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PubMed2000

The role of the advanced practice nurse in facilitating a clinical research study. Screening for delirium.

As advanced practitioners, clinical nurse specialists and nurse practitioners have a leadership role in integrating and promoting nursing research in clinical settings. In this quasi-experimental study, the role of the advanced practice nurse in developing and implementing an intervention that improved delirium screening by staff nurses is described. Screening practices of the treatment group nurses were accurate in 100% of the cases. Control nurses failed to detect any cases of delirium. A discussion of study findings and their relevance to advanced practice nursing are discussed.

Aged↗
PubMed2006

Making it work: the evolution of a medical educational fellowship program.

Longitudinal programs to enhance the educational skills of medical school faculty are present in many medical schools and academic health centers. Multiinstitutional programs are less common. Three health professions schools, Baylor College of Medicine, The University of Texas Medical School at Houston, and The University of Texas Dental Branch have jointly sponsored the Educational Scholars Fellowship Program (ESFP) since 2003. The evolution of this program, from one that addressed the faculty educator development needs of one medical school in the mid-1990s to a more flexible model that includes faculty and fellows from three institutions, reflects the changing needs of faculty as well as those of other health professions schools. The ESFP's strengths lie in the effective use of resources across three schools; the opportunity for an interinstitutional and interdisciplinary collaborative network; the flexibility of the curriculum offerings; and the positive impact on fellows' knowledge, skills and leadership in medical and dental education. The evolution of this program represents a cost-effective and educationally sound response to the changing needs of faculty educators.

Adult↗
PubMed2006

Faculty development in end-of-life care: evaluation of a national train-the-trainer program.

To address serious deficiencies in physician training in end-of-life care, the authors developed and disseminated a faculty development curriculum. The overall goals of this curriculum were to enhance physician competence in end-of-life care, foster a commitment to improving care for the dying, and improve teaching related to end-of-life care. The authors provide descriptions of the curriculum and the train-the-trainer programs (2000-2002) that successfully prepared 17 medical faculty as in-house end-of-life care faculty developers at institutions nationwide. They also report on a study of the effects of the 16-hour, end-of-life care curriculum delivered by trained facilitators to 62 faculty and residents at their home sites. Program evaluation showed that the home-site seminars enhanced the knowledge, skills, and attitudes of participating faculty and residents. When project evaluation concluded in 2003, trained facilitators had disseminated the 16-hour curriculum as well as modified versions of the curriculum to approximately 3,400 medical teachers. An adapted version of the curriculum is available on the Internet for use in health professions education. The importance of this type of faculty development effort was confirmed by the positive impact of the 16-hour curriculum on participants' knowledge, skills, and attitudes related to end-of-life care, the high ratings of the program's educational and clinical relevance, and the finding that, on average, more than 50% of the material was new to them.

Attitude of Health Personnel↗
PubMed2006

Increasing the pool of educational leaders for UCLA.

The dual goals of the faculty Fellowship in Medical Education (MEF) program at the David Geffen School of Medicine at UCLA, established in 1992, are to prepare excellent teachers to serve as clerkship chairs, course chairs, or residency program directors while strengthening their dossiers for promotion based on a scholarly approach to curriculum development, implementation, and evaluation. Fellows are nominated from their departments and must demonstrate a strong interest in assuming educational leadership in their respective specialties. A total of eight fellows are accommodated each year based on interviews with the MEF faculty. The two-year program consists of two seminars and two projects focused on four objectives: to critique teaching and testing practices in medical education in light of current theories of learning; to develop and implement curricula that reflect these theories; to improve personal teaching skills through reflection and feedback; and to design and conduct an educational research or program evaluation study. An analysis of the curricula vitae of faculty members who have completed the fellowship suggest that this program continues to provide educational leaders for the school as originally intended. Of the 71 medical school faculty members who completed the MEF between 1993 and 2004 and have remained at the university, 43 (61%) have assumed new leadership roles in medical education. The evaluation data strongly suggest that the MEF has had a major role since its inception in creating a pool of faculty members with the confidence to manage the tasks of educational planning and implementation.

Adult↗
PubMed2006

Increasing departmental and college-wide faculty development opportunities through a teaching scholars program.

The University of Iowa Teaching Scholars Program was initiated in 1999 at the University of Iowa Carver College of Medicine (CCOM) with the overall goal of promoting leadership in faculty development related to teaching skills. Specific goals of this program are (1) to promote the development of a cadre of faculty members who have the skills to implement faculty development within their departments and the CCOM; (2) to increase departmental involvement in faculty development efforts; (3) to increase resources available for dissemination of college-wide faculty development efforts; and (4) to acknowledge the extra effort faculty put into developing their skills and knowledge in medical education and in providing continuing education to their faculty colleagues. All clinical and basic science departments in the CCOM are given the opportunity to have a faculty member participate in the program. Unlike other programs reported in the literature, competitive decisions for program participation are made at the departmental level. The three-year program combines monthly meetings and other activities to train faculty to provide faculty development in teaching skills. Each scholar develops and implements a project to address departmental faculty development needs as well as needs of other departments in the CCOM. To date (2006), 50 faculty members from 19 different departments have participated in the program with an average of 12 scholars per class. The program has resulted in a substantial increase in departmental and college-wide faculty development programming and has had a positive impact on individual scholars' teaching skills and leadership roles.

Curriculum↗
PubMed2006

Educational fellowship programs: common themes and overarching issues.

The trend toward intensive faculty development programs has been driven by a variety of factors, including institutional needs for educational expertise and leadership, as well as individual faculty members' motivation to augment their educational expertise, teaching skills, and leadership skills. The nine programs described in this issue possess several common features that can be ascribed to shared perceptions of pervasive needs coupled with feasible educational resources and strategies to meet these needs. All programs identify a clear set of goals and objectives for their respective curricula. Curriculum domains include not only teaching skills but also educational research, curriculum development, and educational leadership. In spite of many similarities, each program reflects the unique character of its home institution, the faculty, educational resources, and the specific goals of the program. Each program has documented gains in such key outcomes as participant promotions, new leadership positions both locally and nationally, and scholarly productivity in the form of peer-reviewed papers and presentations. Evidence of institutional benefits includes the production of innovative curricula and a pool of educational leaders. The programs have also developed a community of knowledgeable scholars who interact with each other and serve as a catalyst for continuing change and educational improvement. Although each program was developed largely independently of the others, the common elements in their design provide opportunities to evaluate collaboratively the successful aspects of such programs and to share ideas and resources for program curricula between existing programs and with institutions considering implementing new programs.

Adult↗
PubMed2006

Teaching medical education principles and methods to faculty using an active learning approach: the University of Michigan Medical Education Scholars Program.

The Medical Education Scholars Program (MESP) at the University of Michigan Medical School was established in 1998 to develop educational leadership, improve teaching skills, and promote educational scholarship among medical school faculty. The Department of Medical Education designed and implemented the program. Eighty-one scholars have completed the MESP, with 15 more currently enrolled. While most scholars have been clinical faculty, some have been basic science faculty or from other allied health fields. The selection process emphasizes potential for contributing to the educational mission of the medical school. Each cohort is limited to two participants per department. The curriculum of the MESP is designed to provide an overview of a wide range of topics in education. It is divided into five broad domains: principles and theories of education, teaching methods, educational research methods, assessment and evaluation, and educational leadership. During the sessions, active learning of content is expected and encouraged. For instance, scholars share responsibility with the session presenters for planning and evaluating individual program sessions. To graduate, scholars are expected to attend the sessions regularly, and to make a final presentation of their project, which demonstrates near-completion or substantial progress toward that goal. Over its eight years, the MESP has evolved in response to environmental changes and ongoing evaluation of the program. Overall, the Medical Education Scholars Program has proven effective in developing faculty skills and educational leadership locally at the University of Michigan Medical School and nationally.

Adult↗
PubMed2006

Promoting academic excellence through leadership development at the University of Washington: the Teaching Scholars Program.

The University of Washington Teaching Scholars Program (TSP) was established in 1995 to prepare faculty for local and national leadership and promote academic excellence by fostering a community of educational leaders to innovate, enliven, and enrich the environment for teaching and learning at the University of Washington (UW). Faculty in the Department of Medical Education and Biomedical Informatics designed and continue to implement the program. Qualified individuals from the UW Health Sciences Professional Schools and foreign scholars who are studying at the UW are eligible to apply for acceptance into the program. To date, 109 faculty and fellows have participated in the program, the majority of whom have been physicians. The program is committed to interprofessional education and seeks to diversify its participants. The curriculum is developed collaboratively with each cohort and comprises topics central to medical education and an emergent set of topics related to the specific interests and teaching responsibilities of the participating scholars. Core sessions cover the history of health professions education, learning theories, educational research methods, assessment, curriculum development, instructional methods, professionalism, and leadership. To graduate, scholars must complete a scholarly project in curriculum development, faculty development, or educational research; demonstrate progress towards construction of a teaching portfolio; and participate regularly and actively in program sessions. The TSP has developed and nurtured an active cadre of supportive colleagues who are transforming educational practice, elevating the status of teaching, and increasing the recognition of teachers. Graduates fill key teaching and leadership positions at the UW and in national and international professional organizations.

Adult↗
PubMed2006

Fifteen years of aligning faculty development with primary care clinician-educator roles and academic advancement at the Medical College of Wisconsin.

Starting in 1991, the Medical College of Wisconsin's (MCW) primary care-focused faculty development programs have continuously evolved in order to sustain tight alignment among faculty members' needs, institutional priorities, and academic reward structures. Informed by literature on the essential competencies associated with academic success and using educational methods demonstrated to achieve targeted objectives, MCW's initial 1.5-day per month comprehensive faculty development programs prepared faculty as clinician-researchers, leaders, and educators. As institutional priorities and faculty roles shifted, a half-day per month advanced education program was added, and the comprehensive faculty development program transitioned to its current half-day per month program. Using a modular approach, this program focuses exclusively on clinician-educator competencies in curriculum, teaching, leadership, evaluation, and learner assessment. Instructional methods combine interactive, face-to-face sessions modeling a range of instructional strategies with between-session assignments now supported through an e-learning platform. All participants complete a required project, which addresses a divisional or departmental need, meets standards associated with scholarship, and is submitted to a peer-reviewed forum. To date, over 115 faculty members have enrolled in MCW's faculty development programs. Program evaluation over the 15-year span has served to guide program revision and to provide clear evidence of program impact. A longitudinal evaluation of comprehensive program graduates from 1993 to 1999 showed that 88% of graduates' educational projects were implemented and sustained more than one year after program completion. Since 2001, each participant, on average, attributes more than two peer-reviewed presentations and one peer-reviewed publication to program participation. Based on 15 years of evaluation data, five tenets associated with program success are outlined.

Adult↗
PubMed2003

Using clinical risk management as a means of enhancing patient safety: the Irish experience.

This paper outlines the process and context in which the Clinical Risk Modification Project at Sligo Hospital, Ireland was established and focuses on the issues encountered from conception to implementation. The project is based in the emergency and orthopaedic departments and is of two years duration. The stated aim of this project is to design and test a framework incorporating the core components of a workable Clinical Risk Modification programme in the context of an Irish general hospital. This involved making an explicit commitment to the principles of a learning organisation including blame free risk reporting, providing education and awareness training to promote understanding of clinical risk management locally, and developing a clinical incident/near miss reporting system to address clinical risk in both a proactive and reactive way.

Forms and Records Control↗
PubMed1996

The use of student journals in problem-based learning.

This paper describes several examples of the use of journals in a Bachelor of Dental Surgery course. The examples cover: the use of journals in first year subjects and in later-year clinical subjects; the effect of changes in policy and practise as a result of experience with journals; and student views on their experiences with journals. The use of journals offers a means of achieving some of the more important goals of problem-based learning (PBL), particularly those requiring students to reflect upon and evaluate their experiences. When effectively integrated in a PBL course, journals have several functions: to formalize reflection; an outlet for personal feeling; an opportunity for feedback about a student's progress and about the course; to provide the student with a summary of the year's work; and a means whereby students and teachers gain insight into the learning process. However, our experience in Dentistry raises several contentious issues, especially with regard to confidentiality and assessment. We make several recommendations for the effective use of journals based on the need for frequent communication between students and staff, the development of an environment of trust, and the need for staff and student education in journal use.

Adult↗
PubMedDate not supplied

Performance improvement through self-paced learning.

Organizations are facing the economic challenges of managed care while employees are facing the domino effect. Both are having an arduous time with changes in healthcare delivery. Employees don't automatically fall into line with strategic plans for organizational change. They need current information and assistance into obtaining the necessary training related to their jobs. How does a medical center help employees to integrate the organization's mission, vision, and values into all work processes in ways that meet their needs? Adult learners need to know why they need to grasp the concept of managed care and how they can apply it on the job.

Efficiency, Organizational↗
PubMedDate not supplied

Discovery Path: a retention strategy for mid-career nurses.

As health care administrators, policymakers, nursing organizations, and nurses begin to deal with the reality of a looming (and to an increasing extent, existing) serious shortage of nurses both in Canada and globally, recruitment and retention issues are again in the news. Much attention has been directed towards two responses: (a) attracting young people into the profession and helping them integrate into and identify with nursing as a lifelong career, and (b) developing sustainable retention strategies to ensure that nurses remain in nursing. One population that requires particular attention is the mid-career group of nurses. Those nurses, in their late 30s and 40s with 15 and more years of experience, have the professional memory that employers count on, the expertise that patients and clients require, and the experience and wisdom that young nurses depend on for coaching, mentoring, and support. Retention strategies targeted to these mid-career nurses require a diverse set of activities that are focused on those nurses' specific stage of personal and professional development and that recognize their unique needs. The purpose of this article is to describe a program that targets mid-career nurses, predominantly women who, having spent much of their careers and lives caring for others-children, parents, patients-are beginning to question their own futures. The goals of the program and the experiences of one group of nurses in the program, as well as the results of a two-year follow up with them, will be discussed. Recommendations for future retention strategies will also be offered.

Adaptation, Psychological↗
PubMed1995

Developing nurses' moral reasoning skills.

Analysis of data from a Nursing Dilemma Test administered to 69 registered nurses employed at the Groote Schuur Hospital in Cape Town revealed a pattern of principled thinking in the groups with 5 to 9, 20 to 24, 25 to 29 and 30 to 34 years of clinical experience, whereas the group with the least clinical experience (0 to 4 years) showed no distinguishable pattern of thinking stages in moral judgement development.

Clinical Competence↗
PubMed2005

Growing our own: a model for encouraging and nurturing aspiring leaders.

DEVELOPMENTS IN western society have led us to question traditional leadership structures. This is particularly so in the context of care as people's health and social care needs change, technology advances and public expectations rise (Department of Health 1999). Bennis (2000), and Kouzes and Posner (2003), identify a style of leadership known as 'transformational leadership', which describes the ability of leaders to influence others by transforming their behaviour without necessarily being in positions of authority. Such leaders can inspire others to follow them by displaying characteristic leadership behaviours. These leadership behaviours are described by Kotter (1990) and are laid out in Table 1.

Attitude of Health Personnel↗
PubMed1993

Lessons learned in developing a total quality management process.

While the barriers to TQM implementation are many and the lessons learned can be very painful, we are convinced the results are well worth the effort. TQM implementation is a long term strategic approach and while results can be fairly quick, organizational cultural change and strategic redirection take time. Progress can be very slow. By reducing waste, rework, and variation we can both improve quality and reduce cost. The ultimate goal of TQM is to have organizational members using the quality tools in their daily work life. As an increasing number of health care organizations move through the four phases of implementation, sharing lessons learned can help us understand how to evaluate our quality processes and sustain the improvement process.

Consumer Behavior↗