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Results for “Competency framework”

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PubMed2003

Fostering students' personal and professional development in medicine: a new framework for PPD.

CONTEXT: Altruism, accountability, duty, integrity, respect for others and lifelong learning are qualities that have been identified as central to medical professionalism. However, we do not have a systematically developed understanding of what is needed to optimise medical students' personal and professional development (PPD). We need some level of agreement on how to teach and assess PPD, but traditional educational methods may not be strong determinants of students' or graduates' actual behaviour in clinical settings. AIMS: This paper considers the factors that demonstrably influence doctors' behaviour as a contribution to the development of a model for considering PPD within the broader context of medical practice. The model presented acknowledges that behaviour change comes about through a number of influences including education, feedback, rewards, penalties and participation. These elements can be plotted against the cognitive, affective and metacognitive processes that are intrinsic to learning. IMPLICATIONS: A framework that promotes the consideration of all of these factors in PPD can provide guidance for schools undergoing curriculum reform and inform further research into one of the most important and challenging aspects of medical education.

Clinical Competence↗

PubMed2002

The master's portfolio: validating a career in advanced practice nursing.

PURPOSE: To describe the process of portfolio development and faculty review that offers graduate credit within a framework of structural empowerment and mentoring for documented educational and clinical accomplishments for family nurse practitioners (FNPs). DATA SOURCES: Selected literature and examples from one student's portfolio to illustrate the process. CONCLUSIONS: The degree granting process assists certified FNPs to fulfill career aspirations through achieving graduate level education at the University of Massachusetts, Amherst, School of Nursing. IMPLICATIONS FOR PRACTICE: The portfolio process affords practicing FNPs not only the opportunity to acquire an advanced degree but a framework for examining and validating a career. For the student in this exemplar, it was a "significant, introspective, satisfying learning experience," a rare opportunity in a busy professional life.

Clinical Competence↗

PubMed1995

Discussing cardiopulmonary resuscitation with patients and relatives.

This paper aims to give clear guidance for doctors working in the UK about their responsibilities when discussing cardiopulmonary resuscitation with patients and their relatives. The ethical and legal framework for making decisions is outlined and the commonly encountered dilemmas are discussed.

Aged↗

PubMedDate not supplied

Where will clinical nurse specialists be placed on Agenda for Change?

The imminent introduction of a new approach to pay and career development known as Agenda for Change will raise and dash many nurses' expectations. Among them clinical nurse specialists (CNS) could have a lot to gain if they are able to convince employers that they should be in the highest pay band. Already nurse consultants (NC) are in the top band, but the question needs to be asked as to whether this is simply to fulfil political directives, or whether it is because they match the job evaluation criteria? The political context for the introduction of Agenda for Change and for NCs is outlined, as is the professional debate about higher level practice. Job evaluation factors and the career progression framework are discussed, and suggestions are made regarding how to compare job profiles. If CNSs do not present themselves as expert practitioners, they will not be paid or recognized for what they might already do.

Career Mobility↗

PubMed1993

The clinical decision-making processes of student nurses.

This descriptive study examined the clinical decision-making processes used by 19 female senior diploma nursing students in a simulated client situation. The subjects were divided into two groups, with either an internal or external locus of control, as measured by the Rotter Internal-External Locus of Control Scale. From a content analysis of the data, six decision-making elements and eight decision-making processes were identified. The frequency and pattern of use of the decision-making processes differed between internally and externally oriented subjects. Internal subjects used a significantly higher proportion of complex decision-making processes than the external subjects (z = 3.48; p < .01). All subjects were found to use decision-making elements and processes in a manner that reflected novice characteristics and supported the theoretical framework of information-processing theory. These findings have implications for nurse educators in relation to teaching strategies that facilitate clinical decision-making ability and internalization strategies for students with an external locus of control.

Clinical Competence↗

PubMed1987

Intraprofessional team building.

This article discusses the importance of team building between occupational therapists and occupational therapy assistants and the relationship of teamwork to the effectiveness of service delivery within the profession of occupational therapy. If team members' needs are not satisfied, dysfunctional intraprofessional teams result. Team building is based on the satisfaction of three areas of individual need: (a) ministration, which leads to mutual respect; (b) mastery or effective performance; and (c) maturation or personal growth and professional socialization. A better understanding and appreciation of the roles of therapist and assistant and their relationships can resolve the team deficits. A developmental team chart that uses a systems theory model as an organizing framework is presented as an action plan for team building. Suggestions are made to academic and fieldwork educators and professional and technical clinicians to strengthen intraprofessional relationships in occupational therapy.

Clinical Competence↗

PubMed2026

Facilitators and Barriers to Volunteers' Involvement in Palliative Care: A Qualitative Meta-Synthesis.

OBJECTIVE: This study aims to systematically synthesize qualitative evidence on facilitators and barriers to volunteer involvement in palliative care services, providing insights to inform strategies for strengthening volunteer support systems. METHODS: PubMed, Web of Science, Embase, Cochrane Library, Medline, EBSCO, ProQuest, China National Knowledge Infrastructure, Wanfang, VIP, and Sinomed were searched from inception to December 2025 to identify qualitative studies examining factors influencing volunteer participation in palliative care. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data were analyzed using Thomas and Harden's thematic synthesis approach and managed using NVivo 12.0 software, following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. RESULTS: Thirty-one studies involving 1042 participants were included, yielding 68 findings. Facilitators included intrinsic motivation and meaning-making at the individual level; supportive relationships and teamwork at the interpersonal level; structured support and professional recognition at the organizational level; social recognition and resource integration at the community level; and institutional safeguards and governmental incentives at the policy level. Barriers included emotional burden and limited competencies at the individual level; relationship conflicts and insufficient collaboration at the interpersonal level; management deficiencies at the organizational level; community resource imbalances at the community level; and inadequate regulations and incentives at the policy level. CONCLUSION: Volunteer participation in palliative care is influenced by multiple interacting factors. Strengthening training and support systems, enhancing team collaboration, and improving institutional frameworks may help sustain volunteer engagement and improve the quality of palliative care services.

Palliative Care↗

PubMed2001

Genetic and physical mapping in mosquitoes: molecular approaches.

The genetic background of individual mosquito species and populations within those species influences the transmission of mosquito-borne pathogens to humans. Technical advances in contemporary genomics are contributing significantly to the detailed genetic analysis of this mosquito-pathogen interaction as well as all other aspects of mosquito biology, ecology, and evolution. A variety of DNA-based marker types are being used to develop genetic maps for a number of mosquito species. Complex phenotypic traits such as vector competence are being dissected into their discrete genetic components, with the intention of eventually using this information to develop new methods to prevent disease transmission. Both genetic- and physical-mapping techniques are being used to define and compare genome architecture among and within mosquito species. The integration of genetic- and physical-map information is providing a sound framework for map-based positional cloning of target genes of interest. This review focuses on advances in genome-based analysis and their specific applications to mosquitoes.

Animals↗

PubMed1996

Clinical research in a hospital--from the lone rider to teamwork.

Clinical research of high international standard is very demanding and requires clinical data of high quality, software, hardware and competence in research design and statistical treatment of data. Most busy clinicians have little time allocated for clinical research and this increases the need for a potent infrastructure. This paper describes how the Norwegian Radium Hospital, a specialized cancer hospital, has reorganized the clinical research process. This includes a new department, the Clinical Research Office, which serves the formal framework, a central Diagnosis Registry, clinical databases and multicentre studies. The department assists about 120 users, mainly clinicians. Installation of a network software package with over 10 programs has strongly provided an internal standardization, reduced the costs and saved clinicians a great deal of time. The hospital is building up about 40 diagnosis-specific clinical databases with up to 200 variables registered. These databases are shared by the treatment group and seem to be important tools for quality assurance. We conclude that the clinical research process benefits from a firm infrastructure facilitating teamwork through extensive use of modern information technology. We are now ready for the next phase, which is to work for a better external technical framework for cooperation with other institutions throughout the world.

Cancer Care Facilities↗

PubMed1988

Behavioral treatment of violent psychiatric patients.

This article reviewed major accelerative and decelerative behavioral treatments for aggressive and destructive behavior in psychiatric patients. Accelerative procedures supplant antagonistic behavior by teaching adaptive skills, and by strengthening competing responses; they are realized in token economies, social skills training, differential reinforcement of other behavior, and activity programming. Current decelerative procedures reduce violent behavior by decreasing reinforcement accessible to the patient following violent acts; they are exemplified by social extinction, response cost, time out from reinforcement, overcorrection, and contingent restraint. All behavioral interventions are applied within a philosophic framework that emphasizes observable behavior, measurement of treatment effects, and restructure of the social and physical environment to improve patients' response patterns. This approach extends beyond a problem-oriented model and presents proven techniques for developing and maintaining patients' adaptive functioning.

Behavior Therapy↗

PubMed2004

Interactive behavior change technology. A partial solution to the competing demands of primary care.

BACKGROUND: Primary care practices are faced with the challenge of having too much to do in too little time. As a result, behavioral counseling is often overlooked, especially for patients with multiple health behaviors in need of change. METHODS: This paper describes recent examples of the application of interactive behavior change technologies (IBCTs) to deliver health behavior change counseling before, during, and after the office visit to inform and enhance patient-clinician interactions around these issues. The 5A's framework (assess, advise, agree, assist, arrange follow-up) is used to consider how interactive technology can be used to implement behavior change counseling more consistently. RESULTS: A variety of IBCTs, including the Internet, clinic-based CD-ROMs, and interactive voice-response telephone calls have been shown to be feasible and potentially valuable adjuncts to clinic-based behavioral counseling. These technologies can both increase the effectiveness of behavioral counseling and extend the reach of these services to patients with barriers to face-to-face interactions. CONCLUSIONS: If appropriately developed with the context of primary care in mind and integrated as part of a systems approach to intervention, IBCT can be a feasible and appropriate aid for primary care. Recommendations are made for the types of IBCT aids and research that are needed to realize this potential.

Behavior Therapy↗

PubMed1993

Putting the family back in the child.

As clinicians and scientists we see daily the close tie between parental competence and emotional functioning and how children succeed with many of life's stressors. Inadequate attention has been paid to the theoretical underpinnings of predicting children's emotional reactions to stress from a systems perspective. Longitudinal developmental studies of parental influence on children's ability to cope with life's frustrations, through reciprocal interactions and genetic predispositions, are mandatory. Theoretical frameworks are already developed which must be drawn on to derive the best predictions of when and how to involve our child patients with family support. The current essay will attempt to bridge family systems and social network theories to the understanding of children's coping with medical stressors.

Adaptation, Psychological↗

PubMed2004

Changes in patterns of knowing the patient: the case of British district nurses.

British district or home nurses, have until recent years been hidden from the wider context of the British National Health Service. Policy changes in UK over the last two decades of the 20th century have increasingly focussed on Primary Care Services and district nurses (DNs) have seen substantial changes to their workload. This paper addresses the question of how the changes in the organisation of Primary Care Services affected some aspects of DNs' work. Thus, the focus of this paper is an examination of the relationship DNs had with patients through a period of turbulent change. Knowing the patient is a central element of nursing practice. Data are presented here form a multi-site ethnographic study of DNs' work undertaken in four purposively sampled study sites. Applying Carper's (1978) framework, the data presented here show that there has been a shifting emphasis in knowing the patient from aesthetic and personal knowing to knowing about and empirical knowing.

Anthropology, Cultural↗

PubMed1999

Communication teaching and assessment in medical education: an international consensus statement. Netherlands Institute of Primary Health Care.

The importance of communication between doctors and patients has been well established, and there is growing acceptance of the need to teach and assess communication skills in medical schools. Faculty meeting at a consensus workshop during the International Conference on Teaching Communication in Medicine (Oxford, July 1996) generated a series of recommendations for developing and implementing teaching and assessment programmes. The points were refined in subsequent discussions with other interested groups, and endorsed in their current form by a workshop of teachers attending the Communication in Health Care Conference organized by NIVEL, the Netherlands Institute of Primary Health Care (Amsterdam, June 1998). While focused on medical schools, the eight recommendations highlighted in this consensus statement are also relevant to both graduate and continuing medical education programmes: (1) teaching and assessment should be based on a broad view of communication in medicine; (2) communication skills teaching and clinical teaching should be consistent and complementary; (3) teaching should define, and help students achieve, patient-centred communication tasks; (4) communication teaching and assessment should foster personal and professional growth; (5) there should be a planned and coherent framework for communication skills teaching; (6) students' ability to achieve communication tasks should be assessed directly; (7) communication skills teaching and assessment programmes should be evaluated; (8) faculty development should be supported and adequately resourced.

Clinical Competence↗

PubMed1998

AI in medical education--another grand challenge for medical informatics.

The potential benefits of artificial intelligence in medicine (AIM) were never realized as anticipated. This paper addresses ways in which such potential can be achieved. Recent discussions of this topic have proposed a stronger integration between AIM applications and health information systems, and emphasize computer guidelines to support the new health care paradigms of evidence-based medicine and cost-effectiveness. These proposals, however, promote the initial definition of AIM applications as being AI systems that can perform or aid in diagnoses. We challenge this traditional philosophy of AIM and propose a new approach aiming at empowering health care workers to become independent self-sufficient problem solvers and decision makers. Our philosophy is based on findings from a review of empirical research that examines the relationship between the health care personnel's level of knowledge and skills, their job satisfaction, and the quality of the health care they provide. This review supports addressing the quality of health care by empowering health care workers to reach their full potential. As an aid in this empowerment process we argue for reviving a long forgotten AIM research area, namely, AI based applications for medical education and training. There is a growing body of research in artificial intelligence in education that demonstrates that the use of artificial intelligence can enhance learning in numerous domains. By examining the strengths of these educational applications and the results from previous AIM research we derive a framework for empowering medical personnel and consequently raising the quality of health care through the use of advanced AI based technology.

Artificial Intelligence↗

PubMed1999

Preparing for the future: the status of genetics education in diploma-level training courses for nurses in the UK.

This paper offers new information about genetics education provided by diploma level training programmes for nurses in the UK. Those responsible for the development and provision of curricula were asked to complete a questionnaire that attempted to assess the nature of genetics education and their attitudes towards it. The response rate was 84%. Whist genetics teaching is included on all but two training courses, variation in content, delivery and timetable allocation indicates disparity. Genetics is taught for 10 hours or less on most courses, utilizing a limited number of approaches. Most courses do not have compulsory assessment. The majority of respondents (81%) agreed that genetics will have a major impact on health care, and will become an increasingly important issue in education. A small majority (58%) agreed that genetics should have a higher profile in professional training yet many respondents (68%) felt that the teaching they were already offering was appropriate to meet patients' needs. In the absence of any clear national framework for delivery and assessment of genetics education, the author questions whether current training is sufficient to provide nurses with the basic genetic literacy needed to respond to developments in genetics as they impact on health care.

Clinical Competence↗

PubMed2002

Theory of domain patterns in systems with long-range interactions of Coulomb type.

We develop a theory of the domain patterns in systems with competing short-range attractive interactions and long-range repulsive Coulomb interactions. We take an energetic approach, in which patterns are considered as critical points of a mean-field free energy functional. Close to the microphase separation transition, this functional takes on a universal form, allowing us to treat a number of diverse physical situations within a unified framework. We use asymptotic analysis to study domain patterns with sharp interfaces. We derive an interfacial representation of the pattern's free energy which remains valid in the fluctuating system, with a suitable renormalization of the Coulomb interaction's coupling constant. We also derive integro-differential equations describing stationary domain patterns of arbitrary shapes and their thermodynamic stability, coming from the first and second variations of the interfacial free energy. We show that the length scale of a stable domain pattern must obey a certain scaling law with the strength of the Coulomb interaction. We analyzed the existence and stability of localized (spots, stripes, annuli) and periodic (lamellar, hexagonal) patterns in two dimensions. We show that these patterns are metastable in certain ranges of the parameters and that they can undergo morphological instabilities leading to the formation of more complex patterns. We discuss nucleation of the domain patterns by thermal fluctuations and pattern formation scenarios for various thermal quenches. We argue that self-induced disorder is an intrinsic property of the domain patterns in the systems under consideration.

Journal Article↗

PubMed2005

Critically appraising quantitative research.

Critical appraisal of quantitative research is a skill that is necessary for adequate evidence-based practice. This paper describes critical appraisal and offers a process for its implementation. Four categories of quantitative studies are reviewed and associated links to relevant critical appraisal frameworks are provided. The implications for students, nursing faculty members, and practicing nurses are discussed.

Curriculum↗