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Results for “Competency-Based Education”

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Development of an instrument to evaluate critical incident performance.

A performance evaluation instrument was developed for the clinical components of a course in a coordinated undergraduate program (CUP) in dietetics. The critical incident technique was chosen as being most appropriate. Twenty-six students in the "Foodservice Systems" course of the CUP at Kansas State University comprised the research population. The course instructor, clinical instructors, and dietitians in the affiliations served as observers. The performance evaluation instrument, as developed consisted of ten categories of behavioral activities. Entries into the form were either behaviors to be encouraged or suggestions for improvement. Students' reactions were extremely favorable because of the feedback element. The instrument should be an effective tool and worthy of adaptation for other courses.

Attitude of Health Personnel↗

Surgical continuing medical education: format and impact.

A survey of 140 continuing medical education (CME) offerings in surgery for 1975-1976 was undertaken. In no instance was there evidence of evaluation of learning or behavior changes after the experience on the part of the sponsors. Estimated cost from the data obrained, 83 courses, was approximated at two million dollars. There is no evidence that this modality achieves the objective of improved patient care. A change from the education-based existing system to a competency-based evaluation system is proposed. The latter, a multicomponent system, has an objective cognitive skills measurement and a measurement of behavior as major elements. Computer simulation-modeling using patient-problems is proposed to define deficits and to be used as an active participatory educational modality. Development of practice profiles, establishment of a data base for determining patient outcome, including morbidity and mortality data, and identification of measures to determine rate of adoption of innovation and loss of obsolescent concepts are required to define behavioral changes. Under the guidance of academic and professional societies working in the community, an effective competency-based educational system dedicated to improved patient care can be specified and implemented.

California↗

Developing an integrated, competency-based medical technology program.

The authors describe a competency-based, integrated medical technology educational program currently being implemented at Weber State College in Ogden, Utah. Problems associated with the traditional three academic years plus one year clinical education program are described, as well as problems involved in creating new programs. This type of program may prove to be a major advance in the future of medical technology education.

Curriculum↗

Reexamination/recertification: measurement of professional competence and relation to quality of medical care.

Over the past half decade, there has been an increment in forces moving the profession toward recertification and a decrement in the restraining forces. The whole process will be catalyzed by available funding through grants to implement continuing medical education, development of performance-, and competency-based assessment measures and recertification. Specialty boards serving relatively small numbers of candidates have serious difficulty funding certification, to say nothing of recertification. An adequate mechanism to implement recertification can emerge only from the profession itself, working through the American Board of Medical Specialties and specialty boards. The means to discharge this responsibility should, at the outset, come from public and private sources. Eventually the system may become self-supporting through evaluation and certification fees. The public interest will be best served when there are adequate mechanisms to assess continuing competence of all physicians. As a minimum, there must be a system to guard against incompetence through obsolescence of any of the practicing professionals.

Certification↗

Standardized visual overlays enhance laparoscopic instruction: A mixed-methods evaluation.

Effective communication during laparoscopic procedures is frequently undermined by spatial disorientation and inconsistent terminology between instructors and trainees. This study examined whether standardized visual overlays on endoscopic monitors could enhance communication and learning. We conducted a three-phase mixed-methods study: qualitative observation of 20 laparoscopic teaching cases; a randomized trial of 63 second-year medical students assigned to control, clock, or alphanumeric grid (AG) overlays during three trials of a standardized transfer task; and intraoperative implementation in 44 cases (30 AG, 14 clock) with post-case surveys and qualitative feedback. In simulation, the clock overlay produced the fastest completion times, whereas the AG yielded the lowest error scores, and both overlays outperformed the control. Intraoperatively, the AG was rated higher than the clock for communication clarity, spatial orientation, perceived operative efficiency, and trainee confidence. Standardized visual overlays, particularly the AG, appear to support intraoperative teaching by providing a shared spatial frame of reference.

Laparoscopy↗

Grading secondary vocational education students with disabilities: a national perspective.

A nationwide purposive sample of secondary vocational educators completed a questionnaire that examined practices and perceptions toward grading students with disabilities. A variety of grading methods was reportedly used, but over two-thirds of respondents included a competency-based grading component. An overwhelming majority believed that student effort should be used to determine grades. Two-thirds of vocational educators had never been involved in their students' IEP development. The most common changes teachers have made over time in their grading practices included becoming more flexible and individualized in grading. Overall, teachers displayed moderately positive attitudes toward grading students with disabilities.

Adult↗

Interdisciplinary diabetic team in a community hospital.

An interdisciplinary diabetic team which provides inpatient and outpatient diabetic instructional services in a 200-bed community hospital is discussed. The team consists of a pharmacist, a dietitian, and a registered nurse, each of whom is assigned to a specific area of diabetic education. Instructional objectives include coordination of teaching efforts by hospital personnel, standardization of education, and development of evaluation procedures. Upon notification of a physician request for diabetic team services, a form which contains competency-based instructional objectives and patient referral questions is placed in the patient's chart. Diabetic instruction may then be initiated by ward personnel or a member of the diabetic team. Outpatient classes are offered for those who desire or require additional or indepth instruction.

Adolescent↗

Competency-based training for severely behaviorally handicapped children and their parents.

This paper describes the major components of a treatment program for severely behaviorally handicapped children. The program's goal is to help the children develop the necessary skills to function in regular classrooms or special education classes. The article presents descriptions of the procedures used in the Day School Learning and Treatment Center and the Parent Training Program at the Judevine Center for Autistic Children. Criteria for acceptance, assessment systems, training techniques, and methods for follow-up are outlined. Also, the paper delineates what are considered to have been five major trends in the development of the program.

Adolescent↗

Providing for the severely handicapped: a case for competency-based preparation of occupational therapists.

Recent court decisions that mandate the development of new instructional alternatives for severely handicapped children will have significant implications for occupational therapists. Focusing on such issues as mainstreaming, accountability, and certification standards, this paper places in perspective the problems and trends that have led to this new challenge. It also provides suggestions for the development and disposition of training programs that can ultimately result in more appropriate programming for the handicapped children in the new population to be served in the public schools. Illustrated with examples of competency components and behavioral objectives, competency-based occupational therapy preparation programs are emphasized.

Child↗

Child development and disability: competency-based clerkship.

The training of medical students in the subject of mental retardation is important in broadening the physician's role in dealing with chronic disability. A competency-based training model is presented which specifies competencies, achievement methods, and evaluation procedures for a clerkship. The focus for training is on developing practical skills and a positive orientation toward developmental problems. Evaluative measures for 12 students rotating through the clerkship showed positive knowledge and attitude changes. Competency-based training is recommended as a model for preparing physicians to serve as advocates and resources for persons with chronic conditions.

Attitude↗

Evolution of a Family Nurse Practitioner Program to improve primary care distribution.

The Family Nurse Practitioner Program of the Univeristy of California, Davis, has effectively improved the distribution of primary health care manpower in medically underserved areas. This has been accomplished by selecting students, preceptors, and faculty from areas of need; decentralizing the clinical and didactic training sites; developing a competency-based, portable curriculum; and coordinating it all with a circuit-riding, institutionally based faculty.

California↗

Using a competency-based program to assess interviewing skills of pediatric house staff.

A program has been initiated to assess objectively the interviewing skills of pediatric house staff. Each entering house staff member interviews and is evaluated by a nonphysician mother who presents the medical history of her child. Remedial instruction is provided for all who do not perform in accordance with established minimum criteria. As a result of this competency-based program, all house staff members are now known to have attained at least a minimum level of competence in interviewing technique.

Educational Measurement↗

Guidelines for competency-based instruction in psychiatry.

This paper presents guidelines for teachers who wish to design competency-based instructional activities in psychiatry. Developed over a 3 year period, these guidelines outline the methods used by teachers to construct competency-based seminars and clinical rotations. The guidelines describe the process of stating knowledge objectives, performance objectives and experiential objectives for psychiatric trainees to attain prior to completion of training in a given area. Selection of appropriate teaching strategies as well as criteria and conditions for assessment of the residents' abilities are also reviewed. Comments regarding the authors' experience using these guidelines with teachers are offered.

California↗