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PubMed2002

Knowledge fields and inner patterns in clinical laboratory science.

OBJECTIVE: The purpose of the study was to clarify the knowledge base of clinical laboratory science (CLS). This research was motivated by questions concerning the knowledge base itself and its abilities to meet the demands of reality. The following questions were therefore asked to achieve the purposes of the study: What are the knowledge fields and inner patterns in CLS? Which research objects could CLS focus on in order to promote development in practice, education, and research? DESIGN: The findings of the study were arrived at by means of hypothetical-deductive approach and inductive, content analytical strategy. The journal Clinical Laboratory Science of the American Society for Clinical Laboratory Science (ASCLS) provides the source material for the analysis. SETTING: Abo Akademi University, Faculty of Social and Caring Sciences. RESULTS: The findings of the study are discussed in the light of starting points of the theory of science and lead to nine hypotheses concerning CLS. CONCLUSION: The purpose of the present study was to create clarity in CLS as a science of its own. This has been achieved by capturing and describing facts and qualities, and thereafter presenting fundamental hypotheses in CLS. The results of this study give a thought structure for continued development and deepening within the theory and practice of CLS.

Clinical Laboratory Techniques↗
PubMed2004

Evaluation of an environmental health education program: assessing changes in knowledge of health professionals.

Knowledge about environmental health is crucial for nurses so they can take into account both the living and occupational environments of clients during history taking and physical assessments. When focused on local environmental conditions and exposures, outreach educational programs on environmental health can result in a measurable increase of interest to learn and enhance the knowledge base of participants. Public health agencies and educational institutions should consider entering into partnerships to sponsor such professional development programs for nurses and other health professionals to promote the health of local populations.

Education, Nursing, Continuing↗
PubMedDate not supplied

Faculty development for family medicine: a status report.

Stability in family medicine residency program growth has resulted in a trend to redefine faculty development in terms of changing needs. Recent literature has indicated these needs to be in the areas of increased research, improved clinical skills, reassessment of content and methods of faculty development, and changes in educational methods. To identify the status of faculty development programs in 1985, 126 family medicine university-based programs were surveyed. Data were obtained regarding the content of faculty development programs, the perceived competence of faculty in six clinical teaching areas and three academic areas, and the importance of eight areas of faculty development. The most frequent activity reported by the 74 respondents was in the area of teaching and evaluation. Research was the academic area listed in which directors noted a particular lack of competence. In the clinical content area, both procedural skills and critical care stood out as areas of faculty needs. Results suggested that more than one track of faculty development should be provided to meet complex and changing faculty development needs.

Education, Continuing↗
PubMedDate not supplied

Introduction of a microcomputer for health research in a developing country--the Bangladesh experience.

In November 1984, a powerful microcomputer was taken to Dhaka, Bangladesh, to aid health professionals at the National Institute for Preventive and Social Medicine (NIPSOM) in processing and analyzing locally derived health data. It was anticipated that this installation and an accompanying workshop on the analysis of health, population, and family planning data by microcomputer would enable the faculty at NIPSOM to share the results of their research with other public health and medical colleagues, provide administrators with timely analyses for policy or program implementation, and assist with internal management of information essential to the workings of the institute. This paper provides (a) a brief overview of NIPSOM and its recognized need for computing assistance, (b) a brief description of the 2-week workshop, (c) a description of the assembled software and hardware, and (d) a summary of the experience and the various problems encountered in bringing the computer to Dhaka and in teaching its use to educated health professionals with no prior computer contact.

Bangladesh↗
PubMed2003

2003 AUR Joseph E. And Nancy O. Whitley Award. Developing tomorrow's academic radiologists: a 3-month residency elective in education.

RATIONALE AND OBJECTIVES: The shortage of academic radiologists reveals an urgent need to attract more residents into academic careers. A great deal of attention has been focused on research, but few programmatic initiatives have addressed the development of the next generation of radiology educators. The purpose of this study was to develop and test a new 3-month residency elective in education. MATERIALS AND METHODS: A large academic radiology department developed a 3-month education elective, during which two residents would be relieved of clinical duties and focus full-time on tasks related to their development as educators, including the completion of a major educational project. RESULTS: Two residents, in their 3rd year and 4th year of residency, respectively, proposed to collaborate in developing a Web-delivered tutorial for the department's senior medical student clerkship. At the end of 3 months, their radiology tutorial was introduced. In its 1st month, it received a mean rating of 4.3 on a five-point scale. The residents stated that the elective had enabled them to develop important skills in instructional technology, put into practice their enhanced understanding of learning psychology, and substantially strengthened their overall commitment to academic careers. CONCLUSION: It is vital that residency programs focus on developing the next generation of radiology educators. This ongoing education elective represents one successful model.

Career Choice↗
PubMed1993

Practice parameters benefit all. Patient management strategies improve outcomes for patients, lower costs for payers.

Practice parameters, patient management strategies designed to help physicians make clinical decisions, can eliminate thousands of unwarranted medical procedures each year, resulting in greater satisfaction for patients and lower costs for payers. But physicians have yet to adopt many recently issued parameters. The enthusiasm with which they embrace newer guidelines depends on their views concerning the expertise of the sponsoring organization and the participants in the group that developed the parameter. Practice parameter development is costly. Before creating a practice parameter, it is a good idea to find out if a parameter already exists that can be modified for local use, or if one is being developed elsewhere. Some think inertia is a major obstacle to carrying out practice parameter guidelines. Others believe healthcare professionals' opposition is a more substantial roadblock. Some physicians believe practice parameters threaten their autonomy and the art of their practice. Pressure from patients to use certain procedures can also be an obstacle. Practice parameters work best if developed by authoritative physician specialty organizations. Implementation needs to be backed up with continuing education and feedback.

Attitude of Health Personnel↗
PubMed1997

Nursing ideology and the 'generic career'.

A review of the concept of ideology in a nursing context is presented. The meaning of a nursing ideology is explored and that meaning compared to the proposals for the future of nursing contained in the 1996 report on The Future Healthcare Workforce published by the University of Manchester, England. The paper suggests a number of core beliefs and values that are generally supported in nursing and their implications for the future development of the profession. These include a commitment to the role of science in nursing, the concept of caring in nursing practice and the continued pursuit of the professional project. The paper will demonstrate the extent to which the proposals contained within the report for a 'generic career' compliment or conflict with the suggested ideology of nursing. It concludes with a reference to the policy-making process at local and national levels and the opportunities available to nurses to influence the direction of change. The paper reflects the volatility of the current political climate in health care and the extent to which nurses operating in that climate feel empowered or disenfranchised.

Empathy↗
PubMed2001

Audiology in Latin America: hearing impairment, resources and services.

Evidence is presented about the limitation of information available on prevalence/incidence of deafness and hearing impairment in the developing world; particularly in Latin America. Two questionnaires on audiological resources and services were mailed to Latin American and Caribbean countries in general and to Central American nations in particular. The information returned by Argentina, Chile, Colombia, Costa Rica, Cuba, Belize, El Salvador, Grenada, Guatemala, Honduras, Mexico, Nicaragua, Panama, Puerto Rico and Uruguay was analysed. Data was gathered about epidemiological studies on hearing impairment, about specific programmes, such as early identification of hearing impairment, national registers on deafness and programmes on hearing screening. Training programmes and availability of professionals in the field of hearing and deafness is also shown. Hearing services, hearing aids provision, hearing testing equipment, professional organization and legislation in audiology is also documented. It is our conclusion that hearing impairment is a low priority for health systems in the developing world, technology continues to be excessively costly and material and human resources are limited, and services are poor and restricted.

Audiology↗
PubMed1992

Practitioners' use of theory: examples from a workgroup.

There is a continuing discussion within the field of health education about the relationship between theory and practice. Much of this discussion, particularly that which appears in professional journals, has been developed by academicians and is prescriptive. That is, it identifies ways in which theory should be used by practitioners. The purpose of this article is to facilitate this ongoing discussion by providing descriptive information on how theory is used by a group of health educators who work for the same organization. This information is used as a springboard for discussion more generally about the nature of theory in health education. This article represents the thinking and experiences of a dozen health professionals, in reaction to the question. "How do you use theory in your practice?" The authors believe this information will be useful in helping theoreticians develop more useful theory and helping practitioners increase their understanding of the utility of good theory. The division between theory and practice in the field of health education represents a significant opportunity and challenge to the discipline if energy can be redirected from criticism of the other "camp" to effective collaboration and enhanced effectiveness of health education efforts.

Attitude of Health Personnel↗
PubMed1991

The Flying Obstetric and Gynaecology Service in rural Queensland: its first two years.

OBJECTIVE: To present a report of the first two years of the Queensland Flying Obstetric and Gynaecology (FOG) Service which commenced operation in July 1988, and to assess the impact of the service on rural Queensland. DESIGN: Data were collected retrospectively for the surgical treatment and consultations provided by the FOG Service in its first two years, and for the obstetric and gynaecological surgery performed at Alpha Hospital, a typical rural hospital, before and after the inception of the service. SETTING: The service provides specialist routine and emergency care for the women of 24 western Queensland towns scattered over approximately three-quarters of the area of the State. RESULTS: In the first two years of operation of the service, the team performed 4985 consultations, 1127 colposcopies, 1793 operations, 1143 ultrasound scans, answered 100 emergency calls and flew 318,650 km, equivalent to eight times around the world. In the seven years before the FOG Service began, only 17 gynaecological operations were performed at Alpha Hospital; in the first two years of the service the team performed 47 operations in this town. CONCLUSIONS: The FOG Service has made a very significant impact on the delivery of specialist services to the women of outback Queensland, and has also provided continuing education opportunities and professional support for remotely placed rural medical and nursing staff. The service has proved its worth in Queensland, and provides a model for the development of similar services in other large States of Australia.

Adult↗
PubMed1998

A virtual university Web system for a medical school.

This paper describes a Virtual Medical University Web Server. This project started in 1994 by the development of the French Radiology Server. The main objective of our Medical Virtual University is to offer not only an initial training (for students) but also the Continuing Professional Education (for practitioners). Our system is based on electronic textbooks, clinical cases (around 4000) and a medical knowledge base called A.D.M. ("Aide au Diagnostic Medical"). We have indexed all electronic textbooks and clinical cases according to the ADM base in order to facilitate the navigation on the system. This system base is supported by a relational database management system. The Virtual Medical University, available on the Web Internet, is presently in the process of external evaluations.

Computer-Assisted Instruction↗
PubMed1997

Sociocultural dilemma of Japanese steeplejacks.

Japanese steeplejacks are good at working in high places as construction workers, and they have been called tobi for a longtime. They now play an important role in completing modern civil engineering projects and in the construction of high-rise buildings; however, their lifestyle is considered by most to be quaint but outdated. Originally, they were unskilled workmen at construction sites. In the 18th century, they were engaged in repairing houses or setting up scaffolding, helping carpenters, but they worked as firefighters whenever fires broke out. Their traditional work system did not change throughout the Meiji era, although Japanese society became greatly modernized. After World War II, the industrialization of Japanese society required highly developed technology in civil engineering and architecture. This provided an opportunity for them to establish their positions as trained professional workers. However, the number of skilled tobi professionals has continued to decrease because the younger generation does not consider this profession desirable career. Improving not only the professional skills but also the way of living to the extent as a modern high-tech society demands will be the key for the tobi's work system to become attractive.

Career Choice↗
PubMedDate not supplied

Growing your own: planting seeds for healthy rural hospitals.

Rural areas continually suffer from shortages of healthcare providers and healthcare professionals. Although research exists that addresses unique problems and opportunities associated with rural medical careers, little contributes to the development of providers from within the community. This article proposes a new approach to alleviating the shortage of rural healthcare professionals by looking toward the community's youth.

Health Workforce↗
PubMed1993

Historical perspectives on law, medical malpractice, and the concept of negligence.

Since the dawn of human history, the inherent morbidity and mortality of human beings has made the diagnosis and treatment of human disease a high-risk profession. The ancient risk of physical retribution against the physician has been replaced by the modern risk of economic indemnity or compensation. Monetary settlements and awards are at times so huge that they may result in personal bankruptcy and professional disgrace. This article should not discourage health care providers from continuing their pursuits, but encourage them to enhance their knowledge about how and why medical malpractice has developed. It has been intended to facilitate the "prudent practitioner" with a more thorough understanding of some of the elements of negligence that have caused concerns in the past and will certainly create new concerns as science continues to drag the law in its wake.

Criminal Law↗
PubMed2004

Manufacturing desire: the commodification of female sexual dysfunction.

The process of bringing new drugs to market interweaves commercialism, science, clinical medicine, and governmental regulation. Through their authority and public persona as medical experts, academic clinical trial researchers studying these pharmaceuticals are integral to this process, serving as mediators between producers (the pharmaceutical companies) and consumers (clinicians and patients) of new drugs through a complex set of exchange networks. Using examples from my ethnographic research on the search for pharmaceuticals to treat what has become known as female sexual dysfunction, this paper explores the links academic researchers make with drug manufacturers and consumer markets. Academic researchers have become an integral aspect of drug development, not only by conducting clinical trial research, but also by participating in a number of other activities that assist pharmaceutical companies in identifying and creating new markets. In this paper, i examine how researchers attend professional meetings where they present clinical trial data, lecture at continuing medical education conferences, and offer themselves as ' experts' to raise awareness about disorders and their treatments. Modifying a sociology of technology approach, this paper focuses on the actors in the social network who mediate the junctions between technological producers and consumers. This extends work in this area through theorizing the linkages between exchange networks, commodification techniques, and technoscientific developments.

Commerce↗
PubMed2003

Home care nurses' descriptions of important agency attributes.

PURPOSE: To identify attributes of home care agencies described by nurses as important to their professional practice and job satisfaction. DESIGN: Seven focus groups with home health care staff nurses were conducted at 6 home care agencies located in three states in the Mid-Atlantic region of the United States. A total of 58 home care nurses participated in the study. METHODS: Transcriptions of tape-recorded focus groups were subjected to open and axial coding techniques. RESULTS: Six major categories and eight subcategories of organizational attributes described by home care nurses as important to the support of their practice and job satisfaction were identified. CONCLUSIONS: Attributes described by home health nurses were not only similar to those described by hospital-based nurses as reported in the "magnet hospital" literature, but they also were consistent with key concepts described in theories of professional workforce organization. Findings provide insight into developing workplace environments to support home care nurses.

Adult↗
PubMed1998

Position of the American Dietetic Association: the role of nutrition in health promotion and disease prevention programs.

A healthful diet and wise food choices are critical components of promoting health and reducing the risk of chronic disease. A substantial amount of health care resources could be saved by expanding health promotion and disease prevention programs that target dietary change among Americans. To effectively reduce health care costs, the emphasis and delivery of health care must promote health as well as deliver treatment and rehabilitative services to the sick. Prevention measures, such as nutrition interventions that also encourage physical activity, can help prevent or halt progression of full-blown chronic disease and thus decrease chronic disease disability. Health promotion and disease prevention need to be integral parts of all health care, community, public health, and worksite programs across the life cycle. Correspondingly, such programs must be culturally competent and address the specific needs of vulnerable or underserved populations. Dietetics professionals in all areas of practice should play an integral role in health promotion and disease prevention programs. Achieving this goal will require expansion of training programs and active learning by dietetics professionals that includes theory and practice in using team approaches, developing coalitions, and managing complex systems. Dietetics professionals also need to amplify their understanding of politics, administration, health care financing, and reimbursement. Attention must also be expanded to include social and behavioral sciences and to address program evaluation, outcomes, and cost-benefit and cost-effectiveness in nutrition-focused health promotion and disease prevention programs. Continued training in program development, research, and evaluation will help build the body of evidence that supports ongoing inclusion of prevention in a rapidly changing health care environment.

Chronic Disease↗
PubMed2003

Royal Rehabilitation Centre Sydney: towards Clinical Development Units (Nursing).

Clinical Development Units (Nursing), also known as Practice Development Units and Nursing Development Units, are nursing units that continually strive for excellence in nursing practice. Nursing units endeavouring to attain, or having achieved, the standards required of a Clinical Development Unit (Nursing)--CDU(N)--provide a very motivating and stimulating environment for nursing professional development. This paper provides readers with an understanding of the underpinnings of a CDU(N) along with why and how a nursing unit would strive for this status. A priority of senior nurse management at a rehabilitation facility in Sydney, the Royal Rehabilitation Centre, has been working towards the upgrading of every nursing unit in their facility to the level of a CDU(N) over the past three years. By way of an innovative course, the Clinical Development and Leadership course developed by Professor Jennifer Greenwood in 1997, senior nurses are being provided with the knowledge and skills to enable them to work towards their goal of becoming part of a Clinical Development Unit (Nursing).

Credentialing↗