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Reflective practice (RP) is a key skill for developing one’s professional practice. It has, however, not been unanimously prioritised in public health (PH) competency and education frameworks. Reflection activities are often unstructured in higher education. There is also a dearth of literature on the RPs of undergraduate PH students. This study aims to explore in greater depth how RP helps undergraduate PH students explore their own learning in internships.

Reflection prompts were designed using the DEAL model. 124 written reflection entries from 32 students were collected and analysed thematically using a deductive-inductive approach. The conceptual framework of internship learning goals by Ash and Clayton (2009) was used to guide the deductive analysis.

Three themes were identified: initial engagement with reflective learning; gradual integration of reflective learning, and a transformative phase involving professional development, personal growth, civic learning, growth through struggle, being confronted with differences in expectations, and skill acquisition.

This study extends the limited evidence regarding RP in undergraduate non-medical PH education, and contributes toward informing the revision of undergraduate PH programmes, for example, by integrating structured reflection earlier in the curricula, and establishing/supporting mentorship programmes between institutions. The findings call for PH educators to be more intentional in creating opportunities to nurture RP among budding PH professionals.

The Canadian Society for Medical Laboratory Science (CSMLS) Peer Support Project was a formal and virtual peer support group pilot for medical laboratory professionals in Canada to determine its application for CSMLS members and obtain information regarding the current state of medical laboratory professionals’ mental health, well-being and burnout. CSMLS learned what is contributing to stress at work, coping strategies and barriers to accessing support or help for their mental health among medical laboratory professionals.

The qualitative and exploratory pilot study examined medical laboratory professionals from Canada. Two peer support groups were facilitated in April and May 2022 by a trained mental health clinician. Peer support delivery was virtual and delivered via Zoom. The purposive sample featured medical laboratory technologists, Educators and Supervisors/Directors who were CSMLS members. The qualitative analysis was conducted via analytical memos and incorporated both manual and NVivo software analysis.

Overall themes were identified within the data analysis and included barriers to mental health care; increased stigma for mental health; mixed messaging regarding mental health; feeling invisible; medical laboratory professionals would like to manage stress better but their increasing workload demands and challenges with scheduling and staffing add to their stress. Participants also highlighted their role and its context using metaphors such as “the silent firefighters”, and “the Bass Guitar of the Hospital”. Based on the evaluations, the peer support sessions encouraged participants to address their own mental health, validate their experiences and increase their comfort level in discussing mental health.

It identified a potential resource for medical laboratory professionals and determined that further mental health resources would be beneficial for their field. It also identified their strong commitment to patient care and their role as a medical laboratory professional.

To the best of the authors’ knowledge, this study is one of the first to examine peer support as a mental health resource for medical laboratory professionals. Additionally, its focus was on a Canadian population with virtual delivery.

The resource crisis in healthcare can be alleviated by engaging external stakeholders and resources in healthcare delivery. The authors use value and open innovation concepts to understand what motivates the stakeholders to join the healthcare innovation ecosystem and what value such an ecosystem brings to healthcare.

A systematic literature review following the PRISMA framework method was applied to reach the research objective. Out of a total of 509 identified articles published till 2021, 25 were selected as relevant for this review.

Six categories of actors were identified, including innovation intermediaries, which were so far neglected in the healthcare innovation literature. Furthermore, patients, healthcare providers, innovation suppliers, investors and influencers were described. The authors also distinguished internal and external stakeholders. The authors show why and how open innovation projects contribute to involving external stakeholders and resources in healthcare delivery by contributing to patient autonomy, relationship building, knowledge transfer, improving collaborative mindset and culture, advancing know-how and bringing additional finances.

This article is the first one to systematically describe the value of open innovation in healthcare. The authors challenge the positivist approach in value presented by value-based healthcare. The authors show how openness contributes to addressing the resource crisis by involving new stakeholders and resources in the care delivery process.

Various health systems are challenged by a multifaceted crisis of increased service demand and workforce shortages. The effects are devastating and may end up in decreased access to care, poor quality of patient care and extreme demands on the workforce. The introduction of the physician assistant (PA) profession provided an avenue to address such challenges in several countries. In Germany, the integration of PAs has been proceeding slowly.

To understand the integration of the profession in Germany, we conducted 15 expert interviews to reveal how the PA profession is perceived among healthcare experts as well as the barriers and facilitators of integration in inpatient care.

Our results highlight a generally positive perception of PAs, particularly in terms of workload relief and bridging the gap between healthcare professionals. Nonetheless, barriers include resistance from healthcare workers unfamiliar with the PA role, while workforce shortages and collaborative teamwork facilitate integration.

These findings lay the groundwork for potential integration-enhancing strategies in Germany.

While spontaneous and voluntary knowledge contribution in online communities promotes value co-creation, dysfunctional knowledge behaviors hamper the effectiveness and development of such communities. The study conceptualizes physicians' proactive knowledge sharing and knowledge withholding behaviors in physician-driven online health communities (OHCs) and integrates the theories of role identity as well as communal and exchange relationships to understand the root causes and motivations behind these two types of knowledge behaviors.

The authors collected survey data from 166 users from one of the largest physician-driven OHCs in China and applied the covariance-based structural equation modeling approach to test the hypotheses.

The findings suggest that (1) physicians' professional role identity had a positive indirect effect on proactive knowledge sharing behaviors through communal motivation, and work pressure weakened this indirect effect; and (2) professional role identity had a negative indirect impact on knowledge withholding behaviors through exchange motivation.

This study extends proactive knowledge sharing and knowledge withholding behaviors from the organizational management domain to the online environment, exploring the underlying causes and motivations behind both behaviors in the unique context of physician-driven OHCs. The findings offer practical suggestions for the effective management of OHC platforms, as well as policy implications that respond to the workforce shortage of healthcare providers, a crisis that is unfolding globally.

Changes in regulation systems make professional organizations more likely to undergo rapid, profound and radical change. The issue of how micro-institutional change in professional organizations can be carried out is somewhat ignored.

We conducted a process study of a primary hospital in China to trace a pathway through which low-status professionals successfully proceed with radical change at the micro-level.

We present a model involving three strategies that, reconfiguring jurisdictional boundaries in combination, activate low-status professionals' long-standing implicit jurisdictions: expertise redefinition, value reorientation and promotion.

Our study contributes to understanding how low-status professionals reconcile needs for change with contradictions from the core attributes and ambiguities of professional work. Rather than mixed practices enhancing the role of dominant professions, a desire to separate jurisdiction space opens up the access of newly dominant experts.

Changes in the regulation system make professional organizations more likely to undergo rapid, profound and radical change. The issue of how micro-institutional change in professional organizations can be carried out is somewhat ignored.

This chapter focuses on the COVID-19 pandemic’s impact on the recognition through discourses of essentiality, of low-status workers and more specifically of care aides as an occupational group that performs society’s ‘dirty work’. The pandemic appears as a privileged moment to challenge the normative hegemony of how work is valued within society. However, public recognition through political discourse is a necessary but insufficient element in producing social change. Based on the theory of performativity, this chapter empirically probes conditions and mechanisms that enable a transition from discourse of essentiality to substantive recognition of the work performed by care aides in healthcare organizations. The authors rely on three main sources of data: scientific-scholarly works, documents from government, various associations and unions, and popular media reports published between February 2020 and 1 July 2022. While discourse of essentiality at the highest level of politics is associated with rapid policy response to value the work of care aides, it is embedded in a system structure and culture that restrains the establishment of substantive policy that recognizes the nature, complexity, and societal importance of care aide work. The chapter contributes to the literature on performativity by demonstrating the importance of the institutionalization of competing logics in contemporary health and social care systems and how it limits the effectiveness of discourse in promulgating new values and norms and engineering social change.

The purpose of this study is to evaluate the level of sustainability consciousness (SC) and sustainable development (SD) awareness of medical students, as well as to identify the factors associated with them.

This cross-sectional and descriptive study was conducted among 1,435 medical students. The socio-demographic questionnaire and the sustainability consciousness questionnaire (SCQ-L) were the data collection instruments.

A significant proportion of medical students had not heard of the concept of SD (63.6%), only 7.9% of the participants reported that they could define the SD concept. Female gender and good economic status were associated with significantly higher median SCQ-L total score (p = 0.001). Although all SD goals are closely related to health, almost half of the medical students reported no impact on SD. Besides, 47.8% of the medical students reported that physicians could have an active role in achieving SD.

As the realization of SD and health services are closely linked, it is important to examine the sustainability knowledge, attitude and behavior of health professionals.

This study examined the SD awareness and SC knowledge, attitude and behavior among medical students, the leading health-care professionals of the future.

The migration of physicians is a global interest, causing imbalances between developed and developing countries. Romania is one of Europe's major providers of physicians, not because there is a surplus, but because physicians are drawn to places with better living and working conditions. Medicine in Romania is increasingly highly advanced, and Romanian physicians are well appreciated all over the world. Despite being one of the countries with the most medical graduates in the world, Romania is suffering a doctor exodus. After joining the EU, the problem of physician migration became widespread, resulting in a deficient and inefficient healthcare system. Therefore, the purpose of this study is to estimate the losses registered by Romania because of physicians' decision to migrate.

These losses were calculated in two ways: utilizing the statistical life value and the amount of money invested in training a medical graduate.

According to the findings, the losses in 2018 were 104.16 million euros, approximately 0.12% of GDP.

The originality of this paper consists in data, being provided by the College of Physicians from Romania and the method used, this study being the only one that estimates the cost of Romanian physicians' migration. The paper adds to existing knowledge an empirical results regarding quantifying the value reflecting the departure of physicians, using value of statistical life and the amount of money invested in preparing a medical graduate.

Gender and geographical imbalance in production and impact levels is a pressing issue in global knowledge production. Within Health Sciences, while some studies found stark gender and geographical biases and inequalities, others found little empirical evidence of this marginalization. The purpose of the study is to clear the ambiguity concerning the topic.

Based on a comprehensive and systematic analysis of Health Sciences research data downloaded from the Scival (Scopus/Scimago) database from 2017 to 2020 (n = 7,990), this study first compares gender representation in research productivity, as well as differences in terms of citation per document, citations per document view and view per document scores according to geographical location. Additionally, the study clarifies whether there is a geographic bias in productivity and impact measures (i.e. citation per document, citations per document view and view per document) moderated by gender.

Results indicate that gender inequalities in productivity are systematic at the overall disciplinary, as well as the subfield levels. Findings also suggest statistically significant geographical differences in citation per document, citations per document view, and view per document scores, and interaction effect of gender over the relation between geography and (1) the number of citations per view and (2) the number of views per document.

This study contributes to scientometric studies in health sciences by providing insightful findings about the geographical and gender bias in productivity and impact across world regions.