Self-evaluation as an aspect of accountability.
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Education, Nursing, Diploma Programs↗
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Geriatrics and internal medicine.
If medical education is to respond adequately to the growing number of citizens encompassed by the field of geriatric medicine, it must intensify its commitment to the special health and health-related problems of the elderly at every level, from student to certified specialist. This paper discusses the various intellectual, epidemiologic, economic, and attitudinal factors related to the teaching and practice of geriatric medicine. The emergence of a positive philosophy emphasizing coping and possible reversibility of disease is vital. The recent report of the Institute of Medicine on Aging and Medical Education is also reviewed, as well as graduate training opportunities and ways in which the American Board of Internal Medicine could play a leading role in this process by providing increased emphasis on geriatrics in its training programs and certifying examinations. The medical profession must continue its self-evaluation to ascertain how it can most effectively contribute to improving the lives of the elderly, perhaps our greatest national resource.
Attitude of Health Personnel↗
Family (parental) history and prevalence of hypertension. Results of a nationwide screening program.
In a nationwide screening program, blood pressure measurements, family (parental) histories of hypertension, and self-evaluations of weight class were obtained for more than a half million people. Positive family history was associated with hypertension prevalence double that found in persons with negative history and was independent of weight. When overweight was also present, however, hypertension prevalence was three to four times as high. Hypertension was more likely to have been previously diagnosed in screenees if family history was positive. However, such screenees did not have a higher proportion receiving effective treatment than those with negative family history. When an index case of hypertension is found, other family members should be examined. For persons with positive family history, nutritional-hygienic recommendations to avoid overweight may be important in reducing the risk of becoming hypertensive.
Adult↗
The effect of two kinds of role playing on self-evaluation of improved assertiveness.
The study investigated the "differential effect of role-playing enactments" hypothesis through self-evaluations of improvement in assertiveness by participants in an assertive training program. Twenty-two nonassertive Israeli students were trained in two groups: mimetic-replications (action modeling, n = 12) and spontaneous (self-produced action, n = 10) role-playing interventions. Comparisons of their scores on the Self-Expression College Scale (CSES) before and after the training showed that both groups significantly improved their self-evaluations, but the mimetic-replication group did better. In particular, this group scored significantly higher on the CSES first factor (the willingness to take risks in situations that involved other, significant persons).
Adult↗
Attachment learning: a humanistic educational experience. Final practicum in a coordinated undergraduate program.
Throughout the five stages, the student has ample opportunity for expression and self-evaluation in the counseling sessions that accompany each stage. The student experiences progress with increasing responsibility to the ultimate functioning as an administrative dietitian under supervision. It is believed that the experiences of attachment learning will enable the student, on graduation, to enter professional practice with confidence and a strong likelihood of success. Thus far, experiences with attachment learning at the University of Missouri-Columbia have demonstrated superiority over methods used previously. It is believed that this method can be readily adapted to other learning situations in dietetics, such as traineeships and internships. In fact, our enthusiasm for the method prompts the suggestion that it might well be considered for the final stage of education for any profession in which entry-level competencies can be established.
Curriculum↗
Outcome research on treatment and on the drug abuser: an exploration.
The study of treatment outcome has its own history, and the experience of other service fields in this area may be of considerable interest to researchers concerned with the effectiveness of treatment for drug abusers. Methodological issues that emerged from psychotherapy's efforts at self-evaluation are reviewed and contrasted with work done on treatment outcome in drug programs. An overview is presented of current research on the improvement of drug abusers and on treatment effectiveness.
Age Factors↗
A cognitive-behavioral versus nondirective group treatment program for opioid-addicted persons: an adjunct to methadone maintenance.
Fourteen methadone maintenance individuals participated in a 10-week program comparing the relative effectiveness of a cognitive-behavioral (CB) versus discussion-type (DISC) group in developing adaptive behavioral skills and self-evaluations. Posttreatment and follow-up results indicated that the CB group was significantly more successful than the DISC group in lowering reported levels of anxiety, depression, and situational non-assertiveness. These data are discussed in terms of a comprehensive, social rehabilitation program that involves multiple treatment techniques and measurement criteria.
Adult↗
The role of the academic medical center in the PSRO program.
The professional standards review organization (PRSO) program offers both a challenge and an opportunity to the academic medical center. Application by the local PSRO of objective measures of the quality and medical necessity of services challenges the medical center to demonstrate that its self-image of excellence is correct. Educating and training medical students and house staff in methods of self-evaluation and peer review could have a major impact on both the success of the PSRO program and the quality of medical care. Evaluation of the educational programs of the medical center through review of actual practice behavior presents an unparalleled means for improvement in undergraduate, graduate, and continuing medical education.
Attitude↗
[Formative evaluation of education].
The formative evaluation tries to obtain, analyze and furnish information over the planning and development of a course, which is brought about through a continuous performance of the students during the course. This method allows for the adoption of corrective measures with reference to the course (presentation of other learning opportunities, preparation of instructive materials, revision of curriculum, etc.) and with reference to the student (studies prescribed). The formative evaluation may be fulfilled by means of repeated tests which the student himself will correct and, subsequently, will discuss with the professor; it can also be processed by means of the students self-evaluation, interacting with computer terminals. CLATES/Rio presents its experience employing minicomputers to allow for self-evaluation in bioscience courses.
Computers↗
Shaping behavior in voice therapy.
This study demonstrates the process of learning and shaping of behavior which occurs during a program of therapy for individuals with hyperfunctional hoarse voice quality. First a therapy program delineating the techniques and criteria to be used was written. The program was presented during 16 individual half-hour sessions over an eight-week period to three clients known to have vocal nodules. The clients' responses were charted at various points from audiotape recordings of each therapy session using a modification of the Boone-Prescott analysis system, to obtain data to demonstrate the learning processes. It was concluded that: (1) the client's behaviors in this vocal rehabilitation program reflected a learning process; (2) facilitating techniques were used to modify or shape behavior through successive approximations to the terminal goal; (3) self-evaluation is an important factor needed to bring about successful changes in behavior; (4) analysis of client's behaviors in relation to the learning process can aid in evaluating the effectiveness of the facilitating techniques; and (5) from such evaluation intraclient and interclient program changes are derived hopefully resulting in a greater success rate and maximum benefits from time spent in therapy.
Behavior Therapy↗
[Counseling in the prevention of fatigue in psychiatric nurses].
Nursing is a stressful activity and therefore it is necessary for nurses to develop effective coping mechanisms, or to strengthen existing ones in a healthy manner, in order to be capable of dealing with stress, arising from their personal and professional lives. It is, however, not solely stress itself which predisposes nurses to fatigue (physical, psychological and emotional exhaustion) but rather the chronic nature and excessive amount of stressors which place excessive demands on the energy resources and coping, mechanisms of nurses resulting in the ineffective handling of stress which in turn leads to the eventual development of fatigue. The detrimental results of this experience are, however, not confined to the nurse herself, but extends further to the patient and the organization. Thus, if fatigue is not controlled or dealt with, all parties and organizations concerned could suffer. This research covers the accompaniment function of the psychiatric nurse specialist in the prevention of fatigue in psychiatric nurses by strengthening their mental preparedness. As a possible solution to the experience of fatigue, a structured, accompanied program of three days was offered to a group of psychiatric nurses. The Solomon four group design was followed in order to eliminate influences on the subjects resulting from the completion of the self-evaluation scale as pre-test. The data which was obtained from the test results was statistically compared. Results showed that there was a definite decrease in the levels of fatigue experienced by the experimental group that received the structured accompanied programme, but no real change occurred in the control group that had merely been provided with relevant literature.(ABSTRACT TRUNCATED AT 250 WORDS)
Adaptation, Psychological↗
Improving clinical teaching. Evaluation of a national dissemination program.
This study assessed a dissemination approach to improve clinical teaching. We hypothesized that (1) physicians from a variety of institutions nationwide could be trained to conduct teaching improvement seminars for faculty colleagues; (2) such seminars would be perceived as highly useful; (3) pre/post self-evaluations by faculty participants and evaluations of faculty participants by house staff/students would indicate improved teaching performance. Selected medical faculty completed 1 month of facilitator training at the Stanford Faculty Development Program, Palo Alto, Calif. They then delivered teaching improvement seminars for other faculty. From 1986 to 1988, 12 facilitators from 12 institutions trained 107 faculty at their home institutions in their initial seminar series. Their seminars were rated as highly useful by participants. Both faculty self-assessments and house staff/student ratings indicated improved teaching performance. We concluded that this dissemination approach provides one possible mechanism for ongoing teaching improvement within institutions across the country.
Education, Medical, Undergraduate↗
Competency-based education and creative thinking.
When creativity is considered as an approach to problem-solving, rather than as an innate talent, then education can play an important role in its development. This paper postulates that competency-based education, because of its emphasis on stated objectives, feedback, self-evaluation, and alternative learning experiences, is an approach to curriculum design that should lead students to become more creative thinkers. A description of competency-based-education is given, and research on educational methods and creativity is surveyed. The implications of this type of program for occupational therapy education are considered.
Creativity↗
[Quality assurance exemplified by perinatology and surgery].
Quality assurance encompasses all activities which are necessary to obtain a demanded quality of medical care. Typically, a quality assurance process ("monitoring- and evaluation-process") includes the following steps: systematic observation of quality of medical care using quality indicators, assessment of quality by comparison with standards and recognizing problems, analysis of the most important problem, realization of appropriate problem solving strategies and evaluation, if the problem is successfully solved through the corrective action. The quality assurance programs in perinatology and surgery--established in all the states of the Federal Republic of Germany--support the hospitals in the application of this quality assurance process. Uniform documentation and preparation of quality relevant information (lists of complications, profiles, charts, etc.) help the hospitals to perform a self-evaluation, to recognize problems and to verify the elimination of the problems. Hence, comparisons with local results and with results of other hospitals are possible.
Cesarean Section↗
Short-term group therapy for people in crisis.
The author describes a short-term group therapy program that he believes is more effective than the traditional one-to-one approach for people in crisis. The group focuses on the problems of one member at a time and helps him examine his role, identity, and value system, the significant people in his community, and his ability to appreciate the positive things that exist within himself. Short-term goal-setting, self-evaluation, and written homework assignments are used to teach the client a new process that can help him look at his life positively and accept defeats and failures as a part of the growth process.
Community Mental Health Services↗
Predictors of black medical student success.
This study identifies those variables, cognitive and noncognitive, that relate significantly to the successful completion of the combined BA/MD degree program. The study sample included 69 black students who entered at year one, directly from high school, between 1972 and 1981. The Student's t-test identified statistically significant differences in the means of selection variables of successful and nonsuccessful black students. Single order correlations between predictor variables and the criterion of graduation were determined. This was followed by a stepwise regression procedure. The same predictor variables were correlated with grade point average (GPA) at the end of year one, and a further analysis added year one GPA to the predictors of graduation in a stepwise regression procedure. The same statistical analyses were carried out on a stratified sample of 69 nonminority students. Predictors of graduation for black students were parents' level of education, admission test score, self-evaluation, and council index (average vote of all committee members on an applicant). Year one GPA was a strong predictor of success for both cohorts of students. This study supports the inclusion of noncognitive information when considering black applicants for medical school. In particular, parents' levels of education and applicants' self-appraisals, along with admission test scores, showed a significant relationship to graduation 6 years later with the MD degree.
Black or African American↗
Testing a model for counsellor training in three public health care organisations.
The article describes a training programme arranged for 26 specially qualified nurses who were to be placed in the role of nurse counsellors. The programme was tested over a period of 2 years in three public health care organisations: a central university hospital, a regional hospital and a community health centre. The aims were to develop a basic model for counsellor training and to test the model in practice; and more specifically, to evaluate the relevance of the theoretical instruction, practical exercises, and reading assignments included in the programme. Finally, on the basis of self-evaluations by the nurses involved, the aim was to find out how far the objectives set for the practical counselling by the nurses themselves were realised. The data were collected by means of a semi-structured questionnaire after the completion of the training course, and analysed using the method of content analysis. Percentage and frequency distributions were used for purposes of statistical description. The small sample size and the differences in the nature and goals of the health care organisations involved mean that there are important restrictions to the generality of these results. Nevertheless they give important clues for the further development of counsellor training schemes.
Attitude of Health Personnel↗
The development and evaluation of a community mental health education program for seminarians.
Because the clergy stands in an ideal position to serve the mental health needs of the community, seminaries have, for some time, included courses in pastoral counseling and related skills. While valuable, these courses tend to focus on the traditional clinical relationship excluding the broader role of community interventionist. Viewing this need, a course was developed to train seminarians in principles and practices of community mental health. The 28 students were compared to 24 controls at the beginning and end of the term. Evaluative instruments were the Community Mental Health Ideology Scale, two scales adapted from the Theological School Inventory, a self-evaluative competence scale, and a role evaluation scale. Data within a 2 X 2 X 2 design were subjected to an analysis of variance. Experimentals were found to exceed controls on the Community Mental Health Ideology Scale (p less than or equal to .001), the competence scale (p less than or equal to .01), and role evaluation scale (p less than or equal to .01).
Adult↗