Patient education. IV. Evaluating patient education programs.
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During the 1996-1997 academic year, the State University of New York Health Science Center at Brooklyn, in partnership with North Central Bronx Hospital, implemented the first direct entry (DE) midwifery education program to be preaccredited by the American College of Nurse-Midwives. Five DE midwifery students were admitted and graduated. During their one-year course of studies, these students were provided supplementary didactic and clinical instruction in the medical sciences and basic health skills in addition to the identical course of midwifery studies offered to their registered nurse-student peers. The experience of students and faculty during this first year was that there was no significant difference in academic performance between the DE and nurse-midwifery students. Moreover, once oriented to the clinical environment, DE students progressed through the clinical practicums, and acquired entry-level midwifery skills, at a pace equivalent to that of their nurse peers and consonant with all expectations of safe practice. In addition, the Basic Health Skills and Integrated Medical Science course offerings served as effective instructional supplements to the curriculum by providing DE students with an opportunity to equalize their knowledge base with that previously acquired by registered nurse-prepared students; an unanticipated discovery was that some nurse-midwifery students could equally benefit from enrollment in these courses.
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Of all the problems experienced by children with learning disabilities, a language disorder may be the most detrimental to school performance. Because the problems of a child with a language disorder are frequently not recognized until he begins school, it is important that the educational clinician, teacher, related professional, and parents understand what a central auditory disorder is, that it may manifest itself as language disorder, and the way it can academically and emotionally affect a child. Evaluation and identification of a child with a central auditory disorder is vital at an early stage of development; however, testing, while it appears simple, is an extremely complex process and is not always exact. Therefore, the educational clinician must be skilled and understand the frailties which exist in the test instrument and the testing situation. It must be remembered, also, that testing in only part of the diagnostic procedure. Organized, perceptive classroom observations are essential. These must be followed by multidisciplinary meetings that generate remedial procedures and directions to be taken by parents and teachers. Finally, parents must be accepted by professionals as reasonable, concerned, and able to offer knowledgeable insight into their child's learning problems. If a language disorder is suspected, professional help should be sought immediately. Truth is better than fiction or fantasy in helping a child become a happy, adjusted, productive human being.
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Prenatal classes are commonly offered by hospitals with obstetrical units. To evaluate their effectiveness in one hospital, the relationship between the amount of medication used by women during labor and the birth weight of their infants following participation in one of three treatment groups was determined by a multivariate nonorthogonal analysis of covariance design. Women who attended a prenatal class program, it was found, required significantly less medication during labor than women exposed to other structured programs during pregnancy. There were no significant differences in birth weights among the infants born to women in the study. These findings, consistent regardless of age, race, and parity, suggest the value of prenatal education in reducing levels of medication required by women during labor.
The need for clinical pharmacology as an integral part of medical training is emphasized. The lack of a formal system of educating candidates in this discipline in a small country with limited means of personnel and funds has to be compensated for by close cooperation among practicing physicians, clinical pharmacologists in universities and some hospitals, industry technologists, and the personnel serving on national drug regulation committees. The system of drug regulation in Denmark and its tangential contribution to educating the younger clinical pharmacologists are described. The efficiency as well as the limitations of the system are assessed.
Using the Cervero model of behavior change and questionnaires developed by Brigham, Ryan, and Elkins (1996), this study assessed the impact of a workshop on behavior change. Data on the individual professional (receptiveness), proposed change (feasibility), social system (climate), and program (quality), as well as self-report data about outcomes (expertise and actions) were included. Information on perceived expertise was obtained before the workshop, immediately after the workshop, and 3 months after the workshop. Information on actions initiated by the participants was obtained 3 months after the workshop. There were 70 participants in this study, with a variety of educational backgrounds and nursing experience. A matched test comparing expertise between time 1 and time 2, as well as time 1 and time 3 was significant at p = 0.00. There were significant correlations among the four variables influencing behavior change and actions and expertise. All except one participant in the study reported taking specific actions after the workshop. The mean number of actions taken was 4.0, with a range from 1 to 9. These findings indicate that a continuing education program can lead to behavior change.
BACKGROUND: This study describes the development of a required 1-week curricular program in geriatric medicine for 3rd-year medical students and presents 3 years of evaluation data. DESCRIPTION: Successful aging, heterogeneity of the aging population, and comprehensive geriatric assessment were emphasized. In addition to didactic sessions, students participated in panel discussions and small group case conferences, and performed history and physical examinations on older patients. EVALUATION: Students' acquisition of knowledge about geriatric medicine was assessed with pre-and posttests; posttest scores showed statistically significant improvement. Because attitudes toward older patients can impact the care provided, students' completed pre- and postattitude assessment scales. Attitude measures were repeated for 2 student cohorts, 1 and 2 years after completion of the program. Independent t tests comparing mean pretest and posttest scores revealed significant improvement in students' attitudes, which were maintained when attitudes were retested. Standardized mean difference scores were computed to measure the relationship between the educational intervention and students' attitude measures. CONCLUSIONS: Time in the medical school curriculum is scarce, but these results indicate that significant improvements can be made in medical students' attitudes toward and knowledge of older patients in 1 week.
Preoperative teaching is an important part of patient care and can prevent complications, as well as promote patient fulfillment during hospitalization. A study was conducted at Alton Ochsner Medical Foundation in New Orleans, LA, in 1989, to determine the impact of a preoperative teaching program on the incidence of postoperative atelectasis and patient satisfaction. Results showed no significant difference of postoperative complications and patient gratification after participating in a structured preoperative teaching program. As part of this study, it was identified that a patient evaluation tool for a preoperative teaching class needed to be developed. The phases of this process are explained in the following article.
Experiences of students using optically scanned cards were compared with those of students using personal digital assistants (PDAs) to log patient encounters in a primary care clerkship. From April to September 2001, students were offered the option of using a PDA in lieu of scanned cards to track clinical encounters. Data obtained from PDA users were compared with those previously obtained from scanned card users. Verbal and written feedback was obtained from all students. Of the 71 students invited to participate, 21 (30%) owned a PDA, and of these, 20 agreed to participate. Eighteen students completed the pilot. One student was unable to participate owing to software installation problems; another student lost data because of improper back-up. Students using the PDAs recorded more encounters per rotation and had fewer missing data when compared with students who used scanned card. Additionally, feedback from students suggested that PDAs offered other important educational benefits.