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The American Medical Association formed the Accelerating Change in Medical Education Consortium through grants to effect change in medical education. The dissemination of educational innovations through scholarship was a priority. The objective of this study was to explore the patterns of collaboration of educational innovation through the consortium’s publications. Publications were identified from grantee schools’ semi-annual reports. Each publication was coded for the number of citations, Altmetric score, domain of scholarship, and collaboration with other institutions. Social network analysis explored relationships at the midpoint and end of the grant. Over five years, the 32 Consortium institutions produced 168 publications, ranging from 38 papers from one institution to no manuscripts from another. The two most common domains focused on health system science (92 papers) and competency-based medical education (30 papers). Articles were published in 54 different journals. Forty percent of publications involved more than one institution. Social network analysis demonstrated rich publishing relationships within the Consortium members as well as beyond the Consortium schools. In addition, there was growth of the network connections and density over time. The Consortium fostered a scholarship network disseminating a broad range of educational innovations through publications of individual school projects and collaborations.

In Future Studies and the History of Technology accelerating change is a perceived increase in the rate of technological change throughout history. This may suggest faster and more profound change in the future and may or may not be accompanied by equally profound social and cultural change. Responding to the accelerating technological landscape and contemporary life, this paper researches how the concept of ‘time’ plays a significant role. The author, an experimental filmmaker, charts an experiential journey within several pivotal ‘dream films’, along with relevant artists’ moving images in relation to time and slowness in the moving image as critical media. As contemporary life has become more and more fast paced, and one year on the impact of COVID-19 is still being felt, the idea of stillness is beginning to become a more desirable commodity. The author explores ‘slow cinema’, acknowledging seminal directors Andrei Tarkovsky and Claire Denis, as well as art films which frequently emphasise long takes, offering minimalist aesthetics with little or no narrative. In an endeavour to portray different temporalities and reveal and allude to the invisibility of time, the author relates to Julia Kristeva’s notions of intertextuality, transposition and time, and Lutz Koepnik’s concept of slowness as a strategy of the contemporary. The author discusses four ‘dream films’, where painterly, poetic, non-linear narratives, and ‘in-between’ spaces are played out: FRIDA Travels to Ibiza, Cycle, Llafarganu Papagei and Frock.

The explosion of medical information demands a thorough reconsideration of medical education, including what we teach and assess, how we educate, and whom we educate. Physicians of the future will need to be self-aware, self-directed, resource-effective team players who can synthesize and apply summarized information and communicate clearly. Training in metacognition, data science, informatics, and artificial intelligence is needed. Education programs must shift focus from content delivery to providing students explicit scaffolding for future learning, such as the Master Adaptive Learner model. Additionally, educators should leverage informatics to improve the process of education and foster individualized, precision education. Finally, attributes of the successful physician of the future should inform adjustments in recruitment and admissions processes. This paper explores how member schools of the American Medical Association Accelerating Change in Medical Education Consortium adjusted all aspects of educational programming in acknowledgment of the rapid expansion of information.

In the last two decades, prompted by the anticipated arrival of the 21st Century and on the centenary of the publication of the Flexner Report, many in medical education called for change to address the expanding chasm between the requirements of the health care system and the educational systems producing the health care workforce. Calls were uniform. Curricular content was missing. There was a mismatch in where people trained and where they were needed to practice, legacy approaches to pedagogical methods that needed to be challenged, an imbalance in diversity of trainees, and a lack of research on educational outcomes, resulting in a workforce that was described as ill-equipped to provide health care in the current and future environment. The Lancet Commission on Education of Health Professionals for the 21st Century published a widely acclaimed report in 2010 that called for a complete and authoritative re-examination of health professional education. This paper describes the innovations of the American Medical Association Accelerating Change in Medical Education Consortium schools as they relate to the recommendations of the Lancet Commission. We outline the successes, challenges, and lessons learned in working to deeply reform medical education.

In 2010, several key works in medical education predicted the changes necessary to train modern physicians to meet current and future challenges in health care, including the standardization of learning outcomes paired with individualized learning processes. The reframing of a medical expert as a flexible, adaptive team member and change agent, effective within a larger system and responsive to the community's needs, requires a new approach to education: competency-based medical education (CBME). CBME is an outcomes-based developmental approach to ensuring each trainee's readiness to advance through stages of training and continue to grow in unsupervised practice. Implementation of CBME with fidelity is a complex and challenging endeavor, demanding a fundamental shift in organizational culture and investment in appropriate infrastructure. This paper outlines how member schools of the American Medical Association Accelerating Change in Medical Education Consortium developed and implemented CBME, including common challenges and successes. Critical supporting factors include adoption of the master adaptive learner construct, longitudinal views of learner development, coaching, and a supportive learning environment.

Aim Simulation models are important tools for quantifying the resilience (i.e., persistence under changed environmental conditions) of forest ecosystems to global change. We synthesized the modelling literature on forest resilience, summarizing common models and applications in resilience research, and scrutinizing the implementation of important resilience mechanisms in these models. Models applied to assess resilience are highly diverse, and our goal was to assess how well they account for important resilience mechanisms identified in experimental and empirical research. Location Global. Time period 1994 to 2019. Major taxa studied Trees. Methods We reviewed the forest resilience literature using online databases, selecting 119 simulation modelling studies for further analysis. We identified a set of resilience mechanisms from the general resilience literature and analysed models for their representation of these mechanisms. Analyses were grouped by investigated drivers (resilience to what) and responses (resilience of what), as well as by the type of model being used. Results Models used to study forest resilience varied widely, from analytical approaches to complex landscape simulators. The most commonly addressed questions were associated with resilience of forest cover to fire. Important resilience mechanisms pertaining to regeneration, soil processes, and disturbance legacies were explicitly simulated in only 34 to 46% of the model applications. Main conclusions We found a large gap between processes identified as underpinning forest resilience in the theoretical and empirical literature, and those represented in models used to assess forest resilience. Contemporary forest models developed for other goals may be poorly suited for studying forest resilience during an era of accelerating change. Our results highlight the need for a new wave of model development to enhance understanding of and management for resilient forests.

Disease presentations can vary between different skin phototypes, at times requiring distinct management and therapies. Medical education curricula have yet to be updated to better reflect and address the dermatologic needs of an increasingly diverse population. The objective of this study was to determine if the preclinical dermatology curriculum at 3 US medical schools provided adequate representation of skin of color patients in their didactic presentation slides. Three US medical schools-all members of the American Medical Association (AMA) Accelerating Change in Medical Education consortium-were included in the study. The institutions were a blend of private and public schools located across different geographic boundaries. The main outcome measures included the proportion of total skin of color photographs for each institution, the number of priority conditions for skin of color patients, and the discussion of differences between skin types. The results strongly suggested that skin of color is underrepresented in the preclinical dermatology curriculum at all 3 institutions. Efforts should be made to increase images and discussion of skin of color in preclinical didactics.

Promoting optimal health outcomes for diverse patients and populations requires the acknowledgement and strengthening of interdependent relationships between health professions education programs, health systems, and the communities they serve. Educational programs must recognize their role as integral components of a larger system. Educators must strive to break down silos and synergize efforts to foster a health care workforce positioned for collaborative, equitable, community-oriented practice. Sharing interprofessional and interinstitutional strategies can foster wide propagation of educational innovation while accommodating local contexts. This paper outlines how member schools of the American Medical Association Accelerating Change in Medical Education Consortium leveraged interdependence to accomplish transformative innovations catalyzed by systems thinking and a community of innovation.

The National Collaborating Centre for Methods and Tools (NCCMT) is part of a network of six National Collaborating Centres for Public Health (NCC) created in 2005 by the federal government following the severe acute respiratory syndrome (SARS) epidemic to strengthen public health infrastructure in Canada. The work of the NCCMT, to support evidence-informed decision-making (EIDM) in public health in Canada, is accomplished by curating trustworthy evidence, building competence to use evidence and accelerating change in EIDM. Ongoing engagement with its target audiences ensures NCCMT’s relevance and ability to respond to evolving public health needs. This has been particularly critical during the coronavirus disease 2019 (COVID-19) pandemic, which saw NCCMT pivot its activities to support the public health response by conducting rapid reviews on priority questions identified by decision-makers from federal to local levels as well as create and maintain a national repository of in-progress or completed syntheses. These efforts, along with partnering with the COVID-19 Evidence Network to support Decision-Making (COVID-END), sought to reduce duplication, increase coordination of synthesis efforts and support decision-makers to use the best available evidence in decision-making. Data from website statistics illustrate the successful uptake of these initiatives across Canada and internationally.

Human activities have been affecting rivers and other natural systems for millennia. Anthropogenic changes to rivers over the last few centuries led to the accelerating state of decline of coastal and estuarine regions globally. Urban rivers are parts of larger catchment ecosystems, which in turn form parts of wider nested, interconnected systems. Accurate modelling of urban rivers may not be possible because of the complex multisystem interactions operating concurrently and over different spatial and temporal scales. This paper overviews urban river syndrome, the accelerating deterioration of urban river ecology, and outlines growing conservation challenges of river restoration projects. This paper also reviews the river Thames, which is a typical urban river that suffers from growing anthropogenic effects and thus represents all urban rivers of similar type. A particular emphasis is made on ecosystem adaptation, widespread extinctions and the proliferation of non-native species in the urban Thames. This research emphasizes the need for a holistic systems approach to urban river restoration.

This study has been conducted based on the main question how urban policies focusing on economic growth and urban sprawl affect green areas and forests in the course of time. Its main goal is to assess the effects of Turkey’s rapid urbanization policy on the green areas in Istanbul. The sub-goals of the study are: (i) To determine the land use and land change in 1984-2000–2017, (ii) To explain the ecological response of the pressure of land change on urban green areas and (iii) To discuss the urban and forestry policies accelerating change of land use. Physical data, socio-economic data and media news on urban policy, and other statistical data were used in the study. To determine the changes in inland use in Istanbul, satellite images of 1984, 2000 and 2017 as well as the DEM data for Istanbul from ASTER GDEM v2 were classified via Remote Sensing (RS) and Geographic Information System (GIS). The study has concluded that transformations in Istanbul’s land forms occurred not individually, but connected to each other, and these changes might have different trends in different periods, yet these changes always occur in expanding urban areas. It has been numerically identified and interpreted that these changes evolved within the scope of unearned income and private benefits. It has been suggested that country’s policies change towards social policies, which highlight ecology, as opposed to neoliberal policies, which highlight economy, to improve Turkey’s green areas.

Defining entrepreneurship within healthcare Accelerating change, increasing complexity and the need to control costs are the operative terms driving the healthcare environment today, with the goals of improving metrics in both healthcare and patient health. Yet, physicians are not educated to understand the concepts nor trained to practice the necessary skills to carry out activities directed towards these goals.1 Thus, Myers and Pronovost have proposed making management skills core components of medical education.2 These include the management domain skill sets that concern individual and interpersonal dynamics, team and unit dynamics, and organisational dynamics that would have the potential to enhance interactions at all management levels, not only senior management. These ‘soft’ skills can contribute to quality improvement, that is, incremental improvements in the effectiveness and efficiency of processes throughout healthcare. However, these skills alone do not address the further critical need for innovation in those processes. The discipline of entrepreneurship, as it bridges the broad complementary disciplines of management and leadership, can make a meaningful contribution to this discussion. In the first landscape review and thematic analysis of innovation and entrepreneurship programmes in medical education in the USA, Niccum and colleagues identified 13 programmes that provide training in these disciplines.3 They identify seven educational themes, the top two of which, innovation (92%) and entrepreneurship (85%), show the gaining relevance of these disciplines to medical education and to the future careers of medical professionals who will benefit from skill sets that address complex problem solving and solution design. Defined broadly, entrepreneurship is the ‘pursuit of opportunity beyond resources controlled’,4 (box 1) embodying a singular focus to bring forth innovation5 (box 1) in any form, for example, in pioneering new technology that improves an existing process while counteracting resource constraints. Within the healthcare sector, entrepreneurship has taken the form of design …

Medical education and the health system must address challenges that, despite significant effort, seem unsolvable. Health systems science (HSS)-the fundamental understanding of how care is delivered, how health professionals work together to deliver that care, and how the health system can improve patient care and health care delivery-is increasingly being recognized as a potential source of solutions to these challenges. In this article, the authors review the 43 abstracts submitted to the American Medical Association Accelerating Change in Medical Education 2018 Health Systems Science Student Impact Competition that aligned with the goals of HSS. Their qualitative review identified 3 long-standing problems in medicine and medical education that were frequently addressed by the submissions: improving care for those with mental illness (5 submissions), improving diversity in medicine (4 submissions), and improving teamwork and interprofessional education (4 submissions). The authors extracted lessons learned from these abstracts. Many of the projects detailed in this article continue to make an impact at multiple levels. While not all projects were scientifically rigorous enough to be published on their own and the quality of the data presented in the abstracts varied widely, many provide innovative ideas for potentially solving long-standing problems that may have been overlooked or not considered sufficiently. These projects and their subsequent analysis demonstrate that, not only do medical students make significant impacts on the health system, patients, and other health professionals when equipped with HSS skills, working in health care teams, and advised by mentors, but they also may be able to address some of medicine's and medical education's long-standing challenges. The fresh perspective and high energy of medical students is valuable and should be nurtured and encouraged.

EXECUTIVE SUMMARY The Argus Commission examined changes that should be considered by colleges and schools of pharmacy to meet the bold aim of better integrating pharmacists’ and physicians’ practices articulated by President Sorensen. The Commission assessed the readiness of pharmacy educators to contribute to the acceleration of practice transformation. The primary focus of the report is on how the doctor of pharmacy curriculum and post-graduate training might be modified and better aligned to ensure that graduates complete their education ready to engage in roles partnered with primary care clinicians. The aim is to achieve comprehensive medication management and other pharmacist patient care services as standards of care. The Argus Commission provides preliminary recommendations for new or more intensified priorities by the 2020-21 AACP Strategic Planning Committee as they update the AACP plan. This includes the recommendation that AACP should create the Center for Academic Innovation and Practice Transformation, a hub to coordinate many current and emerging activities relevant to accelerating change in pharmacy education and practice.

Issue: Despite clear relevance, need, descriptive literature, and student interest, few schools offer required curriculum to develop leadership skills. This paper outlines a proposed shared vision for leadership development drawn from a coalition of diverse medical schools. We advocate that leadership development is about self (looking inward), teams (not hierarchy), and change (looking outward). We propose that leadership development is for all medical students, not for a subset, and we believe that leadership curricula and programs must be experiential and applied. Evidence: This paper also draws on the current literature and the experience of medical schools participating in the American Medical Association's (AMA) Accelerating Change in Medical Education Consortium, confronts the common arguments against leadership training in medical education, and provides three cross-cutting principles that we believe must each be incorporated in all medical student-centered leadership development programs as they emerge and evolve at medical schools. Implications: By confronting common arguments against leadership training and providing a framework for such training, we give medical educators important tools and insights into developing leadership training for all students at their institutions.

The number of global tobacco-related deaths is projected to increase from about 6 million to 8 million annually by 2030, with more than 80% of these occurring in low- and middle-income countries (LMICs). The World Health Organization Framework Convention on Tobacco Control (FCTC) came into force in 2005 and Article 14 relates specifically to the treatment of tobacco dependence. However, LMICs, in particular, face several barriers to implementing tobacco dependence treatment. This paper is a descriptive evaluation of a novel grant funding mechanism that was initiated in 2014 to address these barriers. Global Bridges. Healthcare Alliance for Tobacco Dependence Treatment aims to create and mobilize a global network of healthcare professionals and organizations dedicated to advancing evidence-based tobacco dependence treatment and advocating for effective tobacco control policy. A 2014 request for proposals (RFP) focused on these goals, particularly in LMICs, where funding for this work had been previously unavailable. 19 grants were awarded by Global Bridges to organizations in low- and middle-income countries across all six WHO regions. Virtually all focused on developing a tobacco dependence treatment curriculum for healthcare providers, while also influencing the political environment for Article 14 implementation. As a direct result of these projects, close to 9,000 healthcare providers have been trained in tobacco dependence treatment and an estimated 150,000 patients have been offered treatment. Because most of these projects are designed with a “train-the-trainer” component, two years of grant funding has been a tremendous catalyst for accelerating change in tobacco dependence treatment practices throughout the world. In order to foster such exponential growth and continue to maintain the impact of these projects, ongoing financial, educational, and professional commitments are required.

Volatility, uncertainty, ambiguity, and complexity (VUCA) are drivers in today’s business world. Therefore, an increasing number of organizations implement agility (agile methods) to cope with the rapid and accelerating change. However, these agile transformations do not succeed unhindered, and some fail. One reason for that is the employees lacking an agile mindset and they do not support or participate in the transformation. So far, knowledge of the agile mindset is in its infancy. A conceptualization for developing a measuring instrument on the individual level is lacking. Furthermore, the relevance of the agile mindset regarding organizational performance in a VUCA world is still unclear. Our study aims to close this gap. To do so, we examine the agile mindset with 15 qualitative interviews and conduct an online survey (N=449) to predict organizational agility and organizational performance based on the agile mindset. As for results, we conceptualize the agile mindset as an attitude that comprises four dimensions: ’learning spirit’, ‘collaborative exchange’, ‘empowered self-guiding’, and ‘iterative value creation’. We have found an indirect effect of the agile mindset affecting organizational performance towards organizational agility. These findings contribute to the agility and management research by providing both a conceptualization and a measuring instrument for the agile mindset. Furthermore, the agile mindset´s relevance in agile transformation is explained and its relation to organizational performance outlined. For successful agile transformation, executives must focus on the agile mindset of their employees and foster this by e.g. being a role model.

The continued exponential growth of the price-performance of computing is likely to effectuate technologies that radically transform both the global economy and the human condition over the course of this century. Conventional visions of the next 50 years fail to realistically account for the full implications of accelerating technological change driven by the exponential growth of computing, and as a result are deeply flawed. These flawed visions are, in part, a consequence of three interrelated errors in reasoning: 1) the linear projection fallacy, 2) the ceteris paribus fallacy, and 3) the arrival fallacy. Each of these informal fallacies is likely a manifestation of shortcomings in our intuitions about complex dynamic systems. Recognizing these errors and identifying when and where they affect our own reasoning is an important first step toward thinking more realistically about the future.

The authors performed a review of 30 Accelerating Change in Medical Education full grant submissions and an analysis of the health systems science (HSS)-related curricula at the 11 grant recipient schools to develop a potential comprehensive HSS curricular framework with domains and subcategories.In phase 1, to identify domains, grant submissions were analyzed and coded using constant comparative analysis. In phase 2, a detailed review of all existing and planned syllabi and curriculum documents at the grantee schools was performed, and content in the core curricular domains was coded into subcategories. The lead investigators reviewed and discussed drafts of the categorization scheme, collapsed and combined domains and subcategories, and resolved disagreements via group discussion.Analysis yielded three types of domains: core, cross-cutting, and linking. Core domains included health care structures and processes; health care policy, economics, and management; clinical informatics and health information technology; population and public health; value-based care; and health system improvement. Cross-cutting domains included leadership and change agency; teamwork and interprofessional education; evidence-based medicine and practice; professionalism and ethics; and scholarship. One linking domain was identified: systems thinking.This broad framework aims to build on the traditional definition of systems-based practice and highlight the need for medical and other health professions schools to better align education programs with the anticipated needs of the systems in which students will practice. HSS will require a critical investigation into existing curricula to determine the most efficient methods for integration with the basic and clinical sciences.

Purpose The impact of changing roles, skill mix and a shortage of consultant radiologists on the profession of diagnostic radiography is not clearly understood in Scotland although the anecdotal perspective suggests the situation in many areas does not equate to that of England. Method A questionnaire survey was administered to ‘lead diagnostic radiographers' across all Health Boards in Scotland and this was supplemented with telephone interviews. Results The implementation of skill mix initiatives and particularly advanced/extended scope practice was found to be geographically variable with limited evidence of change in some areas. Lack of effective funding and backfill for training was found to be a major barrier to change, although it was also acknowledged that opposition from some professional groups could be a major factor. Conclusion Although there is some optimism and evidence of accelerating change, development of the radiographic workforce in Scotland does not in general compare favourably to the findings of Price et al., in 2007. The reasons are multi-factorial including fiscal, professional and geographical elements.

NCS are the contents such as knowledge, technology, and culture demanded for performing the duties in the industrial field systemized by a nation classified with industrial divisions and levels. It is an ability standardized in the national level necessary for performing duties of industrial field successfully. Now, the society structure, due to abrupt change and development, has to secure core ability demanded to human resources in common, irrespective of kinds and positions, and lays an emphasis on vocational basis ability to softly cope with the accelerating change of labor market. This dissertation, on the basis of NCS-based vocational education curriculum, focuses on information ability, computer use ability(information management ability), one of vocational core competency used for the duties related at the department of video & broadcasting to develop learning module. In addition, this dissertation researches learning results such as satisfaction and accomplishment over learning on the object of the students who took the education.

A new wave of technological innovations, often called “fintech,” is accelerating change in the financial sector. What impact might fintech have on financial services, and how should regulation respond? This paper sets out an economic framework for thinking through the channels by which fintech might provide solutions that respond to consumer needs for trust, security, privacy, and better services, change the competitive landscape, and affect regulation. It combines a broad discussion of trends across financial services with a focus on cross-border payments and especially the impact of distributed ledger technology. Overall, the paper finds that boundaries among different types of service providers are blurring; barriers to entry are changing; and improvements in cross-border payments are likely. It argues that regulatory authorities need to balance carefully efficiency and stability trade-offs in the face of rapid changes, and ensure that trust is maintained in an evolving financial system. It also highlights the importance of international cooperation.

Community-managed reserves (CMRs) comprise the fastest-growing category of protected areas throughout the tropics. CMRs represent a compromise between advocates of nature conservation and advocates of human development. We ask whether CMRs succeed in achieving the goals of either. A fixed reserve area can produce only a finite resource supply, whereas human populations exploiting them tend to expand rapidly while adopting high-impact technologies to satisfy rising aspirations. Intentions behind the establishment of CMRs may be admirable, but represent an ideal rarely achieved. People tied to the natural forest subsist on income levels that are among the lowest in the Amazon. Limits of sustainable harvesting are often low and rarely known prior to reserve creation or respected thereafter, and resource exhaustion predictably follows. Unintended consequences typically emerge, such as overhunting of the seed dispersers, pollinators, and other animals that provide services essential to perpetuating the forest. CMRs are a low priority for governments, so mostly operate without enforcement, a laxity that encourages illegal forest conversion. Finally, the pull of markets can alter the “business plan” of a reserve overnight, as inhabitants switch to new activities. The reality is that we live in a hyperdynamic world of accelerating change in which past assumptions must continually be re-evaluated.

Lesbian, gay, bisexual, and transgender (LGBT) populations face numerous barriers when accessing and receiving healthcare, which amplify specific LGBT health disparities. An effective strategic approach is necessary for academic health centers to meet the growing needs of LGBT populations. Although effective organizational change models have been proposed for other minority populations, the authors are not aware of any organizational change models that specifically promote LGBT inclusion and mitigate access barriers to reduce LGBT health disparities. With decades of combined experience, we identify elements and processes necessary to accelerate LGBT organizational change and reduce LGBT health disparities. This framework may assist health organizations in initiating and sustaining meaningful organizational change to improve the health and healthcare of the LGBT communities.

The chapter recognizes fundamental aspects of change as crucial barriers that block the critical power sector from adapting to a complex future, such as the Pace Problem (despite relative advances made by utilities in adapting to changes, more aggressive, speedier change outside the industry leaves utilities falling behind, raising consequent risks to long-term stability in this essential industry). This chapter offers a compelling solution that borrows successful best practices from other industries to accelerate adaptation to change. It proposes a framework for Iterative Innovation to accelerate the pace of change inside individual utilities and the industry as a whole. Integrating this five-step framework with a five-phase business transformation maturity model creates a standardized platform for change—Quintessential Innovation (Q2i)—to answer the confounding aspects of ongoing and accelerating change. By adapting this platform for an expanding energy ecosystem, utilities can also unite with consumers and rising prosumers for integrated, sustainable, innovative change.

Purpose – Compliance is defined as conforming to a rule, such as a policy framework, standard or law. Regulatory compliance encompasses all processes that require an entity to be aware of and conform to relevant regulations. As a result, organisation of compliance function remains complex due to the overwhelming set of compliance requirements that exert pressure on various business segments. This report aims to investigate how banks and financial services firms are responding to the regulatory-driven changes to the current compliance landscape, with particular attention paid to nascent challenges and structural changes affecting the organisation of compliance. Design/methodology/approach – The current research project is based on in-depth, semi-structured interviews with five universal banks and three financial services firms to pursue the best practices of adapting to the accelerating change in the regulatory-driven compliance landscape. Findings – In the aftermath of the global financial crisis, banks and financial institutions across the globe have been required to adapt to numerous regulatory reforms that are exerting increased pressure on compliance functions. Amid recent events of multi-million fines to banks that displayed flawed surveillance systems and control failings, the changing regulatory landscape has shown that the relationship with the regulators and compliance with the new regulatory frameworks is a difficult process even for the tier-1 global banks. Originality/value – Embarking on a peer review of the structures, roles, strategies and responsibilities of different compliance functions across banks and financial services institutions, this paper provides advice to financial institutions on ways of dealing with the complex emerging issues to ensure that the regulatory and compliance arrangements do not turn detrimental. At this point, the paper recognizes that the precise design of a compliance function will vary across individual banks and financial services firms. Nonetheless, this paper addresses the root issues and characteristics that are commonly shared despite the differences in organisations of compliance.

At the present time characterized by globalizing market, increasing competition, accelerating change and the occurrence of many risks it is necessary for businesses, which want to remain competitive, to be able to respond flexibly to the changes in a timely manner and to identify and manage risks. Companies try to diversify business risks, such as the loss of market share in the domestic market, by entering the foreign markets and participating in international trade. Involvement in the internationalization process cannot be understood only as an opportunity to achieve greater profits and a competitive advantage, it is necessary to consider potential risks accompanying this process, because engaging in the internationalization process may bring the companies many different specific risks. It would be useful for companies to identify the factors of failure resulting from internationalization. Identifying the barriers to internationalization, the main risk factors associated with it and designing their possible prevention or elimination could provide SMEs an impetus to enter foreign markets. Although the risk is a frequently discussed issue in the international discussion, only few studies were strictly focused on risk management in the internationalization process. Risk management is a broad discipline that requires a specific knowledge in practice. However, particularly small and medium-sized enterprises are often unable to identify the potential risks of the internationalization process and therefore are not able to manage the risks. This is due to the fact that SMEs usually do not have managers with a deep knowledge of risk management and, moreover, these managers also often lack experience with foreign markets. Unfortunately, the surveys of SMEs conclude that the poorly predicted risks of entering foreign markets are one of the most common causes of failure of SMEs internationalization process.The main objective of this paper is to identify the risks of the internationalization process of Czech small and medium-sized enterprises. To achieve the main aim, it was necessary to make a survey of current situation in Czech small and medium-sized enterprises with focus on the participation in international trade, compared to the situation of these enterprises in recent years. It was also important to define the risk factors faced by Czech small and medium-sized enterprises in connection with the entry and activities on foreign markets and to identify key risk factors SMEs in the internationalization process are exposed to. It was also necessary to find out the obstacles to the internationalization process affecting the decision of Czech SMEs to penetrate foreign markets. And the last but not least task was to suggest some elementary methods that could be used by Czech small and medium-sized enterprises to eliminate risks in their internationalization process.

by EJ Wals and BP Corcoran, Netherlands, Wageningen Academic Publishers, 2012, 550 pp., €69 (hardback), ISBN 978-1-4020-9685-3 This is an ambitious book, and is weighty in every sense. Its 31 chapt...

Despite wide consensus on needed changes in medical education, experts agree that the gap continues to widen between how physicians are trained and the future needs of our health care system. A new model for medical education is needed to create the medical school of the future. The American Medical Association (AMA) is working to support innovative models through partnerships with medical schools, educators, professional organizations, and accreditors. In 2013, the AMA designed an initiative to support rapid innovation among medical schools and disseminate the ideas being tested to additional medical schools. Awards of $1 million were made to 11 medical schools to redesign curricula for flexible, individualized learning pathways, measure achievement of competencies, develop new assessment tools to test readiness for residency, and implement new models for clinical experiences within health care systems. The medical schools have partnered with the AMA to create the AMA Accelerating Change in Medical Education Consortium, working together to share prototypes and participate in a national evaluation plan. Most of the schools have embarked on major curriculum revisions, replacing as much as 25% of the curriculum with new content in health care delivery and health system science in all four years of training. Schools are developing new certification in quality and patient safety and population management. In 2015, the AMA invited 21 additional schools to join the 11 founding schools in testing and disseminating innovation through the consortium and beyond.

Currently a wealth of data is available that can help inform both global and national efforts toward FGM/C abandonment. This information can help identify where and with whom to work as well as provide insight about potential opportunities for accelerating change. While national data can provide a useful snapshot of the extent of the problem in a country further analysis that compares age cohorts and takes into account age at cutting as well as subnational variations by region or ethnicity can provide even greater insight about trends over time and population groups where the practice is concentrated. Careful analysis of data on daughters can also provide important information about the effectiveness of particular interventions. This report looks at the main sources of data of FGM/C where it is practiced and among how many number of girls and women affected and the variation in when and how FGM/C is performed.

In 1987, the authors of Our common future argued that unless the world embraced and operationalized sustainable development, it would risk being overwhelmed by a series of interlocking crises related to population growth, urbanization, poverty and environmental degradation. Since then, many authors have argued that the world is on a worst case scenario trajectory. Post-Rio assessments of progress towards sustainable development have been largely negative. Since 1987, climate change has added a new stressor to the mix while shortening the time frame for transformation. In the context of accelerating change and converging stresses is the concept of sustainable development as compelling today as it was twenty years ago? Is it reasonable to believe there are means by which to reduce poverty and simultaneously protect the environment? This article briefly reviews the global challenges that first stimulated the concept of sustainable development and asks how contemporary processes of global change are affecting both these challenges and this approach to addressing them. While there are some grounds for optimism, several variables are identified that make sustainable development increasingly difficult to design and implement. The article concludes with an evaluation of how these difficulties might be overcome, and why it is essential that we try.

This study investigates the complex relationships between organisational strategic change, developing accountabilities, and materialised values in the emerging public-service network. The study highlights the importance of bilateral governance, relational forms of behaviour, and the voluntary exchange of information that is based upon shared values and that regulates networked behaviour in a much less overt way than formal attempts at control. In these circumstances accountancy basically serves as an assistant, helping to mediate, shape and construct inter-organisational relations through various socio-economic and discursive power-based mechanisms. The results indicate that for some organisations value-based management may still have elements of value-adding contributions of a more non-financial and social nature despite the veneer of the rhetoric. In combining participation in development work, work in practice, and theoretical analysis, the study carries both theoretical and practical implications.

PurposeThis article seeks to introduce how the convergence of globalization, emergence of the knowledge society and accelerating change contribute to what might be best termed a new paradigm of knowledge production in higher education.Design/methodology/approachA review of the literature was conducted regarding the three driving trends of the new paradigm. Following a discussion on these trends, the new paradigm is discussed in relation to old and emergent paradigms of the twenty‐first and twenty‐second centuries.FindingsThe article concludes that the new paradigm requires a systems approach to thinking and leading in higher education.Practical implicationsThis article provides a macro‐level perspective of the three phenomena as they impact higher education. Such perspectives provide insight to higher education leaders throughout the world on how tertiary institutions relate to the new paradigm of knowledge production. By putting the pieces of the new paradigm together, improved leadership directions for higher education and relevant policy actions may be identified to secure success through the twenty‐first century and beyond.Originality/valueWhile the three component trends in the new paradigm are not unknown to the academic community, discussion of the trends as elements of a larger system is absent from most literature. Together, these new patterns of thought and belief are forming to harness and manage the chaos, indeterminacy, and complex relationships of the postmodern.

In England, numerous government policies and initiatives have been developed to encourage the active participation of patients in their care and to engage the public in the planning and development of health services. Despite an intense focus, progress in this area has been disappointingly slow. The concept of patient and public involvement (PPI) is often dismissed by critics as irrelevant and impractical and true patient engagement is still the exception rather than the rule. In order to move away from a tokenistic approach to PPI there is much work to be done. National patient surveys provide a valuable evidence base for monitoring levels of involvement. Examples from the Patients Accelerating Change programme show the positive difference that effective, well-executed involvement can achieve. Such demonstrations of the added value of partnership working are essential to help ensure that involvement becomes embedded within the culture of healthcare organisations.

PurposeThe purpose of this paper is to describe an approach to managing the supply chain from the perspective of design which the paper refers to as integrated collaborative design (ICD).Design/methodology/approachBuilding on a substantial program of research using a range of methodologies previously reported, the concept of a design chain is described the argument is made that the industry needs to center the development of integrated teams (as proposed in accelerating change) around collaborative working of all parties involved in the design process.FindingsThe research recognizes that the construction sector is too often focused on the short‐term objectives of projects, rather than long‐term business strategy and organizational relationships. The ICD approach involves three steps: identifying tasks (process management); allocating roles (as part of supply chain management); and focusing design solutions to deliver value.Originality/valueThe paper outlines the principles and approach to ICD and provides a strategic overview within which various techniques and practices can be utilized to integrate organizations and more effectively manage the design process.

It has been estimated that approximately 50 percent of technology implementation failures are due to scheduling and budget issues and 27 percent are due to customer dissatisfaction. If typical technology solutions face these odds, how can riskier emerging technology and innovation activities succeed? This paper describes the IBM Technology Adoption Program (TAP), an effort by its technology and innovation team to formalize its innovation management discipline. Instead of using structured governing processes, the program uses an organic approach for accelerating change. TAP is focused on cultivating and harnessing the existing early adopter and innovator communities within the enterprise to shorten the technical development cycle and deliver solutions that engage a variety of users, ensuring rapid, widespread accommodation. We describe TAP in the context of the challenges enterprises face in fostering and measuring innovation, focusing on three key areas: rallying the community, encouraging the technical investment supporting the community, and gauging the priority and value of new technology. We present several examples to illustrate the benefits that materialize from overcoming obstacles and delivering significant innovation.

This article examines three practices of strategising/organising – strategy workshops, the project management of strategic and organisational initiatives, and the creation of symbolic artefacts to communicate strategic change. These are seen through a practice theory lens that emphasises practical activity and the tight linkage between strategising and organising. The article argues that, in a world of accelerating change, approaching strategy and organisation as interlinked and practical activities is more effective than traditional static and detached approaches that, privilege analysis. As change drives repeated strategising/organising, it is mastery of the tools and procedures that matters, at least as much as the perfection of any transitory design. Drawing on a qualitative study of ten strategic reorganisations, the article analyses particular vignettes of strategy workshops, strategy projects and strategy artefacts in action. A common theme across all three practices is the importance of hands-on, practical crafting skills in getting strategising done. The article argues for a greater recognition of these kinds of craft skills in strategy, alongside traditional analytical skills, and addresses implications for practitioners and business schools. For practitioners, there is no need to reject formal strategy making, as some critics have proposed. Rather, practitioners can renew formal strategy by injecting craft directly into the process. Business schools, as managerial trainers for the strategy process, should extend both their research and their teaching. Strategy research needs to move beyond its traditional domain of economic analysis in order to understand the whole range of effective practices in strategising/organising work, drawing on close observation of what strategists actually do. Strategy teaching needs to bring the practicalities of strategising/organising work directly into the mainstream strategy curriculum, instead of marginalizing them into adjacent sub-disciplines such as consulting skills.

The article provides an overview on the state of research with regard to a comparative analysis of health care systems. The focus is on the financing, provision, and regulation of health care systems. Finally, some concepts are discussed which aim at the development of a typology of health care systems. It is demonstrated that existing models (for instance, a Beveridge versus a Bismarck type of system or a National Health Service type versus a Social Insurance type) are not sufficient to capture the accelerating change of health care systems in a systematic way. The development of a health care system typology, based on concepts which are discussed in this article, is a promising objective of future research.

Recent education policy in the UK has encouraged universities and industry to work in partnership as a means of improving the quality of student learning and preparing graduates to enter the workplace. Indeed, both the Lambert Review of Business–University Collaboration (Lambert, 2003) and the White Paper on The Future of Higher Education (DfES, 2003) highlight the need for collaboration and closer working relationships. This paper reports on the results of a research effort to assess the extent of university–industry collaboration in the UK's built environment sector and to measure the impact of such activity. The ‘Accelerating Change in Built Environment Education’ (ACBEE) initiative sought to identify the nature of engagement activities in the built environment and to formulate, evaluate and develop guidelines for best practice. Forty case studies of engagement were collected from the built environment sector using a standard template, and many sustained engagement activities and established collaborations were identified. The paper explains how these case studies were categorized and evaluated to develop an understanding of the nature of the different types of engagement. A framework was subsequently developed for the classification of the case studies. Finally, the paper considers how the quality of such engagement can be measured and proposes appropriate key performance indicators.

PurposeThe purpose of this survey was to evaluate the impact and experience of the Patients Accelerating Change (PAC) project from the perspective of 28 people who were closely involved in the project.Design/methodology/approachData were collected by telephone interview with 28 individuals from nine acute NHS Trusts which piloted the PAC project.FindingsPAC was seen to make a positive impact in terms of improving communication and information, helping patients feel valued and listened to, providing real direction as a result of listening to feedback from patients, and improving processes and procedures in the participating Trusts. The PAC project raised the profile of the Patient and Public Involvement Agenda within the NHS Trust organisations that participated in the project.Research limitations/implicationsThe PAC project was still in its infancy at the time of data collection for this study, and over half of the sample was likely to have been composed of enthusiasts for the process: this may have contributed to a positive bias.Practical implicationsThe PAC project works on a “staggered approach” in terms of realising short‐ and then long‐term improvements in the patient's experience. By the end of the project it was expected that some “quick wins” could be identified and the PAC organisers acknowledged that more time is needed in order to realise longer‐term improvements.Originality/valueThis survey provides useful information to patients and staff at NHS Trusts who may be considering how best to involve patients in planning and improving the quality of care that they receive.

Sir John Egan's 1998 report on the construction industry (Construction Task Force 1998) noted its confrontational and adversarial nature. Both the original report and its subsequent endorsement in Accelerating Change (Strategic Forum 2002) called for improved working relationships—so-called ‘integration’—within and between both design and construction aspects. In this paper, we report on our observations of on-site team meetings for a major UK project during its construction phase. We attended a series of team meetings and recorded the patterns of verbal interaction that took place within them. In reporting our findings, we have deliberately used a graphical method for presenting the results, in the expectation that this will make them more readily accessible to designers. Our diagrams of these interaction patterns have already proved to be intuitively and quickly understood, and have generated interest and discussion among both those we observed and others who have seen them. We noted that different patt...

The paper examines the contribution of inscriptions, in particular new accounting measures, to a process of transforming the ethos and operations of ‘Britech', a high-tech division of a major British manufacturer. Focusing upon the increased and changing use of inscriptions at this site, we interpret them as moves to signify and facilitate an increasingly “commercial” orientation towards activities. We describe how new writings, particularly new management accounting measures, were deployed to create spaces of representation in which traditional views and practices were problematized in a strategic effort to constitute a new organisational reality for Britech employees. The new systems of inscription, we argue, were a key resource in the translation of established practices. This translation was facilitated by writings that expressed and promoted conditions of accelerating change that were prompted by pressures to avoid closure or divestment of the Britech assembly site. Analysis of the inscriptions is thus of significance for understanding how a human agency deemed capable of enacting the new commercial agenda at ‘Britech' is constituted and reproduced.

Forces that are transforming the global economy are now sweeping through higher education. As the higher education environment becomes more turbulent, administrators and academic leaders are caught between opposing forces that both demand and resist change. Suggests five strategies to help universities adapt to the changing environment while preserving important academic values.

Over the past few decades universities in the United Kingdom have undergone fundamental and accelerating change with the resultant outcome of a radical move from what can be described as an elitist model of education to a popular or "populist" model. Entrance routes to higher education courses of study have diversified, and as a consequence the student population has also diversified in terms of age, gender, ethno-religious background and socio-economic profile. This paper describes one author's response to these changes and assesses his implementation of a technologically rich approach to introducing the principles of business marketing to under-graduate students. The political, intellectual and institutional contexts which generated the desire to make increased use of technology in the classroom are considered as well as student feedback. The paper concludes with some recommendations for possible areas of development in the use of computer technology as a means of improving the quality of learning and teaching.