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PubMed1993

[The directional axes in the reform of medical teaching. A strategic proposal].

The circumstances preceding the future revision of the medical curriculum are analysed, main internal and external stimuli are described, and sources of resistance to changes in medical training require new educational philosophy, privileging oriented training during undergraduation, as a preliminary phase of medical education. The definition and accompaniment of the general and specific objectives, the strategy and programme used, the design and adequacy of the available support, and the related engagement of all political, academic and socially responsible persons and institutions, are fundamental factors for successful change. The education and training of polyvalent medical doctors requires methodological modifications, namely the definition of a core curriculum, made dynamic through the teaching of interdependent subjects and earlier contact with common clinical problems. Learning through interconnected basic and clinical matters will benefit the technical and psychosocial education of future doctors. The education resulting from a renewal in undergraduate medical education will be mostly determined by organizational and institutional frameworks, teaching methods and the evaluation process used, as well as by teacher commitment, pedagogic and scientific capacities. Professional competence should be the end product of efficient training. Otherwise, undergraduate medical education would not prepare the professional development of the young doctors, thus diminishing the quality of medical training in the future.

Curriculum↗
PubMed2003

Assessment of competency for execution: professional guidelines and an evaluation checklist.

The issue of whether mental health professionals should be involved in conducting evaluations of competency for execution is a topic that has elicited controversy and heated debate. This article picks up at a point beyond the controversy and addresses issues of professionalism and the objective assessment of competency for execution. Specifically, this article identifies professional standards for conducting competence for execution (CFE) evaluations, describes current practices in this area, and provides an interview checklist that can be used as an evaluation guide by involved professionals.

Capital Punishment↗
PubMed2001

Metaphors of learning and professionalism.

The overall health of the community is based, in part, on the degree or level to which individual members choose to participate as a professional. Do they remain on the periphery or progress to full participation in the professional association? CLS education has been highly successful in preparing practitioners, yet the educational process as a whole has failed to reach the more challenging goal of preparing practitioners as professionals. When designing curricula for educating professionals, educators need to teach the importance of a professional association as a critical and necessary component of the whole. Our goal should be to prepare "practitioners who are constantly seeking to increase their professional competence". To achieve this goal, practitioners must transfer knowledge and skills as they, with guided participation from other professionals, move into professional activities.

Allied Health Personnel↗
PubMed1975

The independent nurse practitioner. Alive and well and living in rural Saskatchewan.

At this point, it is impossible to express analysis of the data collected in concrete terms as the project will not be finalized until October, 1976. It is possible, however, to make some personal observations. Each nurse practitioner has been truly independent in carrying out her role in the community, influenced to a degree by the communities' felt need and the attitudes of other health professionals. All began practice with a heavy emphasis on diagnosis and cure rather than comprehensive care. As time evolves and the nurses feel more confident in their new role, some are continuing a cure orientation, and others are beinning to find that they have a unique dimension to add to health care services. Those who were professional "nurses" in the true sense of the word before the project began have not stopped being nurses, but have only become more competent professionals by recognizing and responding to the health needs of today.

Clinical Competence↗
PubMed2005

Recognition of client values as a basis for tailored care: the view of Dutch expert patients and family caregivers.

In the Netherlands confusion is signalled about the introduction of new care concepts like demand-oriented care. The aim of this article is to explore the phenomenon 'interaction aimed at care tailored to the client demand' as seen by expert clients: patients and their family caregivers. Focus interviews were held with expert patients and expert family caregivers of the 'Dutch Council of the Chronically ill and the Disabled'. Grounded theory methodology was used to analyse the results. Recognition by the professional of client values underlying their demand (uniqueness, comprehensiveness, continuity of life, fairness and autonomy) and underlying the care-relationship (equality, partnership and interdependence) emerged as central element within the interaction. Feelings of recognition with the client seem to reinforce autonomy, self-esteem and participation. Recognition was optimally felt in a dialogue. Four professional competencies could be identified related to recognition: attentiveness (ongoing actions to know and understand the patient); responsiveness (active, committed and responsible care guided by respect of patient identity); being a critical partner in care (giving and grounding professional opinion and discuss boundaries); being a developer of client competencies (facilitating and developing client participation within care). The findings offer possibilities to operationalize care concepts aimed at tailored care. Further research aimed at refining and testing the hypothesis developed is recommended.

Adult↗
PubMed1999

Human sciences in the first semester of the dental undergraduate course at the Karolinska Institute, Stockholm.

The first 9 weeks of the dental undergraduate education at the Karolinska Institutet comprises a transition course, designed to introduce students to university studies leading to professional qualifications in patient-related health sciences. 1 week has been set aside for the theme Man and Society, highlighting the importance of the human sciences for the development of behavioural skills necessary for achieving professionalism and a holistic patient concept. Some essential ethical questions are addressed: intercultural communication, empathy, professional demeanour and the development of professional competence, and group dynamics. In this context, more specific subjects are considered, such as the emergence of the multicultural society and its implications for health services, interpersonal skills and patient communication in the health and medical fields. There are several reasons for including this theme, which forms the basis for the ethical and communicative strands throughout the entire curriculum. As 30-40% of freshmen dental students are of non-Swedish origin, it is essential to include cultural awareness seminars. Another reason is that within the EU, cultural and communicative skills are recognised proficiencies for health professionals; it is also acknowledged that effective delivery of health care may be impeded by misunderstandings in communication and conflict in ethical beliefs. Group discussions are scheduled during the week in order to allow the students to discuss their own experiences related to the theme. The students are also given a written assignment in relation to one of the seminars; the report is assessed as a part of the examination. The week is concluded by a plenum discussion summarising the group discussions. To date, 4 course evaluations, with a response rate of 92.5%, show that 97.3% of the students were positive to the theme as a whole or to specific seminars held during the week, especially intercultural communication, ethics and empathy. The students also believe that the theme is of great importance for dental health professionals.

Competency-Based Education↗
PubMed1995

Developing competency standards for occupational health nurses in Australia.

Standards for occupational health nurses were developed by the Australian College of Occupational Health Nurses principally to assist in maintaining professional competency. The standards were developed in conjunction with the profession, management, unions, and other key groups. The research techniques were a combination of nominal and expert activity and a consultation phase. The standards are organized around nine units of competency (major areas of occupational health nurse practice) with 38 elements and 110 performance criteria. A guideline document on "Assessment of Occupational Health Nurse Competencies" is currently being developed to assist assessors of the competency standards.

Australia↗
PubMed1995

Validation of cues for competencies of beginning level mental health nurses: an exploratory study in South Australian mental health agencies.

This paper outlines competency statements and their validation in mental health nursing. It describes: the background to the study, developments in perspectives on professional competency, the research process, the results, and issues that arose out of the research. The authors suggest that such research allows for the exploration of both nursing practice and the context in which psychiatric/mental health nursing is practised. This research has highlighted the complexity of mental health nursing practice in Australia, and an area of research that needs further development.

Clinical Competence↗
PubMed1994

Caring for medically fragile children at home: the parent-professional relationship.

Forty-eight mothers and fathers caring for a medically fragile child at home completed questionnaires and were interviewed about the impact of this caregiving on their family and about their relationship with home care professionals. Factors contributing to a positive parent-professional relationship were professional competence, genuine caring for the child, and respectful, supportive collaboration with the family. More hours of care provided by home health aides increased mothers' strain with the professional caregivers; more hours of care from nurses increased fathers' strain. Family cohesion, family organization, and support from the community reduced the amount of strain parents reported having with home care providers. Implications for training providers and reducing the negative impact of home care are discussed.

Adolescent↗
PubMedDate not supplied

Standard setting and litigation.

The courts apply the standard of the reasonable professional exercising a particular skill to determine liability. This is known as the Bolam test. If there is a body of competent professional opinion that supports the defendant's actions, a claim for negligence will fail. The standards applied are those that were acceptable at the time of the alleged negligence. Lower locally agreed standards would not be accepted in place of higher national ones. The courts do not accept a concept of team liability. Lack of resources is not an acceptable defence to a failure to provide the correct standard of care. Standards in NHS agreements are not enforceable by the patient but may be of evidential value in litigation.

Humans↗
PubMed1990

Neurosurgery in the decade of the brain. The 1990 AANS presidential address.

The decade of the 1990's has provided neurosurgery with multiple challenges and opportunities. Numerous developments hold a promise for making the 1990's the most rewarding decade of the 20th century for neurosurgery. The "Decade of the Brain" resolution, adopted by the United States House and Senate and signed into law by President Bush in 1989, has provided the specialty with staggering opportunities. Neurosurgery and the basic and clinical neurosciences would be strengthened by the development of a major new philanthropic organization called the "American Brain Association" that would carry the activities of the Decade of the Brain into the 21st century. Major efforts are being made to improve organized neurosurgery's responsiveness to member needs. These include the strategic planning project undertaken by the Board of Directors of the American Association of Neurological Surgeons (AANS) and efforts to strengthen the Joint Council of State Neurosurgical Societies. The AANS has been extremely active in representing the specialty in legislative matters in Washington and in multiple other forums. This Association has joined The American Board of Neurological Surgery and the Residency Review Committee in responding to orthopedic surgery's proposal for spine fellowships. It is proposed that the logo of the state, regional, and national neurosurgical societies be changed to depict our involvement in spinal surgery (as well as brain surgery) because spinal surgery represents more than half of the total effort of this specialty. The standards of worth and value that provide the driving force behind our work emphasize the need to grow in compassion as manifested by our kindness, sincerity, and concern as we grow in professional competence as reflected by our training, knowledge, and skill.

Brain↗
PubMedDate not supplied

Dental hygiene preceptorship: an issue of risk management.

The potential for legal liabilities exists in all aspects of dental hygiene practice. Contemporary malpractice law demands the highest standards for oral healthcare. Formal educational credentials of dental hygiene practitioners contribute to the provision of quality healthcare, an environment that elicits societal trust, and the prevention of legal risks. The purpose of this paper is to explore an alternative to formal dental hygiene education--preceptorship training--as it relates to current theories and practices in risk management. Key issues explored include expectations and rights of society, responsibility of the professional and the profession to society, risk management in the practice setting, and how preceptorship and formal education compare, relative to these key issues. The paper also analyzes whether the preceptorship concept is counterproductive for society, the profession, and the employer; and explains how the malpractice crisis in America is challenging oral health providers to rise to higher levels of education and professional competence.

Adult↗
PubMedDate not supplied

Ensuring excellence and competence in surgery: the imperative of mentorship from historical and philosophical perspectives.

PURPOSE: How can the surgical disciplines (1) attract and recruit students of the highest capabilities and ideals; (2) ensure professional competency; and (3) maximize efficacy and safety of biotechnology translated to patient care? METHODS: Critique of the occidental humanistic literature. RESULTS: The imperative of mentorship is grounded in the philosophical traditions of occidental society dating from antiquity. CONCLUSION: This essay affirms that imperative in relationship to the surgical disciplines from an historical perspective.

Journal Article↗
PubMed2004

Nurse competence scale: development and psychometric testing.

BACKGROUND: Self-assessment assists nurses to maintain and improve their practice by identifying their strengths and areas that may need to be further developed. Professional competence profiles encourage them to take an active part in the learning process of continuing education. Although competence recognition offers a way to motivate practising nurses to produce quality care, few measuring tools are available for this purpose. AIM: This paper describes the development and testing of the Nurse Competence Scale, an instrument with which the level of nurse competence can be assessed in different hospital work environments. METHODS: The categories of the Nurse Competence Scale were derived from Benner's From Novice to Expert competency framework. A seven-step approach, including literature review and six expert groups, was used to identify and validate the indicators of nurse competence. After a pilot test, psychometric testing of the Nurse Competence Scale (content, construct and concurrent validity, and internal consistency) was undertaken with 498 nurses. The 73-item scale consists of seven categories, with responses on a visual analogy scale format. The frequency of using competencies was additionally tested with a four-point scale. RESULTS: Self-assessed overall scores indicated a high level of competence across categories. The Nurse Competence Scale data were normally distributed. The higher the frequency of using competencies, the higher was the self-assessed level of competence. Age and length of work experience had a positive but not very strong correlation with level of competence. According to the item analysis, the categories of the Nurse Competence Scale showed good internal consistency. CONCLUSION: The results provide strong evidence of the reliability and validity of the Nurse Competence Scale.

Adult↗
PubMed1999

Occupational health education in Poland: new needs, new requirements, new programmes.

The conditions of modern work environment in Poland generate new problems, new needs and new expectations in the area of occupational health. They are associated not only with the rapidly changing technologies and new professions but also with the psychosocial factors pertaining to extensive transformations of the political and economic systems. New needs and expectations determine a new approach: firstly, to the responsibilities of the occupational health specialists; secondly, to the organisation and management of the workers health care; and thirdly, to the general principles of the occupational health, including in particular relevant legislation. The new requirements concerning the operation of the occupational health system in all the three dimensions must be addressed in the design of the new training programmes in occupational health whether under- or postgraduate. Subjects to updating and modification should be not only the content of the training but also its forms and methodology. Competence-based learning should be accompanied by the modern methods of problem solving, distant learning, organised self-education and self-assessment. The growing interest in the quality of the training should be expressed, first of all, in the activities aiming at the development of procedures to assess the effectiveness of the training. It seems also necessary to adopt the active learning approach intensifying acquisition and verification of the knowledge and skills. This approach would also lead to deeper changes in the students' mentality and behaviour, e.g. to make them able to estimate their own and others' level of professional competence or shape the personal system of professional values under the conditions of the free-market economy in the health care which entails quality requirements for the services and the competition among its providers.

Curriculum↗
PubMed1995

Responding to graduate students' professional deficiencies: a national survey.

Seventy-one doctoral programs in professional psychology were surveyed with respect to the incidence of students' professional deficiencies and related procedures. Professional deficiencies, particularly limited clinical skills and personality/emotional problems, were reported by 89% of the respondents, twice the number that have official policies for dealing with such problems. Incidence of limited clinical skills was related positively to interviewing applicants and use of practicum grades for evaluation and related negatively to using recommendation letters and reliance on clinical supervisor's assessment. Responses to deficiencies reflected appropriate due process concepts and were most likely to include terminating students and psychotherapy referral. Recommendations are made for definitions of professional competencies, development of policies, and research on the reliability and validity of screening and evaluation mechanisms.

Affective Symptoms↗
PubMed1984

Megatrends in personality assessment: toward a human science professional psychology.

Societal megatrends have assessment counterparts--superempiricism, biopsychosocial perspective, person-centering, population-specificity, self-assessment--which are used to examine the contemporary status of professional psychology. A human science approach to research, training, and practice can exemplify a profession that acknowledges these megatrends. The nurture of competent professional psychologists requires a reinvestment in Boulder Model ideology, a human science that is shared with consumers on the basis of values which communicate caring and understanding.

Journal Article↗