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PubMed1996

Midwives' motivation for continuing education.

This study examined midwives' motivations for continuing their education by conducting a survey amongst a sample population of midwives, employed in 4 Health Authorities in the North West of England. The survey was carried out using a questionnaire which asked midwives to indicate the 'importance' of a series of requirements of continuing education. Of 120 midwives who received the questionnaire, 83 (69%) replied. Motivational factors included: learning for professional and personal development; fulfilling legal or statutory practice requirement, or as a social activity. The results showed that motivation for continuing education was strongest in relation to professional competence and an innate desire for knowledge. Where personal development was achieved, the emphasis was to promote professional advancement rather than social interaction. Less emphasis was placed on fulfilling the legal requirements for practice. The strongest motivators were learning orientated, which suggests that the subjects were self-directed to fulfil their needs, based on a desire to learn, this being less dependent on external motivators, which may be activated by statutory or employer requirements. Social interaction was seen as the least important aspect, although subjects found it beneficial to meet colleagues from other areas and felt that they learnt from exchanging views about various clinical practices.

Adult↗
PubMed1999

[Evaluation of clinical competence. The immediate future of nursing].

In this article, the authors analyze the concept of professional competence and they describe some of the methods destined to be used in the evaluation of said competence in nursing professionals. The authors describe different levels of professional performance to which an evaluation may be carried out according to the conceptual model developed by Miller. Special emphasis is placed on the third level of evaluation which is based on simulations of professional practice whose protagonists are the so called simulated or role-playing/standardized sick. One type of very novel evaluation test is the Objective Structured Clinical Examination (OSCE) which makes use of, besides the simulated or role-playing/standardized sick, other mediums such as manikins, standardized tests, open-ended short answer questions, etc. This is one of the most complete clinical competence evaluation methods currently available, although one should not forget that this evaluation is carried out in a simulated, laboratory, setting.

Clinical Competence↗
PubMedDate not supplied

Maintaining competent practice: information settings for the gastroenterology nurse.

Professional standards of practice for the gastroenterology nurse address the nurse's need to maintain and enhance professional competency through knowledge acquisition. With the rapidly increasing knowledge base in the nursing profession, it is increasingly important for the nurse to "keep current." In this article, the authors present information settings that assist the gastroenterology nurse in information retrieval and management.

Clinical Competence↗
PubMed1998

Continuing competence in the health professions.

The health professions are confronted with external pressures to assure the public of the continuing competence of health care providers and internal pressures for self-regulation. This article describes the forces driving continuing competence, the difficulty defining the scope of professional competencies for experienced practitioners, the difficulty creating valid measures to evaluate continuing competence, and the need for shared responsibility and collaboration among regulatory boards, professional associations, and specialty certification programs. The article presents findings from the Study of Professions, which was based on literature review, document review, and telephone interviews with key informants from 13 regulated health professions.

Certification↗
PubMed1998

There is no moral authority in medicine: response to Cowdin and Tuohey.

Central to the Cowdin-Tuohey paper is the concept of a moral authority proper to medical practitioners. Much as I agree with the authors in refusing to degrade doctors to the status of mere technicians, I argue that one does not succeed in retrieving the moral dimension of medical practice by investing doctors with moral authority. I show that none of the cases brought forth by Cowdin-Tuohey really amounts to a case of moral authority. Then I try to explain why no such cases can be found. Developing an insight that is common to all the major moral thinkers in the philosophia perennis, I show that doctors are professionally competent with respect only to a part of the human good; morally wise persons are competent with respect to that which makes man good as man. I try to show why it follows that a) professional expertise has no natural tendency to pass over into moral understanding, and that b) doctor and non-doctor alike start from the same point in developing their understanding of medical morality. It follows that the authors fail in their attempt to de-center the moral magisterium of the Church by setting up centers of moral authority outside of the Church.

Abortion, Induced↗
PubMed2002

Defining and evaluating professionalism: a core competency for graduate emergency medicine education.

Professionalism, long a consideration for physicians and their patients, is coming to the forefront as an essential element of graduate medical education as one of the six new core competency requirements of the Accreditation Council for Graduate Medical Education (ACGME). Professionalism is also integral to the widely endorsed Model of the Clinical Practice of Emergency Medicine (Model). Program directors have now been charged with implementing the new core competencies in training programs and to assess the acquisition of these competencies in their trainees. To assist emergency medicine (EM) program directors in this endeavor, the Council of Emergency Medicine Residency Directors (CORD-EM) held a consensus conference in March 2002. A focused Consensus Group addressed the specific core competency of professionalism during the course of this conference, and the results are highlighted in this article. The definition and curricular requirements relating to professionalism are highlighted, specific techniques for evaluating this core competency in EM are reviewed, and recommendations are provided regarding the most appropriate assessment method for EM programs.

Behavior↗
PubMedDate not supplied

Perceptions of work in humanitarian assistance: interviews with returning Swedish health professionals.

Health personnel volunteering for humanitarian assistance assignments work in increasingly dangerous situations and increasingly complex roles. A qualitative analysis of interviews with returning Swedish aid workers, who collectively had been on 74 missions in 32 different countries, revealed that they felt positive about their contribution, but experienced high levels of stress and frustration. They were also surprised and inadequately prepared for tasks that fell outside their professional health care training, including ones demanding pedagogic and management skills. The volunteers perceived their success on humanitarian assistance assignments as being affected not only by their own professional competence and special preparatory training, but also by many other factors. In particular, recruiting organizations could improve volunteer performance by accepting only experienced professionals, requiring special preparatory training, clarifying the exact nature of the work, and providing better support during the assignment. Further analysis of humanitarian assistance as a complex and dynamic system involving multiple 'actors' could lead to improved understanding and better performance.

Adult↗
PubMed1987

Ethical guidelines in fetal medicine.

The ethical guidelines in the clinical practice of fetal medicine are discussed, largely from the point of view of early prenatal diagnosis. The discussion concentrates on several specific aspects including counselling, good procedure, prenatal screening, disclosure of results including fetal sex, experimentation and assessment of new technologies and health education. The emphasis is placed on the importance of informed consent, choice and understanding on the part of the patient, and the professional competence of the doctor and other professionals she may meet.

Choice Behavior↗
PubMed2001

[Indicators of quality of care in nursing homes from the perspective of elderly residents].

The purpose of this study was to explore the indicators of quality of care in nursing homes from the perspective of residents. A qualitative research method with in-depth interviews and participant observation was used to collect the data. Sample consisted of 10 residents from three accredited nursing homes in Keelung, Chia-I, and Kaohsiung. The study found 7 groups of indicators of quality of care for nursing homes including indicators of environment, nursing professional competence, quality assurance, basic human rights, direct care attitude, social interaction, and needs satisfaction. Findings of this study may sensitize long-term care professionals to the needs of nursing home residents. These findings can also provide a basis for setting indicators for nursing home quality evaluation and for further improvement of the life quality of nursing home residents.

Aged↗
PubMed2005

Continuing professional development--supporting the delivery of quality healthcare.

Patients and the general public have a right to expect that doctors remain up to date and are professionally competent. The ultimate aim of continuing professional development (CPD) is to contribute to high-quality patient care. The General Medical Council in the UK has published guidance in relation to standards for CPD, appraisal and revalidation. Doctors in the UK participate in an annual appraisal, the outcome of which is the development of the Personal Development Plan. This paper describes a framework for effective CPD and includes methods of self-assessment of clinical practice. Contributions to effective CPD come from 3 sources--doctors, CPD providers and accrediting bodies. The CPD system of recording credits currently in use by the Royal Colleges of Physicians in the UK is also described.

Education, Medical, Continuing↗
PubMed2002

Patient satisfaction and referral intention: effect of patient-physician match on ethnic origin and cultural similarity.

The study brought a cultural perspective into the mainstream model of health service quality by taking into account minorities' unique experience, patient-physician match on ethnic origin and cultural similarity. Survey data from Asian-American respondents supported a three-dimensional humaneness-professionalism-competence model of physician attributes. Physician humaneness and professionalism, patient-physician match on ethnic origin and cultural similarity predicted patient overall satisfaction and referral intention among Asian-Americans. Interestingly, the 3-dimensional model of physician attributes was also revealed in a Caucasian-American sample. However, Caucasian-Americans differ from Asian-Americans in several ways: physician competence was a significant predictor of overall satisfaction; professionalism was the only determinant of referral intention; and cultural similarity was not a significant factor with regards to either overall satisfaction or referral intention.

Adult↗
PubMed1995

Side-effects of teaching--the divergence between formal and factual qualification in Germany.

There is talk of a crisis in Germany ('Pflegenotstand'); the lack of staff and the fall in the number of students therefore make it most important for nursing schools to reflect on their problem management capacity. This paper offers some of the findings from a research study which inquires into why students discontinue their training and explores how satisfaction might be increased. This article focuses on the impact of assessment on the students' learning. It argues that it is crucial for the implementation of changes in the training to differentiate between formal qualification (examinations, certificates, etc.) and factual qualification (professional competence).

Adult↗
PubMedDate not supplied

Exploring the efficacy of continuing education mandates.

OBJECTIVE: This study explored the link between mandatory continuing education (CE) for relicensure and the development of professional competence. BACKGROUND DATA: Boards of nursing protect the public by establishing requirements for safe entry-level practice and assessing ongoing nursing competence. Some boards have mandated accumulation of CE hours as a means of assuring continued competence. The use of CE for this purpose has been controversial because no link had been established between CE and nurse competencies. METHODS: A survey was sent to 4000 randomly selected nursing subjects: 2000 licensed practical or vocational nurses (LPN/VNs) and 2000 registered nurses (RNs). RESULTS: Nurses perceived that work experience, their basic professional education, and mentors and preceptors were stronger contributors to their professional development than CE. Nurses mandated to collect CE hours did not experience more growth in their professional abilities nor did they accumulate more total hours of CE than those without such a mandate. Those with mandates did, however, attend more hours of CE that were unrelated to their work or interest, and were more likely to attend CE by correspondence. CONCLUSIONS: Nurses attend CE classes whether they are mandated to do so or not.

Education, Nursing, Continuing↗
PubMed2006

Reflection: a critical proficiency essential to the effective development of a high competence in communication.

Reflection, or the ability to step back from an experience and consider it critically, in an analytical, non-subjective manner, is an essential aspect of problem solving and decision making, and also of effective communication with clients and colleagues. Reflective practice has been described as the essence of professionalism and is therefore a core professional skill; rarely, however, has it been explicitly taught in veterinary curricula, and it has only a recent history in undergraduate human medical curricula. We describe here two preliminary case studies, one in a veterinary medical education context and the other within a human medical education framework, as examples of approaches to assessing a student's ability for ''reflection.'' The case studies also illustrate some of the key principles. Both of the case studies described had as their end goal the enhancement of communication skills through critical reflection. At Monash University, Australia, the majority of students were assessed as being at a level of ''reflection in development.'' The students in the Ontario Veterinary College case study showed moderately good use of self-awareness and critical reflection as a basis for modifying and integrating communication skills into practice. While both preliminary case studies point to the fact that students recognize the importance of communication and value the opportunity to practice it, few students in either case study identified the importance of reflection for lifelong learning and professional competence. Opportunities to complete critical reflection exercises in other parts of curricula and outside of communication would likely reinforce its importance as a generic skill. Ongoing scholarly approaches to teaching, learning, and evaluating reflection and self-awareness are needed.

Cognition↗
PubMed1997

Teacher consultation: impact on teachers' effectiveness and students' cognitive competence and achievement.

Teachers from six ethnically diverse inner-city schools participated in weekly mental health consultation for more than two years. Using a quasi-experimental design, a longitudinal sample of 91 teachers and 209 students was assessed periodically through multiple standardized measures. Results indicate that a low-cost, indirect intervention had a direct impact on teachers' sense of professional competence and was linked to positive changes in students' sense of cognitive competence and their academic achievement.

Achievement↗
PubMed1994

Impediments to progress in health care workforce policy: license and practice laws.

Any meaningful reform of health care delivery will have to overcome current barriers to effective utilization of nonphysician providers. These barriers include cultural and professional realities, as well as a number of explicit legal impediments. Medical practice acts remain overly broad and indeterminate, with concomitant and unnecessary restrictions in the licensure and practice acts of nonphysician providers. If we are to achieve our goal of offering high-quality care, at an affordable cost, to everyone who needs it, we must ensure that all health care providers are able to practice within the full scope of their professional competencies.

Allied Health Personnel↗
PubMed1995

Nurses' perceptions of the impact of continuing professional education on the quality of nursing care.

The purpose of this study was to understand what impact nurses perceived continuing professional education (CPE) to have on the quality of nursing care. Given that CPE will become mandatory once the necessary legislation has been implemented, the value and worth of CPE with regard to the quality of nursing care, in both a consumer-led and financially-driven NHS, merits serious consideration. Little research has been conducted into the real impact that CPE has on the quality of nursing care and this paper begins by providing an overview of the current debate within the profession. The method chosen for the study was qualitative and 18 nurses from a large hospital in the South of England were interviewed. The data were analysed using the grounded theory method and three categories emerged. The categories are described in detail and reveal some of the problems with which the nursing profession is faced. The study demonstrates how issues of finance were particularly high, with service managers sometimes negating nurses' CPE needs. However, the study reveals the real importance that nurses attached to CPE in supporting their professional status and the real impact that CPE and knowledge have on professional competence and the quality of patient care.

Attitude of Health Personnel↗
PubMed2002

[Methods and results of the assessment of efficacy of postgraduate students in public health].

Training programs, courses contents and teaching personnel of the postgraduate studies in School of Public Health were assessed by students using special questionnaires in the Nofer Institute of Occupational Medicine in Łódź in the years 1998-2001. The evaluation studies with the use of a questionnaire of acquired competences self-assessment was also carried out. The data gathered in this way were included in the reports directed to the course managers, whereafter were subjected to a comparative analysis in result of which: the quality of the curriculum contents and the professional and didactic skills of the members of teaching personnel was defined, as perceived by the students, the degree in which particular curriculum in public health produced professional competences' increase perceived by the students was defined, the degree in which particular teaching subjects influenced public health knowledge and skills of the students was pointed out. The presented method of monitoring and measurement of teaching efficiency has confirmed its practical usefulness. Analysis can be performed on the level of particular competencies, particular teaching subjects or particular classes. Results correspond with some current intuitions, set in order many particular observations and are useful in the process of training programme construction and modification.

Curriculum↗