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There are numerous ways to add value and make a contribution. We can offer gifts of the heart, the head, and the hand. We can provide emotional support, ideas, or tangible help. When it comes to adding value to our own lives, we can increase our happiness, study new things, find meaning in life, and develop physically and spiritually. There are really countless ways to make our life more exciting, goal-oriented, virtuous, and passionate, and it is up to each one of us to discover what actions will make that happen. Needless to say, our opportunities are influenced by the environment we live in. Some social ecologies are more supportive than others, but the aspiration to add value remains, regardless of the particular context. The needs to make a difference, to master the environment, and to express ourselves are well ingrained in all of us. We yearn to be in control of our destiny and to learn new skills. These needs are expressions of self-determination and the pursuit of meaning.
How can we tell that people are adding value? How do they add value to themselves? How do they help others? How do they achieve greatness in domains as varied as chess, music, sport, politics, business, physics, and literature? Excelling at friendship or parenting is part of interpersonal wellness. You want to be the best partner, friend, or parent that you can be. Shining in athletics is part of physical, occupational, and even psychological well-being. Leading social change is part of community wellness; your calling is to improve the social condition. Regardless of your particular focus, there are six investments you have to make. People who get better at anything invest in six things. We call them the six Ts: Transcendence: Going beyond the norm to pursue a passion and a purpose; Time: Dedicating thousands of hours; Thought: Concentrating and creating mental representations of the subject matter; Training: Practicing to reach stretch goals and acquire skills with a coach; Tenacity: Persevering and following through; and Trust: Believing in yourself, your mentors, and the process.
If young people are to be equipped to shape the future, then a key outcome of their learning experience needs to be the development of their own agency. Learners who have agency are purposive, reflective and action-oriented. Agency means developing goals, initiating action, reflecting on and regulating progress and belief in self-efficacy. Just like thriving, we can understand agency as a process or as an outcome of learning at a variety of levels: individual, collaborative and collective. Agency – and co-agency – are at the heart of the OECD Framework for Education and Skills 2030. Agency is central to transformational competencies: creating new value; taking responsibility; coping with tensions and trade-offs. In the school context, agency can be learned and exercised through stutdent voice, student leadership and student ownership of learning. Beyond the school walls, agency can be learned and exercised when students engage in community issues that matter. Some systems are now explicitly promoting agency with support resources and materials but government can do more to ensure that schools can promote learner agency while meeting regulative and accountability requirements.
The chapter examines attributes of public work environments that lead employees to develop ties to an organization's values. Empirical research indicates a supportive work environment is critical to sustaining public service motivation. Institutional arrangements promote employees’ basic psychological needs and create conditions for common pool resources. The chapter discusses two strategies for reinforcing supportive work environments: creating learning and growth opportunities and balancing job security and performance. Possibly the biggest key to promoting personal growth is creating opportunities for employee growth and learning throughout a career. Leadership development programs could also be offered to employees up and down the hierarchy. Finally, organizations should pay attention to subjective career success, ensuring that employees feel they are fulfilling their purpose in life. The chapter then examines strategies for developing organizational norms that balance job security with performance, including balancing performance and property rights, improving performance management systems and performance appraisals, and utilizing performance-based reductions in force.
Coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently a global pandemic that has affected over 7 million people worldwide, resulting in over 400,000 deaths. In the past 20 years, they have been several viral epidemics that were primarily transmitted by respiratory droplets. The use of face masks is proven to be effective in protecting health-care workers as they perform their duties. Still, there is limited evidence about whether the widespread use of face mask would be very useful in protecting the general population. This study aimed to conduct a review to determine if face masks would be beneficial in the general population as a means of reducing the spread of COVID-19. The widespread implementation of wearing face masks by the general population is challenging due to a variety of factors. However, the extensive use of cloth masks in conjunction with other preventative measures such as social distancing and handwashing can potentially reduce the risk of transmission of COVID-19.
Global organizations demand a heterogeneous global talent pool. For decades, this talent pool has been dominated by what we consider traditional “there-and-back” expatriates, overseas assignees who are transferred to a host-country for three to four years and subsequently return to the home-country organization. To accommodate the pressures of globalization, it is argued that organizations today would benefit from a more dynamic talent pool which is composed of a cadre of managers that includes but also goes beyond the traditional expatriate. We speak of the global manager “family” which in addition to expatriates includes flexpatriates and inpatriates. Together these complimentary pools of talent help to facilitate the development of a global mindset among global managers that is necessary to compete beyond domestic borders. The mix of managers differs greatly relative to the duration of assignments, destinations, number of destinations, and commitment to the organization and career. As a result, we argue that each manager requires a combination of intercultural competencies or a “tool set” to reflect the demands of the assignment type which allows them to be successful in their roles. This chapter draws on a competency-based view to form the basis of the critical elements for building intercultural competency in global managers.
The purpose of this study was to investigate differences in the perception of disaster issues between disaster directors and general health care providers in Gyeonggi Province, South Korea.
The Gyeonggi provincial committee distributed a survey to acute care facility personnel. Survey topics included awareness of general disaster issues, hospital preparedness, and training priorities. The questionnaire comprised multiple choices and items scored on a 10-point Likert scale. We analyzed the discrepancies and characteristics of the responses.
Completed surveys were returned from 43 (67%) of 64 directors and 145 (55.6%) of 261 health care providers. In the field of general awareness, the topic of how to triage in disaster response showed the greatest discrepancies. In the domain of hospital level disaster preparedness, individual opinions varied most within the topics of incident command, manual preparation. The responses to “accept additional patients in disaster situation” showed the biggest differences (> 21 versus 6~10).
In this study, there were disaster topics with discrepancies and concordances in perception between disaster directors and general health care providers. The analysis would present baseline information for the development of better training programs for region-specific core competencies, knowledge, and skills required for the effective response.
High rates of mortality and morbidity result from disasters of all types, including armed conflicts. Overwhelming numbers of casualties with a myriad of illnesses and patterns of injuries are common in armed conflicts, leading to unpredictable workloads for hospital health care providers (HCPs). Identifying domains of hospital HCPs’ core competency for armed conflicts is essential to inform standards of care, educational requirements, and to facilitate the translation of knowledge into safe and quality care.
The objective of this study is to identify the common domains of core competencies among HCPs working in hospitals in armed conflict areas.
A scoping review was conducted using the Joanna Briggs Institute framework. The review considered primary research and peer-reviewed literature from the following databases: Ovid Medline, Ovid EmCare, Embase, and CINAHL, as well as the reference lists of articles identified for full-text review. Eligibility criteria were outlined a priori to guide the literature selection.
Four articles met the inclusion criteria. The studies were conducted in different countries and were published from 2011 through 2017. The methods included three surveys and one Delphi study.
This review maps the scope of knowledge, skills, and attitudes required by HCPs who are practicing in hospitals in areas of major armed conflict. Incorporation of identified core competency domains can improve the future planning, education, and training, and may enhance the HCPs’ response in armed conflicts.
In order to conduct translational science, scientists must combine domain-specific expertise with knowledge on how to identify and cross translational hurdles, and insights on positioning discoveries for the next translational stage. Expert educators from the Clinical and Translational Science Awards (CTSA) Consortium identified 97 knowledge, skills, and abilities (KSAs) important to include in training programs for translational scientists. To assist educators and trainees to use these KSAs, a conceptual model called “Personalized Pathways” was developed that prioritizes KSAs based on trainee background, research area, or phenotype, and expertise on the research team.
To understand how CTSA educators prioritize specific KSAs when developing personalized training plans for different translational phenotypes and to identify areas of similarity and difference across phenotypes.
A web-based, cross-sectional survey of CTSA educators was done. For a selected phenotype, respondents recommended one of four levels of mastery for each of the 97 KSAs. Results were tabulated by frequency, weighted by importance, and divided into tertiles representing high, middle, and lower priority KSAs. Agreement across phenotypes was compared using Krippendorff’s alpha.
Ten KSAs were high training priority for Preclinical, Clinical, and Community-Engaged phenotypes. These address research methods, responsible conduct of research, team building, and communicating research results. Nine KSAs were in the next tertile for priority reflecting KSAs in biostatistics, bioinformatics, regulatory precepts, and translating implications of research findings.
A smaller set of KSAs can be prioritized for training Preclinical-, Clinical-, and Community-Engaged researchers. Future work should explore this approach for other phenotypes.
NHS Education for Scotland (NES) plays a lead role in training the NHS Psychological Therapies workforce across Scotland. Ferguson et al. (2016) outlined the challenges, opportunities and proposed evaluation of the NES Specialist Supervision Training in Cognitive Behavioural Therapy (NESSST-CBT). The aims of the training were to provide an evidence-based, flexible and learner-focused training in CBT specific supervision competencies. This paper will provide an update on the evaluation of the training using Kirkpatrick’s Impact Evaluation Model (1967, 1987). Results indicate that: (1) delegates rated the training experience positively in various ways; (2) delegates described increases in their confidence and competence in using structured measures of CBT and supervision; (3) a majority of delegates completing a 3-month follow-up questionnaire described continued use of a structured CBT measure in supervision and for self-reflection; and (4) 392 psychological therapists in Scotland have now been formally trained in CBT specific supervision skills. NESSST-CBT continues to adapt and improve as a resource for staff as NES moves forward in its Digital Strategy for Scotland’s NHS and partnership staff. Further implications of this are discussed, as well as limitations of the study.
Key learning aims
(1) Readers will be able to further understand the multi-faceted role of NHS Education for Scotland in implementing CBT supervision training in Scotland.
(2) Readers will be able to list three key outcomes from the feedback data on 4 years of a specialist supervision blended-learning training for CBT supervision.
(3) Readers will be able to identify three key limitations of the study and recommendations for future research.
The UK’s Improving Access to Psychological Therapy Programme (IAPT) has improved transparency of primary mental health care in relation to the mandatory reporting of clinical outcomes. However, the data reveal a significant variance in outcomes. These findings have led to a growing body of research investigating to what extent therapist variables account for the difference in clinical outcomes. Previous studies have not had access to sufficient recordings or transcripts of therapy sessions in order to fully address this question. The purpose of this study was to use therapy transcripts derived from internet enabled cognitive behavioural therapy (CBT) treatment sessions in order to investigate whether and how therapist variables are associated with clinical outcome. A hierarchical log-linear analysis examined the relationship between therapist/patient variables and clinical outcome. Therapist fidelity to the CBT model and associated adherence to an evidence-based protocol were significantly related to clinical outcome. A graphical representation of the statistical model suggests that patient recovery is directly linked with fidelity and indirectly with adherence, after adjusting for patient attributes of age, gender and clinical presentation. Corroborating previous research, therapist competence and adherence to an evidence-based treatment protocol appear to be important in improving outcomes. These findings have implications for the continuing professional development of qualified therapists, potentially reinforcing the importance of reducing therapist drift.
Key learning aims
(1) To develop an understanding in relation to which therapist variables are associated with clinical outcome in IAPT.
(2) To reflect on how fidelity to the CBT model and adherence to evidence-based treatment protocols may affect clinical outcomes.
(3) To exemplify use of a statistical method for enhanced visual understanding of complex multi-factorial data.
Written by educational researchers and professionals working with children and adolescents in and out of school, this book shows how self-regulation involves more than an isolated individual's ability to control their thoughts and feelings, particularly in a learning environment. By using Vygotsky's cultural-historical psychological theory, the authors provide a unique set of four analytical lenses for a better understanding of how self-regulation, co-regulation, and other-regulation function as a system of regulatory processes. These lenses move beyond a focus on solitary individuals, who self-regulate behavior, to centre on individuals as relational, agential, and contextually situated. As agents, teachers and their students build their learning contexts and are influenced by these self-engineered contexts. This is a dynamic perspective of a social context and underlies the view that regulatory processes are an integral part of a functional system for learning.
Upon reflection, I had, as a child, become a sound state-school student within a culturally diverse student group. The physical environment, from infants and primary school sites to the secondary school site, was not particularly diverse. It was often characterised by interiors of neutral-coloured linoleum, regulation departmental mid-blue accents, modular timber cupboards and exteriors defined by seriously brown brick walls, asphalt playgrounds and modestly allocated grass areas. Grey wire-fences surrounded the built environments of almost every school site. Landscaping was limited to an agglomeration of concrete-bound, sandstone forms providing an edging to the asphalt and was usually located near the entrance of the school. The plants inside were mostly hardy ‘natives’ that irrespective of their apparent suitability seemed to struggle to survive.
Introduction: Short-term gains in knowledge and skills of critical emergency procedures are demonstrated after simulation, but there is uncertainty regarding long term retention. Our objective was to determine whether simulation of critical emergency procedures promotes long term retention of procedural skills in non-surgical physicians likely to perform them. Methods: MEDLINE and Embase (from start of database to June 2018) and the CENTRAL Trials Registry of the Cochrane Collaboration (May 2018 Issue) were searched using a peer-reviewed strategy. Studies were eligible if they (1) were observational cohorts, quasi-experimental or randomized controlled trials, (2) assessed intubation, cricothyrotomy, periocardiocentesis, tube thoracostomy or central line placement performance by non-surgical physicians, (4) utilized any form of simulation (all levels of realism and technology), and (4) assessed skill performance immediately after and at ≥3 months post-simulation. There was no language restriction. Two reviewers independently assessed article eligibility. One reviewer extracted data and assessed study quality. Primary outcome was skill performance 3 months post-simulation. Secondary outcomes included skill performance at 6 and ≥12 months post-simulation, and skill competency at 3 months post-simulation. Results: 1370 citations were identified. 12 studies were eligible. Methodological quality was uniformly poor with high risk of bias, lack of defined primary outcomes, inadequate sample sizes, and non-standardized, unvalidated tools of unclear clinical significance. Given significant heterogeneity in design, populations, procedures, and outcome timing, a narrative synthesis of results was undertaken. In 10 studies participants’ performance at 3, 6 and 12 months retention testing remained above baseline assessment. However, 3 studies showed a significant decrease in performance at 3 months post-simulation compared to immediately post-simulation. Performance was also lower in 2 studies at 6 months post-simulation, and 2 studies at ≥12 months post-simulation. Four studies assessed competency and 3 demonstrated maintenance of competency. Conclusion: There was significant heterogeneity and poor methodological quality among the eligible studies. Results were conflicting for retention of procedural skills and competency. Future directions should include development of robust assessment tools, and improved research methodology of simulation education targeted at critical procedural skills.
Sense of competence defines a caregiver’s feeling of being capable to manage the caregiving task and is an important clinical concept in the caregiving literature. The aim of this review was to identify the factors, both positive and negative, associated with a caregiver’s perception of their sense of competence.
A systematic review of the literature was conducted, retrieving both quantitative and qualitative papers from databases PsycINFO, CINAHL, EMBASE, and Medline. A quality assessment was conducted using the STROBE and CASP checklists, and the quality rating informed the inclusion of papers ensuring the evidence was robust. Narrative synthesis was employed to synthesize the findings and to generate an updated conceptual model of sense of competence.
Seventeen papers were included in the review, all of which were moderate to high quality. These included 13 quantitative, three mixed-methods and one qualitative study. Factors associated with sense of competence included: behavioral and psychological symptoms of dementia (BPSD), caregiver depression, gratitude, and the ability to find meaning in caregiving.
The results of this review demonstrate that both positive and negative aspects of caring are associated with caregiver sense of competence. Positive and negative aspects of caregiving act in tandem to influence caregiver perception of their competence. The proposed model of sense of competence aims to guide future research and clinical interventions aimed at improving this domain but requires further testing, as due to the observational nature of the include papers, the direction of causality could not be inferred.
The main objective of this study was to use the principles of cognitive load theory to design a curriculum that incorporates a progressive part practice approach to teaching ultrasound-guided (USG) internal jugular catheterization (IJC) to novices. A secondary objective was to compare the technical proficiency of residents trained using this curriculum with the technical proficiency of residents trained with the current local standard of a single simulation session.
The experimental group included 16 residents who attended three 2-hour sessions of progressive part practice in a simulation lab. The control group included 46 residents who attended the current local standard of a single 2-hour simulation session just prior to their intensive care unit rotation. Technical proficiency was assessed using hand motion analysis and time to procedure completion.
After three sessions, median scores for right hand motion (RHM) (34.5; [27.0-49.0]), left hand motion (LHM) (35.5; [20.0-45.0]), and total time (TT) (117.0 s; [82.7-140.0]) in the experimental group were significantly better than the control group (p<0.001). Results for eight experimental group residents who were assessed for retention at a later date revealed median scores for RHM (45.0; [32.0-58.0]), LHM (33.5; [20.0-63.0]), and TT (150.0 s; [103.0-399.6]), which were significantly better than those of the control group (p=0.01, p<0.01, and p=0.02, respectively).
These results support multiple sessions of progressive part practice in a simulation lab as an effective competency-based approach to teaching USG IJC in preparation for the clinical setting.
This study will evaluate radiation medicine professionals’ perceptions of clinical and professional risks and benefits, and the evolving roles and responsibilities with artificial intelligence (AI).
Radiation oncologists (ROs), medical physicists (MPs), treatment planners (TP-RTTs) and treatment delivery radiation therapists (TD-RTTs) at a cancer centre in preliminary stages of implementing an AI-enabled treatment planning system were invited to participate in uniprofessional focus groups. Semi-structured scripts addressed the perceptions of AI, including thoughts regarding changing roles and competencies. Sessions were audiorecorded, transcribed and coded thematically through consensus-building.
A total of 24 participants (four ROs, five MPs, seven TP-RTTs and eight TD-RTTs) were engaged in four focus groups of 58 minutes average duration (range 54–61 minutes). Emergent themes addressed AI’s impact on quality of care, changing professional tasks and changing competency requirements. Time-consuming repetitive tasks such as delineating targets, generating treatment plans and quality assurance were thought conducive to offloading to AI. Outcomes data and adaptive planning would be incorporated into clinical decision-making. Changing workload would necessitate changing skills, prioritising plan evaluation over generation and increasing interprofessional communication. All groups discussed AI reducing the need for TP-RTTs, though displacement was thought more likely than replacement.
It is important to consider how professionals perceive AI to be proactive in informing change, as gains in quality and efficiency will require new workflows, skills and education.