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Results for “Competency framework”

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PubMed1996

The development of diagnostic competence: comparison of a problem-based, an integrated, and a conventional medical curriculum.

PURPOSE: To compare the diagnostic performances of students in five curriculum years educated at schools with problem-based, integrative, or conventional medical curricula. METHOD: Data were analyzed in 1994 for 612 students in their second, third, or fourth (preclinical) or fifth or sixth (clinical) years at three Dutch medical schools with problem-based, integrative, or conventional curricula. The students gave differential diagnoses for 30 case histories that were epidemiologically representative of Dutch society and covered all organ systems. The numbers of accurate diagnostic hypotheses were tallied for each of the groups involved. The data were analyzed using analysis of variance and post-hoc Newman-Keuls tests. RESULTS: Overall, the students trained within the problem-based framework and the students trained within the integrated curriculum made more accurate diagnoses than the students trained within the conventional curriculum. No overall differences were found between the students in the problem-based and integrated curricula, although the second- and third-year students from the latter performed better than the second- and third-year students from both other schools. CONCLUSION: Integration between basic and clinical sciences and an emphasis on patient problems may be the critical factors that determine superior diagnostic performance rather than whether a curriculum is self- or teacher-directed. Problem-based learning seems to live up to its expectations, but so does the integrated approach to medical education. In addition, the procedure for measuring diagnostic performance appears to be valid and to provide a simple means of measuring curriculum effects. It remains to be seen whether the findings would be replicated when students are allowed to freely gather data in open interaction with patients rather than respond to written presentations of cases.

Aged↗

PubMed2004

What do students want? Perspectives from the front line of doctoral training in professional and Combined-Integrated psychology.

Doctoral students in professional psychology face broad challenges, such as changing market demands and increased competition for careers in traditional practice settings. To prepare for these demands, students must decide how much and when to specialize, if at all, predoctorally. Complicating matters, students in single practice area programs (clinical, counseling, or school) may risk becoming insulated within the culture of their practice area, which can limit exposure and understanding of the larger practice field. Despite conditions that may drive potential students away from psychology, little research exists on efforts to address student needs, or on student perspectives of doctoral training in general. One training model that is sensitive to these student needs and concerns is the Combined-Integrated (C-I) model. An exploratory study of C-I student and graduate opinions, experiences, and aspirations revealed that C-I students value breadth of training, diversity of experience, and professional flexibility, and that they experience diverse training opportunities and socialization experiences. Implications of these results vis-à-vis the larger framework of student concerns are examined.

Adult↗

PubMed1989

The effect of clinical experience on dental students' ability to design removable partial denture frameworks.

To determine whether clinical experience influenced dental students' ability to correctly design removable partial denture frameworks, four combinations of six casts depicting various partially edentulous situations were used in the study. The authors independently rated the casts as to the degree of difficulty on a three-point scale. Only those casts for which there were 100% agreement were used. All of the casts that were used had a moderate degree of difficulty rating (level 2). The dental student sample consisted of 34 second-year students who had just completed 98 hours of instruction in removable partial dentures. Each student was given six casts on which to design removable partial denture frameworks. The students were evaluated before clinical experience in removable prosthodontics and after 1 year of removable prosthodontic experience. The results indicated that the dental students made significantly fewer errors in framework design after clinical experience. Errors on two of 13 framework design items were increased postclinically. The increase in errors on these two items may have been the result of a lack of attention to detail or a lack of reinforcement in learning certain basic concepts.

Clinical Clerkship↗

PubMed1993

A framework for the continual improvement of health care: building and applying professional and improvement knowledge to test changes in daily work.

We seem to lack a well-defined, comprehensive, and shared understanding of what is required for the continual improvement of health care--at the organizational and the industry levels. This article presents a framework that defines the new body of knowledge which, when joined with the professional knowledge of health care workers, can make continual improvement possible; and gives requirements for building and applying this knowledge to bring about improvement in health care organizations.

Clinical Competence↗

PubMedDate not supplied

How nurses approach ethical problems in Turkey.

Previously, nurse's adherence to ethical standards meant obedience to the physician and loyalty to the hospital; now, however, it means following ethical standards and rules set forth by professional codes of ethics. The International Council of Nurses' Code for Nurses (1973) has been the model for professional codes of ethics in countries throughout the world. Using ICN's Code as a framework, a study was conducted in 1993 to find out how nurses in Turkey respond to ethical dilemmas. Below, a summary of the findings.

Adolescent↗

PubMed2005

A model of supervision in mental health for general practitioners.

OBJECTIVE: If general practitioners (GPs) are to provide effective ongoing care to patients with mental health difficulties, it is argued that they need access to effective supervision. This paper aims to describe a specific framework for the provision of supervision to GPs involved in mental health-related work in a rural area. CONCLUSIONS: An innovative model of supervision is currently being trialled with GP practices in the Bendigo area of country Victoria. It is essential for a formal supervision framework to be available for GPs in mental health, so that effective outcomes in primary mental health care are maximized, facilitating better support for GPs and better outcomes for patients with mental health difficulties.

Adult↗

PubMed2004

Audit of nuclear medicine scientific and technical standards.

The British Nuclear Medicine Society has developed a process for the service-specific organizational audit of nuclear medicine departments. This process identified the need for a scheme suitable for the audit of the scientific and technical standards of a department providing such a service. This document has evolved following audit visits of a number of UK departments. It is intended to be used as a written document to facilitate the audit procedure and may be used for both external and self-audit purposes. Scientific and technical standards have been derived from a number of sources, including regulatory documents, notes for guidance and peer-reviewed publications. The audit scheme is presented as a series of questions with responses graded according to legal and safety obligations (A), good practice (B) and desirable aspects of service delivery (C). This document should be regarded as part of an audit framework and should be kept under review as the process evolves to meet the future demands of this high-technology-based clinical service.

Equipment Failure Analysis↗

PubMed1999

The management of opiate addicts in police custody.

Many suspects detained at police stations for questioning are under the influence of illicit drugs. This presents a problem, as the reliability of confessions made under the influence of drugs or whilst experiencing withdrawal symptoms may be adversely affected. This paper reviews the current management of opiate addicts in police custody and relevant legislation in the UK to highlight some of the difficulties that arise. It concentrates in particular on the specific problem of defining and assessing fitness for interview in this group and reviews the current evidence of the effect of opiates and opiate withdrawal symptoms on the reliability of testimony. It concludes that any framework for the assessment of fitness for interview must address the question of reliability. More needs to be known about the effects of opiates and opiate withdrawal symptoms on the reliability of testimony in the police interview situation.

England↗

PubMed1999

Institutionalized older adults' perceptions of nurse caring behaviors. A pilot study.

The purpose of this article is to identify which behaviors performed by nursing staff were important indicators of caring as perceived by older adults residing in institutional settings. Using Watson's Theory of Transpersonal Care as the framework for the study, the Caring Behavior Assessment (CBA) instrument, which is congruent with Watson's carative factors, was used to interview residents. A convenience sample of 21 residents residing in long-term care and assisted-living facilities answered the 63-item CBA. Descriptive statistics were used to analyze the importance of each identified behavior. The analyses revealed that the highest indicator of nurse caring focused on the nurses' technical competency (instrumental activities). This study noted a significant gender-specific perception of caring. This may reflect differences in gender communication styles and interpersonal processes which may affect connotations of caring expressions. Humanistic caring (expressive activities) was the second most important indicator of care. Older adults desired care which preserved and enhanced individual dignity.

Aged↗

PubMed2005

The roles and responsibilities of newly qualified children's nurses.

The roles and capabilities of newly qualified nurses have been studied in the past but little is known about whether newly qualified children's nurses undergo similar transitions. Six recently qualified children's nurses were interviewed in this small qualitative study to explore the meaning of being a staff nurse and identify factors that facilitated or inhibited transition from child branch student to registered nurse. A theoretical framework of role transition and situated learning was derived from the interview data. The findings indicated that becoming a staff nurse is a process leading to an identity that is actively and continuously being created

Adaptation, Psychological↗

PubMed2002

Confidentiality for mental health concerns in adolescent primary care.

Guidelines from several national professional groups and a patchwork of state laws support the option to provide confidential mental healthcare for adolescents as a way to reduce barriers to treatment. These guidelines do not, however, help doctors decide when and to what extent confidentiality might be appropriate. We propose a set of practical considerations that clinicians can use to develop and justify confidentiality and family involvement in individual cases. Use of this framework may increase clinician comfort in discussing confidentiality and mental health topics with adolescents, and thus reduce barriers to the management of mental health problems in adolescent primary care.

Adolescent↗

PubMed2004

Development of certified health education specialists (CHES) in the United States: focusing on the CHES responsibilities and competencies.

Health education is an important profession. The certification of health education specialists (CHES) has evolved in the United States (U.S.) over the past 50 years. This article briefly focuses on the CHES system in the U.S. and research studies related to this topic, including coverage of the CHES responsibilities and competencies by professional school programs in the U.S., as well as other CHES issues. The CHES credentialing system in the U.S. was successfully developed over a long period of time, and its history in the U.S. is unique. Japan has now started to develop a similar certification process and is concerned about academic programs for training Japanese health educators. Awareness of the CHES system and the U.S. health education certification process and framework may help Japanese health educators and academics to tailor their health education certification processes more effectively.

Certification↗

PubMed2005

Sharing patient data: competing demands of privacy, trust and research in primary care.

BACKGROUND: Patient privacy may conflict with the advancement of knowledge through data sharing. The data contained in primary care records are uniquely comprehensive. AIM: To explore the knowledge and attitudes of patients and members of the primary healthcare team regarding the sharing of data held in primary care records, with particular reference to data sharing for research and the impact that this may have on trust between patients and health professionals. DESIGN OF STUDY: Qualitative study using quota sampled, semi-structured interviews. SETTING: Five general practices in Leicestershire, UK. METHOD: Grounded theory and framework methodology were used. Interviews were transcribed and analysed thematically. RESULTS: Twenty patients and 15 healthcare professionals and managers were interviewed. Patients had limited knowledge of the type of information held in their general practice records and the ways in which these data are shared, but appeared ready to form preliminary views on issues such as data sharing for audit and disease registration. In this climate of limited awareness, there was no suggestion that concern about data sharing for research adversely affects patient trust or leads patients to withhold relevant information from health professionals in primary care. Interviews carried out with staff suggested a lack of clear practice policies regarding data sharing. CONCLUSIONS: General practices may need to develop policies on data sharing, bring these to the attention of their patient population and improve patient awareness about the nature of the data contained in their records. Researchers should ensure that patients are adequately informed about the nature of data contained in patient records when seeking consent for data extraction.

Confidentiality↗

PubMed2007

What to do when 'there is nothing more to do'? A study within a salutogenic framework of family members' experience of palliative home care staff.

The aim of this study was to develop a theoretical framework of family members' experience of palliative home care staff based on a secondary analysis of four previous studies. A salutogenic framework was used, i.e. with the origin of health in focus. Data had been collected (semi-structured tape-recorded interviews and postal questionnaires with open-ended questions) from 469 family members of mainly cancer patients referred to advanced palliative home care. Walker and Avant's strategies for theory construction were used. The secondary analysis generated three theoretical blocks: (1) general components of staff input (including five generalized resistance resources (GRRs): competence, support, spectrum of services, continuity, and accessibility); (2) specific interactions with staff (including two GRRs: being in the centre and sharing caring); (3) emotional and existential consequences of staff support (including six health-disease continuums: security-insecurity, hope-hopelessness, congruent inner reality-chaos, togetherness-isolation, self-transcendence-feelings of insufficiency and retained everyday life-disrupted everyday life). It seems important that all three aspects of family members' experience of palliative care staff are to be considered in evaluations of palliative care, in goal-setting and in teaching role models. The study is specific to the Swedish model of palliative home care and replication of the work in other countries is recommended.

Aged↗

PubMed2003

Assessing anchor damage on coral reefs: a case study in selection of environmental indicators.

Because environmental conservation can remove scarce natural resources from competing uses, it is important to gain support for conservation programs by demonstrating that management actions have been effective in achieving their goals. One way to do this is to show that selected significant environmental variables (indicators) vary between managed and unmanaged areas or change over time following implementation of a management regime. However, identifying indicators that reflect environmental conditions relevant to management practices has proven difficult. This paper focuses on developing a framework for choosing indicators in a coral reef habitat. The framework consisted of three phases: (1) information gathering to identify candidate variables; (2) field-testing candidate variables at sites that differ in intensity of human activity, thus identifying potential indicators; and (3) evaluating potential indicators against a set of feasibility criteria to identify the most useful indicators. To identify indicators suitable to measure the success of a management strategy to reduce anchor damage to a coral reef, 24 candidate variables were identified and evaluated at sites with different intensities of anchoring. In this study, measures that reflected injuries to coral colonies were generally more efficient than traditional measures of coral cover in describing the effects of anchoring. The number of overturned colonies was identified as the single most useful indicator of coral reef condition associated with anchoring intensities. The indicator selection framework developed here has the advantages of being transparent, cost efficient, and readily transferable to other types of human activities and management strategies.

Animals↗

PubMed2000

Scripts and medical diagnostic knowledge: theory and applications for clinical reasoning instruction and research.

Medical diagnosis is a categorization task that allows physicians to make predictions about features of clinical situations and to determine appropriate course of action. The script concept, which first arose in cognitive psychology, provides a theoretical framework to explain how medical diagnostic knowledge can be structured for diagnostic problem solving. The main characteristics of the script concept are pre-stored knowledge, values acceptable or not acceptable for each illness attribute, and default values. Scripts are networks of knowledge adapted to goals of clinical tasks. The authors describe how scripts are used in diagnostic tasks, how the script concept fits within the clinical reasoning literature, how it contrasts with competing theories of clinical reasoning, how educators can help students build and refine scripts, and how scripts can be used to assess clinical competence.

Diagnosis↗

PubMedDate not supplied

Touchpoints: changing the face of pediatric nurse practitioner education.

Touchpoints is an interdisciplinary relational model of healthcare primarily used with parents and young children. The underlying premise of the Touchpoints approach is to support the parent/child relationship during the health encounter by enhancing parents' efforts to optimize their child's physical and psychological development. Nurse practitioners who use this approach in practice find they are able to connect quickly to the parents' most urgent concerns for their child. Our experience has been that a pediatric nurse practitioner program that uses Touchpoints as the underlying framework can assist students in achieving a holistic view of families by focusing the curriculum more directly on development and relationships. Students learn that building a relationship with parents, and joining them in the care of their child, produces an atmosphere in the health encounter of mutual respect and trust. Parents leave the encounter feeling satisfied their concern for their child has been heard and questions have been seriously discussed; students leave feeling competent and valued by their patients. Touchpoints provides a model for teaching and demonstrating the development of interpersonal relationships by using the language of the child's behavior.

Curriculum↗

PubMedDate not supplied

Application of the critical pathway and integrated case teaching method to nursing orientation.

BACKGROUND: Nursing staff development programs must be responsive to current changes in healthcare. New nursing staff must be prepared to manage continuous change and to function competently in clinical practice. METHOD: The orientation pathway, based on a case management model, is used as a structure for the orientation phase of staff development. The integrated case is incorporated as a teaching strategy in orientation. The integrated case method is based on discussion and analysis of patient situations with emphasis on role modeling and integration of theory and skill. RESULTS: The orientation pathway and integrated case teaching method provide a useful framework for orientation of new staff. Educators, preceptors and orientees find the structure provided by the orientation pathway very useful. CONCLUSION: Orientation that is developed, implemented and evaluated based on a case management model with the use of an orientation pathway and incorporation of an integrated case teaching method provides a standardized structure for orientation of new staff. This approach is designed for the adult learner, promotes conceptual reasoning, and encourages the social and contextual basis for continued learning.

Adult↗