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Emotional competence in professional communication.

This paper explores the notion of emotional competence for professional practitioners and the impact of different levels of emotional competence on communication in mental health nursing practice. It comments on available approaches to assessing competence in this area and on factors that obstruct and impair such assessment. Practitioner awareness of both the concept of emotional competence and its assessment is examined at a professional and personal level. Strategies for the achievement and maintenance of effective communication and emotionally competent professional practice are proposed.

Clinical Competence↗

Nursing's epistemology revisited in relation to professional education competencies.

As nursing continues to debate entry-into-practice issues, it is important to re-examine patterns of knowing as well as their end products for the discipline in relation to the overall competencies of liberal and professional education. The changing landscape of society, along with the needed skills to provide comprehensive care that promotes the health and well-being of the people nursing serves, requires a close examination of what institutions of higher education can provide the discipline of nursing. A discussion of the epistemology of the nursing profession, needed competencies, and the goals of higher education are presented in this article. Patterns of knowing distinguish disciplines from one another. Nursing patterns of knowing and subsequent clinical, conceptual, and empirical knowledge require placement in institutions of higher learning that promotes both professional competencies and attitudes.

Clinical Competence↗

Dualistic level competencies for professional nursing practice: an international educational initiative.

Ensuring professional nurses are competent is integral to promoting quality outcomes for persons with spinal cord impairment (SCI). This project, funded by the American Association of Spinal Cord Injury Nurses (AASCIN), was designed to develop instruments to validate the competencies of registered nurses (RNs) caring for persons with SCI. The project expanded a 1994 model project focusing on the competencies of licensed practical nurses and licensed vocational nurses (LPNs/LVNs) and RNs in an adult rehabilitation setting. Using the earlier project as a foundation, investigators identified competencies for RNs applicable to the life span trajectory of persons with SCI including pediatric, adolescent, adult, and geriatric populations. Additionally, the focus was broadened to encompass acute, rehabilitation, outpatient community, and long-term settings. This innovative project resulted in the development of the SCI Knowledge/Skill Competency tool for dualistic competency levels of "competent" RNs with two years of recent SCI nursing experience, and "expert" RNs with five years of recent SCI experience. Additionally, the SCI Behavior Competency tool for the "competent" level was developed using hermeneutic techniques and Patricia Benner's (1983) framework, "Novice to Expert." This complemented the "expert" level tool devised in the 1994 model project. Implementation will enable RNs to validate the competencies that are essential to provide care that results in quality outcomes for persons with SCI, their families, and other consumers of SCI health care services.

Adult↗

To protect the public: professionalism vs competence in dentistry.

This paper uses evidence from reports in the British Dental Journal from 1958 to 1979 of disciplinary charges against dentists in the United Kingdom to question the General Dental Council's (GDC) claim that it is protecting the public in relation to the competence of dental practitioners. In that 20-year period only one charge out of 86 heard by the GDC Disciplinary Committee had to do with a possible lack of professional competence, whereas 47% of the charges were for fraud and other criminal offences, 18% were for drug-related offences, 18% were for sex offences and 16% were for breaches of professional ethics or discipline. The paper argues that the GDC has been much more concerned with developing a professional image and style for dentists than it has been with assuring an adequate level of dental care for patients by dentists once they graduate. Although the data used to support the argument are fom Britain and from dentistry, the argument may be extended to all professional occupations and countries where there is a State-enforced medical monopoly in relation to clients.

Certification↗

Using professional specialty competencies to guide course development.

This article describes how an RN-to-BSN community health nursing (CHN) course was reconceptualized from a traditional model to a competency-based model. The traditional course assigned students to CHN preceptors and required a set number of clinical contact hours. As clinical preceptor placement opportunities diminished, students and faculty became increasingly dissatisfied with the course structure and requirements. Faculty endorsed the use of professional competencies to measure course learning outcomes and selected competencies identified by the Association of Community Health Nursing Educators. These competencies were clustered into units, with learning activities and grading criteria based on the critical knowledge, values, and clinical skills needed to demonstrate mastery of specific competencies. Course faculty, rather than agency preceptors, assessed student learning outcomes and mastery of competencies. The students demonstrated mastery of competencies and liked the degree of self-directed learning that built on their professional status as RNs.

Clinical Competence↗

Education for the practice of occupational medicine: knowledge, competence, and professionalism.

The multistep process of education is delineated by the sequential phases: (1) Knowledge Transfer, (2) Competence Development, and (3) Professional Inculcation. The realities of practice modes and curricular time constraints are important determinants of the breadth and depth of the information provided in the Knowledge Transfer process. Accordingly, it is proposed that Phase 1, the Knowledge Acquisition Process, be organized into two components: (1) Core Knowledge, requiring both significant breadth and depth; and (2) Augmentive Knowledge, providing wide breadth and appropriate but variable depth. This curricular organizing proposition recognizes that: (1) the wide breadth of multiple stores of knowledge inherent in the practice of PM and EOM considerably exceeds many other medical specialities; (2) the duration of training is inherently shorter; and (3) its practitioners generally operate as members of teams consisting of other professionals (e.g., attorneys, engineers, business administrators, industrial hygienists, sociologists, psychologists). Obviously, it is unreasonable to expect the members of such teams to each have comparable depth and breadth of knowledge. A broad knowledge base, implicit in Augmentive Knowledge, provides the capacity for recognition, understanding, and application of capabilities brought by other professionals. Facilitating communications between team members, each possessing a broad knowledge base, enhances the effectiveness of the knowledge, competence, and professionalism of collaborative efforts. Phase 2, Competency, consists of the coherent integration of multiple stores of information applicable to the management of a clearly defined task with a clearly measurable outcome. The accomplishment of true competency is not based on the simple possession of multiple stores of knowledge; rather it depends on the facility and effectiveness with which information bases are marshaled, integrated, and communicated. Clearly, the effectiveness of this process increases with its interaction; it is unreasonable to expect a significant degree of competence immediately upon graduation from a training program. Phase 3, Professionalism, and its basic ethos provides the governing context for the sound application of competencies. Although it is difficult to teach, only with its accomplishment can the educational process be considered whole, albeit never complete.

Clinical Competence↗

The therapeutic partnership: legal and ethical aspects of consumer health information.

Patients' rights to information in the UK are based on a mixture of statute (including legislation on access to medical records) and case law (principally revolving around the issue of informed consent). These rights are set out in the Patient's Charter, which is itself a mixture of rights based on legislation and those enforced by management practice. Failure to provide adequate information to a patient could expose a medical practitioner to action for negligence or battery. Negligent information-giving could also expose consumer health information services to damages, for which the best defence is a high standard of professional competence and adequate professional indemnity insurance. Sharing information about the risks and benefits of treatment to enable truly informed decision making and consent by the patient is a key element of an ethical relationship between care giver and consumer--the therapeutic partnership.

Confidentiality↗

Project management: a core competency for professional nurses and nurse managers.

Project management is a core competency for nurses and managers. In this article, the project life cycle and project planning and controlling tools are described. Managers can readily see that using project management can be done with minimal training and disruption to the organization. Clearly, the costs of adopting project management are small compared to the benefits in productivity, reduced work stress, and reduced interpersonal conflict.

Humans↗

A national medical education needs' assessment of interns and the development of an intern education and training programme.

A needs' assessment of interns was undertaken using a self-completion questionnaire and a semistructured interview. The questionnaire explored to what degree graduates had been helped to acquire a range of competencies and professional characteristics. In the interviews graduates discussed their self-perceived learning needs, their educational and training experiences and made suggestions. A 25% random sample of 1996 graduate doctors was selected from the five medical schools in Ireland (n=95). The overall response rate was 88% (n=84). The software package SPSS was utilized to carry out descriptive statistics on the questionnaire data while the interview data were analysed qualitatively. Of the responders, 91% reported that they were not prepared for all the skills needed as an intern. History taking and clinical examination were considered well covered at the undergraduate level but little training was received in a range of professional competencies and personal characteristics. Formal education and training during the intern year was found to be poor. However, some skills and characteristics improved during the year as a result of work experience. In the interviews the graduates explored educational issues. They considered an improved clinical experience throughout the undergraduate years to be at the heart of curriculum development but stressed that, in order to succeed, it would have to be accompanied by leadership within the healthcare system and efforts to improve the learning environment.

Clinical Competence↗

Characteristics of ratings of physician competence by professional associates.

Although the evaluation of medical students and residents frequently includes the use of global ratings scales as measures of clinical competence, few studies have investigated the use of global ratings in evaluating the performance of practicing physicians, or the psychometric properties of these ratings. In this article, the characteristics of ratings of physician competence by professional associates are described, using practicing internists as the subjects for the study. Ratings of nine aspects of clinical competence for 210 internists were obtained from four physician associates with whom patient care had been shared. The results suggest that ratings of physicians' clinical competence by professional associates are both reliable and potentially useful in identifying physicians with low performance. Studies are needed to clarify further the psychometric properties of peer ratings, and to determine factors that affect these ratings.

Attitude of Health Personnel↗

The clinical doctorate: a framework for analysis in physical therapist education.

This article explores major considerations for analysis and discussion of the role of the clinical doctorate as the first professional degree in physical therapist education (DPT). A process for this analysis is posed based on a conceptual framework developed by Stark, Lowther, Hagerty, and Orczyk through grounded theory research on professional education. External influences from society and the profession, institutional and programmatic influences, and articulation of critical dimensions of professional competence and professional attitudes as major categories are discussed in relation to the DPT. A series of questions generated from the application of the model are put forth for continued discussion and deliberation concerning the DPT. We conclude that the DPT provides the best pathway to serve society, the patient, and the profession.

Clinical Competence↗

Substance misuse training in graduate psychology programs.

A total of 436 graduate psychology training programs, including both academic and internship programs, were surveyed to determine the extent to which they included issues of substance misuse in their curricula. The survey consisted of a 37-item questionnaire and a multiple-mailing methodology that yielded a 78% response rate. The results indicate that a majority of programs provide students with at least some exposure to substance misuse issues, that programs focus both on alcoholism and on misuse of other drugs, that misuse is considered from several different combinations of perspectives (theory, research and treatment), and that both abstinence and moderation training are included in many curricula as potential goals of treatment. Additionally, data are presented on locations of training, measurement of student competence, professional involvement of faculty and staff members in the area of substance misuse, and plans that programs are making for future research and training activities. The role of psychology in general in the provision of substance misuse training is also discussed.

Counseling↗

Self, peer, and tutor assessments of MSN competencies using the PBL-evaluator.

Professional competencies are derived from formal, informal, and hidden curricula. Problem-based learning (PBL) is one pedagogy that addresses all three curricula types and facilitates the development of key professional competencies such as critical thinking, communication skills, interpersonal relations, and self-assessment. This article reports on a formative evaluation study completed by three cohorts of master's degree students and two nurse faculty-tutors who used the Web-based PBL-Evaluator after each of 10 PBL cases delivered over two semesters. Major findings included notable differences among self, peer, and tutor in rating the five domains; an increase in ratings by PBL case and evaluator type as the two semesters progressed; and substantial differences among evaluators in providing positive and negative feedback.

Clinical Competence↗

[Methods of pedagogical assessment of qualifications in postgraduate medical education].

The methods of pedagogical assessment of qualification in postgraduate medical education play a decisive role in assessing both the effectiveness of training and the level of professional competence of physicians. The methods of pedagogical assessment of qualification provide an opportunity to measure and evaluate each of the didactic categories--knowledge, professional competence, practical skills, professional credo. The described methods of assessing the knowledge, professional competence and practical skills can form an objective picture of the level of educational goals achieved (in the process of education) and determine whether the level of professional training of physicians meet professional requirements.

Clinical Competence↗

[Ethical aspects in the treatment of females with cancer].

Ethical aspects in oncology are relevant in four areas: (1) professional competence, (2) patient information, (3) truth and (4) supportive attendance. Professional competence is the ethical imperative in oncology. Only it can mediate between the realms of humanity and technology for the doctor and patient. Extreme opinions on the topic of truth are wrong. Aiding patients in dying, in the sense of aiding them during the process of dying, is aiding them in living. Professional competence, medical responsibility, and humanity are the basis of medical handling. What the doctor does is therefore always concrete philosophy (Jaspers).

Ethics, Medical↗