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Results for “Competency-Based Education”

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PubMed1976

Evolution of a Family Nurse Practitioner Program to improve primary care distribution.

The Family Nurse Practitioner Program of the Univeristy of California, Davis, has effectively improved the distribution of primary health care manpower in medically underserved areas. This has been accomplished by selecting students, preceptors, and faculty from areas of need; decentralizing the clinical and didactic training sites; developing a competency-based, portable curriculum; and coordinating it all with a circuit-riding, institutionally based faculty.

California↗
PubMed1978

Using a competency-based program to assess interviewing skills of pediatric house staff.

A program has been initiated to assess objectively the interviewing skills of pediatric house staff. Each entering house staff member interviews and is evaluated by a nonphysician mother who presents the medical history of her child. Remedial instruction is provided for all who do not perform in accordance with established minimum criteria. As a result of this competency-based program, all house staff members are now known to have attained at least a minimum level of competence in interviewing technique.

Educational Measurement↗
PubMed1983

Six years of experience using patient instructors to teach interviewing skills.

In 1974 a competency-based program was developed at the University of Arizona College of Medicine that used patient instructors (PIs) to evaluate interviewing skills objectively. PIs are nonphysicians who are taught to function in the multiple roles of patient, teacher, and evaluator. For each specialty area, objective evaluation instruments have been developed to measure the student's interviewing technique (interview process) and the amount of relevant historical information obtained from the patient (interview content). Data from the six most recent classes of second-year medical students demonstrate that: (a) there is a positive correlation between process and content scores; (b) students learn from their interviews with PIs; and (c) there is a positive relationship between the scores students obtain on their first interview with each of two different PIs in two different specialty areas. It is concluded that the PI program provides an effective way to teach interviewing skills to medical students.

Clinical Competence↗
PubMed2002

Assessment of an integrated curriculum in radiology.

OBJECTIVE: To describe an interdisciplinary team's experience using a six-stage curriculum-development model to assess an integrated curriculum in radiology. DESCRIPTION: In 1996 the University of Maryland School of Medicine implemented reforms of its undergraduate curriculum. A third-year required clerkship in radiology was eliminated, but an integrated curriculum was developed for first- and second-year students and for third-year students during their core clinical clerkships. A fourth-year elective was retained. In 2000 the school's Curriculum Coordinating Committee found that it lacked data regarding program performance or learner competencies in radiology since the reforms were implemented. The Committee designated an interdisciplinary team including a radiologist, an anatomist, and an internist with medical education expertise to conduct a rapid review of the adequacy of the curriculum as it is currently integrated. The team mapped the curriculum, identifying where radiology was taught, and analyzed each sub-curriculum according to a six-stage curriculum-development model. This method permitted nearly concurrent assessment of the national literature, local needs assessment, presence and adequacy of educational objectives and methods, adequacy of resources to support curriculum implementation, and the availability and adequacy of learner and program outcome measures. The team identified changes in the clinical classrooms that have been unanticipated four years earlier, including implementation of PACS systems for digital film storage and retrieval, rapid advances in clinical imaging capabilities, and diminished faculty teaching time due to increased clinical volumes. The team concluded its work in four months and issued a report recommending revisions to third-year curricula. The Curriculum Committee, the Dean's Office, and the Department of Radiology accepted the analysis and have dedicated personnel, technical, and financial resources to effect the recommended revisions, which include (1) revision of clinical clerkship objectives for competencies in radiology, (2) development of Web-based modules for self-directed learning, (3) faculty development to enhance teaching skills, and (4) competency-based assessment measures based on learning objectives. DISCUSSION: Schools and faculty are often faced with the need to develop and implement innovative curricula rapidly. Periodic assessments by oversight groups such as curriculum committees identify where additional information is required to assess the performances of learners and curricula in rapidly-changing clinical contexts. In this study a three-member team with focused expertise in radiology, anatomy, and medicine/medical education conducted a rapid in-depth review of an integrated radiology curriculum "hosted" by several departments. A curriculum-development model provided a template for analysis of needs, objectives, methods, resources, and assessment measures for all curricula, and guided the team's recommendations for targeted revision. Each team member brought expertise in some element of the integrated curriculum or in curriculum design. The team identified what integrated curricular elements had not been designed adequately, what could no longer be supported with current resources, and how curricular revisions could be assessed for adequacy.

Curriculum↗
PubMed2001

External Practicum-Year Residency Training in Occupational and Environmental Medicine: the University of Pennsylvania Medical Center Program.

We describe a competency-based training program that allows physicians employed full-time in occupational and environmental medicine to satisfy the supervised practicum year of training required by the American Board of Preventive Medicine (ABPM). The program is designed for trainees with greater clinical experience than the 1 clinical year required by the ABPM. To date, 25 physicians from clinic-based, academic, corporate, and government employment across most geographic regions of the United States have been admitted into the program. Most completed a master's in public health (MPH) in a distance-learning, on-job, on-campus, or executive program. The practicum-year training has been highly successful, as evidenced by improvements in resident self-assessment of competency, resident satisfaction with the training, faculty evaluation of resident performance, and success rate in the ABPM examination. The program has opened a new pathway for physicians making a mid-career shift to occupational and environmental medicine to obtain high-quality, in-depth education and board certification.

Academic Medical Centers↗
PubMed1978

Guidelines for competency-based instruction in psychiatry.

This paper presents guidelines for teachers who wish to design competency-based instructional activities in psychiatry. Developed over a 3 year period, these guidelines outline the methods used by teachers to construct competency-based seminars and clinical rotations. The guidelines describe the process of stating knowledge objectives, performance objectives and experiential objectives for psychiatric trainees to attain prior to completion of training in a given area. Selection of appropriate teaching strategies as well as criteria and conditions for assessment of the residents' abilities are also reviewed. Comments regarding the authors' experience using these guidelines with teachers are offered.

California↗
PubMed1983

Critical performance analysis of rotating resident doctors in Iraq.

The present study was undertaken to evaluate the competence of rotating residents in handling clinical problems, falling under the purview of the major clinical disciplines, which they come across during their routine work. Three hundred and one rotating residents (55% of the total) who graduated in June 1981 from the four universities of Iraq, namely, Mustansiryia, Basrah, Mosul and Baghdad, and were currently undergoing their residency posting in the various hospitals of Iraq were selected for the study. Two approaches were used to assess the level of competence: first, on the basis of the resident's responses to fifty simulated patient-management problems and, secondly, their critical performance in patient care adjudged by their respective supervisors. A minimum passing level (MPL) was fixed for patient management problems (PMP). The score for the consultant's observations could range from -70 to +100 to represent the very poor and the very good performance. Only 2% of the residents were found to have reached the minimum pass level of competence taking their overall performance in the various disciplines. No significant variation in performance was observed in relation to the university of graduation. None of the residents could reach the MPL in the case of obstetrics and gynaecology. In the case of medicine and medical emergency the findings were almost similar. The residents put up a much better performance in orthopaedics and paediatrics (45.0% and 27.5% respectively). According to the supervisors' assessment nearly two-thirds of the residents secured at least 50% of the maximum score. The study underscores the need to redefine our educational objectives specifically, with aim of developing competences at a defined level in the learner befitting the needs of the health system through a competency-based curriculum.

Clinical Competence↗
PubMedDate not supplied

Second skill educational development of personnel for a single-room maternity care system.

A modified cross-training approach was used to train nurses for a single-room maternity care unit. This cross-training program included development of a skills list for the labor/delivery and nursery/postpartum areas and an instruction program including formal lectures, independent study, and clinical experience. The clinical part of the program was a preceptor-based experience. The results of this program indicated that competency-based skills and objective selection criteria are mandatory for a successful cross-training program.

Female↗
PubMed1994

Validating interpretive arguments for licensure and certification examinations.

To validate the interpretation assigned to test scores is to support the rationale for this interpretation. The interpretations for licensure and certification tests involve a sequence of inferences, or an argument, leading from the test score to decisions about licensure or certification. This article examines several possible interpretive arguments for licensure and certification test scores and analyzes the evidence required to support each type of argument. Particular attention is given to a competency-based argument that involves a sequence of several inferences leading from test scores to statements about competence, and then to conclusions about expected performance in practice. Decisions about licensure or certification are based on expected performance in practice.

Certification↗
PubMed1994

Identifying and comparing competencies for social work management: a practice driven approach.

The study explicates a competency-based model of contemporary social work management practice and compares this model with frameworks derived from earlier studies. Using a purposive sample of 184 social work managers throughout the country, an exploratory factor analysis yielded twelve sets of competencies required of today's social work manager. A comparison of the present model to earlier management frameworks reveals that substantive changes in the nature, scope, complexity, and priorities assigned to management competencies and skills have transformed the role of the social work manager over the last decade. Implications for social work manager education are reviewed and future research directions are proposed.

Administrative Personnel↗
PubMed2000

Competency development in public health leadership.

The professional development of public health leaders requires competency-based instruction to increase their ability to address complex and changing demands for critical services. This article reviews the development of the Leadership Competency Framework by the National Public Health Leadership Development Network and discusses its significance. After reviewing pertinent literature and existing practice-based competency frameworks, network members developed the framework through sequential use of workgroup assignments and nominal group process. The framework is being used by network members to develop and refine program competency lists and content; to compare programs; to develop needs assessments, baseline measures, and performance standards; and to evaluate educational outcomes. It is a working document, to be continually refined and evaluated to ensure its continued relevance to performance in practice. Understanding both the applications and the limits of competency frameworks is important in individual, program, and organizational assessment. Benefits of using defined competencies in designing leadership programs include the integrated and sustained development of leadership capacity and the use of technology for increased access and quality control.

Curriculum↗
PubMed1997

The Federated Council of Internal Medicine's resource guide for residency education: an instrument for curricular change.

The Federated Council of Internal Medicine has developed a resource guide to help internal medicine residency programs produce internists who are prepared for today's practice of internal medicine and the challenges of practice in the future. The guide situates general internal medicine as the primary care profession that focuses on preventive, short-term, and long-term care of adult patients. It assumes that a single pathway is sufficient for educating general internists and subspecialty-bound trainees. It identifies the learning experiences that should be part of general internal medicine residency training, lists the clinical competencies that are important for primary care practice, and describes the role of the integrative disciplines that should inform the care of every patient. It also describes a process that program directors and local program committees can use to develop competency-based curricula.

Curriculum↗
PubMed1984

The role of the primary care PA.

At a time when roles of various allied health care providers frequently overlap, it is important to clearly delineate who does what, so there is less provider and patient confusion. In the case of the PA, it is also advantageous to determine periodically whether there are new functions to the role previously not described in the literature. The roles of primary care PAs were validated by using a mail survey developed through a review of PA roles frequently mentioned in the literature. The survey was sent to 47 training programs and 222 Emory University PA graduates working in primary care and non-primary care practices. Mean and median scores for each role per respondent category are reported and compared with mean differences between groups about role perceptions. Strong agreement occurred between and among respondent groups for PA roles dealing with documentation of health status, analysis of data, formulation and conduction of treatment and/or management plan, management of life-threatening emergencies, and patient education. From these data, competencies, performance criteria, and objectives can be generated for each validated role to assist in creating a competency-based curriculum for PAs.

Georgia↗
PubMedDate not supplied

Certification and credentialing to define competency-based practice.

One of the challenges that healthcare organizations face today is how to effectively establish, document, and evaluate competency in intravenous practice. The process used to define practice parameters based on national certification and credentialing versus organizational policies is described. Key attributes, the role of mentoring, and adverse outcomes are addressed.

Certification↗
PubMedDate not supplied

The multinational transfer of competency-based foster parent assessment, selection, and training: a nine-country case study.

The UN Convention on the Rights of the Child mandates (Articles 19 and 20) that alternative care be available to protect children from maltreatment by parents and caregivers. Increasingly, countries around the world have recognized the benefits to child well-being of family-based care as an alternative to institutional care. The special if not extraordinary needs of children separated from parents because of abuse, neglect, and maltreatment and placed with foster families requires a commensurate effort to develop foster families who have special if not extraordinary skills. Methods that are effective and replicable across countries offer significant advantages, reducing investments in policies and practices that otherwise would have to be developed independently, country by country. This case study describes the factors that contributed to the transfer of knowledge in the assessment, selection, and training of foster parents and the impact to date.

Child↗