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The responsibilities and contributions of professional educators in surgery departments.

BACKGROUND: The purpose of the study is to describe the academic preparation, scope of duties, and scholarly activity of professional educators in surgery departments. METHODS: Educators with doctoral degrees employed as full-time faculty in surgery departments were surveyed to determine terms of employment, academic preparation, scope of duties, and job satisfaction. RESULTS: Twelve of 13 educators responded and participated in the study. Educators spent, on average, 22% of their time on research activities, 33% on administrative responsibilities, 13% on teaching, 13% counseling students and residents, and 7% writing grants. They spent approximately 34% of their time with surgical faculty, 19% with residents/fellows, and 14% with medical students. Educators' contributions to surgery departments included improvements in assessment and evaluation, educational conferences, recruitment, and research productivity. CONCLUSIONS: Professional educators provide support needed to meet the growing demands and requirements of surgical education. Study findings may inform those interested in recruiting a professional educator to their faculty.

Adult↗

Keeping afloat: student nurses' experiences following assignment referral.

The retention of nursing students is an ongoing problem, both within the United Kingdom (UK) and internationally. While there is a plethora of literature relating to student attrition, there is an absence of evidence in relation to the experiences of those students who are struggling to meet the demands of nursing programmes. Using an inductive sociological enquiry based approach, this study sought to examine the experiences of student nurses after referral on the first attempt of a summative assessment. Nursing students who had failed an assignment (n=20) were invited to participate. Data was collected using focus groups, with the emergent themes collapsed into a concise format using thematic content analysis. Four key themes were identified: desire to succeed; acceptance of personal failure; recognition of personal attributes required for success; and responsibility for personal success and failure. Students remained on the programme, despite struggling with financial and personal difficulties, because the desire to become a qualified nurse outweighed transient hardships. This paper will illustrate the benefits of understanding the students' experiences, in order to ensure the support students receive is appropriate to their needs. Understanding the support strategies as perceived by the students may prevent further wastage from nursing programmes.

Adaptation, Psychological↗

Effects of Snoezelen room, Activities of Daily Living skills training, and Vocational skills training on aggression and self-injury by adults with mental retardation and mental illness.

Multi-sensory stimulation provided in a Snoezelen room is being used increasingly for individuals with mental retardation and mental illness to facilitate relaxation, provide enjoyment, and inhibit behavioral challenges. We observed aggressive and self-injurious behavior in three groups of 15 individuals with severe or profound mental retardation and mental illness before, during, and after being in a Snoezelen room. All participants were receiving psychotropic medication for their mental illness and function-derived behavioral interventions for aggression, self-injury, or both. Using a repeated measures counterbalanced design, each group of participants was rotated through three experimental conditions: Activities of Daily Living (ADL) skills training, Snoezelen, and Vocational skills training. All other treatment and training activities specified in each individual's person-centered plan were continued during the 10-week observational period. Both aggression and self-injury were lowest when the individuals were in a Snoezelen room, followed by Vocational skills training and ADL skills training. The levels in the Snoezelen room were significantly lower than in both the other conditions for aggression but only in ADL skills training for self-injury. The difference in levels before and after Snoezelen were statistically significant with self-injury but not with aggression. The order of conditions showed no significant effect on either behavior. Snoezelen may provide an effective context for reducing the occurrence of self-injury and aggression.

Activities of Daily Living↗

A cost-benefit analysis of community and institutional placements for persons with mental retardation in Oklahoma.

Matched samples of 174 pairs of persons with mental retardation who live in either community settings or congregate care settings were compared on both cost and outcome dimensions. It was learned that costs were significantly lower in community programs. Greater levels of service and integration were evident in the community programs, but institutional programs offered vocational opportunities for more individuals. Although we were able to predict with accuracy who lived in community and institutional settings, we were unable to predict costs.

Adult↗

A model of educational resource use by children with cochlear implants.

We have tracked patterns of use of educational and rehabilitative resources as part of an initial assessment of cost-benefit ratios of cochlear implants in children. Forty-two children with cochlear implants in the Listening Center at Johns Hopkins program of aural rehabilitation have served as our study cohort to develop the measures to be assessed. An educational resource matrix stratifies school setting (residential vs special education vs non-specialized "mainstream" setting) and levels of rehabilitative support (speech and language therapy and interpreter use) to map past and current use of these services. Initial cost-benefit projections based on observed advancement toward educational independence in the educational resource matrix indicate an extremely favorable net present value of the implant (cost savings minus cost). These cost-benefit projections will need to be supplemented with measures of the impact on quality of life and future educational and vocational options to determine the overall cost-effectiveness of cochlear implants in children.

Baltimore↗

Psychiatric rehabilitation: efficacy of four models.

This paper is a critical review of four major rehabilitation programs: assertive community treatment, case management, vocational rehabilitation, and educational rehabilitation. Reported outcomes are reviewed in the context of study design, service characteristics, client characteristics, and operationalization of outcomes. Findings from the four programs are compared with one another. The authors concluded that clients are able to learn most of the skills taught, independently of the rehabilitation model. Furthermore, skills learned in one life domain generalized to a moderate extent to other areas. The four rehabilitation programs had varied effects on the outcome variables, and part of the variability in the findings appears to be related to client characteristics. Limitations of the studies reviewed are identified and a set of recommendations was suggested for the future practice of research into psychiatric rehabilitation.

Activities of Daily Living↗

A community-based trial of vocational problem-solving to increase employment among methadone patients.

UNLABELLED: Unemployment remains a common problem among methadone patients. This study examined the effectiveness of the Vocational Problem-Solving Skills (VPSS) intervention to help unemployed methadone patients obtain employment. METHODS: 109 patients were randomly assigned to receive 10 sessions of either VPSS (n=62) or Interpersonal Problem-Solving (IPS) (n=47). Fourteen counselors from two methadone programs were trained to deliver both the VPSS and IPS counseling sessions. RESULTS: Overall, 93% (101/109) of the patients completed a 6-month follow-up assessment which revealed that 58.6% (34/58) of patients in the VPSS condition were employed, whereas 37.2% (16/43) in the comparison condition worked (chi-square=4.53, 1 df, p<0.05). However, a multinomial regression equation found that the VPSS intervention did not significantly contribute to the prediction of employment. Other factors such as longer length of previous work experience, 40 years of age or older, treatment site, and baseline patient motivation to work emerged as significant predictors. CONCLUSION: Although VPSS alone was not a strong independent predictor of improved employment functioning, improvements in employment functioning were detected at one of the two sites as a function of VPSS.

Adult↗