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PubMed2000

Evaluating faculty development outcomes by using curriculum vitae analysis.

BACKGROUND AND OBJECTIVES: Many faculty development (FD) programs depend on external private and public sponsors that routinely require systematic studies on FD outcomes. The results of evaluation studies can influence whether or not programs continue to be funded. To better evaluate program outcomes on academic productivity, this paper presents and illustrates an evaluation method that uses the curricula vitae (CVs) of FD program graduates. METHODS: The evaluation method is implemented by first preparing a record-review template of coding categories that is applied to FD graduates' updated CVs. Next, semi-structured interviews are held with subjects to resolve uncertain CV codes. Finally, coded data are entered into standardized forms and analyzed to yield descriptive findings. The method was piloted with two groups of FD graduates (n = 17) to determine its utility and limitations. RESULTS: Results show excellent inter-rater reliability (Cohen's Kappa = .79). There was an overall increase in productivity, measured by the CV, during and after the FD program. CONCLUSIONS: CV analysis can be a useful method for assessing FD program outcomes. Several limitations of the method, such as incomplete CVs and self-report bias, must be considered.

Cohort Studies↗
PubMed1989

Therapy supervision: the phenomena and the need.

Nursing has lagged behind in development, utilization, and valuing of therapy supervision. Nevertheless the mental health nursing clinical specialist is expected to be supervised and to be a supervisor of other professional staff. The integral nature of supervision in mental health nursing practice is demonstrated when one defines "therapy supervision," identifies its characteristics, and studies its clinical phases. As the role of the mental health clinical nurse specialist continues to expand, the importance of supervision in developing high level therapeutic skill has become more evident. In this paper various meanings of the concept of supervision and its similarities and differences with associated concepts, such as teaching and therapy, are explored. Essential characteristics are identified, and the application of the concept in practice and research is discussed. The inclusion of supervision training in graduate nursing curriculum, continuing education and in-service programs is advocated.

Education, Nursing↗
PubMed2003

Respiratory therapists' attitudes toward recredentialing.

Recredentialing, sometimes referred to as recertification, is the process whereby people maintain their professional credentials by retesting or continuing education. The National Board for Respiratory Care has proposed mandatory recredentialing policies for respiratory therapists who receive a professional credential after July 1, 2002. The purpose of this study was to determine respiratory therapists' attitudes toward recredentialing. The author developed a survey instrument that was mailed to a systematic random sample of 1,000 subjects drawn from the active membership of the American Association for Respiratory Care. Data analysis consisted of frequencies, percentages, and measures of central tendency. Group means were compared using the independent groups t-test, with a significance level of p < or = 0.05. Of the surveys, 562 (56.2%) were returned. Of the 15 statements about recredentialing that were rated on a 5-point Likert scale, the respondents were most in agreement with "Proof of continuing education should be sufficient for recredentialing"; "There should be a way to determine whether a respiratory therapist is competent to practice"; and "I don't want to be required to recredential." In response to the multiple-choice question "Who should be in charge of assuring the continuing competency of respiratory therapists, the most frequently selected response was "Employers of respiratory therapists." Most respiratory therapists do not want to be required to recredential. If they are required to recredential, however, they prefer the use of contining education rather than retesting.

Allied Health Personnel↗
PubMed1999

Threat assessment: defining an approach for evaluating risk of targeted violence.

Although the field of risk assessment has made tremendous advances in the past 20 years, assessments of targeted violence continue to pose a significant challenge to law enforcement, mental health, and other professionals. These specific and critical assessments require an innovative approach. The threat assessment model, developed and refined by the U.S. Secret Service, provides a useful framework for thinking about assessments of potential for targeted violence. In this paper, we attempt to define this approach as it has been developed by the Secret Service, and apply it within the existing professional/scientific literature on risk assessment. We begin with a brief review of existing models and approaches in risk assessment, and identification of some gaps in our existing knowledge as it relates to assessments of targeted violence. We then proceed with an outline of the threat assessment approach, including a review of principles and guiding operational questions, and discussion of its use in assessment of targeted violence.

Female↗
PubMed1995

Development of an eating disorder in a 40 year-old male lung transplant candidate: a case study.

This paper presents the treatment of a lung transplant candidate suffering from an eating disorder who refused communication between the Eating Disorders Clinic and the transplant team. The importance of psychiatric evaluation in transplantation and the need for the free flow of information among all health professionals working with the transplant patient are discussed. Explanations are proposed for the role of dieting in the development of the eating disorder and the patient's continued food restriction, vomiting, and laxative abuse after transplantation.

Adult↗
PubMed1978

Reappraisals of J. Marion Sims.

Sims' development of repair for vesicovaginal fistula introduced the present epoch of gynecology. He remained professionally active for 30 years thereafter and achieved national and international reputation. He continued to contribute medically until his death. Sims was extravagantly eulogized. Now, 90 years later, he is being roundly denounced for using slaves as experimental subjects and for doing multiple procedures on hapless women. One must however be skeptical of judging 1850 decisions by 1975 norms. Sims undoubtedly exploited the misery of his patients but their abject state must be remembered. Sims was insensitive to the status and needs of women, but in that he was a product of his era. His medical achievements have borne up well in the test of time.

Alabama↗
PubMed1994

Continuing clinical chemistry education in the United States.

Governmental licensing agencies, professional certifying organizations, and healthcare institutions are establishing increasingly comprehensive requirements for formal continuing education in all branches of medicine, including clinical chemistry. Administrative procedures have been developed to accredit continuing education programs, and documentation of participation is frequently required for renewal of state licenses, reappointment to hospital staffs, and recertification by medical specialty boards. The rapid development of science and technology in clinical chemistry makes effective continuing education a mandatory objective both for the individual clinical chemist and for the profession.

Accreditation↗
PubMed2005

Nursing informatics knowledge and competencies: a national survey of nursing education programs in the United States.

An online survey of deans/directors of 266 baccalaureate and higher nursing programs in the U.S. was developed by informatics expert nurses. Participants (1) identified nursing informatics (NI) competencies and knowledge of undergraduate and/or graduate students in their nursing programs; (2) determined faculty preparedness to teach NI and to use informatics tools; and (3) provided perceptions of NI requirements of local practicing nurses. Frequency data and qualitative responses were analyzed. Approximately half of undergraduate nursing programs were teaching information literacy skills and required students to enter with word-processing and email skills. Least visible informatics content at all levels included the use of information system data standards, the Nursing Information and Data Set Evaluation Center criteria, the unified medical language system (UMLS), and the nurse's role in the life cycle of an information system. Almost 50% of respondents perceived faculty as "novice" and "advanced beginners" in teaching and using NI applications. Participants reported no future plans to offer NI training in their region. Findings have major implications for nurse faculty, staff developers, and program administrators who are planning continuing education opportunities and designing nursing curricula that prepare nurses for use of the electronic health record and 21st century professional practice.

Clinical Competence↗
PubMed1995

Outcomes research on one continuing education activity.

Outcomes evaluation research on continuing education (CE) is virtually unexplored in the perioperative and general nursing literature. This outcomes evaluation research study explored whether participants changed their practice behaviors after participation in a one-day CE activity (eg, used knowledge gained, consistently performed new skills, integrated new values into their practices). One hundred seventy-one attendees participated. Data analysis revealed that behaviors and practices did change as a result of attending the CE activity. Participants reported that the organizations, settings, or departments in which they were employed and their peers were challenges to their use of CE in practice.

Education, Nursing, Continuing↗
PubMedDate not supplied

[A study of the Edinburgh Postnatal Depression Scale (EPDS) on 859 mothers: detection of mothers at risk for postpartum depression].

The postpartum is a high-risk period for the occurrence of anxious and depressive episodes. Indeed, during the first few days after delivery, mothers can present postpartum blues symptomatology: fatigue, anxiety, disordered sleeping and a changing mood. Postpartum depression is characterised by a changing mood, anxiety, irritability, depression, panic and obsessional phenomena. It occurs in approximately 10 to 20% mothers. The exact prevalence depending on the criteria used for detection. The first symptoms usually appear between the fourth and sixth week postpartum. However, postpartum depression can start from the moment of birth, or may result from depression evolving continuously since pregnancy. We can add that the intensity of postpartum blues is a risk factor that can perturb maternal development. So it is important for health professionals to dispose of predictive tools. This study is a validation of the French version of the EPDS. The aims of the study were to evaluate the postpartum depression predictive value at 3 days postpartum and to determine a cut-off score for major depression. Subjects participating in this study were met in 3 obstetrical clinics in, or in the vicinity of, Toulouse. Mothers with psychological problems, under treatment for psychological problems or mothers whose babies present serious health problems were excluded from the study. The EPDS was presented to 859 mothers (mean age=30.3; SD=4.5) met at one of the clinics at 3 days postpartum (period 1). They had an EPDS mean score of 6.4 (SD=4.6); 258 (30%) mothers had an EPDS score 9. 82.6% of these mothers experienced a natural childbirth and 17.3% a caesarean section; 51.5% gave birth to their first child, 36.2% to their second child and 12.3% to their third or more. All subjects were given a second EPDS with written instructions to complete the scale during the period 4 to 6 weeks postpartum and return it for analysis (period 2). Between the 4 to 6 weeks postpartum period, 722 mothers replied again to the EPDS. 131 mothers had an EPDS score 11 (mean age=30.3; SD=4.8). They had an EPDS mean score of 13.6 (SD=3.3). Mothers with probable depression were interviewed and assessed, using the Mini (Mini Neuropsychiatric Interview, Lecrubier et al. 1997), the SIGH-D (Structured Interview Guide for the Hamilton Depression Scale) and the BDI (Beck Depression Inventory) in order to diagnose a major depressive episode. They had a HDRS mean score of 13.7 (SD=5.1) and a BDI mean score of 13.6 (SD=5). At 3 days postpartum, we observed that 258 mothers (30%) had an EPDS scores 9 and 164 mothers (19%) had an EPDS scores 11. Between 4 and 6 weeks postpartum, we observed 18.1% of postpartum depression (EPDS 11) and 16.8% (EPDS 12) of major postpartum depression. The analysis of the sensitivity and the specificity at 3 days postpartum provides a cut-off score of 9 (Sensibility: 0.88) (Specificity: 0.50) as predictive of postpartum depression, for this cut-off score, the type I error is low (5.8%) but the type II error is more higher (18.9%). The analysis of the sensitivity and the specificity between 4 and 6 weeks postpartum provides a cut-off score of 12 (Sensibility: 0.91) (Sensibility: 0.74) for the detection of major postpartum depression. Factor analysis shows at 3 days postpartum that the internal structure of the scale is composed of two subscales. The first factor F1 "anxiety" accounts 28% of the variance and the second factor F2 "depression" accounts 20% of the variance. Between 4 and 6 weeks postpartum, factor analysis suggests an unidimensional model in the evaluation of postpartum depression which is better than a two factor model. This factor accounts 40% of the variance. The scale has a good predictive value, and we can observe a significant correlation with the EPDS periods 1 and 2 (r=0.56; p<0.05). This result shows that the depressive mothers mood intensity predicts a future depressive risk. Furthermore, correlations between EPDS and BDI (r=0.68; p<0.05) and EPDS and HDRS (r=0.67; p<0.05) show a good convergent validity. The reliability study confirms the good internal consistency of the EPDS, at 3 days postpartum and in the postpartum depression -symptomatology evaluation (Cronbach's Alpha>0.80). In conclusion, this scale demonstrates good validity and is fast and easy use in obstetrical services, allowing early detection of women who risk to develop postpartum depression and, in the first week of postpartum, of mothers who suffer from a major postpartum depression. The use of the EPDS for an early screening of the risk of postnatal depression which is essential considering the consequences that postnatal depression can have on the development of the infant, on the quality of the relationship within the couple and on other social relationships. Mothers at risk for postnatal depression should be controlled and surveyed by the health professionals in obstetrical clinics.

Adult↗
PubMed2003

Reproductive health and human rights.

Reproductive health programs should adopt an approach based on human rights at the levels of clinical management as well as national policy, especially those programs responsible for abortion and post-abortion care. Resource-poor women face greater maternal mortality and morbidity, suffer continuous risk because of a lack of access to adequate reproductive health services, and are likelier than more affluent women to resort to unsafe, inaccessible, and/or unaffordable abortion services. The public health and medical communities are highly effective when providing safe abortion procedures and treatment in the event of complications. Efforts must be continued to develop strategies to prevent unwanted pregnancies, unsafe abortions, and abortion-related deaths; to treat abortion complications; to broaden the types of medical and health professionals who are allowed to perform abortions; and to enhance training for abortion providers.

Abortion, Induced↗
PubMed1997

Latex allergy.

An overview of latex allergy, including methods for preventing reactions and reducing exposure to latex, is provided. Latex allergy is a serious medical problem for an increasing number of patients and health care workers. From an institutional perspective, several precautionary procedures need to be followed to ensure safe care for patients and to protect employees from unnecessary latex exposure. These include establishing a multidisciplinary committee to develop policies and procedures; identifying products containing latex; identifying latex-sensitive patients and employees as well as those at high risk of developing the sensitivity; implementing precautions against allergic reactions to latex; educating personnel and patients on latex allergy; and reviewing quality assurance data to continually improve precautionary procedures. Pharmacists should be involved in developing and implementing these procedures. In particular, they can play a major role in the education of health professionals and patients. There is a strong need for more information on latex sensitivity, especially in the areas of epidemiology, product development, and effectiveness of procedures. Each institution, including its pharmacists, must evaluate the available information about latex sensitivity and determine appropriate actions.

Allergens↗
PubMed2004

Pharmacist-managed service providing penicillin allergy skin tests.

PURPOSE: A penicillin allergy skin-testing service run by pharmacists is described. SUMMARY: A board-certified allergist trained pharmacists at a tertiary care teaching hospital to administer penicillin allergy skin tests and interpret the results. A major objective of the service was to avoid unnecessary use of vancomycin and quinolones in patients claiming but not actually having a penicillin allergy. Patients with a severe type I reaction to penicillin during the preceding five years, patients with a confirmed history of a type II-IV reaction to penicillin, and severely immunosuppressed patients were not eligible for testing. As of July 2003, 26 patients had been enrolled in the service. A type I penicillin reaction was ruled out by the drug allergy history for 3 patients. The results were negative in 22 of the 23 patients who received skin testing, and in 1 the result was indeterminate. A penicillin or a beta-lactam antibiotic was administered to all 26 patients. No patient had a significant adverse reaction to skin testing or drug administration. CONCLUSION: A pharmacist-managed penicillin allergy skin-testing service was well received by physicians and showed potential to avoid unnecessary use of alternative antibiotics.

Academic Medical Centers↗
PubMedDate not supplied

The misuse of alcohol and other drugs by doctors: a UK report and one region's response.

This Commentary reviews the report from the Working Group on the Misuse of Alcohol and Other Drugs by Doctors, and considers the response of a Scottish region to it. The report confirms that alcohol and drug misuse in doctors is a threat to patients and that the problem in doctors is not being addressed satisfactorily. Support for the establishment of dedicated services is outlined. Local enquiries confirmed that the reported conclusions were universally supported, but extensive work was required to incorporate the issues into student teaching, postgraduate training, continuing professional education, and future revalidation procedures. A proposal to establish a local, confidential, anonymous, informal contact point is outlined to promote early intervention and limit the development of entrenched morbidity relating to substance misuse. The intention is to monitor the utility of that arrangement by audit.

Alcoholism↗
PubMed1986

The role of health promotion in primary health care.

A major transformation has been occurring in primary health care during the past 20 years. The changes are reviewed briefly for the benefit of those who do not work in the front-line of care and for those who have not had the opportunity to experience the changes. Two major components of the transformation are stressed: (i) the shift towards person (patient) centred methods; (ii) a broad framework of reference which encourages horizontal integration of skills in the nonspecialized way. The opportunities for health promotion in primary health care are legion and evidence from worldwide experimental sources is reviewed to show how different levels of achievement can be demonstrated and monitored. Responsibility, empowerment and participation were firmly declared principles in the WHO Alma Ata Declaration on primary health care. The practical realisation of such principles in the field is occurring at an increasing rate, but their continuation will depend on the further growth and development of appropriate community-centred skills and practices. Evidence for the power of a "social sieve" to moderate professional or official health recommendations is also discussed in the light of current research. If recent research data is upheld, the relationship between primary health care personnel and the social network around them is likely to be shown to make a critical difference to health outcomes.

Health Promotion↗
PubMed1993

The academic base for general practice: the case for change.

University departments of general practice and the postgraduate education system for general practice have developed separately over the past 30 years. This separation is now impeding the academic development of the discipline and causes difficulties with recruitment and career progression. These problems could be eased by the creation of integrated departments. This would establish a critical mass for research and educational development, allow human and other resources to be used more flexibly and effectively, and provide a strong base for undergraduate education, vocational training, higher professional training, and continuing education. It could encourage collaborative ventures with other disciplines and also lead to higher standards of patient care.

Education, Medical, Graduate↗