BMJ Leader最新文献

Background/aim: The physician-administrator dyads are a strategic method of collaboration in healthcare organisations. Dyad leaders are part of a multidisciplinary team that integrates their expertise to generate better patient, physician, and organisational outcomes. An assumption of team science is that diverse experts, while knowledgeable, struggle to work together to resolve problems because of their vastly different decision-making and implementation strategies. Similarly, conflicting priorities, competing pressures, and lack of clear understanding of the other member's role will result in ineffective teamwork between the dyad.

Methods: We conducted a literature review of dyad leadership in healthcare and connected these insights to the teamwork literature.

Results: We connect the challenges of dyad leadership with practical solutions that help physicians and administrators integrate their diverse expertise. To overcome these challenges, healthcare employees, teams, and organisations must implement an effective structure for diverse dyads to work together effectively. We develop a framework based on a review of the literature on dyads and describe what is needed for an effective partnership between the physician and administrator.

Conclusions: We describe the teamwork mechanisms that develop as teams use these strategies, which ultimately makes the dyads effective in the organisation. Dyad leaders who use these strategies will develop their teamwork behaviours and teamwork processes to reduce conflict and sustain the viability of their team to complete their goals, benefiting the patient, the team, and the organisation.

Aim: To examine trends in quality of work life and health outcomes of managers in nursing homes in Western Canada pre-pandemic.

Methods: A repeated cross-sectional descriptive study using data collected in 2014-2015, 2017 and 2019-2020, in the Translating Research in Elder Care Programme. Self-reported measures of demographics, physical/mental health and quality of work life (eg, job satisfaction, burnout, work engagement) were administered and completed by nursing home managers. We used two-way analysis of variance to compare scores across times, controlling for clustering effects at the nursing home level.

Results: Samples for data collection times 1, 2, 3, respectively, were 168, 193 and 199. Most nursing home managers were nurses by profession (80.63-81.82%). Job satisfaction scores were high across time (mean=4.42-4.48). The physical (mean=51.53-52.27) and mental (mean=51.66-52.13) status scores were stable over time. Workplace engagement (vigour, dedication and absorption) scores were high and stable over time in all three dimensions.

Conclusions: Nursing home managers were highly satisfied, had high levels of physical and mental health, and generally reported that their work was meaningful over time pre-COVID-19 pandemic. We provided a comparison for future research assessing the impacts of the pandemic on quality of work life and health outcomes.

Background: Retention of faculty constitutes a significant challenge for higher education institutions, especially in times of crisis. Lebanon has been experiencing economic recession since the end of its civil war in 1990 until its complete collapse in 2019. This resulted in a massive faculty exodus, escaping the daily struggle with the sinking economy.

Purpose: The purpose of this study was to empirically investigate the factors that precipitate faculty attrition and the measures that foster long-term commitment to the institution in a time of unprecedented crisis.

Methods: An online anonymous survey, using a Likert scale, gathered responses from 92 faculty members. Quantitative findings were complemented by a qualitative exploration of emergent themes in comments. A team of three certified researchers conducted the analysis. Inductive analysis identified recurring themes, with steps like intercoder reliability checks and member-checking enhancing data validity. The researchers ensured methodological rigour, subject expertise, and overall reliability and validity of the thematic analysis.

Results: A total of 78 faculty participated in the survey (84.8%), with 79.5% reporting overall satisfaction, but a varying degree of satisfaction was noted across items. Faculty satisfaction was highest in areas such as respectful interactions (91.0%), belonging to the workplace (85.9%), communication from the Dean's office (85.9%), supportive environment and medical school leadership's commitment to retaining faculty (82.1%). Financial assistance, support for research and professional assistance were identified as important retention measures. Effective, transparent communication from leadership was highlighted as a critical factor during times of crisis.

Conclusion: This study provides strategies for faculty retention in times of crisis that include ensuring timely salary payments, supporting research and professional development, fostering a positive work environment and implementing bonding programmes. Transparent communication from leadership is vital for faculty satisfaction and retention. These findings can aid medical schools and other institutions facing faculty attrition during crises.

Background: Residents need and want practical leadership training, yet leadership curricula are lacking in graduate medical education (GME). We describe our process of curriculum mapping, a method for auditing a curriculum, and its role in iterative leadership curriculum development.

Aims: To show how to create a curriculum map for auditing a curriculum using examples from our leadership curriculum and to demonstrate its value through case examples of leadership education integration into existing resident experiences.

Methods: We selected our recent systematic review on current leadership curricula to prioritise leadership content given it was the basis for our initial curriculum. We identified existing resident experiences where training can occur. We use the selected content and training environments, layered with a modified Miller's pyramid, to construct a curriculum map.

Results: Our curriculum map provides an example of curriculum auditing that reveals opportunities for leadership training that could be integrated into current residency experiences. We provide case examples of application.

Discussion: Effective leadership training should address critical topics and capitalise on experiential learning opportunities that exist within residency training programmes. The training must be seamlessly integrated into the demanding obligations of GME trainees, a process that can be achieved using curriculum mapping. Curriculum mapping can provide insight into a residency programme's leadership curriculum and create a direction for future leadership curriculum development.

Background/aim: Overweight and obesity (OAO) is a major and growing public health crisis in the world. There is convincing medical evidence that caloric overconsumption, rather than lack of exercise, is the primary driver of OAO.

Methods: In this translation piece, we summarise our programme of research on laypeople's beliefs about the primary cause of OAO, the origins of these beliefs and implications for clinicians and leadership in healthcare organisations.

Results: In contrast to the medical consensus, our research conducted in several countries has found that approximately half of the population mistakenly believes that lack of exercise is the primary cause of obesity. These misbeliefs have consequences: people who mistakenly believe that exercise is the most important factor are more likely to be overweight or obese than people who correctly believe that diet is the primary cause of obesity. We argue that these misbeliefs are caused in part by systematic and multipronged communications efforts by the food and beverage industry-a phenomenon we term 'leanwashing'.

Conclusions: Not only does leanwashing require public policy intervention by the government, healthcare professionals also need to respond appropriately. In this article, we focus on the implications of leanwashing for leaders of public health organisations, health delivery organisations and clinicians.

Objectives: To understand the impact of public discourse and reaction around the COVID-19 pandemic on healthcare worker (HCW) experiences and well-being caring for patients with COVID-19.

Methods: We conducted 60 min in-depth interviews with 11 physicians and 12 nurses who were providing care to patients with COVID-19 in acute care settings at two health systems in the Western USA. Interviews were conducted in Spring-Summer 2022 using a semi-structured interview protocol that guided respondents through different stages of the pandemic.

Results: Three themes emerged from the data around providing care in the unique social context of the COVID-19 pandemic including: (1) public polarisation and disagreement with science; (2) feelings of hope and optimism during the pandemic and (3) the compounded strain of providing care within this unique social context of the pandemic.

Conclusions: To prepare for future pandemics, improved public health communications and social-emotional supports for HCWs are critical to ameliorate the physical and emotional impacts related to the social context of modern US pandemic response.

Introduction: There is a notable gap in studies examining the impact of gender within sociocultural norms in non-western professional settings, especially concerning the well-being of women physicians.

Methods: Using purposive sampling and thematic data analysis, we recorded interviews with 30 physicians in India during May-July 2023. Participants were aged 34 to 65 years, with experience ranging from five to 35 years, in various clinical (37%), surgical (30%), paraclinical (23%) and hospital administration (10%) roles, 97% were postgraduates and 53% were women. The research questions explored how leadership roles happened, managing key challenges, barriers and enablers, and practical interventions to support women into medical leadership positions.

Results: Findings revealed that the majority of interviewees believed gender-related barriers were obstructing women's progress and success in medical leadership roles in India. These barriers were identified within three overarching domains: (1) specialty, (2) organisational and (3) sociocultural. Interviewees commonly acknowledged the male-dominated landscape of medical leadership although some women stated that they did not perceive any barriers for women's advancement into leadership roles. Interestingly, some men surgeons held the perception that women might not be as effective in certain surgical disciplines, such as orthopaedics and neurosurgery. Some men physicians, however, considered women physicians in India to be highly effective multitaskers.

Conclusion: We recommend structural reforms in medical education, leadership development, workplace systems and cultures, and improved implementation of equality, diversity and inclusion policies in the Indian context.