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PubMed1983

Reliability of faculty assessments of student case histories: a problem in chiropractic education.

A competency based educational model necessitates reliable evaluation. This study examined faculty reliability in assessing students' case histories at one chiropractic college. Previous studies have found great variation in faculty assessment of clinical performance in medical residents. In this study, sixteen faculty members at the Canadian Memorial Chiropractic College evaluated three case histories by completing five rating scales on each one. The study found little faculty agreement in judging the case histories. Faculty evaluations ranged from extremely poor to extremely excellent for the same case history. In addition, the data indicate that the faculty's ratings were influenced by a halo effect. Evaluators made a general judgement, which influenced the ratings on the five scales. It is suggested that meetings of clinical instructors to standardize criteria of assessment may be beneficial.

Chiropractic↗
PubMed1997

[Evaluation of risk factors of alcohol consumption by adolescents].

OBJECTIVE: This study aims to discover the individual, microsocial and macrosocial factors and the milieu which lead to today's pattern of adolescent alcohol consumption. DESIGN: A descriptive, crossover study without randomisation. SETTING: Primary Care. School population from the Bajo-Asón Centre 1 Health Area, Cantabria. PATIENTS AND OTHER PARTICIPANTS: Adolescents between 11 and 15 in school. A group of key people from the population was also included. MEASUREMENTS AND MAIN RESULTS: The PRECEDE health education model was applied to three groups of adolescents. A discussion group with key people connected with adolescents and alcohol was formed. The main results were the wrong information recognised by those involved, the easy access of minors to alcohol, the influence of social acceptance, scant social skills and the lack of alternatives. CONCLUSIONS: In view of these results it is clear that action must be taken. Therefore, a community-based prevention programme for adolescents was set up, its key points being information to parents and pupils, ways of communicating and social skills, creation of alternatives and the creation of a local committee to monitor the rules on provision of alcohol to minors.

Adolescent↗
PubMed1987

Regional program for prevention of premature birth in northwestern North Carolina.

We present our experience with introducing and implementing a prematurity prevention program in a 20-county region in northwest North Carolina. The program is based on the risk assessment and educational model. In the first 25 months of results available, 17,370 births occurred in women enrolled in the project. During 1985, 42.5% of all births in the region occurred in the project. During the time span examined, a downward trend was seen for rates of low birth weight births in public and private patients and for very low birth weight births in private patients. During 1985, private births in the project were significantly less likely to be low birth weight or very low birth weight than private births to women not in the project. These results suggest that regional implementation of prematurity prevention programs is feasible and that such programs are particularly appropriate for private patients.

Costs and Cost Analysis↗
PubMed2006

A randomized, double-blind, placebo-controlled, clinical trial of the impact of malaria prevention on the educational attainment of school children.

A double-blind, placebo-controlled trial of nine months duration was carried out to investigate the impact of malaria and its prevention on the educational attainment of school children in a malaria-endemic area in southern Sri Lanka where both Plasmodium falciparum and P. vivax infections are prevalent. A total of 587 children attending grades 1-5 in four schools and resident in the area were randomly allocated to chloroquine (n = 295) and placebo (n = 292) arms. Language and mathematics scores of end-of-term school examinations for 1998 and 1999 and number of days absent and reasons for absenteeism during seven months pre-intervention and nine months of the intervention were recorded. The results indicate that there were no differences in language (95% confidence interval [CI] = 48.44-53.78 in chloroquine group and 50.43-55.81 in placebo group) and mathematics (95% CI = 49.24-54.38 in chloroquine group and 51.12-56.38 in placebo group) scores between the two groups prior to the intervention. During the intervention, the malaria incidence rate decreased by 55% (95% CI = 49-61%) and school absenteeism due to malaria was reduced by 62.5% (95% CI = 57-68%) in children who received chloroquine compared with the placebo group. Post-intervention, children who received chloroquine scored approximately 26% higher in both language (95% CI = 21-31%) and mathematics (95% CI = 23-33%) than children who received placebo. In a multivariate model, educational attainment was significantly associated with taking chloroquine prophylaxis and absenteeism due to malaria (P < 0.001 for both) but not due to health causes other than malaria or non-health causes. Language scores were associated with number of malaria attacks (P < 0.022). Educational attainment was significantly better among children whose compliance to chloroquine prophylaxis was higher (P < 0.001). The data suggest that malarial attacks have an adverse impact on the educational attainment of the school child and prevention of these attacks significantly improves educational attainment of children living in malaria-endemic areas.

Achievement↗
PubMed2006

Health education and social representation: an experience with the control of tegumentary leishmaniasis in an endemic area in Minas Gerais, Brazil.

This study was developed in an endemic area of tegumentary leishmaniasis in Minas Gerais, Brazil, with the objective of analyzing a health education process based on the social representations theory. The educational model was developed in two phases with 34 local residents. In the first phase, social representations of leishmaniasis were identified and analyzed. The second phase was based on the interaction between social representations and scientific knowledge. The results showed that social representations were structured in a central core by the terms "wound" and "mosquito" and in the peripheral system by the terms "mountains", "standing water", and "injection" related respectively to place, transmission, and treatment of the disease. We concluded that tegumentary leishmaniasis is viewed as a wound caused by a mosquito, portrayed by metaphors. The results of the second phase showed that social representations are systems that favor adherence to scientific knowledge, at times more rigidly in the central core, other times more flexibly when linked to the peripheral systems.

Adolescent↗
PubMed1994

A longitudinal study of the effects of parental smoking on pulmonary function in children 6-18 years.

The association between parental cigarette smoking and children's pulmonary function was investigated in 8,706 nonsmoking white children, followed annually by questionnaire and spirometry between 6 and 18 yr. Exposure to maternal and paternal smoking was each divided into three components: exposure in the first 5 yr of life, cumulative exposure between age 6 and the year prior to each visit; parental smoking status reported at each visit. Regression splines were used to assess the effects of parental smoking on the level and growth rate of pulmonary function adjusting for age, height, city of residence, and parental education. Models best predicting pulmonary function level included current maternal smoking and exposure to maternal smoking in the first 5 yr of life but did not include the other measures of parental smoking. After adjusting for early exposure, current maternal smoking for each pack/d was associated with a reduced level of FEV1 (-0.4%, 95% CI: -0.9, 0.1), FEV1/FVC (-0.6%, 95% CI: -0.9, -0.4), and FEF25-75% (-2.3%, 95% CI: -3.6, -1.0) in children 6 to 10 yr. These effects were slightly smaller in children 11 to 18 yr. Adjusting for current maternal smoking, those exposed to maternal smoking in the first 5 yr of life had higher FVC (+0.5%, 95% CI: -0.1, 1.2) and lower FEV1/FVC (-0.7%, 95% CI: -1.1, -0.4) and FEF25-75% (-2.8%, 95% CI: -4.4, -1.2) than those not exposed in children 6 to 10 yr.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Use and application of structural models in dental education research.

The notion of prediction implies causation. Path and structural models explore the causal links rather than mere empirical relationships between variables. This technique involves a breakdown of correlations; it differs from correlation and regression methods in that it provides relevant information in the presence of important but unobserved (latent) explanatory variables and of measurement errors in the data. It also allows for more than one regression analysis simultaneously and affords inference through tests of the model. In this study, latent abilities of dental students were analyzed as causes and professional achievements as effects, with preadmission performances as indicators of latent abilities. A model with three constructs is consistent with the observed data. The results demonstrate that whereas correlation analysis presents limitations in interpretation, structural analysis focuses clearly on the direct impact of the quality of dental school education, rather than preadmission background, on clinical performance and board success as measures of future professional performance.

Aptitude↗
PubMedDate not supplied

Beyond preceptorship and supervision: a third clinical teaching model emerges for Australian nursing education.

In Australia, there are two established models for teaching in the clinical setting, supervision and preceptorship. Both models are used in the final year unit at the University of Canberra. In 1995, seven clinical supervisors and 34 preceptors responded to a questionnaire about their perceptions of their respective roles. The most significant findings were that (1) clinical supervisors did not feel prepared for their role and felt that the supervision requirements were unreasonable and (2) although preceptors did feel adequately prepared for their role and able to supervise the students assigned, there were times when they felt that the demands of 'work' overtook the learning needs of the student. A review of the contemporary literature in the field of clinical education for undergraduate nursing students revealed a pattern of similar weaknesses in other programs. Compounded by the climate of economic restraint, these weaknesses could evolve into obstacles to effective student learning. A collaborative clinical education model, adapted from North America, is proposed as a third clinical teaching model to overcome the identified difficulties and capitalise on the combined benefits of supervision and preceptorship.

Australia↗
PubMed1997

A causal functional explanation of maintaining a dependent elder in the community.

A causal functional structure demonstrates how a perpetual process, like caregiving, maintains itself. The caregiver functional learning model was used to identify factors influencing caregivers when maintaining dependent elders in the community. These factors include seriousness of illness, power, burden, care quality, self-assurance, an understanding of the elder's needs, and time spent in caregiving. This five-stage theoretical model was tested using a sample of 70 caregivers. Findings supported two of the theoretical relationships: seriousness of illness (beta = .60) with burden (R2 = 0.35), and self-assurance (beta = .36) with time (R2 = 0.18). Three new relationships were added with the empirical model: power (beta = .48) with burden (R2 = 0.52), seriousness of illness (beta = .36) with self-assurance (R2 = 0.11), and burden (beta = .33) with time (R2 = 0.24). A causal functional structure can be used to explain how the phenomenon of caregiving maintains itself.

Activities of Daily Living↗
PubMed2004

Comparison of clinical reasoning skills in occupational therapy students in the USA and Scotland.

Problem-based learning (PBL) in occupational therapy (OT) education has become increasingly important. However, the efficacy in identifying clinical reasoning skills has not been well researched. The purpose of this study was to evaluate the utilization of clinical reasoning by students in the USA and Scotland. Thirty OT students were videotaped during a PBL case. Responses were transcribed and compiled into 122 statements. The two primary investigators independently coded each of the responses into one of five categories: Procedural, Interactive, Conditional reasoning, N/A, or Other. Intraclass correlation coefficients reflected strong reliability between the two raters (ICC = 0.914). Results of this study indicated that the predominant form of clinical reasoning was procedural in nature (61%) followed by conditional reasoning (27%) and interactive reasoning (12%). Students in Scotland tended to use interactive reasoning more than the students in the USA. Further research is needed to explore educational models to foster clinical reasoning skills in occupational therapy students.

Adult↗
PubMed2005

The school community council: creating an environment for student success.

A model of community-school partnerships is developing within a school district in Evansville, Indiana. Based on a full-service community school philosophy, the model started in one elementary school in the Evansville-Vanderburgh School Corporation and has expanded into a districtwide initiative called the School Community Council. The council is made up of over seventy community organizations and social service agencies working together to establish full-service schools as places of community and to enhance youth and family development.

Adolescent↗
PubMed2005

Schools uniting neighborhoods: the SUN initiative in Portland, Oregon.

The SUN Community Schools Initiative is a community-driven model that allows each school community to design the programs that fit neighborhood needs in Portland, Oregon. County and city governments, local school districts, and community agencies have jointly leveraged resources to support fifty-one community schools. The program is managed by the Multnomah County Department of School and Community Partnerships. The City Parks and Recreation Bureau oversees twelve sites staffed by city employees. Strong support across political systems aligns funding and reduces the fragmentation in existing funding patterns.

Adolescent↗
PubMed1998

A systems approach to developing staff training.

This chapter shows how concepts from organizational psychology can be used to design a comprehensive staff training model for a statewide mental health service system, and emphasizes the importance of competency identification in this model.

Clinical Competence↗
PubMedDate not supplied

Strategies for developing competency models.

There is an emerging trend within healthcare to introduce competency-based approaches in the training, assessment, and development of the workforce. The trend is evident in various disciplines and specialty areas within the field of behavioral health. This article is designed to inform those efforts by presenting a step-by-step process for developing a competency model. An introductory overview of competencies, competency models, and the legal implications of competency development is followed by a description of the seven steps involved in creating a competency model for a specific function, role, or position. This modeling process is drawn from advanced work on competencies in business and industry.

Behavioral Medicine↗