias que los encuestados consideraron necesarias destacan las siguientes: capacidad de gestión del tiempo y el estrés; técnicas de motivación; tecnologías digitales de comunicación; y aptitudes de escritura y oratoria. Entre las intervenciones normativas específicas que se propusieron y discutieron figuran: en la etapa estudiantil, formación práctica adecuada en las facultades de veterinaria y evaluación de estas competencias como condición para la entrega del título; implantación de un examen para la concesión de licencia para ejercer la veterinaria; refuerzo de las competencias mediante cursos de iniciación y programas de formación continua veterinaria; y mejora de los mecanismos institucionales para evaluar periódicamente las competencias.

AAVP Recommendations for Core Competency Standards Relating to Parasitological Knowledge and Skills.

As part of the accreditation process, the American Veterinary Medical Association Council on Education has defined nine broad areas of core competencies that must be met by graduating students earning a Doctor of Veterinary Medicine degree. To define competencies in veterinary parasitology, the American Association of Veterinary Parasitologists (AAVP) has developed a detailed list of knowledge and skills that are recommended for inclusion in professional curricula. These recommendations were developed by instructors from colleges/schools of veterinary medicine in the US, Canada, and the Caribbean, and were reviewed and endorsed following AAVP guidelines.

[Applying the Modified Delphi Technique to Develop the Role of HIV Case Managers and Essential Nursing Competencies in HIV Care].

BACKGROUND: Since 2005, the Taiwan Centers for Disease Control (Taiwan CDC) initiated an HIV case management program in AIDS-designated hospitals to provide integrative services and risk-reduction counseling for HIV-infected individuals. In light of the increasingly complex and highly specialized nature of clinical care, expanding and improving competency-based professional education is important to enhance the quality of HIV/AIDS care. PURPOSE: The aim of this study was to develop the essential competency framework for HIV care for HIV case managers in Taiwan. METHODS: We reviewed essential competencies of HIV care from Canada, the United Kingdom, and several African countries and devised descriptions of the roles of case managers and of the associated core competencies for HIV care in Taiwan. The modified Delphi technique was used to evaluate the draft framework of these roles and core competencies. A total of 15 HIV care experts were invited to join the expert panel to review and rank the draft framework. RESULTS: The final framework consisted of 7 roles and 27 competencies for HIV case managers. In Round 1, only 3 items did not receive consensus approval from the experts. After modification based on opinions of the experts, 7 roles and 27 competencies received 97.06% consensus approval in Round 2 and were organized into the final framework for HIV case managers. These roles and associated core competencies were: HIV Care Expert (9 competencies), Communicator (1 competency), Collaborator (4 competencies), Navigator (2 competencies), Manager (4 competencies), Advocate (2 competencies), and Professional (5 competencies). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The authors developed an essential competency framework for HIV care using the consensus of a multidisciplinary expert panel. Curriculum developers and advanced nurses and practitioners may use this framework to support developments and to ensure a high quality of HIV care.

Faculty prediction of in-training examination scores of emergency medicine residents.

BACKGROUND: The Emergency Medicine In-Training Examination (EMITE) is one of the only valid tools for medical knowledge assessment in current use by emergency medicine (EM) residencies. However, EMITE results return late in the academic year, providing little time to institute potential remediation. OBJECTIVE: The goal of this study was to determine the ability of EM faculty to accurately predict resident EMITE scores prior to results return. METHODS: We asked EM faculty at the study site to predict the 2012 EMITE scores of the 50 EM residents 2 weeks prior to results being available. The primary outcome was prediction accuracy, defined as the proportion of predictions within 6% of the actual score. The secondary outcome was prediction precision, defined as the mean deviation of predictions from the actual scores. We assessed several faculty background variables, including years of experience, educational leadership status, and clinical hours worked, for correlation with the two outcomes. RESULTS: Thirty-two of the 38 faculty (84.2%, 95% confidence interval [CI] 69.6-92.6) participated in the study, rendering a total of 1600 predictions for 50 residents. Mean resident EMITE score was 81.1% (95% CI 79.5-82.8%). Mean prediction accuracy for all faculty participants was 69% (95% CI 65.9-72.1%). Mean prediction precision was 5.2% (95% CI 4.9-5.5%). Education leadership status was the only background variable correlated with the primary and secondary outcomes (Spearman's ρ = 0.51 and -0.53, respectively). CONCLUSION: Faculty possess only moderate accuracy at predicting resident EMITE scores. We recommend a multicenter study to evaluate the generalizability of the present results.

Enrichment of core competencies to maximize health system impact: An analysis of an embedded research training program.

Introduction: The Health System Impact (HSI) Fellowship is an embedded research training program that aims to prepare doctoral trainees and postdoctoral fellows for stronger career readiness and greater impact as emerging leaders within and beyond the academy, including in learning health systems (LHS). The program supports fellows to develop 10 leadership and research competencies that comprise the Enriched Core Competency Framework in Health Services and Policy Research through a combination of experiential learning, mentorship, and professional development training. This study tracks competency development of HSI fellows over time and examines fellows' perspectives on which program design elements support their competency development. Methods: A competency assessment tool developed for the program was independently completed by 95 postdoctoral and 36 doctoral fellows (self-assessments) and their respective 203 dyad (academic and health system) supervisors in the 2017 to 2019 program cohorts, who independently rated the strength of fellows' 10 competencies at baseline and several points thereafter. Competency strength ratings were analyzed to understand change over time and differences in ratings across groups (between fellows' sex, supervisor type, and supervisor vs. fellow). Program design element ratings were examined to understand perspectives on their contribution toward fellows' competency development. Results: Fellows' competency strength significantly improved in all 10 domains over time, based on independent assessments by the fellows and their dyad supervisors. Supervisors tended to rate the fellows' competency strength higher than the fellows did. Differences in competency ratings between male and female fellows (self-assessments) and between academic and health system supervisors were either negligble or not significant. Fellows identified all nine program design elements as enriching their competency development. Conclusion: The HSI Fellowship provides an opportunity for fellows to develop the full suite of enriched core competencies and to prepare a cadre of emerging leaders with the skills and experience to contribute to the advancement of LHS.

A cross-sectional survey on nurses in burn departments: Core competencies and influencing factors.

BACKGROUND: Nurses of burn departments play a vital role in caring for and rehabilitating burn patients. However, the situation of nurses in burn departments is seldomly reported. The current study aims to identify the status and influencing factors of nurses in burn departments' core competencies nationwide. METHODS: This is a cross-sectional and multicenter study. Purposive sampling was used to recruit registered nurses who worked in burn departments of 12 tertiary hospitals in Mainland China. We issued an online survey including structured questionnaires consisting of socio-demographic information and the Self-rating Scale for Core Competencies. RESULTS: Totally 267 nurses in burn departments participated in our study. The mean score of nurses in burn departments' core competencies was (3.81 ± 0.53), with a scoring rate of 76.22%. Professional title, length of employment and experiences in burn intensive care units (BICUs) were influencing factors of NBDs' core competencies (P < 0.05), explaining 21.0% of the total variance. CONCLUSIONS: Our findings indicate that the core competencies of nurses in burn departments were at a moderate level generally. Moreover, this study highlights that nursing administrators and educators should promote the specialized knowledge and skills, teaching skills and critical thinking of nurses in burn departments.