Integrating general practice medical education. The North Queensland model.
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Family Practice↗
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An evaluation of the baccalaureate-nursing program within the (MOPH), Thailand.
This research study was designed to evaluate the baccalaureate-nursing curricula undertaken in the nursing colleges under the jurisdiction of the Ministry of Public Health (MOPH), Thailand. A stakeholder approach was used to incorporate mixed methods of data collection and models of evaluation within the research framework. Both qualitative and quantitative approaches were used. Newly registered nurses and their colleagues were generally positive about the course outcomes. However, qualitative data demonstrate a need to focus more on the development of abilities related to life-long learning and critical thinking. The findings suggest challenges in achieving program outcomes attributed to the feasibility of implementation strategies. Concepts in the curriculum plan are not fully translated into practice. A number of factors have a major impact on the actual program implementation or course organisation and teaching/learning processes. There is evidence of competing or conflicting ideologies about nursing practice and education. Findings suggest that the preferable educational models for contemporary and future nursing education are process rather than content-based. It is challenging to develop ways of accommodating the more desirable professional nursing and educational approaches within the context of Thailand and MOPH nursing education policies where resources are limited and the maintenance of Thai culture is of paramount importance.
Curriculum↗
Integrating centralized and decentralized organization structures: an education and development model.
Organization change efforts have led to critically examining the structure of education and development departments within hospitals. This qualitative study evaluated an education and development model in an academic health sciences center. The model combines centralization and decentralization. The study results can be used by staff development educators and administrators when organization structure is questioned. This particular model maximizes the benefits and minimizes the limitations of centralized and decentralized structures.
Academic Medical Centers↗
Development of an interdisciplinary women's health training model.
In response to expanded residency training requirements in women's health, faculty from internal medicine, obstetrics/gynecology, and psychiatry at Yale University School of Medicine established an interdisciplinary women's health training and education model, the Interdisciplinary Women's Health Clinic (IWHC). The model was one component of a larger, comprehensive women's health program at Yale funded by the Department of Health and Human Services between 1996 and 2000 under the National Centers of Excellence in Women's Health (CoE) designation. This article describes the structure and function of the model, its value to residents and the institution, and its limitations that led to its closure when Department of Health and Human Services support ended. The IWHC was designed as a consultation service that augmented the primary care provided to low-income, minority-group women in an established outpatient primary care setting. An interdisciplinary team of residents and faculty provided and coordinated a range of services for patients and participated in a weekly core curriculum. The model was an important resource to residents and provided high-level integrated care to patients. The combined educational experience helped refine a core interdisciplinary women's health curriculum. Despite these benefits, the IWHC could not be sustained outside the financial and programmatic structure of the larger CoE program. This experience suggests that longitudinal models where residents from different disciplines train in a shared educational and clinical setting may be more durable. Interdisciplinary models are effective ways to train residents and provide integrated care to women. The model's success depends on highly developed collaborative relationships between faculty, nonclinical sources of support, and long-term institutional commitment.
Academic Medical Centers↗
Dental education in Queensland I: the 1-3-1 model.
Dental education worldwide is under great pressure. This pressure is being driven not only by changing patterns of oral disease but also by economic factors both inside and outside universities. Technological advances and changing educational philosophies across the board also impact significantly on what we do and how we do it. This article outlines how the School of Dentistry at The University of Queensland is responding to these pressures within the context of local political, educational and economic realities. The so-called 1-3-1 model that has been adopted involves one year of basic science, three years of applied dental science and one year of extramural clinical practice. This model represents a partnership with the Queensland Department of Health and will: Involve dental education and the Dental School in the provision of health care to the community. Place the Dental School in a position to influence the delivery and quality of oral health care in the population and to assume some of the responsibility for it. Provide a wide range of clinical and community experiences for students prior to graduation. Allow the adoption of modern teaching methods such as Problem Based Learning (PBL) in Years II-IV with all the additional benefits e.g. communication skills. Provide an extended clinical period for the acquisition and development of clinical and technical skills prior to graduation. Be cost-effective both to the university and the health service. Allow for outside input without compromising the knowledge and research base. It is recognised that while the 1-3-1 model may meet the demands of a large, decentralised state such as Queensland, it may not be suitable for all institutions. In this context diversity in approach is one of the strengths of dental education, nationally and internationally.
Clinical Competence↗
The evaluation and selection of adequate causal models: a compensatory education example.
Procedures for ascertaining relative model adequacy in latent variable structural relations models are discussed. Under diverse methods of estimation, this determination may be assessed using the chi square goodness of fit statistic, incremental fit indices for covariance structure models, and latent variable coefficients of determination. An example from evaluation research is taken (cf. Magidson, 1977; Bentler & Woodward, 1978). Numerical sensitivity of parameter estimates under alternative model specifications is demonstrated. Interpretive implications based on these procedures are discussed in terms of parameter sensitivity to alternative model specifications.
Child↗
Quality of life for people with intellectual disabilities in China: a cross-culture perspectives study.
BACKGROUND: The concept of quality of life (QOL) is explained on the basis of traditional Chinese culture and contemporary social and cultural trends. METHOD: The importance of internationally recognized QOL domains and indicators was determined for three respondent groups: consumers, parents of the consumers, and teachers and rehabilitation professionals working with the clients. RESULTS: Principal component analysis confirmed seven factors influencing QOL for people with intellectual disabilities (ID) in China. These seven components are conceptually equivalent to the eight domains found in the international QOL literature. CONCLUSION: The concept of QOL has become one of the most sensitive issues in present Chinese society and peoples' lives, and an important theoretical framework for the education and rehabilitation for people with ID in several ways: curriculum development, service delivery models, education and rehabilitation practices, and employment models.
Adult↗
Training pathways for occupational medicine.
OBJECTIVE: Consider the funding, organization, and applicant pool for occupational medicine residency training positions concerns in the United States. METHODS: Postgraduate training models are compared for responsiveness to competence and workforce needs, including traditional residency, nontraditional residency, postdoctoral fellowship, extended courses, multiple certificate preparation, continuing medical education, "executive MPH," and implicit education (learning from consultants in the course of practice). RESULTS: Educational models differ in comprehensiveness, crossdisciplinary experience, socialization to core professional values, financial requirements, accessibility to physicians currently in practice, potential number of trainees, and short- and long-term impact on training outcomes. CONCLUSION: There are tradeoffs between the benefits of comprehensive program standards and the benefit of facilitated training access by reducing barriers or requirements. Recognizing and understanding assumptions about training in our discipline may inform future choices.
Education, Medical, Continuing↗
Two models of psychiatric rehabilitation: a need for clarity and integration.
Two distinct models are identifiable in the processes of psychiatric rehabilitation: treatment and training. The treatment model, which also can be presented as the "medical model," approaches the issues on the basis of defect which needs to be diagnosed and rectified. On the other hand, the training model, which can also be referred to as the "educational model," approaches the situation from the perspective of recognizing what strengths or abilities the individual may have which can be brought to bear constructively, and how to orchestrate that process. These two models involve different perspectives and different processes, and the model which is chosen affects the relationship of the clinician to the consumer. In the practical clinical situation, a thoughtful amalgam of these two orientations is called for in order best to serve the recipient. But clinicians nevertheless benefit from remaining aware of the two models involved and their attendant assumptions and modes of action, so that inconsistencies are minimized while the most effective and integrated services are provided. Administrators, payers, and researchers will similarly benefit from an understanding of the potential benefits of each of these two approaches to intervention.
Journal Article↗
Ethical considerations in rehabilitation medicine.
As the number of patients with chronic illness or disability grows, rehabilitation professionals will face increasingly difficult questions. Traditional concepts of medical ethics can help find solutions to some, but not all of those questions. Rehabilitation medicine needs an expanded vision of informed consent, one that embraces the needs of patients and promotes rehabilitation's educational model. To insure that rehabilitation professionals use this model appropriately, we need to make certain that their education integrates humanistic and caring virtues with medical knowledge and skill.
Education, Medical↗
Transformative professional development of physicians as educators: assessment of a model.
PURPOSE: Medical education reform has been the clarion call of U.S. medical educators and policymakers for two decades. To foster change and seed reform, Harvard Medical School created a professional development program for physicians and scientists actively engaged in educating future physicians that sought to transform both participants and their schools. This study focused on identifying the long-term effects of a professional development program on physician educators. METHOD: A follow-up survey of the 1995-97 cohorts of the Harvard Macy Program for Physician Educators was conducted by sending the 99 program participants a questionnaire two years after their participation. Main outcome measures studied were individual changes as reflected in participants' self-reported shifts in teaching behaviors, academic productivity, career advancement, and sense of commitment. RESULTS: A total of 63 participants completed the questionnaire, for a response rate of 63.6%. Two years following participation in the program, a majority (88.8%) of respondents reported that participation had significantly affected their professional development, including long-term changes in teaching behaviors (77.8%), engagement in new educational activities from committee work (86%) to grant funding (52.4%), and renewed vitality/identification of themselves as educators. CONCLUSIONS: Long-term follow-up of participants enrolled in an intensive program for physician educators suggests that professional development programs that create an immersion experience designed in a high-challenge, high-support environment, emphasizing experiential and participatory activities can change behaviors in significant ways, and that these changes endure over time.
Education, Medical↗
The body mass index-mortality relationship in white and African American women.
OBJECTIVE: To examine the association of body mass index to all-cause and cardiovascular disease (CVD) mortality in white and African American women. RESEARCH METHODS AND PROCEDURES: Women who were members of the American Cancer Society Prevention Study I were examined in 1959 to 1960 and then followed 12 years for vital status. Data for this analysis were from 8,142 black and 100,000 white women. Body mass index (BMI) was calculated from reported height and weight. Associations were examined using Cox proportional hazards modeling with some analyses stratified by smoking (current or never) and educational status (less than complete high school or high school graduate). RESULTS: There was a significant interaction between ethnicity and BMI for both all-cause (p<0.05) and CVD mortality (p<0.001). BMI (as a continuous variable) was associated with all-cause mortality in white women in all four groups defined by smoking and education. In black women with less than a high school education, there were no significant associations between BMI mortality. For high school-educated black women, there was a significant association between BMI and all-cause mortality. Among never smoking women with at least a high school education, models using the lowest BMI as the reference indicated a 40% higher risk of all-cause mortality at a BMI of 35.9 in black women vs. 27.3 in white women. DISCUSSION: The impact of BMI on mortality was modified by educational level in black women; however, BMI was a less potent risk factor in black women than in white women in the same category of educational status.
Adult↗
An evaluation of the integration of non-traditional learning tools into a community based breast and cervical cancer education program: the Witness Project of Buffalo.
BACKGROUND: Breast and cervical cancer continue to represent major health challenges for African American women. among Caucasian women. The underlying reasons for this disparity are multifactorial and include lack of education and awareness of screening and early detection. Traditional educational methods have enjoyed varied success in the African American community and spawned development of novel educational approaches. Community based education programs employing a variety of educational models have been introduced. Successful programs must train and provide lay community members with the tools necessary to deliver strong educational programs. METHODS: The Witness Project is a theory-based, breast and cervical cancer educational program, delivered by African American women, that stresses the importance of early detection and screening to improve survival and teaches women how to perform breast self examination. Implementing this program in the Buffalo Witness Project of Buffalo required several modifications in the curriculum, integration of non-traditional learning tools and focused training in clinical study participation. The educational approaches utilized included repetition, modeling, building comprehension, reinforcement, hands on learning, a social story on breast health for African American women, and role play conversations about breast and cervical health and support. RESULTS: Incorporating non-traditional educational approaches into the Witness Project training resulted in a 79% improvement in the number of women who mastered the didactic information. A seventy-two percent study participation rate was achieved by educating the community organizations that hosted Witness Project programs about the informed consent process and study participation. CONCLUSION: Incorporating non-traditional educational approaches into community outreach programs increases training success as well as community participation.
Adult↗
Imagery: stimulating critical thinking by exploring mental models.
The use of guided imagery in the classroom or clinical setting has traditionally been directed at decreasing anxiety or increasing skill performance (Rodriguez, 1991; Stephens, 1992; Tuyn, 1994). This article describes an innovative use of imagery as a teaching strategy to unearth and possibly reframe, what Senge (1990) has identified as "mental models." The approach described differs from traditional uses of imagery related to decreasing anxiety and increasing skill performance. This approach is directed at increasing critical thinking and has offered new insights for both students and faculty. By using both guided imagery as a teaching strategy and Senge's concepts of mental models, educators can encourage students to become critical thinkers and what Senge calls "systems thinkers." Mental models are deeply ingrained, often unacknowledged, assumptions or images that individuals develop as a result of their life experiences. These images influence values, thoughts, and actions, albeit at times, unknowingly. These images, or mental models, also influence the ability to learn and translate learning into action. Lack of knowledge and awareness of one's mental models can be an obstacle to high-quality critical thinking. The concept of mental models has been best articulated by Senge (1990), who is known for his work in systems-thinking. Senge believed that new insights are rarely followed with substantive action because the new learning, at some level, conflicts with deeply held, internal images. One way to remove this gap between insight and action is to examine mental models that may prohibit both insight and action.
Education, Nursing↗
A partnership model of distance education: students' perceptions of connectedness and professionalization.
This article describes a partnership model of distance education for a master's nursing program in a midwestern state and an evaluation that assessed students' perceptions of professionalization and connectedness in the program. Students at the originating and distance sites were asked to complete evaluations at the end of each course. Connectedness and professionalization were measured using rated satisfaction with three modes of contact for each item. Results indicated that students at the distance site had a significantly higher overall level of satisfaction with interactive television (ITV) and experienced high levels of connectedness and professionalization through the ITV courses. However, among the three modes of connectedness, students at the distance site rated satisfaction with contact with same-site students as the highest, followed by contact with the instructor. Students also perceived that their professional identity increased through the three modes, particularly for contact with same-site peers at the distance site and for contact with instructors at both sites. Recommendations for faculty and student responsibilities are provided to ensure a positive learning environment.
Adult↗
HIV education for gay, lesbian, and bisexual youth: personal risk, personal power, and the community of conscience.
Adolescent gay and bisexual males face a higher risk of infection with HIV than most other young people because of their behaviors and because HIV prevention programs have failed to address their unique concerns. Ironically, current efforts to heighten public awareness about the AIDS pandemic may be nullifying the potential for gay, lesbian, and bisexual young persons at high risk to form the support networks needed to modify their behavior. The personal and group empowerment of gay, lesbian, and bisexual young people is a necessary prerequisite to their ability to make healthy behavioral choices around HIV and other health issues. This paper proposes a comprehensive health education model for HIV prevention for gay, lesbian, and bisexual adolescents. Current health education efforts would be augmented by broader self and group empowerment training that would develop self-esteem, social skills, support networks, and access to risk reduction materials. An integrated system of care involving school-based programs, multi-service youth agencies, and self-help groups would be in a position to deliver appropriate educational, mental health, medical, and social support services. Such a system of care presents gay, lesbian, and bisexual youth with their best chance to reduce their risk of infection with HIV and develop into emotionally healthy individuals.
Adolescent↗
Microteaching: a model for employee counseling education.
An instructional model for the implementation and use of videotape simulation to improve dietetic students' skills in employee counseling was explored in the coordinated undergraduate program at the University of Tennessee, Knoxville. A five-day intensive workshop was conducted for senior students in the program, utilizing the microteaching technique. Students and actors simulated an employee counseling session on videotape; then, a small group and a clinical instructor evaluated the session. Suggestions from these evaluations were used in a repeat of the situation on videotape. A team of experts randomly viewed all the situations, judging a significant improvement in composite scores for the workshop participants. The students indicated on a Self-Perception of Confidence (SPOC) scale that they felt a higher degree of comfort in handling potential employee counseling after completing the workshop. They were pleased with the workshop and suggested expansion of the technique to other phases of their dietetic education.
Counseling↗
Ethics education for clinical pharmacy practice.
A review of the literature on pharmacy ethics found little concern for ethical issues that arise from pharmacist involvement in clinical practice. This lack of recognition and concern for ethical dilemmas that arise from new pharmacist roles has serious implications for clinical practitioners because of their close involvement in patient care and with other professionals. Also, implications for the profession are serious since a lack of internal control invites external control. Pharmacy educators must provide a leadership role in addressing this lack of concern by systematic evaluation and improvement of ethics education. A model of ethics education is presented that is based on a science education model--both a theoretical and a practical component leading to skill development in recognizing and resolving ethical dilemmas. In other words, pharmacy students will be trained to become their own ethics experts through the application of critical ethical thinking.
Education, Pharmacy↗