Recognizing Magnet® Program Directors.

The Gastroenterology Core Curriculum, Third Edition

Impact of COVID-19 on Saudi Neurosurgery Residency: Trainers' and Trainees' Perspectives

Current Opinion in Allergy and Clinical Immunology was launched in 2001. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of allergy and clinical immunology are divided into 14 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Editors and Section Editors for this issue. EDITORS Mark BallowMark BallowDr Mark Ballow received his MD from the University of Chicago Pritzker School of Medicine, USA. After a pediatric residency at Yale-New Haven Hospital, USA, he completed an immunology fellowship at the University of Minnesota Hospitals, USA. He was the Chief of Clinical and Experimental Immunology at Walter Reed Army Medical Center, USA. He was then appointed as Chief of the Division of Clinical Immunology in the Department of Pediatrics at the University of Connecticut, USA from 1975 to 1988, and became Chief of the Division of Allergy/Clinical Immunology and Pediatric Rheumatology, and Program Director of the Allergy/Immunology fellowship program at The Women and Children's Hospital of Buffalo, State University of New York at Buffalo, USA from 1988 to 2012. He is presently Training Program Director of the Allergy/Immunology Fellowship program at University of South Florida, Allergy & Immunology Division at All Children's Hospital in St Petersburg, FL. Dr Ballow is certified by the American Board of Pediatrics, American Board of Allergy & Immunology (ABAI), and in Clinical Laboratory Immunology. He was on the Board of Directors of the ABAI from 1992–1998. He has served on four editorial boards including the Journal of Allergy and Clinical Immunology (1984–1989; 1995–2000), and is an Ad Hoc reviewer for a number of pediatric, allergy and immunology journals. He has recently been appointed to the editorial board of Journal of Allergy and Clinical Immunology: In Practice. Dr Ballow has served as an ad hoc member of several NIH study sections, and was a member of the committee that published the first Allergy and Immunology Medical Knowledge Self Assessment Program (MK-SAP), and was a member of the new 3rd edition AI-MK-SAP. Dr Ballow is a Fellow of the American Academy of Asthma, Allergy and Immunology, and has served on the Board of Directors of the Academy (1996–1999), and has chaired the A/I Training Program Directors, Basic Clinical immunology Interest Section, and the Post-graduate Education Program. He was President of the American Academy of Allergy, Asthma and Immunology in 2010–2011. Dr Ballow is a member of the Clinical Immunology Society, the Florida Allergy Society, and the American College of Allergy, Asthma and Immunology. He also has served on the Blood Product Advisory Committee of the FDA. Dr Ballow's major clinical interests include chronic sinusitis, primary immune deficiency disorders, and the uses and mechanisms of action of Intravenous Immune Globulin (IGIV). His research interests include the immunology of the newborn infant and the immunoregulatory effects of IVIG, Vitamin A and retinoic acid. G. Walter CanonicaG. Walter CanonicaProfessor Giorgio Walter Canonica is Director of the Allergy & Respiratory Diseases Clinic, Genoa University, Italy, a GALEN Centre of Excellence. Professor Canonica first specialised in pulmonary diseases after having received his medical degree from the University of Genoa, Italy. He then specialised in Allergy and Clinical Immunology at Florence University, Italy. He subsequently conducted clinical immunology and allergology research in several European universities and institutes, in addition to two years at the Medical University of South Carolina, USA. Since returning to the University of Genoa in 1995, Professor Canonica has held a number of academic positions including Director of the Speciality School of Allergy and Clinical Immunology, Director of the Specialty School of Pulmonary Diseases and Chairman of Chairman of the Dept of Medical Specialties (University Hospital S. Martino Genoa, Italy). He is Board Member of ARIA (Allergic Rhinitis and its impact Asthma) guidelines) and GALEN (Global Allergy and Asthma European Network). Professor Canonica's research interests include examination of the molecular events and interactions between immunocompetent cells, inflammatory cells and epithelial cells in allergic inflammation and airway remodelling. He is particularly involved in new strategies in the treatment of allergic disease, including biological response modifiers, such as specific immunotherapy (with a special focus on SLIT – sublingual immunotherapy - and Severe Asthma treatment with biologics). Professor Canonica has published extensively in international journals and acts as a referee of many immunology journals. In addition, Professor Canonica is a member of a number of societies, he was President of World Allergy Organization 2008/09. He is also currently President of Global Asthma Association - Interasma. He was President of SIMeR (Italian Society of Respiratory Medicine) 2000–2003 and he is Honorary President of this same Society since 2007. He is currently President of SIAAIC Italian Society of Allergy, Asthma and Clinical Immunology (2014–2017). SECTION EDITORS Ruby PawankarRuby PawankarProf. Ruby Pawankar MD, PhD, FRCP (UK), FAAAAI is currently the Immediate Past President of the World Allergy Organization (WAO) and was WAO President from January 2012 to December 2013, after serving as a member of the Board of Directors since 2001, as Treasurer 2008–2009 and as President-Elect 2010–2011. She is currently also the President of the Indian Academy of Allergy. She is Professor of Allergy in the Department of Pediatrics at Nippon Medical School, Tokyo, Japan, and Guest Professor at the Kyung Hee University School of Medicine in Seoul, Korea and the Showa University School of Medicine in Tokyo, Japan. After graduating in medicine from the Armed Forces Medical College, Pune, India, Prof. Pawankar did her residency and post-graduation from BJ Medical College, Pune, India. Thereafter, she trained in Allergy & Clinical Immunology at the Nippon Medical School and Juntendo University School of Medicine in Tokyo, Japan from where she obtained her doctorate. Prof. Pawankar serves on numerous committees and boards of many academic organizations and grant reviews, is a Member/Fellow of organizations including the Collegium International Allergolicum, the American Academy of Allergy, Asthma and Immunology, the American College of Allergy and Immunology, the European Academy of Allergy and Clinical Immunology and the Japanese Society of Allergology. She has delivered several orations/named lectures nationally and internationally including the SK Malik Oration and DN Shivpuri Oration. She is a recipient of many academic awards including the World Achievement Award in Allergy from Thailand; the International Distinguished Fellow Award from the American College of Allergy, Asthma & Immunology; and especially the Pravasi Bharatiya Samman Award from the President of India for excellence in medicine. Prof. Pawankar's research has focused on the cellular and molecular mechanisms of allergy, immune cells like mast cells and T cells, epithelial cell-immune cell interactions, novel roles of IgE, mast cell-IgE cascade, environmental pollution, immunotherapy and novel therapies for respiratory allergies. In 1995, she was the first to report on the increased presence and role of gamma delta T cells in allergic rhinitis. In 1997, she was among the first to show that mast cells in perennial allergic rhinitis exhibit increased expression of the IgE receptor as well as being a major source of the obligatory pro- allergic Th2 cytokines interleukin IL-4, and IL-13 capable of driving local allergen-specific IgE synthesis by B lymphocytes and has formed the basis of the successful therapeutic targeting of these cytokines with biological therapeutics. Her research and educational activities have been strongly translational as it applies to clinical science. This has resulted in 411 publications including peer-reviewed original articles in: Journal of Allergy and Clinical Immunology, Journal of Clinical Investigation, Journal of Immunology, Blood, American Journal of Respiratory and Critical Care Medicine, Allergy, Clinical & Experimental Allergy, International Archives of Allergy and Immunology, Current Opinion in Allergy and Clinical Immunology etc, and invited reviews and book chapters. She is an Editor/ Associate Editor of peer-reviewed journals such as: International Archives of Allergy, Clinical Experimental Immunology, Current Opinion in Allergy and Clinical Immunology etc., and books including the 6 volume book ‘Allergy Frontiers’, the WAO White Book on Allergy, Update on Respiratory Disorders, and is a co-author of several consensus documents. She has mentored over 30 fellows from Japan and abroad. Prof. Pawankar has chaired as President and organized several international congresses including: the 10th Trans Pacific Allergy Congress in Mumbai, India; the first and the Middle East Allergy Congress, in 2009 and 2011 respectively; the WAO International Scientific Conference (WISC) 2012, India; the World Allergy Asthma Congress 2013, Milan, Italy, as well as several educational programs and has been a visiting faculty to lecture at several institutions such as Harvard Medical School, USA; the University of Wisconsin, USA; Imperial College, London, UK; Catholic University, Argentina; the University of Sao Paolo, Brazil and Mahidol University, Thailand. At an organizational level, her vision is to create a channel of dialogue with all stakeholders to address the unmet global public health issue of asthma and allergies in the context of non-communicable diseases (NCDs) via an integrated approach that could lead to increased resources for research, improved patient care, better health care delivery, and preventative strategies. David P. SkonerDavid P. SkonerDr David P. Skoner is Director of the Division of Allergy, Asthma, and Immunology in the Department of Medicine of Allegheny General Hospital in Pittsburgh, Pennsylvania, USA. He is also Professor of Medicine at the Temple University School of Medicine in Philadelphia, Pennsylvania, USA and Clinical Professor of Pediatrics, West Virginia University School of Medicine, USA. Previously, he was Associate Professor of Pediatrics and Otolaryngology at the University of Pittsburgh, School of Medicine, USA and has served as the Chief of the Section of Allergy/Immunology and Director of the Allergy and Immunology Training Program at the Children's Hospital of Pittsburgh, USA. Dr Skoner received his BS degree from Juniata College in Huntingdon, Pennsylvania, USA and his MD degree from Temple University in Philadelphia, Pennsylvania, USA. He served his residency in general pediatrics at Children's Hospital in Cincinnati, Ohio, USA, and he completed his fellowship in allergy/immunology at Children's Hospital in Pittsburgh. His current research interests include the relationships between respiratory viruses, asthma, immunity, and stress; the relationship between viral and allergen-induced nasal inflammation and middle ear disease; and the efficacy and safety (HPA axis function and growth in children) of inhaled and intranasal steroids. Dr Skoner has received NIH funding and written more than 100 articles and given more than 200 presentations on respiratory disease. His articles and abstracts have been published in many leading journals, including Pediatrics, Journal of Allergy and Clinical Immunology, Pediatric Research, American Journal of Respiratory and Critical Care Medicine, The Journal of the American Medical Association, and American Review of Respiratory Disease. Dr Skoner serves on the editorial advisory boards of the journals Current Allergy and Asthma Reports, and Current Opinion in Allergy and Clinical Immunology, and previously served on the editorial board of the American Journal of Rhinology. He is a Fellow of the American Academy of Pediatrics and a member of the Society of Pediatric Research, the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma & Immunology, the Association for Research in Otolaryngology, and the American Pediatric Society. He has been recognized as one of America's ‘Top Doctors’ (Pediatric Allergy & Immunology, Castle Connolly Medical Ltd.) from 2001 to 2014, as one of the Most Influential Doctors by USA TODAY (http://www.usatoday.com/yourlife/health/most-influential-doctors.htm), and as a U.S. News Top Doctor (www.usnews.com/top-doctors). He was invited to join the Best Pharmaceuticals for Children Act (BPCA) Pediatric Asthma Therapeutics Group convened by the National Institute of Child Health and Human Development. Dr Skoner co-founded the Nemacolin Asthma Conference (www.ahn.org/nemacolin-asthma), a continuing medical education (CME) program that attracts a national and an international audience and faculty, now in its ninth year. He also founded and is the President of ‘For Your Good Health’ (www.fygh.org), a Pennsylvania non-profit corporation that brings together asthma stakeholders in the development and implementation of state-of the-art programs to educate children with asthma and their caregivers about the disease and its management. The aim of these programs is to reduce asthma's impact on patients, caregivers, the community, and the healthcare system by helping the patients to lead near-normal lives. He also serves on the board of the non-profit Greater Pittsburgh Allergy Asthma and Immunology Society (GPAAIS), which serves to educate and inform physicians and other health care providers. Dr Skoner was selected as a finalist in the category of ‘Health Care Provider: Physician’ for the 2013 Pittsburgh Business Times Health Care Heroes Awards. J. Andrew GrantJ. Andrew GrantDr Grant is a native of Florida and received his undergraduate degree from Harvard University, USA, in biochemical sciences. After attending Duke Medical School, USA, he did a residency in internal medicine at New York Hospital – Cornell Medical Center in New York City, USA. He did a fellowship in immunology with Leroy Hood at the National Institutes of Health and an allergy-immunology clinical fellowship at Johns Hopkins University, USA, with Phillip Norman and Lawrence Lichtenstein. In 1973, he established the first basic and clinical research program in allergy in Texas at the University of Texas Medical Branch in Galveston, USA. Presently he is Clinical Professor in the Departments of Medicine and Microbiology-Immunology and training program Director in Allergy-Immunology at that institution. He has served as Division Director and Vice Chair for Research within the Department of Internal Medicine. He vacations during the summer months in Colorado and has been appointed Clinical Professor at University of Colorado Medical School, USA. Dr Grant has been an active member of the American Academy of Allergy, Asthma and Immunology for over four decades. His contributions to this organization include chairing the Program Directors Assembly, Mechanisms of Allergy Interest Section, Postgraduate Education Committee, Scientific Workshops and Exhibits Committee, and Immunotherapy Committee. He served on the Editorial Board of the Journal of Allergy and Clinical Immunology. He founded In-training Examination for Allergy-Immunology postdoctoral fellows, the first subspecialty exam of its type. Dr Grant served as President of the Texas Allergy Asthma and Immunology Society and a Director of the American Board of Allergy and Immunology, and a member of the Residency Review Committee for Allergy and Immunology. He chaired the Pulmonary Allergy Drugs Advisory Committee of the Food and Drugs Administration and currently is a member of the Allergenic Products Advisory Committee. He was a visiting professor at the National Heart and Lung Institute with Professor Barry Kay in 1994. Dr Grant's research interests have included mechanisms of cellular activation especially the role of chemokines and novel therapies for allergic disorders. Currently he is emphasizing management of difficult patients with urticaria and angioedema. He has authored over 190 publications and chapters and 175 presentations at national and international meetings. Peter Howarth Professor Peter Howarth is Professor of Allergy and Respiratory Medicine and Honorary Consultant Physician within Medicine at the University of Southampton with a clinical and research focus on asthma, particularly severe asthma, and allergy. Professor Howarth has supervised over 20 PhD and DM students (scientists and clinicians) and his research involves Local, National and International collaboration. He has participated in EU funded collaborative programmes, such as BIOAIR and GA2LEN, focusing respectively on severe asthma and allergic diseases, and is joint work package 4 lead for UBIOPRED, the EU/EFPIA funded IMI programme on severe asthma. Professor Howarth has published over 200 peer reviewed papers and lectured extensively at National and International specialist society meetings as an invited speaker. Professor Howarth has contributed to National, European and International (World Health Organisation) guidelines on the management of rhinitis and asthma. He has been on the council of The British Society of Allergy and Clinical Immunology, advisor on allergy to Asthma UK and has been chairman of the board of trustees of Allergy UK. He is currently President of Allergy UK and a trustee of AAIR.

Reflecting on the multifaceted role of Education Program Coordinators (EPCs) in Graduate Medical Education (GME), this perspective piece offers insights drawn from the author's tenure at the Mayo Clinic. The complexity of the EPC role is explored, emphasizing its pivotal impact on program success and stakeholder relationships. Key attributes for success are discussed, including the importance of a robust support network, the cultivation of confidence, and the development of collaborative partnerships with program directors. Flexibility isidentified as a crucial skill for navigating the dynamic demands of educational programs. An informal survey ofprogram directors reveals the complementary nature of the EPC's skills in enhancing program directors' strengths and addressing their weaknesses. The article concludes with recommendations for EPCs to engage in candid conversations with program directors to align expectations and promote continuous improvement, ultimately enhancing the educational environment and supporting the physicians they serve.

Jerry A. Mansfield Interview

Objective: Relative to the global investment in hospital accreditation programs overall, both the total amount and methodological quality of existing accreditation research is mediocre. To address this apparent gap in knowledge, we undertook a study of the experiences and perspectives of hospital staff, those most underrepresented in the accreditation research literature, including those working on the front lines and non-leaders who may or may not have been directly involved in the preparation for the accreditation survey visit.Methods: Design: Qualitative descriptive interview study. Setting: Tertiary care teaching hospital in Toronto, Ontario Canada. Study Participants: Program directors, unit managers, physicians, nurses, health discipline professionals (HDP), and non-clinical staff.Results: We have grouped what we heard from the data into three major groups of findings which we have titled: a) perceptions of the purpose of accreditation; b) the “work” of accreditation; and c) dissemination gaps regarding results. Informative finding from this study include the fact that participants put surprising value on the accreditation process, although mistaken feel it is mandatory; that the “work” of accreditation can be disappointing and feels disconnected from the bigger QI picture, and that the disconnect also exists in terms of their knowledge of and belief in the actual results of the process.Conclusions: These findings point to potential gaps in the accreditation culture which can be detrimental to the impact of the accreditation process. Such gaps likely exist in other health care organizations and could inform similar evaluations in other settings.

Prevalence of Drug Testing Among Family Medicine Residents and Students: Much Needed Data.

One of the blueprints used by health care organizations for attaining and sustaining nursing excellence is the American Nurses' Credentialing Center's (ANCC) Magnet designation. The ANCC requires organizations to identify a Magnet program director (MPD), who serves as the contact and communication point through the process of application, designation, and maintenance of the credential. The MPD role is complex, has a wide variety of necessary skills and competencies, and can be challenging and overwhelming to undertake. Literature reveals no guidelines nor recommendations regarding educational preparation for assuming the role. Chief nursing officers (CNOs) support "program director" as a potential employment option for doctor of nursing practice (DNP) graduates. Given the complexity of the MPD, would DNP education provide elements that would help new MPDs prepare for the position? The purpose of this project was to determine if MPDs recommend concepts within DNP program Essentials as preparation for their roles. A mixed methods design was used, with qualitative data obtained from a focus group and quantitative, nonexperimental data obtained through a cross-sectional survey. Data were collected from current MPDs. The concepts of DNP Essentials presented in the survey were all recommended as preparation for the MPD role, making DNP education a relevant option.

Nancy Borkowski, DBA, FACHE, CPA, FHFMA is a professor in the Department of Health Services Administration at the University of Alabama at Birmingham (UAB). Dr. Borkowski has more than 20 years of experience in the healthcare field and is the author of several textbooks that are used both nationally and internationally in graduate and undergraduate administration and nursing programs. Her research has been published in numerous prominent journals in health services administration, management, and organizational behavior.Dr. Borkowski is the recipient of several awards, including ACHE's Exemplary Service Award and Distinguished Service Award. She also is a two-time recipient of the ACHE Southern Florida Regent's Senior Career Healthcare Executive Award, which recognizes individuals who have made significant contributions to the advancement of healthcare management excellence.Dr. Kash: You began your career as a certified public accountant. What attracted you to the healthcare field and to academia specifically?Dr. Borkowski: After 10 years of working in public accounting at national and regional firms, as well as in my own practice, I decided to transition into the private sector. The question was, in which industry did I want to focus my energies? Of all my clients, the ones I most enjoyed working with were connected in some way to the healthcare field-hospital executives, physicians managing large practices, and administrators of long-term care facilities. I decided to focus my attention on healthcare and returned to school to obtain a master's degree in health services administration. Over the next decade, I served in various leadership roles with large physician practices and managed care organizations.In 1995, I entered into a partnership with a physician colleague to own and operate what were referred to at that time as partial-risk primary care provider (PCP) clinics. This was the point at which I found my way into academia. As the administrator for our PCP clinics, I became increasingly aware that the entry-level and midlevel staffwe were hiring lacked the knowledge and skill sets necessary for them (and, in turn, the clinics) to be successful. To remedy the situation, I approached a local university that offered undergraduate and graduate degrees in health services administration. The program director asked if I would be interested in teaching to share my knowledge of and experience in the healthcare field. Like many other people, I usually avoided situations requiring public speaking, but I was always up for a challenge. I accepted the adjunct faculty position and spent the next few months developing lectures, performing research, and writing notes in preparation for my first day of class. When I walked into the classroom for the first time and began to engage the students in discussions of healthcare delivery challenges, I knew that teaching was my life's calling. Fast-forward 20 years, and I still experience that same feeling every time I walk into the classroom. I am blessed and thankful to be able to teach others, conduct research, and provide service in an area that I am passionate about-healthcare-and, more specifically, the efficient and effective delivery of health services. That is how I found my way from public accounting to the healthcare field and finally into academia.Dr. Kash: Many healthcare management education programs are moving toward competency-based curriculum and training. What are the pros and cons of competency-based education for healthcare management?Dr. Borkowski: Given what I experienced during my practitioner years, I am a strong supporter of competency-based education. Although somewhat new to healthcare management, competency-based education is ingrained in other healthcare fields, such as nursing and medicine. If we think about the definition of competency-based education-development of the behaviors, knowledge, skill sets, and abilities needed to be successful not just in healthcare but in life-it is difficult to find any negatives. …

A new model of training physicians and health care professionals in women's primary health care: the women's health scholar program

Although policymakers are increasingly interested in how integrated delivery systems and managed care plans implement clinical guidelines and improve performance and quality of care, few data have been compiled about how these organizations are undertaking change. Interviews with officials in organizations that are engaged in improving practice across the country documented that there is a profound transformation under way with substantial similarity in the approaches being used by otherwise very different plans. Better evaluation of the effectiveness and cost-effectiveness of these approaches could provide a more solid foundation for policies to improve quality of care.

The fiscal cliff and opportunities for change☆: El abismo fiscal y las oportunidades de cambio

Academic leadership in undergraduate and graduate medical education requires a specific set of leadership and managerial skills that are unique to academic leadership positions. While leadership development training programs exist for traditional leadership roles such as department chairs, executives, and deans, there are fewer models of leadership training specifically geared for academic leadership positions such as program and clerkship directors, and designated institutional officials. There are academic programs at the national level, but there is sparse literature on the specific decisions required to create such programs locally. With growing regulatory and accreditation requirements as well as the challenges of balancing the clinical and educational missions, effective leadership is needed across the spectrum of academic medicine. To meet this need for the military health care system in the United States, we used Kern’s six-step framework for curriculum development to create a 1-week academic leadership course. This paper describes the process of development, implementation, outcomes, and lessons learned following the initial 3 years of courses. Specific discussions regarding who to train, which faculty to use, content, and other elements of course design are reviewed. The course and process outlined in the paper offer a model for other organizations desiring to establish an academic leadership course.

HIV and tuberculosis in the former Soviet Union

This month, the director of the Magnet Recognition Program® takes an in-depth look at the Magnet® model component transformational leadership. The author examines the expectations for Magnet organizations around this component. What are the qualities that make a nursing leader truly transformational, and what is the best approach to successfully lead a healthcare organization through today's volatile healthcare environment?