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PubMed2002

Self and peer assessment in tutorials: application of a relative-ranking model.

PURPOSE: While self assessment continues to be touted as being of paramount importance for continuing professional competence, problem-based learning curricula, and adult learning theory, techniques for ensuring valid judgments have proven elusive. This study tested the applicability of an innovative relative-ranking procedure to problem-based learning tutorials. METHOD: A total of 36 students in the McMaster University Faculty of Health Sciences' MD program were provided relative-ranking forms listing seven domains of competence along with their definitions. The student, two of the student's peers, and the student's tutor were asked to complete the ranking exercise after their second, fourth, and sixth tutorials. RESULTS: Combining each level of the time and rater variables generated 66 correlation coefficients, none of which was significantly different from zero. Re-performing the analysis on only the extreme domains did not improve this result. CONCLUSION: The relative-ranking instrument developed did not prove to be a reliable measure of tutorial performance. Ratings were inconsistent from one week to the next as well as across raters within a week.

Attitude of Health Personnel↗
PubMed2005

Maximizing participation in peer assessment of professionalism: the students speak.

BACKGROUND: Medical students have unique information about peers' professionalism but are reluctant to share it through peer assessment. METHOD: Students (231 of 375; 62%) in one school replied to a survey about whether various characteristics of peer assessment (e.g., who receives the assessment, its anonymity, implications for the classmate) would prevent or encourage their participation. RESULTS: Sixty-six percent of the students agreed that there should be peer assessment of professionalism as long as the assessment reflected their preferences for how the assessment should take place. Some of their preferences included reporting unprofessional behavior to an impartial counselor, a 100% anonymous process, and having the classmate receive corrective instruction. Students across year levels generally agreed about the characteristics of peer assessment. Men and women disagreed about some characteristics. CONCLUSION: Most students are willing to participate in peer assessment as long as their preferences are taken into consideration.

Female↗
PubMed1992

Evaluation of clinical nurse specialist practice.

Evaluation of the impact of clinical nurse specialist (CNS) practice in today's health care environment is currently one of the most important issues facing these advanced practitioners and nursing administrators. The unique contributions of CNS practice can be demonstrated through use of sophisticated evaluation methods. This paper begins with a discussion of types of evaluation (structure, process, and outcome) that have been utilized in the past and then describes the structure, developmental process, and function of an evaluation instrument recently implemented by a group of CNSs. The evaluation instrument is a step towards the ultimate goal of process-outcome evaluation, the most sophisticated method of evaluating the impact of the CNS. The benefits of utilization of this tool are presented from the perspective of CNSs and nurse administrators.

Employee Performance Appraisal↗
PubMed2001

Attitudes of patients with breast and prostate cancer toward complementary therapies in Finland.

This study aimed to describe the attitudes of patients with breast cancer and those with prostate cancer toward complementary therapies. The data were collected with a postal questionnaire administered to 216 patients with breast cancer (response rate, 55.4%) and 1 90 patients with prostate cancer (response rate, 54.9%) in southern and southwestern Finland. The questionnaire was composed of 44 Likert-type statements, which were analyzed using descriptive statistics, chi2 tests, t tests, and two-way analyses of variance. More than half (54%) of the patients with breast cancer and 45% of the patients with prostate cancer believed that people with cancer may benefit from complementary therapies, although they did not think these therapies actually could cure cancer. More than half of the respondents were dubious about using complementary therapies as long as there was no solid scientific evidence. Most believed that complementary therapies were used because they gave people hope (women, 88%; men, 72%) or "something to cling to" (women, 83%; men, 76%). The respondents believed most in dietary therapies and least in healing. There was much confusion and uncertainty about the professional competencies and expertise of the people who provided complementary therapies. Approximately one fourth of the respondents had spoken to their physician about complementary therapies. Only a few had talked about the matter with nursing staff. About half of the respondents thought that physicians and nurses took a negative attitude toward complementary therapies. In both groups, patients who had talked with their physician about complementary therapies tended to show a more positive attitude.

Adult↗
PubMed1984

Potential role of nurses in assessing house officer performance in the critical care environment.

A prospective study was conducted to examine the possible contribution of acute care nurses to the evaluation of resident physicians. During a 10-month interval, 98 house officers rotating through a trauma unit were assessed by 2 staff physicians, 1 trauma/critical care fellow, and 3 registered nurses. Residents were evaluated on 33 factors related to 4 categories of activity: personal conduct, professional competence, patient-oriented behavior, and interdisciplinary relations. In all 4 categories, the mean scores of the nurses were significantly (p less than .05) higher than those of the staff physicians, but not significantly different from those of the trauma/critical care fellow. The mean ratings of the latter were generally between the other 2 groups of evaluators. This study revealed that nurses can participate successfully in the resident evaluation process, and that senior physicians on the acute care team are more critical of house officer performance than are nurses or fellows on the team.

Clinical Competence↗
PubMed1996

Medical staff leadership: a national panel survey.

Dramatic change in health care has challenged traditional medical staff governance and leadership. The role of medical staff leaders, particularly the chief of staff, and of the medical executive committee is explored through a national panel survey.

Decision Making, Organizational↗
PubMedDate not supplied

The profession of clinical engineering.

This paper reviews the sociology of professions, examines the background and historical development of professions, and then reviews the present status of the profession of clinical engineering. The historical components of the professionalization process are investigated along with the societal perceptions, the role of education, and the functions of professional societies. The progress of an occupation toward professionalization involves: the appearance of training schools; establishment of university educational programs; licensure or certification; a formal code of ethics; and establishment of one or more national professional associations. A rationale is presented here for the formation of a clearly identified professional society for clinical engineers based on: (1) The need to identify the territory of the clinical engineer by defining the body of knowledge on which clinical engineering is based; (2) The need to structure the educational system of clinical engineering; (3) The need to represent the clinical engineer in the healthcare system; and (4) The need to gain status as a profession.

Biomedical Engineering↗
PubMed1978

Behavioral contracting in a burn care facility: a strategy for patient participation.

Behavioral contracting is a valuable tool for resolving persistent behavioral problems interfering with the treatment and recovery of severely burned patients. Coercive bidding of the patients for more control occurs in an environment where they experience extreme forms of loss of control and associated enforced regression. The ensuing conflicts between patient and staff often lead to breakdown in mutual cooperation, with deleterious effects on patient-staff morale. Staff experience highly ambivalent feelings toward a problem patient and may wish to withdraw from him, feeling threatened in their image of themselves as competent professionals. Beyond reducing disruptive conflicts on the ward, behavioral contracting aims to mobilize patient and staff around common and explicit goals, and to maximize patient cooperation and productive control in the recovery process. Contracts are valuable because: 1) they facilitate productive communication about issues which underlie patient-staff conflict; 2) they facilitate solutions to problem interactions between patients and staff; 3) they afford both patients and staff a sense or self-control. We provide a rationale for behavioral contracting and discuss the indications for initiating contracts with hospitalized burn patients, and describe methods for developing, implementing, and managing behavioral contracts in order to improve communication and effectiveness in patient-staff interactions.

Adolescent↗
PubMed1975

Correlates of satisfaction and dissatisfaction with medical care: a community perspective.

The attitude of the public toward physicians and medical services is an issue of current concern and debate. To address this problem, an instrument was developed using Thurstone scaling methods in conjunction with a Likert format and a modified scoring technique. Following pretesting of the instrument among both patient and population samples, a survey was conducted among the residents of a probability sample of households in a city of 200,000 people. The attitude questionnaire was completed by 1,713 adults in 1,112 households. Overall, attitudes were favorable toward the professional competency and the personal qualities of physicians. Accessibility, including costs and convenience, were less highly regarded. Men were less satisfied than women and blacks less satisfied than whites. Particularly negative attitudes were expressed toward the personal qualities of physicians by young blacks, whereas among blacks over 60 the negative effect was toward cost and convenience. Having a regular physician and long attendance with that physician were correlated with positive attitudes. The most negative sentiment was expressed by women without regular source of care. Medical services are being sought and obtained by a large segment of society, but problems of costs and acceptability for the elderly, low social class persons, members of large families, and for blacks still remain.

Community Health Services↗
PubMedDate not supplied

Nursing leadership succession planning in Veterans Health Administration: creating a useful database.

An electronic database was developed for succession planning and placement of nursing leaders interested and ready, willing, and able to accept an assignment in a nursing leadership position. The tool is a 1-page form used to identify candidates for nursing leadership assignments. This tool has been deployed nationally, with access to the database restricted to nurse executives at every Veterans Health Administration facility for the purpose of entering the names of developed nurse leaders ready for a leadership assignment. The tool is easily accessed through the Veterans Health Administration Office of Nursing Service, and by limiting access to the nurse executive group, ensures candidates identified are qualified. Demographic information included on the survey tool includes the candidate's demographic information and other certifications/credentials. This completed information form is entered into a database from which a report can be generated, resulting in a listing of potential candidates to contact to supplement a local or Veterans Integrated Service Network wide position announcement. The data forms can be sorted by positions, areas of clinical or functional experience, training programs completed, and geographic preference. The forms can be edited or updated and/or added or deleted in the system as the need is identified. This tool allows facilities with limited internal candidates to have a resource with Department of Veterans Affairs prepared staff in which to seek additional candidates. It also provides a way for interested candidates to be considered for positions outside of their local geographic area.

Career Mobility↗
PubMedDate not supplied

Don't let the grievance process cause grief.

Faculty in a division of nursing at a state university has developed a unique way to handle student grievances. Community nurses serve on arbitration boards. These boards hear relevant evidence from both sides and render decisions, which are binding within the division. The process has been successful and has helped take "grief" out of the grievance process.

Attitude of Health Personnel↗
PubMed2000

Don't get underrepresented.

Beware of the situations that can arise when a nurse fails to retain an attorney, hires a generalist when the case requires a specialist, or shares an attorney with other parties in the same case. Check your answers to the following questions at http://www.nursingmanagement.com.

Conflict of Interest↗