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"Humans"

Background: A shortage of general practitioners (GPs) is common to many European countries. To counteract this, it is essential to understand the factors that encourage or discourage medical students from choosing to become a GP Objective: To evaluate medical students' attitudes towards general practice and to identify factors that discourage them from considering a career as a GP. Methods: In this multinational cross-sectional online survey, 29 284 students from nine German, four Austrian and two Slovenian universities were invited to answer a questionnaire consisting of 146 closed and 13 open-ended items. Results: Of the 4486 students that responded (response rate: 15.3%), 3.6% wanted to become a GP, 48.1% were undecided and 34.6% did not want to be a GP. Significant predictors for interest in becoming a GP were higher age [odds ratio (OR) = 1.06; 95% confidence interval (CI) = 1.02-1.10], positive evaluation of the content of a GP's work (OR = 4.44; 95% CI = 3.26-6.06), organizational aspects (OR = 1.42; 95% CI = 1.13-1.78), practical experience of general practice (OR = 1.66; 95% CI = 1.08-2.56) and the country of the survey [Slovenian versus German students (Reference): OR = 2.19; 95% CI = 1.10-4.38; Austrian versus German students (Reference): OR = 0.50; 95% CI = 0.32-0.79]. Conclusion: Strategies to convince undecided students to opt for a career as a GP should include a positive representation of a GP's work and early and repeated experience of working in a general practice during medical school. © 2020 The Author(s). Published by Oxford University Press. All rights reserved.

It is estimated that by 2055 humans will have entered the fourth industrial revolution, a period where technology devices will replace or redefine the human workforce. In preparation, countries around the world have transitioned their educational practices to address the needs of the ever-changing global economy and technology advancements. This shift towards preparing a technology literate workforce is frequently referred to as 21st century skills, the implementation of curriculum which meets the projected needs of learners in the future workforce. Although educators are encouraged to integrate technology in training to better equip the learner in navigating the continuously evolving digital workspace, how this is done is less clear. The purpose of this chapter is to share an inclusive method of how educational systems can digitize constructivism with 21st century skills to ensure all students are prepared for the global workforce. © 2021 by IGI Global. All rights reserved.

Background: Little evidence exists on the livelihoods of young people with disabilities in low- and middle-income settings. Objective: This study examined employability and livelihood outcomes among a cohort of youth with disabilities who participated in an economic empowerment programme in rural Uganda. Methods: Prospective cohort of youth with disabilities participating in an economic empowerment programme in rural Uganda. Livelihood outcomes of participants were assessed through structured interviews at baseline (n = 297) and again at 12 months (n = 252) and analysed using chi-squared tests and generalized estimating equations. Results: Of 297 participants at baseline, 144 (48%) were women and the mean age was 21.7 years. At 12 months follow-up, participants were significantly more likely to have a job (OR 3.04, 95% CI 2.10–4.39); to have accessed finance (OR 5.52, 95% CI 3.18–9.56); and experienced community support (OR 2.23, 95% CI 1.51–3.29) compared with baseline. There were no statistically significant changes in having enough money for food or in having experienced community discrimination. Conclusions: The findings suggest that targeted vocational skills training, apprenticeships scheme and a start-up financial package may improve the livelihoods of young people living with disabilities in rural African settings. © 2021 The Author(s)

[No abstract available]

Mental skills and emotional regulation training are gaining acceptance in surgical education as vital elements of surgeon development. These skills can effectively enhance technical skill development, improve well-being, and promote career longevity. There is evidence emerging in the surgical education literature to support the incorporation of mental skills and emotional regulation training curricula in residency training. In this study, we present the existing evidence supporting the use of this training with high performers to reduce stress and optimize well-being and performance. We also consider the recent research emerging in surgical education that offers validity evidence for use of mental skills training with surgeons. Finally, we provide a framework to guide the incorporation of these skills throughout the career of a surgeon and suggest methods to promote the development of mental skills training efforts nationally. © 2021 Elsevier Inc.

Background, aims and methods: Participation in employment by individuals with autism spectrum disorders (ASD) remains restricted despite their high motivation and evident abilities. Challenges to employment result from personal characteristics and environmental barriers. This phenomenological research explores the accessibility of a competitive work environment according to the perceptions of adults with ASD. Procedures and outcomes: We conducted in-depth interviews with 19 employees with ASD, followed by a thematic content analysis. Three themes emerged: (a) the employees’ motivation for employment, (b) challenges and abilities at work, and (c) workplace accessibility (types of accommodations, implementation process). Results and conclusions: The findings contribute a classification of accommodations that addresses the core characteristics of autism—challenges as well as abilities and motivations for employment. Four types of accommodations were identified: job-performance communication, attitudes and interpersonal communication, daily workplace routines, and physical and sensory environments. Hence, this study supports the centrality of environmental factors in successful employment of individuals with ASD. Implications: This study presents an evidence-based foundation for autism-related workplace accessibility. It offers an approach to enhance employees’ abilities, strengths, and motivation for employment, as well as to decrease barriers and challenges. The findings may expand organizational policies regarding accessibility and thereby anchor workplace accommodations within organizations’ corporate cultures. © 2021 Elsevier Ltd

Entrustable professional activities (EPAs) have emerged as a meaningful framework for achieving competency-based medical education (CBME). However, little is known about how to adapt EPAs to large-scale, multispecialty, system-wide implementations. The authors describe the design and experience of creating such a system based on EPAs and the Van Melle Core Components Framework for all accredited training programs under the auspices of the Royal College of Physicians and Surgeons of Canada. The resulting design is a unique configuration and use of EPAs, called Royal College EPAs. Others looking to implement EPAs for large-scale health professions education systems may want to consider this design approach. © Copyright by the Association of American Medical Colleges.

Building capacity for developing skills as leadership, teamwork, and continuous academic support has become essential for fulfilling a successful pharmacy career. This study aims to assess Jordanian pharmacists' views on professional development, namely: the continuous education infrastructure, strategies and programs for personal development, leadership skills, incentive schemes, drug information resources and digital services. As well as exploring options for better academic support delivered to pharmacists. To capture participant's views, an online validated and reliable survey was developed. Non-probability sampling design was used. Participants were qualified pharmacists working at Royal Medical Services (RMS) and Community Pharmacists (CP). Comparison and descriptive statistics were used to report the results. A total of 271 pharmacists participated, 144 from RMS (8% more than the needed sample) and 127 CP (7% more than the needed sample). There was a strong desire amongst both RMS and PC groups for continuous educational training particularly in the following areas, first: Advanced counselling and communication skills (means = 8.99±0.145, CI 95% = 3.70-4.28 and 9.37±0.096, CI 95% = 4.18-4.56). Second: Personal development skills (mean = 8.92±0.142, CI 95% = 3.64-4.20 and 9.02 ±0.145, CI 95% = 3.73-4.30). Third, Pharmaceutical health promotion (mean = 8.05 ±0.180, CI 95% = 2.70-3.41 and 8.57±0.159, CI 95% = 3.26-3.89). Only 19.4% and 18.1% of the RMS and CPs respectively reported the presence of a written policy for personal development and leadership in their workplace. There were few incentives for pharmacists to participate in research. Few pharmacists used the available drug information and toxicology centers. The professional and continuous personal development of pharmacists support an evolving healthcare system. This study emphasizes the need for a tailored and documented postgraduate educational strategy, personal development, and leadership skills training in Jordan. Implementing a well-defined scheme of incentives should be encouraged to engage pharmacists in continuous professional development programs and pharmaceutical research. Such strategy and training should enhance both professional and personal performance. © 2021 Odeh et al.

Rationale and aims: Deprescribing is the health-professional-supervised process of withdrawal of an inappropriate medication to manage polypharmacy and improve patient outcomes. Given the harms of polypharmacy and associated inappropriate medicines, practitioners, especially general practitioners (GPs), are encouraged to take a proactive role in deprescribing in older patients. While trial evidence for benefits of deprescribing is accumulating, there is currently little epidemiologic evidence of clinicians’ (including GPs’) deprescribing behaviours. We aimed to establish the prevalence and explore associations of deprescribing of inappropriate medicines by early-career GPs. Methods: A cross-sectional analysis of the ReCEnT study of GP registrars’ in-consultation experience, 2016-18. Participants recorded 60 consecutive consultations, three times at 6-month intervals, including medicines ceased (our measure of deprescribing). The outcome was deprescribing of an inappropriate medicine (defined by a synthesis of three accepted classification systems) in patients 65 years or older. Logistic regression determined the associations of deprescribing inappropriate medicines. Results: One thousand one hundred and thirteen registrars reported 19 581 consultations with patients 65 years and older. Inappropriate medicines were deprescribed in 2.6% (95% CIs 2.4%-2.9%) of consultations. Of deprescribed medicines, 43% had been prescribed for three months or longer. Most commonly deprescribed were opioids (19%), proton pump inhibitors (9.2%), anti-inflammatory drugs (9.0%), statins (7.8%), and antidepressants (6.6%). The most common reason for deprescribing was: “no longer indicated” (38%). Significant adjusted associations of deprescribing included patients identifying as Aboriginal or Torres Strait Islander (OR 2.86); continuity-of-care (ORs 0.71 and 0.20 for the patient being new to practice and to the registrar, respectively); inner-regional compared to major-city location (OR 1.33); the problem/diagnosis being chronic (OR 1.90); and longer consultations (OR 1.03 per minute increase in duration). Conclusion: These findings will have important implications for the education of GPs in deprescribing as a clinical skill. © 2021 John Wiley & Sons Ltd.

Young adults have a high societal relevance but are still an under-represented target group in health promotion. Health literacy is widely acknowledged as one of the strongest predictors and key determinant of health, so its influence on work ability is of great interest. The purpose of the study was to examine the associations between health-related skills and work ability within the structural model of health literacy of Lenartz, Soellner and colleagues, which explains health behaviour and health through the indirect and direct influence of six 'advanced skills' ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The cross-sectional study was based on baseline data of a health literacy promotion intervention (495 vocational school students, 59.0% female, age span 18-25 years). Structural equation modelling with partial least squares was used to examine the associations between the six constructs of the model and the Work Ability Index (WAI). Mean WAI score was 39.7 ± 4.5 (51.1% categorized 'moderate'/'poor'). Five out of six constructs of the model showed a statistically significant indirect or direct effect, respectively, on work ability. The model explained 24.8% of the WAI score variance. Our findings show associations between the health literacy model and the work ability among young employees. In view of demographic change, it is crucial to develop and analyse target group-specific health literacy interventions. The model offers new facets in the modelling of health literacy. © The Author(s) 2020.