Exploration of the representation of the allied health professions in senior leadership positions in the UK National Health Service

BACKGROUND

Allied health professionals (AHPs) are an important group within the National Health Service (NHS) in the UK and make up a large portion of the workforce. Investment in AHP leadership is believed to lead to improvements in patient care, resource use, collaboration and innovation. This study aims to assess the current state of AHP strategic leadership within the NHS.

METHODS

A freedom of information (FOI) request was sent to all NHS Trusts and health boards (HBs) within the UK NHS. The questions focused on the AHP workforce, with a particular interest in the chief AHPs (or equivalent roles) working in an NHS setting. Analysis of the FOI used a range of descriptive statistics.

RESULTS

Of the 217 Trusts/HBs contacted, responses were received from 160 (74%). The majority (81%) reported that they employed a Chief AHP or equivalent role, with only 14% of these having a position on the Trust/HB executive board. There were 50 different job titles reported as the titles for the chief AHP or equivalent roles: with director of AHPs (18.6%), lead AHP (13.9%) and chief AHP (11.6%) being the most reported titles. The results identified an inequity of representation of AHP professions within senior AHP leadership; with most of these roles (70%) held by physiotherapists and occupational therapists.

CONCLUSION

Changes in AHP strategic leadership are needed to address the inequities identified in this study. Addressing these issues is required to enable inclusive leadership, which is crucial to improve the contribution of AHPs to healthcare.

Professional nurses supporting learners during professional socialisation in Limpopo province

Background

Professional nurses play a significant role in the professional socialisation of learner nurses during clinical placement. Clinical placements are areas of experiential learning as learner nurses come in contact with real-life experiences. Professional nurses are custodians of learners and need to offer them support.

Aim

The study sought to explore the role of professional nurses in supporting learner nurses during professional socialisation.

Setting

Four clinical health facilities in Limpopo province at different levels of care were purposely sampled to obtain information from different levels of care.

Methods

An ethnonursing approach and qualitative, explorative design was used. Non-probability purposive sampling was used to select 25 professional nurses. The criteria were professional nurses with 3 years of experience in professional socialisation and working in institutions accredited for clinical placement of learner nurses registered in the undergraduate programme. Data were collected through a face-to-face interview until data saturation was reached. Tesch's open coding system was used to analyse data.

Results

Professional nurses acknowledged that their responsibilities in supporting learners during professional socialisation are mentoring, teaching and being competent practitioners. Professional nurses were aware of their role in transferring ethical skills and knowledge to learners through professional socialisation.

Conclusion

The effectiveness of professional socialisation of learner nurses depends on the support offered during clinical placements.

Contribution

The study adds to the body of knowledge in nursing education and practice because when learners are offered support in the clinical areas, their learning journey will be of positive experience leading to competent practitioners.

Prevention of tobacco use in an adolescent population through a multi-personal intervention model

INTRODUCTION

The study aimed to assess the impact of a new intervention proposal involving students, teachers, and parents on smoking prevalence in secondary school adolescents.

METHODS

A quasi-experimental study was conducted, in which the response to a preventive multi-personal intervention model (intervention) against tobacco consumption was compared with a standard anti-smoking activity carried out by the local government administration (control). The study was carried out during the 2017-2018 academic year. The study population included 306 students (intervention 151, control 155) with a mean age of 13.4 years. The model involved the parents, the students (aged 15-17 years), and the teachers. The primary outcome was the change in smoking status one year after the intervention.

RESULTS

The percentage of non-smokers increased from 84.1% to 88.7% in the intervention group and remained almost unchanged among controls (89.3% vs 89.9%). After one year, there was an increase in the prevalence of non-smokers of 4.6% and a decrease in the prevalence of smokers of 4.7% among students who received the multi-personal intervention, whereas changes among controls were almost negligible (there was in fact a slight increase in the prevalence of smokers of 0.9%). The students who received the intervention smoked less or quit smoking more than those in the control group (OR=0.135; 95% CI: 0.019-0.973, p=0.047).

CONCLUSIONS

The multi-personal model developed in the study with the participation of teachers and parents focused on students was feasible, and effectively reduced the prevalence of smoking among high school adolescents.

Gender and ethnicity intersect to reduce participation at a large European hybrid HIV conference

OBJECTIVE

To evaluate how gender and ethnicity of panel members intersect to effect audience participation at a large European hybrid conference.

DESIGN

An observational cross-sectional study design was used to collect data at the conference and descriptive survey was used to collect data retrospectively from the participants.

SETTING

European AIDS Clinical Society 18th Conference; a 3223-delegate, hybrid conference held online and in London over 4 days in October 2021.

MAIN OUTCOME MEASURES

We observed the number and type of questions asked at 12 of 69 sessions and described characteristics of the panel composition by ethnicity, gender and seniority. A postconference survey of conference attendees collated demographic information, number of questions asked during the conference and the reasons for not asking questions.

RESULTS

Men asked the most questions and were more likely to ask multiple questions in the observed sessions (61.5%). People from white ethnic groups asked >95% of the questions in the observed sessions. The fewest questions were asked in the sessions with the least diverse panels in terms of both ethnicity and gender. Barriers to asking questions differed between genders and ethnicities.

CONCLUSIONS

Our study aims to provide evidence to help conference organisers improve leadership, equality, diversity and inclusion in the professional medical conference setting. This will support equitable dissemination of knowledge and improve education and engagement of delegates. To our knowledge, this is the first study describing conference participation by both ethnicity and gender in panellists and delegates within a hybrid conference setting.

Perception of Current and Future Commitment of Medical Teachers to the Varied Roles of a Teacher: An Observational Study

Background Medical education is gradually moving towards self-directed learning, thus the roles of a teacher have assumed wider dimensions than before. The awareness of these roles among medical teachers has been studied in several countries, but no study on the awareness of these roles among Indian medical faculty has been found. The aim of this research was to assess the current and future commitment perception of the roles of a teacher among Indian medical faculty. Methods A cross-sectional questionnaire-based survey regarding the 12 roles of a teacher, as defined by Harden and Crosby, was conducted among medical teachers in a tertiary-level hospital and medical college. The questionnaire consisted of three categories: importance in medical teaching, current commitment, and preferred future commitment to these roles, all measured on a five-point Likert scale. Results The highest mean scores were given to the roles of learning facilitator and on-the-job role model. In contrast, the lowest scores were designated to the production of study guides. Interestingly, the teachers' current commitment to roles such as curriculum planner and course organizer was found to be low. A significant difference was observed between the three categories for the majority of the roles. Younger faculties showed significant difference among categories, while the senior professors did not show significant variations across the roles. Conclusion This study of Indian medical teachers emphasizes the decreased importance attributed to roles like curriculum planning and course organization. Further studies in other developing countries are essential to understand this issue more comprehensively.

Teacher as role model in developing professional behavior of medical students: a qualitative study

Objectives

This study aimed to explore students' perspectives on the attributes of medical teachers as role models to students' professional behaviour in the educational process.

Methods

A phenomenological study was conducted to obtain participants' perceptions concerning the professional attributes of medical teachers. The participants were 21 final-year medical students in the School of Medicine, Universitas Gadjah Mada, who had completed and passed the national examination. The participants were recruited purposively to represent genders and performance (i.e., high-performing and average-performing students). The participants were divided into two focus groups based on their performance, each facilitated by non-teaching faculty members to avoid bias. Thematic analysis was conducted to analyze focus group transcripts by two independent coders. Codes were synthesized into themes related to the study aims.

Results

Seven themes were identified related to observed role model attributes, for instance, passionate lecturers, caring and empathetic, supportive and involving, objectivity, incompetence and compromising, poor communication and conflict, and time management. Subsequently, five themes were identified in participants' responses towards the observed role model, for instance, exemplary models, respect and motivating, confusion and inconvenience, avoiding and hate, and value collision and harmonization.

Conclusions

This study revealed a range of role model attributes and responded positively and negatively during learning encounters. As negative attributes are also prominent and observed by students, there is a need for medical schools to perform faculty development for the professional enhancement of medical teachers. Further study should be conducted to investigate the impact of role modelling on learning achievement and future medical practice.

Nurses' role model duties for health and COVID-19 pandemic precautions

Role modelling communicates a standard of behavior to another person. Silent role modelling occurs when this standard can be communicated without articulating reasons for the action; articulate role modelling occurs when it is necessary to articulate reasons in order to effectively role model the standard of behavior, and to avoid misinterpretation. Nurses are role models in virtue of the respect and admiration given to the nursing profession. As such, nurses have role model obligations. This paper examines nurses' role model obligations for healthy behaviors and pandemic precautions. Research often identifies nurses as role models for healthy behavior, despite the fact that nurses are typically no healthier than the general population. This paper argues that nurses do not have a duty to role model healthy behaviors. The ability to adopt healthy behaviors is affected by numerous personal and individual factors. For a nurse to share their struggles to adopt healthy behaviors as articulate 'imperfect' role models violates their right to privacy. By contrast, nurses do have a moral duty to role model pandemic precautions during the COVID-19 pandemic, such as correctly wearing appropriate masks, maintaining social distancing, avoiding gatherings of multiple households when pandemic precautions are not being taken, and staying up to date on vaccination. Nurses' duty to role model pandemic precautions does not involve sharing any personal information. Nurses have a duty to be silent role models when the risk of misinterpretation is low, and a duty to be articulate role models, who explicitly communicate reasons for the role modelled behavior, when necessary to ensure they are not misinterpreted. When articulate role modelling goes beyond the minimal role modelling duty, and imposes a comparative cost to the nurse, articulate role modelling is not obligatory, but supererogatory.

Pharmacy Student Perceptions of the Roles and Attributes of Pharmacist Preceptors in Australia

The pharmacist preceptor is key to the success of pharmacy student experiential placements with a recent focus being placed on the quality of preceptors. This study sought to investigate student perceptions of the ideal roles and attributes of pharmacist preceptors to inform the development of a preceptor training program. This was a mixed methods study using an online survey of pharmacy students from levels two to four of an undergraduate pharmacy honours program at a regional Australian university followed by qualitative, semi-structured focus group interviews. Surveys were analysed using descriptive statistics and content analysis while interviews were thematically analysed. Thirty-seven complete survey responses were received, and three student focus groups were conducted. Students identified the key role of preceptors in linking theory to practice and felt that the role of the preceptor in student assessment should focus on practical skills, such as communication and professionalism. There was overall strong agreement between the quantitative and qualitative findings on the ideal preceptor attributes with good communication, enthusiasm for the profession and the provision of clear and honest student feedback thought to be most important. Students regarded these attributes as essential for a good preceptor-student relationship to promote learning in the practice environment.

Psychiatric care and education understood from a student perspective: Enhancing competences empowering personal and social recovery

BACKGROUND

During the last decades, a recovery-based approach has called for a change in mental health care services. Several programmes have been presented, and the need to develop student and professional competences in education and clinical practice has been documented.

AIM

The aim of this study was to explore how psychiatric care is understood seen from a student perspective (nursing students, masters nurses and a master in applied philosophy) with focus on their personal competences and the educational interventions empowering processes for users' personal and social recovery.

METHOD

A qualitative design with a phenomenological-hermeneutic approach based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through semi-structured interviews.

FINDINGS

All interviewees expressed that both theoretically and clinically students did not experience a recovery-oriented approach empowering users' personal and social recovery process. On the contrary, they experienced that both education and practice were dominated by a biomedical approach providing clinical recovery. However, several students were aware of their need of developing personal and relational competences to be able to support the users' personal and social recovery journey. The students expressed that there is a need for educational processes targeting personal competences in 'becoming a professional' supporting 'presentness and awareness' and thereby the development of relational abilities and the courage to engage. The results relate to two nursing schools and two universities.

CONCLUSION

A biomedical approach dominates and makes it difficult to develop students' personal competences during education in practice and theory vital to the development of personal and social recovery-oriented practices. It is recommended that educators-in practice and in school-accentuate presentness, awareness and creativity as crucial relational capabilities and incorporate this in their teaching and supervision method, supporting the education and formation of the students' (and teachers' and supervisors') personal development processes.

Prosocial modelling matters: the association between parent and faculty involvement in fighting COVID-19 with medical students' career commitment

BACKGROUND

Role models are essential in medical education, yet empirical research is relatively insufficient on the influence of prosocial modelling on medical students' career commitment. The prosocial behaviour of medical staff involved in the fight against the novel coronavirus disease 2019 (COVID-19) at the beginning of 2020 presents an opportunity to fill the research gap. We explored and compared the different associations of the two most important role models for medical students - parents and faculty- with medical students' career commitment.

METHODS

The cross-sectional study was conducted with 99,559 undergraduate students majoring in clinical medicine in mainland China. Questions were asked to collect information about participants in the battle against COVID-19, medical students' determination to practice medicine after graduation, as well as students' socio-demographic characteristics. Chi-square tests and hierarchical regressions were performed to examine the associations between parent and faculty involvement and students' career commitment.

RESULTS

The results showed statistically significant associations between prosocial modelling during the COVID-19 pandemic in China and students' intention to pursue medical careers. The association of faculty involvement (OR = 1.165, p < .001) with students' career commitment was greater than that of parents (OR = 0.970, p > .05). For faculty involvement, the association was stronger among male students (OR = 1.323, p < .001) and students who were already determined to be doctors (OR = 1.219, p < .001) before the pandemic.

CONCLUSIONS

Our study provides new evidence on the potential roles of parents and faculty in shaping medical students' career commitment. Encouraging faculty to act as positive role models could help medical students increase their intention to become doctors.KEY MESSAGESProsocial modelling could enhance students' intention to pursue medical careers.The association of prosocial behaviour of faculty is larger than that of parents on medical students.Those who have prior medical career commitment are much more likely to persist in the medical profession, and prosocial modelling of faculty is positively associated with their medical career commitment.

Entrepreneurship Education and Founding Passion: The Moderating Role of Entrepreneurial Family Background

In this paper, we examine the relationship between entrepreneurship education and entrepreneurial passion. Despite the advancement of entrepreneurship education literature and the increasing focus on entrepreneurship education in business schools, we lack empirical exploration on how entrepreneurship education can impact students’ passion for founding new organizations. We hypothesize that students who take entrepreneurship classes would develop high levels of founding passion due to a great perception of skills and abilities that increase positive emotions and decrease negative emotions about the entrepreneurship process. Moreover, we draw on the literature on role models to suggest that students’ entrepreneurial family background (students whose immediate family members are entrepreneurs) strengthens the influence of entrepreneurship education on entrepreneurial passion. Utilizing survey data collected from 160 university students, we found that entrepreneurship education positively influences students’ founding passion and that this relationship is strengthened when students have entrepreneurs in their immediate family.

Discovering presence as part of nurse educators' role modelling at a public nursing college in the North West province

Background

Nursing students learn the science and art of nursing, including presence, from classroom content, using skills in practice, or by watching an experienced nurse interact with a patient. Nursing education must be designed so that nursing students can construct the art and science of nursing practice. Nursing students must be educated to be sound practitioners in the 'being' of nursing practice. Nurse educators modelling presence to nursing students will improve the quality of patient care during clinical training and throughout their professional role.

Aim

To explore and describe nurse educators' role modelling of presence to nursing students.

Setting

This study was conducted at a public nursing college in the North West province.

Methods

A qualitative, ethnographic study was conducted. Purposive sampling was used. Four nurse educators participated in the study and data saturation was reached. Data were collected through shadowing and informal reflective conversations over a period of 8 days.

Results

The following relationships emerged: nurse educators model 'being professional', 'being facilitating, nurturing, caring and compassionate, encouraging, and motivating', and 'being purposeful in their nursing education approach'.

Conclusion

Participants role modelled presence to nursing students despite daily challenges in their work.

Contribution

Creating awareness of how nurse educators can model presence despite daily challenges in their work will influence and motivate nursing students to develop presence skills. This will have a positive impact on managing patients in practice. Recommendations can guide nursing education, policy development and future research to strengthen nurse educators modelling presence.

Reading Struggle Stories of Role Models Can Improve Students' Growth Mindsets

Previous studies have suggested that reading stories of role models can improve the growth mindsets of students. The current study aimed to investigate the types of stories that can increase the growth mindsets of high school students, undergraduates, and graduates and how many specific stories undergraduates with low and high perseverance need to read to improve their growth mindsets. In study 1, high school students, undergraduates, and graduates were assigned to read either five struggle stories or five achievement stories of role models. Their mindsets were measured before and after reading the stories. The results showed that reading struggle stories rather than achievement stories of role models increased the growth mindsets of undergraduates and graduates. In study 2, undergraduates with high and low perseverance were assigned to read five struggle stories or five achievement stories of role models. Their mindsets were measured before reading stories and after reading each story. The results showed that the growth mindsets of undergraduates with low perseverance increased after reading two struggle stories of role models, and increased further after reading five struggle stories of role models. More importantly, the level of growth mindsets of undergraduates with low perseverance was equal to that of undergraduates with high perseverance after reading five struggle stories of role models. These findings reveal that reading struggle stories of role models can improve the growth mindsets of undergraduates and graduates. The personality of students affects the effectiveness of story-based mindset intervention.

Factors Associated with Healthcare Workers' (HCWs) Acceptance of COVID-19 Vaccinations and Indications of a Role Model towards Population Vaccinations from a Cross-Sectional Survey in Greece, May 2021

A Knowledge, Attitudes and Practices (KAP) study was conducted at the end of May 2021 engaging 1456 healthcare workers (HCWs) from 20 hospitals throughout Greece. Acceptance of vaccination against coronavirus disease 2019 (COVID-19) was estimated at 77.7%, with lower vaccine acceptance identified in nurses compared to physicians. Fears related to vaccine safety, lack of information and general knowledge about vaccinations, influenza vaccine acceptance, education level and years of practice were among the factors independently associated with vaccine acceptance. A strong association was identified between vaccination of HCWs in each health region and the population coverage, indicating that HCWs may be role models for the general population. Information campaigns should continue despite decisions taken regarding mandatory vaccinations.

Strategies to Advance Women: Career Insights From Senior Leadership Women in Professional Sport in Canada

Women remain minimally represented in senior leadership roles in sport, despite increased female participation in both sport, sport management education programs, and in entry levels positions in the industry. Many women prematurely exit mid-level leadership positions in sport, or are often overlooked for senior leadership positions. To uncover the experiences and strategies of women who made it through the process, we interviewed all the women (N = 7) who now hold senior leadership positions with professional sport properties in Canada. Participants revealed they overcame real and perceived barriers, and they suggested women seeking senior leadership roles in the industry: (a) find, and later become role models, mentors, and sponsors; (b) create access to networks and opportunities; (c) strategically self-promote, and; (d) purposefully build a varied career portfolio. Recommendations for the industry and all those who work in the industry are presented with a goal to break the cycle and help ensure more equitable and inclusive leaders in the senior leadership ranks.

Sun Protection and Sunburn in Children Aged 1-10 Years in Germany: Prevalence and Determinants

Seeking shade, the use of textile sun protection and sunscreen, and protecting one’s eyes by wearing sunglasses are recommended sun protection measures in children. We aimed to quantify the use of these measures as well as the prevalence of sunburn in children aged 1 to 10 years in Germany and to identify their determinants. Data collected via telephone interviews in a nationwide sample of 554 parents or caregivers in family were analyzed. Use of sunscreen was the most common measure applied (77.8%), while sunglasses were least frequently used (12.5%). The prevalence of sunburn during the past year was 21.8%, and it was positively associated with children’s age. The use of sun protection measures was significantly associated with the age and skin color of the child, while characteristics and tanning behaviors of the caregivers only played a minor role. The use of sun protection measures was higher when caregivers perceived themselves as a role model (Odds Ratio (OR) = 4.33, p < 0.001). Our nationwide data show that there remains a need for the improved use of sun protection measures, especially in children aged 7 to 10 years. In educational material, parents should be encouraged to become positive role models for their children regarding sun protection.

The Effect of Modeling on Self-Efficacy and Flow State of Adolescent Athletes Through Role Models

This study aimed to verify the effects of role modeling on adolescent athletes’ self-efficacy and flow state. The subjects were middle school and high school athletes registered with the Korean Sport & Olympic Committee. From the collected data, descriptive statistics, confirmatory factor analysis, correlation analysis, and structural equation model analysis were performed. To verify the mediating effects of self-efficacy in the relationship between modeling and flow state, structural equation modeling analysis was conducted. The direct effects of adolescent athlete modeling on flow state (β = 0.416, B = 0.244, p < 0.01) and self-efficacy (β = 0.479, B = 0.500, p < 0.01) were all significant, and the direct effects of self-efficacy on flow state (β = 0.404, B = 0.227, p < 0.01) were also significant. Furthermore, it was confirmed that the indirect effect of modeling on flow state (β = 0.194, B = 0.114, p < 0.01) was significant, and that the partial mediated effects of self-efficacy were significant. Thus, we confirmed that when adolescent athlete use modeling through a role model, their self-efficacy increased which in turn led to a positive effect on the ability to achieve a flow state.

Women in thoracic surgery: European perspectives

During the last decades, women have been discouraged from entering the medical career and in particular in the surgical specialties. This situation is changing across continents and national and international initiatives are supporting aspiring female surgeons in pursuing the surgical career through mentorship and fellowship programmes. Due to the differences in training programmes, Health Care systems and cultural backgrounds, it’s not easy to describe unanimously the pathways and obstacles that junior female thoracic surgeons are experiencing in Europe. The development of female surgical associations, mentorship programmes and national initiatives will further champion the gender equality in this specialty across Europe. During the recent years, the European Society of Thoracic Surgeons (ESTS) has established initiatives like the first ESTS Women in Thoracic Surgery Scientific Session or the annual Women in Thoracic ESTS Reception during the Annual Conference, which are done in an effort to encourage all female colleagues to join this specialty and increase the opportunity to share their experience and meet potential mentors. In this article we will depict the situation in some of the European countries whose female thoracic surgeons have led their way. We aim to give the next generation the examples that can influence women’s choice of surgical career, and the possible strategies and initiatives to reduce the gender discrimination within healthcare.

Women in thoracic surgery: lesson learned from medical industry partners

Medical technology has led to important achievements in surgery as minimally invasive techniques have expanded over the past several years. These innovations have changed the dynamic between industry and surgeons towards a more collaboration relationship forming partnerships important to surgical advancement and technical training opportunities. On this backdrop of transformation is growing awareness of the gender disparity that exists within the thoracic surgery workforce where we have experienced strikingly little change. At the same time, medicine is not unique with its gender disparity. As we have benefited from important partnerships to create excellence in technical innovation, so too may we benefit from drawing upon some of the successes within the medical industry towards achieving gender equity. This paper highlights examples of female leaders in the medical industry surrounding thoracic surgery, who have demonstrated excellence in the advancement and promotion of female thoracic surgeons through fellowships, mentorships or networking.

Girls' perceptions of their mothers at work and home: Warm does not mean weak

Upper elementary school girls were surveyed about their mothers' and fathers' warmth, competence, and agency at home and how they imagine their parents at work. Mothers' warmth at home was positively correlated with perceived competence and agency both at home and at work. Differences between daughters' perceptions of their mothers and fathers at work are discussed.

Unveiling the Hurdles in Cultivating Humanistic Physicians in the Clinical Setting: An Exploratory Study

Background

The importance of cultivating a humanistic physician has gained attention in medical education. Humanistic values are established in early education and medical schools should provide a suitable environment to nurture and grow these values into professional identity. The clinical setting has a significant impact due to its direct involvement of students in real-life situations.

Objectives

The present study aims to explore the hurdles in cultivating humanistic physicians in the clinical setting.

Methods

We conducted a qualitative study involving medical students in the clinical phase, as well as residents, clinical teachers, and module administrators in the clinical setting under study.

Results

Respondents from different groups of stakeholders shared the same definition for 'humanistic physician': a physician who provides patient-centred care while demonstrating empathy, respect, compassion, integrity, knowledge, competence and a collaborative spirit. Despite changes in the healthcare system and technological advancements, humanistic physicians are still needed.

Conclusion

Cultivating humanistic physicians is a complex process, requiring various methods and assessments. Role models play a significant role in this process, which included not only clinical teachers but also peers. Feedback from peers was perceived as an important factor. The key hurdles identified were negative role models, and a less humanistic learning environment and the students' personal backgrounds.

Role Modeling for Female Surgeons in Japan

Japan is still a patriarchal society. There is an increasing number of female doctors who wish to follow a career path in surgery. This new generation of female surgeons need support not only in their career but also in work-life balance, especially after they have a family. We founded the Japan Association of Women Surgeons (JAWS) with the aims to advance females in surgery by providing networking and to develop leadership, mentorship, education, expertise and advocacy. This article describes our philosophy and activities, and our concept of role modeling. To find a single perfect role model is impossible in Japan, because lifestyle and family situations are quite different among individuals. Many young doctors in Japan find difficulties in identifying role models appropriate to their own situations. Our concept of remote role modeling is to identify multiple outstanding persons with excellent roles that one wishes to emulate; classify them by field of work, lifestyle, family situations, and others; then select the parts that one needs and assemble them to customize one's own ideal role model. This type of role modeling is probably the most practical approach. While modern technology is good for communication, meeting role models in person at meetings and social occasions is important in building an ideal role model.

Association of Existence of Third Places and Role Model on Suicide Risk Among Adolescent in Japan: Results From A-CHILD Study

Objective: Low self-esteem among adolescents can be considered a risk factor for suicidal behavior in adolescents. Thus, the purpose of this study is to investigate the association between the existence of a third place and role model on self-esteem among adolescents in Japan, where low self-esteem is prevalent among adolescents. Methods: We analyzed data from the 2016 Adachi Child Health Impact of Living Difficulty (A-CHILD) study, in which a school-based questionnaire was conducted among children in grades 4, 6, and 8 living in Adachi City, Tokyo (N = 1,609). Children self-rated their own levels of self-esteem. Low self-esteem was defined as lower 10 percentile group. The existence of a third place was defined as a place where children spent time after school other than the home or school campus, and role model was defined as having someone, other than a parent, who they looked up to, and these concepts were assessed via questionnaire. Results: Adolescents without a third place and role model accounted for 10.5 and 6.1%, respectively. We found that children who lacked a third place also showed a significant association with low self-esteem (OR: 1.75, 95% confidence interval (CI): 1.09-2.81), and those who lacked a role model were 3.34 times more likely to have lower self-esteem (95% CI: 1.98-5.62). Conclusion: The existence of a third place and a role model may be important to prevent low self-esteem among adolescents in Japan.

When imitating successful others fails: Accidentally successful exemplars inspire risky decisions and can hamper performance

We examined the impact of viewing exemplars on people's behaviour in risky decision-making environments. Specifically, we tested if people disproportionally choose to view and then imitate the behaviour of successful (vs. unsuccessful) others, which in the case of risky decision-making increases risk-taking and can hamper performance. In doing so, our research tested how a fundamental social psychological process (social influence) interacts with a fundamental statistical phenomenon (regression to the mean) to produce biases in decision-making. Experiment 1 (N = 96) showed that people indeed model their own behaviour after that of a successful exemplar, resulting in more risky behaviour and poorer outcomes. Experiment 2 (N = 208) indicated that people disproportionately choose to examine and then imitate most successful versus least successful exemplars. Experiment 3 (N = 381) replicated Experiment 2 in a context where participants were offered the freedom to examine any possible exemplar, or no exemplar whatsoever, and across different incentive conditions. The results have implications for decision-making in a broad range of social contexts, such as education, health, and finances where risk-taking can have detrimental outcomes, and they may be particularly helpful to understand the role of social influence in gambling behaviour.

Perceptions Regarding Tobacco Cessation Counselling among Dental Students and Graduates: A Cross-Sectional Study

Background:

Tobacco usage is a global concern and it is essential to curb its usage and increase awareness among patients. Dental professionals’ contribution in tobacco cessation will definitely make a stark difference. Thus it is important to assess dental students’ and graduates’ knowledge, attitude and practice towards Tobacco cessation counselling (TCC).

Materials and Methods:

The descriptive, cross-sectional survey was carried out among 286 students of a dental college in South India. A well-structured, pretested, self-administered questionnaire consisting of 17 close-ended questions was employed to assess knowledge, attitude and practice towards TCC.

Results:

Almost all study participants agreed that tobacco cessation counselling is under the scope of dental practice and admitted that it is the responsibility of dental professionals to educate patients for the same. Majority of graduates responded that they have done tobacco cessation counselling whereas less than two-third of undergraduates have done the same and difference between two groups was statistically significant (p<0.001). A significantly higher number of graduates (79%) were aware of 5A’s and 5R’s protocol for TCC as compared to undergraduates (50%). But less than one-fifth of study population have actually applied this protocol for TCC in clinical practice.

Conclusion:

There is a need to modify the dental curriculum and motivate young graduates and students about TCC. This will develop a more professional competence and helps to encourage the dental professionals in developing a preventive mind set about tobacco use. Thus, it will help in enhancing the long-term rates of quitting tobacco among patients, which will prove beneficial in controlling tobacco related diseases in near future.

How to be a great occupational physician: Lessons from Tar-Ching Aw

Tar Ching Aw (1948-2017) or Ching, as he was known to many of us, was highly regarded as an excellent occupational physician and role model. He was an inspirational teacher, a selfless mentor and a great advocate for the discipline of occupational medicine. Among the lessons we can learn from Ching on how to be an excellent occupational physician are the importance of: getting the right training (including clinical training); having good teachers and role models; believing in and being passionate about one's work; delivering quality work on time; networking and being culturally sensitive; thinking of future generations and mentoring them; and having fun and a healthy work life balance.

Practicing what we preach: A pilot study on oral health practices of dentists in Massachusetts

AIM

Dentists are perceived as leaders and role models of good oral health, but do dentists practice what they preach? The current study was a pilot evaluation dentists of the oral health and oral health practices of dentists in Massachusetts.

METHODS

The Massachusetts Dental Society sent emails to 3957 member dentists for whom an email contact was available. One reminder was sent 3 months later, and there was no incentive offered. Institutional review board approval was acquired prior to administering the survey through the Harvard Medical School Committee on Human Studies.

RESULTS

A total of 4.9% of dentists had a comprehensive oral examination more than 8 years ago, and 3.1% had diagnostic bitewings 3-5 years ago. Our study revealed that 5.8% had untreated caries and only 70.8% reported having no oral health problems. A total of 37% reported that lack of time was a barrier in seeking care, and 7.8% reported financial barriers. Finally, 4.1% reported that a non-dentist coworker examined and managed their oral health.

CONCLUSIONS

The current study revealed that many dentists are not following American Dental Association guidelines for prevention for themselves. Subsequently, many in our profession are recommending preventive care for their patients that they are not adhering to themselves.

Role models and professional development in dentistry: an important resource: The views of early career stage dentists at one academic health science centre in England

BACKGROUND

The importance of role models, and their differing influence in early, mid- and late careers, has been identified in the process of professional development of medical doctors. There is a paucity of evidence within dentistry on role models and their attributes.

AIM

To explore the views of early career dentists on positive and negative role models across key phases of professional development, together with role models' attributes and perceived influence.

METHODS

This is a phenomenological study collecting qualitative data through semi-structured interviews based on a topic guide. Dentists in junior (core training) hospital posts in one academic health science centre were all invited to participate. Interviews were recorded, transcribed verbatim and analysed using framework analysis.

RESULTS

Twelve early career stage dentists, 10 of whom were female, reported having role models, mainly positive, in their undergraduate and early career phases. Participants defined role models' attributes in relation to three distinct domains: clinical attributes, personal qualities and teaching skills. Positive role models were described as "prioritising the patient's best interests", "delivering learner-centred teaching and training" and "exhibiting a positive personality", whilst negative role models demonstrated the converse. Early career dentists reported having largely positive dentist role models during- and post-dental school and report their impact on professional values and aspirations, learning outcomes and career choice.

CONCLUSION

The findings suggest that these early career dentists in junior hospital posts have largely experienced and benefitted from positive role models, notably dentists, perceived as playing an important and creative influence promoting professionalism and shaping the career choices of early career stage dentists.

Do family physicians suffer an identity crisis? A perspective of family physicians in Bangalore city

Background:

The need of the hour in Indian healthcare is well-qualified, competent family physicians, but there is an overwhelming importance given to specialized medical care. Family physicians feel that they do not get the recognition they deserve. This study was undertaken to explore the views and perceptions of family physicians and residents about their specialty.

Materials and Methods:

This cross-sectional study was conducted among 110 doctors who are undergoing family medicine (FM) residency and practicing family physicians in Bangalore. The questionnaire was developed with domains on patient or family relationship, balancing breadth and depth in practice, comprehensive nature of patient care, career flexibility, and patient advocacy. Data were analyzed using SPSS version 17.0, and P value less than 0.05 was considered as statistically significant.

Results:

The majority of the participants (55.5%) felt that there is poor acceptance among the people about FM doctor as a specialist. A significant proportion (39.1%) of them indicated that thought of “Jack of all trades and Master of none” bothers them much. More than 90% of respondents felt a sense of pride being family physicians. FM practitioners (28.4 ± 3.1) had a good perception score when compared with residents (27 ± 3.6) (P < 0.05). There was a significant difference among FM residents and practitioners on being pride of FM physician sense of belonging to larger community FM physicians.

Conclusion:

FM residents go through more identity crisis when compared with practitioners. This can be addressed well by incorporating FM curriculum in undergraduate medical training and strong FM department where students have role model as mentors and take FM as specialty as their preferred choice.

Lessons learned from narrative feedback of students on a geriatric training program

Geriatrics continues to draw insufficient numbers of medical students today. Currently, little is known regarding how education can motivate students to choose geriatrics. The authors' aim was to examine geriatrics from the students' perspective to identify elements that can be useful in education and improving attitudes toward, interest in, and knowledge about geriatrics. The authors analyzed narrative reflection essays of 36 students and clarified the themes from the essays during focus group sessions. Four overarching themes that influenced students' perspective on geriatrics were identified: professional identity, perception of geriatrics, geriatric-specific problems, and learning environment. Students have an inaccurate image of clinical practice and the medical professional identity, which has a negative impact on their attitude toward, interest in, and knowledge of geriatrics. Furthermore, this study yielded the important role of the hidden curriculum on professional identity, the novelty of geriatric-specific problems to students, and the importance of educational approach and good role models.

Entrepreneurship education revisited: perceived entrepreneurial role models increase perceived behavioural control

Relying on Bandura's (1986) social learning theory, Ajzen's (1988) theory of planned behaviour (TPB), and Dyer's (1994) model of entrepreneurial careers, this study aims to highlight the potential of entrepreneurial role models to entrepreneurship education. The results suggest that entrepreneurial courses would greatly benefit from real-life experiences, either positive or negative. The results of regression analysis based on 426 individuals, primarily from Austria, Finland, and Greece, show that role models increase learners' entrepreneurial perceived behaviour control (PBC) by increasing their self-efficacy. This study can inform the research and business communities and governments about the importance of integrating entrepreneurs into education to stimulate entrepreneurial PBC. This study is the first of its kind using its approach, and its results warrant more in-depth studies of storytelling by entrepreneurial role models in the context of multimedia entrepreneurship education.

The influence of role models in undergraduate nurse education

AIMS AND OBJECTIVES

To explore the concept of role modelling in undergraduate nurse education and its effect on the personal and professional development of student nurses.

BACKGROUND

Effective educative strategies are important for student nurses, who have to cope with learning in both clinical and university settings. Given the contemporary issues facing nurse education and practice in the United Kingdom (UK), it is timely and important to undertake pedagogical research into the concept of role modelling as an effective educative method.

DESIGN

A descriptive narrative approach.

METHODS

Unstructured interviews were conducted with 14 current/recently discontinued students from Adult and Mental Health branches of nursing degree programmes in the north-west region of England, United Kingdom (UK). Data were thematically analysed.

RESULTS

Students valued exposure to positive role models in clinical and university settings and viewed them as beneficial to their learning. Exposure to negative role models occurred, and this provided students with opportunities to consider the type of nurse they aspired to become. In some cases, students' exposure to perceived poor practice had an adverse effect on their learning and led to negative feelings about nursing work. Clinical staff might be perceived as more relevant role models than those in the university setting although there were still opportunities for academic staff to model professional behaviours.

CONCLUSION

The study found that role modelling is an effective way to support learning and led to student satisfaction across both clinical and university settings. The findings support the use of role models in nurse education, and further research about conscious positive modelling of practice is required.

RELEVANCE TO PRACTICE

Exploring the use of role models is important when examining ways in which the quality of nurse education might be developed.

Development of Physical Activity-Related Parenting Practices Scales for Urban Chinese Parents of Preschoolers: Confirmatory Factor Analysis and Reliability

BACKGROUND

Valid instruments of parenting practices related to children's physical activity (PA) are essential to understand how parents affect preschoolers' PA. This study developed and validated a questionnaire of PA-related parenting practices for Chinese-speaking parents of preschoolers in Hong Kong.

METHODS

Parents (n = 394) completed a questionnaire developed using findings from formative qualitative research and literature searches. Test-retest reliability was determined on a subsample (n = 61). Factorial validity was assessed using confirmatory factor analysis. Subscale internal consistency was determined.

RESULTS

The scale of parenting practices encouraging PA comprised 2 latent factors: Modeling, structure and participatory engagement in PA (23 items), and Provision of appropriate places for child's PA (4 items). The scale of parenting practices discouraging PA scale encompassed 4 latent factors: Safety concern/overprotection (6 items), Psychological/behavioral control (5 items), Promoting inactivity (4 items), and Promoting screen time (2 items). Test-retest reliabilities were moderate to excellent (0.58 to 0.82), and internal subscale reliabilities were acceptable (0.63 to 0.89).

CONCLUSION

We developed a theory-based questionnaire for assessing PA-related parenting practices among Chinese-speaking parents of Hong Kong preschoolers. While some items were context and culture specific, many were similar to those previously found in other populations, indicating a degree of construct generalizability across cultures.

Nurses' Perceptions of Self as Role Models of Health

This study purposed to determine the relationship between nurses' personal health practices and their perceptions of themselves as role models for health promotion, and assess the relationship of personal and professional characteristics both on perception of self as role model and on the practice of healthy behaviors. In this study of 804 Tennessee registered nurses, 4% report smoking, 24.9% drink alcohol, 34% are overweight, and 30% are obese. Approximately 70% do not meet the weekly physical activity recommendations of 150 min, and 36.2% follow guidelines for a healthy diet only 50% of the time or less. There were significant correlations between following a healthy diet or physical activity and the Self as a Role Model of Health Promotion (SARMHEP) scores. Based on the regression analysis, working in an acute care or ambulatory setting negatively affected the SARMHEP, as opposed to age and sex having a positive effect on the SARMHEP score.

Should nurses be role models for healthy lifestyles? Results from a modified Delphi study

AIM

To explore the expectation that nurses should be role models for healthy behaviours.

BACKGROUND

Nurses are expected to be role models for healthy behaviours. Whether this is a realistic and acceptable expectation has not been explored.

DESIGN

Modified Policy Delphi study with two rounds of data collection.

METHOD

Purposive sampling was used to explore areas of agreement and disagreement among six stakeholder groups who influence nursing roles: practising nurses, nursing students, service users, policy makers, workforce development leads and stakeholders working in nurse education. Two rounds of a modified Policy Delphi study were conducted between February - June 2015. The first round used telephone interviews for an open exploration of opinions. The second round used attitude statements to explore convergence and divergence of opinions across stakeholder groups. Responses were analysed thematically.

RESULTS

Policy and professional discourse that asserts that nurses should be healthy role models was seen as unrealistic and unhelpful. Contrary to the view that nurses should epitomize and demonstrate healthy behaviours to encourage patients and to be credible in advice, stakeholders agreed that it was more important to be seen as 'human' and understand the challenges of health behaviour change. Student and practising nurses did not see role modelling healthy behaviours as a reasonable professional expectation.

CONCLUSIONS

The findings challenge the assumptions underpinning the argument that nurses be healthy role models. Further research is needed to understand the views of frontline nurses and to further explore avenues by which health services staff health can be improved.

Innovative integrative bedside teaching model improves tutors' self-assessments of teaching skills and attitudes

INTRODUCTION

Patient bedside is the ideal setting for teaching physical examination, medical interviewing, and interpersonal skills. Herein we describe a novel model for bedside teaching (BST) practiced during tutor training workshop and its resulting effect on practitioners' self assessment of teaching skills and perceptions.

METHODS

One-day tutor training workshop included theoretical knowledge supplementation regarding tutors' roles as well as implementing practical tools for clinical education, mainly BST model. The model, which emphasizes simultaneous clinical and communication teaching in a stepwise approach, was practiced by consecutive simulations with a gradual escalation of difficulty and adjusted instruction approaches. Pre- and post-workshop-adjusted questionnaires using a Likert scale of 1 to 4 were completed by participants and compared.

RESULTS

Analysis was based on 25 out of 48 participants who completed both questionnaires. Significantly improved teaching skills were demonstrated upon workshop completion (mean 3.3, SD 0.5) compared with pre-training (mean 2.6, SD 0.6; p<0.001) with significant increase in most examined parameters. Significantly improved tutor's roles internalization was demonstrated after training completion (mean 3.7, SD 0.3) compared with pre-workshop (mean 3.5 SD 0.5; p=0.002).

DISCUSSION

Successful BST involves combination of clinical and communication skills. BST model practiced during the workshop may contribute to improved teaching skills in this challenging environment.

Multiset Statistics for Gene Set Analysis

An important data analysis task in statistical genomics involves the integration of genome-wide gene-level measurements with preexisting data on the same genes. A wide variety of statistical methodologies and computational tools have been developed for this general task. We emphasize one particular distinction among methodologies, namely whether they process gene sets one at a time (uniset) or simultaneously via some multiset technique. Owing to the complexity of collections of gene sets, the multiset approach offers some advantages, as it naturally accommodates set-size variations and among-set overlaps. However, this approach presents both computational and inferential challenges. After reviewing some statistical issues that arise in uniset analysis, we examine two model-based multiset methods for gene list data.

Lay perspectives on the social and psychological functions of heroes

Declaring and thinking about heroes are common human preoccupations but surprisingly aspects of heroism that reinforce these behaviors are not well-understood. In four thematically consistent studies, we attempt to identify lay perspectives about the psychological functions served by heroes. In Study 1, participants (n = 189) freely generated open-ended descriptions of hero functions, which were then sorted by independent coders into 14 categories (e.g., instill hope, guide others). In Study 2, in an attempt to identify the most important functions associated with heroes, participants (n = 249) rated how each function corresponded with their personal views about heroes. Results from a confirmatory factor analysis suggested that a three-factor model of hero functions fit the data well: participants thought that heroes enhanced the lives of others, promoted morals, and protected individuals from threats. In Study 3 (n = 242), participants rated heroes as more likely to fulfill a protecting function than either leaders or role models. In Studies 4A (n = 38) and 4B (n = 102), participants indicated that thinking about a hero (relative to a leader or an acquaintance) during psychological threat fulfilled personal enhancement, moral modeling, and protection needs. In all, these findings provide an empirical basis to spur additional research about the social and psychological functions that heroes offer.

Facilitating the initiation of the physician's professional identity: Cornell's urban semester program

Calling for major reform in medical education, the Carnegie Institute report 'Educating Physicians' espoused the importance of assisting student trainees in forming their professional identities. Here, we consider the question: At what educational stage should future physicians begin this process? The literature suggests that the process begins when students matriculate in medical school; we posit, however, that premedical students can begin their proto-professional development as college undergraduates. We describe here the pedagogy of Cornell University's urban semester program (USP), which enables college students to participate in shadowing experiences as part of an integrated structured study programme. USP students report improved communicative competency, changes in their perceptions and attitudes toward medical practice, and powerful influences on their personal and professional development upon completion of the programme. We suggest the solution to the question of 'When and under what conditions should shadowing take place?' is to utilize a structure that combines the exposure of college students to the professional environment with a didactic and self-reflective curriculum, thereby supporting students in their early professional development. We conclude that educational efforts aimed at developing professional identity and behaviour can begin before students enter medical school.

Role models play the greatest role - a qualitative study on reasons for choosing postgraduate training at a university hospital

Objective: Why physicians choose a certain specialty at a university hospital for their postgraduate training is incompletely understood. Our aim was to identify factors that led physicians from different generations to opt for postgraduate training in a specialty with high or low patient contact at a university hospital.

Methods: We conducted 14 semi-structured interviews with residents and attending physicians from the departments of Internal Medicine (high patient contact) and Laboratory Medicine (low patient contact) at the University Hospital Hamburg-Eppendorf, Germany. We used template analysis to code the interview transcripts and iteratively reduced and displayed the data. Initial codes and concepts were shaped into categories until agreement on the final template was reached.

Results: We identified five main categories of factors that influenced postgraduate specialty selection. Role models with a civilized code of behavior and expertise in their specialty had had the greatest influence on participants’ choice of a specialty across generations. Electives and a doctoral thesis project had also influenced participants’ decisions, mainly because of meeting a role model in their supervisor. Patient contact and intellectual challenges were identified as contributing factors in the selection of a specialty with high patient contact. As reasons for selecting a university hospital for postgraduate education four categories were identified: the possibility to participate in scientific research, a broad spectrum of activities, personal contacts and future career opportunities.

Conclusions: The professional attitudes of teachers as role models were identified as having the greatest influence on postgraduate education choices. Besides other actions to attract students to certain specialties for their postgraduate education, the aspect of being perceived as a role model while teaching requires particular attention when preparing medical faculty for undergraduate medical teaching.

Mentorship

The world of medicine is in a state of flux with major and substantive changes in its educational model. Students, residents, and junior attendings can no longer rely entirely on experiential development through clinical immersion. Instead, to attain similar levels of knowledge, technique, and situational comfort, there must be innovations in medical education that take advantage of the experience of mentors. Mentoring has been a part of medicine and surgery since the days of apprenticeship. Mentors must now teach more basic medicine than ever before and adapt to changes in the structure of medical education such as the use of simulation, yet still continue to foster career development among trainees and junior colleagues. For mentoring to succeed and benefit mentees, it must be supported. This patronage starts with each local university or hospital system but eventually must permeate the greater medical culture.

Experiences of role model instructors and nursing students about facilitator factors of role-modeling process: A qualitative research

BACKGROUND

One of the key strategies in students' learning is the influence of models on them. Understanding the factors affecting the implementation of role-modeling process in education will help to make greater use of this training strategy. This study aimed to understand the experiences of role model instructors and nursing students about the facilitator factors in the role-modeling process.

MATERIAL AND METHODS

This qualitative study was carried out by using thematic analysis method and purposeful sampling. Data were collected until saturation by using three focus group discussions (n = 20) and two individual interviews with nursing instructors, as well as six semi-structured face-to-face interviews with role model instructors from five nursing faculties of Tehran universities in 2011.

RESULTS

Six themes, "effort for humanistic and professional growth of students," "individual and managerial empowerment of instructor," "instructor and student's modeling," "motivation and effort of student," "strategies governing the education system," and "appropriate facilities and equipment," were extracted as the facilitating factors.

CONCLUSIONS

For development of role-modeling process in nursing education, paying attention to personal and environmental factors, especially effort for professional and humanistic growth of nursing students is necessary.

Benefits of off-campus education for students in the health sciences: a text-mining analysis

BACKGROUND

In Japan, few community-based approaches have been adopted in health-care professional education, and the appropriate content for such approaches has not been clarified. In establishing community-based education for health-care professionals, clarification of its learning effects is required. A community-based educational program was started in 2009 in the health sciences course at Gunma University, and one of the main elements in this program is conducting classes outside school. The purpose of this study was to investigate using text-analysis methods how the off-campus program affects students.

METHODS

In all, 116 self-assessment worksheets submitted by students after participating in the off-campus classes were decomposed into words. The extracted words were carefully selected from the perspective of contained meaning or content. With the selected terms, the relations to each word were analyzed by means of cluster analysis.

RESULTS

Cluster analysis was used to select and divide 32 extracted words into four clusters: cluster 1-"actually/direct," "learn/watch/hear," "how," "experience/participation," "local residents," "atmosphere in community-based clinical care settings," "favorable," "communication/conversation," and "study"; cluster 2-"work of staff member" and "role"; cluster 3-"interaction/communication," "understanding," "feel," "significant/important/necessity," and "think"; and cluster 4-"community," "confusing," "enjoyable," "proactive," "knowledge," "academic knowledge," and "class."

CONCLUSIONS

The students who participated in the program achieved different types of learning through the off-campus classes. They also had a positive impression of the community-based experience and interaction with the local residents, which is considered a favorable outcome. Off-campus programs could be a useful educational approach for students in health sciences.

The art of medical education

Is the art of medical education just making sure to provide sufficient up to date medical knowledge and a lot of clinical experience? It is much more. The art of medical education is about a teaching program that is designed to serve the community of the near future. The program is the result of a thorough evaluation of societal needs and is capable of influencing the properties of future care. New care professionals who are trained in the program will -become instrumental in solving complex problems in health systems. The art of medical education is about the change of traditional ideas of how to cope with these health systems. This change will raise anger and resistance. Effective change management is essential to survive attacks from laggards and to maintain enthusiasm to invest in the health care of the future. Educationalist science provides several important insights that help us find the optimal shape of the program. Good role models and a learning environment that is an example of the intended professional and organisational behaviour, learning by doing, simulation programs, educational tools like e-learning systems, a good assessment and feedback system, and a portfolio to prove and discuss professional progress are all pivotal components of the ideal program. To achieve mastery within the art of medical education, a quality improvement program will be the crown of the process. Medical education is a multifaceted process and so the quality improvement should be. The art of medical education is a great challenge. The health care of your future deserves it.

Clinical pharmacy consultation for pharmacogenetic testing

The clinical application of pharmacogenetic testing will help to bring personalized medicine into clinical practice. Due to the complex process involved in delivering pharmacogenetic testing, optimal clinical implementation of pharmacogenetic tests will require the coordinated effort of multiple disciplines including medicine, clinical laboratory medicine and clinical pharmacy. This will help to bridge the gap between the basic and laboratory science, and the clinical application of these results. How may clinical pharmacy contribute to the clinical application of pharmacogenetic testing as a member of a multidisciplinary team? In this perspective, we propose a potential new role for pharmacists: as an interpreter of pharmacogenetic test results. Interpreting the results of pharmacogenetic tests, particularly, those intended to guide drug dosing, requires an understanding of pharmacogenetics, pharmacokinetics and pharmacodynamics. Pharmacists who are knowledgeable in these areas may play an important role in interpretation of the test results.

Influence of role models and hospital design on hand hygiene of healthcare workers

We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) were observed in the old hospital and 417 (58%) in the new hospital. Hand-hygiene compliance was significantly better in the old hospital (161/304; 53%) compared to the new hospital (97/417; 23.3%) (p<0.001). Health-care workers in a room with a senior (e.g., higher ranking) medical staff person or peer who did not wash hands were significantly less likely to wash their own hands (odds ratio 0.2; confidence interval 0.1 to 0.5); p<0.001). Our results suggest that health-care worker hand-hygiene compliance is influenced significantly by the behavior of other health-care workers. An increased number of hand-washing sinks, as a sole measure, did not increase hand-hygiene compliance.

Parenting influences on the development of alcohol abuse and dependence

Both alcohol-specific and non-alcohol-specific parenting influences affect the development of alcohol abuse and dependence in the offspring. Alcohol-specific influences (e.g., the modeling of parental drinking behavior, the development of alcohol expectancies, and certain aspects of the parent-child relationship) are particularly relevant to the development of alcohol abuse and dependence in children of alcoholics. In contrast, non-alcohol-specific influences generally promote deviant behavior, including alcohol problems, in the offspring and affect children of alcoholics and nonalcoholics equally. These influences, which include inadequate parenting and other parent-child interaction patterns that promote aggressive, antisocial behavior in children, increase the offspring's risk of an alcoholism subtype associated with antisocial personality disorder. A different set of non-alcohol-specific family influences may contribute to an alcoholism subtype that emerges after the onset of depression.