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Continuing medical education by satellite: implications for oncology education.

The need for rapid dissemination of medical information is linked with the requirement for training and career grade doctors to be up-to-date with their knowledge. Over 220 sites in Europe receive EuroTransMed oncology programmes, during the academic terms. The non-profit foundation brings together expert panels, providing the latest evidence for best practice. Viewers are able to interact during the programme with the panel members using phone, fax, ISDN and e-mail. Increasing use of telematics has helped in the development of this important quality learning initiative for doctors in Europe, and addressed the continuing education need of oncology health professionals.

Benchmarking↗

Sexuality during the climacteric.

Menopause is a time of psychologic adjustment as well as of physical change. Its effects are closely related to sexuality, a neglected aspect. Sexual desire may increase, decrease, or remain the same, but the general pattern is one of declining sexual interest and activity with increasing age. The male climacteric is considered a time of decreasing sexual activity and capability, lowered self-esteem, and declining energy. Physical symptoms are milder than in women, and the process if more gradual. Health care professionals involved with menopausal patients should provide factual information and give supportive guidance which will permit women to continue to develop their full sexual potential.

Aged↗

Twelve tips for potential distance learners.

Distance learning courses are becoming popular among medical professionals due to their flexibility, allowing minimal disruption to personal and professional commitments. The ability to continue professional duties, allied to the reduced cost of distance learning courses, also makes them attractive to institutions looking to develop the skills of their staff. However the nature of distance learning courses means that they are often of long duration and many students fail to maintain motivation while working in isolation. This is reflected by high non-completion rates. This article outlines issues that all students planning a distance learning course should consider, relating to choice of course, time management, funding and adjusting to the different nature of distance learning. The authors advise developing a support network for distance learning students, either in person or electronically, to increase motivation and completion.

Journal Article↗

Cost effective clinical engineering internships in community hospitals.

A cooperative Clinical Engineering Internship Program has been developed jointly by California State University, Sacramento, and Sutter Community Hospital of Sacramento, California. The program, in existence since 1972, was developed and continues to operate on a cost-effective basis. The hospital has benefitted through the utilization of skilled professional personnel (interns), and the university has benefitted from the availability of a clinical engineering "laboratory" for experiential training.

Biomedical Engineering↗

Accountability and competence: occupational therapy practitioner perceptions.

OBJECTIVE: Occupational therapy practitioners must meet ever-increasing accountability demands in all service delivery environments. Accountability is made possible through the ongoing development of continued competence throughout a practitioner's career. Behaviors that demonstrate accountability and reflect competence include commitment, leadership, and professional knowledge. This article discusses issues related to accountability and competence, presents findings from focus group discussions with occupational therapy practitioners regarding professional competence, and identifies actions that will bring about greater understanding of this topic. METHOD: Thirty-nine randomly selected occupational therapy practitioners attended one of two focus groups. Participants responded to a structured discussion guide, including questions addressing the definition, process for sustaining, and outcomes of continued competence. RESULTS: Several themes emerged from these discussions. Views about what constitutes and contributes to continued competence in occupational therapy were diverse, and perceptions of occupational therapy "practice" were broad. Participants believed that the "outcomes" of a practitioner's continued competence were best defined as autonomy in executing the occupational therapy process. CONCLUSIONS: Findings offer potential language to articulate competence in occupational therapy and facilitate a discipline-wide conversation. The findings likewise challenge practitioners to assume new professional behaviors that require both personal and interpersonal skills. Such behaviors are critical to demonstrating accountability and competence.

Attitude of Health Personnel↗

[Leadership and communication: development of a measurement tool for graduating nursing students].

Leadership and communication are themes of importance for the development of Nurse's work so that the upbringing of this professional needs to begin in the undergraduate course and continue through professional life. The present study aimed to identify the knowledge of students of the 4th year of the Nursing School of a public University about leadership na communication. In order to achieve this goal, the authors elaborated an instrument and submitted it to apparent and content validation, pilot test and statistic treatment. Data was collected through the application of the instrument to 67 students in October of 1998. The analysis of the results indicated that the students showed knowledge about leadership and communication, although they did not affirm that what they had learned it in the Undergraduate Course about it was enough.

Communication↗

Problem-based learning.

Problem-based learning is now a well-established approach to the design and implementation of undergraduate, postgraduate and continuing medical education. This article describes how it functions and examines how it contributes to more enjoyable and effective professional development.

Adolescent↗

Issues for academia.

When colleges and universities provide supervised clinical experiences for students, their models of supervision must consider a number of issues related to individuals and program objectives. Although the importance of each issue will vary from one program to another, increased awareness of specific concerns may be helpful to administrators in developing and implementing more appropriate models. Providing high quality in the supervision of new professionals should help the professions achieve continuous improvements in the quality of service to consumers.

Female↗

The complexities of health education in leprosy.

The authors describe in some detail the problems involved in establishing an educational diagnosis of leprosy patients-an area which is badly overlooked. The paper provides a comprehensive view on the sociological factors which have to be identified prior to the planning of the health education component. The paper also attempts to describe the steps to be followed in the integration of health education in leprosy control programmes. Since leprosy continues to be a public health problem in many of the developing countries, there is a pressing need for health professionals and especially health educators to focus attention on the importance of a systematic approach in developing health education programmes for the control and ultimately the elimination of this scourge.

Family Planning Services↗

Professionalization and the dietitian.

Professionalization as a process is reviewed and characteristics an occupation acquires as it becomes professionalized are outlined. Those attributes include founding a professional association with membership requirements to exclude the unqualified; control of education and admission to the profession by current members, frequently working through the professional organization; possible licensure or certification as a prerequisite to practice; a name change to provide enhanced status or prestige; and elaboration of an altruistic, service-oriented code of ethics. Relevant developments in dietetics and the history of The American Dietetic Association are then compared with this model. Advances have been and continue to be made in the above areas as the professionalization of dietetics and the dietitian progresses.

Accreditation↗

Enhancing the health professional's role in requesting transplant organs.

The shortfall in organs for transplant continues in the UK. To address this problem, methods of organ procurement are continuously widening with the recent development of protocols in elective ventilation and non-heart beating donors. Until recently, the nurse's role in the success of organ procurement was largely limited to those working in intensive care units involved in cadaveric transplant and community-based nurses working with patients on kidney dialysis who may become involved with live related transplant. Involvement in organ procurement has now extended to nurses working in general wards and accident and emergency centres. It is imperative that health professionals are aware of the large numbers of patients for whom donors have not been found. They need to be aware of the possible reasons which deter relatives from giving consent for potential donors and prevent relatives themselves from becoming potential live donors. Those who are involved in the organ request process need to be alerted to the factors that affect the decision to give consent. It is hoped that these efforts will help to reduce the drastic shortage of available organs for transplant in the UK.

Family↗

Coordinating community and public-institutional mental health services: some unintended consequences.

Where a target group such as the mentally ill tend to use multiple and varied services over a long period of time, service coordination is often seen as the key to continuity of care. This article argues that coordination also has its perverse effects. To demonstrate, two types of community organizations (COs) working in mental health in the Canadian province of Québec are examined: alternative COs, which have their roots in community action and maintain few formal links with each other or with institutional resources; and transitional structures, COs which are developed with the cooperation of psychiatric professionals, are closely linked to hospitals and are often part of a tightly coordinated system of community services. With respect to access, continuity, programs, internal structure and flexibility, each type of community resource has particular strengths and weaknesses. In the first part of the article, these are described and compared. In the second part of the article, we examine the possible effects of Québec's new mental health policy on COs working in mental health. The policy seeks to create comprehensive systems coordinating all services at the regional level-including alternative organizations, transitional structures and public institutions. The imperatives of the complex planning process risk diluting or even eradicating the differences between the two types of mental health COs described earlier. The process may thus rob certain service users of the particular advantages they found in alternative COs. For those mentally ill who, by choice or by chance, remain marginal to the coordinated system, there may ultimately be no resources available at all.

Community Mental Health Services↗

Area health services as learning organisations: the rural experience.

Staff development units (SDUs) across New South Wales Health are in a state of flux. Traditional models of training may no longer be meeting the continuing professional education needs of staff. This paper outlines how one SDU, the Rural Health Education and Research Centre at Tamworth, with few resources, has successfully negotiated the transformation from delivering ad hoc, face-to-face teaching, to a model encompassing competency-based training, recognition of prior learning, workplace assessment and distance education.

Competency-Based Education↗

Patients' accounts of the differences in nurses' and general practitioners' roles in primary care.

AIM: This paper reports a study of patients' accounts of the differences in nurses' and general medical practitioners' roles in primary care. BACKGROUND: Nurses are now diagnosing and treating illnesses including conducting first contact care consultations. However, the findings of international studies reporting patients' views of developments in nursing roles are not consistent. Whilst some studies report higher satisfaction following nurse consultations, others suggest that patients do not want nurses to replace general medical practitioners. Healthcare professionals' views of the boundaries of their roles have been studied, but patients' views have not been reported. METHOD: Semi-structured interviews were conducted with 28 adults attending general practices for urgent 'same day' appointments during 2004. Participants were interviewed prior to their consultation with either the nurse or general medical practitioner and 19 participants were interviewed after the consultation. Data collection and analysis were concurrent, and based on the constant comparative method. FINDINGS: Participants' views reflected traditional hierarchies in primary care. They preferred to consult with general medical practitioners if they perceived their symptoms to be serious and with nurses for minor symptoms and reassurance. They thought that nurses had more time for them and were more compassionate. Interpersonal/relational continuity of care was important and for most participants this was with a general medical practitioner who knew them. Participants trusted known practitioners; they also placed trust in professional groups and familiar structures such as the practice. CONCLUSION: New nursing services should incorporate patients' views on continuity of care provider when developing models of care delivery. Patient information leaflets in general practices should be used to explain the roles of general practitioners and nurse practitioners/practice nurses. As these roles develop further, more research is needed into all aspects of their implementation and patients' views should particularly be evaluated.

Adult↗

Termination of a successful internship program.

The internship was discontinued in June 1983. With the availability of alternative resources, the general economic situation, and the decreases in vacancies, turnover rate, and internship applicants, it was decided it would be more cost-effective to terminate the internship program. The 20 staff nurse positions assigned to the internship program could be utilized to meet the need for increased numbers of positions on various units. In addition, more patient care hours would be available without the demand on the units to provide "extra" orientations. With the decreased turnover, there is a lessening of pressure to recruit more nurses. Recruitment of new graduates could be continued through scholarship programs that are funded from an outside source and other less costly alternatives. In order to avoid negating the professional development of both the new graduate and the experienced nurse, certain administrative changes could be instituted. Individualized counseling could be offered to the new nurse who is seeking first employment or who is unsure of the area of nursing she wishes to work. All new nurses could be assigned preceptors for the period of time needed to complete their designated individualized orientation plan. Emphasis could now be placed on retention of nurses and the development of an organizational ladder for advancement of qualified staff nurses. Hospital educational resources could be used to extend the preceptor program and to assist the staff in developing activities to improve care such as patient education and research related to direct care.+2

Career Mobility↗

Managing nurses and nursing: short courses as role development.

This paper describes the development over a 3-year-period of short management courses for registered nurses offered as part of a professional development educational programme by Oxfordshire Health Authority (OHA) Clinical Education and Practice Team (OXCEPT). The courses were seen as role development for staff nurses, team leaders, sisters, charge nurses and senior sisters, and the content and length of courses were altered, extended and developed in response to evaluation of the courses by tutors and participants. The emphasis is on integrating participants' clinical, managerial and educational roles, as professional practitioners managing nurses and nursing.

Curriculum↗