Beyond band aids: school health nurses as program developers and coordinators.
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OBJECTIVE: To improve clinical teaching with emphasis on improving provision of feedback through a faculty development series modeled on clinical rounds. METHOD: Seven 1-hour conferences were held for the pediatric faculty during the academic year 1994-1995. Clinical rounds were emulated, with a simulated learner functioning as the patient with a chief complaint of some instructional problem. The conferences progressed from discussion about teaching in a particular situation, to videotapes of clinical teaching, and finally to live clinical teaching. Evaluation of the conferences was assessed by attendance records, participants' evaluations of the conferences, and comparing student and resident evaluations of faculty who attended (i.e., those who attended > or = 2) with faculty who did not attend. Comparisons were made for the academic year before and after the conferences using paired t tests. RESULTS: Forty percent of the faculty attended 2 or more conferences. Mean conference ratings were 4.00 to 4.35, (1 is poor; 5, excellent). Faculty who attended had a significant improvement in ratings for feedback (P = .01) and overall teaching effectiveness (P = .04). Ratings for faculty who did not attend did not change. CONCLUSION: These conferences were well received by the faculty and are an effective way to improve clinical teaching.
The purpose of this study is to construct and evaluate a self-development programme for obese female students. The important role of psychological factors in the etiology of obesity, affects self-development in the client through methods of growth stimulation, and will promote ego strength to assist in the demands of mass control. A self-development programme is constructed and applied to a group of obese female students. The experimental design comprised a pre, post and post-post evaluation with physical and psychological measuring instruments on an experimental and a control group. No significant changes in body mass occurred. Psychologically the programme promoted self-actualisation in terms of (intrapersonally) increased spontaneity, self-regard, confidence, worthiness and decreased nervousness, and (interpersonally) increased general social adaptation and the capacity for intimate, personal contact. It is recommended that the stimulation of psychological growth be stressed even more in mass control programmes. Also, the contents of this type of programme should be investigated to promote behaviour change over a longer period of time.
Most nurse educators incorporate some kind of media into their teaching strategies. The widespread availability of professionally developed media resources, however, does not guarantee effectiveness. The ASSURE model was presented as one method of selecting these materials on the basis of their suitability for the subject, the adult learner, and the instructor in achieving the desired educational outcomes. Furthermore, it offers guidelines for modifying or designing materials to be used in settings where media resources may be limited. The ASSURE model can help staff development educators provide effective instruction by making the best use of available media through the use of systematic instructional design principles.
This report has described the measurement and operational procedures used for the design, development, and implementation of the newly inaugurated Fellow of The American Dietetic Association credentialing program. The program was established to identify and certify registered dietitians who possess the characteristics of advanced-level practice. The main features of the Fellow program are as follows. It is based on the results of an empirical study that identified the characteristics of advanced-level practice. It is guided by the Fellow Assessment Plan, which specifies the content and level of dietetics practice involved and the psychometric and operational requirements for sound measurement. It is a performance-based portfolio assessment of six professional characteristics (education, work experience, professional achievement, professional roles, professional contacts, and approach to practice). It uses objective automated computer scoring and independent peer-review grading of candidate materials in relation to an explicit scoring rubric. It requires statistical analysis of the database of candidate scores, which is conducted to ensure that the scoring of candidate materials is accurate and reliable and that the assessment, as a measurement instrument, is psychometrically sound. It involves a standard-setting workshop in which a panel of subject-matter experts establish the lowest level of acceptable candidate performance on Approach to Practice; the passing standard for the other five characteristics was preestablished by the empirical study. A careful review of all evidence on the development and implementation of the 1994 Fellow assessment suggests that these procedures are technically sound and produce psychometrically defensible results. Our evaluation and commentary from CDR and CTB staff, subject-matter expert participants, and the candidates themselves suggested a number of ways to improve the Fellow program in subsequent administrations of the assessment. Changes have been implemented and CDR will continue to consider all data in its ongoing improvement efforts.
An intrathoracic, electrohydraulically actuated, left ventricular assist system (LVAS) was subjected to formal device readiness testing. Endurance testing was initiated on eight systems before testing was halted due to failure of four of the systems. Three failed due to environmental leakage. Solutions were straightforward, involving gasket changes and o-ring resizing. The fourth failure involved a magnetic coupling piston swelling and seizing. The failure was attributed, after long investigation, to hydrogen adsorption by the samarium-cobalt magnets. An unknown number of coupling magnets were affected in this fashion, necessitating complete replacement of magnets to resolve the problem. However, this was beyond the scope of the program, and no further endurance testing was accomplished. The test experience of the Nimbus/CCF LVAS has demonstrated all functional aspects of the complete LVAS, both in vitro and in vivo, and the endurance and reliability potential is indicated as well. Although the LVAS program is currently inactive, its legacy of technical innovations continue to drive the development of other medical devices.
The development and present status of the Emergency Health Services (EHS) national and educational programs are discussed. Instituted in 1951 for medical and dental practitioners at a military school at Camp Borden, professional civilian indoctrination was later assumed by EHS at Canadian Emergency Measures College (CEMC). The federally sponsored courses there are now specialized; provincial EHS authorities undertake general indoctrination. Courses for graduates in pharmacy and nursing are also offered at CEMC. Hospital Disaster Institutes have been held across the country since 1954; Public Health Disaster Institutes, since 1966. Schools of Hygiene include the subject in graduate programs. Some years ago, three medical faculties introduced undergraduate teaching in mass casualty care; now, encouraged by the Association of Canadian Medical Colleges, a larger number are doing so. Several faculties of Dentistry, all faculties of Pharmacy, and 132 of 177 nursing schools teach apposite aspects. Professional journals have published many articles on this subject; this, for example, is the fourth Emergency Health Services Symposium presented by The Canadian Medical Association Journal.
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While more and more institutions of higher education are offering cost-free continuing education programs to older men and women, the enrollment of this target population is quite low. This study was conducted to identify factors that would positively influence the decisions of individuals over sixty years of age to participate in such programs. Sixty-five white predominantly upper middle-class, highly educated (means = 16.92 years of schooling) women aged sixty years and over (means = 68.80) were given a questionnaire concerning attitudes toward continuing education. The majority (86%) indicated a high level of interest in taking geology, political science, world and art history, music, literature, and language courses. In addition, 85 percent preferred to participate in learning situations that included younger and older individuals; 58 percent reported interest in having a companion enroll with them; 48 percent preferred no specific learning environments (i.e., lecture, discussion, or workshop); and 75 percent reported that family members did not suggest that they enroll in continuing education classes. It is suggested that the high level of interest in taking courses offered by institutions of higher education displayed by the women surveyed is because of personal experience with university level education in young adulthood.
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One of the common functional features among G-protein coupled receptors is the occurrence of multiple subtypes involved in similar signal transduction events. The cAMP chemoattractant receptor family of Dictyostelium discoideum is composed of four receptors (cAR1-cAR4), which are expressed sequentially throughout the developmental transition from a unicellular to a multicellular organism. The receptors differ in affinity for cAMP and in the sequences of their C-terminal domains. In this study, we constitutively expressed cAR1, cAR2, and cAR3 as well as a series of chimeric and mutant receptors and assessed the capacity of each to mediate chemotaxis, activation of adenylyl cyclase and actin polymerization, and rescue the developmental defect of car1-/car3- cells. We found that various receptors and mutants sense different concentration ranges of cAMP but all can mediate identical responses during the aggregation stage of development. The responses displayed very similar kinetics, suggesting no major differences in regulatory properties attributable to the C-terminal domains. We speculate that switching of receptor subtypes during development enables the organism to respond to the changing concentrations of the chemoattractant and thereby program morphogenesis appropriately.
The United States National Cancer Institute (NCI) has long supported research in radiotherapy since its establishment by an act of Congress in 1937. One of the first grants for research awarded in 1938 was to support work in developing a cyclotron for conducting clinical research on therapeutic uses of neutrons and radioactive isotopes. Support for training cancer specialists was given high priority in the early days of NCI. In 1961, the Cancer Centers Program was instituted which included a radiation research program that became the primary source of grant support for radiotherapy clinical research centers in the US. There is a need for radiotherapy research because approximately 50-60% of people with newly diagnosed cancers will receive radiotherapy at some time during their disease. In 1979, the Radiotherapy Development Branch (RDP) assumed responsibility for all radiation program grants including radiation physics, radiobiology, and radiotherapy. The RDB manages a portfolio of grants and contracts with an annual budget of over $45 million. In fiscal year (FY) 1984, research support for individual investigator grants, program project grants, and contracts amounted to $22, 15, and 6 million, respectively. The accomplishments of NCI research grantees and contractors in radiotherapy-related areas have been considerable over the past 45 years. It is essential that NCI continue its commitment to radiotherapy research and development.
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The American Optometric Association has been concerned with ophthalmic standards for over fifty years. This paper describes this involvement and how it has led to the creation of the Commission on Ophthalmic Standards. The commission's scope and function and the responsibilities of the Director of Standards Development are given. The progress of the commission's program has been temporarily delayed due to a proposed FTC rule on voluntary standards setting organizations.
An era of disciplined thinking may result not only in acknowledging but also in addressing those questions that may lead to a consistent examination of existing programs within a profession. This paper is one attemp at encouraging the professional membership to continue to address: 1. the nature and focus of the content and practice environments of the field of Occupational Therapy; 2. two approaches to investigating the distinctive character of the field of Occupational Therapy-the Separate Domain Approach and the Retroductive Approach; 3. and the basic documents developed and/or sponsored by the professional organization-in this case-The Ohio State Study (1), the NIH Study (2), and the Curriculum Guide (3).
One of the Department of Defense's initiatives to contain costs of the Civilian Health and Medical Program of the Uniformed Services is the Catchment Area Management (CAM) Demonstration Project. CAM's fundamental coordinated care concept is to contain the military's health care costs by granting the military treatment facility (MTF) commander full clinical and fiscal responsibility for the health care of all beneficiaries within the MTF's catchment area. This article describes the CAM Demonstration Project at Fort Sill during its developmental and implementation phase from June 1989 to April 1991. The six operational goals of the CAM Project are identified and discussed. Additionally, nine essential lessons learned are briefly reviewed.
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