Creating a Diverse Physician Workforce Through Training in Diversity, Bias, and Selection: An Innovative Approach to Preparing Medical Students as Future Academic Leaders

Medical students are the future of academic medicine. They will serve as admissions committee members, deans, and program directors with responsibility for selecting future physicians. At the same time, schools and programs are working to diversify the physician workforce to care for diverse patient populations. At UAB Heersink School of Medicine, we developed an elective course, Holistic Review: Creating a Mission-Driven Physician Workforce, to train learners in bias, diversity, and data-informed decision-making. Students applied lessons to the admissions process by participating in application screening and multiple-mini interview rating. Student reflections demonstrated course applicability for careers in medicine and beyond.

Learn from the best hospitals: a comparison of the mission, vision and values

BACKGROUND

The hospital's mission, vision, and values are the core of the hospital's culture and the most profound expression of the hospital's culture. Although there have been many comparative studies on the mission, vision and values of organizations in the past, there have been few studies on the mission, vision and values of hospitals in the healthcare field. The purpose is to understand how the world's top hospitals develop the use of mission, vision and values in their "day-to-day management" and this may help other hospitals to develop their mission, vision and value effectively.

METHODS

This paper collects and discusses the approaches of the world's top five hospitals in mission, vision and value through a qualitative analysis method. Documents for the study were collected from the publicly available information of the five hospitals, including their websites, annual reports, and relevant academic literature published in English on Google Scholar, PubMed, Medline, and Web of Science.

RESULTS

These five hospitals have similarities and differences in the development of their missions, visions and values, which are worthy of study by other hospitals. The setting of a mission is a useful reflection of the hospital's focus and direction showing the social responsibility and sustainability of the hospital. The development of a vision has a guiding role in the equity and development of patients and employees and can improve the efficiency and effectiveness of hospital management and ensure the quality of services. The elaboration of values can greatly help hospitals to develop strategic plans and improve daily management.

CONCLUSION

The top five hospitals in the world have several common valuable cultures in their missions, visions, and values, regardless of the properties of the hospitals or their management models. In addition, each hospital also has some enlightening descriptions that reflect their particularities.

Some People are Different from You: A Case Study of a Cultural and Ethical Problem in Global Health

Pharmacists, student pharmacists, and other healthcare providers are frequent participants on short-term medical service trips (MSTs) to medically underserved areas. Many such MSTs take place in areas like sub-Saharan Africa where cultural beliefs about healthcare and society may be very different from what volunteers from the Global North believe. These cultural divergences may then give rise to ethical problems MST volunteers need to navigate. This case study provides an example of such an ethical problem developing from a difference in cultures - the case of female genital cutting. Often, the ethical training that most MST volunteers receive during their clinical education is inadequate to help them address these kinds of cultural differences and the problems that result. A six-step process to provide MST volunteers with the tools to address such cultural-ethical problems is included. Medical, Public Health, and Microfinance Teams with local interpreters in Nana Kenieba, Cercle of Kati, Koulikoro Region, Southwest Mali.

A public health mission in Canada in response to the coronavirus disease 2019 (COVID-19) pandemic

Many governments in the world reacted to the coronavirus disease 2019 pandemic by swiftly offering stimulus packages to their populations. While public unpreparedness was dramatic, it was not unexpected: many alarms had been sounded. Strategies by the federal and various provincial governments of Canada in core sectors predisposed the country to the current situation and weakened its capacity to respond adequately. This paper reviews the cumulative effects of these strategic orientations: a deficient investment strategy in fundamental science; disconnect between laboratory work and the country's capacity to produce vaccines and antiviral drugs; the priority of cost efficiency that led to overwhelming dependency on foreign production of medical supplies; and dramatic spending cuts in public health. We will discuss a Mission strategy to exit the crisis that takes a long-term perspective, in which public interest and public health, combined with a strong State leadership, stimulate innovation and collaboration between national and international actors.

Science Objectives for Flagship-Class Mission Concepts for the Search for Evidence of Life at Enceladus

Cassini revealed that Saturn's Moon Enceladus hosts a subsurface ocean that meets the accepted criteria for habitability with bio-essential elements and compounds, liquid water, and energy sources available in the environment. Whether these conditions are sufficiently abundant and collocated to support life remains unknown and cannot be determined from Cassini data. However, thanks to the plume of oceanic material emanating from Enceladus' south pole, a new mission to Enceladus could search for evidence of life without having to descend through kilometers of ice. In this article, we outline the science motivations for such a successor to Cassini, choosing the primary science goal to be determining whether Enceladus is inhabited and assuming a resource level equivalent to NASA's Flagship-class missions. We selected a set of potential biosignature measurements that are complementary and orthogonal to build a robust case for any life detection result. This result would be further informed by quantifications of the habitability of the environment through geochemical and geophysical investigations into the ocean and ice shell crust. This study demonstrates that Enceladus' plume offers an unparalleled opportunity for in situ exploration of an Ocean World and that the planetary science and astrobiology community is well equipped to take full advantage of it in the coming decades.

Ministers of Life: A Call to Mission for Healthcare Workers

In its new charter, the Vatican calls on healthcare workers to be ministers of life. This is a challenging task and a most noble mission. The mission field itself is the vast, complex and mysterious field of suffering (Pope John Paul II). For Catholic healthcare professionals, it is not so much to have a mission, but to be a mission on this earth, as Pope Francis often reminds us. The daily mission needs to be nourished by a commensurate spirituality. Each deed can be offered to the Lord as part of our response. Healthcare professionals may feel called to specific mission fields too, such as working to reduce the culture of gun violence or to promote the culture of life. The ongoing formation of conscience is a vital prerequisite, so we can continually respond to the novel ethical challenges that progress in technology and medicine inevitably bring. May we each respond enthusiastically to the call to mission: "Here I am Lord, send me!" (Isaiah 6:8).

A comprehensive investigation of the Galilean moon, Io, by tracing mass and energy flows

Io is the most volcanically-active object in the solar system. The moon ejects a tonne per second of sulphur-rich gases that fill the vast magnetosphere of Jupiter and drives million-amp electrical currents that excite strong auroral emissions. We present the case for including a detailed study of Io within Voyage 2050 either as a standalone mission or as a contribution to a NASA New Frontiers mission, possibly within a Solar System theme centred around current evolutionary or dynamical processes. A comprehensive investigation will provide answers to many outstanding questions and will simultaneously provide information on processes that have formed the landscapes of several other objects in the past. A mission investigating Io will also study processes that have shaped the Earth, Moon, terrestrial planets, outer planet moons, and potentially extrasolar planets. The aim would be simple - tracing the mass and energy flows in the Io-Jupiter system.

Mars and the ESA Science Programme - the case for Mars polar science

Current plans within the European Space Agency (ESA) for the future investigation of Mars (after the ExoMars programme) are centred around participation in the Mars Sample Return (MSR) programme led by NASA. This programme is housed within the Human and Robotic Exploration (HRE) Directorate of ESA. This White Paper, in response to the Voyage 2050 call, focuses on the important scientific objectives for the investigation of Mars outside the present HRE planning. The achievement of these objectives by Science Directorate missions is entirely consistent with ESA's Science Programme. We illustrate this with a theme centred around the study of the Martian polar caps and the investigation of recent (Amazonian) climate change produced by known oscillations in Mars' orbital parameters. Deciphering the record of climate contained within the polar caps would allow us to learn about the climatic evolution of another planet over the past few to hundreds of millions of years, and also addresses the more general goal of investigating volatile-related dynamic processes in the Solar System.

The Pediatrician as Prophet

In the gospels, Jesus got angry with his disciples because they were hindering the children from coming to him. When the disciples tried to turn them away, Jesus said "Let the children come to me" (Matt 19:14). Our Lord spoke out on behalf of the little ones at a time when they were generally despised and ignored by society. The gospels also record specific instances of Jesus healing very sick children (see Mk 5: 22-44, 35-42). In continuing the healing ministry of Jesus today, pediatricians continue to work for the welfare of many neglected children and continue to be the voice of the voiceless. Collectively as a profession, pediatric doctors have a voice that people will listen to, and they can have an important say in some problematic issues regarding children in our world of today.

Summary

Our Lord healed sick children, and pediatricians carry on his same mission today. From their very baptism, Catholic pediatricians are asked to share in the prophetic mission of the Church. Pope Francis stated that all the baptized are "agents of evangelization." There are various areas where pediatricians can advocate on behalf of suffering children. The individual and collective voices of pediatricians can be a powerful force for change in society.

Guidelines for Short-Term Hand Surgery Outreach Trips: Building Trust and Establishing Continuity

Global outreach in hand surgery can be exceptionally rewarding for volunteers and their organizations, patients and their communities, and the host medical community. Success can be defined by individual cases that restore function and provide opportunities for a patient and family to contribute to society; however, the broader missions of medical collaboration, education, cultural exchange, and personal growth are critical factors toward building trust and establishing continuity of care for long-term success. Each outreach site and brigade encounters challenges; however, careful planning facilitates optimal conditions and reasonable expectations for enhancing outcomes.

Leadership in an academic discipline

Leading an academic discipline poses moral and ethical challenges, requiring a special set of capabilities. Leadership in a clinical academic discipline involves leading the transformation of education, research, leadership and patient care. Daily struggles within strategic, political and cultural milieu are the norm and effective leaders are able to navigate through these struggles and see opportunities for growth.

Identification of the technical and medical requirements for HEMS avalanche rescue missions through a 15-year retrospective analysis in a HEMS in Switzerland: a necessary step for quality improvement

BACKGROUND

Avalanche rescues mostly rely on helicopter emergency medical services (HEMS) and include technical rescue and complex medical situations under difficult conditions. The adequacy of avalanche victim management has been shown to be unexpectedly low, suggesting the need for quality improvement. We analyse the technical rescue and medical competency requirements of HEMS crewmembers for avalanche rescue missions, as well as their clinical exposure. The study aims to identify areas that should be the focus of future quality improvement efforts.

METHODS

This 15-year retrospective study of avalanche rescue by the Swiss HEMS Rega includes all missions where at least one patient had been caught by an avalanche, found within 24 h of the alarm being raised, and transported.

RESULTS

Our analyses included 422 missions (596 patients). Crews were frequently confronted with technical rescue aspects, including winching (29%) and patient location and extrication (48%), as well as multiple casualty accidents (32%). Forty-seven percent of the patients suffered potential or overt vital threat; 29% were in cardiac arrest. The on-site medical management of the victims required a large array of basic and advanced medical skills. Clinical exposure was low, as 56% of the physicians were involved in only one avalanche rescue mission over the study period.

CONCLUSIONS

Our data provide a solid baseline measure and valuable starting point for improving our understanding of the challenges encountered during avalanche rescue missions. We further suggest QI interventions, that might be immediately useful for HEMS operating under similar settings. A coordinated approach using a consensus process to determine quality indicators and a minimal dataset for the specific setting of avalanche rescue would be the logical next step.

Organizational health management through metaphor: a mission-based approach

Purpose The purpose of this paper is to identify the underlying metaphors that hospitals use to establish their organizational mission. Metaphors impact the direction and managerial decision making of organizations, and provide a method to more easily communicate to a variety of stakeholders. Design/methodology/approach A text analytics process is run to evaluate the mission statements from the largest hospitals by revenue in each of the 50 states of the USA and District of Columbia to identify the types of metaphor-based organizational health management methods. Findings A cluster analysis is generated to evaluate primary mission-based metaphors, and metatriangulation is used to evaluate output, develop theory and provide practical implications for healthcare management. Originality/value Key contributions include a review of healthcare metaphors, an analysis for understanding commonly utilized metaphors, a theory building process for developing a new integrated value-based care management metaphor, and a value-based process is developed for providing healthcare managers an easy to follow and repeatable process for improving organizational communication.

Management by missions in the healthcare sector

This article discusses the importance of the mission statement in the healthcare sector. It's also argued that only formal declaration of the mission it's insufficient to the appropriate professional coordination of doctors, nurses and managers. It's proposed a systematic approach to facilitate the introduction of the mission within the systems of the organization, what is called "Management by missions." It promotes horizontal and vertical integration between doctors, nurses and managers. Criteria that ensure this integration are specified.

Using 501c3 Foundations in the Care of Cleft and Craniofacial Children

This article relates to the use of 501c3 foundations in the care of patients with cleft and craniofacial disorders. Both authors are medical directors and founders of foundations that serve these children: A Smile for a Child Foundation was set up to help children locally; Free to Smile was set up as an international missions foundation. This article explores the advantages and disadvantages of each type of foundation as well as the struggles and successes foundations face to help children locally and internationally.