Patient perspectives of a diagnosis of myeloproliferative neoplasm in a case control study

BACKGROUND: Myeloproliferative neoplasms (MPNs) including the classic entities; polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis are rare diseases with unknown aetiology. The MOSAICC study, is an exploratory case-control study in which information was collected through telephone questionnaires and medical records. METHODS: As part of the study, 106 patients with MPN were asked about their perceived diagnosis and replies correlated with their haematologist's diagnosis. For the first time, a patient perspective on their MPN diagnosis and classification was obtained. Logistic regression analyses were utilised to evaluate the role of variables in whether or not a patient reported their diagnosis during interview with co-adjustment for these variables. Chi square tests were used to investigate the association between MPN subtype and patient reported categorisation of MPN. RESULTS: Overall, 77.4 % of patients reported a diagnosis of MPN. Of those, 39.6 % recognised MPN as a 'blood condition', 23.6 % recognised MPN as a 'cancer' and 13.2 % acknowledged MPN as an 'other medical condition'. There was minimal overlap between the categories. Patients with PV were more likely than those with ET to report their disease as a 'blood condition'. ET patients were significantly more likely than PV patients not to report their condition at all. Patients from a single centre were more likely to report their diagnosis as MPN while age, educational status, and WHO re-classification had no effect. CONCLUSIONS: The discrepancy between concepts of MPN in patients could result from differing patient interest in their condition, varying information conveyed by treating hematologists, concealment due to denial or financial concerns. Explanations for the differences in patient perception of the nature of their disease, requires further, larger scale investigation

Developing professional identity in health professional students

Professional identity formation is a relatively new area of interest within health professional education, gaining academic attention after the Carnegie Foundation Report on Medical Education of 2010 called for its introduction into medical curricula in the United States. This chapter presents a critical discussion, introducing various schools of thought, and provides theoretically informed suggestions for practice. The authors explore both conventional identity formation and more complex modern reconfigurations of healthcare professional identity. The chapter starts with an overview of different stances on what professional identity means, drawing on a variety of literatures including sociological and organizational scholarship. Next, a range of theories of identity formation are presented, including socialization and transformation. A matrix model is introduced to inform curricular planning, which can be used flexibly within different institutions or contexts. The authors discuss and critique a number of focused strategies for educators including role modeling, mentoring, reflective practice, responding to the hidden curriculum, authentic role experiences and simulation-based education, communities of practice and activity theory, student engagement, and assessment practices. The chapter concludes with possible future directions in healthcare professional identity education. Kathleen Leedham-Green is a research fellow in the Medical Education Research Unit at Imperial College London with interests in the social and behavioral aspects of clinical practice as well as healthcare innovation and quality. Alec Knight is a postdoctoral researcher and educator at King’s College London with interests in health services research, applied psychology, medical education, public health, health policy, and implementation science. Rick Iedema is professor and director of the Centre for Team-Based Practice and Learning in Health Care at King’s College London

Expertise in Business Process Management

As organizations attempt to become more business process-oriented, existing role descriptions are revised and entire new business process-related roles emerge. A lot of attention is often being paid to the technological aspect of Business Process Management (BPM), but relatively little work has been done concerning the people factor of BPM and the specification of BPM expertise in particular. This study tries to close this gap by proposing a comprehensive BPM expertise model, which consolidates existing theories and related work. This model describes the key attributes characterizing “BPM expertise” and outlines their structure, dynamics, and interrelationships. Understanding BPM expertise is a predecessor to being able to develop and apply it effectively. This is the cornerstone of human capital and talent management in BPM