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PubMed1996

Enlightenment, empowerment and emancipation: the case for critical pedagogy in nurse education.

This paper explores the notion that nurse education is a political activity which is value laden and has multiple social meaning. As long as teachers continue to pursue liberal and andragogical theories of learning, students will fail to develop a critical consciousness. The implications are vast as nursing prepares to enter the next millennium: notions such as the reflective practitioner and the knowledgeable doer feature highly on the profession's educational agenda, both of which implicitly require critical thinking skills. By using Habermas' definition of 'critique' as a framework and Paulo Freire's concept of 'conscientisation' as an educational model, it is argued that nurse teachers can expose the oppressive structures which confine and limit the nursing experience. Only then, when our oppression, both as women and nurses has been recognised, and a critical consciousness achieved, can true humanistic care be given. Through the development of emancipatory nursing actions can the profession stop colluding with the social structures which keep many people and groups in oppressive conditions. We should, in short, be teaching for 'peaceful revolution'.

Education, Nursing, Baccalaureate↗
PubMedDate not supplied

Outreach strategies for Southeast Asian communities: experience, practice, and suggestions for approaching Southeast Asian immigrant and refugee communities to provide thalassemia education and trait testing.

This article outlines general strategies for outreaching to Southeast Asian immigrant and refugee communities with thalassemia education. Because of positive net migration and increased birthrates during the last 15 years, Asian Pacific Islanders are among the fastest growing populations in California. Dr. Fred Lorey of California Newborn Screening shows that 1 of 12 Southeast Asians is a carrier of hemoglobin E, demonstrating a particular need to outreach to these communities. The challenge of educating Southeast Asian populations include language barriers, differences in cultural and/or religious beliefs, geographic location, and unfamiliarity with and/ or mistrust of Western health care systems. In addition, outreach workers must consider the great diversity of ethnicity, language, literacy, and education levels, and degree of acculturation to the US within the Asian/Southeast Asian groups. It is crucial before embarking on any outreach campaign to understand the history and make-up of the target audience, including ethnic minorities and dialects, to translate written materials into appropriate languages or audio formats, and to have a group of trained interpreters for events. Additionally, a continuing education model for the outreach/medical staff is important to maintain robust understanding of these diverse communities. Specific strategies include using visual aids, medical professionals as authority figures, and bicultural high school and college students during presentations. Finally, establishing trust and maintaining a continued presence in communities are the most important aspects of a successful outreach campaign.

Asia, Southeastern↗
PubMed1997

Proposed curriculum model for resident education in pediatric orthopaedic surgery.

A curriculum developed for pediatric orthopaedic residency training is described. The curriculum is practice based, emphasizing those components thought to be necessary for orthopaedic practice. Highly technical or esoteric topics are deemphasized, because they are not relevant to practice capabilities at the end of residency training. The curriculum is designed to serve as a guide for educational direction in pediatric orthopaedic residency training, and not as a description of competency. Resource materials are being developed to provide the educator with relevant clinical material, objectives, and bibliography. The advantages of a practice based curriculum warrant further development of this model for other orthopaedic subspecialties.

Clinical Competence↗
PubMed2003

Building teen power for sexual health.

Alarming numbers of teens engage in behaviors that place them at risk for pregnancy and sexually transmitted infections (STIs) including AIDS. Intervention studies targeted toward reducing risky sexual behavior and improving school retention and literature about variables that affect risky sexual behavior and school performance were reviewed to develop the Social-Cognitive Model for Sexual Behavior During Adolescence. Interventions that target change in the family and school environments in addition to building the personal capacities of each teen have the potential to be effective. Many environmental factors cannot be altered, but the intervention can help reframe the situation and provide the knowledge, specific skills, role models, and rehearsal that promote change. The 13-week school-based intervention assists students identify how personal strengths and family, school, and neighborhood environmental factors can reinforce health behaviors and choices.

Adolescent↗
PubMed2004

["The Others". Portuguese nursing experience].

The teaching of nursing in Portugal has weathered and still weathers a series of problems over which reflection is warranted. That is the objective of this article. Underlying the problem is the fact that there is a lack of a global clarification for the educational model for nurses, and for other professions which integrate health teams facing the Bologna process, as well as a lack of the development of the route which nurses should follow; furthermore, nebulous zones continue to exist in the definition of this process. We shall speak about facts, about things which have occurred or which one had hoped would occur; we shall analyze some and question others; we will attempt to provide some ideas for the future among the items mentioned.

Education, Nursing↗
PubMed2001

Leap for Life: innovative patient education to optimize outcomes among patients with cardiovascular disease.

OBJECTIVE: To evaluate the Leap for Life cardiovascular risk factor education program based on outcome measurements of self-reported hospital readmission, goal achievement, satisfaction, and educational model preference. SETTING: Four hospitals and one senior center of Baylor Health Care System in the Dallas, Texas, area. DESIGN: Administration of a satisfaction questionnaire and resurvey of participants by telephone at 3, 6, and 12 months. PATIENTS: 161 patients with cardiovascular disease enrolled in the Leap for Life program during calendar year 1997. Patients were primarily male (59%), with an average age of 66 years; they had an average of 4 cardiovascular disease risk factors. RESULTS: Of the 152 participants who took part in the telephone follow-up, 19% reported a hospital admission with a cardiovascular diagnosis during the 12-month follow-up period. Twenty-one percent reported meeting all of their goals; 56%, some of their goals; and 23%, none of their goals. All stated that the educational sessions met their informational needs, and 75% preferred the Leap for Life setting over other educational settings. CONCLUSION AND NEXT STEPS: These data provide initial validation of the program and are being used as a starting point for another assessment that involves individualized health enhancement measures and 6- and 12-month follow-up of participants using a survey designed to assess readiness, lifestyle changes, and quality of life.

Journal Article↗
PubMed2006

Do themes in consumer medicines information literature reviews reflect those important to stakeholders?

OBJECTIVE: To compare the themes emerging from a stakeholder workshop on consumers' medicines information with themes in relevant published reviews. METHODS: A stakeholder workshop was held to permit consumer orientation of a systematic review of consumer medicines information. Analysis of the workshop outputs was compared to a content analysis of the identified published reviews. RESULTS: The workshop generated a range of responses inductively grouped into 12 over-arching themes. No reviews tackled all of these themes, nor addressed 'informed choice and autonomy'. More recent reviews reflected more workshop themes than older ones, suggesting a temporal trend towards a greater sensitivity to consumer issues. The most common workshop themes were covered by all reviews. Six themes in the reviews were related to traditional professional concerns including compliance, which did not arise in the workshop. CONCLUSION: The results highlight a mismatch between the themes in previous published reviews and the themes emerging from the workshop. The most commonly reflected themes in reviews conform to the 'patient education' model of discourse, while workshop themes less often echoed in reviews reflect the discourse of 'patient empowerment'. PRACTICE IMPLICATIONS: The findings suggest the importance of involving patients in the development of patient literature from the outset.

Aged↗
PubMedDate not supplied

Critical care outreach: creating a safe culture.

Critical care 'outreach' and early warning scoring tools have become fundamental in identifying patients at risk of clinical deterioration and promoting their optimization within the ward environment. Outreach has been implemented in various ways, ranging from the 'flying squad' (staff attending to a patient at risk of deterioration on the ward) approach to an educational model. This article describes the unique approach taken within the cardiothoracic directorate at South Manchester University Hospital Trust. The authors' approach focused on linking critical care outreach to the clinical governance agenda through incident reporting. This enabled the authors to demonstrate the effectiveness of the critical care outreach service by producing both quantitative and qualitative data in respect of patients who had deteriorated following cardiothoracic surgery, and required intervention from the outreach service.

Acute Kidney Injury↗
PubMed1997

Availability of school health services for young children.

A survey to assess availability of school health services was distributed to 221 directors of Schools of the 21st Century, an educational model that provides integrated services to children and families. Of this distribution, 126 (57%) surveys were returned; 88% of respondents reported they provided some type of school health services for their students; 75% of schools had access to school nursing services, yet only 33% had a school nurse on-site; 50% had less than daily access to a school nurse. Despite a high reported prevalence of physical and mental health problems, other services such as acute care, nutrition counseling, dental screenings, or mental health services were provided less frequently. Barriers perceived as problematic for schools providing health services included inadequate funding, limited parental awareness, and opposition by school or community members. Respondents believed transportation, limited financial resources, and inadequate health insurance were barriers to care for children and families. Among this sample of schools, school health services varied in availability and comprehensiveness. Educators, health providers, and parents must work together to provide improved school health services for children.

Child↗
PubMed2006

Evaluation of 'partnership care model' in the control of hypertension.

One of the shared common goals of World Hypertension League (WHL) and World Health Organization (WHO) is the control of hypertension. Despite many local and international interventions, the goal has not been achieved. This study evaluated an intervention based on the partnership care model to control hypertension in a rural population in the north of Iran. The results showed that the intervention was effective in decreasing systolic and diastolic blood pressure and in increasing the rate of controlled hypertensives (based on criteria of WHO/WHL). The intervention also had positive effects on health-related quality of life, body mass index, anxiety, high density lipoprotein level and compliance score. Based on these results, the partnership care model is effective in hypertension control and is recommended as a model to replace previous approaches in hypertension control.

Anxiety↗
PubMed2000

Saving our children: strategies to empower African-American adolescents to reduce their risk for HIV infection.

Adolescence is normally a healthy period of life. For some young people it is a period of experimentation with risky behavior. For others, it marks the development of habitual risk behaviors that persist into adulthood. Of special concern is adolescent involvement with sexual behaviors that increase the risk of infection with HIV and other sexually transmitted diseases (STDs). Nurses who work with adolescents are seeing an increase in STDs, including HIV infection occurring disproportionately among African-American adolescents. Although the use of condoms can reduce the risk of these sexually transmitted diseases, most sexually active adolescents do not consistently use condoms. This paper will discuss the scope of the problem of STDs, especially HIV infection among African-American adolescents. It will describe the Theory of Planned Behavior as a framework for designing interventions to reduce the sexual transmission of HIV and other STDs. Finally, it will provide strategies for nurses to intervene by empowering African-American adolescents to reduce their risk for sexually transmitted HIV infection.

Adolescent↗
PubMed1976

The adult development program: an educational approach to the delivery of mental health services.

The adult development program is an intensive, shortterm program for individuals who want to change their behavior. It is based on an educational model; participants, who are called students, set their own behavior-change goals, and a multidisciplinary staff teach them techniques for reaching those goals. The program curriculum consists of about 20 seminars and workshops, which give the students an opportunity to learn and to practice new behaviors. Students pay fees that vary from $40 to $500 per month depending on the number of classes they take. Approximately 1750 students have participated in the program since it began six years ago.

Behavior Therapy↗
PubMed2003

Effectiveness of addiction science presentations to treatment professionals, using a modified Solomon study design.

OBJECTIVES: Knowledge of addiction research findings is critical for healthcare professionals who treat addicted patients. However, there is little information available about the instructional effectiveness of lecture-slide presentations in changing knowledge vs. beliefs of such professionals. DESIGN: A modified Solomon four-group experimental design was used to assess the instructional effectiveness (knowledge gain vs. belief changes) of three-hour addiction science workshops presented to health-care professionals by neurobiologically-trained academic researchers. Effectiveness of the workshops was assessed by a 28-item questionnaire on participant versus control group knowledge/beliefs on addiction. Six-month follow-up questionnaires measured "retention" of knowledge and belief changes. RESULTS: The workshop participants showed significant knowledge gain and belief changes, whereas the two control groups showed no change in knowledge or beliefs. After six months, knowledge gains decreased, but were still higher than pre-test scores. In contrast, belief changes on three subscales persisted over six months in 40 to 52 percent of the subjects. CONCLUSIONS: These results illustrate a successful continuing education model by which academic researchers who are skilled teachers present a three-hour lecture-slide workshop with extensive question-and-answer sessions on addictions. We conclude that motivated health-care professionals can experience important knowledge gains and belief changes by participating in such workshops. In contrast to the transient retention of knowledge, belief changes persisted surprisingly well for at least six months in about half the subjects. These results suggest that long-term changes in the professional orientation of these health-care workers are possible.

Adult↗
PubMed2000

A process evaluation model for patient education programs for pregnant smokers.

OBJECTIVE: To describe and apply a process evaluation model (PEM) for patient education programs for pregnant smokers. METHODS: The preparation of a process evaluation plan required each program to define its essential "new" patient assessment and intervention procedures for each episode (visit) of patient-staff contact. Following specification of these core implementation procedures (p) by each patient education program, the PEM, developed by the Smoke-Free Families (SFF) National Program Office, was applied. The PEM consists of five steps: (1) definition of the eligible patient sample (a); (2) documentation of patient exposure to each procedure (b); (3) computation of procedure exposure rate (b/a = c); (4) specification of a practice performance standard for each procedure (d); (5) computation of an implementation index (c/d = e) for each procedure. The aggregate of all indexes (e) divided by the number of procedures (P(n)) produced a program implementation index (PII = Sigmae/P(n)). PARTICIPANTS AND SETTINGS: Data from four SFF studies that represent different settings were used to illustrate the application of the PEM. RESULTS: All four projects encountered moderate to significant difficulty in program implementation. As the number and complexity of procedures increased, the implementation index decreased. From initial procedures that included patient recruitment, delivery of the intervention components, and conducting patient follow ups, a variety of problems were encountered and lessons learned. CONCLUSION: This process evaluation provided specific insight about the difficulty of routine delivery of any new methods into diverse maternity care setting. The importance of pilot testing all procedures is emphasised. The application of the PEM to monitor program progress is recommended and revisions to improve program delivery are suggested.

Adult↗
PubMed2004

International training in health informatics: a Brazilian experience.

Technology is transforming not only the practice of health-care but also professional training and educational models. Developing countries, such as Brazil, are increasingly suffering from a severe shortage of health informatics specialists. Training of professionals in this field is expensive, and there is a limited supply of high-quality teaching resources available. We envision that training in health informatics can be better achieved if cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our four-year experience of a Brazil/USA training program and discuss lessons learned during its implementation. Eleven onsite courses, one seminar, and two conferences were developed under this unique initiative, which made possible the collaboration among different countries and distinguished leaders in the field of medical informatics.

Brazil↗
PubMed1997

Evaluation of consulting skills of trainee general practitioners.

OBJECTIVE: This pilot survey was performed primarily to confirm the identity of areas of observed weakness in the consulting styles of young graduates, thus enabling educational models to be set up to correct any deficiencies. A secondary objective was to trial the design of a research instrument and detect and rectify any design flaws for subsequent and improved surveys. The consulting skills of 98 GP registrars, enrolled in the various stages of the RACGP Training Program in Western Australia were surveyed. METHOD: A pilot survey was conducted using a recording form with a Likert rating format, designed to analyse certain defined areas of the consultation. This was conducted by skilled observers who explored five hypothesised areas of weakness. RESULTS: Seven areas of concern were identified in the consulting skills of GP Registrars, with consistency across the observers. Modest improvements of skills in some but not all of these parameters occurred in the later stages of the RACGP Training Program. CONCLUSION: One task of the pilot study was to assess the quality of the statements used with reference to the 14 aspects identified (items 9 to 22); the aim being to produce an improved instrument, with less chance of misinterpretation, in a further survey. Areas of concern were defined with some constancy across the raters and largely coincided with the hypothesised concerns. Suggestions for remedial educational input and for additional research into the same area are made.

Clinical Competence↗
PubMed1996

Competency-based learning in neonatology.

An educational model integrating structured teaching with clinical experience, or clerkship, has been designed to enable students to learn the core knowledge, skills and attitudes necessary to care for the newborn. The programme is run for fifth year medical students as part of four, 9-week periods in Obstetrics and Gynaecology each year. A SCORPIO teaching session is held in week 1 to introduce students to the core competencies in the subject areas of newborn examination, breastfeeding, resuscitation, respiratory distress and anthropometry. Groups of four students rotate through each topic, which is conducted by a neonatologist or registrar in training. Eight problem-based learning sessions are held during weeks 2-9. Several students assess a clinical problem, identify learning issues and meet colleagues and a facilitator to share their learning experiences and resolve the problem. The clinical experience, or clerkship, is based in the neonatal nursery where 2-3 students spend a week consolidating their clinical and procedural skills. A study group was assessed at the end of the programme by an Objective Structured Clinical Examination (OSCE) and a Multiple Choice Questionnaire (MCQ). A control group did the same assessment in week 1. All students were asked to rate the educational value of the three learning methods on a 5-point Likert scale. The study group (n = 20) achieved a mean composite mark of 66% (SD 10%). This was significantly higher (P < 0.001) than that of the control group (n = 18), mean 45% (SD 7%). All students (100%) rated the educational value of SCORPIO as high or very high, and the comparative rating for problem-based learning and clerkship was 65%, respectively. The programme was enthusiastically received by the students and resulted in mastery of a range of core competencies necessary for care of the newborn.

Australia↗