SEARCH · Search PubMed

Results for “Professional Competence”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources

PubMed2006

Nurse education--the role of the nurse teacher.

AIM: To explore and analyse the role of the nurse teacher. BACKGROUND: This paper examines the issue of clinical credibility among nurse teachers which has been ongoing for over a decade. The move of nurse education from colleges of nursing to the Higher Education Institutes was seen in 1992. Since then, nurse teachers have been faced with the need to juggle the roles of teaching, administration, research and clinical support for students. Nursing students within these Higher Education Institutes require more than the traditional theoretical classroom teaching. Nurse teachers have a role beyond this in encouraging students to link theory with practice, and practice with theory. Therein lies a challenge for nurse teachers to ensure they remain credible within the clinical setting and continue to provide education and support, which is firmly grounded in both practice and theory. METHOD: The authors have critically reviewed the evidence related to the role of the nurse teacher in an attempt to identify key concepts and ideas, assumptions, supporting examples and the implications for their role. CONCLUSION: The role of the nurse teacher, it would appear, is a dynamic one that needs to engage actively the needs of the student. Nurses therefore need to be dynamic in their approach in order to respond to both local and global demands and ensure that students become competent, professional, knowledgeable and caring in their approach. RELEVANCE TO CLINICAL PRACTICE: This paper demonstrates the complex and ever changing role of the nurse teacher. This paper attempts to help nurse teachers understand the complex nature of their role.

Clinical Competence↗

PubMed1985

Surgeon's role in ethical decisions.

Three clinical cases are summarized to provide examples of reasonably common dilemmas in decision making. Instead of a focus on the solutions, the issue of "who decides" is raised. Contrary to frequent practice, the position is taken that, legally and ethically, substantive patient involvement is required. Factors implicated in physician dominance are briefly discussed, including subjectivity, medical care environments, and notions of the proper role of the physician. Suggestions for the surgeon's role include professional competence, patient education (including effective communication), and separation of the medical/technical aspects of decisions from the ethical/personal ones.

Decision Making↗

PubMed1996

What is accountability in health care?

Accountability has become a major issue in health care. Accountability entails the procedures and processes by which one party justifies and takes responsibility for its activities. The concept of accountability contains three essential components: 1) the loci of accountability--health care consists of at least 11 different parties that can be held accountable or hold others accountable; 2) the domains of accountability--in health care, parties can be held accountable for as many as six activities: professional competence, legal and ethical conduct, financial performance, adequacy of access, public health promotion, and community benefit; and 3) the procedures of accountability, including formal and informal procedures for evaluating compliance with domains and for disseminating the evaluation and responses by the accountable parties. Different models of accountability stress different domains, evaluative criteria, loci, and procedures. We characterize and compare three dominant models of accountability: 1) the professional model, in which the individual physician and patient participate in shared decision making and physicians are held accountable to professional colleagues and to patients; 2) the economic model, in which the market is brought to bear in health care and accountability is mediated through consumer choice of providers; and 3) the political model, in which physicians and patients interact as citizen-members within a community and in which physicians are accountable to a governing board elected from the members of the community, such as the board of a managed care plan. We argue that no single model of accountability is appropriate to health care. Instead, we advocate a stratified model of accountability in which the professional model guides the physician-patient relationship, the political model operates within managed care plans and other integrated health delivery networks, and the economic and political models operate in the relations between managed care plans and other groups such as employers, government, and professional associations.

Delivery of Health Care, Integrated↗

PubMed1990

Some ethical issues in continuing medical education.

In Israel there is increasing pressure for a commitment towards accredited continuing medical education (CME) in the expectation that this will improve the quality of medical care. Some ethical problems in these trends are discussed in relation to adult learning, various educational methods, the assessment of quality of medical care and the problems of cognitive assessments, examinations, peer review and medical audit. It is recommended that high priority be given to educational research on the methodology of CME and its potential impact on professional competence and the quality of medical care. A voluntary commitment to regular CME should be considered as much a part of the responsibility of the practising doctor as his service commitment. In this context, accreditation could serve as a means towards facilitating and verifying the doctor's commitment to CME. The basic problem is however, not only the transference of scientific concepts, but also the change in professional behaviour in response to constantly changing medical needs.

Accreditation↗

PubMed2004

The status of vascular surgery as an independent specialty in Europe: are the relationships with general and cardiothoracic surgery a problem?

Vascular surgery has established a clear clinical and scientific profile in Europe over the last decade, but it presents a highly complex, disorganized, and unplanned pattern. It is a specialty in the majority of the present member states of the European Union (EU), but in the United Kingdom, Germany, the Netherlands, and Sweden this is not the case. With the current expansion of the EU with 13 countries, mainly from the former Eastern Bloc, it will be even more necessary to ensure at least some level of convergence in the standards of training, certification, quality assured practice, continuing medical education, recertification, access to and quality of care, etc, because free migration of doctors, and patients, is a derivative of the cornerstones of the EU treaties, namely free movement of the citizens (and capital). The profession has been successful in creating a simple and coherent system for organization within the European Union of Medical Specialists with a board of vascular surgery, for a (voluntary) European proficiency test for specialists (the EBSQ-Vasc), and for European continuing medical education, all in close collaboration with the premier scientific society, the European Society for Vascular Surgery. The fantastic reductions in working hours for young doctors in the EU represent a serious threat to standards of training and, ultimately, to the patients. This, in connection with increased litigation and compensation demands for incompetence and negligence, makes it even more necessary to establish European minimum standards for training, professional competence, and an obligatory European specialist examination. A key element in this difficult process is the establishment of vascular surgery as a specialty in all member states. Day-to-day collaboration with radiologic interventionalists has developed pragmatically at the local level in most places, but only when the administrative structures mature and vascular surgery becomes a specialty in all countries will the necessary tools be available for the avoidance of professional conflicts with colleagues from other specialties.

Education, Medical, Graduate↗

PubMed1997

Credentialing and privileging: insight into the process for acute-care nurse practitioners.

Acute-care nurse practitioners must be knowledgeable of the mechanisms whereby their scope of practice is defined and regulated, and through which professional competence is ensured. The mechanisms whereby hospitals determine scope and practice parameters is through credentialing and the delineation of clinical privileges. This article supplies background for the influences to the credentialing and privileging process and provides insight into how the process is conducted. The potential future trend of economic credentialing is discussed briefly. Acute-care nurse practitioners are encouraged to negotiate for delineation of clinical privileges that are consistent with their professional and legal scope of practice, educational and individual capabilities, and the safe delivery of quality patient care. It is important that the process not be misused to erect barriers to practice, resulting in underserving of patient and organizational needs.

Humans↗

PubMed1993

The HIV-infected house officer: residency training issues.

Efforts to fully integrate physicians infected with the human immunodeficiency virus (HIV) into residency programs have been complicated by concerns of the potential risks of viral transmission from physician to patient. Despite numerous studies, this potential risk has not been quantified. This article addresses the issue of HIV-infected interns and residents, classifying HIV as a potential disability. The suggested recommendations emphasize routine monitoring and evaluation of professional competence and compliance with proper infection control procedures, as delineated by the Centers for Disease Control and Prevention. The need for hospitalwide guidelines and adequate health and disability insurance are also discussed.

Female↗

PubMed1997

[Job satisfaction among physicians employed in public health services].

For several years the high turnover of doctors in municipal public health positions has been a cause of concern in Norway. More information on the causes of the higher turnover, and of factors that could promote greater satisfaction, could provide a basis for discussing what needs to be done. In order to find out the main sources of satisfaction, or dissatisfaction, and their relative importance, a questionnaire was mailed to all doctors in public health positions from 1988 through 1991. They were asked about 12 different aspects of their jobs and general family well-being. 218 (81%) of the doctors who had held such a position for the whole period ("the stable"), and 98 (87%) of those who had quit ("the quitters") responded. Sources of great satisfaction were opportunities for outdoor recreation and the well-being of the family. The doctors were least satisfied with the level of income and the heavy load of work. When asked to state the most important sources of satisfaction, both stable and quitters gave first priority to the professional content of the work and collaboration with colleagues. The stable also gave high priority to general family well-being. For the quitters, an important negative factor was the heavy work load. About 27% of the stable and 42% of the quitters thought the job required too much effort. More of the stable group than of the quitters felt professionally competent, and that they were doing a good job. On the other hand, more of the quitters than of the stable group felt they had little influence on the local health policy, and that the job was uninteresting. In the efforts to reduce the turnover of doctors in public health positions, the health authorities should consider the wider aspects of the job, not just the wage. To increase stability and job satisfaction, greater attention should be given to the professional content of the work, the need for professional collaboration, and the heavy work load.

Adult↗

PubMed2005

Cardiac nursing: achieving competent practitioners.

This paper describes how competency statements were integrated into an academic framework to provide a transparent yet flexible career pathway for the nurse working in acute cardiac care. Nurses are expanding and developing their roles and use wide ranging skills and knowledge to care for patients. Additionally, models of care delivery are changing and patients are cared for in a variety of settings. Where evidence exists, these models demonstrate improvement in the provision and quality of services and contribute to improved quality of life, maximise medication and therapy and reduce waiting times for investigations. However, whilst many studies have demonstrated benefit, translating these results into routine practice requires skilled nurses who are "fit for purpose," and to support this, professional competencies can be used to measure competence in practice whilst informing educational initiatives. This paper outlines the development of competency statements that identify the knowledge and skills required for safe, effective and competent care and direct the cardiac nurse acquire skills and knowledge in a focused and coherent way.

Attitude of Health Personnel↗

PubMedDate not supplied

Knowing what the others know: a study on interprofessional communication between nurses and medical doctors.

Communication and cooperation between experts from different specialties is a necessary element of professional competence. We have set up a research program to investigate cognitive aspects of interprofessional and interdisciplinary communication. We assume that successful communication essentially relies on communicants' ability to take the perspective of the other, i.e., assessing the background knowledge, expertise, plans, and so on, of one's co-communicators. The present paper reports on an interview study with medical doctors and nurses from three paediatric oncology units. The research interview was especially designed to allow for a detailed assessment of the professionals' ability to take their work-partners' perspective. Two areas will be examined: The ability to assess the work demands resulting from parental questions, and the use of differences in professional perspectives for prognosis. With respect to parental questions, doctors' and nurses' assessments of their respective work partner's task demands turned out to be only partly correct. Furthermore, the results suggest that doctors do not effectively benefit from nurses' experiential knowledge about patients when venturing prognoses. Educational measures designed to improve interprofessional communication could help to overcome these deficits.

Child↗

PubMed2006

An elective course in cultural competence for healthcare professionals.

OBJECTIVES: To develop and assess a cultural competence elective course used to increase students' levels of awareness, acceptance, and understanding of the role of culture on healthcare perceptions. DESIGN: Classroom and at-home assignments were designed, small group discussions were conducted, and guest speakers were recruited to allow students to explore different viewpoints about other cultures. ASSESSMENT: Student performance was assessed based on assignments and participation in class discussions. Student satisfaction with the course was assessed using a standard course evaluation form. CONCLUSION: Participation in the course resulted in greater student understanding of cultural issues facing healthcare providers and in students feeling more capable of integrating cultural factors into patient care.

Cultural Diversity↗

PubMed2002

Shifting paradigms: from Flexner to competencies.

Realizing medical education is on the brink of a major paradigm shift from structure- and process-based to competency-based education and measurement of outcomes, the authors reviewed the existing medical literature to provide practical insight into how to accomplish full implementation and evaluation of this new paradigm. They searched Medline and the Educational Resource Information Clearinghouse from the 1960s until the present, reviewed the titles and abstracts of the 469 articles the search produced, and chose 68 relevant articles for full review. The authors found that in the 1970s and 1980s much attention was given to the need for and the development of professional competencies for many medical disciplines. Little attention, however, was devoted to defining the benchmarks of specific competencies, how to attain them, or the evaluation of competence. Lack of evaluation strategies was likely one of the forces responsible for the three-decade lag between initiation of the movement and wide-spread adoption. Lessons learned from past experiences include the importance of strategic planning and faculty and learner buy-in for defining competencies. In addition, the benchmarks for defining competency and the thresholds for attaining competence must be clearly delineated. The development of appropriate assessment tools to measure competence remains the challenge of this decade, and educators must be responsible for studying the impact of this paradigm shift to determine whether its ultimate effect is the production of more competent physicians.

Clinical Competence↗

PubMed1994

Trends in alcoholism among male doctors in Scotland.

Alcohol abuse within the medical profession has long been an issue of concern. Recently, the General Medical Council reported that half of the doctors reported for health difficulties liable to affect professional competence were found to have an alcohol problem. This paper examines how rates of alcoholism among male doctors in Scotland have changed over the last three decades. Admission and discharge rates for doctors to psychiatric inpatient beds with diagnoses of alcoholism are compared with non-medical professions, for the years 1963-87. The results, assessed in the light of changing Standardized Mortality Rates for liver cirrhosis for the medical profession, suggest that doctors as a group remain at a higher risk of alcoholism compared to other professionals, but that this increased risk appears to be largely accounted for by a cohort of heavy-drinking doctors over the age of 45 years.

Adult↗

PubMed1990

[Psychological characteristics of the physician].

As a result of psychological survey of professionally competent physicians with more than ten-year experience general distinguishing features of physicians were revealed--cordiality, communicativeness, kind disposition towards people, critical assessment of motives of other people, critical assessment of motives of other people, discretion, honesty. A physician is oriented towards success in his activity while being fully responsible for his actions. There are some peculiarities typical for personality of a therapist, surgeon and emergency care physician. The data obtained could be used for the purpose of improving public health as well as for the purpose of professional selection of applicants and subinterns.

Attitude of Health Personnel↗

PubMed2002

The impact of the 9-21 earthquake experiences of Taiwanese nurses as rescuers.

The powerful earthquake of September 21, 1999 wrought incalculable havoc on lives and properties in Taiwan. Although the scars of the earthquake can never be erased, the calamity can lead to a more full understanding of the experiences, perceptions and reflections of nurses involved directly in post-rescue situations. The purpose of this study was to compare the impacts of rescue experiences on Taiwanese female and male nurses who worked as rescuers following the earthquake of 21 September. A purposive sample of 46 nurses (40 women, 6 men) (mean age 26) who worked in a renowned hospital with a reputation for high quality of emergency care in Northern Taiwan was obtained. Data were collected by in-depth semi-structured interviews and analyzed by a unique mode of between-method triangulation. The majority of the subjects (38 female, 6 male) reported various impacts from their rescue experiences. They are: (a) recognition of the impermanence of life and wishing to lead a more significant life (32 female, 3 male); (b) more caring relationships with others and for their homeland (19 female, 5 male); (c) a clearer concept of disaster care (19 female, 4 male); (d) a better appreciation of the value of nursing and their own self-worth (11 female, 3 male); (e) enhanced knowledge of the survivors' needs (3 female); and (f) enhanced ability to identify the factors hindering rescue operations (1 female, 2 male). However, one female nurse complained of having been bothered by feelings of fear of earthquake disasters resulting from her rescue experience. Rescue experiences help to strengthen most Taiwanese nurses' professional competency, reinforce their commitment to nursing, and lead them to have positive life goals. The relative weight of the impacts for male and female nurses were somewhat different. The vulnerability of nurses, which was manifested in the post-rescue stage, requires attention and long-term follow-up. A comprehensive and organized pre-rescue training program which recognizes the need to care for both acute and chronic post-disaster conditions, along with spiritual care for the survivors, as well as a "disaster reduction" course for health professionals are suggested.

Adult↗

PubMed2004

Evaluation of primary health care reform in Estonia from patients' perspective: acceptability and satisfaction.

AIM: To analyze the population's view of the primary health care reform five years after the formal implementation of the reform investigating the acceptability of the primary health care system, patients' preferences, and satisfaction with their family doctors. METHODS: Face-to-face interviews using structured questionnaires were preformed with a random sample of the Estonian residents aged 15-74 years (n=999). RESULTS: Out of 999 respondents, 35% prefer to first see their family doctor and if necessary to get a referral or a recommendation to see a specialist. The referral to the specialist by the family doctor is more preferred by older respondents, rural people, by the respondents with a lower level of education and income as well as by people who were more satisfied with their family doctor. The people who were more satisfied with their family doctor found that the whole health care system was functioning better than the previous primary health care system. Out of all the respondents who have had a contact with their family doctor during the last 12 months 87% (n=585) were satisfied with his work. The overall satisfaction with the family doctor depended on 1) perceived competence of the physician (OR=0.624, 95% confidence interval (CI)=0.419-0.933); 2) understanding the patient's problem (OR=0.699, 95%CI=0.496-0.984); 3) punctuality of the physician (OR=1.533, 95%CI=1.075-2.186); and 4) the location of the primary health care center/clinic (OR=0.751, 95%CI=0.574-0.983). CONCLUSION: During the five-year-period most of the Estonian population has accepted the new primary health care system and the satisfaction rate has increased. Family doctors are in the center of the primary health care systems and their professional competence plays a great role in making the system acceptable for the patients.

Adolescent↗

PubMed1994

Psychotherapist reactions to the suicide of a patient.

A patient's suicide may evoke the therapist's personal grief and influence professional competence or suicide prevention skills. The incidence of suicide by patients in therapy is examined and empirical studies of therapist response--which commonly includes grief, guilt, self-blame, anger, fear, and self-doubt--are reviewed. Bereavement theories and support programs are described.

Adaptation, Psychological↗

PubMed2003

[Disorder attribution in psychiatric problems of adolescents. A pilot study of inventory validation of disorder attribution of psychiatric problems in adolescents].

OBJECTIVES: The first Questionnaire on Disorder Concepts for Mental Problems in Adolescents (SPPJ) was developed on the basis of the attributional theory (health locus of control) and validated in a population of 54 adolescents with mental disorder hospitalized primarily as in-patients. METHODS: Analysis of consistency, correlation with the test for locus of control in health and illness (KKG-Test), scale intercorrelation, correlation with the Frankfurt Self-Concept Scales, therapy cooperation and prognosis. RESULTS: The SPPJ distinguishes between causal attributions and locus of control and proves to be a reliable measuring instrument that delivers satisfactory correlations to the statement of general measuring instruments (KKG-Test). Contrary to our expectations there is no significant positive correlation between internal locus of control and cooperation and prognosis. An external, powerful-others causal attribution has a negative effect upon cooperation, while an external powerful-others locus of control has a positive effect upon it. CONCLUSIONS: Adolescent self-assessment of mental problems is a defined research subject different from illness or health concept variables in adults or concerning bodily illness. Adolescents who are less inclined to blame others for their problem and who value professional competence are probably more accepting of interventions and more compliant. Further research in this area is necessary. On the basis of the attributional theory more attention must be paid to the substantial difference between locus of (treatment) control and causal attributions.

Adolescent↗