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Results for “Competency framework”

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PubMed2002

Metrics for objective Assessment.

As the need for improved methods of assessing surgical competence grows, it is imperative to establish the basic infrastructure to ensure the ability to communicate among educators, education researchers, responsible training bodies, and credentialing boards. A workshop was conducted to provide a foundation for communication and a standardization of definitions, measurements, and criteria. Future conferences and workshops will be needed to review and refine this initial framework.

Australia↗

PubMed1994

What the doctor ordered? Referrer satisfaction with a mood disorders unit.

Assessment of referrers' needs, patterns and satisfaction ratings with a psychiatric service provides both a clinical and service performance indicator. This study explored referrer satisfaction with a tertiary referral mood disorders unit (MDU). The 147 responders comprised 75 psychiatrists, 59 general practitioners and 13 others. Thirty-two percent of referrers were "very satisfied" and 42% "quite satisfied" with their contact with the unit. Components of satisfaction were defined by principal components analysis as "technical competence"; "adequate information and follow-up support"; and "access" to the facility, dimensions confirmed by responses to open-ended questions. Differences were established between the referral needs of psychiatrists and general practitioners, suggesting different treatment emphases. Such surveys provide a framework which can facilitate review and restructuring of important service components of any psychiatric facility.

Clinical Competence↗

PubMedDate not supplied

Using the "Seven A's" assessment tool for developing competency in case management.

In the latter part of the 20th century, healthcare reform sparked a transition in the nursing curriculum from acute care to primary and secondary care. Faculty responded to this challenge by redesigning curricula in creative ways. The transitional curriculum introduced community clinical experiences designed to challenge students to practice in diverse, nontraditional sites and in more independent ways. Such practice requires the nurse to function as designer, coordinator, and manager of patient care in addition to the traditional provider role. Additionally, the transitional curricula emphasized the roles of communicator, educator, facilitator, listener, and advocate to a greater degree. For students to achieve competence in the above roles, the curriculum must include learning activities that allow them to practice as case managers in the community. This paper presents the "Seven A's" as a framework for students to gain an understanding of and engage in the role and process of case management in the community.

Case Management↗

PubMed2003

Helping health and social care professionals to develop an 'inequalities imagination': a model for use in education and practice.

BACKGROUND: The 'inequalities imagination model' originated from our own research, and led to findings and recommendations regarding clinical and education issues. This article focuses on the creation of the model which, we suggest, could be used to facilitate the development of an 'inequalities imagination' in health and social care professionals. AIM: To describe and critically analyse the thinking that led to the concept of an 'inequalities imagination' and provide the framework for the theoretical model. METHODOLOGICAL APPROACH: Influencing concepts from the fields of social work, sociology, nursing and midwifery, and debates around antidiscriminatory and antioppressive practice, cultural safety, cultural competence and individualized care are analysed. INEQUALITIES IMAGINATION MODEL: Ideas generated from an analysis of the concepts of antidiscriminatory/anti-oppressive practice and from the research data led us to conceptualize a flexible model that incorporated issues of individual and structural agency and a broad definition of disadvantage. The literature review underpinning the theoretical framework means that the model has the potential to be truly interdisciplinary. CONCLUSIONS: Professional educators face a difficult task in preparing practitioners to work with clients in ways that take account of differences in background and lifestyle and which respect human rights and dignity. The model makes explicit a process that enables practitioners to think about their current practice and move towards a greater understanding and awareness of the way they work with disadvantaged clients, and ways in which they prepare others to do so. We suggest that professionals develop an 'inequalities imagination' in order to enhance equality of care. The development of an 'inequalities imagination' helps practitioners to bridge the gap between the challenges they face in day-to-day practice and what they need to achieve to aspire to provide equality of care to all.

Attitude of Health Personnel↗

PubMedDate not supplied

[Good practice for medical surveillance by occupational physicians].

Society--employers, workers, trade unions, public--demands the highest standards of professional competence and ethical conduct from occupational physicians. However, defining what exactly constitutes good medical practice and acceptable standards of professional competence and conduct is not so easily done. Good practice in occupational medicine should be aimed not only at improving the effectiveness of preventive action in the strict sense, but also at constantly adopting rigorous methodologies based on evidence and procedures breaking loose from rigid formats, which must be as uniform as possible throughout the country. It's essential, therefore, to develop consensus documents on workers' health surveillance, meeting with approval of occupational health physicians both operating in a free market context or within the framework of public sector health service.

Clinical Competence↗

PubMedDate not supplied

Beyond the milestone model--a systems framework for alternative infant assessment procedures.

Recent theoretical and methodological advances in developmental psychology offer new possibilities in the assessment of developmentally disordered infants which carry significant advantages over current procedures. It is argued that infant competence is not solely a quality inherent within the individual, but is a function of a particular individual within a particular environment. The understanding of early developmental processes as being based upon infant-environment transactions, requires an assessment methodology which can take account of complex and changing relationships, and can recognize the role of the infant in determining characteristics of the caregiving environment. It is proposed that systems theory offers a useful framework on which to construct new assessment procedures. Different levels of the infant environment system are identified, and examples of the ways in which recently developed procedures may be incorporated into the model are described.

Adaptation, Psychological↗

PubMed2005

Enhancing professional competence through developmental approaches to supervision.

There has been a recent increase in interest in defining and describing the competencies for professional practice in psychology. Perhaps the most important mechanism for enabling the acquisition of competencies is the process of supervision. This article takes the position, based on a review of relevant research in supervision and the author's experiences, that developmental theories of supervision have stimulated considerable research and provide a direction for future work in research and practice. It is argued that the most detailed of these theories, the Integrated Developmental Model, provides a useful framework for understanding how supervisees change over time and how various supervision environments (broadly) and supervision interventions (specifically) can enhance or detract from the development of professional competencies.

Awards and Prizes↗

PubMed2006

Risk estimation for carcinogens based on epidemiological data: a structured approach, illustrated by an example on chromium.

It is generally recognized that human, epidemiological data, if available, are preferred as the starting point for quantitative risk analysis above the use of data from animal studies. Although methods to obtain proper risk estimates from epidemiological data are available, several impediments prevent their widespread application. These impediments include unfamiliarity with epidemiological methods and the lack of a structured and transparent approach. We described a framework to conduct quantitative cancer risk assessment based on epidemiological studies in a structured, transparent, and reproducible manner. Important features of the process include a weight-of-the-evidence approach, estimation of the optimal exposure-risk function by fitting a regression model to the epidemiological data, estimation of uncertainty introduced by potential biases and missing information in the epidemiological studies, and calculation of excess lifetime risk through a life table to take into account competing risks. Sensitivity analyses are a useful tool to obtain insight into the impact of assumptions made and the variability of the underlying data. The framework is sufficiently flexible to allow many types of data, ranging from published, sometimes incomplete data to detailed individual data, while maintaining an optimal result, i.e., a state-of-the-art risk estimate with confidence intervals, based on all available evidence of sufficient quality.

Animals↗

PubMedDate not supplied

The therapeutic relationship: dead or merely impeded by technology?

The ways in which current nurse education is delivered, combined with rapid increases in technological advances in health care, are having a major impact on the delivery of care to patients. This article focuses on one aspect of that care: the establishment, development and maintenance of the therapeutic relationship. The authors argue that the changes in education delivery and the rapid introduction of technologies are contributing to the possible demise of the contemporary nurse-patient relationship and, therefore, the loss of that essence of nursing which is essential to the patients' well-being and the nurses' professional satisfaction. The article explores the requisite knowledge and skills competences essential for the formation of the therapeutic relationship and asks whether these are being impeded by simulated educational activities and the advent of ubiquitous computing. The authors acknowledge the difficulties associated with the assessment of an effective therapeutic relationship and suggest a possible framework in which a performance of understanding of the formation of a therapeutic relationship can be established.

Clinical Competence↗

PubMed1991

[Occupational health care as a basis of occupational medicine monitoring in small companies. Common occupational medicine/ergonomic approach to prevention].

Set out from various specific angles, the concept concerning a modern common industrial medicine/safety/ergonomics approach can be fitted into the present legal framework. Adapted according to specific needs, this approach can equally be applied in all areas--health promotion, prevention, cure, rehabilitation. Those involved in the current debate about industrial health policies start out from the premise that industrial medicine could contribute strongly in this respect. While the workmen's compensation scheme, together with the industrial medical profession, is to a considerable extent involved in the subject as a whole on the basis of the industrial safety Act, its competencies are however limited, being in actual fact confined to the field of health maintenance in the occupational context. The examinations they effect in this framework cannot be based on a holistic medical orientation, because our constitution has expressly excluded the private sphere of the individual (self-management domain). Hence, there are very little chances of success for any attempt of changing current health care practice solely via the workmen's compensation administrations. It currently is, rather, the health and pension insurance schemes who hold the potential for influence. The common approach of industrial medicine, safety and ergonomics outlined may be of considerable use also in view of their goals, and holds sufficient justification for their intervening favourably in the ongoing debate about quality and quantity of industrial medical service provision with the ministries in charge.

Ergonomics↗

PubMed2004

Ethanol decomposition: C--C cleavage selectivity on Rh(111).

Ethanol adsorption, desorption and decomposition on Rh(111) have been studied by X-ray photoelectron spectroscopy and tem-perature-programmed desorption experiments. The evolution of the C is and O is core level spectra was monitored as a function of ethanol exposure and surface temperature. Ethanol adsorption at 90 K results in two nonequivalent ethanol-adsorbed species at low surface coverage, while a third species--related to multilayer formation--appears after longer exposures. Upon surface annealing, ethanol undergoes both desorption and dissociation, thus creating intermediate surface species which further decompose to hydrogen, carbon monoxide and atomic carbon. Our results clearly show that C--C bond cleavage is the preferential dissociation channel, while C--O bond scission is not observed. Calculations performed within the framework of the unity bond index-quadratic exponent potential model, have been used to test and compare different competing dissociation channels, providing an estimate of adsorption energies and dissociation barriers.

Journal Article↗

PubMed1994

The institutionalization of the good death.

There has been some recent concern in Britain and North America that the increasing institutionalization of hospice care may compromise the movement's founding ideals. The threats posed by the encroachment of mainstream medicine and the medical technological imperative to treat, are also a source of concern to hospice administrators and staff. This study uses Australian data based on interviews with nurses and participant observation in an in-patient hospice unit and a community based hospice service to investigate whether the Good Death ideal, as central to the hospice philosophy, is compatible with the institutionalization of hospice care. The issues that arise, although interrelated are conceptualized as the following five challenges to hospice care: (1) encroachment of mainstream medicine and the medical technical imperative; (2) competing motivations; (3) delimitation of intellectual structures; (4) organizational maintenance; and (5) routinization of the Good Death. This conceptual framework is based on the way in which nurses and other health care professionals have used shared logic and strategies to negotiate the daily demands of their work and illustrates the tension that arises between the maintenance of the ideal and the maintenance of the organization.

Attitude of Health Personnel↗

PubMed2006

A loop network within the anthrax toxin pore positions the phenylalanine clamp in an active conformation.

Heptameric pores formed in the endosomal membrane by the protective antigen moiety of anthrax toxin serve as portals for entry of the enzymatic moieties of the toxin into the cytosol. In the aqueous lumen of each pore is a "Phe clamp," a heptad of narrowly apposed Phe residues (Phe-427), that catalyzes the unfolding and translocation of the enzymatic moieties across the membrane. Here, we provide evidence for a "loop swap" between neighboring protective antigen subunits, which is required for efficient translocation and is mediated by a salt bridge formed between the side chains of Lys-397 and Asp-426. We propose that the interaction between residues 397 and 426 creates a structural framework that positions Phe-427 within the pore lumen, forming a functional Phe clamp and, hence, a translocation-competent pore.

Amino Acid Sequence↗

PubMed2000

Predictors of intrinsic motivation among adolescent students in physical education.

This study examined the relationships among social factors, individual differences, intrinsic motivation, and effort and persistence in the physical education context using cognitive evaluation theory as a framework. Female (n = 201) and male (n = 206) high school students completed measures of motivational climate, teaching style, perceived competence, self-determination, goal orientations, and intrinsic motivation. Teachers rated the students on effort and persistence in the class activities. Hypothesized relationships among the variables were tested using structural equation modeling. Results revealed that perceived competence and goal orientations directly predicted intrinsic motivation and mediated the effects of motivational climate and teaching style on intrinsic motivation. Intrinsic motivation directly predicted effort and persistence. Task goal orientation mediated the effects of learning climate on perceived competence and self-determination. The strongest predictors of intrinsic motivation and effort and persistence were task goal orientation perceived competence, and learning climate.

Adolescent↗

PubMed1991

Semantic inhibition of ignored words during a figure classification task.

Two experiments investigated inhibitory processes in visual spatial attention. In particular, factors influencing the suppression of ignored visual stimuli were investigated. Subjects responded to geometric shapes while distractors were presented in the periphery. Distractors consisted of a single word, a pair of unrelated words, or a single word paired with a string of non-linguistic symbols. Semantic processing of the ignored words was measured with a subsequent lexical decision task. Test probes presented after the prime displays revealed suppression effects for words semantically related to a previously ignored word, but only for conditions in which two distractor words were presented. Suppression was not observed when the prime consisted of a single word or a single word paired with non-linguistic symbols. In Experiment 2 two different time delays between the onset of the primes and the onset of the test probes were used. At the shorter interval facilitatory priming was observed, while at longer intervals suppression was observed. The facilitation-suppression pattern suggests that ignored items are recognized before being suppressed. In summary, the results suggest the following: (1) that selectively attending does not restrict ignored items from gaining access to their semantic representations, and (2) that inhibition is an important process in determining the focus of attention. These results are discussed within a selective attention framework in which all items in a display gain access to memory representations, and attention to selected items causes competing items to be inhibited.

Attention↗

PubMed2005

Advanced practice nursing: leadership to effect policy change.

Nursing leaders used evidence-based thinking to engage key stakeholders when implementing advanced practice nursing roles in a traditional medically oriented tertiary oncology center. A strategic orientation to the policy change initiative was guided by a theoretical framework for connecting research and policy. Policy approaches that addressed stakeholder values and beliefs, while attending to questions of competence, standards of practice, fiscal savings, medical and nursing workload, and ongoing multidisciplinary teamwork were essential to facilitate change.

Cancer Care Facilities↗

PubMed2026

Exploring Immersive Virtual Reality as an Approach to Improve School Participation-Related Constructs in Children With ADHD.

BACKGROUND: School participation is frequency and involvement from person-environment transactions, not diagnosis, per the International Classification of Functioning, Disability and Health (ICF) and the family of participation-related constructs (fPRC). In this framework, the environmental and child determinants of school participation (e.g., school routines and peer/teacher context; self-regulation, activity competence and preferences) interact bidirectionally to shape everyday participation. However, many interventions still target isolated impairments, overlooking coordinated changes in capacities and context. Grounded in this contemporary view, this study aimed to investigate the impact of an immersive virtual reality (IVR) intervention on school participation-related constructs in children with ADHD. METHODS: The study included 92 children aged between 7 and 12 years diagnosed with ADHD. Participants were randomly assigned into intervention (n = 46) and control (n = 46) groups. Both groups completed the School Participation Questionnaire (SPQ) and Bruininks-Oseretsky Test of Motor Proficiency Test 2 Brief Form (BOT2-BF) assessment prior to the intervention. The intervention group received an IVR intervention program twice a week for 8 weeks. During this period, the control group did not receive additional therapy. At the end of the 8 weeks, the SPQ was readministered to both groups. RESULTS: Baseline characteristics showed no significant differences in SPQ and BOT2-BF results between groups, confirming homogeneity prior to intervention. Following the intervention, the study group demonstrated significant improvements across all domains of the SPQ (doing, being, symptoms and environment), with large effect sizes for SPQ total score (d = 0.978) and subdomains (d = 0.452-0.910). In contrast, the control group showed no improvements and even declines in subdomains. Post-intervention, between-group comparisons revealed significant differences favouring the study group across all domains (p < 0.001), with large effect sizes (d = 0.878-1.165). CONCLUSIONS: Findings suggest that the IVR program was associated with improvements in teacher-rated environmental and child determinants of school participation (SPQ domains) in children with ADHD.

Humans↗

PubMed2006

Gender perspective in medicine: a vital part of medical scientific rationality. A useful model for comprehending structures and hierarchies within medical science.

BACKGROUND: During the past few decades, research has reported gender bias in various areas of clinical and academic medicine. To prevent such bias, a gender perspective in medicine has been requested, but difficulties and resistance have been reported from implementation attempts. Our study aimed at analysing this resistance in relation to what is considered good medical research. METHOD: We used a theoretical model, based on scientific competition, to understand the structures of scientific medicine and how they might influence the resistance to a gender perspective in medicine. The model was originally introduced to discuss how pluralism improves rationality in the social sciences. RESULTS: The model provided a way to conceptualise different fields of research in medicine: basic research, applied research, medical philosophy, and 'empowering' research. It clarified how various research approaches within medicine relate to each other, and how they differ and compete. It also indicated why there might be conflicts between them: basic and applied research performed within the biomedical framework have higher status than gender research and other research approaches that are performed within divergent research paradigms. CONCLUSION: This hierarchy within medical research contributes to the resistance to a gender perspective, causing gender bias and making medical scientific rationality suboptimal. We recommend that the theoretical model can be applied in a wider medical context when different and hierarchically arranged research traditions are in conflict. In this way, the model might contribute to shape a medical community where scientific pluralism is acknowledged to enlarge, not to disturb, the scientific rationality of medicine.

Biomedical Research↗