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PubMedDate not supplied

[The White Paper of the health professions of Catalonia].

The White Paper of the Health Professions of Catalonia (WPHPC) is a strategic document for the development of the health professions. It deals with the main components of the manpower development (education, management and planning) in relation to the health services development required to attain the objectives defined in the Catalan Health Plan. The WPHPC fosters the coherence between social needs and professional competencies required to respond to them, as well as to the quantitative aspects of service needs under adequate standards of quality, effectiveness and efficiency. The WPHPC has followed a methodological process with maximum stakeholder participation and transparency. Citizens, professionals and health organizations have contributed significantly. The conclusions and recommendations of the WPHPC are organized around four axis: the citizenship, the professionals, the health care organizations and the health care model. Key elements are: the requirement of a new social contract between the different stakeholders, the values of professionalism, the need for a new credentialism of professional competencies, innovation in the education process, innovation of governance and management for organization of knowledge, the redistribution of work inside teams requires deregulation and reregulation of the professions, the need for actualized data on workforce and job positions and the permanent requirement of sociological research.

Health Planning Guidelines↗
PubMed2002

Enhanced clinical consulting--moving toward the core competencies of laboratory professionals.

The large menu of laboratory assays available today makes it increasingly difficult for the non-specialist to order all necessary tests, avoid medical errors, and still contain cost. Curbside consultations, "intelligent" laboratory information systems, and medical information from the Internet cannot fully fill the need for expert advice on test selection and interpretation of laboratory results. In this communication, we show the need for a more active role for laboratory physicians to select and interpret tests, demonstrate that existing attempts to deal with this issue are insufficient, and describe the model system which we have instituted at our institution. We combine reflexive testing algorithms with narrative interpretations provided by medical laboratory professionals and thereby enable physicians to obtain relevant laboratory results and to arrive at a definitive diagnosis without having to order individual tests. In our experience, such an arrangement can significantly improve the quality of care and reduce the cost per case by decreasing the time to diagnosis, the number of tests ordered, and the number of patient visits. In addition, interpretations provide a new source of professional revenue for the expert laboratory physician. This leads to a new role for laboratory professionals, in which their expertise in the selection and interpretation of laboratory tests is fully utilized.

Algorithms↗
PubMed2004

Diving for PERLS: working and performance portfolios for evaluation and reflection on learning.

Professional competence requires a commitment to lifelong learning, self-assessment, and excellence. Complex skills such as these require flexible and comprehensive teaching and assessment measures. We describe a combination of working and performance portfolios that both foster and evaluate the development of professional competence. We explain the conceptual and practical underpinnings that maximize the effectiveness of these tools. Drawing on experience with University of Washington residents, we identify 5 criteria that can help promote successful use of portfolios: separate working and performance functions of portfolios, developing a supportive climate, developing skills in faculty and residents, observing progress over time, and fostering mentorship opportunities.

Education, Medical↗
PubMedDate not supplied

[Competences of professional nurses in transfusion: medico-legal aspects].

This paper explains the regulations in force in our Country about the competences of the nurse during the blood transfusion and the blood astraction. Successively it underlines how it is important for the nurse to be conscious of belonging to a medical team, considering also the ethical point of view suggested, by the care activity, to all the operators. Finally the paper notices the independence of the nurse's work compared with the other medical professional figures, and the following liabilities. It points out especially the role of the nurse in handling the information and the consent for the operating action, to the entrusted patient.

Blood Transfusion↗
PubMed2003

[Postgraduate studies in public health: the problem of efficiency evaluation].

The satisfaction of customer is the main measure and the most important, generally recognized criterion for evaluating the quality of products and services. In the case of education and training, the quality is frequently understood as effectiveness, i.e., the degree to what educational objectives of a training institution are met; the objectives previously formulated on the basis of analyzed and defined demands and expectations of customers (clients). In the first part of the paper: (1) the problems related to the question who in fact is the customer in the context of an institution providing education in public health are discussed; (2) a proposal for resolving these problems is presented; and (3) the main directions of evaluation activities, which should be undertaken under monitoring and effectiveness assessment of postgraduate training in public health are pointed out. In the years 1998-2002, the students' assessment data on educational programs, curriculum contents and subject teachers in the field of postgraduate studies in the School of Public Health, Nofer Institute of Occupational Medicine, Łódź, were collected with the help of specially-designed evaluation questionnaires. The data on the students' self-assessment of gained professional competencies were also collected. All students who completed the School of Public Health in these years were subjected to the evaluation inquiries. The data collected were analyzed. Due to the analysis it was possible to define: the quality of the curriculum contents, as well as the professional and didactic skills of the teaching staff as perceived by the students; the degree to what particular curriculum in public health contributed to the increase in professional competence as perceived by the students; the degree to what particular teaching subjects influenced the students' knowledge of and skills in Public Health. The results obtained provided information very useful in the teaching process, designing of educational programs and their modification.

Evaluation Studies as Topic↗
PubMedDate not supplied

Continuing competency for health professionals: caveat emptor.

Continuing competency presents a challenge for professionals in the environmental health field and other public heath disciplines. It is argued that traditional continuing professional education alone is inadequate and other alternatives need to be developed which are complementary. Issues and concerns related to mandatory vs. voluntary continuing professional education are discussed. Communities of interest in the process are described which include practitioners, employers, faculty and consumers, each of whom contribute to a definition of competence. A format for increasing interaction among these communities and a credentialing--continuing competency model is presented. The model addresses the notion that obtaining and maintaining competency is an on-going dynamic process.

Credentialing↗
PubMedDate not supplied

[Evaluation of clinical competence in the nursing profession].

The quality of health services depends on the competence of the health service professionals. It is essential to define and evaluate professional competences in order to improve professional development, ensure the quality of, and manage, professionals in terms of their competences. To do so, it is necessary to utilize a combination of different methods. The evaluation of the diverse stages related to nursing--at the end of undergraduate studies, postgraduate studies or specialization, and during independent work--has different proposals, content and methods; and the institutions implicated in these stages should make themselves responsible to acquire the professional which society needs. Since 1994, more than 150 projects have been carried out in Catalonia which confirm the validity, trustworthiness, acceptability and utility of these evaluative methods in undergraduate and postgraduate studies and in the selection and accreditation of professionals.

Clinical Competence↗
PubMedDate not supplied

[Good practice for medical surveillance by occupational physicians].

Society--employers, workers, trade unions, public--demands the highest standards of professional competence and ethical conduct from occupational physicians. However, defining what exactly constitutes good medical practice and acceptable standards of professional competence and conduct is not so easily done. Good practice in occupational medicine should be aimed not only at improving the effectiveness of preventive action in the strict sense, but also at constantly adopting rigorous methodologies based on evidence and procedures breaking loose from rigid formats, which must be as uniform as possible throughout the country. It's essential, therefore, to develop consensus documents on workers' health surveillance, meeting with approval of occupational health physicians both operating in a free market context or within the framework of public sector health service.

Clinical Competence↗
PubMed1997

[Brain death and organ transplantation: ethical dilemmas for nursing?].

According to the WHO Program, nurses should be active in public health care as equal members of a multiprofessional team. This position requires competent professional action, which also implies moral competence, especially necessitated by the coming paradigmatic changes caused by shifts in the previous and current boundaries of the paradigm human being. One reason for this shift are the greater medical technical possibilities. The medical definition of brain death as the death of a human being per se is one example of the altered boundary and its consequences. Must future components of the nursing metaparadigm be changed because of this? To what extent is nursing ethically obligated to integrate changes in social values into its metaparadigm, ethics and objectives? The nursing metaparadigm, Henderson's definition of nursing, the ICN's Basic Code of Ethics, and the nursing model according to Roper, Logan & Tierney were used as the basis in the analysis of the subject matter and problems. Furthermore, philosophical viewpoints of Jonas & Harris will be included to clarify the deontological and teleological aspects of standard ethics. Finally, conclusions are drawn about the intra- and interprofessional ethical discourse about brain death and organ transplantation among nursing professionals.

Brain Death↗
PubMed1999

[Continuing medical education and the professional career].

The great scientific and technical advances in medicine make it necessary that the professional competence of the doctor needs to be brought up to date every now and then by the use of a continuing medical education (CME). The complexity and diversity of the professional subjects and the different areas of specialization give us reasons why the education of the doctor to-day should not be limited to the years of studying for a degree at university but that this education should be prolonged to include successive stages of specialized education and of the CME. The way of doing the latter (CME) is varied by means of different types of activities and it is recommended that it should be of a voluntary nature, through the personal motivation of the doctor, although he should also be spurred on because of different types of "prizes", as, for instance, social recognition, prestige, promotion to higher posts, etc. The organization of the activities of the CME should look to the recognition of the quality of the work by means of the corresponding accreditations according to uniform criteria established by a national central commission which should also establish the credits necessary for obtaining periodically the certificate for the bringing up to date of professional competence. This certificate, which should be gained in periods of 3 or 4 years duration, constitutes the basis, along with other elements (works of investigation, publications, years of tests, etc.) for the professional career of the doctor, the possible structure and development of which is shown in this presentation.

Accreditation↗
PubMed2002

The future for clinical scientists in laboratory medicine.

Clinical science in the UK has been presented with a range of opportunities and new initiatives in recent years. This review summarizes the contribution of clinical scientists to the changing face of laboratory medicine, and describes some recent UK Government initiatives to modernize the scientific service and develop the people who work in it. Recent changes in the regulation of professional practice and the need for maintenance of professional competence are also discussed.

Career Mobility↗
PubMed2006

Integrating professionalism in early medical education: the theory and application of reflective practice in the anatomy curriculum.

Renewed emphases on teaching professionalism require physicians to develop the ability to critically reflect upon their own decisions. Innovative programs that address teaching professionalism within medical curricula have been implemented in almost all medical schools. The foundation for many of these programs is "reflection," which is regarded as a core skill in professional competence. In order to achieve the desired outcomes and meet the demands of a required curriculum, an understanding of educational concepts in the designing of medical curricula is essential. Educators recognize that, for most medical students, professional growth is initiated during the first year of the medical curriculum and, therefore, traditionally pure content delivery courses such as first year anatomy course are being utilized now in order to explore issues related to critical thinking and professionalism. As a result, learning strategies such as "reflective practice" are beginning to play an important role in curriculum design. This article provides an overview of the theory of reflective practice, and demonstrates how reflective practice may be integrated into the anatomy curriculum. In order to incorporate reflective exercises into a curriculum, the basic elements of a reflective process are defined, strategies to implement reflective exercises within the course are described, and the benefits of reflective practice are highlighted. Therefore, in creating an environment that fosters reflective learning, the gap between theory and practice may be consolidated, which in the context of anatomy promotes the issue of teaching for relevance and clinical application.

Anatomy↗
PubMed2002

Reflective practice skills in undergraduates.

Critical self-appraisal skills are fundamental to professional competence. This study evaluated the educational contribution of self-assessment during individual students' projects.

Education, Medical, Undergraduate↗
PubMed2000

Physicians and patient spirituality: professional boundaries, competency, and ethics.

Clinical studies are beginning to clarify how spirituality and religion can contribute to the coping strategies of many patients with severe, chronic, and terminal conditions. The ethical aspects of physician attention to the spiritual and religious dimensions of patients' experiences of illness require review and discussion. Should the physician discuss spiritual issues with his or her patients? What are the boundaries between the physician and patient regarding these issues? What are the professional boundaries between the physician and the chaplain? This article examines the physician-patient relationship and medical ethics at a time when researchers are beginning to appreciate the spiritual aspects of coping with illness.

Adaptation, Psychological↗
PubMed1975

The assets and liabilities of mammography.

Anyone using mammography should perform it seriously with one or two radiologists in any group as the primary physicians. It is only by being exposed to a high patient volume day after day and having a thorough knowledge of all the pathologic conditions that one can truly appreciate the subtle mammographic patterns present. In only this way is the diligent radiologist optimally helpful to the surgeon and pathologist, and this best serves patient welfare. Conversely, the part-time mammographer, although not necessarily besmirching his professional competence, will tend to give the examination a bad reputation by unnecessary hedges and reporting uncertainties characterized by long winded reports. Patients undergoing mammography should undergo a physical examination by the radiologist. Thus, accuracy rates for the detection of cancer can approach, 98 per cent. Liabilities consequent to mammography can be minimized by the professional competence of the radiologist, understanding the limitations of the examination and the expertise of the reporting style.

Breast Diseases↗