Student nurses: introductory course preparation and work world expectations. Report of a pilot study.
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Clinical Competence↗
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Results for “introductory programming”
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A systems approach to the development and evaluation of a minicourse for nurses.
An autotutorial, audiovisual minicourse was designed to: 1) inform nurses and other hospital personnel to handle effectively problems associated with contamination and decontamination of respiratory therapy equipment according to the best procedures currently availabel, 2) investigate how different instructional methods are related to student achievement, and 3) determine an effective approach for implementing this educational modality. The subjects-137 allied health students, predominantly nurses, enrolled in introductory microbiology in the Department of Biology, Georgia State University, Atlanta, during the Spring Quarter 1974-were randomly placed in four treatment groups: 1-programmed instruction (PI), 2-audiovisual (AV), 3-AV-PI combined, 4-no exposure to the mini-course-control group. Achievement was measured by comparing pre- and posttest scores on a subject matter achievement test. An analysis of variance revealed that not all treatment population means were equal. Tukey's Honestly Significant Difference Test showed that all three groups exposed to one or both methods of the minicourse scored higher than the control group, with the AV-PI group scoring highest.
Audiovisual Aids↗
Making developmental biology relevant to undergraduates in an era of economic rationalism in Australia.
This report describes the road map we followed at our university to accommodate three main factors: financial pressure within the university system; desire to enhance the learning experience of undergraduates; and motivation to increase the prominence of the discipline of developmental biology in our university. We engineered a novel, multi-year undergraduate developmental biology program which was "student-oriented," ensuring that students were continually exposed to the underlying principles and philosophy of this discipline throughout their undergraduate career. Among its key features are introductory lectures in core courses in the first year, which emphasize the relevance of developmental biology to tissue engineering, reproductive medicine, therapeutic approaches in medicine, agriculture and aquaculture. State-of-the-art animated computer graphics and images of high visual impact are also used. In addition, students are streamed into the developmental biology track in the second year, using courses like human embryology and courses shared with cell biology, which include practicals based on modern experimental approaches. Finally, fully dedicated third-year courses in developmental biology are undertaken in conjunction with stand-alone practical courses where students experiencefirst-hand work in a research laboratory. Our philosophy is a "cradle-to-grave" approach to the education of undergraduates so as to prepare highly motivated, enthusiastic and well-educated developmental biologists for entry into graduate programs and ultimately post-doctoral research.
Australia↗
Joint mobilization for children with central nervous system disorders: indications and precautions.
Because clinicians are introducing joint mobilization into treatment programs for children with cerebral palsy, we felt that a review of the procedure and its scientific basis would be timely. The goals of the introductory section of this article are to define joint mobilization as it has been used for adults with musculoskeletal disabilities, to discuss various rationales for its effects, to describe contraindications and precautions for its use, and to discuss its efficacy as reported in the research literature. The latter part of the article deals with the use of joint mobilization for children with central nervous system (CNS) disorders. In an effort to understand precautions for the use of joint mobilization in children, musculoskeletal development will be described both for typically developing children and for children with spastic cerebral palsy. Indications for using joint mobilization techniques in children with spasticity will be outlined. Specific neurodevelopmental disabilities for which joint mobilization would be strongly contraindicated will be listed. Finally, future research directions in evaluating reliability of assessment of joint dysfunction and efficacy of joint mobilization in children will be discussed.
Biomechanical Phenomena↗
Forensic methods and the podiatric physician.
This is an introductory study of forensic podiatry. To elevate forensic podiatry to the level of forensic odontology and forensic anthropology, the podiatric medical profession must begin educational programs and research. A system for monitoring the activities of podiatrists involved in forensic medicine must be established to ensure that the high degree of integrity to which the profession is committed is maintained. By following these guidelines, the author believes that sometime in the future a podiatrist will be on the staff of every major police department in the country. At that point, the podiatric medical profession will have achieved unsurpassed status, recognition, and prestige.
Forensic Medicine↗
Improving the supervision of therapy assistants in Western Australia: the Therapy Assistant Project (TAP).
INTRODUCTION: Multidisciplinary therapy assistants (TAs) are increasingly seen as a model suited to the provision of allied health services in rural and remote areas. Supervision is a key aspect of therapy assistant practice. The rural context presents many challenges in supervising TAs including: a multidisciplinary TA role, outreach service delivery models, inexperienced allied health professionals (AHPs) and a high turnover of AHPs. At present there are no accepted standards for supervising TAs in this context. This study aimed to improve the supervision of TAs by AHPs in a rural setting. Improving supervision formed one aspect of the Therapy Assistant Project (TAP). METHODS: Minimum standards for supervision were developed, a process for recording TA supervision introduced, and training in supervision skills was delivered to AHPs. A mixed method study design was used to determine the impact of introducing minimum standards and supervisor training on supervision practices. RESULTS: Minimum supervision standards included: program and administrative discussion, observation, and demonstration of therapy sessions. Methods recommended for supervising allowed regular supervision of TAs in small, distant rural towns. Developing minimum standards for supervision, a process for recording supervision, and training in supervisory skills resulted in increased supervision between AHPs and TAs. AHP and TA participants expressed satisfaction with minimum supervision standards. The frequency and amount of supervision increased although videoconferencing for supervising TAs in distant towns was not widely used for supervision. CONCLUSION: This study provides a new resource for supervision practices for rural TAs. The minimum standards for supervision would be a suitable resource to assist health services seeking to improve supervision of TAs or commencing a TA program. Further exploration of the use of videoconferencing for supervising TAs in distant rural towns is suggested. Training in supervision skills for AHPs should include introductory and complex supervision methods. This study represents one step in defining standards for rural and remote TA practice.
Allied Health Personnel↗
The geriatric interdisciplinary team training (GITT) program.
Geriatric interdisciplinary team training (GITT) is an initiative funded by the John A. Hartford Foundation since 1995. Building from the substantial knowledge gained from the Veteran's Administration project in interdisciplinary team training and lessons from the Pew Foundation initiative, GITT was reconceived by the Foundation to address the need for teams in the care of older adults in the new era of managed care and health care cost containment. This training program has served to help us understand attitudes toward teams, how teams function, and how teams should be trained in the changing health care environment, where length of stay is dramatically different from the earlier team training projects. This introductory paper provides an overview of GITT, and the companion papers give detail of the GITT curricula, measures and lessons learned.
Aged↗
Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: an open U.S.-U.K. study.
OBJECTIVE: To evaluate the efficacy and acceptability of a self-help program for mild-to-moderate depression that combined treatment booklets and telephone calls to a computer-aided Interactive Voice Response (IVR) system. METHOD: In an open trial, 41 patients from Boston, Massachusetts; Madison, Wisconsin; and London, England, used COPE, a 12-week self-help system for depression. COPE consisted of an introductory videotape and 9 booklets accompanied by 11 telephone calls to an IVR system that made self-help recommendations to patients based on information they entered. RESULTS: All 41 patients successfully completed the self-assessment in the booklets and telephone calls; 28 (68%) also completed the 12-week self-help program. Hamilton Rating Scale for Depression (HAM-D) and Work and Social Adjustment scores improved significantly (41% and 42% mean reduction in the intent-to-treat sample, respectively, p < .001). Eighteen (64%) of the 28 completers were considered responders on the basis of > or = 50% reduction in their HAM-D scores. There was a higher percentage of completers in the pooled U.S. sites (82% vs. 43%), and U.S. completers improved more than those in the United Kingdom (73% vs. 43% were responders). Most (68%) of the calls were made outside usual office hours, Monday-Friday, 9:00 a.m. to 5:00 p.m. Expectation of effectiveness and time spent making COPE calls (more treatment modules) correlated positively with improvement over 12 weeks. Mean call length for completers was 14 minutes. CONCLUSION: A self-help system comprised of a computer-aided telephone system and a series of booklets was used successfully by people with mild-to-moderate depression. These preliminary results are encouraging for people who cannot otherwise access ongoing, in-person therapy.
Adult↗
[Recovery of intersubjectivity and empathy in schizophrenics: through a characteristic type of friendship "frolicking"].
The author has noticed a characteristic form of close, frolicsome friendship between recovering adolescent schizophrenic patients. It occurs in groups of young patients in a psychiatric clinic and in a day-care institution. Through this type of friendship, their intersubjectivity, ability for empathy and human relations develop, essential changes for the amelioration of schizophrenia. It is characterized by 1 A mutual relationship on equal terms with another schizophrenic patient of the same sex and generation; particularly close friendship between two patients, or sometimes several patients who form a group, spending much time together. 2 Playful, childish behavior, jokes and jests; Patients laugh and make others laugh, playing together. 3 Touching the friends' bodies and coordinated playing such as dancing and singing together. 4 Chatting and having common interests, along with sharing various experiences. 5 Enjoyment with so much energy that sometimes, as in a gang, social norms are contravened. 6 Being a transient phenomenon that ends naturally after a certain period. Through such friendship, the adolescents show mental growth compared with their premorbid state. They come to sympathize with others' feelings and willingly cooperate. Their social relationships and spheres of activity expand, and spontaneity and self-esteem become improved. They come to assert themselves adequately, tolerate stress, and conform to social norms. Moreover, they advance to developing a purpose. e.g. work. To be able to have empathy through friendship with those of the same sex and generation is a basic developmental theme generally seen in childhood and pre-adolescence. Such friendship between the patients studied represents benign regression in such a developmental period. This type of friendship is characterized by a frolicsome and playful atmosphere. Frolicking by means of jokes, jests and body-touching, and play with coordinated acts lead to the sharing of emotions and development of their intersubjectivity, the latter improving the person's empathy, spontaneity and self-esteem. This type of friendship appears in patients in their teens or twenties once a certain period has passed after the disappearance of positive symptoms. Its typical course is seen in teen-agers who show a premorbid personality deviation such as difficulty in establishing social relationships. No particular tendency as to gender or family type was found. Therapists should provide the opportunity and setting for this type of friendship to develop. Adolescent schizophrenics can gather together and are open-mindedly accepted in such a setting, which has an informal component where therapeutic staff may not interfere in this playful atmosphere. Therapists should act as third persons, once friendly play begins, after the introductory period during which the therapists' protection and limits on social stimulation are needed. It is desirable to appreciate patients' friendships and self-help, offering a rehabilitation program and adequate support, as they step forward to the future.
Adolescent↗
Emergency department use among Michigan children with special health care needs: an introductory study.
OBJECTIVE: To describe patterns of emergency department (ED) use among children dual-enrolled in Medicaid and Michigan's Children's Special Health Care Services (CSHCS). DATA SOURCES: Individual claims and enrollment data from Michigan's Medicaid and CSHCS programs for the period January 1, 1998, to June 30, 1999. Claims data were linked with eligibility data and then used to develop a 100 percent sample of claims for individuals enrolled in both Medicaid and CSHCS. STUDY DESIGN: Poisson regression analysis was used to examine the rate of ED use for dual-enrolled children. A time-varying hazard analysis was also used to examine the impact of changes over time. The key variables were gender, age, race, county of residence, Medicaid eligibility category, and qualifying diagnosis. PRINCIPAL FINDINGS: Dual-enrolled children under one year of age, and those with qualifying diagnoses of anemia, hemophilia, asthma, epilepsy, and juvenile diabetes displayed especially high rates of ED use. Significant geographic variation in ED use remained after controlling for qualifying diagnoses, race/ethnicity, and other factors. African Americans displayed higher rates of ED utilization than non-Hispanic whites. Supplemental Security Income (SSI) recipients demonstrated higher utilization than other groups. CONCLUSIONS: Children dually enrolled in CSHCS and Medicaid face diverse challenges of both poverty and chronic illness. Differences in patterns of use highlight the importance, but also the difficulty, of developing systems of care to manage complex chronic conditions in low-income populations.
Adolescent↗
Medical students as co-instructors in an introductory clinical medicine course.
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Clinical Medicine↗
[Udder health care as part of a veterinary care program for dairy farms. II. Methodology during the control phase].
A model of an udder health control programme is presented in three papers. The first paper was concerned with the objectives of the programme, the materials required and the procedures at the introductory phase of the programme. This second paper is concerned with the procedures used during the control phase of the programme. Activities, fields of attention and advice given during the visits to farms are part of these procedures. They are derived from a five-point schedule of udder health control on which the model is based.
Animals↗
Applications of errorless learning for improving work performance in persons with schizophrenia.
OBJECTIVE: Until recently, few training methods used in the psychosocial rehabilitation of persons with schizophrenia have taken into account the neurocognitive deficits common to this illness. The present study tested a training method called errorless learning (which theoretically compensates for neurocognitive impairments) for efficacy at teaching entry-level job tasks to persons with serious and persistent mental illness. METHOD: Sixty-five unemployed, clinically stable outpatients with schizophrenia or schizoaffective disorder were randomly assigned to training by means of either errorless learning or conventional instruction for two entry-level job tasks (index card filing and toilet tank assembly). Training was conducted in small groups of four subjects for 90-120 minutes in a simulated workshop. Efficacy-as measured by accuracy, speed, and overall productivity-was assessed immediately after training and at a 3-month follow-up evaluation. RESULTS: Significant group differences in accuracy that favored errorless learning were found on both job tasks. In terms of productivity, the errorless learning group was superior to the conventional instruction group on the card filing task, and differences for the tank assembly task approached significance. There were no significant group differences in speed. Both groups showed significant drops in accuracy and productivity on the tank assembly task from immediately after training to the 3-month follow-up evaluation; performance levels were more stable for both groups on the card filing task. CONCLUSIONS: Errorless learning appears to be a useful training method for establishing introductory high levels of performance in the work rehabilitation of persons with schizophrenia. Future studies may wish to test its long-term durability by embedding it within supported employment programs.
Adult↗
Columbia University's fellowship in public psychiatry.
In 1981 the fellowship in public psychiatry was established at New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons to provide subspecialty training for psychiatrists who plan careers in the public sector. Ten one-year postresidency fellowships are awarded annually. The fellowship consists of supervised work and didactic experiences focused on the clinical modalities most effective in public mental health services and the managerial skills that the psychiatrist must possess to make those services work well. Fellows work three days a week at collaborating public-sector agencies throughout the New York metropolitan area. The curriculum includes an academic seminar, which gives fellows an introductory overview of major topics in public psychiatry; an organizational practicum, which is an exercise in management principles and practices; an evaluation practicum, which addresses the theory and practice of program evaluation; and an applied seminar, organized as a cycle of clinical, administrative, fiscal, and evaluation presentations in which each fellow applies the concepts learned in the other seminars to his or her field placement work. Of the 75 fellows who have graduated from the program, only six have chosen to leave the public arena. Nearly all work full time in the public sector, where more than half hold management positions. More than three-fourths hold academic appointments at medical schools in the area in which they are working as public psychiatrists.
Career Choice↗
Online randomized controlled trial of brief and full cognitive behaviour therapy for depression.
BACKGROUND: Effective internet-based programs for depression usually incorporate a component that provides telephone or email contact. Open access websites, without such contact, show high rates of attrition and poorer outcomes. The present study was designed as an exploratory investigation of the parameters that influence the effectiveness and retention of users on open access websites. We investigated whether brief cognitive behaviour therapy (CBT) was as effective as an extended version, whether add-on components of behaviour therapy or stress management contributed to positive outcomes, and whether longer programs were associated with greater attrition. METHOD: An online randomized controlled trial (RCT) was conducted between 13 January 2005 and 26 May 2005 (19 weeks). A total of 2794 registrants (1846 women and 948 men; median age category 35-44 years) with elevated scores on the Goldberg Depression Scale of 5.96 (S.D.=2.09) elected online to be randomized to one of six versions of a CBT website. The versions were compiled consisting of various components of brief CBT, extended CBT, behaviour strategies, stress management and problem solving. RESULTS: A total of 20.4% of participants completed the assigned intervention. The interaction of measurement occasion and treatment version was significant [F(13,131)=2.20, p=0.01]. A single module of brief introductory CBT was not effective in reducing depression symptoms. However, extended CBT with or without the addition of behaviour strategies resulted in the reduction of depression. CONCLUSIONS: Brief CBT-based interventions are not as effective as extended interventions. However, longer programs are associated with higher rates of dropout.
Adult↗
Towards an understanding of nuclear morphogenesis.
In the age of "virtual reality," the imperfect microscopic silhouettes of cells and organelles are gradually being replaced by calligraphic computer drawings. In this context, textbooks and introductory slides often depict the cell nucleus as a smooth-shaped, featureless object. However, in reality, the nuclei of different cells possess distinct sizes and morphological features which develop in a programmed fashion as each cell differentiates. To dissect this complex morphogenetic process, we need to identify the basic elements that determine nuclear architecture and the regulatory factors involved. Recently, clues about the identity of these components have been obtained both by systematic analysis and by serendipity. This review summarizes a few recent findings and ideas that may serve as a first forum for future discussions and, I hope, for further work on this topic.
Adaptation, Physiological↗
Operant learning principles applied to teaching introductory statistics.
A grade of A was given in an introductory statistics course for meeting a set of contingencies that included no work outside of class (except by request), near-perfect performance on exams following each unit of work in a programmed text, correction of all exam errors, self pacing of work, and the chance to finish the course early. A grade of incomplete was given otherwise. Correlations among performance measures failed to show any meaningful relationships between time taken to finish the course, errors made on exams, and errors made in the programmed text. Responses to a five-part questionnaire were overwhelmingly favorable to the course, but did not vary as a function of grade point average, time taken to finish the course, or number of errors made on exams. The uniformly high level of performance, the students' lack of interest in social contact with the instructor during class, and the absence of drop-outs are all attributed to the contingencies employed, chief among which, according to the instructor's judgment and student rankings, were self-pacing, frequent non-punitive exams and a guaranteed grade of A for near-perfect work at every stage.
Journal Article↗
Computer applications in clinical nutrition.
The computer can help the clinical nutrition specialist become a productive, visible, and important professional. Currently available programs perform nutrient analysis of dietary intakes, menus, and recipes; offer simple forms of nutritional assessment, and provide creative educational applications. Many possibilities exist for new applications. Beginners are advised to acquire introductory skills and experience before initiating a computer application.
Computers↗