Physicians are supportive of the value of screening, however the reliability of and evidence to support DRE and PSA as prostate cancer screening tests are in question. CME which addresses issues surrounding prostate screening and areas related to patient education and counselling are of greatest need.

A team of practitioners, university researchers, and health care policy makers has been working to develop and apply “design sciences” thinking within the challenging context of a national system aiming to bring about a “revolution in health care.” As members of that team, the authors share that thinking and early findings with those interested in the concept, theory, and practice of design as an approach to large-scale organizational change. The article builds on what to date has been a somewhat abstract debate around the design sciences, its aim being to forge stronger links between the concept and the practice of design. Using empirical data from the English National Health Service as a case study, the article seeks to demonstrate how design sciences may first, expand our thinking around organizational theory and practice and second, offer organization development some new methods, approaches, and processes around the “doing” of large-scale change.

The West Virginia School of Osteopathic Medicine (WVSOM) educated and retained more primary care physicians for practice in rural Appalachia than did any other U.S. medical school from 1978 through 1990. This article describes the most important methods used at WVSOM to place physicians in rural areas: (1) The school has a focused, achievable mission (to provide primary care physicians who are trained to meet the medical needs of rural Appalachia and to improve the health care of the rural Appalachian population) that is agreed upon by the administration, faculty, and students; (2) it participates in a multistate educational exchange program with a similar mission; (3) it emphasizes personalized and interactive recruiting, admission, and placement processes aimed to attract nontraditional, rural students; (4) it provides early and long-term clinical training in rural sites (both hospitals and physicians' offices); (5) it is dedicated primarily to the education of medical students rather than to research or other goals; and (6) it is a freestanding school in a rural environment. The authors state that although WVSOM is unusual in some respects, at least some of its methods may be useful to other medical schools as they seek to produce more primary care physicians for rural and other underserved areas.

In Canada in 2015, the pass rates on the National Council Licensure Examination (NCLEX-RN) were considerably lower than pass rates on the Canadian Registered Nurse Examination (CRNE) causing nurse educators to express concern regarding the NCLEX-RN. The purpose of this study was to examine the relationship between candidate variables (e. g. academic performance, demographics) on their NCLEX-RN outcome (pass/fail). A cross-sectional data linkage design was employed using multiple sources of data on nursing graduates who wrote the NCLEX-RN in 2015, 2016 and 2017 (n = 259). Results showed that fewer questions answered on the NCLEX-RN and higher grades in various nursing courses (e. g. Introduction to Nursing, Statistics) predicted higher odds of passing the NCLEX-RN. To improve pass rates, nurse educators must integrate diverse methods of testing into existing curricula that mimic the NCLEX-RN exam, specifically computer adaptive exams. Further research is needed to determine other possible challenges for countries considering adopting the NCLEX-RN.

The Macmillan Values Based Standard aims to achieve a transformation in patients' and families' experience of care. Importantly, the standard provides a framework and methodology for improving both patient and staff experience. Of all health professionals, healthcare assistants (HCAs) spend the most ‘face-time’ with patients and are therefore crucial in the drive to transform patients' experience of care. HCAs have contributed to the implementation of the Values Based Standard in a number of Macmillan pilot sites and they have demonstrated how the framework can help drive improvement. Macmillan believes HCAs are key to changing the way patients and their families experience care. For this reason, Macmillan is investing in testing a new development programme, designed specifically to support HCAs, while also ensuring that the organisations they work within focus on the Values Based Standard and provide workforce support to HCAs. This article introduces the programme.