Adapting nurse competence to future patient needs using Checkland's Soft Systems Methodology

Managing food security using blockchain-enabled traceability system

Purpose

Food insecurity is a major concern for developing economies. Operational inadequacies get introduced with unorganized interactions among stakeholders in the food supply chain, affecting social, economic, environmental and operational (SEEO) aspects of a nation. This study analyzes India's largest food safety net program, Public Distribution System (PDS) and develops a perception-based model, mapping the root causes (of food insecurity) with possible solutions. The novelty lies in leveraging blockchain in the implementation of food traceability system.

Design/methodology/approach

Soft system methodology (SSM) is used to identify and analyze problems in PDS, leveraging the learning and inquiry process. It relies on system thinking and action research to create a defendable and rational model, which helps in proposing recommendations for addressing the problem.

Findings

Blockchain-enabled food traceability system increases transparency, thus enabling the fulfillment of basic food necessities for beneficiaries.

Practical implications

The proposed model enables policymakers to build a profound understanding of existing operational issues and provides insightful recommendations for making informed decisions to deal with the grave issue of food insecurity.

Originality/value

Unlike previous studies, this research attempts to understand operational inefficiencies during interactions among stakeholders. It proposes a perception-based conceptual model for the final implementation at the ground level. It also reveals significance of three systems: a delivery system, an enabling system empowering delivery system and a criteria system to control and monitor processes. This study thus bridges an important gap in the literature by proposing a blockchain-driven traceability system, under the control of criteria system, through the integration of system-thinking and action-research approach.

Using the Soft Systems Methodology to Link Healthcare and Long-Term Care Delivery Systems: A Case Study of Community Policy Coordinator Activities in Japan

Due to the rapidly aging population in Japan, the government has been attempting to link the healthcare delivery system with the long-term care delivery system. However, there are complex challenges that must be overcome to link the two systems. A new methodology should be used to organize complex community challenges and propose solutions. This study aimed to visualize the unique challenges and worldviews of interested parties in each community, using the soft systems methodology (SSM). We aimed to visualize issues and clarify challenges associated with linking the healthcare and long-term care delivery systems; in turn, clarifying the thought process behind solution proposals. We gathered information regarding those who are actively linking these systems in communities in a Japanese municipality (community care coordinators) and organized the information according to the SSM procedure. By organizing information using the SSM, we were able to summarize the present situations of the community healthcare and long-term care delivery systems, visualize issues, clarify challenges associated with linking these two systems, and propose solutions. The SSM may be useful in organizing complex community information and deriving solutions.

Modeling e-Livestock Indonesia

The demand for beef resources in Indonesia is always increasing every year. However, Indonesia's national beef supply cannot meet those needs. The import of beef in large numbers likely to remain performed. The government has made various efforts to reduce imports and achieve self-sufficiency in beef. However, the government does not yet have a good identification, registration, documentation, and traceability system, so there is no truly valid data regarding the actual stock condition. Inaccuracy of data can lead to inappropriate policymaking in the livestock sector. Therefore, an e-Government initiative in the form of e-Livestock has been proposed. The definitions and success factors regarding e-Livestock have been revealed in our previous researches. Based on those researches, by using soft system methodology, hermeneutics, focus group discussion, and success factors, the business process models for e-Livestock in Indonesia will be created in this research. Apart from that, various kinds of recommendations for action to solve the problem will also be generated from this research. Those recommendations are about the functional requirement, the identification tool, the location numbering rule, the ownership documentation, the socialization of the e-Livestock, the institutional aspect of e-Livestock, the regulations underlie e-Livestock and the conceptual infrastructure diagram of e-Livestock. All of the business process models produced have been validated and their complexities are also calculated. Most of the business process model is very easy to understand. All the business process models and recommendations generated from this research can be a guide for the government when implementing e-Livestock.

The level of competence of graduating nursing students in 10 European countries-Comparison between countries

AIM

To analyse graduating nursing students' self-assessed competence level in Europe at graduation, at the beginning of nursing career.

DESIGN

An international cross-sectional evaluative design.

METHODS

Data were collected in February 2018-July 2019 from graduating nursing students in 10 European countries. Competence was assessed with a validated instrument, the Nurse Competence Scale (NCS). The sample comprised 3,490 students (response rate 45%), and data were analysed statistically.

RESULTS

In all countries, graduating nursing students assessed their competence as good (range 50.0-69.1; VAS 0-100), albeit with statistically significant differences between countries. The assessments were highest in Iceland and lowest in Lithuania. Older students, those with working experience in health care, satisfied with their current degree programme, with excellent or good study achievements, graduating to 1st study choice and having a nursing career plan for future assessed their competence higher.

Evaluation of the Indonesia national strategic policy of science and technology development

Purpose

The purpose of this study is to outline the improvement of framing in Indonesia science and technology policy content, policy formulation model, policy strategy implementation and policy performance indicators.

Design/methodology/approach

This study is conducted by implementing action research model to generate new knowledge as a research interest, through the search for solutions or improvements to problematical situation, applying Soft Systems Methodology. Thus, this research model is regarded as Soft Systems Methodology-based Action Research (SSM-based AR).

Findings

Policy formulation is not evidence based in which policy documents remain theoretical and are impractical or not detailed in engaging real conditions and strategic issues, yet the targets are measurable despite predictive results. Change and strengthening are required in the national science and technology policy for the next period, on the basis that future research policies are encouraged to address problems and solutions to build a country based on science and technology. Indonesia requires policies involving both effective and efficient national research; therefore, the need for an integrated policy direction conveying science and technology and other related sectors, such as the health sector and food, remains vital.

Originality/value

Previously, science and technology policy planning in Indonesia was not equipped with data and indicators of success, having no target to achieve within a five-year period. In the coming periods, science and technology policy documents in Indonesia are issued in the form of government regulations/presidential decrees, including indicators of science and technology achievements (quantitatively) for five years.

Designing health professional education curricula using systems thinking perspectives

BACKGROUND

Medical students navigate complex personal learning pathways from entry into medical school, through an educational program, and into life-long practice. However, many stakeholders have called for substantive reforms in contemporary curricula, citing concerns about the lack of key abilities amongst newly graduated doctors to work in complex healthcare environments. Despite the need for educators to focus on curricula design, there is a paucity of overarching perspectives that allow synthesis of the various curricular elements in a way that lends meaningfulness and appreciation to the students in terms of navigating the immediate program requirements and beyond. Without such guidance, educators risk creating fragmented program designs that can lead to both unintended and unactionable outcomes for students as well as curriculum designers. Using systems thinking, we set out to address this gap by providing an overarching perspective for curriculum designers to appreciate the relationships and the interactions of the various curricular elements that inform and impact student's preparedness for practice.

METHODS

By framing a curriculum as a complex adaptive system, we used soft systems thinking to develop an initial prototype of a conceptual curricular toolkit, underpinned by an appraisal of relevant literature within health professional education and the broader educational context. The prototype was further refined iteratively after critical reflection by the authors with a diverse range of national and international colleagues via posters, short communications, and workshops at several conferences, and through social media.

RESULTS

We describe how the 3P-6Cs toolkit captures a learner's personal journey through an educational program into a field of practice by logically linking the three key elements: the personal, the program, and the practice. We demonstrate its application in three examples related to contemporary health profession education curricula. These are: creating integrated educational designs to capture students' developmental continua, conceptualising immersive clinical placements in non-traditional settings, and complexity-consistent evaluation of curricular interventions.

CONCLUSION

Applying the 3P-6Cs curricular toolkit to problems of curricula (re)design can provide overarching perspectives that enable educators to have a better understanding of how integration of elements within education programs can inform and impact student's preparation for lifelong practice.

Addressing operational complexities through re-inventing leadership style: A systemic leadership intervention

This research investigates leadership practice in private organisations in Nigeria. It focuses on learning about the application of leadership styles to address operational complexities in organisations. The research is based on a case study of a commercial livestock farm in Nigeria using systemic intervention as the methodology. Data collection tools, such as a workshop, semi-structured interviews, boundary setting and participant observation, were applied. Key leadership issues identified in the case study were addressed via the creation of an effective approach from different leadership underpinnings. Part of the findings is the difficulty in sustaining the implementation of a particular leadership style(s) due to unstructured nature of complexities involved in the determination of suitable leadership style at different stages of the research. The research wrapped up with the suggestion for further research on systemic leadership intervention to consider exploring the public sector, as well as the need to further review on the use of CATWOE in the research process, to avoid the occurrence of marginalisation in its apllication.

How 'smart' is smart dentistry?

Background: Latest advances in information and health technologies enabled dentistry to follow the paradigm shift occurring in medicine - the transition to so called smart medicine. Consequently, the aim of this paper is to assess how 'smart' is smart dentistry as of the end of 2018. Methods: We analysed the state of the art in smart dentistry, performing bibliometric mapping on a corpus of smart dentistry papers found in the Scopus bibliographical database. Results: The search resulted in a corpus of 3451 papers, revealing that smart dentistry research is following the progress in smart medicine; however, there are some gaps in some specific areas like gamification and use of holistic smart dentistry systems. Conclusions: Smart dentistry is smart; however, it must become smarter.

How 'smart' is smart dentistry?

Background: Latest advances in information and health technologies enabled dentistry to follow the paradigm shift occurring in medicine - the transition to so called smart medicine. Consequently, the aim of this paper is to assess how 'smart' is smart dentistry as of the end of 2018. Methods: We analysed the state of the art in smart dentistry, performing bibliometric mapping on a corpus of smart dentistry papers found in the Scopus bibliographical database. Results: The search resulted in a corpus of 3451 papers, revealing that smart dentistry research is following the progress in smart medicine; however, there are some gaps in some specific areas like gamification and use of holistic smart dentistry systems. Conclusions: Smart dentistry is smart; however, it must become smarter.