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PubMed1986

Frequency and diversity of use of statistical techniques in oncology journals.

We describe the frequency with which various statistical techniques are reported in almost 5,000 articles published in five major American oncology journals during 1983 and 1984. A reader familiar with about a dozen techniques can expect to understand approximately 90% of the quantitative concepts cited in these journals. With the exception of survival analysis, these were typically the techniques encountered in many introductory statistical texts. Oncology training program preceptors concerned about making their graduates more effective consumers of the literature can use these findings in structuring exposure to quantitative skills. In four of the five journals reviewed, failure to identify the statistical methodology was among the ten most commonly encountered "techniques." This made it impossible to identify the analytical procedures used in many articles, and hence to judge their scientific validity. We encourage more editorial boards to adopt guidelines requiring a standardized format for presenting results based on a statistical analysis.

Actuarial Analysis↗

PubMed1986

Teaching of bioethics within a residency program in obstetrics and gynecology.

A formal curriculum for the teaching of bioethics was instituted within an obstetric and gynecologic residency program. The curriculum included an introductory lecture series, an ongoing series of case presentations, and occasional grand rounds on particular issues. An emphasis was placed on physician responsibilities within contemporary bioethical parameters. A summary of the first year of such an effort is presented.

Adolescent↗

PubMed1997

Introduction to the AFDC program. Aid to Families with Dependent Children.

This journal issue discusses the policy challenges of helping parents move from welfare to work. As a foundation, this introductory article explains the federal-state program of cash assistance called Aid to Families with Dependent Children (AFDC), to which the term welfare refers in most of these articles. While a number of other social programs are sometimes included under the umbrella of welfare-such as the Supplemental Security Income program for the disabled, food stamps, and Medicaid-the program that has drawn the most public scrutiny and negative attention, and the centerpiece of the 1996 welfare reform legislation, is AFDC. This article explains the basic structure of the AFDC program, including eligibility criteria and benefits; discusses the characteristics of families that have received AFDC; describes trends in the program's size and cost from the 1970s to 1996; and indicates the major ways in which the block grant established in the 1996 welfare reform legislation compares to the AFDC program that it replaced.

Adult↗

PubMed2005

Practice-based education at Michigan State University.

Practice-based large animal education at Michigan State University (MSU) was initiated in 1995. Urbanization of the area surrounding MSU and the declining number of livestock and farms to provide clinical experience under field conditions were the major reasons for adopting this educational model. Veterinary students, as a requirement for graduation from the professional program, must successfully complete a three-week clerkship in a private practice that has either a food animal or an equine emphasis. The objective of the practice-based program is to provide students with introductory on-the-farm experience, with emphasis on examination, diagnosis, treatment, and prevention of common medical and surgical conditions of horses and/or food animals. Participating practices must be located in Michigan, have a sufficient case load, be interested in teaching senior veterinary students, and be willing to interact with the program coordinator and attend annual meetings. Sixty-nine practices are currently participating. The program coordinator matches students to practices based on the students' species interest and background, the personalities of the student and practitioner, and any special concerns or needs of the students (health conditions, child care). Assessment of students includes a practitioner's performance evaluation and review of written assignments (case log, clinical case reports, and a practice management assessment report) by campus faculty. A pass/no pass grading system is used. Overall, the Practice-Based Ambulatory Program represents a successful model for meeting the clerkship objectives. Additionally, exposing students to a high volume of commonly encountered conditions in a private business setting complements the referral cases seen in our large animal teaching hospital.

Animals↗

PubMed1991

Participation of older adults in health programs and research: a critical review of the literature.

This collection of five papers evaluates the participation of older adults in clinical trials, health promotion/disease prevention initiatives, and health programs designed to maintain or improve the functioning of chronically ill older adults. Understanding the willingness or unwillingness of older adults to participate in these programs is critical to the development and implementation of health programs and policies for this population. In this introductory paper we briefly review illustrative literature to provide both an overview of the participation of older adults in health programs as well as background information relevant to the symposium papers.

Aged↗

PubMedDate not supplied

Teaching becomes learning. Our lived experience.

Two teachers involved in the curriculum transformation process describe how they created and implemented a new learning environment with first-year nursing students in a basic baccalaureate nursing program. The authors have taught the introductory nursing course within this paradigm shift and describe the process of developing ends-in-view and relevant student experiences. They also reflect on the new meaning of the teaching-learning process within this paradigm.

Curriculum↗

PubMed1991

Accreditation, evaluation, and review in Australian programs: the end of the beginning?

The approaches to accreditation, evaluation and review, particularly in health services management education, in the U.S.A. and England are contrasted briefly. The Australian approaches, in first a binary system and then a unified national system, are described. Differences between the proposals in the Federal Policy Statement on higher education and actual practice in the establishment of accreditation as an external process with developmental objectives are analyzed. The introductory approach in developing a methodology for program self-review is outlined, as is the extensive but largely informal system of evaluation.

Accreditation↗

PubMed1988

The national survey of health administration program graduates on management information systems education.

A national survey of alumni of AUPHA programs from the classes of 1983, 1984, and 1985 was undertaken to assess their experiences in management information systems education, both formally and on the job. The survey covered 38 AUPHA graduate member programs and resulted in 1,181 responses. Over 40 percent of the alumni indicated that they had had an introductory management information systems (MIS) course in a health administration program. Since graduation, almost 90 percent have had some significant on-the-job involvement with computers, computer-generated information, or MIS. More than one-third of the respondents felt that their MIS course work did not adequately prepare them for what was expected on the job. Alumni stressed that microcomputer software applications, such as spreadsheets and data bases, are important areas for student hands-on experiences. When asked the importance of certain areas to be included in a required introductory MIS course, the alumni also recommended spreadsheet analysis and design, report writing and data presentation, and other management areas. Additional comments suggested more access to personal computers (PCs), more relevance in the curriculum to the "real world," and the importance of MIS to the career paths of alumni. Faculty suggestions from a 1984-85 survey are compared with alumni responses in order to identify curricular changes needed. Recommendations are outlined for consideration.

Attitude of Health Personnel↗

PubMed2006

Enhancing diversity in science: is teaching science process skills the answer?

The Biology Fellows Program at the University of Washington aims to enhance diversity in science by helping students succeed in the rigorous introductory biology classes and motivating them to engage in undergraduate research. The composite Scholastic Achievement Test scores and high school grade point averages of the Biology Fellows are comparable to those of students who are not in the program; however, they earn, on average, higher grades in introductory biology classes than non-Biology Fellows. Underrepresented minorities and disadvantaged students in the program also earn higher grades in the introductory biology classes than do their non-Biology Fellows counterparts. Analysis of the performance of Biology Fellows shows that the program assists students who are not proficient in certain science process skills and that students who lack these skills are at risk for failing introductory biology. This evaluation provides insight for designing programs that aim to enhance the performance of beginning students of biology, particularly for underrepresented minorities, who want to obtain a life science degree.

Attitude↗

PubMed2003

[Randomized controlled trial on effectiveness of the community re-entry program to inpatients with schizophrenia spectrum disorder, centering around acquisition of illness self-management knowledge].

OBJECTIVE: The objective of this study was to examine by randomized controlled trial the effectiveness and safety of the Japanese version of the Community Re-Entry Program, a manualized psycho-educational program with cognitive-behavioral therapy techniques, in discharge preparation for inpatients with schizophrenia. Our hypotheses are that firstly the program is effective for patients in acquiring illness self-management knowledge, that secondly the program shows positive effects on objective behavior and symptoms, and that thirdly the program has no adverse effects on subjective quality of life (QOL). METHOD: The subjects were 32 psychiatric inpatients, 24 male and 8 female, hospitalized in psychiatric rehabilitation wards, who gave written informed consent to participate in this study. The Community Re-Entry Program consists of 16 small-group sessions of one hour each that teach illness self-management knowledge and related skills to prepare patients for discharge from hospital and re-entry to the community with cognitive-behavioral techniques such as demonstration, roleplay, feedback, behavioral modeling and homework assignments. A specialized trainer's manual, demonstration videotape and patient workbook are utilized in the program. The program content includes defining discharge readiness, identifying symptoms and medication effects, assisting with discharge planning, connecting with community care, medication self-management, monitoring relapse warning signs, and preparing for emergencies. Except for considerations of the sex ratio in both groups, subjects were randomly allocated to the program (the program group) or ordinary occupational therapy (the control group). Of 32 patients, 31 were diagnosed with schizophrenia and 1 with schizotypal disorder. For the patients in the program group, we administered the program of 16 sessions as well as introductory and closing sessions, twice a week for 9 successive weeks. Nursing staffs in the wards took the roles of trainers with careful fidelity to the manual and supervision by psychiatrists with extensive experience in cognitive-behavioral therapy. The subjects were assessed concerning psychopathology with PANSS by psychiatrists, objective behavior with REHAB by nurses, subjective QOL with subjects' self-reports on WHO/QOL-26 and illness self-management knowledge also by self-report questionnaire attached to the trainers' manual of the program, before and after the whole program. RESULTS: Before the program, no significant differences were observed between groups concerning age, illness duration, education, length of current hospitalization, amount of antipsychotic medication, psychopathology, objective behavior, subjective QOL and illness self-management knowledge. One patient dropped out of the program because of transient ischemic attack. After the program, the patients in the program group significantly improved in illness self-management knowledge, as well as in speech skills and social activity score, factors of REHAB concerned with objective behavior evaluation, compared with those in the control group. Positive symptoms thus seemed to improve in the patients in the program group compared with those in the control group. No significant changes were observed in other items, including subjective QOL, in the patients of both groups. No patients experienced psychotic relapse in the observation term. DISCUSSION: We consider that the results supported most of our hypotheses, as they showed positive effects of the program in learning illness self-management knowledge, objective behavior and possible positive effect on positive symptoms, and no adverse effects were observed in psychopathology, behavior or subjective QOL. Further study is necessary on illness self-management behavior acquisition and the effects on long-term clinical outcomes. Study on whether the program is effective for younger patients with shorter hospitalization are expected, because the subjects in this study were rather older (45.9 +/- 11.5 years in the program group) and hospitalized longer (37.8 +/- 36.7 months in the program group). CONCLUSION: The Japanese version of the program was effective and relatively safe for schizophrenia spectrum disorder inpatients for learning illness self-management knowledge in preparation for discharge and planning community re-entry.

Adult↗

PubMed2005

Preparing African Americans for careers in health care: the Jackson Heart Study.

The Jackson Heart Study Undergraduate Training Center (UTC) at Tougaloo College was developed to increase the numbers of African-American students entering public health and health related fields. The UTC includes a scholars program for undergraduate students at Tougaloo College, three four-week programs for high school students called the SLAM (science, language arts, and mathematics) workshops, and an introductory epidemiology course for healthcare professionals and graduate students. The scholars program recruits 12 Tougaloo College freshmen annually for the duration of their undergraduate education. As of the 2005 summer, 512 students have enrolled in the SLAM workshops. The introduction to epidemiology course has provided training for 155 individuals from 1999 to 2004. This paper documents the need for this program based on the conspicuously small proportion of African Americans who are health practitioners in Mississippi. The content and selection process for each program is described, and a summary of the enrollment history, characteristics of the program participants, and their accomplishments is presented. Finally, the methods of program assessment and tracking are discussed.

Adolescent↗

PubMed2003

Evaluation of transplant procurement management courses: an educational project as a tool for the optimization of transplant coordination.

The process of obtaining organs and tissues includes a series of procedures and skills that are fundamental to obtain a large number and high quality of transplants. Health professionals involved in transplant coordination require robest and comprehensive training to integrate the donation-transplantation process within the clinical health care field. Based on a learning-through-experience model, Transplant Procurement Management (TPM) designed various courses adapted to local educational need to train transplant coordinators, to increase active donor detection, and to promote a positive attitude towards donation; namely, Advanced, Introductory and New Life Cycle courses respectively. Moreover, TPM has coordinated international programs (INTERCATT and INTERITALY). Since 1991, the model has included 29 Advanced courses (1215 participants), 22 Introductory courses (575 pupils), and 7 New Life Cycle courses (more than 400 attendees). The Advanced courses were attended by medical (intensive care unit, nephrology, and others) and nursing professionals. Assessment of the educational program showed achievement of teaching objectives. The evaluation averages above 3.5 (scale, 1-5) for content, presentation, and ability to answer questions. Likewise, the program's organization showed an average score of 4.4. The acquired knowledge was assessed by means of a self-evaluation test (correct answers >69%). Practical skills assessed through direct observation showed an average of 7 (scale, 1-10). The TPM educational program offers a range of necessary knowledge and skills to increase organ donation. Health professionals concerned about the organ shortage may find TPM training useful to increase their knowledge.

Curriculum↗

PubMedDate not supplied

A national study of required family medicine clinical rotations.

The authors collected information from each family medicine department with a required clinical rotation. Timing of such rotations are predominantly during the third year (56%), using a combination of family practice centers and community preceptor sites. Formal didactic instructions are offered for a mean of 28 hours. This instruction is offered in combinations of introductory, weekly, and terminal didactic blocks. Most programs (68%) assign reading from an article file, and 51% develop their own examinations. Clinical evaluations represent the largest portion (61%) of final grades, with 30% coming from examinations and lesser amounts from home visits, student presentations, etc. The implications of these findings are discussed.

Clinical Clerkship↗

PubMed1994

GRATEFUL MED-LOANSOME DOC outreach project in central Pennsylvania.

The Geisinger Medical Center Library implemented a GRATEFUL MED outreach project in rural north-central Pennsylvania directed at providing physicians access to current medical literature. A total of 1,327 physicians affiliated with twenty-three hospitals practice in a thirteen-county area the size of the state of New Jersey. Of these hospitals, only four have hospital libraries, which vary in size and in staff abilities to meet the information needs of their affiliated physicians. The outreach project encompassed two stages--demonstrations of GRATEFUL MED and LOANSOME DOC at county medical society or hospital meetings, and installation and training in individual offices. The eighteen-month project ended in March 1992. Statistics were collected for the number of GRATEFUL MED software packages loaded (sixty-two), the number of document delivery items supplied by Geisinger Medical Center Library to project participants (367), and the number of physicians attending introductory demonstrations or follow-up training programs (455 at sixty-eight sessions). By the end of the project, 147 (32%) of those who had attended a seminar had access to GRATEFUL MED.

Grateful Med↗

PubMedDate not supplied

An assessment of the nine-month lactational amenorrhea method (MAMA-9) in Rwanda.

This report presents a secondary data analysis based on prospectively collected records gathered during a field assessment that was carried out in Rwanda in August 1993. The assessment used service statistics and follow-up interviews to evaluate the efficacy of a modified lactational amenorrhea method (LAM) as a nine-month introductory postpartum natural family planning method. The program, carried out by Action Familiale Rwandaise (AFR), reflects high efficacy of the method in a compliant sample that sought this method followed by another form of family planning. These results are promising and provide guidance for the extended use of LAM past six months. Programmatic findings suggest that studies be conducted of the contribution of extended LAM to improved weaning practices, the high efficacy of continued reliance on substantial lactation and amenorrhea beyond nine months, and male involvement in LAM and breastfeeding.

Algorithms↗

PubMed2002

Effective Use of Multimedia Technology in Athletic Training Education.

OBJECTIVE: To examine the effectiveness of using a CD-ROM, Sports Injuries 3-D, by Cramer Products (Gardner, KS) in an introductory athletic training laboratory class as a supplement to traditional lecture instruction. Attitudes toward the computer-assisted instruction and usefulness of the CD-ROM program were also examined. DESIGN AND SETTING: Students in 2 introductory athletic training laboratory classes from one institution were randomly assigned to either a traditional lecture (n = 11) or traditional-lecture/CD-ROM (n = 15) group. SUBJECTS: Undergraduate kinesiology majors enrolled in "Techniques of Athletic Training" (10 men, 16 women; mean age = 22.39 +/- 3.64 years). MEASUREMENTS: We compared scores from 2 written examinations and 1 practical examination between groups. Subjects also completed weekly journals and participated in a focus-group interview at the end of the semester to elaborate on how often they accessed each resource and their feelings toward their various resources. Subjects in the traditional lecture/CD-ROM group also completed the Allen Attitude Toward Computer-Assisted Instruction Survey to evaluate pre- and poststudy attitudes toward computer-assisted instruction. RESULTS: No significant differences (P =.05) were found between groups on either the written or practical examination scores. The journals and interviews both indicated that subjects used their lecture notes (8/11 [73%] in the control group, 14/15 [93%] in the CD-ROM group) most frequently, while several students used a combination of lecture notes and the laboratory manual when studying for their examinations. Although they did not list it as their primary resource, most subjects in the experimental group reported accessing the CD-ROM for anatomical landmarks on a weekly basis. CONCLUSIONS: Although no significant difference was found between groups, we feel that given the correct application, computer-assisted instruction may have a place in athletic training education. Student attitudes toward the CD-ROM program were favorable, and the qualitative data suggest that students would use this type of educational resource provided it was targeted toward the specific course and offered a time-efficient method for access. We recommend examining the use of a CD-ROM specifically designed for a course to determine whether it would prove to be a more effective resource for students than traditional instructional resources.

Journal Article↗

PubMedDate not supplied

RN students' satisfaction with clinical teaching in a distance education program.

This study examined student satisfaction with clinical teaching and student-perceived difficulties in three introductory nursing courses offered by distance education. The sample consisted of 41 registered nurse respondents enrolled in a baccalaureate nursing program. Quantitative and qualitative data were collected by mailed questionnaire. The results indicate that the degree of satisfaction with the clinical teacher role was high and that unfamiliarity with the clinical settings and roles were perceived as difficulties. As well, the qualitative data suggest that RN learners need gradual exposure to self-directed learning to acquire these skills.

Consumer Behavior↗

PubMedDate not supplied

AMA offers technology assessment program.

This issue of Physician Executive inaugurates a new column designed to provide information and insights regarding current issues in medical technology. The introductory offering in the column describes the Diagnostic and Therapeutic Technology Assessment (DATTA) program, the foundation of the American Medical Association's major activities in health care technology.

American Medical Association↗