[Nursing development and nursing professional education: teaching and content - teaching of form].
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OBJECTIVES: To analyse the results of the immediate evaluation of an European teaching session using a questionnaire provided by the French College of anaesthesiologists. STUDY DESIGN: Open evaluation. MATERIAL: Questionnaires completed after each topic by 50 participants of an European course including 15 lectures were collected. METHODS: The types of professional exercise and the medical practise reliable to the different topics were pointed out. The evaluation included 4 items noted from 1 to 10: new information for medical practise, definition of pedagogic objectives, quality of means used for teaching, interest for the treated subject. The global mean score for each item and for each speaker was calculated. Results were compared according to the professional mode of exercise, the own medical practise and the project to modify it in the future. RESULTS: Scores affected to items were significantly lower for participants exercising in PSPH compared to general and university hospitals and private clinics (p < 0.001). New information was better found in case of poor or absence of practise, but interest was improved when medical practise was frequent. 2/3 of the participants projected to modify their practise after the session. CONCLUSION: The analysis of medical evaluation should allow to determine an acceptable zone of quality which may be useful for accreditation. However, distorting results according to the professional mode of exercise and the own medical practise should encourage the development of adapted continuous medical education. Delayed evaluation may be necessary to objective the putative benefits of CME on medical practise.
This paper describes a group of registered nurses' investigation of the use of 'double staff time' in a neonatal unit. Using participatory action research, the nurses explored why it was difficult for the unit's staff to take part in continuing education programs that were provided during double staff time. The group drew on their personal experiences as well as data collected from peers in the neonatal unit. The data illustrated that nursing activities and nursing handovers were two factors that encroached on nurses' professional development time.
This article describes how the University of Teesside School of Health and Social Care practice development team, in partnership with local professional colleagues and organizations, have addressed the issue of providing continuous quality evidence-based practice within the context of clinical governance. The newly devised Excellence in Practice Accreditation Scheme (EPAS) measures the standard of practice for a given health and social care setting by providing objective data indicating the level of clinical excellence obtained for the team or organization. The EPAS differs from other organizational accreditation schemes by facilitating excellence based upon a comprehensive set of measurable core standards: working in organizations, collaborative working, user-focused care, continuous quality improvements, performance management, and measuring efficiency and effectiveness. The standards are derived from a professional peer review of best practices. The uniqueness of EPAS is in consolidating the various organizational standards to elicit the core themes related to best practice where individuals, teams and organizations can be benchmarked and accredited for a level of excellence.
The Northern Outreach Program (NOP) in Ontario, Canada was initiated in 1980 by the Health Sciences Faculties at The University of Western Ontario and the Ontario Ministry of Health. Objectives of the NOP are to contribute to development of health services and health manpower in Northern Ontario and to develop supportive research programs. NOP Coordinators are appointed to their respective faculties from each of the following disciplines: Communicative Disorders, Library Science, Nursing, Occupational Therapy, and Physical Therapy (PT). PT coordinators identify needs and opportunities for development of PT service and manpower in the North, collaborating with District Health Councils and health professionals. Programs are developed considering the areas of service, manpower, education, and research. Programs include workshops, consultations, student clinical placements, and access to library resources. An external evaluation of the NOP was carried out and ongoing evaluation of the PT program is based on feedback from program participants. The NOP has been effective in supporting development of PT services in Northern Ontario, decreasing professional isolation and also serves as a model for other programs. Alternatives for recruitment and retention of manpower and research opportunities must continue to be developed to ensure optimal delivery of health care to underserviced areas.
This is the second of a two-part condensed review of data compiled from a survey conducted during December, 1977 by the Council on Nurse Anesthesia Practice. The survey questionnaires were originally sent to 14,344 active members of the American Association of Nurse Anesthetists. A total of 5,980 usable surveys were returned, reflecting a response rate of 41.7 percent. Part I of this review, published in the December, 1979 issue of the AANA Journal, centered upon the responses of hospital employed Certified Registered Nurse Anesthetists (CRNAs). Part II addresses itself to the responses of those CRNAs in a freelance or group practice setting. Survey questions were formulated to illuminate trends in anesthesia practice, training, continuing education, areas of responsibilities and the milieu in which anesthetists work. All statistical tables in this report are identical to those in Part I to eliminate redundancies and ensure the integrity of this review. The intent is to help readers extract information, make comparisons, and develop a useful information base for their clinical practice and professional growth.
The long-term goals of developing research within the specialty of emergency medicine include the following: (1) to continue to improve the quality and quantity of emergency patient care; (2) to maximize the research potential of emergency health care professionals to develop new emergency research talent and enthusiasm; and (3) to establish the academic research credentials of the specialty of emergency medicine to become competitive for federal research funding, and further improve emergency patient care. This article addresses the process by which the infrastructure for emergency medicine research can be developed at academic medical centers and provides recommendations. The roles of the academic chair, research director, senior researcher, and departmental faculty are discussed.
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The wider use of telematics in public health and patient care will be a very important strategy for Member States, and one that can help bring expert knowledge to new areas and institutions in a cost-effective and rapid manner. However, such a strategy should take into account a number of elements that are given below. Health telematics systems and services should be dictated by health need s and by clinical and public health standards, not be technology-driven. The values and principles of Health for All (HFA), notably equity, sustainability, participation and accountability, should apply fully to the development of health telematics. Health telematics requires new skills from the relevant decision-makers , operators and users, calling for a mix of participatory education, skills training, continuing professional education and lifelong learning. Given the fast rate of technological obsolescence and changing price-performance ratios, countries will benefit from closer collaboration on the development of technological standards, compatibility, open architecture, competitive prices and pilot applications. Managing health information developments in an effective and rational way at the level of the European Region will require the major organizations active in this field to enter into more formal agreements of cooperation than is the case today; most importantly, this will involve World Health Organization (WHO), the European Commission and Organization for Economic Co-operation and Development (OECD).
BACKGROUND: Audit and feedback has been identified as having the potential to change the practice of health care professionals. OBJECTIVES: To assess the effects of audit and feedback on the practice of health professionals and patient outcomes. SEARCH STRATEGY: We searched MEDLINE up to June 1997, the Research and Development Resource Base in Continuing Medical Education, and reference lists of related systematic reviews and articles. SELECTION CRITERIA: Randomised trials of audit and feedback (defined as any summary of clinical performance of health care over a specified period of time). The participants were health care professionals responsible for patient care. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Thirty-seven studies were included, involving more than 4977 physicians. The reporting of study methods was inadequate for almost all studies. In 31 out of 37 studies the randomisation process could not be determined. Information regarding data analysis was also lacking. For example, power calculations were not mentioned in 27 out of 37 studies. A variety of behaviours were targeted including the reduction of diagnostic test ordering, prescribing practices, preventive care, and the general management of a problem, for example hypertension. Twenty-eight studies measured physician performance, one study targeted patient outcomes in diabetes and the remaining eight studies measured both physician performance and patient outcomes. The relative percentage differences ranged from -16% to 152%. The clinical importance of the changes was not always clear. REVIEWER'S CONCLUSIONS: Audit and feedback can sometimes be effective in improving the practice of health care professionals, in particular prescribing and diagnostic test ordering. When it is effective, the effects appear to be small to moderate but potentially worthwhile. Those attempting to enhance professional behaviour should not rely solely on this approach.
Teacher education at both the preservice and the inservice level has been criticized for not adequately preparing teachers for the demands and challenges in the classrooms of today, or for the future. This article describes a federally funded project awarded through the Office of Special Education Programs. The intended outcome was to improve the knowledge and application of professional skills and competencies for both preservice teachers (student teachers) and inservice teachers (supervising master teachers) through continuous, focused staff development, reflection, discussion, and coaching. The project focused attention on three related issues: (a) the role and training of the supervising and/or master teacher, (b) better partnerships between teacher preparation programs and the public schools, and (c) the effects of school structure on teachers' continued professional growth. This article describes the program planning, goals, activities, components, and impact of this personnel preparation project.
Training in a developing country provides additional value for Dutch physicians who are training for a medical specialty. Knowledge of and experience with tropical diseases is also important in the Netherlands. The limited access to diagnostic tests and treatments in developing countries forces physicians to perform physical examinations meticulously and prescribe treatments conscientiously. Limited abilities to communicate can lead to an appreciation of the importance of communication and insights regarding optimal methods for communication. By working with staff in developing countries, physicians learn to be flexible in regard to work attitudes and cooperation. Physicians also learn to develop a personal academic programme independently. In addition, physicians become more readily involved in improving standards of living and healthcare in the community as a whole, and in the coordination and organization of work. Lastly, the ability to work professionally with limitations in healthcare is also valuable in medical practice in the Netherlands. Therefore, the decision to do part of the training as a medical specialist in a developing country should be supported. This experience should also count as part of the training.
The changing healthcare environment is placing new demands on today's professionals to demonstrate evidence of their continued competence to practice. Obtaining relicensure may soon require the use of a professional portfolio. In many instances, portfolios are already necessary for recertification by some specialty organizations. The author describes a course that teaches students how to prepare a professional portfolio.
This article details the development of a project conceived by the author to assist colleagues in fulfilling the professional development requirements of the UKCC.
In England, general practice vocational training schemes (GP VTS) have traditionally lasted for three years. Many commentators have suggested that such a short period of structured training is inadequate to prepare GPs for the variety of experiences and challenges that they encounter within the first years of their practice. The education of GPs in all regions of England is administered by the local Deanery whose task is to commission postgraduate medical and dental education and to implement national policies on postgraduate dental and medical education. Deaneries have developed higher professional education (HPE) programmes to address further training needs for newly qualified GPs. This report is the first of a series evaluating the experience of HPE participants in the London area and focuses on the area of self and professional development.