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Biomedical subjects

E H O'Neil

Publications and source records attributed to E H O'Neil.

At least 19 recordsLinked to original sources
PubMed1999

Responses of baccalaureate and graduate programs to the emergence of choice in nursing accreditation.

Specialized accreditation in nursing is a widely recognized and respected hallmark of program quality. The advent of a second specialized accrediting agency for baccalaureate and higher degree programs in nursing prompted a survey of these programs to determine their choice of nursing accreditation agency, factors influencing their choice, their perceptions of the value added by nursing accreditation, and the difficulties encountered with the accreditation process. These study variables and the relationships between choice of accrediting agency and types of degree-granting nursing education programs offered by the institution, agency membership in the National League of Nursing (NLN) or the American Association of Colleges of Nursing (AACN), expected date of next accreditation visit, geographic region, public versus private status, and type of institution (Carnegie classification) were analyzed. Findings revealed that nearly a quarter (24%) of respondents intend to continue with the NLN Accrediting Commission (NLNAC), whereas 30% indicated they have already switched to the Commission on Collegiate Nursing Education (CCNE) or intend to do so prior to their next accreditation cycle. However, nearly a quarter (24%) of respondents said they plan to be accredited by both agencies for the immediate future, and 21% indicated they are still undecided. Study findings suggest an end to single-source accreditation, and the beginning of a new market-oriented approach.

Accreditation↗
PubMed1998

Academic deans' perceptions of current and ideal curriculum emphases.

This study assessed the current and ideal for dental curriculum emphasis of thirty-three curriculum topic areas and evaluated barriers to curriculum change. A forty-six item survey was mailed to the academic deans of all U.S. dental schools with an 86 percent e response rate (n = 57). The means of their responses for current curricular emphasis and ideal emphasis on the thirty-three topic areas were compared. "Health promotion/disease prevention," "primary care," and "effective patient-provider relationships/communication" were the three topic areas rated most highly (for ideal emphasis) by the academic deans. "Case management," "outpatient/ambulatory care," and "continuous quality improvement" also received high mean scores for ideal emphasis. The most significant barrier to curriculum reform was "an already crowded curriculum." The academic deans reasserted the traditional emphasis in dentistry on primary care. There also appears to be considerable support for educational programs that will foster better patient relationships and greater quality assurance and control.

Ambulatory Care↗
PubMed1997

Insights into medical students' career choices based on third- and fourth-year students' focus-group discussions.

PURPOSE: To identify previously unrecognized factors influencing medical students' career choices and to better characterize the effects of educational experiences, role models, and educational debt on career decisions. METHOD: Fifty-two third- and fourth-year students were recruited from three California medical schools to participate in focus-group discussions. The students were assembled into 12 groups of about four classmates from the same school, each facilitated by a medical student from another school. Focus-group discussions were audiotaped and qualitatively analyzed using content analysis. RESULTS: The students' perceptions of their abilities to influence patients' outcomes and to cope with a large knowledge base differentiated those interested in primary care fields from those attracted to procedure-oriented specialties. Negative role models, based on the students' assessments of interpersonal interactions and career satisfaction, were particularly influential in closing doors to certain fields. Many of the women reported an absence of role models. Most of the students denied any effect of debt or potential income on career choice; while many cited their small debts, some of the women alluded to the anticipation of being in dual-income families. CONCLUSION: Students' career decisions are complex, dynamic, and individualized processes. The use of qualitative measures helps bolster understanding of these processes by identifying new factors (such as mastery of knowledge) and by further characterizing known factors (such as role models and financial considerations). A comprehensive and valid understanding of students' career-decision making is necessary to develop successful strategies to sustain and encourage the choice of primary care careers.

California↗
PubMed1997

Academic deans' views on curriculum content in medical schools.

PURPOSE: To determine which of 33 topics academic deans identify as worthy of greater emphasis in medical curricula. Also, to assess the barriers to needed curricular changes. METHOD: In March 1996 a questionnaire was developed and mailed to the academic deans of all U.S. schools affiliated with the Association of American Medical Colleges (n = 126) and all schools associated with the American Association of Colleges of Osteopathy (n = 17). There were 46 questions in a five-point Likert-type format (1 = not at all, 5 = to a great extent) and one open-ended question. The deans were queried as to what extent each of 33 topics (1) was included in medical students' required learning experiences (current emphasis) and (2) should be included in medical students' required learning experiences (ideal emphasis). The deans were also asked to what extent they believed 12 different factors would be barriers to needed curriculum changes in their programs. Primary data analysis focused on simple comparisons of response means and frequencies. RESULTS: Two separate mailings resulted in the return of 100 questionnaires (70%): 85 from the allopathic schools (67%) and 15 from the osteopathic schools (88%). "Effective patient-provider relationships/communication," "outpatient/ambulatory care," and "health promotion/disease prevention" had the three highest mean ratings for ideal emphasis by the allopathic school deans. "Primary care," "professional values," and "use of electronic information systems" also had high mean rankings for ideal emphasis. "Primary care," "outpatient/ambulatory care," and "health promotion/disease prevention" had the three highest mean ratings for ideal emphasis by the osteopathic school deans. CONCLUSION: Changes in health care delivery and an increasing generalist orientation are influencing academic deans' perspectives on needed curriculum changes, and there appears to be considerable support for medical school curricula that will foster a broader, more humanistic role for physicians.

Attitude↗
PubMed1996

Characteristics, importance, and implications of comprehensive drug therapy management.

Ideas and opinions about comprehensive drug therapy management (CDTM) were gathered from an expert panel representing health care practitioners, educators, and consumers. A qualitative method of inquiry, the Delphi technique, was used to aggregate opinions of an expert panel of health care professionals, health care educators, and consumer representatives. The 66 experts who agreed to participate in the study consisted of 10 from pharmacy education, 10 from pharmacy professional associations, 20 from managed care, 19 from primary care, and 7 consumers (public members of health care regulatory and governing boards). Each participant was sent a questionnaire designed to evaluate a preliminary definition of CDTM and gather opinions on related topics. A second questionnaire was sent to the participants to determine the extent of their agreement with each statement generated by the first questionnaire. A third questionnaire was sent, asking participants to reconsider their ratings in light of the group's responses and to choose the most important elements. The response rates were 83% for the first questionnaire, 70% for the second, and 76% for the third. The panel reached a high level of agreement on a definition of CDTM. Panel members also identified many critical aspects of CDTM, including what makes it worthwhile, barriers to and facilitators of engaging in CDTM, key participants, ways in which responsibility for CDTM may be shared, and the competencies needed for CDTM. An expert panel of health care leaders and future leaders, within and outside the pharmacy profession, reached a high level of agreement on a definition of CDTM and identified many critical aspects of this concept.

Consumer Behavior↗
PubMed1996

"Bimodal" medical schools: excelling in research and primary care.

The authors studied four "bimodal" medical schools--those ranked in the top 20% by the Association of American Medical Colleges both in production of primary care physicians and in receiving research grants from the National Institutes of Health. A descriptive, anthropologic method was used to describe the cultures of these schools and to determine common factors in their success. The four schools are at the University of Washington, the University of North Carolina, the University of California, San Francisco, and the University of California, San Diego. These common factors ranged from characteristics of the schools to characteristics of their external environments. All four are part of large, state-supported universities. They are relatively new schools in areas of the country that have blossomed in biotechnology, aerospace, and computer industries. The schools' missions, admission committees, and educational programs reflect their dual role: to meet the health care needs of their states and to advance basic science knowledge in medicine. Each state has a strong Academy of Family Practice, and the medical schools have been in the forefront of residency training in this specialty. Federal- and state-funded Area Health Education Centers and private foundations have provided seed money for educational programs in community and rural settings that attract medical students to primary care. Research-intensive medical schools can encourage students to enter primary care specialties if they have strong primary care leaders and programs and if they support medical education programs outside the academic, tertiary-care center. A culture of mutual respect and commitment to community service is also essential to achieving this bimodal success.

California↗
PubMed1995

Health care reform and medical education: forces toward generalism.

The transformation of U.S. health care is driven by underlying principles. The tensions between what exists now and what will emerge over the next 15 years pervade health care delivery and financing, the doctor-patient relationship, the provider-payer relationship, and the atmosphere within educational institutions for the health professions. The institutions that early on develop the capacity to forge and sustain strategic partnerships will be well positioned to take advantage of the opportunities of a rapidly changing system, but those that do not will risk being isolated without the diversity of resources needed to make meaningful contributions to health care. The tensions also drive major changes in the way health professionals are educated, trained, and deployed. Health care reforms will dramatically change the culture of the medical school in areas of patient care, research, and education programs. These institutions face external pressures to change and internal barriers to change, not the least of which are the lack of sustained leadership and collective vision. Academic medical centers must take active steps now to assess their strengths and weaknesses objectively, look realistically at options, and construct new, mutually beneficial partnerships that will be the keys to success.

Academic Medical Centers↗
PubMed1995

Professional competencies in the changing health care system: physicians' views on the importance and adequacy of formal training in medical school.

PURPOSE: To examine physicians' attitudes toward 16 competencies deemed essential to the effective practice of medicine in the changing health care system. METHOD: In early 1991 a telephone survey was conducted of 300 physicians from random samples selected as representative of the physician population in the continental United States. The physicians were categorized as general practitioners, surgery specialists, and other specialists, and as belonging to the graduation cohorts of 1960-1969, 1970-1979, and 1980-1989. The physicians were asked to rate (1) the importance of formal undergraduate training in each of 16 competencies and (2) the adequacy of their own undergraduate training in the competencies (these ratings are reported only for the 87 physicians in the 1980-1989 cohort). The competencies were derived from the skills, attitudes, and behaviors defined by the Pew Health Professions Commission as necessary for the nation's health care practitioners to meet society's evolving health care needs. RESULTS: Fifty percent or more of the physicians thought that 12 of the 16 competencies were "very important" to include in undergraduate training. Over 75% thought that it was "very important" to include the five competencies involving skills traditionally valued in medical practice: diagnosis and treatment, effective communication with patients, problem solving, lifelong learning, and counseling on medical ethics. More than 50% thought that undergraduate training was "very important" in some competencies that reflect the changing dynamics of medicine and care delivery over the past ten years: health promotion and preventive medicine, involvement of patient and family in care, management of large volumes of information, appropriate use of technology, working on a team with other professionals, and consideration of cost in clinical decision making. In rating their own training, over 50% felt well prepared (ratings of "excellent" or "good") in the five traditional competencies and, in addition, in their abilities to promote health, to manage large volumes of information, to work in teams, to understand and respond to diverse cultures, and to expand access to care. However, a majority felt that their training was only "fair" or "poor" regarding the involvement of patients and their families, evaluation of the appropriateness of costly technology, consideration of cost implications in their decision making, and understanding and supporting the community's role in health care. Forty percent or more felt poorly prepared to work in managed care settings or to accommodate increasing external scrutiny. CONCLUSION: The physicians validated the traditional strengths of medical schools, but revealed curricular weaknesses in the teaching of competencies proposed as important for the emerging health care system, especially in the managed care environment.

Attitude of Health Personnel↗
PubMed1995

Public attitudes toward dentists: a U.S. household survey.

This article reports on research that assessed public attitudes toward dentists and the dental profession and compared them to dentists' own attitudes about their roles. Enhanced knowledge of patients' perceptions can help practicing dentists gain a better understanding of public perceptions of themselves and of dentistry as a profession, as well as enhance their relationships with patients.

Adult↗
PubMed1995

Community health workers: integral members of the health care work force.

As the US health care system strives to function efficiently, encourage preventive and primary care, improve quality, and overcome nonfinancial barriers to care, the potential exists for community health workers to further these goals. Community health workers can increase access to care and facilitate appropriate use of health resources by providing outreach and cultural linkages between communities and delivery systems; reduce costs by providing health education, screening, detection, and basic emergency care; and improve quality by contributing to patient-provider communication, continuity of care, and consumer protection. Information sharing, program support, program evaluation, and continuing education are needed to expand the use of community health workers and better integrate them into the health care delivery system.

Community Health Workers↗
PubMed1994

The physician's role. Views of the public and the profession on seven aspects of patient care.

OBJECTIVES: To determine the importance of various areas of physician competency and to assess the public's ratings of their own physicians. DESIGN: A nationwide household telephone survey. PARTICIPANTS: A random sample of 640 US adults (61% response rate). MAIN OUTCOME MEASURES: Ratings of importance and physicians' competencies in diagnosing and treating illness, communication, ethical conduct, cooperation with other health care professionals, promotion of preventive care, use of technology, and consideration of the cost of care to the patient. RESULTS: Physicians were rated lowest on communication skills and on attention to the costs of the recommended treatment. A comparison of the results with a similar survey of physicians shows that physicians rate their training the lowest in these same areas. Physicians in general practice were rated lower on several competencies than were other physicians. CONCLUSIONS: Health care consumers and physicians share similar values about what is important in the role of a physician. In the areas of communication and attention to the costs of treatment, public needs are not always being met.

Adult↗