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PubMed2005

[An inter-university diploma on tobacco and smoking cessation: pedagogical evaluation and professional impact].

The aim of the post-graduate degree course on tobacco and smoking cessation is to train professionals who have dedicated themselves to the fight against tobacco and smoking. An educational assessment of the degree programme was carried out in order to evaluate its impact on practice. A questionnaire was mailed to 60 students registered in the programme at Strasbourg University between 1997 and 2002 (with a response rate of 71.6%). The evaluation was able to shed light on the strengths and weaknesses of the teaching in the programme and the level of student satisfaction. The tobacco control and smoking cessation interventions of the students before and after completing the course were compared in order to assess the impact on their professional practice. The programme's participants came from a variety of professions including medical doctors (74.4%), paramedical staff (16.3%) and other professions (6.9%). The students acknowledged the course's high level of quality (the teachers were appreciated, and the programme was comprehensive). The structure of the course was operational; however, the students admitted that they felt that the practical application and the interactive aspects of the learning (such as case studies, role playing, training in a specific smoking cessation intervention were insufficient. They also noted a lack of emphasis on treatments that do not rely on pharmacotherapy such as behavioural therapy and psychological support. Tobacco cessation related problems or side effects of quitting like weight gain, anxiety or insomnia were not appropriately developed. The majority of students were very satisfied with the theoretical basis of the curriculum and with their internship in a tobacco cessation consultation intervention. Today, 69% of the students trained are working in smoking cessation and tobacco control. They have been able to diversify their activities, going from prevention to tobacco cessation, and vice versa. Course tracks focusing on pregnant women, adolescents and behavioural therapies have now been introduced into the degree programme. In terms of further investing in the improvement of skills and competencies, the programme could better respond to the students' needs by taking into account the development of interactive teaching methods such as role playing and workshops.

Adult↗
PubMed1999

Increasing the proportion of women in academic medicine: one institution's response.

OBJECTIVE: To increase gender diversity among the physician consulting staff (PCS) at a major medical center. DESIGN: Because the proportion of female PCS at academic medical centers in the United States has not increased commensurately with increases in the proportion of female graduates from American medical schools, a modeling and graphing technique was developed to analyze this problem and recommend solutions for one large academic medical center. MATERIAL AND METHODS: Personnel data, by gender and year from 1980 through 1994, were collected for all PCS at Mayo Clinic Rochester (MCR). These data were compared with similar data from other US academic medical centers and were used to develop models to predict the proportion of female PCS at MCR yearly until 2005, assuming various hiring and resignation patterns. Novel techniques were developed to illustrate and compare the models. Model-based predictions were compared with national projections, and a realistic target proportion of female PCS was defined on the basis of assumptions about the proportion of female graduates from medical school and internship programs during the next 10 years as well as probable hiring, retention, and resignation rates at MCR. To identify issues critical to recruitment, retention, and professional growth of female PCS at MCR, we used factor analysis to assess responses to a confidential questionnaire sent to all female faculty members. RESULTS: In 1994 and 1995, the proportion of female PCS was 25% at US academic medical centers but only 15% at MCR, and the rate at which this proportion increased from 1980 through 1994 at MCR was also lower than the national rate. Model-based predictions demonstrated that gradually (1.5% per year) increasing the female percentage of new recruits from 26% in 1995 to 40% in 2005 would achieve the targeted 25% female PCS in 13 years. Questionnaire responses from 119 (68%) of the 175 female PCS at MCR identified 6 important recommendations for recruitment and retention of female PCS: survey resignees and candidates who decline positions; appoint more qualified women to policy-making committees; require sensitivity and diversity training for all staff (especially leaders); develop explicit, gender-sensitive criteria for selecting department and division chairs; compare Mayo gender and diversity data with national data at the department or division level; and develop mechanisms for mentoring junior female staff members. CONCLUSION: We developed useful methods for analyzing the PCS gender distribution, defined feasible hiring strategies, and identified specific recommendations to enhance the professional experience of female PCS. These methods can provide a model for other institutions seeking to optimize gender diversity among their staff.

Academic Medical Centers↗
PubMedDate not supplied

Education and training of occupational therapists for neonatal intensive care units.

OBJECTIVE: The neonatal intensive care unit (NICU) is an area in which occupational therapists require specialized advanced training and skills. The purpose of this study was to evaluate the nature of current practice among occupational therapists in NICU settings, their training, and their opinions regarding educational experiences necessary for NICU work. METHOD: One hundred seventy-four NICU occupational therapists completed a survey questionnaire designed to elicit information about these issues. RESULTS: The majority of respondents were engaged in similar practice duties in NICUs, most of which had been using therapy services for less than 10 years. Most of the respondents (83%) reported that their primary source of training was on the job rather than through formal course work or training programs. Many of the respondents (40%) lacked training in the use of any infant assessments, and 50% had 2 years or less of pediatric work experience before entering practice in the NICU. The respondents indicated that mentored experience, on-the-job training, pediatric work experience, extended continuing education courses, and formal internships could prove helpful to future occupational therapists who wish to acquire the knowledge and skills to become competent in the NICU. CONCLUSION: Results of the survey indicate that current training and education to work in an NICU is inadequate and needs to be addressed. Occupational therapists working in NICUs desire and express the need for specialized training to work in this practice area. A more aggressive effort toward standard NICU education and training is necessary to ensure that occupational therapists are competent members of the NICU team.

Adult↗
PubMedDate not supplied

Outcomes of a vocational program for persons with AIDS.

Advances in medical treatment combined with changes in the demographics of persons who are becoming infected with autoimmune deficiency syndrome (AIDS) have transformed this illness from a rapidly progressing to a chronically disabling condition in a short period of time. This paper describes the development, implementation, and outcomes of a program of vocational services for persons with AIDS. This program was studied using a single group design, in which participatory action research strategies were used to investigate and improve the program as it unfolded. In addition to examining the overall outcomes of services, the study aimed to discover which components were most helpful to participants and which participants were most likely to benefit from the program. Of 129 participants of who initially enrolled, 39 dropped out before finishing the program. Sixty of the 90 participants who completed the program achieved employment, returned to school, or began a volunteer position or internship. Consequently, the overall success rate was 46.5% and the success rate for program completers was 66.7%. The occupational narrative, which participants told in their initial assessment interview, was closely associated with both program completion and successful outcomes. This association adds support to the importance of narrative for understanding participants and predicting future behavior, as well as for the therapy process.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Assessing prescription writing skills of pre-clerkship medical students in a problem-based learning curriculum.

OBJECTIVE: To audit the acquisition of prescribing skills of pre-clerkship medical students in a problem-based learning (PBL) curriculum that incorporates a prescribing program. MATERIAL AND METHODS: Student performance in pharmacotherapy stations included in six out of eight end-of-unit-objective structured practical examinations (OSPE) was evaluated using a rating checklist. RESULTS: Prescription writing skills of 539 students (66.2% female and 33.8% male) were appraised. With the exception of refill element, the other physician-related components including prescriber's identity, date of prescription order, patient's identity, the symbol Rx "Take Thou", and prescriber's signature were written by 96.1% of the students (95% confidence interval (CI) 94.1 - 97.5). However, the drug-related components such as the appropriateness of drug(s) selected, strength, dosage form, quantity to be dispensed and directions for use were written satisfactorily by 50.2% of the students (95% CI 46.0 - 54.4). With respect to prescribing skills, the mean total score of Year 4 students did not significantly differ from that of Year 2 (69.4 (CI 65.7 - 73.1) vs. 66.3 (CI 62.7 to 69.9); p = 0.237). However, the mean scores of individual drug-related components such as appropriateness of drug(s) selected, dosage form, and direction for use were significantly higher in Year 4 than that of Year 2 students (p < 0.05). Of 381 rationally prescribed drugs, 81.1% were written with generic names. CONCLUSION: This study revealed that the students acquire prescribing skills to a limited extent during the pre-clerkship phase in a PBL program. Prescribing errors and deficits were found to be mainly associated with drug-related components. Further training and assessment of prescribing skills during the clerkship and internship period are needed to achieve mastery of this skill as a terminal competency of graduating physicians.

Bahrain↗
PubMed1996

Preliminary findings on the use of osteopathic manipulative treatment by osteopathic physicians.

The literature suggests that the extent to which osteopathic physicians actually use osteopathic manipulative treatment (OMT) and the factors that predict the use of OMT remain virtually unexplored. A mailed survey of practicing osteopathic physicians was used to query respondents about their use of OMT and about the effects of a number of factors on use of OMT. The survey showed that 71% of 100 practicing physicians used OMT with 5% or more of their patients, and 14% in 50% or more of their patients. Multivariate statistical procedures revealed that a physician's having learned a new OMT format since graduation from medical school was the primary predictor of the use of OMT, followed by interest in OMT during internship. The other predictor was whether the respondent had a family member who was also a DO. Physician's specialty, emphasis on OMT during graduate and postgraduate training, and the era during which DOs received their training were not significant predictors of OMT use. These results indicate a need for further research on OMT use and the variables examined in this study.

Adult↗
PubMed1999

Perceptions and reported practices of osteopathic physicians in diagnosing and treating addiction.

The objective of this study was to assess the perceptions and reported practices of osteopathic physicians in the diagnosis and treatment of addiction. Copies of survey questions were sent to the 344 members of the West Virginia Osteopathic Society. A total of 176 (51.2%) physicians responded; of these responses, 166 surveys were used for analysis. Respondents included 130 practicing physicians and 36 physicians in internship or residency training programs. Of those responding, 133 were men and 33 were women, and ages ranged from 24 to 81 years with a mean of 41.6 years. Respondents who were graduates of the West Virginia School of Osteopathic Medicine numbered 132 (79.5%), and 99 (59.6%) were in family practice. Characteristics most commonly attributed to addiction were a chronic nature and psychological or physical dependence. More than half of the test subjects did not consider addiction to be a primary disease independent of other factors or psychiatric conditions. Respondents reported a mean addiction prevalence of 20.4%, with the most common substances reported as tobacco, alcohol, and benzodiazapines, respectively. Individual prevalence reports varied from 0% to 95% (SD +/- 20.4%). The most commonly used diagnostic tools were the CAGE (Cut down, Annoyed, Guilty, and Eye-opener) test, DSM III-R (Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised) or DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) criteria, and quantity and frequency questions. Medical sequelae such as jaundice or emphysema were the most likely reasons for the respondents to address a substance abuse problem. For referral resources, respondents were most likely to use inpatient or outpatient treatment. A mean success rate of 27.7% was reported by the 133 physicians responding. The wide variance in reported prevalence and the low success rate reported in comparison to that demonstrated in published treatment studies indicate that there is a need for further education of both physicians in training and those presently in practice. Medical sequelae are frequently irreversible signs of late-stage addiction, and physicians should be urged to include such tools as the CAGE test in each regular physical to facilitate earlier intervention.

Adult↗
PubMed1976

Curriculum for the new college of health sciences: A departure from the traditional medical education.

As an outgrowth of the Report of the Imperial Commission on the Study of Health and Medical Problems, The College of Health Sciences was established as the basic educational unit to provide comprehensive health care education within the framework of a team approach to Iranian national health care. The programs are to nonrestrictive, thereby demonstrating the principles of the concept and practice. Because of this, the College is a multidiscipline institution, and will expand to include programs of study in all health care specialties. The program of study for the equivalent of the baccalaureate degree in the College is based on functional analysis of the tasks to be performed by the primary care workers called behdars. The curriculum is task oriented and is made up to two sections, each of 33 months instruction. The first year concentrates on basic functional science and medicine in an academic setting, and the following two years are spent in clinical training in geographically diverse dispensaries and health care facilities. The second stage of the academic program will be available to graduate behdars who have successfully completed two or more years of work in the health care network and who display academic and professional excellence. Through a unit system approach these candidates for doctor of medicine will complete eleven months or more of comprehensive instruction in functional basic sciences, and this will be followed by two years in comprehensive hospital internship.

Allied Health Personnel↗
PubMed1997

Benchmarks: investing in civil rights and diversity.

HSL talks to leaders of four healthcare organizations in various states of developing programs for ensuring a workforce representative of the communities they serve. Programs range from internships for future leaders to creating diversity ambassadors among the workforce.

Attitude of Health Personnel↗
PubMed1993

The changing role of volunteerism.

As the number of Americans who volunteer grows, the definition of "volunteer" is becoming more broad. In addition to the traditional volunteer opportunity, there are community service, student internship, and court-ordered service programs, all of which pose a set of complicated managerial questions for those charged with designing and running volunteer programs. Today, volunteers' motives may extend further than the simple desire to help their neighbor. For example, given the tough job market, some individuals are volunteering as a possible bridge to employment, and are eager to learn skills and gain experience that they might transfer to a new work setting. The growth in the number of volunteers is not without its down side, however. As governments have cut back on service programs, some responsibilities traditionally assumed by government are being shunted to volunteer organizations, an inappropriate solution. Although volunteer programs deserve support, governments cannot be let off the hook. Volunteers cannot and should not replace paid staff. There are a number of exciting and innovative approaches to recruiting, managing, and motivating volunteers. Some programs are responding to the new kinds of volunteers by restructuring the volunteer opportunity to make it more accessible to those who work from 9 to 5. Others are responding to the diversity of the communities they serve by seeking training in cultural sensitivity and recruiting volunteers from the community. Whatever the volunteer opportunity, the screening and placement interview is a crucial first step. It should be used to clarify expectations--of the volunteer and of the volunteer administrator. Once volunteers are on board, the key to managing and retaining volunteers is to recognize what motivates the individual volunteer--whether it is the desire to acquire job-related skills, to socialize, or simply to learn new things--and to provide the volunteer with these opportunities. Continuing education, training, and feedback are essential ingredients of any volunteer program. Another key to retaining volunteers is appropriate recognition. Although volunteers may appreciate the traditional pin or letter of thanks, volunteer administrators should explore other means of recognition that are tied in to the individual volunteer's motives for volunteering in the first place. Involving volunteers in the development and refinement of the volunteer program and considering their suggestions for improvements are important ways of keeping them involved and signaling recognition of their expertise and value.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Delivering health education programs: a model.

The OPT/EVALUATE delivery model provides a system for applying principles of organizational management to the problems of administering health education. Whether one is a new health educator, or part of a health education team, solving operational problems calls for expertise in a variety of fields. Most health educators are not prepared for program administration functions. The article includes a diagram of the OPT/EVALUATE model and an Action Step Checklist. The checklist may be for professional self-assessment, for guiding internships and on-the-job training experiences, or for systematically coordinating a health education project. Each section of the checklist is explained in the article with resources for further reading. Individuals can adapt the OPT/EVALUATE model to their own work setting and target populations. The importance of the checklist steps will vary from project to project. Some specific steps may need to be added.

Evaluation Studies as Topic↗
PubMed1987

East-West medical student cooperation.

These are extensive excerpts from "The World Students' Congress" The Interne, Vol. XIII, No. 2 (February 1947), pp. 80-85 and "The International Union of Students," The Interne, Vol. XIII, No. 3 (March 1947), pp. 132-139. Bernard Lown, at the time covered by this report, had just finished an internship at Yale. As many H&M readers know, he was a founder of Physicians for Social Responsibility in 1961 and is the co-president of the International Physicians for the Prevention of Nuclear War.

Europe↗
PubMedDate not supplied

Clinical laboratory technician to clinical laboratory scientist articulation and distance learning.

Laboratory workers and educators alike are challenged to support access to education that is current and provides opportunities for career advancement in the work place. The clinical laboratory science (CLS) program at the Medical College of Georgia in Augusta developed a clinical laboratory technician (CLT) to CLS articulation option, expanded it through distance learning, and integrated computer based learning technology into the educational process over a four year period to address technician needs for access to education. Both positive and negative outcomes were realized through these efforts. Twenty-seven students entered the pilot articulation program, graduated, and took a CLS certification examination. Measured in terms of CLS certification, promotions, pay raises, and career advancement, the program described was a success. However, major problems were encountered related to the use of unfamiliar communication technology; administration of the program at distance sites; communication between educational institutions, students, and employers; and competition with CLT programs for internship sites. These problems must be addressed in future efforts to provide a successful distance learning program. Effective methods for meeting educational needs and career ladder expectations of CLTs and their employers are important to the overall quality and appeal of the profession. Educational technology that includes computer-aided instruction, multimedia, and telecommunications can provide powerful tools for education in general and CLT articulation in particular. Careful preparation and vigilant attention to reliable delivery methods as well as students' progress and outcomes is critical for an efficient, economically feasible, and educationally sound program.

Computer-Assisted Instruction↗
PubMed1999

Training medical assistants for surgery.

A successful programme is reported from Mozambique for training middle-level health workers to perform fairly advanced surgical procedures in remote areas where the services of consultants are virtually unobtainable. Manpower and financial constraints obliged Mozambique to train medical assistants to perform surgical work in rural areas, where three broad priorities were identified: pregnancy-related complications, trauma-related complications, and emergency inflammatory conditions. Since 1984, 20 health workers have emerged from three-year courses to become técnicos de cirurgía (assistant medical officers), and it is expected that there will be 46 by 1999. The training comprises two years of lectures and practical sessions in the Maputo Central Hospital, and a practical internship lasting a year at a provincial hospital. Three workshops organized since 1989 suggest that the upgraded personnel are performing well. More detailed evaluation and follow-up are in progress. Throughout 1995 a follow-up was conducted on 14 assistant medical officers. They performed 10,258 surgical operations, some 70% of which were emergency interventions. Low rates of complication occurred and postoperative mortality amounted to 0.4% and 0.1% in emergency and elective interventions respectively.

Adult↗
PubMed1999

[Integration of health into the school curriculum in Botucatu, São Paulo].

This study focuses on the drafting and development of a public health program aimed at strategies to integrate health activities and the school curriculum. The program is based on three main lines of activity: full health care for schoolchildren, with special emphasis on the public school system; training of personnel in the fields of health and education by means of internships allowing participants to experience, work, and reflect critically on the activities with an interdisciplinary team; and work with teachers from the public elementary school system to implement and develop innovative measures in the fields of health and education to respond to the demand by schools and the community.

Brazil↗
PubMed1999

[Vocational training for persons with psychiatric illnesses in Gütersloh BTZ. Occupational rehabilitation by training comprehensive key qualifications with concomitant social adjustment services, but without independent training centers--can it be done?].

Gütersloh BTZ has practiced vocational training for the mentally handicapped since August 1995. The main goal is to place the clients into employment in the regular workforce. This is done by intensive vocational training yet without having workshops attached to the institution itself. Gütersloh BTZ is comparable to other training centres in Germany like those in Hamburg, Duisburg, Köln, Dortmund, Paderborn, Straubing, Wiesloch and Schleusingen. They are similar in terms of personnel key, financial support for participants and standards of quality. The main difference between Gütersloh BTZ and other training centres is the absence of attached workshops. In Gütersloh training takes place on the job in the regular labour market like industrial firms, craftsmen establishments and service agencies. The "heart" of Gütersloh BTZ's concept is the reference group. It consists of not more than 8 participants. Two social workers are assigned to each group and provide intensive attention from the participant's first day in BTZ to aftercare on the regular job. The individual rehabilitation aim can only be achieved by establishing a tailor-made concept of support. This calls for a broad range of media, flexible methods and individual aims. In addition to the individual orientated concept, pedagogical group-work with three to five participants plays an important role in the work. Here the emphasis is on close relationship. Incentive, start, duration and contents of internships in agencies and firms are to a high degree individually structured. A flexible graduated plan helps the participants to progress from a trial practicum to a long-term practicum and finally to a regular (and subsidized) job in an agency. The Gütersloh BTZ's quota of successful placement into the regular labour market as well as into subsidized jobs is similar to those in other BTZs in Germany. Participants who can't be placed in a job have to achieve a defined perspective of life and an alternative to regular work. This standard of quality is established in the written concept of BTZ. Gütersloh BTZ compares its work and success with other BTZs through uniform social-scientific BTZ evaluation.

Adult↗
PubMedDate not supplied

Teaching and evaluation of basic surgical techniques: the University of British Columbia experience.

Surgical technical education has traditionally followed an apprenticeship format. The need for innovative undergraduate programs using dry and wet labs prior to clinical exposure continues to be an area of debate. Specific programs have been described to improve surgical skills; however, an accepted platform for training and evaluation of surgical skills programs has not been recognized. Therefore, introduction of specific programs to teach undergraduate medical students surgical skills is essential. This article describes the Basic Surgical Technique (BST) program taught at the University of British Columbia and reports the effectiveness of this program in improving the practical skills of undergraduate medical students. The program includes BST I for third-year students performed in a dry lab setting, and BST II for medical student interns (MSI) performed at the animal laboratories using female domestic swine as subjects. A total of 87 students participated in the study. The program is designed using Piaget's and Vygotsky's pedagogical philosophy of "learning by doing." A semiquantitative method is used to measure and analyze the outcome of this project. Data were validated using student self-evaluation tests and by quantitative evaluation by surgical staff from the surgical wards. Results of this prospective project indicated that the BST program significantly (p < .05) improved the surgical performance of undergraduate students, and that the time lapse between BST I and II has had a negative impact in retention of acquired surgical skills. This study concludes that the BST program taught at the University of British Columbia significantly improves the surgical skills of medical students and improves their self-confidence during their internship.

British Columbia↗
PubMed1999

Assessment of the need for a training course in rational use of drugs: a cross-sectional pilot study.

Rational use of drugs means need-based use of them keeping in mind the pathological status, therapeutic indices, drugs interactions and adverse drug reactions. Lacunae in the existing undergraduate curriculum cause irrational use of drugs. The present study was undertaken among 2,200 fresh medical graduates from all over the country with a list of questionnaire distributed among them and analysing the answers. The aim was to ascertain the adequacy of present undergraduate curriculum on pharmacology in equipping the doctors on rational use of drugs and to assess the need and feasibility of Refresher's course. More than half (55%) replied prescriptions were not truly rational. Ninety-eight per cent opened Refresher's course is beneficial in rational prescribing. This cross-sectional survey could provide a glimpse of existing undergraduate pharmacology curriculum and its impact on rational prescribing practice. The Refresher's course in the early internship period involving the clinical departments and department of pharmacology is suggested.

Cross-Sectional Studies↗