Health Professional Education and Primary Health Care

Homogeneous waiting group (HWG) criteria are central to the patient referral process, guiding primary care physicians and hospitalists in directing patient care to specialists. This cross-sectional observational study, conducted in South Tyrol, Italy, in 2023, aimed to assess the implementation and impact of HWG criteria on healthcare from the perspective of general practitioners and hospital physicians. A questionnaire was developed to gain knowledge about referral practices as perceived by general practitioners and specialists. The survey included 313 participants (82 general practitioners and 231 hospital physicians) and was designed to capture a range of factors influencing the application of HWG criteria, including communication and collaboration practices. The results showed moderate levels of familiarity with HWG criteria and opinions about the need for criteria refinement among hospitalists, indicating that further education and refinement of these criteria are warranted. Both general practitioners and hospital physicians expressed dissatisfaction with the current specialist referral system, highlighting the significant gaps in effective communication and collaboration. The survey also demonstrated the influence of patient demands and waiting times on referral practices, and the need for streamlined and accessible specialist care. This study highlights the need for improvement and adaptation of HWG criteria to better meet the needs of healthcare providers and patients in South Tyrol. By addressing the identified gaps in communication, collaboration, and education related to the HWG system, the efficiency, effectiveness, and patient-centeredness of the referral process can be improved, ultimately leading to better health outcomes. Full article

Few post-graduate training programs offer a comprehensive curriculum that includes structured clinical experiences to teach interprofessional care. To address this need, the United States Department of Veterans Affairs, Office of Academic Affiliations funded the Centers of Excellence in Primary Care Education (CoEPCE) from 2011–2019 to provide interprofessional curricula for health profession trainees (HPTs), including physician residents, nurse practitioner residents, pharmacy residents, and psychology residents. We examined changes over time in curricular domains, system impacts, and program practices based on HPT survey data and the qualitative evaluation of narrative feedback. An annual survey was administered to participants. Indirect standardized ratios were calculated for interprofessional professional education (IPE) program domains, system impacts, and program practices. Qualitative responses were coded based on curricular domains and key program components. The study cohort included 369 HPTs. Site and profession standardized indirect ratios across all professions indicated improvements in curricular domains, system impacts, and program practices, with significant differences observed for associated health HPTs as compared to other HPTs for performance improvement. Qualitative data indicated that profession was associated with differences in perceptions of the curriculum. Although improvements occurred over time, our findings support the need for the thoughtful consideration of profession-specific identity characteristics when designing interprofessional curricula. Full article

This was a prospective observational study based on clinical simulation courses taught in 2017 at the IDEhA Simulation Center of Alcorcón Foundation University Hospital. Two courses in metabolic emergencies (MEs) and respiratory emergencies (REs) were offered to primary care physicians all over Spain. The main objective was to teach nontechnical skills (crisis resource management). Using a modified five-level Kirkpatrick–Phillips education evaluation model, level I (reaction, K1), level II (learning, K2) and level III (behavioral change, K3) changes were evaluated through surveys at the end of the courses and one year later. Thirty courses were held (15 ME courses and 15 RE courses) with 283 primary care physicians. The overall satisfaction (K1) was high: ME courses, 9.5/10; RE courses, 9.6/10. More than 80% of the participants rated the organization, resources, content, debriefing and scenarios as excellent, with no significant differences between the two courses. After one year (156 responses), the respondents for both courses reported that they would repeat the training annually (K2), encourage debriefing with colleagues (K3) and have modified some aspects of their workplace (K3), citing improvements in procedures and in the organization of the health team as the most important. After the ME course, few participants, i.e., 5 (6%), reported providing improved care to patients; after the RE course, 15 (19%) participants reported providing improved care; the difference between groups was significant (p < 0.05). Compared with the ME course, the RE course imparted greater knowledge about patient safety (K2) (38 (49%) vs. 24 (31%) (p < 0.05)) and more useful tools for daily clinical practice (K3) (67% vs. 56.4%) and resulted in participants paying more attention to personal performance and to colleagues when working as a team (K2) (64% vs. 50%). Clinical simulation courses are highly valued and potentially effective for training primary care physicians in patient safety and CRM tools. Future studies with objective measures of long-term impact, behavior in the workplace (K3) and benefits to patients (K4) are needed. Based on the results of our study, the areas that are important are those aimed at improving procedures and the organization of health teams. Full article

(1) Background: The Austrian health care system is extremely fragmented. Primary care is mainly provided by self-employed GPs. Other health professionals are rarely integrated into primary care. But, according to the political plans of the Austrian government, a system of community nurses and community health nurses should be implemented and several pilot projects have already been started. (2) Objective: The present study explores the skills and competences needed in the planning, management and collaboration for the change in the system and gives recommendations for community health nurse education in Austria. (3) Methodology: Fifteen qualitative, problem-centered interviews were conducted with experts in the field of community health nursing and analyzed using qualitative content analysis. (4) Results: The skills and competences often and widely mentioned are interprofessional collaboration, cooperation with other actors, systems thinking, project and change management, and basic management skills, including strategic planning, communication, accounting and finance. Areas such as health planning and lobbying are also highlighted. The main competences are broken down into subcompetences, making it possible to create a detailed competence grid. Competences in planning, management and collaboration are particularly important in the initial stages of the first implementation of a community health nursing system. (5) Conclusions: Skills and competences in these areas occupy a central position. A multilayered breakdown of these competences is required in order to create a targeted requirements profile. Due to the small-scale fragmentation of the Austrian health care system, collaboration and coordination are more difficult and costly, but all the more important. The aforementioned skills and competences represent an essential expansion of nursing education in Austria. Full article

Introduction: This study was designed to evaluate whether the Workshop on Basic Principles for Clinical Gynaecological Exploration, offered to medical students, improves theoretical–practical knowledge, safety, confidence, global satisfaction and the achievement of the proposed objectives in the area of gynaecological clinical examinations. Materials and Methods: This was a quasi-experimental pre–post-learning study carried out at the Gynaecology and Obstetrics department of Gregorio Marañón Hospital in Madrid (Spain). The volunteer participants were 4th-year students earning a degree in Medicine during the 2020–2021 and 2021–2022 academic years. The study period was divided into the following stages: pre-workshop, intra-workshop and 2 weeks post-workshop. In the pre-workshop stage, students completed a brief online course to prepare for the workshop. The effectiveness of the workshop was evaluated through multiple-choice tests and self-administered questionnaires to assess self-assurance, self-confidence, self-satisfaction and the achievement of the objectives. Results: Of the 277 students invited in both academic years, 256 attended the workshop (92.4%), with a total participation in the different stages of the study greater than 70%. A total of 82.5% of the students in the 2020–2021 academic year and 80.6% of students in the 2021–2022 academic year did not have any type of experience performing gynaecological clinical examinations. Between the pre-workshop and 2 weeks post-workshop stages, there was significant improvement in theoretical–practical knowledge (improvement mean = 1.38 and 1.21 in 2020–2021 and 2021–2022 academic years, respectively). The security and confidence of the students prior to the workshop were low (average scores less than 5 points) in both academic years. However, post-workshop scores for satisfaction and the achievement of objectives were high in the two academic years; all the values approached or exceeded 8 points. Conclusions: Our students, after outstanding participation, evaluated the BPCGE, and improved their theoretical and practical knowledge, as well as their skills in a gynaecological clinical examination. Moreover, in their view, after the workshop, they felt very satisfied, far outreaching the proposed aims. In addition, excellent results were maintained over time, year after year. Full article

The implementation of competency-based medical education (CBME) focuses on learners’ competency outcomes and performance during their training. Competencies should meet the local demands of the healthcare system and achieve the desired patient-centered outcomes. Continuous professional education for all physicians also emphasizes competency-based training to provide high-quality patient care. In the CBME assessment, trainees are evaluated on applying their knowledge and skills to unpredictable clinical situations. A priority of the training program is essential in building competency development. However, no research has focused on exploring strategies for physician competency development. In this study, we investigate the professional competency state, determine the driving force, and provide emergency physicians’ competency development strategies. We use the Decision Making Trial and Evaluation Laboratory (DEMATEL) method to identify the professional competency state and investigate the relationship among the aspects and criteria. Furthermore, the study uses the PCA (principal component analysis) method to reduce the number of components and then identify the weights of the aspects and components using the ANP (analytic network process) approach. Therefore, we can establish the prioritization of competency development of emergency physicians (EPs) with the VIKOR (Vlse kriterijumska Optimizacija I Kompromisno Resenje) approach. Our research demonstrates the priority of competency development of EPs is PL (professional literacy), CS (care services), PK (personal knowledge), and PS (professional skills). The dominant aspect is PL, and the aspect being dominated is PS. The PL affects CS, PK, and PS. Then, the CS affects PK and PS. Ultimately, the PK affects the PS. In conclusion, the strategies to improve the professional competency development of EPs should begin with the improvement from the aspect of PL. After PL, the following aspects that should be improved are CS, PK, and PS. Therefore, this study can help establish competency development strategies for different stakeholders and redefine emergency physicians’ competency to reach the desired CBME outcomes by improving advantages and disadvantages. Full article

This study developed a professional identity (PI) scale and compared the scores of male and female nursing students. Few studies have focused on male nursing students to understand their PI vis-à-vis related background variables relative to female ones. We recruited 384 male nursing students in Taiwan to construct the PI scale based on the Rasch model with 12 items and 3 factors, namely cognitive, emotional, and behavioural identity. The PI scale showed a good model fit in confirmatory factor analysis, with factor loadings ranging from 0.56 to 0.73. Cronbach’s alpha coefficients ranged from 0.72 to 0.79 for the three subscales and 0.88 for the entire scale. The results of the multiple latent regression analyses showed that male nursing students had higher PI in the total scale and its three factors than did female ones. Having mothers with medical or nursing-related jobs may help promote the cognitive PI of male nursing students. Experiences of caring for family members can help promote PI among female nursing students but not among male ones. Future research should focus on decreasing loss in behavioural PI for both genders after graduation and on reinforcing the association between behavioural PI and interest in nursing among male nursing students. Full article