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PubMedDate not supplied

Assessment of pragmatic difficulties and socio-emotional adjustment in practice.

BACKGROUND: In professional practice, psychologists and other professionals such as therapists and teachers receive referrals of many children who present with social, emotional and behavioural difficulties that are difficult to understand and assess. The problems of some of these children may stem from pragmatic difficulties in communication. This paper reports the results of a study on the use of checklists in professional practice to assist in the identification of these difficulties. AIMS: (1) To ascertain whether two checklists, Bishop's (1998) Children's Communication Checklist and Goodman's (1997) Strengths and Difficulties Questionnaire, would discriminate between groups of children diagnosed as having autism, autistic spectrum disorder/Asperger's syndrome, pragmatic difficulties and children with other types of specific language impairment. (2) To investigate whether specific aspects of pragmatic difficulties can be identified as relating to difficulties in peer relationships. (3) To investigate whether ratings of pragmatic difficulties are related solely to difficulties in social relations or whether other aspects of socio-emotional adjustment are also affected. METHODS & PROCEDURES: The Children's Communication Checklist and the Strengths and Difficulties Questionnaire were completed by the teachers and other professionals working with a sample of children (n = 38) with a range of types of communication difficulty and being educated in schools run by one English Local Education Authority. OUTCOMES & RESULTS: Analyses of variance indicated that the scores for pragmatic competence and socio-emotional adjustment difficulties were useful in discriminating between groups of children with diagnoses of autism or autistic spectrum disorder, Asperger's syndrome, and other types of language impairment. No specific pragmatic correlates of social interactional difficulties were found, but ratings of hyperactivity were significantly correlated with pragmatic difficulties. CONCLUSIONS: The two checklists if used together provide useful information on the profiles of strengths and weaknesses of children with a range of communication and or emotional/behavioural difficulties. The use of both checklists in this study demonstrated the differential profiles of pragmatic competence and socio-emotional adjustment of children with different types of communication difficulty.

Affective Symptoms↗
PubMed2000

Transforming practice organizations to foster lifelong learning and commitment to medical professionalism.

Practice organizations will increasingly engage in activities that are the functional equivalents of continuing medical education. The authors maintain that if these activities are properly structured within practice organizations, they can become powerful engines of socialization to enhance physicians' lifelong learning and commitment to medical professionalism. They propose that this promise can be realized if new or reformed practice organizations combine education and service delivery and institutionalize processes of individual and collective reflection. The resulting "institutions of reflective practice" would be ones of collegial, experiential, reflective lifelong learning concerning the technical and normative aspects of medical work. They would extend recent methods of medical education such as problem-based learning into the practice setting and draw on extant methods used in complex organizations to maximize the advantages and minimize the disadvantages that practice organizations typically present for adult learning. As such, these institutions would balance the potentially conflicting organizational needs for, on the one hand, (1) self-direction, risk taking, and creativity; (2) specialization; and (3) collegiality; and, on the other hand, (4) organizational structure, (5) coordination of division of labor, and (6) hierarchy. Overall, this institutionalization of reflective practice would enrich practice with education and education with practice, and accomplish the ideals of what the authors call "responsive medical professionalism." The medical profession would both contribute and be responsive to social values, and medical work would be valued intrinsically and as central to practitioners' self-identity and as a contribution to the public good.

Adult↗
PubMed1992

The influence of liberal education on professional nursing practice: a proposed model.

Nursing has embraced philosophically the importance of liberal education to professional practice. Yet there has been little exploration of how and if liberal education influences professional action. Based on a series of studies designed to examine the role of liberal education in professional practice, this article describes six competencies related to liberal and professional education and puts forth a model of practice that appears to be influenced by liberal education.

Clinical Competence↗
PubMed1989

Personnel management in dairy practice. The professional staff.

Group practices have advantages and disadvantages. Effective management of the professional staff makes the most of the benefits and minimizes the drawbacks. Management does not mean controlling people; rather, it allows both the individual doctors and the practice as a whole attain maximum development and satisfaction.

Dairying↗
PubMed2003

Professional nursing practice: impact on organizational and patient outcomes.

OBJECTIVE: To test a causal model of the impact of (a) nursing unit context on professional nursing practice; (b) professional practice on selected organizational (nurses' work satisfaction, nursing turnover, average length of patient stay) and patient outcomes (patient satisfaction, rate of reported medication errors, and falls); and (c) nursing unit context on these same organizational and patient outcomes. SUMMARY BACKGROUND DATA: Professional nursing practice has been linked to positive outcomes for both nurses and patients. In contrast to other studies, this study focuses on professional nursing practice specifically at the nursing unit level, and uses a new analytic technique that permits examination of the simultaneous effects of professional nursing practice on both organizational and patient outcomes. METHODS: Data were collected from 1682 registered nurses, and 1326 patients on 124 general medical-surgical nursing units in 64 general short-term acute care hospitals in the southeast. Multilevel structural equation modeling was used to analyze the data. RESULTS: We found that professional nursing practice had consistent effects across model levels on nursing satisfaction, but very limited effects on other outcomes. Important differences in the hospital- and nursing unit level models support continued use of multilevel modeling techniques in the study of organizational and patient outcomes.

Accidental Falls↗
PubMedDate not supplied

The interdependence of exempt salary status and professional nursing practice.

Because a salaried/exempt compensation structure is assumed to support professional status, it is a part of several professional practice models. The authors identify the placement of the salary component in a hospital-based professional nursing practice model and propose necessary conditions for successfully introducing a salary compensation structure.

Humans↗
PubMed1998

Problem-posing in education: transformation of the practice of the health professional.

This study was developed by a group of professionals from different areas (nurses and educators) concerned with health education. It proposes the use of a problem-posing model for the transformation of professional practice. The concept and functions of the model and their relationships with the educative practice of health professionals are discussed. The model of problem-posing education is presented (compared to traditional, "banking" education), and four innovative experiences of teaching-learning are reported based on this model. These experiences, carried out in areas of environmental and occupational health and patient education have shown the applicability of the problem-posing model to the practice of the health professional, allowing transformation.

Health Education↗
PubMed2003

The Vanderbilt Professional Nursing Practice Program, part 2: Integrating a professional advancement and performance evaluation system.

Developing a performance-based advancement system requires evaluation tools that capture essential behaviors and outcomes reflective of key nursing functions. To ensure relevance to clinical practice and enhance buy-in from nursing staff, the behaviors and outcomes were defined by a broad cross-section of nursing staff and administrators. The first article (September 2003) in this 3-part series described the foundation for and the philosophical background of the Vanderbilt Professional Nursing Practice Program (VPNPP), the career advancement program under way at Vanderbilt University Medical Center. This second article describes the development of the evaluation tools used in the VPNPP, the implementation and management of this new system, program evaluation, and improvements since the inception of the program. Additionally, the authors present the challenges and lessons we learned in development and implementation of a dynamic evaluation system that supports our career advancement program. The process of advancing within the program will be described in part 3.

Academic Medical Centers↗
PubMed2005

Assessment of allied health graduates' preparation to integrate genetic knowledge and skills into clinical practice.

Allied health professionals are in a unique position to address the concerns of and provide information to clients with genetic disorders. This study assessed the preparation of recent graduates of allied health training programs to provide these services by determining their (1) professional practices, (2) confidence in performing skills that require genetic knowledge, (3) extent of genetic training, and (4) interest in genetic topics. A survey was sent to 698 alumni of six allied health training programs who graduated between 1997 and spring 2002 from a midwestern university. A total of 235 alumni responded to the survey (34%). Forty-three percent of respondents reported discussing at least one of eight topics, such as patterns of inheritance, recurrence risks, genetic testing, and characteristics of genetic conditions and/or prognosis. Referrals for genetic services were made by 12.6% of respondents. Of the 10 genetic assessment, counseling, and referral skills that were assessed, eliciting family history was the skill most commonly performed. Many respondents discussed the genetic basis of disorders, provided guidance to clients about the impact of their condition, and corrected misconceptions. Only 22% of the respondents rated the amount of genetic knowledge/skills covered in training as satisfactory, and 78% rated it as marginal or none. However, there is strong interest in genetic topics, especially related to common disorders. A correlation was found between the respondents' training and confidence in performing these skills. Allied health professionals are providing genetic-related services in clinical settings. However, sufficient instruction in genetic knowledge and skills is not being provided in their undergraduate and graduate training programs. Preservice and continuing educational interventions designed to prepare allied health professionals for the genetic age are needed. This study establishes baseline data regarding professional practices and perceived clinical confidence related to genetics that can be used to develop and evaluate the effectiveness of future educational interventions.

Adult↗
PubMed1994

A transformational model for the practice of professional nursing. Part 1, The model.

Our healthcare system is undergoing major transformation. Most nurse executives know that change is necessary and inevitable, but are less certain how to position their departments for these changes. The Transformational Model for the Practice of Professional Nursing was developed as a "road map" for that purpose. Part 1 of the model discusses the paradigm shifts that need to occur in professional practice for future success. The various components of the model are presented, and applications are identified. Part 2 will appear in the May 1994 issue of JONA, and will discuss the implementation of this model into a practice setting.

Humans↗
PubMed1994

A transformational model for the practice of professional nursing. Part 2, Implementation of the model.

Our healthcare system is undergoing major transformation. Most nurse executives are convinced that change is necessary and inevitable, but they are less certain how to position their departments for future success. The Transformational Model for the Practice of Professional Nursing was developed as a "road map" for that purpose. Part 1 (JONA, April 1994) discussed the professional practice paradigm shifts that are needed for future success. The model components were presented and applications identified. Part 2 discusses the implementation of this model in a practice setting.

Humans↗
PubMed1998

Cut from the right wood: spiritual and ethical pluralism in professional nursing practice.

Today, different cultures and contexts of nursing adhere to different codes of ethics. This pluralism may be traced back to differing beliefs about the nature of man and the world, involving different approaches to, and understandings of, spirituality. How significant is this pluralism of beliefs surrounding spirituality for proper nursing practice? I argue that certain introductory nursing textbooks perceive the significance of spirituality for nursing practice as marginal, because of certain assumptions as to what constitutes a proper, or professional, practice. After arguing that such assumptions are problematic, especially from an ethical point of view, I will advance an alternative understanding of professional practice, by drawing upon Alasdair MacIntyre's work. The aim is to give the spiritual dimension of nursing care its rightful place.

Cultural Diversity↗
PubMed1999

Review of magnet hospital research: findings and implications for professional nursing practice.

The label "magnet hospitals" originally was given to a group of U.S. hospitals that were able to successfully recruit and retain professional nurses during a national nursing shortage in the early 1980s. Studies of magnet hospitals illuminated the leadership characteristics and professional practice attributes of nurses within these organizations. Recent investigations within magnet hospitals document significant relationships between nursing and patient outcomes, including mortality and patient satisfaction. The purpose of this review is to: 1) synthesize the magnet hospital research that describes and evaluates the professional practice of nurses within these institutions and (2) identify areas for future research to advance professional nursing models within current hospital organizations.

Attitude of Health Personnel↗