Resilience and health (care): A dynamic adaptive perspective

Martin, Carmel M.

doi:10.1111/jep.13043

Cited by 6 publications

(4 citation statements)

References 23 publications

(30 reference statements)

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“…Since the support network is self-organizing, adapts to the challenges of a worsening prognosis, and adjusts to the demands and needs of the intimate partner, it is apparent that the members' behavior applies to the dynamics of a resilience process defined as the process of adapting well to adversity [19]. However, being supported by a resilient network as such cannot guarantee the emergence of a resilience process in the individual.…”

Section: Discussionmentioning

confidence: 99%

Resilience in advanced cancer caregiving promoted by an intimate partner’s support network: insights through the lens of complexity science. A framework analysis

et al. 2023

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Background The tremendous physical and mental burden that comes with caregiving puts the intimate partners of patients diagnosed with advanced cancer at risk for mental disorders. However, most partners seem to be protected by resilience. Such a resilience process is promoted by certain individual characteristics (e.g., flexibility, positive attitude, internal strength, capacity to balance incoming and outgoing information, and ability to ask for and accept support and advice) and by the availability of a support network, consisting of family, friends, and healthcare professionals. Such a heterogeneous group striving towards the same goals can be considered a complex adaptive system (CAS), a concept stemming from complexity science. Aims To study the behavior of the support network through the lens of complexity science and to provide insights to the means by which an available network may promote resilience. Methods Nineteen interviews with members from the support networks of eight intimate partners were analyzed deductively using the CAS principles as a coding framework. Subsequently, the quotes under each principle were coded inductively to concretize patterns in the behavior of the support networks. Eventually, the codes were charted into a matrix to identify intra- and inter-CAS similarities, differences, and patterns. Findings The network’s behavior adapts dynamically to the changing circumstances as the patient’s prognosis worsens. Furthermore, the behavior is based on internalized basic rules (such as reassuring availability and maintaining communication without being intrusive), attractors (e.g., feeling meaningful, appreciated, or connected), and the history of the support network. However, the interactions are non-linear and often unpredictable due to the context member’s own concerns, needs, or emotions. Conclusions Applying the lens of complexity science to the behavior of an intimate partner’s support network gives us insight into the network’s behavioral patterns. Indeed, a support network is a dynamic system that behaves according to the principles of a CAS and adapts resiliently to the changing circumstances as the patient’s prognosis worsens. Moreover, the behavior of the support network appears to promote the intimate partner’s resilience process throughout the patient’s care period.

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Section: Discussionmentioning

confidence: 99%

Resilience in advanced cancer caregiving promoted by an intimate partner’s support network: insights through the lens of complexity science. A framework analysis

et al. 2023

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“…The design of educational programs must adapt to ensure that future doctors are equipped for the challenges of modern health-care. This need is exemplified by a lens of complexity science on health-care systems [ 60 ] which views health-care as built around multiple interacting systems [ 61 ], requiring us to treat health-care improvement as a learning system where participants, including doctors, are attuned to systems features and can build momentum for change [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

Attributes and generic competencies required of doctors: findings from a participatory concept mapping study

Ogden

Kilpatrick

Elmer

et al. 2021

BMC Health Serv Res

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Background Medical education should ensure graduates are equipped for practice in modern health-care systems. Practicing effectively in complex health-care systems requires contemporary attributes and competencies, complementing core clinical competencies. These need to be made overt and opportunities to develop and practice them provided. This study explicates these attributes and generic competencies using Group Concept Mapping, aiming to inform pre-vocational medical education curriculum development. Methods Group Concept Mapping is a mixed methods consensus building methodology whereby ideas are generated using qualitative techniques, sorted and grouped using hierarchical cluster analysis, and rated to provide further quantitative confirmation of value. Health service providers from varied disciplines (including medicine, nursing, allied health), health profession educators, health managers, and service users contributed to the conceptual model’s development. They responded to the prompt ‘An attribute or non-clinical competency required of doctors for effective practice in modern health-care systems is...’ and grouped the synthesized responses according to similarity. Data were subjected to hierarchical cluster analysis. Junior doctors rated competencies according to importance to their practice and preparedness at graduation. Results Sixty-seven contributors generated 338 responses which were synthesised into 60 statements. Hierarchical cluster analysis resulted in a conceptual map of seven clusters representing: value-led professionalism; attributes for self-awareness and reflective practice; cognitive capability; active engagement; communication to build and manage relationships; patient-centredness and advocacy; and systems awareness, thinking and contribution. Logic model transformation identified three overarching meta-competencies: leadership and systems thinking; learning and cognitive processes; and interpersonal capability. Ratings indicated that junior doctors believe system-related competencies are less important than other competencies, and they feel less prepared to carry them out. Conclusion The domains that have been identified highlight the competencies necessary for effective practice for those who work within and use health-care systems. Three overarching domains relate to leadership in systems, learning, and interpersonal competencies. The model is a useful adjunct to broader competencies frameworks because of the focus on generic competencies that are crucial in modern complex adaptive health-care systems. Explicating these will allow future investigation into those that are currently well achieved, and those which are lacking, in differing contexts.

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“…Understanding these enables mapping of curricula and development of innovative pedagogies and opportunities required for capability and to transform the medical workforce to meet current and future health-care needs [55,56], moving beyond a reductionist approach [57]. The design of educational programs must adapt to ensure that future doctors are equipped for the challenges of modern healthcare, exempli ed by lens of complexity science on health-care systems [58,59,60].…”

Section: Go-zones For Individual Statementsmentioning

confidence: 99%

Attributes and Generic Competencies Required of Doctors In 21st Century Health-Care Systems: A Participatory Concept Mapping Study

Ogden

Kilpatrick

Elmer

et al. 2020

Preprint

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Background: Health professionals’ education should ensure graduates are equipped for practice in modern health-care systems. One hundred years after the Flexner Report on medical education, transformation in health-care systems has warranted reflection on priorities for medical education. Practicing effectively in modern health-care systems requires contemporary attributes and competencies, complimenting core clinical competencies. These need to be made overt and opportunities to develop and practice them provided. This study explicates these attributes and generic competencies using Group Concept Mapping methodology, with the aim of informing curriculum development in pre-vocational medical education.Methods: Group Concept Mapping consists of four phases: 1) Idea generation, review and synthesis; 2) Sorting and rating 3) Analysis of data using quantitative and qualitative techniques to produce a visual concept map; and 4) Confirmation and interpretation of results using logic model transformation. Multiple stakeholders contributed to the development of the conceptual model, including junior doctors who rated competencies according to importance to their practice and preparedness at graduation.Results: Sixty-seven participants from stakeholder groups generated 338 responses to the prompt: ‘An attribute or non-clinical competency required of doctors for effective practice in modern health-care systems is...’ These responses were synthesised into 60 statements which were sorted by participants into groupings according to similarity. Multi-dimensional scaling and hierarchical cluster analysis led to a conceptual map of seven clusters representing: Value-led professionalism; Attributes for self-awareness and reflective practice; Cognitive capability; Active engagement; Communication to build and manage relationships; Patient-centredness and advocacy; and Systems awareness, thinking and contribution. Logic model transformation identified three overarching meta-competencies: Leadership and systems thinking; Learning and cognitive processes; and Interpersonal capability. Ratings indicated that junior doctors believe system-related competencies are less important than other competencies, and they feel less prepared to carry them out. Conclusion: Group Concept Mapping was used to conceptualise the attributes and generic competencies required for effective practice modern health-care systems. The operationalization of the model through logic model transformation further identifies the links between attributes, their application through competency, and the outputs that they lead to. Rating of items can identify priorities for ensuring a medical education which addresses contemporary health-care needs.

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Resilience and health (care): A dynamic adaptive perspective

Cited by 6 publications

References 23 publications

Resilience in advanced cancer caregiving promoted by an intimate partner’s support network: insights through the lens of complexity science. A framework analysis

Resilience in advanced cancer caregiving promoted by an intimate partner’s support network: insights through the lens of complexity science. A framework analysis

Attributes and generic competencies required of doctors: findings from a participatory concept mapping study

Attributes and Generic Competencies Required of Doctors In 21st Century Health-Care Systems: A Participatory Concept Mapping Study

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