Systems Based Practice

Team Strategies and Tools to Enhance Performance and Patient Safety ® (TeamSTEPPS) is a patient safety tool developed by the defense industry and based on four competencies: leadership, communication, situational monitoring, and mutual support. Unfortunately, there are barriers that prevent TeamSTEPPS from reaching its full potential, including: (a) lack of administrative support and resources, (b) lack of training focus to address hierarchal differences and incivility at all levels of health care practice and administration, (c) inadequate TeamSTEPPS instruction and simulation practices, and (d) educators’ resistance to change from crew resource management concepts. Suggestions for improvement include providing command and health care agency emphasis for the TeamSTEPPS program, providing adequate material and personnel resources, designing training that is geared to trainer implementation at the departmental level, prioritizing and saturating training, and striving toward a just culture.

""Networks are mathematically directed (in practical applications also undirected) graphs and a graph is a one-dimensional abstract complex, i.e., a topological space. Network theory focuses on various topological structures and properties, dynamic properties, and functionality-topology relationship, etc. There are some common mathematical foundations, theories and methodology for network analysis, in which graph theory, statistics, and operational research, etc., are the fundamental sciences of network analysis. Various emerging biological networks, at both micro- and macro- levels, will provide numerous sources for the development of general network theory and methodology and also facilitate the development of theory and methodology of biological networks.

Biological network analysis is a fast moving science. Many core scientific issues, for example, ecological structure, co-evolution, co-extinction and biodiversity conservation in ecology, and cancer development and metabolic regulation in health science, etc., are expected to be addressed by network approaches and network analysis. Network analysis is becoming the core methodology to treat complex biological systems. As the fast development of this area, more and more papers on biological networks are published.

At present explosive numbers of quality papers on biological networks are being published each year. The initiation of the journal, Network Biology, will provide a public and unified platform for the publication of these studies. From this integrated and unique journal, researchers, university teachers and students will thoroughly have an in-depth and complete insight on knowledge, methodology and recent advances of biological networks.

In the view of system dynamics, biological networks are always self-organized systems with emergent, autonomous and adaptive properties. Their dynamics can be represented by agent-based modeling, individual-based modeling and some other methodologies like neural network modeling. Therefore, agent-based modeling, individual-based modeling, self-organization of biological systems, and neural network modeling, etc., fall into the aims and scope of the journal, Network Biology.

The NETWORK BIOLOGY (ISSN 2220-8879) is an open access, peer-reviewed online journal that considers scientific articles in all different areas of network biology. It is the transactions of the International Society of Network Biology.It dedicates to the latest advances in network biology. The goal of this journal is to keep a record of the state-of-the-art research and promote the research work in these fast moving areas. The topics to be covered by Network Biology include, but are not limited to:

•Theories, algorithms and programs of network analysis
•Innovations and applications of biological networks
•Ecological networks, food webs and natural equilibrium
•Co-evolution, co-extinction, biodiversity conservation
•Metabolic networks, protein-protein interaction networks, biochemical reaction networks, gene networks, transcriptional regulatory networks, cell cycle networks, phylogenetic networks, network motifs
•Physiological networks
•Network regulation of metabolic processes, human diseases and ecological systems
•Social networks, epidemiological networks
•System complexity, self-organized systems, emergence of biological systems, agent-based modeling, individual-based modeling, neural network modeling, and other network-based modeling, etc.
We are also interested in short communications that clearly address a specific issue or completely present a new ecological network, food web, or metabolic or gene network, etc.

Authors can submit their works to the email box of this journal, networkbiology@iaees.org. All manuscripts submitted to this journal must be previously unpublished and may not be considered for publication elsewhere at any time during review period of this journal. Authors are asked to read Author Guidelines before submitting manuscripts.

In addition to free submissions from authors around the world, special issues are also accepted. The organizer of a special issue can collect submissions (yielded from a research project, a research group, etc.) on a specific research topic, or submissions of a scientific conference for publication of special issue.

Network Biology 
ISSN 2220-8879
URL: http://www.iaees.org/publications/journals/nb/online-version.asp
RSS feed: http://www.iaees.org/publications/journals/nb/rss.xml
E-mail: networkbiology@iaees.org
Editor-in-Chief: WenJun Zhang""

The failures of health professional education are multi-faceted. The governance issues described by de Leeuw represent ‘the tip of the iceberg’ of the problems. Other, probably more important issues, are the loss of the ‘core values’ underpinning the healing professions, and a  scientism-based approach to practice based on a naive view of evidence that fails to register ‘one’s delusion of certainty’. The selection of students lacking humanistic trades perpetuates the demise of the healing  meaning making whole again of all of the dis-ease domains) professions. The change required to achieve ‘balanced’ health professionals that treat the human condition of dis-ease with the scientific advances of managing disease is a change in core values and a selection of patient-centred role models. An example shows how patients can ultimately be our best allies in achieving these ‘long-overdue’ changes.

The aim of this study is to explore identity change in medical students over their first year of medical training, particularly in relation to their experience of human dissection. Each of our four participants completed two repertory grids at the end of term one and, again, towards the end of term three. One grid tapped their identity construction, and the other, their experience of human dissection. Our participants were optimistic about becoming similar to a doctor they admired and, towards the end of term three, began to develop a stable identity as a medical student. Their identity constructs involved three common themes: dedication, competence, and responsibility. However, the data also revealed negative reactions to the demands of training, such as feeling driven and stressed. Three major themes were apparent in their experience of human dissection: involvement, emotional coping, and ability. Our participants’ dedication to their studies was reflected in their appreciation of the need to become involved actively in the process of dissection but some experienced an erosion of their self-confidence and perceived some of their colleagues to have lost much of their enthusiasm for learning. Emotional coping could be an additional challenge within this context and their reaction tended to reflect distancing processes previously identified in the literature. In all, we see a development of a vulnerable sense of professionalism alongside a frustration of losing out potentially on wider aspects of personal development due to the high work demands.

Our purpose is to examine the possibilities of Bakhtinian dialogical analysis for understanding students’ experiences of medical training. Twenty-three interviews were conducted with eleven British medical students intercalating in psychology. Forty emotionally resonant key moments were identified for analysis. Our analysis illustrates students’ use of the professional genre to present their training as emotionally neutral. However, we show how medical training can be framed in more unofficial and affective-laden ways in which threshold moments of crisis are presented as space-time breaches characteristic of the genres of adventure-wonder and adventure-ordeal. This affect was often depotentiated in the narratives through brief allusion to the professional genre. This cycling between genres suggests that the students were searching for an appropriate way in which to frame their experiences, a central dilemma being the extent to which medical training makes sense within an immediate and affect-laden, or future-orientated and affect-neutral, pedagogy. Finally, we identify how consultants are an important aspect of the affective experience of medical training who, at their best, offer inspiring exemplars of flexible movement between official and unofficial ways of being a doctor. In conclusion, we demonstrate the potential of genres to make sense, and to organize the experience, of medical training spatially in terms of moving between personal and impersonal contact, temporally in terms of moving between the extraordinary and routine, and affectively in terms of moving between potent and neutral affect. Learning to use the professional genre is part of enculturation as a doctor and can be helpful in providing a framework restoring coherence and composure through engaging with, and reformulating, difficult experiences. However, it is important to take seriously the resistance many of the students demonstrated to the professional genre as a possible barometer of its acceptability to the general public.

"Background: Despite advances in understanding the “systems-based practice” competency in resident education, this topic has remained difficult to teach, assess, and document. The goal of this study was to perform a needs assessment and an analysis of the current state of systems-based practice education in orthopaedic residency programs across the U.S. and within our own institution.

Methods: A sample of orthopaedic educators and residents from across the U.S. who were attending the 2010 American Orthopaedic Association (AOA) Effective Orthopaedic Educator Course, AOA Resident Leadership Forum, and AOA Council of Residency Directors meeting were surveyed to determine (1) which aspects of systems-based practice, if any, were being taught; (2) how systems-based practice is being taught; and (3) how residency programs are assessing systems-based practice. In addition, an in-depth case study of these issues was performed by means of seven semi-structured focus group sessions with diverse stakeholders who participated in the care of musculoskeletal patients at the authors’ institution. A quantitative approach was used to analyze the survey data. The focus group data were analyzed with procedures associated with grounded theory, relying on a constant comparative method to develop salient themes arising from the discussion.

Results: “Clinical observation” (33%) and “didactic case-based learning” (23%) were reported by the survey respondents as the most commonly used teaching methods, but specific topics were taught inconsistently. Competency assessment was reported to occur infrequently, and 36% of respondents reported that systems-based practice areas were not being assessed by any methods. The focus group discussions emphasized the need for standardized experiential learning that was closely linked to the patient’s perspective. Orthopaedic faculty members were uncomfortable with their knowledge of this competency and their ability to teach and assess it.

Conclusions: Teaching the systems-based practice competency occurs inconsistently, and formal assessment occurs infrequently. In addition to formal teaching, learning systems-based practice will be best achieved experientially and from the patient’s perspective."

Humanity is on the threshold of recognizing the fundamental error in its view of life and death. Both death as well as active life is necessary to the vital formation of a larger, more essential whole. In this paper, I apply the sociology of knowledge and change as it pertains to death and focus on ways in which we can step outside its traditional frameworks and limitations. I also discuss topics related to death such as birth, aging, sickness, and war, and examine cultural differences in attitudes toward death. I offer varying perspectives including the Buddhist view and from these draw implications and conclusions. I apply the lenses of contemporary social scientists such as Edgar Morin, Kenneth Gergen, Edward Stewart, Milton Bennett, Mary Catherine Bateson, E. Doyle McCarthy, Philip Slater, and Piotr Sztompka. To these I add other relevant passages from the writings and speeches of key thinkers on the topic of death, in particular, Buddhist philosopher, peacebuilder, and educator, Daisaku Ikeda. To construct a more humanistic and sustainable view of life, it is first of all crucial to establish a culture which perceives death in its larger living context as but one cycle in the expansive eternity of life.