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PubMed2005

Twenty-first century graduate education in clinical psychology: a four level matrix model.

Clinical psychology is positioned to play key roles in mental and physical health issues of 21st century America. In this regard, however, the present Boulder model of educating clinical psychologists is not preparing our graduates to meet the diverse demands of either today's or tomorrow's marketplaces. Accordingly, we introduce a new, four level "matrix model" for the education of future clinical psychologists. The core focus of the proposed matrix model is on the weaknesses and strengths of people in their personalities and their environments. Moreover, this matrix model operates at the individual, interpersonal, institutional, and societal-community levels of analyses. The details and implications of this proposed educational curriculum are described.

Curriculum↗
PubMed1988

Sex role stereotyping and role strain of male registered nurses.

Because of sex role stereotypes, certain occupations are considered appropriate for only one sex and elicit role strain in members of the opposite sex. The role strain of males in nursing, a predominantly female profession, is described in this article. A Role Strain instrument developed by the investigators was administered through mail questionnaires to 367 randomly selected male RNs in Oregon. As a group, these men: (a) experienced only mild role strain in contacts with community members, co-workers, and patients; (b) received support on their career choices from their families; and (c) considered inadequate pay a major source of strain in their work. Several explanations are offered for the general lack of severe role strain among these male nurses.

Gender Identity↗
PubMed2006

Palliative or curative treatment intent affects communication in radiation therapy consultations.

OBJECTIVE: To assess whether communication in radiotherapy consultations is affected by palliative or curative treatment intent. SUBJECTS AND METHODS: The study involved 160 patients and 8 radiation oncologists. Eighty patients visited the radiation oncologist (RO) for palliative treatment and 80 for curative treatment. The consultation prior to radiation treatment was analyzed with the Roter Interaction Analysis System (RIAS). Within three days, patients completed a quality of life questionnaire (EORTC-QLQ-C30). RESULTS: In palliative radiotherapy (PRT) consultations, ROs asked more (closed-ended) biomedical and psychosocial questions and provided more information on prognosis than in consultations for curative radiotherapy (CRT). Patients in both groups provided a great deal of psychosocial information but asked few questions. The ROs expressed more concerns in the PRT consultations, while patients did not. PRT patients received fewer supportive remarks than CRT patients. In both groups, explicit decision-making received little attention. Proxies who accompanied the patients took a more active role in PRT than in CRT consultations. CONCLUSION: Communication in radiotherapy is affected by treatment intent with respect to the main contents of the consultation.

Aged↗
PubMed2000

Identification of high-risk residents.

BACKGROUND: Identification of high-risk residents allows remediation and support for administrative action when necessary. This study characterizes differences in documentation of marginally performing residents in a general surgery residency. METHODS: High-risk residents were identified by the former program director. Twenty-four of one hundred fifteen residents over a 10-year period had one to four problematic areas: cognitive, synthetic, family/health, and interpersonal skills. Outcomes included finished (18), voluntary withdrawal (1), and involuntary withdrawal (5). A case-control study matching controls to cases by date of entry into the training program was used. Records were reviewed for demographics, preentry qualifications, American Board of Surgery In-Training Exam (ABSITE) scores, letters of complaint or praise, events of counseling, and monthly ratings. The records of 48 residents were reviewed. Ward evaluations were on eight categories with a 5-point Leikert scale (3-unacceptable to 7-outstanding). The evaluation score assigns points only to low ratings. High scores represent progressively poorer performance. A Wilcoxon signed ranks test was used to compare the cases and controls for continuous variables. The McNemar test was used in comparisons of categorical data with binary outcomes. Exact P values are reported. RESULTS: Objective data were similar for both groups. Study residents tended to score higher on monthly evaluations at Year 2 and by Year 3 this achieved significance (0.026). Study residents were more likely to have negative faculty letters (0.016) and events of counseling by a faculty member (0.017) and the program director (0.005). CONCLUSIONS: Identification of residents at risk should begin as early as possible during training. A combination of faculty evaluations and evidence of letters of counseling can detect high-risk residents. Programs may use such indicators to support decisions regarding remedial work or administrative action.

Documentation↗
PubMed1975

Special role and role expectation of black administrators of neighborhood mental health programs.

This paper attempts to portray the role conflict and ambiguity of black administrators in community mental health programs. The paper is not about mental health programs themselves but rather focuses on the problems of blacks in leadership positions in such programs. The implication of this paper is that blacks cannot escape being black despite their professional position or training. They are regarded by their superiors, colleagues, staff, and the community as performing what Hughes called a "racial function." This function presents an interesting dilemma. On the one hand, the black administrators are recruited and employed out of the needs expressed by the black community. On the other hand, their white superiors determine whether they remain in those positions. To offend either group risks the loss of their position. The black community and white employer sometimes make conflicting demands on these black administrators. The result is that blacks find themselves unable to please either. Blacks have reacted by withdrawal from the black community or resignation from the organization. This paper attempts to explain these conflicts. Although the problems of black administrators are called special cases it does not mean that other ethnic groups have not experienced any or all of these problems. It is called a special case because the black community is undergoing a special and unique kind of socioeconomical transition. Black administrators in other types of public organizations will recognize some of the conflicts described in this paper.

Administrative Personnel↗
PubMed1994

Managing change in an interdisciplinary inpatient unit: an action research approach.

This case study describes the application of the action research model to managing change in an interdisciplinary inpatient unit. Special attention is given to potential resistances to the process and methods for addressing these. A needs assessment instrument assessing 40 program domains produced the initial data from which direction for change was derived. Active participation by all members in each phase of the process was found to contribute positively to the development and implementation of change efforts. Results indicate that the use of the model coupled with participation by the client group promoted positive staff morale, open communication, lower staff turnover, team problem solving, and improved goal attainment.

Data Collection↗
PubMed2001

A conceptual model for describing decision-making situations in integrated natural resource planning and modeling projects.

A conceptual model is developed herein for the purpose of stimulating discussions within groups planning and carrying out integrated natural resource projects. We first describe four basic components of integrated planning and modeling efforts: people, databases, technology, and organizational commitment. Second, we provide one view of the relationship between the size of the project's decision-making body and the timing of decisions during a project's life cycle. Finally, these two discussions are combined into a conceptual model describing the dynamic nature of decision-making within integrated projects. The abstractions and generalizations described here are not unique to private industry or governmental organizations and should provide the basis for a discussion of decision-making issues among interdisciplinary professionals embarking on large-scale or complex modeling efforts.

Computing Methodologies↗
PubMed2005

Developmental mentoring match characteristics: correspondence between mentors' and mentees' assessments of relationship quality.

Understanding the factors that contribute to high-quality mentoring relationships is critical to developing and sustaining effective mentoring programs. In study 1, sixty-three adolescent mentors, from two high schools, were surveyed four to six weeks after being matched with elementary-age mentees. Hierarchical regression models revealed that mentees' academic and behavioral risk status, parental involvement, and program quality all explained variance in mentor-perceived relationship quality, but none remained significant predictors after mentors' self-efficacy, motivations for self-enhancement, and assessments of their mentees' support seeking behaviors were accounted for. Study 2 cross-validates the regression model in study 1 and examines the concurrent validity and predictive validity of a measure of mentoring match characteristics using mid-year and end-of-year assessments from mentees and mentors. Editors' Strategic Implications: The focus on mentors' initial impressions of their mentees and the relationship represents a novel contribution to the study of relationship formation and persistence. The authors provide a promising strategy - and descriptions of specific measures - to help programs study relationships that endure or terminate. Coordinators will benefit from the knowledge that if mentors feel efficacious and if the mentoring relationship is strong, mentors are more likely to persist.

Adult↗