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A comprehensive plan to meet the unit-based education needs of nurses from several specialty units.

Nursing staff development departments across the country have responded to the anticipated changes in health care in a variety of ways. This need to reexamine the traditional role of the clinical instructor has resulted in the development of creative strategies designed to meet the unit-based education needs of nurses. In this article, the authors describe a comprehensive approach that not only meets the learning needs of staff members from several specialty units but also fosters their professional development.

Education, Nursing, Continuing↗

Emerging crisis of continuing professional education: becoming a dead letter between external pressure and personal incentive?

Continuing professional education (CPE) has been recognized as an effective tool for equipping health professionals with updated knowledge and skills for improving health services quality. However, there is globally increasing skepticism concerning the effectiveness of CPE. In developed countries, the major reasons for participation in CPE include compliance with employers' requirements and renewal of specialist qualifications and licences. In developing countries, CPE, frequently supported by development agencies, often provides subsistence support to participants and is possibly perceived as an extra income opportunity or tool for promotion among health professionals. The knowledge and skills learned are insufficiently applied in daily practice. This carrot-and-stick approach should be reduced and efforts should be made to increase the level of application of what has been learned. To deliver more effective and efficient CPE, it is critical to study this issue in more depth.

Developed Countries↗

The new health care civilization: integration of physician land and manageria.

Changes occurring in health care demand that physicians expand their professional knowledge and skills beyond the medical and behavioral sciences. Subjects absent from traditional medical education curricula, such as the economics and politics of health care, practice management, and leadership of professional organizations, will become important competencies, particularly for physicians who serve in management roles. Because physicians occupy a central role in planning and allocating medical care services and other health care resources, they must be better prepared to work with other health care professionals to create a new civilization, even if this means leaving the cloistered domain of "physician land" to serve as interface professionals between the delivery of medical services and the management of health care. Our research findings and conclusions strongly suggest that economic, management, and leadership competencies need to be incorporated into the professional development of physicians, especially in postgraduate and continuing education curricula.

Attitude of Health Personnel↗

[Expectations of continuing medical education at first level of attention in Chiapas].

OBJECTIVE: To analyze the expectations of first level of attention physicians (FLAP) about continuing medical education. MATERIAL AND METHODS: An exploratory qualitative study was made from the cognitive view of motivation, in order to know the expectations of the FP at the Mexican Institute of Social Security (IMSS) in Chiapas. RESULTS: The FLAP show little interest in continuing medical education staff, because they find traditional professors and training courses off their work schedule, becoming difficult for them to attend. However, FLAP consider the library facilities and research activities as strategies to keep themselves updated, but they lack the required time to do so. CONCLUSIONS: The FLAP have low expectations caused by direct and indirect negative experiences at the work place as a result of ineffective communication among them and with the respective authorities of each unit. The FLAP show personal characteristics which limit their participation in the programs made by the continuing medical education staff, as well as their professional development.

Adult↗

Health policy development in Lithuania.

The process of formulating a national health policy in Lithuania, a country in transition, has undergone several stages. Despite the existence of a national critical mass of professionals who understand the major principles of health policy development and who have a solid database to scientifically back the suggested decisions, and despite general acceptance by the public of the broader dimensions of health, the actual process of developing health policy is still facing considerable difficulty. Many factors obstruct this process, such as the inflexibility and resistance of the medical profession, traditions from the previous health service model and an extremely difficult economic situation. Nevertheless, one of the most important factors is the frequent change of government and, subsequently, of ministers of health, which makes continuity difficult. Fortunately, however, in contrast to the political level, the health professionals involved in health policy development and implementation assure at least one level of this necessary continuity. As a result of continuous efforts by the Health Reform Management Group and research and education institutions, and with the constant support of WHO, a policy and strategy for health for all continues to be developed, and the groundwork is being laid for improved dialogue and participation.

Cooperative Behavior↗

Good end-of-life care according to patients and their GPs.

BACKGROUND: Most patients prefer to die at home, where a GP provides end-of-life care. A few previous studies have been directed at the GPs' values on good end-of-life care, yet no study combined values of patients and their own GP. AIM: To explore the aspects valued by both patients and GPs in end-of-life care at home, and to reflect upon the results in the context of future developments in primary care. DESIGN OF STUDY: Interviews with patients and their own GP. SETTING: Primary care in the Netherlands. METHOD: Qualitative, semi-structured interviews with 20 GPs and 30 of their patients with a life expectancy of less than 6 months, and cancer, heart failure or chronic obstructive pulmonary disease as underlying disease. RESULTS: Patients and GPs had comparable perceptions of good end-of-life care. Patients and GPs identified four core items that they valued in end-of-life care: availability of the GP for home visits and after office-hours, medical competence and cooperation with other professionals, attention and continuity of care. CONCLUSIONS: Future developments in the organisation of primary care such as the restriction of time for home visits, more part-time jobs and GP cooperatives responsible for care after office hours, may threaten valued aspects in end-of-life care.

Aged↗

A study of the effectiveness of professional development groups.

In 1995 Nursing Times published my study (Thomas, 1995) on the effectiveness of staff support groups within community nursing settings. This work has continued to develop over the past seven years and this article looks at the development of the model within acute mental health wards and discusses a recent evaluation of the groups by its members. It is encouraging to find that these groups continue to be found valuable by the participants. The rationale behind the name change from staff support groups to professional development groups reflects the concept of staff using the groups to reflect on their roles and take responsibility for their professional development rather than the concept of support groups, which may indicate passivity.

Attitude of Health Personnel↗

Development of Web-based intervention system for periodontal health: a pilot study in the workplace.

BACKGROUND: It has recently been accepted that periodontal disease is a risk factor for not only tooth loss but also systemic diseases. An effective system of public intervention for periodontal health to enable continuous intervention of dental professionals has been sought. We developed a Web-based intervention system regarding periodontal health and evaluated the effects of the system in the workplace. METHODS: The system was capable of storage and display of personalized oral health records including video images pertaining to toothbrush manipulation within their own oral cavities based on instructions by dental professionals. The system enabled clients to view movement of their own skill, and repeatedly. Thirteen workers of a company were randomized to either an experimental or control group. The control group received face-to-face toothbrushing instruction at the company and follow-up via telephone. The experimental group received follow-up through our system in addition to those components employed in the control group. MAIN RESULTS: The workers in the experimental group benefited in terms of improvements of not only plaque removal but also periodontal health over 3 months. CONCLUSIONS: These results indicate that implementation of an Web-based approach for periodontal health affords the possibility of remote instruction and produces additional public benefit.

Health Promotion↗

Interactive multimedia program for imaging the spleen: concept, design, and development.

The authors present some of the decision making and design goals that guided the development of computer-based educational programs, specifically a module to teach the role of computed tomography in detection and evaluation of splenic disease. One goal was that the program would take advantage of the computer yet allow users to recognize or learn quickly the techniques used to navigate through the program. A game interface was chosen as a means to aid retention of the material being taught, as well as to make use of the module enjoyable. The structure used to present the program content was based on the common means by which radiology has traditionally been taught. The four sections of the module consist of the slide lecture, traditional text, a quiz, and teaching files. Each question in the quiz section is linked to the relevant text section for review, and the teaching file section can be used as a self-test by hiding the text and diagnosis fields. Computer-based educational programs are an important resource for residents and practicing professionals, and they will continue to evolve with developments in technology. However, it should be the goal of all new projects to find a balance of form, in which the value of traditional teaching methods can be preserved with the maximum opportunity for innovation.

CD-ROM↗