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PubMed2002

The role of open learning in nurse education. Does it have a place?

A perceptible shift has begun, away from mass lectures towards more flexible, novel and adaptable methods of teaching and learning. A variety of terms (open, distance, flexible) have been used to describe such instructional methods, a key characteristic of which is that they do not require constant and/or synchronous contact between teacher and learner. This paper explores students' views of a distributed learning initiative within a University in the South of England. The initiatives were in response to increase in the number of students in each intake which was just one of the recent changes called for by the Government. This evaluation consisted of a longitudinal research project following two cohorts of nursing students (n=288) through the first two years of their education (and will continue in the final year). The study assessed the perceived influence of distributed learning (DL) on their academic education and professional training as well as their satisfaction with the workbooks. The evaluation used a mixture of qualitative and quantitative data collection, questionnaires and focus groups. DL was seen as a flexible way of studying for students. Students were able to study a topic area at their own pace and at a time convenient to them. The activities in the workbook stimulated discussions and triggered ideas and thoughts for both students and lecturers. With the commencement of the workbooks lecturers were given the opportunity to reflect on their teaching styles and were encouraged to utilise a number of different teaching and learning methodologies.

Education, Distance↗
PubMed2004

Should we establish a North American school of global health sciences?

Since 1997, an unprecedented amount of American philanthropy from both private and federal sources has been directed toward research and control programs for the major tropical infectious diseases of developing countries. The US and Canadian capacity to respond to these new initiatives might prove inadequate, however, as tropical disease research and training infrastructures have deteriorated at most North American academic health centers over the last three decades. Training opportunities in clinical tropical medicine, parasitology laboratory diagnostics, vector control, and public health practice are especially depleted and portend a lost generation of experts in these areas. In addition, unlike some of the European schools of tropical medicine, no North American medical or public health school currently boasts a comprehensive faculty in the global health sciences, with expertise that spans laboratory investigation, clinical and translational research, health policy, and international development. To meet the challenge presented by the new philanthropy targeting the global diseases of poverty, a North American school of global health sciences should be established. The North American school, possibly in association with one of the existing schools of medicine or public health, would provide interdisciplinary training to produce a new generation of global health scientists.

Canada↗
PubMed1990

Research careers in child psychiatry: an update on five NIMH workshops.

To foster research in child psychiatry, the National Institute of Mental Health and the American Academy of Child and Adolescent Psychiatry sponsored three workshops in 1981-82 and two others in 1984. Overall, 60 trainees and several senior researchers participated. A 30-month follow-up of the careers of 34 residents who participated in the first three workshops and a description of the workshops were published earlier. This report summarizes the nature and degree of postworkshop activities of 23 additional child psychiatrists involved in the 1984 workshops, along with the needs, problems, and sources of help that they recognized as important. Promising is the fact that the vast majority were involved in research and research training and employed in academic settings.

Adolescent Psychiatry↗
PubMedDate not supplied

Intraoperative cytologic diagnosis of breast sentinel lymph nodes in the routine, nonacademic setting: a highly specific test with limited sensitivity.

Intraoperative determination of metastatic breast carcinoma in sentinel lymph nodes (SLNs) by cytologic methods has been proposed as highly specific and sensitive. Much of these data are derived from academic institutes with highly trained personnel and without axillary dissection occurring as a direct result of the intraoperative interpretation. This prospective study was undertaken to assess the sensitivity and specificity of cytology in the routine, private-practice, intraoperative setting. A total of 207 SLNs from 96 breast carcinoma patients were evaluated by intraoperative cytologic preparations by general surgical pathologists; positive results led to axillary lymphadenectomy. Ten nodes were positive by intraoperative cytology (IC). Permanent section analysis confirmed the presence of carcinoma in the IC-positive cases and documented carcinoma in 19 of the IC-negative cases. IC sensitivity and specificity were 34% and 100%, respectively. False-negative IC interpretations occurred in nodes with occult micrometastases (12 of 19 nodes) and lobular carcinoma (6 of 19 nodes). Only one of eight grossly positive sentinel nodes resulted in a false-negative IC. While near-perfect specificity and high sensitivity can be achieved with grossly positive sentinel nodes by IC, sensitivity is quite low in cases with micrometastatic and lobular carcinoma.

Breast Neoplasms↗
PubMed2000

Research ethics: ethical issues of data reporting and the quest for authenticity.

The search for truth and its unbiased reporting are ultimate goals of conducting scientific research. Ideally, the reporting of research data ought to be an objective task. In practice, however, it is fraught with numerous statistical and ethical pitfalls, seldom addressed in formal emergency medicine training. The lure of academic celebrity and related influences may persuade researchers to report results in ways that make data appear more interesting, or worthy of publication. Several examples of potentially misleading data reporting are illustrated, including using inappropriate statistical tests, neglecting negative results, omitting missing data points, failing to report actual numbers of eligible subjects, using inappropriate graph labels or terminology, data dredging, and others. Although potentially inaccurate or inflated methods of data reporting may not constitute overt scientific misconduct, the intentional misrepresentation of data is a form of fraud or deception. Publicly funded academic inquiry is a privilege and honor enjoyed by a trusted few. Regardless of outcome, every effort should be made to report data in the most scientifically accurate method. To this end, the Society for Academic Emergency Medicine Code of Conduct and American College of Emergency Physicians Code of Ethics provide important guidance toward the accurate, compassionate, competent, impartial, and honest conduct of scientific research. Accuracy and authenticity in data reporting are first and foremost a matter of individual integrity, and are crucial to the preservation of academic credibility, the protection of future patients, and the public's trust in the medical research enterprise.

Emergency Medicine↗
PubMed2026

Teacher- Versus Video-Delivered Classroom Activity Breaks and Student Physical Activity: The PAAC-3 Trial.

BACKGROUND: Classroom activity breaks may increase moderate-to-vigorous physical activity (MVPA); however, few studies have compared teacher and video-delivered approaches under real-world conditions. METHODS: In this cluster randomized trial, 11 elementary schools were assigned to teacher-delivered (PAAC-T; 5 schools, 192 students) or video-delivered (PAAC-V; 6 schools, 276 students) classroom activity breaks across one academic year. Teachers were trained to deliver two 10-min breaks daily. Intervention delivery was tracked via a web-based platform, and classroom MVPA was assessed using accelerometers at baseline and follow-up. RESULTS: Implementation fidelity was low and highly variable, but comparable between PAAC-T (42.3&#x2009;&#xb1;&#x2009;57.1 activity breaks/teacher/year) and PAAC-V (39.2&#x2009;&#xb1;&#x2009;33.9; p&#x2009;=&#x2009;0.96), with teachers delivering &#x223c;50% of the intended daily activity. Classroom MVPA increased significantly in both groups (PAAC-T: 9.8&#x2009;&#xb1;&#x2009;15.9; PAAC-V: 9.1&#x2009;&#xb1;&#x2009;15.3&#x2009;min/day; p&#x2009;<&#x2009;0.001), with no intervention arm-by-time interaction (p&#x2009;=&#x2009;0.43). IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Classroom physical activity breaks may increase student MVPA, but effectiveness in elementary schools appears to depend on implementation fidelity, administrative support, and equitable system-level infrastructure. CONCLUSIONS: Modest increases in classroom MVPA were observed across both delivery formats, although low and variable implementation fidelity limited conclusions regarding effectiveness and highlighted the need for stronger implementation supports. TRIAL REGISTRATION: NCT03493139.

Humans↗
PubMed1986

The clinician-researcher in psychiatry.

As clinical research in psychiatry has grown in importance and promise in the past decade, the need for a growing pool of skilled clinician-researchers has been increasingly recognized. Compared with physicians in other specialties, psychiatrists in academic positions have less training in research and devote less time to it, which is reflected in the growing concentration of research funds from the National Institute of Mental Health in just a few of the strongest medical school departments. To focus attention on the need for developing the role of clinician-researchers, the authors examine four major tasks faced by clinician-researchers and present a developmental perspective on the transition to research.

Career Choice↗
PubMed1989

Followup in psychoanalysis: clinical and research values.

Psychoanalysis has never developed a tradition of systematic followup study to evaluate outcome and to improve technique and theory for a variety of reasons, partly theoretical, stemming from the conception of the unfolding transference neurosis and its analytic resolution as the precondition for cure, and partly historical, having to do with the happenstance of its development as a private practice-based discipline and training outside of the academic setting. Freud, however, was never bound by such strictures and published whatever post-treatment data he acquired on all his best-known case histories. But following Freud most analysts, with some notable exceptions, eschewed followup activity as unanalytic. It is this tradition that more recent studies like those of Pfeffer in New York and the Psychotherapy Research Project of The Menninger Foundation in Topeka have squarely challenged. Data are presented from the Menninger project dealing specifically with the impact of routine planned followup on issues of treatment termination and resolution and on the nature of the post-treatment period. The degree and kind of patient cooperation with the followup inquiry, the impact of followup on treatment termination and resolution (both impeding and facilitating), and the role of followup intervention in relation to return to formal post-treatment therapy (or consolidating against it), are all discussed.

Adaptation, Psychological↗
PubMed1991

Cognitive training in ADHD children: less to it than meets the eye.

This article reviews cognitive training studies that have been carried out with children with attention deficit-hyperactivity disorder (ADHD) during the past decade. The efficacy of cognitive training as a single intervention and as an adjunct to stimulant treatment is discussed. The impact of training on the cognitive, academic, and behavioral functioning of youngsters with ADHD is summarized. Although this treatment modality is inherently appealing, there is little empirical support for its clinical utility with children with hyperactivity.

Attention Deficit Disorder with Hyperactivity↗
PubMed1996

Research training and productivity among faculty: the Canadian Association of Professors of Psychiatry and the Canadian Psychiatric Association Survey.

OBJECTIVE: This survey assesses the research training and productivity of academic faculty in Canadian departments of psychiatry and compares the findings with those of colleagues in the United States. METHOD: A questionnaire was adapted to suit the Canadian milieu and was distributed to a target population of 2484, including a core 522 full-time faculty. RESULTS: The response rate among full-time faculty was 65%, but only 26.5% for clinical and adjunct faculty. A small proportion (16%) of our MD and a greater proportion (57%) of our PhD respondents were included in a fairly lenient definition of researcher. Departments seek to recruit PhDs with an active involvement in research. Overall there appear to be more similarities than differences in research interests with our colleagues in the United States. The pharmaceutical industry was the most frequently mentioned source of research funding for MDs, while the availability of a mentor was perceived as the most influential factor determining the choice of a research career. CONCLUSIONS: Recommendations include adequate exposure to research during medical school and residency as well as appropriate inducements for the recruitment and retention of practising researchers.

Canada↗
PubMedDate not supplied

The future of professional education in natural family planning.

Nurses and other health care professionals often have little knowledge of methods of natural family planning (NFP) and do not readily prescribe natural methods for their patients. One reason for this is that little or no information on NFP is provided in nursing or medical schools. The holistic, informational, and integrative nature of NFP fits well with professional nursing practice. A university online distance education NFP teacher training program, which offers academic credit and includes theory, practice, and the latest developments in fertility monitoring, has been developed for health care professionals. Professional NFP services in the United States need to meet worldwide standards and include documenting and assessing pregnancy outcomes, tailoring NFP services to the client or couple, and simplifying them for ease of use in a standard health care practice.

Attitude of Health Personnel↗
PubMed2005

The shifting sands of a professional identity.

I decided while an undergraduate that I wanted to be a psychologist. Beyond that, I'm still not sure what I'll do when I grow up. This brief autobiography maps the shifting sands of my professional identity: from psychotherapist to developmental psychopathologist and then to primary concerns with education and training, from psychologist to academic administrator and then back again, to forensic psychologist and on to whatever may come next. Through all of these shifts in focus, however, there has been one recurring theme--the appeal of being an assessment psychologist. The events that kept bringing me back to assessment, whatever else my focus at the time, are recorded in the story that follows.

Career Choice↗
PubMed2006

Foundation training: first experiences.

Foundation training is the first step in the delivery of Modernising Medical Careers. Significant changes are occuring in the first year of foundation compared with previous preregistration house officer training. Career planning, new academic programmes, changes in general practice and interprofessional learning are all areas of real change. Some trusts are also developing innovation and creativity in the way that the curriculum is being delivered.

Clinical Competence↗
PubMed2004

Enhancing attitudes, knowledge and skills of paraprofessional service providers in elder care settings.

The preparation of paraprofessional providers of services to older adults is often a "back-burner" issue, even though most direct care of older clients and patients is provided by paraprofessionals. This community-academic project delivered gerontological training to 74 paraprofessional service providers and evaluated the impact of training on gerontological attitudes, knowledge, and skills, and client satisfaction. Key features are that paraprofessional trainees selected training topics, gerontological social workers provided the training, pre- and post-tests assessed the impact of training, and interactive training modeled processes to apply with older adults. Findings suggest that age-related "attitudes" and "skills" can progressively develop, "knowledge" is likely to change sooner, and "client satisfaction" can be enhanced. Future training initiatives can address the value of "reinforcement training," enhancing the capabilities of gerontology and geriatric educators to meet needs of paraprofessionals who influence the quality of later lives.

Adult↗
PubMed1995

Violence in America: an integrated approach to understanding and prevention.

Violence in our country has reached epidemic proportions, especially among our youth. Of 22 industrialized nations, the United States has the highest homicide rate among young males 15 to 24 years of age. To reduce the incidence of violence, we must radically shift our approach to emphasize prevention and intervention. There are several ways of achieving violence reduction through these means. The scientific approach requires the determination of causation and risk factors to shed light on the patterns of violence and the effects on subgroups of the population. Also required is the development of targeted programs aimed at specific high-risk populations. In the area of youth violence intervention, programs must focus on young children and their parents, often children themselves, to prompt appropriate changes in knowledge, skills, and attitudes. Community-based programs can go a step further to initiate changes in the social environment that will create opportunities for adequate housing, job training or employment, or academic achievement. These efforts exemplify the notion that violence is not a factor of race, but rather is based on socioeconomic factors, particularly poverty and racism.

Adolescent↗
PubMedDate not supplied

Brain injury: analysis of outcome in a post-acute rehabilitation system. Part 1: General analysis.

During the past decade the rehabilitation field has developed new, non-hospital based programmes of cognitive, behavioural, social, educational and vocational treatments to address the higher order cognitive, behavioural and social deficits following brain injury. These new arrays of programmes are referred to under the term 'post-acute' rehabilitation. No comprehensive, methodologically sound study of the effects of these new treatments has been made to date. This paper reports data from brain-injured patients who underwent treatment within a co-ordinated system of post-acute brain-injury rehabilitation programmes. This system consists of a continuum of neurobehavioural, residential, day treatment and community and home programmes, and provides overt components of medical and rehabilitation care: behavioural management; activities of daily living, self-management, substance-abuse, social, academic and vocational skills training; counselling; and family education. The changes in function during the course of treatment by this post-acute sequence of rehabilitation have been obtained and are reported here. A defined total population of N = 192 is examined, with exclusions for appropriate causes (e.g. patients seen only for evaluation) producing a study population of N = 173; of these, follow-up was achieved in 145 cases, a follow-up rate of 83.8%. Time from date of injury to data of admission, severity of deficit at time of admission to programme, and other appropriate independent variables are used to characterize the population. A single-blind interview methodology was employed in obtaining dependent measures of outcome at 6, 12, or 24 month periods post-discharge. Measures of outcome included residential status, level of productivity activity and hours per day of attendant care or supervision required. Dependent variables were analysed for the total study population and a subgroup greater than 1 year from date of injury at entry to treatment and not from a treatment facility. Results are presented in terms of the percentage change in dependent measures from the point of admission to follow-up. Appropriate parametric and non-parametric statistical analyses of significance have been carried out. The results document substantial improvements in function during the post-acute rehabilitation of this population and such improvements are unlikely to be the result of spontaneous improvement alone.

Activities of Daily Living↗
PubMed1999

[Value of the laryngeal mask in emergency care--a survey of North German emergency physicians].

In clinical routine, the laryngeal mask airway (LMA) has proved an alternative to both endotracheal intubation and mask ventilation. In a survey among North German emergency physicians, aspects such as doctors' acquaintance with the LMA, the degree of ist distribution, its use and its potential benefits under non-hospital emergency conditions were evaluated. Seventeen per cent (n = 162) of physicians responded to the questionnaire, 75% of them (n = 122) anaesthetists. Although 73% (n = 119) were familiar with the use of the LMA from clinical experience, and again 73% would welcome having LMA use and application as part of the training of non-academic members of ambulance teams, only 24% (n = 37) of the responding doctors have an LMA on their emergency ambulances and merely twelve (7.4%) physicians reported actually using the LMA, one of them unsuccessfully. Sixty-three per cent considered the LMA the first-choice alternative in an unexpected "can't-ventilate-can't-intubate" situation. Use of the LMA should be extended in emergency medicine especially as its application is relatively easy to learn in clinical routine.

Attitude of Health Personnel↗