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How private groups increasingly set public policy and regulate lives—with little public knowledge or attention. From accrediting doctors and lawyers to setting industry and professional standards, private groups establish many of the public policies in today’s advanced societies. Yet this important role of nongovernmental groups is largely ignored by those who study, teach, or report on public policy issues. Public Policymaking by Private Organizations sheds light on policymaking by private groups, which are not accountable to the general public or, often, even to governments. This book brings to life the hidden world of policymaking by providing an overview of this phenomenon and in-depth case studies in the areas of finance, food safety, and certain professions. Far from being merely self regulation or self-governance, policymaking by private groups, for good or ill, can have a substantial impact on the broader public—from ensuring the safety of our home electrical appliances to vetting the credit-worthiness of complex financial instruments in the run-up to the 2008 financial crisis. From nonprofit associations to multinational corporations, private policymaking groups are everywhere. They certify professionals as competent, establish industry regulations, and set technical and professional standards. But because their operations lack the transparency and accountability required of governmental bodies, these organizations comprise a policymaking territory that is largely unseen, unreported, uncharted, and not easily reconciled with democratic principles. Anyone concerned about how policies are made—and who makes them—should read this book.

For customs administrations to function effectively and uphold EU values, it is crucial that administrations work together, with consistent quality standards and with uniform application of regulations and initiatives. Besides, different approaches and standards in education and training make it difficult to share information on best practices and disseminate knowledge and skills between different customs administrations. The EU (European Union) Customs Competency Framework (CustCompEU) is the foundation which sets out a consensus view of the optimal set of knowledge, skills and behaviours required by customs professionals in the EU. From the perspective of the customs institution, on the other hand, several practical issues arise, namely how to provide its employees with the necessary knowledge and skills in cost effective and efficient way, investing in customs employee training. This study creates a flexible competency generation methodology which allows to systematize the requirements for specific customs positions and to connect with the requirements of international and supranational organizations. The provided approach is practical from the perspective of the customs institution and provides the educators and human resource managers with the necessary information on the knowledge and skills acquired as a result of the educational process. The Meta analysis of the study is based on the use of qualitative data based on existing data sources based on the professional standards system implemented in Latvia, the EU implemented initiatives and the principles of process management system. The customs profession standard is a key element in the development of an integrated learning and professional customs officer management model, which would be a central element in a coordinated and harmonized vocational education and training system.

The National Board of Public Health Examiners (NBPHE, the Board) is the result of many years of intense discussion about the importance of credentialing within the public health community. The Board is scheduled to begin credentialing graduates of programs and schools of public health accredited by the Council on Education for Public Health (CEPH) in 2008. Among the many activities currently underway to improve public health practice, the Board views credentialing as one pathway to heighten recognition of public health professionals and increase the overall effectiveness of public health practice. The process underway includes developing, preparing, administering, and evaluating a voluntary certification examination that tests whether graduates of CEPH-accredited schools and programs have mastered the core knowledge and skills relevant to contemporary public health practice. This credentialing initiative is occurring at a time of heightened interest in public health education, and an anticipated rapid turnover in the public health workforce. It is fully anticipated that active discussion about the credentialing process will continue as the Board considers the many aspects of this professional transition. The Board wishes to encourage these discussions and welcomes input on any aspects relating to implementation of the credentialing process.

Background Clinical reasoning is at the core of health professionals’ practice. A mapping of what constitutes clinical reasoning could support the teaching, development, and assessment of clinical reasoning across the health professions. Methods We conducted a scoping study to map the literature on clinical reasoning across health professions literature in the context of a larger Best Evidence Medical Education (BEME) review on clinical reasoning assessment. Seven databases were searched using subheadings and terms relating to clinical reasoning, assessment, and Health Professions. Data analysis focused on a comprehensive analysis of bibliometric characteristics and the use of varied terminology to refer to clinical reasoning. Results Literature identified: 625 papers spanning 47 years (1968–2014), in 155 journals, from 544 first authors, across eighteen Health Professions. Thirty-seven percent of papers used the term clinical reasoning; and 110 other terms referring to the concept of clinical reasoning were identified. Consensus on the categorization of terms was reached for 65 terms across six different categories: reasoning skills, reasoning performance, reasoning process, outcome of reasoning, context of reasoning, and purpose/goal of reasoning. Categories of terminology used differed across Health Professions and publication types. Discussion Many diverse terms were present and were used differently across literature contexts. These terms likely reflect different operationalisations, or conceptualizations, of clinical reasoning as well as the complex, multi-dimensional nature of this concept. We advise authors to make the intended meaning of ‘clinical reasoning’ and associated terms in their work explicit in order to facilitate teaching, assessment, and research communication.

Digital health technologies can be key to improving health outcomes, provided health care workers are adequately trained to use these technologies. There have been efforts to identify digital competencies for different health care worker groups; however, an overview of these efforts has yet to be consolidated and analyzed. The review aims to identify and study existing digital health competency frameworks for health care workers and provide recommendations for future digital health training initiatives and framework development. A literature search was performed to collate digital health competency frameworks published from 2000. A total of 6 databases including gray literature sources such as OpenGrey, ResearchGate, Google Scholar, Google, and websites of relevant associations were searched in November 2019. Screening and data extraction were performed in parallel by the reviewers. The included evidence is narratively described in terms of characteristics, evolution, and structural composition of frameworks. A thematic analysis was also performed to identify common themes across the included frameworks. In total, 30 frameworks were included in this review, a majority of which aimed at nurses, originated from high-income countries, were published since 2016, and were developed via literature reviews, followed by expert consultations. The thematic analysis uncovered 28 digital health competency domains across the included frameworks. The most prevalent domains pertained to basic information technology literacy, health information management, digital communication, ethical, legal, or regulatory requirements, and data privacy and security. The Health Information Technology Competencies framework was found to be the most comprehensive framework, as it presented 21 out of the 28 identified domains, had the highest number of competencies, and targeted a wide variety of health care workers. Digital health training initiatives should focus on competencies relevant to a particular health care worker group, role, level of seniority, and setting. The findings from this review can inform and guide digital health training initiatives. The most prevalent competency domains identified represent essential interprofessional competencies to be incorporated into health care workers' training. Digital health frameworks should be regularly updated with novel digital health technologies, be applicable to low- and middle-income countries, and include overlooked health care worker groups such as allied health professionals.

Standards and standardization aim to render the world equivalent across cultures, time, and geography. Standards are ubiquitous but underappreciated tools for regulating and organizing social life in modernity, and they lurk in the background of many sociological works. Reviewing the relevance of standards and standardization in diverse theoretical traditions and sociological subfields, we point to the emergence and institutionalization of standards, the difficulties of making standards work, resistance to standardization, and the multiple outcomes of standards. Rather than associating standardization with totalizing narratives of globalization or dehumanization, we call for careful empirical analysis of the specific and unintended consequences of different sorts of standards operating in distinct social domains.

Background/objectivesTo maintain and optimise the quality of care provided by health professionals in rheumatology (HPRs), adequate educational offerings are needed. This task force (TF) aimed to develop evidence-based recommendations for the generic core competences of HPRs, with specific reference to nurses, physical therapists (PTs) and occupational therapists (OTs) to serve as a basis for their postgraduate education.MethodsThe EULAR standardised operating procedures for the development of recommendations were followed. A TF including rheumatologists, nurses, PTs, OTs, patient-representatives, an educationalist, methodologists and researchers from 12 countries met twice. In the first TF meeting, 13 research questions were defined to support a systematic literature review (SLR). In the second meeting, the SLR evidence was discussed and recommendations formulated. Subsequently, level of evidence and strength of recommendation were assigned and level of agreement (LoA) determined (0–10 rating scale).ResultsThree overarching principles were identified and 10 recommendations were developed for the generic core competences of HPRs. The SLR included 79 full-text papers, 20 of which addressed the competences, knowledge, skills, attitudes and/or educational needs of HPRs from multiple professions. The average LoA for each recommendation ranged from 9.42 to 9.79. Consensus was reached both on a research and educational agenda.ConclusionEvidence and expert opinion informed a set of recommendations providing guidance on the generic core competences of HPRs. Implementation of these recommendations in the postgraduate education of HPRs at the international and national level is advised, considering variation in healthcare systems and professional roles.

Background ChatGPT, a recently developed artificial intelligence (AI) chatbot, has demonstrated improved performance in examinations in the medical field. However, thus far, an overall evaluation of the potential of ChatGPT models (ChatGPT-3.5 and GPT-4) in a variety of national health licensing examinations is lacking. This study aimed to provide a comprehensive assessment of the ChatGPT models’ performance in national licensing examinations for medical, pharmacy, dentistry, and nursing research through a meta-analysis. Methods Following the PRISMA protocol, full-text articles from MEDLINE/PubMed, EMBASE, ERIC, Cochrane Library, Web of Science, and key journals were reviewed from the time of ChatGPT’s introduction to February 27, 2024. Studies were eligible if they evaluated the performance of a ChatGPT model (ChatGPT-3.5 or GPT-4); related to national licensing examinations in the fields of medicine, pharmacy, dentistry, or nursing; involved multiple-choice questions; and provided data that enabled the calculation of effect size. Two reviewers independently completed data extraction, coding, and quality assessment. The JBI Critical Appraisal Tools were used to assess the quality of the selected articles. Overall effect size and 95% confidence intervals [CIs] were calculated using a random-effects model. Results A total of 23 studies were considered for this review, which evaluated the accuracy of four types of national licensing examinations. The selected articles were in the fields of medicine ( n  = 17), pharmacy ( n  = 3), nursing ( n  = 2), and dentistry ( n  = 1). They reported varying accuracy levels, ranging from 36 to 77% for ChatGPT-3.5 and 64.4–100% for GPT-4. The overall effect size for the percentage of accuracy was 70.1% (95% CI, 65–74.8%), which was statistically significant ( p  < 0.001). Subgroup analyses revealed that GPT-4 demonstrated significantly higher accuracy in providing correct responses than its earlier version, ChatGPT-3.5. Additionally, in the context of health licensing examinations, the ChatGPT models exhibited greater proficiency in the following order: pharmacy, medicine, dentistry, and nursing. However, the lack of a broader set of questions, including open-ended and scenario-based questions, and significant heterogeneity were limitations of this meta-analysis. Conclusions This study sheds light on the accuracy of ChatGPT models in four national health licensing examinations across various countries and provides a practical basis and theoretical support for future research. Further studies are needed to explore their utilization in medical and health education by including a broader and more diverse range of questions, along with more advanced versions of AI chatbots.

On February 2020, Italy, especially the northern regions, was hit by an epidemic of the new SARS-Cov-2 corovirus that spread from Chi between December 2019 and January 2020. The entire healthcare system had to respond promptly in a very short time to an exponential growth of the number of subjects affected by COVID-19 (Corovirus disease 2019) with the need of semi-intensive and intensive care units.