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PubMed2006

Reflection on academic protected time: an opportunity to integrate educational programs.

OBJECTIVES: We sought to identify the structure of academic protected time curriculum and to determine interest in a knowledge-sharing, web-based initiative. METHODS: We undertook a survey of the 16 obstetrics and gynaecology program directors in Canada. RESULTS: The response rate was 88%. Seventy-one percent of the responding program directors are responsible for developing protected time curriculum. Seventy-eight percent use a template based on a two-year rotation of topics, 64% use lectures as the main educational format, and 50% have incorporated professional competencies into academic time. The largest barrier to curriculum development is time constraints. Seventy-eight percent of program directors are interested in a network for sharing ideas. CONCLUSIONS: In most programs, the curriculum for academic protected time is developed by program directors, who are dependent upon lectures and limited by time constraints. Programs therefore have difficulty integrating professional competencies into the academic curriculum. This educational environment could prove fertile ground for establishing a collaborative curriculum initiative.

Alberta↗
PubMedDate not supplied

[Women's satisfaction with pregnancy follow-up. Differences among healthcare levels].

OBJECTIVES: To determine women's satisfaction with pregnancy follow-up and to evaluate possible differences among healthcare levels. METHODS: Cross-sectional study in women who had given birth in the University Hospital of Salamanca (Spain) between November 2002 and April 2003. Satisfaction was measured by a self-completed questionnaire after delivery. The questionnaire contained 28 items, with five optional answers (1, not satisfied; 5, highly satisfied), distributed in four dimensions: accessibility, equipment, organization of the consultation, and professional competence. Social demographic and healthcare-related variables were also included. Student's t-test, variance analysis, Pearson's correlation coefficient and logistic regression were used to study the association between these variables and satisfaction. RESULTS: A total of 27.1% of pregnancies were followed-up in primary care. The mean global satisfaction was 3.92 (95% CI, 3.88-3.97), and satisfaction was higher in women followed-up in primary care than those followed-up in specialized care. All dimensions obtained a global satisfaction of more than 3; "accessibility" received the worst score and "professional competence" the highest. The factors significantly associated with satisfaction were age, educational level, the presence of risk factors and complications, and the possibility of choosing the physician. CONCLUSIONS: General satisfaction was good. Because satisfaction was higher in women followed-up in primary care than in those followed-up in specialized care, pregnancy follow-up at this level of healthcare should be supported.

Adult↗
PubMed2001

The Freiburg approach to ethics consultation: process, outcome and competencies.

The paper describes how ethics consultation can be valuable to health professionals, patients and their families in understanding and evaluating ethical values and their consequences in a particular situation. Ethics consultation as it is practised at the university hospital of Freiburg is a special professional service offered by members of an academic institution. The practical approach and the goals are illustrated by a case study showing the difficulties of deciding about the limitation of intensive care medicine after heart surgery in the setting of maximum treatment. Here, the ethics consultation was initiated by the relatives of the patient who wanted a decision to withhold further life-sustaining treatment. Following the experiences in Freiburg, it is concluded that clinical ethicists have to cover a variety of relevant fields of knowledge, need special analytical skills, and should have professional competence in counselling, including conflict mediation or crisis intervention.

Ethicists↗
PubMed1989

In-training examinations as predictors of resident clinical performance.

Previous attempts to predict resident clinical performance based solely on measures of cognitive skills have been uniformly unsuccessful. For the past 8 years, a formative residency evaluation system has been used that includes yearly comprehensive oral in-training examinations (OITEs) assessing each resident's performance in the three areas of professional competence: cognitive, psychomotor, and affective. The results of these examinations and scores received on the written in-training examination (WITE) given by the American Board of Pediatrics were compared with faculty ratings received during the subsequent year of residency. No significant correlation was found at any level of training between WITE scores and clinical performance. Analysis based on clinical setting did not improve these results. Oral in-training examination scores, however, were highly correlated with clinical performance ratings. In addition, with oral in-training examination scores, the "problem" interns--those whose clinical performance rating placed them in the lower 10% of interns--were predicted with a high degree of significance, sensitivity, and specificity. Predictions based on WITEs were not significant. Simultaneous evaluation of all three areas of professional competence should be done when predictions of resident performance are attempted. The OITE is a powerful formative evaluation tool, providing valuable learning experiences as residents are objectively assessed while they perform patient-centered tasks that represent critical skills in the practice of medicine. It allows early detection and possible amelioration of future problems in the clinical performance of a resident.

Clinical Competence↗
PubMedDate not supplied

Reciprocity, credentials, or the same old politics?

In Wyoming--and in view of the ADA's policy, probably throughout the United States--dentists and dental hygienists are dissatisfied with current licensing procedures. That is not to imply that state licensing boards should be eliminated. They should continue to oversee licensure and perform their other important functions. Accreditation involves strict requirements for dental schools. In turn, the schools require their students to pass the National or Regional Board Examinations, or both. That seems sufficient to ensure professional competence of new graduates. The dental schools should be permitted to act as the principal screening mechanism; successful completion of their requirements should be sufficient for licensure, after the other requirements are met. We urge the Wyoming Board of Dental Examiners and other state boards to adopt new standards for licensure, with successful completion of National Board examinations and any of the Regional Board examinations as the standard.

Attitude of Health Personnel↗
PubMed2005

The CME professional: challenges and opportunities in reforming CME.

A rationale for reforming and repositioning continuing medical education (CME) is featured in this article. As envisioned by the Conjoint Committee Report on CME and presented in other literature, the CME professional is defined, along with requisite CME professional competencies. Perspectives of CME professionals regarding the Maintenance of Certification program are presented, with a focus on requirements for physician self-assessment and lifelong learning and continuous practice improvement.

Education, Medical, Continuing↗
PubMed2006

Ethical clinical practice and sport psychology: when two worlds collide.

From their own practices, the authors offer insight into potential ethical dilemmas that may frequently develop in an applied psychology setting in which sport psychology is also being practiced. Specific ethical situations offered for the reader's consideration include confidentiality with coaches, administration, parents, and athlete-clients; accountability in ethical billing practices and accurate diagnosing; identification of ethical boundaries in nontraditional practice settings (locker room, field, rink, etc.); and establishment of professional competence as it relates to professional practice and marketing.

Clinical Competence↗
PubMed1996

Assessment of competence.

While it is essential that professional competence should be maintained, it is equally important that entry to the specialist ranks should be conditional on the demonstration of an acceptable level of competence. Multiple-choice papers and videotaped consultations are two parts of a multi-format approach to assessment which also includes a trainer's report and an audit report. The number of doctors identified as unsatisfactory at the recertification stage could be reduced by these methods, and the system could also provide a template for the introduction of recertification procedures.

Certification↗
PubMedDate not supplied

Continuing education: avoiding professional obsolescence.

The purpose of this paper is to describe how professional excellence can be maintained by participation in continuing education, thus avoiding professional obsolescence, and to describe essential factors in planning programs. Health professionals must recognize that lifetime licensure in a health care field is no longer a viable method of operation. Mandatory recertification requiring continuing educational experiences seems to present a possible alternative. Factors that contribute to professional obsolescence are reviewed and a rationale supporting continuing educational experience is developed. It is argued that health care professionals must participate in lifelong educational experience to maintain professional competence. Processes for planning continuing education programs for health professionals are reviewed. Seven steps necessary for program planning are outlined: set the philosophy, goals, objectives, obstacles, scope and the control and evaluation guidelines. The factors that reduce resistance to change and facilitate planning are discussed. The author concludes by noting that the health professional will become incompetent and a danger to the health care delivery system if he or she ignores the need for continuing education.

Canada↗
PubMed1987

Periodic competency review. An assessment and policy model.

Periodic review of professional competence or performance is on the public agenda as a response to rising malpractice suits, iatrogenic morbidity, and mortality resulting directly from professional incompetence, and the inadequacy of current licensing and discipline systems. This article reviews several continuing competency programs, such as mandatory education, as well as recent experiments in selective performance evaluation. The evaluation literature suggests that mandatory continuing education and most peer review programs are not sufficiently related to improvement of performance. An Ontario experiment provides useful data and insight about a positive reinforcement (nonpunitive) independent peer review process. Policymakers should consider, as an alternative to mandatory continuing education, directing professional associations, professional schools, and regulatory boards to design cost effective review procedures which selectively monitor performance.

California↗