Crisis leadership: a case for inclusion in accredited Master of Public Health program curricula

Disaster medicine in Swedish undergraduate medical education: analysing current programs and future integration in the six-year curriculum

BACKGROUND

Disaster medicine involves managing situations where medical needs exceed available resources. In Sweden, disaster medicine is not yet a mandatory component of the medical education. Since the introduction of a revised six-year medical curriculum in 2021, it is unclear how disaster medicine will be integrated into the new program. This study aimed to evaluate the status of undergraduate disaster medicine education in Swedish medical schools, the teaching methodologies employed, plans for future curriculum integration, and the extent of variation across universities.

METHODS

We conducted a comprehensive review of syllabi from all Swedish medical programs to identify the inclusion of disaster medicine. Additionally, semi-structured interviews were conducted with 13 representatives from all seven Swedish medical schools, including those responsible for disaster medicine education or members of the education boards. The interviews explored teaching methods, curriculum content, and plans for the new six-year program. Data were analysed using qualitative content analysis.

RESULTS

Disaster medicine is included in the curriculum of all Swedish medical programs; however, its content, extent, and teaching approaches vary. Lectures are the most common teaching method, with some schools incorporating case discussions, tabletop exercises, and disaster simulations. Most medical faculties plan to maintain or expand their disaster medicine curriculum. However, there is no formal collaboration between universities in developing or standardizing disaster medicine education for the new curriculum.

CONCLUSION

The current level of disaster medicine education in Swedish medical schools requires enhancement in both quality and scope. Variations between universities would need to be minimized to ensure a more consistent approach. Preliminary plans for the new six-year medical program suggest that disparities between universities may persist, underscoring the need for a coordinated effort in standardizing disaster medicine education at the undergraduate level.

Developing a crisis leadership evaluation system for Chinese nursing staff during major infectious disease emergencies: a modified Delphi study

AIMS

To create a consensus on the nursing crisis leadership evaluation system during major infectious disease emergencies.

BACKGROUND

Crisis leadership is critical to prevent and mitigate an infectious disease infectious disease public health emergency during crisis time. However, there has been no crisis leadership evaluation system for nursing staff during major infectious diseases emergencies in China.

METHODS

We used a two-part modified Delphi method. Part 1 focused on creating a pool of indicators and developing an evaluation framework through a systematic literature review and a qualitative interview. Part 2 revised the indicators and built the final the evaluation system using two rounds of the Delphi surveys, following the Conducting and REporting of DElphi Studies (CREDES) guidance. Indicators were scored by a panel of experts based on the 5-point Likert scale. The weights of the indicators at each level were identified by analytical hierarchy process (AHP) methods.

RESULTS

A consensus was reached on a framework for assessing crisis leadership in nursing. Experts who met the inclusion criteria participated in round 1 (n = 23) and 2 (n = 19). The recovery rates for the two rounds of the Delphi survey were 92% and 82%. The authority coefficients (Cr) were 0.88 and 0.93, respectively, indicating the high reliability of the consultation results. The Kendall coefficients (W) of the two rounds were 0.106 and 0.150 (P < 0.001). The final consensus set comprised 6 primary indicators, 18 secondary indicators, and 38 tertiary indicators. The Weights of the six primary indicators allocated by AHP, namely loading the responsibility, heading the team, governing the situation, foreseeing the crisis, thriving on crisis, and insisting on the faith, were 0.3056, 0.2500, 0.1944, 0.1389, 0.0833, and 0.0278.

CONCLUSION

A consensus-based, contemporary set of nursing crisis leadership evaluation systems in the context of major infectious disease emergencies has been identified. Ongoing work is needed to further develop a highly reliable scale, determine the current state of nursing crisis leadership, construct a targeted training curriculum, and implement the program into practice that managers may wish to use to assess, select, and develop the next generation of nursing leaders.

Exploring the spiritual foundations of public health leadership

The Covid-19 pandemic has laid bare the challenges of public health leadership. Faced with criticism, threats, and even violence, many public health leaders have left the field. A healthier future for the nation may well rest on training aspiring public health leaders to build deeper capacity for perseverance, healing, and resilience. Reflecting the growing experience of a team of public health educators at the Harvard T.H. Chan School of Public Health (Harvard Chan), this article offers recommendations for public health schools to recognize, and incorporate into leadership education, themes of spirituality-ie, the way people seek ultimate meaning and purpose and deep connectedness to something larger than themselves. Doing so can serve as a foundation for the lifelong journey of leadership. Over the past decade, Harvard Chan has incorporated meaning, purpose, and connectedness themes to complement more traditional coursework addressing research and translation. While many established leadership frameworks address the "what" and "how" of career development, the spirituality framework can support aspiring leaders to more fully understand their "why" and its alignment with challenging work. Such a deeply personal topic, traditionally kept private, has been shared and nurtured in Harvard Chan classrooms through a range of pedagogical strategies including personal reflection, one-on- one coaching, experiential learning, case discussions, and candid conversations with public health leaders. By encouraging a values-based foundation for decision-making in crises and difficult leadership moments, such grounding can help aspiring leaders navigate the challenges of public health leadership that inevitably lie ahead.

Simulation as a key training method for inculcating public health leadership skills: a mixed methods study

Background

Successful management of public health challenges requires developing and nurturing leadership competencies. We aimed to evaluate the effectiveness of training simulations to assess public health leadership and decision-making competencies during emergencies as an effective learning and training method.

Methods

We examined the effects of two simulation scenarios on public health school students in terms of their experience (compared to face-to-face learning) and new skills acquired for dealing with similar emergent situations in the future. A mixed-methods design included developing a validated and pre-tested questionnaire with open-and closed-ended questions that examined the simulation impact and the degree of student satisfaction with the conditions in which it was conducted. Semi-structured in-depth interviews were conducted with the students after going through the simulations. The questionnaire results were evaluated using descriptive analytics. The interviews were analyzed using thematic analyses. All data were collected during June 2022.

Results

The questionnaire results indicate that students strengthened their interpersonal communication skills and learned about the importance of listening to the opinions of others before formulating their positions. Four themes emerged from 16 in-depth interviews, according to Kolb's experimental learning cycle. Students emphasized the effectiveness of experiential learning versus traditional classroom learning. The simulation scenarios were felt to realistically convey critical issues regarding leadership, decision-making, and teamwork challenges. They effectively conveyed the importance of building a culture of conducting substantive and respectful discussions.

Conclusion

Simulation is a powerful pedagogical training tool for public health leadership competencies. Simulations were seen to be advantageous over face-to-face learning in imparting a range of leadership skills and hands-on practice. We recommend integrating simulations in all public health leadership training programs.

Why time matters when it comes to resilience: how the duration of crisis affects resilience of healthcare and public health leaders

The meaning of time, especially in crisis, where situations are likely to become even more complex, uncertain, and disruptive, is crucial. Incorporating previous research on organizational crises, organizational resilience, extreme context, and individual resilience, we know that leaders do play a crucial role when it comes to handle adversity in organizations but also that leaders might influence organizational resilience and employee resilience. Intensified by the COVID-19 pandemic, the leaders' ability to effectively deal with a critical situation becomes even more important in healthcare organizations. We argue that time is not only important when it comes to crisis management but also that it is highly significant when it comes to leaders' resilience. Considering the aspect of time implies that different temporal demands, especially regarding the persistence of adversity, require different resilience strategies applied by the leader. Therefore, we call for future research on examining how different leaders' resilience strategies (short term vs. long term) affect crisis management outcomes as well as the resilience in healthcare and public health organizations.