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PubMed2006

Promoting minority access to health careers through health profession-public school partnerships: a review of the literature.

Partnerships between health profession schools and public schools provide a framework for developing comprehensive, creative solutions to the problem of minority underrepresentation in health careers. This review examines the functioning of partner relationships, focusing on elements of the social context that determine success or failure, and stages of partnership development. Influential aspects of the social context include cultural differences between personnel in higher education and K-12 institutions, the resources available to the partnership, and constraints on partnership activity. Stages of the process that partner institutions must negotiate include initiation, ongoing management, and institutionalization. Strategies to improve minority student achievement are reviewed, including specific types of programmatic interventions and best practices. Strategies available to partnerships for improving minority achievement include academic enhancement, science or math instructional enrichment, career awareness and motivation, mentoring, research apprenticeship, reward incentives, and parental involvement. Of these, academic enhancement and instructional enrichment have the greatest potential for improving minority student outcomes. Partnerships need to take a sustained multipronged approach, providing intensive interventions that target students, teachers, and curricula at appropriate educational stages. Documenting program impact is critical for attracting more resources to increase minority access to health careers: sponsoring organizations should dedicate funds for assessment of the partnership's functioning and for rigorous evaluation of interventions.

Health Occupations↗
PubMed1979

Graduate education in family practice: a ten-year review.

Assessment of the progress of graduate education in family practice after ten years shows that the original goals established for residency training in this specialty are being effectively met. There are now more than 360 approved family practice residencies in the United States with over 6,000 residents in training. Student interest in these programs has remained at a high level, and attrition has been low. Graduates of these programs have favored partnership and group family practice, and are well distributed in rural, suburban, and metropolitan areas. Heavy emphasis has been placed upon quality control mechanisms for both internal and external review of family practice residency programs. This paper outlines some concerns regarding the present status of family practice residencies, and suggests some directions for future development of these programs.

Curriculum↗
PubMed2000

Bridging the gap. Community partnerships in nursing education: advancing primary health care in practice.

An innovative approach to nursing education was piloted by the School of Nursing at Flinders University and Noarlunga Health Services, a generic community health service, in Adelaide, South Australia. The approach, encapsulated in the four-year Community Enrichment Project (CEP), focused on Primary Health Care (PHC) and nursing practice. The CEP developed curriculum and organised student placements, which promoted understanding of PHC in a way that integrated acute and community sectors. This paper considers the impact of splitting the students' third year final practicum, of seven weeks, between acute and community placements. Integral to the overall outcome of the project was the community agencies' cooperation in accepting students for longer clinical placements than had previously been the norm. This resulted in students being engaged in activities and projects in diverse areas. The students were aided in linking PHC theory to practice by the CEP team members who mentored them throughout these placements. Outcomes demonstrated the ability of students to integrate PHC theory to practice, across a variety of health settings. Students moved from a position of little knowledge or understanding of PHC, to an integrated knowledge of PHC principles and the relationship to enhanced nursing practice.

Attitude of Health Personnel↗
PubMed2004

Introducing operations research into management and policy practices of a non-governmental organization (NGO): a partnership between an Indian leprosy NGO and an international academic institution.

This paper reports on a partnership between LEPRA, a non-governmental organization (NGO), and the London School of Hygiene and Tropical Medicine (LSHTM) to explore the feasibility and appropriateness of incorporating operations research into the management and decision-making of a leprosy NGO. A pilot study in Orissa was used to determine the advantages and disadvantages of introducing operations research to assist in decision-making and programme implementation within the organization. The results highlight the difficulty and complexity of the process, but point to several important themes: partnership, changing perspectives, use of time and priority-setting, identification of gaps in systems, and building institutional and personal capabilities. The results of the study provide support to encourage NGOs to become actively involved in research. Because of their work and service to local communities, NGOs have the opportunity to collect information about the perceptions, resources and constraints of individuals, families and the communities themselves in accessing appropriate care. Their proximity to communities gives them a feeling of responsibility for ensuring that this information is translated to the district, national and ultimately international level. This will help to ensure the creation of appropriate infectious disease control policies that support the needs of patients. 'Outside' academic institutions can help NGOs to facilitate this up-stream flow of information from the local to the national and international level, to help to ensure that international disease control policies are appropriately serving local communities.

Communicable Disease Control↗
PubMed1999

Assessing immunization performance of private practitioners in Maine: impact of the assessment, feedback, incentives, and exchange strategy.

INTRODUCTION: A provider-based vaccination strategy that has strong supportive evidence of efficacy at raising immunization coverage level is known as Assessment, Feedback, Incentives, and Exchange. The Maine Immunization Program, and the Maine Chapter of the American Academy of Pediatrics collaborated on the implementation and evaluation of this strategy among private providers. METHODS: Between November 1994 and June 1996, the Maine Immunization Program conducted baseline immunization assessments of all private practices administering childhood vaccines to children 24 to 35 months of age. Coverage level assessments were conducted using the Clinic Assessment Software Application. Follow-up assessments were among the largest practices, delivering 80% of all vaccines. RESULTS: Of the 231 practices, 58 were pediatric and 149 were family practices. The median up-to-date vaccination coverages among all providers for 3 doses of diphtheria-tetanus-pertussis vaccine and 2 doses of oral polio vaccine, and 4 doses of diphtheria-tetanus-pertussis vaccine, 3 doses of oral polio vaccine, and 1 dose of measles-mumps-rubella vaccine at age 12 and 24 months were 90% and 78%, respectively, and did not vary by number of providers in a practice or by specialty. Urban practices had higher coverage than rural practices at 12 months (92% vs 88%). The median up-to-date coverage for 4 doses of diphtheria-tetanus-pertussis vaccine, 3 doses of oral polio vaccine, and 1 dose of measles-mumps-rubella vaccine at 24 months of age improved significantly among those practices assessed 1 year later (from 78% at baseline to 87% at the second assessment). On average, the assessments required 21/2 person-days of effort. CONCLUSIONS: We document the feasibility and impact of a public/private partnership to improve immunization delivery on a statewide basis. IMPLICATIONS: Other states should consider using public/private partnerships to conduct private practice assessments. More cost-effective methods of assessing immunization coverage levels in private practices are needed.

Child↗
PubMedDate not supplied

A nursing partnership: the forces of magnetism guiding evidence-based practice in the Republic of Armenia.

A team of nurses at North Shore University Hospital in Manhasset, New York, has been participating in a global collaboration with nurses at Erebouni Medical Center in Yerevan, Armenia. During this collaboration, they have built on work initiated by representatives of the American International Health Alliance and the American Nurses Credentialing Center (ANCC) to develop application of evidence-based practice in the Armenian nurse's work environment. Their collective efforts have resulted in initiating nursing assessments and plans of care, position descriptions and performance appraisals, competency assessment tools, and performance improvement tools. Overall, the respect for nurses at Erebouni Medical Center has significantly improved. In October 2004, nurses at Erebouni Medical Center were recognized by the ANCC with the Journey to Nursing Excellence Award.

Armenia↗
PubMed1994

[Female dentists. Style of their professional practice].

In many Western countries during the past decades there has been a strong increase in the number of women dentists. This review on current literature shows that women dentists differ from their male colleagues in their way of practising the profession. More so than men they prefer to work in a group practice or in some kind of partnership. Women dentists also appear to have relatively smaller practices than their male colleagues and on average they practise fewer hours per week. However, it is important to notice that for women dentists motherhood is an important restricting factor with regard to practising their profession, often resulting in career break and diminishing professional productivity. Because of the strong increase in the percentage of women dentists, it is important for future policies to recognise their specific issues and concerns, as well as the consequences for dentistry of their way of practising. Thus, planning of manpower and infrastructure of dentistry can be done in a more adequate way.

Dental Care↗
PubMedDate not supplied

Professional learning partnerships: a collaboration between education and service.

Escalating mental health care needs coupled with a decreasing nurse labor force demand a fundamental paradigm shift in undergraduate education and service partnerships among psychiatric-mental health nursing students and practicing nurses. The purpose of this two-group comparative study was to identify factors that contribute to a successful learning partnership between nursing students and practicing nurses engaged in a clinical specialty partnership program within an acute psychiatric-mental health setting. The convenience sample consisted of 51 partners: 33 undergraduate students and 18 practicing nurses. The Learning Partnership Survey was administered to all partners allowing comparison of ranking among factors important to the partner relationship. Contrary to previous research, student and nurse partners were more similar in their factor ranking in the present study. Statistically significant differences were noted in the ranking of 2 of the 15 factors that fostered successful learning partnerships. Implications for professional learning partnerships between nursing academia and service institutions are discussed.

Acute Disease↗
PubMed2002

Learning to plan? A critical fiction about the facilitation of professional and practice development plans in primary care.

A shift from continuing medical education towards professional and organisational development policies, coupled with the introduction of accountability frameworks (clinical governance), has generated interest in professional and practice development plans (PPDPs) in general practice. The problems of implementing this change in an independent contractor-based service remain unexplored and the aims of this study were to focus on the facilitator's experience of the issues that hampered or fostered development in general practice. Facilitators of PPDPs were asked to document their experience of supporting 12 practices in an all Wales feasibility study. In order to maintain organisational anonymity while reporting accurate accounts of the obstacles encountered, a method known as critical fiction was employed. This method allowed the authors to write detailed reflective accounts that were then fictionalised. The culture of general practice reflects the development of an independent contractor service that has developed into partnerships that employ some professionals (practice nurses, managers and administrative staff) and collaborate with others in variable arrangements (community nurses, health visitors, midwives and others). Developing organisation-wide systems in so-called 'primary health care teams' is a difficult exercise, given the ethos of autonomous decision-making processes and the lack of experience of 'whole systems' approaches in primary care. The potential for multiprofessional synergy and the evidence that systematic changes lead to sustained health care improvements are well established. But the implementation issues of these concepts have not been addressed. Existing educational policies are based in uniprofessional paradigms and the protected time requirements and funding streams required for PPDPs have not been clarified.

Attitude of Health Personnel↗
PubMedDate not supplied

Agenda for children and youth: linking research, policy, and practice.

ISSUES AND PURPOSE: In this past century, we have made significant strides in our understanding of children's needs, but there is still much to learn as we enter the coming century. We must seek this new knowledge not only for the sake of knowing, but also for the sake of making change, ensuring that what we learn helps improve the future for our children and youth. These efforts require a strong link between policy, practice, and research. CONCLUSIONS: Research partnerships can build our base of knowledge and help answer emerging policy and practice questions. Through research that focuses on the diversity and developmental phases of children, we can bring policy and practice into line with an increasingly refined understanding of children and their needs. PRACTICE IMPLICATIONS: Because nurses look at the holistic needs of individuals, it is critical that they are involved in setting the social service research agenda and seeking ways that policy and practice can both inform and be informed by this research.

Adolescent↗
PubMed1975

General practitioners and social help for the handicapped.

A study was undertaken by the Greater London Association for the Disabled in consultation with the Royal College of General Practitioners, to explore the depth of knowledge of the Chronically Sick and Disabled Persons Act and statutory and voluntary social provision, of 22 general practitioners in 16 practices served by one area social services office in a London borough.The doctors were mainly middle-aged, of British or Irish birth and training and had no language barrier. The majority lived in or near their practices. Half the practices were groups or partnerships, half were singlehanded. Only in three groups was there any attached district nursing staff and in only one was there an attached health visitor. More than half the general practitioners had reception staff only during surgery hours. Four practices had no reception staff during National Health Service surgery hours, two of which had no reception staff at all. In no practice was there any privately employed nursing staff. All the practices had private patients.Nine of the 22 doctors in the study had never heard of the Chronically Sick and Disabled Persons Act, and a further five had not mentioned the Act to their patients. Fifty per cent had no knowledge of the extent of functional disability in their practice. More than half the doctors knew no more of the social services than that home helps and meals-on-wheels were available, while six doctors knew of no provision at all. Knowledge and use of the voluntary services was almost non-existent. No meetings with team members were held, other than in the group practices with attached staff, and the team members were largely unknown to most of the doctors.Attempts were made through various channels to extend the knowledge of the general practitioners of the services provided by both statutory and voluntary agencies, and to introduce them and their receptionists to their team, but little use was made of the opportunity.

Adolescent↗
PubMed2002

Morale among general practitioners: qualitative study exploring relations between partnership arrangements, personal style, and workload.

OBJECTIVES: To explore general practitioners' experiences of wellbeing and distress at work, to identify their perceptions of the causes of and solutions to distress, and to draw out implications for improving morale in general practice. DESIGN: Three stage qualitative study consisting of one to one unstructured interviews, one to one guided interviews, and focus groups. SETTING: Fife, Lothian, and the Borders, South East Scotland. PARTICIPANTS: 63 general practitioner principals. RESULTS: Morale of general practitioners was explained by the complex interrelations between factors. Three key factors were identified: workload, personal style, and practice arrangements. Workload was commonly identified as a cause of low morale, but partnership arrangements were also a key mediating variable between increasing workload and external changes in general practice on the one hand and individual responses to these changes on the other. Integrated interventions at personal, partnership, and practice levels were seen to make considerable contributions to improving morale. Effective partnerships helped individuals to manage workload, but increasing workload was also seen to take away time and opportunities for practices to manage change and to build supportive and effective working environments. CONCLUSIONS: Solutions to the problem of low morale need integrated initiatives at individual, partnership, practice, and policy levels. Improving partnership arrangements is a key intervention, and rigorous action research is needed to evaluate different approaches.

Attitude of Health Personnel↗
PubMed1992

Nursing care partnerships at the Denver Nursing Project in Human Caring: an application and extension of caring theory in practice.

Jean Watson's theory of nursing as the art and science of human caring provides the framework for practice at the Denver Nursing Project in Human Caring, a nurse-managed center for people living with HIV/AIDS. The purpose of this article is to describe the development, implementation, and evaluation of a new model of nursing practice at the Caring Center, called nursing care partnerships. Client and nurse narrative accounts are presented as a means of grounding the reader in the care partners' relationships that are formed during the journey of HIV/AIDS.

Ambulatory Care↗
PubMed1995

Working in partnership with people who use services; reaffirming the foundations of practice for Mental Health Nursing.

This paper reports on work produced by a Government Review of Mental Health Nursing in England conducted in 1993/4. The Review reported to the British Government in January 1994 and offered 42 recommendations for their consideration. At the heart of the Review Report was a determination that patients, carers and all people who use services should be engaged in a new partnership with nurses in the delivery of care. Within the 42 recommendations there are a number which relate particularly to developing this partnership. This paper discusses these recommendations and the issues which surround them.

Civil Rights↗
PubMed1996

Social work practice in health care: looking to the future with a different lens.

Social work practice in health care must change to better meet the needs of individuals and their families as the system of care changes from an acute care focus to a community based focus and as individuals seek more active participation in their own care decisions. Practitioners and educators must renew their partnership to create a practice based on the needs of individuals to move most effectively through a more complex system of care and back home again. A paradigmatic shift can redefine social work in health care for the future. Renewed leadership with vision is required.

Community Health Services↗
PubMed2004

Virtual interactive practice: utilizing healthcare information systems to contextualize the skills associated with clinical decision making within nurse education.

This paper reports on a Virtual Interactive Practice (VIP) project that has the potential to revolutionise the educational delivery and learning of clinical skills complementing "real" practice. The focus is currently on nurse learning but the principles could equally be applied to multi and inter-professional learning and clinical decision-making. This project represents a new model to enhance clinical skill acquisition and clinical reasoning using a structured competency base. Integral to this is a strong partnership between education and practice utilising "real" live and recorded anonymised patient data from a critical care clinical information system (CIS) within a large district general hospital to structure scenarios fostering problem-based learning. This educational practice interface enables the synthesis of clinical data using virtual technology and sophisticated scenario-based simulation within a skills laboratory. The aim is to enhance the more ad hoc system of learning within conventional practice placements. Early findings suggest that VIP enhances practice providing a safe but challenging learning experience with the benefit of instant performance feedback to students.

Clinical Competence↗
PubMedDate not supplied

The shadowing experience: valuing the link between faculty practice and student learning.

Nurse faculty members, engaged in active, clinical practice roles, can enhance student learning through a shadowing experience. A shadowing, or observational, experience was designed by the writer to enhance undergraduate student learning, contribute to student socialization to the profession, and assist students to develop career goals. The shadowing experience linked an undergraduate student with the faculty member in a learning partnership in an advanced practice clinical setting. Fifteen undergraduate nursing students participated in a pilot shadowing experience with a faculty member in her private practice. Both the students and faculty reported that the experience was mutually rewarding. Students reported they were able to learn new information, apply theory from the classroom, and develop interest in graduate school. The shadowing experience provided the faculty member with an opportunity to show the value of her clinical practice within a traditional academic environment. The value of the shadowing experience for the faculty member can be enhanced by formal mechanisms that support faculty clinical practice work.

Clinical Competence↗