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Development, utilization, and evaluation of educational programs for patients with maxillary and mandibular defects.

Prior to the development of these two rehabilitation programs, there was no informational material available for patients having undergone debilitative maxillary or mandibular surgery. Realizing that what little information the patients and their families did receive during the rehabilitative process was often fragmented, misunderstood, or simply forgotten, two audiovisual programs were designed to fulfill a long-neglected need. Experience with this project indicates that if patient rehabilitation programs are to be effective, it is essential that the patients contribute to the program's development. Only in this way can members of the health-care team be assured that the transmission of pertinent information through variatious educational materials is totally effective.

Audiovisual Aids↗

The evaluation of educational and economic effects on life expectation by linear regression analysis.

Socioeconomic effects are supposed to have a fairly long time delay in regard to health development. Taking into consideration time lags, correlation and regression analysis are executed to explain the difference in health levels which exist among countries. The infant mortality rate, life expectation at birth, adult literacy rate, proportions of school enrollment and GNP per capita are taken as variables and their characteristics are discussed. In addition, countries are divided into three groups, i.e. low income, middle income, and industrialized countries, to show that the educational and economic effects on health development vary according to the economic level of the countries.

Developing Countries↗

System, environmental, and policy changes: using the social-ecological model as a framework for evaluating nutrition education and social marketing programs with low-income audiences.

A variety of nutrition education interventions and social marketing initiatives are being used by the Food Stamp Program to improve food resource management, food safety, dietary quality, and food security for low-income households. The Social-Ecological Model is proposed as a theory-based framework to characterize the nature and results of interventions conducted through large public/private partnerships with the Food Stamp Program. In particular, this article suggests indicators and measures that lend themselves to the pooling of data across counties and states, with special emphasis on systems, environment, and public policy change within organizations at the community and state levels.

Food Services↗

The clinical skills resource: a review of current practice.

This review is based on the findings of the Southampton Clinical Skills Project, which was a needs assessment and feasibility study to consider the development of a multiprofessional Clinical Skills Resource at Southampton. The project spanned a period of 18 months and used a range of methods of data collection, including visits to 12 clinical skills facilities in the UK. Most existing clinical skills centres have developed in response to changing healthcare policy, curricular initiatives and increasing emphasis on the quality of assessments and competencies. There is also increasing recognition that clinicians are no longer able to teach effectively all skills to students in the traditional ways, and that clinical skills training and assessment, particularly for undergraduates, is an area of deficiency. The potential scope of clinical skills centres is broad and encompasses not only clinical and communication skills but medical informatics, computer assisted learning, multiprofessional learning and assessment. Skills centres can also promote self directed and lifelong learning methods. The planning of skills centres involves a variety of stakeholders and users, including undergraduates, postgraduates, acute and community Trusts, Postgraduate Deans and medical schools. A successful skills centre needs to be flexible in its design, integral to the curriculum and relevant to educational and training requirements. This requires planning, organization and resources. Different organizational models can be used, depending on local factors. The management of skills centres involves consideration of issues such as security, safety, supervision of learners and staff development, informed by a network of experts and everyday users. The development of skills centres should include ongoing educational evaluation of outcomes and educational research. The use of a clinical skills centre has potential benefits for staff and students, including the provision of a safe environment in which to learn and practise skills before using them in the real clinical setting. This can reduce anxiety in students and protect patients from novice practice. Clinical skills centres provide a setting for structured learning with feedback as well as assessment of competence. The limitations of a skills centre are that it can only provide simulated experiences which are an adjunct to, but can never replace real clinical experience.

Clinical Competence↗

Can the strength of candidates be discriminated based on ability to circumvent the biasing effect of prose? Implications for evaluation and education.

PURPOSE: Residents have greater confidence in diagnoses when indicative features are presented in medical terminology. The current study examines the implications of this result by assessing its relationship to clinical ability. METHOD: Candidates writing the Medical Council of Canada's Qualifying Examination completed six questions in which the terminology used was manipulated. The influence of aptitude was examined by contrasting groups based on performance on the medicine section of Part I. RESULTS: The difference between the candidates was greatest in the mixed conditions in which the features consistent with one diagnosis were presented in medicalese and those consistent with a second diagnosis were presented using lay terminology; weaker candidates were more biased by language than stronger candidates. CONCLUSIONS: The results suggest that the language used in presenting case histories will influence the reliability of medical examinations. Furthermore, they suggest that weaker candidates might benefit from practice in making the translation between lay terminology and medicalese.

Age Factors↗

Evaluation of educational methods in a comprehensive cost-containment project in ambulatory care.

The cost of medical care in the United States is a matter of great concern to many health policy makers and physicians as well as to the seekers of care. At the University of New Mexico, a comprehensive cost-containment education program was devised and put into effect with residents from three primary care disciplines. In addition to documenting the effectiveness of the educational package in reducing patients charges, we asked house staff to state which parts of the package were of most use. Wall posters displaying charges for commonly ordered tests, procedures, and prescription items and the distribution of sample bills for patients seen by the individual resident were rated most highly. A test of knowledge of charges to patients did not show resident improvement after education. Cost-containment education can be effective in reducing patient charges, even if physicians do not internalize the actual charge data. We recommend the inclusion of cost-containment education in all primary care training programs, as these physicians play such an important role in the generation of patient charges.

Ambulatory Care↗

Evaluation of educational programs in inflammatory bowel disease.

BACKGROUND: Little is known about the status of patient knowledge in inflammatory bowel disease (IBD) and potential benefit of educational programs. The authors conducted this study to assess 1) the knowledge of IBD of participants attending educational workshops offered to the public and 2) the effect of the workshop on participants' knowledge level. METHODS: Workshops on IBD were offered to the public at nine communities in the United States. Each workshop consisted of a combination of 3 hours of presentations and question-and-answer sessions. Participants, including patients with IBD and their parents, spouses, siblings, friends, and significant others, were asked to complete the Crohn's and Colitis Knowledge Score questionnaires just before (Q1) and immediately after (Q2) the workshop and approximately 3 months later (Q3). The authors scored one point for each correct answer to the 30 questions in the Crohn's and Colitis Knowledge Score. RESULTS: Of the 734 who completed the Q1, 33.7% gave correct answers for questions about IBD complications, 36.2% for treatment, 61.4% for general knowledge, and 64.8% for diet. After the workshop, the proportion for these four knowledge areas increased by 11.0% to 19%. For the participants who completed all of the three questionnaires and answered all the 30 questions (N=59), the mean score was 18 at Q1, 22 at Q2 (p<0.001, Q2 vs. Q1), and 21 at Q3 (p<0.001, Q3 vs. Q1). CONCLUSIONS: The public's general knowledge of IBD is low. Educational programs oriented toward IBD improve participant's knowledge, and the knowledge they acquired is retained for at least 3 months.

Educational Measurement↗

Parent education: an evaluation of STEP on abusive parents' perceptions and abuse potential.

PROBLEM: To examine the effects of a structured, time-limited parent training group on abusive or potentially abusive parents. METHODS: A pretest-posttest control group design was used with consenting parents (N = 18) to examine the effects of Systematic Training for Effective Parenting (STEP) on abusive parents' perceptions of their children's behaviors and on the parents' potential to physically abuse. The Adlerian Parental Assessment of Child Behavior Scale and the Child Abuse Potential Inventory were used to measure treatment effects. FINDINGS: After participating in STEP, abusive parents had significantly more positive perceptions of their children and were significantly less potentially abusive. Using volunteers, the project cost an average of $100 for each parent. CONCLUSIONS: The research lends empirical support to individual psychology and family systems theory. Future research is indicated using larger samples to examine lay vs. professional leadership of the groups, as well as comparisons of different parenting programs with abusive parents.

Adult↗

A breastfeeding evaluation and education tool.

New parents needs a way to assess the adequacy of their baby's breastfeeding. Health care providers, in addition, need a tool for teaching breastfeeding technique. This article describes a tool that focuses parental attention on eight elements relating to early breastfeeding: feedings, positioning, latch, suck, milk flow, intake, output, and infant weight gain.

Breast Feeding↗