scholarly journals A Call for Leadership and Management Competency Development for Directors of Medical Services—Evidence from the Chinese Public Hospital System

2020 ◽  
Vol 17 (18) ◽  
pp. 6913
Author(s):  
Zhanming Liang ◽  
Peter Howard ◽  
Jian Wang ◽  
Min Xu
Keyword(s):  
Assessment Tool ◽  
System Level ◽  
Medical Services ◽  
Competency Assessment ◽  
Competency Development ◽  
Hospital System ◽  
Health Service Provision ◽  
Leadership And Management ◽  
Medical Leadership ◽  
Management Competency

Background: A competent medical leadership and management workforce is key to the effectiveness and efficiency of health service provision and to leading and managing the health system reform agenda in China. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentive for competency development and improvement. Methods: A three-component survey including the use of a validated management competency assessment tool was conducted with Directors of Medical Services (n = 143) and Deputy Directors of Medical Services (n = 152) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey identified the inadequacy of formal and informal management training received by hospital medical leaders before commencing their management positions and confirms that the low self-perceived competency level across two medical management level and three hospitals was beyond acceptable. The study also indicates that the informal and formal education provided to Chinese medical leaders have not been effective in developing the required management competencies. Conclusions: The study suggests two system level approaches (health and higher education systems) and one organization level approach to formulate overall medical leadership and management workforce development strategies to encourages continuous management competency development and self-improvement among clinical leaders in China.

scholarly journals Developing senior hospital managers: does ‘one size fit all’? – evidence from the evolving Chinese Health System

2020 ◽  
Author(s):  
Zhanming Liang ◽  
Peter F Howard ◽  
Jian Wang ◽  
Min Xu ◽  
Mei Zhao
Keyword(s):  
Health Service ◽  
Performance Management ◽  
Assessment Tool ◽  
Core Competencies ◽  
Management Training ◽  
Competency Assessment ◽  
Training Experience ◽  
Health Service Provision ◽  
Hospital Managers ◽  
Management Competency

Abstract Background: To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency. Methods: A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n=498) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate. The core competencies identified in the Australia context were applicable to the management roles in Chinese hospitals. In addition. the senior executives had low levels of confidence in their management competence. Furthermore, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence. Conclusions: The study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management.

scholarly journals Developing senior hospital managers: does ‘one size fit all’? – evidence from the evolving Chinese Health System

2020 ◽  
Author(s):  
Zhanming Liang ◽  
Peter F Howard ◽  
Jian Wang ◽  
Min Xu ◽  
Mei Zhao
Keyword(s):  
Health Service ◽  
Performance Management ◽  
Assessment Tool ◽  
Core Competencies ◽  
Management Training ◽  
Competency Assessment ◽  
Training Experience ◽  
Health Service Provision ◽  
Hospital Managers ◽  
Management Competency

Abstract Background: To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency. Methods: A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n=498) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate. The core competencies identified in the Australia context were applicable to the management roles in Chinese hospitals. In addition. the senior executives had low levels of confidence in their management competence. Furthermore, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence. Conclusions: The study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management.

Medical leadership and management for military clinicians

2019 ◽  
Vol 105 (3) ◽  
pp. 180-184
Author(s):  
L Cottey ◽  
C Lillington ◽  
E Frost
Keyword(s):  
Healthcare Professionals ◽  
Medical Training ◽  
Medical Services ◽  
Management Skills ◽  
Management Competencies ◽  
Military Experience ◽  
Leadership And Management ◽  
Essential Requirement ◽  
Medical Leadership

AbstractThe development of medical leadership and management skills is an essential requirement for the progression of Defence Medical Services personnel in both military and medical training. This review will summarise how military experience can contribute to achieving medical leadership and management competencies and will signpost further opportunities and resources available. While it specifically focuses on doctors, this article has relevance to all Defence Healthcare Professionals.

scholarly journals Development and Evaluation of the Validity and Reliability of the Leading and Managing Care Pre-Registration Nursing Student Assessment Tool

2021 ◽  
Vol 7 ◽  
pp. 237796082110002
Author(s):  
John Unsworth ◽  
Andrew Melling ◽  
Debra Porteous
Keyword(s):  
Factor Analysis ◽  
Internal Consistency ◽  
Assessment Tool ◽  
Nursing Leadership ◽  
Student Nurse ◽  
Competency Assessment ◽  
Theory Analysis ◽  
Leadership And Management ◽  
Clinical Nursing ◽  
Generalisability Theory

Background Clinical nursing leadership influences patient safety and the quality of care provided. Nurses at all levels require leadership and management skills. Despite recognition of the importance of leadership, student nurses often feel ill prepared to make the transition to Registered Nurse and struggle with prioritisation and delegation. In order to standardise student experience and promote the development of skills and attributes, a leadership and management competency assessment was developed and implemented. Aims This study aimed to identify the constructs that should be part of an assessment of student nurse competence in relation to clinical nursing leadership, and to evaluate the tool’s reliability. Method The first phase was to construct the competency assessment tool, using a mixture of deductive methods, including literature and expert review. Second, psychometric evaluation of the tool, including tests to examine its internal consistency and reliability, comparing test and retest reliability, exploratory factor analysis and generalisability theory analysis to identify reliability and sources of error. Results Five attributes were identified for inclusion in the tool alongside a scale of competence. 150 assessments were conducted with an average time between each assessment of three days. The results show that the tool was consistent over time with no significant difference in the mean scores. The Cronbach alpha was 0.84 and the tool had good internal consistency. The results of the factor analysis revealed loading onto a single construct. Generalisability theory analysis revealed 0.90 global reliability, with students accounting for the majority of the variation in scores. Conclusions The Leading and Managing Care assessment tool represents a valid and reliable assessment of student nurse competence to lead care delivery. Use of the tool during practice placement allows for a structured approach to the development of skills around prioritisation, management of resources, communication and the management of risk.

ERCP assessment tool: evidence of validity and competency development during training

Endoscopy ◽  
2019 ◽  
Vol 51 (11) ◽  
pp. 1017-1026 ◽  
Author(s):  
Keith Siau ◽  
Paul Dunckley ◽  
Mark Feeney ◽  
Gavin Johnson ◽  
Keyword(s):  
Assessment Tool ◽  
Multivariable Analysis ◽  
Learning Curves ◽  
Competency Assessment ◽  
Independent Practice ◽  
Competency Development ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
The Uk ◽  
Selective Cannulation

Abstract Background The endoscopic retrograde cholangiopancreatography (ERCP) direct observation of procedural skills (DOPS) is a 27-item competency assessment tool that was developed to support UK ERCP training. We evaluated validity of ERCP DOPS and competency development during training. Methods This prospective study analyzed ERCP DOPS performed in the UK between July 2016 and October 2018. Reliability was measured using Cronbach’s alpha, and DOPS scores were benchmarked using the contrasting groups method. The percentage of competent scores was averaged for each item, domain, and overall rating, and stratified by lifetime procedure count to evaluate learning curves. Multivariable analyses were performed to identify predictors of DOPS competence. Results 818 DOPS (109 trainees, 80 UK centers) were analyzed. Overall Cronbach’s alpha was 0.961. Attaining competency in 87 % of assessed DOPS items provided the optimal competency benchmark. This was achieved in the domain sequence of: pre-procedure, post-procedure management, endoscopic non-technical skills, cannulation & imaging, and execution of selected therapy, and across all items after 200 – 249 procedures (89 %). After 300 procedures, the benchmark was reached for selective cannulation (89 %), but not for stenting (plastic 73 %; metal 70 %), sphincterotomy (80 %), and sphincteroplasty (56 %). On multivariable analysis, lifetime procedure count (P = 0.002), easier case difficulty (P < 0.001), trainee grade (P = 0.03), and higher lifetime DOPS count (P = 0.01) were predictors of DOPS competence. Conclusion This study provides novel validity, reliability, and learning curve data for ERCP DOPS. Trainees should have a minimum of 300 hands-on ERCP procedures before undertaking summative assessment for independent practice.

Validation of a management competency assessment tool for health service managers

2018 ◽  
Vol 32 (1) ◽  
pp. 113-134 ◽  
Author(s):  
Peter F. Howard ◽  
Zhanming Liang ◽  
Sandra Leggat ◽  
Leila Karimi
Keyword(s):  
Health Service ◽  
Assessment Tool ◽  
Community Services ◽  
Public Hospitals ◽  
Competency Assessment ◽  
Validity And Reliability ◽  
Content Type ◽  
Australian Health ◽  
Service Managers ◽  
Management Competency

Purpose The purpose of this paper is to report on the validation of a management competency assessment tool for health services managers (HSM), which resulted from the development and validation of the framework, addressed by a previous paper. Design/methodology/approach The management competency assessment tool (MCAP Tool) was validated using assessment data from a sample of 117 senior and middle managers working in two public hospitals and five community services in Victoria, Australia. The assessments were conducted between January 2013 and September 2014. Findings Both validity and reliability of the MCAP Tool were demonstrated. Practical implications The MCAP Tool has the potential to assist in the measurement of the competencies of HSM. Further research is required to determine if the framework and tool are applicable to HSM in other settings. Originality/value This is the first published study outlining the validity and reliability of an assessment tool to measure the management competencies of Australian health service managers.

scholarly journals Developing senior hospital managers: does ‘one size fit all’? – evidence from the evolving Chinese Health System

2019 ◽  
Author(s):  
Zhanming Liang ◽  
Peter F Howard ◽  
Jian Wang ◽  
Min Xu ◽  
Mei Zhao
Keyword(s):  
Health Service ◽  
Performance Management ◽  
Assessment Tool ◽  
Core Competencies ◽  
Management Training ◽  
Competency Assessment ◽  
Health Service Provision ◽  
Management Positions ◽  
And Performance ◽  
Training And Support

Abstract Background: To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps.Methods: A three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n=498) from three categories of hospital in Jinan, Shandong Province, China.Results: The survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate, the applicability of core competencies identified in the Australia context to the management roles in Chinese hospitals, and the low confidence of the senior executives in their management competence. In addition, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence.Conclusions: The study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management.

scholarly journals Direct observation of procedural skills (DOPS) assessment in diagnostic gastroscopy: nationwide evidence of validity and competency development during training

2019 ◽  
Vol 34 (1) ◽  
pp. 105-114 ◽  
Author(s):  
Keith Siau ◽  
◽  
James Crossley ◽  
Paul Dunckley ◽  
Gavin Johnson ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Direct Observation ◽  
Roc Analysis ◽  
Assessment Tool ◽  
Technical Skills ◽  
Competency Assessment ◽  
Competency Development ◽  
Procedural Skills ◽  
Post Procedure

AbstractBackgroundValidated competency assessment tools and the data supporting milestone development during gastroscopy training are lacking. We aimed to assess the validity of the formative direct observation of procedural skills (DOPS) assessment tool in diagnostic gastroscopy and study competency development using DOPS.MethodsThis was a prospective multicentre (N = 275) analysis of formative gastroscopy DOPS assessments. Internal structure validity was tested using exploratory factor analysis and reliability estimated using generalisability theory. Item and global DOPS scores were stratified by lifetime procedure count to define learning curves, using a threshold determined from receiver operator characteristics (ROC) analysis. Multivariable binary logistic regression analysis was performed to identify independent predictors of DOPS competence.ResultsIn total, 10086 DOPS were submitted for 987 trainees. Exploratory factor analysis identified three distinct item groupings, representing ‘pre-procedure’, ‘technical’, and ‘post-procedure non-technical’ skills. From generalisability analyses, sources of variance in overall DOPS scores included trainee ability (31%), assessor stringency (8%), assessor subjectivity (18%), and trainee case-to-case variation (43%). The combination of three assessments from three assessors was sufficient to achieve the reliability threshold of 0.70. On ROC analysis, a mean score of 3.9 provided optimal sensitivity and specificity for determining competency. This threshold was attained in the order of ‘pre-procedure’ (100–124 procedures), ‘technical’ (150–174 procedures), ‘post-procedure non-technical’ skills (200–224 procedures), and global competency (225–249 procedures). Higher lifetime procedure count, DOPS count, surgical trainees and assessors, higher trainee seniority, and lower case difficulty were significant multivariable predictors of DOPS competence.ConclusionThis study establishes milestones for competency acquisition during gastroscopy training and provides validity and reliability evidence to support gastroscopy DOPS as a competency assessment tool.

Uji Validitas Dan Reliabilitas Kuesioner Pengukuran Kompetensi Sistem Informasi Keperawatan: NICAT Dalam Bahasa Indonesia

2019 ◽  
Vol 8 (1) ◽  
pp. 39-43
Author(s):  
Stephanie Dwi Guna ◽  
Yureya Nita
Keyword(s):  
Patient Safety ◽  
Electronic Health Record ◽  
Assessment Tool ◽  
Competency Assessment ◽  
Health Record ◽  
Nursing Informatics ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Electronic Health ◽  
Bahasa Indonesia

Integrasi Teknologi Informasi (TI) di bidang kesehatan terbukti meningkatkan kualitas pelayanan kesehatan dengan meningkatkan patient safety serta mempercepat waktu layanan. Salah satu inovasi TI di bidang kesehatan yaitu rekam medik elektronik (electronic health record). Rekam medik jenis ini sudah umum digunakan di negara maju namun masih jarang digunakan di negara berkembang termasuk Indonesia. Sebelum pengimplementasian suatu sistem informasi baru di pelayanan kesehatan, perlu dipastikan bahwa user dapat mengoperasikannya dengan baik sehingga hasil dari sistem tersebut optimal. Perawat sebagai tenaga kesehatan dengan jumlah paling banyak di suatu pelayanan kesehatan seperti Rumah Sakit merupakan user terbesar bila rekam medik elektronik ini diterapkan.  Oleh karena itu diperlukan suatu alat untuk mengukur kemampuan atau literasi sistem informasi keperawatan (SIK). Salah satu alat ukur kompetensi SIK yaitu NICAT (Nursing Informatics Competency Assessment Tool) yang memiliki 3 bagian serta 30 item pertanyaan. Penulis melakukan alih bahasa pada kuesioner ini, kemudian melakukan uji validitas dan reliabilitas. Jumlah sampel pada penelitian ini yaitu 233 perawat di salah satu Rumah Sakit Pemerintah di Pekanbaru, Indonesia. Hasil uji validitas pada 30 item dengan r tabel 0.128 menunjukkan r hitung diatas nilai tersebut dengan Cronbach’s Alpha 0,975. Dapat disimpulkan kuesioner pengukuran kemampuan SIK (NICAT versi Bahasa Indonesia) telah valid dan reliabel sehingga dapat digunakan mengukur kemampuan SIK perawat Indonesia.

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