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Assessing the feasibility of continuing an allied health educational program: a strategic planning model.

Some allied health programs consume more resources than they generate. Decision makers are often required to evaluate the need for continuing such programs. This paper presents a methodology for analysis of programs that do not cover their costs with the revenue that they generate. Although the subject presented is a clinical laboratory science program, the methodology and the examples provide a model and instruction on how to conduct a similar analysis for any allied health program, and a summary of the types of conclusions such an analysis might afford.

Allied Health Personnel↗

Rural mental health and aging: implication for case management.

Older adults are underrepresented as recipients of mental health services, despite evidence that preventive interventions are effective and complement physical health interventions. Barriers to using these services include the stigma associated with mental health problems, lack of trained professionals and general barriers of availability and accessibility in rural service delivery. Case managers can play an important role in breaking down some of these barriers and assisting older adults to access t-ese services. Several outreach and educational models have been developed that are replicable and available to case managers.

Aged↗

The development of a model for geodesic learning: the geodesic information processing model.

The current article suggests that alternatives to the current traditional learning methods are essential if learning institutions are to provide people with effective life skills that enable them to be autonomous learners. This suggestion is based on a body of literature on alternative learning which stresses the need for fundamental change and hence, a paradigm shift in the perception of learning in order to cope with the world-wide information explosion. The alternative non-traditional approach proposed is geodesic learning which stresses learning how to learn and self-directed inquiry as essential life-skills which enable systems as well as the people in the systems to bring about their own transformation in response to changing situations and requirements. The current article discusses an alternative service delivery model, the geodesic information processing model, which falls within the realms of the geodesic philosophy. The implications of this alternative approach for the speech-language therapist are discussed.

Child↗

Applying Senge's concepts of organizational learning to clinical outcomes research and practice.

The purpose of this article is to use Senge's concepts of organizational learning as a framework for discussing issues and challenges in clinical outcomes research. Clinical outcomes research is about learning how to improve clinical practice. A learning organization balances attention to the structure and the culture in order to produce effective results. Future health care leaders will need to understand and attend to the importance of the organization's structure, but their greatest contribution will be in attending to the organizational culture to produce enduring organizational change.

Humans↗

PROSPER community-university partnership model for public education systems: capacity-building for evidence-based, competence-building prevention.

This paper presents a model to guide capacity-building in state public education systems for delivery of evidence-based family and youth interventions-interventions that are designed to bolster youth competencies, learning, and positive development overall. Central to this effort is a linking capacity agents framework that builds upon longstanding state public education infrastructures, and a partnership model called PROSPER or PROmoting School-community-university Partnerships to Enhance Resilience. The paper presents an overview of the evolving partnership model and summarizes positive results of its implementation over a 12-year period in an ongoing project.

Community-Institutional Relations↗

A study of the applicability of a truly objective measurement model in medical education.

The main purpose of this study is to examine a new measurement model, to explore the range of situations to which it can be applied, and to establish its value in the improvement of the decision-making process in medical education. The objective of this set of investigations is thus to help fill the gap between theory and practice, particularly in the light of a strong movement toward criterion-referenced testing.

College Admission Test↗

Teacher receptivity to a system-wide change in a centralized education system: a Rasch measurement model analysis.

The Education Department of Western Australia has implemented a new system called Student Outcome Statements, by trial in 1995/1996, then an a voluntary basis from 1997, with the intention of making it mandatory after 2001. The system describes, in order, the outcomes that students are expected to achieve in eight broad learning areas. The study has three aims. One, to create a scale for teacher receptivity to the use of Student Outcome Statements, based on eight orientations to receptivity: evaluative attitudes, behavior intentions, feelings towards Student Outcome Statements compared to the previous system, the benefits of the new system, support from significant others, alleviation of concerns, collaboration with other teachers, and involvement in decision-making. Two, to analyze the psychometric properties of the scale using the Extended Logistic Model of Rasch (Andrich, 1988; Rasch, 1960/1980) with the computer program RUMM (Andrich, Sheridan & Luo, 1997). Three, to provide advice to decision-makers about how better to implement the system of Student Outcome Statements.

Achievement↗

A patient-centered paradigm: a model for chiropractic education and research.

Within the chiropractic profession there is concern over both the appropriate paradigm for educating the student and the appropriate research model for investigating health care and promotion. The purpose of this study was to identify, interpret, and describe a paradigm for chiropractic education and research. Chiropractic first principles and existing health care paradigms were identified and integrated with the characteristics of chiropractic practice described in sociological studies of the chiropractic profession. A patient-centered paradigm emerged, incorporating the principles of vitalism, holism, humanism, conservatism, naturalism, and rationalism. Characteristics of a patient-centered paradigm that were identified were then subjected to an eight-member consensus panel with representatives drawn from chiropractic education, research, and sociology. The characteristics of a patient-centered paradigm agreed upon include self-healing, recognition of the patient as a unified whole, respect for the patient's values, beliefs, and dignity, involvement of the patient as a partner in health promotion, and a natural and conservative approach to evidence based care. Patient-centered research must reach beyond the randomized controlled trial, involving designs where clinicians apply their own patient-centered therapy in a "real world" assessment. A pluralism of methods, including both qualitative and quantitative studies, needs to be designed and implemented. Patient-centered research is a process that is pragmatic, realistic, and grounded in the day-to-day experiences of both patients and chiropractors. A patient-centered paradigm offers a useful model to critically study what benefits patients and to prepare chiropractic students to practice in the patient's interest.

Chiropractic↗

Abductive machine learning for modeling and predicting the educational score in school health surveys.

The use of modern abductive machine learning techniques is described for modeling and predicting outcome parameters in terms of input parameters in medical survey data. The AIM (Abductory Induction Mechanism) abductive network machine-learning tool is used to model the educational score in a health survey of 2,720 Albanian primary school children. Data included the child's age, gender, vision, nourishment, parasite infection, family size, parents' education, and educational score. Models synthesized by training on just 100 cases predict the educational score output for the remaining 2,620 cases with 100% accuracy. Simple models represented as analytical functions highlight global relationships and trends in the survey population. Models generated are quite robust, with no change in the basic model structure for a 10-fold increase in the size of the training set. Compared to other statistical and neural network approaches, AIM provides faster and highly automated model synthesis, requiring little or no user intervention.

Achievement↗

Watch, Discover, Think, and Act: a model for patient education program development.

In this report we describe the development of the Watch, Discover, Think and Act asthma self-management computer program for inner-city children with asthma. The intervention focused on teaching two categories of behaviors--asthma specific behaviors such as taking preventive medication and self-regulatory processes such as monitoring symptoms and solving asthma problems. These asthma self-management behaviors were then linked with empirical and theoretical determinants such as skills and self-efficacy. We then further used behavioral science theory to develop methods such as role modeling and skill training linked to the determinants. We matched these theoretical methods to practical strategies within the computer simulation and created a culturally competent program for inner-city minority youth. Finally, we planned a program evaluation that linked program impact and outcomes to the theoretical assumptions on which the intervention was based.

Asthma↗

A planning model for continuing education presenters.

To recap the seven considerations, they include location, structure and sequence, duration, participants, acceptable participant behavior, instructional moves, and content and materials. This planning model (see Figure 2) is one way of developing a well-organized continuing education program. The pain management topic has been used to demonstrate a practical application of the model and to stimulate thinking on planning. While this model could undoubtedly be expanded or adapted, it is a starting point for nurse presenters in the current void of guidelines for preparing continuing education programs. This model can serve as a baseline from which individual speakers can develop and create their own unique presentations.

Curriculum↗

Partnership model for practice and education.

The faculty practice partnership model provides a framework for collaboration between a practice setting and a university school of nursing. The model created between the Bergen County Department of Heath Services (BCDHS), the Office of Public Health Nursing (PHN) and Pace University's Lienhard School of Nursing (LSN) is one that supports faculty practice and student involvement in population-based activities. The partnership provides BCDHS with the assistance it needs to provide the three core functions of public health: assessment, assurance, and policy development. It provides LSN with a practice site where faculty members are able to maintain their clinical expertise, as well as a site for student clinical experiences and research. This article describes the partnership model and its accomplishments from both practice and educational perspectives.

Education, Nursing↗

An efficient and effective teaching model for ambulatory education.

Teaching and learning in the ambulatory setting have been described as inefficient, variable, and unpredictable. A model of ambulatory teaching that was piloted in three settings (1973-1981 in a university-affiliated outpatient clinic in Portland, Oregon, 1996-2000 in a community outpatient clinic, and 2000-2001 in an outpatient clinic serving Dartmouth Medical School's teaching hospital) that combines a system of education and a system of patient care is presented. Fully integrating learners into the office practice using creative scheduling, pre-rotation learning, and learner competence certification enabled the learners to provide care in roles traditionally fulfilled by physicians and nurses. Practice redesign made learners active members of the patient care team by involving them in such tasks as patient intake, histories and physicals, patient education, and monitoring of patient progress between visits. So that learners can be active members of the patient care team on the first day of clinic, pre-training is provided by the clerkship or residency so that they are able to competently provide care in the time available. To assure effective education, teaching and learning times are explicitly scheduled by parallel booking of patients for the learner and the preceptor at the same time. In the pilot settings this teaching model maintained or improved preceptor productivity and on-time efficiency compared with these outcomes of traditional scheduling. The time spent alone with patients, in direct observation by preceptors, and for scheduled case discussion was appreciated by learners. Increased satisfaction was enjoyed by learners, teachers, clinic staff, and patients. Barriers to implementation include too few examining rooms, inability to manipulate patient appointment schedules, and learners' not being present in a teaching clinic all the time.

Ambulatory Care↗

The educational attainment of young women: role model effects of female high school faculty.

To test for the presence of role model effects of female high school faculty and professional staff on young women in high school, we estimate several models of educational attainment for young women using data from the National Longitudinal Survey of Youth. Exposure to female high school faculty and professional staff has a positive impact on the educational attainment of young women. This result, combined with our finding that female faculty and professional staff have no significant impact on the educational attainment of young men, supports a female role model hypothesis.

Achievement↗

An application of the health belief model to patient education and compliance: acute otitis media.

This study made use of concepts from the health belief model to test the influence of educational intervention on patient attitude and subsequent sick-role behavior. The hypothesis tested was as follows: Mothers of pediatric patients in an experimental group (N-29) receiving specially designed education about otitis media, would consequently acquire greater awareness of their children's susceptibility to the disease, the possibility of its serious effects, and the benefits of treatment than a comparable control group (N-30) not receiving the educational intervention. It was further hypothesized that patient compliance would be higher in the experimental group. Experimental group health beliefs changed in a significant, positive direction with respect to illness susceptibility and severity, the benefits of treatment, and patient modifying factors. Control group attitudes did not significantly change. Compliance rates for both groups were very high; 91.8% compliance was noted for experimental subjects and 85.6% for controls. This may reflect the additional time and attention given all those participating in the study.

Acute Disease↗