PubMed · 16035406
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Victoria Hoban. For the record.. https://pubmed.ncbi.nlm.nih.gov/16035406/
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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.
CONTEXT: In-training assessment (ITA), defined as multiple assessments of performance in the setting of day-to-day practice, is an invaluable tool in assessment programmes which aim to assess professional competence in a comprehensive and valid way. Research on clinical performance ratings, however, consistently shows weaknesses concerning accuracy, reliability and validity. Attempts to improve the psychometric characteristics of ITA focusing on standardisation and objectivity of measurement thus far result in limited improvement of ITA-practices. PURPOSE: The aim of the paper is to demonstrate that the psychometric framework may limit more meaningful educational approaches to performance assessment, because it does not take into account key issues in the mechanics of the assessment process. Based on insights from other disciplines, we propose an approach to ITA that takes a constructivist, social-psychological perspective and integrates elements of theories of cognition, motivation and decision making. A central assumption in the proposed framework is that performance assessment is a judgment and decision making process, in which rating outcomes are influenced by interactions between individuals and the social context in which assessment occurs. DISCUSSION: The issues raised in the article and the proposed assessment framework bring forward a number of implications for current performance assessment practice. It is argued that focusing on the context of performance assessment may be more effective in improving ITA practices than focusing strictly on raters and rating instruments. Furthermore, the constructivist approach towards assessment has important implications for assessment procedures as well as the evaluation of assessment quality. Finally, it is argued that further research into performance assessment should contribute towards a better understanding of the factors that influence rating outcomes, such as rater motivation, assessment procedures and other contextual variables.
OBJECTIVES: To determine whether it is possible to develop a feasible, valid, and reliable multisource feedback program (360 degree evaluation) for emergency physicians. METHODS: Surveys with 16, 20, 30, and 31 items were developed to assess emergency physicians by 25 patients, eight coworkers, eight medical colleagues, and self, respectively, using five-point scales along with an "unable to assess" category. Items addressed key competencies related to communication skills, professionalism, collegiality, and self-management. RESULTS: Data from 187 physicians who identified themselves as emergency physicians were available. The mean number of respondents per physician was 21.6 (SD +/- 3.87) (93%) for patients, 7.6 (SD +/- 0.89) (96%) for coworkers, and 7.7 (SD +/- 0.61) (95%) for medical colleagues, suggesting it was a feasible tool. Only the patient survey had four items with "unable to assess" percentages > or = 15%. The factor analysis indicated there were two factors on the patient questionnaire (communication/professionalism and patient education), two on the coworker survey (communication/collegiality and professionalism), and four on the medical colleague questionnaire (clinical performance, professionalism, self-management, and record management) that accounted for 80.0%, 62.5%, and 71.9% of the variance on the surveys, respectively. The factors were consistent with the intent of the instruments, providing empirical evidence of validity for the instruments. Reliability was established for the instruments (Cronbach's alpha > 0.94) and for each physician (generalizability coefficients were 0.68 for patients, 0.85 for coworkers, and 0.84 for medical colleagues). CONCLUSIONS: The psychometric examination of the data suggests that the instruments developed to assess emergency physicians were feasible and provide evidence for validity and reliability.