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A survey has been conducted of cancer education programs for medical students in United States medical schools by the American Association for Cancer Education with grant support from the Department of Detection and Treatment of the American Cancer Society (formerly the Professional Education Department). Two questionnaires were used, an Educational Resources Questionnaire (ERQ), which 126 of the 128 medical schools completed and returned, and a Faculty and Curriculum Questionnaire (FCQ), which was completed and returned by 1,035 faculty members who had been named as active in undergraduate medical student cancer education by respondents in each school who had been designated by the Dean's Office to complete the ERQ. Overall conclusions included: (1) increased coordination of cancer education activities is a major need in many schools; (2) there is widespread interest in the further development of cancer education objectives; (3) development of a national cancer education curriculum is needed; (4) there is interest in the development of improved instructional materials and methods; (5) development of evaluation methods is needed for cancer education programs; and (6) an ongoing funding process is needed to provide support for interdepartmental coordination of cancer education activities. Cancer prevention and detection topics were ranked above cancer treatment in plans for future curriculum emphasis. More detailed conclusions and recommendations are provided in this publication and three subsequent articles in this issue of the Journal of Cancer Education.
BACKGROUND: Because of the unpredictability people with arthritis face on a daily basis, patient education programmes have become an effective complement to traditional medical treatment giving people with arthritis the strategies and the tools necessary to make daily decisions to cope with the disease. OBJECTIVES: To assess the effectiveness of patient education interventions on health status in patients with rheumatoid arthritis. SEARCH STRATEGY: We searched MEDLINE, EMBASE and PsycINFO and the Cochrane Controlled Trials Register. A selection of review articles (see references) were examined to identify further relevant publications. There was no language restriction. SELECTION CRITERIA: Randomised controlled trials (RCT's) evaluating patient education interventions that included an instructional component and a non-intervention control group; pre- and post-test results available separately for RA, either in the publication or from the studies' authors; and study results presented in full, end-of-study report. MAIN RESULTS: Twenty-four studies with relevant data were included. We found significant effects of patient education at first follow-up for scores on disability, joint counts, patient global assessment and psychological status. Physician global assessment was not assessed in any of the included studies. The two separate dimensions of psychological status: anxiety and depression showed no significant effects, nor did the dimensions of pain and disease activity. At final follow up no significant effects of patient education were found. REVIEWER'S CONCLUSIONS: Patient education as provided in the studies reviewed here had moderate short-term effects on patient global assessment, and small short-term effects on disability, joint counts and psychological status. There were no long-term benefits.
BACKGROUND: The models that have been used so far to describe the process underlying educational attainment have been almost always linear. Little research has been aimed at studying interactions among the determinants of educational attainment. AIM: The aim of the study is to examine the interactions between parents' education, cognitive ability and educational expectations in determining educational attainment. SAMPLE: Participants were 8570 Americans who were born between 1957 and 1964. METHOD: The information was taken from the National Longitudinal Survey of Youth. Information about parents' education, cognitive ability and educational expectations was taken from the 1979 survey. Information about educational attainment was taken from the 1991 survey. RESULTS: The findings indicate that there is an offsetting relationship between the education of the two parents in the formation of expectations, but not in the determination of attainment; and that, both for expectations and for attainment, the cognitive ability of the child has an offsetting relationship with mother's education but not with father's education. The findings also indicate that there is a synergistic relationship between cognitive ability and educational expectations in determining educational attainment. CONCLUSIONS: There are theoretically meaningful interactions between the determinants of educational attainment. The pattern of these interactions capture some of the intricate psychological processes underlying the combined influence of background variables and children's characteristics on educational attainment.
PURPOSE: This study assessed diabetes educators' perspectives on barriers that potentially affect patient access to and utilization of diabetes education. METHODS: A 40-item questionnaire was developed to collect needs assessment data on diabetes education programs. The questionnaire was mailed to a Washington State professional practice group in diabetes education (N = 143). RESULTS: Most respondents were registered nurses (61%) or registered dietitians (27%); 74% were certified diabetes educators. The educators' perceptions of the difficulty that type 1 versus type 2 patients experience in different areas of self-management after diabetes education underscored the importance of learning effective long-term skills for self-care. Some of the reasons given for type 2 patients dropping out of diabetes education programs were also cited as barriers to conducting follow-up, such as education being a low priority for the patient and the patient not being able to afford diabetes care services. CONCLUSIONS: Educators appeared to relate many patient barriers to a lack of patient understanding of the evolving nature of diabetes and the subsequent need for educational support. The role of continuing education for all patients needs to be emphasized to the patient during the initial education, as well as to the healthcare community and the patient's support network.
The educational attainment of general practitioners in the west of Scotland region who subscribed to a centrally organized educational scheme for the postgraduate education allowance was compared with that of their colleagues who did not subscribe to the scheme. During the year studied (1990-91) 1712 of the 1830 principals in general practice in the region had sufficient sessions to claim their postgraduate education allowance. Of these 1712 doctors the 1353 who subscribed to the educational scheme attended a mean of 15.7 educational half day sessions during the study year in comparison with a mean of 12.5 half days attended by the 359 doctors who did not subscribe to the scheme. This difference was observed in all three categories of education--disease management, service management and health promotion--and was greatest in health promotion where subscribers attended a mean of 4.7 half days and non-subscribers 3.1. The doctors who were members of the scheme had achieved a better balance of education. A higher number had attended an educational day in each of the three categories, with the increase being 10.5% for subscribers versus non-subscribers for disease management, 20.0% for service management and 39.1% for health promotion. The differences between the two groups were greater for combinations of categories and 66.6% of subscribers had attended an educational day in each of the three categories compared with 40.9% of non-subscribers. A centrally organized educational scheme for a region can give a balanced spread of education and is likely to meet the educational requirements of the new contract for general practitioners.
The development of the Best Evidence Medical Education (BEME) Collaboration is introduced in the context of other systematic review initiatives, specifically the Cochrane and Campbell collaborations. The commentary addresses two goals: to describe the current status of BEME and to situate BEME in the broader context of the medical education community's need to be accountable, to conduct research to understand educational processes and results, and the key role that medical educational research must play within the quality-improvement agenda. Lessons drawn from the evidence-based practice movement of the last ten years and the current experience with BEME suggest that, although BEME will inform some educational policies and practices, its initial success may be limited because of the paucity of studies that meet current standards for evidence and the great difficulty in conducting methodologically rigorous studies in the complex social interaction called education. Nonetheless, the need exists for medical education research to continue to address key issues in medical education using experimental designs, while at the same time anticipating the need for more situation-specific data to permit educators to monitor and benchmark their existing programs within a quality-improvement and accountability framework. The authors conclude that the very nature of being professional in today's social and fiscal context demands that medical educators provide evidence of effectiveness and efficiency of their programs while at the same time BEME and medical education research continue to grow and mature.
This article presents results from a study focusing on Norwegian nurse educators' opinions of the importance and application of different nurse educator competence domains. The sample consisted of all nurse educators in Norway (N = 828). The Ideal Nursing Teacher Questionnaire was used to assess nurse educator competence. The questionnaire was returned by 348 nurse educators, yielding a response rate of 42%. Results show both teacher competence and nursing competence were rated more important than evaluation skills, personality factors, and relationship with students. Correlation analyses (Pearson's r) between the ratings of how important the educator assessed the statement of a good teacher and whether the statement was applied in practice showed in general few and weak relationships. Multivariate classification analyses (ANCOVA), controlling for age, showed teachers who have more than 10 years experience in education report the relationship with student domain as more important than those with shorter careers in education. Determination of the relative importance and application of different competency domains in nursing education has implications for graduate level nursing curriculum development, as well as for professional development activities for nurse educators.
Current health care policy and practice contexts in the UK point to the importance of nurses' ability to make an effective contribution to educating patients about medication, as part of their role in health education and health promotion. Nurses' potential contribution to this important activity will inevitably be dependent on knowledge and skills acquired during preregistration and postregistration programmes of education. Against this backdrop, changes in pre and postregistration nurse education in the UK in the past decade highlight the importance and timeliness of evaluating the adequacy of educational preparation for a medication role. This paper reports on the findings from an evaluation of UK educational preparation for a medication education role in practice. A case study design was used to investigate current educational preparation at three education institutions. Multiple methods of data collection at each site involved focus group discussions with lecturers and practitioners, individual interviews with key personnel, nonparticipant observation of teaching sessions, postobservation interviews with students and curriculum analysis. Findings highlighted the importance of a number of dimensions of preparation for practice of such a role: the need for sufficient taught pharmacology; opportunities for application and integration of prerequisite knowledge and skills; the importance of practice-based learning; the need for an evidence-based curriculum, and the importance of clarifying outcomes and competencies required for a medication education role within pre and postregistration curricula. The paper concludes with a discussion and implications of the findings.
The RIPPLE study is a randomized controlled trial of peer-led sex education in English secondary schools. In 1997, 27 schools were recruited and randomly allocated to a programme of peer-led sex education or to act as control schools. In experimental schools peer educators in Year 12 (aged 16/17 years) were recruited in two successive cohorts and, having received a standardized training programme, delivered classroom-based sex education sessions to Year 9 students (aged 13/14 years). This paper is the first of two focusing on data gathered from these peer educators. Through analysis of pre-(n = 505) and post- (n = 331) programme questionnaire data, the paper describes the profile of peer educators and examines the impact on them of their involvement. Compared to the students receiving the peer-led sex education, more peer educators were female, white, high academic achievers and less socially disadvantaged. Peer educators reported positive changes in sexual knowledge and changes towards more liberal attitudes, and believed the programme would have a positive impact on their confidence in relationships and on their sexual behaviour. There was an increase in confidence about communication and interaction in groups. The paper discusses the methodological difficulties of assessing how involvement in such a programme impacts on peer educators.
AIM: The aim of this paper is to discuss the opinions of the key individuals involved in implementing the integration of nurse education into higher education in the United Kingdom (UK) about why nurse education moved into higher education and why this happened when it did. BACKGROUND: In 1995 the last of the old-style schools of nursing in the UK was fully integrated into higher education and were detached financially, legally and organizationally from District Health Authorities. However, only 6 years before, when Working Paper 10 was produced, there were only a few nursing degree courses located within higher education. What made this move into higher education particularly noteworthy was that there was never a clear statement of intent from the government that this integration of health care education was intended. Despite the fact that this is one of the most significant changes ever to take place in nurse education, there has been relatively little empirical research about why the development occurred. METHODS: A qualitative approach was selected for this study and the methods used were policy analysis and interviews. A purposeful sample of 70 implementers involved in the integration process was selected and asked for their views on this issue. FINDINGS: Participants believed that integration had occurred because of a combination of complex factors, but there was a division between those who thought that it was centrally planned and others who felt that it was an accidental outcome of the particular events of the time. CONCLUSIONS: It is not clear whether policy was influencing action or action influencing policy. Understanding of why this change occurred is needed if health care professionals wish to have greater control over future changes in education.
School-based health education can help young people develop the knowledge, skills, motivation, and support they need to choose health-enhancing behaviors and resist engaging in behaviors that put them at risk for health and social problems and school failure. The health of school-age youth is significantly associated with their school achievement. However, in the midst of today's increased emphasis on school accountability in the areas of reading, writing, and mathematics, subject areas such as health education tend to receive less prominence in the school curriculum. Recalling their own lackluster school experiences related to health topics, decision makers may not realize that today's skills-based school health curriculum involves a highly interactive and engaging approach to promoting good health and preventing the most serious health problems among youth. Health education is one important component of a coordinated school health program that includes health education, physical education, school health services, nutrition services, school counseling and psychological services, a healthy school environment, school promotion for faculty and staff, and involvement of family and community members. The purpose of this PowerPoint presentation--Healthy Keiki, Healthy Hawaii: Hawaii's "7 by 7" for School Health Education--is to educate health and education decision makers, teachers, parents, and community members on how Hawaii has integrated seven health education standards with seven priority health content areas to create an effective approach to school health education in grades kindergarten through 12. The goal of Hawaii's "7 by 7" curriculum focus is to ensure that all of Hawaii's keiki (children) have well-planned opportunities at school to become fit, healthy, and ready to learn.
This paper presents the rationale, theoretical developments and operationalization of the role of contexts of care and education in practice, choice of methods and effects of patient education in chronic diseases. Starting from a review on the evolution of models of care, education and health education, and on the influence of characteristics of organization of care, it proposes an analysis model of contexts of care and education. A study carried out in 1993 in 10 Belgian and northern France hospitals, with 400 patients, is presented. Simultaneously, pre-post test evaluations of the effects of current patient education work on 40 compliance factors, and in-depth analyses of contexts of care and education were undertaken. The possible relationship between variety and number of effects of education and type of care and education is examined and discussed.
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Health education professional preparation programs were surveyed to determine the extent of HIV/AIDS education health educators are receiving. The survey also addressed content areas, skills being developed or enhanced, areas of deficiency in preparation programs, and areas in which national professional associations may assist in the preparation of AIDS educators. One hundred eight-three surveys were mailed; 114 (68%) were completed and returned. Twenty-one institutions reported planning a separate course on HIV/AIDS. Most were designing general service courses to reach a broad cross-section of students. Twenty-five institutions (23.8%) reported previously offering or currently offering a specific course on AIDS. One hundred two (89.5%) respondents reported HIV/AIDS warranted the attention and funding it had received. Thirty-seven (35.2%) respondents reported AIDS education was of sufficient importance to influence hiring of faculty members in their departments. Survey findings demonstrate that current AIDS education courses targeted to the general student population may not be adequate in meeting the professional preparation needs of health educators charged to provide AIDS education.
A survey assessed the perceptions of 1350 Zambian teachers and parents and 512 Finnish teachers regarding inclusive education and consequently the best placement for children with different disabilities. On the whole, perceptions varied but were quite critical. On inclusion in general, the regular (also termed "ordinary") Finnish teachers were the most critical group and the Finnish special education teachers the most optimistic. Most respondents felt that inclusive education enhances social justice. However, the pursuit of inclusion in practice, especially the guarantee of good and effective education for all, was seen as problematic. Compared with Finnish respondents, the Zambian respondents preferred a more segregated educational environment for children with different disabilities. Type and severity of disability affected the preferred educational setting and there were clear differences in this regard between the respondents from the two countries. The findings support the idea that educators' attitudes towards inclusion are important in developing inclusive school systems and that inclusive education is best understood as a multidimensional concept that, at the practical level, is highly context-dependent.
The study presents information on why teacher educators in deaf education move from school classrooms to universities. These educators' priorities as university faculty are examined in regard to teaching, scholarship, and service; their scholarly productivity and perceptions of workplace conditions in school and university environments are studied. Findings show that these schoolteachers moved to higher education for various reasons, but primarily to pursue research and a scholarly life, and to have a greater influence on deaf and hard of hearing children and deaf education. As faculty, they are most interested in and committed to teaching; they publish at a modest rate. These educators perceive workplace conditions that support autonomy, flexible schedules, collegiality, and decision-making opportunities as more evident in university environments than in school environments. The researchers discuss the need for teacher educators in deaf education to pursue scholarly interests and to consider working with colleagues at the university and in schools to design collaborative research. Universities' need to support these efforts is also discussed.