Biomedical subjects

Colin Coles

Publications and source records attributed to Colin Coles.

4 recordsLinked to original sources

PubMed2002

Developing professional judgment.

The concept of professional judgment is considered, including its theoretical foundations, how it is developed, and how it may be assessed. Professionals are asked to engage in complex and unpredictable tasks on society's behalf, and in doing so must exercise their discretion, making judgments--decide what is "best" in the particular situation rather than what is "right" in some absolute sense. Inevitably, some of these judgments lead to "error," which is endemic to professional practice. This challenges some current ideologies in health care regarding the primacy of evidence-based practice and the application of protocols. At the foundation of professional judgment is a form of knowledge--called practical wisdom--which is not formally taught and learnt but is acquired largely through experience and informal conversations with respected peers. Wisdom develops through "the critical reconstruction of practice," including deliberation, which is distinguished from mere reflection. Professionals need to engage in the appreciation of their practice--not just to understand what informs their own practice but to consider critically the contestable issues endemic to practicing as a professional.

Decision Making↗

PubMed2002

Enhancing reliability in portfolio assessment: discussions between assessors.

This paper reports the reliability in assessments of a series of portfolios assembled by a cohort of participants attending a course for prospective general practice trainers. Initial individual assessments are compared with open discussion between random pairs of assessors to produce paired composite scores, and analysed using kappa statistics. Overall reliability of a global pass/refer judgement improved from a kappa of 0.26 (fair) using individual assessment, to 0.5 (moderate) with paired discussants.

Cohort Studies↗

PubMed2001

Enhancing reliability in portfolio assessment: 'shaping' the portfolio.

This paper reports a follow-on project that assessed a series of portfolios assembled by a cohort of participants attending a course for prospective general practice trainers. In an attempt to enhance reliability, a framework for defining and addressing problems using a reflective practice model was offered to participants. The reliability of the judgements made by a panel of assessors about individual 'components', together with an overall global judgement about performance were studied. The reliability of individual assessors' judgements (i.e. their consistency) was moderate, but inter-rater reliability did not reach a level that could support making a safe summative judgement. Despite offering a possible structure for demonstrating reflective processes, the levels of reliability reached were similar to the earlier work and other subjective assessments generally, and perhaps reflected individuality of personal agendas of both the assessed and the assessors, and variations in portfolio structure and content; even agreement among the assessors about evidence of the framework being used was poor. Suggestions for approaches in the future are made. The conclusion remains that while portfolios might be valuable as resources for learning, as assessment tools they should be treated as problematic.

Journal Article↗

PubMedDate not supplied

Self-management in diabetes: training implications for professional carers.

A workshop was convened to examine factors determining patient self-management and implications for those providing care. It was attended by 15 doctors and 15 nurses with considerable expertise in education for those with diabetes. Discussion included: the experience of training programmes to date; factors determining effective patient self-management; the implications for training of professionals, skills required, their current availability and proposals for their development. The conclusions were that training and experience of these skills are both inadequate. Programmes of training, which are equally applicable to the management of other chronic diseases, should be embedded in the system of care and delivered at local level. Regional or national programmes are required to develop trainers in all districts able to deliver and maintain local programmes. This critical element of care in diabetes must be adequately funded if self-care standards are to be improved and expensive complications prevented.

Adaptation, Psychological↗