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Biomedical subjects

Katherine Camacho Carr

Publications and source records attributed to Katherine Camacho Carr.

8 recordsLinked to original sources
PubMed2006

Professional liability issues and practice patterns of obstetric providers in Washington State.

OBJECTIVE: To describe recent changes in obstetric practice patterns and liability insurance premium costs and their consequences to Washington State obstetric providers (obstetrician-gynecologists, family physicians, certified nurse midwives, licensed midwives). METHODS: All obstetrician-gynecologists, rural family physicians, certified nurse midwives, licensed midwives, and a simple random sample of urban family physicians were surveyed about demographic and practice characteristics, liability insurance characteristics, practice changes and limitations due to liability insurance issues, obstetric practices, and obstetric practice environment changes. RESULTS: Fewer family physicians provide obstetric services than obstetrician-gynecologists, certified nurse midwives, and licensed midwives. Mean liability insurance premiums for obstetric providers increased by 61% for obstetrician-gynecologists, 75% for family physicians, 84% for certified nurse midwives, and 34% for licensed midwives from 2002 to 2004. Providers' most common monetary responses to liability insurance issues were to reduce compensation and to raise cash through loans and liquidating assets. In the 2 years of markedly increased premiums, obstetrician-gynecologists reported increasing their cesarean rates, their obstetric consultation rates, and the number of deliveries. They reported decreasing high-risk obstetric procedures during that same period. CONCLUSION: Liability insurance premiums rose dramatically from 2002 to 2004 for Washington's obstetric providers, leading many to make difficult financial decisions. Many obstetric providers reported a variety of practice changes during that interval. Although this study's results do not document an impending exodus of providers from obstetric practice, rural areas are most vulnerable because family physicians provide the majority of rural obstetric care and are less likely to practice obstetrics. LEVEL OF EVIDENCE: III.

Adult↗
PubMed2002

Midwifery education today.

Today, there are more than 7000 CNMs and CMs in the United States, who attend approximately 9% of American births annually in hospitals, birth centers, and homes. Midwives work in a variety of practice models, including group practices with physicians, HMOs, private practices, rural and urban community health centers, and large managed care organizations. CNMs and CMs also serve as administrators, policy makers, and consultants in international maternal and child health. Midwifery education has come a long way since 1931, when the first education program started. The dedication of CNMs to our clients and the midwifery model of care, as well as these midwifery educational innovations, will continue to support the profession's goals of offering humane, holistic, and safe health care to women and their families.

Curriculum↗
PubMedDate not supplied

Innovations in midwifery education.

Midwifery educators and the American College of Nurse-Midwives (ACNM) have created educational pathways for Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) based on sound principles and creativity. A review of these educational innovations portrays the strong foundation that exists and provides direction for the future. Accreditation of educational programs, the development of core competencies, and the certification process for graduates of midwifery education programs form the foundation for excellence in midwifery education, while the early development of the modular mastery learning curriculum provided a transition to later use of telecommunications and the incorporation of various instructional technologies into midwifery education. Midwifery educators have continued to innovate with distance-learning, Web-enhanced curricula and community-based clinical preceptorships, and a master's degree in midwifery option to increase access to midwifery education and degree programs. Continued innovation and creativity will be required to prepare midwives for the 21st century.

Certification↗
PubMedDate not supplied

Redesigning courses for the World Wide Web.

The use of computer-based instructional technologies has become almost ubiquitous in education, including health professions education. In addition, clinical practice requires the use of digital information, networking, and continued learning. Faculty, students, and clinicians must be prepared to use computer-based technologies and telecommunications. Many faculty members in the health professions need assistance with the transfer of traditional (campus-based) courses or course material to the World Wide Web. This article presents the instructional design and pedagogical aspects of redesigning a traditional campus-based course for the World Wide Web. Specific steps and a template are identified. The development of a virtual community of learners is also discussed as a critical element of on-line teaching and learning.

Computer-Assisted Instruction↗
PubMedDate not supplied

Cervical cancer screening in low resource settings using visual inspection with acetic acid.

Cervical cancer is one of the leading causes of death for middle-aged women in the developing world, yet it is almost completely preventable, if precancerous lesions are identified and treated in a timely manner. Cervical cancer screening based on cytologic examination is largely unavailable in developing countries or made available to a small, select group of women in private facilities, maternal child health sites, or family-planning clinics, missing the age groups at highest risk for precancerous lesions. Visual inspection with acetic acid (VIA) can be used to screen women. It can be done by nurses or midwives with appropriate training. Although still under investigation, research results show that VIA is simple, accurate, cost-effective, and acceptable to most women. This article reviews the natural history of cervical cancer and important aspects to consider related to cervical cancer screening in low resource settings. The VIA technique is described in detail.

Acetic Acid↗