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PubMed1997

Application of the problem-based learning model for continuing professional education: a continuing medical education program on managed care issues--Part II.

Physicians must incorporate concepts of practice management and knowledge of managed care into their practices. Managed care presents an immediate and challenging opportunity to providers of continuing medical education to offer effective educational programs for physicians on managed care issues. In this exploratory research, the problem-based learning model was used to develop a continuing medical education program that would offer an interactive and effective method for teaching physicians about managed care. Problem-based learning is a departure from the traditional lecture format of continuing medical education programs because it is designed for small groups of self-directed learners who are guided by a faculty facilitator. Although only a small number of participants participated in this program, the findings offer important considerations for providers of continuing medical education. For example, participants reported increased confidence in their knowledge about managed care issues. Participants also clearly indicated a preference for the small group, interactive format of the problem-based learning model.

Education, Medical, Continuing↗
PubMed1998

Testing a causal model of community-based education in the Sudan.

PURPOSE: To develop and test a model of community-based education. METHOD: In 1995, after developing a hypothesized causal model for community-based education, the authors collected data for 106 students at the University of Gezira, the Sudan, who had participated over three summers in an interdisciplinary field training research and rural development course. The students rated each other on leadership, interaction with the community, subject-matter contributions, and effort. Teaching staff assessed the readiness of the community to collaborate. The students' achievement was measured by short essays measuring knowledge, supervisors' assessments of the students' performances in the community, the community's observations of the students' activities, the community's satisfaction, and a group-produced report evaluated by faculty. The effect of the students' activities on the community was measured by comparing baseline and post-intervention community health data. The students also indicated their levels of interest in the community's problems. The authors analyzed the resulting covariances using structural-equations modeling. RESULTS: After minor adaptations, the model fitted the data reasonably well. The path coefficients were quite high, particularly among the peer ratings. Leadership had a potent effect on the outcome measures, as did, to a lesser extent, the readiness of the community to collaborate with the students. CONCLUSION: This study was the first reported attempt to test a model of community-based education. Although the fit of the data to the model in the study was reasonable, further study is needed to unearth additional important elements of community-based education. This article also discusses methodologic shortcomings of the present study, such as a possible "halo effect" in the peer ratings and the retrospective nature of many of the measurements.

Ambulatory Care Facilities↗
PubMed1996

Working from upstream to improve health care: the IHI interdisciplinary professional education collaborative.

BACKGROUND: Recognizing the need to find new models for educating health professionals, the Institute for Healthcare Improvement (IHI) initiated the Interdisciplinary Professional Education Collaborative in April 1994. The goal of the Collaborative is to improve health care by working from upstream, to address the health professions workforce changes demanded by the need to deliver better care at a lower cost. With support and advice from IHI and others, faculty leaders in health professions education from the disciplines of medicine, nursing, and health administration framed a vision of the future in which "health professions education has evolved into an integrated teaching/learning environment in which health professionals are working together across discipline boundaries, using the best knowledge for improvement to continuously improve health care". This article describes the first year of the three-year project. SUMMARY: The 1994-1995 pilot year of the Collaborative involved more than 60 learners and 50 faculty members, across multiple disciplines. At each of the four sites, education was integrated with efforts to improve health care delivery. Education-oriented outcomes include assessment of student learning (applied knowledge and skills) and program evaluation (student and faculty feedback on the effect of the project on community-based experiential learning sites). Even at this early stage, there is evidence of change in participating institutions. The Collaborative in now planning how to increase the number of students and faculty involved in such a way that a deeper understanding of how to prepare new health professionals to improve health care may be determined.

Academies and Institutes↗
PubMed2004

Clinical education of physiotherapy students in Australia: perceptions of current models.

The aim of this study was to seek opinions regarding the perceived advantages and disadvantages of the two main models of clinical education used in Australia. A questionnaire was designed specifically for this study and distributed to physiotherapists involved in clinical education at health units throughout Australia. There were 343 respondents (giving an approximate response rate of 74.5%). In most health units (78.4%) the model of clinical education currently used involves a number of physiotherapists sharing responsibility for the clinical education of students (SR model). Only a minority reported employing a designated clinical educator (DCE) to provide clinical education. Overall, respondents preferred the DCE model to the SR model. The perceived advantages of the DCE model included an increased time to devote to clinical education, improved consistency of supervision and decreased stress levels for staff.

Australia↗
PubMed1993

Health education poster: a teaching model for clinical medical students.

The teaching of health education or health promotion to medical students is often difficult because they have little experience on which to base their learning. They have limited clinical knowledge and in particular their awareness of the value of and the opportunities for health promotion in general practice is limited. The problem-oriented teaching method described here attempts to make the subject interesting and relevant by asking students, while in their practice attachments, to identify areas of need for health promotion or health education and then to prepare a poster, with supportive background and research, to satisfy that need for display in their given practice.

Education, Medical, Undergraduate↗
PubMed1997

Effectiveness of two models of brief family education: retention of gains by family members of adults with serious mental illness.

The retention of benefits from two models of family education was compared with maturational effects in an untreated control group. The three-month interventions showed an initial effect for self-efficacy regarding a mentally ill relative that did not significantly diminish during the following six months. However, no significant differences on this measure were found between the treated groups and the untreated controls. Ways of refining the interventions and measures so as to improve gains and retain them over time are discussed.

Adaptation, Psychological↗
PubMed2001

A rural service-learning model for health administration education.

Service learning for students in the health professions can best be described as an educational methodology based on the collaboration between an academic discipline and a community agency to link student learning with community-based service. This paper describes a service-learning model in rural and medically underserved communities used in a master in health administration program in a rural Southern state. It presents the process, components, outcomes, and challenges. Over the past five years, 56 students completed 116 experiences involving internships, field projects, or special projects in rural and medically underserved communities. A total of 27 percent of our graduates who completed rural and medically underserved experiences accepted job positions in rural health care entities. Strategies utilized by this rural service-learning model include interdisciplinary team training, partnerships among rural and medically underserved community health care entities and academic institutions, faculty-preceptor retreats, and involvement in local community initiatives. These experiences prepare future health administrators to contribute in a meaningful way toward building an effective rural health care delivery system.

Anecdotes as Topic↗
PubMed2003

Health education and multimedia learning: connecting theory and practice (Part 2).

Part 1 of this article reviewed the contributions of educational psychology to the early development of health behavior theory and the difficulties faced by health education in adopting some of the perspectives that today guide multimedia learning. Whereas Part 1 involved discussion at the theoretical level, the purpose of Part 2 is to connect theory and practice by describing the most relevant multimedia learning theories and by providing recommendations for developing multimedia health education programs. It also provides practitioners with specific examples of the features that may make computer-based interventions more attractive to their particular audiences.

Communication↗
PubMed1992

Incorporating explanatory models in planning nutrition education programmes in Thailand.

An intersectoral child development services project is being undertaken in Thailand to develop a model process for providing age appropriate care and education to rural children through an integrated programme of nutrition, health and educational services designed to meet community needs and perceptions. Using behavioral analysis and explanatory models, project results show that the effectiveness of nutrition education can be facilitated by (1) recognizing the family as the unit of service, (2) focusing on solutions rather than problems, (3) using a two-stage promotional message strategy to encourage better child caretaking, and (4) viewing potential new practices as behavioral processes, rather than single entities aimed at a specific outcome. Program planning should also include the successive construction and analysis of community-based explanatory models which justify people's nutrition and health behaviors. The ultimate aim is to identify differences between explanatory models held by community members and health/nutrition educators, negotiate this conflict, and thereafter develop more practical and realistic methods for modifying behavior.

Child↗
PubMed1993

The psychoeducational model of prepared childbirth education.

Prepared, childbirth education classes are designed to teach the expectant mother how to effectively cope with the childbirth experience through active participation, informed decision making, and noninvasive pain management skills. As knowledge and technology increase, it often becomes difficult for the childbirth educator to complete the important task of determining the essential content for each class. The childbirth educator can follow established guidelines for class content with a review the literature or structure the class to meet the needs of the participants. An approach used less often, but a powerful and effective one, is using a conceptual model as a framework for selecting the essential content for classes.

Curriculum↗
PubMed1999

[Connecting care models and trends in health education: grants for nursing education].

In this article the authors establish a connection between health care models and pedagogical trends considering their education and health care experiences in the hospital and in the communities and also the review of the literature. The pedagogical trends and health care models used by nurses in nursing education demonstrate their world view. Therefore it is important that they understand what is behind their practice so that nursing is in a political and historical context and its practice can foster the social transformation or keep the status quo. The purpose of this study is to contribute to the construction of nursing education.

Attitude of Health Personnel↗
PubMed2001

Models of psychiatric nursing education in developing African countries: a comparative study of Botswana and Nigeria.

BACKGROUND: Against the perspectives of the mental health needs of the people of Africa, this study explored and compared the models of psychiatric-mental health nursing education (PMHNE) in two sub-Saharan African countries--Botswana and Nigeria. METHOD: Examination of the existing PMHNE programmes and responses to a self-reporting questionnaire administered to psychiatric nurse educators from Botswana and Nigeria provided the sources of data. FINDINGS: Findings from both countries revealed that participants used various terms to describe the same model for PMHNE programmes in the countries. Botswana adopted a more functional generalist basic diploma nursing education approach that encouraged an advanced postbasic diploma specialization and practice in community psychiatric-mental health nursing. Nigeria's model leaned towards a hospital-based basic specialization with no defined role for the generalist nurse within the psychiatric-mental health nursing care system. Although community theme occurred in both countries' curricula, PMHNE in Botswana appeared to be more geared towards the community than in Nigeria. While PMHNE and nursing education generally is affiliated to the University with a clear pathway within the formal higher education system in Botswana, basic and postbasic nursing programmes are mostly run independent of the country's formal higher education system in Nigeria. CONCLUSION: A model that streamlined PMHNE within the general system of education in both countries was proposed. It was stressed that one key concept that must underlie the development of PMHNE in the two countries, and Africa in general, was the need to create a psychiatric-mental health nursing education programme and role that would be appropriate for people's mental health needs and the provision of quality nursing care.

Adult↗
PubMedDate not supplied

Concept maps as an assessment tool in a nursing course.

A concept map can be thought of as a scheme representing visual knowledge in the form of a hierarchical graphic network composed of nodes and links. In the complex health environment, it is very important for nursing educators to cultivate in nursing students thinking and judgment skills. Concept mapping is an instructional strategy that requires learners to identify, graphically display, and link key concepts by organizing and analyzing information. Concept maps can be successfully used to teach conceptual thinking, thus increasing students' competence in critical thinking in the modern paradigm. The purpose of this study was to implement concept mapping as a learning strategy in a nursing course and to evaluate students' learning progress through the construction of concept maps based on scenarios. Forty-three students, who had enrolled in a 2-year nursing program and took Nursing I in the fall semester of 2002, were invited to participate in this study, which was approved by the institutional research committee. Written informed consent was obtained from all the students. The class met for 4 hours, once a week, for 16 weeks. Participants were divided into seven groups, and during the course, they were required to complete six concept maps, five of which dealt with physical functions, including activity and rest, fluids and electrolytes, neuroendocrines, sensory-perception, and sexuality. The last map dealt with role functions. All the first drafts of the concept maps received low scores, but the third and following drafts made by all the teams showed improvement. The results of this study indicated that the students developed their concept maps from a linear sequence of concepts at the beginning into a highly integrated web of concepts in the final draft. In this study, despite complaints about the heavy workload and time consumption, the students acquired problem-solving and critical-thinking skills by organizing complex patient data, analyzing concept relationships, and identifying interventions.

Attitude of Health Personnel↗
PubMed1999

[Qualitative methods in the planning and designing of teaching units in the nursing profession].

New teaching methods for the continuing education need to be developed in order to further professionalize nursing. Favoring qualitative procedures in teaching units of the planning and structure of nursing help make subjective theories that influence happenings in nursing more transparent. The aim of practical-oriented teaching units in nursing is to influence nursing according to the new nursing paradigm.

Clinical Competence↗
PubMed1980

Nutrition-education research: an interdisciplinary evaluation and review.

An interdisciplinary evaluation approach was developed to analyze and compare school nutrition education programs systematically. Theoretical models from education, preventive medicine, health education and statistical evaluation were applied to 22 studies published between 1968 and 1978 to judge program impact on nutrition knowledge, behavior, and attitudes. Six studies reported XS and SDs for control and experimental groups. Effect sizes, showing average treatment effect in standard deviation units, were calculated for those six studies. It can be concluded that the more interdisciplinary criteria a study fulfills, the more likely it is to influence knowledge, behavior, and attitudes.

Adolescent↗
PubMed2001

[Polish Multicenter Study on Diabetes Epidemiology (PMSDE)--1998-2000].

Diabetes mellitus is a growing health problem at all ages in all countries. The Saint Vincent Declaration signed by the representatives of all European countries--among them by Poland--indicated the main goals to reduce this burden. This may be achieved by elaboration and initiation of the nation-wide programme for early detection and control of diabetes on the population level. The Polish Task Force for Diabetes Management worked out and put into operation in 1998 the project commissioned by the Ministry of Health funded by the Polish State Committee for Research (PBZ-018-11). The urgent need for the implementation of this programme was a result of the increasing number of diabetic patients on the primary health care level, diabetic complications and hospitalisations. The programme was based on the assumption that primary and secondary prevention of NIDDM may eliminate or reduce its risk factors and therefore decrease its prevalence and morbidity and should integrate epidemiology, identification of risk factors, education, intervention models and economics of diabetes. This issue of the Polish Archives of Internal Medicine contains the main results of the programme and reflects an actual situation of diabetes in Poland creating a rational basis for intervention on the population level. Evaluation of the incidence rate of the diabetes type 1 in 10 selected areas (population basis 30% of age group 0-29) revealed values from 8.4 to 14.7/100,000 in the age group 1-14 and from 4.4 to 11.2/100,000 in the age group 15-29. It accounts for the 2-3 fold increase in comparison with the results achieved in 1986 (Z. Szybinski). However an ascertainment of the register in the age group 15-29 dropped down during the last 10 years and additional sources of data must be involved in the survey. Prevalence of diabetes type 2 in 3 selected areas Krakow 10.77% (M. Szurkowska), Lublin 15.6% (J. Łopatynski) and Łódź 15.7% (J. Drzewoski) based on the population random sample over 35 years of age, constitutes over 90% of all patients with diabetes. When standardized to the Polish population the prevalence of diabetes type 2 accounts for 5.37% and reflects a true endemic state. With comparison to a similar survey carried out in 1986 in Wrocław the prevalence 3.71% of the diabetes type 2 increased 2-3 times. It allowed to calculate an actual number of patients with diabetes type 2--over 2 million and around 50% of them represents "unknown" diabetes. Such high contribution of the unknown non-diagnosed diabetes has been confirmed in the survey carried out in Poznań on the non-randomized professional group of persons (B. Wierusz-Wysocka) in investigation on the first-degree relatives of patients with known diabetes in Warsaw (T. Kasperska-Czyzyk) and in Wroclaw (R. Wasikowa). This raises the question about the criteria of diagnosis for unknown diabetes. Comparative analysis carried out in Krakow revealed that fasting glycemia 7.0 mmol/L allowed to diagnose diabetes with 50% with respect to the 2 hours oral glucose tolerance test (WHO 1985) and shouldn't be use as a tool for early diagnosis of diabetes type 2 (Z. Szybinski, M. Szurkowska) Identification of the risk factors in PMSDE for diabetes type 2 allowed to introduce the term "global risk factors", divided into two groups primary (obesity, age, pregnancy and genetic background) and secondary (hyperinsulinemia, hyperglycemia, dyslipidemia and hypertension). In the multifactor analysis obesity and hyperinsulinemia are the strongest predictors and modifiable risk factors of the development of diabetes type 2 and late complications. Especially hyperinsulinemia as an independent secondary risk factor for hypertension, dyslipidemia--in consequences late diabetic complications and perhaps carcinogenesis may play an important role as a predictor of diabetes type 2 and biochemical marker of effectiveness of non-pharmacological and pharmacological approach in the global concept of diabetes type 2 treatment (Z. Szybinski). Analysis of the late complications of diabetes were focussed on visual disability and lower extremity amputation due to diabetic foot development. Analysis of prevalence (PR) of visual disability due to diabetes in Krakow (J. Pantoflinski) and Olsztyn (E. Bandurska-Stankiewicz) revealed similar values, in the both areas around 6% of general visual disability in population. Monitoring of the visual disability in diabetic patients seems to be a good indicator of the quality level of the diabetic care. Analysis of the lower extremity amputation carried out in Krakow district (A. Nazim) revealed that incidence rate of amputation in diabetics was 15 times higher than in non-diabetics and in 10.8% of cases amputation was performed in unknown diabetes type 2. The preventive measures and non-pharmacological and pharmacological management approximately in diabetes should be solved with education based on the separate post of a diabetic educator within a diabetic team and on the primary health care level. The articles presenting elaborated educational model in diabetes are published in "Diabetologia Polska" (A. Czyzyk). Intervention model was tested in Krakow in the groups of obese patients with newly diagnosed "unknown" diabetes and was based on the 12 weeks supervised dietician education with standardized physical activity programme. In obese diabetic patients the weight loss less than 10% of the initial body weight can markedly improve biochemical parameters like hyperglycemia dyslipidemia and hyperinsulinemia without pharmacological therapy and 45% of patients has been transferred to the group of Impaired Glucose Tolerance (A. Gilis-Januszewska). Another model of intervention may be applied in menopausal women (J. Nadel, K. Cypryk) treated with hormonal replacement therapy as a complementary factor to education and if necessary to anti-diabetic drugs. Increase number of diabetic patients especially of the "unknown" type 2 has serious economic aspect by increasing a burden of patients, theirs families, society and health care system. Within PMSDE programme elaboration of the model for calculation the direct costs about of diabetes and burden in terms of years of life lost using DALY measure was performed (K. Kissimova-Skarbek). Average diabetes type 1 patients costs 7 times and type 2 over 3 times higher than average health care cost and 95% of total time lost due to disability is caused by diabetes type 2. Therefor primary and secondary prevention of diabetes typ 2 have highest priority among strategic preventive targets. The Review Conference held in Warsaw at 24-25 February 2001 in the presence of WHO Experts formulated the recommendations focused on: 1. Elaboration of high risk strategy for early diagnosis of unknown diabetes type 2 based on the 2-hours OGTT (WHO 1985) 2. Continuation of the epidemiologic study in diabetes 3. Instituting the professional post for diabetes educator on the specialized and primary health care levels. 4. Further research are recommended for evaluation of the role of fasting glycemia and hyperinsulinemia as predictors and risk factors of diabetes type 2, for development of preventive models in diabetes type 2 and for development of the economical models to asses the costs of diabetes (Recommendations).

Adult↗