PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Competency framework”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 685 records · Page 38Linked to original sources
PubMed2004

Integrating the Accreditation Council for Graduate Medical Education Core competencies into the model of the clinical practice of emergency medicine.

In response to public pressure for greater accountability from the medical profession, a transformation is occurring in the approach to medical education and assessment of physician competency. Over the past 5 years, the Accreditation Council for Graduate Medical Education (ACGME) has implemented the Outcomes and General Competencies projects to better ensure that physicians are appropriately trained in the knowledge and skills of their specialties. Concurrently, the American Board of Medical Specialties, including the American Board of Emergency Medicine (ABEM), has embraced the competency concept. The core competencies have been integral in ABEM's development of Emergency Medicine Continuous Certification and the development of the Model of Clinical Practice of Emergency Medicine (Model). ABEM has used the Model as a significant part of its blueprint for the written and oral certification examinations in emergency medicine and is fully supportive of the effort to more fully define and integrate the ACGME core competencies into training emergency medicine specialists. To incorporate these competencies into our specialty, an Emergency Medicine Competency Taskforce (Taskforce) was formed by the Residency Review Committee-Emergency Medicine to determine how these general competencies fit in the Model. This article represents a consensus of the Taskforce with the input of multiple organizations in emergency medicine. It provides a framework for organizations such as the Council of Emergency Medicine Residency Directors (CORD) and the Society for Academic Emergency Medicine to develop a curriculum in emergency medicine and program requirement revisions by the Residency Review Committee-Emergency Medicine. In this report, we describe the approach taken by the Taskforce to integrate the ACGME core competencies into the Model. Ultimately, as competency-based assessment is implemented in emergency medicine training, program directors, governing bodies such as the ACGME, and individual patients can be assured that physicians are competent in emergency medicine.

Accreditation↗
PubMed1990

The ego competency model of psychiatric nursing: theoretical overview and clinical application.

The Ego Competency Model (ECM) of Psychiatric Nursing provides a focus for the role and function of the psychiatric nurse. The ECM offers a framework for assessing the patient's level of functioning in terms of certain ego strengths and deficits. Emphasizing a balanced health/illness focus, the model identifies three major goals of psychiatric nursing. The ECM scale allows nurses to rate the client on specific ego functions in order to address patient care problems arising from deficits in ego functioning. Ego functions that are systematically assessed with the ECM include impulse control, reality testing, judgment, mood, object relations, activities of daily living, competency, self-perception, thought process, and stimulus barrier.

Ego↗
PubMed2006

The National Health Service Knowledge and Skills Framework and its implications for continuing professional development in nursing.

The National Health Service Knowledge and Skills Framework has been introduced as part of the Agenda for Change Reforms in the United Kingdom to link pay and career progression to competency. The purpose of this paper is to consider the implications for nurses, their managers and the impact on university departments delivering continuing professional development for nurses. The new system has the potential to increase the human resources management aspect of the clinical nurse managers' role and could have legal implications, for example if practitioners perceive that their needs for continuing professional development have been overlooked to the detriment of their pay and career aspirations. The new system also has implications for providers of continuing professional development in the universities and is likely to demand closer liaison between education providers and trust staff who commission education and training. The Knowledge and Skills Framework is of interest to nurses and nurse educators internationally because the system, if effective, could be introduced elsewhere.

Career Mobility↗
PubMedDate not supplied

Beyond cultural competence: what child protection managers need to know and do.

This article addresses issues for child protection managers, such as hiring, program design, service evaluation, and policy development. It presents three frameworks for levels of organizational change: cultural sensitivity, which modifies existing services to better meet the needs of target populations; self-reflective cultural sensitivity, which calls for managers to be aware of personal and organizational cultural values; and cultural solidarity, which acknowledges that organizational power is vested in managers, which can oppress clients.

Administrative Personnel↗
PubMed2003

Community health nursing, wound care, and...ethics?

Because of changing demographics and other factors, patients receiving care for wounds, ostomies, or incontinence are being referred in increasing numbers to community health nursing organizations for initial or continued care. As home-based wound care becomes big business, little discussion is being focused on the moral and ethical issues likely to arise in the high-tech home setting. Progressively more complex and expensive home care relies on family members to take on complicated care regimens in the face of decreasing numbers of allowable skilled nursing home visits. A framework and a principle-based theory for reflection on the character and content of moral and ethical conflicts are provided to encourage informed and competent care of patients in the home. Common moral and ethical conflicts for WOC nurses in the United States are presented. These conflicts include issues of wound care supply procurement; use of documentation to maximize care or profit; problems of quality, care consistency, and caregiver consent; and dilemmas of tiered health care options. The advantages of a framework to address ethical conflicts are discussed.

Community Health Nursing↗
PubMed1995

A framework to develop a sexual abuse prevention program.

In 1993, the Province of Ontario proclaimed the Regulated Health Professions Act (RHPA) and 21 health profession acts, including the Medical Radiation Technology Act. Under the RHPA, 21 health care regulatory colleges were created to ensure that Ontario patients receive safe, competent and quality care. Programs administered by the colleges ensure that all patients are treated with dignity and respect, and include measures for preventing or dealing with the sexual abuse of patients. This article sets out a framework and discusses issues related to the development and implementation of a sexual abuse prevention program. Key components include: establishing a patient-relations committee, preparing a statement of philosophy, defining sexual abuse, setting guidelines for professional behaviour, and educating members, staff and the public. Other aspects of such programs include procedures for complaints and discipline, mandatory reporting and penalties, and funding for therapy and counselling for patients who have been sexually abused by members.

Communication↗
PubMed1998

A conceptual framework for the analysis of health care organizations' performance.

Organizational performance remains an elusive concept despite its importance to health care organizations' (HCOs') management and analysis. This paper uses Parsons' social system action theory to develop a comprehensive theoretically grounded framework by which to overcome the current fragmented approach to HCO performance management. The Parsonian perspective focuses on four fundamental functions that an HCO needs to ensure its survival. Organizational performance is determined by the dynamic equilibrium resulting from the continual interaction of, and interchange among, these four functions. The alignment interchanges allow the creation of bridges between traditional models of organizational performance that are usually used as independent and competing models. The attraction of the Parsonian model lies in its capacity to: (1) embody the various dominant models of organizational performance; (2) present a strong integrative framework in which the complementarity of various HCO performance perspectives are well integrated while their specificity is still well preserved; and (3) enrich the performance concept by making visible several dimensions of HCO performance that are usually neglected. A secondary objective of this paper is to lay the foundation for an integrative process of arbitration among competing indicators and perspectives which is absolutely necessary to make operational the Parsonian model of HCO performance. In this matter, we make reference to the theory of communicative action elaborated by Habermas. It offers, we think, a challenging and refreshing perspective on how to manage HCO performance evaluation processes.

Canada↗
PubMed1985

Perioperative functions. Classification of knowledge and required skills.

The study results form a beginning framework from which values of resource appropriateness could be developed, which was the original intent of this study. An algorithm could be designed to score an individual's formal and informal training in specific skills as they relate to the O-Types identified. These results could be translated into resource appropriateness scores under each of the four factors. The results also provide a means for simplifying categories of the Operating Room Staffing Model and provide a beginning framework to assess resource appropriateness.

Clinical Competence↗
PubMed2002

Translating emotion theory and research into preventive interventions.

Scientific advances in the field of emotions suggest a framework for conceptualizing the emotion-related aspects of prevention programs that aim to enhance children's socioemotional competence and prevent the emergence of behavior problems and psychopathology. A conception of emotions as inherently adaptive and motivational and the related empirical evidence from several disciplines and specialities suggest 7 principles for developing preventive interventions: the utilization of positive and negative emotions, emotion modulation as a mediator of emotion utilization, emotion patterns in states and traits, different processes of emotion activation, emotion communication in early life, and the development of connections for the modular and relatively independent emotions and cognitive systems. Each principle's practical implications and application in current prevention programs are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

"Thinking upstream" to evaluate and to improve the daily work of the newborn intensive care unit.

One may divide patient care problem-solving approaches into two categories: (1) "Ready, aim, fire" and (2) "Ready, fire, aim." The present paper invites the reader to think about these distinctions and to identify which of these categories might apply to the reader's daily work experience. Espousing the first of these categories, and anchored in the notions of systems thinking, this paper offers the reader a framework to better understand and implement the daily work of the newborn intensive care unit. This knowledge and competence may be achieved by "thinking upstream," connecting "downstream" outcomes with "upstream" work process steps. The central elements that govern and inform the process of "thinking upstream" are articulated here in actionable terms.

Humans↗
PubMed2000

Regulated competition and citizen participation: lessons from Israel.

OBJECTIVE: To investigate the relationship between health system structure and citizen participation, in particular whether increased reliance on competition encourages or depresses citizen involvement. SETTING: The case of Israel's ongoing health reform, based on regulated competition among sick funds, is examined. DESIGN: Interviews with government officials and representatives of consumer groups; analysis of policy documents, judicial rulings, public surveys and journalistic accounts. RESULTS: The Israeli reform is based in large measure on a regulated competition model, in which citizens have free choice among highly regulated competing sick funds. At the same time, the reform process has been accompanied by legal, institutional and political frameworks, as well as significant interest group activity, all aimed at increasing public input into processes of health policy making and implementation. The Israeli case, it is argued, lends support to the proposition that citizen participation (voice) and individual choice (exit) are complementary, rather than alternative, modes of ensuring citizen influence over health services. The question is whether the development of multiple avenues for citizen involvement represents disarray or a healthy social learning process regarding the running of the health system. CONCLUSION: This paper expresses cautious optimism that citizen participation is a projection of a healthy social learning process, and suggests directions for public policy to encourage this outcome.

Journal Article↗
PubMed2005

Ethical reasoning and mental health services with deaf clients.

Ethical problems encountered by mental health practitioners working with deaf clients are often complex and involve issues not fully addressed in professional codes of ethics. A principles-based ethical reasoning process can assist in resolving many of these ethical concerns. Principles such as beneficence, nonmaleficence, autonomy, fairness, integrity, and respect are found in the ethical codes of many disciplines; these can also create a common language or reference point when professionals from different fields attempt to deal with shared problems. This article discusses some applications of these principles in working with deaf individuals and proposes an ethical decision-making process that can provide a framework for ethical reasoning in thinking through complex problems.

Clinical Competence↗
PubMedDate not supplied

A phenomenological study of patient expectations concerning nursing care.

This phenomenological study explored the expectations patients have of nursing care, specifically spiritual care, using the framework of humanistic nursing. Four themes emerged: (1) the definition of "good" and "bad" nursing, (2) surveillance and competence, (3) spiritual care expectations, and (4) the concept of time.

Adult↗
PubMed2004

Suppression of ecological competition by an apex predator.

In the framework of Lotka-Volterra dynamics with evolutionary parameter variation, it is shown that a system of two competing species which is evolutionarily unstable, if left to themselves, is stabilized by a common predator preying on both of them. Game-theoretic implications of the results are also discussed.

Adaptation, Biological↗
PubMed1979

Training in family therapy: perceptual, conceptual and executive skills.

This paper presents a comprehensive and detailed outline of family therapy skills to aid in providing a more precise focus in the training of clinicians in family therapy. The skills are based on an integrated treatment model within a systems framework. Four major functions performed by a family therapist are separated and are further differentiated into general therapeutic competencies. Specific perceptual, conceptual, and executive skills are described in the form of instructional objectives and are listed under each competency. Occasional clarifying notes or examples are cited along with particular skills. Clinicians and trainees should find this outline a useful guide in skill development.

Concept Formation↗
PubMed1989

An industrial hygienist's perspective on generic standards.

OSHA and EPA regulations promulgated to date contain the necessary framework to consider generic standards in the 1990s. Missing in OSHA standards has been the requirement for a competent person to define and manage an occupational health program and the requirement for all employers who have toxic materials with significant exposures to have a basic occupational health program. Certainly we have evolved to a point where every worker significantly exposed to toxic materials has a right to know what that exposure is. Fundamental to generic standards is the need to define what is meant by toxic substance and significant exposure level. It is suggested that NIOSH maintain a list of recognized safe exposure levels that have been recommended by credible organizations including NIOSH. It is suggested that action levels be defined as one-half the lowest recognized safe exposure level. It is proposed that all employers be required to conduct an initial inspection of their workplace, using competent persons, to determine if exposures exceed action levels. This is only one step beyond the requirements of the OSHA Hazard Communication Rule which requires that employers identify and maintain a list of all hazardous materials known to be present in the workplace and to inform workers of the hazards. If exposure levels are found in excess of action levels, then the basic elements of current standards would be required, including regular employee-exposure monitoring, medical surveillance, sanitation, training and education, and a management plan.

Asbestos↗