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PubMed1989

[The expansion of the educational system and the birth decline in the Federal Republic of Germany: a cohort-based simulation on the impact of the changing educational structure on reproductive behavior].

"Demographic studies on cohort fertility have revealed that the birth decline in the [Federal Republic of Germany] was accompanied or even brought about by a considerable postponement in parenthood. By means of event history analysis and micro-simulation this article shows that the postponement of motherhood can be attributed to the expansion of the educational system that took place in the 60s and early 70s. Furthermore, changes in educational structure have contributed markedly to increased childlessness in the younger generation, whereas there is no relation between the reduction in family size and the structural changes in education. The impact of increased education on the family life-cycle can be explained by labour market theories, whereas traditional theories have neglected biographic aspects of fertility." (SUMMARY IN ENG)

Cohort Studies↗
PubMed2006

The effectiveness of sex education and HIV education interventions in schools in developing countries.

OBJECTIVE: To review the impact of sex education and HIV education interventions in schools in developing countries on both risk behaviours for HIV and the psychosocial factors that affect them. METHODS: We conducted a systematic review. Searches identified studies in developing countries that evaluated interventions using either experimental or strong quasi-experimental designs and measured the impact of the intervention on sexual risk behaviours. Each study was summarized and coded, and the results were tabulated by type of intervention. FINDINGS: Twenty-two intervention evaluations met the inclusion criteria: 17 were based on a curriculum and 5 were not, and 19 were implemented primarily by adults and 3 by peers. These 22 interventions significantly improved 21 out of 55 sexual behaviours measured. Only one of the interventions (a non-curriculum-based peer-led intervention) increased any measure of reported sexual intercourse; 7 interventions delayed the reported onset of sex; 3 reduced the reported number of sexual partners; and 1 reduced the reported frequency of sexual activity. Furthermore, 16 of the 22 interventions significantly delayed sex, reduced the frequency of sex, decreased the number of sexual partners, increased the use of condoms or contraceptives or reduced the incidence of unprotected sex. Of the 17 curriculum-based interventions, 13 had most of the characteristics believed to be important according to research in developed and developing countries and were taught by adults. Of these 13 studies, 11 significantly improved one or more reported sexual behaviours, and the remaining 2 showed non-significant improvements in reported sexual behaviour. Among these 13 studies, interventions led by both teachers and other adults had strong evidence of positive impact on reported behaviour. Of the 5 non-curriculum-based interventions, 2 of 4 adult-led and the 1 peer-led intervention improved one or more sexual behaviours. CONCLUSIONS: A large majority of school-based sex education and HIV education interventions reduced reported risky sexual behaviours in developing countries. The curriculum-based interventions having the characteristics of effective interventions in the developed and developing world should be implemented more widely. All types of school-based interventions need additional rigorous evaluation, and more rigorous evaluations of peer-led and non-curriculum-based interventions are necessary before they can be widely recommended.

Adolescent↗
PubMed1990

Humanism in medical education: a study of educational needs perceived by trainees of three Canadian schools.

The authors examined how medical trainees and recent graduates of three Quebec medical schools value 16 dimensions of medical competence classified in four broad categories: clinical, technological, humanistic, and social and preventive. To assess perceived educational needs, the trainees' perceptions of the importance that medical faculties attribute to these same dimensions in the education of physicians were also examined. The survey was conducted in 1986-87 via a questionnaire mailed to 2,030 individuals, including freshmen, juniors, interns, residents, and newly practicing generalists; 80.3% responded. Compared with the views attributed to the faculty, the medical trainees gave more importance to basic diagnostic and therapeutic skills such as the medical history, the physical examination, and the treatment of common diseases. They also valued to a greater extent non-biological dimensions of clinical competence, such as communication with patients, patient education, the social context of disease, and the multidisciplinary nature of patient care, while they ascribed less importance to medical technology and rare diseases. The study raises the question of the relevance of medical education to medical practice by suggesting that those who are preparing themselves to become doctors may not be receiving the training they wish to receive.

Attitude of Health Personnel↗
PubMedDate not supplied

Dental health education for adolescents: assessing attitude and knowledge following two educational approaches.

A study of knowledge and attitudes towards dental health of 666 youths in their early teens has been conducted in Quebec. Its purpose is to compare the effectiveness of two instructional approaches often used in dental health education: a sound and slide presentation or a verbal demonstration. This experiment also included a control group. The measures were two scores obtained from a knowledge and an attitude test, which were the two dependent variables. These measures were repeated on four occasions: pre-test, immediate post-test, post-test after two months, and post-test after six months. During the experimental months, no other form of dental education was given by community health workers. The statistically significant interaction of time with treatments allowed reaching the conclusion that the evolution of subjects was different according to the treatment they had received, considering both dependent variables simultaneously. The sound and slide presentation appeared to be better than the verbal presentation for improving dental knowledge in young adolescents. Both educational approaches enhanced adolescents' attitude towards better dental health for a short period, but results were no longer significant after two months, thus reinforcing the importance of repetition in dental health education. Measures for knowledge tests revealed significant differences between boys and girls.

Attitude to Health↗
PubMed1994

[The credit system. Post-graduate medical education and continuous medical education].

The author examines the objectives behind the possible adoption of a Credit System by the Portuguese Medical Association. Credits are units that allow physicians to keep a record of their educational and professional undertaking. The paper defines Postgraduate Medical Education and Continuing Medical Education and specifies to which group of physicians each term applies. It describes the types of activities and objectives of each form of medical education and explains the philosophy underlying both. The author also urges that the Portuguese Medical Association set up essential structures to ensure the efficient functioning of the system. The paper outlines the criteria to be used for awarding Credits and discusses the natures of credit-granting institutions. The Credits are grouped into pre-defined Categories of differing weight. The author also recommends a credit value for each activity and, taking into account the nature of each activity, assigns it to a specific Category. Several types of Forms for Applying for and Registering Credits are shown. The information on these Forms is to go on the physicians record, to be filed on a database with the Portuguese Medical Association at a place set aside for the purpose.

Education, Medical, Continuing↗
PubMed1997

[Education, postgraduate and continuing education in surgery--data for quality control].

Despite intensive educational training during medical school, there is hardly any occupational group like physicians that tries to keep further education on a very high level. However, under the aspect of quality control, there is a need for different certificates. The education itself needs quality control; the laying down of rules as a rational basis is to advance, but facts that deal with quality control are not easy to find. The analysis of the committee of education of the Ruhr University Bochum must be considered as ideal; the results have to be transferred. Objective medical care results and patient satisfaction are influenced by many factors.

Clinical Competence↗
PubMed2003

[Praxis approach in educational interventions at the Institute of Nursing Education].

The current development of health awareness in France will not be felt in hospitals and other healthcare organizations in regards to health and health education. Curative and preventive do not seem to be in complete interaction. None-the-less, in the face of a conceptual and political evolution, it is urgent to enlighten, through initial nursing training, future health-care workers towards new functions in the area of education. Therefore in this study we suggest a reflective study on the creation of practical educational competencies. We will be able to demonstrate through this praxiological approach how we will succeed in elaborating two work models: the elaboration of a competency reference pertinent to public health-care the conception of a didactic learning strategy based on a progressiveness concept.

Clinical Competence↗
PubMed2005

Teleconferenced educational detailing: diabetes education for primary care physicians.

INTRODUCTION: Formal didactic continuing medical education (CME) is relatively ineffective for changing physician behaviour. Diabetes mellitus is an increasingly prevalent disease, and interventions to improve adherence to clinical practice guidelines (CPGs) are needed. METHODS: A stratified, cluster-randomized, controlled trial design was used to evaluate the effects of a teleconferenced educational detailing (TED) CME on glycemic control (hemoglobin [Hb] A1c) and family physician adherence to national diabetes guidelines. TED employed sequential, small-group, case-based education using CPGs delivered by a diabetes specialist. Medical record audit data from baseline through the end of a 12-month postintervention period were compared for the control and intervention groups. Satisfaction with the intervention was evaluated. RESULTS: Sixty-one physicians provided 660 medical records. The intervention did not affect mean Hb A1c levels but did significantly (p = .04) alter the distribution of patients by category of glycemic control, with fewer in the intervention group in inadequate control (15.8% versus 23.9%). More patients took insulin (alone or with oral agents) in the intervention group (21.2% versus 12.0%, p = .03), and more took oral agents only in the control group (89.0% versus 82.9%, p = .005). More patients in the intervention group had documentation of body mass index (7.8% versus 1.9%, p < .02), eye exam (12.1% versus 5.1%, p = .02), and treatment plan (43.5% versus 23.6%, p = .01) and used a flow sheet (14.6% versus 7.7%, p < .03). Although there was general satisfaction with the teleconferencing format, specialist educators found the format more challenging than the family physicians. DISCUSSION: CME delivered by teleconference was feasible, well attended, well received by participants, and improved some key diabetes management practices and outcomes.

Diabetes Mellitus↗
PubMedDate not supplied

An approach to the education about, and assessment of, attitudes in undergraduate medical education.

BACKGROUND: Attitudes have been shown to be important determinants of the quality and efficacy of medical care. There is little research on the education about, and assessment of, attitudes in undergraduate medical education. AIM: To describe the design and delivery of an attitude awareness workshop, and the associated objective structured clinical examination (OSCE) station used as the assessment tool. METHODS: Development, delivery, assessment and evaluation of an attitude awareness workshop were performed. RESULTS: Data are presented from 144 students. In 1999, the overall mean OSCE score was 62.44% (SD 7.6, n=73). The mean score for the attitude station was 57.97% (SD 12.9). In 2000, these figures were 67.11% (SD 8.3, n=71) and 73.75% (SD 10.8) respectively. In 1998/99, the average mark out of 10 for the educational quality of the attitude workshop was 6.6 and in 1999/00 this rose to 7.8. CONCLUSION: Development of both an educational and assessment programme concerning attitudes appears feasible.

Attitude of Health Personnel↗
PubMedDate not supplied

Master's degree-level community health nursing educational needs: a national survey of leaders in service and education.

This study identified the core components of the curriculum for master's degree-level community health nurses (CHNs) and assessed whether existing educational programs provide this knowledge base. According to 588 leaders in community health nursing (CHN) service and education, all master's degree-prepared CHNs require skills in the administrative role. Interdisciplinary core content areas needed to fulfill role responsibilities include a practicum experience; epidemiology; community health assessment and diagnosis; administration and management, including program planning and evaluation, financial management, budgeting, and quality assurance; research methods and biostatistics; health promotion and disease prevention; interventions at the aggregate level; and leadership theory. There were notable discrepancies between what was considered essential and what actually was included in CHN education. This article provides suggestions and possible alternatives for initiating change to ensure adequate educational preparation for graduate-level CHN practice.

Clinical Competence↗
PubMed2006

'Help, educate, encourage?': Geographical variations in the provision and utilisation of diabetes education in New Zealand.

In New Zealand, as elsewhere, it is argued that a diabetes epidemic is underway. With careful management from individuals and professionals and appropriate levels of education, it is possible to prevent many complications of diabetes. The overall objective of the paper is to evaluate the role and impact of Diabetes New Zealand (DNZ), the key voluntary sector provider of diabetes education and support services, with respect to four criteria: (i) the extent to which DNZ is reaching groups most at risk of diabetes; (ii) the degree to which it has encouraged levels of member involvement; (iii) whether voluntary group provision of education is that most preferred by members; and (iv) the extent to which members see the voluntary sector model as being effective in combating the growth of diabetes. A survey of members of six of the 41 affiliated societies of DNZ suggests that such organisations, although having a high proportion of older members, have generally failed to target more deprived groups. While the societies generally score more positively in encouraging member involvement and being perceived as effective by their members, they do not always utilise the preferred form of educational provision. However, there are significant contextual variations by urban-rural location and according to the organisational structure of the societies. Rural societies and those with decentralised organisational structures generally score highest on the above criteria. The results pose a problem for DNZ which, like many other voluntary sector organisations, is facing pressures of increased corporatisation and centralisation. We see this as an important challenge that DNZ needs to address if New Zealand is going to better cope with the emerging diabetes epidemic.

Aged↗
PubMed2000

[Health education in schools for adults: by a teacher or health education lecture?].

OBJECTIVE: To compare the results of two ways of teaching the rational use of medicines to students of centres of permanent education of adults (CPEA): one taught by the normal teachers (after training by health personnel) and one through a lecture given by the health staff. DESIGN: Intervention study without randomised distribution and with a control group. SETTING: Five CPEA in an urban centre. PARTICIPANTS: 385 students and 15 CPEA teachers. INTERVENTIONS: Three groups: a) "teachers" group: consisting of students who received education on medicines in the class-room through their teachers, who had been previously trained by health personnel; b) "lecture" group: students who had received a health education lecture on medicines given by health staff; c) non-intervention group. All three groups were administered a questionnaire before and after the intervention. Both questionnaires were paired. MEASUREMENTS AND MAIN RESULTS: 248 people completed the first questionnaire and 149 the second. Significant gains in knowledge were only found in the teachers intervention group (p < 0.01; 7.8% increase in score). Dividing the students into terciles made these gains significantly greater (11.7%) in the students of the teachers group who in the first questionnaire had intermediate scores than in the students in the other groups who had intermediate scores. CONCLUSIONS: Intervention with teachers seems more effective than either a health education lecture or no intervention, especially in the improvement in knowledge of students who already had beforehand intermediate knowledge.

Adult↗
PubMed1996

The social impact of Life Education: estimating drug use prevalence among Victorian primary school students and the statewide effect of the Life Education programme.

Evaluations of drug education programmes focus on the effect on participating students. Although this is appropriate, where programmes are institutionalized the wider population impact should also be considered. This paper examines this argument and provides a practical methodology for examining programme impacts on populations. It illustrates this using the example of the Life Education (LE) programme-a mature early intervention programme operating internationally-on the Victorian (Australia) population of Year 6 schoolchildren. Data from a recent evaluation of Life Education in Victoria, Australia, were re-analysed enabling estimation of adjusted attributable risk percentage (which provide an estimate of programme effect among those who are exposed to it), population prevalence estimates and population attributable risk percentage (which provide estimates of programme impacts on the entire population). In 1992 when the data were collected LE operated in 43% of all Victorian primary schools. The findings showed that within LE-schools 43% of girls' and 35% of boys' recent smoking was attributable to participation in the LE-programme. For drinking within LE-schools, while there was no apparent effect on girls, the programme was associated with 40% of boys' recent drinking. When the data were extrapolated to the state-wide smoking and drinking estimates, these showed that of all smoking among Year 6 schoolchildren, 25% of girls' and 19% of boys' smoking could be attributed to participation in Life Education, as could 22% of all boys' recent drinking. This re-analysis showed there was no preventive effect associated with the programme, at either the school or the population level. The findings suggest that intervention programmes should be thoroughly evaluated prior to widespread implementation, and that such evaluations should include reference to the community-wide impacts of such programmes.

Adolescent↗
PubMed1998

Educating young children about asthma: comparing the effectiveness of a developmentally appropriate asthma education video tape and picture book.

Asthma self-management programmes have been shown to increase children's knowledge about asthma and improve their management practices and health status. However, existing programmes have rarely addressed the unique learning needs of very young children. This study aimed to develop and assess the effectiveness of a video tape and picture book designed to teach children about the prevention and management of acute episodes of asthma. The information content of the educational resources was determined by analysis of relevant medical information and asthma management skills. Social Learning Theory and consideration of the developmental stage of the target population informed the format and style of presentation of the resources. Eighty children aged between 2 and 5 years who had been diagnosed with asthma by their medical practitioner and who required daily asthma medication participated in a controlled experimental study. The study evaluated the impact of the asthma education resources on children's knowledge about asthma, compliance with medication regimens and health status. Children were randomly allocated to one of three experimental groups. Children in these groups were exposed to either the video tape alone, the book alone or both the video tape and book, or to a control group who viewed materials unrelated to asthma. The results for the three experimental groups were compared with the control group who did not receive exposure to any of the asthma education resources. The results showed that children in each experimental group had significantly greater gains in asthma-related knowledge than children in the control group and children exposed to both resources showed the greatest increases in knowledge. Children in each of the three experimental groups also had better compliance and health than children in the control group. These findings indicate that carefully designed asthma education resources are useful for providing even the youngest children with information about asthma and its management.

Asthma↗
PubMed1999

The Palliative Care Education Group for Gloucestershire (PEGG): an integrated model of multidisciplinary education in palliative care.

Multidisciplinary teamwork is an essential part of palliative care. Traditionally, in the UK, education of health care professionals has been carried out within single professional disciplines. The Palliative Care Education Group (PEGG) for Gloucestershire, a county in the south-west region of England, UK, is a multidisciplinary group, which promotes and integrates palliative care education across the county. This report describes the evolution of the group, its aims and objectives and the methods used to evaluate its impact on clinical practice. PEGG is a practical model of multidisciplinary education, which could be adopted in other areas.

Attitude of Health Personnel↗
PubMed2001

A team education project: an evaluation of a collaborative education and practice development in a continuing care unit for older people.

The team education project aims to improve the impact of education on practice. The principles of this approach are that all clinical disciplines are involved and education activities are based in the practice area. This project took place in a continuing care unit for older people and the design was negotiated with staff in the unit. Bereavement was identified as the focus for the project. An education programme which combined information giving with reflective workshops was implemented and evaluated. Emerging findings reflect the complex nature of loss and bereavement in the continuing care unit. Staff adopted the term 'living bereavement ' to describe the reactions to the ongoing losses experienced by those living, working and visiting a continuing care unit. A core group of staff used the groups to reflect on practice and expand their understanding. Although the staff reported the groups were successful, it has been difficult to demonstrate any change in practice. A psychoanalytic approach to analyzing the organizational behaviour offered useful explanations relating to the difficulties in attempting change.

Aged↗
PubMed2005

Key elements for interprofessional education. Part 1: the learner, the educator and the learning context.

This paper is the first of two that highlights key elements needed for consideration in the planning and implementation of interprofessional educational (IPE) interventions at both the pre and post-licensure qualification education levels. There is still much to be learned about the pedagogical constructs related to IPE. Part 1 of this series discusses the learning context for IPE and considers questions related to the "who, what, where, when and how" related to IPE. Through a systematic literature review that was conducted for Health Canada in its move to advance Interprofessional Education for Patient Centred Practice (IECPCP), this paper provides background information that can be helpful for those involved in an interprofessional initiative. A historical review of IPE sets the international context for this area and reflects the work that has been done and is currently being initiated and implemented to advance IPE for health professional students. Much can be learned from the literature related to the pedagogical approaches that have been tried and the issues that need to be addressed related to the learner, the educator and the learning context which this paper examines.

Canada↗
PubMed1994

General practitioners' use of health education material. Results from a nationwide survey in Denmark in 1991. The Danish Health Education Study Group.

In November 1991 69% of a random sample of 998 Danish general practitioners (GPs) participated in a survey by anonymously filling in a mailed questionnaire concerning the way in which they use health education in their practices. Among the participating GPs, 97% used health education material. The study showed differences in attitudes towards and use of health education material. The material most often used by GPs at the consultation concerned diet/overweight, allergy and pregnancy. Pamphlets and posters in the waiting room mainly dealt with vaccination, alcohol and smoking. The female practitioners were generally most sympathetic to the use of health education material, but they are also those most critical of material advertising for medicine. The male practitioners thought that there was too much material and that they did not have enough time to use it.

Adult↗