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Visiting clinician program in primary care internal medicine.

As part of a primary care internal medicine training program, a visiting clinician program was created to improve house staff education, provide an ongoing critique of the training program, and improve communication between program faculty and other institutions. Thirty-one visitors participated in the program during the two years covered by this report. The visitors were effective teachers, and residents noted that teaching by local faculty improved because the visitors demonstrated effective teaching techniques. Visitors made 337 suggestions to improve the primary care medicine program. A telephone survey after the visit indicated that more than half of the visitors had applied ideas from the host institution to their own programs. The program enhanced resident education, provided a periodic review of the training program, and fostered communication with faculty in other programs. The program's evolution over the two years is reported and suggestions are offered for institutions planning similar programs.

Evaluation Studies as Topic↗

Evaluating the effectiveness of a communication board training program.

This study introduces a technique for systemically observing the consequences of various aspects of treatment on the communicative effectiveness of nonspeaking persons using communication boards in natural settings. The case study of Kay, a 24-year-old nonspeaking woman residing in a nursing home, is presented. Three major factors were found to operate cumulatively in increasing Kay's overall communicative effectiveness: 1) revising the design of her original communication board; 2) training her to functionally use her new board to meet her daily communicative needs; and then 3) introducing interaction strategies to her listeners through an inservice training program. Highlights of Kay's and her staff's programs are discussed.

Adult↗

The effects of a 24-h psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study.

The usefulness of psychological training programs (P.T.P.) in health care settings devoted to cancer care is beginning to be recognised but their content, form and effectiveness need further investigation. Seventy-two oncology nurses were randomly assigned to a 24-h P.T.P. or to a waiting list period. Attitudes were assessed by a semantic differential questionnaire, occupational stress was assessed by the Nursing Stress Scale and communication skills were assessed by standardised videotaped role-playing exercises. These were used to compare trained (T.S.) and control subjects (C.S.). The results show a significant training effect on attitudes (P = 0.05), especially on those related to self concept (P = 0.004), and on the level of occupational stress related to inadequate preparation (P = 0.02). Limited changes were found regarding post-training communication skills. T.S. were significantly more in control of the interview than C.S. (P = 0.02). The results indicate that 24-h P.T.P. assessed here are effective. The data also demonstrate the need to consolidate the skills acquired by regular post-training sessions.

Adult↗

Support of programs for the communicatively disadvantaged child: role of the private foundation.

In comparison to its support of life-threatening diseases, the Federal government has given little support to preventing and alleviating communicative disorders. The very fact that they are not life threatening, means that communicative disorders can remain an uncomfortable, costly, and debilitating factor throughout the lives of millions of children and adults. In view of the magnitude of the problem and the lack of Federal support, responsible leaders are going to have to turn to the general public for support. Foundations, corporations and individuals can provide support for training and organizing services. Such support may well provide them with an opportunity to assist in an area which has touched their families or them personally. Research, training and service programs for the communicatively disadvantaged child are urged to seek financial support from private foundations.

Academies and Institutes↗

Development and evaluation of the Families, Cultures and Augmentative and Alternative Communication (AAC) multimedia program.

PURPOSE: The Families, Cultures and AAC Project was designed to provide professionals and families with accurate, culturally sensitive information about augmentative communication technologies and decision-making strategies through an innovative, user-friendly format. METHODS: The project resulted in the development of the first interactive bilingual CD-ROM designed to be used by professionals at the pre- or in-service level, and family members from diverse cultures to develop AAC decision-making competencies. RESULTS: The Interactive Health Communication (IHC) model provided an effective structure for conceptualizing, developing and evaluating the program. The program also incorporated universal access design concepts. The program was evaluated in the following 10 categories: usability, visual appearance, consistency, error tolerance, navigation, feedback, user control, redundant formats, content accuracy, and engaging styles. CONCLUSION: Reviewers of the program indicated that it was well designed and would be useful for the intended purpose.

Adult↗

Communication aids for the speech impaired. Cost and quality-of-life outcomes of assessment programs provided by specialist Communication Aids Centers in the United Kingdom.

An evaluation was conducted of the approaches, costs, and quality-of-life outcomes associated with communication aid assessment programs for the speech-impaired provided by specialist Communication Aids Centres (CACs) in the United Kingdom. The average costs of CAC assessment programs was 410 pounds per client, which is not excessive. There was evidence of moderate quality-of-life benefits from clients' use of the recommended aids.

Adolescent↗

Effects of a 105 hours psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study.

There is today a wide consensus regarding the need to improve communication skills (CS) of health-care professionals (HCPs) dealing with cancer patients. Psychological training programs (PTPs) may be useful to acquire the needed CS. Testing the efficacy of PTP will allow to define their optimal content. The present study was designed to assess the impact of a PTP on HCP stress, attitudes and CS, and on HCP and patients' satisfaction with HCP communication skills in a randomised study. A total of 115 oncology nurses were randomly assigned to a 105-h PTP or to a waiting list. Stress was assessed with the Nursing Stress Scale, attitudes with a Semantic Differential Questionnaire, CS used during one simulated and one actual patient interview with the Cancer Research Campaign Workshop Evaluation Manual, and satisfaction with the nurses' CS with a questionnaire completed by the patients and the nurses. Trained (TG) and control (CG) groups were compared at baseline, after 3 months (just following training for TG) and after 6 months (3 months after the end of training for TG). Compared to controls, trained nurses reported positive changes on their stress levels (P</=0.05) and on their attitudes (P</=0.05). Positive training effects were found on CS used during the simulated interview: a significant increase in facilitative behaviours (open questions: P</=0.001; evaluative functions: P</=0.05) and a significant decrease in inhibitory behaviours (inappropriate information: P</=0.01; false reassurance: P</=0.05). Less positive training effects were found regarding interviews with a cancer patient: a significant increase in educated guesses (P</=0.001) was noticed. No training effect was observed on nurses' satisfaction levels, but a positive training effect was found on patients' satisfaction levels (P</=0.01). Although results outline PTP efficacy, they indicate the need to design PTP, amplifying the transfer of learned CS to clinical practice.

Adult↗

[Professionals and managers on internal communication in the Program of Mother-Child Health of Andalucia. Evaluation Team of the PSMI].

OBJECTIVE: To find the views of primary health area directors and of professionals in health centres (HC) in Andalusia on internal communication within the Mother-Child Health Programme introduced in this autonomous community. DESIGN: Descriptive study that uses qualitative and quantitative methodology. SETTING: Primary care (PC) areas and HC in Andalusia, between July 1994 and February 1995. PARTICIPANTS: 51 PC area directors and 91 HC professionals. MEASUREMENTS AND MAIN RESULTS: Self-administered questionnaire (directors) and focus groups (professionals) were used. Analysis by non-parametric tests compared averages and analysed discourse contents. Internal communication was an important weakness in the Mother-Child Health Programme and in PC in general. There were important differences between the perceptions of directors and professionals in relation to the guidelines of the Mother-Child Programme. As such, in all the area administrations it was affirmed that there were programme objectives agreed with the professionals, and transmission channels for these objectives between the area and the centres, although these were transmitted in writing in under 25% of the areas. However, professionals thought that the objectives and guidelines of the programme were unclear and ill-defined. In addition, the view that the annual objectives are not negotiated was quite common. CONCLUSIONS: Internal communication in PC is a considerable weakness in HC management. The professionals perceive considerable conflicts of interest between them and the organisation's directors.

Communication↗