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Biomedical subjects

C E Osborne

Publications and source records attributed to C E Osborne.

14 recordsLinked to original sources
PubMed1982

Assessing needs for community hospital continuing medical education.

Between July 1, 1979, and June 30, 1980, 765 programs eligible for Category 1 credit were offered in 35 community hospitals. Data were collected to determine how the need was identified, who was responsible for conducting the needs assessment, and what influenced the choice of method. Data were collected by two methods: reviewing records for each course and interviewing each course director. Courses were planned using analysis of hard data (16 per cent) and an impressionistic method (84 per cent). The course director conducted the needs assessment and chose topics for 47 per cent; learners determined needs for 19 per cent. Possibly, CME programs should be viewed as offering systematic assistance in identifying personal needs and stimulating a physician to learn more by providing an opportunity to compare one's current practice with a desired or standard level. If discrepancies are identified, the physician must decide why they exist and assign levels of priority on resolution.

Education, Medical, Continuing↗
PubMed1982

Medical teachers' perspectives on development and use of objectives.

Experienced medical teachers were interviewed regarding creation and use of objectives for instruction. This paper summarizes reported advantages and disadvantages of objectives, describes reported changes in strategy with experience, and provides advice on the creation and use of objectives. Medical teachers agree that the process of writing objectives leads to clarification of intuitively held teaching goals and thus leads to better teaching and testing decisions. To achieve this benefit, an instructor must invest considerable time, effort and creativity in the process. The path of least resistance in writing objectives often leads to goals which serve no useful function and may be harmful to the teaching-learning process.

Education, Medical↗
PubMed1980

Relationship between medical audit results and the planning of continuing medical education programs.

The Medical Audit Committee chairmen in each of the 70 general hospitals in central and southern Illinois were interviewed. Each chairman was specifically asked questions related to 1) the purpose of their hospital's medical audit; 2) how audit topics are determined; and 3) their committee's competence at developing, conducting and following up on the results of their audit. Questions were also designed to investigate the usefulness of these audit results in planning formal continuing medical education (CME) activities. A total of 75 interviews were conducted with the following individuals: 32 chairmen from small hospitals, 18 from medium hospitals, 12 from large hospitals and 13 from hospitals that had department audit committees. Seventy-nine per cent of the chairmen believe that the Joint Commission on Accreditation of Hospitals' (JCAH) requirements are at least partially responsible for their hospitals conducting audits. More than half of the chairmen from small hospitals and one quarter of the other chairmen believed they would suspend conducting audits if the JCAH requirements were lifted. While 81 per cent of the chairmen believed audit was a good method of planning continuing medical education, only 23 per cent of the chairmen could identify a CME program that had been developed from audit. Even though it appears theoretically sound to base formal continuing medical education programs on needs identified through medical audit, those most directly involved in audit at the local hospital level in central and southern Illinois do not perceive this to be a workable model.

Attitude of Health Personnel↗
PubMed1977

Management criteria, recording of performance, and peer review of tonsillopharyngitis.

As part of a national study to formulate criteria for chart audit of quality assurance of child health care, criteria were developed for diagnosis and management of tonsillopharyngitis. These criteria were validated by pediatricians and family physicians in academic medicine and in practice. They were judged relevant to the medical care process and patient outcome by both. The selected criteria were also recommended by the majority of two large physician groups for use in peer review. In the first three phases of the study most of these criteria were said to be performed and recorded by a majority of physicians. However, in the fourth (community) phase, when charts of 166 primary-care physicians were actually audited, documentation was so poor that peer review by chart audit would be impractical at present.

Child↗
PubMed1977

Interdiagnosis relationships of physican recording in ambulatory child health care.

The joint Committee on Quality Assurance developed and validated by expert opinion a list of criteria for each of seven areas of ambulatory child health care: well-child supervision in four age ranges: bith to 1 year, 1 through 5 years, 6 through 12 years, and 13 through 18 years; and three diseases: bronchial asthma, tonsillopharyngitis, and urinary tract infection in the female. Each physician was scored on a list of criteria for each of the seven areas. The relationship among the areas was studied by correlating the scores on these criteria. The degrees of the relationships among the seven areas of care, and the reliability of each list of criteria are reported. All relationships were positive. Various age ranges of health supervision were more strongly related to one another than to any of the diseases. Individual diseases were more strongly related to one another than to health supervision. Reliabilities of each list ranged from .74 to .95. All correlations between areas were positive and, except for health supervision (birth to one year) with the three diseases, significant (p less than.01). These high correlations would imply a great deal of homogeneity among health care areas of ambulatory child health care.

Adolescent↗
PubMed1976

Quality assurance of ambulatory child health care opinions of practicing physicians about proposed criteria.

This paper reports the opinions of a representative sample of 1,329 physicians providing primary care regarding criteria developed by the Joint Committee on Quality Assurance for evaluation of ambulatory child health care. Areas of care were health supervision (in four age ranges), tonsillopharyngitis, bronchial asthma, and urinary infection. The criteria had been previously appraised by 452 "experts"--academicians and practitioners. Physicians rated criteria for relevance to health outcome, and desirability for use in peer review. They also stated whether they usually performed and recorded each item and gave reasons for not recording. Agreement between the pediatricians and other physicians of the sample and the "experts" was close regarding relevance to health outcome, but many fewer criteria were recommended for peer review by the sample. A significant number of respondents said they performed but did not record many of the criteria. Documentation of only abnormal findings was the main reason given for not recording. Criteria dealing with developmental or behavioral assessment or with counseling were rated lower in all categories than more easily measured items.

Adolescent↗
PubMed1976

Office records in the evaluation of quality of care.

Trained reviewers audited 10,500 charts in the offices of 166 pediatricians and family physicians. Criteria for child health supervision and three diseases had been previously validated for relevance to health outcome and suitability for peer review. Overall documentation of criteria was approximately 50 per cent. Measurements and laboratory data were recorded frequently; counseling items infrequently. Pediatricians documented health supervision items more often than family physicians. Members of large groups recorded more than those in solo practice or small groups. The presence of equipment considered important for health care did not correlate with percentage of recording. The method of review was judged accurate and acceptable by physicians, but only 50 per cent said the results accurately portrayed their performance. Lack of accurate recording may make it impossible to achieve valid peer review of ambulatory child care.

Adolescent↗
PubMed1976

Management criteria, documentation, and peer review of initial urinary tract infection.

During part of a national study to formulate criteria for chart audit of quality assurance of child health care, criteria were developed for diagnosis and management of urinary tract infections. These criteria were validated by pediatricians and family physicians in academic medicine and in practice. They were judged relevant to the medical care process and patient outcome by both. The selected criteria were also recommended by the majority of two large physician groups for use in peer review. An important aspect of the study assessed the frequency of performing and recording indicated procedures or tests. In the first three phases of the study these criteria were said to be performed and recorded by a large majority of physicians. However, in the fourth (community) phase, when charts of 166 primary care physicians were actually audited, documentation was so poor that peer review by chart audit would be impractical at present. Assuming proper documentation of the medical care process, similar criteria could be used for chart audit, clinical research, and educational purposes. Since the diagnostic and management process of initial urinary tract infection is established, development of structured health care forms and education in proper record-keeping are two important challenges for those interested in the evaluation of ambulatory care.

Adolescent↗