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PubMed2006

Brief report: Brief instrument to assess geriatrics knowledge of surgical and medical subspecialty house officers.

PROBLEM: Initiatives are underway to increase geriatrics training in nonprimary care disciplines. However, no validated instrument exists to measure geriatrics knowledge of house officers in surgical specialties and medical subspecialties. METHODS: A 23-item multiple-choice test emphasizing inpatient care and common geriatric syndromes was developed through expert panels and pilot testing, and administered to 305 residents and fellows at 4 institutions in surgical disciplines (25% of respondents), emergency medicine (29%), medicine subspecialties (19%), internal medicine (12%), and other disciplines (15%). RESULTS: Three items decreased internal reliability. The remaining 20 items covered 17 topic areas. Residents averaged 62% correct on the test. Internal consistency was appropriate (Cronbach's alpha coefficient=0.60). Validity was supported by the use of expert panels to develop content, and by overall differences in scores by level of training (P<.0001) and graded improvement in test performance, with 58%, 63%, 62%, and 69% correct responses among HO1, HO2, HO3, and HO4s, respectively. CONCLUSIONS: This reliable, valid measure of clinical geriatrics knowledge can be used by a wide variety of surgical and medical graduate medical education programs to guide curriculum reform or evaluate program performance to meet certification requirements. The instrument is now available on the web.

Clinical Competence↗
PubMed1991

The role of the psychologist on the drug user treatment team.

Current practice in drug user treatment tends to provide, within any one agency, essentially the same treatment for all clients entering that agency. Instead, an agency should use a team approach, with a specific and unique treatment plan for every client, provided by the members of the team. The psychologist should play a central role on this team, being responsible for the treatment plan, for an individual evaluation plan, for assessing progress, for program evaluation, and, in many instances, for supervision of treatment staff. The functions and the different roles played by the psychologist are described, and the characteristics and skills needed for success are listed.

Adolescent↗
PubMed2000

An innovative art therapy program for cancer patients.

Art therapy is a healing art intended to integrate physical, emotional, and spiritual care by facilitating creative ways for patients to respond to their cancer experience. A new art therapy program was designed to provide cancer patients with opportunities to learn about the McMichael Canadian Art Collection and to explore personal feelings about their cancer experience through combined gallery and studio components. The role of the facilitator was to assist in the interpretation of a participant's drawing in order to reveal meaning in the art. This paper presents patients' perspectives about the new art therapy program. Content analysis of participant feedback provided information about the structure, process, and outcomes of the program. Evaluation of the art therapy/museum education program demonstrated many benefits for cancer patients including support, psychological strength, and new insights about their cancer experience.

Adaptation, Psychological↗
PubMed2002

Screening and prevention of chronic kidney disease.

The burden of kidney disease is disproportionately high in African Americans, and the condition often remains undiagnosed until late-stage disease. In order to reduce this burden, strategies must be implemented to improve the detection of kidney disease, and preventative measures must be targeted at those at greatest risk of disease. Important risk factors among African Americans in the US include hypertension, diabetes, and obesity. In this review, we discuss screening strategies that will allow earlier detection of kidney disease. The sensitivity of serum creatinine, proteinuria, and microalbuminuria as markers of disease are discussed, as is the importance of calculating glomerular filtration rates in individual patients. Implementation of community-based programs, such as the Kidney Early Evaluation Program developed by the National Kidney Foundation, can offer screening for kidney disease and its risk factors, and can educate and protect African Americans at risk of this prevalent disease.

Chronic Disease↗
PubMed2005

Prevention of substance abuse: a brief overview.

Recent advances in psychosocial research and neurosciences have provided new avenues for prevention of substance abuse at the individual and community level. A series of risk and protective factors affecting the likelihood of using and abusing substances have been identified. The scope of prevention has been broadened, allowing the prescription of different interventions for individuals according to their varying degrees of vulnerability to substance experimentation, continuous use and dependence. An increased awareness of comorbidity between mental and substance use disorders provides an arena for prevention within psychiatry and related disciplines. Emphasis on program evaluation has helped identify cost effective programs and policies. The integration of prevention within healthy life style policies and programs, including interventions at the school, family and community levels, is more likely to produce the desired outcomes.

Journal Article↗
PubMed1978

A family practice residency network. Affiliated programs in the Pacific Northwest.

The Department of Family Medicine at the University of Washington School of Medicine has developed a regional network of affiliated family practice residency programs in the Pacific Northwest. Collaborative efforts among the seven participating programs are directed to common needs such as curriculum development, sharing of educational resources, program evaluation, problem-solving of operational programs, and coordination of resident rotations. This family practice residency network is a logical and necessary extension of the program that has been developed in Washington, Alaska, Montana, and Idaho for teaching medical students. Regional undergraduate and graduate teaching programs in family practice represent an important role for the university relating to its surrounding region through the collaborative efforts of the medical school and participating hospitals and physicians in the community.

Curriculum↗
PubMed1994

Faculty mentors for minority undergraduate students.

The author discusses the Faculty Mentoring Program, its' effects on minority student academic progression, retention and graduation rates at a large regional university campus in the west. Results of a comprehensive program evaluation are discussed.

Education, Nursing, Baccalaureate↗
PubMed1996

Guidelines for school health programs to promote lifelong healthy eating. Centers for Disease Control and Prevention.

Healthy eating patterns in childhood and adolescence promote optimal childhood health, growth, and intellectual development; prevent immediate health problems, such as iron deficiency anemia, obesity, eating disorders, and dental caries; and may prevent long-term health problems, such as coronary heart disease, cancer, and stroke. School health programs can help children and adolescents attain full educational potential and good health by providing them with the skills, social support, and environmental reinforcement they need to adopt long-term, healthy eating behaviors. This report summarizes strategies most likely to be effective in promoting healthy eating among school-age youths and provides nutrition education guidelines for a comprehensive school health program. These guidelines are based on a review of research, theory, and current practice, and they were developed by CDC in collaboration with experts from universities and from national, federal, and voluntary agencies. The guidelines include recommendations on seven aspects of a school-based program to promote healthy eating: school policy on nutrition, a sequential, coordinated curriculum, appropriate instruction for students, integration of school food service and nutrition education, staff training; family and community involvement, and program evaluation.

Adolescent↗
PubMed1988

[Continuous evaluation of the general effect of the campaign against AIDS in Switzerland].

Since 1985 the Swiss Federal Office of Public Health and the Swiss AIDS Foundation are promoting AIDS prevention campaigns. A multimedia information campaign with the main slogan "STOP-AIDS" began in Feb. 1987 and is still under way. Multiplying effects are stimulated. An evaluation program is following continuously these campaigns, examines knowledge, attitude and behaviour changes in several groups of the population and analyses the conditions of these changes. The evaluation shows that the campaign and its objectives reached the general population and the target groups. Noticeable changes in attitudes and behaviors are taking place in the way of better protection in various observed groups, moderately or strongly exposed to HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Casemix and rehabilitation: evaluation of an early discharge scheme.

This paper presents a case study of an early discharge scheme funded by casemix incentives and discusses limitations of a casemix model of funding whereby hospital inpatient care is funded separately from care in other settings. The POSITIVE Rehabilitation program received 151 patients discharged early from hospital in a twelve-month period. Program evaluation demonstrates a 40.9% drop in the average length of stay of rehabilitation patients and a 42.6% drop in average length of stay for patients with stroke. Other benefits of the program include a high level of patient satisfaction, improved carer support and increased continuity of care. The challenge under the Australian interpretation of a casemix model of funding is ensuring the viability of services that extend across acute hospital, non-acute care, and community and home settings.

Aftercare↗
PubMedDate not supplied

An evidence-based project to improve depression and alcohol use screening.

Using research to improve practice is a high priority. Research shows that routine screening helps identify adults who are at risk for various disorders. Depression and alcohol use screening tools can improve evaluation and treatment. Nurses aimed to improve the screening rates for depression and alcohol use from the existing 50%-80% to 100% with a 1-hour educational program on depression screening and alcohol use disorders screening for 2 clinic areas: primary care and home-based care. Post program evaluation revealed that depression screening and alcohol use disorders screening rates increased to 100%.

Alcohol-Related Disorders↗
PubMed2000

A ten-year analysis of surgical education research.

BACKGROUND: Surgical education peer-reviewed publications have markedly increased over the last decade. The purpose of this study was to review the surgical education literature published over the last 10 years and address the following questions: What subjects in surgical education tend to be studied? What are the most to least commonly employed research designs and statistics? Has there been a change in how research data are collected? Where are these studies published? METHODS: A literature search encompassing surgical education papers published between January 1988 and August 1998 was performed. Four investigators coded qualifying abstracts on journal type, subject of research, data collection methods, research design, and statistics. Each investigator was asked to code 10 articles at the start of the study to assess interrater reliability. RESULTS: A total of 420 abstracts were evaluated. Interrater reliability yielded percent agreements ranging from 82% to 96%. Curriculum and teaching were the most frequent topics studied (40%), followed by assessment (23%) and program evaluation (18%). Most research designs used were descriptive (41%). Experimental design has progressively increased from 2% in 1988-89 to 16% in 1998. A total of 551 statistical methods were accounted for in the 420 abstracts. The most common statistical analyses used were descriptive statistics (32%). The predominant mode of data collection was through testing or direct observations (34%). Survey instruments followed closely as a popular data collection method at 27%. The majority of papers were published in peer-reviewed surgical journals (64%),followed by medical education journals (22%) and "other" journals (14%). CONCLUSIONS: An analysis of the surgical education literature demonstrates the growing emphasis on the use of educational research to explore relevant issues and problems. Descriptive research is most popular, with an increasing trend in experimental research. Publication of educational research in peer-reviewed surgical journals is becoming more popular. This study informs those interested in the surgical education research literature of current trends, and what they need to know for a more critical appraisal of this body of literature.

Clinical Competence↗
PubMed1990

Evaluation of a program to train Saudi Arabian physicians.

The authors evaluated a program at the University of Calgary, in Alberta, Canada, that provided residency training for 11 Saudi Arabian physicians. Through a series of semistructured meetings in 1989 involving the Saudi residents, other residents in the program, members of residency training committees, faculty, and program directors, the program was reviewed to assess whether the Saudi physicians were prepared for the program and progressed satisfactorily when compared with the other residents, whether the training and evaluation were equivalent to those of the other residents, the advantages of the program to the university, and whether the university should be pursuing opportunities to train other foreign nationals. The interviews showed that there was variability in the preparation and progress made by the Saudi residents but the benefits to the university in providing training to a small group of carefully selected foreign-trained physicians were greater than the disadvantages. The information gained during the review reinforced the need to do periodic examinations of training opportunities for foreign physicians and yielded recommendations for improving such training.

Alberta↗
PubMed2000

Social and emotional learning: a framework for promoting mental health and reducing risk behavior in children and youth.

Many programs have been developed to help schools enhance students' health and reduce the prevalence of drug use, violence, and high-risk sexual behaviors. How should educators choose among these? This article describes selection criteria based on theory, research, and best educational practice that identify key social and emotional learning (SEL) competencies and program features. The SEL competencies for students include 17 skills and attitudes organized into four groups: awareness of self and others; positive attitudes and values; responsible decision making; and social interaction skills. The 11 program features critical to the success of school-based SEL programs emphasize curriculum design, coordination with larger systems, educator preparation and support, and program evaluation. Developed by the Collaborative to Advance Social and Emotional Learning (CASEL), the SEL framework can be used to guide selection of research-based prevention programs that address health, substance abuse, violence prevention, sexuality, character, and social skills.

Adolescent↗
PubMed2003

Effect of the transformation of the Veterans Affairs Health Care System on the quality of care.

BACKGROUND: In the mid-1990s, the Department of Veterans Affairs (VA) health care system initiated a systemwide reengineering to, among other things, improve its quality of care. We sought to determine the subsequent change in the quality of health care and to compare the quality with that of the Medicare fee-for-service program. METHODS: Using data from an ongoing performance-evaluation program in the VA, we evaluated the quality of preventive, acute, and chronic care. We assessed the change in quality-of-care indicators from 1994 (before reengineering) through 2000 and compared the quality of care with that afforded by the Medicare fee-for-service system, using the same indicators of quality. RESULTS: In fiscal year 2000, throughout the VA system, the percentage of patients receiving appropriate care was 90 percent or greater for 9 of 17 quality-of-care indicators and exceeded 70 percent for 13 of 17 indicators. There were statistically significant improvements in quality from 1994-1995 through 2000 for all nine indicators that were collected in all years. As compared with the Medicare fee-for-service program, the VA performed significantly better on all 11 similar quality indicators for the period from 1997 through 1999. In 2000, the VA outperformed Medicare on 12 of 13 indicators. CONCLUSIONS: The quality of care in the VA health care system substantially improved after the implementation of a systemwide reengineering and, during the period from 1997 through 2000, was significantly better than that in the Medicare fee-for-service program. These data suggest that the quality-improvement initiatives adopted by the VA in the mid-1990s were effective.

Fee-for-Service Plans↗
PubMed1993

[The annual evaluation of a program to aid the smoker].

OBJECTIVE: To evaluate the impact over a year of a systematic, structured intervention with smokers, called the Smokers' Aid Project (SAP), at a primary care centre in Barcelona. DESIGN: Observational study with a descriptive intervention. SETTING: Urban primary care centre. PATIENTS AND OTHERS PARTICIPANTS: Between April, 1990, and March, 1991, every adult (over 15) who smoked more than one cigarette a day was counselled verbally and/or in writing. The different replies were placed into eight groups and a personal follow-up was made for each category. The groups were: winner, reduction, alone, with help, doubtful, backslider, negative and pending. MEASUREMENTS AND MAIN RESULTS: There was a follow-up on 178 people. Among those monitored, the initial cigarette average was 15.0 (SD 11.4) and the final, 12.45 (SD 11.45). The response was favorable (winner or reduction) in 35.4%, with 10.6% showing a favorable attitude (alone and with help) and 16.3% showing a negative response. A follow-up programme of 7.5 months (SD 3.5) was implemented, with an average of 1.82 (SD 1.05) interventions for each individual. CONCLUSIONS: Programmes of systematic help to the smoker appear to provide more favorable responses than isolated counselling. The SAP can be put into practice within our Primary Care system, although effectiveness will have to be assessed over longer-term follow-ups.

Adolescent↗
PubMed1994

[The control of arterial hypertension in primary care: the evaluation of a program of self-care].

OBJECTIVE: To evaluate the efficacy of a self-care hypertension programme within primary care. DESIGN: Two models of intervention by means of self-care were compared, both using individual education and family support, with one of them using group education. SETTING AND PATIENTS: All those attending 10 health centres in Andalucía and who had a recent diagnosis of light or moderate Hypertension or with their hypertension not monitored over the preceding 6 months, were included. MEASUREMENTS AND MAIN RESULTS: These 160 people were assigned at random to the intervention group (group education) or the control group (individual education). Data analysis provided the results for the 95 people who completed the study. Both systolic and diastolic arterial pressure (SAP and DAP) diminished significantly during the study period, both in the sample as a whole and in the intervention group. However, the lessening of systolic pressure only reached statistically significant differences in the control group. Over the study period, the lessening of SAP was 6.2 in the intervention group and 8.0 in the control group; whereas the lessening of DAP was 7.0 in the intervention group and 2.3 in the control group. CONCLUSIONS: Arterial hypertension can be controlled in primary care by health education for self-care. On the basis of this study's findings, it is not valid to conclude that group is more efficacious than individual education.

Adult↗
PubMedDate not supplied

Practical outcome evaluation: patient behavioral health care demonstration project.

A cost-effective outcome evaluation project for inpatient psychiatric units was designed and implemented for use in a busy clinical setting. The project consisted of (a) a behavioral health care management team that was committed to developing program evaluation, (b) use of direct care clinical staff, (c) computerized data management, and (d) feedback to clinical staff and administrators. The outcome evaluation project demonstrated that clinical databases and direct care staff can be used to implement a continuous quality loop that has the potential to improve patient care and to increase available data for marketing and program planning decisions.

Database Management Systems↗