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PubMed1992

The U.S. health care system: challenges for the academic health professions community.

The author discusses the need to create structural reforms in the nation's health care system, built around a consensus on workable, affordable solutions, the first of four needs in this area, and presents a set of principles that must frame the debate on health care reform (e.g., that health care must be accessible to all Americans). He also presents practical options that address the United States' most urgent health care concerns (e.g., making the cost of health insurance more affordable for small businesses). The second need is to preserve and strengthen the nation's biomedical research enterprise; the author outlines steps that are already under way to deal with this need (e.g., the development of a Biomedical Research Initiative in the Public Health Service and the allocation of funds for various research-connected activities). The third need is to increase the participation of minority youth in science and the health professions; the author outlines steps that are being taken to encourage such participation (e.g., helping historically black colleges and universities and funding training programs for training minority professionals in health care). The last need discussed is to foster a culture of character: empowering citizens to take control of their own lives to eliminate costly debilitating illness before it strikes. For all these needs to be addressed successfully, it is crucial that the involvement of the academic health professions community and the community at large be expanded.

Delivery of Health Care↗

PubMed2001

Diminished use of osteopathic manipulative treatment and its impact on the uniqueness of the osteopathic profession.

PURPOSE: To determine whether osteopathic manipulative treatment (OMT), a key identifiable feature of osteopathic medicine, is becoming a "lost art" in the profession, and whether the long-term evolution of osteopathic medicine into mainstream medicine and particularly specialization has had a similar impact on the use of OMT by family practitioners and specialists. METHOD: In April 1998, a two-page questionnaire was mailed to 3,000 randomly selected osteopathic physicians in the United States to assess factors affecting their use of OMT. Descriptive statistics, linear regression analyses, and analysis of variance techniques were used to test for differences. RESULTS: The response rate was 33.2%. Over 50% of the responding osteopathic physicians used OMT on less than 5% of their patients, and analysis of variance revealed OMT use was significantly affected by practice type, graduation date, and family physicians versus specialists. For specialists, 58% of the variance regression was attributed to barriers to use, practice protocol, attitudes, and training, whereas for family physicians, 43% of the variance regression was attributed to barriers to use, practice protocol, and attitudes. More important, the eventual level of OMT use was related to whether postgraduate training had been undertaken in osteopathic, allopathic, or mixed staff facilities, particularly for osteopathic specialists. CONCLUSIONS: The evidence supports the assertion that OMT is becoming a lost art among osteopathic practitioners. Osteopathic as well as allopathic medical educators and policymakers should address the impact of the diminished use of OMT on both U.S. health care and the unique identifying practices associated with the osteopathic profession.

Adult↗

PubMed2003

Student providers aspiring to rural and underserved experiences at the University of Washington: promoting team practice among the health care professions.

In the United States there are shortages of health care providers for both rural and underserved populations. There are also shortages of interprofessional or team-based training programs. To address these problems, the University of Washington's Area Health Education Center program and School of Medicine offer a voluntary extracurricular program for students in the university's six health science schools. The Student Providers Aspiring to Rural and Underserved Experiences (SPARX) program is an interprofessional, student-operated, center/school-supported program consisting of a wide range of activities. SPARX supports students interested in practicing among rural and urban medically underserved patients and in interacting with their peers in other health professions schools. A brief history and description of the program are presented, along with results of a survey of students indicating that SPARX reinforces their interest in practice among the underserved and influences their understanding of other health professions. Data on residency choices of medical students who have participated in the SPARX program are presented, indicating that these students are more likely to select primary care residency programs than the average students in their classes.

Education, Medical, Undergraduate↗

PubMedDate not supplied

The significance of autonomy in the nursing home administrator profession: a qualitative study.

Nursing home administration is seeing high turnover and low entrance into the profession. Face-to-face interviews were conducted with thirty NH administrators and coded using qualitative analytical techniques. It was found that constrained autonomy contributes to job dissatisfaction in the nursing home administrator profession, and that autonomy contributes to increased satisfaction and may lower administrator turnover.

Adult↗

PubMed1977

Physician assistants: an overview of an emerging health profession.

This article describes the background characteristics, work environments, and job characteristics of the physician assistant profession as they existed in late 1974 and early 1975. Of the 939 physician assistants participating in this study, three-fourths were working in primary care specialties and half were located in communities having fewer than 50,000 persons. Favorable levels of responsibility for patient care, supervisory support, and role acceptance were reported by respondents. The mean income was $14,285. Job opportunities appeared plentiful, but career opportunities were considered by most to be either limited or nonexistent. Physician assistants are providing important additional medical manpower in primary care fields and in smaller communities, but the preceived lack of opportunities for career advancement may prove to be a significant problem for this emerging health profession in the years ahead.

Career Mobility↗

PubMed1985

The American Journal of Nursing and the socialization of a profession, 1900-1920.

The editorial position and content of each issue of the first 20 years of the American Journal of Nursing were explored in relation to the emergence of nursing as a profession. Themes identified reflect professional issues, socialization of nurses, and the influences between other major social/political movements. The evidence of the study reveals strong nursing leadership toward (1) legitimatizing nursing as a self-controlled profession and (2) generating reform in nursing and society at large. The evidence of this study contradicts many prevalent popular views about the history of nursing.

History of Nursing↗

PubMed1997

Compression stockings and rubber floor mats: do they benefit workers with chronic venous insufficiency and a standing profession?

Chronic venous insufficiency (CVI) is a burden to many workers, especially to those with a standing profession. Preventive measures are seldom taken. A quasirandomized parallel group trial was performed in 114 male workers with CVI and a standing profession. For 3 months, class II compression stockings or rubber floor mats were used vs controls. Outcome measures were diurnal volume changes (leg swelling) and complaints of the lower legs. With the stockings, a significant decrease in complaints was found, as well as a significant decrease in leg swelling. Rubber mats were often not suitable for hygienic and safety reasons. The decrease in complaints in the group using rubber mats was less pronounced, and leg swelling did not differ from that of the control group. Compression stockings appeared to be superior to rubber mats with regard to applicability, diminishing subjective complaints, and decrease of diurnal leg swelling.

Analysis of Variance↗

PubMed2001

The credentialing of a population-based health profession: lessons learned from health education certification.

This article summarizes research and issues related to health education certification. Health education's experience with certification provides valuable insight for other public health professions because of the credential's population-based emphasis, its recent development, and its broadly defined cross-cutting skill set. Although data are still emerging on the outcomes of health education certification, most studies indicate that it has had a positive impact across multiple dimensions. Critical to this success has been providing profession-wide opportunities for input, communicating with key stakeholders, establishing an independent credentialing agency, and basing the credential on scientifically and legally defensible competencies that are linked to job responsibilities.

Certification↗

PubMed2001

The impact of the Balanced Budget Act of 1997 on the physical therapy profession.

The Balanced Budget Act (BBA) of 1997 was one of the most significant acts of legislation ever to affect the physical therapy profession. Three months after the BBA was implemented, a survey of over 600 physical therapists in the state of Florida was conducted. This article examines the immediate impact of the BBA on physical therapists and their ability--or their perception of their ability--to maintain or successfully seek full-time employment in the profession.

Adult↗

PubMed2006

Working across the boundaries of health professions disciplines in education, research, and service: the University of Washington experience.

The Institute of Medicine's vision for health professions education specifies working together across professions and schools to provide patient-centered care. Improvement in collaborative preparation of health professionals is seen as central to achieving substantial improvement in the quality of health care. In this article, the authors address one central question: How can medical schools work with other health-sciences schools to promote their educational, research, and service missions? The authors summarize the history of the University of Washington (UW) Health Sciences Center in promoting interprofessional collaboration in education, service and research; analyze the key strategic, structural, cultural and technical elements that have promoted success or served as barriers in the development of the UW Center for Health Sciences Interprofessional Education and Research; and suggest strategies that may be transferable to other institutions seeking to implement an interprofessional health sciences program. These include both top-down and bottom-up authority and function in key working groups, institutional policies such as interprofessional course numbers and shared indirect costs, and development of a culture of interprofessionalism among faculty and students across program boundaries.

Biomedical Research↗

PubMed2004

Important computer competencies for the nursing profession.

Nursing requires computer competencies. This study aimed at identifying those competencies required for the nursing profession in Taiwan. The Delphi technique was deployed in this study. In the Delphi questionnaires, computer competencies were sorted into seven domains: concepts of hardware, software, and networks; principles of computer applications; skills of computer usage; program design; limitations of the computer; personal and social issues; attitudes toward the computer. In three Delphi questionnaires, nursing informatics experts gave us their opinions on the importance of each computer competency for the nursing profession. The experts also designated when the competency should be cultivated. This study provides a comprehensive list for nursing professionals to check on their computer competence. The results of this study should also serve as good references for teachers and schools in designing related curriculums.

Adult↗

PubMed2005

Sleep and the medical profession.

PURPOSE OF REVIEW: This review addresses the way in which sleep physiology influences the medical profession and health care delivery. RECENT FINDINGS: The training process for the medical professional has undergone dramatic changes over the past century. In recent times, however, the complexity and level of care delivered has out-stripped a trainee's ability to forego sleep and is compromising both physician and patient safety and thereby threatens the foundation of the profession. Recently, significant strides have been made in our understanding of sleep loss and consequences to physicians-in-training. Nevertheless, the implementation of changes fostered by such findings faces numerous conceptual and practical obstacles. This review updates the reader on recent evidence for changing the way medical professionals are trained, and opines on how solutions generated from such research should be embraced. Additionally, the deficiencies in our current understanding of sleep and medical training are identified so that future research can be undertaken in such areas. SUMMARY: Acknowledging the defects in our current system of training physicians and enacting further changes is sorely needed to improve patient safety and the well-being of physicians-in-training.

Clinical Competence↗

PubMed1983

An analysis of the factors which impinge on a nurse's decision to enter, stay in, leave or re-enter the nursing profession.

As part of a wider study concerned with the changing nurse employment patterns a detailed questionnaire was completed by a total of 2325 qualified female nurses, 841 of whom were working fulltime in nursing, 634 were inactive, 678 were offering their services on a part-time basis and 172 were working in some other occupation. In a previous article the results of the analysis conducted on the responses to the attitude questions were presented. In this paper the replies to those questions aimed at soliciting the reasons felt to have impacted on the respondent's decision to take up nursing, to stay or to leave the profession and to re-enter the profession are analysed. As the questionnaires were distributed in the course of two projects separated by 4 years, what is of particular interest is the similarity of the two sets of results. These indicate that there is still a very high level of job satisfaction as evidenced by the extent to which nursing would be recommended to a friend or relative. The primary obvious reason for inactivity is the existence of a young child but when further intentions are explored it is clear that there is a large pool of qualified nurses keen to resume a career the main obstacle being the lack of sufficient flexibility of hours of working.

Adult↗

PubMed2004

The construction and development of health professions: where will it end?

AIM: The aim of this paper is to evaluate the construction and development of professional health work as it has occurred over the past 15 years in the UK and present an informed, speculative analysis of present and future health care work. BACKGROUND: Since the early 1990s, there has been a strong political imperative in the United Kingdom (UK) to develop existing roles in nursing and the allied health professions, blurring professional boundaries and emphasizing patient/client-centred care delivery. This has already led to major changes in professional work patterns and the privileging of interprofessional work. Many of these changes have been shaped and determined by cultural and economic considerations. DISCUSSION: The socio-political context for the major changes in the roles of non-medical professionals in the UK is explored to demonstrate both consistency and contradictions with postmodern, consumerist values. The theoretical concepts that underpin professional formation and enable professionalization are examined in relation to present health service drivers for interprofessional work and the development of advanced practice roles, noting similarities and differences in aspirations. CONCLUSION: While professionalization and role development appear to have benefited both professions and service users in the short-term, their adoption and institutionalization by policymakers are influencing its direction in ways which both may ultimately find troublesome.

Delivery of Health Care, Integrated↗

PubMed1995

Health professions development.

Health professions development is an integral part of national health plans. It is influenced by various factors and should be continuously updated to meet the changing health situation and related disciplines of the country. There are three forms of establishing a health manpower development plan: a market-oriented form, a goal-achievement form and a normative form. A combination of all forms is best if carried out by a community-oriented team of academic health professions and health care providers. Although countries of the Eastern Mediterranean Region share many demographic, geographic, and sociocultural characteristics, there are marked differences in resources, health manpower structure and availability in health services. Health professional development plans should be formulated according to existing situations. Other factors influencing health manpower development in the future include political, social and economic trends, changes in morality and disease patterns, industrialization, availability of health services and academic institutions. Perspectives guiding planning for the development of various categories of health professionals are presented.

Delivery of Health Care↗

PubMed2006

History for a practice profession.

This essay explores the meaning of history for a practice profession. It argues that our clinical backgrounds suggest particular kinds of historical questions that colleagues with different backgrounds would not think to ask. This essay poses three possible questions as examples. What if we place the day after day work of caring for the sick - that which is nursing - at the center of an institution's history? What if we were to embrace a sense of nurses and nursing work as truly diverse and different? What if we were to analytically engage the reluctance of the large number of nurses to formally embrace feminism? This essay acknowledges that these are not the only possible questions and, in the end, they most likely will not even be the important ones. But this essay does argue that we, who are both clinicians and historians, need to more seriously consider the implications of our questions for disciplinary practice and research. It argues, in the end, that the meaning of history to a practice profession lies in our questions: questions that are different than those raised by other methods, and questions that may escape notice in the press of daily practice and research.

Attitude of Health Personnel↗

PubMed2006

Representations of the dental surgery profession and the motivations given by second-year French students for applying for dental surgery.

AIM: The aim of the present study was to evaluate the representations odontology students had of their career path. Second-year odontology students were questioned about their own motivations and the motivations they attributed to dentists in choosing this profession. METHODS: The students were asked to complete a questionnaire during the first course and again after 5 months. It was thus possible to study the evolution of their motivations after 5 months of interactions with their fellow students and professors. RESULTS: Whether or not students were able to choose their career path following the selection examination at the end of the first year of the medical programme was an important variable in determining individual motivations and the motivations they attributed to dentists in choosing the dental profession. For example, students who were unable to choose their career path reported that they would like to work in the public health system, while those who were able to choose said they chose odontology as a vocation. The closing of the gap between the two groups during the period between the two questionnaires highlighted the increasing cohesion of the group. CONCLUSION: Beyond the differences between the motivations provided, this study showed that students who had not planned to become dentists before the selection examination needed some time to familiarise themselves with the situation and accept the change in their career path.

Attitude↗

PubMedDate not supplied

Is nursing's image a deterrent to recruiting men into the profession? Male high school students respond.

The extremely small number of men choosing the nursing profession as a career, coupled with the continuing shortage of nurses, prompted an investigation of male high school students' opinions about nursing. Kohler and Edwards' Career Questionnaire was administered to 126 male high school students representing grades 9-12 from three area public schools. Findings show that although the majority of subjects have a positive perception of nurses and nursing, the vast majority are not planning on entering the profession. Analysis of subjects' beliefs about nurses' financial status offers a possible explanation.

Adolescent↗