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Educating educators in problem-based learning.

Growing numbers of nursing faculties around the world believe that problem-based learning (PBL) fosters students' knowledge, skills and attitudes and allows them to participate as more efficient and effective health care team members. McMaster University School of Nursing has a long history of PBL. Their Institute for Nurse Educators now offers a professional development program where nurse educators from around the world learn to make the transition from traditional teaching to the development of a PBL curriculum.

Curriculum↗

Improving medication adherence through patient education distinguishing between appropriate and inappropriate utilization. Patient Education Study Group.

OBJECTIVE: To evaluate the effectiveness of a computer assisted educational intervention to facilitate appropriate utilization of an antiinflammatory medication (Arthrotec) and investigate the mechanism by which it produces these effects. METHODS: A double blind, multicenter, randomized, controlled trial studied patients over age 50 years with hip or knee osteoarthritis (OA). All patients (n = 252) were treated with the medication (diclofenac + misoprostol). Patients randomized to the experimental group interacted with a computer program delivering information about their disease, the medication, its intended and side effects, appropriate utilization (distinguishing between appropriate versus inappropriate continuation and discontinuation of medication), patient involvement in treatment related decision making, and communication with service providers. In the control condition, another computer program presented generic information about OA. Data were collected at pre-test, post-test, and 8 week followup. RESULTS: Appropriate utilization of the medication occurred more frequently in the experimental than the control group (p<0.029). Compared to controls, the experimental group demonstrated significant improvements in knowledge, realistic expectations of drug benefits, perceived ease of adherence, and self-efficacy (all p<0.05). There was no difference between the groups with regard to illness intrusiveness, pain, or disability, but there was a greater improvement in stiffness in the experimental group (-0.63; 95% CI -0.81 to -0.45) compared to the control group (-0.39; 95% CI -0.53 to -0.25) at a level of p = 0.04. CONCLUSION: In conditions such as OA, where patient involvement in decision making is essential to the effectiveness of care, computer assisted education focussing on appropriate vs inappropriate continuation and discontinuation of medications has the potential to improve knowledge, increase self-efficacy, maintain realistic expectations, and facilitate adherence, resulting in more beneficial clinical outcomes.

Aged↗

Childhood fever education in a military population: is education enough?

PURPOSE: Parental knowledge of childhood fever and clinic and emergency room utilization were studied in a military pediatric clinic population to determine if intervention would improve parental understanding and management of childhood fever. METHODS: Multiple choice tests evaluating childhood fever knowledge were given to control and intervention groups. Clinic and emergency room utilization were tracked for appropriateness of visits based on criteria used in previous similar studies. RESULTS: Initial test scores showed no difference between the two groups. Subsequent test scores revealed a difference between the two groups as reflected by improved test scores. Evaluation of clinic and emergency room utilization of the groups did not show an overall improvement except in one subgroup analyzed. CONCLUSION: Intervention improved parental knowledge; however, intervention did not translate into anticipated improvement in clinic and emergency room utilization patterns. Emphasis on education and preventative services are important in both civilian and military pediatric practice. Results of this study highlight the need to discuss and reinforce fever education as a topic in pediatric preventive health care visits.

Child↗

The physician's role in educating patients. A comparison of mailed versus physician-delivered patient education.

BACKGROUND: Patients value receiving educational information during office visits, but physicians often lack the time or training to satisfy this need. We examined whether an increased physician role in educating patients is an effective means of improving patient satisfaction. METHODS: Using a nonrandomized controlled research design, we compared patient satisfaction with self-care information provided by traditional direct-mail approaches and by physicians during routine office visits. We also studied a control group of patients receiving usual care. RESULTS: Patients who received a medical self-care book from a physician were significantly more likely to be satisfied with their office visit than those who received the book in the mail or those who experienced usual care. The intervention group reported greater satisfaction with 11 out of 13 variables related to physician-patient communication and quality of care. There were no significant differences between the control group and the direct-mail group. CONCLUSIONS: The patients who received self-care information from their physicians were significantly more satisfied with their care and their physician-patient communication experience than those in either the direct-mail group or the control group. Our findings lend support to the growing evidence that patients informed by their physicians are more satisfied with their care.

Adolescent↗

[Health and primary education in the regenerationist ideology at the open educational institution].

The objective of this work is to reconstruct the discourse of the authors who published about issues establishing links between health and primary education in the Boletin de la Institucion Libre de Ensenanza at the time of the Spanish colonial crisis in 1898. This source has been chosen due to its relevance to Spanish pedagogical renovation. Physical education was taken as a model for analysis for two reasons: firstly, it is the aspect that received the most attention; secondly, it became the engine for change in the renovation programme. In addition, its holistic nature was intended to lead to the new citizen that was needed by the country after the loss of the colonies.

Colonialism↗

National MOTTEP: educating to prevent the need for transplantation. Minority Organ Tissue Transplant Education Program.

The purpose of this study was to determine whether participation in culturally appropriate, community-developed, health education programs addressing organ/tissue donation and preventing the need for transplantation, is an effective strategy for contributing to sustained behavior change among members of minority population groups. Within 15 target cities, 800 (40%) minority participants consented to a 2-3 month telephone follow-up survey. The 5-item questionnaire using items extracted from the pre- and post-survey instrument, addressed: 1) knowledge and beliefs; 2) willingness to sign donor cards and have family discussions; and 3) prevention/health behaviors. The preliminary findings based on telephone interviews with 253 participants indicate the following: [table: see text] The conclusions indicate that the community-based, culturally appropriate health education strategies used contributed to and sustained behavior changes.

Attitude to Health↗

Nutrition and education. IV. Clinical signs of malnutrition and its relationship with socioeconomic, anthropometric, dietetic and educational achievement parameters.

The objective of this study was to determine the prevalence of clinical signs of malnutrition, and to measure the interrelationship with socioeconomic, anthropometric, dietetic and educational achievement parameters. A random sample of 550 Chilean elementary and high school graduates (1:1), of both sexes (1:1), from public and private schools (1:1) and from high, medium and low socioeconomic status (SES) (1:1:1), was chosen in the Metropolitan Area of Santiago, Chile. SES was measured through the Graffar Modified Scale. Clinical signs of malnutrition were assessed according to Jelliffe. Nutritional status was determined by means of anthropometric measurements: percentages of weight/age (W/A), height/age (H/A) and weight for height (W/H) were compared with the WHO Tables; head circumference/age (HC/A) with the Tanner Tables, and branchial anthropometric parameters by applying the Frisancho norms. Standard procedures for the 24 hour dietary recall interviews were used to collect data, and adequacy of intake was assessed by the FAO/WHO pattern. Educational achievement (EA) was measured through the Achievement Evaluation Program, (AEP) and Academic Aptitude Test (AAT) in elementary and high school graduates, respectively. Results showed that apart from caries (87.5%), most prevalent clinical signs of malnutrition were dermatosis (13.4%), follicular hyperkeratosis type I (13.2%), nasolabial dyssebacea (7.9%), lustreless hair (7.7%), angular stomatitis (4.4%) and cheilosis (2.7%). The number of clinical signs of malnutrition was found inversely and significantly associated with SES, H/A, vitamin A and calcium intake, as well as with EA, besides registering a lower nutrient intake, specially for energy, riboflavin and niacin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The dedicated education unit: a practice and education partnership.

Both educational institutions and health care agencies have a propensity to look to the past for solutions to their present and projected problems, such as the nursing shortage. One problem that continually surfaces and has become one of two primary limitations on expanding nursing school enrollments is finding and sustaining quality clinical experiences in acute care settings. The demand for these clinical sites continues to grow and the consequent need for effective clinical partnerships grows with it. The Dedicated Education Unit is a creative strategy for addressing the confluence of highly sophisticated marketing efforts promoting the profession of nursing as a whole, the high demand job market for nurses, and the increase in nursing school enrollments at both undergraduate and graduate levels.

Clinical Clerkship↗

Communication and health education research: potential sources for education for prevention of drug use.

Studies conducted by the Stanford Center for Research in Disease Prevention have been carried out over the last 15 years. These studies indicate that, with systematic planning by interdisciplinary research teams, field research projects, based on appropriate theory, can be mounted successfully both at the community level and in schools for the study of adolescents and for adolescent children. Both final and interim results are for the most part encouraging. While all of the research reported here applies to health problems completely different from AIDS, some useful suggestions may emerge. For one thing, in both AIDS prevention and chronic disease prevention, the most effective measures to be taken appear to be behavioral. The research reported here is almost exclusively concerned with developing and testing methods for assisting people to change their behavior in ways that are likely to promote health and reduce risk of disease. They involve education at a community level and in schools. Perhaps education for AIDS prevention can follow similar lines with some success. Recently, several studies have been directed toward the prevention of drug abuse habits being formed by schoolchildren. A 1984 Rand Corporation report summarizes a number of relevant studies and describes models that have been applied (Polich et al. 1984). These programs are aimed at nonuser adolescents who otherwise might become users. It depicts four stages of experimental use of drugs: (1) nonuse--never tried drugs, (2) experimental or episodic use, (3) regular or frequent use, and finally (4) heavy use. Primary prevention is aimed at the early stages of use. The methods used are essentially those described above. Students need to be able to identify pressures to begin usage, especially from peers. They then need to know the dangers and problems arising from drug use. Next, and crucially, they need to develop skills to resist such pressures and practice using the skills in the presence of such pressure. Role-play situations can help in this process. Project Star at the University of Southern California (not yet published) has recently completed a large-scale seventh grade study in Los Angeles junior high schools. They found the following social approaches worked best in the prevention of drug abuse behavior. These approaches promoted group identification, explained the nature of peer pressure, clarified the misinformation on the prevalence of drug use among peers, made clear the consequences of drug use, and used role-playing techniques to teach resistance skills.(ABSTRACT TRUNCATED AT 400 WORDS)

California↗

Strengthening the effectiveness of patient education: applying principles of adult education.

In spite of the recognized significance of patient education, many factors contribute to difficulties in providing effective patient teaching: diminished time from reduced hospital stays, the shortage of nursing personnel, and often, the patient's compromised physical and emotional status. With these constraints, teaching must be effective and efficient. In reviewing the literature, primary emphasis was found on providing sound clinical information with little attention to the techniques of effective methods for teaching adults. This article draws upon the principles of andragogy--the methods of teaching adults delineated by Malcolm Knowles--to provide a conceptual framework for developing effective patient education practice. Examples of both effective and ineffective practice are provided from the nursing literature. The information provided should assist nurses in understanding how adults learn and provide them with a structure to use in tailoring their teaching to meet the individual needs of their patients.

Adult↗

The GPEP report on undergraduate medical education. Implications for rehabilitation medicine. Association of American Medical Colleges, panel on the General Professional Education of the Physician.

The Association of American Medical College's project panel on the General Professional Education of the Physician (GPEP) and College Preparation for Medicine and its working groups appear to share many values with professionals involved in rehabilitation medicine. The GPEP report stresses that learning about disability or functional status, chronic illness and its impact on the individual, his family and the community, and developing the ability to work as a team with other health professionals are important elements in the education of all physicians.

Education, Medical, Undergraduate↗

Improving education and research through the Pan American Health and Education Foundation (PAHEF).

A highly productive method for aiding medical education in the Americas has been developed that involves using a revolving fund to buy large quantities of essential textbooks at low cost. The procedure, which utilizes medical schools as intermediaries, has made it feasible to sell books directly to medical students. Establishment of the revolving fund was made possible by a loan of US$2 million from the Inter-American Development Bank. To facilitate the operation an independent nonprofit corporation, the Pan American Health and Education Foundation (PAHEF), was created to receive and administer the funds. The foundation works closely with PAHO. In the first six years since its establishment the PAHEF program has grown rapidly, involving a total of 146 medical schools in the PAHEF-sponsored distribution of 335,000 texts. The program has also been extended successfully to nursing schools, and plans are now underway to extend it still further to a wide variety of other health workers.

Books↗

Continuing education in general practice. 2. Impact of education activities.

Should continuing education for doctors be compulsory? Our study of General Practitioners in Queensland evaluated the usefulness of and preference for various types of educational activities. Lectures and consultants' letters were considered the most useful while pharmaceutical company evenings and visiting lecturers were most regularly attended. These latter activities were a useful source of medical knowledge: patient management skills were gained at weekend conferences; and procedural skills were obtained through hospital training courses.

Australia↗

Acoustics in educational settings. Subcommittee on Acoustics in Educational Settings of the Bioacoustics Standards and Noise Standards Committee American Speech-Language-Hearing Association.

The Americans with Disabilities Act (enacted July 26, 1990) has brought into focus the need for removing barriers and improving accessibility of all buildings and facilities. It is clear that the definition of barrier must be expanded to include not only structural features that limit physical accessibility, but also acoustical barriers that limit access to communication and information. Acoustical interference caused by inappropriate levels of background noise and reverberation presents a barrier to learning and communication in educational settings and school-sponsored extracurricular activities, particularly for students with hearing loss or other language/learning concerns. ASHA has provided these guidelines and acoustical improvement strategies in order to assist communication-related professionals, teachers, school officials, architects, contractors, state education agencies, and others in developing the best possible learning environment for all students. Additional research on both the acoustical characteristics of learning environments and the communication requirements of learners is encouraged.

Acoustics↗

[Educational and health dimensions of health education at school: a participative total experience in 2 health regions of Murcia].

BACKGROUND: The results of and experience on School Health Education during two years and in two health areas, which intends to promote solid contacts between all people interested in carrying out activities included in daily work, and, this way, to improve the schoolchildren habits are shown. METHODS: The activity is situated in the Investigation Action paradigm. Quantitative and qualitative methods are used in the process and product evaluation. RESULTS: The programme has had an statistically significant effect on the habits considered to be of interest (dental hygiene and physical exercise) and no effects on those habits on which no work was done. There have been 13 Educational Centers, 2 Health Centers and the Faculty of Medicine Sociosanitary Sciences Department. Collaboration, among all interested people, has been increasing, although there have been found difficulties and giving up. CONCLUSIONS: Our opinion is that the role to be played by the Health Councils and the School Councils is essential to develop the recent ministerial dispositions on the matter, within the scope of health areas.

Adolescent↗