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PubMed1992

Impact of a clinical preventive medicine curriculum for primary care faculty: results of a dissemination model.

BACKGROUND: This study was designed to test a dissemination model for providing clinical preventive medicine (CPM) training to general internal medicine faculty across the United States. METHODS: The model incorporated direct instruction of a few faculty as seminar facilitators who, in turn, taught a CPM curriculum to their faculty colleagues, who then could teach it to housestaff and students. The CPM curriculum consisted of six seminars that focused primarily on the risk factors for chronic diseases and on behavior change methods for modifying smoking, diet, and exercise. RESULTS: Faculty who participated in the seminars had significant pre- to post-test increase in knowledge and reported self-efficacy to implement CPM strategies with patients, as well as changes in CPM clinical practices. These faculty, in turn, successfully disseminated CPM information to their housestaff, who also had increases in self-efficacy and changed clinical practices regarding CPM topics. CONCLUSIONS: The successful implementation of the dissemination model attests to its viability as a mechanism for disseminating CPM curricula and increasing the emphasis on CMP issues in both clinical teaching and clinical encounters with patients.

Adult↗

PubMed1981

A curriculum for the psychiatric training of family physicians.

This curriculum is designed with the expectation of considerable involvement by family physicians in mental health care delivery. Psychiatry education is initiated early, before attitudes become fixed, to emphasize self-reliance and mental health problem-solving skills, to make the learning experience longitudinal, and to integrate psychiatric training into the rest of the residents' curriculum. Seminars, clinical experience, and liaison with a mental health team are all utilized in the training design. The effectiveness of this training program will be studied over time to obtain needed data about the best teaching model for the mental health role of the family physician.

Curriculum↗

PubMed1984

The teaching of consultation-liaison psychiatry in the undergraduate curriculum of Canadian medical schools.

The teaching of consultation liaison psychiatry in the undergraduate curriculum of the 16 Canadian medical schools and the views of the directors of undergraduate psychiatric education were surveyed with a 25-item questionnaire. Some teaching in consultation liaison psychiatry is provided by 14 medical schools. The predominant format of teaching is that of supervised experience, and systematic evaluation of this teaching is uniformly absent. The amount of consultation liaison teaching was small. More than 90% of the students were assigned primarily or exclusively to an inpatient service during their psychiatric clerkship. The majority of the respondents thought that the response of staff and students to the teaching of consultation liaison was good or excellent, that this teaching should be an obligatory part of the curriculum, that it would increase in the next five years, that insufficient staff was a factor impeding it, and that an increase in staff psychiatrists specializing in consultation liaison psychiatry would facilitate this teaching in their department. It is suggested that the consultation liaison psychiatry teaching of medical students should be increased, in the short term by making greater use of services and resources. In the longer term, however, such increase would be dependent on the growth and development of consultation liaison services in the teaching hospitals across the country.

Attitude of Health Personnel↗

PubMed1989

An exercise in curriculum development--the process of putting theory into practice.

Many nurses coming on post-registration courses have widely varying backgrounds and levels of experience. In addition they seek to develop their knowledge base and therapeutic skills, as well as address their personal and professional development. As adult learners they may have a clear idea of their own objectives for the course, and will often benefit most from a student-centred approach to learning. This paper describes the process of reviewing and redesigning a post-registration course in community psychiatric nursing, using this knowledge and a curriculum development model as a starting point. The review particularly addressed the role and influence of student assessment, and the concepts of integration within the curriculum, and student/teacher negotiation of elements of the course.

Community Health Nursing↗

PubMed1990

Nursing models in the curriculum: the nursing degree course at Bristol Polytechnic.

This article discusses the use of nursing models as a basis for curriculum planning in a Nursing degree course. Each module in the course is based on a Nursing model, as are assessment of theoretical aspects and of nursing competencies. Rationales for the structure of the course and choice of models are given, and the article concludes by emphasising the need for continuing evaluation of this way of planning and implementing the curriculum.

Clinical Competence↗

PubMed1991

Faculty development: the essence of curriculum development.

For years, nurse educators' approach to curriculum building has been one entrenched in the behaviourist school of thinking. The outcome for nursing was a graduate who could function well in a predictable environment. However, as nursing practice is becoming increasingly complex, nurse educators feel more and more disenchanted with this approach and are turning to orientations which support a professional model of education. Shifting orientation to a paradigm for professional education requires that educators change their views and practices to reflect the assumptions underlying the new paradigm. This paper examines the process involved in shifting orientations to curriculum development and proposes strategies to mobilise educators in their own resocialisation to their new roles as educators and learners.

Curriculum↗

PubMed1992

Project 2000 curriculum evaluation: the case for teacher evaluation.

Project 2000 has changed the role of nurse teachers. Thus evaluation of Project 2000 should incorporate a theoretical framework that not only evaluates the individual school/college of nursing curriculum but also enhances the teachers' professional development. This paper suggests that teacher professional development would be enhanced by teacher self-evaluation (action research). A collaborative approach between teachers and an evaluation co-ordinator would ensure that the quality of the curriculum is maintained (MacDonald 1991). It is argued that the implementation of monitored innovation would fulfil the criteria for the developing school/college of nursing put forward by Holly et al (1989).

Curriculum↗

PubMed1992

An integrated approach to curriculum development.

This paper explores some aspects of what is meant by integration in a nursing curriculum, by looking at both integration of course content and subject matter, and a consequent move away from separated academic disciplines towards a thematic approach, and at integration of the student group, so that different groups of nurse learners study and learn together for a certain proportion of the programme. We consider reasons for adopting an integrated approach by discussion: issues related to learners and the learning context (these include theories of how adults learn and our perspective on the part to be played by experiential learning); the potential implications for client/patient care and the need for transferable skills to work as a member of a team; and staff development for the teachers, including moves away from possible isolation towards team-teaching. We then go on to describe a model for curriculum development devised in our own institution and based on these principles, which incorporates the development of learners professionally, educationally and personally. This paper discusses the topic from a mainly theoretical perspective, and many of the issues will be relevant to a wide range of courses.

Clinical Competence↗

PubMed1993

Towards a theory of student-centred nurse education: overcoming the constraints of a professional curriculum.

Student-centred learning is an educational philosophy which became popular during the 1960s, but which has gradually fallen from favour as the educational and political climate has changed over the years. This is particularly true of nursing, where the transition to higher education ushered in by Project 2000 has signalled a return to traditional teaching methods such as the lecture and the seminar. This paper argues that the current demands for holistic practice, professional autonomy and primary nursing can best be met by educationalists by employing a student-centred approach to learning. However, it is recognised that a radical student-centred approach will conflict with the constraints imposed on curriculum writers by a professional body, and that a modified strategy is required. The paper goes on to identify several of the more pressing constraints, and suggests some methods for overcoming these problems within a student-centred framework, while maintaining the requirements of a professional training which confers upon the students a license to practise. The paper concludes by suggesting that most problems will only be identified once courses are up and running, and that a new student-centred framework can only emerge from educational practice. Teachers and curriculum writers are therefore encouraged to come together to share ideas and experiences in order to carry forward the theory and practice of student-centred nurse education.

Curriculum↗

PubMed1994

The use of a curriculum model in an Accident and Emergency Department.

This paper describes the adaptation and use of Beattie's curriculum model in an Accident and Emergency (A/E) Department. The rationale behind the undertaking was to reduce the incongruity between the triangle of the college, A/E and the student that creates the theory-practice gap in the context of A/E nursing. The article discusses firstly the decision to use a curriculum model. Secondly the reasons for the choice of model and the factors influencing that choice are discussed. The difficulties in applying the model and teaching methods that may be employed are examined. Student evaluation and the difficulties encountered in implementing the model is the final avenue explored. The article concludes that the strength of Beattie's model in A/E lie in its eclecticism. By combining all four approaches, the practical and theoretical contexts become integrated and in doing so reduce the theory/practice gap between A/E, the college and the student. It also provides a sense of balance for both student and teacher alike, amalgamating the four design briefs with the differing teaching methods thus catering for both group and individual student's differing learning styles.

Clinical Competence↗

PubMed1991

The problem of poor retention of cardiopulmonary resuscitation skills may lie with the instructor, not the learner or the curriculum.

Many studies (several even before American Heart Association recommended in 1973 that lay public be trained in cardiopulmonary resuscitation (CPR] have documented that retention of CPR skills is poor, unaffected by modifications in curriculum or whether the students are lay or professional. We chose to investigate what actually occurs during a CPR course, and gained the following insights: despite clearly defined curricula, we found that instructors did not teach in a standardized way. Practice time was limited and errors in performance were not corrected. Instructors consistently rated the students' overall performance as acceptable; at the same time, using the same checklist, we consistently rated performance as unacceptable. The checklist is an inaccurate tool for evaluating CPR performance. Despite the poor performance that we documented, students and instructors were satisfied with the courses and believed that the level of performance was high. As a result of these studies, we discovered that the problem of poor retention of CPR skills may lie not with the learner or the curriculum, but with the instructor. But, since lives are being saved with bystander CPR, does this documented poor retention matter? Perhaps the solution is not only to improve instructor training to make certain that students receive adequate practice time and accurate skill evaluation, but also to modify the criteria for correct performance when testing for retention. These criteria should be based on the minimum CPR skills that are required to sustain life for the critical 4-8 min before defibrillation and other advanced cardiac life support are delivered.

American Heart Association↗

PubMedDate not supplied

Development, implementation, and evaluation of a medical Spanish curriculum for an emergency medicine residency program.

A 45-hour medical Spanish curriculum for an emergency medicine residency program was implemented in response to a need for "functionally bilingual" physicians in our practice setting, and to reduce reliance on translation assistance from nursing and clerical personnel. Course goals were to achieve a vocabulary level of 5,000-10,000 words for participants, and to achieve sufficient language capabilities for basic information exchange, obtaining uncomplicated medical histories, conducting unassisted physical examinations, and giving patient discharge instructions. Feedback obtained from post course interviews and instructor assessment indicated that the curriculum employed resulted in the attainment of the above goals for fully participating physicians.

Curriculum↗

PubMedDate not supplied

Augmenting the critical care data base of junior medical students with an emergency medicine lecture curriculum: a controlled study.

A mandatory lecture course in emergency medicine, consisting of 13 lectures, was given to junior medical students over 3 years at Texas Tech University Regional Academic Health Center--El Paso. The performance of the students on a 25-question pretest and posttest was compared to a statistically similar group of their classmates on geographically separate campuses of Texas Tech University School of Medicine undergoing an otherwise comparable junior year clinical curriculum. Both groups exhibited improvement in posttest scores from pretest score values; additionally, students exposed to the lecture series at Texas Tech--El Paso performed significantly higher on the posttest, compared to the other campuses. We conclude that some emergency medicine material is successfully learned by junior medical students during their required third year clerkships; however, important learning objectives within the domain of emergency medicine can be most successfully taught if a mandatory junior year lecture course in emergency medicine is also incorporated into the third year curriculum.

Critical Care↗

PubMed1996

Italian consensus on a curriculum for volunteer training in oncology.

Volunteers' education, together with selection and organization, are fundamental for an adequate volunteer service in oncology, which is focused on patient and family needs and is fully integrated with the activity of the care team. To achieve such an aim, well-defined requirements and educational objectives are essential. A curriculum for voluntary service in oncology was developed through a consensus of experts. By comparing the work carried out by six different teams, a questionnaire was drafted, which grouped 91 educational aims. For each, the questionnaire queried whether the aim was relevant or not, and, if yes, whether it should be pursued through (a) knowledge, (b) skill, and/or (c) attitude (with a possible multiple answer). To improve comprehension, the questionnaire was divided into five sections: (a) the association; (b) the disease, therapies, and care site; (c) voluntary service in oncology; (d) psychosocial aspects of the patient and family; and (e) approach, communication, and acceptance. The questionnaire was sent to 117 delegates from 93 Italian volunteer organizations who, during a period of 8 years, had attended a course for volunteer trainers held by the Italian League Against Cancer. As indicated in the letter forwarded with the questionnaire, the final document would report only the aims considered relevant by at least 70% of the participants. Moreover, the area(s) of pursuit (knowledge, skill, and attitude) would be stated for each goal when indicated by at least one-half of the participants. Of 117 individuals questioned, 83 (71%) replied. Of the 91 aims proposed, 60 were considered relevant, and a type of approach (knowledge, skill, and/or attitude) was suggested. The formative curriculum of voluntary service in oncology represents a consensual guideline for future training programs.

Adult↗

PubMedDate not supplied

Training parents to observe and record: a data-based outcome evaluation of a pilot curriculum.

Despite the prevalence of training parents in the use of child behavior management strategies, relatively little investigative attention has been devoted to promoting acquisition of parent observational and recording skills. In this study, we examined the efficacy of a brief curriculum designed to teach parents how to observe and record targeted child behaviors systematically. Subsequent to instruction, each of six participating parents demonstrated, in an analogue context, higher levels of both occurrence and nonoccurrence agreement, based upon their recordings of child behavior, when compared with those of a panel of experienced professionals. Agreement of parental recordings with those of professionals typically increased to a predetermined mastery criterion and stabilized subsequent to training, relative to a high degree of variability during baseline. Results are discussed in terms of directions for further refinement of the curriculum and additional study of its impact.

Behavior Therapy↗

PubMed2005

The impact of a novel educational curriculum for first-time DUI offenders on intermediate outcomes relevant to DUI recidivism.

The Preventing Alcohol-Related Convictions (PARC) program is a novel educational curriculum for first-time DUI offenders, with the ultimate goal of reducing DUI recidivism. It differs from traditional DUI education and prevention programs in that it does not suggest to DUI offenders that they must abstain from alcohol entirely or control their drinking to prevent a future DUI; rather, it teaches students to prevent a future DUI by not driving their cars to drinking events. Thus, the emphasis of the curriculum is on controlling driving rather than controlling drinking to avoid future DUI convictions. The implementation of the program is ongoing throughout the state of Florida. The current randomized study focused on intermediate outcomes relevant for DUI recidivism; specifically, individuals' readiness for change regarding drinking and driving, and their endorsement of a PARC planning and action approach (controlling driving) versus a traditional approach (controlling drinking). The current research demonstrated that the PARC program is effective in moving participants toward more readiness for change and toward a strategy of planning ahead to avoid driving to any venue in which drinking may occur. Future research will assess the ultimate effect on DUI recidivism.

Alcoholic Intoxication↗

PubMed2006

Radiology curriculum topics for medical students: students' perspectives.

RATIONALE AND OBJECTIVE: We sought to establish medical students' perspectives of a set of curriculum topics for radiology teaching. MATERIALS AND METHODS: A multicenter study was conducted in New Zealand. A modified Delphi method was adopted. Students enrolled in two New Zealand Universities received a questionnaire. Each learning topic was graded on a scale of 1 (very strongly disagree) to 6 (very strongly agree). Students could also put forward and grade suggestions that were not on the questionnaire. RESULTS: Of 200 questionnaires, 107 were returned. Fifty male and 57 female students participated, with an average age of 23.7 years. The five highest ranking curriculum topics in order of importance were developing a system for viewing chest radiographs (5.77, SD 0.7), developing a system for viewing abdominal radiographs (5.66, SD 0.8), developing a system for viewing bone and joint radiographs (5.56, SD 0.8), distinguishing normal structures from abnormal in chest and abdominal radiographs (5.38, SD 0.9), and identifying gross bone or joint abnormalities in skeletal radiographs (5.29, SD 0.9). CONCLUSION: Medical students want to know how to look at radiographs, how to distinguish normal from abnormal, and how to identify gross abnormalities.

Adult↗

PubMed2004

Impact of a preventive medicine and nutrition curriculum for medical students.

BACKGROUND: United States public health goals call for increased physician counseling about diet and exercise, but many medical schools lack adequate curriculum on these topics. At Harvard Medical School, second-year students take a preventive medicine and nutrition (PMN) course. This study evaluated the impact of this innovative curriculum on students' confidence about addressing patients' diet and exercise patterns and on their own health habits. METHODS: Students enrolled in the 2003 PMN course (N =137) completed a confidential 43-item written survey before and after the course. Surveys were completed by 134 students (98%) and 118 students (86%), respectively. The survey assessed students' diet and exercise habits and students' confidence in their ability to address diet and exercise with patients and family members. RESULTS: Students' confidence in their ability to assess and counsel about diet and exercise significantly improved after the course (all p <0.001). The course was also associated with a decrease in students' self-reported consumption of saturated fat (p =0.002) and trans fatty acids (p <0.001). Following the course, 72% of students perceived an improvement in their diet but only 18% perceived an improvement in exercise habits. CONCLUSIONS: An innovative PMN course improved medical students' confidence in diet and exercise counseling and perceived dietary habits. Improving these mediators of physician counseling in medical students may translate into changes in their practice patterns.

Adult↗