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Contemporary Healthcare Initiative Report (Assessment)

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Updated: Jan 15th, 2020

The Health Care Initiative

My place of work is a military college for health sciences. The college constitutes a part of Saudi’s armed forces medical services in the ministry of defence. The college receives funds from the ministry of defence. Therefore, its budget must be developed in accordance with the national funds that are allocated to the department of defence.

The college’s hierarchical structure of management begins with the College Director (must be a military officer), College Dean (a military person), College Deputy Dean, and then the Heads of Department (Nursing, RT, and Paramedic). The current paper proposes a healthcare initiative and conducts a situational analysis of the college with the objective of establishing the appropriate recommendations on how the college can improve its capacity to achieve its mandates.

This goal is accomplished through the development of a simulation programme to enhance situational awareness and critical decision making/communication skills to prepare new graduates for the medicine field. One of the major mandates of any organisational managers is to establish a means of identifying incidents that are likely to pose health threats to its works.

Similarly, the government has a responsibility of responding appropriately to health threats to ensure that the nation maintains the collective health of its populace. The government establishes various institutions that have the responsibilities of delivering quality care to all people. However, in some cases, special care units may be established to provide healthcare to some selected groups of people, including children and military hospitals.

People who work in such institutions are graduates from different healthcare training institutions. Currently, I work in one of such training institutions in Saudi Arabia. Therefore, I have a noble role to play in ensuring quality care in Saudi Arabia. I have to ensure that the graduates are well prepared to achieve the Saudi Arabian government’s objective of delivering quality care to all citizens.

The Rationale for the Choice

Workplaces require requisite care plans to ensure accessibility to quality care for all workers. Such accessibility can lower people’s exposure to risks that may impair their health. In fact, one of the fundamental human privileges is the right to access good healthcare. To achieve this fundamental human right, virtually all nations have established various programmes and public health campaigns to ensure that people recognise the need for being risk-free from preventable and curable ailments.

Health care initiatives should aim at improving the outcomes of the healthcare needs of the target population. Therefore, the rationale for a care plan should be based on the existing problem. In case of my organisation, such needs should respond to the personal factors and internal or external drivers within the administration.

The college graduates 1200 students and 250 graduates every year in areas such as Nursing, Respiratory Therapy, and Paramedics. The Saudi’s ministry of higher education has approved the college’s curriculum. Although its top-ranking leaders are military people, the graduates are non-military. However, they are given an opportunity to join the armed forces upon their completion of the training in their respective areas of specialisation.

To accomplish this agenda, they are required to make official applications. When students graduate as non-military professionals, they are given the flexibility to work in any healthcare organisation, including those in the public and private sector. The above flexibility comes with some disadvantages for the students who may wish to join the military upon the completion of their training.

In fact, even though the institution is a military college, the students’ curriculum does not include any Battlefield Medicine courses or training. This observation means that people who join the military as medical care professionals have inadequate skills in Battlefield Medicine and training. This situation is amplified by the fact that the college experiences challenges of shortage of instructors and educations.

It only has two hospitals. It does not have any medical simulation centre. These problems form the rationale for the development of a simulation programme to enhance situational awareness and critical decision making/communication skills to prepare new graduates for Battlefield Medicine. In the college, I serve as the clinical education coordinator.

My job description entails planning, arranging, allocating, and monitoring the clinical training for the students. Considering that I am also taking my Master’s Degree in medical and health care simulation, the healthcare initiative falls squarely within my responsibilities as the education and training coordinator.

PESTEL Analysis

PESTEL situation analysis approach is considered vital here since it indicates the likely forces that may influence the success of the new programme externally. These factors are beyond the control of the college. Therefore, understanding their implications on the new programme is crucial in determining whether to design the programme, notwithstanding its implementation.

Several factors influence the decisions of leaders of any organisation. From the PESTEL organisational analysis approach, these factors have a political, financial, collective, technical, ecological, and legal bearing (Gerry, Kevan, & Whittington 2005). For the case of the college, the political environment influences the operations of a healthcare organisation via the willingness of the current political regime to alter its policies towards health care (Kavilanz 2011).

Indeed, the college suffers the lack of and/or inadequacy of training facilities and resources. Considering that the new programme requires the pledge of high financial and human resources, especially where technology-enhanced simulations are to be incorporated, the participation of the political regime in decision-making is critical to the success of the new health initiative.

Political stability constitutes a central aspect that defines the importance of the new health care initiative. Indeed, the programme is appropriate because of political instabilities that arise from the war in the Middle East region, particularly in Yemen. War presents challenging situations to medical practitioners.

Therefore, according to Bruch and Gerber (2011), it is crucial for students at the college to learn how to access various situations in war-torn zones for them to develop the capacity to administer health care to the military personnel and communities within these areas in a risk-aware manner.

Since exposing students directly to high-risk situations may be dangerous, the remedy for preparing them for the field via the military medical training is through the simulation of similar situations such as those that would be encountered in the real work environment.

The management of the college must also comply with environmental regulations, tariffs, and employment laws that have been established in Saudi Arabia. From the perspective of economic factors, Saudi Arabia depends largely on oil to fund its budget (Yizraeli 2000). Hence, any turbulence in the economy arising from the interference of the oil mining may adversely influence the budget of the college.

Therefore, monetary allocation to purchase specialised simulation equipment has to suffer. This situation is particularly wanting considering instabilities in neighbouring nations such as Yemen, which may affect the exportation of oil and oil-related products across the gulf coast. However, war in Yemen also proves the importance of offering special training to the military medics, especially where care must be provided in a battlefield.

This training can reduce the fatality rates for people who are injured on the battlefield. Social factors act as an immense success factor to the college. The college brings together people from different backgrounds. Therefore, commitment to respecting individual differences has always been a major area of concern.

For this purpose, the institution has established an organisational culture that ensures that all people accomplish their educational goals with cultural, religious, or any other diversity-related conflict. Technology has been critical to ensuring that students share knowledge and/or exchange information on the current evidence-based practices in their career. However, lack of technology-based simulations programmes has limited the exposure of students to battlefield medical experiences

Among the other components of PESTEL situational analysis, technology constitutes an essential factor in improving training at the college. Scholarly literature on the education of care providers suggests that education and training are critical to ensuring patient safety. For healthcare provider education, advocates of the simulation approach to training such as Ziv et al. (2003) say that the modality offers an opportunity for learners to rehearse their professional skills in a non-detrimental environment.

Reznick and MacRae (2006) add that the incorporation of simulation in training on healthcare provides an opportunity for the students to participate in deliberate and structured practice while at the same time getting instant and timely feedback on their performance. This plan gives them an opportunity to improve on their areas of weakness.

In the programmes that are deployed in the simulation process of training students at the college in preparation for Battlefield Medicine, incorporating education technologies is incredible. Educational technologies can enormously foster better learning through simulation models. For instance, although it is possible to depict flawlessly how throbs occur and/or how they cause resonance using a regulation fork, it is complex to express what ideally development is and/or how particles can work when they are exposed to different circumstances.

In the same way, it would be enormously hard for a teacher to demonstrate the danger that is brought about by mixing two specific chemicals. However, amid these difficulties, with educational technologies, such experiments can be accomplished precisely and comprehensively in classroom settings with the help of digital simulations.

Lipsitz and Reisner (2010, p. 91) say, ‘digital simulations and models can help teachers to explain concepts that are too big or too small, or processes that happen too quickly or too slowly to demonstrate in a physical classroom’. Indeed, technology application in an educational setting fosters learning. Concord Consortium Company’s technology provides a working illustration to support this claim.

This company is a non-profit-making firm whose mandate is to develop science, math, and engineering educational technologies. Indeed, the company has developed software that is open source to all teachers. Teachers can deploy the software to aid them in the modelling of concepts.

One of the most conspicuous successes of the company is the development of molecular workbench software. This software helps science teachers to replicate issues such as compound attachment, gas rules, and even fluid technicalities among others. The overall impact is that although these topics may present abstract ideas, especially to new students, visual simulations make their teaching much easier. Hence, teachers’ work becomes both effective and efficient in terms of the delivery of the goals.

Research is also in the process of coming up with software that can be used to experiment evolution through virtual greenhouses. Moreover, to make learning physics more effective, various software tools have been developed to can aid students to appreciate the physics behind the efficiency of energy utilisation through the employment of model houses and simulations of the manner in which matter interacts with the electron clouds.

These examples explain how technology can be deployed to make education effective via the creation of digital models and simulations (Mishra & Koehler 2006). The college is incredibly concerned about its environmental impacts, especially based on the evident inappropriate disposal of materials that wrap the consumables that are used by students while in its premises.

The organisation is established and authorised to train health care personnel by the ministry of higher education. Therefore, it is also bound by various legal provisions that regulate its manner of conducting educational training of medical practitioners in the Saudi Arabia in accordance with the acceptable international standards.

Critical Analysis

The simulation expertise has immensely enabled many instructors to stretch far outside the text-focused and linear education methods by helping them to commit learners proactively to other means of scholarship. Consequently, while many nations, especially in the developed world, ask whether they need to use more simulation technologies in their education systems, other nations want to know how technologies can be used to improve training in health care settings.

Technology is one of the mechanisms that can be used to improve training and development at the college where I work. However, for it to be effective, it needs to reflect the manner in which the students learn in the settings of education. It can help in the realisation of the effective educational interventions since it possesses elements of educational psychology and more importantly profiles that closely match the organisational and school social psychology (Woolfolk, Winnie, & Perry 2008).

Hence, educational technologies need to be effective in improving education even to people who have special needs that arise from their physical and mental disabilities at the college. The proposed care plan relies on technology. This situation introduces a scholarly question on the efficacy of potential technologies that can be deployed in the implementation of care plans.

Quantitative meta-analysts such as Cook, Erwin, and Triola (2010) and Cook et al. (2012) investigate virtual patients and technological simulation modalities for their efficacy. Indeed, their findings may be essential in the case of my workplace that is in the process of implementing the healthcare initiative programme. Cook, Erwin, and Triola (2010, p. 1589) define virtual patient simulations as ‘computer-based interactive cases in which learners emulate the role of healthcare providers to obtain a history, conduct a physical exam, and/or make diagnostic and therapeutic decisions’.

On the other hand, technology-based simulations require learning institutions to possess educational devices that can facilitate learners’ physical interactions with situations that reflect clinical care environments and variables. The devices need to be used for the assessment and teaching purposes. These approaches involve the deployment of frameworks, manikins, practical certainty apparatus and structures, and cadaver.

Virtual patient simulations do not require the college to possess specialised healthcare paraphernalia. However, technology-enhanced simulation techniques demand them. Does simulation-based training work in healthcare settings? More than 600 separate studies that have brought together above 36,500 subjects have endeavoured to respond to the above question.

They accomplish this role by comparing training approaches that involve simulation and the ones that do not consider any intervention. According to Cook et al. (2011) and Cook et al. (2013), technology-focused and virtual patients in simulation approaches have statistically significant advantages in training aspects such as the attainment of skills and knowledge as measured by CPU scores, experiment setting, ranking of trainers, and the development of behaviours that are similar to those in real-life patient-care environments.

In case of effects that involve patients directly, including the event of critical problems, transience, and people who stay in the healthcare facilities, the merits of simulations are essential, despite their little significance (Zendejas et al. 2013). This observation implies that the incorporation of simulation in training students in preparation for Battlefield Medicine can work well in comparison with the current situation that involves no instructions.

An important question is whether it is appropriate to replace the current teaching methods with technologically enhanced teaching methods. Arguably, at the college, the traditional teaching models are ineffective. Educational technologies can make such models effective. However, many people may want to know how this goal can be attained.

The Concord Consortium exemplifies a good example of how this outcome can be achieved. The company developed software that enables students to understand the concepts of genetics through the ‘breeding of dragon’ concept. With the help of the software, teachers can give their students problems that closely relate to performance assessments.

When a student is requested to develop a dragon, teachers can follow stepwise what the students did to achieve the results. To this extent, incorporating simulation programmes is critical to increasing both situational awareness and student preparedness in the Battlefield Medicine. Any endeavour to improve training at the college has always been a challenging one considering the problems of inadequate tutors and training facilities.

This situation has been a major problem in many nations, not just in Saudi Arabia. For this reason, test scores are conducted together with comparisons of the perceived performance of a nation’s education against other nations. This case has resulted in pushing education to the forefronts of the state level politics. In this context, improvement of education ranks right behind the concerns of health care reforms within any nation, including Saudi Arabia.

Given the intense need to increase the quality of training and preparedness to deal with Battlefield Medicine, the deployment of educational simulation technologies is inevitable at the college if the need to address challenge such as providing health care to people in battlefield such as the current war in Yemen will have to be sufficiently addressed.

However, it is crucial to note that technology does not act in a similar manner with physical mechanisms for improving training in preparing the graduates for Battlefield Medicine. For instance, while smaller classes are preferred for effective learning, using technology to enhance education cannot act in such a similar manner.

Force-field Analysis

Force-field analysis is a strategy for evaluating a decision based on forces that oppose and/or are in support of the decision. To determine whether to proceed with the decision, scores of the force that support or oppose the decision are determined. When compared to the opposing ones, higher scores of supporting forces mean that the decision is appropriate.

Alternately, leaders can focus on seeking strategies for increasing the weaknesses of the opposing forces while at the same time strengthening those that are in support of the decision to ensure that the change is successful (Lewin 2015). The design and implementation of the simulation programmes that can help to increase situational awareness and preparedness of the students for the Battlefield Medicine will involve a change in the manner, which the college has been conducting its training. Change may involve proactive and reactive approaches.

In my place of work, the change arises due to the need of altering the way of preparing students for their future career to prevent the occurrence of a crisis. Crises occur when the volatility of the Middle East region increases such that the need to have medical practitioners who are experienced in the Battlefield Medicine exceeds the ability of the college to train them at once. The transactional or planned change constitutes a key force that drives the necessity of the health care initiative.

In the battlefield, situational awareness is vital compared to gathering tools, weapons, and equipment to face the enemy. Indeed, knowing the enemy’s strategy helps in the development of counter strategy and/or the making of key decisions on the appropriate equipment and weapons to use to defeat the attacker. To this extent, the simulation of battlefield conditions can help to develop the expertise and capacity to evaluate and determine the appropriate strategy for offering medical services in the battlefield.

Considering the increasing instability in the Middle East, especially with the emerging and continuous war in Yemen, the force of situational awareness surpasses any opposing force such as high monetary requirement to provide specialised equipment for technology-enhanced simulations.

Key Findings

As the educational coordinator of the college, I have the responsibility of developing the proposed healthcare initiative. Although students do not graduate as military officers and that this policy cannot change to promote the flexibility of career selection, it is becoming almost inevitable to treat patients in warring conditions. This claim holds considering the example of the war in Yemen in which people, including civilians, are injured.

They need medical attention while in the war-torn areas. This setting may subject the medical practitioners to dangers. Therefore, knowledge and skills in the situational analysis are crucial. This learning cannot be conducted in a real war environment since such a strategy can expose untrained students to high risks and hence the rationale for the need to conduct situational training while preparing the students for Battlefield Medicine.

In the development of the programme and its implementation, effective leadership during change is necessary. Leadership plays the function of identifying any potential crisis and then setting the vision and goals for ensuring that organisations change their business models so that they do not experience the crisis (Bruch & Gerber 201).

Indeed, the new programme will involve increasing budgetary allocation to the department of defence to fund it. This case suggests that effective communication of how and why the funds are required is critical since increasing funds that are allocated to the ministry of defence implies a reduction of monetary allocation to fund other public goods and services. Therefore, to create and sustain stakeholders’ confidence, effective communication is necessary.

Only the educational training coordinator in conjunction with other college top leaders can play this role. Leadership will also help in reducing any hindrance to the success of the project by linking the Saudi Arabian visions of maintaining a healthy and productive citizenry and the need to offer medical services in war-prone environments.

Recommendations

The Middle East region is susceptible to political risks that are presented by the evident instabilities in nations such as Syria, Iraq, Iran, and the conflict between Israel and Palestine. Today, Yemen is also involved in the war. During a military confrontation, whether between two nations or with terror groups, injuries and casualties are inevitable. Hence, offering medical aid in a battlefield environment is unavoidable.

However, the workers who offer the aid need to be secure and aware of the potentiality of the enemies harming them (workers) while executing their work. The best way to train them on how to avoid the danger is through the simulation of the real work environments. To this extent, the proposed healthcare initiative involving the development of a simulation programme to enhance situational awareness and critical decision making/communication skills to prepare new graduates for Battlefield Medicine is highly recommended.

The college should consider implementing the programme through technology-enhanced simulation approaches and/or through virtual patient simulations. Both strategies are recommended since they offer students an opportunity to train on Battlefield Medicine before their exposure to the actual environment. This plan helps to develop the appropriate behaviours that can prevent any exposure to high-risk cases during their work in unstable environments.

References

Bruch, H & Gerber, P 2011, ‘Strategic change decisions: Doing the right change right’, Journal of Change Management, vol. 11, no. 5, pp. 1-99.

Cook, D, Brydges, R, Hamstra, R, Zendejas, B, Szostek, H, Wang, T, Erwin, J & Hatala, R 2012, ‘Comparative effectiveness of technology-enhanced simulation versus other instructional methods: a systematic review and meta-analysis’, Simulation Healthcare, vol. 7, no. 2, pp. 308-320.

Cook, D, Erwin, J & Triola, M 2010, ‘Computerised virtual patients in health professions education: a systematic review and meta-analysis’, Acad Med, vol. 85, no. 11, pp. 1589-1602.

Cook, D, Hatala, R, Bryges, R, Zendejas, B, Szostek, H, Wang, T, Erwin, J & Hamstra, J 2011, ‘Technology–Enhanced Simulation for Health Professions Education: A Systematic Review and Meta-Analysis’, JAMA, vol. 306, no. 5, pp. 978-988.

Cook, D, Hamstra J, Brydges R, Zendejas, B, Szostek, H, Wang, T, Erwin, J & Hamstra, J 2013, ‘Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis’, Med Teach, vol.35 no.5, pp 844-875.

Gerry, J., Kevan, S & Whittington, R 2005, Exploring corporate strategy: text and cases, Prentice Hall, London.

Kavilanz, P 2011, ‘Healthcare reform stands: how it impacts employers’, Journal of Health Politics, vol.13, no. 2, pp. 113-119.

Lewin, K 2015, . Web.

Lipsitz, L & Reisner, T 2010, The Computer and Education, Educational Technology, Englewood.

Mishra, P & Koehler, J 2006, ‘Technological pedagogical content tent knowledge: a framework for integrating technology in teacher knowledge’ Teachers College Record, vol. 108, no.6, pp. 1017-1054.

Reznick, K & MacRae, H 2006, ‘Teaching surgical skills-changes in the wind’, N Engl J Med, vol. 355, no. 12, pp. 2664-2669.

Woolfolk, A, Winnie, P & Perry, N 2008, Educational Psychology, Pearson Publishers, Canada.

Yizraeli, S 2000, ‘how important is Saudi Oil?’, The Middle East Quarterly, vol.7, no.1, pp 57-64.

Zendejas, B, Brydges R, Wang, T & Cook, A 2013, ‘Patient Outcomes in Simulation-Based Medical Education: A Systematic Review’, Journal of General International Medicine, vol. 1, no. 3, pp. 312-339.

Ziv, A, Wolpe, R, Small, D & Glick, S 2003, ‘Simulation-based medical education: an ethical imperative’, Academic Medicine, vol. 78, no. 8, pp. 783-788.

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