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At least 937 records · Page 52Linked to original sources
PubMed2005

Medication management model as experiential education tool for students of pharmacy.

A visiting nurse association (VNA) and a college of Pharmacy sought cost-effective models by which consultant pharmacy services could be offered at a rural branch office to improve medication management for high-risk patients. Through a collaborative relationship with the Albany College of Pharmacy, the Eddy VNA used the structure and support of the Partners In Care Foundation (The Model) Medication Management Model to simultaneously provide patient services and train Doctor of Pharmacy candidates. The Model brings the pharmacist into the homecare team to provide pharmaceutical care and can provide the framework by which pharmacist preceptors and interns can effectively provide services to high-risk patients identified through the agency's CQI process. Results from program implementation with 100 Medicaid waiver patients indicate positive staff response and an overall 43% acceptance rate with prescribers and suggest that this is a cost-effective medication management service with implications for adaptation by other HHAs.

Education, Pharmacy↗
PubMed1999

The relevance of clinical nutrition education and role models to the practice of medicine.

Clinical nutrition is concerned with the diagnosis and treatment of diseases that affect the intake, absorption, and metabolism of dietary constituents and with the promotion of health through the prevention of diet related diseases. Adult diseases of clinical nutrition encompass the most common causes of mortality in the developed world and include obesity with its co-morbidities of hypertension, diabetes, dyslipidemias, increased risks of cardiovascular disease, some cancers, and pulmonary failure; intestinal disorders related to inadequate nutrient absorption; eating disorders; and malnutrition associated with chronic illness and surgical trauma. Scientific advances on the relationship of dietary substances to the cellular mechanisms of disease occur with regularity and frequency. Yet, despite the prevalence of nutritional disorders in clinical medicine and increasing scientific evidence on the significance of dietary modification to disease prevention, present day practitioners of medicine are typically untrained in the relationship of diet to health and disease. In the absence of reliable medical advice on nutrition, patients increasingly turn to herbal dietary supplements, costly diet schemes for weight reduction, and other unproved and potentially harmful remedies. Standardization of curricula for nutrition education of medical students and trainees and the provision of knowledgeable clinical nutrition specialist educators and role models in medical institutions is increasingly relevant to the cost-effective integration of nutritional concepts into medical practice.

Adult↗
PubMedDate not supplied

Feedback on prescribing rate combined with problem-oriented pharmacotherapy education as a model to improve prescribing behaviour among general practitioners.

OBJECTIVE: To develop a working model with which prescribing behaviour among general practitioners might be influenced. DESIGN: Intervention based on feedback on prescribing rates and problem-oriented educational outreach visits, using educational material and local opinion leaders. Randomised study with three parallel intervention groups of general practitioners, which also served as controls for each other. The pharmacotherapeutic fields chosen were hypertension, peptic ulcer/dyspepsia and depression. Prescription data were retrieved from the electronic patient records for periods of 1 year before and after the intervention. SETTING: Six health care centres and three continuing medical education groups in Stockholm. SUBJECTS: Forty general practitioners. MAIN OUTCOME MEASURES: Drug prescribing rates and patterns before and after the intervention. RESULTS: In the hypertension field, desired trends in fractional prescribing (favouring diuretics and beta blocking agents) were recorded, with a significant (P < 0.05) effect on prescriptions for agents acting on the renin-angiotensin system, despite a pre-existing prescribing behaviour already much in line with the goals. In the peptic ulcer/dyspepsia field, desired trends were recorded for both types of therapies addressed. The fractional prescribing rates for proton-pump inhibitors decreased from 61.0% to 52.6% in the intervention arm and increased from 68.1% to 76.0% in the control arm (not significant due to low power). The depression group focused on better general attention to the disease and only minor changes were registered. CONCLUSION: Feedback of individual prescribing rates, combined with problem-oriented educational outreach visits, is a promising model for the improvement of prescribing behaviour. Data from the electronic patient record were feasible for feedback on prescribing rates.

Education, Medical, Continuing↗
PubMed2002

Live streaming video for medical education: a laboratory model.

At the University of Kentucky (UK), we applied streaming video technology to develop a webcast model that will allow institutions to broadcast live and prerecorded surgeries, conferences, and courses in real time over networks (the Internet or an intranet). We successfully broadcast a prerecorded laparoscopic paraesophageal hernia repair to domestic and international clients by using desktop computers equipped with off-the-shelf, streaming-enabled software and standard hardware and operating systems. A web-based user interface made accessing the educational material as simple as a mouse click and allowed clients to participate in the broadcast event via an embedded e-mail/chat module. Three client computers (two connected to the Internet and a third connected to the UK intranet) requested and displayed the surgical film by means of seven common network connection configurations. Significantly, no difference in image resolution was detected with the use of a connection speed faster than 128 kilobytes per second (kbps). At this connection speed, an average bandwidth of 32.7 kbps was used, and although a 15-second delay was experienced from the time of data request to data display, the surgical film streamed continuously from beginning to end at a mean rate of 14.4 frames per second (fps). The clients easily identified all anatomic structures in full color motion, clearly followed all steps of the surgical procedure, and successfully asked questions and made comments by using the e-mail/chat module while viewing the surgery. With minimal financial investment, we have created an interactive virtual classroom with the potential to attract a global audience. Our webcast model represents a simple and practical method for institutions to supplement undergraduate and graduate surgical education and offer continuing medical education credits in a way that is convenient for clients (surgeons, students, residents, others). In the future, physicians may access streaming webcast material wirelessly with hand-held computers, so that they will be freed from computer stations.

Computer Communication Networks↗
PubMed2004

Improvement in diabetes care of underinsured patients enrolled in project dulce: a community-based, culturally appropriate, nurse case management and peer education diabetes care model.

OBJECTIVE: To improve clinical diabetes care, patient knowledge, and treatment satisfaction and to reduce health-adverse culture-based beliefs in underserved and underinsured populations with diabetes. RESEARCH DESIGN AND METHODS: A total of 153 high-risk patients with diabetes recruited from six community clinic sites in San Diego County, California were enrolled in a nurse case management (NCM) and peer education/empowerment group. Baseline and 1-year levels of HbA(1c), lipid parameters, systolic and diastolic blood pressure, knowledge of diabetes, culture-based beliefs in ineffective remedies, and treatment satisfaction were prospectively measured. The NCM and peer education/empowerment group was compared with 76 individuals in a matched control group (CG) derived from patients referred but not enrolled in Project Dulce. RESULTS: After 1 year in Project Dulce, the NCM and peer education/empowerment group had significant improvements in HbA(1c) (12.0-8.3%, P < 0.0001), total cholesterol (5.82-4.86 mmol/l, P < 0.0001), LDL cholesterol (3.39-2.79 mmol/l, P < 0.0001), and diastolic blood pressure (80-76 mmHg, P < 0.009), which were significantly better than in the CG, in which no significant changes were noted. Accepted American Diabetes Association standards of diabetes care, knowledge of diabetes (P = 0.024), treatment satisfaction (P = 0.001), and culture-based beliefs (P = 0.001) were also improved. CONCLUSIONS: A novel, culturally appropriate, community-based, nurse case management/peer education diabetes care model leads to significant improvement in clinical diabetes care, self-awareness, and understanding of diabetes in underinsured populations.

Adolescent↗
PubMed1994

The experiential curriculum: an alternate model for anaesthesia education.

The shift to direct entry into residency training from medical school for all graduates will offer new challenges for anaesthesia training programmes. In this paper we argue that it also offers us an opportunity to re-evaluate our current approach to anaesthesia education. Emphasis in the residency programmes should be to provide trainees with clinical experiences and stimulation that will develop the required traditional competencies. It should also cultivate competency in clinical decision-making, intuition and judgement. Our purpose is to generate discussion by proposing an alternate curriculum model, the experiential curriculum. The basic premise is that learning is a process and outcome is to a large extent related to what the learner does. The process begins with an experience that provides for observation and reflection. Integration of the thoughts provides the basis for executing either existing or new actions. In the experiential curriculum residency training and learning are enhanced by documenting and critically evaluating the experiences to which the resident is exposed. Included within such a structured programme are the methodologies of problem-based and evidence-based learning. Faculty development will be required to help the resident pursue these skills of self-evaluation and efficient learning. We believe that incorporation of an experiential curriculum into the residency training programme will achieve the goals listed above and allow maturation of the process of lifelong learning. It will also allow greater achievement of the application of new information to one's practice.

Anesthesiology↗
PubMed1982

The health belief model and nutrition education.

Five axioms of learning explain the stability of dietary practices and suggest approaches to teaching more healthful habits. These axioms include the influence of prior beliefs and attitudes upon people's interpretations, the fact that effective learning is incremental, the value of reinforcement, the habitual nature of much behavior, and the fact that learning includes both cognitions and skills. The Health Belief Model (HBM), a specification of the first axiom, holds that people are likely to follow health recommendations if they are motivated about their health and if they believe that they are susceptible to an ill health condition; that the occurrence of that condition would have serious impact on their lives; that following a particular set of health recommendations would be beneficial in reducing either their susceptibility to or the severity of the condition; and that the psychological benefits of following the health recommendation outweighs its costs. Educational diagnosis may be made by identifying peoples' status on each variable in the HBM and then formulating an educational plan directed toward modifying beliefs, as needed, taking into account the other learning axioms. An ethical stance is adopted that holds that informed individuals should be entitled to maintain the practices they prefer.

Attitude to Health↗
PubMedDate not supplied

A dual degree model for associate and baccalaureate nursing education.

The dual degree model shared by an associate degree and baccalaureate nursing program allows dual enrollment in both programs and the completion of the baccalaureate nursing degree in four academic years with summer enrollment. This model outlines a dual course of study that strengthens associate degree nursing course work with important general education and nursing foundational courses.

Career Mobility↗
PubMed2006

An asset based model for postgraduate education online.

There has been much written about web-based learning and teaching, this paper considers many of the issues raised previously but goes further in suggesting a model that is both easy to use from a teacher's perspective and through two case studies demonstrates the effectiveness of the model in online learning and teaching in nursing and allied professions.

Alberta↗
PubMed1997

The effectiveness of a preceptorship model in postgraduate education for rural nurses.

This retrospective study was designed to evaluate the effectiveness of a preceptor program in meeting the needs of first-year graduate nurses employed in a large rural hospital. In particular, this project aimed to assess whether the program leads to improvement in the clinical skills of the graduate over the 12-month period of the program; the suitability of the program to meet the graduates' needs; and the perceptions of nursing unit managers, preceptors and enrolled nurses regarding the program. Questionnaires were designed and distributed to the above categories of nurses, as well as graduates. Results indicated that the graduates considered the program to be excellent and that it met their needs to a high degree, while the clinical nurses rated the program between adequate and good. The paper will define the strengths and limitations of the program and the effect on recruitment and retention of nurses in a rural area.

Clinical Competence↗