Brennan, Niamh M. and Flynn, Maureen A. [2013] Differentiating Clinical Gover...Prof Niamh M. Brennan
Purpose – This paper reviews prior definitions of the umbrella term ‘clinical governance’. The research question is: do clinical governance definitions adequately distinguish between governance, management and practice functions? Three definitions are introduced to replace that umbrella term.
Design/Methodology/Approach – Content analysis is applied to analyse twenty nine definitions of clinical governance from the perspective of the roles and responsibilities of those charged with governance, management and practice.
Findings – The analysis indicates that definitions of the umbrella term ‘clinical governance’ comprise a mixture of activities relating to governance, management and practice which is confusing for those expected to execute those roles.
Practical implications – Consistent with concepts from corporate governance, we distinguish between governance, management and practice. For effective governance, it is important that there be division of duties between governance roles and management and practice roles. These distinctions will help to clarify roles and responsibilities in the execution of clinical activities.
Originality/Value – Drawing on insights from corporate governance, in particular, the importance of a division of functions between governance roles, and management and practice roles, we propose three new definitions to replace the umbrella term ‘clinical governance’.
Assessment of Cardiovascular Fitness (VO2 Max) among medical students by Queens College Step test
Khushoo, T. N., Rafiq, N., & Qayoom, O. (2015). Assessment of cardiovascular fitness [VO2 max] among medical students by Queens College step test. International Journal of Biomedical and Advance Research, 6(5), 418–421. https://doi.org/10.7439/ijbar.v6i5.1965
Combining a leadership course and multi source feedback has no effect on lead...Narirat Pinkul
Combining a leadership course and multi source feedback has no effect on leadership skills of leaders in postgraduate medical education. an intervention study with a control group
Brennan, Niamh M. and Flynn, Maureen A. [2013] Differentiating Clinical Gover...Prof Niamh M. Brennan
Purpose – This paper reviews prior definitions of the umbrella term ‘clinical governance’. The research question is: do clinical governance definitions adequately distinguish between governance, management and practice functions? Three definitions are introduced to replace that umbrella term.
Design/Methodology/Approach – Content analysis is applied to analyse twenty nine definitions of clinical governance from the perspective of the roles and responsibilities of those charged with governance, management and practice.
Findings – The analysis indicates that definitions of the umbrella term ‘clinical governance’ comprise a mixture of activities relating to governance, management and practice which is confusing for those expected to execute those roles.
Practical implications – Consistent with concepts from corporate governance, we distinguish between governance, management and practice. For effective governance, it is important that there be division of duties between governance roles and management and practice roles. These distinctions will help to clarify roles and responsibilities in the execution of clinical activities.
Originality/Value – Drawing on insights from corporate governance, in particular, the importance of a division of functions between governance roles, and management and practice roles, we propose three new definitions to replace the umbrella term ‘clinical governance’.
Assessment of Cardiovascular Fitness (VO2 Max) among medical students by Queens College Step test
Khushoo, T. N., Rafiq, N., & Qayoom, O. (2015). Assessment of cardiovascular fitness [VO2 max] among medical students by Queens College step test. International Journal of Biomedical and Advance Research, 6(5), 418–421. https://doi.org/10.7439/ijbar.v6i5.1965
Combining a leadership course and multi source feedback has no effect on lead...Narirat Pinkul
Combining a leadership course and multi source feedback has no effect on leadership skills of leaders in postgraduate medical education. an intervention study with a control group
Medical Students in Global Neurosurgery: Rationale and RoleAhmad Ozair
Approximately 5 million essential neurosurgical cases are unmet each year, all in low- and middle-income countries (1). After the Lancet Commission on Global Surgery described the absence of global surgery from global health discourse in January 2014 (2), the field of neurosurgery quickly recognized the importance of increasing equity in care globally (3-5). Although existing initiatives in global neurosurgery have focused on neurosurgeons and trainees, medical students represent a promising group for sustainable long-term engagement. We characterize why medical students are fundamental to success, outline the importance of incorporating medical students, and delineate how to increase medical student interest and participation in global neurosurgery.
CLINICAL GOVERNANCE SYSTEMS - AS A TOOL FOR IMPROVING PATIENT SAFETY Ruby Med Plus
This essay explores how Clinical governance as a process is interpreted,
understood and practiced for improving the quality of patient care and Patient
safety.
Specific Objectives-
1. To give an overview of corporate governance and Clinical governance and
to focus on Definition, principles, need, components, key features and
benefits of Clinical governance.
2. To Understand the principles and Pre-requisites of Governance and
clinical governance.
3. To comprehend Power Culture, Quality Assurance, Clinical Audit, and
Clinical Governance.
4. To analyse decision making, safety culture, Integrated pathways,
informed consent, right clinical information, Acrediation and Clinical
Governance.
Background: Optimum learning environments (LEs) are linked with positive training outcomes for residents. However, there is few data concerning how the residents perceive the learning environments in teaching hospitals. This study aims to analyze the residents’ perceptions of their learning environments.
Methods: This cross-sectional, hospital-based study was carried out between November 2020 and January 2021, using a Postgraduate Hospital Educational Environment Measurement (PHEEM) questionnaire. Statistical analysis was conducted using SPSS 20.
Results: The total number was 45 participants, 40 of them successfully responded. The total Cronbach`s alpha score was 0.93, which reflects good reliability. The full-scale score was 128 out of 160, which indicates a good learning environment. The autonomy score was 44, the teachers' score was 50, and social support was 34. Finally, the overall mean score for females was 43.3 compared to 39.4 for males, with a P-value of 0.55. Furthermore, no significant difference in residents’ perceptions of their learning environment according to their training was observed in this study.
Conclusion: Significant challenges in the LE were identified; more attention and effort should be given, especially to the poorly rated point in this study: the existence of an informative program, clear clinical protocols, and proper setting expectations. The lowest score was for catering, housing. A high social support score indicates a healthy workplace environment and job satisfaction.
Health Care Delivery System in India at Primary Secondary & TeritaryVamsi kumar
Health Care Delivery System in India at Primary Secondary & Teritary by Abdul Rehman, Aditya Upadhyay, Students of Medical Lab Technology (MLT) Galgotias University
Turkish Residency Programs and Research in Medicine Presentation to MedicReS 5th World Congress on October 19-25, 2015 in New York by Irfan Sencan, MD, Deputy Under Secretary, Turkish Ministry Health Substitute Speaker Burak Akicier, General Director of MedicReS
The perceived global impact of the COVID-19 pandemic on doctors medical and s...Ahmad Ozair
Introduction: The COVID-19 pandemic has resulted in a significant burden on healthcare systems causing disruption to medical and surgical training of doctors globally. Aims and objectives: This is the first international survey assessing the perceived impact of the COVID-19 pandemic on training of doctors of all grades and specialties. Methods: An online global survey was disseminated using Survey Monkey® between 4th August 2020 and 17th November 2020. A global network of collaborators facilitated participant recruitment. Data was collated anonymously with informed consent and analysed using univariate and adjusted multivariable analysis. Results: 743 doctors of median age 27 (IQR: 25-30) were included with the majority (56.8%, n=422) being male. Two-thirds of doctors were in a training post (66.5%, n=494), 52.9% (n=393) in a surgical specialty and 53.0% (n= 394) in low- and middle-income countries. Sixty-nine point two percent (n=514) reported an overall perceived negative impact of the COVID-19 pandemic on their training. A significant decline was noted among non-virtual teaching methods such as face-to-face lectures, tutorials, ward-based teaching, theatre sessions, conferences, simulation sessions and morbidity and mortality meetings (p≤0.05). Low or middle-income country doctors' training was associated with perceived inadequate supervision while performing invasive procedures under general, local or regional anaesthetic. (p≤0.05) CONCLUSION: In addition to the detrimental impact of the COVID-19 pandemic on healthcare infrastructure, this international survey reports a widespread perceived overall negative impact on medical and surgical doctors' training globally. Ongoing adaptation and innovation will be required to enhance the approach to doctors' training and learning in order to ultimately improve patient care.
Medical Students in Global Neurosurgery: Rationale and RoleAhmad Ozair
Approximately 5 million essential neurosurgical cases are unmet each year, all in low- and middle-income countries (1). After the Lancet Commission on Global Surgery described the absence of global surgery from global health discourse in January 2014 (2), the field of neurosurgery quickly recognized the importance of increasing equity in care globally (3-5). Although existing initiatives in global neurosurgery have focused on neurosurgeons and trainees, medical students represent a promising group for sustainable long-term engagement. We characterize why medical students are fundamental to success, outline the importance of incorporating medical students, and delineate how to increase medical student interest and participation in global neurosurgery.
CLINICAL GOVERNANCE SYSTEMS - AS A TOOL FOR IMPROVING PATIENT SAFETY Ruby Med Plus
This essay explores how Clinical governance as a process is interpreted,
understood and practiced for improving the quality of patient care and Patient
safety.
Specific Objectives-
1. To give an overview of corporate governance and Clinical governance and
to focus on Definition, principles, need, components, key features and
benefits of Clinical governance.
2. To Understand the principles and Pre-requisites of Governance and
clinical governance.
3. To comprehend Power Culture, Quality Assurance, Clinical Audit, and
Clinical Governance.
4. To analyse decision making, safety culture, Integrated pathways,
informed consent, right clinical information, Acrediation and Clinical
Governance.
Background: Optimum learning environments (LEs) are linked with positive training outcomes for residents. However, there is few data concerning how the residents perceive the learning environments in teaching hospitals. This study aims to analyze the residents’ perceptions of their learning environments.
Methods: This cross-sectional, hospital-based study was carried out between November 2020 and January 2021, using a Postgraduate Hospital Educational Environment Measurement (PHEEM) questionnaire. Statistical analysis was conducted using SPSS 20.
Results: The total number was 45 participants, 40 of them successfully responded. The total Cronbach`s alpha score was 0.93, which reflects good reliability. The full-scale score was 128 out of 160, which indicates a good learning environment. The autonomy score was 44, the teachers' score was 50, and social support was 34. Finally, the overall mean score for females was 43.3 compared to 39.4 for males, with a P-value of 0.55. Furthermore, no significant difference in residents’ perceptions of their learning environment according to their training was observed in this study.
Conclusion: Significant challenges in the LE were identified; more attention and effort should be given, especially to the poorly rated point in this study: the existence of an informative program, clear clinical protocols, and proper setting expectations. The lowest score was for catering, housing. A high social support score indicates a healthy workplace environment and job satisfaction.
Health Care Delivery System in India at Primary Secondary & TeritaryVamsi kumar
Health Care Delivery System in India at Primary Secondary & Teritary by Abdul Rehman, Aditya Upadhyay, Students of Medical Lab Technology (MLT) Galgotias University
Turkish Residency Programs and Research in Medicine Presentation to MedicReS 5th World Congress on October 19-25, 2015 in New York by Irfan Sencan, MD, Deputy Under Secretary, Turkish Ministry Health Substitute Speaker Burak Akicier, General Director of MedicReS
The perceived global impact of the COVID-19 pandemic on doctors medical and s...Ahmad Ozair
Introduction: The COVID-19 pandemic has resulted in a significant burden on healthcare systems causing disruption to medical and surgical training of doctors globally. Aims and objectives: This is the first international survey assessing the perceived impact of the COVID-19 pandemic on training of doctors of all grades and specialties. Methods: An online global survey was disseminated using Survey Monkey® between 4th August 2020 and 17th November 2020. A global network of collaborators facilitated participant recruitment. Data was collated anonymously with informed consent and analysed using univariate and adjusted multivariable analysis. Results: 743 doctors of median age 27 (IQR: 25-30) were included with the majority (56.8%, n=422) being male. Two-thirds of doctors were in a training post (66.5%, n=494), 52.9% (n=393) in a surgical specialty and 53.0% (n= 394) in low- and middle-income countries. Sixty-nine point two percent (n=514) reported an overall perceived negative impact of the COVID-19 pandemic on their training. A significant decline was noted among non-virtual teaching methods such as face-to-face lectures, tutorials, ward-based teaching, theatre sessions, conferences, simulation sessions and morbidity and mortality meetings (p≤0.05). Low or middle-income country doctors' training was associated with perceived inadequate supervision while performing invasive procedures under general, local or regional anaesthetic. (p≤0.05) CONCLUSION: In addition to the detrimental impact of the COVID-19 pandemic on healthcare infrastructure, this international survey reports a widespread perceived overall negative impact on medical and surgical doctors' training globally. Ongoing adaptation and innovation will be required to enhance the approach to doctors' training and learning in order to ultimately improve patient care.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
1. Issue 2 July 2014
Welcome to When Doctors Lead
The Newsletter of the World Federation of Medical Managers
WFMM Vision: To establish a recognized international network for the discussion of
issues, research, and development of standards and performance benchmarks in
effective physician leadership.
1. NHS (England) hosts WFMM Members at the 2014 International
Medical Leaders Forum (IMLF)
The 2014 IMLF was held in conjunction with NHS Medical Directors at the Hilton
Brighton Metropole Hotel, Brighton, England. NHS medical directors/responsible officers
held a one day conference on 4 June titled Ahead of the Curve. This was opened by
Professor Sir Bruce Keogh, the National Medical Director of NHS England. There were
informative discussions and insights about the UK revalidation program for international
delegates
Professor Jenny Simpson and Dr Mike Bewick from the NHS, generously hosted the
WFMM International Leaders Forum (IMLF) on 5 June with invited WFMM members and
guests. The program outline is below.
1
2. IMLF Program at a glance
Welcome: Dr Roger Boyd (Australia), Chair WFMM Steering Committee
Session 1: Chair: Prof. Walter Riccardi (WFMM Member: Italy)
Providing the vision, leadership and know-how to drive change and quality
improvement
Professor Nick Black, London School of Hygiene and Tropical Medicine
Do leaders’ personal values make them victims or saviours?
Dr Peter Brambleby, Public Health Consultant and past Director of Public Health in
NHS Primary Care Trusts
Session 2: Chair: Dr Peter Angood (WFMM Member: USA)
How can skilled medical leaders create value for health care?
Workshop:
International perspectives on UK
Revalidation
Professor Jenny Simpson (UK) and
Dr Mike Bewick (Medical Director of
Primary Care NHS England, UK)
Workshop:
Partnering for performance to drive
reform
Professor Graham Dickson (Canada) and
Professor Peter Spurgeon (UK)
Session 3: International Policy Dialogue: a relational approach to support
medical leadership development in health care
Study visits were organised for international delegates over two days:
On Monday June 2, 2014 delegates visited the offices of International SOS where Dr Dick
Hooper, the Responsible Officer and Regional Director for global clinical governance
International SOS, Dr Ray Field, the Revalidation Lead for the NHS, Dr Henrietta Hughes, Medical
Director of North East London NHS, and other SOS staff led discussions around revalidation.
International SOS is an organisation of 11,000 employees, 3600 of whom are doctors; they
provide services in remote places, such as advice, retrievals and related services.
In the afternoon delegates had the opportunity to visit the Riverside Medical Practice in
Vauxhall. Dr Clare Gerada (immediate past Chairperson of the Royal College of GPs) and Dr Lucy
Warner (the Chief Executive of the Practitioner Health Program) hosted the visit.
In the morning of June 3, 2014 a visit was made to the St Thomas's campus of the Guys and St
Thomas Foundation Trust. A tour was made of the new Evelina London Children's Hospital, with
the medical director, Dr Sara Hanna. A wide ranging discussion with Dr Ian Abbs, the Medical
Director of the entire Trust, was included in the tour. This Trust has some 1200 - 1400 beds
across two campuses; about 850 consultants and 1500 – 1750 doctors in training and some 2
million patient contacts per year.
In the afternoon delegates visited the UK Department of Health where Dr Jenny Simpson
(Clinical Director of Revalidation), Dr Mike Berwick (Deputy Medical Director of NHS England)
and Dr Celia Ingham-Clarke (the National Director for Reducing Premature Deaths) responded in
depth to questions across a broad range of significant issues.
2
3. 2. WFMM Steering Committee Meeting
The WFMM Steering Committee held its annual meeting on Friday 6 June, hosted by the Faculty
of Medical Leadership and Management at its offices in London. Dr Roger Boyd retired as Chair
of the WFMM Steering Committee with significant thanks from members. As the inaugural Chair
Dr Boyd has been a significant supporter and founding leader in establishing the WFMM. Dr Lee
Gruner, current President of The Royal Australasian College of Medical Administrators took over
as the Chair and will steer the WFMM through a review and into development of a new
Memorandum of Understanding for WFMM members.
3. Physician Leadership: Development and Practice
In collaboration with Emerald publishing the World Federation of Medical Managers
member organisations and others have contributed new research and papers to a soon
to be published “special edition” journal about health services management and
leadership.
Journal contributions have been received from authors across the spectrum of medical
leadership, covering the following topics:
• What is medical leadership and what do medical leaders do?
o What are its core components and how does it differ from other types of
leadership in health systems?
o Does medical leadership differ from medical management, and if so,
how?
• Is there a unique perspective or world view that informs and shapes how doctors
manage and lead? If so, how does this differ from other health system leaders?
• What exemplar programs are used to help physicians learn the capabilities of
modern leadership?
o How effective are these programs?
o What competency models or curriculum models are used as a foundation
for medical leadership development?
o What instructional practices enhance physician leadership development?
o How do different jurisdictions recognize doctors who have taken formal
programs and who move from clinical practice to full-time medical
leadership roles?
o Are there re-certification expectations of physicians in medical leadership
roles?
o What models exist to assess leadership capability? Is accountability for
performance of medical leadership conducted? If so, how, and how
effective are these models?
• What processes do health systems and health organizations use to ‘create an
environment in which excellence in medical leadership will flourish’? Do they
differ from conditions that enhance physician engagement? If so how?
3
4. • Should physician-led healthcare settings be differentiated from non physician-led
healthcare settings in terms of patient outcomes?
Selected papers have been reviewed and the Special Issue of the Leadership in Health
Services journal will be published by Emerald in late 2014.
We are interested in further empirical research articles and conceptual pieces using
either quantitative, qualitative or mixed-method studies. If you are interested please
contact the Guest Editors of this Special Issue as we hope to stimulate further
publication.
Guest Editors:
Professor Emeritus Graham Dickson
Leadership Studies
Faculty of Social and Applied Sciences
Royal Roads University
gdickson@royalroads.ca
Dr Karen Owen
Chief Executive
The Royal Australasian College of Medical
Administrators
KOwen@racma.edu.au
4
5. 4. Member Profiles
WFMM Member Profile 1 : The Hong Kong College of Community
Medicine (HKCCM)
The Hong Kong College of Community Medicine (HKCCM) is a member of the Hong Kong
Academy of Medicine (AM). HKCCM now has 67 Fellows in Administrative Medicine. The
College currently has 13 Basic Specialist Trainees (BST) and 6 Higher Specialist Trainees
(HST). Examinations are held annually.
An in-depth review of the training outcomes in the AM training has been conducted in
2013/2014 comparing these with those promulgated in RACMA’s training program. It
has been agreed to retain the current College training competencies but to further
contextualise each competency domain.
HKCCM has initiated discussions on medical leadership on 2 occasions in the past year—
at the College’s own Annual Scientific meeting held in September 2013 with the theme
of Medical Leadership and Management (Global Outlook and Local Landscape), when
the keynote speaker was RACMA’S Dr Roger Boyd. The second occasion was a session at
the HKAM’s 20th Anniversary Congress, held in December 2013, when the role of
simulation in building leaders for global humanitarian assistance was reviewed.
HKCCM (AM) works in close collaboration with The Royal Australasian College of Medical
Administrators (RACMA). Currently 30 HKCCM (AM) Fellows are also RACMA Fellows. In
the past year, 2 RACMA Accelerated Pathway candidates based in Hong Kong have
presented for the RACMA Fellowship examination. The two Colleges have reciprocal
professional development arrangements in place. RACMA’s CEP Coordinator in Hong
Kong participates in RACMA’s CEP Committee meetings and is also a member of the
2014 RACMA Annual Scientific Conference programme committee. This year the
conference will be held in Sydney in September 2014. Dr Fung Hong, President of
HKCCM, is an invited speaker. There is commitment to reciprocal Fellow attendance at
respective annual meetings.
Hong Kong Hospital Authority (HKHA) is a major employer of medical managers in Hong Kong
and holds a 2 day annual convention, usually in May. In 2014 there were > 5000
registrants. One of the plenary sessions focused on medical leadership and teamwork.
5
6. WFMM Member Profile 2: The Canadian Society of Physician Executives
(CSPE)
The Canadian Society of Physicians Executives (CSPE) remains the organization where
physicians in the leadership arena find a home. The CSPE is exploring new directions by
embarking on research around leadership and by developing a firm and established
publication forum for physician leaders. Because it has been claimed that every
physician is a leader, not just executives, our organization, in partnership with the
Canadian Medical Association, tries to offer something for all physicians in general and
for physicians with specific leadership roles in particular. Our three main areas of focus
for the coming year are:
The 2014 conference “Courage: Bringing Authenticity to Action” took place in Toronto
on April 11-12th. The conference was well attended by over 400 physician participants
and the overall energy and enthusiasm was quite high. Plans for the 2015 conference
are now underway. The theme “Thriving in Complexity: Physicians Enabling
Transformational Change” will be held in Vancouver on April 24-25, 2015.
Leadership Survey
The CSPE will launch a large “Canadian physician leadership” survey in early June. The
survey in partnership with the Canadian Medical Association and the University of
Manitoba will be sent to physician leaders across Canada. Currently, there is limited
Canadian data on physician leadership. The results from this survey will be the first is
quite limited and this survey will hopefully provide us with new data that will help to
build future leaders.
Canadian Journal of Physician Leadership
It has been long awaited, but we will finally launch the Canadian Journal of Physician
Leadership electronically this summer. The journal will be published quarterly and
mailed to all members.
6
7. WFMM Member Profile 3: The Royal Australasian College of Medical
Administrators (RACMA)
RACMA is the recognised medical speciality college which sets the standards for
doctors in medical management. The College awards the fellowship in medical
administration which permits the medical practitioner to join the College in the
membership class of Fellow and to apply for registration as a specialist medical
administrator.
2013 Census Executive Summary
The College monitors its specialist medical management workforce on a regular basis.
The most recent Census survey was conducted in late 2013. While there was a
relatively low response rate (34.2%), the results show some indicative patterns:
1. 68.4% of respondents work in public sector health services, 15.2% in private
sector health services with others working in a variety of settings, including
Defence and self-employment.
2. As the health service bed capacity increases so does the number of RACMA
trained specialist medical managers employed increase
3. RACMA specialist medical managers working in hospitals have Physician
managers reporting directly to them. Depending on the size of the hospital, the
variation is from less than five clinicians up to over 45 clinicians in hospitals with
over 500 beds.
4. The RACMA specialist medical manager workforce is ageing: 54.4% of the 2013
survey respondents were aged 55-59 years or older.
5. 72 respondents indicated they might retire within the next 5 years and 69 in 5-9
years’ time. Most of those who propose retirement within the next 10 years,
plan to take up alternative work e.g. locum physician management work,
consulting and advisory, academic work.
6. Junior medical staff continues to be managed across the entire hospital spectrum
by all classes of College membership; the major proportion of junior doctor
management is in the larger hospitals.
7. Mobility is high among RACMA specialist medical managers with 25% of 2013
survey respondents changing jobs in the last 12 months: 90% of these did so
because of job opportunities.
7
8. Physician leaders at work
The following table shows how a sample of medical managers in Australia reported
how they spent their time at work (hours) over a recent 4 week period. Using a
notional average for the ranges (measured in hours), calculations were completed
on the total hours worked on the profile of tasks and for each task the percent of
total time worked.
Calculations were made to gauge relativities in the proportion of medical
management work tasks spent as part of the total work performed.
Source: RACMA Surveys of Membership June 2012, and October, 2013
The significant leadership of quality improvement in health services/patient
outcomes is clear. Between 2012 and 2013 Australian hospitals have been impacted
by new national quality standards. The role of medical leaders is evidenced.
Who does this compare with what happens in your country?
8
9. 5. What is the WFMM?
WFMM Mission: To develop leadership skills in clinicians and demonstrate the value
proposition for doctors and physicians in leadership and management of health services
worldwide.
The WFMM was formed at a meeting in Hong Kong in September 2010, when a group of
doctors in senior management and leadership of health services in eight countries came
together to discuss the potential value of international actions to promote clinical
(medical) leadership in advancing the quality of care and performance of health services.
Since that time like minded organisations have signed a Memorandum of Understanding
to collaborate and support each other to promote physician leadership and
engagement.
WFMM signatories and member organisations are:
• American College of Physician Executives (ACPE) – USA
• College of Medical Administrators of Sri Lanka (CMASL) – Sri Lanka
• Canadian Society of Physician Executives (CSPE) – Canada
• Danish Association of Medical Directors (DAMD) – Denmark
• Faculty of Medical Leadership and Management (FMLM) – UK
• Hong Kong College of Community Medicine (HKCCM) – Hong Kong
• Israeli Society of Medical Management (ISMM) – Israel
• Italian Society of Medical Managers (SIMM) – Italy – including European Alliance of
Medical Managers (EAMM) – Europe
• The Royal Australasian College of Medical Administrators (RACMA) – Australia & New
Zealand
• South African Society of Medical Managers (SASMM) - South Africa
Since 2011, WFMM has held annual International Medical Leaders Forums in association
with one of its member organisation’s annual conferences. These have been held in
Rome in 2011, hosted by SIMM; in San Francisco in 2012, hosted by ACPE, and in
Vancouver in 2013, hosted by CSPE and the Canadian Medical Association, in 2014
hosted by the NHS (England). In 2015 the International Medical Leaders Forum (IMLF)
will be held in Hong Kong on 20 May. Watch for details at www.wfmm/org/
9