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Results for “Competency framework”

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PubMed1998

Investigating psychosocial aspects of participation in early anti-cancer drug trials: towards a choice of methodology.

This paper presents the methodological approach and research methods chosen to explore psychosocial aspects of participation in early anti-cancer drug trials from the perspective of those actually involved. The paper describes how an appropriate methodology, or principles of reasoning behind the choice of research methods, emerged. The choice of methodology was based on three elements: first, an understanding of the competing philosophies about how research can be approached and conducted; second, the author's view of the subject area; and third, a consideration of previous research approaches which have investigated psychosocial aspects of cancer clinical trials. A qualitative methodology situated within an interpretative paradigm was eventually chosen as the most appropriate means of exploring trial participants' experiences and the aim and objectives of the research were developed within this methodological framework.

Antineoplastic Agents↗

PubMed1993

A comprehensive assessment plan for professional preparation programs in health education at Eastern Illinois University.

Federal- and state-mandated criteria for accountability have promoted an "assessment movement" in higher education. The federal focus caused higher education's regional accrediting bodies to place greater emphasis on assessment for institutional accountability. Numerous approaches have been identified for the assessment process including comprehensive examinations, evaluation by alumni and internship preceptors, and self-report data by students. The Role Delineation Project Curriculum Framework also has been useful in assessing curricula. Strategies used in a comprehensive assessment plan for the Health Studies Dept. at Eastern Illinois University include focus group interviews, Departmental Advisory Council review, and assessment by internship preceptors. Data indicate the professional preparation program adequately prepares students in Responsibilities I, II, III, IV, and VII. Further consideration will be given to revising the curriculum to include material to prepare students in competencies required for Responsibilities V and VI.

Accreditation↗

PubMed1991

Involving patients in do not resuscitate (DNR) decisions: an old issue raising its ugly head.

A recent paper in this journal (1) suggests that involving terminally ill patients in choices concerned with Cardio-Pulmonary Resuscitation (CPR) produces 'psychological pain' and therefore is ill-advised. Such a claim rests on anecdotal observations made by the authors. In this paper I suggest that drawing conclusions in ethics, no less than in science, requires a rigorous framework and cannot be relegated to personal observation of a few cases. The paper concludes by suggesting that patients, if we acknowledge their valid interest in making their own choices, must themselves be allowed to make a prior choice about choosing. Those who may not wish to choose may properly be relieved of this burden and may allow another to choose for them. Routinely allowing others to make choices for competent adults, however, is likely to decrease communication with the dying patient and to introduce an atmosphere of suspicion and fear and to exclude the competent patient from his/her rightful place in the community.

Attitude to Death↗

PubMed1994

Patient satisfaction with a mood disorders unit: elements and components.

Patient satisfaction is an indicator of effective service provision and may influence compliance with treatment. Of 265 patients attending a specialised mood disorders unit and surveyed at least two years after their initial contact, 221 (83%) replied. Characteristics of responders and non-responders were compared on demographic and clinical information from index assessment and follow-up. Sixty-four percent of responders were very satisfied and 21% partly satisfied with their management. Components of satisfaction included perceived competence of clinical management; the unit's administrative and after-treatment accessibility; and the support of staff and other patients. Those with a more adequate personality and melancholic depression at baseline assessment were more satisfied. A low current mood state at time of survey was associated with lower satisfaction in non-melancholics only. There were interactions between improvement in condition, diagnosis, personality and satisfaction. The survey provided a framework for formulating treatment programmes and was a useful quality assurance tool.

Adolescent↗

PubMedDate not supplied

[The competency model of old age: possibilities in clinico-psychiatric interpretation exemplified by a history group (oral history group)].

Regardless of the increasing prevalence of gerontopsychiatric diseases the increase of age-related treatments is only gradual. Due to the deficit centered image of elderly patients, which impairs the physician-patient interaction, the proper perception of cognitive and social competences of these patients within the clinical routine is impeded. To start a first approach to an age-related treatment format in regard to the "assets" of elderly patients an "oral history"-group was established in a general psychiatric ward that stressed topic-related autobiographical memories of daily life occurrences. The author proposes that elderly patients who attempt to give an age-related contribution within the social framework of a general psychiatric ward feel better about their illness.

Aged↗

PubMed1988

[Early detection of developmental disorders: the need for a new perspective].

Early detection of abnormality in young children (aged 0-7) in the Netherlands is to be organized on two levels. First, regional cooperation between child-health professionals and institutions will be stimulated in order to form a nationwide network of 'multidisciplinary teams', with the task of coordinating early detection in a specific area. These teams are to advise parents and professionals in those cases where a child's development is suspected of being 'at risk'. The second part of the program is a campaign to promote the idea of early detection among the population. The aim is to develop the 'signalizing' and diagnostic abilities of parents, teachers and child-health professionals through education and training. The subject of early detection seemed and still seems to be a focus of different interests, and of conflicts of competence between different groups and schools of professionals and different institutions. In this article some of the main conflicting issues are discussed. One of the important problems concerning early detection is the question of defining normality and abnormality. It is concluded that in the case of early detection of both somatic and psychosomatic disorder there can be no such thing as an absolute scientific rationality, as is often suggested. Theoretical frameworks underlying methods of early detection are influenced by social, cultural and historical factors, and thus form a social construction. Finally a protocol-approach is being suggested, a method that might clear some of the problems concerning the content and organizational procedures of the Dutch system for early detection.

Child↗

PubMedDate not supplied

Liberal and professional undergraduate nursing education: maintaining the connections.

Current recommendations to improve undergraduate education range from increasing the proportion of general education credits to removing professional preparation from undergraduate education. The authors argue for the necessity of integrating general education and professional preparation throughout all levels of higher education. A conceptual framework to study professional preparation developed by Stark et al. is presented. Methods to integrate both general education and professional preparation are analyzed, and specific implications for nursing are discussed.

Curriculum↗

PubMed1999

Moral guidance, moral philosophy, and moral issues in practice.

Approaches to teaching ethics to nurses have been debated in literature for some years. Three issues in particular are commonly addressed: the intentions of such teaching; the value of examples and case studies; and the compatibility of philosophical approaches with the clinical reality experienced by students. It is argued here that moral guidance as a strategy is unacceptable, and that a basic introduction to philosophical methods is the key to effective learning of the skills required for autonomous analysis and decision making. A means for including the use of personal experiences and case study material is presented which relies upon the provision of a framework of analysis to facilitate structured thinking and the pursuit of justifiable arguments. The approach suggested is compatible with students' existing experiences and work-context, and enhances the integration of ethical reasoning into the multi-faceted totality of clinical practice.

Clinical Competence↗

PubMed2005

Developing an outcome-focused core curriculum.

BACKGROUND: Many UK medical schools have modified their curricula to meet the requirements of the General Medical Council and other external agencies. In particular, efforts have been focused on increasing integration and reducing factual overload through the definition of a core curriculum. Various approaches to curriculum change have been adopted in an attempt to meet such demands. PURPOSE: This paper describes a curriculum development process, which commences with a clear vision, adopts an outcome-based approach and identifies clear statements of learning outcomes. The process led to the development of an outcome-focused core curriculum structured around clinical problems, which is available to all students and staff. CONCLUSION: A model of curriculum development has evolved which is relatively simple in concept, and appears to be easy to comprehend by students, teaching staff and visitors from other institutions. It provides a practical framework for managing the difficult problems of integration and factual overload. It should be of general interest and applicability to other schools with health professional programmes looking for a realistic and acceptable way of defining a core curriculum.

Clinical Competence↗

PubMed1999

Describing expert practice in physical therapy.

In this article, the authors demonstrate how grounded theory may be used to develop models for understanding clinical practice. Through a series of research studies involving novice, experienced, and expert physical therapy practitioners, conceptual frameworks were continually revised based on data obtained from returning to the field and relevant literature available at the time. As concepts and relationships moved to larger themes, a theoretical framework for expertise in clinical practice was proposed. Current work on verifying the theoretical framework continues. Grounded theory is an excellent research approach to bound and help guide a multistage research program involving multiple researchers working in multiple settings.

Humans↗

PubMed2001

Understanding physicians' skills at providing end-of-life care perspectives of patients, families, and health care workers.

BACKGROUND: A framework for understanding and evaluating physicians' skills at providing end of life care from the perspectives of patients, families, and health care workers will promote better quality of care at the end of life. OBJECTIVE: To develop a comprehensive understanding of the factors contributing to the quality of physicians' care for dying patients. DESIGN: Qualitative study using focus groups and content analysis based on grounded theory. SETTING: Seattle, Washington. PARTICIPANTS: Eleven focus groups of patients with chronic obstructive pulmonary disease, AIDS, or cancer (79 patients); 3 groups of family members who had a loved one die of chronic disease (20 family members); 4 groups of nurses and social workers from hospice or acute care settings (27 health care workers); and 2 groups of physicians with expertise in end-of-life care (11 physicians). RESULTS: We identified 12 domains of physicians' skills at providing end-of-life care: accessibility and continuity; team coordination and communication; communication with patients; patient education; inclusion and recognition of the family; competence; pain and symptom management; emotional support, personalization; attention to patient values; respect and humility; and support of patient decision making. within these domains, we identified 55 specific components of physicians' skills. Domains identified most frequently by patients and families were emotional support and communication with patients. Patients with the 3 disease groups, families, and health care workers identified all 12 domains. Investigators used transcript analyses to construct a conceptual model of physicians' skills at providing end-of-life care that grouped domains into 5 categories. CONCLUSIONS: The 12 domains encompass the major aspects of physicians' skills at providing high-quality end-of-life care from the perspectives of patients, their families, and health care workers, and provide a new framework for understanding, evaluating, and teaching these skills. Our findings should focus physicians, physician-educators, and researchers on communication, emotional support, and accessibility to improve the quality of end-of-life care.

Adult↗

PubMed2003

The evaluation of preprocessing choices in single-subject BOLD fMRI using NPAIRS performance metrics.

This work proposes an alternative to simulation-based receiver operating characteristic (ROC) analysis for assessment of fMRI data analysis methodologies. Specifically, we apply the rapidly developing nonparametric prediction, activation, influence, and reproducibility resampling (NPAIRS) framework to obtain cross-validation-based model performance estimates of prediction accuracy and global reproducibility for various degrees of model complexity. We rely on the concept of an analysis chain meta-model in which all parameters of the preprocessing steps along with the final statistical model are treated as estimated model parameters. Our ROC analog, then, consists of plotting prediction vs. reproducibility results as curves of model complexity for competing meta-models. Two theoretical underpinnings are crucial to utilizing this new validation technique. First, we explore the relationship between global signal-to-noise and our reproducibility estimates as derived previously. Second, we submit our model complexity curves in the prediction versus reproducibility space as reflecting classic bias-variance tradeoffs. Among the particular analysis chains considered, we found little impact in performance metrics with alignment, some benefit with temporal detrending, and greatest improvement with spatial smoothing.

Adult↗

PubMed1996

Development and validation of alternative metabolic systems for mutagenicity testing in short-term assays.

We present here the results obtained within the framework of an EU funded project aimed to develop and validate alternative metabolic activating systems to be used in short-term mutagenicity assays, in order to reduce the use of laboratory animals for toxicology testing. The activating systems studied were established cell lines (Hep G2, CHEL), genetically engineered V79 cell lines expressing specific rat cytochromes P450, erythrocyte-derived systems, CYP-mimetic chemical systems and plant homogenates. The metabolically competent cell lines were used as indicator cells for genotoxic effects as well as for the preparation of external activating systems using other indicator cells. The following endpoints were used: micronuclei, chromosomal aberrations and sister chromatid exchanges, mutations at the hprt locus, gene mutations in bacteria (Ames test), unscheduled DNA synthesis and DNA breaks detected in the comet assay. All metabolic systems employed activated some promutagens. With some of them, promutagens belonging to many different classes of chemicals were activated to genotoxicants, including carcinogens negative in liver S9-mediated assays. In other cases, the use of the new activating systems allowed the detection of mutagens at much lower substrate concentrations than in liver S9-mediated assays. Therefore, the alternative metabolizing systems, which do not require the use of laboratory animals, have a substantial potential in in vitro toxicology, in the basic genotoxicity testing as well as in the elucidation of activation mechanisms. However, since the data basis is much smaller for the new systems than for the activating systems produced from subcellular liver preparations, the overlapping use of both systems is recommended for the present and near future. For example, liver S9 preparations may be used with some indicator systems (e.g., bacterial mutagenicity), and metabolically competent mammalian cell lines may be used with other indicator systems (e.g., a cytogenetic endpoint) in a battery of basic tests.

Animals↗

PubMed2000

Illusory correlation and group impression formation in young and older adults.

This study investigated whether a greater illusory correlation bias is present in older adults' memory and evaluative judgment for majority and minority social groups and, if so, whether this bias might be due to an age-related decline in the ability to engage in on-line processing of group-trait information. Young and older adults read desirable and undesirable trait adjectives about the members of 2 groups under either no-distraction or distraction conditions. Group A had twice as many members as Group B and, for both groups, desirable traits occurred twice as often as undesirable traits. Afterwards, participants completed group-trait memory and evaluative judgment tasks. Greater illusory correlation in memory and evaluative judgment after distraction suggested that diverting resources to competing tasks produced deficits in both memory for specific group-trait information and on-line group impression formation. Older adults' memory for specific group-trait information was disrupted more by distraction than was young adults' memory. However, there were no age differences in evaluative judgment after either distraction condition, suggesting that on-line impression formation activities remain intact in old age. These findings are interpreted within the framework of fuzzy trace theory.

Adult↗

PubMed2007

The evolution of the CDC HIV prevention capacity-building assistance initiative.

As the HIV/AIDS epidemic neared the end of its first decade in the late 1980s, the US Centers for Disease Control and Prevention (CDC) recognized the disparate impact on racial and ethnic minority communities. In response, a program was initiated to build capacity to prevent the further spread of HIV and other STDs in these communities. Since that time, the program has expanded in scope, intensity of efforts, and funding. Today, the CDC's Capacity Building Assistance (CBA) Initiative serves communities across the nation by building community, organizational, and HIV prevention program/intervention capacity designed to reduce the number of new HIV infections among at-risk populations. This article focuses on the history and evolution of these efforts, lessons learned, and how these were used to develop the current, more responsive system. A conceptual framework is presented that describes the taxonomy of CBA services designed to (1) enhance organizational infrastructure; (2) enhance HIV prevention interventions; (3) strengthen community capacity; and (4) strengthen community planning. It includes language and definitions, approaches and mechanisms for delivering capacity-building services, and a Web-based request-and-referral system that serves as the foundation for tracking, monitoring, and ensuring the delivery of appropriate, efficient, and culturally competent CBA.

Centers for Disease Control and Prevention, U.S.↗

PubMed1995

Parents and families of children with communication disorders.

The role of parents in the development of the communicative competence of their children has been of growing interest to researchers and practitioners in the field of speech and language therapy. Researchers have attempted to define and test specific hypotheses regarding the nature and degree of the influence of parental interaction styles upon the developing child's pragmatic skills. The literature includes studies regarding normal children and those with speech and language impairments. Practitioners have endeavoured to move towards a firmer framework of partnership with parents which will ultimately be of benefit to children with speech and language impairments and their families.

Child↗

PubMed2000

Domestic violence and the nursing curriculum: tuning in and tuning up.

Domestic violence is a major health, social, and criminal justice problem in the United States. Although not confined to women, it is a growing concern of women and those who care for women. Nurses are often the first health care provider with whom the battered woman and her family interact. Reports of several studies indicate educational preparation of nurses is inadequate to assure sensitive, quality, and effective nursing care to those who have survived domestic violence. One purpose of this qualitative study was to identify and describe the essential knowledge and skills needed by nurses to provide competent, sensitive care. Interviews were conducted with 13 informants who were considered experts in violence-related care. Their responses were analyzed for categories of response and themes related to their feelings about domestic violence and the essential knowledge and skills nurses need to provide appropriate care. Findings provide data that can form the empirical bases for review of current curriculum content and strategies, indicate needed revisions, and serve as a framework for future curriculum development.

Battered Women↗

PubMed2005

A framework for studying minority youths' transitions to fatherhood: the case of Puerto Rican adolescents.

A theoretical framework is proposed for studying minority young men's involvement with their babies that combines the integrative model of minority youth development and a life course developmental perspective with Lamb's revised four-factor model of father involvement. This framework posits a relationship between demographic and family background variables (such as education, employment, income, and family of origin) and fatherhood outcomes moderated by personal characteristics (such as sex-role ideology, acculturation, risk taking, and alienation) and mediated by definitions of fatherhood, life priorities normative for the culture under study, and sexual behavior. Once there is an acknowledged infant, a father's involvement is influenced by child characteristics, perceived fathering competence, social support, and quality of the relationship with the mother.

Acculturation↗