We argue that empowered nurses are more likely to empower their patients, which results in better patient and system outcomes. Strategies for managers to empower nurses and for nurses to empower patients are suggested.
Artificial intelligence (AI) and machine learning are changing our world through their impact on sectors including health care, education, employment, finance, and law. AI systems are developed using data that reflect the implicit and explicit biases of society, and there are significant concerns about how the predictive models in AI systems amplify inequity, privilege, and power in society. The widespread applications of AI have led to mainstream discourse about how AI systems are perpetuating racism, sexism, and classism; yet, concerns about ageism have been largely absent in the AI bias literature. Given the globally aging population and proliferation of AI, there is a need to critically examine the presence of age-related bias in AI systems. This forum article discusses ageism in AI systems and introduces a conceptual model that outlines intersecting pathways of technology development that can produce and reinforce digital ageism in AI systems. We also describe the broader ethical and legal implications and considerations for future directions in digital ageism research to advance knowledge in the field and deepen our understanding of how ageism in AI is fostered by broader cycles of injustice.
Background
Fundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals.
Methods
Using a comparative case study approach and similar systems policy analysis design, we present and discuss four different regulatory approaches from the US, Canada, Australia and the UK. For each case, we highlight the jurisdictional differences in how these countries regulate health professional scopes of practice in the interest of the public. Our comparative Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis is based on archival research carried out by the authors wherein we describe the evolution of the institutional arrangements for form of regulatory approach, with specific reference to scope of practice.
Results/conclusions
Our comparative examination finds that the different regulatory approaches in these countries have emerged in response to similar challenges. In some cases, ‘tasks’ or ‘activities’ are the basis of regulation, whereas in other contexts protected ‘titles’ are regulated, and in some cases both. From our results and the jurisdiction-specific SWOT analyses, we have conceptualized a synthesized table of leading practices related to regulating scopes of practice mapped to specific regulatory principles. We discuss the implications for how these different approaches achieve positive outcomes for the public, but also for health professionals and the system more broadly in terms of workforce optimization.
Changes to Ontario's health professions regulatory system were initiated through various legislative amendments. These amendments introduced a legislative obligation for health regulatory colleges to support interprofessional collaboration (IPC), collaborate where they share controlled acts, and incorporate IPC into their quality assurance programs. The purpose of this policy analysis was to identify activities, strategies, and collaborations taking place within health professions regulatory colleges pertaining to legislative changes related to IPC. A qualitative content analysis of (1) college documents pertaining to IPC (n = 355) and (2) interviews with representatives from 14 colleges. Three themes were identified: ideal versus reality; barriers to the ideal; and legislating IPC. Commitment to the ideal of IPC was evident in college documents and interviews. Colleges expressed concern about the lack of clarity regarding the intent of legislation. In addition, barriers stemming from long-standing issues in practice including scope of practice protection, conflicting legislation, and lack of knowledge about the roles of other health professionals impede IPC. Government legislation and health professional regulation have important roles in supporting IPC; however, broader collaboration may be required to achieve policy objectives.
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