Future Health: constants and challenges Professor Steven Boyages AMSA FutureMed Sydney
Who do you want to be?• Endocrinologist• Researcher• Teacher• Patient Advocate• Public Health Physician• Sonologist• Policy maker• Chief Executive, Area Health Service• Chief Executive, Clinical Education and Training Institute• Medical Director eHealth
Constants of health• Clinician patient relationship• Clash of culturesChange Drivers• Patient experience and safety• Staff experience and safety• DemographyResilience• Individual, self efficacy, social cognitive theory• OrganisationalAdaptability and Agility• New models of education and learning• Technology
Health is a knowledge based profession Impart Knowledge • Research • Care • Development • Education • Prevention • Training Generate Apply Knowledge Knowledge
Constants of HealthTO RECHON him who taught me this Art equally dear to me as my parents, to share mysubstance with him, and relieve his necessities if required; to look up his offspring in thesame footing as my own brothers, and to teach them this art, if they shall wish to learn it,without fee or stipulation; and that by precept, lecture, and every other mode ofinstruction, I will impart a knowledge of the Art to my own sons, and those of my teachers,and to disciples bound by a stipulation and oath according the law of medicine, but tonone others. (Hippocrates 460-370 BC)
Future workforce growth at Feb 2010Future industry job growth – Australia 5 years from 2009-10 to 2014-15(‘000) - DEEWR projections
What are we trying to do? To improve teamwork, communication and collaboration for safer patient-centred care, and better staff experiencesWhy are we trying to do this? Increased staff motivation, well-being and retention Decrease in staff turnover Increased patient and carer satisfaction Increased patient safety Increase in appropriate use of specialist clinical resources Reductions in patient mortality and critical incidents Increase in access to and coordination of health services 19
Team Health Foundations – Right Start • Individual • Roles and Responsibilities • Risks and Rewards High Performance Teams • Roles • Reflection • Respect • Resilience Advanced Settings of Care • Advanced Clinical Modules • Simulation
What Is Self-Efficacy?According to Albert Bandura, self-efficacy is “thebelief in one’s capabilities to organize and executethe courses of action required to manageprospective situations” (1995, p. 2).In other words, self-efficacy is a person’s belief inhis or her ability to succeed in a particular situation.Bandura described these beliefs as determinants ofhow people think, behave, and feel (1994).
Sources of self efficacy1. Mastery Experiences• "The most effective way of developing a strong sense of efficacy is through mastery experiences," Bandura explained (1994). Performing a task successfully strengthens our sense of self-efficacy. However, failing to adequately deal with a task or challenge can undermine and weaken self-efficacy.2. Social Modeling• Witnessing other people successfully completing a task is another important source of self-efficacy. According to Bandura, “Seeing people similar to oneself succeed by sustained effort raises observers beliefs that they too possess the capabilities master comparable activities to succeed” (1994).3. Social Persuasion• Bandura also asserted that people could be persuaded to belief that they have the skills and capabilities to succeed. Consider a time when someone said something positive and encouraging that helped you achieve a goal. Getting verbal encouragement from others helps people overcome self-doubt and instead focus on giving their best effort to the task at hand.4. Psychological Responses• Our own responses and emotional reactions to situations also play an important role in self-efficacy. Moods, emotional states, physical reactions, and stress levels can all impact how a person feels about their personal abilities in a particular situation. • Bandura, A. (1995). Self-Efficacy in Changing Societies. Cambridge University Press.
Review ArticleAmerican Medical Education 100 Years after the Flexner ReportMolly Cooke, M.D., David M. Irby, Ph.D., William Sullivan, Ph.D., and Kenneth M. Ludmerer, M.D. N Engl J Med Volume 355(13):1339-1344 September 28, 2006
Figure 1Source: The Lancet (DOI:10.1016/S0140-6736(10)61854-5)Terms and Conditions
ReflectionsConstants of health• Clinician patient relationship• Clash of culturesChange Drivers• Demography• Patient experience and safety• Staff experience and safetyResilience• Individual, self efficacy, social cognitive theory• OrganisationalAdaptability and Agility• New models of education and learning• Technology