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Results for “Competency framework”

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PubMed1999

The "professional" work of experienced physical education teachers.

This study investigates whether experienced physical education teachers perceive the same frustrations and negative orientations as beginning teachers. Furthermore, it considers if the professionalization-deprofessionalization tension is a useful theoretical framework for analyzing the perspectives of experienced physical educators. In-depth interviews were conducted with 11 experienced physical education teachers. Data suggest that in many respects their working conditions and orientations are more supportive and positive than those reported for beginning physical educators. After presenting the teachers' perspectives in terms of their sense of commitment, competence, and power, it is concluded that the professional satisfaction of these experienced teachers can be instructive for improving the working conditions of all teachers.

Adult↗

PubMed2002

Caring for the patient who has undergone female circumcision.

Home health and hospice nurses are increasingly called to care for patients the world over. The provision of culturally competent and culturally sensitive care is critical to patient care planning. Viewing the patient holistically and within the context of family and culture provides the basis of most effective care. While nurses may not be providing skilled care directly related to female circumcision, it is important to include all of the patient's concerns within the framework of a comprehensive plan of care.

Africa↗

PubMed1998

Toward a functional analysis of the basal ganglia.

Parkinson patients were tested in two paradigms to test the hypothesis that the basal ganglia are involved in the shifting of attentional set. Set shifting means a respecification of the conditions that regulate responding, a process sometimes referred to as an executive process. In one paradigm, upon the appearance of each stimulus, subjects were instructed to respond either to its color or to its shape. In a second paradigm, subjects learned to produce short sequences of three keypresses in response to two arbitrary stimuli. Reaction times were compared for the cases where set either remained the same or changed for two successive stimuli. Parkinson patients were slow to change set compared to controls. Parkinson patients were also less able to filter the competing but irrelevant set than were control subjects. The switching deficit appears to be dopamine based; the magnitude of the shifting deficit was related to the degree to which 1-dopa-based medication ameliorated patients' motor symptoms. Moreover, temporary withholding of medication, a so-called off manipulation, increased the time to switch. Using the framework of equilibrium point theory of movement, we discuss how a set switching deficit may also underlie clinical motor disturbances seen in Parkinson's disease.

Aged↗

PubMed2000

[Contribution to the development of political-pedagogical nursing projects].

Based on the concepts of project and political-pedagogic project, authors presented a proposal for the development of such a project. The framework includes: the reference, the philosophy, the concept and the structure. The reference is the starting point, meaning the knowledge and critical view of reality; the philosophy represents the faith and the community's values involved in the project; the concept represents the theory that gives support to the proposal; and, finally the structure establishes the competences and the profile of the professional to be formed as well as the methodologic option for the organization and development of courses and disciplines. The Habermas' theory of communicative action is proposed as a methodology for the development of projects.

Education, Nursing↗

PubMed1992

Retail versus private dental practices: do the patients differ?

Using a consumer-oriented framework, the authors contrast private dental patrons and retail dental patrons in terms of demographic characteristics, choice criteria, and patronage behavior in selecting a dental care provider. Assessments are made of these consumers' attitudes and perceptions toward various dental practice attributes or characteristics. Differences are found across several attributes, but dimensions of quality service, reputation, and competence are not distinguishing characteristics between the two dental patron groups. These results provide some insights and interesting debate about the image and general marketing practice of private dentists and retail dental facilities.

Data Collection↗

PubMed2005

Workplace assessment for licensing in general practice.

With the redesign of general practice training implicit in the Department of Health's programme of reform, Modernising Medical Careers, there is the opportunity to bring summative assessment and the MRCGP examination together into a unified assessment framework for licensing. It is likely that assessment in the workplace will play a central role in such a process. Workplace assessment is of high validity and has the potential to reconnect teaching and testing in general practice. Five principles to underpin the design of a workplace assessment are proposed, namely that it should be: competency-based, developmental, evidential, locally assessed, and triangulated. Successful implementation of workplace assessment will not only serve to reduce the current testing burden on trainees, but will also harness the involvement of medical teachers. In doing so, general practice has the opportunity to create a powerful tool for professional development.

Education, Medical, Continuing↗

PubMed2005

The office of strategy management.

There is a disconnect in most companies between strategy formulation and strategy execution. On average, 95% of a company's employees are unaware of, or do not understand, its strategy. If employees are unaware of the strategy, they surely cannot help the organization implement it effectively. It doesn't have to be like this. For the past 15 years, the authors have studied companies that achieved performance breakthroughs by adopting the Balanced Scorecard and its associated tools to help them better communicate strategy to their employees and to guide and monitor the execution of that strategy. Some companies, of course, have achieved better, longer-lasting improvements than others. The organizations that have managed to sustain their strategic focus have typically established a new corporate-level unit to oversee all activities related to strategy: an office of strategy management (OS M). The OSM, in effect, acts as the CEO's chief of staff. It coordinates an array of tasks: communicating corporate strategy; ensuring that enterprise-level plans are translated into the plans of the various units and departments; executing strategic initiatives to deliver on the grand design; aligning employees' plans for competency development with strategic objectives; and testing and adapting the strategy to stay abreast of the competition. The OSM does not do all the work, but it facilitates the processes so that strategy is executed in an integrated fashion across the enterprise. Although the companies that Kaplan and Norton studied use the Balanced Scorecard as the framework for their strategy management systems, the authors say the lessons of the OSM are applicable even to companies that do not use it.

Benchmarking↗

PubMed1987

[Patient-centered group therapy--an indirect form of managing gerontopsychiatric patients].

Indirect care for gerontopsychiatric patients by means of patient-centered group discussions under the heading "How to deal with Difficult Patients" is presented as a succession of case reports concerning the progress and course of the first year of a team counselling project in a home for aged persons. The theoretical results outline the framework of such patient-centred group discussions with the following cornerstones: Specialist training or continuing education, supervision, sociopsychiatric counselling and advising the institution; these topics are dealt with in detail. Our model of group discussions is subdivided into the following patient-centred developmental stages: Initiation, acceptance of the psychiatric line of thought, increasing specialist competence. Our paper supplies pointers with regard to the demands made on the discussion leaders, together with hints as to which factors connected with the individual cornerstones and developmental stages should be given special attention. It became evident that these group discussions help to impart more knowledge to the individual partners of the team and hence promote a greater amount of understanding of the psychological patterns of linkups in the development of each patient, thus enabling the medical staff to respond better and more adequately to the psychological needs of the individual patient. As the feeling grows in each individual that he can now cope better with the demands his profession makes on him, a feeling of satisfaction also grows among the team members and there is less job fluctuation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed2002

A framework for evaluating and continuously improving the NCHL transformational leadership initiative. National Center for Healthcare Leadership.

The National Center for Healthcare Leadership transformational leadership project is a broad and ambitious initiative that seeks to bring to the table top leaders from industry and academe. Their charge is to accomplish nothing short of resetting the course for health management education and practice in the coming decades. Four councils were recruited to launch the four major interventions: (1) recruitment and diversity, (2) core competencies, (3) the advanced learning institute, and (4) accreditation and certification. After describing intervention goals, we provide examples of baseline measures for tracking educational and performance outcomes longitudinally. We believe this transformation is only beginning, and it will take many years or decades. The transformation will be most successful if it is guided by data and systematic evaluation.

Accreditation↗

PubMed2005

Dwelling with Alison: a reflection on expertise.

Reflection is always purposeful toward realising expert practice. Yet how might expertise be recognised? Using a narrative approach, Benner, Tanner and Chesta (Expertise in nursing practice. Springer Publishing, New York, 1996) explicated a model of expertise that offers the practitioner a useful framework to reflect on their expertise which I do using my own narrative of dwelling with Alison, given that expert practice must be the concern of every practitioner.

Attitude of Health Personnel↗

PubMed2005

Partner, Learn, Progress: a conceptual model for continuous clinical education.

In practice disciplines, such as nursing, learning can be maximised through experience located in the clinical setting. However, placement in the clinical setting does not automatically mean that the learner's professional practice will improve. Experiences in 'real-life' settings need to be effectively facilitated to obtain the desired outcomes. This paper through the discussion of 'Partner, Learn, Progress' details a conceptual model for promoting learning in the clinical context. 'Partner' refers to the positive association between the learner and the experienced clinician that engenders trust. It occurs on a personal level in the context of a broader social and political environment. 'Learn' refers to the process whereby the experienced clinician is able to assist the learner make sense of theoretical knowledge or knowledge that has previously been 'distal' to their practice to be integrated into their immediate practice. The clinician requires to be cognisant of the learner's existing knowledge level so that the activities and accompanying discussion assist in making connections between theory and practice. Learning incorporates mutual collaboration whereby the learner is able to practise the application of knowledge in a safe context and make their own connections. The further exploration of meanings through experiences, feelings, attitudes leads the learner to 'progress': the development of knowledge. Such a conceptual model provides a framework for educators and supervisors of clinical learning to educate and learn from the next generation of nurses that will lead the nursing profession into the future.

Attitude of Health Personnel↗

PubMed2006

Measuring patient and physician participation in exchanges on medications: Dialogue Ratio, Preponderance of Initiative, and Dialogical Roles.

OBJECTIVE: To identify, describe and characterize the patient and physician participation in content production in medication-related exchanges during primary care consultations. METHODS: Descriptive study of audio recordings of 422 medical encounters. MEDICODE, a validated instrument was used to analyze verbal exchanges on medications. Two main indicators of participation were developed: Dialogue Ratio (DR), a 0-1 scale indicating extent of monologue/dialogue; Preponderance of Initiative (PI), a -1 to +1 scale for patient/physician initiative. Participation analyses were conducted by content theme and medication categories (New, Represcribed and Active). RESULTS: We identified 1492 discussions of medications. Categorical analyses identified four communication roles patients and physicians adopted when participating in medication-related exchanges during consultations: (a) Listener, (b) Information Provider, (c) Participant, and (d) Instigator. The mean observed DRs and PIs indicated that monologues and physician initiation dominated medication-related exchanges. CONCLUSION: Four factors are suggested to explain the communicational behaviors observed: (1) patient knowledge about medications, (2) physician expertise, (3) patient experience with the medication, and (4) the act of prescribing. Our data indicate a generally low level of dialogue when discussing medications during primary care encounters since physicians' monologues seem to be the rule rather than the exception, pointing to a lack of mutuality in exchanges on medications. PRACTICE IMPLICATIONS: The proposed concepts offer a unique vocabulary and conceptual framework to help physicians master the necessary content and process skills required to discuss medications with patients.

Abstracting and Indexing↗

PubMed1993

Teaching and testing technical skills.

Teaching technical skills is one of the most important tasks of a surgeon. This article discusses current issues in teaching and testing technical skills. For the most part, the level of technical skills cannot be predicted before a surgical resident starts a program. Different methods of teaching technical skills are reviewed (in and out of the operating room). For optimal effectiveness in teaching residents, we must apply principles of adult learning to the surgical domain. A methodologic framework for skill acquisition, adapted from the educational psychology literature, is discussed. Five methods of assessing technical skills are presented. Structuring the assessment process has resulted in higher levels of reliability and improved validity.

Clinical Competence↗

PubMed2000

Do young children have adult syntactic competence?

Many developmental psycholinguists assume that young children have adult syntactic competence, this assumption being operationalized in the use of adult-like grammars to describe young children's language. This "continuity assumption" has never had strong empirical support, but recently a number of new findings have emerged - both from systematic analyses of children's spontaneous speech and from controlled experiments - that contradict it directly. In general, the key finding is that most of children's early linguistic competence is item based, and therefore their language development proceeds in a piecemeal fashion with virtually no evidence of any system-wide syntactic categories, schemas, or parameters. For a variety of reasons, these findings are not easily explained in terms of the development of children's skills of linguistic performance, pragmatics, or other "external" factors. The framework of an alternative, usage-based theory of child language acquisition - relying explicitly on new models from Cognitive-Functional Linguistics - is presented.

Adult↗

PubMed2003

The evolution of developmental mechanisms.

Over the past two to three decades, developmental biology has demonstrated that all multicellular organisms in the animal kingdom share many of the same molecular building blocks and many of the same regulatory genetic pathways. Yet we still do not understand how the various organisms use these molecules and pathways to assume all the forms we know today. Evolutionary developmental biology tackles this problem by comparing the development of one organism to another and comparing the genes involved and gene functions to understand what makes one organism different from another. In this review, we revisit a set of seven concepts defined by Lewis Wolpert (fate maps, asymmetric division, induction, competence, positional information, determination, and lateral inhibition) that describe the characters of many developmental systems and supplement them with three additional concepts (developmental genomics, genetic redundancy, and genetic networks). We will discuss examples of comparative developmental studies where these concepts have guided observations on the advent of a developmental novelty. Finally, we identify a set of evolutionary frameworks, such as developmental constraints, cooption, duplication, parallel and convergent evolution, and homoplasy, to adequately describe the evolutionary properties of developmental systems.

Animals↗

PubMed1999

QALYs and the integration of claims in health-care rationing.

The paper argues against the polarization of the health economics literature into pro- and anti-QALY camps. In particular, we suggest that a crucial distinction should be made between the QALY measure as a metric of health, and QALY maximization as an applied social choice rule. We argue against the rule but for the measure and that the appropriate conceptualization of health-care rationing decisions should see the main task as the integration of competing and possibly incommensurable normative claim types. We identify the main types as consequences, rights, social contracts, individual votes and community values and note situations in which the contribution of each claim type is limited. We go on to show that the integration of (at least some of) these claim types can be formalized within the mathematical framework provided by non-linear programming.

Attitude to Health↗

PubMed2003

Psychiatric rehabilitation: an empowerment-based approach to mental health services.

Psychiatric rehabilitation is a framework for providing services to people with mental illness that encourages adaptive community functioning in all life domains. Despite its well-established inclusion in community mental health treatment programs, psychiatric rehabilitation has received little attention in the discipline-specific social work literature. The philosophical base of psychiatric rehabilitation is built around the principles of empowerment, competence, and recovery. Its goal of promoting adaptive community functioning is consistent with social work values and contemporary social work practice models. This article provides an overview of the history, philosophy, and services components of psychiatric rehabilitation and analyzes its compatibility with social work. Further integration of psychiatric rehabilitation and social work services is suggested.

Community Health Planning↗

PubMed2001

Building relationships with families in the NICU: exploring the guarded alliance.

Extremely low-birthweight infants and their families experience prolonged hospitalization in the newborn intensive care unit (NICU). Prolonged hospitalization is particularly stressful for the family, leading to distress in most aspects of their lives, including separation of parents from each other and from other family members, a need for increased psychological support, and increased economic concerns. Based on these characteristics, these families appear to have needs more similar to that of families caring for chronically ill members. Indeed, this initial hospitalization may be the prelude to coping and surviving with a chronic illness for many of these children and families. This article proposes the adaption of "guarded alliance" as a framework for developing relationships and providing care to families in the NICU. This framework was derived from research with families of the chronically ill. Supportive research is used to justify the adoption of this framework for interactions with families in the NICU. In addition, linkages to family-centered care principles in critical care settings are also discussed.

Adaptation, Psychological↗