Patient education: a model for autonomous decision-making and deliberate action in diabetes self-management.
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Blood Glucose↗
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Results for “Models, Educational”
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An osteopathic prescription for medical education reform: Part 1. Curriculum and infrastructure.
Medical education has not kept pace with the evolving healthcare system. Criticism from industry and policy observers focuses on four major areas requiring reform: the curriculum, the fragmented educational infrastructure, the specialist-to-generalist mix, and the alienation from community and public health. The dominance of managed care organizations in the delivery and financing of healthcare is forcing a new set of physician competencies to the fore and changing projections of physician manpower and specialty needs. The authors address the four major criticisms from a uniquely osteopathic point-of-view. In this first of two articles, the authors describe the evolving osteopathic medical education model, and then employ a medical analogy to diagnose the causes of and propose treatments for curricular issues and infrastructure fragmentation. In the second article of the pair, they explore the causes of and propose strategies to address the generalist-to-specialist imbalance and the alienation of medicine from community and public health; the article also explores the role of technology in support of reform. In each article, the authors propose treatments to correct the problems in the osteopathic medical education model, and conclude that the profession is well-positioned to lead medical education reform.
Curriculum↗
[Model plan for schooling & education of internists, 1st degree & model plan for schooling & education of ward physicians].
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Humans↗
The Roper nursing model as an educational and research tool.
Models are thought to be of value as guides to professional practice; however, nursing models are often criticized. This article examines the concept of a model as a 'tool' and describes how the Roper model was used in a research project and proved to be both flexible and educationally sound as a teaching model.
Activities of Daily Living↗
Role of standardized patients in medical education.
Standardized patients are volunteers from the community who participate actively in the teaching and evaluation of our future physicians. The SP program augments medical student learning in both clinical and basic sciences by providing opportunities to practice on patients who are available and willing to be examined. SPs allow "teachable moments" to be created, rather than waited for. SP-based examinations are the most reliable and standardized methods for performance-based assessment of bedside clinical skills. The problem-based-learning (PBL) approach to medical education at JABSOM is designed to foster self-directed learning, interpersonal skills and early hands-on clinical experiences. JABSOM SP experiences are integrated within the PBL curriculum. The CCS and SPs are now vital components of the JABSOM educational model.
Clinical Competence↗
Application of the Concerns-Based Adoption Model to the installation of telemedicine in a rural Missouri nursing home.
The Concerns-Based Adoption Model (C-BAM) was developed in education for the purpose of implementing innovations and change within the school/college system. This study used the principles of the C-BAM and, for the first time, applied them to the process (implementation/training) and product (computer) of the telemedicine technologies in a rural nursing home setting in Missouri. Three rural counties of the 23 Missouri Telemedicine Network sites were chosen to pilot implementation of the computer as one mode of telemedicine technology. One rural nursing home was enlisted for an in-depth study to examine how telemedicine would affect communication between and among community health professionals. Methodological triangulation was used to study individuals' concerns about and utilization of telemedicine through interviews, participant observations, chart reviews, and the Stages of Concern (SOC) survey. Responses to the SOC over time are reported here. The participants consisted of nursing home employees: administration, nursing, housekeeping, and dietary. Forty-three of 52 employees participated in the SOC survey at Time 1 (preimplementation). Twelve months later, 40 participated in the SOC survey at Time 2. While the majority of respondents expressed awareness of the technology, they also expressed a high concern for informational and personal implications. Concern scores in all subscales decreased at Time 2. Findings from this study provided feedback for the implementation and training phases of the project. Most importantly, findings support the appropriateness of this educational model to the healthcare setting.
Adaptation, Psychological↗
Australian evidence for interprofessional education contributing to effective teamwork preparation and interest in rural practice.
A pilot interprofessional education (IPE) placement for undergraduate health care professional students was undertaken in rural Victoria, Australia from 2001 to 2003. Medical, nursing, physiotherapy and pharmacy students were involved, and the project is ongoing. This paper briefly outlines the educational model, then focuses on the evaluation methods and results obtained from student evaluations. The placement experience improved self-reported teamwork skills and knowledge, and supported participating students' belief in the value of interprofessional practice. Placements strengthened nursing and allied health students' intention to work in rural health settings after graduation. The rural interprofessional educational experience improved interprofessional abilities in a group of students who have the potential to influence change towards collaborative practices in their future workplaces. The results obtained provide sufficiently strong evidence to justify the continuation and expansion of this educational model in the Australian setting. Pedagogical and evaluation modifications are discussed that may benefit future IPE programs.
Education, Medical, Undergraduate↗
Prevention in practice. How do general practitioners discuss life-style issues with their patients?
Forty-six representative consultations in general practice were video recorded. Afterwards the patients and the GPs separately reviewed the recordings and gave their spontaneous comments. A hypothetical-deductive analysis, with a starting point in current health educations models, was carried out in order to characterize the health counselling discussions. Life-style issues (diet, exercise, smoking and alcohol) were discussed in 15 sequences in eight consultations. Four types of sequences were discerned: short advice by the physician (I), a short question by the patient (II), lengthy advice by the physician (III) and a patient-centred discussion (IV). Most health education constructs studied were identified in the type IV sequence but few in type I-III. In the short and the lengthy advice sequences there was a similar structure; the strategy to affect patients' life-style was condemnations of the patient behaviour and exhortations to change. No physician commented positively on these sequences. Appropriate training might improve life-style counselling in general practice through a patient-centred approach and with guidance from constructs in health education models.
Adult↗
Dentistry, nursing, and medicine: a comparison of core competencies.
Health care, including oral health care and oral health education, is under great stress in the United States. The cost of and access to care, the cost of dental education, and a shortage of educators have led leaders in dental education, organized dentistry, and the public sector to underscore the problem. One of the proposed solutions is to find synergies and new health care and education models by building bridges among the health professions. One potential solution is being implemented at the NYU College of Dentistry (NYUCD). Dentistry and nursing are seemingly unrelated professions, and they are rarely if ever modeled together. That is about to change with the joining together of NYUCD and the Division of Nursing of the NYU Steinhardt School of Education in creating a College of Nursing within the College of Dentistry. This process has not been without controversy. Following the Division of Nursing's request to join NYUCD, and the subsequent announcement of the proposed combination by NYU in December 2004, some members of the dental profession responded by questioning the appropriateness of the merger and the similarity of the two programs. Nevertheless, substantial parallels exist in the education and practice of dentists and nurse practitioners (NP) including basic, social, and some clinical science education, practice models, research synergies, and community service. However, similarities in the core competencies of these professions have not been analyzed formally and in detail. Accordingly, the purpose of this study was to compare the core competencies of nurse practitioner and dental education programs. The results show a surprising overlap of the core competencies of the dental and nursing professions (38 percent partial or total overlap). A similar overlap with medicine also exists, albeit lower (25.4 percent). These results are notable because they demonstrate that the three health professions, independently of one another, developed very similar basic competencies and learning objectives. These data should encourage other health professions programs to seek new collaborative models for education, beyond the current silos of training, and new health care delivery systems as has been strongly recommended by the Institute of Medicine. Such collaborative education redirects health care toward providing truly interdisciplinary comprehensive primary care for patients.
Competency-Based Education↗
[Testing student knowledge of emergency care at the Charles University School of General Medicine and the processing of certain conditions in primary emergency care into computerized educational training models].
The objective expression of the state of knowledge of 6th year students of the Faculty of General Medicine in the field of emergency care is an important factor in the evaluation of their preparation for the medical profession, regardless of the specialty they choose. Knowledge of these data is essential for improvement of undergraduate teaching of emergency care. Suitable application of computer technique can supplement the possibilities how to achieve this. The application of so-called model situations on personal computers makes it possible to extend training of decision taking to all spheres of medical training.
Computer Simulation↗
Planning of educational courses--a model of the management of an educational workshop for teachers of medicine.
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Communication↗
High-risk vulnerable populations and volunteers: a model of education and service collaboration.
Extending our earlier work (Hutchison & Quartaro, 1993) describing a training program for volunteers caring for high-risk vulnerable populations, we identify and explicate factors contributing to the successful collaboration of education and service organizations. Addressing the management of linkages essential to mutual goal setting and shared responsibility for planning, implementation, and evaluation of patient/client outcomes, each factor is discussed with specific reference to improving caregiving to persons with AIDS and their families through well-trained volunteer services. The model has been applied to training for service to homeless persons and to the frail elderly and may be more broadly applicable to other high-risk vulnerable populations.
Acquired Immunodeficiency Syndrome↗
Group diabetes patient education. A model for use in a continuing care retirement community.
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Aged↗
The hospice: an educational-service model providing counseling opportunities and indirect benefits for older widows.
The article focuses on the large and increasing number of older widows who are available for human service work within the hospice movement caring for the dying and the bereaved. The need for preparation for widowhood is cited as one major reason why widows should assist potential widows to prepare more adequately for this eventuality. Widows are portrayed as effective lay counselors in hospice because they have experienced the reality of death and possess an empathetic readiness for work in this human service field. The hospice training program for widows is appealing because it presents learning experiences that are satisfying for the older learner. Numerous therapeutic and educational benefits are available to the older widows who participate in hospice work and training. Widows, therefore, become both the beneficiaries and the benefactors of their service efforts.
Aged↗
The adult learner rediscovered: psychiatry residents' push for cognitive-behavioral therapy training and a learner-driven model of educational change.
OBJECTIVE: This study surveyed residents' experiences learning an emerging area of demand in psychiatry at a time when there is a lag in training resources. Unexpectedly, the data generated useful evidence in support of adult learning theory. The result is a post hoc examination of learner attitudes and activities during the spread of a new medical content domain. Implications of the results for adult learning theory are considered. METHODS: A survey evaluating interest, motivation, perceptions, and barriers toward learning cognitive-behavioral therapy (CBT) was given to 85 psychiatry residents at a single institution, with a 95% return rate and even distribution across years of training. RESULTS: The vast majority of residents were highly interested and motivated to learn CBT. One hundred percent considered CBT clinically useful, and 99% anticipated using it in future practice. Consistent with the model of adult learning theory, reasons for seeking CBT training tended to focus on personal interest (86%), motivation (81%), and opinion of its clinical usefulness (68%). Only a minority considered training requirements a motivation for seeking training (44%). The most commonly reported difficulty in gaining exposure to CBT was supervisor availability (65%). CONCLUSIONS: Residents exhibited qualities of adult learners for whom personal interests were more important than training requirements with regard to seeking training in new modes of treatment. In the wake of recent theoretical scrutiny of adult learning and its applicability to undergraduate medicine, these results suggest that postgraduate medicine might be uniquely suited to the study of adult learning theory.
Adult↗
Levels of physician involvement with patients and their families. A model for teaching and research.
BACKGROUND: We present an educational model that describes physician skills for addressing psychosocial concerns of patients, ranging from basic medical questions to in-depth psychotherapy. This model improves upon previously published models by integrating into one hierarchy levels of physician involvement with individual patients and levels of involvement with families. METHODS: Ten faculty family physicians were videotaped during 200 office visits. Interviews were categorized according to the model, with a 79% interrater agreement. RESULTS: Most visits involved the lower three levels of physician involvement (41%, level 1; 35.5%, level 2; and 23%, level 3). Discussion of family context occurred in a majority (58.5%) of visits, primarily when another family member was in the room and during preventive care visits. Higher levels were associated with longer visits--about 3 minutes more for each additional level. CONCLUSIONS: This investigation suggests that the levels of physician involvement model can be reliably measured. This model may be a useful tool for education and research, particularly the study of physician interview skills appropriate to family medicine.
Adult↗
Alcohol problems in later life: evaluation of a model community education program.
Described is the development and evaluation of a three hour multi-media community education program on alcohol problems in later life. Designed for families, older adults and service providers, the program provides information and skills needed to recognize and to take appropriate action with regard to alcohol abuse among the elderly. Compared to a control group, program participants had significant gains in knowledge and in their intent to take appropriate action in response to alcohol problems.
Aged↗
Daily life therapy: a Japanese model for educating children with autism.
The controversial practice of Daily Life Therapy, as demonstrated at the Boston Higashi School in Massachusetts, is reviewed. Five fundamental principles of Daily Life Therapy are examined: instruction that is group-oriented; routine activities that are highly structured; instructional techniques that center on learning through imitation; a method for reducing children's levels of unproductive activity through rigorous physical exercise; and a curriculum that focuses on movement, music, and art. These central features of Daily Life Therapy are discussed in light of current theory, research, and educational practices in autism. Empirical questions raised by this unique treatment mode are outlined.
Art↗