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Understanding the value added to clinical care by educational activities. Value of Education Research Group.

In an era of competition in health care delivery, those who pay for care are interested in supporting primarily those activities that add value to the clinical enterprise. The authors report on their 1998 project to develop a conceptual model for assessing the value added to clinical care by educational activities. Through interviews, nine key stakeholders in patient care identified five ways in which education might add value to clinical care: education can foster higher-quality care, improve work satisfaction of clinicians, have trainees provide direct clinical services, improve recruitment and retention of clinicians, and contribute to the future of health care. With this as a base, an expert panel of 13 clinical educators and investigators defined six perspectives from which the value of education in clinical care might be studied: the perspectives of health-care-oriented organizations, clinician-teachers, patients, education organizations, learners, and the community. The panel adapted an existing model to create the "Education Compass" to portray education's effects on clinical care, and developed a new set of definitions and research questions for each of the four major aspects of the model (clinical, functional, satisfaction, and cost). Working groups next drafted proposals to address empirically those questions, which were critiqued at a national conference on the topic of education's value in clinical care. The next step is to use the methods developed in this project to empirically assess the value added by educational activities to clinical care.

Ambulatory Care Facilities↗

Continuing education in general practice. 2. Impact of education activities.

Should continuing education for doctors be compulsory? Our study of General Practitioners in Queensland evaluated the usefulness of and preference for various types of educational activities. Lectures and consultants' letters were considered the most useful while pharmaceutical company evenings and visiting lecturers were most regularly attended. These latter activities were a useful source of medical knowledge: patient management skills were gained at weekend conferences; and procedural skills were obtained through hospital training courses.

Australia↗

Students' educational activities during clerkship.

PURPOSE: To quantify the educational activities and types of teachers that medical students had in third-year clerkships at community-based teaching hospitals. METHOD: In October-November 1992, 201 students in third-year medical clerkships at nine community-based hospitals completed a log that recorded the primary activity, site, and educator and method of education (for teaching or supervised activities) for each 15-minute interval of a 24-hour day. Each hospital offered at least three of the clerkships studied: medicine, obstetrics-gynecology (ob-gyn), pediatrics, psychiatry, and surgery. Statistical comparisons of the clerkships were done with chi-square analysis and one-way analysis of variance. RESULTS: The students received 6.5 hours a day of teaching with an instructor and committed an additional 4.9 hours to clerkship-related learning. Nearly 75% of the teaching fell to full-time faculty members and residents. In just over half of their educational activities the students participated with other learners, such as residents. The clerkships did not differ significantly in the amounts of formal teaching given; however, medicine did significantly more informal teaching, and surgery and ob-gyn did significantly more supervised practice. CONCLUSION: This preliminary study quantified medical students' educational activities in 1992 during third-year clerkships and provides baseline data describing these activities and the educators involved. Some findings may not be replicable, however, with the increasing demands of full-time faculty members in inpatient and outpatient settings and the shifting emphases in how and where residents provide instruction. Another study such as this one would help assess the effects on medical education of changes in the health care environment.

Analysis of Variance↗

A formal audit of continuing medical education activity for license renewal.

Formal audits of the continuing medical education activities of physicians licensed in Michigan were undertaken to assess compliance with a law mandating participation in 150 hours of continuing medical education each 3 years. A random sample of all physicians renewing their licenses in 1987 and 1988 were asked to provide documentation of their continuing medical education activities. The average physician participated in 175 hours of category I approved activities; 53.1% of the hours were obtained in a different state, and only 27.6% were obtained in the home community. A total of 13.7% (132/967) of the physicians were initially unable to document 150 hours of credit. Documentation deficiencies and addition errors were found on 72.5% of forms. If formal audits of compliance with legislation are to be undertaken, early notification of the participants and specific instructions for compliance are needed. Because of problems with documentation, only category I approved activities, with exclusions for trainees, should be used to assess compliance.

Adult↗

[Factors associated with the participation of pregnant women in maternal education activities at a health center].

OBJECTIVE: To determine the factors associated with participation in Maternal Education activities offered to pregnant women monitored at a Health Centre. DESIGN: A descriptive, transversal study. SETTING: Urban Health Centre. Population group with a medium to high social and economic level. PARTICIPANTS: A total of 107 pregnant women monitored at the Health Centre, whose probable delivery date was between 1.1.95 and 30.12.95. MEASUREMENTS AND RESULTS: The variables analysed were social and demographic, the presence of clinical and/or social risk, wanted pregnancy or not, week of attendance for clinical controls, referrals and health conduct during pregnancy (tobacco dependency). The profile of the pregnant women not receiving maternal education at our Health Centre was: average age 30; 86% married; 73% working outside the home; with an average of 1.4 children; 60.8% with medium to low educational level. The factors linked to not receiving maternal education were: leaving the programme (73.9% against 24%) and number of children (1.39 against 0.360). CONCLUSIONS: Women with more children and who stop attending for check-ups take less part in Maternal Education activities at our Health Centre.

Adult↗

Theory-based health education activities for third to sixth grade children.

Eight educational activities based on social learning and social support theories were used as part of a comprehensive cardiovascular risk reduction program for families with children in the third to sixth grades. These activities focused on providing the children with skills in recognizing high-salt and high-saturated fat foods, preparing such foods, resisting pressures to each such foods, increasing aerobic activity and providing support to peers and family in attempting such changes. Data analyses revealed significantly greater decreases in high-salt and high-saturated, fat food consumption and perceived increases in aerobic activity, in the experimental than the control group. The participative, enjoyment and inexpensive aspects of these activities are emphasized to encourage their use in school health programs.

Cardiovascular Diseases↗

[Educational activities of the Hungarian National Institute of Traumatology].

Author recalls the nearly four decades education activity of the National Institute of Traumatology and the Chair of Traumatology of the Postgraduate University of Medicine. The importance of the high standard therapeutical activity is stressed. Similarly the education based on scientific activity is also thought indispensable. He describes the technical conditions and the data of the more important courses.

Academies and Institutes↗

[Educational activities on the prevention of AIDS in a municipal basic health unit: participation of a nurse].

This is an exploratory descriptive study with a qualitative approach that had as its purpose to characterize the educational activities of the nurses that work in the prevention and control program for sexually transmittable diseases and AIDS in the municipality of Natal, RN. The study ws conducted in the basic health care units with 10 (ten) nurses that implemented educational activities in AIDS prevention. A structured interview was used and content analysis techniques were applied to the data. It was identified that the majority of the nurses understood health education as the transmission of information and that the AIDS prevention program had insufficient actions, lacked structure in the service settings and institutional support by the Municipal Secretariat of Health. The program activities were characterized as traditional limited, sporadic, and lacking human and material resources.

Acquired Immunodeficiency Syndrome↗

[Perceptions of the head physician concerning educational activities in Municipal Health Services].

The results of a research project carried out along with head-physicians of the Municipal Health Services (PAMs) of the city of S. Paulo in order to survey their knowledge, expectations and willingness to participate in and incentivate educational programs in the various PAMs, are reported on. An open-ended questionnaire was answered by 88.6% of the head-physicians. Results showed that the concept of health of the majority of the PAMs' head-physicians (66.3%) was coincidental with that adopted by the WHO. Only 2.9% considered that health is related to quality of life. Health education was seen as the provision of information by 70.0%; only 6.7% recognized their responsibility for the process of social and health change. According to 68.2% of them, health actions were acknowledged to be useful tools for making the users aware of the importance of having the diseases treated. Health actions, their planning, implementation and evaluation were considered to be the responsibility of all who work at the PAMs, but mainly of nurses, social workers and the health educator. Some difficulties in implementing educational activities were indicated; among them being lack of sufficient material and adequate space for their implementation, lack of professional Public Health Educators and, mainly, a lack of motivation on the part of both staff and population. The majority of the head-physicians recognized that educational activities are important, that they are carried out at least by part of their staffs, although frequently hampered by technical and operational difficulties.

Attitude of Health Personnel↗

Current status of Geriatric Dentistry Educational Activities in U.S. dental schools.

The current status of Geriatric Dentistry Educational Activities (GDEA) in U.S. dental schools is reported in this survey. Data were collected regarding faculty involvement in geriatric programs, didactic and clinical academic curricula, and other aspects of the ongoing activities in schools. Data were reported by 50 (88 percent) of the nation's 57 dental schools in continuing operation. Forty-two schools reported discrete GDEA at the time of the study. Seven of these schools had a formal division or department of geriatric dentistry. The survey indicated that educational qualification of GDEA coordinators had risen significantly in recent years. The mean number of didactic hours (29) of instruction in geriatric education available to students has also risen. Curriculum time and financial considerations were the primary obstacles to expansion of clinical geriatric activities. With the current economic constraints in dental education, present GDEA levels are unlikely to expand in the foreseeable future, unless governmental or private agencies recognize the importance of developing GDEA and increase their support.

Curriculum↗

[Educational activity during rooming-in: report of the experience of a nurse].

This study aimed at describing the experience of a group of nursing students as to the mother-child binomial while mothers roomed is at a university hospital. The main objective was to develop an educational activity related to caring for the newborn and the mother during hospital stay, immediately after the birth. This is a descriptive study and, in order to develop its activities, the participative method and teaching techniques were used. During this learning process, we could observe the interest and participation of the parturient women. It is the authors' belief that by offering an educational activity during the postnatal hospital stay, the level of awareness regarding the relevance of self-care and of the care for the newborn infant increases, which will result in an enhanced quality of life.

Brazil↗

Dietitians' participation in nutrition education activities for the public.

A questionnaire mailed to a random sample of 1,000 members of The American Dietetic Association produced responses from 375 dietitians who reported the frequency with which they had participated in nutrition education activities for the public in 1986. Respondents reported participating in 3,188 job-related nutrition education events and 1,201 volunteer activities. There was a very highly significant difference (p = .0001) in the number of job-related and volunteer nutrition education activities reported. The mean frequency of both job-related and volunteer nutrition activities in 1986 was 11.7, approximately one activity per month. When frequency of participation in 1986 was compared with a previous study in 1978, the total frequency was not significantly different.

Dietetics↗

A comparison of attitudes and exercise habits of alumni from colleges with varying degrees of physical education activity programs.

A survey of alumni attitudes about their college physical education activity (PEA) program and current exercise habits was sent to a representative sample (N = 3169) of alumni who had graduated between 1970 and 1984 from four private colleges. The percent returned was 48, 31, 43, and 41 from Colleges A-D, respectively. Three of the four colleges had required PEA programs. College A had an eight-credit-hour requirement, College B required four credit-hours, College C required two credits, and College D did not have a PEA requirement. Results indicated a significant difference among the four colleges in the alumni's perceived value of their college PEA program in terms of its contribution to their knowledge about fitness, attitude towards fitness, and current exercise habits. Additionally, alumni differed in their perception of the health value of exercise and in their frequency of weekly exercise. When alumni exercise behaviors were quantified by aerobic points and classified according to type of activity, no statistically significant differences were found. The conclusion of the study was that the attitudes and exercise behaviors of alumni are related to the type of college PEA requirement; however, aerobic points earned are not affected. Students graduating from colleges with higher PEA requirements demonstrate more positive exercise attitudes and behaviors.

Adult↗

An international survey of the educational activities of schools of pharmacy on psychoactive drugs.

A survey of the educational activities of schools of pharmacy on psychoactive drugs in 92 countries was carried out. All the schools which replied felt that there was a need for specific education on psychoactive drugs, and the majority felt that the rational use of such drugs should also be taught. Both the amount of teaching given and the methods used varied. This was particularly true for related subjects such as alternatives to psychoactive drug use. Almost a third of schools considered that they did not devote adequate time to psychoactive drugs and their rational use, and many would be grateful for specific educational guidelines in this area.

Curriculum↗

Effectiveness of a worksite nutrition education activity in a factory in China.

To evaluate the effectiveness of a worksite nutrition education activity in China, a two-group pretest-posttest nutrition education lesson was designed and carried out in two divisions (N = 240 in each division) of a steel tube factory in Chengdu, Sichuan. Special features of the program were nutrition education materials developed from both (a) the results of a pretest survey of the employees, and (b) focus group discussions conducted with factory hospital and workteam staff; a colloquial style; a slogan; and an illustrated handout depicting the new Chinese Dietary Guidelines and a proposed Food Guide. Analysis of variance, chi-square, and t-tests showed both significant increases (p < 0.05) in nutrition knowledge and attitude scores and significant improvements in dietary practices in the group receiving the education. It is concluded that the method is a useful and practical model for designing and developing worksite nutrition education in China.

China↗

IDEA: an index of dental educational activity.

This paper reports on the construction of an index of dental educational activities (IDEA) developed as part of an exploration of continuing professional development activities among a sample of general dental practitioners (GDPs) in the Yorkshire Region in Britain. To assist in the interpretation of the index scores an analogy is drawn to an academic examination. Only 50% of the GDPs passed, 31% achieving scores of 40% or less and 9% distinctions. Higher IDEAS were achieved by practitioners who spent a lot on their dental education, those who intended to attend continuing education events next year practice principals, those who worked in larger practices and men GDPs. Little difference in the scores was observed by the age of the practitioner, experience of working in hospital or distance from the central continuing education centre. Discussion centres on the utility of the index as a summary of updating practices and its potential as a comparative measure across health professions. High levels of continuing professional development and thus high IDEAs must be encouraged, but they need to be accompanied by high quality care and effective job performance.

Education, Dental, Continuing↗