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PubMed1991

Job stressors and coping in health professions.

In spite of their knowledge about stressors, health hazards and coping, health professionals are in general not aware of their own health risks. In an attempt to clarify the issue results of our own studies are compared to the relevant literature. A survey on 1,248 Swiss nurses confirmed the major stressors known: ethical conflicts about appropriate patient care, team conflicts, role ambiguity, workload and organizational deficits. In doctors workload and shortage of time, combined with specific responsibility in decision making, are most prominent. Nevertheless, job satisfaction is still high in both professions. Health hazards in doctors are considerable, although life expectancy has improved and is comparable to the general public, but still lower as compared to other professionals. Depression and substance abuse are related to higher suicide rates. The specific role strain of female doctors is responsible for health risks with an alarming 10 years lower life expectancy than in the general population. Little is known about specific health hazards in nurses, except for burnout. A lack of coping research in the field makes conclusions difficult. Our own studies show limited coping skills in nurses, but good buffering effect in 1,700 Swiss dentists.

Adaptation, Psychological↗
PubMed2004

History, memory, and profession: a view of American psychiatry through APA presidential addresses, 1883-2003.

The address of the retiring president of the American Psychiatric Association has been a traditional part of the annual meeting of the association since 1883. The presidential address, which has explicitly been exempted from general discussion or criticism, has become an opportunity for the elected leader of the association to reflect on the state of the profession. Over the last 120 years, the presidents of the association have themselves engaged with the history of psychiatry in ways that reflect the changes in psychiatry of the time. In the process, memory has served a professionalizing purpose, as some aspects of psychiatry's history have been remembered while others have not. In the presidential addresses, history is not just a story about the past but also a story about psychiatry's self-definition and its future.

Historiography↗
PubMed1978

The impact of the Health Professions Educational Assistance Act on state mental health systems.

One effect of the Health Professions Educational Assistance Act of 1976 is to severely limit the number of foreign medical graduates entering the United States. To examine the impact of the law in Michigan, the authors gathered data on the number of psychiatrists practicing in the state and projected future manpower needs. They conclude that it is unlikely that, given other provisions in the law, American medical graduates can numerically replace foreign medical graduates, and that alternative manpower resources will have to be developed. State mental health systems must form new relationships with universities and the private psychiatric sector, and new methods of training personnel and sharing resources must be developed. The authors emphasize the importance of giving state mental health systems sufficient time and resources to develop effective manpower plans.

Education, Medical↗
PubMed1995

The intellectual foundation of pastoral counseling: a perspective on the future of the profession.

Reflects on the intellectual nature of pastoral counseling, compares it with certain aspects of contemporary research in psychiatry and clinical psychology, and offers some observations regarding the uniqueness of pastoral counseling as a profession. Argues that pastoral counseling can offer a truly wholistic view of mental health if (1) its intellectual foundation is developed in theological perspective, (2) continues to integrate its theological dimension with clinical psychology and psychiatry, and (3) evaluates its applied research within the framework of the normative standards of mental health.

Chaplaincy Service, Hospital↗
PubMed1996

A scale for curriculum evaluation and development in the health professions.

Schools responsible for the education of health professionals throughout the world are seeking ways to respond to the changing realities of the health professions and society. In an effort to be responsive to as many people as possible, there is a need to develop evaluative instruments that are effective and easily understood by multiple stakeholders. The authors describe the effective utilization of a simple scale for curricular evaluation, innovation, and reform. The scale, which incorporates two previously described instruments, can be used as an aid in several phases of curricular design: (a) during the development of a statement of educational philosophies that aid in goal and objective development, (b) during the selection and organization of learning experiences, and (c) during the evaluation of a curriculum.

Curriculum↗
PubMed1994

Children, psychiatrists and the courts: understanding the ambivalence of the legal profession. Part 1--General principles.

Psychiatrists and other mental health professionals are frequently involved as expert witnesses in court proceedings related to children and adolescents. Their testimony may be based on a therapeutic relationship, but frequently arises because of an assessment conducted specifically for the court process. This two part paper discusses some of the issues that arise when child psychiatrists are involved as expert witnesses in litigation, with specific focus on their role in child custody, sexual abuse and young offender cases. It also offers some practical advice for those who may be called as witnesses. There is controversy in the legal profession about the role of mental health professionals in the court process. While there is recognition of their expertise, there is also a concern about not wanting to have experts usurp the role of the courts. Legal professionals also question the "objectivity" of experts, and the reliability of their opinions. Frequently the opinions of psychiatrists about children and adolescents involved in litigation have inherently speculative and value based dimensions, and not "scientific". Participation in the court process by mental health experts is nevertheless a vitally important role, providing information, analysis and recommendations about what are often very difficult societal decisions. Part two of this paper starts on page 531.

Adolescent↗
PubMed1991

The profession of pharmacy in Zimbabwe.

Zimbabwe (formerly Rhodesia) is a developing country in central southern Africa where great strides have been made in healthcare since black-majority rule began in 1980. Shortages of personnel, equipment, and drugs continue to be a problem. Challenges facing the pharmacy profession include improving drug supply, promoting rational use of essential drugs, and educating healthcare professionals and the public. Persuading pharmacists to practice in the government sector of healthcare rather than to serve the small percentage of the public that can afford private healthcare should be a major priority. Zimbabwe is a land of opportunity for pharmacy practice but the financial constraints are formidable.

Curriculum↗
PubMed1994

Whistle while you work in the health-related professions?

The spate of correspondence and publicity, following the disciplining, and subsequent settlement in his favour, at an Industrial Tribunal, of Stockport Health Authority Charge Nurse Graham Pink, suggested that the urge to blow the whistle was at almost epidemic proportions in the NHS. It might have been surmised that the only device which kept this under control was the fear of discipline and perhaps dismissal. This fear has been increased by the contracts of employment of the NHS Trusts which have outlawed acts of whistleblowing. There are similar pressures for those working in other health-related professions, and in health and safety, and environmental protection. It is important to question whether such severe strictures are in the public interest, or whether they are there to make the life of senior managers easier, or to make it possible to ensure that doctors, nurses, and other caring professionals and support staff, conform to budgetary constraints without resort to campaigning.

Confidentiality↗
PubMed2003

Defining biomedical informatics competency: the foundations of a profession.

Is biomedical informatics a science or a profession? This question has been asked of many members in the biomedical informatics community, yet we still lack a response that galvanizes our community. We debate the issues over lunch. We create long, multi-threaded e-mail discussions, we write papers on the topic, and still we aren't able to convince ourselves-let alone the rest of the scientific community. In this paper, I will describe a curriculum model for biomedical informatics and research that is developing at Columbia University, Department of Biomedical Informatics (DBMI). We believe that a strong educational foundation creates competent professionals who, in turn, comprise a bioinformatics culture. The outcome of DBMI's curriculum design and competency project will be a set of biomedical informatics competencies which we believe will define the core knowledge and skills of the field.

Computational Biology↗
PubMed2006

The Council on Chiropractic Education's new wellness standard: a call to action for the chiropractic profession.

BACKGROUND: The chiropractic profession has long considered itself to be a preventive science. Recently the Council on Chiropractic Education (CCE) has defined a set of standards that must be implemented at all US chiropractic colleges as of January of 2007. These are specific to wellness measures and health promoting efforts that should be performed by chiropractors. This will mandate traditional health promotion and prevention methods be taught to students at accredited colleges and to practicing chiropractors. OBJECTIVE: To present the idea of performing traditional health promotion and wellness-concepts in chiropractic practice as a call to action for clinicians and generate discussion on the topic. DISCUSSION: This manuscript discusses relevant topics of health promotion and prevention for chiropractors and other practicing clinicians that should be made priorities with patients in order to enhance both patient health and community and population health. CONCLUSION: All practicing chiropractors, as well as other clinicians should take these new standards from the CCE as a call to action to begin helping patients address the removable causes of morbidity, disability and premature mortality where they exist, in addition to treating their painful spinal conditions.

Editorial↗
PubMed1996

Preventing harm and promoting ethical discourse in the helping professions: conceptual, research, analytical, and action frameworks.

The first in a series of 4 articles, this article provides an overview of the concepts and methods developed by a team of researchers concerned with preventing harm and promoting ethical discourse in the helping professions. In this article we introduce conceptual, research, analytical, and action frameworks employed to promote the centrality of ethical discourse in mental health practice. We employ recursive processes whereby knowledge gained from case studies refines our emerging conceptual model of applied ethics. Our participatory conceptual framework differs markedly from the restrictive model typically used in applied ethics. Our research relies on lived experiences of ethics, while our analytical framework draws attention to the multiple levels and contexts in which ethical dilemmas take place. Finally, our action framework is designed to collaborate with research participants and practitioners in making use of our data and interpretations. We demonstrate how the various frameworks inform each other in an integrative fashion. The article sets the stage for 2 case studies presented in subsequent articles.

Administrative Personnel↗
PubMed2006

The impact of internet use on the public perception of physicians: a perspective from the sociology of professions literature.

This study uses literature on the sociology of professions and explores the impact of Internet use on the degree to which patients believe doctors are the sole source of expert medical knowledge. A survey of 406 respondents was conducted to assess this question. Findings lend some support to the idea that the spread of Internet-based professional knowledge erodes the ability of professionals to control their knowledge. Specifically, findings suggest that increased access and use of online health information is related to the belief that doctors may be bypassed in the pursuit of medical information and diagnoses. Indirectly, age was found to be a significant factor, in that the younger the individual, the greater the use of online health information. This finding suggests that Internet use will likely continue to provide challenges to physician authority.

Data Collection↗
PubMed2005

Writing-skills development in the health professions.

BACKGROUND: Studies have found that students in the medical professions often lack the writing skills required during their education and career. One contributing factor to this deficiency is that writing tends to be discipline specific, rather than requiring general skills acquired in undergraduate schools. PURPOSE: To determine the extent to which a rigorous writing exercise impacted the quality of students' medical writing based on a specified rubric. METHOD: In the context of a basic science course, we developed 6 weekly writing exercises called Question of the Week, along with a rubric for scoring students' work. The rubric evaluated 6 specific aspects of students' writing including Comprehensiveness/Thoroughness, Accuracy, Conciseness, Logical Organization, Justification of Assertions, and Use of Appropriate Terminology. RESULTS: Except for Justification of Assertions and Accuracy, which did not change, scores for all categories improved between Weeks 1 and 2. Use of Appropriate Terminology was the only category for which scores increased after Week 2. CONCLUSION: The clearest indication of writing development came from students' augmented ability to use medical terminology in appropriate ways. This is an important observation, given that each Question of the Week covered a separate body system, characterized by distinctly different terms and jargon. We concluded that students need much more practice to attain the level of proficiency outlined by our rubric.

Educational Measurement↗
PubMed2006

Procedures for establishing defensible absolute passing scores on performance examinations in health professions education.

BACKGROUND: Establishing credible, defensible, and acceptable passing scores for performance-type examinations in real-world settings is a challenge for health professions educators. Our purpose in this article is to provide step-by-step instructions with worked examples for 5 absolute standard-setting methods that can be used to establish acceptable passing scores for performance examinations such as Objective Structured Clinical Examinations or standardized patient encounters. SUMMARY: All standards reflect the subjective opinions of experts. In this "how-to" article, we demonstrate procedures for systematically capturing these expert opinions using 5 research-based methods (Angoff, Ebel, Hofstee, Borderline Group, and Contrasting Groups). We discuss issues relating to selection of judges, use of performance data, and decision-making processes. CONCLUSIONS: Different standard-setting methods produce different passing scores; there is no "gold standard." The key to defensible standards lies in the choice of credible judges and in the use of a systematic approach to collecting their judgments. Ultimately, all standards are policy decisions.

Clinical Competence↗
PubMedDate not supplied

Nursing as a research-based profession: 22 years after Briggs.

This review examines the growth of nursing research in the UK over the past 22 years and questions nursing's claim to be a research-based profession, as the consensus of opinion is that research findings have generally failed to influence clinical practice.

Clinical Competence↗
PubMed1989

Challenges for social work as a core profession in cancer services.

Social work's claim to be a core profession in cancer services carries the challenge to articulate the basis for that central position. In answer to that challenge, this paper considers the essentially psychosocial nature of cancer and the usefulness of empowerment as a practice premise for conceptualizing social work in oncology. Specific responsibilities are suggested for practitioners at the levels of clinical service, organizational and political action, and writing and research.

Chronic Disease↗
PubMedDate not supplied

Preceptors' perspectives on benefits of precepting student pharmacists to students, preceptors, and the profession.

OBJECTIVES: To educate pharmacists on the shortage of quality preceptors and the benefits received from precepting; present insights from successful preceptors and offer guidance to current and prospective preceptors; and encourage pharmacists to become preceptors and mentor aspiring pharmacy professionals. SETTING: Advanced experiential settings for Nova Southeastern, Ohio Northern, and Creighton Universities. PRACTICE DESCRIPTIONS: Hospital, community, and outpatient clinic settings. PRACTICE INNOVATION: Successful incorporation of student pharmacists and the experiential process into pharmacy practice. MAIN OUTCOME MEASURE: Not applicable. RESULTS: A variety of factors has produced an increased demand for qualified pharmacist preceptors, including workload issues, an increasing number of pharmacy schools, and an increased experiential load in the pharmacy school curricula. Characteristics of quality preceptors include demonstrating enthusiasm in their teaching, being open to questions, and providing constructive feedback. Sites and preceptors can benefit from teaching student pharmacists by receiving assistance in developing and maintaining clinical services, sensing the satisfaction of giving back to the profession, and material rewards provided by schools of pharmacy. In this article, three successful preceptors share their perspectives and insights about precepting, and a professional organization perspective is included to highlight the support for precepting student pharmacists. CONCLUSION: Additional introductory and advanced quality pharmacy experiential practice sites are needed, and pharmacists are encouraged to contact nearby pharmacy schools to become preceptors.

Attitude of Health Personnel↗
PubMed2004

Building an academic-community partnership for increasing representation of minorities in the health professions.

We evaluated collaboration among academic and community partners in a program to recruit African American youth into the health professions. Six institutions of higher education, an urban school system, two community organizations, and two private enterprises became partners to create a health career pipeline for this population. The pipeline consisted of 14 subprograms designed to enrich academic science curricula, stimulate the interest of students in health careers, and facilitate entry into professional schools and other graduate-level educational programs. Subprogram directors completed questionnaires regarding a sense of common mission/vision and coordination/collaboration three times during the 3-year project. The partners strongly shared a common mission and vision throughout the duration of the program, although there was some weakening in the last phase. Subprogram directors initially viewed coordination/collaboration as weak, but by midway through the project period viewed it as stronger. Feared loss of autonomy was foremost among several factors that threatened collaboration among the partners. Collaboration was improved largely through a process of building trust among the partners.

Academic Medical Centers↗