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A study undertaken in 1991 focused on the role fulfilment of the preceptor in staff development in training hospitals in Namibia. As in the case in many countries the nursing service climate in Namibia is characterised by constant change in the practice of professional nurses. The preceptor must accompany the professional nurses in their personal and professional development.
Facilitating the orientation process has historically been the responsibility of staff development personnel. In recent years, hospitals have experienced the need to enhance the clinical orientation of new nurses; thus, the preceptor has emerged as a viable means of orienting nurses to the clinical setting and in socializing the graduate nurse to the role of a professional nurse. This article discusses the preceptor program for nurse orientation at The Cleveland Clinic Foundation.
Internationalization, one of the most important forces in higher education today, presents a powerful challenge and an opportunity for medical schools. Factors encouraging internationalization include (1) globalization of health care delivery, (2) governmental pressures, (3) improved communication channels, (4) development of a common vocabulary, (5) outcome-based education and standards, (6) staff development initiatives, and (7) competitiveness and commercialization. A three-dimensional model--based on the student (local or international), the teacher (local or international), and the curriculum (local, imported, or international)-offers a range of perspectives for international medical education. In the traditional approach to teaching and learning medicine, local students and local teachers use a local curriculum. In the international medical graduate or overseas student model, students from one country pursue in another country a curriculum taught and developed by teachers in the latter. In the branch-campus model, students, usually local, have an imported curriculum taught jointly by international and local teachers. The future of medical education, facilitated by the new learning technologies and pedagogies, lies in a move from such international interconnected approaches, which emphasize the mobility of students, teachers, and curriculum across the boundaries of two countries, to a transnational approach in which internationalization is integrated and embedded within a curriculum and involves collaboration between a number of schools in different countries. In this approach, the study of medicine is exemplified in the global context rather than the context of a single country. The International Virtual Medical School serves as an example in this regard.
This article describes a grassroots approach to developing an educational program on nursing diagnosis and computerized care planning. The process involved staff nurses in program design, implementation, and evaluation. Using this process, staff development educators will be better able to successfully initiate grassroots programs that educate large numbers of nurses at minimal cost.
In conjunction with the development of a computerized goal-oriented record system at Forest Hospital Des Plaines, Illinois, research staff developed a psychiatric goal list from goal statements most frequently used at the hospital. Treatment methods written by hospital staff were also reviewed and classified under the goal statement for which they were most frequently written. The result is the Treatment Methods Index, which currently contains more than 500 goal statements and 1500 treatment method statements, and also lists all drugs and activity therapies used in the hospital. The index is stored in a computer, and a comprehensive treatment plan can be generated by entering the numbers of selected goals and treatment methods. The authors emphasize the advantages of the system in writing and updating treatment plans and its importance in peer review and other medical-care evaluations.
Staff nurses are responsible for providing care to acutely ill patients, therefore, educators and managers can no longer be comfortable with developing staff to a basic level of competence; they have the responsibility to develop expert practitioners. To achieve this goal, a program using the "novice-to-expert" model for developing educational programs for each level of proficiency is described.
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.
This article describes a study that explored perceptions of quality health care among physicians, nurses, patients, and hospital administrators. A self-report questionnaire evaluating interpersonal relationships, needs fulfillment, and education as dimensions of health care was developed. Results indicated that all groups differed in their perceptions of quality health care. Staff development educators should be particularly mindful of such differences. Making nurses aware of these differences during orientation and continuing education programs can assist them more effectively to deliver quality nursing care and meet patients' perceived needs.
Action research has long been used in educational research and increasingly features in the professional development of university staff. A brief review of the historical development of action research is presented together with the range of approaches covered and their common characteristics. To illustrate the elements of action research, an example is drawn from operative dentistry. The steps taken by a lecturer to improve a pre-clinical course in operative dentistry are described in some detail and the outcomes of the action are reported and evaluated. The findings support the suitability of action research for professional development in dental education. The kinds of problems likely to be encountered by teachers using this methodology are reported. The ability of the participant investigators to reflect critically on the action taken was found to be a key component of action research.
In this article, the authors describe the concept of workplace advocacy, workplace hazards experienced by hospital nurses, methods for teaching workplace advocacy behavior, and strategies for controlling specific workplace hazards. Workplace advocacy is a universally applicable concept for maintaining professional nursing practice. Staff development educators are key in helping staff nurses achieve autonomous nursing practice.
Facilitating team development is a frequent intervention in hospitals and seen as a probate mean to support the staff. As the method spreads, a need for scientific evidence is articulated. At Freiburg University Hospital, facilitating team development for nursing teams has been empirically evaluated on a broad data basis. The studies focussed on how nurses in a university centre of high tech medicine experience their work situation, what (psychological) stress they feel exposed to and how they appraise the contribution of facilitating team development to prevent and come to terms with that stress. Results prove the effects and benefits of the intervention, particularly with regard to communicational difficulties within the nursing staff and to problems of interdisciplinary cooperation. The sine qua non of successful intervention, as notifying future participants about this particular method or the adequate formation of the group is highlighted.
OBJECTIVE: To develop an effective and efficient method for basing nursing practice on research evidence. SETTING: The Royal Women's Hospital, Brisbane, Australia. METHOD: Nurses and midwives from various clinical areas were invited to participate in an evidence-based practice project. Standard procedures for retrieving relevant articles and evaluating their quality were observed. Where possible, raw data from studies with similar methods were summarised using appropriate statistical tests. FINDINGS: Several guidelines have been developed, staff involved with the project have become 'research literate' and the project is contributing to the hospital-wide quality improvement activities. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: It is possible to translate research findings into practice when small groups use systematic reviews to develop practice guidelines.
To help staff to make links between the NHS Knowledge and Skills Framework and their continuing professional development, staff at the School of Nursing, University of Salford, have linked all educational provision for qualified healthcare professionals to the NHS KSF. This was carried out in partnership with NHS colleagues.
Celtic Life Insurance Company's (Celtic) utilization management program demonstrates that insurance companies, like hospitals, can develop a high level of quality assurance in utilization management by maintaining a professional clinical staff, developing special programs to target specific medical concerns, and conducting ongoing audits. Celtic's High Risk Maternity Program, developed in 1988 as an adjunct to the utilization management program, provides education about pregnancy and childbirth, screens pregnant insureds, and offers case management for high-risk pregnancies. Pregnant insureds who volunteer to case management are referred to the Rose Bud Program, a premature labor prevention program that was developed by Northwestern National Life Insurance Company with Abbott Northwestern Hospital.
BACKGROUND: The study of human factors is a scientific discipline that deals with the interactions between human beings and the elements of a system. This is important because shortcomings in these areas, if unchecked, can result in adverse outcomes. Research into human factors in industries where safety is paramount has provided the basis of countermeasures against human error. Adverse outcomes in medicine resulting from human error exact a high cost in both patient suffering and financial outlay. CRM TRAINING: One of the approaches used to minimise the effect of human error is to train people in a set of knowledge, skills and attitudes that underpin the domain-specific competencies for that profession. These are referred to as non-technical skills (NTS). In aviation, such an approach has been shown to be both translatable from the training environment to the workplace and effective in reducing adverse outcomes. DISCUSSION: Medicine has incorporated this style of training, usually centred around simulator-based courses, but as yet in a piecemeal, episodic fashion which relies on participants volunteering to attend courses. Unlike other industries there is no systematic approach to linking the content of this teaching with the more conventional range of topics. As a consequence it is difficult to assess the impact of human factors training in medicine. This is partly because very little work has been done to date in identifying the key non-technical skills required in medicine, and the overall experience of workplace based assessment is limited. Lessons from other high reliability organisations may help to address the main challenges of developing the content, integrating it into the curriculum, reinforcing the concepts in the workplace through staff development and establishing its role in summative assessment.
After hospital-wide efforts at empowerment, an ICU staff developed and implemented a self-governance model. Difficulties included lack of involvement by some staff and lack of recognition of the elected Professional Practice Council as "director" of ICU. After one year, these problems have been overcome in part.
Providing educational activities and learning resources for professional nurses, particularly those who work off-shifts and weekend schedules, is a challenge for staff development personnel. At Northwestern Memorial Hospital, Professional Briefcases offer these self-directed learners an alternative to classroom instruction. The Briefcases can be used in a variety of settings: at home, on the clinical units, or in a resource center. This article describes the contents of the Professional Briefcases and their development and use.
In this case study, a provincial government residential treatment center for mentally and emotionally disturbed adolescents, used Gestalt Therapy as its primary therapeutic and staff-development ideology. Based on participant observation, document analysis, source material Survey on Gestalt Therapy, staff-sample interview and patient sample (of diagnostic, socioeconomic status and intelligence) data, it was demonstrated that Gestalt Therapy was neither designed nor intended for treatment of young adolescents manifesting severe psychiatric or behavioral disorders, for people from lower socioeconomic status families, or of low verbal skill and intelligence. It was discovered that a disporportionately large number of the case study population were: young adolescents, from lower socioeconomic status families, and that a significant proportion were of low verbal skill and intelligence. It was further suggested th,t Gestalt criteria for: physical environment, behavioral expectations (on staff and patient) and group-living ideology were incompatible with professional, legal and treatment expectations in an institutional treatment setting.