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Results for “Competency framework”

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PubMed1979

[Graduate teaching aspects to be considered in the planning of undergraduate dental courses].

The general part of the present paper deals with questions concerning the demanding conceptual design of teaching from the aspect of creative studying. The students' qualification for responsible scientific work and creative studying is considered to be an essential question of the conceptual design of the demanding process of learning and acquiring the scientific bases. Thus, it will be possible to improve effectively the attitude towards studying and the engagement in creative achievements (in a narrow sense or in explicit forms of organization). In the empirical part of the present paper, the results from the interviewing of 240 dental students on relevant conceptual factors of teaching are discussed. An analysis of situation led to valuable insights and conclusions as to more effective teaching in the framework of stomatological study.

Competency-Based Education↗

PubMed2001

Two successful models for preparing competent critical care nurses. The Parkland Health and Hospital System Critical Care and Trauma Nurse Internship and Critical Care Residency.

Part of the mission statement of Parkland Health and Hospital System involves participating in educational programs dedicated to the art and science of caring for the sick and injured, the promotion of wellness, and the delivery of health services. The concept of the Nurse Internship and Nurse Residency fits well in the framework of this hospital. The continued support of these programs from the PHHS administration is visible evidence of the institution's commitment to excellence. Together these programs provide a continual supply of competent critical care practitioners to meet the never-ending demand in this large county facility as well as opportunities for new graduates to begin the exciting and rewarding journey into critical care nursing.

Critical Care↗

PubMed1985

National Health Service waiting lists. A discussion of competing explanations and a policy proposal.

A discussion of the main arguments advanced to explain waiting lists in Britain's National Health Service (NHS) is presented in a framework which focuses upon 'demand' and 'supplier induced demand' considerations. The difficulties associated with determining an optimum waiting list are explicitly emphasised. Hence it is in the context of an alleged requirement to reduce numbers waiting that the proposal to offer a price subsidy for private medical care is appraised. Such a policy is compared with that of direct expansion of expenditure on the NHS. Attention is drawn to the second round effects of 'supplier induced demand' which may be associated with these policies.

Appointments and Schedules↗

PubMed2006

Cultural competence and medical education: many names, many perspectives, one goal.

Two contemporary reports from the Institute of Medicine--Crossing the Quality Chasm and Unequal Treatment--highlighted the importance of patient-centered care and cultural competence training as a means of improving the quality of health care for all and eliminating racial/ethnic disparities in health care. Previous efforts in cultural competence have aimed to teach about the attitudes, values, beliefs, and behavior of certain groups. A more effective approach is to learn a practical framework to guide inquiry with individual patients about how social, cultural, or economic factors influence their health values, beliefs, and behaviors. Rather than learning about individual cultures and their characteristics, this approach focuses on the issues that arise most commonly due to cultural differences, and how they may affect a physician's interaction with any patient. At the end of the day, physicians need a practical set of tools and skills that will enable them to provide quality care to patients everywhere, from anywhere, with whatever differences in background that may exist, in what is likely to be a brief clinical encounter. Call it what you will, the field of cultural competence aims quite simply to assure that health care providers are prepared to provide quality care to diverse populations.

Cultural Diversity↗

PubMedDate not supplied

Understanding the experience of training for overseas nurses.

AIM: To explore the perceptions of overseas nurses during their induction programme. SAMPLE: A pilot cohort of 20 overseas nurses. METHOD: A qualitative research approach was used. RESULTS: The key themes were: communication issues, culture, role definition and feelings of self-worth, which are interrelated and suggest how the experience has influenced each nurse's professional development and ultimate achievement of 'competence' as a registered nurse able to practise in the UK. CONCLUSION: These findings confirm there is a need for greater understanding of the 'adjustment process' and integration into the workforce. Recommendations are made that for future projects to succeed, comprehensive support frameworks are required to fully support both the overseas nurse and the organisation as a whole.

Adaptation, Psychological↗

PubMed2003

Legal and regulatory concerns about transgenic plants in Brazil.

Brazil has a biosafety law that was approved in 1995. This law provides for a horizontal type of regulation that coordinates other existing regulatory frameworks in the areas of agriculture, health and environment. Various federal government departments are responsible for implementing the law. The National Technical Biosafety Commission is the national competent authority on biosafety with overall responsibility. In the case of Bt plants or any insecticidal organism, the Agrochemical Law also applies and authorization for laboratory, greenhouse and field studies must be obtained from the Plant Protection Secretariat, the Brazilian Institute of Environment and the National Agency of Health. Furthermore, the National Environmental Council must issue a license for commercialization of any GMO. There is pressure needed for capacity building and to harmonize the regulatory and administrative frameworks among the different federal departments involved. Some perspectives and challenges for the commercial registration of transgenic crops are discussed.

Animals↗

PubMed2006

Introduction to ISO 15189: a blueprint for quality systems in veterinary laboratories.

BACKGROUND: A trend in human and veterinary medical laboratory management is to achieve accreditation based on international standards. The International Organization for Standardization (ISO) 15189 standard is the first developed especially for accreditation of medical laboratories, and emphasizes the laboratory-client interface. European veterinary laboratories seeking to train candidates for the certification examination of the European College of Veterinary Clinical Pathology (ECVCP) require approval by the ECVCP Laboratory Standards Committee, which bases its evaluation in part on adherence to quality systems described in the ISO 15189 standards. OBJECTIVE: The purpose of this article was to introduce the latest ISO quality standard and describe its application to veterinary laboratories in Europe, specifically as pertains to accreditation of laboratories involved in training veterinary clinical pathologists. METHODS: Between 2003 and 2006, the Laboratory Standards Committee reviewed 12 applications from laboratories (3 commercial and 9 university) involved in training veterinary clinical pathologists. Applicants were asked to provide a description of the facilities for training and testing, current methodology and technology, health and safety policy, quality assurance policy (including internal quality control and participation in an external quality assurance program), written standard operating procedures (SOPs) and policies, a description of the laboratory information system, and personnel and training. Also during this time period multiple informal and formal discussions among ECVCP diplomates took place as to current practices and perceived areas of concern with regard to laboratory accreditation requirements. RESULTS: Areas in which improvement most often was needed in veterinary laboratories applying for ECVCP accreditation were the written quality plan, defined quality requirements for the tests performed, written SOPs and policies, training records, ongoing audits and competency assessments, and processes for identifying and addressing opportunities for improvement. Recommendations were developed for a stepwise approach towards achieving ISO 15189 standards, including 3 levels of quality components. CONCLUSION: The ISO 15189 standard provides a sound framework for veterinary laboratories aspiring to meet international quality standards.

Accreditation↗

PubMed2007

Integration of pediatric aspects into the general drug development process.

Drug treatment of children is today less regularly based on formal clinical testing than adults. This has led to concerns regarding the safety and efficacy of pediatric medicines and resulted in public action in the United States and the European Union. The reasons for the increasing awareness include better understanding of child physiology, increased trust in GCP (good clinical practice), improved treatment of several severe childhood diseases, a changed view of the child as a subject in society, and more. The US has successfully introduced pediatric legislation that facilitates participation of children in phar maceutical innovation, and comparable approaches are now being discussed in Europe and Japan. While the outcome of the EU pediatric regulation in the near future is still open, the US pediatric legislation has been highly successful over the past 8 years and will be revised before it expires in September 2007. Innovative drugs are today being developed by global pharmaceutical companies. Adding pediatric aspects to this development process is a complex task where companies need to build up internal competency. Bureaucratic procedures that could be harmful to the companies' economic fundaments need to be avoided, and an appropriate ethical framework is required. This needs to be addressed by all partners in healthcare, including regulatory authorities, the pharmaceutical industry, pediatricians, patients and others in a sense of shared responsibility.

Chemistry, Pharmaceutical↗

PubMed2006

Assessing urinary diversion experience in urologic residency programs-are we adequately training the next generation?

PURPOSE: Operative experience is important in developing surgical skills and technical competency. There is also emerging evidence directly linking increased surgical volume to patient outcomes. Accordingly, resident training should provide the framework for mastery of complex operations. We evaluated the current urological residency experience in performing adult urinary diversion. MATERIALS AND METHODS: The Accreditation Council for Graduate Medical Education-Residency Review for Urology Operative Log Reports were reviewed from 2000 to 2004 with an emphasis on urinary diversion experience. Resident logs were analyzed specifically for all procedures that included CPT codes for continent and incontinent diversions. The logs were compared by year of training and type of urinary diversion. RESULTS: Overall, the total number of urinary diversions performed by graduating residents from 4-year programs has increased from 2,259 (2000 to 2001) to 4,017 (2003 to 2004). In addition, the mean and median number of urinary diversion cases among residents completing training have remained relatively constant. For graduating urology residents in 2003 to 2004, the mean (median) number of continent urinary diversion and incontinent urinary diversion cases were only 6.7 (3.0) and 9.5 (4), respectively. CONCLUSIONS: Current Accreditation Council for Graduate Medical Education data suggest the average urology resident has limited exposure to urinary diversion in general, and even less experience with more complex continent urinary diversion. These results suggest that many urology residency programs may not have sufficient volume to provide residents with a broad experience in urinary diversion, and alternative strategies to ensure proper training should be explored.

Internship and Residency↗

PubMed2003

Moving research on resilience into the 21st century: theoretical and methodological considerations in examining the biological contributors to resilience.

Empirical investigations of resilience over the past 30 years have examined a wide range of psychosocial correlates of, and contributors to, this phenomenon. Thus far, theoretical treatments of resilience have focused almost exclusively on psychosocial levels of analysis to derive explanatory models. However, there have been no formal discussions of either theory or research that have examined the biological contributors to, or correlates of, competent functioning despite the experience of adversity. This paper seeks to fill this gap and sets forth a preliminary theoretical framework and outline of empirical strategies for studying the biological underpinnings of resilience. The initial sections of the paper discuss the particular suitability of a transactional organizational theoretical perspective as a conceptual foundation for including a biological level of analysis within the extant theoretical framework of resilience. Subsequently, other important theoretical considerations for the inclusion of a biological perspective on resilience are discussed, including the avoidance of an approach that would reduce resilience to merely a biological process, the application of the constructs of multifinality and equifinality to a biological perspective on resilience, as well as a general discussion of the potential for utilization of brain imaging and other technologies in the study of resilience. The possible relation between the mechanisms of neural plasticity and resilience are examined in some detail, with specific suggestions concerning research questions needed to examine this association. Sections of the paper discuss the likely relation of several areas of brain and biological functioning with resilience, including emotion, cognition, neuroendocrine and immune functioning, and genetics. The paper concludes with a discussion of the implications of a biological perspective on resilience for preventive interventions.

Affect↗

PubMed2001

Application of demand-control theory to sign language interpreting: implications for stress and interpreter training.

The translation work of sign language interpreters involves much more than language. The characteristics and goings-on in the physical environment, the dynamics and interactions between the people who are present, and even the "inner noise" of the interpreter contribute to the accuracy, or lack thereof, of the resulting translation. The competent interpreter must understand and respond appropriately to the language and nonlanguage aspects of each interpreting assignment. We use the framework of demand-control theory (Karasek, 1979) to examine the complex occupation of sign language interpreting. Demand-control theory is a job analysis method useful in studies of occupational stress and reduction of stress-related illness, injury, and burnout. We describe sources of demand in the interpreting profession, including demands that arise from factors other than those associated with languages (linguistic demands). These include environmental, interpersonal, and intrapersonal demands. Karasek's concept of control, or decision latitude, is also explored in relation to the interpreting profession. We discuss the prevalence of cumulative trauma disorders (CTD), turnover, and burnout in the interpreting profession in light of demand-control theory and data from interpreter surveys, including a new survey study described herein. We conclude that nonlinguistic demand factors in particular and perceived restrictions in decision latitude likely contribute to stress, CTD, burnout, and the resulting shortage of sign language interpreters. We make suggestions for improvements in interpreter education and professional development, including the institution of an advanced, supervised professional training period, modeled after internships common in other high demand professional occupations.

Journal Article↗

PubMed2006

A novel approach to assessing achievement goals in the context of the 2 x 2 framework: identifying distinct profiles of individuals with different dominant achievement goals.

In two studies, individuals' dominant achievement goals were assessed using a new, simple, and conceptually precise measure based on Elliot and McGregor's (2001) 2 x 2 framework. Next, the four groups were compared in terms of achievement-relevant variables, including need for achievement, perfectionism, perceived competence, interest, and graded performance. As expected, a very high percentage (approximately 85%) of people indicated they had a dominant achievement goal. Furthermore, the results suggest that individuals with different dominant achievement goals have clear, distinct profiles that can be characterized as positively valenced (mastery-approach), both positively and negatively valenced (performance-approach), negatively valenced (performance-avoidance), or neither positively nor negatively valenced (mastery-avoidance).

Achievement↗

PubMed2003

The scope of enrolled nurse practice: a review of the literature.

In this paper the scope of nursing practice of enrolled nurses (EN) is discussed within the context of the current demands of the health care environment and the impact of a changing grade mix for qualified nurses. Discussion is provided about EN practice, roles, functions, and competencies. The need for consistency in legislative and national guidelines, educational preparation, and the implementation of a decision-making framework is argued.

Australia↗

PubMed1990

The education of future senior health service managers.

Primarily due to economic forces, health services are being forced into a tight organisational framework of hospitals, clinics and services which need to be managed by educated professional managers. These managers need to be competent general and financial managers, competent planners, knowledgeable about health status, health issues, the Australian health care systems and knowledgeable about society, law and ethics. Assumptions that recruitment of people with such a formidable array of talents would be difficult are incorrect as judged by current experiences. Very talented and experienced candidates are being attracted to graduate education programs in health service management in many Australian universities. Accordingly the future management of Australian health services should be in good hands.

Australia↗

PubMed1994

The No Harm Contract in the emergency assessment of suicidal risk.

BACKGROUND: The No Harm Contract has been widely accepted in clinical practice, yet there is no broad consensus as to its value. This paper examines the contract and offers recommendations for its use as well as cautions about its misuse. METHOD: After a literature review, the No Harm Contract is examined from diagnostic, therapeutic, and medicolegal perspectives. RESULTS: Diagnostically, the No Harm Contract can be used to assess the nature and severity of a patient's suicidality, uncover specific troubling issues precipitating suicidal thoughts, and evaluate the patient's competency to contract. Therapeutically, the contract affords an opportunity to initiate a therapeutic alliance, establish the limits of the psychotherapeutic framework, and reduce both patient and clinician anxiety. Medicolegally, the contract is not legally binding and grants no suicide malpractice suit protection. CONCLUSION: Although the No Harm Contract is a frequently used clinical tool that can provide diagnostic information and therapeutic advantage, it can also short-circuit comprehensive suicidal assessment and disposition decisions.

Adult↗

PubMed1996

[Concise International Chemical Assessment Document (CICAD): a new chemical safety series in IPCS, internationalizing national reviews].

The Concise International Chemical Assessment Document or CICAD is a new chemical safety document series. It was launched by the IPCS in 1995, based on the decision of the International Forum on Chemical Safety in 1994, to internationally assess safety of 500 additional chemicals by the year 2000. The strategy to achieve this ambitious goal is to internationalize existing national assessment documents by rearranging contents of them into a standardized format, succinctly describing critical data, and adding international assessment process so as to be prepared efficiently, concisely and reliably. Critical review of document drafts by competent experts and input from countries including developing ones is required in the preparation. The author wishes to establish a framework to develop national reviews of chemical risk assessment domestically, while cooperating with this international programme.

Computer Communication Networks↗

PubMed1998

Consultation skills in radiology: a qualitative study.

OBJECTIVE: Consultation is an important part of radiologic practice. Recently, many concerns have been expressed about the lack of emphasis on consultation skills as part of the training requirements for radiologists. In order to improve the teaching and assessment of trainees, we designed a qualitative study to specify the consultation skills expected from a trainee by the end of residency. METHODS: Three successive focus groups were held with professors of radiology, residents in radiology, and referring physicians. Participants were asked to identify the various competencies required from radiologic consultants (1) spontaneously, (2) by reacting to a previously generated list, and (3) by reacting to common clinical problems encountered in radiology. RESULTS: Consultation skills thus identified were organized in a framework consisting of 2 groups: observable skills and standards of practice. Observable skills were subdivided into 5 "problem-setting" skills and 6 "results-management" skills. Seven qualities and attitudes identified were combined under the rubric "standards of practice." CONCLUSION: The specification of these abilities and competencies through a consensus process should permit the teaching of these skills and their evaluation through objective, structured clinical examinations.

Internship and Residency↗

PubMed2005

Culture and domestic violence: transforming knowledge development.

Cultural competence continues to receive limited attention in domestic violence service provision from research to the evaluation of programs. Yet with changing demographics reflecting larger numbers of people of color and increasing needs for more effective responses, it is critical that we change the way we think about domestic violence. Using a feminist framework, this article examines how knowledge has been developed in domestic violence and its consequence related to service provision and perceptions. The article ends with recommendations as to how to better include culturally competent responses in domestic violence.

Black or African American↗