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PubMed1991

[A surgeon's rating as objective criterion for professional competence].

The authors suggest evaluation of the qualification of a general surgeon by means of an individual coefficient-rating which is determined from 2 tables: basic and working. Its value is expressed in scores and depends, on the main, on the number of operations carried out during the year. Comparison of the rating in dynamics for several years facilitates the control over the surgeon's professional background, optimal formation of the operating team, and reduction of the degree of operative risk.

Educational Measurement↗
PubMed1994

Human diversity and professional competence. Training in clinical and counseling psychology revisited.

Psychologists have increasingly recognized the need to appropriately train students to serve individuals from diverse groups. These groups have been characterized by racial-ethnic membership or defined by sexual orientation, socioeconomic status, gender, and physical ability. Recent reports have documented that many applied graduate training programs still do not provide courses and experiences specific to working with diverse populations. This study presents results from a survey of 259 graduates of counseling and clinical psychology programs. Respondents were asked about training and professional work experiences with diverse groups. Results indicate restricted opportunities for training with diverse clients. Training experiences reported to be most effective are presented. Findings are discussed in light of continuing efforts to promote appropriate services.

Education↗
PubMed1984

Development of professional competence via self-instructional units.

In recent years, self-instructional teaching methods have come under criticism from educators, much of it warranted. But when self-instructional materials are written by experienced educators who teach the topic and are developed within a versatile process using a proven format, they are extremely valuable teaching aids. We discuss here the results of a grant project funded by W. K. Kellogg Foundation and describe the process used at Kettering Medical Center's School of Medical Technology to develop and produce over 100 self-instructional units. We also discuss potential uses of self-instructional units in professional continuing education programs and suggest ways self-instructional units might be used to promote interdisciplinary health care and expansion of professional knowledge banks. This project confirmed that professions can create their own educational materials through the independent efforts of their members.

Curriculum↗
PubMed2003

Chinese dragon or toothless tiger? Regulating the professional competence of traditional Chinese medicine practitioners.

The escalation in popularity of complementary and alternative medicine (CAM) has begun to stimulate regulatory responses to ensure the safety and efficacy of different modalities. The Therapeutic Goods Authority in Australia oversees a scheme of listing and registration, said to lead the world. Established CAM courses now confer recognised bachelor degrees. Victoria has recently regulated Traditional Chinese Medicine (TCM) practitioners, through the Chinese Medicine Registration Act 2000 (Vic), modelled on legislation regulating medical practitioners. CAM is being integrated into conventional medical (especially general) practice, and calls for the "mainstreaming" of CAM are increasing. Integrating CAM, however, involves a critical incoherence, well illustrated by the Victorian legislation. Clinical competence can only be properly assessed against standards established through scientific validation. If CAM systems, which purport to offer alternatives to science-based medicine, are regulated through conventional instruments, they may well be relinquishing the very identities which set them apart.

Australia↗
PubMed2000

[Control and assessment of the quality of professional competence among physicians and students].

The paper presents a new test method of control which permits to estimate objectively both formal knowledges of students, hospital physicians, post-graduates, physicians and their ability for logical reasoning, for determination of cause-effect relationships between separate phenomena. The list of the standards generally accepted for the test's tasks is proposed as well as recommendations for the users are given. 6 variations of the test's tasks are presented as the examples.

Education, Medical↗
PubMed1998

[How does professional competence develop?].

The reality of medical practice demands not only proficiency but also educational provisions, an aspect which traditionally has been given little attention in medicine. The competence of a general practitioner does not consist solely of professional knowledge and practical skills; it consists to a large extent of personal (intuition and creativity based on personal experience) and communicative elements, both of which are necessary in managing the unpredictable complexity and the many controversies of general practice. Such competence is difficult to develop outside the practice. By sharing the experience of actual consultations with experienced colleagues, and reflecting upon this experience within a small group, general practitioners will probably develop better professional judgement and increased awareness of their learning needs, as well as of their limitations and potential. This article discusses these topics using the authors' personal experiences in the continuous medical education effort which is based on reciprocal practice visits among a small group of experienced general practitioners.

Clinical Competence↗
PubMed1995

A supervisory model of professional competence: a joint service/education initiative.

This article is concerned with describing how a National Health Service (NHS) Hospital Trust teamed up with a College of Nursing and Midwifery to develop a model of clinical supervision. The article discusses definitions of clinical supervision, which were used as a basis for the development of the model; identifies the roles and responsibilities of clinical supervisors and describes the foundations of an integrated system of educational and professional development. The model aims to set standards for clinical competence which facilitate continuity in professional development throughout the practitioner's career. The collaboration between the two organisations has ensured that the model reflects the inter-relationship between theory and practice, thus enhancing both academic and professional development. The result is a comprehensive model for clinical supervision which encompasses key national initiatives in both professional and educational fields; in particular the United Kingdom Central Council (UKCC) requirements for continuing registration, maintenance of a portfolio of professional development, and continuing education (PREP) and the Ten Key Characteristics of the English National Board (ENB) Higher Award. It also encourages practitioners to demonstrate good practice through the requirement to articulate and enhance professional knowledge using a portfolio, along with a system of peer review and defined clinical competencies.

Clinical Competence↗
PubMed2005

Vocational analysis of health care professions as a basis for innovative curricular planning. An analysis and prognosis of the development of the professional competencies of midwives--cornerstones of innovative curricula in tertiary education.

This article describes current and future tendencies in the development of curriculum planning for health care professions in Germany, using the example of midwifery education. In particular, it discusses 'output-based control' of curriculum planning giving consideration to issues related to German education, health policies and professional educational theories with a view to the general international development. The results of this analysis constitute the starting point for the conceptual planning of a dissertation at the medical faculty of the Berlin Charité with the goal of developing a competency model for the curriculum planning of midwifery education, thus creating a modern curriculum as a basis for a fundamental reform of German midwifery education.

Competency-Based Education↗
PubMed1995

Professional competencies in the changing health care system: physicians' views on the importance and adequacy of formal training in medical school.

PURPOSE: To examine physicians' attitudes toward 16 competencies deemed essential to the effective practice of medicine in the changing health care system. METHOD: In early 1991 a telephone survey was conducted of 300 physicians from random samples selected as representative of the physician population in the continental United States. The physicians were categorized as general practitioners, surgery specialists, and other specialists, and as belonging to the graduation cohorts of 1960-1969, 1970-1979, and 1980-1989. The physicians were asked to rate (1) the importance of formal undergraduate training in each of 16 competencies and (2) the adequacy of their own undergraduate training in the competencies (these ratings are reported only for the 87 physicians in the 1980-1989 cohort). The competencies were derived from the skills, attitudes, and behaviors defined by the Pew Health Professions Commission as necessary for the nation's health care practitioners to meet society's evolving health care needs. RESULTS: Fifty percent or more of the physicians thought that 12 of the 16 competencies were "very important" to include in undergraduate training. Over 75% thought that it was "very important" to include the five competencies involving skills traditionally valued in medical practice: diagnosis and treatment, effective communication with patients, problem solving, lifelong learning, and counseling on medical ethics. More than 50% thought that undergraduate training was "very important" in some competencies that reflect the changing dynamics of medicine and care delivery over the past ten years: health promotion and preventive medicine, involvement of patient and family in care, management of large volumes of information, appropriate use of technology, working on a team with other professionals, and consideration of cost in clinical decision making. In rating their own training, over 50% felt well prepared (ratings of "excellent" or "good") in the five traditional competencies and, in addition, in their abilities to promote health, to manage large volumes of information, to work in teams, to understand and respond to diverse cultures, and to expand access to care. However, a majority felt that their training was only "fair" or "poor" regarding the involvement of patients and their families, evaluation of the appropriateness of costly technology, consideration of cost implications in their decision making, and understanding and supporting the community's role in health care. Forty percent or more felt poorly prepared to work in managed care settings or to accommodate increasing external scrutiny. CONCLUSION: The physicians validated the traditional strengths of medical schools, but revealed curricular weaknesses in the teaching of competencies proposed as important for the emerging health care system, especially in the managed care environment.

Attitude of Health Personnel↗
PubMed2004

Linking appraisal of PRHO professional competence of junior doctors to their education.

In the UK, new medical graduates are known as Pre-registration House Officers (PRHOs). Postgraduate Deans are responsible for the PRHO year and for the final certification of PRHOs to allow them to be fully registered by the GMC as medical practitioners. However, as much as appraisal of professional growth is central to PRHO training, they are in need of a robust assessment mechanism to detect, at an early stage, individuals with significant clinical and professional deficiencies. Documented, reliable and valid ongoing information on PRHO performance will provide information for early intervention and will establish 'hard' observable evidence, for certification decisions. Thus, an approach that links appraisal/assessment of professionalism and clinical skills to education is the way forward. This paper describes a new approach to appraisal/assessment of PRHOs, which is currently being piloted in a number of regions in Scotland. The conceptual paradigm was developed during the last three years as a proposal for a Scottish national PRHO reform. 'Grounded' qualitative studies were employed to explore trainees' and trainers' perceptions of the expected competences (outcomes) of PRHO performance for appraisal/assessment purpose. The GMC recommendations are reviewed in light of the study results. An assessment model emerged that links appraisal to education. PRHOs' cumulative performance is documented over one year of training resulting in diagnostic profiles that provide guidance for evaluation and training of PRHOs. Poor performers are flagged in the early stages of training, thus allowing early intervention. The feasibility and acceptance of the model by educators, the health system and PRHOs has yet to be established.

Education, Medical↗
PubMed2005

Assessing professional competence: from methods to programmes.

INTRODUCTION: We use a utility model to illustrate that, firstly, selecting an assessment method involves context-dependent compromises, and secondly, that assessment is not a measurement problem but an instructional design problem, comprising educational, implementation and resource aspects. In the model, assessment characteristics are differently weighted depending on the purpose and context of the assessment. EMPIRICAL AND THEORETICAL DEVELOPMENTS: Of the characteristics in the model, we focus on reliability, validity and educational impact and argue that they are not inherent qualities of any instrument. Reliability depends not on structuring or standardisation but on sampling. Key issues concerning validity are authenticity and integration of competencies. Assessment in medical education addresses complex competencies and thus requires quantitative and qualitative information from different sources as well as professional judgement. Adequate sampling across judges, instruments and contexts can ensure both validity and reliability. Despite recognition that assessment drives learning, this relationship has been little researched, possibly because of its strong context dependence. ASSESSMENT AS INSTRUCTIONAL DESIGN: When assessment should stimulate learning and requires adequate sampling, in authentic contexts, of the performance of complex competencies that cannot be broken down into simple parts, we need to make a shift from individual methods to an integral programme, intertwined with the education programme. Therefore, we need an instructional design perspective. IMPLICATIONS FOR DEVELOPMENT AND RESEARCH: Programmatic instructional design hinges on a careful description and motivation of choices, whose effectiveness should be measured against the intended outcomes. We should not evaluate individual methods, but provide evidence of the utility of the assessment programme as a whole.

Clinical Competence↗
PubMed2006

[Implications for professional development in nursing; focus based on professional competencies (II)].

To work with quality criteria is a demand Nursing care has, but one which requires recognition inside and outside the profession. The authors propose a focus based on competencies as a tool for continuous quality improvement. One area in this focus centers on the professional development for Nurses in the field of research and action which will permit one to enter in the spiral of continuing learning, establishing multiple connections.

Clinical Competence↗