SEARCH · PubMed Health

Results for “Competency framework”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,333 records · Page 74Linked to original sources

PubMed1998

Portfolio: authentic assessment in the age of the curriculum revolution.

This article provides an extensive review of the literature on portfolio use in education. There is a gap in the literature related to portfolio use in nursing education. Portfolios are one method of authentic assessment, showing evidence of student growth and achievement over time. Development of the student portfolio promotes collaboration between student and faculty. The Integrated Proficiency-Criterion (IPC) framework is one proposed method for portfolio development and evaluation, using Benner's stages of proficiency and NLN criteria for accreditation of baccalaureate nursing programs.

Clinical Competence↗

PubMed2002

Portfolio assessment and evaluation: implications and guidelines for clinical nursing education.

With the advent of Outcomes-Based Education in South Africa, the quality of nursing education is debatable, especially with regard to the assessment and evaluation of clinical nursing education, which is complex and renders the validity and reliability of the methods used questionable. This paper seeks to explore and describe the use of portfolio assessment and evaluation, its implications and guidelines for its effective use in nursing education. Firstly, the concepts of assessment, evaluation, portfolio and alternative methods of evaluation are defined. Secondly, a comparison of the characteristics of the old (traditional) methods and the new alternative methods of evaluation is made. Thirdly, through deductive analysis, synthesis and inference, implications and guidelines for the effective use of portfolio assessment and evaluation are described. In view of the qualitative, descriptive and exploratory nature of the study, a focus group interview with twenty students following a post-basic degree at a university in Gauteng regarding their perceptions on the use of portfolio assessment and evaluation method in clinical nursing education was used. A descriptive method of qualitative data analysis of open coding in accordance with Tesch's protocol (in Creswell 1994:155) was used. Resultant implications and guidelines were conceptualised and described within the existing theoretical framework. Principles of trustworthiness were maintained as described by (Lincoln & Guba 1985:290-327). Ethical considerations were in accordance with DENOSA's standards of research (1998:7).

Attitude of Health Personnel↗

PubMed2003

A buddy program for international nurses.

To help alleviate the nursing shortage, nurses from overseas are being recruited. These nurses must adjust to numerous cultural, social, and organizational experiences. Using Pilette's phases of adjustment and a theoretical framework, the author discusses a Buddy Program that has been instituted in a community hospital to provide support and resources to help international nurses with their earliest phase of acculturation.

Adaptation, Psychological↗

PubMedDate not supplied

Benchmarking physician performance, Part 1.

The performance of 16 primary care physicians in the same medical specialty and university clinic is compared using data envelopment analysis (DEA) efficiency scores. DEA is capable of modeling multiple criteria and automatically determines the relative weights of each performance measure. In this research, the performance measures include physician work relative value units (RVUs) as an input variable and patient satisfaction and total billable charges as the two output variables. The results provide insights into: 1. Who are the best-performing physicians? 2. Who are the underperforming physicians? 3. How can underperforming physicians improve? 4. What are the underperformers' performance targets? 5. How do you deal with full- and part-time physicians in a university setting? This research also provides a preliminary framework for how work measurement and DEA analysis can be used as a basis for a medical team or physician compensation system.

Benchmarking↗

PubMed2006

Exploring the human resource implications of clinical governance.

In 1998, clinical governance was introduced in the National Health Service, UK (NHS) as a major policy initiative to improve the quality of clinical care. The implementation of clinical governance is crucially dependent on the skills, competencies and willingness of the NHS staff. In turn, clinical governance influences the way people work in health care organisations. Therefore, it is no surprise that the introduction of clinical governance has thrown-up new challenges for human resource management. However, what are these human resource management challenges under the clinical governance framework? The current literature on the subject provides no answer. This article attempts to fill this gap in the literature. A qualitative approach influenced by phenomenological case study approach has been adopted. A heterogeneous group of 33 persons identified through a purposive sampling procedure were interviewed using a semi-structured format. The results indicate that the staff members appreciate the crucial role of human resources management in the implementation of clinical governance. However, there is little evidence to suggest that senior management is paying attention to develop the human resources function around the clinical governance agenda. The seven major human resource implications of clinical governance that emerged from the data analysis are discussed. The author argues that a more proactive HR approach is needed to make clinical governance everyone's business in the NHS organisations.

Evidence-Based Medicine↗

PubMed2003

Evolution of secondary metabolites from an ecological and molecular phylogenetic perspective.

Secondary metabolites, at least the major ones present in a plant, apparently function as defence (against herbivores, microbes, viruses or competing plants) and signal compounds (to attract pollinating or seed dispersing animals). They are thus important for the plant's survival and reproductive fitness. Secondary metabolites therefore represent adaptive characters that have been subjected to natural selection during evolution. Molecular phylogenies of the Fabaceae, Solanaceae and Lamiaceae were reconstructed and employed as a framework to map and to interpret the distribution of some major defence compounds that are typical for the respective plant families; quinolizidine alkaloids and non-protein amino acids for legumes; tropane and steroidal alkaloids for Solanaceae, and iridoids and essential oils for labiates. The distribution of the respective compounds appears to be almost mutually exclusive in the families studied, implying a strong phylogenetic and ecological component. However, on a closer look, remarkable exceptions can be observed, in that certain metabolites are absent (or present) in a given taxon, although all the neighbouring and ancestral taxa express (or do not express, respectively) the particular trait. It is argued that these patterns might reflect differential expression of the corresponding genes that have evolved earlier in plant evolution. The inconsistent secondary metabolite profiles mean that the systematic value of chemical characters becomes a matter of interpretation in the same way as traditional morphological markers. Thus, the distribution of secondary metabolites has some value for taxonomy but their occurrence apparently reflects adaptations and particular life strategies embedded in a given phylogenetic framework.

Alkaloids↗

PubMed1997

The structure of problem and positive behavior among American Indian adolescents: gender and community differences.

Using Problem-Behavior Theory as framework, the latent structure of problem and positive behaviors was examined within a sample of 1,894 American Indian adolescents. Support was found for a two-factor second-order structure in which problem behaviors (antisocial behavior, alcohol use, drug use, and risky sexual behavior) and positive behaviors (school success, cultural activities, competencies, and community-mindedness) represented two relatively uncorrelated aspects of behavior. Hierarchical multiple regressions demonstrated that the positive behaviors construct contributed significant incremental construct validity in the statistical prediction of psychosocial outcomes, over and above the problem behaviors. In addition, the fit of the structure was examined across gender and the four participating communities. The importance of the inclusion of positive behaviors is discussed from the standpoint of both prevention/promotion activities and the communities' perceptions. Further recommendations are made for deeper understandings of community concerns and strengths in conducting preventive/promotive research efforts.

Adolescent↗

PubMed1998

Selective attention: a reevaluation of the implications of negative priming.

The notion that inhibitory processes play a critical role in selective attention has gained wide support. Much of this support derives from studies of negative priming. The authors note that the attribution of negative priming to an inhibitory mechanism of attention draws its support from a common assumption underlying priming procedures, together with the procedure that has been used to measure negative priming. The results from a series of experiments demonstrate that selection between 2 competing prime items is not required to observe negative priming. This result is demonstrated across several experiments in which participants named 1 of 2 items in a second display following presentation of a single-item prime. The implications of these results for existing theories of negative priming are discussed, and a theoretical framework for interpreting negative priming and several related phenomena is forwarded.

Adult↗

PubMed2001

Review Article: is Helicobacter pylori relevant in the management of reflux disease?

Data on the interaction of reflux disease and Helicobacter pylori infection are limited in scope and rigour, controversial and difficult to interpret. Despite this, a framework of understanding is emerging, which is consistent with known effects on gastric acid secretion. In patients with moderate to severe H. pylori-induced corpus gastritis, eradication can increase substantially impaired gastric acid secretion sufficiently to precipitate reflux disease in people with pre-existing sub-clinical defective gastro-oesophageal competence. By contrast, reflux disease in duodenal ulcer patients probably benefits from eradication of H. pylori. There appears to be no significant impact on reflux disease from eradication in healthy subjects or individuals whose primary problem is reflux disease. Helicobacter pylori-infected reflux disease patients respond slightly better to proton pump inhibitors. These agents cause a topographic alteration of gastritis from antrum to corpus, the clinical significance of which is controversial. Many practitioners misjudge the risks and benefits of the effects of H. pylori eradication on reflux disease. Regardless of patient diagnosis, the balance is in favour of H. pylori eradication. For those in whom reflux oesophagitis development is a defined possibility, oesophagitis is mild, easily treated and most unlikely to be associated with any major risk for development of oesophageal adenocarcinoma.

Duodenal Ulcer↗

PubMed2004

A status report on the practice of forensic neuropsychology.

The practice of forensic neuropsychology has experienced tremendous growth over the past two decades, becoming perhaps the most rapidly expanding area of practice within the field of clinical neuropsychology. Indeed, there have been many important advancements in the field that have helped to position neuropsychologists as instrumental participants within the forensic arena. Yet, there is currently no consensus in our field regarding what constitutes competency in forensic neuropsychology and also no specific guidelines or standards of practice to inform neuropsychologists about how to operate in the forensic arena. There are even fewer safeguards to protect the public from questionable methods of practice. This article provides a status report on the practice of forensic neuropsychology. It employs a framework emphasized by Otto and Heilbrun (2002) in their assessment of the field of forensic psychology. Emphasis is directed toward identifying recent advances in the field and documenting some of the inherent flaws and weaknesses in forensic practice to help advance the practice of forensic neuropsychology toward a more established specialty area.

Forensic Medicine↗

PubMed1976

Planning infant learning programs.

Based on a review of the literature, a theoretical basis for planning learning programs for infants is presented. The prerequisites for effective programming include attention to the characteristics of the learning environment, the infant or learner, and the stimulus-response mechanism. The goals of such a program include provision of sensorimotor experience and promotion of infant attachment to a mother or mother-surrogate as a basis for establishing a sense of security and competency in the infant. The parent must be taught to recognize the infant's best periods of alertness, develop sensitivity to the infant's signals, and utilize appropriate stimulation routines in interactive patterns in order to create an environment most conducive to cognitive development. Specific program content may be varied within the theoretical framework to fit the needs of special children and their families.

Attention Deficit Disorder with Hyperactivity↗

PubMed1994

Total quality management and shared governance: synergistic processes.

"Synergism" accurately describes the gains that can be made when total quality management (TQM) and shared governance are employed for reciprocal development. This article explores the relationship between TQM and shared governance from a systems perspective. Systems thinking is the fundamental framework that must be learned by nursing managers. An example of this synergistic process is described from the National Institutes of Health nursing department's experience in implementing TQM and shared governance. The idea that structure is fundamental to problems and solutions when implementing change and focusing upon interdependency issues are the systemic competencies nursing managers need to develop in order to become strong nursing leaders.

Decision Making, Organizational↗

PubMed1999

Alcohol, stroke and coronary heart disease. Are there anti-oxidants and pro-oxidants in alcoholic beverages that might influence the development of atherosclerotic cardiovascular disease?

Anti-oxidant effects of polyphenolic flavonoid compounds found in alcoholic beverages, especially red wine, have been proposed to mediate, at least in part, protective effects of regular light-to-moderate alcohol use against stroke and coronary artery disease. The proposed mechanism is through the quenching of free radicals decreasing the oxidative modification of low-density lipoprotein cholesterol particles and hence reducing their atherogenicity. In this review, the extent and limitations of the evidence in support of such a hypothesis are outlined. In particular, the paucity of epidemiological evidence linking dietary flavonoids to stroke and coronary artery disease is highlighted. The competing notion that alcohol itself has direct and indirect pro-oxidant and pro-atherogenic effects is canvassed, and the limitations of the in vitro rather than in vivo nature of much of the evidence linking red wine polyphenolics to reduced lipid peroxidation and other relevant biological effects is discussed. Within this framework of current epidemiological evidence together with the results of basic laboratory studies, the conclusion at present is that while we may continue to speculate that there are anti-oxidants and pro-oxidants in alcoholic beverages that influence the development of atherosclerotic cardiovascular disease, this cannot yet be considered as an established scientific fact.

Alcohol Drinking↗

PubMed1990

Teaching problem-oriented therapy.

The therapeutic concept is problem- and patient-oriented. In analogy to it the didactic concept is problem- and therapist-oriented. The essential point is learning in groups from practical cases. Problem-oriented in this context means that the problems-solving process in which the patient and the therapist are engaged is supported by the observer group. Therapist-oriented means that the learning process should take account of the different preferences and experiences of the therapists. That can only be accomplished by problem-oriented learning. Each psychotherapy training group consists of 4 assistant doctors and a supervisor and stays together about 1 year. The strongly structured concept of problem-oriented therapy (POT) [Blaser et al., 1988] offers the beginner a framework by which he can guide the dialogue with the patient. The eclecticism of POT allows the more experienced therapist to try out new methods without losing track of the problem. The constantly changing role of being observer or therapist supports the group coherence, and furthermore it promotes an important element of therapeutic competence, the ability to get into a close relation with the patient and at the same time being able to observe oneself, the patient and the therapeutic process from a more distant view. In addition to the POT training group tutorials in special psychotherapy methods and single supervision sessions are offered.

Clinical Competence↗

PubMed2002

Supporting ethical practice in primary care research: strategies for action.

Researchers in primary care share the general ethical obligations of all researchers. However, these obligations may raise different issues in the unique context of primary care. Current professional ethical guidance for primary care research is complex and fragmentary. The newly introduced research governance framework does not specifically address primary care research, and recent changes in legal requirements have significant implications for research. In this paper, ethical issues arising from research in primary care are considered, current standards and resources are described, and strategies for supporting ethical practice are discussed. Four ethical issues are discussed: consent and competence; confidentiality; power relations; and procedural issues. In the final part of the paper, broad strategies to support ethical practice in primary care research are recommended. These include education and resources, greater clarity of relevant standards, financial support, a greater role for primary care networks, and greater public debate.

Clinical Competence↗

PubMedDate not supplied

[The World Health Organization and the development of human resources of the health system].

Health workforce is among the main components of the health care system. The performance of the latter depends on the knowledge, competence and motivations of the various categories of health workers. The task of the World Health Organization is to analyze the main problems related to health workforce and to help member-states overcome these problems. An other task is to facilitate intercountry comparisons. To attain these objectives, WHO has developed a conceptual framework, taking into account elements such as the labour market, the health care system, the policies and macro-factors (economic, socio-demographic). Among the main issues related today to health workforce, one can quote: the numbers and distribution of health workers, their migration, their involvement into the field of public health, the contents of their training, and, finally, the increased risk factors they are challenging.

Career Mobility↗

PubMed2002

A mechanistic framework for co-transcriptional folding of the HDV genomic ribozyme in the presence of downstream sequence.

Hepatitis delta virus (HDV) is a circular pathogenic RNA that uses self-cleavage by closely related 84 nt genomic and antigenomic ribozymes to facilitate the replication of its genome. Downstream of each ribozyme is a stretch of nucleotides termed the attenuator that functions to base-pair with and unfold the ribozyme into a rod-like fold. The competing rates of RNA synthesis, ribozyme folding and cleavage, and rod folding are therefore likely to affect the efficiency of co-transcriptional self-cleavage. In these studies, co-transcriptional folding of the genomic ribozyme was assayed in vitro by monitoring co-transcriptional self-cleavage of transcripts having variable lengths of sequence downstream of the ribozyme. Co-transcriptional cleavage data were simulated successfully only with kinetic models in which cleavage-inactive channels were populated during transcription. Partitioning to and escape from these channels was influenced, in part, by whether the available attenuator sequence could form structures with the ribozyme, and by the stability of such structures. Surprisingly, only 23 nt of attenuator were needed for strong inactivation of cleavage. Self-cleavage of certain 3'-virus-containing sequences could be restored, partially, by renaturation; however, self-cleavage of transcripts with a full-length attenuator could not be restored efficiently by renaturation in vitro. This suggests that in the presence of the attenuator, the cleavage-active ribozyme fold is not the thermodynamically most stable species. In accordance with this model, the efficiency of self-cleavage of the ribozyme followed by a full-length attenuator was increased by decreasing the rate of transcription. These results suggest that, in the absence of additional factors, efficient co-transcriptional cleavage of the full-length genomic HDV RNA may require cleavage to occur prior to synthesis of the attenuator.

Base Sequence↗

PubMed2005

Defining the "disruptive" in preschool behavior: what diagnostic observation can teach us.

This paper presents the clinical/developmental framework underlying a new diagnostic observational tool, the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). The special importance of observation for clinical assessment during the preschool period is delineated. The developmental rationale for a multi-dimensional assessment of disruptive behavior in young children, including problems in modulation of negative affect and low competence is discussed. The ways in which the DB-DOS will elucidate distinctions between normative and atypical behavior during this developmental period via (a) the integration of qualitative and quantitative dimensions of behavior within a clinically-sensitive coding system, (b) the observation of child behavior both within, and outside of, the parent-child context and (c) the use of specially designed tasks to "press" for clinically salient behaviors are addressed. The promise of this new method for yielding a more precise, developmentally based description of the phenotype of early onset disruptive behavior problems and for providing a standardized clinical tool for observational assessment of disruptive behavior in young children is presented. Large-scale validation of the measure is currently underway.

Attention Deficit and Disruptive Behavior Disorder↗