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J P Bellack

Publications and source records attributed to J P Bellack.

At least 37 records · Page 2Linked to original sources
PubMed1996

Environmental health competencies: a survey of U.S. nurse practitioner programs.

Because of widespread public and governmental concern about the health effects of environmental hazards and exposure in recent years, and the increasing incidence of environmentally-induced diseases, it is important that primary care nurse practitioners possess the knowledge and skills to effectively address environmental health as a component of their practice. A mailed questionnaire survey of 187 U.S. nurse practitioner (NP) programs was conducted, with a response rate of 64%, to determine: 1) current and ideal emphasis on environmental health, 2) faculty preparation for teaching environmental health, 3) environmental health competencies expected of graduates, 4) didactic and clinical contact hours devoted to environmental health, and 5) barriers and incentives to greater emphasis on environmental health. Findings reveal that more than two-thirds of NP program directors believe there should be greater emphasis on environmental health in their programs, but expressed concerns about overcrowded curricula and lack of faculty preparation as barriers to change. Competencies with the highest mean ratings included understanding the relationship between environmental hazards and human health, accessing information resources related to environmental hazards and health, and counseling clients about how they can reduce risks associated with environmental hazards. The two factors identified as most likely to increase the emphasis on environmental health in NP programs were having nurse faculty with expertise and being able to access information resources related to environmental health. Currently, insufficient attention is given to environmental health in nurse practitioner education programs.

Curriculum↗
PubMed1996

Environmental health training: a survey of family practice residency program directors.

BACKGROUND: The Institute of Medicine and the American College of Physicians have advocated that physicians broaden their participation in the environmental aspects of medical care. Accordingly, both organizations recommend training of future primary care physicians for greater competency in and appreciation of this area of medicine. This study assessed the present emphasis on environmental health in family practice residency programs by examining the extent program directors expect graduates to have specific competencies in environmental medicine. METHODS: A written survey was mailed to directors of all 393 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs. Respondents were asked to indicate the extent to which each of eight environmental health competencies was expected of their graduates. The list of environmental health competencies was based on the literature and on interviews with family practice educators. Perceptions about the "present" and "ideal" environmental health emphasis in their programs were also measured. RESULTS: A total of 262 completed surveys were returned for a response rate of 67%. Respondents reported that they expected their graduates to have general knowledge of and competence in environmental health areas that pertain to patient care. Competencies with social and political implications were least likely to be expected. Two thirds of respondents indicated that "minimal emphasis" is presently placed on environmental health. Seventy percent indicated that the "ideal" amount of emphasis placed on this topic is "moderate." CONCLUSIONS: This survey's results suggest that family practice residency program directors expect their graduates to know basic environmental health concepts and be skilled in related aspects of patient care. The development of environmental health training programs must take into account that environmental health may be viewed as a topic of secondary importance and that in most residencies, faculty expertise in this area is limited. For this reason, a self-tutoring strategy, aimed toward the educational needs of both faculty and residents, is recommended.

Curriculum↗
PubMed1996

Environmental health competencies: a survey of nurse practitioner programs.

Because of widespread public and governmental concern about the health effects of environmental hazards and exposure in recent years, and the increasing incidence of environmentally induced diseases, it is important that primary care nurse practitioners possess the knowledge and skills to effectively address environmental health as a component of their practice. A mailed questionnaire survey of 187 United States' nurse practitioner (NP) programs was conducted, with a response rate of 64%, to determine: 1) current and ideal emphasis on environmental health, 2) faculty preparation for teaching environmental health, 3) environmental health competencies expected of graduates, 4) didactic and clinical contact hours devoted to environmental health, and 5) barriers and incentives to greater emphasis on environmental health. Findings reveal that more than two thirds of NP program directors believe there should be greater emphasis on environmental health in their programs, but expressed concerns about overcrowded curricula and lack of faculty preparation as barriers to change. Competencies with the highest mean ratings included understanding the relationship between environmental hazards and human health, accessing information resources related to environmental hazards and health, and counseling clients about how they can reduce risks associated with environmental hazards. The two factors identified as most likely to increase the emphasis on environmental health in NP programs were having nurse faculty with expertise and being able to access information resources related to environmental health. Currently, insufficient attention is given to environmental health in NP education programs.

Clinical Competence↗
PubMed1995

Environmental health in medical school curricula: views of academic deans.

Academic deans at 126 US medical schools were surveyed in Spring 1994. Comparisons of means and frequencies, multiple regression, and factor analysis were used. Study results showed only low to moderate expectations for graduate competence in seven environmental health competency areas. Over two-thirds of deans (70%) indicated that there was "minimal" emphasis on environmental health at their schools; 61% thought that ideally there should be "moderate" emphasis. An "already crowded curriculum" and "too few qualified faculty" were frequently cited as barriers to greater emphasis on environmental health. Students were identified most commonly as the group expressing the greatest support for environmental health education. Although there was not a clear consensus, occupational medicine departments were most often selected as best suited to offer environmental medicine education.

Attitude↗
PubMedDate not supplied

Curriculum trends in nurse-midwifery education. Views of program directors.

The purpose of this study was to determine the extent to which nurse-midwifery education programs are addressing the practice competencies that have been recommended by the Pew Health Professions Commission and others as essential for effective practice in the 21st century. This study was part of a larger survey of eleven health professions education programs. The 56 nurse-midwifery program directors whose names and addresses were provided by the American College of Nurse-Midwives were surveyed by mailed questionnaire, with a response rate of 59% (n = 33). The study sought to identify current and ideal emphasis placed on 33 broad topics, most important curriculum topics, and barriers to curriculum change as perceived by respondents. Findings revealed that nurse-midwifery program directors would like to see greater emphasis placed on every topic except one (tertiary/quaternary care). Desired increases ranged from .04 to 1.36. The overall mean rating for all topics was 3.51 for current emphasis (5-point scale) and 4.18 for ideal emphasis, both of which were higher than any other survey group. The greatest desired increases (> 1.00) were for "primary care," "managed care," "use of electronic information systems," and "business management of practice." Respondents identified "primary care," "health promotion/disease prevention," and "accountability for cost-effectiveness and patient outcomes" as the most important topics. The top three barriers to curriculum change were identified as "already crowded curriculum," "inadequate funding," and "limited availability of clinical learning sites," the last being statistically significant compared with other survey groups. Findings indicate that nurse-midwifery program directors perceived that they are adequately addressing most of the curriculum topics, while continuing to focus on the need for curriculum change as the health care environment changes.

Curriculum↗
PubMedDate not supplied

Curriculum trends in nurse practitioner programs: current and ideal.

The purpose of this study was to ascertain the extent to which nurse practitioner (NP) education programs are addressing curriculum topics related to practice competencies needed for the next century as recommended by the Pew Health Professions Commission and other professional organizations, including the American Association of Colleges of Nursing and the National Organization of Nurse Practitioner Faculties. The study was part of a comprehensive survey of 11 health professions education programs. NP program directors indicated greatest dissatisfaction with curriculum coverage of "use of electronic information systems" and "business management of practice." The three most important curriculum topics identified by respondents were "primary care," "health promotion/disease prevention," and "effective patient-provider relationships/communication," identical to the three topics rated most important by all groups combined. The most significant barriers to change identified by the respondents included "an already crowded curriculum" and "limited availability of clinical learning sites." Findings show that NP program directors perceive that they are doing an effective job addressing most of the 33 curriculum topics, but they also recognize a need to continue to improve their curricula in response to the ever-changing health care environment. Barriers to achieving the desired curricular improvements, however, may be significant. Recommendations for overcoming these barriers to change are offered.

Clinical Competence↗
PubMedDate not supplied

Developing BSN leaders for the future: the Fuld Leadership Initiative for Nursing Education (LINE).

The Helene Fuld Leadership Initiative in Nursing Education (LINE) program was designed to enhance beginning leadership competencies of baccalaureate nursing students. Given the increasing need for strong and effective leadership throughout the health care system, and the demands new graduates encounter as they move into practice, the LINE program is built on the premise that leadership skills must be instilled at the undergraduate level. The program achieves its goal through an intensive 5-day institute focused on assessing and developing the leadership competencies of nurse educators and their clinical partners to enable them to be effective agents of curriculum change in their home institutions. The institute also assists participants to redesign their baccalaureate nursing (BSN) curricula to ensure that students learn to: (1) work effectively within and across complex, integrated organizational and institutional boundaries; (2) think and act from the perspective of a system; and (3) communicate, negotiate, lead, and facilitate change within health care organizations. D. Goleman's (1998) framework of emotional intelligence, which addresses both personal competence (managing oneself) and social competence (handling one's relationships with others) provides the framework for operationalizing leadership in the BSN curriculum. To date, 26 BSN programs and their clinical partners have participated in the LINE program, which has the potential to influence the beginning leadership development of more than 2,400 BSN students. Program outcomes reveal that education-practice collaboration, professional networking, individual leadership development of nurse educators and their clinical partners as change agents, and the integration of leadership experiences at all levels of the BSN curriculum are important in developing beginning leadership competencies in BSN students.

Communication↗
PubMedDate not supplied

Characteristics and outcomes of a statewide nurse refresher project.

This article describes a 3-year, federally funded statewide nurse refresher course offered by the South Carolina Area Health Education Consortium (S.C. AHEC) to address the state's nursing shortage. A total of 222 inactive RNs enrolled in the 160-hour course during the project period. A follow-up survey of the first 160 graduates of the course revealed that 76% had returned to active nursing practice, the majority in hospital staff nurse positions. Forty percent of respondents returned to work full-time, the remainder part-time. Respondents were employed in 72 health care facilities in 36 different communities in the state. Nearly 25% reported working in rural, underserved areas designated as health professions shortage areas. A survey of employers of course graduates revealed a high degree of satisfaction with their performance. As health care reform takes shape and nursing roles shift, the nurse refresher course will be revised and updated to assure its continued relevance for current and future practice.

Education, Nursing, Continuing↗
PubMedDate not supplied

Recreating nursing practice for a new century. Recommendations and implications of the Pew Health Professions Commission's final report.

The erratic path of evolution of health care in the United States creates daunting threats as well as new opportunities for institutions, professionals, and the public. Perhaps no stakeholder has more to risk or gain than professional nursing. As the largest of all the health professions, nursing serves as the backbone for much of the care delivery system. Historically, nurses have been employed primarily in hospital settings. Toward the latter part of the 20th century, however, nurses assumed such expanded roles as independent practitioners, managers of care in large health plans, and providers of alternative and complementary health care services. These new roles point to how nursing may rapidly evolve as the health care system addresses continuing issues of cost, performance, access, and consumer satisfaction. While today's opportunities are great, threats remain to the traditional role of the nurse in the hospital setting, through regulatory constraints on nursing practice and the lack of clear purpose and direction within the broad professional nursing community. Following a decade of leadership and advocacy for health professions education, the Pew Health Professions Commission issued its fourth and final report in December 1998. In this report, the Commission assessed the challenges facing professionals in the 21st century and made general and profession-specific recommendations for action.

Delivery of Health Care↗
PubMedDate not supplied

A proposed framework for differentiating the 21 Pew competencies by level of nursing education.

Now nearly a decade old, the original Pew Health Professions Commission Competencies have stood up well to the test of time. The competencies were designed to provide all health professionals, from physicians to physical therapists, with a general guide to the values, skills, and knowledge they would need to be successful in the health care system that was beginning to emerge in the late 1980s. They have been used across the range of health professions and in many practice settings to create a framework for curricular change, work redesign, and assessment of professional competence. The interpretation of the competencies offered here should prove to be a useful tool to nurses and health system leaders as they carry on the hard work of adapting the current model of nursing practice to the demands and realties of the contemporary and continually evolving health care environment. This work is important for two reasons. First, many of the skills and attributes of the professional nurse are not adequately used or valued by the health care system because the profession is both fragmented and poorly differentiated and articulated. Without markers that define and promote collaborative practice within nursing, the full potential of nurses at all levels of preparation will continue to be inadequately and inappropriately deployed. This model exacerbates the current nursing shortage because it fails to use nurses in appropriate, well-delineated, and challenging roles. Without this kind of differentiation, one that can be owned and supported by all nurses, there will continue to be suboptimal use of the nursing workforce in the United States. The framework of differentiated Pew competencies and the companion teaching-learning strategies proposed here offer one approach to rationalizing both nursing education and practice, with the potential for improving the quality of care, and reducing fragmentation, cost, and public confusion.

Accreditation↗