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PubMed1994

An integrated health care model in medical education: interviews with faculty and administrators.

PURPOSE: To broaden the understanding of how medical schools can help students learn an approach to health care that reflects the integration of psychosocial and biomedical factors in health and illness. METHOD: A qualitative research design was used, with data collected through document review and semi-structured interviews conducted in the spring and summer of 1992 with 22 faculty and administrators from 17 U.S. and Canadian medical schools. The interviewees represented the following disciplines: internal medicine, family medicine, pediatrics, psychiatry, and preventive/behavioral medicine. An analytic framework was developed, within which the constant comparative method was used on a continuous basis during and after data collection. Category development focused on (1) defining the scope and character of an integrated perspective, (2) delineating various ways to incorporate such a perspective in medical education, and (3) identifying barriers to and facilitative factors for incorporating such a perspective in medical education. Validity was assessed by having the interviewees and three other faculty members review the analyses and preliminary results. RESULTS: The interviewees' conceptions of an integrated perspective on health care focused on the theoretical need for a broader scientific model and on the practical need for more inclusive approaches to medical practice. The interviewees described patient-level and community-level approaches as equally important. The ideal curricula envisioned by the interviewees were patient-centered, integrated, developmental, and population-based. In addition to naming many barriers to integration (e.g., negative attitudes of faculty and administrators, diffuse organization of medical schools, ignorance of appropriate curriculum design and implementation), the interviewees identified certain facilitative factors (e.g., strong leaders, faculty development programs, and reform of the faculty reward system). CONCLUSION: The interviewees envisioned an integrated model of health care that suggests that medical curricula should address the development of physicians' knowledge, attitudes, and skills regarding physicians' relationships with both patients and community.

Administrative Personnel↗
PubMed1999

Political influence: a model for advanced nursing education.

Involvement in shaping healthcare policy is an expected outcome for the leadership standard of advanced nursing practice as outlined by American Nurses Association's Scope and Standards of Advanced Practice Registered Nursing (1996). From personal experience teaching a healthcare policy course over a 10-year period, the author has found that beginning graduate students are primarily in an apolitical state, reluctant to participate in such activity, and have not considered the ramifications of inactivity for the profession and for healthcare policy. The skills for political influence are an essential component of graduate education to increase awareness of, and foster activity in, the political arena. A model for the development of these skills is presented. The model consists of four interrelated dimensions: information, commitment, initiative, and involvement. Model dimensions are described and made operational through student activity. Ultimately, students move from an apolitical state to a moderate level of involvement. The model has been intended for educational purposes; however, it is applicable for any advanced practice nurse (APN).

Attitude of Health Personnel↗
PubMed2004

The academic hematology-oncology firm:a model for postgraduate cancer education.

OBJECTIVE: To examine whether the introduction of a subspecialty firm system results in improving fellowship training in hematology and oncology. METHODS: A subspecialty firm in Hematology-Oncology was created to provide ambulatory and inpatient, primary, and subspecialty care. A survey was conducted of all fellows who trained in this firm while enrolled in an affiliated University subspecialty fellowship program. RESULTS: The survey showed a positive impact of the firm in improving trainee-patient relationships, achievement of educational goals, and clinical competency. CONCLUSIONS: Larger observational studies are needed to evaluate the full impact of this model on educational outcomes in cancer patients.

Arkansas↗
PubMed1998

The continuum of care: the process and development of a nursing model for stroke education.

A recent focus in health care is to develop a seamless transition for patients between the variety of health care agencies with whom they interact. The continuum of care for patients with stroke is complex and many levels of care are required, from acute intervention through to rehabilitation and reintegration into the community. A group of nurses from a variety of agencies in Southwestern Ontario received funding from the Ontario province Wide Nursing Project to effect a desirable change in the way nurses care for the stroke patient. This article describes the Ontario Province Wide Nursing project and the process of and challenges in developing a nursing model for stroke. The development of a nursing model for stroke patients and their families involved conducting nursing, and patient and family focus groups to identify key issues. Thirty-eight nurses participated in the nursing focus groups, and 8 patients and 18 family members participated in the patient and family focus groups. The common themes were the need for improved communication and the need to better prepare patients and families for the many transitions they experience during their recovery from stroke. A Stroke Education Record, which identifies a comprehensive list of potential learning needs of stroke patients and their families, and a Stroke Education and Resource Guide, which provides a reference for nurses, were developed and will be implemented in September 1998. Implementation of the model included a workshop, staff inservices, a self-learning package, and unit displays. Evaluation of the model will include nursing and patient and family focus groups, a chart review, written nursing evaluations, and patient and family telephone interviews.

Cerebrovascular Disorders↗
PubMed1990

Malignant melanoma as a model for cancer education and prevention. 1989 Harvey lecture American Association for Cancer Education.

Cutaneous malignant melanoma is one of the most rapidly increasing and highly fatal cancers in the world today. Current estimates suggest that 1 in 90-100 Caucasians will develop MM by the year 2000, and 20%-30% will eventually die of the disease. The cause of the epidemic of malignant melanoma is clearly increasing exposure to the sun from lifestyle and clothing habits that have changed over the past 50 years. The disease occurs primarily in preexisting nevi in sun-exposed sites in specific high risk populations who can be, and have been, defined. These are primarily middle- and upper middle-class Caucasians with blue eyes, brown or blonde hair, and fair skin, with predominantly indoor occupations who spend, or have spent, considerable time outdoors in leisure and other activities. The presence of a clearly definable cause (exposure to the sun) in specific risk groups, the ease of early detection by simple means, and the devastating outcome of late diagnosis make malignant melanoma an ideal model for teaching the basic tenets of cancer causation, development, and prevention to the public and professionals alike.

Adult↗
PubMed2002

Problem-Based Learning in Entry-Level Athletic Training Professional-Education Programs: A Model for Developing Critical-Thinking and Decision-Making Skills.

OBJECTIVE: To establish the underlying theory and benefits and describe the implementation of a problem-based learning curriculum. DATA SOURCES: I searched MEDLINE, SPORT Discus, and nursing, evidence-based medicine, and educational psychology databases from 1987 through 2002 using the terms problem-based learning, physical therapy, nursing, and medicine. DATA SYNTHESIS: In the problem-based learning process, students encounter a problem, bring to it their preconceived understanding (accurate or not), learn to identify what they need to learn to better understand the problem, engage in self-directed study, and begin to resolve the problem. Problem-based learning has its origins in medical education but is widely used in K-12 education, social sciences, health professions education, law, business administration, engineering, and aviation. An entry-level master of science degree program in athletic training based on problem-based learning and integrated clinical education is described. CONCLUSIONS/RECOMMENDATIONS: Problem-based learning curricula, if implemented correctly, can facilitate the entry-level athletic training student's professional development into that of a life-long learner who bases clinical decisions and procedures on the best available evidence.

Journal Article↗
PubMed1993

Coping with challenge in adolescence: a conceptual model and psycho-educational intervention.

This paper presents a conceptual model for understanding the nature, timing, synchronicity and impact of developmental stressors and their implications for adolescent mental health trajectories. The model is derived, in part, from a longitudinal program of research investigating the development of adolescent mental health. Developments in the areas of life-span development, developmental psychopathology, and stress and coping also inform the model. In this model, stressors are viewed as challenges to the coping responses and resources of adolescents. Some challenges can be risks to adolescent mental health while others can be opportunities for further growth and development. Moderators of the association between challenge and mental health outcomes include internal/personal and external/interpersonal resources. This model has led to a psycho-educational program to enhance coping and reduce depression. Its design and some preliminary results from a longitudinal study of the short- and long-term effectiveness of the program in enhancing adolescent mental health are described.

Adaptation, Psychological↗
PubMed1994

[The approach of the letterbox: a model of sex education in a traditional society].

The present article describes a new approach for imparting sex-education to adolescents in a conservative and orthodox society like India. The initial community resistance to sex education was overcome by conducting a survey on the sex behaviour of adolescents. Contrary to popular belief and notions, the survey proved that some adolescents are sexually active and that they are not adequately equipped to prevent and protect themselves against sexually transmitted diseases, AIDS and unwanted pregnancies. The new model is essentially based on the team/group approach and utilises a group of trained and motivated teachers in schools to impart sex education to a group of students. The students' response to this approach has been heartening and encouraging.

Adolescent↗
PubMed2001

A conceptual model for public health education in podiatric medicine.

This article discusses the need for and the advantages of a dual degree program between podiatric medicine and public health. The authors expand on the existing program for public health education at the first professional degree level to include a conceptual model for a dual degree program developed at Temple University's Department of Health Studies, through the Graduate School and the School of Podiatric Medicine. The model combines didactic and clinical education at the graduate level to ensure that clinicians involved in determining health policy are prepared to represent the profession in the restructuring of the health-care system.

Community Health Planning↗
PubMed1998

Seattle YouthCare's prevention, intervention, and education program: a model of care for HIV-positive, homeless, and at-risk youth.

YouthCare's project for youth who are human immunodeficiency virus (HIV)-positive or at high risk for becoming HIV positive is one of 10 supported by Special Projects of National Significance Program, HIV/Acquired Immunodeficiency Syndrome Bureau, Health Resources and Services Administration. Throughout its 23-year history, YouthCare has focused on serving runaway, homeless, sexual minority, and other youth "on the margins." To respond effectively to the needs of these youth, YouthCare has developed creative service approaches including involving youth in program design and taking the programs to where the youth live. Building on this experience, the agency developed a continuum of services which has provided care to 906 youth, including 37 who are HIV positive. The five major elements of the model include: (a) youth-specific HIV antibody test counseling, (b) outreach, (c) intensive case management for HIV-positive youth, (d) prevention services for youth at high risk of HIV infection, and (e) peer involvement. Quantitative evaluation helped in identifying youth served by the project (e.g., over one third self-identify as a sexual minority) and the sites at which services should be provided. Preliminary results from qualitative evaluations have stressed the importance of teamwork in designing clinical interventions and providing support to direct-service staff. This report's conclusion stresses that case management for this population, even though time and resource-intensive, is effective, and that services need to be flexible and tailored to each client's needs.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Developing a health mind-set--description of caritative health promotion].

This investigation describes health promotion from a caring science perspective. Caring is defined as an act of "caritas" c.e. love and mercy (Eriksson 1991). The investigation is theoretical and comes as a result in a model for health education. The model will be empirically tested in the future further on. The research method is qualitative and descriptive consisting of three processes: the abductive, deductive and inductive. This method was created by Charles Peirce (1839-1914). The inductive process will be implemented by testing the model. Abduction is the process of forming an explanatory hypothesis. The abductive hypothesis of this investigation is formed in the following way: "the kind of mood od mind, the kind of health". Main emphasis has been in examining the meaning of the mood of mind for ones health and the possibilities to develop it. The following question were asserted; 1. What is meant by the mood of mind? 2. What attributes are required in order to talk about health's mood of mind? 3. What are the possibilities of developing the mood of mind as a way for health education? The result of this investigation is presented as a model for health promotion. The model is upbuilt by the caritative elements featuring belief, hope, love and the concept of virtue. The model shows the consequences for a human beings daily living. In the case of having too much belief a human being may develop some kind of health fanatism. In the case of having too much belief a human being may develop some kind of health fanatism. In the case of having too much hope a human being puts forward the decisions about health for tomorrow. In the case of having too much love it may lead to a irresponsible lifestyle. An assumption is that a balance between belief, hope and love leads in choosing health, planning for health and living in health.

Attitude to Health↗
PubMed2001

[Patient education before orthopedic elective interventions. "The Lagenthal model of 3-step patient education"].

There is still quite a controverseY when and how an informed consent should be obtained from a patient in the surgical field. As has been stated of the federal court the patient need to be given that information which is understandable to him and which will not cause him undue anxiety. This information has to be sufficient for the decision whether to proceeD or decline a surgical procedure. The federal courts are therefore asking for the optimal patient consent not necessarily the total and complete revelation during the patient information. For this reason the act of obtaining an informed consent was thought to be turned into a scientific question in identifying the base from optimal quality of giving informed consent respecting at the same time the principal of evidence based medicine. The support presents a sample of an oral and written consent-form given in three stages as it is currently being used in the orthopaedic service of the Langenthal hospital. 100 patients were given this type of a consent and were later on asked for their opinion of acceptance. Most of the patients felt to be sufficiently informed on their procedure after having undergone a three times repeated interview as well as having been given a consent form including hand-drawings concerning their particular procedure. The advantages as well as the disadvantage of this type of consent form are being discussed.

Adolescent↗