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Patient education is important in reducing the risk of recurrence of myocardial infarction. Education should be specific to patients' individual needs. Patients need motivating to achieve the required behaviour changes. A multidisciplinary, multifactorial approach to education is most effective.
OBJECTIVE: This study investigated the impact of a collaborative clinical education model on students' perception of the psycho-social learning environment. DESIGN: A pre-test and post-test quasi experimental design. SETTING: A tertiary referral centre. SUBJECTS: Second and third year undergraduate nursing students were asked to rate their perceptions of the psycho-social learning environment at the completion of the clinical practicum. TOOL: The tool used to measure psycho-social perceptions of the clinical learning environment was the Clinical Learning Environment Inventory previously validated in Australian health care contexts. INTERVENTION: A collaborative arrangement with the university and ward staff where eight students are placed on a ward and a ward staff member is paid by the university to be 'off-line' from a clinical workload to supervise the students. This is in contrast to the standard facilitation model where students are placed with registered nurses in different localities under the supervision of a 'roving' registered nurse paid by the university. RESULTS: No significant differences were found in pre-test mean scores when comparing wards. Significant differences in post-test scores for the intervention group were identified in the sub scales of Student Involvement, Satisfaction, Personalisation and Task Orientation. CONCLUSIONS: The adoption of a collaborative clinical education model where students are integrated into the ward team and the team is responsible for student learning can positively enhance capacity for student learning during their clinical practicum.
For continuity in delivering healthcare across the continuum, an institutionally based home healthcare department was established at Georgia Baptist Medical Center, Atlanta, Georgia. The overall mission of home healthcare services is to maintain high levels of care while maintaining the lowest reasonable costs. Much of the department's patient care focuses on patients challenged with diabetes. This article describes the creation of a progressive, self-directed diabetes education model within this hospital-based home care program.
Although most clinical clerkship curricula are designed to provide all students consistent exposure to defined course objectives, it is clear that individual students are diverse in their backgrounds and baseline knowledge. Ideally, the learning process should be individualized towards the strengths and weakness of each student, but, until recently, this has proved prohibitively time-consuming. The authors describe a program to develop and evaluate an iterative, Web-based educational model assessing medical students' knowledge deficits and allowing targeted teaching shortly after their identification. Beginning in 2002, a new educational model was created, validated, and applied in a prospective fashion to medical students during an internal medicine clerkship at Harvard Medical School. Using a Web-based platform, five validated questions were delivered weekly and a specific knowledge deficiency identified. Teaching targeted to the deficiency was provided to an intervention cohort of five to seven students in each clerkship, though not to controls (the remaining 7-10 students). Effectiveness of this model was assessed by performance on the following week's posttest question. Specific deficiencies were readily identified weekly using this model. Throughout the year, however, deficiencies varied unpredictably. Teaching targeted to deficiencies resulted in significantly better performance on follow-up questioning compared to the performance of those who did not receive this intervention. This model was easily applied in an additive fashion to the current curriculum, and student acceptance was high. The authors conclude that a Web-based, iterative assessment model can effectively target specific curricular needs unique to each group; focus teaching in a rapid, formative, and highly efficient manner; and may improve the efficiency of traditional clerkship teaching.
This paper describes an integrated, needs-led palliative care education model for qualified nurses, developed by collaboration between a hospital-based palliative care team of a large NHS Trust and a specialist palliative care unit, in order to serve its common healthcare users. The aim of this model was to develop the knowledge and skills gained through clinical practice and ongoing education in order to achieve a basic level of expertise, and to enhance communication and collaboration between the hospital and community-based nursing services throughout the geographical area for for patients requiring palliative care.
Midwifery education has a rich tradition of blending innovation with educational methods that have demonstrated their value to the profession. Examples of innovations that have influenced midwifery education include the use of the asynchronous modular system, the development of distance methodologies, and most recently the use of computer and telecommunications technologies to mediate education. This study was designed to explore trends in approaches to the education of midwives in both traditional and distance education programs. Program directors were surveyed and interviewed to assess their degree of instructional synchrony, their use of distance modalities, and their predominate methods of curriculum presentation. Results of the survey suggest that programs are using a variety of these approaches to educate their students. Decisions to integrate new educational technologies appear to be based on institutional values, community resources, and student needs.
The objectives of undergraduate medical education have been shifted drastically during the last decades. As the world standard, basic medical knowledge, skill, and attitude to practice patient-centered medical care became main objectives in undergraduate medical education. In response to these changes in the environment of medical practice and education, the Medical Education Model Core Curriculum (MEMCC), was published in 2001. MEMCC describes general and specific behavioral objectives in an integrated form to be used in the practice of medicine. The achievement of MEMCC will be evaluated by the Nationwide Common Achievement Test. The test examines knowledge, skill, and attitude that is required for clinical clerkship. Pharmacological teachers in medical schools should discuss, study, and evaluate MEMCC based on their experience in the use of the curriculum. MEMCC and the Nationwide Common Achievement Test will enhance intra- and inter-disciplinary, as well as inter-institutional informational exchange in the context and strategies in pharmacological education.
BACKGROUND: Transmission of microorganisms from the hands of health care workers is the main cause of health care-acquired infections. Recent studies on bacterial contamination of hands by medical care specialty found the highest bacterial contamination on the hands of health care workers from rehabilitation units. The objective of this study is to determine the effect of a patient education model on hand hygiene (HH) compliance in a rehabilitation unit. METHODS: A 6-week pre- and post-intervention study with a 3-month follow-up using a patient education model was conducted in a 24-bed inpatient rehabilitation unit located in an acute care hospital. Thirty-five patients were enrolled in the intervention phase of the study after agreeing to ask all health care workers who had direct contact with them, "Did you wash/sanitize your hands?" Compliance with the program was measured through soap/sanitizer usage per resident-day before, during, and after the intervention. RESULTS: Usage increased from 5 HH per resident-day during the preintervention to 9.7 HH per resident-day during the intervention (P <.001), 6.7 HH per resident-day postintervention (6 weeks) (P <.001), and 7.0 HH per resident-day at 3 months (P <.001). CONCLUSIONS: Patient education increased HH compliance in an inpatient rehabilitation unit by 94% during the 6-week intervention, 34% during the 6 week post intervention, and 40% at 3-month follow-up. This program empowers patients with responsibility for their own care and provides ongoing HH education.
One reason that school nursing education programs vary from one geographic region to another is the difference in requirements for nurse certification by the different state boards of education. This has led to fragmentation and conflicting beliefs between the education and nursing communities about what should be included in a core curriculum. Changing family structure and health care needs of children today demand a more specific health focus in the education of school nurses. A recently-developed curriculum used the basic nursing core of a baccalaureate nursing program to identify the outcomes of school nurse education as specified by the professional bodies of the ANA and the NASN. The model incorporates only education course work that does not duplicate that in the BSN program.
Firstly, the many characteristics of expertise are examined: they include aspects of pattern recognition, knowledge, skill, flexibility, metacognitive monitoring, available cognitive space and teaching abilities. Secondly, three educational models from different domains (Nursing, Surgical Education, Education) are analysed, compared and contrasted, in relation to both educational approach and the development of expertise. Thirdly, a new model for the development of expertise is proposed, incorporating aspects of each of the three previously discussed models. Within this new model, four phases of development are proposed, culminating in the achievement of expertise. Furthermore, it is noted that under certain circumstances performance can deteriorate, and that with appropriate support, there can be recursion back through earlier phases of development. Significant implications for both healthcare education and practice are discussed, in relation to concepts of expertise, potential educational approaches and the proposed model for the development of expertise.
In recent years, a steady decline in the number of perfusion education programs in the United States has been noted. At the same time, there has been a parallel decline in the number of students graduated from perfusion educational programs in the United States. Also, as noted by several authors, there has been an increase in demand for perfusion graduates. The decline in programs and graduates has also been noted in anesthesia and surgical residency programs. The shift is caused by a combination of economic and clinical factors. First, decreased reimbursement has led to reallocation of hospital resources. Second, the original enthusiasm for beating heart coronary artery bypass surgery was grossly overestimated and has led to further reallocation of hospital resources and denigration of cardiopulmonary bypass. This paper describes two models of perfusion education programs: serial perfusion education model (SPEM) and the distributed perfusion education model (DPEM). Arguments are presented that the SPEM has some serious limitations and challenges for long-term economic survival. The authors feel the DPEM along with dependence on tuition funding can survive the current clinical and economic conditions and allow the profession to adapt to changes in scope of practice.
Implemented in New York City, the Child Welfare Fellowship Project is an international collaboration between social work educators in the United States and Jamaica, the West Indies, the public child welfare agency, and selected community-based agencies. This model educational program prepared selected Masters of Social Work (MSW) Fellowship students for exemplary child welfare practice with English-speaking Caribbean families by providing enhanced programs designed to support culturally competent skill development and a preventive approach to child welfare practice. These educational enhancements, combined with academic course work, increased professionalism, self-efficacy, and culturally competent skill development among participants and averted foster care placement for families seen over the duration of the project.
We designed a clinical education model for training staff orthopedic physical therapists to provide basic skills in orthopedic manual therapy. The program evolved in a health maintenance organization, where a large number of patients with acute and chronic musculoskeletal disorders receive care. As physical therapy became primary in the treatment of these patients, the staff needed to develop specialized clinical skill. We divided the program into four phases: Phase I--Lecture Series, Phase II--Evaluation of Clinical Skill, Phase III--Self-directed Study, and Phase IV--Re-evaluation. This clinical education assures the staff physical therapist of a supportive learning environment. The program enhances clinical development by identifying individual strengths and weaknesses and providing a positive framework for improvement and self-evaluation.
Nurses in this ambulatory care center recognized a need for a systematic, planned approach to health education, and developed a health education model. The nurses on the committee serve as inhouse consultants to help other nurses develop, implement, and evaluate health education programs.
As new opportunities for acute care nurse practitioners (ACNP) evolve, there is increasing recognition of the need to distinguish between the knowledge base and the role functions generic to all advanced practice nurses, and the knowledge base specific to different areas of clinical specialization. This necessitates differentiating between converging core curriculum elements and merging the roles of advanced practice nurses. This article presents an educational model for the ACNP.
The different Health Education (HE) models appeared in the scientific literature are analyzed, trying to eliminate the confusion produced by its great diversity, applying a general and systematic point of view. Due to the relevance of that topic in the activities of Health Promotion in Primary Health Care it is urgent a deep reappraisal due the heterogeneity of scientific papers dealing with that topic. The curriculum, as the confluence of thought and action in Health Education, is the basic concept thanks to which it is possible to integrate both scientific logic, the biological one and that pertaining to the social sciences. Of particular importance have been the different paradigms that have emerged in the field of HE from the beginning of the present century: a first generation with a "normative" point of view, a second one orientated from positivistic bases, and a third generation adopting an hermeneutic and critic nature. This third generation of paradigms in HE has taken distances from the behaviouristic and cognitive perspectives being more critical and participative. The principal scientific contributors in the field of HE, internationals as well as spaniards are studied and classified. The main conclusions obtained from this Health Education paradigm controversy are referred to both aspects: 1) planning, programming and evaluating activities, and 2) models, qualitative and quantitative methodologies. Emphasis is given to the need of including Community Participation in all phases of the process in critic methodologies of HE. It is postulated the critic paradigm as the only one able to integrate the rest of the scientific approaches in Health Education.
To effectively educate nurses who are able to meet changing health care needs, new models for clinical experiences must be considered. Collaborative arrangements between practice and education are particularly useful. The preceptor approach is used widely for seasoned students in senior experiences nearing graduation. The "paired" model, a variation on the preceptor model, has worked well in one setting for beginning students. It needs to be tried in other settings with different faculty and perhaps in other types of courses, and it needs to be tested. Collaboration between education and practice not only benefits education, but lays the groundwork for shared scholarly endeavors. Ultimately these relationships have a positive impact on patient care.
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