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PubMed2002

What knowledge and skills are essential for specialists in Clinical Pharmacology and Therapeutics? Results of a Delphi study.

AIMS: To identify the knowledge and skills that should be considered essential for specialists in Clinical Pharmacology and Therapeutics (CPT) with a commitment to the National Health Service (NHS). METHODS: A Delphi study using a sample of current specialists. RESULTS: Members of the expert panel (20 in all, representative of the Clinical Section membership) identified 78 statements for consideration, in four domains (core of knowledge, therapeutic skills, educative skills, and investigative skills), of which 58 (74.4%) were accepted by more than two-thirds of respondents. Of these, 35 were knowledge items, whereas 23 were skills (11 therapeutic, 4 educative and 8 investigative). The large majority (79.3%) of these statements were endorsed by at least four out of five panel members. CONCLUSIONS: Despite the varied work patterns and responsibilities of specialists in CPT, it is possible to identify a core of knowledge and skill that most consider essential for the delivery of their commitment to the NHS. The findings will provide NHS Trusts with a clear idea of what they can expect from these specialists, and will act as a checklist for specialists themselves to direct their Continuing Professional Development within the consultant appraisal process. The results also describe a curriculum for continuing education in CPT, which the BPS Clinical Section can use to develop information resources and training opportunities.

Clinical Competence↗
PubMed2002

Curriculum reform for reproductive health.

A new model of reproductive health care delivery is unfolding, driven by emerging health issues, expanding technology and increasing public expectations. Additional imperatives in service provision for women's health compel reforms to undergraduate medical education using reproductive health as the basis for restructuring curriculum contents. These developments provide an opportunity for implementing the recommendations from various international conferences through continuing professional development and an evidence-based approach to clinical decision-making. A three-pronged approach based on reproductive health, problem-based learning and evidence-based medicine, has much potential for improving subsequent clinical practice and the overall reproductive health of the community. Appropriate changes to existing curricula will facilitate integration of the principles of reproductive health and the new philosophy of doctor-patient relationship into clinical supervision and training of students.

Africa↗
PubMed1997

All change again! Midwifery education & government initiatives.

The success of the midwifery profession in the new millennium will depend to a large extent on the appropriate preparation of future midwives and the continuing professional development of existing practitioners. Currently, pre-registration midwifery education, and some recordable continuing education for qualified staff, is regulated by the statutory body-but will this always remain so? It is sometimes difficult to comprehend where the seemingly endless changes in the NHS will lead.

Education, Nursing↗
PubMed2003

GDPs' self-perceived confidence and anxiety in their clinical and communication skills used when screening for oral cancer: UK variations.

OBJECTIVE: To compare anxieties of general dental practitioners (GDPs) across the UK in communicating with patients about oral cancer and confidence in clinical skills required to perform soft tissue screening for oral cancer. DESIGN: A questionnaire was sent to 2200 randomly selected GDPs from across the UK. Responses to the questionnaires were analysed using 95% confidence intervals. SETTING: Dental practitioners in general practice within England, Northern Ireland, Scotland and Wales. RESULTS: The response rate varied between 57% in England and 65% in Northern Ireland. A high percentage of dental practitioners across all UK regions reported performing soft tissue examinations (range 78% to 88%). The number of soft tissue examinations per month varied between 129 (95% CI 109, 148) and 162 (95% CI 154, 170) indicating criteria when selecting patients for screening. Using a nine-point rating scale (1 = not at all, 9 = extremely), confidence in the clinical skills required during oral cancer screening was generally good (ratings varying between 5.4 and 6.7). With the exception of reporting positive findings to patients (rating 4.5 to 5.2), anxiety in communication skills used during oral cancer screening was generally low (ratings varying between 1.8 and 3.9). CONCLUSION: While concerns over generalizing the results exist, the situation with respect to the clinical and communication skills required by GDPs during oral cancer screening is generally encouraging. An area of concern is discussing positive findings with patients. This may be overcome by developing specialist courses on breaking bad news within undergraduate dental curricula and programmes of continuing professional development.

Adult↗
PubMed2001

Developing organizational learning in the NHS.

Learning has been identified as a central concern for a modernized NHS. Continuing professional development has an important role to play in improving learning but there is also a need to pay more attention to collective (organizational) learning. Such learning is concerned with the way organizations build and organize knowledge. Recent emphasis within the NHS has been on the codification of individual and collective knowledge - for example, guidelines and National Service Frameworks. This needs to be balanced by more personalized knowledge management strategies, especially when dealing with innovative services that rely on tacit knowledge to solve problems. Having robust systems for storing and communicating knowledge is only one part of the challenge. It is also important to consider how such knowledge gets used, and how routines become established within organizations that structure the way in which knowledge is deployed. In many organizations these routines favour the adaptive use of knowledge, which helps organizations to achieve incremental improvements to existing practices. However, the development of organizational learning in the NHS needs to move beyond adaptive (single loop) learning, to foster skills in generative (double loop) learning and meta-learning. Such learning leads to a redefinition of the organization's goals, norms, policies, procedures or even structures. This paper argues that moving the NHS in this direction will require attention to the cultural values and structural mechanisms that facilitate organizational learning.

Education, Medical↗
PubMed1994

General practitioners' reasons for not attending a higher professional education course.

BACKGROUND: A proposal to run a higher professional education course attracted strong initial interest. However, only 12% of those 74 general practitioners expressing an interest subsequently enrolled on the course. AIM: A study was undertaken to examine the factors that demotivated the remaining 88% from attending. METHOD: A questionnaire was sent to the non-attenders, asking them to rank the impact of each of six factors on their decision not to attend. RESULTS: Major factors included time commitment, general practice workload and family pressures. Cost, attitudes of practice partners and structure of the course were much less important. CONCLUSION: It seems that the conditions imposed by the current demands of working as a general practitioner, rather than the attitudes of the general practitioners themselves, inhibit this form of continuing professional development.

Attitude of Health Personnel↗
PubMed2003

The implementation of a quality assurance procedure for the Veterinary Services of France.

Due to the increasing complexity of food production systems and the concerns that these systems raise, there has been increasing demand from the general public for more State control of these processes. In France, it is the official Veterinary Services who are responsible for food safety and who must respond to these demands. The Veterinary Service is formulating a quality assurance procedure in accordance with standard EN 45004-ISO 17020, which determines the requirements that inspection bodies must follow to be recognised, at national, European and international level, as competent and reliable. As part of this procedure, the Veterinary Service will review requirements in terms of organisation, functions, qualifications and resources. The progress of inspection service orders, from their conception by the Central Administration, to their implementation by decentralised services, must be carefully managed. It is essential that service orders be implemented effectively and systematically by using recognised methods and issuing adequate inspection reports. The training and qualifications of inspectors are very important: their skills must remain up-to-date so that there is always a network of qualified staff, that is, staff who have an understanding of production processes and who have recognised competences in terms of initial training, continuous professional development and adequate experience. The quality systems implemented will only meet expectations if they are continuously monitored by means of regular evaluations. For this reason, both internal and external audits are performed. These new practices contribute to establishing a basis for the improvement of internal evaluation. In order to facilitate the implementation of a quality assurance procedure for inspection services, several tools, that are linked with the information system of the government department responsible for food, are, or will be, at the disposal of the decentralised Veterinary Services, i.e. a national database, mail and service order processing software, and inspection procedures.

Animals↗
PubMed1988

Professional-development and continuing-education programs for pharmacists in large hospitals.

Pharmacy directors at large hospitals nationwide were surveyed to determine the status of professional-development and continuing-education programs for staff pharmacists at their institutions. An 18-item questionnaire was developed and mailed in July 1987 to pharmacy directors of 445 large (bed capacity of greater than or equal to 450) hospitals. The questionnaire was designed to elicit information about who holds responsibility for the professional-development programs, the programs' frequency and format, how attendance is documented, and the types of individuals who present the programs. A total of 327 (73.5%) of the questionnaires were returned, with 256 (78.3%) of the respondents indicating that their department had some form of developmental-training program. Only 45 (17.6%) of these respondents indicated that their department employed an individual whose job title was specific for education or training functions. Hour-long lectures and videotaped programs were the most popular formats; programs were most frequently presented by pharmaceutical sales representatives or clinical or staff pharmacists. Of 251 respondents, only 90 (35.8%) indicated that an educational needs assessment of pharmacists had been conducted in the 18 months before the survey. Of 252 respondents, 138 (54.8%) indicated that their departments had no annual budget for these programs. Although program attendance was documented by 248 (97.3%) of the 256 departments, 111 (43.3%) did not require any type of certification for some programs. Evaluations were required by only 127 (49.6%) of the 256 pharmacy departments offering these programs. Inhouse programs offer opportunities for professional development, but resource allocation, program organization, and incentives for participation such as standards of performance could be improved in many of the programs explored by this survey.

Certification↗
PubMedDate not supplied

Developing and accrediting a CPD framework.

This article describes the process to formally accredit existing in-house education courses in a continuing professional development (CPD) framework. The partnership was between two Lothian NHS organisations and a higher education institution (HEI). The nature of the partnership and the differing approaches taken by the organisations are discussed. The authors explore the context of learning in the NHS in relation to the different organisations, and describe the issues identified and the strategies used to address these. The benefits to all stakeholders are listed. Although this case study refers to an initiative in Scotland, the framework model for flexible and work-based education could be adopted across the UK.

Accreditation↗
PubMed2006

Neuropharmacology and mental health nurse prescribers.

AIMS AND OBJECTIVES: To outline the development and content of a 'top-up' neuropharmacology module for mental health nurse prescribers and consider how much pharmacology training is required to ensure effective mental health prescribing practice. BACKGROUND: Debate about the content of prescribing training courses has persisted within the United Kingdom since the mid-1980s. In early 2003 supplementary prescribing was introduced and gave mental health nurses the opportunity to become prescribers. The challenge of the nurse prescribing curriculum for universities is that they have only a short time to provide nurses from a range of backgrounds with enough knowledge to ensure that they meet agreed levels of competency for safe prescribing. There is growing concern within mental health care that the prescribing of medication in mental health services falls short of what would be deemed good practice. Over the past two decades, nurse training has increasingly adopted a psychosocial approach to nursing care raising concerns that, although nurses attending prescribing training may be able to communicate effectively with service users, they may lack the basic knowledge of biology and pharmacology to make effective decisions about medication. METHODS: Following the completion of a general nurse prescribing course, mental health nurses who attended were asked to identify their specific needs during the evaluation phase. Although they had covered basic pharmacological principles in their training, they stated that they needed more specific information about drugs used in mental health; particularly how to select appropriate drug treatments for mental health conditions. This paper describes how the nurses were involved in the design of a specific module which would enable them to transfer their theoretical leaning to practice and in so doing increase their confidence in their new roles. RESULTS: The findings of this study suggest that the understanding and confidence of mental health nurse prescribers about the drugs they prescribe coupled with the information they provide to service users can be improved as a result of specific educational support. It would appear that adopting a prescribing dimension to one's role requires nurses to revisit a number of skills that are integral to the work of the mental health nurse, e.g. good communication, establishing empathy, listening to what clients say, responding to what is required and involving clients in their own care. CONCLUSIONS: Mental health nurses from one particular Trust in the West Midlands were provided with a 'top-up' course in neuropharmacology and, although they found this challenging, ultimately they found this to be helpful. As nurse prescribing is 'rolled out' to other nursing specialities it is important that local Trusts and Workforce Development Directorates maintain a dialogue about nurse prescriber training to ensure that nurse prescribers receive the appropriate time and support for their ongoing Continued Professional Development. As increasing numbers of nurses from different specialities qualify as nurse prescribers it is vital that they are supported by their employing organizations and given the opportunity to maintain their competency and confidence in their prescribing practice.

Attitude of Health Personnel↗
PubMed2005

A case study of successful e-learning: a web-based distance course in medical physics held for school teachers of the upper secondary level.

Learning activities and course design in the new context of e-learning, such as in web-based courses involves a change both for teachers and students. The paper discusses factors important for e-learning to be successful. The development of an online course in medical physics and technology for high school teachers of physics, details of the course, and experience gained in connection with it are described. The course syllabus includes basics of radiation physics, imaging techniques using ionizing or non-ionizing radiation, and external and internal radiation therapy. The course has a highly didactic approach. The final task is for participants to design a course of their own centered on some topic of medical physics on the basis of the knowledge they have acquired. The aim of the course is to help the teachers integrate medical physics into their own teaching. This is seen as enhancing the interest of high school students in later studying physics, medical physics or some other branch of science at the university level, and as increasing the knowledge that they and people generally have of science. It is suggested that the basic approach taken can also have applicability to the training of medical, nursing or engineering students, and be used for continuing professional development in various areas.

Biomedical Engineering↗
PubMed2005

The development, implementation, and evaluation of a clinical leadership program for mental health nurses.

A structured clinical leadership program was developed to assist nurses working in a metropolitan mental health service to develop and consolidate clinical leadership skills. The Nurses' Self-Concept Questionnaire (NSCO) was used to elicit responses from participants prior to commencement of the leadership program and again at completion. Findings indicate that the program was considered useful and its benefits were carried over into the workplace via the sharing of information. The self-directed nature of this program was found to be an effective way for clinical nurses to undertake continued professional development within the exigencies of clinical practice.

Adult↗
PubMed2006

Singapore National Medical Image Resource Centre (SN.MIRC): a world wide web resource for radiology education.

Radiology education is heavily dependent on visual images, and case-based teaching files comprising medical images can be an important tool for teaching diagnostic radiology. Currently, hardcopy film is being rapidly replaced by digital radiological images in teaching hospitals, and an electronic teaching file (ETF) library would be desirable. Furthermore, a repository of ETFs deployed on the World Wide Web has the potential for e-learning applications to benefit a larger community of learners. In this paper, we describe a Singapore National Medical Image Resource Centre (SN.MIRC) that can serve as a World Wide Web resource for teaching diagnostic radiology. On SN.MIRC, ETFs can be created using a variety of mechanisms including file upload and online form-filling, and users can search for cases using the Medical Image Resource Center (MIRC) query schema developed by the Radiological Society of North America (RSNA). The system can be improved with future enhancements, including multimedia interactive teaching files and distance learning for continuing professional development. However, significant challenges exist when exploring the potential of using the World Wide Web for radiology education.

Computer-Assisted Instruction↗
PubMed2005

Developing assessment of emergency nurse practitioner competence--a pilot study.

AIM: This paper reports a study evaluating baseline competence levels among Emergency Nurse Practitioners using an Objective Structured Clinical Examination. The study also aimed to document change in competence over time and following an educational intervention. BACKGROUND: Emergency Nurse Practitioners form an increasingly established part of the minor injury service workforce in the United Kingdom (UK). At present, there is no national requirement for them to undergo formal preparation, gain a formal qualification, have continuing professional development or revalidate. Given that it is certain that the use of these professionals to deliver unplanned emergency care will increase in the UK, skill maintenance and extension of skills need to be considered in order to ensure the continued delivery of a quality service. Objective Structured Clinical Examinations aim to test a wide range of knowledge and skills in an objective fashion and can be developed to serve a number of educational requirements. METHODS: A competence assessment was planned using an Objective Structured Clinical Examination. It was developed following questionnaire consultation with Emergency Nurse Practitioners and also in conjunction with Emergency Department specialists and experts in medical education. The Objective Structured Clinical Examination was piloted with Emergency Department junior doctors. Baseline Objective Structured Clinical Examination assessment was conducted in 2001. An educational intervention followed and then a further Objective Structured Clinical Examination assessment took place in 2002. RESULTS: A total of 17 of 20 Emergency Nurse Practitioners consented to involvement in the study. Comparison of their performance showed a statistically significant overall improvement in performance between the two assessment periods (P < 0.05). Participant feedback on the experience of undertaking an Objective Structured Clinical Examination assessment was very positive. CONCLUSIONS: The assessment process worked well, and provides a framework for competence assessment that can be compared over time, between practitioners and between departments.

Clinical Competence↗
PubMed1998

Motivational forces affecting participation in post-registration degree courses and effects on home and work life: a qualitative study.

Over the past decade, pre- and post-registration education for nurses and midwives in the United Kingdom has undergone major change, creating an atmosphere where continuing professional development is a matter of priority for individual health care staff. Against this context of change, and as part of a larger study of continuing education and training in the National Health Service, a cohort of participants in a part-time health studies degree course were interviewed using a semi-structured schedule. Twenty-nine nurses, midwives and allied professional staff described their motives for participation in the course and its effects on their professional and personal lives. Data collected in interviews were analysed using qualitative methods and revealed that participation was encouraged by both professional and personal factors. For many staff participation was prompted by negative feelings about themselves and their professional status. Participation in the course was associated with (largely negative) changes in home and family life and most participants faced additional financial burdens. The findings of the study have implications for policy relating to the funding of continual professional education for nurses and other health care staff. Health care staff are receiving mixed messages about continuing education from policy makers and employers. Dependence on willingness and ability to pay for post-registration degree-level studies is unlikely to be an efficient or equitable means of ensuring lifelong learning for healthcare staff.

Adult↗
PubMed2006

Developing rigour in observation of the sick child: Part 1.

This is the first of a five part series focused on the continuing professional development of rigour in observation of the sick child. Part 1 provides an in-depth analysis of basic principles underpinning observation generally. Parts 2 to 5 will provide in-depth analyses of specific nursing observations.

Humans↗
PubMed2001

Joining them up: the challenges of organisational change in the professional politic of general practice.

Primary health care in the UK is currently centred around independent contractor organisations (general practices). Although the development of these organisations is considered necessary to improve the quality of health care, no structures exist to support the systematic development necessary to attain this goal. Part of the failure to change clinical processes has been the requirement that general practitioners attend passive educational events for continuing professional development, without reference to organisational or local health priorities. A feasibility study to integrate professional and practice development planning sought to overcome this mismatch. NHS Staff College Wales, as a facilitating organisation in this study, developed a model to assist practices to identify, prioritise and implement developments, interlinked with individuals' professional development. The paper summarises the experiences of facilitators supporting this integrated approach, using Senge's model of the challenges to the successful implementation of change. The role of facilitation in negotiating these challenges is also explored. The paper concludes that the approach is effective in the integration of professional and practice development and offers a useful framework to progress the quality improvement agenda.

Cooperative Behavior↗
PubMed2001

Nurse education in Mbarara, Uganda.

AIM: To describe the establishment of a professional development programme for qualified nurses at Mbarara University Teaching Hospital, Uganda. BACKGROUND: Between 1997 and 1999, a group of hospital-based nurses and university lecturers in Hull, United Kingdom, planned and delivered a series of modules to set the Ugandan nurses on course for continuing professional development. APPROACH: A descriptive account of the delivery of the programme. FINDINGS: Evaluation of the programme indicates that the nurses' morale was raised by satisfactory completion of the modules and that there were visible improvements in the organization of patient care in the hospital. CONCLUSIONS: This professional development programme was a learning experience for all the parties involved. Support from Hull for the education of nurses in Mbarara will continue.

Curriculum↗