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PubMed1993

Collaborative experiences for NICU and early childhood education personnel.

Participation of NICU staff in special education teacher training is discussed as a method for improving follow-up care of high-risk infants and for helping agencies comply with Public Law 99-457, which mandates services for disabled preschoolers and encourages intervention for infants and toddlers. Through a collaborative training program involving a medical center and a university, education students spent 15 to 20 hours in the NICU. Nurses gained a greater understanding of community-based early intervention programs and available providers and made referrals with more confidence. Student teachers witnessed the medical conditions and treatments experienced by NICU patients, gaining an understanding of the types of medical histories their future clients would have. The collaborating hospital developed working relationships with agencies that provide follow-up care to NICU graduates. The article discusses medical and educational models of care, implications and benefits of incorporating developmental care into NICU practice, effects of the law on early intervention programs, and features of the model collaborative program.

Child Development↗
PubMed1993

A proposed model for a residency experience in mass gathering medicine: the United States Air Show.

STUDY OBJECTIVE: Mass gathering medicine is an increasingly important responsibility for emergency physicians. A formal experience in mass gathering medicine can introduce emergency medicine residents to this aspect of community medicine. DESIGN: Educational model based on field experience and retrospective chart review from 1981 through 1991. SETTING: The US Air Show is a summer event that attracts an average of 223,000 spectators annually. Medical care is provided by physicians, nurses, and technicians operating within an organized system of care. Emergency medicine resident physicians (first-, second-, and third-year) evaluate and treat patients appropriate for the resident's level of responsibility. Residents provide immediate medical control and are integrated into the event disaster plan. On-site attending physician supervision is available at all times. Didactic instruction and event orientation are integrated into the residency curriculum. Residents participate in the planning stages of the event. RESULTS: During the study period, 2,091 patients were seen. The most common presenting problems were heat illness (28%), blisters and scrapes (25%), headaches (23%), fractures and lacerations (9%), and eye injuries (5%). One hundred forty-eight patients (7%) required transportation to the hospital. Approximately 16 residents participate each year and treat an average of 13.7 patients during their four-hour shift. A resident training model for a mass gathering experience is proposed to include adequate crowd size to generate useful patient volumes; a regularly scheduled event; organized medical and disaster preparations meeting local or published standards; didactic instruction on history, principles, and current issues; on-site attending supervision; degree of responsibility appropriate for training level; participation in planning and organizing the event; and postevent debriefing. CONCLUSION: A residency experience and training program in mass gathering medicine can introduce the principles of planning and providing care for crowds attending large public events.

Curriculum↗
PubMed1980

Pharmacists as instructors of health education in community colleges.

The public is demanding quality information on the appropriate use of medicinal agents. The pharmacist is a potential source of this information; however, lack of time and appropriate environment often limit this interaction. An educational model has been developed, used, and evaluated in order to increase public knowledge on nonprescription medications, increase pharmacist professional visibility in the community, and provide a practical means of creating this interaction. Using the setting of four California community colleges, consumer education courses were developed during 1972 to 1977. Instructional syllabi, written and audiovisual materials, and evaluations were developed at these colleges by five pharmacists. The courses were presented in an aggregate of 17 semesters to 514 enrollees. Results from objective examination on presented topics showed a mean score increase from 18 to 82% among 62 enrollees. Subjectively, participant response was enthusiastic, with frequent reports of daily usefulness and increased awareness of the pharmacist as a health information resource person. The described model has proven to be an effective means of providing lay persons access to important health care information, while providing pharmacists with an effective means of meeting professional responsibilities, increasing professional visibility in the community, and gaining professional satisfaction.

California↗
PubMed2005

Comparison of directed and self-directed learning in evidence-based medicine: a randomised controlled trial.

OBJECTIVES: To compare 2 educational programmes for teaching evidence-based medicine (EBM). DESIGN: Prospective randomised controlled trial accompanied by a qualitative evaluation. SETTING: University of Oslo, Norway, 2002-03. PARTICIPANTS: A total of 175 students entered the study. All tenth semester medical students from 3 semesters were eligible for inclusion if they completed baseline assessment and consent forms and either attended teaching on the first day of the semester or gave reasons for their absence on the first day in advance. Interventions One intervention was based on computer-assisted, self-directed learning (self-directed intervention), whilst the other was organised as workshops based on social learning theory (directed intervention). Both educational interventions consisted of 5 half-day sessions. MAIN OUTCOME MEASURES: The primary outcomes were knowledge about EBM and skills in critical appraisal. A secondary outcome measured attitudes to EBM. Outcomes were compared on an intention-to-treat basis using a stratified Wilcoxon rank-sum test. RESULTS: There were no differences in outcomes for the 2 study groups in terms of EBM knowledge (mean deviation 0.0 [95% confidence interval - 1.0, 1.0], P = 0.8), critical appraisal skills (MD 0.1 [95% CI - 0.9, 1.1], P = 0.5), or attitudes to EBM (MD - 0.3 [95% CI - 1.4, 0.8], P = 0.5). Follow-up rates were 96%, 97% and 63%, respectively. CONCLUSIONS: This trial and its accompanying qualitative evaluation suggest that self-directed, computer-assisted learning may be an alternative format for teaching EBM. However, further research is needed to confirm this and investigate alternative educational models.

Adult↗
PubMedDate not supplied

Open exchange as a model for continuing education.

The Global Nursing Exchange is a unique, annual opportunity for a select group of nurses to confer with each other and learn in an unstructured, nonrestrictive forum for free uncensored exchange of ideas. It is an unusual "conference" in that both the structure and process have been designed to encourage spontaneity, creativity, and group sharing. Relaxation and work comingle. Networking, dialog, and inclusiveness are operating themes at all times. Started in 1988 by 9 nurses with a mix of backgrounds and experience, the Global Nursing Exchange has expanded to include international participants. In 2003, over 60 nurses joined in celebrating the 15th year of this group gathering. Examples of outcomes that have resulted from this unique "conferencing" experience are described.

Attitude of Health Personnel↗
PubMed2006

A study of network education application on nursing staff continuing education effectiveness and staff's satisfaction.

The rapid development of computer technology pushes Internet's popularity and makes daily services more timely and convenient. Meanwhile, it also becomes a trend for nursing practice to implement network education model to break the distance barriers and for nurses to obtain more knowledge. The purpose of this study was to investigate the relationship of nursing staff's information competency, satisfaction and outcomes of network education. After completing 4 weeks of network education, a total of 218 nurses answered the on-line questionnaires. The results revealed that nurses who joined the computer training course for less than 3 hours per week, without networking connection devices and with college degree, had the lower nursing informatics competency; while nurses who were older, at N4 position, with on-line course experience and participated for more than 4 hours each week, had higher nursing informatics competency. Those who participated in the network education course less than 4 hours per week were less satisfied. There were significant differences between nursing positions before and after having the network education. Nurses who had higher nursing information competency also had higher satisfaction toward the network education. Network education not only enhances learners' computer competency but also improves their learning satisfaction. By promoting the network education and improving nurses' hardware/software skills and knowledge, nurses can use networks to access learning resources. Healthcare institutions should also enhance computer infrastructure, and to establish the standards for certificate courses to increase the learning motivation and learning outcome.

Computer-Assisted Instruction↗
PubMed2004

The anatomy of complications workshop: an educational strategy to improve the training and performance of fellows in gynecologic oncology.

OBJECTIVES: In Australasia, the USA, and Canada, certified gynecologic oncologists (CGO) are expected to be competent in performing intestinal, urological, and vascular procedures relevant to gynecologic oncology. This competency may be difficult to achieve and experience with simulation rather than human patients may be preferable during initial training. We present the structure, objectives, rationale, and outcomes for a surgical skill workshop aimed to improve the performance of fellows in gynecologic oncology. WORKSHOP STRUCTURE: The overall objective of the workshop is the prevention and management of complications in gynecologic oncology surgery. Preworkshop preparation includes anatomical illustrations to guide reading and a training video describing surgical procedures and the relevant aspects of ovine and porcine anatomy. There are four modules: (i) Anatomy includes an interactive lecture, cadaveric dissection, and examination of prosections. (ii) Porcine surgery involves the demonstration, practice, and learning of techniques needed to deal with unexpected or deliberate operative injury to bowel, bladder, ureter, and major blood vessels and performance of less common operations. (iii) Live ovine surgery allows further supervised practice of these procedures plus the repair of vascular injury. (iv) Case presentations allow each participant to present a complicated case in a facilitated group session with discussion and feedback from their peers. This session is controlled, nonthreatening, and interactive. CONCLUSION: Participant feedback and evaluation suggests that this workshop format and the opportunity to practice less common procedures are helpful to clinical practice. This educational model is presented in the hope that it may act as a template for the development of similar programs for fellows in other countries.

Animals↗
PubMed2000

STI prevention and the male sex industry in London: evaluating a pilot peer education programme.

OBJECTIVE: To evaluate the effectiveness of a pilot peer education STI prevention programme with male sex workers. DESIGN: A process and outcome evaluation of the pilot programme undertaken in three London male escort agencies, using a quasi-experimental design. SUBJECTS: Workers in three London escort agencies, including 88 who completed a questionnaire, five peer educators, and a further 16 men (including management) working in two of these agencies. METHODS: A peer education STI prevention programme run by the Working Men Project (WMP), a specialist sexual health service for male sex workers, was piloted in two London escort agencies. Five male sex workers participated in a 2 day peer education training programme. They then returned to their respective agencies to disseminate information and condoms, in an attempt to influence norms of behaviour. An outcome evaluation aimed to assess changes in STI related knowledge, high risk sexual behaviour, and attendance at a sexual health service. A pre-intervention questionnaire assessing variables such as STI related knowledge, sexual behaviour, and demographic information was administered in both agency A and agency B and a third agency, C, which acted as a control. Ten weeks after the peer educators returned to their agencies, the same questionnaire was administered in the same agencies. Peer educator referrals to the WMP were also recorded over this time period. The process evaluation involved interviews and focus groups with peer educators, and the completion of diaries about their experiences in the role. A further 16 men working in the agencies (including managers and an owner) were interviewed about their experience of the programme. Participant observation was also undertaken through regular outreach work to the agencies. RESULTS: 57 men completed the questionnaire at time 1 and 44 at time 2. Unfortunately, only 13 of these were matched, precluding any meaningful analysis of change in STI related knowledge and sexual behaviour. The questionnaire provided a profile of the men working in the agencies. Of the 88 men who completed the questionnaire at least once, the majority were homosexual, and in their late teens/early 20s. Most were of a "white" ethnic group, though there was some range within these categories. Most preferred to speak English and education levels were high. Relative STI knowledge revealed a high understanding of HIV and hepatitis B, moderate understanding of gonorrhoea, syphilis, genital warts and herpes, and little knowledge of non-specific urethritis (NSU) or chlamydia. Sexual behaviour suggested a highly sexually active population with both male and female paying and non-paying partners. Condom use was highest for paying partners, particularly for anal sex. Condom use for oral sex with all partners was less consistent, and condom use for all types of sex with regular partners was lower than with other partners. The small number of men engaging in vaginal sex with paying and regular partners were less likely to use condoms. 26 new patients registered at the WMP as a result of peer educator referrals, representing 65% of all new contacts over the study period. The process evaluation revealed that while the training programme was considered adequate and while peer educators felt the programme and their roles to be a success, their experience of the role was difficult. The role of management support was crucial in supporting the programme. The assumption that "peers" are particularly effective educators was not borne out by the results. While peers were considered suitable to discuss some aspects of the industry, many preferred to consult "professionals" about health related matters. The concept of "peers" was problematic with most of the men drawing "peers" from subgroups within the agencies. Other constraints on behaviour such as a lack of power, particularly with regard to a lack of management support, or poverty, had a substantial impact on behaviour which were not influenced by the peer educators. CONCLUSIONS: The study illustrated the difficulties of utilising quasi-experimental evaluation methodology with this client group. It also demonstrated the limitations of peer education based on information provision health education models which focus on individual behaviour change. Suggestions are given for future interventions.

Adolescent↗
PubMed2000

Collaboration between pharmacy and osteopathic medicine to teach via the Internet.

This article describes the results of a survey from graduate pharmacy students who completed a neurology/psychiatry course taught by a pharmacist and an osteopathic physician via the Internet. Seventeen practicing pharmacists completed the 11-week course, and thirteen students completed the survey provided at the end of the course. Results indicated that students were pleased with the course. Mean evaluation scores ranged from 4.31 to 4.77 on a five-point scale. Additionally, students indicated that the collaboration of medicine and pharmacy provided an educational model that should be duplicated for future courses.

Adult↗
PubMed2003

Comprehensive approaches to school health promotion: how to achieve broader implementation?

The Health Promoting School (HPS) and Comprehensive School Health Program (CSHP) initiatives have been proposed as a means of going beyond some of the limitations associated with health promotion initiatives aimed at school-aged children. This involves moving beyond practices that rely mainly on classroom-based health education models, to a more comprehensive, integrated approach of health promotion that focuses both on child-youth attitudes and behaviors, and their environment. Despite the tremendous potential of these initiatives in terms of health and educational gains, only rarely are they actually put into practice. This article briefly reviews the features of these initiatives, as well as the extent of their implementation and current benefits. Against that backdrop, the authors identify some issues to consider and propose four conditions with a view to achieving broader practical application of these approaches. These issues, which are discussed from the standpoint of potential avenues of further study and courses of action, relate to the comprehensive, integrated nature of the intervention, the school/family/community partnership, political and financial support from policy makers, and, finally, evaluative research as a support to implementation.

Health Promotion↗
PubMed1991

Immediate and sustained reduction in serum cholesterol achieved in 4-week Heart Tune program.

Currently, there is limited information about educational models effective in assisting individuals to lower their serum cholesterol. Dietitians and nutritionists involved in cholesterol-reduction programs need to inform other health professionals about programs utilized and the success of those programs. The National Cholesterol Education Program has published guidelines for the detection, evaluation, and treatment of high blood cholesterol in adults. Educational programs should be systematically evaluated to confirm their success in cholesterol reduction. The Heart Tune program is a 4-week class developed by a dietitian to assist clients in cholesterol reduction. An evaluation of the lipoprotein levels of 49 program participants demonstrated that serum total cholesterol levels significantly decreased at the completion of the 4-week class (0.65 mmol/L) and after 1 year (0.80 mmol/L).

Adult↗
PubMed2002

Design of an intervention addressing multiple levels of influence on dietary and activity patterns of low-income, postpartum women.

Low-income, multi-ethnic women are at elevated risk for obesity and chronic diseases, yet influences at different levels may act as barriers to changing risk behaviors. Following the birth of a child, childrearing and social isolation can exacerbate these influences. The social ecological framework integrates behavior-change strategies at different levels, providing a strong theoretical base for developing interventions in this high-risk population. The primary purpose of this randomized controlled trial is to test the efficacy of an educational model delivered by community-based paraprofessionals in improving diet, activity and weight loss among new mothers over a 12-month postpartum period and a 6-month maintenance period. This model fosters institutional change to support behavior changes influenced at intrapersonal and interpersonal levels, through collaboration with federal programs for low-income families: the Special Supplemental Food Program for Women, Infants and Children (WIC), and the Expanded Food and Nutrition Education Program (EFNEP). Participants are randomized to the Usual Care, e.g. WIC nutrition and breastfeeding education, or Enhanced EFNEP intervention arm, consisting of Usual WIC Care plus a sustained, multi-component intervention including home visits, group classes and monthly telephone counseling. If shown to be efficacious, this program will be readily sustainable through existing federal agencies.

Adult↗
PubMed1983

Application of humanistic learning theory in an associate degree program for occupational therapy assistants.

A humanistic education model was implemented in a 2-year associate degree curriculum for occupational therapy assistants. The goal of this model was to help students to become responsible and successful with their own lives. This prepares students with higher levels of ability to cope effectively with clients in crises. The curriculum presented here supports the framework of The American Occupational Therapy Association role delineation document (Entry-Level Role Delineation for OTRs and COTAs, approved by the Representative Assembly, AOTA, March 1981).

Adult↗
PubMed1980

[Group work within the framework of the Nyon experience for the prevention of cardiovascular diseases].

The Swiss National Research Program on primary prevention of cardio-vascular disease has raised new approaches for reducing the exposure level to known risk factors. In Nyon, lay-groups conducted by dieticians, nurses and social workers were created. They dealt with alimentary habits, tobacco consumption, blood pressure and stress. The same educational model was applied in the group devoted to preventive activities and for training the team of the group conductors. A preparatory document for group activities is given as an example. The discussion points out the importance of defining educational goals, the usefulness of various educational tools, and of a proper evaluation. The principles underlying the group activities in Nyon were based on non directive teaching to the participants and on ability to take for individual responsibility.

Blood Pressure↗
PubMedDate not supplied

Individual teaching as a first-step intervention for the education of diabetic subjects.

The effects of individual teaching imparted during routine diabetologic counselling on the knowledge concerning diabetes and metabolic control, were assessed in 42 outpatients (28 IDDM; 14 NIDDM), attending the diabetic clinic (study group, SG). We evaluated the outcome of a multiple-choice questionnaire and fasting blood glucose (FBG), 24-h urine glucose (UG), mean regulation index (MRI) and glycated hemoglobin (HbA1), before and 60 days after providing information about diet (D), physical exercise (E) and hypoglycemic drugs (HD) or insulin therapy (IT). Results were compared with those obtained in a group of 57 age- and sex-matched patients (36 IDDM; 21 NIDDM) who did not receive individual teaching (control group, CG). Knowledge concerning diabetes at the second evaluation was significantly higher (p less than 0.001) in SG than in CG for D and IT, although an improvement was observed in all items. SG patients showed a significant improvement of knowledge (p less than 0.05) for D, a not significant improvement for HD and IT and no change for E. No change was observed for HbA1, MRI and UG, while a significant decrease (p less than 0.05) was observed for FBG in SG. At the second evaluation, FBG of SG patients was significantly lower (p less than 0.05) than that of CG patients. Our results go to show that individual teaching can improve the level of knowledge of patients without affecting metabolic control. Individual teaching during routine diabetologic counselling represents in our opinion an effective and economic educational model.

Adolescent↗
PubMedDate not supplied

Shaping the advanced practice psychiatric-mental health nursing role: a futuristic model.

As advanced practice psychiatric-mental health nursing has transitioned from earlier models of practice, elements of clinical specialist and psychiatric nurse practitioner roles are being blended to produce a new type of practitioner. The challenge of preserving mental health expertise while expanding advanced practice primary and primary mental health care competencies is addressed in several nursing education models. At New York University's Division of Nursing, faculty have designed a program around elements identified as essential to the autonomy demanded of the evolving role, knowledge, and skills basic to broad based health care and mental health care delivery with quality patient care outcomes and the competencies necessary for accountability as care providers in a changing health care delivery system. Essential elements, resources to identify them, and strategies to attain them are discussed. Approaches that promote student, clinician, and faculty development and maximize education affirm the specialty's capacity for innovation and the profession's capacity for new direction and futuristic change.

Curriculum↗