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PubMed1979

Teaching physicians to teach: a three-year report.

To meet the needs for an expanded preceptor faculty, the Department of Family Medicine at the College of Medicine and Dentistry of New Jersey-Rutgers Medical School has for three years conducted yearly training programs designed to prepare practicing family physicians for the teaching role. Thirty-six physicians have completed the program, which consists of four group seminars and three individual learning site visits spent in the office of an experienced preceptor while a fourth year student is present. Many lessons were learned in the course of these yearly programs which may be useful to others who plan to undertake similar faculty development activities. Therefore, detailed, practical, experiential information is presented regarding recruitment, orientation, the educational program of seminars and individual learning experiences, evaluation, and required resources. Some problems proved to be particularly difficult, such as the uneven quality of the individual learning visits and the attrition of some participants from the program. Feedback from participating physicians has been extremely positive.

Faculty, Medical↗
PubMed1983

Faculty development for clinical instructors in allied health: an inservice approach.

Allied health faculty in the clinical setting are traditionally practitioners with both service and teaching responsibilities. Much effort is expended on ensuring quality performance by the practitioner in his or her health care specialty with little emphasis on the faculty member's preparation for teaching. This article describes an inservice program designed to provide applied teaching techniques for clinical faculty members faced with such a situation. The inservice program addresses four areas of interest to clinical faculty: orientation to the educational process, development and implementation of behavioral objective, selection of the most effective clinical teaching method, and evaluation of student clinical performance. The effectiveness of the inservice program in meeting its objectives was estimated by use of gain scores between pre- and posttest performance.

Allied Health Personnel↗
PubMed1976

Components in program development.

There has been a great deal of discussion and deliberation concerning the composition of program development. Nonetheless, the question still remains--what is program development? What are possible components in program development? In this paper the following components are described, differentiated, and integrated: Statement of Purpose, Curriculum Design, Program Competencies, Content, Content Competencies, and Practice Environments.

Curriculum↗
PubMed1994

Autogenic-feedback training: a potential treatment for orthostatic intolerance in aerospace crews.

Postflight orthostatic intolerance has been identified as a serious biomedical problem associated with long-duration exposure to microgravity in space. High priority has been given to the development of countermeasures for this disorder that are both effective and practical. A considerable body of clinical research has demonstrated that people can be taught to increase their own blood pressure voluntarily, and that this is an effective treatment for chronic orthostatic intolerance in paralyzed patients. The current pilot study was designed to examine the feasibility of adding training in control of blood pressure to an existing preflight training program designed to facilitate astronaut adaptation to microgravity. Using an operant conditioning procedure, autogenic-feedback training (AFT), three men and two women participated in four to nine training (15-30-minute) sessions. At the end of training, the average increase in systolic and diastolic pressure, as well as mean arterial pressures, that the subjects made ranged between 20 and 50 mm Hg under both supine and 45 degrees head-up tilt conditions. These findings indicate that AFT may be a useful alternative treatment or supplement to existing approaches for preventing postflight orthostatic intolerance. Furthermore, the use of operant conditioning methods for training cardiovascular responses may contribute to the general understanding of the mechanisms of orthostatic intolerance.

Adult↗
PubMed1987

Evaluation and implementation of self-management programs for children with asthma.

We have reviewed the needs and problems associated with the evaluation and implementation of programs designed to assist children with asthma and their parents to manage the illness. To date, there are several programs that have been evaluated and found to be effective in terms of the objectives and dimensions described. Implementation has presented a larger problem because there are few implementors and because of the major barriers to be overcome by those who would make these programs available to the significant numbers of children and families who would benefit. Unless ways can be found to overcome the medical and reimbursement barriers, asthma self-management programs will not thrive. The growing number of individuals enrolled in some form of health maintenance organization, however, suggests a greater market for asthma self-management programs, under circumstances in which the costs of emergency room use and hospital services must be borne by physicians and hospitals, rather than by their patients.

Asthma↗
PubMed1982

Families at risk of poor parenting: a descriptive study of sixty at risk families in a model prevention program.

Sixty families assessed to be at risk of poor parenting were the subject of this study. These families were participants in a model multidisciplinary program designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. The model program consists of special medical, psychological, social and developmental services to families on an inpatient, outpatient, and in-home basis. Demographic information on these 60 families was tabulated. Each family was given a monthly rating on a simple measure of family function. Ratings over time were observed, and families were characterized in terms of a family rating vector (up, up-plateau, plateau, fluctuating, and down). Families were also described in terms of the constellation of problems brought to the therapy situation. Problem lists for each family were subjected to factor analysis. Five factor constructs which made clinical sense emerged from the analysis. Each factor could be labeled as a "family type." These types were: (I) Abusive Family, (II) Neglectful or Antisocial Family. (III) Family with an Emotionally Unstable Parent, (IV) Family with Cultural or Intellectual Limitation, and (V) Family with Child-Rearing Difficulties. Approximately 20% of these families did not fit the typology. Families were then divided into two groups--those who were relatively long-term, ongoing recipients of services, and those who left the program in the observation interval. Families were categorized according to family function rating vector and "family type." It was noted among long-term families, measured improvement in family function was most evident in families with transient situational crisis (who did not fit the typology) and those with intellectual and cultural deficits (Type IV). Among the families who dropped from the program, 15% were no longer at risk. Sixty-three percent of the remaining families were not improving. These techniques may be useful in determining which at risk families are more successful candidates for prevention efforts.

Adolescent↗
PubMed1988

Automated classification of candidate structures for computer-assisted structure elucidation.

In computer-assisted structure elucidation, a large number of candidate structures for the unknown compound can be generated. A computer program designed to aid in the recognition of significant differences between these structures is described. The goal of the program is to group the candidates into meaningful classes with a minimum of input from the user; each class is distinguished by a substructure its members have in common. A computational approach is developed based on the combinatorial problem of set covering. The program evaluates its results using an information-theoretical criterion. An application of the program to a real-word structure problem is presented.

Chemical Phenomena↗
PubMed1981

A multi-component program to increase family physicians' faculty skills.

A fellowship program designed to increase nonclinical faculty skills among academic family physicians is described. In contrast to most faculty development programs, the fellowship is continuous for a full academic year and involves activities at a university medical center and the participants' home settings. The fellowship curriculum addresses five components of the academic physician's responsibilities: (a) curriculum planning, evaluation, and instruction; (b) clinical and educational research; (c) professional and organizational development; (d) ethics and human values; and (e) professional communication. Methods of program planning and operation are discussed, and particular attention is given to the match between the fellowship curriculum and the realities of academic medical work. Preliminary evidence suggests the program is achieving its intended goals.

Curriculum↗
PubMed1994

Medicaid managed care: the next generation?

The author provides an overview of the motivation leading nearly every state to develop managed health care arrangements under the state and federally funded Medicaid program for the poor. With managed care already a reform movement in state Medicaid efforts, further expansions of similar types of organized systems of care are anticipated in the future U.S. health care system. The author explores the acceleration of state investment in managed care planning and operations in terms of what is happening and whether expectations are being met. Specific plan features representing two very different managed care models within the evolution of how these plans have developed over time--Arizona's statewide prepaid plan begun in 1982 and New York's recently expanded statewide program designed to enroll 50% of those eligible within five years--are described. The author raises questions about these programs based on recent literature and discussions with key informants. Are sufficient providers out there and are there optimum ways to organize delivery networks? What additional safeguards may be required to protect consumers under managed care arrangements, and what are the effects of such programs on access to services and quality of care? What obstacles do health plans that traditionally serve mainly poor women and children have to overcome when serving people with disabilities or those with chronic health conditions? The author considers other barriers faced by states, providers, and policymakers in meeting the high expectations for the current generation of state-supported managed care plans. These questions and issues will remain important for some time as the states' efforts to promote managed care continue their anticipated expansion under health care reform.

Arizona↗
PubMedDate not supplied

The culturally diverse student: a model for empowerment.

The student who is at a disadvantage due to race, educational background, or cultural background is often unsuccessful in higher education. Specific programs designed to assist the culturally diverse student can make a significant difference in the successful completion of a program of nursing and passing of the National Council Licensure Examination (NCLEX). The authors discuss a model that assists culturally diverse students' success in a program of nursing.

Cultural Characteristics↗
PubMed1985

Student heart health knowledge, smoking attitudes, and self-esteem.

The Chicago Heart Health Curriculum Program (CHHCP) is a comprehensive, cardiovascular disease, risk-reduction program designed for a multiracial urban population of sixth-grade students and their families. The study showed strong program impact on student health knowledge, and found that independence of peers significantly influenced smoking attitudes and self-esteem. The latter was associated strongly with humanistic teacher attitudes and behavior as well. Smoking attitudes were found to be related significantly to general health attitudes. The results suggest that future programs conveying heart health knowledge should consider student learning in the affective context of self-esteem, independence of peers, and teacher humanism. Reinforcement through continual intervention over a prolonged period may produce more permanent change over time.

Attitude to Health↗
PubMed1975

Nutritional status of black preschool children in Mississippi. Influence of income, mother's education, and food programs.

The nutritional status of 247 black preschoolers in two counties of Mississippi was studied by relating caloric and nutrient intakes and anthropometric measurements to homemaker's education, family income, and participation in Food Stamp and donated food programs..23AUTHOR Low intakes of calories, iron, calcium, vitamin A, and ascorbic acid were found in many of the children, regardless of the variable considered. These findings--in comparison with similar studies--imply that, as time passes, low education and income are having less impact on child nutrition. This ameliorating effect may be due to programs designed to educate parents and extend purchasing power of food dollars. Thus, it seems advisable to continue these programs.?23AUTHOR

Black or African American↗
PubMedDate not supplied

A cost-effective, unit-based approach to computerized care planning education.

This article describes a grassroots approach to developing an educational program on nursing diagnosis and computerized care planning. The process involved staff nurses in program design, implementation, and evaluation. Using this process, staff development educators will be better able to successfully initiate grassroots programs that educate large numbers of nurses at minimal cost.

Computer User Training↗
PubMed1991

Parallel computation and FASTA: confronting the problem of parallel database search for a fast sequence comparison algorithm.

We have parallelized the FASTA algorithm for biological sequence comparison using Linda, a machine-independent parallel programming language. The resulting parallel program runs on a variety of different parallel machines. A straight-forward parallelization strategy works well if the amount of computation to be done is relatively large. When the amount of computation is reduced, however, disk I/O becomes a bottleneck which may prevent additional speed-up as the number of processors is increased. The paper describes the parallelization of FASTA, and uses FASTA to illustrate the I/O bottleneck problem that may arise when performing parallel database search with a fast sequence comparison algorithm. The paper also describes several program design strategies that can help with this problem. The paper discusses how this bottleneck is an example of a general problem that may occur when parallelizing, or otherwise speeding up, a time-consuming computation.

Algorithms↗
PubMed1993

Evaluation of a faculty development program in substance abuse education.

OBJECTIVE: To determine whether a faculty development program was effective in increasing clinical skills and the amount of substance abuse teaching of individual general medical faculty. DESIGN: Program participants were evaluated with a structured assessment before and several months after participating in a faculty development program in substance abuse education. PARTICIPANTS: Eighty percent were general internal medicine faculty, who on average devoted 25% of their time to teaching. The remainder of the participants were family medicine, psychiatry, or other internal medicine faculty and nonphysician teachers. INTERVENTION: The participants attended a learner-centered, largely experiential faculty development program in substance abuse education to improve their clinical and teaching skills relevant to substance abuse among patients in the general medical setting. MEASUREMENTS AND MAIN RESULTS: Eighty-six percent of the participants completed the evaluation. The participants reported increased confidence in their clinical skills in recognizing substance abuse, presenting the problem to the patient, and referring the patient for treatment. The participants also reported improved attitudes toward patients and increased teaching about the management of the primary problem of substance abuse, but not at the expense of teaching about medical complications. CONCLUSIONS: Clinically oriented, interactive faculty development courses in substance abuse education can contribute to increased confidence in clinical skills in substance abuse as well as teaching about substance abuse.

Alcoholism↗
PubMed1990

A program to find regions of similarity between homologous protein sequences using dot-matrix analysis.

MATRIX is a program designed primarily to enable the user to visualize all regions of similarity between two proteins at a glance. The program helps the user to see where they are similar--at what relative positions in the amino acid sequences of the two proteins in question does the similarity exist; how they are similar--what functional characteristics the two similar sequences have in common; and to what extent they are similar--is the similarity significant, if so how significant relative to other similar sequences in the protein. This is achieved by constructing a diagram in which quantitative parameters of amino acids are used to compare every amino acid residue of the first protein with every amino acid residue of the second. Another function of the program is, given two sets of atomic coordinates--either of different proteins or for the same protein (for self-comparison)--to demonstrate which residues of the two proteins, when the two proteins are superimposed upon each other, appear in the same space (or are close to each other).

Amino Acid Sequence↗
PubMedDate not supplied

Patterns of blood utilization by physicians: transfusion of nonoperated anemic patients.

Prior studies have suggested that a high percentage of blood transfusions to hospital patients are unnecessary. If such transfusions can be reduced, more blood would be made available for those patients with legitimate blood requirements. In this study, blood transfusion of 401 nonoperated hospital patients with anemia as the final diagnosis explaining admission and with admission hemoglobin values equal to or greater than 10 gm/dl was analyzed. These patients were drawn from a 300 hospital sample distributed across the United States. Descriptive data showing the extent to which this selected population of patients is transfused with blood must be considered as one measure of unnecessary blood transfusion in this country. Hospital-based programs designed to identify and eliminate unnecessary blood transfusions should be established. The first step in the creation of such programs at the hospital level must be the development of guidelines for blood transfusion derived through the cooperative efforts of hospital physicians who fully understand and accept the rationale for them. Once guidelines for blood transfusion are established in a hospital, transfusion practice need only be measured against them.

Adult↗