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Results for “Competency framework”

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PubMed1993

[Curricular reform of undergraduate nursing--the Ribeirão Preto School of Nursing, the University of São Paulo. The Commission on Curriculum Restructuring of the Ribeirão Preto/USP School of Nursing].

The objective of the present study was to describe the process of curricular renovation for the undergraduate Nursing course developed by the Nursing School of Ribeirão Preto, USP, with emphasis on the following planning stages: diagnosis, educational objectives, selection and organization of content, curricular organization, curricular strategies, and curricular evaluation. In view of a diagnosis of current reality based on a philosophical-pedagogic approach which demonstrates the need to train general duty nurses, we present a conceptual framework directed at the view of man, community, health-sickness process, nursing, general duty nurses, competence, and curriculum. We propose a stronger emphasis on the teaching of biological and human sciences in the basic cycle, as well as on administrative aspects in sanitary and hospital activities. This curriculum covers the cycles of preprofessional and professional training to be offered over eight semesters in the undergraduate Nursing course at EERP-USP.

Brazil↗

PubMed1994

A single mutation in bacteriophage T4 DNA polymerase (A737V, tsL141) decreases its processivity as a polymerase and increases its processivity as a 3'-->5' exonuclease.

The bacteriophage T4 DNA polymerase mutant A737V (tsL141 and tsCB120) was originally characterized as temperature-sensitive for DNA replication and an antimutator for transition mutations. Its antimutator phenotype is suppressed by the L771F mutation (Reha-Krantz, L. J., Stocki, S., Nonay, R., and Maughan, C. (1989) J. Cell. Biochem. 13D, 140). We find that the A737V polymerase arrests much more frequently than the wild type when polymerizing on primed single-stranded DNA templates. Although the 3'-->5' exonuclease of the mutant is indistinguishable from the wild type on single-stranded DNA, it is more active than the wild type on duplex DNA. In a single encounter with the primer, the wild type polymerase can incorporate more than 50 nucleotides. The processivity of the A737V polymerase is less than the wild type as a polymerase, but is greater than the wild type as an exonuclease. The L771F polymerase resembles the wild type in each of these properties, while the double mutant (A737V, L771F) is intermediate between the two single mutants. Kinetic studies of wild type T4 DNA polymerase (Capson, T. L., Peliska, J. A., Kaboord, B. F., Frey, M. W., Lively, C., Dahlberg, M., and Benkovic, S. J. (1992) Biochemistry 31, 10984-10994) suggest that DNA binds first to the polumerase active site, before adopting a configuration in which it can be hydrolyzed by the exonuclease. Within this framework, our studies suggest that DNA moves more readily from the polymerase- to the exonuclease-competent configuration on the A737V mutant polymerase, and that this movement is decreased by the compensating L771F mutation.

Amino Acid Sequence↗

PubMed2004

Use of community health workers in research with ethnic minority women.

PURPOSE: To explore roles and effectiveness of community health workers in research with ethnic minority women in the United States (US). METHODS: Medline (1966-2002) and CINAHL (Cumulative Index to Nursing and Allied Health Literature; 1982-2002) databases were used to locate published research studies on the use of community health workers with ethnic minority women in the US. Key words for searches were community health workers, community health aides, health promoters, and community workers. RESULTS: An integrative analysis of 24 studies showed that, despite varying roles and functions, evidence indicates that community health workers are effective in increasing access to health services, increasing knowledge, and promoting behavior change among ethnic minority women. Other advantages of using community health workers are to provide social support and culturally competent, cost-effective care. Recommendations for future directions of research with community health workers and ethnic minority women include improved conceptualization of the community health worker role, theoretical frameworks for research designs, enhanced methods for evaluating effectiveness, and increased community involvement.

Clinical Competence↗

PubMed2003

[Transposition of an American-designed comprehensive medical student examination within the framework of the forthcoming French nationwide comprehensive examination. A preliminary study].

Medical training is undergoing extensive revision in France. A nationwide comprehensive clinical competency examination will be administered for the first time in 2004, relying exclusively on essay-questions. Unfortunately, these questions have psychometric shortcomings, particularly their typically low reliability. High score reliability is mandatory in a high-stakes context. The National Board of Medical Examiners-designed multiple choice-questions (MCQ) are well adapted to assess clinical competency with a high reliability score. The purpose of this study was to test the hypothesis that French medical students could take an American-designed and French-adapted comprehensive clinical knowledge examination with this MCQ format. Two hundred and eighty five French students, from four Medical Schools across France, took an examination composed of 200 MCQs under standardized conditions. Their scores were compared with those of American students. This examination was found assess French students' clinical knowledge with a high level of reliability. French students' scores were slightly lower than those of American students, mostly due to a lack of familiarity with this particular item format, and a lower motivational level. Another study is being designed, with a larger group, to address some of the shortcomings of the initial study. If these preliminary results are replicated, the MCQ format might be a more defendable and sensible alternative to the proposed essay questions.

Adult↗

PubMed1995

Changes in student learning styles and adaptive learning competencies following a senior preceptorship experience.

The purpose of this pre-post comparison study was to examine the effect of the preceptorship experience on the learning styles (the manner in which individuals process information from the environment), adaptive competencies (the congruences between personal skills and task demands) and environmental press perceptions (the subjects' perceptions of the importance of each adaptive competency to effective functioning in a designated environment) of 37 fourth-year baccalaureate nursing students. Using Kolb's theory of experiential learning as the theoretical framework for the study, it was found that the students' learning styles were inconsistently categorized by two versions of Kolb's learning style inventory. The preceptorship experience was perceived by students to have significantly (P < 0.05) improved the development of their adaptive learning competencies. Students perceived the importance of divergent, accommodative and convergent learning competencies to be lower after the preceptorship experience, with the only significant difference (P < 0.05) being between pre- and post-convergent competencies. The preceptorship experience, however, was found to contribute significantly more (P < 0.001) to the students' development of most adaptive competencies than their weekly clinical experiences. The findings support the notion that a senior preceptorship programme is a valuable and worthwhile learning experience to include in baccalaureate nursing curricula.

Adult↗

PubMed2026

A systematic literature review of cultural concepts taught by pharmacist preceptors during pharmacy student experiential placements.

BACKGROUND: Cultural concepts such as cultural intelligence, awareness, competency and safety are essential in guiding culturally responsive care in health professional practice. Pharmacist preceptors play a pivotal role in sharing both clinical and cultural safe practice with pharmacy students. Culturally responsive care can contribute to achieving health equity, which is especially important for Indigenous communities. AIM: To review literature on cultural concepts in pharmacist preceptorship practices, and how these concepts are taught and communicated to pharmacy students during experiential learning. METHOD: The systematic review followed the PRISMA 2020 guideline. Scopus, PubMed, and Google Scholar were used to identify articles specific to pharmacist preceptors and pharmacy students published between 2015 and 2025, and available in English. RESULTS: Three full-text articles met the inclusion criteria. Major themes and subthemes were identified; pharmacist preceptors lacked preparedness to teach cultural concepts, resulting in variability in preceptors' understanding of cultural concepts and confidence in fulfilling preceptor responsibilities, underutilised structured frameworks to guide students' learning, challenges with preceptorship due to limited resources and support, and the influence of preceptorship on student learning, which impacted students' learning and competency. CONCLUSION: Pharmacy students had minimal exposure to culturally informed pharmacist preceptorship. It is likely that pharmacist preceptors require country-specific educational resources to support culturally safe preceptorship. Future research is required to substantiate these findings, and to guide culturally responsive practice and promote equitable health outcomes in diverse populations.

Humans↗

PubMed2006

A framework for cohesive healthcare coalition formation.

The mobilisation of cohesive and effective groups of healthcare human resource is important in ensuring the success of healthcare organisations. However, forming the right team or coalition in healthcare organisations is not always straightforward due to various human factors. Traditional coalition formation approaches have been perceived as 'materialistic' or focusing too much on competency or pay-off. Therefore, to put prominence on the human aspects of working together, we present a cohesiveness-focused healthcare coalition formation methodology and framework that explores the possibilities of social networks, i.e. the relationship between various healthcare human resources, and adaptive resonance theory.

Community Health Services↗

PubMed1997

Opening up the options: making the inflexible into a flexible framework.

The post-registration framework for registered nurses and midwives was set up to provide flexible continuing education programmes for registered nurses. For those students who already have the basic professional qualification specific to their area of practice, professional development programmes are intended as a vehicle for improving their own personal professional competence. However, for those individuals who wish to gain further qualification or to change from one practice context to another, it is argued that the framework does not adequately address their needs. At present, pre-registration diplomates emerge from the Project 2000 programme with a qualification which enables them to work in one specific area of practice only. This early specialization is not in line with current and projected USA and European thinking (Castledine 1995) and may lead to a reduction in the broad base of nursing knowledge. It is further argued that pre-registration programmes should provide a generic base of nursing theory and practice, whereas specialist knowledge and practice should be the main thrust of post-registration work. The authors argue that initial development of nurses in specialist areas at pre-registration level restricts their ability to respond to rapidly changing health care needs later in their careers. The post-registration framework should be a flexible vehicle by which individuals can gain expanded knowledge in a particular field of practice or can change professional direction if they wish. Thus, nurses would have the freedom to develop in a way that is most appropriate to their changing individual needs.

Education, Nursing, Baccalaureate↗

PubMed2003

Understanding our mistakes: a primer on errors in clinical reasoning.

Clinical reasoning allows physicians to move from areas of clinical uncertainty to points where the medical literature offers guidance, and is equally important in deducing whether the results of clinical trials are applicable to an individual patient. However, studies in the field of cognitive psychology indicate that the reasoning skills of clinicians are imperfect. Moreover, clinicians may be aware of their mistakes but often do not understand the cognitive processes underlying their errors. Greater understanding of the reasoning process has the potential to improve patient care but independent study of clinical reasoning can be difficult, as the literature is complex and unfamiliar to most physicians. This article provides an introduction to diagnostic reasoning and highlights some of the cognitive factors that lead to errors in clinical problem solving. Clinical scenarios are used to illustrate key points and place the material in a readily accessible framework.

Clinical Competence↗

PubMedDate not supplied

Intuition in nursing relationships: the result of 'skills' or 'qualities'?

Maintaining the scientific orientation of health and nursing care systems has resulted in a lack of focus on nurses' intuitive knowledge base. Consequently, confusion exists as to whether intuition in nursing is the result of acquired skills, or is dependent upon the inherent qualities of the individual. In deconstructing the apparently intuitive process of building rapport, neuro-linguistic programming (NLP) can offer insight, suggesting that rapport building depends on learnt skills that have moved into unconscious competence. The examination of nurses' intuitive knowledge, in order to identify underlying skills, needs to be just as rigorous as the acquisition of scientific knowledge. Examining intuitive knowledge can be achieved within a framework of reflective practice to counter the inherent dangers of an increasingly scientific approach operating within a caring profession.

Clinical Competence↗

PubMed1999

Epistemological development in adolescence and adulthood: a multidimensional framework.

Theories of epistemological development are reviewed. A framework describing variations in adolescents' and adults' intuitive conceptions of knowledge is proposed. Within the proposed framework, naive epistemologies are conceptualized in terms of their assumptions concerning (a) the nature of the knowledge acquisition process, (b) the degree of correspondence between knowledge and reality, (c) the certainty of knowledge, (d) the commensurability of knowledge across individuals, (e) the degree to which knowledge forms or inheres in a coherent system of thought, (f) the nature of meaning, (g) the appropriate procedures for evaluating competing beliefs, (h) the nature and role of authorities as sources of knowledge and justification, and (i) the nature of reality. This framework is used to describe possible developmental changes in adolescents' and adults' concepts of knowledge and to suggest how future researchers might address core issues concerning epistemological development.

Adolescent↗

PubMed2001

A synthesis of nine major reports on physicians' competencies for the emerging practice environment.

Medical education and training programs generally have been slow to introduce curriculum content that reflects important changes in practice organization and health services delivery. However, impetus for curricular reform is gaining momentum as national organizations endorse new content for both medical school and residency education. The authors and colleagues at Tufts Managed Care Institute reviewed nine reports by key national organizations to assess their positions on curricular reform in light of changes in practice and the system of care. The reports agree generally on the evolving nature of practice, the need to address these changes during medical school and residency training, and the description of the new curriculum content that they advocate. The authors grouped these reports' specific recommendations under ten curriculum domains: health care system overview; population-based care; quality measurement and improvement; medical management; preventive care; physician-patient communication; ethics; teamwork and collaboration; information management and technology; and practice management. They describe the reports' rationales and cite specific knowledge and skills that these national organizations identify within each domain. This domain-based framework synthesizes and complements the recommendations of these national organizations. The authors conclude that implementing curricular reform remains a challenge. The information and competencies need to be organized and sequenced for stage of training and specialty, and barriers to change require strategic and operational planning. Having a common nomenclature and framework will facilitate the introduction of new content within schools and programs, across departments, and among institutions nationwide.

Comprehensive Health Care↗

PubMed2005

An algorithmic framework for genome-wide modeling and analysis of translation networks.

The sequencing of genomes of several organisms and advances in high throughput technologies for transcriptome and proteome analysis has allowed detailed mechanistic studies of transcription and translation using mathematical frameworks that allow integration of both sequence-specific and kinetic properties of these fundamental cellular processes. To understand how perturbations in mRNA levels affect the synthesis of individual proteins within a large protein synthesis network, we consider here a genome-scale codon-wide model of the translation machinery with explicit description of the processes of initiation, elongation, and termination. The mechanistic codon-wide description of the translation process and the large number of mRNAs competing for resources, such as ribosomes, requires the use of novel efficient algorithmic approaches. We have developed such an efficient algorithmic framework for genome-scale models of protein synthesis. The mathematical and computational framework was applied to the analysis of the sensitivity of a translation network to perturbation in the rate constants and in the mRNA levels in the system. Our studies suggest that the highest specific protein synthesis rate (protein synthesis rate per mRNA molecule) is achieved when translation is elongation-limited. We find that the mRNA species with the highest number of actively translating ribosomes exerts maximum control on the synthesis of every protein, and the response of protein synthesis rates to mRNA expression variation is a function of the strength of initiation of translation at different mRNA species. Such quantitative understanding of the sensitivity of protein synthesis to the variation of mRNA expression can provide insights into cellular robustness mechanisms and guide the design of protein production systems.

Algorithms↗

PubMed2006

The diversity of critical care nursing education in Australian universities.

A range of critical care nursing educational courses exist throughout Australia. These courses vary in level of award, integration of clinical and academic competence and desired educational outcomes; this variability potentially leads to confusion by stakeholders regarding educational and clinical outcomes. The study objective was to describe the range of critical care nursing courses in Australia. Following institutional ethics approval, all relevant higher education providers (n=18) were invited to complete a questionnaire about course structure, content and nomenclature. Information about desired professional and general graduate characteristics and clinical competency was also sought. A total of 89% of providers (n=16) responded to the questionnaire. There was little consistency in course structure in regard to the proportion of each programme devoted to core, speciality or generic subjects. In general, graduate certificate courses concentrated on core aspects of critical care, graduate diploma courses provided similar amounts of critical care core and speciality content, while master's level courses concentrated on generic nursing issues. The majority of courses had employment requirements, although only a small proportion specified the minimum level of critical care unit required for clinical experience. The competency standards developed by the Australian College of Critical Care Nurses (ACCCN) were used by 83% of providers, albeit in an adapted form, to assess competency. However, only 60% of programmes used personnel with a combined clinical and educational role to assess such competence. In conclusion, stakeholders should not assume consistency in educational and clinical outcomes from critical care nursing education programmes, despite similar nomenclature or level of programme. However, consistency in the framework for speciality nurse education has the potential to prove beneficial for all stakeholders.

Australia↗

PubMed1999