PubMed · 14643125
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Martin Tattersall. 2003-11-22. Learning from experience?. https://doi.org/10.1016/s0140-6736(03)14855-6
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BACKGROUND: Recent European policies emphasise that the training and education of health professionals are a major means of improving mental health services. Little comparative research has been undertaken to ascertain the degree of homogeneity in the training of nurses working in mental health settings across Europe. OBJECTIVE: The aim of this study was to investigate the training of nurses working in mental health settings in a range of European countries. Specifically, information regarding criteria for entry into training, type of qualification awarded and further training opportunities was to be explored. METHODS AND PARTICIPANTS: A specially designed questionnaire was designed to gather data from senior mental health nurses working in the mental health field in a sample of 12 countries from across Europe. RESULTS: Findings disclosed considerable disparity between countries in respect to nurse training, with few countries requiring a specialist nursing qualification to practice in the mental health field. There appears to be little homogeneity in terms of educational provision pre and post-qualification. CONCLUSIONS: More research is needed into how European states deliver nurse training and education, how students are prepared for various practice settings and the effect on outcomes for service users of different models of training.
Use of locum medical officers is increasing in the NSW hospital system. Locums are expensive, and have highly variable expertise and experience. Locum employment arrangements are ambiguous. Locum work may divert junior doctors from participation in specialist training. Attempts to regulate the locum workforce must be accompanied by measures that increase the appeal of public hospital work and vocational training positions.
Despite astounding advances in scientific knowledge and technological capabilities, modern medicine is not free of significant problems. A persistent high rate of diagnostic errors, the prevalence of medical (iatrogenic) harm and the growing demand for complementary and alternative medicine indicate an urgent need for improvement. An important step is a return to three quintessential clinical paradigms that have become neglected with the advent of high-technology medicine: the need to emphasise prevention and early, presymptomatic diagnosis; the crucial role in decision making of skillful history taking and examination, backed by evidence; and enhanced attention to patient autonomy and emotional factors. Possible reasons for the current neglect of these Altneuparadigms ("old-new" paradigms) are considered, and techniques for restoring their primacy in medicine are discussed.