Purpose – This study had five objectives: explain the initial steps that led to the construction of the Ethical Leadership Questionnaire (ELQ); analyze the items and verify the ELQ reliability using item response theory (IRT); examine its factorial structure with a confirmatory factor analysis (CFA) and an exploratory structural equation modeling (ESEM) approach; test the item bias of the ELQ; assess the relation between the ELQ dimensions and ethical sensitivity. The paper aims to discuss these issues. Design/methodology/approach – Study 1 and Study 2 involved 200 and 668 respondents, respectively. Step 1 consisted in IRT; Step 2 in CFA and ESEM analysis; Step 3 in invariance of the ELQ items across gender, and Step 4 in structural equation modeling. Findings – Results indicated the presence of the three types of ethic in the resolution of moral dilemmas, validating Starratt's model. The factor structure was gender invariant. Ethic of critique was significantly related to ethical sensitivity. Research limitations/implications – More replications will be needed to fully support the ELQ's validity. Given that the instrument may be used in diverse cultural contexts, invariance across cultures would be warranted. Practical implications – As educational organizations become aware of the crucial need for more ethical leaders, they will need to pay particular attention to the ethic of critique as it appears to play a significant role in the development of ethical sensitivity. Social implications – Results presented in this paper answer a vital need for more ethical skills in educational leadership. Originality/value – The ELQ provides a validated measure of Starratt's conceptual framework and highlights the key role played by ethical sensitivity and the ethic of critique.
Background Research on the integration of artificial intelligence (AI) into community-based primary health care (CBPHC) has highlighted several advantages and disadvantages in practice regarding, for example, facilitating diagnosis and disease management, as well as doubts concerning the unintended harmful effects of this integration. However, there is a lack of evidence about a comprehensive knowledge synthesis that could shed light on AI systems tested or implemented in CBPHC. Objective We intended to identify and evaluate published studies that have tested or implemented AI in CBPHC settings. Methods We conducted a systematic scoping review informed by an earlier study and the Joanna Briggs Institute (JBI) scoping review framework and reported the findings according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Scoping Reviews) reporting guidelines. An information specialist performed a comprehensive search from the date of inception until February 2020, in seven bibliographic databases: Cochrane Library, MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceDirect, and IEEE Xplore. The selected studies considered all populations who provide and receive care in CBPHC settings, AI interventions that had been implemented, tested, or both, and assessed outcomes related to patients, health care providers, or CBPHC systems. Risk of bias was assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Two authors independently screened the titles and abstracts of the identified records, read the selected full texts, and extracted data from the included studies using a validated extraction form. Disagreements were resolved by consensus, and if this was not possible, the opinion of a third reviewer was sought. A third reviewer also validated all the extracted data. Results We retrieved 22,113 documents. After the removal of duplicates, 16,870 documents were screened, and 90 peer-reviewed publications met our inclusion criteria. Machine learning (ML) (41/90, 45%), natural language processing (NLP) (24/90, 27%), and expert systems (17/90, 19%) were the most commonly studied AI interventions. These were primarily implemented for diagnosis, detection, or surveillance purposes. Neural networks (ie, convolutional neural networks and abductive networks) demonstrated the highest accuracy, considering the given database for the given clinical task. The risk of bias in diagnosis or prognosis studies was the lowest in the participant category (4/49, 4%) and the highest in the outcome category (22/49, 45%). Conclusions We observed variabilities in reporting the participants, types of AI methods, analyses, and outcomes, and highlighted the large gap in the effective development and implementation of AI in CBPHC. Further studies are needed to efficiently guide the development and implementation of AI interventions in CBPHC settings.
The accelerated aging of the Canadian population is a recognized fact and leads to an increasing number of seniors with cognitive impairments (Curateur public du Québec, 2010a). This has a definite impact on health professionals who have to assess their competency to live independently and manage their finances. This decision, which has important consequences for the person, must be based on an objective and rigorous assessment. The purpose of this paper is to analyse the available tools, both in the scientific literature and in clinical settings, to better document the various components to assess seniors' competency to live independently and manage their finances. The goal is to help practitioners who work with older people with cognitive impairments to accurately assess their ability to manage themselves and their property. A review of the relevant literature and training available, as well as three group consultations, showed that there is no consensus about the tools used to assess the capacity to take care of oneself and one's property. Additional studies are thus needed to fill the gap in knowledge about specific tools used to assess competency.
A B S T R A C TThis study, which was sponsored by the Social Sciences and Humanities Research Council of Canada, was conducted in French-language minority schools in seven Canadian provinces: British Columbia, Alberta, Manitoba, Ontario, New Brunswick, Prince Edward Island and Nova Scotia. Using an open-ended interview guide, 47 principals were asked about the tensions and possibilities relating to ethical leadership in linguistic minority contexts. Results show how the presence of an ethic of critique is strongly rooted in a context of struggle for the protection of a French-speaking identity as well as linguistic and cultural survival. Participants' number of years experience as school principals significantly influences their ethical posture. New school principals use only one ethic, the ethic of justice, whereas seasoned principals use a consolidated ethical framework which includes the ethic of care and the ethic of critique. An emerging professional ethic is also observed, built both on each person's ethical nature and his or her life experience. Most importantly, this type of professionalism, very much nurtured by relationships, is auto-regulated rather than externally regulated, as with a deontology code. K E Y W O R D S ethical dilemmas, minority languages, professional ethics, school context
PurposeIn response to the growing need for educational leaders who possess ethical, critical and reflective qualities, a training program was developed based on ethics as a reflective critical capacity and on Starratt's three‐dimensional model. This paper aims to describe the impact of the program on ethical decision making and on educational leaders’ ethical competencies.Design/methodology/approachA three‐year action‐research study was conducted with three groups of educational administrators, totalling 30 participants. Mixed methods were used for data collection: a pre‐ and post‐training questionnaire, individual semi‐structured interviews and group interviews. The questionnaire data were analyzed using SPSS software and interview data were analyzed using thematic analysis.FindingsResults from the pre‐test indicate that, prior to the training program, participants rarely possessed all three ethical dimensions. Post‐test results show how participants experience a significant readjustment process characterized by three different stages which have been called the transformative cycle. Qualitative results show the impact of the training program on improved ethical awareness, judgement structuring, a sense of responsibility, and overall professional conduct. No significant difference is observed between male and female participants but statistically significant differences are found according to number of years of experience and to work situation.Practical implicationsDeveloping sound ethical expertise appears to be promising in training future educational administrators and in improving their leadership skills.Originality/valueThis study is original in many aspects. Theoretically, it is based on a self‐regulated rather than hetero‐regulated approach to ethics and calls for descriptive rather then normative foundations to ethical leadership. With regard to its methodology, it used mixed methods adapted to action research as well as original data collection instruments.
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