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The program was approved for contact hours, and the preceptors received certificates and completed program evaluations. In these evaluations, the preceptors suggested that more time is needed for discussion and role playing and more feedback is needed concerning their own performance as preceptors.
Studies have raised concerns about the reliability of traditional clinical perceptual voice evaluation. References, training, and the analysis-by-synthesis method were proposed to improve this reliability. However, no study has directly compared the effectiveness of these methods. This study compared two training programs that are based on an anchors method and a paired comparison method. The aim of the programs was to improve the ability of naive listeners to detect subtle differences in breathiness. This study found that trained listeners showed significant improvement after training. Equivocal results were found as to which of these training methods was more effective. However, it is suggested that listeners should be trained before they use the analysis-by-synthesis method. The findings of this study provided more information on developing the theoretical framework proposed by Kreiman et al, in particular the "nature" of the internal representations of voice quality. An exemplar-based approach for processing breathiness is proposed.
The practical difficulties of using the experimental model for program evaluation in direct service settings are discussed, and it is suggested that use of this model seems premature. These difficulties, however, can no longer be used as a rationale for delaying program evaluation. A practical alternative model is outlined.
OBJECTIVE: To evaluate the coverage of the programme of control and coverage of Hepatitis B among children doing their 7th year of EGB (basic) in Navarra. DESIGN: Descriptive study. SETTING: School centres in Navarra. PARTICIPANTS: 7th-year EGB students in the 1992-3 school year. INTERVENTION: Vaccination of the susceptible population with three doses of anti-HB vaccine on the 0-1-6 months pattern. MEASUREMENTS AND MAIN RESULTS: Nominal data of children vaccinated were obtained from 171 schools out of a total of 185 (92.43%). For the rest of the centres, it is known only that vaccinations took place within the School Health Programme. The susceptible population was 6,955 children, of whom 97.8% received the first dose, 97% the second and 95.6% the third. The most common cause of non-vaccination in these children was lack of parental authorization, which reached 1.8%. CONCLUSIONS: A School Health programme, which is well-established and closely linked to the Primary Care network, together with a broad diffusion of information about the adolescent Vaccination Programme were key to its widespread introduction and the excellent coverage attained.
In the past few years, "accountability" for public mental health programs has become differentiated in the minds of not only program evaluators, but also program managers and funders, including state and local-level legislators. Increasingly, these officials are becoming concerned with more than just the numbers and targets of services delivered, and the cost involved, and are looking for evidence of positive outcome or impact on clients to justify program implementation and maintenance. This represents a significant move beyond the two accountability models that most recently seemed to be the focus of most formal accountability efforts--performance measurement and quality assurance. Pressures for implementing these two alternatives seem to have been reduced somewhat by the new federal Administration, but even prior to its advent there had been a rapid escalation in awareness of and concern for client outcome measurement among important audiences, including state and local mental health policy-makers and the U.S. Congress. This presents a major new opportunity and challenge for program evaluators at this new accountability focus continues to gather momentum.
The author suggests four ways that management information systems can complement the efforts of program evaluators. These ways are: clarifying the purposes of and uses for collecting information; clarifying the relevancy of information that is collected and stored; constructing a data base that accounts for the differential needs of users; and generating reports in a timely and comprehensible manner. Interwoven throughout these ways is the premise that program evaluators need to attend more to the decisional needs of various users, particularly managers. An information system can assist program evaluators toward this end.
Program rankings and their visibility have taken on greater and greater significance. Rarely is the accuracy of these rankings, which are typically based on a small subset of university faculty impressions, questioned. This paper presents a more comprehensive survey method based on quantifiable measures of faculty publications and citations. The most frequently published core clinical faculty across 157 APA-approved clinical programs are listed. The implications of these data are discussed.
Animal welfare regulations in the United States require that nonhuman primate environmental enhancement plans be made in accordance with currently accepted professional standards; however, little information is available for quantifying common practice. Here we report the results of a 2003 survey that was sent to individuals overseeing enrichment programs at a variety of primate research institutions. The surveys requested information on program administration and management, implementation standards, procedures, and constraints pertaining to major categories of environmental enrichment, as well as intervention plans for animals exhibiting behavioral pathologies. Data were obtained on the management of 35,863 primates in 22 facilities. Behavioral scientists performed program oversight at the majority of facilities. Most programs reported recent changes, most commonly due to external site visits, and least commonly resulting from internal review. Most facilities' institutional animal care and use committees (IACUCs) included of individuals with behavioral expertise, and about two-thirds reported that enrichment issues could influence research protocol design. While most primates were reported to be housed socially (73%), social housing for indoor-housed primates appears to have changed little over the past 10 years. Research protocol issues and social incompatibility were commonly cited constraints. Implementation of feeding, manipulanda, and structural enrichment was relatively unconstrained, and contributions to these aspects of behavioral management generally included individuals in a wide variety of positions within a facility. In contrast, enrichment devices were used on a less widespread basis within facilities, and positive reinforcement programs that involved dedicated trainers were rare. We suggest that altering the role of the IACUC would be a productive avenue for increasing the implementation of social housing, and that an emphasis on prevention rather than intervention against behavioral pathology is warranted. The data from this survey may be useful for anticipating future program evaluations, establishing more effective internal evaluations, and assessing program progress and resource allocation.
Effective measures of knowledge about mental health in later life are valuable in both needs assessments and educational program evaluations. Described is the development of two short, true/false quizzes, one on alcohol problems and one on depression and suicide in later life. These quizzes can be used to plan and evaluate community education programs on mental health problems in later life. Procedures for developing other knowledge assessments are presented.
Subject matter experts from 13 North American corporations provided detailed descriptions of the historical development and the current components and operations of their office ergonomics programs. Results were summarized across corporations and presented for the following programmatic topics: backgrounds of key people, initial awareness and preliminary needs assessment, program development, program implementation, program monitoring and evaluation, program components, education and training, workstation and job analysis, early identification of cases, case management, and alternate office environments. The subject matter experts also provided comments about the strengths of their programs, their advice to others, and lessons they learned. These observations suggested the need for an office ergonomics program, and possibly other occupational health programs, to fit into a corporation's culture and capitalize on its infrastructure. Most corporations used multidisciplinary task forces or teams to develop their programs. Communication, which included training, awareness, advertising, and feedback, was also an important issue. Flexibility and simplicity were important attributes of these programs. It is hoped that this descriptive information will be helpful to some occupational health managers interested in or concerned about managerial perspectives and skills related to the development and implementation of programs within their own corporations.
Our study has two objectives. First, we reviewed the literature, and identified best practices for social model day programs providing care for adults with Alzheimer's disease (AD). Second, in-depth telephone interviews were conducted with directors in all social model day programs (n = 21) dedicated to serving adults with AD in South Carolina to compare practices to those identified. Programs implemented many best practices, despite their rural location and small size. All programs assessed clients' activity preferences, and reassessed activity effectiveness regularly. Most programs provided volunteers and staff with AD-focused training. Many programs incorporated innovative programming such as intergenerational activities. Most programs were offered in a setting not designed for adult day services; thus many programs did not provide suggested environmental features such as extra lighting or walking paths. Most programs evaluated activities from caregivers' perspectives. All programs provided support for caregivers. Practice and policy recommendations are described.
In the post prospective payment system (PPS) era, acute rehabilitation providers are presented with multiple challenges and opportunities. All inpatient rehabilitation facilities (IRFs) face the requisite demands for improved efficiency (e.g., reduced length of stay for persons with stroke) and the re-institution of monitoring for compliance with the 75% rule. However IRFs also now have a dramatic opportunity to shift the paradigm of "how we do business" by adopting cutting edge technology and continuous quality improvement methodology and by rethinking and revising how we evaluate a stroke program. Today, more than ever before in our industry, providers have an opportunity to evolve to a consumer-driven program evaluation model with the resultant modification of rehabilitation outcomes, indicators, and metrics. The article argues for a climactic and dramatic change in how acute rehabilitation providers market for patients, deliver care, and report on their outcomes. In the current context of PPS and the 75% rule, we are quite literally considering the survival of the industry as we know it. Improved rehabilitation processes and revised rehabilitation report cards (customized for the various stakeholders) hold the key to market share and organizational success. If patient access, quality outcomes, patient safety, and functional gains are to be achieved, the industry needs to change the way it does business and as a consequence the way it evaluates its programs.
The third-year clerkship at one college of medicine was modified to reflect an emphasis on adult learning principles and life-long learning habits. Problem-based learning was selected as the educational method, and the development of a cognitive knowledge base, clinical problem-solving skills, and appropriate clinical skills was stressed. At a yearly faculty education retreat, strengths and weaknesses of the clerkship were discussed. As a result of this meeting, several changes were made in the clerkship, including additional stress on students' usage of the medical library and computerized databases, a tutor development program, the addition of expert resource sessions, and more emphasis on students' development of clinical skills through a preceptor program. A comprehensive evaluation program designed to support the educational goals of the clerkship is in place. The major challenge of the program remains the proper synchronization of curricular, clinical, and student self-study activities essential for an ideal learning experience.
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In the programme section 'Psychogeriatrics' of the SGO Health Research Promotion Programme a longitudinal study was carried out in Amsterdam from 1989 until 1994, concerning the course of mild cognitive decline in elderly people (the AMSTEL project). The scientific aims were the development of diagnostical instruments for the early diagnosis of dementia, the development of criteria which predict the course of mild cognitive impairment and the expansion of knowledge on the relationship between somatic and psychiatric pathology and dementia. The programme also had aims regarding medical education and patient care. The results include the following: in order to diagnose dementia in general practice questions regarding orientation and short-term memory are helpful. Risk factors for cognitive deterioration in elderly people include hippocampal atrophy on the MRI scan, a low level of education and subjective complaints regarding memory. Subjective complaints regarding memory are not primarily caused by a depressive mood, as is often thought, but are important as correct self-observations of cognitive deterioration, and go with an increased risk of developing dementia. Besides the AMSTEL project a feasibility study was carried out concerning a psychogeriatric case register in Amsterdam.
Program evaluation can provide objective information relevant to decisions on program maintenance. A program to address problems in the preparation of criminal investigation reports in a metropolitan police department was evaluated. The program permanently altered environmental conditions under which reports were prepared to facilitate performance. Police officers, who had previously prepared reports without assistance, visited the Case Preparation Room to prepare reports with assistance from office personnel. Compared to reports prepared without assistance, reports prepared in the Case Preparation Room documented more case elements required by the state legal code for criminal prosecution, were completed in fewer days following arrests, and received higher ratings from Assistant District Attorneys. Operation of a permanent program available to approximately 945 officers proved a practical solution to improving the preparation of criminal investigation reports.
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Four different clinical populations were administered an elicited imitation task before and after therapy to determine the usefulness of elicited imitation procedures for formulating and evaluating language treatment programs. Children's imitations were analyzed according to the numbers and patterns of omission errors, substitution errors, and correct responses. Results indicated that (1) patterns of responding could be identified; (2) specific patterns were associated with different clinical populations; (3) performance on pretherapy measures could be efficiently analyzed and utilized for formulating language treatment programs; and (4) changes in posttherapy performance could be readily evaluated using this procedure. The data suggest that the elicited imitation procedures can be effectively used to increase the precision of the evaluation and clinical programming of children with language disorders.