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PubMed2006

Home Study Course: Spring 2006.

OBJECTIVE: The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his or hercolposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management or to present colposcopic cases that demonstrate new and important knowledge in the area of colposcopyor pathology. Participants may benefit from reading and studying the material or from testing their knowledge by answering the questions. ACCME ACCREDITATION: The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ASCCP designates this continuing medicaleducation activity for 1 hour category 1 credit of the ASCCP's Program for Continuing Professional Development and the Physician's Recognition Award of the American Medical Association. Credit is available for those who choose to apply. The Home Study Course is planned and produced in accordance with the ACCME's Essential Areas and Elements. DISCLOSURE: Faculty must disclose any significant financial interest or relationship with proprietary entities that may have a directrelationship to the subject matter. For this course, the author had no such relationship to report.

Adult↗
PubMed2005

Home study course: summer 2005.

OBJECTIVE: The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his or her colposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management, or that demonstrate new and important knowledge in the area of colposcopy or pathology. Participants may benefit from reading and studying the material or from testing their knowledge by answering the questions. ACCME ACCREDITATION: The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ASCCP designates this continuing medical education activity for 1-hour Category I credit of the Physician's Recognition Award of the American Medical Association and 1-hour Category I credit of the ASCCP's Program for Continuing Professional Development. Credit is available for those who choose to apply. The Home Study Course is planned and produced in accordance with the ACCME's Essential Areas and Elements.

Adult↗
PubMed2002

Learning needs assessment: assessing the need.

Learning needs assessment is a crucial stage in the educational process that leads to changes in practice, and has become part of government policy for continuing professional development. Learning needs assessment can be undertaken for many reasons, so its purpose should be defined and should determine the method used and the use made of findings. Exclusive reliance on formal needs assessment could render education an instrumental and narrow process rather than a creative, professional one. Different learning methods tend to suit different doctors and different identified learning needs. Doctors already use a wide range of formal and informal ways of identifying their own learning needs as part of their ordinary practice. These should be the starting point in designing formalised educational systems for professional improvement.

Education, Medical, Continuing↗
PubMed2004

Accessible Web design.

As part of the Institute of Medical Illustrators' (IMI) scheme for continuing professional development (CPD), worksheets will be published at regular intervals in this Journal. These are designed to provide the members of IMI with a structured CPD activity that offers one way to earn credits. It is recognized that this worksheet requires some time spent undertaking the exercises. This activity has been tested, and hours have been allocated to individual tasks (see clocks), but these are intended only as a guide. The answers to the questions, along with any notes and reflections you make or other publications you find, should be kept in your CPD portfolio.

Computer Literacy↗
PubMed2003

The Centre for Medical Humanities, Royal Free and University College Medical School, London, England.

The Centre for Medical Humanities is based within the Royal Free and University College Medical School. With a student body of more than 2,000, this large United Kingdom medical school benefits from being a fully integrated component of University College London. With its strong humanities and science faculties, University College London was founded more than 175 years ago to make education available to wider social and religious groups. With this background, it is logistically and ideologically well suited to sustaining a medical humanities program. The Centre's aims are to raise awareness of the field of medical humanities, to develop resources for the academic and teaching communities, and to build a broad and well-grounded educational program supported by sound educational principles and innovative research. Since 1998, the Centre and its predecessor, the Medical Humanities Unit, which was established by a group of medical educators with a diverse range of interests in the arts and humanities, has built interdisciplinary links and collaborative relationships with individuals and institutions within the university and beyond, nationally and internationally. These links and relationships have provided invaluable contributions and stimulus to the Centre's activities. The undergraduate educational program described in this article includes core and optional teaching throughout the curriculum, and a 1-year intercalated Bachelor of Science in Medical Humanities degree. For postgraduates, the Centre offers the United Kingdom's first continuing professional development accredited 2-day course in medical humanities, and an annual residential retreat open only to graduates of the course.

Curriculum↗
PubMed2006

Perceptions of how the Internet has impacted on dentistry.

OBJECTIVES: This study sought to identify how patient information on the Internet has influenced the delivery of oral care and the use practitioners themselves make of the Internet. METHODOLOGY: Data were collected via a self completed 18 item postal questionnaire, sent to a random sample of 620 dentists on the GDC register in Wales. RESULTS: In total 457 (74%) of the questionnaires were returned. One half of all practitioners stated that patients had asked them about material of relevance to dentistry obtained from the Internet, although in the majority of cases this happened less frequently than once a month. The most common topics enquired after were cosmetic procedures, dental amalgam and implants. A minority of dentists, 47 (11%) viewed the Internet as a threat to the dentist-patient relationship. However, 169 (39%) agreed information gained from the Internet had led to patients demanding inappropriate care or more complex treatment (135/31%). Having to take time to discuss Internet material was viewed as a burden by 93 practitioners. The potential of the Internet to widen inequalities in access to oral health information was agreed upon by one third of respondents. Concerns over the quality and reliability of Internet derived information, together with a lack of knowledge of appropriate sites, prevented dentists using the Internet as an oral health education resource. However, only 18.7% claimed never to use the Internet for their own Continuing Professional Development. Access for CPD purposes was mainly from home. Of those working in general practice, 54 had their own practice website, and a further 103 said this was something they were considering. Email was used to communicate with patients by 42 dentists, mainly to make appointments. CONCLUSIONS: Views on the impact of the Internet were generally positive, but there is a long way to go before its full potential is realised.

Appointments and Schedules↗
PubMed2006

Home study course: fall 2006.

OBJECTIVE: The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his/her colposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management, or that demonstrate new and important knowledge in the area of colposcopy or pathology. Participants may benefit from reading and studying the material or from testing their knowledge by answering the questions. ACCME ACCREDITATION: The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ASCCP designates this education activity for a maximum of 1 American Medical Association Physician's Recognition Award Category I Credit. Physicians should only claim credit commensurate with the extent of their participation in the activity. The ASCCP also designates their educational activity for 1 Category 1 credit hour of the ASCCP's Program for Continuing Professional Development. Credit is available for those who choose to apply. The Home Study Course is planned and produced in accordance with the ACCME's Essential Areas and Elements. DISCLOSURES: The clinical history and images in the Home Study Course may represent an actual case, but not always. To improve educational quality, some gross, cytological, or histological images may come from photographic libraries. Good teaching cases are often difficult to obtain, and we encourage our readers to submit cases with high-quality images to the Home Study Course editor or executive editor to consider for publication.

Adult↗
PubMed2005

Can we--and should we--have a Europsychiatry for Children and Adolescents? The work of the UEMS Section and Board for Child and Adolescent Psychiatry/Psychotherapy.

The Union of European Medical Specialists (UEMS) paves the way for harmonisation of training and free movement of medical doctors within the European Union. For more than 10 years, Child and Adolescent Psychiatry has been a distinct specialty at this European level--separate from Adult Psychiatry and Pediatrics. The article gives detailed information on the background of the section/board of Child and Adolescent Psychiatry/Psychotherapy (CAPP), training issues including the Training Log Book and the recent situation as well as future perspectives of Continuous Professional Development (CPD) in CAPP, all of which influence the corner stones of CAPP and its delineation from other medical and non-medical organisations. Child and Adolescent Psychiatry as the application of trained specialist medical practice to mental illnesses and psychological disorders in children and young people up to the age of about 18 years reflects more and more the growing research advances of the last years within the field with more progress to come. On the other hand, shortcomings of patient provision in Europe still have to be resolved and CAPP may help to do so.

Adolescent↗
PubMed2002

Calman-Hine reassessed: a survey of cancer network development in England, 1999-2000.

RATIONALE, AIMS AND OBJECTIVES: The paper assesses preliminary national data on the development of cancer care networks in England. METHODS: In January 2000, a national postal survey was sent to lead clinicians at 36 cancer centres and associate centres. Respondents were asked to provide basic numerical data on the design of the network (i.e. its configuration), detailing how many units it encompassed, and whether the centre was a multiple or a single entity. RESULTS: The survey highlighted national variations in the size and configuration of networks. The survey also highlighted tentative signs of shifts in clinical practice. The results showed that consultants at cancer centres and units were engaging in two forms of collaboration across centre-unit boundaries. Type 1 involved routine multidisciplinary team (MDT) outreach from centres to units, incorporating joint planning between clinicians at cancer centres and cancer units. Type 2 collaboration involved joint planning but also promoted joint centre and unit training and continuing professional development (CPD) programmes. CONCLUSIONS: In our estimation, both forms of collaboration represented early evidence of qualitative changes in medical working practices. Organizational changes within cancer services have moved swiftly since initial soundings were taken in 2000 and we update our initial commentary in the light of recent empirical data. The findings may be of wider significance to managers and health practitioners who are working towards the implementation of delivery network elsewhere in the UK National Health Service.

Cancer Care Facilities↗
PubMed2004

Patient privacy.

As part of the Institute of Medical Illustrators' (IMI) scheme for continuing professional development (CPD), worksheets will be published at regular intervals in this Journal. These are designed to provide the members of IMI with a structured CPD activity that offers one way to earn credits. It is recognized that this worksheet requires some time spent obtaining and reading a number of publications. As a way of ensuring that the allocated time has been spent on the activities a number of self-assessment exercises (SAEs) have been included. Upon completion of this worksheet, you will be credited with 15 CPD points. The answers to the SAEs, along with any notes you make and other publications you find, should be kept in your CPD portfolio.

Confidentiality↗
PubMed2003

Diabetic retinopathy screening.

As part of the Institute of Medical Illustrators' (IMI) scheme for continuing professional development (CPD), worksheets will be published at regular intervals in this Journal. These are designed to provide the members of IMI with a structured CPD activity that offers one way to earn credits. It is recognized that this worksheet requires some time spent obtaining and reading a number of publications. As a way of ensuring that the allocated time has been spent on the activities a number of self-assessment exercises (SAEs) have been included. Upon completion of this worksheet, you will be credited with 10 CPD points. The answers to the SAEs, along with any notes you make and other publications you find, should be kept in your CPD portfolio.

Diabetic Retinopathy↗
PubMed2004

Older community nurses: perspectives and prospects.

In common with the nursing workforces of the developed world, the NHS nursing workforce is ageing. Community nurses, in particular, tend to be older than their acute counterparts and this ageing could have a greater impact on this section of the workforce than on nurses in other sectors. This article reports on a study into the options, decisions and outcomes for nurses over the age of 50 years in the NHS. The study was funded by the Joseph Rowntree Foundation as part of a larger programme of work. Older nurses are a valuable part of the NHS workforce, being a repository of skill and wisdom. While this is generally recognized, and there are policies to support this, there is little recognition or action within the NHS. This study found that older nurses would like to see greater flexibility being shown towards them, in terms of their working hours and conditions of work, without harming their pension prospects. They would like to see return to practice courses and continuing professional development more geared towards their needs. Furthermore, they would like more information about their options. The article includes the experiences of some older nurses working in the community who remain, have left or have returned to the NHS.

Age Factors↗
PubMed2005

A survey of self-perceived educational needs of general dental practitioners in the Merseyside region.

AIM: The aim of this study was to evaluate the self-perceived educational needs of a randomly selected group of general dental practitioners (GDPs) in the Merseyside region (UK). MATERIALS AND METHODS: Eighty-seven GDPs were randomly selected from 850 in the region and asked to complete a self-evaluation questionnaire regarding their self-perceived educational needs. RESULTS: Seventy-five (86%) responded, of which 52 (69.3%) were male and 23 (30.7%) female. There was no significant difference in self-perceived knowledge in any of the dental disciplines when gender and period of time since qualification were used as predictor variables. The majority of the GDPs felt they had a good knowledge of restorative dentistry and dental radiography. Some of the GDPs felt they had poor knowledge in implant dentistry, oral medicine, orthodontics, dental sedation techniques, oral surgery, endodontics, periodontics and dental radiography. None of the respondents felt they had poor knowledge in restorative dentistry, prosthodontics and paediatric dentistry. Seventy-four (98.7%) of the responding GDPs were motivated to attend continuing professional development (CPD) courses because of an interest in a particular dental discipline and only one reported attending out of personal learning needs. Implant dentistry was indicated by 30 (40.0%) of the respondents as their training programme of choice. CONCLUSIONS: The respondents had high self-perceived knowledge of restorative dentistry, dental radiography, periodontics, endodontics, paediatric dentistry and prosthodontics. The respondents had low self-perceived knowledge of implant dentistry, orthodontics, oral medicine and dental sedation techniques. Of GDPs surveyed, 98.7% applied for courses they liked to attend, rather than needed to attend. Fifty-two per cent of male GDPs surveyed expressed a desire for training in implant dentistry.

Anesthesiology↗
PubMed2006

The reliability and validity of a matrix to assess the completed reflective personal development plans of general practitioners.

INTRODUCTION: We wished to determine whether assessors could make reliable and valid judgements about the quality of completed reflective personal development plans (PDPs) for the purpose of accrediting UK general practitioners (GPs) for a postgraduate education allowance using a marking matrix, and secondly, to plan a feasible model of PDP assessment in the context of forthcoming GP appraisal/revalidation that would overcome the main sources of error identified from this study. METHODS: Within generalisability theory, a variance components analysis on PDP scores estimated reliability and the effect on them of varying, for example, the number of assessors. We investigated the construct validity of the matrix through its internal consistency and detection of differences in the quality of PDPs. RESULTS: For a single PDP and one assessor, 37.6% of the variance in scores was due to true differences in the quality of the PDP. Between 5 and 7 PDP assessors are needed to achieve summative reliability of greater than 0.8. While increasing the number of judges is important, reliability could also be improved by addressing assessor subjectivity. Construct validity was demonstrated, as the matrix distinguished between good, satisfactory and poor PDPs, and it had good internal consistency. CONCLUSION: PDP assessment has reasonable summative characteristics for the purpose of assessing GPs' reflective continuing professional development. If doctors could include their PDPs within their revalidation folders as evidence of their reflections on pursuing better clinical performance, we have described a reliable, valid and feasible method of external assessment.

Accreditation↗
PubMed2002

Factors influencing career development of Australian general practitioners.

OBJECTIVE: To evaluate factors influencing career experiences and career choices made by former general practitioner registrars and to ascertain the reasons for these career decisions. METHOD: A postal questionnaire was sent to all former registrars who completed the RACGP Training Program between 1994 and 1996. In addition 21 selected respondents were interviewed to obtain deeper insights into the comments recorded in returned questionnaires. All data were analysed for variance according to age, gender, state and locality of current general practice (i.e. whether metropolitan, rural or remote). RESULTS: Altogether, 472 of the 988 questionnaires distributed were completed and returned. Of the respondents, 62.3% were female and 36.4% male; 68% were aged 30-34 years. Most (85.4%) lived with a partner, and 53.8% had at least one child. The majority (87.9%) of respondents gained their primary medical qualification in Australia. In addition to the FRACGP, 35.6% had also gained a Diploma of Obstetrics and Gynaecology. A number of other qualifications were recorded. Three-quarters (75.6%) of participants were currently working as group GPs, two-thirds of whom were employees; 5.9% were solo GPs; 3.4% locums; and 1.3% rural hospital medical officers. About one-third (32.4%) held a second job; most of these were in subspecialty clinics or attachments. Sixty-six percent were currently in metropolitan practice, 17.6% in rural and 2.7% in remote practice. The two highest ranked career options were continued professional development (70.8%) and performance of minor procedures (67.2%). Family and domestic circumstances stood out as the most influential factor for 79.0% of GPs. The majority (75.8%) felt that vocational training had exerted a positive effect on their careers through, for example, exposure to varied practice types and good overall clinical training. CONCLUSION: While general practice experience in undergraduate education is an important factor in career choice, vocational training strongly influences preparation for, and the type of general practice undertaken. Nevertheless, family circumstances were reported as the most important consideration, although male and female work patterns differed markedly. It is concluded that these differences reflect different priorities in balancing professional and personal demands. The particular needs of the growing proportion of female practitioners have strong implications for future educational and workforce planning.

Adult↗
PubMed2005

Employment transitions for older nurses: a qualitative study.

AIM: This paper aims to explore the influences on employment related decision making in respect of nurses over 50 in the United Kingdom. It investigates the retirement and labour market relationship through the diverse experiences of older nurses and stakeholders in nursing. BACKGROUND: The ageing of the United Kingdom nursing workforce constitutes a potential challenge for the National Health Services. There is evidence of increasing efforts to address this issue by encouraging older nurses to remain in the profession, dissuading early retirement and attracting nurses who have retired to return to nursing. However, decision-making by older nurses is influenced by a wide spectrum of factors and perceived employment options. BACKGROUND: The paper is based on research commissioned by the Joseph Rowntree Foundation as part of its Transitions Over 50 programme. It derives from concern about inadequate knowledge of, and under-developed policy responses to, the ageing United Kingdom workforce and the specific implications of this age shift for the nursing labour market. The research consisted of interviews with nurses over 50 and key stakeholders in nursing in the United Kingdom. Stakeholders included employers, advisers and policy makers in nursing. METHOD: Interviews with older nurses and stakeholders in nursing were conducted over a period of 12 months. They included face-to-face and telephone semi-structured interviews with 84 nurses over 50 and 18 key stakeholders in nursing in the United Kingdom. Stakeholders included employers, advisers and policy-makers. FINDINGS: Employers, policy makers and advisers and older nurses all identified a range of influences on nurses' employment decisions including a lack of flexible hours, the stress of work, pension-related expectations and the pace of change. Some of these related to negative aspects of work that led nurses to leave ('push' factors), and others to the presence of positive factors in nursing or in pension options ('pull' factors). CONCLUSION: The study highlighted the need for increased implementation of more flexible hours of work and greater availability of part-time hours for older nurses. It revealed the salience of improved pay, adequate and flexible pensions provision, and opportunities for continued professional development to the recruitment and retention of older nurses.

Age Factors↗
PubMed2002

Acquisition and maintenance of surgical competence.

Rapidly developing and emerging technologies, unprecedented scientific advances, significant changes in societal expectations, intense focus on physician competence, concerns regarding patient safety, and new mandates all have had a major impact on both surgical practice and surgical education. The definition of 6 general competencies by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties and the introduction of the concept of maintenance of certification require surgical educators, and indeed all surgeons, to reevaluate the methods currently in use to ensure competence in surgery. The multidimensional aspects of competence make verification and certification of a competent surgeon an extremely challenging task. However, a combination of traditional and innovative approaches may be used to facilitate achievement of the general competencies. Such approaches should be based on principles of adult education and experiential learning. Education research has yielded valuable information on the validity and reliability of a number of innovative methods that may be used to teach and assess several general competencies. Additional efforts are needed to address the other competencies effectively using novel approaches. The American College of Surgeons and other surgery specialty societies are well positioned to play a pivotal role in supporting the learning needs of practicing surgeons, residents, and medical students within the context of the general competencies and facilitating their continuing professional development.

Clinical Competence↗
PubMed2006

CLARION: a novel interprofessional approach to health care education.

The authors describe the development and impact of CLARION, a student-run organization at the University of Minnesota founded in 2001 and dedicated to furthering interprofessional education for health professions students. CLARION's student founders recognized that three recent reports from the Institute of Medicine will fuel significant changes in health professions education. Moreover, they deduced that targeted, interprofessional education in the preclinical years could provide fundamental skills and understanding needed to make today's patient care safer and more effective. By engaging health care professionals and faculty, CLARION creates and conducts extracurricular, interprofessional experiences for students that are reflective of the six IOM aims for health care. Student members are from four separate schools of the university's academic health center: medicine, nursing, pharmacy, and public health. The organization's capstone event, the Interprofessional Case Competition, challenges interprofessional teams of students to compete in conducting and presenting a root cause analysis of a fictitious sentinel event. The interprofessional organizational structure of the CLARION board models the kind of interprofessional equality needed to effectively solve problems in the health care system. The interaction among students from different health professions has led them to many new understandings about health care and the realization that many fundamental biases about other professions are firmly rooted in students before they enter the workplace. CLARION has enabled continued professional development of students, faculty, and practitioners, leading individual students to enhanced understanding of the health care system. It is a grassroots catalyst that has prompted faculty to reexamine traditional health professions curricula and look for ways to integrate more interprofessional opportunities into it.

Curriculum↗