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Implementation science offers a compelling value proposition to translational science. As such, many translational science stakeholders are seeking to recruit, teach, and train an implementation science workforce. The type of workforce that will make implementation happen consists of both implementation researchers and practitioners, yet little guidance exists on how to train such a workforce. We—members of the Advancing Dissemination and Implementation Sciences in CTSAs Working Group—present the Teaching For Implementation Framework to address this gap. We describe the differences between implementation researchers and practitioners and demonstrate what and how to teach them individually and in co-learning opportunities. We briefly comment on educational infrastructures and resources that will be helpful in furthering this type of approach.
Self-efficacy can be defined as individuals’ beliefs in their capability to implement a behavior needed to reach a goal or perform a task successfully. A vast amount of empirical research shows that self-efficacy is a key factor in predicting and explaining the successful initiation and maintenance of behavior change in various domains of human life. Less research has been conducted on the sources of self-efficacy (mastery experiences, vicarious experiences, verbal persuasion, somatic and affective states) and how these can be prompted in behavior change interventions. This chapter reviews primary and meta-analytic research on behavior change techniques promoting self-efficacy beliefs in interventions for change in health, work, and academic contexts. It also provides practical guidelines and concrete examples on how to design and evaluate behavior change interventions that target self-efficacy.
Introduction: Providing comfort care support at home without transport to hospital has not traditionally been part of paramedic practice. The innovative Paramedics Providing Palliative Care at Home Program includes a new clinical practice guideline, medications, a database to share goals of care, and palliative care training. This study aimed to determine essential elements for scale and spread of this model of care through the application of an implementation science model, the Consolidated Framework for Implementation Research (CFIR). Methods: Deliberative dialogue sessions were held with paramedic, palliative care, primary care, and administrative experts in a province that had the Program (Nova Scotia, March 2018) and one that had not (British Columbia, July 2018). Sessions were audio recorded and transcribed. The CFIR was used as the foundation for a framework analysis, which was conducted by four team members independently. Themes were derived by consensus with the broader research team. Results: Inter-sectoral communication between paramedics and other health care providers was key, and challenging due to privacy concerns. Relationships with health care providers are critical to promoting the new model of care to patients, managing expectations, and providing follow up/ongoing care. Training was an essential characteristic of the intervention that can be adapted to suit local needs, although cost is a factor. There were challenges due to the culture and implementation climate as a shift in the mindset of paramedics away from traditional roles is required to implement the model. Paramedic champions can play an important role in shifting the mindset of paramedics towards a new way of practice Conclusion: The CFIR construct of cosmopolitanism, emphasizing the importance of breaking down silos and engaging diverse stakeholders, emerged as one of the most important. This will be helpful for successful scale and spread of the program.
Civic republicans have traditionally appealed to friendship as a means of preserving popular liberty, but Machiavelli is a notable exception to this rule. In fact, I argue, he views efforts to reconcile friendship and politics as (1) philosophically dubious, because grounded in false conceptions of person and society, and (2) practically harmful, because they perpetuate patterns of asymmetric dependence that are inconsistent with a free way of life. Machiavelli's neglected skepticism about the political potential of friendship deepens his critique of the Ciceronian concordia, reveals a diminished idea of the common good, and distances him from the civic republican tradition to which he is so often said to belong.
This study examined the effectiveness of a formal postdoctoral education program designed to teach skills in clinical and translational science, using scholar publication rates as a measure of research productivity.
Participants included 70 clinical fellows who were admitted to a master’s or certificate training program in clinical and translational science from 1999 to 2015 and 70 matched control peers. The primary outcomes were the number of publications 5 years post-fellowship matriculation and time to publishing 15 peer-reviewed manuscripts post-matriculation.
Clinical and translational science program graduates published significantly more peer-reviewed manuscripts at 5 years post-matriculation (median 8 vs 5, p=0.041) and had a faster time to publication of 15 peer-reviewed manuscripts (matched hazard ratio = 2.91, p=0.002). Additionally, program graduates’ publications yielded a significantly higher average H-index (11 vs. 7, p=0.013).
These findings support the effectiveness of formal training programs in clinical and translational science by increasing academic productivity.