Search Results (43)

Background: Clinical pharmacists are increasingly demonstrating their value within primary care; this process directly improves patient experiences and outcomes. However, many undergraduate pharmacy students have little or no experience in this area, so that when they first qualify from training, their previous lack of exposure could affect future patient care in this environment. Aim: This study aims to evaluate how pharmacy undergraduate students’ learning and development of competencies are managed and received by general practitioner (GP) educators, clinical tutors, students, and patients in a general practice setting. Design and setting: The General Practice Pharmacy Educational Placement (GPEP) for undergraduates was designed and delivered in half-a-day each week across five weeks in general practice. Students observed patient consultations, interviewed patients, conducted medication reviews, used medicines reconciliation techniques, and also produced patient care plans. Method: Students participating in GPEP completed both pre- and post-course questionnaires rating eight learning outcomes, using a five-point Likert scale. Data analysis incorporated multivariate principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) strategies, and thematic analysis was applied to student focus groups, patient interviews, and GP staff interviews. Following the patient medication interview, students recorded findings and potential interventions for consideration. Results: A total of 112/157 students (71%) completed the questionnaires (June 2016–March 2019), with significant statistical differences in student confidence (p < 0.0005 for all learning outcomes). Thematic analysis revealed largely positive attitudes towards GPEP. Healthcare professionals highlighted benefits and challenges of GPEP. More than 40 issues relating to medicines optimisation and patient safety were identified, with some requiring immediate interventions from GP teams. Conclusions: GPEP demonstrated a positive clinical impact, improving patient safety. The undergraduate activities may encourage students to consider roles in primary and community care, enabling a resilient and able future workforce. Full article

Background: The rising frequency and complexity of disasters underscores the urgent need for robust preparedness in healthcare. Nurses and nursing students, as key frontline responders, often lack sufficient training to respond effectively to emergencies and recovery efforts. Aim: This review evaluates the effectiveness of disaster preparedness training in terms of nurses’ and nursing students’ self-efficacy in providing disaster care and determines which training approaches are most effective. Method: A systematic review was conducted of peer-reviewed articles published in English between 2014 and 2025 across Medline, PubMed, ProQuest, and Health & Medical Col. Search terms included nurses, nursing students, self-efficacy, disaster training, emergency preparedness, training, simulation and scenario-based learning. Results: Nineteen peer-reviewed studies met the inclusion criteria. Overall, disaster preparedness training was found to enhance nurses’ and nursing students’ self-efficacy, knowledge and skills, with simulation-based and scenario-driven approaches producing the most consistent gains. These methods provided realistic and immersive experiences that fostered confidence and strengthened preparedness. Traditional lectures and workshops also improved outcomes but were generally less effective in sustaining self-efficacy over time. Reported challenges included limited faculty expertise, insufficient institutional support, and psychological barriers that may reduce engagement and impact. Conclusion: Integrating disaster preparedness into nursing curricula and professional training is vital for strengthening nurses’ and nursing students’ self-efficacy in crisis response. Evidence shows that simulation-based education, particularly when combined with traditional approaches, is especially effective in building knowledge and skills. Embedding these methods into training frameworks offers a sustainable strategy to ensure a more competent and resilient nursing workforce. Full article

Background/Objectives: A medical–government conflict in South Korea in 2024 led to the collective resignation of resident physicians, causing severe workforce shortages in tertiary hospitals. This study aimed to investigate temporal changes in stress, anxiety, and depression among healthcare workers during this conflict following the COVID-19 pandemic. Methods: This retrospective study analyzed data from 56,137 adults who completed validated questionnaires on stress (KNHANES), anxiety (Clinically Useful Anxiety Outcome Scale, CUXOS), and depression (Center for Epidemiologic Studies Depression Scale, CES-D) between January 2019 and February 2025 at Samsung Changwon Hospital. Temporal trends were assessed using linear mixed-effects models adjusted for demographic variables. Results: Among attending physicians, stress increased by 1.44 points in the post-COVID period (p < 0.001) and 1.17 points during the conflict (p = 0.006), while anxiety increased by 1.25 (p = 0.012) and 1.36 points (p = 0.013), respectively. The most vulnerable subgroups were women, those aged 30–40 years, and physicians with <5 years of service. Depression increased significantly among physicians in their 40s during the post-COVID period (p = 0.018). Nurses demonstrated a significant reduction in stress during the conflict (−0.91, p = 0.002), possibly reflecting a temporary decrease in direct clinical workload, whereas office workers showed continuous increases in depression (+1.66 post-COVID, p = 0.003; +1.74 conflict, p = 0.001). Conclusions: The psychological effects of systemic crises differed by occupation. Attending physicians, who bore the greatest clinical and organizational burden, experienced persistent psychological strain during the medical–government conflict following post-pandemic stress. Tailored, occupation-specific strategies are required to protect healthcare workers’ mental health during future systemic disruptions. Full article

Background/Objectives: Menopause is a significant, universal hormonal transition, with symptoms impacting ~80% of women. Research shows that menopause can be professionally disruptive, contributing to decreased productivity, absenteeism, and early exit from the workplace. The objective of this study was to describe the landscape of menopause among Canadian women physicians and explore its potential impact on work performance, job satisfaction, and absenteeism. Methods: In this exploratory cross-sectional study, Canadian physicians self-identifying as women and peri-menopausal or menopausal were invited to participate in an online survey between May–September 2023. Demographic and practice characteristics data were collected. A modified Menopause Rating Scale (MRS) was used to quantify symptom burden. Qualitative data describing the menopausal experience were collected as well. Primary outcome was self-reported work performance. Secondary outcomes included perceived impact of menopause on promotional opportunities, absenteeism, and job satisfaction. Multivariable regression was used to examine associations between MRS scores and outcomes of interest. Results: Among 217 respondents, 47.7% reported a severe menopausal symptom burden; 40% felt menopause negatively impacted work performance, and 16.1% expressed job dissatisfaction. However, fewer than 10 respondents (4.6%) ever took time off for menopausal symptoms. Increasing MRS scores were significantly associated with negative perceived work performance (p < 0.001), fewer promotional opportunities (p < 0.001), and lower job satisfaction (p = 0.006) when controlling for confounders. Qualitative responses were provided by 43 participants, 6 of whom reported positive aspects of the menopausal transition, whereas 20 elaborated on the challenges. Conclusions: Canadian women physicians can experience severe menopausal symptoms, often without support. This needs assessment highlights an important occupational health issue and suggests that opportunities remain for medical institutions and employers to formally recognize and study this life stage of women physicians to improve well-being for this valuable workforce. Full article

Background and Objectives: Timely recognition of deteriorating ward patients is critical to prevent adverse outcomes. The Deep learning–based Cardiac Arrest Risk Score (DeepCARS), an AI-based early warning system developed in Korea, has demonstrated high sensitivity and specificity, but its impact on real-world physician decision-making remains unclear, especially under healthcare resource constraints. Materials and Methods: We retrospectively analyzed 830 adult ward patients (March 2024–February 2025) who triggered DeepCARS alerts (score ≥ 91) at a tertiary hospital during a nationwide workforce shortage. Physician responses were classified as active intervention (ICU transfer, life-sustaining treatment [LST] decision, or specialty consultation) versus observation. Results: Among patients with DeepCARS ≥ 91, 58.9% received active intervention, with higher in-hospital mortality compared with those observed only (34.8% vs. 9.7%). ROC analysis suggested a cutoff of ≥94 for better intervention discrimination (AUC = 0.708). In multivariable analysis, DeepCARS ≥ 94 (OR 3.52) and chronic liver disease (OR 1.78) independently predicted active intervention. Multinomial analysis showed that patients admitted to medical departments were more often directed toward LST decisions rather than ICU transfer. Hemato-oncologic comorbidities were associated with both ICU transfer and LST decisions, while elevated respiratory rate consistently predicted either ICU transfer or LST discussions. Conclusions: DeepCARS alerts effectively triggered physician-driven decisions regarding ICU transfer and end-of-life care during a healthcare crisis. However, the ultimate clinical responses were shaped by comprehensive clinical judgment that integrated AI-generated risks with patient-specific factors, such as functional status and frailty, not captured by the algorithm. This underscores the indispensable role of individualized clinical assessment in interpreting and acting upon AI-based alerts in high-risk ward patients. Full article

Background: Midwifery leadership is central to delivering safe, high-quality maternity care. Yet despite sustained investment in leadership development and governance frameworks, UK national reviews consistently identify leadership as a weakness. Understanding why this persists is vital to achieving meaningful improvement. Objective: This paper offers a reflective commentary on the challenges of midwifery leadership in the UK, drawing on national evidence, leadership theory, and professional experience. Methods: A reflective commentary approach was adopted, informed by over 30 years of practice across clinical, academic, and national improvement roles. The discussion integrates insights from national maternity inquiries, academic literature, international comparisons, and leadership theories including compassionate, courageous, and adaptive leadership. Findings: Structural and cultural barriers—including workforce shortages, rising clinical complexity, tensions between midwifery- and medically led models of care, and punitive governance systems—limit the effectiveness of midwifery leadership. These conditions erode psychological safety, fuel attrition, and constrain succession planning. Reflection on professional experience highlights the impact of these dynamics on leaders’ ability to act with confidence and influence. Evidence also points to the value of relational, values-based behaviours—compassion, courage, adaptability, and systems thinking—in enhancing resilience and outcomes. International examples show that supportive policy environments and greater autonomy enable midwifery leadership to thrive. Conclusions: Midwifery leadership requires both individual capability and structural support. Practical priorities include dismantling punitive cultures, embedding Safety-II approaches, investing in leadership development, and enabling professional autonomy. Without such systemic reform, the ambitions of the NHS Long Term Plan will remain at risk, regardless of individual leaders’ skills. Full article

Background: Healthcare workers face multiple, interlinked occupational health risks—burnout, post-COVID-19 sequelae (Long COVID), and extended medical leave. These outcomes often share predictors, contribute to each other, and, together, impact workforce capacity. Yet, existing tools typically address them in isolation. Objective: The objective of this study to develop and deploy an integrated, explainable artificial intelligence (AI) framework that predicts these three outcomes using the same structured occupational health dataset, enabling unified workforce risk monitoring. Methods: We analyzed data from 1244 Romanian healthcare professionals with 14 demographic, occupational, lifestyle, and comorbidity features. For each outcome, we trained a separate predictive model within a common framework: (1) a lightweight transformer neural network with hyperparameter optimization, (2) a transformer with multi-head attention, and (3) a stacked ensemble combining transformer, XGBoost, and logistic regression. The data were SMOTE-balanced and evaluated on held-out test sets using Accuracy, ROC-AUC, and F1-score, with 10,000-iteration bootstrap testing for statistical significance. Results: The stacked ensemble achieved the highest performance: ROC AUC = 0.70 (burnout), 0.93 (Long COVID), and 0.93 (extended leave). The F1 scores were >0.89 for Long COVID and extended leave, whereas the performance gains for burnout were comparatively modest, reflecting the multidimensional and heterogeneous nature of burnout as a binary construct. The gains over logistic regression were statistically significant (p < 0.0001 for Long COVID and extended leave; p = 0.0355 for burnout). The SHAP analysis identified overlapping top predictors—tenure, age, job role, cancer history, pulmonary disease, and obesity—supporting the value of a unified framework. Conclusions: We trained separate models for each occupational health risk but deployed them in a single, real-time web application. This integrated approach improves efficiency, enables multi-outcome workforce surveillance, and supports proactive interventions in healthcare settings. Full article

To address healthcare workforce shortages, Poland has experienced a significant expansion in medical education, characterized by a tripling of accredited institutions and a fourfold increase in student admissions over the past two decades. However, in 2024, the suspension of admission quotas for six newly established universities was due to concerns over accreditation of medical degree programs (MD). Given the ongoing discussions in the European Union (EU) member states about the importance of maintaining educational quality and upholding quality standards, this study seeks to thoughtfully examine trends in admissions and the institutional growth of medical education from 2004 to 2024. It draws upon the policies established by the Ministry of Health and the Polish Accreditation Committee (PKA) throughout this timeframe, while also providing an overview of the PKA’s responses to quality assurance. Study findings indicate a misalignment between institutional growth (11 to 39, 254.6% increase) and compliance with education quality, particularly in newly established programs. This study also advocates a more robust, competency-driven framework and continuous quality improvement mechanisms, as enhanced by the international standards to overcome the limitations of Poland’s current accreditation and quality assurance system in medical education. Specifically, to strengthen the institutional capacity of the accreditation body, it would be necessary to introduce the outcome-based evaluation that tracks graduate’s clinical competence, and institutional performance transparency through public reporting. This study emphasizes the critical need to align accreditation processes with national health workforce planning. This alignment is vital for establishing pathways for programs that may be underperforming in their capacity to produce a healthcare workforce that is adequately equipped for both purpose and practice across all regions. Full article

The ongoing global shortage of healthcare personnel, exacerbated by demographic changes and the aftermath of the COVID-19 pandemic, has highlighted the need for efficient workforce utilization and innovative technological support in healthcare. This paper presents LifeLink Monitoring, a prototype of an integrated remote patient monitoring system designed to optimize clinical workflows, support medical personnel, and enhance patient care without replacing human expertise. The system enables real-time patient observation through AI-powered devices, providing automated alerts, live video feeds, and intelligent task management to reduce the burden of non-clinical duties on healthcare professionals. Applications include hospitals, hospices, home care, and remote locations. Key features include seamless integration with medical devices and national health records, advanced computer vision and audio analysis, multi-level deployment models, and a blockchain-secured architecture ensuring high data privacy and cybersecurity standards. Additionally, LifeLink incorporates an entertainment module aimed at improving patient emotional well-being. The solution represents a convergence of artificial and human intelligence to improve healthcare delivery, personnel efficiency, and patient outcomes. Full article

By 2040, more than 80 million Americans will be aged ≥65, yet contemporary senior living communities still operate on a hospitality-first model developed for healthier cohorts three decades ago. This commentary argues that the next generation of senior living must pivot from hotel-style amenities to person-centric health platforms that proactively coordinate medical, functional, and social support. We outline four mutually reinforcing pillars. (1) Data infrastructure that stitches together clinical, functional, and social determinants of health enables continuous risk stratification and early intervention. (2) Ambient and conversational artificial-intelligence tools can extend sparse caregiving workforces while preserving resident autonomy. (3) Value-based contractual arrangements—for example, Medicare Advantage special-needs plans embedded within senior living sites—can realign financial incentives toward prevention rather than occupancy. (4) Targeted policy levers, including low-income housing tax credits for the “forgotten middle” and outcomes-based regulatory frameworks, can catalyze adoption at scale. Ultimately, re-architecting senior living around integrated technology, value-based financing and supportive regulation can transform these communities into preventive-care hubs that delay nursing home entry, improve quality of life, and reduce total cost of care. Full article

Background: While Asian American individuals are well represented in medical schools in the United States, their advancement to senior positions within the field of orthopaedic surgery is disproportionately low. This underrepresentation not only limits diversity in leadership but also constrains the development of people-centred systems that reflect the needs of an increasingly diverse patient population. Objectives: This study systematically examines Asian American representation across the orthopaedic surgery professional pipeline, focusing on disparities between training-level representation and advancement into both faculty and leadership positions., and framing these gaps as a health equity concern. Methods: A comprehensive literature search for peer-reviewed original research articles was conducted via PubMed, EBSCO Open Research, Wiley Online Library, Google Scholar, and ScienceDirect. The potential articles were screened against prespecified eligibility criteria, and risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Data were then systematically extracted and analysed. Results: This analysis included 20 research articles investigating Asian American representation in orthopaedic surgery. The results demonstrated an underrepresentation of Asian Americans in orthopaedic leadership positions despite improvements in training programme representation with subspecialty clustering in adult reconstruction and spine. Asian American surgeons were less likely to occupy academic and leadership roles than their non-Asian American peers. Across studies, underrepresentation was consistently observed, with effect size estimates indicating a substantial disparity (e.g., pooled risk difference = 0.19; 95% CI [0.12, 0.28]) in those studies reporting comparative outcomes. Similarly, while Asian Americans in residency programmes increased, this growth did not translate proportionally to faculty advancement. In contrast, Asian women face compounded barriers, particularly in subspecialties like spine surgery. These inequities undermine workforce inclusivity and may reduce cultural and linguistic concordance with patients. Conclusions: Despite having strong representation in orthopaedic training programmes, Asian Americans are disproportionately absent from leadership positions. This poses a challenge to equity in surgical education and patient-centred care. To promote equity in leadership, focused mentorship, clear promotion processes, and institutional reform are necessary to address structural barriers to career advancement, this will reflect the diversity of both the workforce and populations served. Full article

Operations management personnel emphasize the maintenance of workforce empowerment on the shop floor. This is made possible by implementing effective operations and human resource management practices. However, organizations are adept at controlling the workforce empowerment domain within operational scenarios. In the current industry revolution scenario, industry personnel often face failure due to a laggard mindset in the face of industry revolutions. There are higher possibilities of failure because of standardized operations controlling the shop floor. Organizations utilize well-established human resource concepts, including McClelland’s acquired needs theory, Herzberg’s two-factor theory, and Maslow’s hierarchy of needs, in order to enhance the workforce’s performance on the shop floor. Current SME individuals require fast-paced approaches for tracking the performance and idleness of a workforce in order to control them more efficiently in both flexible and transformational stages. The present study focuses on investigating the parameters and factors that contribute to workforce empowerment in an industrial revolution scenario. The present research is used to develop a framework utilizing operations and human resource management approaches in order to identify and address the issues responsible for deteriorating workforce contributions. The framework includes HRM and operations management practices, including Herzberg’s two-factor theory, Maslow’s theory, and lean and smart approaches. The developed framework contains four phases for achieving desired outcomes on the shop floor. The developed framework is validated by implementing it in a real-life electric vehicle manufacturing organization, where the human resources and operations team were exhausted and looking to resolve employee-related issues instantly and establish a sustainable work environment. The current industry is transforming from Industry 3.0 to Industry 4.0, and seeks future-ready innovations in operations, control, and monitoring of shop floor setups. The operations management and human resource management practices teams reviewed the results over the next three months after the implementation of the developed framework. The results revealed an improvement in workforce empowerment within the existing work environment, as evidenced by reductions in the number of absentees, resignations, transfer requests, and medical issues, by 30.35%, 94.44%, 95.65%, and 93.33%, respectively. A few studies have been conducted on workforce empowerment by controlling shop floor scenarios through modifications in operations and human resource management strategies. The results of this study can be used to fulfil manufacturers’ needs within confined constraints and provide guidelines for efficiently controlling workforce performance on the shop floor. Constraints refer to barriers that have been decided, including production time, working time, asset availability, resource availability, and organizational policy. The study proposes a decision-making plan for enhancing shop floor performance by providing suitable guidelines and an action plan, taking into account both workforce and operational performance. Full article

Indigenous students remain significantly underrepresented in medical education, contributing to persistent health inequities in their communities. Systemic barriers, including cultural isolation, inadequate resources, and biased curricula, hinder their success. But what if generative artificial intelligence (GAI) could be the game-changer? This scoping review explores the potential of generative artificial intelligence (GAI) in making medical education more inclusive and supportive for Indigenous students through a comprehensive analysis of existing literature. From AI-powered engagement platforms to personalised learning systems and immersive simulations, GAI can be harnessed to bridge the gap. While GAI holds promise, challenges like biased datasets and limited access to technology must be addressed. To unlock GAI’s potential, we recommend faculty development, expansion of digital infrastructure, and Indigenous-led AI design. By carefully harnessing GAI, medical schools can take a crucial step towards creating a more diverse and equitable healthcare workforce, ultimately improving health outcomes for Indigenous communities. Full article

Objectives: Scarce data are available regarding preventive medicine in forcibly displaced populations especially regarding non-communicable diseases like neoplasia, while even more limited data are available on Ukrainian refugees in Romania. To address this research gap, the present analysis was performed to investigate Ukrainian refugee women’s beliefs, attitudes, and opinions towards the Romanian and Ukrainian healthcare system in a comparison model while focusing on the HPV immunization rates and factors influencing the uptake for themselves and their children. Methods: Participants were recruited using the snowball sampling method through their General Practitioner (GP) and a health mediator. Results: In total, 105 women completed the online or physical survey. The mean age was 50 years. In total, 40% of women had not been to a gynecological check-up in 3 or more years, and more than 56% had never been screened. Only four were vaccinated against HPV, and none remembered which type of vaccine was dispensed or how many doses were utilized. The primary hindrances to accessing health services or immunization programs were language barriers, financial burdens, and a lack of information. Respondents’ general distrust of health systems and healthcare workforces were recurrent themes. Relationship status, living arrangements, and previous engagement in screening practices influenced immunization rates. Perceiving the healthcare officials as proactive concerning optional vaccination programs such as HPV immunization and actively receiving recommendations drove respondents to pursue vaccination. Conclusions: This analysis offers a foundational insight into the specific needs of refugee women. It can guide the development of effective public health interventions to improve health outcomes and vaccination rates among Ukrainian refugees in Romania. Tailored preventive campaigns with adequate native language information and prompts from medical experts in designated centers should be deployed to ensure inclusive tactics for vulnerable populations. Full article

Teachers with mental illness are vulnerable to work-related triggers that can lead to relapse, affecting their mental health and ability to recover, stay employed, and deliver quality education. This empirical study explored such triggers among public school teachers in Limpopo Province, South Africa. Using Bronfenbrenner’s Ecological Systems Theory, a qualitative phenomenological design was adopted. Semi-structured face-to-face interviews were conducted with 14 participants that were purposively selected across four hospitals. Data were audio-recorded, transcribed verbatim, and analyzed using Tesch’s eight-step open-coding method. Findings revealed being gossiped about by colleagues, excessive workload, limited leadership and parental support, classroom management challenges, high performance expectations without support, and inadequate teacher mental health policies in schools. These triggers can lead to frequent absenteeism and poor teaching outcomes. They will further increase the risk of medication resistance and long-term cognitive decline due to progressive structural brain damage as a result of multiple relapses. The study highlights the urgent need for multi-stakeholder collaboration, including clinicians, academic institutions, union representatives, and the Department of Basic Education, to co-develop effective, context-sensitive strategies to mitigate work-related triggers of mental illness relapse. These strategies are not only essential for enabling long-term workforce participation but also advancing sustainable mental health and well-being. Full article