Sample records for clinical education setting

  1. Nursing students’ experiences of clinical education setting

    Directory of Open Access Journals (Sweden)

    Rahnama M


    Full Text Available Background and Objective: Appropriate clinical environment has an important role in preparing students to use learned knowledge in practice through providing learning opportunities. Since the students’ experiences in the clinical setting affect on quality of their learning, the current study aimed to explain the experiences of nursing students concerning clinical education setting. Materials and Method: The current study was conducted based on conventional content analysis. Sampling was done purposively and the participants were 13 last year nursing students in Zabol Nursing and Midwifery School in 2013-2014. Data collection was done through in-depth semi-structured interviews. Data analysis was conducted through qualitative content analysis approach. Results: Based on the results, five major categories including threats, vision, dual forces, mindset and students’ action to clinical education and also10 subcategorie were identified. Conclusion: Since the formation of students’ experiences in these environments is one of the predictive factors in achieving their learning and in facilitating the professionalization process, thus the attention of managers in clinical settings is very important for decreasing the threats and concerns for students. In this way, the marred prospects of profession can be recovered through the meeting students’ expectations, attractiveness of the profession can be increased and the positive belief, actions and feelings can be created in students.

  2. Selection and Evaluation Guidelines for Clinical Education Settings in Athletic Training. (United States)

    Weidner, Thomas G.; Laurent, Tim


    OBJECTIVE: To develop and test standards and associated criteria for the selection and evaluation of a clinical education setting in athletic training. DESIGN AND SETTING: A previously validated set of 20 standards for physical therapy clinical education settings, the associated criteria, and 2 related evaluation forms were systematically judged, revised, and adapted through a survey process. SUBJECTS: Program directors, clinical instructors, and students involved with athletic training clinical education from 28 athletic training education programs approved by the National Athletic Trainers' Association or accredited by the Commission on Accreditation of Allied Health Education Programs. MEASUREMENTS: We tabulated respondents' critiques and ratings by type of respondent. Items were judged as to whether they were relevant, practical, and suggestive of high-quality clinical education settings. RESULTS: We accepted a final set of 12 standards and 31 associated criteria to measure these standards. The student form lists 23 criteria relevant to these accepted standards. The accepted standards include the following: learning environment, program planning, ethical standards, administrative support, and Setting Coordinator of Clinical Education. CONCLUSIONS: The 12 standards, criteria, and related forms developed in this research project should be used as guidelines rather than as minimal requirements. They could be helpful in forming an impression not only about a particular clinical setting but also about the requirements of clinical education in general. Further research should include evaluating and comparing perceptions between sexes and among ethnic groups concerning their clinical education experiences. Also, standards and criteria for clinical instruction in athletic training should be systematically developed.

  3. Educational Preparation for the Clinic Job Setting: Clinical Athletic Trainers' Perspectives (United States)

    Schilling, Jim; Combs, Martha


    Context: Acquiring input from all stakeholders on the importance of existing competencies and suggestions for new ones is essential to competency-based pedagogical design quality. Objective: To survey athletic trainers (ATs) employed in clinical settings to assess their perceptions of the competencies most pertinent to their settings and whether…

  4. Exploring the Role and Skill Set of Physiotherapy Clinical Educators in Work-Integrated Learning (United States)

    Edgar, Susan; Connaughton, Joanne


    Clinical educators are under increasing pressures in the workplace to provide quality education of healthcare students within varying supervision frameworks. Along with facilitating the teaching of clinical skills, clinical educators play a support role for students and so require more than expert clinical abilities in their vital position linking…

  5. Interprofessional education and practice guide No. 5: Interprofessional teaching for prequalification students in clinical settings. (United States)

    Lie, Désirée A; Forest, Christopher P; Kysh, Lynn; Sinclair, Lynne


    The importance of interprofessional education in health professions training is increasingly recognised through new accreditation guidelines. Clinician teachers from different professions may find themselves being asked to teach or supervise learners from multiple health professions, focusing on interprofessional dynamics, interprofessional communication, role understanding, and the values and ethics of collaboration. Clinician teachers often feel prepared to teach learners from their own profession but may feel ill prepared to teach learners from other professions. In this guide, we draw upon the collective experience from two countries: an institution from the United States with experience in guiding faculty to teach in a student-run interprofessional clinic and an institution from Canada that offers interprofessional experiences to students in community and hospital settings. This guide offers teaching advice to clinician educators in all health professions who plan to or already teach in an interprofessional clinical setting. We anticipate that clinician teachers can learn to fully engage learners from different professions, precept effectively, recognise common pitfalls, increase their confidence, reflect, and become role models to deliver effective teaching in interprofessional settings.

  6. Interprofessional education through shadowing experiences in multi-disciplinary clinical settings

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    Moore Ainsley E


    Full Text Available Abstract The World Health Organization has recently added Interprofessional Education (IPE to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE. Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.

  7. Strategic planning in medical education : enhancing the learning environment for students in clinical settings

    NARCIS (Netherlands)

    Gordon, J; Hazlett, C; ten Cate, O; Kilminster, S; Prince, K; O'Driscoll, E; Snell, L; Newble, D


    Background The 1999 Cambridge Conference was held in Northern Queensland, Australia, on the theme of clinical teaching and learning. It provided an opportunity for groups of academic medical educators to consider some of the challenges posed by recent changes to health care delivery and medical educ

  8. The primary care clinic as a setting for continuing medical education: program description. (United States)

    Pérez-Cuevas, R; Reyes, H; Guiscafré, H; Juárez-Díaz, N; Oviedo, M; Flores, S; Muñoz, O


    The Mexican Institute of Social Security (IMSS) is Mexico's Largest state-financed health care system, providing care to 50 million people. This system comprises 1450 family medicine clinics staffed by 14,000 family physicians, as well as 240 secondary care hospitals and 10 tertiary care medical centres. We developed a program of continuing medical education (CME) for IMSS family physicians. The program had 4 stages, which were completed over a 7-month period: development of clinical guidelines, training of clinical instructors, an educational intervention (consisting of interactive workshops, individual tutorials and peer group sessions), and evaluation of both physicians' performance and patients' health status. The pilot study was conducted in an IMSS family medicine clinic providing care to 45,000 people; 20 family physicians and 4 clinical instructors participated. The 2 main reasons for visits to IMSS family medicine clinics are acute respiratory infections and type 2 diabetes mellitus. Therefore, patients being treated at the clinic for either of these illnesses were included in the study. The sources of data were interviews with physicians and patients, clinical records and written prescriptions. A 1-group pretest-posttest design was used to compare physicians' performance in treating the 2 illnesses of interest. We found that the daily activities of the clinic could be reorganized to accommodate the CME program and that usual provision of health care services was maintained. Physicians accepted and participated actively in the program, and their performance improved over the course of the study. We conclude that this CME strategy is feasible, is acceptable to family physicians and may improve the quality of health care provided at IMSS primary care facilities. The effectiveness and sustainability of the strategy should be measured through an evaluative study.

  9. Early childhood hearing loss: clinical and molecular genetics. An educational slide set of the American College of Medical Genetics. (United States)

    Alford, Raye L; Friedman, Thomas B; Keats, Bronya J B; Kimberling, William J; Proud, Virginia K; Smith, Richard J H; Arnos, Kathleen S; Korf, Bruce R; Rehm, Heidi L; Toriello, Helga V


    An educational slide set entitled "Early Childhood Hearing Loss: Clinical and Molecular Genetics" is offered by the American College of Medical Genetics (ACMG). The slide set is produced in Microsoft PowerPoint 2002. It is extensively illustrated and supported with teaching tools, explanations of each slide and figure, links to Internet resources, and a bibliography. The slide set is expected to be used as a resource for self-directed learning and in support of medical genetics teaching activities. The slide set is available through the ACMG ( for $20, plus applicable tax and shipping. It is the first in a series of educational slide sets to be developed by the ACMG.

  10. Opening Options: Making Field Education Work in a Private Practice Clinic Setting (United States)

    Mooradian, John K.; Knaggs, Constance; Hock, Robert; LaCharite, David


    This article describes the use of social work field placements in a private practice setting to prepare MSW students for clinical work. The authors used "autoethnography", which is personal narrative that explores the writer's experience of life, to describe interpersonal and contextual characteristics, as well as procedures implemented to conduct…

  11. Nursing Education Interventions for Managing Acute Pain in Hospital Settings: A Systematic Review of Clinical Outcomes and Teaching Methods. (United States)

    Drake, Gareth; de C Williams, Amanda C


    The objective of this review was to examine the effects of nursing education interventions on clinical outcomes for acute pain management in hospital settings, relating interventions to health care behavior change theory. Three databases were searched for nursing education interventions from 2002 to 2015 in acute hospital settings with clinical outcomes reported. Methodological quality was rated as strong, moderate, or weak using the Effective Public Health Practice Project Quality Assessment Tool for quantitative studies. The 12 eligible studies used varied didactic and interactive teaching methods. Several studies had weaknesses attributable to selection biases, uncontrolled confounders, and lack of blinding of outcome assessors. No studies made reference to behavior change theory in their design. Eight of the 12 studies investigated nursing documentation of pain assessment as the main outcome, with the majority reporting positive effects of education interventions on nursing pain assessment. Of the remaining studies, two reported mixed findings on patient self-report of pain scores as the key measure, one reported improvements in patient satisfaction with pain management after a nursing intervention, and one study found an increase in nurses' delivery of a relaxation treatment following an intervention. Improvements in design and evaluation of nursing education interventions are suggested, drawing on behavior change theory and emphasizing the relational, contextual, and emotionally demanding nature of nursing pain management in hospital settings.

  12. Mobile Learning in a Rural Medical School: Feasibility and Educational Benefits in Campus and Clinical Settings

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    Debra Nestel


    Full Text Available Students in a new medical school were provided with laptops. This study explored the feasibility and educational benefits of mobile learning for two cohorts of students learning in two settings—university campus (first-year students and rural clinical placements (second-year students. Evaluation involved questionnaires, focus groups (faculty and students, and document analysis. Descriptive statistics were computed. Focus groups were audio-recorded, transcribed, and analysed thematically. Response rates for questionnaires exceeded 84%. Compared with second-year students, significantly more first-year students (60% took their laptops to campus daily (P=0.14 and used their laptops for more hours each day (P=0.031. All students used laptops most frequently to access the internet (85% and 97% and applications (Microsoft Word (80% and 61% and Microsoft PowerPoint (80% and 63%. Focus groups with students revealed appreciation for the laptops but frustration with the initial software image. Focus groups with faculty identified enthusiasm for mobile learning but acknowledged its limitations. Physical infrastructure and information technology support influenced mobile learning. Document analysis revealed significant costs and issues with maintenance. If adequately resourced, mobile learning through university-issued laptops would be feasible and have educational benefits, including equitable access to learning resources, when and where they are needed. However, barriers remain for full implementation.

  13. Interprofessional education in the clinical setting: A qualitative look at the preceptor's perspective in training advanced practice nursing students. (United States)

    Chen, Angel K; Rivera, Josette; Rotter, Nicole; Green, Emily; Kools, Susan


    With the shift towards interprofessional education to promote collaborative practice, clinical preceptors are increasingly working with trainees from various professions to provide patient care. It is unclear whether and how preceptors modify their existing precepting approach when working with trainees from other professions. There is little information on strategies for this type of precepting, and how preceptors may foster or impede interprofessional collaboration. The purpose of this qualitative description pilot study was to identify current methods preceptors use to teach trainees from other professions in the clinical setting, particularly advanced practice nursing and medical trainees, and to identify factors that support or impede this type of precepting. Data collected through observations and interviews were analyzed by the research team using thematic analysis procedures. Three major themes were identified: 1) a variety of teaching approaches and levels of engagement with trainees of different professions, 2) preceptor knowledge gaps related to curricula, goals, and scope of practice of trainees from other professions, and 3) administrative, structural and logistical elements that impact the success of precepting trainees from different professions in the clinical setting. This study has implications for faculty development and evaluation of current precepting practices in clinical settings.

  14. AMTA Monograph Series - Effective Clinical Practice in Music Therapy Early Childhood and School Age Educational Settings (United States)

    Humpal, Marcia Earl, Ed.; Colwell, Cynthia, Ed.


    Educators, families, and media in increasing numbers are recognizing the unique role music plays in young children's development. More and more daycare, preschool, and early intervention centers offer employment opportunities that reflect the needs and attitudes of our ever-changing society. Furthermore, Federal and state regulations, a changing…

  15. The Impact of Structured Inter-professional Education on Health Care Professional Students' Perceptions of Collaboration in a Clinical Setting. (United States)

    Pinto, Alison; Lee, Sam; Lombardo, Samantha; Salama, Mariam; Ellis, Sandi; Kay, Theresa; Davies, Robyn; Landry, Michel D


    Purpose: To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. Methods: This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. Results: There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. Conclusions: Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students.

  16. Fuzzy Sets and Mathematical Education. (United States)

    Alsina, C.; Trillas, E.


    Presents the concept of "Fuzzy Sets" and gives some ideas for its potential interest in mathematics education. Defines what a Fuzzy Set is, describes why we need to teach fuzziness, gives some examples of fuzzy questions, and offers some examples of activities related to fuzzy sets. (MDH)

  17. The Use of Sexually Explicit Material in Clinical, Educational and Research Settings in the United Kingdom and Its Relation to the Development of Psychosexual Therapy and Sex Education (United States)

    Brewster, Marnie; Wylie, Kevan R.


    The present review describes the development and use of sexually explicit material in sex education within UK psychosexual therapy clinics, medical schools and also in state-maintained secondary schools with reference to interests that have shaped the provision of sex education since the early twentieth century. A short summary of published books…

  18. A new online software tool for pressure ulcer monitoring as an educational instrument for unified nursing assessment in clinical settings

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    Andrea Pokorná


    Full Text Available Data collection and evaluation of that data is crucial for effective quality management and naturally also for prevention and treatment of pressure ulcers. Data collected in a uniform manner by nurses in clinical practice could be used for further analyses. Data about pressure ulcers are collected to differing degrees of quality based on the local policy of the given health care facility and in relation to the nurse’s actual level of knowledge concerning pressure ulcer identification and use of objective scales (i.e. categorization of pressure ulcers. Therefore, we have developed software suitable for data collection which includes some educational tools to promote unified reporting of data by nurses. A description of this software and some educational and learning components of the tool is presented herein. The planned process of clinical application of the newly developed software is also briefly mentioned. The discussion is focused on the usability of the online reporting tool and possible further development of the tool.

  19. Setting Goals for Achievement in Physical Education Settings (United States)

    Baghurst, Timothy; Tapps, Tyler; Kensinger, Weston


    Goal setting has been shown to improve student performance, motivation, and task completion in academic settings. Although goal setting is utilized by many education professionals to help students set realistic and proper goals, physical educators may not be using goal setting effectively. Without incorporating all three types of goals and…

  20. 34 CFR 104.34 - Educational setting. (United States)


    ... 34 Education 1 2010-07-01 2010-07-01 false Educational setting. 104.34 Section 104.34 Education... Preschool, Elementary, and Secondary Education § 104.34 Educational setting. (a) Academic setting. A... educational environment operated by the recipient unless it is demonstrated by the recipient that...

  1. Bullying in Early Educational Settings (United States)

    Kirves, Laura; Sajaniemi, Nina


    The aim of this research was to study the prevalence of bullying in early educational settings in Finnish kindergartens. In addition, the study investigated whether bullying in kindergartens differs from school bullying and what forms bullying takes among under-school-age children. Two kinds of data were collected for the study: data from a survey…

  2. 45 CFR 84.34 - Educational setting. (United States)


    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Educational setting. 84.34 Section 84.34 Public... Secondary Education § 84.34 Educational setting. (a) Academic setting. A recipient to which this subpart... handicapped person. A recipient shall place a handicapped person in the regular educational...

  3. 7 CFR 15b.23 - Educational setting. (United States)


    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Educational setting. 15b.23 Section 15b.23 Agriculture... Education § 15b.23 Educational setting. (a) Academic setting. A recipient to which this subpart applies... handicapped person. A recipient shall place a handicapped person in the regular educational...

  4. 45 CFR 605.34 - Educational setting. (United States)


    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Educational setting. 605.34 Section 605.34 Public..., Elementary, and Secondary Education § 605.34 Educational setting. (a) Academic setting. A recipient to which... needs of the handicapped person. A recipient shall place a handicapped person in the regular...

  5. [Midwifery clinical practicum education]. (United States)

    Kao, Chien-Huei; Gau, Meei-Ling


    Midwifery is a practical facet of the health sciences that emphasizes professional competence-oriented teaching and learning. Cognitive and practical processes integrate and build midwifery student professional knowledge, attitudes, and skills. Clinical education is a teaching method and strategy used to prepare midwifery students for professional practice. Midwifery clinical teaching plans are designed using literature review, expert opinions, and student comments and determine total required hours and caseloads. Midwifery clinical teaching activities and methods promote self-reflection, childbirth education fundamentals, learning by role model observation, and learning role function through overseas observership programs. This paper discusses midwifery education dilemmas and coping methods in Taiwan.

  6. Curriculum Revolution: Reconceptualizing Clinical Nursing Education. (United States)

    Lindeman, Carol A.


    While the clinical competence of the nurse is taking on greater importance, the clinical laboratory settings are changing in ways that detract from their suitability for use in entry-level programs. Initial consideration of the health care setting reveals several paradoxes that must be resolved if clinical education is to be affected. (JOW)

  7. Clinical supervision in a community setting. (United States)

    Evans, Carol; Marcroft, Emma

    Clinical supervision is a formal process of professional support, reflection and learning that contributes to individual development. First Community Health and Care is committed to providing clinical supervision to nurses and allied healthcare professionals to support the provision and maintenance of high-quality care. In 2012, we developed new guidelines for nurses and AHPs on supervision, incorporating a clinical supervision framework. This offers a range of options to staff so supervision accommodates variations in work settings and individual learning needs and styles.

  8. Educational Needs in the Psychiatric Setting. (United States)

    Sluckin, Andy; Hanna, Bob


    Case studies in Norwich, England, identified issues in the provision of adult education in psychiatric settings: differing definitions of the role of adult education; role conflict between adult educators and health professionals; and opposing beliefs about outsiders entering an institution. The cases also affirmed the therapeutic value of…

  9. Becoming conscious of learning and nursing in clinical settings

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Pedersen, Birthe D.; Helms, Niels Henrik


    Literature shows several benefits of implementing ePortfolio and focusing on learning styles within nursing education. However, there is some ambiguity, so the aim was to investigate learning mediated by the mandatory part of ePortfolio in clinical settings. The design takes a phenomenological......-hermeneutic approach. The setting was a ten-week clinical course in Basic Nursing, and participants were 11 first-year students randomly assigned. Data was generated by participant observations, narrative interviews and portfolio documents. The entire data material was interpreted according to the French philosopher...

  10. 2010 Federal STEM Education Inventory Data Set (United States)

    Office of Science and Technology Policy, Executive Office of the President — This data set provides information for STEM education (pre-kindergarten through graduate) investments funded by Federal agencies at the level of $300,000 or above.

  11. Goal-setting in clinical medicine. (United States)

    Bradley, E H; Bogardus, S T; Tinetti, M E; Inouye, S K


    The process of setting goals for medical care in the context of chronic disease has received little attention in the medical literature, despite the importance of goal-setting in the achievement of desired outcomes. Using qualitative research methods, this paper develops a theory of goal-setting in the care of patients with dementia. The theory posits several propositions. First, goals are generated from embedded values but are distinct from values. Goals vary based on specific circumstances and alternatives whereas values are person-specific and relatively stable in the face of changing circumstances. Second, goals are hierarchical in nature, with complex mappings between general and specific goals. Third, there are a number of factors that modify the goal-setting process, by affecting the generation of goals from values or the translation of general goals to specific goals. Modifying factors related to individuals include their degree of risk-taking, perceived self-efficacy, and acceptance of the disease. Disease factors that modify the goal-setting process include the urgency and irreversibility of the medical condition. Pertinent characteristics of the patient-family-clinician interaction include the level of participation, control, and trust among patients, family members, and clinicians. The research suggests that the goal-setting process in clinical medicine is complex, and the potential for disagreements regarding goals substantial. The nature of the goal-setting process suggests that explicit discussion of goals for care may be necessary to promote effective patient-family-clinician communication and adequate care planning.

  12. Bullying in undergraduate clinical nursing education. (United States)

    Clarke, Colette M; Kane, Deborah J; Rajacich, Dale L; Lafreniere, Kathryn D


    Although a limited number of studies have focused on bullying in nursing education to date, all of those studies demonstrate the existence of bullying in clinical settings, where nursing students undertake a significant amount of their nursing education. The purpose of this study was to examine the state of bullying in clinical nursing education among Canadian undergraduate nursing students (N = 674) in all 4 years of their nursing program. Results suggest that nursing students experience and witness bullying behaviors at various frequencies, most notably by clinical instructors and staff nurses. Third-year and fourth-year students experience more bullying behaviors than first-year and second-year students. Implications for practice include ensuring that clinical instructors are well prepared for their role as educators. Policies must be developed that address the issue of bullying within nursing programs and within health care facilities where nursing students undertake their clinical nursing education.

  13. Strengthening health human resources and improving clinical outcomes through an integrated guideline and educational outreach in resource-poor settings: a cluster-randomized trial

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    Burciul Barry


    Full Text Available Abstract Background In low-income countries, only about a third of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS patients eligible for anti-retroviral treatment currently receive it. Providing decentralized treatment close to where patients live is crucial to a faster scale up, however, a key obstacle is limited health system capacity due to a shortage of trained health-care workers and challenges of integrating HIV/AIDS care with other primary care services (e.g. tuberculosis, malaria, respiratory conditions. This study will test an adapted primary care health care worker training and guideline intervention, Practical Approach to Lung Health and HIV/AIDS Malawi (PALM PLUS, on staff retention and satisfaction, and quality of patient care. Methods/Design A cluster-randomized trial design is being used to compare usual care with a standardized clinical guideline and training intervention, PALM PLUS. The intervention targets middle-cadre health care workers (nurses, clinical officers, medical assistants in 30 rural primary care health centres in a single district in Malawi. PALM PLUS is an integrated, symptom-based and user-friendly guideline consistent with Malawian national treatment protocols. Training is standardized and based on an educational outreach approach. Trainers will be front-line peer healthcare workers trained to provide outreach training and support to their fellow front-line healthcare workers during focused (1-2 hours, intermittent, interactive sessions on-site in health centers. Primary outcomes are health care worker retention and satisfaction. Secondary outcomes are clinical outcomes measured at the health centre level for HIV/AIDS, tuberculosis, prevention-of-mother-to-child-transmission of HIV and other primary care conditions. Effect sizes and 95% confidence intervals for outcomes will be presented. Assessment of outcomes will occur at 1 year post- implementation. Discussion The PALM PLUS trial

  14. Peer Assisted Learning in the Clinical Setting: An Activity Systems Analysis (United States)

    Bennett, Deirdre; O'Flynn, Siun; Kelly, Martina


    Peer assisted learning (PAL) is a common feature of medical education. Understanding of PAL has been based on processes and outcomes in controlled settings, such as clinical skills labs. PAL in the clinical setting, a complex learning environment, requires fresh evaluation. Socio-cultural theory is proposed as a means to understand educational…

  15. A travelers' clinic in an academic setting.


    Cordes, D H; Baca, C T; Grant, K. J.


    The Department of Family and Community Medicine at the University of Arizona has operated a travelers' clinic since 1983, staffed primarily by faculty and residents from the sections of preventive medicine, occupational medicine, and family medicine. We describe the clinic experience in providing preventive medical services to international travelers. Summer months are the busiest. Destinations of the travelers show a clear predominance of travel to less-developed countries, and this is refle...

  16. The moral development of baccalaureate nursing students: understanding unethical behavior in classroom and clinical settings. (United States)

    Baxter, Pamela E; Boblin, Sheryl L


    Unethical behavior in both classroom and clinical settings is a concern for nurse educators and has the potential to greatly influence the quality of patient care. A review of the literature suggests that students may view unethical clinical behaviors as different from unethical classroom behaviors because they recognize that clinical behaviors may have a direct effect on patient care. An overview of three moral theories, proposed by Kohlberg, Gilligan, and Rest, provides insight into the reasons for unethical behavior. These theories provide the foundation for strategies nurse educators can use to help reduce unethical behavior in both classroom and clinical settings in an attempt to ensure quality patient care.

  17. Boundary Crossings and Violations in Clinical Settings

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    V K Aravind


    Full Text Available Principles of beneficence, autonomy, and nonmaleficence, compassion along with fiduciary partnership are the core concepts in the doctor-patient relationship in therapeutic settings. There are varieties of reasons for boundary problems. Physicians ignorance, exploitative character, emotional vulnerability moral weakness and similar factors may pave the way for boundary issues resulting in nonsexual or sexual boundary crossings and violations.

  18. Interprofessional clinical education: clinicians' views on the importance of leadership. (United States)

    Missen, Karen; Jacob, Elisabeth R; Barnett, Tony; Walker, Lorraine; Cross, Merylin


    The current shortage of health professionals necessitates new approaches to clinical education that can expand the number of undergraduate students undertaking clinical placements without increasing the burden on clinical staff or placing patients at risk. Interprofessional education has the potential to help increase clinical capacity whilst enriching students' clinical experience. This paper reports on a project which investigated the potential for interprofessional education to increase undergraduate clinical placement capacity in clinical settings. The project utilised an exploratory descriptive methodology to obtain the views of health care professionals about the use of interprofessional education in clinical education at three rural health facilities in Victoria, Australia. Participants (n = 57) had a key role with each health care facility in coordinating and facilitating undergraduate clinical placements. This paper examines the clinicians' views about the central role that leadership plays in actioning interprofessional education in the clinical setting. Whilst interprofessional education was regarded favourably by the majority of participants, data indicated that leadership from education providers, health services, and regulatory authorities was crucial to enable interprofessional education to be implemented and sustained within the clinical learning environment. Without leadership from each of these three spheres of influence, interprofessional education will continue to be difficult to implement for undergraduate students and compromise their exposure to an important aspect of the working life of health care professionals. Such a failure will limit graduates' readiness for collaborative and cross-disciplinary practice.

  19. Ultrasound in clinical setting of secondary hyperparathyroidism. (United States)

    Meola, Mario; Petrucci, Ilaria; Cupisti, Adamasco


    Secondary hyperparathyroidism (sHPT) is one of the most common and serious complications of chronic kidney disease (CKD) and maintenance hemodialysis (MHD). In sHPT, the biology of parathyroid cells changes significantly toward diffuse and nodular hyperplasia. Diagnosis and treatment of sHPT are based on intact parathyroid hormone (i-PTH) serum levels and on the parameters of mineral metabolism. The morphological diagnosis of sHPT relies on 2 complementary imaging techniques: high-resolution ultrasonography with color Doppler imaging (US/CD) and 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy. The main objective of this review is to stimulate nephrologists to use US/CD of the parathyroid glands during the progression of CKD in order to aid clinical, pharmacological and surgical strategies. The primary role of US/CD in sHPT should be to integrate the clinical diagnosis by defining the number and volume of hyperplastic glands, although the international guidelines do not state when and why to perform US/CD. This review also evaluates the role of US/CD in clinical follow-up and assessment of therapeutic response of sHPT, and it highlights how US/CD can evaluate the effect of therapy with phosphate binders, vitamin D or its analogues and calcimimetics, which are changing the natural history of sHPT and the frequency of parathyroidectomy. Evaluation of the morphological and vascular changes of hyperplastic parathyroids is useful to guide percutaneous ethanol injection therapy and to support clinical, pharmacological and surgical strategies. Epidemiological studies are needed to establish how US/CD could change the management of sHPT and why it should be repeated in patients with high levels of serum i-PTH.

  20. Do Clinical Librarians Matter? The First Randomized Controlled Trial in Librarianship. A review of: Marshall, Joanne Gard, and Victor R. Neufeld. “A Randomized Controlled Trial of Librarian Educational Participation in Clinical Settings.” Journal of Medical Education 56.5 (1981: 409‐16.

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    Jonathan Eldredge


    Full Text Available Objectives – To determine whether clinical librarian services cause healthcare providers to change their information seeking behaviors. To evaluate librarians’ educational roles for clinicians, patients, and patients’ families.Design – Randomized controlled trial.Setting – An academic, health‐sciences center, teaching hospital in Canada.Subjects – A total of eight teams, each consisting of at least eight members who represented at least three different types of health professionals. Four teams (rheumatology, obstetrics, neurology, and pediatrics were randomized into the intervention group to receive clinical librarian services for a six‐month period,and four teams (hematology, diabetic day care, pain clinic, and community psychiatry were randomized into the control group that did not receive clinical librarian services.Methods – Two half‐time clinical librarians attended the intervention groups’ rounds, clinics, and conferences identified as having educational components or where questions would likely arise related to patient care. The two clinical librarians handled 600perceived or actual information requests, delivered 1,200 documents, and provided over 3,000 references during the twelve month study period of September 1978 to August 1979. The typical service consisted of the clinical librarian securing one or two articles relevant to the question raised along with pertinent references placed in a “hot topics” ring binder located in the clinical wards. Healthcare providers were alerted to or reminded about the clinical librarian service through a brochure and an exhibit. The brochure also advertised the clinical librarian service to patients or their families. Approximately 24% of all information requests fielded by the clinical librarians originated from patients or their families. The remaining information requests originated from physicians (40%, allied health professionals (21%, and nurses (15% belonging to these

  1. Prospective Lymphedema Surveillance in a Clinic Setting

    Directory of Open Access Journals (Sweden)

    Janet Chance-Hetzler


    Full Text Available The potential impact of breast cancer-related lymphedema (LE is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1 time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ; (2 referral to LE management with limb volume increase (LVI and/or LBCQ symptoms; and (3 cost of LE management at lower LVI (≥5%–≤10% versus traditional (≥10%. Findings revealed a visit timeframe mean of 40.3 min (range = 25–60; 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9. LBCQ symptoms and LVI were significantly (p < 0.001 correlated to LE referral; six of the nine patients referred (67% displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings.

  2. Ethnomathematics in non-formal educational settings

    DEFF Research Database (Denmark)

    Pais, Alexandre; Mesquita, Monica

    The push to marry off local and school knowledge has been a growing concern within educational sciences, particularly in mathematics education where a field of studies by the name of ethnomathematics has been producing research around the uses people do of mathematics outside school’s walls....... Notwithstanding the good will of educational agents in bringing to schools local knowledges, criticisms have been made on the sometimes naive way in which such a bridge is theorized and implemented. After a brief description of these criticisms, we present the Urban Boundaries Project as an attempt to avoid...

  3. Revealing the hidden agency of children in a clinical setting

    NARCIS (Netherlands)

    Dedding, C.; Reis, R.; Wolf, B.; Hardon, A.


    Background Interactions with children in clinical settings are often criticized because parents and medical professionals speak for children rather than to them. Such approaches do not take the agency of children into account. Objective First, to examine how children enact agency in a clinical encou

  4. Nursing students’ perspectives on clinical education




    Introduction: The importance of optimal clinical nursing education in professional skills development is undeniable. In clinical education, nursing students are often faced with problems. Recognizing nursing students’ perception on clinical education is the first step to remove the barriers of this challenge. Methods: This descriptive cross-sectional study was conducted to determine the nursing students’ perspectives on clinical education. 150 nursing students were select...

  5. "Set the Pace": Nutrition Education DVD for Head Start Parents (United States)

    Adedze, Pascasie; Orr, Robin A.; Chapman-Novakofski, Karen; Donovan, Sharon M.


    Childhood overweight remains a major public health problem and innovative nutrition education programs are still needed. Thus, the "Set the Pace" is a nutrition education DVD for Head Start parents which provides visual nutrition education and physical activities to incorporate in their daily routines. (Contains 1 table.)

  6. Clinical Pharmacy Education in China (United States)

    Ryan, Melody; Yang, Li; Nie, Xiao-Yan; Zhai, Suo-Di; Shi, Lu-Wen; Lubawy, William C.


    Pharmacy education in China focuses on pharmaceutical sciences, with the bachelor of science (BS) of pharmacy as the entry-level degree. Pharmacy practice curricula in these programs are centered on compounding, dispensing, pharmacy administration, and laboratory experiences, which are the traditional responsibilities for pharmacists. Additional graduate-level training is available at the master of science (MS) and the doctor of philosophy (PhD) levels, most of which concentrate on drug discovery and drug development research. Presently, the emphasis in practice is beginning to shift to clinical pharmacy. With this change, additional degree offerings are being developed to meet the growing demand for clinical pharmacists. There is also interest in developing more clinical skills in practicing pharmacists through additional non-degree training. The Ministry of Education is considering a proposal for an entry-level professional degree of master and/or doctor in clinical pharmacy similar to the doctor of pharmacy (PharmD) degree in the United States. PMID:19325949

  7. Mind-Sets and Equitable Education (United States)

    Dweck, Carol S.


    Much talk about equity in education is about bricks and mortar--about having equal facilities and equal resources. Those factors, although extremely important, are relatively easy to quantify. What may be harder to capture are the beliefs that administrators, teachers, and students hold--beliefs that can have a striking impact on students'…

  8. Crisis Management's New Role in Educational Settings (United States)

    Gainey, Barbara S.


    From natural disasters to the financial debacle, it is clear to the educational community that crises know no boundaries. Far from a passing fad, crisis planning must be an integrated part of effective school district leadership. Two studies explore the status of crisis management in selected public school systems and offer recommendations for…

  9. Democracy and Teacher Education: Setting Priorities (United States)

    Goodman, Jesse H.


    As John Dewey noted in his last book, each generation, in its turn, must assume responsibility as caretaker of democracy. He noted that one should never take democracy for granted. Everyone lives in an imperfect democracy, and teacher educators should play their part in protecting, nurturing, and advancing democratic ideals, rituals, values, and…

  10. Clinical investigation of set-shifting subtypes in anorexia nervosa. (United States)

    Abbate-Daga, Giovanni; Buzzichelli, Sara; Marzola, Enrica; Amianto, Federico; Fassino, Secondo


    While evidence continues to accumulate on the relevance of cognitive inflexibility in anorexia nervosa (AN), its clinical correlates remain unclear. We aimed at examining the relationship between set-shifting and clinical variables (i.e., eating psychopathology, depression, and personality) in AN. Ninety-four individuals affected by AN and 59 healthy controls (HC) were recruited. All participants were assessed using: Eating Disorders Inventory-2 (EDI-2), Temperament and Character Inventory (TCI), Beck Depression Inventory (BDI), and Wisconsin Card Sorting Test (WCST). The AN group scored worse than HCs on set-shifting. According to their neuropsychological performances, AN patients were split into two groups corresponding to poor (N=30) and intact (N=64) set-shifting subtypes. Interoceptive awareness, impulse regulation, and maturity fears on the EDI-2 and depression on the BDI differed across all groups (HC, intact, and poor set-shifting subtype). Self-directedness on the TCI differed significantly among all groups. Cooperativeness and reward dependence differed instead only between HC and AN poor set-shifting subtype. After controlling for depression, only interoceptive awareness remained significant with reward dependence showing a trend towards statistical significance. These findings suggest that multiple clinical variables may be correlated with set-shifting performances in AN. The factors contributing to impaired cognitive inflexibility could be more complex than heretofore generally considered.

  11. Ventrogluteal Site Injections in the Mental Health Setting: A Comprehensive Educational Program. (United States)

    McGee, Helen

    Adoption of the ventrogluteal site for intramuscular injections has been limited in mental health settings despite its decreased risk of sciatic nerve injury and its promotion as best practice among student nurses. At a center for addiction and mental health in Toronto, Canada, registered practical nurses followed a competency checklist in a simulation setting and then observed and administered supervised ventrogluteal injections in clinical settings. This article describes the comprehensive educational program and its outcomes in practice.

  12. Baccalaureate Nursing Students' Communication Process in the Clinical Setting. (United States)

    Kotecki, Catherine Nuss


    Interviews (n=22) and observations (n=14) in clinical settings were coded and analyzed to identify student nurses' problems in communicating with patients and the process of learning solutions. The process involved affirming the self, engaging the patient, experiencing communication breakdown, and refining the repertoire of communication…

  13. Effectiveness of Child Psychoanalytic Psychotherapy in a Clinical Outpatient Setting (United States)

    Deakin, Elisabeth Kuhn; Tiellet Nunes, Maria Lucia


    The objective of this study was to evaluate the outcome of child psychoanalytic psychotherapy in a clinical outpatient setting in a city in southern Brazil. Three psychological tests (Rorschach, Bender and WISC III) were administered to 23 children, aged 6-11 years old, and the Child Behaviour Check List (CBCL) was completed by the parents. All…

  14. Doctoral Clinical Geropsychology Training in a Primary Care Setting (United States)

    Zweig, Richard A.; Siegel, Lawrence; Hahn, Steven; Kuslansky, Gail; Byrne, Kathy; Fyffe, Denise; Passman, Vicki; Stewart, Douglas; Hinrichsen, Gregory


    Most older adults diagnosed with a mental disorder receive treatment in primary care settings that lack personnel skilled in geropsychological diagnosis and treatment. The Ferkauf Older Adult Program of Yeshiva University endeavors to bridge this gap by providing training in geriatric psychology, through coursework and diverse clinical practica,…

  15. Setting the Stage: Global Competition in Higher Education (United States)

    Bagley, Sylvia S.; Portnoi, Laura M.


    In this chapter, the issue editors set the stage for the chapters that follow by delineating recent developments in higher education and common strategies for creating globally competitive higher education institutions. The editors consider social justice concerns that arise with global competition and contend that contextualized priorities can…

  16. Conceptualizing Mathematics as Discourse in Different Educational Settings (United States)

    Güçler, Beste; Wang, Sasha; Kim, Dong-Joong


    In this work, we focus on a relatively new theory in mathematics education research, which views thinking as communication and characterizes mathematics as a form of discourse. We discuss how this framework can be utilized in different educational settings by giving examples from our own research to highlight the insights it provides in the…

  17. Organizational Learning in Educational Settings (Technical): An Indian Perspective (United States)

    Patnaik, B.; Beriha, G. S.; Mahapatra, S. S.; Singh, N.


    Purpose: This paper seeks to present an empirical study on organizational learning in Indian educational organizations. Design/methodology/approach: The Learning Organization Profile (LOP) Survey is used as the tool for eliciting responses from the staff regarding the nature and state of organizational learning prevailing in educational settings.…

  18. Uses and Risks of Microblogging in Organisational and Educational Settings (United States)

    Ahmad Kharman Shah, Nordiana; Latif Shabgahi, Soureh; Cox, Andrew M.


    Purpose: The paper aims to clarify the relationship between organisational and educational use of microblogging. Although enterprise and education are very different sectors of activity and have diverse research traditions, this review argues that there is a benefit to be derived from comparing research work across the two settings.…

  19. Vulnerable Youth: Identifying Their Need for Alternative Educational Settings. (United States)

    Zweig, Janine M.

    This paper examines the extent to which alternative education can meet the needs of disconnected youth who are at risk of economic and social hardship. It summarizes characteristics of disconnected youth, risk factors associated with disconnection, and characteristics of students in selected alternative education settings. The most common factors…

  20. Social interactions between veterinary medical students and their teachers in an ambulatory clinic setting in Finland. (United States)

    Koskinen, Heli I


    In this study, the social interactions between students and their teachers in an ambulatory clinic setting were investigated using Bales's interaction process analysis framework. Observational data were collected during five small-group sessions. The observations were quantified, and the behaviors of students and teachers were compared statistically. This study demonstrated that the interaction between students and their teachers was for the most part equal and could be characterized as "positively task oriented." The study has implications for veterinary educators wishing to use social psychology frameworks to assess the quality of learning in small-group clinical setting.

  1. Peer assisted learning in the clinical setting: an activity systems analysis. (United States)

    Bennett, Deirdre; O'Flynn, Siun; Kelly, Martina


    Peer assisted learning (PAL) is a common feature of medical education. Understanding of PAL has been based on processes and outcomes in controlled settings, such as clinical skills labs. PAL in the clinical setting, a complex learning environment, requires fresh evaluation. Socio-cultural theory is proposed as a means to understand educational interventions in ways that are practical and meaningful. We describe the evaluation of a PAL intervention, introduced to support students' transition into full time clinical attachments, using activity theory and activity systems analysis (ASA). Our research question was How does PAL transfer to the clinical environment? Junior students on their first clinical attachments undertook a weekly same-level, reciprocal PAL activity. Qualitative data was collected after each session, and focus groups (n = 3) were held on completion. Data was analysed using ASA. ASA revealed two competing activity systems on clinical attachment; Learning from Experts, which students saw as the primary function of the attachment and Learning with Peers, the PAL intervention. The latter took time from the first and was in tension with it. Tensions arose from student beliefs about how learning takes place in clinical settings, and the importance of social relationships, leading to variable engagement with PAL. Differing perspectives within the group were opportunities for expansive learning. PAL in the clinical environment presents challenges specific to that context. Using ASA helped to describe student activity on clinical attachment and to highlight tensions and contradictions relating PAL in that setting. Planning learning opportunities on clinical placements, must take account of how students learn in workplaces, and the complexity of the multiple competing activity systems related to learning and social activities.

  2. Challenges Associated With Using Large Data Sets for Quality Assessment and Research in Clinical Settings. (United States)

    Cohen, Bevin; Vawdrey, David K; Liu, Jianfang; Caplan, David; Furuya, E Yoko; Mis, Frederick W; Larson, Elaine


    The rapidly expanding use of electronic records in health-care settings is generating unprecedented quantities of data available for clinical, epidemiological, and cost-effectiveness research. Several challenges are associated with using these data for clinical research, including issues surrounding access and information security, poor data quality, inconsistency of data within and across institutions, and a paucity of staff with expertise to manage and manipulate large clinical data sets. In this article, we describe our experience with assembling a data-mart and conducting clinical research using electronic data from four facilities within a single hospital network in New York City. We culled data from several electronic sources, including the institution's admission-discharge-transfer system, cost accounting system, electronic health record, clinical data warehouse, and departmental records. The final data-mart contained information for more than 760,000 discharges occurring from 2006 through 2012. Using categories identified by the National Institutes of Health Big Data to Knowledge initiative as a framework, we outlined challenges encountered during the development and use of a domain-specific data-mart and recommend approaches to overcome these challenges.

  3. Violence Experienced By Nursing Students in Clinical Practice Settings

    Directory of Open Access Journals (Sweden)

    Meltem KÜRTÜNCÜ


    Full Text Available The study was made to determine violence experienced by nurse students in clinical settings. It was applied to the School of Health Nursing Student of a university during a week in June, 2010. There were 360 students, 53 of whom were senior, 60 of whom were thirdyear, 114 of whom were sophomore, 79 of whom were first-year and 102 of whom were prep-school students, at the school. Students in preparatory classes were not included in the scope of the study since they didn't take applied courses. 70,58% of the students were reached. It was determined that the students were often exposed to verbal abuse and sexism in clinical setting and the abuse was performed by their colleagues.

  4. Manual Linear Movements to Assess Spasticity in a Clinical Setting (United States)

    Marinelli, Lucio; Trompetto, Carlo; Mori, Laura; Vigo, Gabriele; Traverso, Elisabetta; Colombano, Federica; Abbruzzese, Giovanni


    In a clinical setting, where motor-driven systems are not readily available, the major difficulty in the assessment of the stretch reflex lies in the control of passive limb displacement velocity. A potential approach to this problem arises from the use of manual sinusoidal movements (made by continuous alternating flexions and extensions) paced by an external stimulus. Unfortunately, there are conditions in which sinusoidal movements induce interfering phenomena such as the shortening reaction or postactivation depression. In the present paper, a novel manual method to control the velocity of passive linear movements is described and the results obtained from both healthy subjects and spastic patients are reported. This method is based on the synchronisation of movements with tones played by a metronome at different speeds. In a first set of experiments performed in healthy subjects, we demonstrated consistent control of velocity during passive limb movements using this method. Four joints usually examined during muscle tone assessment were tested: wrist, elbow, knee and ankle joints. Following this, we conducted a longitudinal assessment of the stretch reflex amplitude in wrist flexor muscles in patients with spasticity treated with botulinum toxin type A. The evaluators were not only able to vary the movement velocity based on the metronome speed, but also could reproduce the respective speeds two weeks later, despite the changing degree of hypertonia. This method is easy to perform in a clinical setting and hardware requirements are minimal, making it an attractive and robust procedure for the widespread clinical assessment of reflex hypertonia. PMID:23335966

  5. Selecting a clinical intervention documentation system for an academic setting. (United States)

    Fox, Brent I; Andrus, Miranda; Hester, E Kelly; Byrd, Debbie C


    Pharmacists' clinical interventions have been the subject of a substantial body of literature that focuses on the process and outcomes of establishing an intervention documentation program within the acute care setting. Few reports describe intervention documentation as a component of doctor of pharmacy (PharmD) programs; none describe the process of selecting an intervention documentation application to support the complete array of pharmacy practice and experiential sites. The process that a school of pharmacy followed to select and implement a school-wide intervention system to document the clinical and financial impact of an experiential program is described. Goals included finding a tool that allowed documentation from all experiential sites and the ability to assign dollar savings (hard and soft) to all documented interventions. The paper provides guidance for other colleges and schools of pharmacy in selecting a clinical intervention documentation system for program-wide use.

  6. Evaluation of a novel electronic genetic screening and clinical decision support tool in prenatal clinical settings. (United States)

    Edelman, Emily A; Lin, Bruce K; Doksum, Teresa; Drohan, Brian; Edelson, Vaughn; Dolan, Siobhan M; Hughes, Kevin; O'Leary, James; Vasquez, Lisa; Copeland, Sara; Galvin, Shelley L; DeGroat, Nicole; Pardanani, Setul; Gregory Feero, W; Adams, Claire; Jones, Renee; Scott, Joan


    "The Pregnancy and Health Profile" (PHP) is a free prenatal genetic screening and clinical decision support (CDS) software tool for prenatal providers. PHP collects family health history (FHH) during intake and provides point-of-care risk assessment for providers and education for patients. This pilot study evaluated patient and provider responses to PHP and effects of using PHP in practice. PHP was implemented in four clinics. Surveys assessed provider confidence and knowledge and patient and provider satisfaction with PHP. Data on the implementation process were obtained through semi-structured interviews with administrators. Quantitative survey data were analyzed using Chi square test, Fisher's exact test, paired t tests, and multivariate logistic regression. Open-ended survey questions and interviews were analyzed using qualitative thematic analysis. Of the 83% (513/618) of patients that provided feedback, 97% felt PHP was easy to use and 98% easy to understand. Thirty percent (21/71) of participating physicians completed both pre- and post-implementation feedback surveys [13 obstetricians (OBs) and 8 family medicine physicians (FPs)]. Confidence in managing genetic risks significantly improved for OBs on 2/6 measures (p values ≤0.001) but not for FPs. Physician knowledge did not significantly change. Providers reported value in added patient engagement and reported mixed feedback about the CDS report. We identified key steps, resources, and staff support required to implement PHP in a clinical setting. To our knowledge, this study is the first to report on the integration of patient-completed, electronically captured and CDS-enabled FHH software into primary prenatal practice. PHP is acceptable to patients and providers. Key to successful implementation in the future will be customization options and interoperability with electronic health records.

  7. A Comparison of Standard-Setting Procedures for an OSCE in Undergraduate Medical Education. (United States)

    Kaufman, David M.; Mann, Karen V.; Muijtjens, Arno M. M.; van der Vleuten, Cees P. M.


    Compared four standard-setting procedures for an objective structure clinical examination (OSCE) in medical education. Applied Angoff, borderline, relative, and holistic procedures to the data used to establish a cutoff score for a pass/fail decision. The Angoff and borderline procedures gave similar results; however, the relative and holistic…

  8. Clinical decision making of nurses working in hospital settings. (United States)

    Bjørk, Ida Torunn; Hamilton, Glenys A


    This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.

  9. Adapting Formal Education Materials for Out-of-School Settings (United States)

    Smith, Denise A.; Gibbons, H.


    Out-of-school programs present significant opportunities to reinforce and extend classroom learning. How can we work effectively with these programs to engage youth in science and technology? What types of materials can be easily integrated into out-of-school learning experiences? How can existing formal education materials be adapted for use in out-of-school settings? To address these questions, the Space Telescope Science Institute and the Pacific Science Center have engaged in a project that builds on a network of informal science education centers and community-based organizations developed for a national outreach program associated with the NOVA/PBS Origins series. As part of this effort, the Pacific Science Center has held a focus group with local community-based organizations serving underserved and underrepresented youth, and engaged 20 sites in Washington, California, and Tennessee in testing formal education materials adapted for use in out-of-school settings. We report preliminary focus group and field-test results, including emerging best practices for adapting formal education materials for use in out-of-time settings. Results from this project will enable a variety of education and public outreach programs to extend the reach of their materials to new audiences in a way that bridges the formal and informal science education realms.

  10. Synthetic MRI of the brain in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Blystad, I.; Smedby, O. [Center for Medical Image Science and Visualization, CMIV, Linkoeping University, Linkoeping (Sweden); Radiology, Department of Medical and Health Sciences, Linkoeping University, Department of Radiology, UHL, County Council of Oestergoetland, Linkoeping (Sweden)], E-mail:; Warntjes, J.B.M. [Center for Medical Image Science and Visualization, CMIV, Linkoeping University, Linkoeping (Sweden); Clinical Physiology, Department of Medical and Health Sciences, Linkoeping University, Department of Clinical Physiology, UHL, County Council of Oestergoetland, Linkoeping (Sweden); Landtblom, A.-M. [Center for Medical Image Science and Visualization, CMIV, Linkoeping University, Linkoeping (Sweden); Neurology, Department of Clinical and Experimental Medicine, Linkoeping University, Division of Neurology, UHL, LiM, County Council of Oestergoetland, Linkoeping (Sweden); Lundberg, P. [Center for Medical Image Science and Visualization, CMIV, Linkoeping University, Linkoeping (Sweden); Radiation Physics, Department of Medical and Health Sciences, Linkoeping University, Department of Radiation Physics, UHL, County Council of Oestergoetland, Linkoeping (Sweden); Larsson, E.-M. [Center for Medical Image Science and Visualization, CMIV, Linkoeping University, Linkoeping (Sweden); Department of Radiology, Oncology and Radiation Science/Radiology, Uppsala University, Uppsala (Sweden)


    Background. Conventional magnetic resonance imaging (MRI) has relatively long scan times for routine examinations, and the signal intensity of the images is related to the specific MR scanner settings. Due to scanner imperfections and automatic optimizations, it is impossible to compare images in terms of absolute image intensity. Synthetic MRI, a method to generate conventional images based on MR quantification, potentially both decreases examination time and enables quantitative measurements. Purpose. To evaluate synthetic MRI of the brain in a clinical setting by assessment of the contrast, the contrast-to-noise ratio (CNR), and the diagnostic quality compared with conventional MR images. Material and Methods. Twenty-two patients had synthetic imaging added to their clinical MR examination. In each patient, 12 regions of interest were placed in the brain images to measure contrast and CNR. Furthermore, general image quality, probable diagnosis, and lesion conspicuity were investigated. Results. Synthetic T1-weighted turbo spin echo and T2-weighted turbo spin echo images had higher contrast but also a higher level of noise, resulting in a similar CNR compared with conventional images. Synthetic T2-weighted FLAIR images had lower contrast and a higher level of noise, which led to a lower CNR. Synthetic images were generally assessed to be of inferior image quality, but agreed with the clinical diagnosis to the same extent as the conventional images. Lesion conspicuity was higher in the synthetic T1-weighted images, which also had a better agreement with the clinical diagnoses than the conventional T1-weighted images. Conclusion. Synthetic MR can potentially shorten the MR examination time. Even though the image quality is perceived to be inferior, synthetic images agreed with the clinical diagnosis to the same extent as the conventional images in this study.

  11. The Educational Psychology of Clinical Training. (United States)

    Bailey, Jessica H; Rutledge, Brian


    Clinical training is paramount to the educational experience of learners, and the purpose of this training can be categorized into the following 4 categories of learning taxonomies: socialization, clinical reasoning, medical management of patient care and attitudinal change. This article investigates the educational psychology that provides the foundation of the categories of learning that take place in the clinical environment. Understanding this is critically important to create an opportunity for learners to activate their knowledge repertoire at the precise time of appropriate application.

  12. Transitioning Pharmacogenomics into the Clinical Setting: Training Future Pharmacists (United States)

    Frick, Amber; Benton, Cristina S.; Scolaro, Kelly L.; McLaughlin, Jacqueline E.; Bradley, Courtney L.; Suzuki, Oscar T.; Wang, Nan; Wiltshire, Tim


    Pharmacogenomics, once hailed as a futuristic approach to pharmacotherapy, has transitioned to clinical implementation. Although logistic and economic limitations to clinical pharmacogenomics are being superseded by external measures such as preemptive genotyping, implementation by clinicians has met resistance, partly due to a lack of education. Pharmacists, with extensive training in pharmacology and pharmacotherapy and accessibility to patients, are ideally suited to champion clinical pharmacogenomics. This study aimed to analyze the outcomes of an innovative pharmacogenomic teaching approach. Second-year student pharmacists enrolled in a required, 15-week pharmaceutical care lab course in 2015 completed educational activities including lectures and small group work focusing on practical pharmacogenomics. Reflecting the current landscape of direct-to-consumer (DTC) genomic testing, students were offered 23andMe genotyping. Students completed surveys regarding their attitudes and confidence on pharmacogenomics prior to and following the educational intervention. Paired pre- and post-intervention responses were analyzed with McNemar's test for binary comparisons and the Wilcoxon signed-rank test for Likert items. Responses between genotyped and non-genotyped students were analyzed with Fisher's exact test for binary comparisons and the Mann-Whitney U-test for Likert items. Responses were analyzed for all student pharmacists who voluntarily completed the pre-intervention survey (N = 121, 83% response) and for student pharmacists who completed both pre- and post-intervention surveys (N = 39, 27% response). Of those who completed both pre- and post-intervention surveys, 59% obtained genotyping. Student pharmacists demonstrated a significant increase in their knowledge of pharmacogenomic resources (17.9 vs. 56.4%, p < 0.0001) and confidence in applying pharmacogenomic information to manage patients' drug therapy (28.2 vs. 48.7%, p = 0.01), particularly if the student

  13. Becoming conscious of learning and nursing in clinical settings

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Pedersen, Birthe D.; Helms, Niels Henrik


    -hermeneutic approach. The setting was a ten-week clinical course in Basic Nursing, and participants were 11 first-year students randomly assigned. Data was generated by participant observations, narrative interviews and portfolio documents. The entire data material was interpreted according to the French philosopher...... Paul Ricoeurs theory of interpretation. This paper reports that the mandatory part promotes consciousness of own learning and competencies in clinical nursing and raises students` consciousness of nurse identity. It gives preceptors the opportunity to differentiate their supervision for individual...... students and guide them to improve their learning potential. However, the language used in the individual study plan must be clarified to avoid ambiguity, and there is potential to tailor the individual study plan....

  14. Setting the Governmental Agenda for State Decentralization of Higher Education. (United States)

    McLendon, Michael K.


    State decentralization of higher education emerged as a significant governance trend of the 1980s to 1990s. Yet little is known about how or why decentralization first became an issue to which state governments paid serious attention. This study employs multiple theories to analyze the agenda-setting stage of policy formation in three states…

  15. Federalism, Agenda Setting, and the Dynamics of Federal Education Policy. (United States)

    Manna, Paul

    This paper is part of a larger project on agenda setting in the U.S. federal system and the development of the federal education agenda since 1965. Two questions motivate the paper, one theoretical and the other empirical: (1) how does federalism affect the federal agenda?; and (2) what explains the development of federal involvement in K-12…

  16. The Impact of Postmodernism on The UAE Educational Setting (United States)

    Sarsar, Nasreddine


    This assignment discusses post-modernity and its effect on the UAE educational setting. Impacts of globalization, individualization, and uncertainty have all been explored in depth. In the first part of this essay, a definition of what it means to think sociologically has been provided and the importance of such thinking to understand the times we…

  17. The Impact of Technology on Relationships in Educational Settings (United States)

    Costabile, Angela, Ed.; Spears, Barbara, Ed.


    As the linguistic, cognitive and social elements of individuals' lives are transformed by new and emerging technologies, educational settings are also challenged to respond to the issues that have arisen as a consequence. This book focuses on that challenge: using psychological theory as a lens to highlight the positive uses of new technologies in…

  18. [Screening of sexually transmitted diseases in clinical and non-clinical settings in Salvador, Bahia, Brazil]. (United States)

    de Codes, José Santiago; Cohen, Deborah Ann; de Melo, Neli Almeida; Teixeira, Guilherme Gonzaga; Leal, Alexandre dos Santos; Silva, Tiago de Jesus; de Oliveira, Miucha Pereira Rios


    The objectives were to study: (1) acceptance of STD screening in non-clinical settings for asymptomatic individuals; (2) risk factors and STD prevalence among individuals in non-clinical and clinical settings; and (3) non-clinical screening of asymptomatic populations as a feasible method for STD control. We recruited 139 males and 486 females between 18 and 30 years of age from a family planning clinic, schools, and community centers in low-income neighborhoods. We asked about STD symptoms and STD/HIV risk behaviors and tested the individuals for gonorrhea, Chlamydia, syphilis, and HIV. Except for HIV, women recruited directly from the community had higher STD rates than those who came in for care at the clinic. Screening in non-clinical settings in Brazil is feasible and has a high yield among young adults in low-income communities. Infected participants would likely never have otherwise sought care or been tested or treated. STD control efforts could be implemented in any site that can reach populations at risk and become a routine procedure in health care settings where people report for problems unrelated to STDs.

  19. Proposed Guidelines for Operating Counselor Education and Supervision Training Clinics (United States)

    Lauka, Justin D.; McCarthy, Amanda K.


    The purpose of this article is to justify and present a set of guidelines for the effective and ethical administration of counselor education and supervision training clinics. Responding directly to a call for creating guidelines, the authors address core issues surrounding their development. Benefits for clear and accessible guidelines and risks…

  20. Integrative Nursing: Application of Principles Across Clinical Settings

    Directory of Open Access Journals (Sweden)

    Mary Jo Kreitzer


    Full Text Available While the essence of nursing has long been whole person (body, mind, and spirit and whole system-focused, in reality the contemporary practice of nursing in many settings around the globe has become increasingly fragmented and de-stabilized. Nursing shortages in many parts of the world are significant, and hierarchies and bureaucracies often remove nurses from the point of care, be that the bedside, home, or clinic, replacing them with less skilled workers and filling their time with documentation and other administrative tasks. Integrative nursing is a framework for providing whole person/whole system care that is relationship-based and person-centered and focuses on improving the health and wellbeing of caregivers as well as those they serve. It is aligned with what is being called the “triple aim” in the United States—an effort focused on improving the patient experience (quality and satisfaction, improving the health of populations, and reducing the cost of care. The principles of integrative nursing offer clear and specific guidance that can shape and impact patient care in all clinical settings.

  1. Integrative nursing: application of principles across clinical settings. (United States)

    Kreitzer, Mary Jo


    While the essence of nursing has long been whole person (body, mind, and spirit) and whole system-focused, in reality the contemporary practice of nursing in many settings around the globe has become increasingly fragmented and de-stabilized. Nursing shortages in many parts of the world are significant, and hierarchies and bureaucracies often remove nurses from the point of care, be that the bedside, home, or clinic, replacing them with less skilled workers and filling their time with documentation and other administrative tasks. Integrative nursing is a framework for providing whole person/whole system care that is relationship-based and person-centered and focuses on improving the health and wellbeing of caregivers as well as those they serve. It is aligned with what is being called the "triple aim" in the United States-an effort focused on improving the patient experience (quality and satisfaction), improving the health of populations, and reducing the cost of care. The principles of integrative nursing offer clear and specific guidance that can shape and impact patient care in all clinical settings.

  2. Can Critical Management Education Be Critical in a Formal Higher Educational Setting? (United States)

    Choo, Kok Leong


    This article attempts to establish the scope of critical management education in a formal educational setting. It is based on an empirical study of 24 academic staffs' experience of engaging critical management education in four UK University Business Schools. The study seems to show that there are significant barriers to and potential pitfalls in…

  3. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

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    Shah M


    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  4. Nursing students’ perspectives on clinical education

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    Full Text Available Introduction: The importance of optimal clinical nursing education in professional skills development is undeniable. In clinical education, nursing students are often faced with problems. Recognizing nursing students’ perception on clinical education is the first step to remove the barriers of this challenge. Methods: This descriptive cross-sectional study was conducted to determine the nursing students’ perspectives on clinical education. 150 nursing students were selected randomly from nursing and midwifery schools (Tehran. Data collection instrument was a researcher made questionnaire consisting of five domains: objective and curricula, instructor, feedback to student in clinical field, clinical environment, supervision and evaluation. Mean and standard deviation were calculated for each item, using SPSS, ver. 14. Chi-square test was used to compare the nursing students’ perspectives on clinical education based on age, sex and the work experience. The significance level was considered 0.05. Results: Mean age of the students was 21.58±26.97 students (66% were male. 44 students (30.1% had work experience (3.58±6.48 month. Male and female students had different perceptions in domains of clinical education (p<0.05. Nursing student had different perceptions as to objectives and curricula (p=0.039, how to deal with students in the clinical environment (p=0.032, supervision, and evaluation (p<0.001 with respect to their work experience duration. The most positive responses were in clinical instructor (81.5% and the most negative ones were the clinical environment (33.66%, respectively. Conclusion: Providing an optimal clinical environment and improving the supervision and evaluation of student practice should prioritized in schools of nursing and midwifery.

  5. Continuing Education Instrumentation Training in Clinical Chemistry. (United States)

    LeBlanc, Jacqueline; Frankel, Saundra


    Describes the continuing education program for clinical chemistry instrumentation training established at The College of Staten Island, New York. A course consisting of 14 sessions is outlined and discussed. (CS)

  6. Clinical Decision Making of Nurses Working in Hospital Settings

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    Ida Torunn Bjørk


    Full Text Available This study analyzed nurses' perceptions of clinical decision making (CDM in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.

  7. Clinical veterinary education: insights from faculty and strategies for professional development in clinical teaching. (United States)

    Lane, India F; Strand, Elizabeth


    Missing in the recent calls for accountability and assurance of veterinary students' clinical competence are similar calls for competence in clinical teaching. Most clinician educators have no formal training in teaching theory or method. At the University of Tennessee College of Veterinary Medicine (UTCVM), we have initiated multiple strategies to enhance the quality of teaching in our curriculum and in clinical settings. An interview study of veterinary faculty was completed to investigate the strengths and weaknesses of clinical education; findings were used in part to prepare a professional development program in clinical teaching. Centered on principles of effective feedback, the program prepares participants to organize clinical rotation structure and orientation, maximize teaching moments, improve teaching and participation during formal rounds, and provide clearer summative feedback to students at the end of a rotation. The program benefits from being situated within a larger college-wide focus on teaching improvement. We expect the program's audience and scope to continue to expand.

  8. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions. (United States)

    Hunter, Sharyn; Arthur, Carol


    Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements. Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool.

  9. A Successful US Academic Collaborative Supporting Medical Education in a Postconflict Setting

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    Patricia McQuilkin MD


    Full Text Available This article describes a model employed by the Academic Collaborative to Support Medical Education in Liberia to augment medical education in a postconflict setting where the health and educational structures and funding are very limited. We effectively utilized a cohort of visiting US pediatric faculty and trainees for short-term but recurrent clinical work and teaching. This model allows US academic medical centers, especially those with smaller residency programs, to provide global health experiences for faculty and trainees while contributing to the strengthening of medical education in the host country. Those involved can work toward a goal of sustainable training with a strengthened host country specialty education system. Partnerships such as ours evolve over time and succeed by meeting the needs of the host country, even during unanticipated challenges, such as the Ebola virus outbreak in West Africa.

  10. A Successful US Academic Collaborative Supporting Medical Education in a Postconflict Setting. (United States)

    McQuilkin, Patricia; Marshall, Roseda E; Niescierenko, Michelle; Tubman, Venée N; Olson, Bradley G; Staton, Donna; Williams, Jackson H; Graham, Elinor A


    This article describes a model employed by the Academic Collaborative to Support Medical Education in Liberia to augment medical education in a postconflict setting where the health and educational structures and funding are very limited. We effectively utilized a cohort of visiting US pediatric faculty and trainees for short-term but recurrent clinical work and teaching. This model allows US academic medical centers, especially those with smaller residency programs, to provide global health experiences for faculty and trainees while contributing to the strengthening of medical education in the host country. Those involved can work toward a goal of sustainable training with a strengthened host country specialty education system. Partnerships such as ours evolve over time and succeed by meeting the needs of the host country, even during unanticipated challenges, such as the Ebola virus outbreak in West Africa.

  11. Utilization of lean management principles in the ambulatory clinic setting. (United States)

    Casey, Jessica T; Brinton, Thomas S; Gonzalez, Chris M


    The principles of 'lean management' have permeated many sectors of today's business world, secondary to the success of the Toyota Production System. This management method enables workers to eliminate mistakes, reduce delays, lower costs, and improve the overall quality of the product or service they deliver. These lean management principles can be applied to health care. Their implementation within the ambulatory care setting is predicated on the continuous identification and elimination of waste within the process. The key concepts of flow time, inventory and throughput are utilized to improve the flow of patients through the clinic, and to identify points that slow this process -- so-called bottlenecks. Nonessential activities are shifted away from bottlenecks (i.e. the physician), and extra work capacity is generated from existing resources, rather than being added. The additional work capacity facilitates a more efficient response to variability, which in turn results in cost savings, more time for the physician to interact with patients, and faster completion of patient visits. Finally, application of the lean management principle of 'just-in-time' management can eliminate excess clinic inventory, better synchronize office supply with patient demand, and reduce costs.

  12. Introduction: Current educational issues: some profiles and settings

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    María Pilar Teruel Melero


    Full Text Available This issue of the Revista Electrónica Interuniversitaria de Formación del Profesorado (REIFOP offers a range of articles focused on the profiles and settings of education today. It also includes the full text of the Pedagogical Manifesto “It is not true”, promoted by RedIres (School updating and research network, to which the journal adheres, taking it as its own. Finally, REIFOP makes available to all its readers a wide database of over 1,700 resources on Education and Psychology, retrievable online through the Internet.The authors of the articles are university lecturers and professors in the field of Education who carry out their academic research at ten Spanish universities: Barcelona, Extremadura, Granada, Las Palmas de Gran Canaria, Murcia, Oviedo, Santiago de Compostela, Sevilla, Valladolid and Zaragoza. We believe that this is a further way of reaching the whole university community.

  13. Salmonella prevalence among reptiles in a Zoo education setting

    DEFF Research Database (Denmark)

    Hydeskov, H. B.; Guardabassi, Luca; Aalbæk, Bent


    Clinically healthy reptiles may shed Salmonella and therefore act as a potential zoonotic threat. Most people in Northern European countries are rarely exposed to reptiles, but many zoos have education departments where children have direct contact with this group of animals. The objectives...... of this study were to determine the prevalence and serotype distribution of Salmonella among reptiles in the Education Department (n = 55) at Copenhagen Zoo and compare it to the Zoo's main reptile collection (n = 145) to evaluate the zoonotic risk. Salmonella was isolated from cloacal swabs by selective...... enrichment, and a single isolate from each positive sample was further identified by biochemical tests and serotyped. The overall prevalence was 35% (69/200) with significant difference between the Education Department (64%, 35/55) and the main reptile collection (23%, 34/145). A total of 28 serotypes were...

  14. Using systematically observed clinical encounters (SOCEs to assess medical students’ skills in clinical settings

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    George R Bergus


    Full Text Available George R Bergus1–3, Jerold C Woodhead4, Clarence D Kreiter2,51Performance Based Assessment Program, Office of Student Affairs and Curriculum, 2Department of Family Medicine, 3Department of Psychiatry, 4Department of Pediatrics, 5Office of Consultation and Research in Medical Education, Roy J and Lucille A Carver College of Medicine, The University of Iowa, Iowa City, IA, USAIntroduction: The Objective Structured Clinical Examination (OSCE is widely used to assess the clinical performance of medical students. However, concerns related to cost, availability, and validity, have led educators to investigate alternatives to the OSCE. Some alternatives involve assessing students while they provide care to patients – the mini-CEX (mini-Clinical Evaluation Exercise and the Long Case are examples. We investigated the psychometrics of systematically observed clinical encounters (SOCEs, in which physicians are supplemented by lay trained observers, as a means of assessing the clinical performances of medical students.Methods: During the pediatrics clerkship at the University of Iowa, trained lay observers assessed the communication skills of third-year medical students using a communication checklist while the students interviewed and examined pediatric patients. Students then verbally presented their findings to faculty, who assessed students’ clinical skills using a standardized form. The reliability of the combined communication and clinical skills scores was calculated using generalizability theory.Results: Fifty-one medical students completed 199 observed patient encounters. The mean combined clinical and communication skills score (out of a maximum 45 points was 40.8 (standard deviation 3.3. The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81. Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.Conclusion: The SOCE can

  15. Melding Research and Education in a Zoological Setting (United States)

    Foote, Dustin

    The first zoo was opened in London in 1828 and was intended for scientific study, but was eventually opened to the public in 1847. Since then, public dogma has dictated the development, role, and standards concerning the use of animals across the zoological community. Too often there is disconnect between research programs, captive propagation, and public education. In the fight against human driven extinction of earth's flora and fauna, it is vital that these areas be aligned. Thus in an effort to unite research and education in a zoological setting, East Carolina University (ECU) and Sylvan Heights Bird Park (SHBP) have partnered for a collaborative project involving the study of evolution in the African brood parasitic finches (Viduidae), specifically he Pin-tailed Whydah (Vidua macroura). I attempt to quantify the educational impact of Avian Pirates and SHBP, and assess basic demographic factors that will allow insights into what areas of exhibit design pertain to education. It is important to understand what aspects of zoos facilitate visitor learning in areas of conservation and biodiversity. This is vital as Zoos are under new pressure to substantiate claims of education during visits.

  16. The role of lectures in quality education of medical students in clinical settings%小讲课在临床医学专业实习生素质教育中的作用

    Institute of Scientific and Technical Information of China (English)

    张彤; 罗碧辉; 何兆初


    Lectures are important methods for students to study step by step in clinical settings.Inthis paper several new formats of lectures were studied including case comparative analysis,roles interchange and SO on.These methods were positive in cultivating students'creativity,responsibility,cooperation and adaptability.%小讲课是医学生在实习阶段深入学习临床理论知识的一种重要方式.根据素质教育的要求并总结以往的教学经验,我们改革了小讲课的形式,通过临床病例对比分析、角色互换等方法,充分发挥了学生的主观能动性,培养了学生的责任感、创新精神、团队精神以及社会适应性.

  17. Physician judgment in clinical settings: methodological influences and cognitive performance. (United States)

    Dawson, N V


    Understanding the quality of physicians' intuitive judgments is essential in determining the appropriate use of their judgments in medical decision-making (vis-a-vis analytical or actuarial approaches). As part of this process, the quality of physicians' predictions must be assessed because prediction is fundamental to common clinical tasks: determining diagnosis, prognosis, and therapy; establishing monitoring intervals; performing screening and preventive maneuvers. Critical evaluation of predictive capabilities requires an assessment of the components of the prediction process: the data available for prediction, the method used for prediction, and the accuracy of prediction. Although variation in and uncertainty about the underlying data elements are often acknowledged as a source of inaccurate predictions, prediction also can be confounded by both methodological and cognitive limitations. During the past two decades, numerous factors have been recognized that may bias test characteristics (sensitivity and specificity). These same factors may also produce bias in intuitive judgments. The use of cognitive processes to simplify judgment tasks (e.g., the availability and representativeness heuristics) and the presence of certain biases in the judgment process (e.g., ego, regret) may present obstacles to accurate estimation of probabilities by physicians. Limitations on the intuitive use of information (cognitive biases) have been demonstrated in both medical and nonmedical decision-making settings. Recent studies have led to a deepening understanding of the advantages and disadvantages of intuitive and analytical approaches to decision making. Here, many aspects of the basis for this understanding are reviewed.

  18. Prevalence of Sarcopenia and Associated Outcomes in the Clinical Setting. (United States)

    Peterson, Sarah J; Braunschweig, Carol A


    Sarcopenia refers to age-associated decrease in muscle mass and function. The condition was originally described in the elderly, but emerging evidence suggests that it is also a concern among the chronically ill nonelderly. Currently there are a number of definitions for diagnosing sarcopenia; however, in the clinical setting, abdominal computed tomography (CT) scans completed for diagnostic purposes can be utilized to identify CT-defined sarcopenia. Recent studies suggest that prevalence of CT-defined sarcopenia is high among chronically ill patients, ranging from 15%-50% in patients with cancer, 30%-45% with liver failure, and 60%-70% for critically ill patients in the intensive care unit. Depleted muscle mass is associated with infectious complications, prolonged duration of mechanical ventilation, longer hospitalization, greater need for rehabilitation care after hospital discharge, and higher mortality. In consideration of the growing population of older adults with multiple comorbidities, more research is needed to identify sarcopenia and develop interventions that are directed at attenuating or reversal muscle loss.

  19. Special Education Teachers' Experiences Supporting and Supervising Paraeducators: Implications for Special and General Education Settings (United States)

    Douglas, Sarah N.; Chapin, Shelley E.; Nolan, James F.


    In recent years, there has been an increase in paraeducator supports, in large part because students with low incidence disabilities are being included more frequently in general education settings. As a result, special education teachers have been given additional supervisory responsibilities related to directing the work of paraeducators in…

  20. Entry-Level Athletic Trainers' Self-Confidence in Clinical Skill Preparedness for Treating Athletic and Emergent Settings Populations (United States)

    Morin, Gary E.; Misasi, Sharon; Davis, Charles; Hannah, Corey; Rothbard, Matthew


    Context: Clinical education is an important component of athletic training education. Concern exists regarding whether clinical experience adequately prepares students to perform professional skills after graduation, particularly with patients in emerging settings. Objective: To determine the confidence levels of athletic training graduates in…

  1. Educational strategies for improving clinical reasoning. (United States)

    Cutrer, William B; Sullivan, William M; Fleming, Amy E


    Clinical reasoning serves as a crucial skill for all physicians regardless of their area of expertise. Helping trainees develop effective and appropriate clinical reasoning abilities is a central aim of medical education. Teaching clinical reasoning however can be a very difficult challenge for practicing physicians. Better understanding of the different cognitive processes involved in physician clinical reasoning provides a foundation from which to guide learner development of effective reasoning skills, while pairing assessment of learner reasoning abilities with understanding of different improvement strategies offers the opportunity to maximize educational efforts for learners. Clinical reasoning errors often can occur as a result of one of four problems in trainees as well as practicing physicians; inadequate knowledge, faulty data gathering, faulty data processing, or faulty metacognition. Educators are encouraged to consider at which point a given learner's reasoning is breaking down. Experimentation with different strategies for improving clinical reasoning can help address learner struggles in each of these domains. In this chapter, various strategies for improving reasoning related to knowledge acquisition, data gathering, data processing, and clinician metacognition will be discussed. Understanding and gaining experience using the different educational strategies will provide practicing physicians with a toolbox of techniques for helping learners improve their reasoning abilities.

  2. DNA barcoding in diverse educational settings: five case studies (United States)

    Imondi, Ralph; James, Karen; Spencer, Diana; Steinke, Dirk


    Despite 250 years of modern taxonomy, there remains a large biodiversity knowledge gap. Most species remain unknown to science. DNA barcoding can help address this gap and has been used in a variety of educational contexts to incorporate original research into school curricula and informal education programmes. A growing body of evidence suggests that actively conducting research increases student engagement and retention in science. We describe case studies in five different educational settings in Canada and the USA: a programme for primary and secondary school students (ages 5–18), a year-long professional development programme for secondary school teachers, projects embedding this research into courses in a post-secondary 2-year institution and a degree-granting university, and a citizen science project. We argue that these projects are successful because the scientific content is authentic and compelling, DNA barcoding is conceptually and technically straightforward, the workflow is adaptable to a variety of situations, and online tools exist that allow participants to contribute high-quality data to the international research effort. Evidence of success includes the broad adoption of these programmes and assessment results demonstrating that participants are gaining both knowledge and confidence. There are exciting opportunities for coordination among educational projects in the future. This article is part of the themed issue ‘From DNA barcodes to biomes’. PMID:27481792

  3. DNA barcoding in diverse educational settings: five case studies. (United States)

    Henter, Heather J; Imondi, Ralph; James, Karen; Spencer, Diana; Steinke, Dirk


    Despite 250 years of modern taxonomy, there remains a large biodiversity knowledge gap. Most species remain unknown to science. DNA barcoding can help address this gap and has been used in a variety of educational contexts to incorporate original research into school curricula and informal education programmes. A growing body of evidence suggests that actively conducting research increases student engagement and retention in science. We describe case studies in five different educational settings in Canada and the USA: a programme for primary and secondary school students (ages 5-18), a year-long professional development programme for secondary school teachers, projects embedding this research into courses in a post-secondary 2-year institution and a degree-granting university, and a citizen science project. We argue that these projects are successful because the scientific content is authentic and compelling, DNA barcoding is conceptually and technically straightforward, the workflow is adaptable to a variety of situations, and online tools exist that allow participants to contribute high-quality data to the international research effort. Evidence of success includes the broad adoption of these programmes and assessment results demonstrating that participants are gaining both knowledge and confidence. There are exciting opportunities for coordination among educational projects in the future.This article is part of the themed issue 'From DNA barcodes to biomes'.

  4. Perception of educational value in clinical rotations by medical students

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    Kandiah DA


    Full Text Available David A Kandiah School of Psychiatry and Clinical Neurosciences, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, WA, Australia Aim: Clinical teaching in Australian medical schools has changed to meet the needs of substantially increased medical student cohorts. As such, formal feedback from these student cohorts is needed about the value they place on the educational input from each clinical rotation. This study aims to determine which aspects of clinical placements are most educationally useful to medical students.Methods: In this study, final year medical students from the University of Western Australia (UWA were surveyed via an anonymous online questionnaire, identifying which clinical placements were found to be the most and the least useful to their learning and the positive aspects of these placements. Two focus groups were conducted prior to the design of the questionnaire to determine the key areas of focus important to medical students. Ethics approval for this study was obtained from the UWA Human Research Ethics Committee.Results: Our focus groups were consistent in finding that students enjoyed placements where they were included as a part of the medical team and played a role in patient care. This was consistent with the concept that inclusiveness and participation in the clinical setting are important in developing competence in tasks and skills. The ratio of students to doctors was crucial, with a low ratio given a higher rating as seen in the rural clinical school.Conclusion: The results of this project could benefit both the local and national medical curricula in identifying the most effective clinical attachments for learning and preparation for prevocational training. This is relevant especially due to the limited number of clinical placements and growing cohort of medical students. The results of this study can also be extrapolated to international medical education. Keywords

  5. How can coaching make a positive impact within educational settings?


    Devine,Mary; Meyers, Raymond; Houssemand, Claude


    There is growing acceptance that large scale educational reform is needed to meet the challenges of the 21st century. The contribution that coaching can make in these settings has been the focus of recent discussions and research. Much of the research comes from the UK, USA and Australia and these will be reviewed to provide an overview of some of the approaches that have been used. A systematic literature search has been done using the keywords “coaching” and “education”, followed by a manua...

  6. Identifying elders with neuropsychiatric problems in a clinical setting

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    Shilpa Sadanand


    Full Text Available Objective: Multiple health problems among the elderly necessitate a comprehensive enquiry to detect problems early and also initiate treatment. We utilized available validated instruments to comprehensively identify older persons with neuro-psychiatric problems including dementia and comorbid medical ailments in the screening desk of the geriatric clinic. Materials and Methods: Individuals aged 60 years and above seeking outpatient care at NIMHANS during a 2-year period (October 2008-September 2010 participated. We used General Health Questionnaire (12-item, AD8, questions to identify psychoses and neurological problems and a checklist of common medical ailments. A probable clinical diagnosis was made at the end by medical personnel based on ICD-10. Results: A total of 5,260 individuals were screened and more than one-third (36.7% were women. About 50% had psychological distress (≥2 on GHQ-12, 20.1% had probable cognitive impairment (≥2 on AD8 and about 17% had symptoms suggestive of psychoses (≥1 on Psychoses screener. More than 65% had either a neurological or neurosurgical problems (≥1 on Neurological screener and headache was the commonest complaint. At probable diagnosis, more than 50% had a neurological problem and over 30% had psychiatric disorders. Of these the most common psychiatric illnesses were psychotic disorders (22.0%, mood disorders (21.4% and dementia (14.4%. The most common medical comorbidity included hypertension (36.4%, visual impairment (31.8% and joint pains (30.5%. Nearly 80% had one or more medical comorbidity in addition to psychiatric illness. The overall set of instruments took about 15-20 minutes. It systematically and comprehensively guided in evaluating the elderly for neuropsychiatric problems and hence was collated to constitute the Instruments for Comprehensive Evaluation of the Elderly (ICE-E. Conclusions: ICE-E was brief, easy to administer and improved decision making even by personnel from a non

  7. Authenticity in Learning--Nursing Students' Experiences at a Clinical Education Ward (United States)

    Manninen, Katri; Henriksson, Elisabet Welin; Scheja, Max; Silen, Charlotte


    Purpose: This study aims to explore and understand first year nursing students' experiences of learning at a clinical education ward. Design/methodology/approach: The setting is a clinical education ward for nursing students at a department of infectious diseases. A qualitative study was carried out exploring students' encounters with patients,…

  8. Salmonella prevalence among reptiles in a zoo education setting. (United States)

    Hydeskov, H B; Guardabassi, L; Aalbaek, B; Olsen, K E P; Nielsen, S S; Bertelsen, M F


    Clinically healthy reptiles may shed Salmonella and therefore act as a potential zoonotic threat. Most people in Northern European countries are rarely exposed to reptiles, but many zoos have education departments where children have direct contact with this group of animals. The objectives of this study were to determine the prevalence and serotype distribution of Salmonella among reptiles in the Education Department (n = 55) at Copenhagen Zoo and compare it to the Zoo's main reptile collection (n = 145) to evaluate the zoonotic risk. Salmonella was isolated from cloacal swabs by selective enrichment, and a single isolate from each positive sample was further identified by biochemical tests and serotyped. The overall prevalence was 35% (69/200) with significant difference between the Education Department (64%, 35/55) and the main reptile collection (23%, 34/145). A total of 28 serotypes were detected. Ten serotypes were isolated from more than one specimen and four from more than one species. Salmonella enterica subsp. enterica serovar Eastbourne was the predominant serotype (32%, 22/69) and was also the serotype isolated from most reptile species (n = 7). Transmission of serotypes from one department to another was very limited indicated by the serotype distribution. Despite the relative high prevalence observed among the reptiles in the Zoo's Education Department compared to the reptiles in the Zoo's main reptile collection, no Salmonella cases have been linked to the Zoo, and Salmonella ser. Eastbourne is very rarely isolated from humans in Denmark. Simple hygienic procedures such as hand washing which is consistently carried out following handling of reptiles at the Education Department may reduce the risk and therefore contribute to this low prevalence.

  9. Ethnographic nexus analysis in clinical nursing education

    DEFF Research Database (Denmark)

    Kjær, Malene


    Purpose/aim(s): Internationally, student nurses' attrition after clinical practice is an increasing problem (Hamshire, Willgoss, & Wibberley, 2012; Pilegård Jensen, 2006). A better understanding of 'becoming a nurse' as situated practice in the hospital wards might help avoid pitfalls...... in the clinical practice. Thus a thorough insight into the field is necessary in order to change it. The purpose of this paper is to show and discuss how it is possible methodologically to do ethnographic research in clinical education and how the field of clinical nursing education in the hospital wards might...... be improved after insights obtained through ethnographic research. Methods: Using nexus analysis (Scollon & Scollon, 2004, 2007) as an ethnographic framework in four Danish hospital wards, a study of the development of a professional identity among student nurses in Denmark was conducted. Scollon and Scollon...

  10. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments

    DEFF Research Database (Denmark)

    Malling, Bente Vigh; Mortensen, Lene Sundahl; Scherpbier, Albert J J;


    The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate...... in clinical departments and the leadership skills of clinical consultants responsible for education....

  11. Integrating clinical guidelines into nursing education. (United States)

    Higuchi, Kathryn A S; Cragg, C E; Diem, Elizabeth; Molnar, Jeanne; O'Donohue, Mary S


    A project planning group consisting of college and university representatives from a collaborative undergraduate nursing program developed an inclusive, process-oriented faculty development initiative to enhance the integration of clinical guidelines in clinical courses. In the first phase, results of a needs assessment were used to inform the development of a six-hour workshop for the third year clinical faculty in acute care, mental health, and community health. Pre-post surveys were conducted with students and clinical faculty during the first phase. Results from the workshop and surveys were used to develop a four-hour workshop for clinical faculty in all years of the program. The relatively short workshop process shows promise for initiating integration of clinical guidelines in undergraduate nursing education.

  12. Using Video Ethnography in Clinical Nurse Education

    DEFF Research Database (Denmark)

    Kjær, Malene; Sørensen, Erik Elgaard; Raudaskoski, Pirkko Liisa


    Training to become a nurse involves education in the clinical practice in hospital wards. It is a multifaceted and complex arena in which the student nurses not only have to learn about medical encounters but also how to interact with colleagues as well as patients and their families. By using...

  13. Implementation of the Clinical Facilitation Model within an Australian rural setting: the role of the Clinical Facilitator. (United States)

    Sanderson, Helena; Lea, Jacqueline


    Education providers globally use various models for undergraduate nurse clinical education. This paper presents the major findings of a research project conducted by a rural university in Australia that aimed to explore the Clinical Facilitation Model of undergraduate nursing education from a rural perspective. In particular how the Clinical Facilitators enacted their role within the rural environment and to identify any barriers to the provision of effective clinical learning during facilitated clinical experience within this context. This qualitative study used a phenomenological approach to explore the experiences of Clinical Facilitators. Individual in-depth interviews were conducted with eight Clinical Facilitators. Data was analysed using thematic analysis and several themes emerged from the study. This paper will report two of the major findings which are based on how Clinical Facilitators enacted their role within the rural environment. Whilst this study has a rural focus the findings will add to the limited body of knowledge internationally regarding the Clinical Facilitation model used as a result of balancing educational needs of the student with the care needs of the patients in the current health policy climate. The findings will be useful for informing undergraduate curricula, and will assist faculty and health services in planning and implementation of models of clinical education that meet the needs of the student and that are specific to the rural environment. In addition, the findings will provide insight into strategies that the rural Clinical Facilitator can utilise to assist in fulfilling their teaching role.

  14. Perception of educational value in clinical rotations by medical students (United States)

    Kandiah, David A


    Aim Clinical teaching in Australian medical schools has changed to meet the needs of substantially increased medical student cohorts. As such, formal feedback from these student cohorts is needed about the value they place on the educational input from each clinical rotation. This study aims to determine which aspects of clinical placements are most educationally useful to medical students. Methods In this study, final year medical students from the University of Western Australia (UWA) were surveyed via an anonymous online questionnaire, identifying which clinical placements were found to be the most and the least useful to their learning and the positive aspects of these placements. Two focus groups were conducted prior to the design of the questionnaire to determine the key areas of focus important to medical students. Ethics approval for this study was obtained from the UWA Human Research Ethics Committee. Results Our focus groups were consistent in finding that students enjoyed placements where they were included as a part of the medical team and played a role in patient care. This was consistent with the concept that inclusiveness and participation in the clinical setting are important in developing competence in tasks and skills. The ratio of students to doctors was crucial, with a low ratio given a higher rating as seen in the rural clinical school. Conclusion The results of this project could benefit both the local and national medical curricula in identifying the most effective clinical attachments for learning and preparation for prevocational training. This is relevant especially due to the limited number of clinical placements and growing cohort of medical students. The results of this study can also be extrapolated to international medical education. PMID:28223855

  15. Clinical Guide to Music Therapy in Physical Rehabilitation Settings (United States)

    Wong, Elizabeth


    Elizabeth Wong, MT-BC presents tools and information designed to arm the entry-level music therapist (or an experienced MT-BC new to rehabilitation settings) with basic knowledge and materials to develop or work in a music therapy program treating people with stroke, brain injury, and those who are ventilator dependent. Ms. Wong offers goals and…

  16. Evaluation of pharmacist clinical interventions in a Dutch hospital setting

    NARCIS (Netherlands)

    Bosma, Liesbeth; Jansman, Frank G. A.; Franken, Anton M.; Harting, Johannes W.; Van den Bemt, Patricia M. L. A.


    Objective Assessing the relevance of a clinically active pharmacist method compared to the traditional working method. Method The study was carried out in a general internal/gastro-enterology unit during two 8-weeks periods in 2004. It was an observational, non-randomized prospective study. Outcome

  17. Music Therapy with Traumatized Refugees in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Jaap Orth


    Full Text Available As music therapists now deal more often with traumatized refugees, and the demand for documentation, research, and a methodical description has grown, in this article I would like to make a contribution to the development of a methodology in music therapy with traumatized refugees. Various methods used by music therapists in trauma treatment will be described. An overview of the development of a set of methods at Phoenix, a highly specialized inpatient treatment facility for refugees and asylum seekers, will be presented and I will focus on four approaches I developed in my work with traumatized refugees.

  18. A real life clinical practice of neurologists in the ambulatory setting in Thailand: a pragmatic study

    Directory of Open Access Journals (Sweden)

    Kannikar Kongbunkiat


    Full Text Available The burden of neurological disorders is high in developing countries. Real life data from neurologists as to how they practice in Thailand are limited in literature. Practices of neurologists in a university hospital clinical setting in Thailand were studied. A prospective study was performed at the ambulatory neurology clinic, Khon Kaen University Hospital, between 1 February and 31 October 2009. The following data were recorded: numbers of patients, characteristics of patients, consultation notes, and time spent for each patient. There were three neurologists, each of whom ran one afternoon clinic, once a week. There were 6137 visits during the 9 months, with an average of 681 visits per month. The total number of patients was 2834. The three most common diseases were cerebrovascular diseases (33%, epilepsy (16%, and movement disorders (non-Parkinson’s disease, 12%. Neurologists spent an average of 6.34 minutes per patient. In conclusion, neurologists in medical schools have limited time to take care of each patient. Several strategies are needed in medical education and neurology training to improve the quality of care.

  19. Electronic clinical decision support systems attitudes and barriers to use in the oncology setting.

    LENUS (Irish Health Repository)

    Collins, I M


    BACKGROUND: There is little evidence regarding attitudes to clinical decision support systems (CDSS) in oncology. AIMS: We examined the current usage, awareness, and concerns of Irish medical oncologists and oncology pharmacists in this area. METHODS: A questionnaire was sent to 27 medical oncologists and 34 oncology pharmacists, identified through professional interest groups. Respondents ranked concerns regarding their use of a CDSS on a scale from 1 to 4, with 4 being most important. RESULTS: Overall, 67% (41\\/61) responded, 48% (13\\/27) of oncologists and 82% (28\\/34) of pharmacists surveyed. Concerns included "difficulty defining complex clinical situations with a set of rules" (mean ± SD) (3.2 ± 0.9), "ensuring evidence base is up to date and relevant" (3.2 ± 0.9) and "lack of clinically relevant suggestions" (2.9 ± 0.9). Ninety-three percent reported using a CDSS but 54% were unaware of this. CONCLUSION: While there are benefits to using a CDSS, concerns must be addressed through user education. This may be a starting point for a user-centred design approach to the development of future local systems through a consultative process.

  20. Can teaching agenda-setting skills to physicians improve clinical interaction quality? A controlled intervention

    Directory of Open Access Journals (Sweden)

    Rogers William H


    Full Text Available Abstract Background Physicians and medical educators have repeatedly acknowledged the inadequacy of communication skills training in the medical school curriculum and opportunities to improve these skills in practice. This study of a controlled intervention evaluates the effect of teaching practicing physicians the skill of "agenda-setting" on patients' experiences with care. The agenda-setting intervention aimed to engage clinicians in the practice of initiating patient encounters by eliciting the full set of concerns from the patient's perspective and using that information to prioritize and negotiate which clinical issues should most appropriately be dealt with and which (if any should be deferred to a subsequent visit. Methods Ten physicians from a large physician organization in California with baseline patient survey scores below the statewide 25th percentile participated in the agenda-setting intervention. Eleven physicians matched on baseline scores, geography, specialty, and practice size were selected as controls. Changes in survey summary scores from pre- and post-intervention surveys were compared between the two groups. Multilevel regression models that accounted for the clustering of patients within physicians and controlled for respondent characteristics were used to examine the effect of the intervention on survey scale scores. Results There was statistically significant improvement in intervention physicians' ability to "explain things in a way that was easy to understand" (p = 0.02 and marginally significant improvement in the overall quality of physician-patient interactions (p = 0.08 compared to control group physicians. Changes in patients' experiences with organizational access, care coordination, and office staff interactions did not differ by experimental group. Conclusion A simple and modest behavioral training for practicing physicians has potential to positively affect physician-patient relationship interaction quality

  1. View the Zoo! Evaluation of Visual Communication in an Outdoor Educational Setting. (United States)

    Schnackenberg, Heidi L.; And Others

    Almost all of what people learn from outdoor educational settings such as zoos and gardens stems from the exhibits themselves or signs about the exhibits. Evaluation of the various forms of visual communication in outdoor educational settings is necessary to determine the effectiveness of exhibitions, educational activities, and/or conservation…

  2. Single-Sex Education in Public School Settings (United States)

    Crawford-Ferre, Heather Glynn; Wiest, Lynda R.


    Although researchers have studied the effectiveness of single-sex education (SSE), the findings have been mixed. This exploratory study reports the perceived goals and effectiveness of single-sex education based on interviews with a small group of educators involved with SSE in various ways. Research participants included a school principal and…

  3. A Lifestyle Medicine Clinic in a Community Pharmacy Setting

    Directory of Open Access Journals (Sweden)

    Thomas L. Lenz, PharmD, MA, PAPHS


    Full Text Available Chronic diseases continue to be a significant burden to the health care system. Pharmacists have been able to show that drugtherapy for patients with chronic diseases can be improved through medication therapy management (MTM services but have yet to become significantly involved in implementing lifestyle modification programs to further control and prevent chronic conditions. A novel and innovative lifestyle medicine program was started by pharmacists in a community pharmacy in 2008 to more comprehensively prevent and manage chronic conditions. The lifestyle medicine program consists of designing seven personalized programs for patients to address physical activity, nutrition, alcohol consumption, weight control, stress management, sleep success, and tobacco cessation (if needed. The lifestyle medicine program complements existing MTM services for patients with hypertension, dyslipidemia, and/or diabetes. This program is innovative because pharmacists have developed and implemented amethod to combine lifestyle medicine with MTM services to not only manage chronic conditions, but prevent the progression of those conditions and others. Several innovative tools have also been developed to enhance the effectiveness of a lifestyle medicine program. This manuscript describes the program’s pharmacy setting, pharmacy personnel, participants and program details as well as the tools used to integrate a lifestyle medicine program with MTM services.

  4. Peer relationships of pupils with and without individualized education plans in co-teaching and maistream educational settings



    Pupils with special educational needs have been shown to experience more problems in peer relationships than their peers. Comparative research across different educational settings has been limited though. The purpose of this study was to compare the peer relationships of fifth-graders with and without individualized education plans (IEP) in co-teaching and mainstream educational settings. Peer relationships were operationalized as peer acceptance, friendship and, as a subjective re...

  5. Does the "Negro" "Still" Need Separate Schools? Single-Sex Educational Settings as Critical Race Counterspaces (United States)

    Terry, Clarence L., Sr.; Flennaugh, Terry K.; Blackmon, Samarah M.; Howard, Tyrone C.


    This article explores whether contemporary educators should consider single-sex educational settings as viable interventions in educating African American males. Using qualitative data from a 2-year study of single-sex educational spaces in two Los Angeles County high schools, the authors argue that when all-male spaces effectively function as…

  6. The educational theory underpinning a clinical workbook for VERT

    Energy Technology Data Exchange (ETDEWEB)

    Nisbet, Heather, E-mail: heather.nisbet@orh.nhs.u [Department of Clinical Oncology, Churchill Hospital, Old Road, Headington, Oxford, Oxon OX3 7LJ (United Kingdom); Matthews, Sara [Department of Clinical Oncology, Churchill Hospital, Old Road, Headington, Oxford, Oxon OX3 7LJ (United Kingdom)


    The introduction of VERT (Virtual Environment for Radiotherapy Training) into radiotherapy departments across England was in response to the National Radiotherapy Advisory Group's (NRAG) recommendation to the Department of Health that it may assist in enhancing the clinical learning experience of student radiotherapy radiographers. It was suggested that this may help to reduce the high attrition rate of students currently experienced, particularly in the first year of training. This paper investigates how VERT may be used in the clinical setting to develop the skills of students, in order to meet this vision. We argue that using an epistemological approach, i.e. using the theory of knowledge, to support the design of the learning resource, is key to enabling the educator to fulfil these expectations. We describe the design of a generic VERT workbook for use in the clinical departments that train students for the University of Hertfordshire. The use of educational theory to underpin the aims and inform the development of the workbook is examined. We then discuss the alignment of the workbook with the curriculum in order to enhance the students' learning experience and nurture their clinical competence. Finally, we will consider the teaching strategies used during the delivered sessions and discuss how we believe they will allow us to achieve these aims.

  7. Group asthma education in a pediatric inpatient setting. (United States)

    Tolomeo, Concettina


    Asthma education is an important component of asthma care and management. Children and parents often do not receive asthma education, and frequently, education programs are time consuming. The purpose of this medical record review was to retrospectively determine the impact of a short, group-based, inpatient asthma self-management program on the number of children/parents who received complete asthma education before discharge. The self-management program was instituted in 2006. Participants consisted of all children admitted to a New England children's hospital from January 1, 2005, through December 31, 2006, with a primary diagnosis of asthma. Findings revealed that significantly more (p asthma education before discharge in 2006 versus 2005.

  8. Expansive learning in the university setting: the case for simulated clinical experience. (United States)

    Haigh, Jacquelyn


    This paper argues that simulated practice in the university setting is not just a second best to learning in the clinical area but one which offers the potential for deliberation and deep learning [Eraut, M., 2000. Non-formal learning, implicit learning and tacit knowledge in professional work. Journal of Educational Psychology, 70, 113-136]. The context of student learning in an undergraduate midwifery programme is analysed using human activity theory [Engeström, Y., 2001. Expansive learning at work: toward an activity theoretical reconceptualization. Journal of Education and Work, 14, 133-156]. The advantages of this approach to student learning as opposed to situated learning theory and the concept of legitimate peripheral participation [Lave, J., Wenger, E., 1991. Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, New York] are discussed. An activity system changes as a result of contradictions and tensions between what it purports to produce and the views of stakeholders (multi-voicedness) as well as its historical context (Historicity of activity). A focus group with students highlights their expressed need for more simulated practice experience. The views of midwifery lecturers are sought as an alternative voice on this tension in the current programme. Qualitative differences in types of simulated experience are explored and concerns about resources are raised in the analysis. Discussion considers the value of well planned simulations in encouraging the expression of tacit understanding through a group deliberative learning process [Eraut, M., 2000. Non-formal learning, implicit learning and tacit knowledge in professional work. Journal of Educational Psychology, 70, 113-136].

  9. Eportfolio and learning styles in clinical nursing education

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Pedersen, Birthe D.; Helms, Niels Henrik


    This study reports the use of electronic portfolio in clinical nursing education. The study is part of a larger study investigating learning mediated by ePortfolio. The method takes a phenomenological-hermeneutic approach. The setting was a ten-week clinical course in basic nursing....... The participants were 11 first-year students randomly selected. Data were generated by participant observations, interviews and portfolio documents. Findings showed that the ePortfolio was used individually and mostly at home. Using ePortfolio in the ward is more time-consuming. The ePortfolio was used to reflect...... only in one way, lack of supervision about how to learn. The study showed some but not unambiguous connection between preferred learning styles and ePortfolio use....

  10. Social learning analytics: Navigating the changing settings of higher education.

    NARCIS (Netherlands)

    De Laat, Maarten; Prinsen, Fleur


    Current trends and challenges in higher education (HE) require a reorientation towards openness, technology use and active student participation. In this article we will introduce Social Learning Analytics (SLA) as instrumental in formative assessment practices, aimed at supporting and strengthening

  11. Physical Education at Preschools: The Meaning of "Physical Education" to Practitioners at Three Preschool Settings in Scotland (United States)

    McEvilly, Nollaig; Verheul, Martine; Atencio, Matthew


    Background: Preschool physical education has been largely unexplored by researchers. This article examines the meaning of the term "physical education", in relation to preschool contexts, to 14 practitioners working at three preschool settings in Scotland. Our focus on preschool physical education reflects a change in the language…

  12. Prevention of Bullying in Early Educational Settings: Pedagogical and Organisational Factors Related to Bullying (United States)

    Repo, Laura; Sajaniemi, Nina


    Research suggests that bullying behaviour begins at an early age (three to six years) and that preventive practices should target early educational settings. However, no previous studies focus on early educational settings (kindergartens) as an arena for bullying behaviour. The aim of this study was to find what kind of organisational and…

  13. Investigating Kindergarten Parents' Selection of After-School Art Education Settings in Taiwan (United States)

    Hsiao, Ching-Yuan; Kuo, Ting-Yin


    The research purpose was to investigate kindergarten parents' selection of after-school art education settings in Taiwan. A review of the literature and interviews with parents were conducted to identify several possible factors that would impact on parents' selection of after-school art education settings for their children. Then, the researcher…

  14. Collecting Behavioral Data in General Education Settings: A Primer for Behavioral Data Collection (United States)

    Lee, David L.; Vostal, Brooks; Lylo, Brooke; Hua, Youjia


    Recent trends toward the inclusion of students with disabilities mean that a majority of students with emotional and behavioral disorders (EBD) now spend at least 40% of their day in general education settings. With this change in location, teachers in general education settings are now asked to perform tasks that were not given much emphasis…

  15. Real-world impact of education: treating patients with ipilimumab in a community practice setting

    Directory of Open Access Journals (Sweden)

    Ledezma B


    Full Text Available Blanca Ledezma,1 Annie Heng2 1Department of Hematology and Oncology, University of California, Los Angeles, Santa Monica, CA, USA; 2Angeles Clinic and Research Institute, Los Angeles, CA, USA Abstract: After decades without promising new treatments for advanced and metastatic melanoma, ipilimumab was the first systemic therapy approved for use in this patient population. A fully human monoclonal antibody that blocks cytotoxic T-lymphocyte antigen 4 (CTLA-4 to augment antitumor T-cell responses, ipilimumab significantly extended overall survival in clinical trials. Because ipilimumab is associated with a set of immune-related adverse events that likely reflect the agent's mechanism of action, a management guide has been established. Nurses play a significant role in initially identifying these adverse reactions and assisting in patient education, treatment, and follow-up. Herein, we discuss commonly asked questions related to ipilimumab therapy and treatment of adverse events, and how nurses can be prepared to answer these questions as they arise from patients and caregivers. Keywords: melanoma, immunotherapy, patient education

  16. Community health clinical education in Canada: part 1--"state of the art". (United States)

    Cohen, Benita E; Gregory, David


    This paper presents the findings of a survey of community health clinical education in twenty-four Canadian pre-licensure baccalaureate nursing programs. A qualitative research design was used, involving a content analysis of Canadian course syllabi and supporting documents for community health courses. This study afforded a cross-sectional understanding of the "state of the art" of community health clinical education in Canadian schools of nursing. Clinical course conceptual approaches, course objectives, types of clinical sites, format and number of clinical hours, and methods of student evaluation are identified. The findings suggest the need for a national dialogue or consensus building exercise regarding curriculum content for community health nursing. Informing this dialogue are several strengths including the current focus on community health (as opposed to community-based) nursing education, and a solid socio-environmental perspective informing clinical learning and practice. The national data set generated by this study may have relevance to nursing programs globally.

  17. Ubiquitous information for ubiquitous computing: expressing clinical data sets with openEHR archetypes. (United States)

    Garde, Sebastian; Hovenga, Evelyn; Buck, Jasmin; Knaup, Petra


    Ubiquitous computing requires ubiquitous access to information and knowledge. With the release of openEHR Version 1.0 there is a common model available to solve some of the problems related to accessing information and knowledge by improving semantic interoperability between clinical systems. Considerable work has been undertaken by various bodies to standardise Clinical Data Sets. Notwithstanding their value, several problems remain unsolved with Clinical Data Sets without the use of a common model underpinning them. This paper outlines these problems like incompatible basic data types and overlapping and incompatible definitions of clinical content. A solution to this based on openEHR archetypes is motivated and an approach to transform existing Clinical Data Sets into archetypes is presented. To avoid significant overlaps and unnecessary effort during archetype development, archetype development needs to be coordinated nationwide and beyond and also across the various health professions in a formalized process.

  18. Nurse Practitioner Perceptions of a Diabetes Risk Assessment Tool in the Retail Clinic Setting. (United States)

    Marjama, Kristen L; Oliver, JoAnn S; Hayes, Jennifer


    IN BRIEF This article describes a study to gain insight into the utility and perceived feasibility of the American Diabetes Association's Diabetes Risk Test (DRT) implemented by nurse practitioners (NPs) in the retail clinic setting. The DRT is intended for those without a known risk for diabetes. Researchers invited 1,097 NPs working in the retail clinics of a nationwide company to participate voluntarily in an online questionnaire. Of the 248 NPs who sent in complete responses, 114 (46%) indicated that they used the DRT in the clinic. Overall mean responses from these NPs indicated that they perceive the DRT as a feasible tool in the retail clinic setting. Use of the DRT or similar risk assessment tools in the retail clinic setting can aid in the identification of people at risk for type 2 diabetes.

  19. Identifying the factors influencing minority language use in health care education settings: a European perspective. (United States)

    Roberts, G W; Paden, L


    The recent enhanced status of many minority languages across the European Community has led to increasing demands for their use within the public sector. This is particularly evident in health care, where, in circumstances of stress and vulnerability, denying opportunities for clients to communicate in their preferred language may place them at a personal disadvantage and compromise their health chances. In view of the exclusion of many minority languages from the public domain over the years, their re-introduction demands adaptations to health care education programmes in order to promote language sensitivity in practice. Before embarking on developments which establish such languages within the professional sphere, valuable insight may be gained by examining their current use in practice education. Furthermore, comparing their use across language communities enables the sharing of common experiences and furthers opportunities for developing networks across Europe. This paper describes an ethnographic study of the use, within midwifery education, of the Welsh language in north Wales, the Catalan language in Barcelona and the Irish language in Western Ireland. Semi-structured interviews were conducted with key lecturers, clinical mentors and students across the three communities in order to determine patterns of language use within a range of learning environments. Focus groups were also held in order to confirm the findings. The data reveal many commonalities in terms of language use across the three settings and important factors are identified which support the use of minority languages in practice education. The findings are invaluable for guiding future bilingual initiatives across health care education programmes.

  20. Accommodations in Homeschool Settings for Children with Special Education Needs (United States)

    Stoudt, Patricia Koelsch


    This qualitative study was designed to examine how homeschooling parents in Pennsylvania make the determination to engage with public school districts to accommodate the special education needs (SEN) of their children. This phenomenological study used direct interviews with 30 Pennsylvania families who are homeschooling children with SEN. Data…

  1. Designing Multimedia for Ecological Tourism in an Educational Setting. (United States)

    Passerini, Katia; Granger, Mary J.

    This paper describes the development process of multimedia software designed to educate and provide awareness of ecotourism in Costa Rica. Ecotourism is a form of nature-based travel and recreational experience combining a respect for nature and local cultures with economic development incentives. The software intends to pursue the goals of…

  2. Implementing Godly Play in Educational Settings: A Cautionary Tale (United States)

    Grajczonek, Jan; Truasheim, Maureen


    At the heart of all curriculum decision-making is the learner. Contemporary early childhood education theory and practice emphasises young children's agency and voice in their learning paying particular attention to valuing each child's sociocultural contexts. As learners, children are considered capable and active participants rather than as…

  3. Educational Goal-Setting in a Native-Canadian Community. (United States)

    Murphy, H. Joseph

    A revitalization of Canadian Indian culture occurred as a result of the 1967 Hawthorn Report, which advocated the integration of Canada natives into white society. On the Eskasoni Indian Reserve, home of 1700 Micma Indians in Nova Scotia, the revitalization was shown in the results of two questionnaires about local education. On the first…

  4. Scoring Los Angeles Landscapes: Environmental Education in an Urban Setting. (United States)

    Salter, Christopher L.; And Others

    This notebook serves as a guide for learning activities in environmental education. Twelve themes are treated in four groups: (1) sense of place includes history and landscape; (2) the natural environment covers air, water, energy, and landforms; (3) the built environment includes architecture, transportation, and housing; and (4) the social…

  5. Social Learning Analytics: Navigating the Changing Settings of Higher Education (United States)

    de Laat, Maarten; Prinsen, Fleur R.


    Current trends and challenges in higher education (HE) require a reorientation towards openness, technology use and active student participation. In this article we will introduce Social Learning Analytics (SLA) as instrumental in formative assessment practices, aimed at supporting and strengthening students as active learners in increasingly open…

  6. Struggles in prescribing : determinants of psychotropic drug use in multiple clinical settings

    NARCIS (Netherlands)

    Stolker, J.J.


    The main objectives of this thesis were to establish the prevalence of psychotropic drug use as well as possible determinants associated with its use in multiple clinical settings: psychiatric admission wards, an intensive care unit and two settings for the intellectually disabled. In this thesis,

  7. Comparison of Clinical Teaching by Residents and Attending Physicians in Inpatient and Lecture Settings. (United States)

    Bergen, Merlynn R.; And Others


    A study examined differences in the clinical teaching of 21 medical residents and 19 attending physicians in 2 settings: inpatient care and lectures. Results indicated that ratings were generally similar for the two groups, but setting was a significant source of variance. Self-assessments were similar. Implications for instruction are discussed.…

  8. Nurse-led clinics: 10 essential steps to setting up a service. (United States)

    Hatchett, Richard

    This article outlines 10 key steps for practitioners to consider when setting up and running a nurse-led clinic. It lays emphasis on careful planning, professional development and the need to audit and evaluate the service to ensure the clinic is measurably effective.

  9. Real-world impact of education: treating patients with ipilimumab in a community practice setting. (United States)

    Ledezma, Blanca; Heng, Annie


    After decades without promising new treatments for advanced and metastatic melanoma, ipilimumab was the first systemic therapy approved for use in this patient population. A fully human monoclonal antibody that blocks cytotoxic T-lymphocyte antigen 4 (CTLA-4) to augment antitumor T-cell responses, ipilimumab significantly extended overall survival in clinical trials. Because ipilimumab is associated with a set of immune-related adverse events that likely reflect the agent's mechanism of action, a management guide has been established. Nurses play a significant role in initially identifying these adverse reactions and assisting in patient education, treatment, and follow-up. Herein, we discuss commonly asked questions related to ipilimumab therapy and treatment of adverse events, and how nurses can be prepared to answer these questions as they arise from patients and caregivers.

  10. Use of objective structured clinical examination and structured clinical instruction module for interprofessional education on cancer: A focused review

    Directory of Open Access Journals (Sweden)

    Senthil P Kumar


    Full Text Available American association for cancer education had emphasized the role of structured educational programs for medical students and residents in primary care specialties in order to improve palliative oncology education. Dissatisfaction with the conventional methods of clinical assessment on the part of teachers and students led assessors to search for appropriate alternatives and in 1975, Harden and his colleagues introduced the objective structured clinical examination (OSCE. OSCE was introduced as a standardized tool for objectively assessing clinical competencies−including history-taking, physical examination, communication skills, data interpretation, etc. It consists of a circuit of stations connected in series, with each station devoted to the assessment of a particular competency using pre-determined guidelines or checklists. The Structured Clinical Instruction Module (SCIM modifies the OSCE for teaching purposes. The objective of this review is to provide a focused update on the status and applicability of SCIM and OSCE in cancer for educational use in palliative care. From the 12 studies which were on OSCE and 6 studies which were on SCIM, it appears that the two competency-based evaluation methodologies used in cancer education namely the OSCE and the SCIM are well validated and reliably used across settings and samples of students, practitioners, and patients. Future studies in Indian palliative care settings are warranted prior to extrapolation of existing evidence.

  11. Disaster Risk Management In Business Education: Setting The Tone

    Directory of Open Access Journals (Sweden)


    Full Text Available Looking for windows of opportunity to mainstream disaster risk management within business education, in 2015, the United Nations Office for Disaster Reduction's (UNISDR Private Sector Alliance for Disaster Resilient Societies (ARISE, partnered with Florida International University's Extreme Events Institute (FIU-EEI and 12 international leading business schools. This partnership began with a call for White Papers to propose innovative approaches to integrate cutting edge disaster management content into business education programs and other academic offerings, based on seven themes or niches identified: (1 Strategic Investment and Financial Decisions; (2 Generating Business Value; (3 Sustainable Management; (4 Business Ethics and Social Responsibility; (5 Business Continuity Planning; (6 Disaster Risk Metrics; and (7 Risk Transfer. In March 2016, an international workshop was held in Toronto, Canada to present the White Papers prepared by the business schools, and discuss the most appropriate approaches for addressing the areas of: teaching and curriculum; professional development and extension programs; internships and placement; research opportunities; and partnerships and collaboration. Finally, the group proposed goals for advancing the implementation phase of the business education initiatives, and to propose mechanisms for monitoring and follow-up.

  12. Using Large Data Sets to Study College Education Trajectories (United States)

    Oseguera, Leticia; Hwang, Jihee


    This chapter presents various considerations researchers undertook to conduct a quantitative study on low-income students using a national data set. Specifically, it describes how a critical quantitative scholar approaches guiding frameworks, variable operationalization, analytic techniques, and result interpretation. Results inform how…

  13. Integrating quality and safety education into clinical nursing education through a dedicated education unit. (United States)

    Masters, Kelli


    The Institute of Medicine and American Association of Colleges of Nursing are calling for curriculum redesign that prepares nursing students with the requisite knowledge and skills to provide safe, high quality care. The purpose of this project was to improve nursing students' knowledge of quality and safety by integrating Quality and Safety Education for Nurses into clinical nursing education through development of a dedicated education unit. This model, which pairs nursing students with front-line nursing staff for clinical experiences, was implemented on a medical floor in an acute care hospital. Prior to implementation, nurses and students were educated about the dedicated education unit and quality and safety competencies. During each clinical rotation, students collaborated with their nurses on projects related to these competencies. Students' knowledge was assessed using questions related to quality and safety. Students who participated in the dedicated education unit had higher scores than those with traditional clinical rotations. Focus groups were held mid-semester to assess nurses' perceptions of the experience. Five themes emerged from the qualitative data including thirsting for knowledge, building teamwork and collaboration, establishing trust and decreasing anxiety, mirroring organization and time management skills, and evolving confidence in the nursing role.

  14. Clinical problem solving ability of BSc and diploma nursing students in Indian setting--a comparison. (United States)

    Ezhilarasu, Punitha


    Clinical Problem Solving Ability (CPSA) is an important skill essential for nurses to achieve professional excellence which is developed during the educational process. A sample of 215 students from BSc and Diploma nursing educational programmes were studied to determine their CPSA and the differences were compared. A written simulation instrument (Ezhilarasu, 2000) with a Cronbach's alpha of 0.81 was used to measure the CPSA. BSc students scored significantly higher than Diploma students (p = 0). Final year students from both the programmes scored higher than the first year students (p = 0.01). The least commonly used step in clinical problem solving is evaluation. Along with other studies, this study also supports the influence of the educational process in the development of CPSA. Appropriate teaching strategies and role modelling by faculty should become an essential part in all nursing educational institutions.

  15. Behavioral Outcomes of Supervisory Education in the Association for Clinical Pastoral Education: A Qualitative Research Study. (United States)

    Ragsdale, Judith R; Orme-Rogers, Charles; Bush, Johnny C; Stowman, Sheryl Lyndes; Seeger, Rodney W


    This study advances the work of developing a theory for educating Clinical Pastoral Education (CPE) Supervisors by describing the behaviors which result from the successful completion of CPE supervisory education. Twenty-eight Association for Clinical Pastoral Education (ACPE) Certification Commissioners were interviewed to identify the behaviors demonstrated by Supervisory Education Students (Candidates) which influenced the decision to certify them at the level of Associate Supervisor. Specific behavioral descriptors are listed for each ACPE supervisory competency.

  16. Nurses and challenges faced as clinical educators: a survey of a group of nurses in Cameroon

    Directory of Open Access Journals (Sweden)

    Vivian E A Eta


    Full Text Available BACKGROUND: Clinical teaching is an important component of clinical education. In nursing, clinical teaching is ensured by clinical nurse educators (CNEs. This study aimed at describing the major challenges faced by CNEs in Cameroon. METHODS: In a qualitative study, supplemented with quantitative methods, CNEs were enrolled from three health districts to represent their frequency in Cameroon’s health delivery system. RESULTS: A total of 56 CNEs participated in the study, of whom, as many as 58.9% acknowledged always facing challenges in clinical teaching and supervision. The major challenges identified were the lack of opportunities to update knowledge and skills, students’ lack of preparedness and the CNEs not being prepared for clinical teaching. CNEs attributed these challenges in major part to the lack of incentives and poor health policies. CONCLUSION: CNEs in Cameroon do indeed face major challenges which are of diverse origins and could adversely affect teaching in clinical settings

  17. Development and use of a genitourinary pathology digital teaching set for trainee education

    Directory of Open Access Journals (Sweden)

    Li Li


    Full Text Available Background : Automated, high-speed, high-resolution whole slide imaging (WSI robots are becoming increasingly robust and capable. This technology has started to have a significant impact on pathology practice in various aspects including resident education. To be sufficient and adequate, training in pathology requires gaining broad exposure to various diagnostic patterns through teaching sets, which are traditionally composed of glass slides. Methods: A teaching set of over 295 glass slides has been used for resident training at the Division of Genitourinary Pathology, Department of Pathology, University of Pittsburgh Medical Center. Whole slide images were prepared from these slides using an Aperio ScanScope CS scanner. These images and case-related information were uploaded on a web-based digital teaching model. Results: The web site is available at: Once logged in, users can view the list of cases, or search cases with or without diagnoses shown. Each case can be accessed through an option button, where the clinical history, gross findings are initially shown. Whole slide images can be accessed through the links on the page, which allows users to make diagnoses on their own. More information including final diagnosis will display when the diagnosis-button is clicked. Conclusion: The web-based digital study set provides additional educational benefits to using glass slides. Residents or other users can remotely access whole slide images and related information at their convenience. Searching and sorting functions and self-testing mode allow a more targeted study. It would also prepare residents with competence to work with whole slide images. Further, the model can be expanded to include pre-rotation and post-rotation exams, and/or a virtual rotation system, which may potentially make standardization of pathology resident training possible in the future.

  18. Clinical polymorphism and variability in education of autistic children

    Directory of Open Access Journals (Sweden)

    Morozov S.A.Morozova T.I.


    Full Text Available Children with autism spectrum disorders are considered a highly heterogeneous group by clinical signs, which makes it impossible to develop a common method of correctional and educational development for them. In this article, results of an analysis of clinical, psychological and pedagogic polymorphism in autism spectrum disorders are shown, emphasized are its main components and basic consequences necessary for organizing education. Results are viewed in the context of the principle of variability in education. A dual structure of variability in education of autistic children has been discovered. Shortly reviewed are some topical problems of correctional education process for autism spectrum disorders

  19. Validation of antibiotic susceptibility testing guidelines in a routine clinical microbiology laboratory exemplifies general key challenges in setting clinical breakpoints. (United States)

    Hombach, Michael; Courvalin, Patrice; Böttger, Erik C


    This study critically evaluated the new European Committee for Antimicrobial Susceptibility Testing (EUCAST) antibiotic susceptibility testing guidelines on the basis of a large set of disk diffusion diameters determined for clinical isolates. We report several paradigmatic problems that illustrate key issues in the selection of clinical susceptibility breakpoints, which are of general importance not only for EUCAST but for all guidelines systems, i.e., (i) the need for species-specific determinations of clinical breakpoints/epidemiological cutoffs (ECOFFs), (ii) problems arising from pooling data from various sources, and (iii) the importance of the antibiotic disk content for separating non-wild-type and wild-type populations.

  20. Clinical Immersion and Biomedical Engineering Design Education: "Engineering Grand Rounds". (United States)

    Walker, Matthew; Churchwell, André L


    Grand Rounds is a ritual of medical education and inpatient care comprised of presenting the medical problems and treatment of a patient to an audience of physicians, residents, and medical students. Traditionally, the patient would be in attendance for the presentation and would answer questions. Grand Rounds has evolved considerably over the years with most sessions being didactic-rarely having a patient present (although, in some instances, an actor will portray the patient). Other members of the team, such as nurses, nurse practitioners, and biomedical engineers, are not traditionally involved in the formal teaching process. In this study we examine the rapid ideation in a clinical setting to forge a system of cross talk between engineers and physicians as a steady state at the praxis of ideation and implementation.


    Directory of Open Access Journals (Sweden)

    Jorge Brantes Ferreira


    Full Text Available This study focuses on identifying factors influencing intention to use m-learning (learning through mobile devices in a higher education environment. Using Structural Equation Modeling, supported by the literature on Technology Acceptance Model (TAM (Davis et al., 1989, a framework has been proposed, and a cross-sectional survey comprising 402 students from a Brazilian university was used to measure several constructs related to technology acceptance (m-learning. Results indicate, through structural equations modeling analysis, that while significant effects were found for ease of use, compatibility and self-efficacy. Lastly, we conclude that perceptions of short-term usefulness exert the greatest effects on students' intention to use m-learning.

  2. Students' Assessment and Self-assessment of Nursing Clinical Faculty Competencies: Important Feedback in Clinical Education? (United States)

    Lovrić, Robert; Prlić, Nada; Zec, Davor; Pušeljić, Silvija; Žvanut, Boštjan


    The students' assessment of clinical faculty competencies and the faculty members' self-assessment can provide important information about nursing clinical education. The aim of this study was to identify the differences between the students' assessment of the clinical faculty member's competencies and the faculty member's self-assessment. These differences can reveal interesting insights relevant for improving clinical practice.

  3. Critical thinking in clinical nurse education: application of Paul's model of critical thinking. (United States)

    Andrea Sullivan, E


    Nurse educators recognize that many nursing students have difficulty in making decisions in clinical practice. The ability to make effective, informed decisions in clinical practice requires that nursing students know and apply the processes of critical thinking. Critical thinking is a skill that develops over time and requires the conscious application of this process. There are a number of models in the nursing literature to assist students in the critical thinking process; however, these models tend to focus solely on decision making in hospital settings and are often complex to actualize. In this paper, Paul's Model of Critical Thinking is examined for its application to nursing education. I will demonstrate how the model can be used by clinical nurse educators to assist students to develop critical thinking skills in all health care settings in a way that makes critical thinking skills accessible to students.

  4. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg, Pharm.D.


    Full Text Available Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic.Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation.Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting.

  5. Clinical and no-clinical setting specificities in first session short-term psychotherapy psychodrama group. (United States)

    Drakulić, Aleksandra Mindoljević


    Modern history of short-term group psychotherapy dates back to the late 1950-ies. From then to present day, this psychotherapeutic method has been used in various forms, from dynamic-oriented to cognitive behavioural psychotherapies. Although it has always been considered rather controversial, due its cost-effectiveness, it has been capturing more and more popularity. This paper presents the specificities of first session short-term psychotherapy psychodrama group through session work with two examined groups: a group of 20 adult women who suffer from mild or moderate forms of unipolar depression and a group of 20 students of the School of Medicine in Zagreb without any psychiatric symptomatology. The results indicate the high importance of having structure in first psychodrama session, of relating it with the previously thoroughly conducted, initial, clinical, interviews, and of the clarity and focus in terms of determining the goals of therapy, especially in a clinical context. This study also confirmed assumptions regarding the need for different approaches of warming-up in psychodrama, both in the clinical and in non-clinical samples. A psychodrama psychotherapist should have good time managing skills and capability to convert the time available into an opportunity for directly boosting the group energy and work on therapeutic alliance.

  6. Implementation of responsiveness to intervention in early education settings. (United States)

    Justice, Laura M; McGinty, Anita; Guo, Ying; Moore, Douglas


    This article provides an overview of how response to intervention (RTI) may be used effectively within early childhood settings. Discussion is organized to address such issues regarding RTI implementation as (1) how to design and implement a high-quality Tier 1 learning environment that systematically improves children's language and literacy outcomes, (2) how to design and implement a high-quality Tier 2 supplemental learning intervention that systematically improves the language and literacy outcomes of children who are unresponsive to Tier 1, and (3) how to design and implement a comprehensive and cohesive assessment system that appropriately identifies children who show inadequate response to the Tier 1 and Tier 2 learning opportunities. A model for implementing RTI using the supplemental curriculum by Justice and McGinty, READ IT AGAIN-PREK! (2008), is presented. This tool was developed to meet the needs of early childhood programs as they seek to implement RIA in a cost-effective and scalable manner.

  7. The Impact of the Clinical Medical Librarian on Medical Education. (United States)

    Sarkis, Jeanne; Hamburger, Stephen


    A University of Missouri-Kansas City School of Medicine team approach is described that combines the knowledge and skills of the physician, nurse, clinical pharmacist, clinical medical librarian, etc., into a cooperative unit to provide health education and health care delivery. The impact of the clinical medical librarian is discussed. (MLW)

  8. Transforming the Academic Faculty Perspective in Graduate Medical Education to Better Align Educational and Clinical Outcomes. (United States)

    Wong, Brian M; Holmboe, Eric S


    The current health care delivery model continues to fall short in achieving the desired patient safety and quality-of-care outcomes for patients. And, until recently, an explicit acknowledgment of the role and influence of the clinical learning environment on professional development had been missing from physician-based competency frameworks. In this Perspective, the authors explore the implications of the insufficient integration of education about patient safety and quality improvement by academic faculty into the clinical learning environment in many graduate medical education (GME) programs, and the important role that academic faculty need to play to better align the educational and clinical contexts to improve both learner and patient outcomes. The authors propose a framework that closely aligns the educational and clinical contexts, such that both educational and clinical outcomes are centered around the patient. This will require a reorganization of academic faculty perspective and educational design of GME training programs that recognizes that (1) the dynamic interplay between the faculty, learner, training program, and clinical microsystem ultimately influences the quality of physician that emerges from the training program and environment, and (2) patient outcomes relate to the quality of education and the success of clinical microsystems. To enable this evolution, there is a need to revisit the core competencies expected of academic faculty, implement innovative faculty development strategies, examine closely faculty's current clinical super vision practices, and establish a training environment that supports bridging from clinician to educator, training program to clinical microsystem, and educational outcomes to clinical outcomes that benefit patients.

  9. Establishing research in a palliative care clinical setting: perceived barriers and implemented strategies. (United States)

    Bullen, Tracey; Maher, Kate; Rosenberg, John P; Smith, Bradley


    There are many challenges in developing research projects in research-naïve clinical settings, especially palliative care where resistance to participate in research has been identified. These challenges to the implementation of research are common in nursing practice and are associated with attitudes towards research participation, and some lack of understanding of research as a process to improve clinical practice. This is despite the professional nursing requirement to conduct research into issues that influence palliative care practice. The purpose of this paper is to describe the process of implementing a clinical research project in collaboration with the clinicians of a palliative care community team and to reflect on the strategies implemented to overcome the challenges involved. The challenges presented here demonstrate the importance of proactively implementing engagement strategies from the inception of a research project in a clinical setting.

  10. Toward clinical scholarship: promoting evidence-based practice in the clinical setting. (United States)

    Mohide, E Ann; Coker, Esther


    Organizational interventions are being suggested to increase the rate of quality research dissemination and uptake. This article describes how one tertiary institution is using an evidence-based nursing (EBN) committee as an organizational strategy to shift its nursing culture toward clinical scholarship. A number of approaches and activities that have stimulated the movement toward evidence-based practice (EBP) are examined: organizational commitment to EBP, strategic positioning of the EBN committee within nursing's administrative structure, articulation of a mission, conceptualization of a model for EBN practice, learning on the job, selection and adoption of an evidence-based model for implementing change, marketing for a change in culture toward clinical scholarship, and other selected examples of projects undertaken by the committee. Action-oriented principles associated with committee experiences are related to the approaches and activities.

  11. Setting up a health care quality management system in a multidisciplinary clinical research center

    Directory of Open Access Journals (Sweden)

    L. V. Laktionova


    Full Text Available The paper discusses the issues of setting up a quality management system in a multidisciplinary specialized clinical research center. It describes the experience with information technologies used in a prophylactic facility to set up effective out- and inpatient health care control. Measures to optimize work under present-day conditions to upgrade the quality of health care are given using the federal health facility as an example.

  12. A Model for Two-Year and Baccalaureate Clinical Dental Hygiene Education. (United States)

    Gluch-Scranton, Joan; Gurenlian, JoAnn Rigolizzo


    Models for associate and bachelors degree programs training dental hygienists are proposed as a step in eliminating technical training for dental hygiene education and in delineating roles for the graduates of two- and four-year programs. They outline clinical and professional skills, practice settings, and supervision levels for each group. (MSE)

  13. An Investigation of the Self-Regulation Components Students Employ in the Physical Education Setting (United States)

    Kermarrec, Gilles; Todorovich, John; Fleming, David


    Research in educational psychology and sport psychology indicates that school achievement depends on students' capacity to self-regulate their own learning processes. The purpose of this study was to investigate the self-regulation components employed by students in a natural physical education setting. Twenty-three French students, 14 and 15…

  14. Using Public Posting as a Motivation Strategy in Physical Education, Sport, and Adult Exercise Settings (United States)

    Martin, Matt; Sharpe, Tom


    One of the ongoing challenges that physical educators, coaches, and fitness professionals face is discovering and implementing motivational strategies that encourage long-term participation and effort. This challenge exists in public school physical education classes, on the playing field, and in structured adult physical activity settings. In…

  15. Adapted Physical Education in Self-Contained Settings: Planning for Successful Instruction (United States)

    Wilson, Wesley J.; Beamer, Jennifer; Block, Martin E.


    Nearly 30% of U.S. schools have students with severe disabilities who participate in a self-contained adapted physical education (SAPE) setting, separate from their typically developing classmates. It is imperative that physical education teachers become familiar with pedagogical strategies for planning and teaching SAPE. The purpose of this…

  16. Towards a Dynamic Conceptual Framework for English-Medium Education in Multilingual University Settings (United States)

    Dafouz, Emma; Smit, Ute


    At a time of increasing internationalization in tertiary education, English-Medium Education in Multilingual University Settings (EMEMUS) has become a common practice. While there is already ample research describing this phenomenon at a local level (Smit and Dafouz 2012a), the theoretical side needs to be elaborated. This article thus aims to…

  17. Barker's Behavior Setting Theory: A Useful Conceptual Framework for Research on Educational Administration. (United States)

    Eklund, S. J.; Scott, M. M.


    Research in educational administration needs a coherent empirical base for a comprehensive, ecologically valid theory of administration. This paper describes Roger Barker's Behavior Setting Theory and promotes it as a broad-based conceptual framework for research on educational administration. (Author/TE)

  18. The Application of Persuasive Technology to educational settings: Some theoretical from the HANDS Project

    DEFF Research Database (Denmark)

    Mintz, Joseph; Aagaard, Morten


    In the HANDS project Persuasive Technology is applied in an educational context in special schools for children with autism, in which social skills development is the aim of the persuasion. We consider how in such educational settings the interventions can be theorized in the context of existing...... educational paradigms. We discuss the relation between such paradigms and persuasive technology, and the specific case of persuasion in the pedagogical context of children with autism....

  19. Learning with Nature and Learning from Others: Nature as Setting and Resource for Early Childhood Education (United States)

    MacQuarrie, Sarah; Nugent, Clare; Warden, Claire


    Nature-based learning is an increasingly popular type of early childhood education. Despite this, children's experiences--in particular, their form and function within different settings and how they are viewed by practitioners--are relatively unknown. Accordingly, the use of nature as a setting and a resource for learning was researched. A…

  20. Military Curriculum Materials for Vocational and Technical Education. Builders School, Ceramic Tile Setting 3-9. (United States)

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This course, for individualized or group instruction on ceramic tile setting, was developed from military sources for use in vocational education. The course provides students with skills in mortar preparation, surface preparation, tile layout planning, tile setting, tile cutting, and the grouting of tile joints. Both theory and shop assignments…

  1. [How to Understand "Clinical Ethics" and "Research Ethics" in Clinical Settings--Incorporation of IRB, REC, and CEC in Hospital Organizations]. (United States)

    Ita, Koichiro


    As the traditional definition of "medical ethics" has recently changed markedly with advances in medical knowledge and technology, medical doctors and researchers in Japan are required to understand and apply both research and clinical ethics. Quite frequently, ethical problems in clinical settings cannot be addressed by the simple application of good will, hard work, and perseverance by medical personnel. The Ministry of Health, Labour and Welfare (MHLW) and the Ministry of Education, Culture, Sports, Science and Technology (MEXT) have jointly published "Ethical Guidelines for Clinical Studies;" however, clear guidelines (legal, ministerial, or governmental) outlining the expectations regarding clinical ethics do not exist. All medical personnel face deep ethical dilemmas. In these instances, if the fulfillment of 'ethics' relies solely on the capacity of personnel to apply their own individual moral efforts, the result will be burn-out among these workers who have a strong sense of responsibility. In order to avoid this, a system which comprises multiple physicians, nurses, and other personnel must be established, allowing collaboration when an appropriate response is required. A major factor supporting this approach is the offering of Clinical Ethics Consultations.

  2. Characteristics of student preparedness for clinical learning: clinical educator perspectives using the Delphi approach

    Directory of Open Access Journals (Sweden)

    Chipchase Lucinda S


    Full Text Available Abstract Background During clinical placements, clinical educators facilitate student learning. Previous research has defined the skills, attitudes and practices that pertain to an ideal clinical educator. However, less attention has been paid to the role of student readiness in terms of foundational knowledge and attitudes at the commencement of practice education. Therefore, the aim of this study was to ascertain clinical educators’ views on the characteristics that they perceive demonstrate that a student is well prepared for clinical learning. Methods A two round on-line Delphi study was conducted. The first questionnaire was emailed to a total of 636 expert clinical educators from the disciplines of occupational therapy, physiotherapy and speech pathology. Expert clinical educators were asked to describe the key characteristics that indicate a student is prepared for a clinical placement and ready to learn. Open-ended responses received from the first round were subject to a thematic analysis and resulted in six themes with 62 characteristics. In the second round, participants were asked to rate each characteristic on a 7 point Likert Scale. Results A total of 258 (40.56% responded to the first round of the Delphi survey while 161 clinical educators completed the second (62.40% retention rate. Consensus was reached on 57 characteristics (six themes using a cut off of greater than 70% positive respondents and an interquartile deviation IQD of equal or less than 1. Conclusions This study identified 57 characteristics (six themes perceived by clinical educators as indicators of a student who is prepared and ready for clinical learning. A list of characteristics relating to behaviours has been compiled and could be provided to students to aid their preparation for clinical learning and to universities to incorporate within curricula. In addition, the list provides a platform for discussions by professional bodies about the role of placement

  3. Assessing the interplay between cognition and gait in the clinical setting.

    NARCIS (Netherlands)

    Snijders, A.H.; Verstappen, C.C.P.; Munneke, M.; Bloem, B.R.


    In this review, we outline how the influence of cognitive processes on gait or balance can be appreciated in a clinical setting. Careful history taking of the patient or direct carer provides information about multiple task problems in daily life and the presence of cognitive impairment, depression

  4. Refining Video Game Use Questionnaires for Research and Clinical Application: Detection of Problematic Response Sets (United States)

    Faust, Kyle A.; Faust, David; Baker, Aaron M.; Meyer, Joseph F.


    Even when relatively infrequent, deviant response sets, such as defensive and careless responding, can have remarkably robust effects on individual and group data and thereby distort clinical evaluations and research outcomes. Given such potential adverse impacts and the widespread use of self-report measures when appraising addictions and…

  5. Psychological, Relational, and Biological Correlates of Ego-Dystonic Masturbation in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Giovanni Castellini, PhD, MD


    Conclusion: Clinicians should consider that some subjects seeking treatment in a sexual medicine setting might report compulsive sexual behaviors. EM represents a clinically relevant cause of disability, given the high level of psychological distress reported by subjects with this condition, and the severe impact on quality of life in interpersonal relationships.

  6. Key issues in setting up and running a nurse-led cardiology clinic. (United States)

    Hatchett, Richard

    This article discusses the key issues involved in setting up and running an effective nurse-led cardiology clinic. These include: developing clear aims and objectives for the service, techniques to reduce resistance from colleagues who are affected by the change in service provision, professional development, audit and evaluation.

  7. The Clinical Nurse Specialist in the School Setting: Case Management of Migrant Children with Dental Disease. (United States)

    Good, Mary Ellen

    This paper presents strategies for the clinical nurse specialist (CNS) in the school setting to use in case management of migrant children with dental disease. Although dental disease is the major health problem of all school-age children in the nation, the problem is even more severe for children of migrant farmworkers. Leininger's transcultural…

  8. Clinical utility of the Snaith-Hamilton-Pleasure scale in the Chinese settings

    Directory of Open Access Journals (Sweden)

    Liu Wen-hua


    Full Text Available Abstract Background The Snaith-Hamilton-Pleasure-Scale (SHAPS is a self-reported scale evaluating anhedonia for neuropsychiatric disorders. It has demonstrated with impressive psychometric properties and advantages in its applicability over other similar instruments. However, very few studies have been conducted to examine the clinical utility of the SHAPS in the context of Chinese settings. The current study aimed to examine the clinical utility of the translated version of the SHAPS in the Chinese clinical settings. Methods A Chinese version of SHAPS was administered to 336 college students to examine the internal consistency and test-retest reliability at a 4-week interval. Moreover, the translated SHAPS was also administered to 141 patients with major depression, 72 patients with schizophrenia, and 72 healthy controls to examine its clinical discrimination. Results The internal consistency of the SHAPS for the non-clinical sample and test-retest reliability at a 4- week interval were 0.85 and 0.64, respectively. Moreover, the SHAPS also showed an excellent internal consistency (alpha was 0.93 and a one-factor solution with the first factor accounted for 51.53% of the variance in the clinical psychiatric samples. ANOVA of the SHAPS total score indicated that the patients with depression scored significantly more anhedonia than the patients with schizophrenia and healthy controls (p Conclusions These findings suggest that the Chinese version of the SHAPS is a useful and promising instrument in assessing anhedonia for clinical patients and non-clinical individuals in the Chinese settings.

  9. Promoting Task Accuracy and Independence in Students with Autism across Educational Setting through the Use of Individual Work Systems (United States)

    Hume, Kara; Plavnick, Joshua; Odom, Samuel L.


    Strategies that promote the independent demonstration of skills across educational settings are critical for improving the accessibility of general education settings for students with ASD. This research assessed the impact of an individual work system on the accuracy of task completion and level of adult prompting across educational setting.…

  10. Outsiders in nursing education: cultural sensitivity in clinical education. (United States)

    Debrew, Jacqueline Kayler; Lewallen, Lynne Porter; Chun, Edna


    Cultural competence is a stated value of nursing and nursing education. However, some institutional and traditional practices in nursing education can unintentionally impede nurses from achieving cultural competence. Both the literature and interviews with nurse educators show that despite educators' intentions to treat all students the same, nontraditional students may feel singled out and may in fact be singled out for closer scrutiny because of their difference from the demographic norms of nursing students. To ensure that the nursing profession reflects the composition of the patient population it serves, nurse educators must first acknowledge the Eurocentric culture of nursing education and, then, work to change the environment in which students are recruited, learn, and take on the role of beginning practicing nurses.

  11. International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271. (United States)

    Robertson, K; Jiang, H; Evans, S R; Marra, C M; Berzins, B; Hakim, J; Sacktor, N; Silva, M Tulius; Campbell, T B; Nair, A; Schouten, J; Kumwenda, J; Supparatpinyo, K; Tripathy, S; Kumarasamy, N; la Rosa, A; Montano, S; Mwafongo, A; Firnhaber, C; Sanne, I; Naini, L; Amod, F; Walawander, A


    Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.

  12. Clinical leadership development and education for nurses: prospects and opportunities

    Directory of Open Access Journals (Sweden)

    Joseph ML


    Full Text Available M Lindell Joseph, Diane L Huber College of Nursing, The University of Iowa, Iowa City, IA, USA Abstract: With the implementation of the Affordable Care Act, elevated roles for nurses of care coordinator, clinical nurse leader, and advanced practice registered nurse have come to the forefront. Because change occurs so fast, matching development and education to job requirements is a challenging forecasting endeavor. The purpose of this article is to envision clinical leadership development and education opportunities for three emerging roles. The adoption of a common framework for intentional leadership development is proposed for clinical leadership development across the continuum of care. Solutions of innovation and interdependency are framed as core concepts that serve as an opportunity to better inform clinical leadership development and education. Additionally, strategies are proposed to advance knowledge, skills, and abilities for crucial implementation of improvements and new solutions at the point of care. Keywords: clinical leadership, nursing leadership, CNL, care coordination, innovation, interdependency

  13. Problems of Clinical Education According to Junior and Senior Nursing Students\\' Viewpoint at Qom Nursing and Midwifery School in 2008

    Directory of Open Access Journals (Sweden)

    M Abbasi


    Full Text Available Objectives : Clinical education is a dynamic process which plays an important role in training professional nurses. The role of ideal clinical education is undeniable in personal and professional development and clinical expertise of nurses. Nevertheless, students encounter some problems in clinical education. Undoubtedly, awareness of these problems is the first step in reducing them. One of the best and almost reliable sources of assessing such problems are the students themselves. The present study was caried out to assess the clinical education problems from the viewpoints of nursing students studying at their third or fourth year of education at Qom School of Nursing and Midwifery in 2008. Method : The study was a descriptive one in which 53 junior and senior students of nursing participated to answer some clinical education problems of nursing through a self-made questionnaire consisting of 5 domains and 31 questions. Results : The most important problems of clinical education from students' viewpoints included: sufficient clinical practice history among trainers (34%, giving information to the students about their evaluation method before clinical training (26.4%, and reinforcing students' self-confidence at clinical environment (24.5%. Low-importance items were: coordination between educational objectives and Personnel Expectations (50.9%, Welfare Facilities (47.2%, use of educational aids at clinical setting, and enough motivation for Employment at nursing (45.3%. Conclusion : On the basis of the findings of the study, it seems possible to decrease some of the most important problems of nursing students through determining goals and coordinating between educational goals and staff's expectations and preparing welfare and educational equipment for clinical wards.

  14. Advances In Infection Surveillance and Clinical Decision Support With Fuzzy Sets and Fuzzy Logic. (United States)

    Koller, Walter; de Bruin, Jeroen S; Rappelsberger, Andrea; Adlassnig, Klaus-Peter


    By the use of extended intelligent information technology tools for fully automated healthcare-associated infection (HAI) surveillance, clinicians can be informed and alerted about the emergence of infection-related conditions in their patients. Moni--a system for monitoring nosocomial infections in intensive care units for adult and neonatal patients--employs knowledge bases that were written with extensive use of fuzzy sets and fuzzy logic, allowing the inherent un-sharpness of clinical terms and the inherent uncertainty of clinical conclusions to be a part of Moni's output. Thus, linguistic as well as propositional uncertainty became a part of Moni, which can now report retrospectively on HAIs according to traditional crisp HAI surveillance definitions, as well as support clinical bedside work by more complex crisp and fuzzy alerts and reminders. This improved approach can bridge the gap between classical retrospective surveillance of HAIs and ongoing prospective clinical-decision-oriented HAI support.

  15. Strengthening Clinical Preparation: The Holy Grail of Teacher Education (United States)

    Darling-Hammond, Linda


    Efforts to improve teacher education have recently focused in on the importance of well-supervised clinical practice as a critical element of effective preparation. This article outlines the challenges to creating productive clinical experiences for prospective teachers, and identifies strategies that have been found successful in confronting…

  16. How Stable are Temperaments in the Clinical Setting: A Pilot Study (United States)

    Karam, Elie G.; El Khoury, Elaine; Itani, Lynn


    Background An essential point in evaluating the utility of measuring temperaments is the stability of the instrument used especially in the presence of mental disorders. One of the most commonly used instruments in the clinical setting is the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A). To our knowledge, the TEMPS-A’s stability in an outpatient adult clinical setting has not been evaluated. Objective: To assess the stability of the effect of temperament, time and clinical intervention. Methods: A sample of 89 adult outpatients was assessed at baseline and follow-up on their TEMPS-A scores. Diagnoses of mental disorders were reached through clinical interviews, and the severity of the conditions was clinically assessed at baseline and follow-up on a Likert scale. Changes in scores were examined in terms of z-scores, and possible predictors of the change in scores were assessed. Results: Eighty-nine percent of all subjects’ temperaments scores did not change or changed less than one z-score, and specifically: 84.2% in the case of depressive, 89.9% for cyclothymic, 92.1% for hyperthymic, 92.2% for irritable, and 86.5% for anxious temperaments. For all of the five temperaments, age, gender, time difference between baseline and follow up, number of diagnoses, and percent improvement were not significantly associated with the change in temperament scores. Limitations: Well-established severity measures would add to the validity of any future findings. Conclusion: Shifts in temperament scores between baseline and follow-up were minor, thus proving the stability of temperaments and the TEMPS-A scale in a clinical setting. PMID:27733865

  17. Priority setting in family change and clinical practice: the Family FIRO Model. (United States)

    Doherty, W J; Colangelo, N; Hovander, D


    We update a theoretical framework for understanding priority setting for the management of family change, with special emphasis on developmental change. We propose that three core dimensions of family interaction--inclusion, control, and intimacy--constitute an optimal priority sequence for managing major family change stemming from life-cycle transitions and other stressful experiences. In the next section of the article, we compare the Family FIRO Model and other models of family change. Finally, we suggest that therapists can benefit from an explicit, clinical decision-making model for setting priorities in treatment: issues of inclusion take precedence over issues of control, which in turn take precedence over issues of intimacy.

  18. Developing students' time management skills in clinical settings: practical considerations for busy nursing staff. (United States)

    Cleary, Michelle; Horsfall, Jan


    In clinical settings, nursing staff often find themselves responsible for students who have varying time management skills. Nurses need to respond sensitively and appropriately, and to teach nursing students how to prioritize and better allocate time. This is important not only for developing students' clinical skills but also for shaping their perceptions about the quality of the placement and their willingness to consider it as a potential work specialty. In this column, some simple, practical strategies that nurses can use to assist students with improving their time management skills are identified.

  19. Assessing the impact of educational campaigns on controlling HCV among women in prison settings (United States)

    Mushayabasa, S.; Bhunu, C. P.; Smith?, Robert J.


    Prior studies have shown that imprisonment is a major risk factor for hepatitis C infection, with the risk of infection directly proportional to the length of incarceration. Women are at least twice as likely as men to contract HCV as they have limited access to information, health services and safe intravenous drug injecting equipments. We develop a mathematical model to assess the impact of educational campaigns on controlling HCV among women in prison settings. Equilibria for the model are determined and their stability are examined. Population-level effects of increased educational campaigns to encourage safe injecting practices among women in prison are evaluated through numerical simulations. The results suggest that educating women prisoners about abstaining from intravenous drug misuse may significantly reduce HCV prevalence among women in prison settings. Targeted education campaigns, which are effective at stopping transmission of HCV more than 80% of the time, will be highly effective at controlling the disease among women in prisons.

  20. Clinical risk and depression (continuing education credit). (United States)

    Sharkey, S


    This article provides information and guidance to nurses on clinical risks in mental health, particularly that of depression. It relates to UKCC professional development category: Reducing risk and Care enhancement.

  1. Genetic counsellors in Sweden: their role and added value in the clinical setting. (United States)

    Pestoff, Rebecka; Ingvoldstad, Charlotta; Skirton, Heather


    Genetic testing is becoming more commonplace in general and specialist health care and should always be accompanied by genetic counselling, according to Swedish law. Genetic counsellors are members of the multi-disciplinary team providing genetic counselling. This study examined the role and added value of genetic counsellors in Sweden, using a cross-sectional on-line survey. The findings showed that the genetic counsellors added value in the clinical setting by acting as the 'spider-in-the-web' regarding case management, having a more holistic, ethical and psychological perspective, being able to offer continuous support and build a relationship with the patient, and being more accessible than medical geneticists. The main difference between a genetic counsellor and medical geneticist was that the doctor had the main medical responsibility. Thus genetic counsellors in Sweden contribute substantially to the care of patients in the clinical genetic setting.

  2. "A golden opportunity": Exploring interprofessional learning and practice in rural clinical settings. (United States)

    Spencer, Judy; Woodroffe, Jessica; Cross, Merylin; Allen, Penny


    Little is known about interprofessional practice (IPP) and interprofessional learning (IPL) in rural health services, despite national funding and continuing emphasis on increasing students' clinical placements in rural areas. This short paper outlines a study in Tasmania, Australia, which investigated how and under what contexts and conditions IPP and IPL occur in rural clinical settings, and the enabling factors and strategies that promote this learning and practice. This study employed a mixed method design comprising focus group discussions and a survey involving health professionals from two rural health services. The findings demonstrate that formal and informal arrangements, the collaborative nature of small, close-knit healthcare teams and patient-centred models of care employed in rural practice settings, provide ideal contexts for IPP and IPL. The study has implications for promoting organisational readiness for IPP and IPL and harnessing the potential of rural services to promote and develop students' interprofessional capability.

  3. Setting Global Standards for Stem Cell Research and Clinical Translation: The 2016 ISSCR Guidelines

    Directory of Open Access Journals (Sweden)

    George Q. Daley


    Full Text Available The International Society for Stem Cell Research (ISSCR presents its 2016 Guidelines for Stem Cell Research and Clinical Translation (ISSCR, 2016. The 2016 guidelines reflect the revision and extension of two past sets of guidelines (ISSCR, 2006; ISSCR, 2008 to address new and emerging areas of stem cell discovery and application and evolving ethical, social, and policy challenges. These guidelines provide an integrated set of principles and best practices to drive progress in basic, translational, and clinical research. The guidelines demand rigor, oversight, and transparency in all aspects of practice, providing confidence to practitioners and public alike that stem cell science can proceed efficiently and remain responsive to public and patient interests. Here, we highlight key elements and recommendations in the guidelines and summarize the recommendations and deliberations behind them.

  4. Habermas’ Cognitive Interests: Teacher and Student Interests and their Relationship in an Adult Education Setting (United States)


    20503. 1. AGENCY USE ONLY (Leaveblank) 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED 3 Sep 97 1 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS HABERMAS ... HABERMAS ’ COGNITIVE INTERESTS: TEACHER AND STUDENT INTERESTS AND THEIR RELATIONSHIP IN AN ADULT EDUCATION SETTING Stephen Lee Butler Doctor of Education...cognitive interest theory of German philosopher Jhrgen Habermas provided the theoretical foundation for this research. Habernas believes that all

  5. [Scientific, practical and educational aspects of clinical epidemiology]. (United States)

    Briko, N I


    This article defines clinical epidemiology and describes its goal and objectives. The author claims that clinical epidemiology is a section of epidemiology which underlies the development of evidence-based standards for diagnostics, treatment and prevention and helps to select the appropriate algorithm for each clinical case. The study provides a comprehensive overview of the relationship between clinical epidemiology and evidence-based medicine. Epidemiological research is shown to be methodological basis of clinical epidemiology and evidence-based medicine with randomized controlled trials being the "gold standard" for obtaining reliable data. The key stages in the history of clinical epidemiology are discussed and further development of clinical epidemiology and the integration of courses on clinical epidemiology in education is outlined for progress in medical research and health care practice.

  6. Suspected pulmonary embolism and deep venous thrombosis: A comprehensive MDCT diagnosis in the acute clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Salvolini, Luca [Radiology Department, ' Umberto I' Hospital - Ospedali Riuniti - ' Politecnica delle Marche' University, Via Conca, 60020 Ancona (Italy)], E-mail:; Scaglione, Mariano [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Giuseppetti, Gian Marco; Giovagnoni, Andrea [Radiology Department, ' Umberto I' Hospital - Ospedali Riuniti - ' Politecnica delle Marche' University, Via Conca, 60020 Ancona (Italy)


    Both pulmonary arterial and peripheral venous sides of venous thromboembolism (VTE) can now be efficiently and safely investigated by multi-detector CT (MDCT) at the same time by a combined CT angiography/CT venography protocol. In the emergency setting, the use of such a single test for patients suspected of suffering from VTE on a clinical grounds may considerably shorten and simplify diagnostic algorithms. The selection of patients to be submitted to MDCT must follow well-established clinical prediction rules in order to avoid generalized referral to CT on a generic clinical suspicion basis and excessive population exposure to increased ionizing radiation dose, especially in young patients. Clinical and anatomical wide-panoramic capabilities of MDCT allow identification of underlying disease that may explain patients' symptoms in a large number of cases in which VTE is not manifest. The analysis of MDCT additional findings on cardiopulmonary status and total thrombus burden can lead to better prognostic stratification of patients and influence therapeutic options. Some controversial points such as optimal examination parameters, clinical significance of subsegmentary emboli, CT pitfalls and/or possible falsely positive diagnoses, and outcome of untreated patients in which VTE has been excluded by MDCT without additional testing, must of course be taken into careful consideration before the definite role of comprehensive MDCT VTE 'one-stop-shop' diagnosis in everyday clinical practice can be ascertained.

  7. Twenty years of the Journal of Clinical Psychology in Medical Settings: we hope you will enjoy the show. (United States)

    Rozensky, Ronald H; Tovian, Steven M; Sweet, Jerry J


    The 20th anniversary of the Journal of Clinical Psychology in Medical Settings is celebrated by highlighting the scientist-practitioner philosophy on which it was founded. The goal of the Journal-to provide an outlet for evidence-based approaches to healthcare that underscore the important scientific and clinical contributions of psychology in medical settings-is discussed. The contemporary relevance of this approach is related to the current implementation of the Patient Protection and Affordable Care and its focus on accountability and the development of an interprofessional healthcare workforce; both of which have been foci of the Journal throughout its history and will continue to be so into the future. Several recommendations of future topic areas for the Journal to highlight regarding scientific, practice, policy, and education and training in professional health service psychology are offered. Successfully addressing these topics will support the growth of the field of psychology in the ever evolving healthcare system of the future and continue ensure that the Journal is a key source of professional information in health service psychology.

  8. Safety of telemental healthcare delivered to clinically unsupervised settings: a systematic review. (United States)

    Luxton, David D; Sirotin, Anton P; Mishkind, Matthew C


    The safety of telemental healthcare delivered to clinically unsupervised settings, such as a personal residence, must be established to inform policy and further the dissemination of telemental health programs. The aim of this article is to provide an overview of safety issues associated with telemental healthcare and, through a systematic literature review, evaluate the safety of telemental healthcare delivered to unsupervised settings. The review resulted in a total of nine studies that specifically evaluated the delivery of telemental healthcare to unsupervised settings. Six of the nine studies reviewed explicitly described safety plans or specific precautions that could be used if necessary. Two of the nine studies reported events that required the researchers to use safety procedures to effectively respond to concerns they had regarding participant safety. In both of these studies, the issues were resolved with prescribed safety procedures. Recommendations and future directions for the development and evaluation of safety protocols are discussed.

  9. Sharing clinical information across care settings: the birth of an integrated assessment system

    Directory of Open Access Journals (Sweden)

    Henrard Jean-Claude


    Full Text Available Abstract Background Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific. Methods From 2002, the interRAI research collaborative undertook development of a suite of assessment tools to support assessment and care planning of persons with chronic illness, frailty, disability, or mental health problems across care settings. The suite constitutes an early example of a "third generation" assessment system. Results The rationale and development strategy for the suite is described, together with a description of potential applications. To date, ten instruments comprise the suite, each comprising "core" items shared among the majority of instruments and "optional" items that are specific to particular care settings or situations. Conclusion This comprehensive suite offers the opportunity for integrated multi-domain assessment, enabling electronic clinical records, data transfer, ease of interpretation and streamlined training.

  10. The clinical nurse leader in the perioperative setting: a preceptor experience. (United States)

    Wesolowski, Michael S; Casey, Gwendolyn L; Berry, Shirley J; Gannon, Jane


    The U.S. Veterans Administration (VA) has implemented the clinical nurse leader (CNL) role nationwide. Nursing leaders at the Malcolm Randall VA Medical Center in Gainesville, Florida, implemented the development of the CNL role in the perioperative setting during the summer of 2012. The perioperative department developed the position in partnership with the University of Florida College of Nursing, Gainesville, Florida. The team developed a description of the roles and experiences of the preceptors, the clinical nurse leader resident, and the University of Florida faculty member. The clinical nurse leader resident's successes and the positive outcomes, such as improved patient outcomes, experienced by the perioperative department demonstrated the importance of the CNL role.

  11. [Conscientious objection in the clinical setting. A proposal for its appropriate use]. (United States)

    Couceiro, A; Seoane, J A; Hernando, P


    Social changes and new technologies have brought new problems in doctor-patient relationships. In many clinical contexts conscientious objection is misused, with negative effects for patients, healthcare professionals and institutions. The paper aims to clarify what conscientious objection means in a plural society based on a deliberative democracy and to show the different ways of understanding this society in order to respect both the ethical reasons of individuals and the compulsory normative framework of the Rule of Law. Furthermore, the paper identifies some clinical settings where conscientious objection is often invoked by healthcare professionals, and points out and analyses the arguments that explain why this appeal for conscientious objection is neither legitimate nor correct. Finally, it provides examples of the legal basis and Spanish jurisprudence, as well as the relevant clinical and ethical literature on this topic.

  12. Open-source mobile digital platform for clinical trial data collection in low-resource settings (United States)

    van Dam, Joris; Omondi Onyango, Kevin; Midamba, Brian; Groosman, Nele; Hooper, Norman; Spector, Jonathan; Pillai, Goonaseelan (Colin); Ogutu, Bernhards


    Background Governments, universities and pan-African research networks are building durable infrastructure and capabilities for biomedical research in Africa. This offers the opportunity to adopt from the outset innovative approaches and technologies that would be challenging to retrofit into fully established research infrastructures such as those regularly found in high-income countries. In this context we piloted the use of a novel mobile digital health platform, designed specifically for low-resource environments, to support high-quality data collection in a clinical research study. Objective Our primary aim was to assess the feasibility of a using a mobile digital platform for clinical trial data collection in a low-resource setting. Secondarily, we sought to explore the potential benefits of such an approach. Methods The investigative site was a research institute in Nairobi, Kenya. We integrated an open-source platform for mobile data collection commonly used in the developing world with an open-source, standard platform for electronic data capture in clinical trials. The integration was developed using common data standards (Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model), maximising the potential to extend the approach to other platforms. The system was deployed in a pharmacokinetic study involving healthy human volunteers. Results The electronic data collection platform successfully supported conduct of the study. Multidisciplinary users reported high levels of satisfaction with the mobile application and highlighted substantial advantages when compared with traditional paper record systems. The new system also demonstrated a potential for expediting data quality review. Discussion and Conclusions This pilot study demonstrated the feasibility of using a mobile digital platform for clinical research data collection in low-resource settings. Sustainable scientific capabilities and infrastructure are essential to attract and

  13. Clinical skills training in undergraduate medical education using a student-centered approach

    DEFF Research Database (Denmark)

    Tolsgaard, Martin Grønnebæk


    development initiatives are required before implementation in large and dispersed settings. In conclusion, this thesis demonstrated different aspects of student-centered approaches to clinical skills learning. Whereas self-directed learning is difficult in clinical clerkship, the experimental studies......This thesis focuses on how to engage students in self-directed learning and in peer-learning activities to improve clinical skills training in undergraduate medical education. The first study examined the clinical skills teaching provided by student teachers compared to that provided by associate...... professors. This study showed that student teachers performed as good as or even better than associate professors when teaching simple clinical skills. The second study of this thesis examined how complex clinical skills--such as patient management skills--develop with increasing levels of competence...

  14. Core components of clinical education: a qualitative study with attending physicians and their residents

    Directory of Open Access Journals (Sweden)



    Full Text Available Introduction: In medical education, particularly in residency courses, most of the training occurs in real clinical environments. Workplace-based learning profoundly affects students’ knowledge, attitudes, and practice; therefore, it should be properly planned. Due to the extensiveness of the clinical environment and its importance in training residents, investigating how residents learn in these environments and detecting factors that influence effectiveness will help curriculum designers to promote residents’ learning by improving their learning environment. Therefore, our qualitative content analysis study, aimed to examine the experiences and perspectives of internal and surgical residents and their attending physicians about learning in clinical settings. Methods: This qualitative content analysis study was conducted through purposeful sampling. Semi-structured interviews were conducted with 15 internal and surgical residents and 15 of their attending physicians at educational hospitals of Tehran University of Medical Sciences. Results: The main categories explored in this study were hidden curriculum, learning resources, and learning conditions. In the context of clinical environment and under its individual culture, residents learn professionalism and learn to improve their communication skills with patients and colleagues. Because of clinical obligations such as priority of treating the patients for education or workload of the attending physicians, residents acquire most of their practical knowledge from colleagues, fellows, or follow-up patients in different learning conditions (such as: educational rounds, morning reports and outpatient clinics. They see some of their attending physicians as role models. Conclusion: Changing cultural and contextual factors is of prime importance to promote a learning-oriented environment in a clinical setting. The present findings will help curriculum planners and attending physicians to improve

  15. A Role for the Clinical Medical Librarian in Continuing Education (United States)

    Christensen, John B.; And Others


    The trial distribution of a specialized abstracting service, using the publication "Current References," to physicians practicing in rural communities in western Missouri is reported. The service was developed by clinical medical librarians who regularly leave the library setting to work with a docent team in the patient care setting.…

  16. A managed clinical network for cardiac services: set-up, operation and impact on patient care

    Directory of Open Access Journals (Sweden)

    Karen E. Hamilton


    Full Text Available Purpose: To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. Methods: This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Results: Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and ‘bed down’. Its primary “modus operand” was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were

  17. Nurse educators and student nurse neophytes’ perceptions of good interaction in the classroom setting

    Directory of Open Access Journals (Sweden)

    Friddah R. Mathevula


    Full Text Available The first session of interaction in the classroom often sets an atmosphere for the entire period of learning. In terms of nurse educator and student nurse neophyte relations, good interaction is essential in helping students to recognise their own responsibilities and to respond positively during the learning process. The purpose of this study was to determine the nurse educators’ and student nurse neophytes’ perceptions of good interaction in the classroom setting. The study attempted to answer the following specific question: ‘What do nurse educators and student nurse neophytes regard as examples of good interaction in the classroom setting?’ The accessible population in this study were all student nurse neophytes registered with the University of Venda for the Baccalaureus Curationis, and nurse educators responsible for teaching first-year student nurses in this programme. The study used probability stratified random sampling to obtain two heterogeneous groups of student participants. Forty first-year student nurses were divided into homogenous subsets of 15 male and 25 female students. A random sampling was conducted to arrive at 10 male and 15 female students. The sampling method relating to nurse educators was purposive sampling. Focus groups were used to interview students using individual in-depth interviews to gather data from nurse educators. Coding was used to organise the data collected during the interviews. The study revealed that nurse educators and student nurse neophytes concur that the ethical behaviours influencing good interaction are respect and support, good communication, honesty and openness. Age, gender and cultural background were also factors. The participants further indicated that good interaction has benefits such as improved co-operation levels, the enhancement of learning, the improvement of pass rates, and a reduction in dropout rates. In conclusion, there is a need for nurse educators and student nurses

  18. The use of portfolios for continuing assessment of physiotherapy students in clinical practice settings

    Directory of Open Access Journals (Sweden)

    N. Naidoo


    Full Text Available Many and varied methods of assessment are used to evaluate undergraduate physiotherapy students. Different modes of assessment occur as a result of contrasting educational theories and because the purpose of assessment is variable. In this era of performance assessment related to  the students’ mastery of the core curriculum, portfolios can enhance the assessment process by revealing a range of skills and understandings. This fits snugly into the physiotherapy curriculum for undergraduate continuous assessment purposes. Portfolio assessment can facilitate more reflection on students’ learning, more ownership of learning and more awareness of self-development. This supports the South African Qualifications Authority’s objective for higher education of reflection and life-long learning in our students. This article presents discussion on the use of portfolios in physiotherapy student learning and assessment in clinical practice.

  19. Nursing preceptors' experiences of two clinical education models. (United States)

    Mamhidir, Anna-Greta; Kristofferzon, Marja-Leena; Hellström-Hyson, Eva; Persson, Elisabeth; Mårtensson, Gunilla


    Preceptors play an important role in the process of developing students' knowledge and skills. There is an ongoing search for the best learning and teaching models in clinical education. Little is known about preceptors' perspectives on different models. The aim of the study was to describe nursing preceptors' experiences of two clinical models of clinical education: peer learning and traditional supervision. A descriptive design and qualitative approach was used. Eighteen preceptors from surgical and medical departments at two hospitals were interviewed, ten representing peer learning (student work in pairs) and eight traditional supervision (one student follows a nurse during a shift). The findings showed that preceptors using peer learning created room for students to assume responsibility for their own learning, challenged students' knowledge by refraining from stepping in and encouraged critical thinking. Using traditional supervision, the preceptors' individual ambitions influenced the preceptorship and their own knowledge was empathized as being important to impart. They demonstrated, observed and gradually relinquished responsibility to the students. The choice of clinical education model is important. Peer learning seemed to create learning environments that integrate clinical and academic skills. Investigation of pedagogical models in clinical education should be of major concern to managers and preceptors.

  20. The use of blogging in tertiary healthcare educational settings to enhance reflective learning in nursing leadership. (United States)

    Levine, Theodora C


    Web 2.0 technologies such as blogs are increasingly used in academic settings; however, they are not widely used in hospital settings. This project explored the effectiveness of using a blog to enhance reflective learning in a nurse manager leadership development course of a tertiary care hospital setting. Differences in reflective learning between the blog group and traditional learning group were measured post training using a Reflective Learning and Interaction Questionnaire. Although the groups did not differ significantly on any reflective learning dimension (p educators contemplating to incorporate blogs into their learning strategies to enhance reflective learning.

  1. Leading School Improvement: African American Women Principals in Urban Educational Settings (United States)

    Mack, Yejide S.


    African American women administrators working in urban educational settings have been found to be effective leaders of school improvement. Underutilized women and people of color are the untapped value that organizations of all types need to enhance creativity, change efforts, teamwork, and financial benefits (Northouse, 2001). During the last…

  2. Leading Teams of Higher Education Administrators: Integrating Goal Setting, Team Role, and Team Life Cycle Theories (United States)

    Posthuma, Richard; Al-Riyami, Said


    Leaders of higher education institutions can create top management teams of academic administrators to guide and improve their organizations. This study illustrates how the leadership of top management teams can be accomplished successfully through a combination of goal setting (Doran, 1981; Locke & Latham, 1990), understanding of team roles…

  3. Lesbian, Gay, and Heterosexual Adoptive Parents' Perceptions of Inclusivity and Receptiveness in Early Childhood Education Settings (United States)

    Goldberg, Abbie E.; Black, Kaitlin; Sweeney, Kristin; Moyer, April


    Little research has examined the experiences of lesbian/gay (LG) parent families or adoptive parent families in early childhood education settings. This study uses interview data to examine the perceptions and experiences of 45 lesbian, gay, and heterosexual couples (90 individuals) with 10 adopted children with respect to their (1) openness with…

  4. Chlamydia screening strategies and outcomes in educational settings: a systematic review. (United States)

    Jamil, Muhammad Shahid; Bauer, Heidi M; Hocking, Jane S; Ali, Hammad; Wand, Handan; Walker, Jennifer; Douglas, Laura; Donovan, Basil; Kaldor, John M; Guy, Rebecca J


    Chlamydia trachomatis (CT) screening programs have been established in educational settings in many countries during the past 2 decades. However, recent evidence suggests that high uptake of screening and management (treatment, partner notification, and retesting for reinfection) improves program effectiveness. We conducted a systematic review to understand the screening strategies, the extent of screening conducted, and uptake of management strategies in educational settings. Screening studies in educational settings were identified through a systematic search of published literature from 2005 to 2011. We identified 27 studies describing 30 screening programs in the United States/Canada (n = 10), Europe (n = 8), Australia/New Zealand (n = 5), and Asia (n = 4). Most studies targeted both male and female students (74%). Classroom-based strategies resulted in 21,117 testes overall (4 programs), followed by opportunistic screening during routine health examination (n = 13,470; 5 programs) and opportunistic screening at school-based health centers (n = 13,006; 5 programs). The overall median CT positivity was 4.7% (range, 1.3%-18.1%). Only 5 programs reported treatment rates (median, 100%; range, 86%-100%), 1 partner notification rate (71%), 1 retesting rate within a year of an initial CT diagnosis (47%), and 2 reported repeat positivity rates (21.1% and 26.3%). In conclusion, this systematic review shows that a variety of strategies have been used to screen large numbers of students in educational settings; however, only a few studies have reported CT management outcomes.

  5. The Use of Weblogs in Higher Education Settings: A Review of Empirical Research (United States)

    Sim, Jeffrey Wee Sing; Hew, Khe Foon


    "Weblogs" or "blogs" are increasingly visible in higher education settings. Some scholars suggest that blogs are useful because of their reflective nature. However, as this review indicates the research regarding blogs is largely self-report data (surveys, interviews) or content analyses. This review summarizes results of this existing research on…

  6. Re-Setting the Concentration Levels of Students in Higher Education: An Exploratory Study (United States)

    Burke, Lisa A.; Ray, Ruth


    Evidence suggests that college students' concentration levels are limited and hard to maintain. Even though relevant in higher education, scant empirical research exists on interventions to "re-set" their concentration during a college lecture. Using a within-subjects design, four active learning interventions are administered across two…

  7. Integrated Educational and Mental Health Services within a Day Treatment Setting. (United States)

    Francis, Greta; Radka, Dale F.

    This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…

  8. Expectations, Realizations, and Approval of Tablet Computers in an Educational Setting (United States)

    Hassan, Mamdouh; Geys, Benny


    The introduction of new technologies in classrooms is often thought to offer great potential for advancing learning. In this article, we investigate the relationship between such expectations and the post-implementation evaluation of a new technology in an educational setting. Building on psychological research, we argue that (1) high expectations…

  9. Adaptive Behavior of Primary School Students with Visual Impairments: The Impact of Educational Settings (United States)

    Metsiou, Katerina; Papadopoulos, Konstantinos; Agaliotis, Ioannis


    This study explored the adaptive behavior of primary school students with visual impairments, as well as the impact of educational setting on their adaptive behavior. Instrumentation included an informal questionnaire and the Vineland Adaptive Behavior Scales. Participants were 36 primary school students with visual impairments. The educational…

  10. Stereoscopy in Static Scientific Imagery in an Informal Education Setting: Does It Matter? (United States)

    Price, C. Aaron; Lee, H.-S.; Malatesta, K.


    Stereoscopic technology (3D) is rapidly becoming ubiquitous across research, entertainment and informal educational settings. Children of today may grow up never knowing a time when movies, television and video games were not available stereoscopically. Despite this rapid expansion, the field's understanding of the impact of stereoscopic…

  11. Informal Music Education: The Nature of a Young Child's Engagement in an Individual Piano Lesson Setting (United States)

    Kooistra, Lauren


    The purpose of this study was to gain insight into the nature of a young child's engagement in an individual music lesson setting based on principles of informal learning. The informal educational space allowed the child to observe, explore, and interact with a musical environment as a process of enculturation and development (Gordon, 2013;…

  12. Setting a Neglected Variable in Science Education: Investigations Into Outdoor Field Trips. Final Report. (United States)

    Falk, John H.; Balling, John D.

    Reported are three studies of attitudes towards and effects of science education field trips. In the first study, 425 fifth and sixth graders participated in outdoor science activities in one of three types of settings. Results indicated that more learning took place when the number of available examples of concepts to be learned and setting…

  13. The Evidence for Student-Focused Motivational Interviewing in Educational Settings: A Review of the Literature (United States)

    Snape, Laura; Atkinson, Cathy


    The current systematic literature review sought to determine the effectiveness of Motivational Interviewing (MI) in educational settings. Student-focused school-based MI (SBMI) studies were assessed using qualitative and quantitative assessment frameworks and data were reported using PRISMA guidelines. Eleven studies met the inclusion criteria,…

  14. Turkish Special Education Teachers' Implementation of Functional Analysis in Classroom Settings (United States)

    Erbas, Dilek; Yucesoy, Serife; Turan, Yasemin; Ostrosky, Michaelene M.


    Three Turkish special education teachers conducted a functional analysis to identify variables that might initiate or maintain the problem behaviors of three children with developmental disabilities. The analysis procedures were conducted in natural classroom settings. In Phase 1, following initial training in functional analysis procedures, the…

  15. A Critical Appraisal of Four Approaches Which Support Teachers' Problem-Solving within Educational Settings (United States)

    Bennett, Sue; Monsen, Jeremy J.


    This paper critically appraises four problem-solving approaches, based on a range of theoretical perspectives and procedures, which are currently used in educational settings to support adults to find solutions to complex problems that arise within classrooms and the wider school community. The four approaches are: Circles of Adults; Teacher…

  16. Children with Cochlear Implants in Australia: Educational Settings, Supports, and Outcomes (United States)

    Punch, Renee; Hyde, Merv


    This Australian study examined the communication, academic, and social outcomes of pediatric cochlear implantation from the perspectives of teachers working with children with cochlear implants. The children were aged from 1 to 18 years and attended a range of educational settings in early intervention, primary, and secondary schooling. One…

  17. Cyberbullying among students with intellectual and developmental disability in special education settings.

    NARCIS (Netherlands)

    Didden, R.; Scholte, R.H.J.; Korzilius, H.; Moor, J.M.H. de; Vermeulen, A.; O'Reilly, M.F.; Lang, R.; Lancioni, G.E.


    OBJECTIVE: To explore the types, prevalence and associated variables of cyberbullying among students with intellectual and developmental disability attending special education settings. METHODS: Students (n = 114) with intellectual and developmental disability who were between 12-19 years of age com

  18. Cyberbullying among students with intellectual and developmental disability in special education settings

    NARCIS (Netherlands)

    Didden, H.C.M.; Scholte, R.H.J.; Korzilius, H.P.L.M.; Moor, J.M.H. de; Vermeulen, A.; O'Reilly, M.F.; Lang, R.; Lancioni, G.E.


    OBJECTIVE: To explore the types, prevalence and associated variables of cyberbullying among students with intellectual and developmental disability attending special education settings. METHODS: Students (n = 114) with intellectual and developmental disability who were between 12-19 years of age com

  19. Cyberbullying among students with intellectual and developmental disability in special education settings

    NARCIS (Netherlands)

    Didden, H.C.M.; Scholte, R.H.J.; Korzilius, H.P.L.M.; Moor, J.M.H. de; Vermeulen, A.; O'Reilly, M.F.; Lang, R.; Lancioni, G.E.


    Objective: To explore the types, prevalence and associated variables of cyberbullying among students with intellectual and developmental disability attending special education settings. Methods: Students (n = 114) with intellectual and developmental disability who were between 12–19 years of age com

  20. Development of EFL Writing over Three Years in Secondary Education: CLIL and Non-CLIL Settings (United States)

    Gené-Gil, Maria; Juan-Garau, Maria; Salazar-Noguera, Joana


    Research on writing development in content and language integrated learning (CLIL) settings is still inconclusive. This study intends to make a contribution in this respect by presenting longitudinal findings on the development of written complexity, accuracy and fluency (CAF) in secondary education CLIL and non-CLIL learners. Participants in the…

  1. Symbolic Non-Violence in the Work of Teachers in Alternative Education Settings (United States)

    Waters, Richard


    Patterns in analysis of research data on alternative education practices as well as on student and teacher experience in mainstream settings seem to support Pierre Bourdieu and Jean Claude Passeron's theory of symbolic violence. Data from teachers and students suggest that students from low socio-economic backgrounds often disengage from education…

  2. IDEA 2004: Section 615 (k) (Placement in Alternative Educational Setting). PHP-c111 (United States)

    PACER Center, 2005


    School personnel may consider any unique circumstances on a case-by-case basis when determining whether to order a change in placement for a child with a disability who violates a code of student conduct. This article describes IDEA 2004: Section 615 (k), which discusses the placement of special needs children in alternative educational settings.…

  3. Objective structured clinical examination (OSCE in pharmacy education - a trend

    Directory of Open Access Journals (Sweden)

    Shirwaikar A


    Full Text Available Pharmacy education has undergone a radical change as it evolves towards becoming a more patient oriented profession. With a greater emphasis on problem based teaching and competency, the Objective Structured Clinical Examination (OSCE, supported by its reliability and validity became the gold standard for the evaluation of clinical skills of undergraduate students of medicine and pharmacy worldwide. Core competency evaluation has become a mandatory and critical norm for accountability of educational objectives as the traditional testing tools cannot evaluate clinical competence. Interpersonal and communication skills, professional judgment, skills of resolution etc., may be best assessed through a well- structured OSCE in comparison to oral examinations, multiple choice tests and other methods of assessment. Though OSCEs as an objective method of evaluation offer several advantages to both students and teachers, it also has disadvantages and pitfalls in implementation. This article reviews the OSCE as a trend in pharmacy education.

  4. Objective structured clinical examination (OSCE) in pharmacy education - a trend. (United States)

    Shirwaikar, Annie


    Pharmacy education has undergone a radical change as it evolves towards becoming a more patient oriented profession. With a greater emphasis on problem based teaching and competency, the Objective Structured Clinical Examination (OSCE), supported by its reliability and validity became the gold standard for the evaluation of clinical skills of undergraduate students of medicine and pharmacy worldwide. Core competency evaluation has become a mandatory and critical norm for accountability of educational objectives as the traditional testing tools cannot evaluate clinical competence. Interpersonal and communication skills, professional judgment, skills of resolution etc., may be best assessed through a well- structured OSCE in comparison to oral examinations, multiple choice tests and other methods of assessment. Though OSCEs as an objective method of evaluation offer several advantages to both students and teachers, it also has disadvantages and pitfalls in implementation. This article reviews the OSCE as a trend in pharmacy education.

  5. Evaluating cognitive impairment in the clinical setting: practical screening and assessment tools. (United States)

    Valcour, Victor G


    HIV-associated neurocognitive disorders (HAND) remain a substantial problem in the era of combination antiretroviral therapy. Neither the Mini Mental State Exam nor the HIV Dementia Scale is sufficiently sensitive for HAND. The Montreal Cognitive Assessment shows promise, but current data suggest that adding an additional test will be needed to improve sensitivity for the clinical setting. Patient reporting of symptoms is insensitive as most cases of HAND are asymptomatic. Examination of cerebrospinal fluid (CSF) is sometimes warranted in select patients to evaluate for CSF HIV RNA detectability. CSF escape of virus, when CSF HIV RNA is detectable but plasma HIV RNA is not, appears to be a relatively uncommon event in the clinical setting where the level of detectability for typical clinical assays is around 50 copies/mL. In cases of CSF escape, cognitive improvement has been linked to changes in antiretroviral regimens that are aimed at either overcoming antiretroviral resistance or improving central nervous system (CNS) penetration-effectiveness. Currently, for most patients with HAND in the absence of unusual features, there are insufficient data for a recommendation to routinely intensify therapy with a neurointensive antiretroviral regimen; however, there is considerable uncertainty given emerging data and variability in approach among experts in the field. This article summarizes a case-based presentation by Victor G. Valcour, MD, at the 14th Annual Clinical Conference for the Ryan White HIV/AIDS Program held in Tampa, Florida, in June 2011. The Clinical Conference is sponsored by the IAS-USA under the Health Resources and Services Administration (HRSA) contract number HHSH250200900010C.

  6. Education in Environmental Chemistry: Setting the Agenda and Recommending Action. A Workshop Report Summary (United States)

    Zoller, Uri


    Worldwide, the essence of the current reform in science education is a paradigm shift from algorithmic, lower-order cognitive skills (LOCS) teaching to higher-order cognitive skills (HOCS) learning. In the context of education in environmental chemistry (EEC), the ultimate goal is to educate students to be science technology environment society (STES)-literate, capable of evaluative thinking, decision making, problem solving and taking responsible action accordingly. Educators need to translate this goal into effective courses that can be implemented: this includes developing teaching strategies and assessment methodologies that are consonant with the goal of HOCS learning. An international workshop—"Environmental Chemistry Education in Europe: Setting the Agenda"—yielded two main recommendations for those undertaking educational reform in science education, particularly to promote meaningful EEC. The first recommendation concerns integration of environmental sciences into core chemistry courses as well as the development and implementation of HOCS-promoting teaching strategies and assessment methodologies in chemical education. The second emphasizes the development of students' HOCS for transfer, followed by performance assessment of HOCS. This requires changing the way environmental chemistry is typically taught, moving from a narrowly focused approach (applied analytical, ecotoxicological, or environmental engineering chemistry) to an interdisciplinary and multidisciplinary approach.

  7. An alternative approach for teacher education framed by a collaborative partnership setting

    DEFF Research Database (Denmark)

    Pontoppidan, Birgitte Schou


    The study presents an alternative didactical approach to teacher education linking practice and theory through a collaborative partnership setting. Using a ―small scale teaching design in which students alternate between schools and college it was possible to show someevidence that, by following...... teacher education on its head and begins with a focus on practice so students alternate between school–based and college–based teaching in a cyclical fashion, and are encouraged to link theory with practice. This kind of college teaching demands a new teacher educational paradigm for which collaboration...... between schools and colleges is paramount. This study indicates that a collaborative partnership setting involving college and S&T- profile schools can provide a ―room for study, and that this kind of teaching design enhances the opportunities for students‘ to develop teacher knowledge (aspects...

  8. Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ash Joan S


    Full Text Available Abstract Background The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS development and implementation and for knowledge management (KM processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results The team identified ten themes related to CDS and KM. These include: 1 workflow; 2 knowledge management; 3 data as a foundation for CDS; 4 user computer interaction; 5 measurement and metrics; 6 governance; 7 translation for collaboration; 8 the meaning of CDS; 9 roles of special, essential people; and 10 communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors.

  9. Using a clinical collaborative model for nursing education: application for clinical teaching. (United States)

    Maguire, Denise J; Zambroski, Cheryl H; Cadena, Sandra V


    The promise of a clinical collaborative model (CCM) is that it engages hospital partners in a mutually beneficial partnership by providing the entire student clinical experience in one institution. The CCM prepares students for the day-to-day reality of patient care through the use of individual staff nurse preceptors, enhancing the relationship between the student and hospital upon graduation. The authors describe a successful paradigm for student nurse clinical education across the baccalaureate program.

  10. Medical Interns’ Satisfaction of Clinical Education's Quality in Rasht Hospitals

    Directory of Open Access Journals (Sweden)

    Arsalan Salari


    Full Text Available Introduction: Clinical education is a dynamic process in which- students, with presence in bedside, gain experience and interact with the teachers and the environment to apply learned concepts in practice. If the education fails to provide appropriate learning conditions, would be no possibility for clinical skills to nurture. This study was performed to deter¬mine the satisfaction of medical interns with the quality of clinical education in Rasht teaching hospitals in 2014-15. Methods: This descriptive-analytical study was carried out on 106 medical interns of Guilan University of Medical Sciences in 2014-15 using convenience sampling. The data were collected by a validated researcher-made questionnaire consisting of 3 sections and 39 items. SPSS.21 and descriptive and inferential statistics (Chi-square test, Fisher's exact test, and Man-Whitney U test, considering 95% confidence interval and 90% test power, were employed to analyze the data. Results: The results showed that 50% of the interns were highly satisfied with the quality of education and the mean-score of students’ satisfaction was 65.68±14.19 out of 102. The interns’ satisfaction rate of different components was: familiarity with the objectives of the course (32.1%, teaching methods (53.8%, evaluation methods (41.5%, facilities and equipment (46.2%, students’ clinical skills (24.5%, and teachers’ skills (51.2%. There was no significant relationship between satisfaction and demographic factors (P>0.05. Conclusion: Given the fact that the students were not highly satisfied with some of the components of clinical education such as familiarity with the objectives of the course and students’ clinical skills, it is recommended that the educational planners pay more attention to these components.

  11. Antibiotic Resistant Superbugs: Assessment of the Interrelationship of Occurrence in Clinical Settings and Environmental Niches

    Directory of Open Access Journals (Sweden)

    Anthony Ayodeji Adegoke


    Full Text Available The increasing threat to global health posed by antibiotic resistance remains of serious concern. Human health remains at higher risk due to several reported therapeutic failures to many life threatening drug resistant microbial infections. The resultant effects have been prolonged hospital stay, higher cost of alternative therapy, increased mortality, etc. This opinionated review considers the two main concerns in integrated human health risk assessment (i.e., residual antibiotics and antibiotic resistant genes in various compartments of human environment, as well as clinical dynamics associated with the development and transfer of antibiotic resistance (AR. Contributions of quorum sensing, biofilms, enzyme production, and small colony variants in bacteria, among other factors in soil, water, animal farm and clinical settings were also considered. Every potential factor in environmental and clinical settings that brings about AR needs to be identified for the summative effects in overall resistance. There is a need to embrace coordinated multi-locational approaches and interrelationships to track the emergence of resistance in different niches in soil and water versus the hospital environment. The further integration with advocacy, legislation, enforcement, technological innovations and further research input and recourse to WHO guidelines on antibiotic policy would be advantageous towards addressing the emergence of antibiotic resistant superbugs.

  12. Haemophilia in a real-world setting: the value of clinical experience in data collection. (United States)

    Dolan, Gerry; Iorio, Alfonso; Jokela, Vuokko; Juusola, Kristian; Lassila, Riitta


    At the 8th Annual Congress of the European Association for Haemophilia and Allied Disorders (EAHAD) held in Helsinki, Finland, in February 2015, Pfizer sponsored a satellite symposium entitled: 'Haemophilia in a real-world setting: The value of clinical experience in data collection' Co-chaired by Riitta Lassila (Helsinki University Central Hospital, Helsinki, Finland) and Gerry Dolan (Guy's and St Thomas' Hospital, London, UK); the symposium provided an opportunity to explore the practical value of real-world data in informing clinical decision-making. Gerry Dolan provided an introduction to the symposium by describing what is meant by real-world data (RWD), stressing the role RWD can play in optimising patient outcomes in haemophilia and highlighting the responsibility of all stakeholders to collaborate in continuous data collection. Kristian Juusola (Oulu University Hospital, Oulu, Finland) then provided personal experience as a haemophilia nurse around patient views on adherence to treatment regimes, and how collecting insights into real-world use of treatment can shape approaches to improving adherence. The importance of elucidating pharmacokinetic parameters in a real-world setting was then explored by Vuokko Jokela (Helsinki University, Helsinki, Finland). Finally, Alfonso Iorio (McMaster University, Hamilton, Ontario, Canada) highlighted the importance of quality data collection in translating clinical reality into scientific advances.

  13. Role of TWEAK/Fn14 signalling pathway in lupus nephritis and other clinical settings. (United States)

    González-Sánchez, Diego A; Álvarez, Cristian M; Vásquez, Gloria; Gómez-Puerta, José A


    Knowledge of the signalling pathways involved in various diseases has enabled advances in the understanding of pathophysiological, diagnostic and therapeutic models of several inflammatory and autoimmune diseases. Systemic lupus erythematosus is a widely studied autoimmune disease that can affect multiple organs, with a major impact on morbidity and mortality when it involves the kidneys. Over the past 10 years, interest in the role of the TWEAK/Fn14 signalling pathway in lupus nephritis, as well as other clinical settings, has increased. By reviewing the literature, this article assesses the role of this pathway in lupus nephritis, underlines the importance of TWEAK in urine (uTWEAK) as a biomarker of the disease and stresses the favourable results published in the literature from the inhibition of the TWEAK/Fn14 pathway as a therapeutic target in experimental animal models, demonstrating its potential application in other settings. Results of ongoing clinical trials and future research will give us a better understanding of the real benefit of blocking this pathway in the clinical course of several conditions.

  14. Three Decades of Comprehensive Geriatric Assessment: Evidence Coming From Different Healthcare Settings and Specific Clinical Conditions. (United States)

    Pilotto, Alberto; Cella, Alberto; Pilotto, Andrea; Daragjati, Julia; Veronese, Nicola; Musacchio, Clarissa; Mello, Anna Maria; Logroscino, Giancarlo; Padovani, Alessandro; Prete, Camilla; Panza, Francesco


    Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA. Evidence from randomized controlled trials and large systematic reviews and meta-analyses suggested that the healthcare setting may modify the effectiveness of CGA programs. Home CGA programs and CGA performed in the hospital were shown to be consistently beneficial for several health outcomes. In contrast, the data are conflicting for posthospital discharge CGA programs, outpatient CGA consultation, and CGA-based inpatient geriatric consultation services. The effectiveness of CGA programs may be modified also by particular settings or specific clinical conditions, with tailored CGA programs in older frail patients evaluated for preoperative assessment, admitted or discharged from emergency departments and orthogeriatric units or with cancer and cognitive impairment. CGA is capable of effectively exploring multiple domains in older age, being the multidimensional and multidisciplinary tool of choice to determine the clinical profile, the pathologic risk and the residual skills as well as the short- and long-term prognosis to facilitate the clinical decision making on the personalized care plan of older persons.

  15. Making User-Generated Content Communities Work in Higher Education - The Importance of Setting Incentives (United States)

    Vom Brocke, Jan; White, Cynthia; Walker, Ute; Vom Brocke, Christina

    The concept of User-Generated Content (UGC) offers impressive potential for innovative learning and teaching scenarios in higher education. Examples like Wikipedia and Facebook illustrate the enormous effects of multiple users world-wide contributing to a pool of shared resources, such as videos and pictures and also lexicographical descriptions. Apart from single examples, however, the systematic use of these virtual technologies in higher education still needs further exploration. Only few examples display the successful application of UGC Communities at university scenarios. We argue that a major reason for this can be seen in the fact that the organizational dimension of setting up UGC Communities has widely been neglected so far. In particular, we indicate the need for incentive setting to actively involve students and achieve specific pedagogical objectives. We base our study on organizational theories and derive strategies for incentive setting that have been applied in a practical e-Learning scenario involving students from Germany and New Zealand.

  16. Andragogy in clinical medicine: implications for medical educators

    Directory of Open Access Journals (Sweden)

    Dr. Geetha Mani


    Full Text Available In Medical education, the final desired outcome is to prepare the students to meet the challenges in delivering health care to individuals and the community in the most competent and professional manner. Application of Andragogy in medical education especially clinical medicine will enrich the learning experience of students with respect to diagnosing their needs, acquiring knowledge, skills and appropriate attitudes. Various strategies such as problem based learning, clinically associated teaching, critical reflection, role modeling and constructive feedback can be used to enhance the students’ competence and inculcate professionalism among the students.

  17. Educator engagement and interaction and children's physical activity in early childhood education and care settings: an observational study protocol (United States)

    Jones, Rachel A; Hagenbuchner, Markus; Nguyen, Tuc V; Okely, Anthony D


    Introduction The benefits of regular physical activity for children are significant. Previous research has addressed the quantity and quality of children's physical activity while in early childhood education and care (ECEC) settings, yet little research has investigated the social and physical environmental influences on physical activity in these settings. The outcomes of this study will be to measure these social and physical environmental influences on children's physical activity using a combination of a real-time location system (RTLS) (a closed system that tracks the location of movement of participants via readers and tags), accelerometry and direct observation. Methods and analysis This study is the first of its kind to combine RTLSs and accelerometer data in ECEC settings. It is a cross-sectional study involving ∼100 educators and 500 children from 11 ECEC settings in the Illawarra region of New South Wales, Australia. A RTLS and Actigraph GT3X+ accelerometers will be concurrently used to measure the level and location of the children's and educators' physical activity while in outside environments. Children and educators will wear accelerometers on their hip that record triaxial acceleration data at 100 Hz. Children and educators will also wear a tag watch on their wrist that transmits a signal to anchors of the RTLS and the triangulation of signals will identify their specific location. In addition to these, up to three random periods (10–25 min in length) will be used to collect observational data each day and assessed with the classroom assessment and scoring system to measure the quality of interactions. In conjunction with the real-time location system (RTLS) and accelerometers, these observations will measure the relationship between the quality of interactions and children's physical activity. Ethics and dissemination The results of this study will be disseminated through peer-reviewed publications and presentations. Ethical approval was

  18. Utilization of Portable Radios to Improve Ophthalmology Clinic Efficiency in an Academic Setting. (United States)

    Davis, Alexander S; Elkeeb, Ahmed M; Vizzeri, Gianmarco; Godley, Bernard F


    Improvement in clinic efficiency in the ambulatory setting is often looked at as an area for development of lean management strategies to deliver a higher quality of healthcare while reducing errors, costs, and delays. To examine the benefits of improving team communication and its impact on clinic flow and efficiency, we describe a time-motion study performed in an academic outpatient Ophthalmology clinic and its objective and subjective results. Compared to clinic encounters without the use of the portable radios, objective data demonstrated an overall significant decreases in mean workup time (15.18 vs. 13.10), room wait (13.10 vs. 10.47), and decreased the total time needed with an MD per encounter (9.45 vs. 6.63). Subjectively, significant improvements were seen in careprovider scores for patient flow (60.78 vs. 84.29), getting assistance (61.89 vs. 88.57), moving patient charts (54.44 vs. 85.71), teamwork (69.56 vs. 91.0), communications (62.33 vs. 90.43), providing quality patient care (76.22 vs. 89.57), and receiving input on the ability to see walk-in patients (80.11 vs. 90.43). For academic purposes, an improvement in engagement in patient care and learning opportunities was noted by the clinic resident-in-training during the pilot study. Portable radios in our pilot study were preferred over the previous method of communication and demonstrates significant improvements in certain areas of clinical efficiency, subjective perception of teamwork and communications, and academic learning.

  19. Essential processes for cognitive behavioral clinical supervision: Agenda setting, problem-solving, and formative feedback. (United States)

    Cummings, Jorden A; Ballantyne, Elena C; Scallion, Laura M


    Clinical supervision should be a proactive and considered endeavor, not a reactive one. To that end, supervisors should choose supervision processes that are driven by theory, best available research, and clinical experience. These processes should be aimed at helping trainees develop as clinicians. We highlight 3 supervision processes we believe should be used at each supervision meeting: agenda setting, encouraging trainee problem-solving, and formative feedback. Although these are primarily cognitive-behavioral skills, they can be helpful in combination with other supervision models. We provide example dialogue from supervision exchanges, and discuss theoretical and research support for these processes. Using these processes not only encourages trainee development but also models for them how to use the same processes and approaches with clients.

  20. The effect of nursing staff on student learning in the clinical setting. (United States)

    Webster, Alanna; Bowron, Caitlin; Matthew-Maich, Nancy; Patterson, Priscilla


    Aim To explore baccalaureate nursing students' perspectives of the influence of nursing staff on their learning and experience in the clinical setting. Method A qualitative description approach was used. Thirty nursing students were interviewed individually or in focus groups. Data were analysed using content analysis. Four researchers analysed the data separately and agreed on the themes. Findings Nursing staff had positive (enabling) and negative (hindering) effects on students' clinical learning and socialisation to nursing. Nursing staff may encourage and excite students when they behave as positive mentors, facilitators and motivators. However, their actions may also have a negative effect on students, decreasing their confidence, learning and desire to continue in the profession. Conclusion Nursing staff influence student learning. Their actions, attitude and willingness to teach are influential factors. The findings have implications for patient safety, nurse retention and recruitment, and preparing students for professional practice.

  1. An easy and reliable automated method to estimate oxidative stress in the clinical setting. (United States)

    Vassalle, Cristina


    During the last few years, reliable and simple tests have been proposed to estimate oxidative stress in vivo. Many of them can be easily adapted to automated analyzers, permitting the simultaneous processing of a large number of samples in a greatly reduced time, avoiding manual sample and reagent handling, and reducing variability sources. In this chapter, description of protocols for the estimation of reactive oxygen metabolites and the antioxidant capacity (respectively the d-ROMs and OXY Adsorbent Test, Diacron, Grosseto, Italy) by using the clinical chemistry analyzer SYNCHRON, CX 9 PRO (Beckman Coulter, Brea, CA, USA) is reported as an example of such an automated procedure that can be applied in the clinical setting. Furthermore, a calculation to compute a global oxidative stress index (Oxidative-INDEX), reflecting both oxidative and antioxidant counterparts, and, therefore, a potentially more powerful parameter, is also described.

  2. Pedagogy, power and practice ethics: clinical teaching in psychiatric/mental health settings. (United States)

    Ewashen, Carol; Lane, Annette


    Often, baccalaureate nursing students initially approach a psychiatric mental health practicum with uncertainty, and even fear. They may feel unprepared for the myriad complex practice situations encountered. In addition, memories of personal painful life events may be vicariously evoked through learning about and listening to the experiences of those diagnosed with mental disorders. When faced with such challenging situations, nursing students often seek counsel from the clinical and/or classroom faculty. Pedagogic boundaries may begin to blur in the face of student distress. For the nurse educator, several questions arise: Should a nurse educator provide counseling to students? How does one best negotiate the boundaries between 'counselor', and 'caring educator'? What are the limits of a caring and professional pedagogic relation? What different knowledges provide guidance and to what differential consequences for ethical pedagogic relationships? This paper offers a comparative analysis of three philosophical stances to examine differences in key assumptions, pedagogic positioning, relationships of power/knowledge, and consequences for professional ethical pedagogic practices. While definitive answers are difficult, the authors pose several questions for consideration in discerning how best to proceed and under what particular conditions.

  3. Assessment set for evaluation of clinical outcomes in multiple sclerosis: psychometric properties

    Directory of Open Access Journals (Sweden)

    Rasova K


    Full Text Available Kamila Rasova,1 Patricia Martinkova,2 Jana Vyskotova,3 Michaela Sedova21Department of Rehabilitation, 3rd Faculty of Medicine, Charles University in Prague and Faculty Hospital Královské Vinohrady, Prague, Czech Republic; 2Center of Biomedical Informatics and Department of Medical Informatics and Biostatistics, Institute of Computer Science, AS CR, Prague, Czech Republic; 3Faculty of Medicine, Ostrava University, Ostrava, Czech RepublicPurpose: Multiple sclerosis (MS manifests itself in a wide range of symptoms. Physiotherapy plays an important role in the treatment of those symptoms connected with mobility. For this therapy to be at its most effective it should be based on a systematic examination that is able to describe and classify damaged clinical functions meaningfully. The purpose of this study was to develop and validate a battery of tests and composite tests that can be used to systematically evaluate clinical features of MS treatable by physiotherapy.Methods: The authors assembled a proposed battery of tests comprising known, standard, and validated assessments (low-contrast letter acuity testing; the Motricity Index; the Modified Ashworth Scale; the Berg Balance Scale; scales of postural reactions, tremor, dysdiadochokinesia, and dysmetria; the Nine-Hole Peg Test; the Timed 25-Foot Walk; and the 3-minute version of the Paced Auditory Serial Addition Test and one test (knee hyperextension of the authors’ own. Normalization was calculated and six composite assessments were measured. Seventeen ambulatory subjects with MS were tested twice with the assessment set before undergoing physiotherapy, and 12 were also tested with the assessment set after the physiotherapy. The test–retest reliability, stability, internal consistency of composite measurements, sensitivity to changes after therapy, and correlation between measurements and the Kurtzke Expanded Disability Status Scale score were evaluated for all tests in the assessment set

  4. Awake surgery between art and science. Part I: clinical and operative settings. (United States)

    Talacchi, Andrea; Santini, Barbara; Casagrande, Francesca; Alessandrini, Franco; Zoccatelli, Giada; Squintani, Giovanna M


    Awake surgery requires coordinated teamwork and communication between the surgeon and the anesthesiologist, as he monitors the patient, the neuroradiologist as he interprets the images for intraoperative confirmation, and the neuropsychologist and neurophysiologist as they evaluate in real-time the patient's responses to commands and questions. To improve comparison across published studies on clinical assessment and operative settings in awake surgery, we reviewed the literature, focusing on methodological differences and aims. In complex, interdisciplinary medical care, such differences can affect the outcome and the cost-benefit ratio of the treatment. Standardization of intraoperative mapping and related controversies will be discussed in Part II.

  5. The attributes of an effective teacher differ between the classroom and the clinical setting. (United States)

    Haws, Jolene; Rannelli, Luke; Schaefer, Jeffrey P; Zarnke, Kelly; Coderre, Sylvain; Ravani, Pietro; McLaughlin, Kevin


    Most training programs use learners' subjective ratings of their teachers as the primary measure of teaching effectiveness. In a recent study we found that preclinical medical students' ratings of classroom teachers were associated with perceived charisma and physical attractiveness of the teacher, but not intellect. Here we explored whether the relationship between these variables and teaching effectiveness ratings holds in the clinical setting. We asked 27 Internal Medicine residents to rate teaching effectiveness of ten teachers with whom they had worked on a clinical rotation, in addition to rating each teacher's clinical skills, physical attractiveness, and charisma. We used linear regression to study the association between these explanatory variables and teaching effectiveness ratings. We found no association between rating of physical attractiveness and teaching effectiveness. Clinical skill and charisma were independently associated with rating of teaching effectiveness (regression coefficients [95 % confidence interval] 0.73 [0.60, 0.85], p attributes that make a teacher effective in one context may not meet the needs of learners in a different context.

  6. The Clinical Interview Schedule--Sinhala version: validation in a community setting in Sri Lanka. (United States)

    Wickramasinghe, Shiranee Champika; Rajapakse, Lalini; Abeysinghe, Ranil; Prince, Martin


    The Clinical Interview Schedule Revised (CIS-R) was validated in a clinic setting for adolescents 15-19 years of age in Sri Lanka. The interview schedule was translated into Sinhala and modified to include sections introducing each symptom group. One-hundred-and-thirty-one adolescents attending a psychiatric clinic for the first time were interviewed by a lay interviewer using CIS-R (Translated). They had previously been examined and rated by a psychiatrist using local (emic) diagnostic procedures. All the filtering questions showed a high level of sensitivity (80%-96%). None of the questions in the sleep problems and phobias sections were effective at discriminating between those who did and did not show significant symptoms in these areas according to the psychiatrist. The internal consistency of the sections of the interview schedule (when these two sections were excluded) varied between 0.60 and 0.82. Linear regression showed that, when both sections were excluded, 97% of the variation of total score could be explained. Therefore, it was decided to exclude the sleep problems and phobias sections from the modified interview schedule. As the population samples are likely to be different from clinic samples it is necessary to test the validity again in a community sample before confirming the validity of the modified interview schedule.

  7. Visual events and the friendly eye: modes of educating vision in new educational settings in Danish art galleries

    DEFF Research Database (Denmark)

    Illeris, Helene


    in order to stimulate the ‘disciplined eye' or the ‘aesthetic eye' of the visitors, this article aims to discuss the practices of looking encouraged by contemporary and experimental educational projects. The first part of the article develops a theoretical perspective on educational settings conceived...... as visual events, and it discusses how ‘the desiring eye' of some constructivist approaches, along with traditional practices of looking, have contributed to the formation of the modern, autonomous individual. The second part of the article analyses two cases from Danish art galleries and, inspired by Mieke...

  8. Professional competencies in health sciences education: from multiple intelligences to the clinic floor. (United States)

    Lane, India F


    Nontechnical competencies identified as essential to the health professional's success include ethical behavior, interpersonal, self-management, leadership, business, and thinking competencies. The literature regarding such diverse topics, and the literature regarding "professional success" is extensive and wide-ranging, crossing educational, psychological, business, medical and vocational fields of study. This review is designed to introduce ways of viewing nontechnical competence from the psychology of human capacity to current perspectives, initiatives and needs in practice. After an introduction to the tensions inherent in educating individuals for both biomedical competency and "bedside" or "cageside" manner, the paper presents a brief overview of the major lines of inquiry into intelligence theory and how theories of multiple intelligences can build a foundation for conceptualizing professional and life skills. The discussion then moves from broad concepts of intelligence to more specific workplace skill sets, with an emphasis on professional medical education. This section introduces the research on noncognitive variables in various disciplines, the growing emphasis on competency based education, and the SKA movement in veterinary education. The next section presents the evidence that nontechnical, noncognitive or humanistic skills influence achievement in academic settings, medical education and clinical performance, as well as the challenges faced when educational priorities must be made.

  9. Using Technology To Educate Deaf and Hard of Hearing Children in Rural Alaskan General Education Settings. (United States)

    Pillai, Patrick


    A survey of 79 teachers of Alaskan students with deafness found those who use instructional technology tended to be older, hold an advanced degree and secondary education certification, benefit from in-service training onsite, are connected to the Internet, and actively use the technology available at their schools. (Contains references.)…

  10. Teaching research in clinical pastoral education: a survey of model practices. (United States)

    Tartaglia, Alexander; Fitchett, George; Dodd-McCue, Diane; Murphy, Patricia; Derrickson, Paul E


    The Association of Professional Chaplains (APC) developed Standards of Practice for Acute and Long-term settings. Standard 12 promotes research-literate chaplains as important for the profession. Since many chaplains receive training in clinical pastoral education (CPE) residency programs, the aim of this study was to identify model practices for the teaching of research in such programs. Using a purposeful sample, this study identified 11 programs that offered "consistent and substantive" education in research. Common features included the existence of a research champion, a culture supportive of research, and the availability of institutional resources. The study identified models and methodologies that CPE programs can adopt.

  11. Balancing patient care and student education: learning to deliver bad news in an optometry teaching clinic. (United States)

    Spafford, Marlee M; Schryer, Catherine F; Creutz, Stefan


    Learning to counsel patients in a teaching clinic or hospital occurs in the presence of the competing agendas of patient care and student education. We wondered about the challenges that these tensions create for clinical novices learning to deliver bad news to patients. In this preliminary study, we audio-taped and transcribed the interviews of seven senior optometry students and six optometrist instructors at a Canadian optometry teaching clinic. The participants described their experiences in learning to deliver bad news. Using a grounded theory approach, our analysis was informed by situated learning and activity theory. Optometry students received formal classroom training regarding how to deliver bad news, including exposure to the medically-based six-step SPIKES protocol (Baile et al. The Oncologist, 5, 302-311, 2000). Yet, application of this protocol to the teaching clinic was limited by the lack of exposure most instructors had received to this strategy. Determinants of the students' complex learning process during their clinical apprenticeship, included: (i) knowing one's place, (ii) knowing one's audience, (iii) knowing through feedback, and (iv) knowing who speaks. The experiences of these participants pointed toward the need for: (1) more instructional "scaffolding" (Bruner and Sherwood Play: Its role in development and evolution, p. 280, 1976) in the clinical setting when the learning task is complex, and (2) explicit discussions about the impacts that unfold when the activities of patient care and student education overlap. We reflect on the possible consequences to student education and patient care in the absence of these changes.

  12. 我国临床医学专业硕士学位研究生课程体系设置现状的分析及设想%Analysis and Design of Course System Settings for Clinical Professional Degree Postgraduate Education on the Current Situation

    Institute of Scientific and Technical Information of China (English)



    临床医学专业硕士学位课程是医学研究生培养过程中的重要环节。本文通过文献研究的方法分析了目前我国临床医学专业硕士学位研究生课程体系设置现状,构建了基于核心能力培养的临床医学专业硕士学位课程体系,通过该体系中所包含的课程目标、课程内容、课程结构、课程实施和课程评价等五个要素,进行详实的分析论证并明确其要求,对当今临床医学研究生教育具有一定的指导意义。%Clinical medicine professional course is an important segment in the process of master ’s de-gree cultivation .This paper ,by means of literature research ,analyzing the current domestic profes-sional degree of clinical medicine postgraduate course system ,rebuilding the course system based on the core competence ability training of the professional degree of clinical medicine .Analyzed and dem-onstrated the requirements by detailed analyzing the most important five factors , like curriculum goal ,curriculum content ,curriculum structure ,curriculum implementation and curriculum evalua-tion .Give a certain guiding significance for the current clinical medicine graduate education research .

  13. Clinical Profile of Children and Adolescents Attending the Behavioural Paediatrics Unit OPD in a Tertiary Care Set up (United States)

    Jayaprakash, R.


    Background: There are limited studies on the clinical profile of children attending child guidance clinic under Paediatric background. Aims: To study clinical profile of Children & adolescents attending the Behavioural Paediatrics Unit (BPU) OPD under department of Paediatrics in a tertiary care set up. Methods: Monthly average turnover in the…

  14. Assessing the relationship between patient satisfaction and clinical quality in an ambulatory setting. (United States)

    Bosko, Tawnya; Wilson, Kathryn


    Purpose The purpose of this paper is to assess the relationship between patient satisfaction and a variety of clinical quality measures in an ambulatory setting to determine if there is significant overlap between patient satisfaction and clinical quality or if they are separate domains of overall physician quality. Assessing this relationship will help to determine whether there is congruence between different types of clinical quality performance and patient satisfaction and therefore provide insight to appropriate financial structures for physicians. Design/methodology/approach Ordered probit regression analysis is conducted with overall rating of physician from patient satisfaction responses to the Clinician and Groups Consumer Assessment of Healthcare Providers and Systems survey as the dependent variable. Physician clinical quality is measured across five composite groups based on 26 Healthcare Effectiveness Data and Information Set (HEDIS) measures aggregated from patient electronic health records. Physician and patient demographic variables are also included in the model. Findings Better physician performance on HEDIS measures are correlated with increases in patient satisfaction for three composite measures: antibiotics, generics, and vaccination; it has no relationship for chronic conditions and is correlated with decrease in patient satisfaction for preventative measures, although the negative relationship for preventative measures is not robust in sensitivity analysis. In addition, younger physicians and male physicians have higher satisfaction scores even with the HEDIS quality measures in the regression. Research limitations/implications There are four primary limitations to this study. First, the data for the study come from a single hospital provider organization. Second, the survey response rate for the satisfaction measure is low. Third, the physician clinical quality measure is the percent of the physician's relevant patient population that met

  15. Clinical and Applied Experience in Rehabilitation Counselor Education (United States)

    Tschopp, Molly K.; Chronister, Julie A.


    Applied training of pre-practicum, practicum, and internship are important gateway experiences for rehabilitation counselors-in-training. Counselor educators and supervisors must be aware of requirements and expectations of counselor-in-training supervision and common ethical issues specific to these clinical experiences of rehabilitation…

  16. Understanding Pica Behavior: A Review for Clinical and Education Professionals (United States)

    Stiegler, Lillian N.


    Pica is defined as the compulsive, recurrent consumption of nonnutritive items. Pica behavior often occurs in individuals with developmental disabilities; therefore, education and clinical professionals may be required to participate in various aspects of management, including identification, assessment, and treatment. This article will discuss…

  17. Computer-Assisted Law Instruction: Clinical Education's Bionic Sibling (United States)

    Henn, Harry G.; Platt, Robert C.


    Computer-assisted instruction (CAI), like clinical education, has considerable potential for legal training. As an initial Cornell Law School experiment, a lesson in applying different corporate statutory dividend formulations, with a cross-section of balance sheets and other financial data, was used to supplement regular class assignments.…

  18. Experiences with developing and implementing a virtual clinic for glaucoma care in an NHS setting

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    Kotecha A


    Full Text Available Aachal Kotecha,1,2 Alex Baldwin,1 John Brookes,1 Paul J Foster1,2 1Glaucoma Service, Moorfields Eye Hospital National Health Service Foundation Trust, 2NIHR BRC, Moorfields Eye Hospital, NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London, UK Background: This article describes the development of a virtual glaucoma clinic, whereby technicians collect information for remote review by a consultant specialist.Design and Methods: This was a hospital-based service evaluation study. Patients suitable for the stable monitoring service (SMS were low-risk patients with “suspect”, “early”-to-“moderate” glaucoma who were deemed stable by their consultant care team. Three technicians and one health care assistant ran the service. Patients underwent tests in a streamlined manner in a dedicated clinical facility, with virtual review of data by a consultant specialist through an electronic patient record.Main outcome measure: Feasibility of developing a novel service within a UK National Health Service setting and improvement of patient journey time within the service were studied.Results: Challenges to implementation of virtual clinic include staffing issues and use of information technology. Patient journey time within the SMS averaged 51 minutes, compared with 92 minutes in the glaucoma outpatient department. Patient satisfaction with the new service was high.Conclusion: Implementing innovation into existing services of the National Health Service is challenging. However, the virtual clinic showed an improved patient journey time compared with that experienced within the general glaucoma outpatient department. There exists a discrepancy between patient management decisions of reviewers, suggesting that some may be more risk averse than others when managing patients seen within this model. Future work will assess the ability to detect progression of disease in this model compared with the general

  19. Clinical characteristics of patients with lymphoproliferative neoplasms in the setting of systemic autoimmune diseases. (United States)

    Suvajdzic, Nada; Djurdjevic, Predrag; Todorovic, Milena; Perunicic, Maja; Stojanović, Roksanda; Novkovic, Aleksandra; Mihaljevic, Biljana


    Clinical features of 40 lymphoproliferative neoplasm patients in the setting of systemic autoimmune diseases managed in the Clinic of Hematology during 1994-2006 were analyzed retrospectively. The classification of systemic autoimmune disease patients was as follows: 15 systemic lupus erythematosus--SLE, 11 rheumatoid arthritis--RA, 12 Sjögren's syndrome--SS, 1 scleroderma, and 1 dermatomyositis. Patients comprised 31 women and 9 men of mean age 55 years (range 33-76). Systemic autoimmune diseases preceeded the development of lymphoproliferative neoplasms in 37/40 (92.5%) patients. Mean latency period between the onset of systemic autoimmune diseases and lymphoproliferative neoplasms occurrence was significantly longer in RA (113 months) than in SLE (75 months) and SS patients (65 months)--P autoimmune diseases type or antirheumatic treatment P > 0.05. Our findings are in line with earlier reports showing a high proportion of patients with advanced disease, constitutional symptoms, extranodal manifestations, high grade histology, and low OS in the systemic autoimmune diseases setting.

  20. Nomenclature and basic concepts in automation in the clinical laboratory setting: a practical glossary. (United States)

    Evangelopoulos, Angelos A; Dalamaga, Maria; Panoutsopoulos, Konstantinos; Dima, Kleanthi


    In the early 80s, the word automation was used in the clinical laboratory setting referring only to analyzers. But in late 80s and afterwards, automation found its way into all aspects of the diagnostic process, embracing not only the analytical but also the pre- and post-analytical phase. While laboratories in the eastern world, mainly Japan, paved the way for laboratory automation, US and European laboratories soon realized the benefits and were quick to follow. Clearly, automation and robotics will be a key survival tool in a very competitive and cost-concious healthcare market. What sets automation technology apart from so many other efficiency solutions are the dramatic savings that it brings to the clinical laboratory. Further standardization will assure the success of this revolutionary new technology. One of the main difficulties laboratory managers and personnel must deal with when studying solutions to reengineer a laboratory is familiarizing themselves with the multidisciplinary and technical terminology of this new and exciting field. The present review/glossary aims at giving an overview of the most frequently used terms within the scope of laboratory automation and to put laboratory automation on a sounder linguistic basis.

  1. An Algorithm for Glaucoma Screening in Clinical Settings and Its Preliminary Performance Profile

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    S-Farzad Mohammadi


    Full Text Available Purpose: To devise and evaluate a screening algorithm for glaucoma in clinical settings. Methods: Screening included examination of the optic disc for vertical cupping (≥0.4 and asymmetry (≥0.15, Goldmann applanation tonometry (≥21 mmHg, adjusted or unadjusted for central corneal thickness, and automated perimetry. In the diagnostic step, retinal nerve fiber layer imaging was performed using scanning laser polarimetry. Performance of the screening protocol was assessed in an eye hospital-based program in which 124 non-physician personnel aged 40 years or above were examined. A single ophthalmologist carried out the examinations and in equivocal cases, a glaucoma subspecialist′s opinion was sought. Results: Glaucoma was diagnosed in six cases (prevalence 4.8%; 95% confidence interval, 0.01-0.09 of whom five were new. The likelihood of making a definite diagnosis of glaucoma for those who were screened positively was 8.5 times higher than the estimated baseline risk for the reference population; the positive predictive value of the screening protocol was 30%. Screening excluded 80% of the initial population. Conclusion: Application of a formal screening protocol (such as our algorithm or its equivalent in clinical settings can be helpful in detecting new cases of glaucoma. Preliminary performance assessment of the algorithm showed its applicability and effectiveness in detecting glaucoma among subjects without any visual complaint.

  2. Job analysis and student assessment tool: perfusion education clinical preceptor. (United States)

    Riley, Jeffrey B


    The perfusion education system centers on the cardiac surgery operating room and the perfusionist teacher who serves as a preceptor for the perfusion student. One method to improve the quality of perfusion education is to create a valid method for perfusion students to give feedback to clinical teachers. The preceptor job analysis consisted of a literature review and interviews with preceptors to list their critical tasks, critical incidents, and cognitive and behavioral competencies. Behaviorally anchored rating traits associated with the preceptors' tasks were identified. Students voted to validate the instrument items. The perfusion instructor rating instrument with a 0-4, "very weak" to "very strong" Likert rating scale was used. The five preceptor traits for student evaluation of clinical instruction (SECI) are as follows: The clinical instructor (1) encourages self-learning, (2) encourages clinical reasoning, (3) meets student's learning needs, (4) gives continuous feedback, and (5) represents a good role model. Scores from 430 student-preceptor relationships for 28 students rotating at 24 affiliate institutions with 134 clinical instructors were evaluated. The mean overall good preceptor average (GPA) was 3.45 +/- 0.76 and was skewed to the left, ranging from 0.0 to 4.0 (median = 3.8). Only 21 of the SECI relationships earned a GPA education program.

  3. 77 FR 41431 - Proposed Collection; Comment Request: Impact of Clinical Research Training and Medical Education... (United States)


    ... Research Training and Medical Education at the Clinical Center on Physician Careers in Academia and... Collection Title: The Impact of Clinical Research Training and Medical Education at the Clinical Center on... clinical research training and medical education of the highest quality to each trainee. Frequency...


    Directory of Open Access Journals (Sweden)

    Dimiter Kirov


    Full Text Available Background: The ability to self-assess is a critical skill that all health professionals must be able to do, in order to achieve competence. This is essential for the doctors of dental medicine. During their education and practice they apply different clinical and para-clinical procedures. The aim is to evaluate the students' self-assessment skills during the education of clinic and pre-clinic of prosthetic dentistry. Material and methods: After the completion of certain work - preparation for full veneer crown, a questionnaire was provided to each student in preclinical course (n=30 and clinical course (n=30 for self-evaluation. The questionnaire involved: axial reduction, occlusal reduction, facial and lingual reduction, smoothing and finishing. The answers were based on the standard for the university grading scale. Than, the same questionnaire was fulfilled by the assistant professor without seeing students' self-evaluation. Results and Discussion: Results have been reported in percentages. 100% respond rate has been achieved. The students from the preclinical course tend to overestimate their performance (50%. The students from the clinical course tend to submit overall lower grades than the faculty evaluation (25%. Conclusions: The students from clinics have better self-assessment skills. The discrepancy was most pronounced in the junior students. The different evaluations (self-assessment and assistant professor's help students to improve their understanding of certain principles and improve the teaching effectiveness of education of prosthetic dentistry.

  5. HIV/AIDS and lipodystrophy: Implications for clinical management in resource-limited settings

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    Julia L Finkelstein


    Full Text Available Introduction: Lipodystrophy is a term used to describe a metabolic complication of fat loss, fat gain, or a combination of fat loss and gain, which is associated with some antiretroviral (ARV therapies given to HIV-infected individuals. There is limited research on lipodystrophy in low- and middle-income countries, despite accounting for more than 95% of the burden of HIV/AIDS. The objective of this review was to evaluate the prevalence, pathogenesis and prognosis of HIV-related lipoatrophy, lipohypertrophy and mixed syndrome, to inform clinical management in resource-limited settings. Methods: We conducted a structured literature search using MEDLINE electronic databases. Relevant MeSH terms were used to identify published human studies on HIV and lipoatrophy, lipohypertrophy, or mixed syndrome in low-, low-middle- and upper-middle-income countries through 31 March 2014. The search resulted in 5296 articles; after 1599 studies were excluded (958 reviews, 641 non-human, 3697 studies were extracted for further review. After excluding studies conducted in high-income settings (n=2808, and studies that did not meet inclusion criteria (n=799, 90 studies were included in this review. Results and Discussion: Of the 90 studies included in this review, only six were from low-income countries and eight were from lower middle-income economies. These studies focused on lipodystrophy prevalence, risk factors and side effects of antiretroviral therapy (ART. In most studies, lipodystrophy developed after the first six months of therapy, particularly with the use of stavudine. Lipodystrophy is associated with increased risk of cardiometabolic complications. This is disconcerting and anticipated to increase, given the rapid scale-up of ART worldwide, the increasing number and lifespan of HIV-infected patients on long-term therapy, and the emergence of obesity and non-communicable diseases in settings with extensive HIV burden. Conclusions: Lipodystrophy is

  6. Dressing-related trauma: clinical sequelae and resource utilization in a UK setting

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    Charlesworth B


    Full Text Available Bruce Charlesworth,1 Claire Pilling,1 Paul Chadwick,2 Martyn Butcher31Adelphi Values, Macclesfield, 2Salford Royal Foundation Trust, Salford, 3Northern Devon Healthcare Trust, Devon, UKBackground: Dressings are the mainstay of wound care management; however, adherence of the dressing to the wound or periwound skin is common and can lead to dressing-related pain and trauma. Dressing-related trauma is recognized as a clinical and economic burden to patients and health care providers. This study was conducted to garner expert opinion on clinical sequelae and resource use associated with dressing-related trauma in a UK setting.Methods: This was an exploratory study with two phases: qualitative pilot interviews with six wound care specialists to explore dressing-related trauma concepts, sequelae, and resource utilization; and online quantitative research with 30 wound care specialists to validate and quantify the concepts, sequelae, and resource utilization explored in the first phase of the study. Data were collected on mean health care professional time, material costs, pharmaceutical costs, and inpatient management per sequela occurrence until resolution. Data were analyzed to give total costs per sequela and concept occurrence.Results: The results demonstrate that dressing-related trauma is a clinically relevant concept. The main types of dressing-related trauma concepts included skin reactions, adherence to the wound, skin stripping, maceration, drying, and plugging of the wound. These were the foundation for a number of clinical sequelae, including wound enlargement, increased exudate, bleeding, infection, pain, itching/excoriation, edema, dermatitis, inflammation, and anxiety. Mean total costs range from £56 to £175 for the complete onward management of each occurrence of the six main concepts.Conclusion: These results provide insight into the hidden costs of dressing-related trauma in a UK setting. This research successfully conceptualized

  7. Can we consider zoledronic acid a new antitumor agent? Recent evidence in clinical setting. (United States)

    Santini, Daniele; Virzi, Vladimir; Fratto, Maria Elisabetta; Bertoldo, Francesco; Sabbatini, Roberto; Berardi, Rossana; Calipari, Nicola; Ottaviani, Davide; Ibrahim, Toni


    New emerging data suggest that bisphosphonates may exert antitumor properties. Preclinical studies have demonstrated that zoledronic acid (ZA) can induce direct and indirect antitumor activities such as inhibition of angiogenesis, invasion and adhesion of tumor cells, and overall tumor progression, stimulation of adoptive and innate immunity and emerging evidence suggests that the use of these agents may prevent the development of skeletal and extra skeletal metastases. This review will critically describe the new growing evidence of antitumor activity exerted by bisphosphonates in cancer patients, both in metastatic disease and in the adjuvant setting. The effects of bisphosphonates on survival in metastatic cancer patients will be described and evidence from retrospective analyses and prospective studies will be critically reported. The early evidence from prospective analyses of survival impact by ZA in the adjuvant setting in breast cancer will be discussed together with the recently published results of the ABCSG-12 study. A new "era" for bisphosphonates in the oncological setting is opening. The clinical data that will be reported in this review represent the first step in a path that will conduct us to explore new horizons in the field of adjuvant and metastatic cancer therapies.

  8. Exploring the clinical information system implementation readiness activities to support nursing in hospital settings. (United States)

    Piscotty, Ronald J; Tzeng, Huey-Ming


    The implementation of clinical information systems can have a profound impact on nurses and their productivity. Poorly implemented systems can lead to unintended consequences that may have a negative impact on clinical processes and patient outcomes. Executives must have adequate knowledge to address nurses' concerns related to implementation. This study explored the clinical information system implementation readiness activities adopted by chief nurse executivesin hospital settings. A descriptive qualitative design was used, including interviews with six chief nurse executives, held from December 2003 through March 2004. The constant comparative method was used to analyze the interviews to extract readiness activity themes and compare these to the literature. The synthesized themes showed that the executives were knowledgeable about and engaged in several key areas, but not all, of the implementation readiness process. The majority of responses were classified into the thematic areas of champion support, staff preparation for change, training, organizational alignment, planning, and vendor support. The theme of a lack of vendor support was not identified in previous studies but was clear in the responses of the chief nurse executives interviewed.

  9. Catatonia: Etiopathological diagnoses and treatment response in a tertiary care setting: A clinical study

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    Santosh Ramdurg


    Full Text Available Aim: Catatonia is caused by a variety of psychiatric and organic conditions. The onset, clinical profile, and response to treatment may vary depending on the underlying cause. The study is an attempt to explore clinical profile, possible etiological correlates with neurotic/psychotic spectrum illnesses, and response to treatment and outcome in patients of catatonia. Materials and Methods: Retrospective chart analysis by using semistructured data sheet for the analysis of sociodemographic data, clinical profile, precipitating event, and response to treatment in patients with catatonic symptoms admitted to IHBAS (Institute of Human Behaviour and Allied Sciences, New Delhi, India from January 2009 to December 2010 was undertaken. Results: Catatonia was commonly observed in patients with the following profile - late twenties, female, Hindu religion, urban background, and housewives. Psychotic spectrum disorder (57%, N=35 was the most commonly entertained diagnosis and affective disorder (18%, N=11 being the second common. Thirty four percent of the subjects responded to lorazepam treatment and rest required modified electroconvulsive therapy (MECT. Conclusion: Catatonia is more likely to be associated with Schizophrenia and Other Psychotic Disorders in Indian settings. Majority of patients responded to therapy either by lorazepam alone or to its augmentation with modified ECT. The study being a retrospective one, the sample being representative of the treatment seeking group only, and unavailability of the follow up data were the limitations of the study

  10. The relationship between cultural competence education and increasing diversity in nursing schools and practice settings. (United States)

    Pacquiao, Dula


    This article attempted to examine the relationship between cultural competence education and increasing diversity in nursing schools and practice settings. In addition to the review of the literature, a panel of experts was interviewed regarding institutional practices in response to the challenge of increasing diversity and cultural competence education. Evidence of positive outcomes of cultural competent care and impact of race and ethnic concordance between patients and providers are presented. The challenge of increasing underrepresented minorities in health care professions remains elusive. An ecological analysis is recommended to address the social and cultural barriers that transcend the micro system of the school and the macro system of the society. The challenge of increasing diversity and realizing outcomes of cultural competence education requires social and comprehensive remedies to level life inequities that perpetuate a history of disadvantages in some groups.

  11. Limiting the risk of injury through safety guidelines in a physical education setting

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    Andrew Fitzgerald


    Full Text Available Physical activity involves risk and thus the physical education classroom requires safety standards to be established and maintained to ensure safety. The number of physical education related injuries in elementary, middle school, and high school increased 150% from 1997 to 2007 and they have continued to rise in the last decade as well. The classroom teacher must employ the highest level of organization and management in order to limit their risk. Working together with administration to establish policy and review safety standards ensures that multiple entities are involved in ensuring safety. Having safety guidelines within a physical education setting could potentially help protect the students from unnecessary injuries and may prevent the school district from legal action in the case of an injury.

  12. The Feasibility of Utilizing a Comic for Education in the Emergency Department Setting. (United States)

    Hanson, Aaron; Drendel, Amy L; Ashwal, Gary; Thomas, Alex


    The objective of this study was to determine the feasibility of a comic education module in the Emergency Department setting. A convenience sample of 50 injured children and their caregivers were enrolled. The comic was found to be likeable, easy to read, and provided important information to both children and their caregivers. Total time to read the comic was three minutes (SD 1.4, range 1.4-7.1). Most children (60%) read the comic independently, including all children over age 14 years. At 72-hour phone follow-up, 86% of caregivers had accurate recall of all three comic teaching points. This innovative comic educational module is feasible for use for children ages 4-18 years in the Emergency Department. Though this comic was intended to educate children, caregivers recalled all three teaching points 72 hours after discharge.

  13. The Quality of Care Provided to Women with Urinary Incontinence in Two Clinical Settings (United States)

    Anger, Jennifer T.; Alas, Alexandriah; Litwin, Mark S.; Chu, Stephanie D.; Bresee, Catherine; Roth, Carol P.; Rashid, Rezoana; Shekelle, Paul; Wenger, Neil S.


    Purpose Our aim was to test the feasibility of a set of quality-of-care indicators for urinary incontinence (UI) and, at the same time, measure the care provided to women with UI in two different clinical settings. Materials and Methods This was a pilot test of a set of quality-of-care indicators (QIs). This was a pilot test of a set of quality-of-care indicators (QIs). Twenty QIs were previously developed using the RAND Appropriateness method. These QIs were used to measure care received for 137 women with a urinary incontinence (UI) diagnosis in a 120-physician hospital-based multi-specialty medical group (MSG). We also performed an abstraction of 146 patient records from primary care offices in Southern California. These charts were previously used as part of the Assessing Care of Vulnerable Elders Project (ACOVE). As a post-hoc secondary analysis, the two populations were compared with respect to quality, as measured by compliance with the QIs. Results In the ACOVE population, 37.7% of patients with UI underwent a pelvic examination, versus 97.8% in the MSG. Only 15.6% of cases in the MSG and 14.2% in ACOVE (p=0.86) had documentation that pelvic floor exercises were offered. Relatively few women with a body mass index (BMI) of >25 were counseled about weight loss in either population (20.9% MSG vs. 26.1% ACOVE, p=0.76). For women undergoing sling surgery, documentation of counseling about risks was lacking, and only 9.3% of eligible cases (MSG only) had documentation of the risks of mesh. Conclusions QIs are a feasible means to measure the care provided to women with UI. Care varied by population studied, yet deficiencies in care were prevalent in both patient populations studied. PMID:27164512

  14. Clinical signs of pneumonia in children: association with and prediction of diagnosis by fuzzy sets theory

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    Pereira J.C.R.


    Full Text Available The present study compares the performance of stochastic and fuzzy models for the analysis of the relationship between clinical signs and diagnosis. Data obtained for 153 children concerning diagnosis (pneumonia, other non-pneumonia diseases, absence of disease and seven clinical signs were divided into two samples, one for analysis and other for validation. The former was used to derive relations by multi-discriminant analysis (MDA and by fuzzy max-min compositions (fuzzy, and the latter was used to assess the predictions drawn from each type of relation. MDA and fuzzy were closely similar in terms of prediction, with correct allocation of 75.7 to 78.3% of patients in the validation sample, and displaying only a single instance of disagreement: a patient with low level of toxemia was mistaken as not diseased by MDA and correctly taken as somehow ill by fuzzy. Concerning relations, each method provided different information, each revealing different aspects of the relations between clinical signs and diagnoses. Both methods agreed on pointing X-ray, dyspnea, and auscultation as better related with pneumonia, but only fuzzy was able to detect relations of heart rate, body temperature, toxemia and respiratory rate with pneumonia. Moreover, only fuzzy was able to detect a relationship between heart rate and absence of disease, which allowed the detection of six malnourished children whose diagnoses as healthy are, indeed, disputable. The conclusion is that even though fuzzy sets theory might not improve prediction, it certainly does enhance clinical knowledge since it detects relationships not visible to stochastic models.

  15. The Effectiveness of Peer Taught Group Sessions of Physiotherapy Students within the Clinical Setting: A Quasi-Experimental Study (United States)

    Scott, Dee; Jelsma, Jennifer


    The study aimed to investigate whether learning from peers, learning from a clinical educator, or being the peer teacher during clinical group sessions was more effective at enhancing student learning outcomes for different health conditions. A secondary aim was to determine which method students found more satisfactory. Physiotherapy students at…

  16. Setting-up nurse-led pilot clinics for the management of non-communicable diseases at primary health care level in resource-limited settings of Africa

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    Jean-Claude Mbanya


    Full Text Available BACKGROUND: This article describes the setting-up process for nurse-led pilot clinics for the management of four chronic diseases: asthma, type 2 diabetes mellitus, epilepsy and hypertension at the primary health care level in urban and rural Cameroon. METHODS: The Biyem-Assi urban and the Bafut rural health districts in Cameroon served as settings for this study. International and local guidelines were identified and adapted to the country's; circumstances. Training and follow-up tools were developed and nurses trained by experienced physicians in the management of the four conditions. Basic diagnostic and follow-up materials were provided and relevant essential drugs made available. RESULTS: Forty six nurses attended six training courses. By the second year of activity, three and four clinics were operational in the urban and the rural areas respectively. By then, 925 patients had been registered in the clinics. This represented a 68.5% increase from the first year. While the rural clinics relied mainly on essential drugs for their prescriptions, a prescription pattern combining generic and proprietary drugs was observed in the urban clinics. CONCLUSION: In the quest for cost-effective health care for NCD in sub-Saharan Africa, rethinking health workforce and service delivery has relevance. Nurse-led clinics, algorithm driven service delivery stands as alternatives to overcome the shortage of trained physicians and other issues relating to access to care.

  17. Virtual glaucoma clinics: patient acceptance and quality of patient education compared to standard clinics

    Directory of Open Access Journals (Sweden)

    Court JH


    Full Text Available Jennifer H Court,1 Michael W Austin1,21Department of Ophthalmology, Singleton Hospital, Swansea, Wales, UK; 2Department of Ophthalmology, Neath Port Talbot Hospital, Swansea, Wales, UKPurpose: Virtual glaucoma clinics allow rapid, reliable patient assessment but the service should be acceptable to patients and concordance with treatment needs to be maintained with adequate patient education. This study compares experiences and understanding of patients reviewed via the virtual clinic versus the standard clinic by way of an extended patient satisfaction questionnaire (PSQ.Patients and methods: One hundred PSQs were given to consecutive patients attending glaucoma clinics in October 2013. All 135 patients reviewed via the virtual clinic from April 2013 until August 2013 were sent postal PSQs in September 2013. Data were obtained for demographics, understanding of glaucoma, their condition, satisfaction with their experience, and quality of information. Responses were analyzed in conjunction with the clinical records.Results: Eighty-five percent of clinic patients and 63% of virtual clinic patients responded to the PSQ. The mean satisfaction score was over 4.3/5 in all areas surveyed. Virtual clinic patients’ understanding of their condition was very good, with 95% correctly identifying their diagnosis as glaucoma, 83% as ocular hypertension and 78% as suspects. There was no evidence to support inferior knowledge or self-perceived understanding compared to standard clinic patients. Follow-up patients knew more about glaucoma than new patients. Over 95% of patients found our information leaflet useful. Forty percent of patients sought additional information but less than 20% used the internet for this.Conclusion: A substantial proportion of glaucoma pathway patients may be seen by non-medical staff supervised by glaucoma specialists via virtual clinics. Patients are accepting of this format, reporting high levels of satisfaction and non

  18. "Discoveries in Planetary Sciences": Slide Sets Highlighting New Advances for Astronomy Educators (United States)

    Brain, David; Schneider, N.; Molaverdikhani, K.; Afsharahmadi, F.


    We present two new features of an ongoing effort to bring recent newsworthy advances in planetary science to undergraduate lecture halls. The effort, called 'Discoveries in Planetary Sciences', summarizes selected recently announced discoveries that are 'too new for textbooks' in the form of 3-slide PowerPoint presentations. The first slide describes the discovery, the second slide discusses the underlying planetary science concepts at a level appropriate for students of 'Astronomy 101', and the third presents the big picture implications of the discovery. A fourth slide includes links to associated press releases, images, and primary sources. This effort is generously sponsored by the Division for Planetary Sciences of the American Astronomical Society, and the slide sets are available at for download by undergraduate instructors or any interested party. Several new slide sets have just been released, and we summarize the topics covered. The slide sets are also being translated into languages other than English (including Spanish and Farsi), and we will provide an overview of the translation strategy and process. Finally, we will present web statistics on how many people are using the slide sets, as well as individual feedback from educators.

  19. Teaching during clinical practice: strategies and techniques used by preceptors in nursing education. (United States)

    Elisabeth, Carlson; Christine, Wann-Hansson; Ewa, Pilhammar


    The preceptor is a nurse who teaches and supports the student and is seen as pivotal to student learning within the clinical setting. Earlier studies have shown that preceptors' pedagogical competence is significant for facilitating learning during clinical practice. However, studies describing pedagogical competence, especially in terms of teaching strategies, seem to be scarce. The aim of this study was to describe which strategies and techniques preceptors use to teach undergraduate nursing students during clinical practice. The study had an ethnographic approach; methods used were participant observations and focus group interviews with nurses who were experienced in precepting undergraduate nursing students. Findings illustrated how preceptors used different strategies and techniques in a continuous process of adjusting, performing and evaluating precepting. Increased knowledge on how the preceptors actually teach student nurses during clinical practice will help facilitate educational programmes for preceptors, which will enhance their pedagogical skills and competences.

  20. Key components of financial-analysis education for clinical nurses. (United States)

    Lim, Ji Young; Noh, Wonjung


    In this study, we identified key components of financial-analysis education for clinical nurses. We used a literature review, focus group discussions, and a content validity index survey to develop key components of financial-analysis education. First, a wide range of references were reviewed, and 55 financial-analysis education components were gathered. Second, two focus group discussions were performed; the participants were 11 nurses who had worked for more than 3 years in a hospital, and nine components were agreed upon. Third, 12 professionals, including professors, nurse executive, nurse managers, and an accountant, participated in the content validity index. Finally, six key components of financial-analysis education were selected. These key components were as follows: understanding the need for financial analysis, introduction to financial analysis, reading and implementing balance sheets, reading and implementing income statements, understanding the concepts of financial ratios, and interpretation and practice of financial ratio analysis. The results of this study will be used to develop an education program to increase financial-management competency among clinical nurses.

  1. Leadership Readiness for Flexibility and Mobility: The 4th Dimensions on Situational Leadership Styles in Educational Settings (United States)

    Rajbhandari, Mani Man Singh; Loock, Coert; Du Plessis, Pierre; Rajbhandari, Smriti


    In educational settings, leadership flexibility and mobility is essential factor for leadership readiness. This incorporates both factors concerning the situational needs and followership situational readiness. Leadership in education require multi facet dimensional approaches that enables the educational leaders to fill in the gaps and reduces…

  2. Clinical reasoning in undergraduate nursing education: a scoping review

    Directory of Open Access Journals (Sweden)

    Sáskia Sampaio Cipriano de Menezes


    Full Text Available Abstract OBJECTIVE This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. METHODS A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. RESULTS From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1 the experience of developing critical thinking/clinical reasoning/decision-making process; 2 teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3 measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4 relationship of variables involved in the critical thinking/clinical reasoning/decision-making process; and 5 theoretical development models of critical thinking/clinical reasoning/decision-making process for students. CONCLUSION The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

  3. Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management. (United States)

    Sechi, Gianpietro; Serra, Alessandro


    Wernicke's encephalopathy is an acute neuropsychiatric syndrome resulting from thiamine deficiency, which is associated with significant morbidity and mortality. According to autopsy-based studies, the disorder is still greatly underdiagnosed in both adults and children. In this review, we provide an update on the factors and clinical settings that predispose to Wernicke's encephalopathy, and discuss the most recent insights into epidemiology, pathophysiology, genetics, diagnosis, and treatment. To facilitate the diagnosis, we classify the common and rare symptoms at presentation and the late-stage symptoms. We emphasise the optimum dose of parenteral thiamine required for prophylaxis and treatment of Wernicke's encephalopathy and prevention of Korsakoff's syndrome associated with alcohol misuse. A systematic approach helps to ensure that patients receive a prompt diagnosis and adequate treatment.

  4. "Collaboration technology": a case study of innovation in order set and clinical care standardization. (United States)

    Yount, Brian; McNamara, Timothy


    Effective standardization of clinical processes, which is a growing priority for healthcare provider organizations and networks, requires effective teamwork among clinicians and staff from multidisciplinary backgrounds--often from geographically dispersed facilities--to reach consensus on care practices. Yet, most healthcare provider organizations have no precedence or tools for managing large-scale, sustained, collaborative activities. This presentation explores the human and social implications of technology. It specifically addresses healthcare collaboration and describes how innovative collaboration management technologies can be used in the healthcare industry to accelerate care standardization, order set standardization and other initiatives necessary for successful computerized provider order entry and electronic health record deployments. These topics are explored through presentation of a survey of healthcare executives and a case study of an advanced collaboration application that was adapted and deployed in a partnership between a large healthcare provider organization and a commercial developer of document management and collaboration management technologies.

  5. Contact with Nature and Children’s Wellbeing in Educational Settings

    Directory of Open Access Journals (Sweden)

    Giuseppe Carrus


    Full Text Available Problem statement: The study explores the role of the spatial-physical features of the environment for the functioning of educational institutions. Previous research in the field of environmental psychology showed how physical characteristics of learning environments might be linked to positive or negative outcomes in terms of learning attitudes and behaviors. In particular, there is consistent empirical evidence showing that contact with natural settings promotes psychological restoration, leading to the recovery of direct attention and stress reduction. The present study aims at investigating the impact of the experience of contact with external green spaces during school time upon children’s capacity of focusing direct attention on a specific task during structured activity with educators and upon the quality of children’s social interaction with peers and adult educators. Approach: A total of 16 children (age range 18-36 months attending a recently opened childcare center in Rome, Italy participated in the study. The physical features of the internal and external spaces of the educational institutions were assessed via on-site observations. Systematic observations of the children were performed, in different spaces of the educational setting and in different moments of the school day. In particular, children’s performance in a visual-spatial task requiring direct attention and children social behavior (using a checklist of social interaction and emotional behavior were assessed by a paper-and-pencil observation grid on a six-step scale. Results: The research suggests that contact with external green open spaces during school time is significantly associated with better performances in structured tasks requiring direct attention and to positive social behaviors. The frequency of educators’ direct interventions is smaller after the children’s contact with external green open spaces. Conclusion/Recommendations: These

  6. Human thermoregulation and measurement of body temperature in exercise and clinical settings. (United States)

    Lim, Chin Leong; Byrne, Chris; Lee, Jason Kw


    This review discusses human thermoregulation during exercise and the measurement of body temperature in clinical and exercise settings. The thermoregulatory mechanisms play important roles in maintaining physiological homeostasis during rest and physical exercise. Physical exertion poses a challenge to thermoregulation by causing a substantial increase in metabolic heat production. However, within a non-thermolytic range, the thermoregulatory mechanisms are capable of adapting to sustain physiological functions under these conditions. The central nervous system may also rely on hyperthermia to protect the body from "overheating." Hyperthermia may serve as a self-limiting signal that triggers central inhibition of exercise performance when a temperature threshold is achieved. Exposure to sub-lethal heat stress may also confer tolerance against higher doses of heat stress by inducing the production of heat shock proteins, which protect cells against the thermolytic effects of heat. Advances in body temperature measurement also contribute to research in thermoregulation. Current evidence supports the use of oral temperature measurement in the clinical setting, although it may not be as convenient as tympanic temperature measurement using the infrared temperature scanner. Rectal and oesophagus temperatures are widely accepted surrogate measurements of core temperature (Tc), but they cause discomfort and are less likely to be accepted by users. Gastrointestinal temperature measurement using the ingestible temperature sensor provides an acceptable level of accuracy as a surrogate measure of Tc without causing discomfort to the user. This form of Tc measurement also allows Tc to be measured continuously in the field and has gained wider acceptance in the last decade.

  7. Collaborative learning of clinical skills in health professions education

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Kulasegaram, Kulamakan M; Ringsted, Charlotte V


    social interaction, motivation, accountability and positive interdependence between learners. Motor skills learning theory suggests that positive effects rely on observational learning and action imitation, and negative effects may include decreased hands-on experience. Finally, a cognitive perspective......OBJECTIVES: This study is designed to provide an overview of why, how, when and for whom collaborative learning of clinical skills may work in health professions education. WHY: Collaborative learning of clinical skills may influence learning positively according to the non-medical literature....... Training efficiency may therefore be improved if the outcomes of collaborative learning of clinical skills are superior or equivalent to those attained through individual learning. HOW: According to a social interaction perspective, collaborative learning of clinical skills mediates its effects through...

  8. Developing the Role of a Health Information Professional in a Clinical Research Setting

    Directory of Open Access Journals (Sweden)

    Helen M. Seeley


    Full Text Available Objective ‐ This paper examines the role of a health information professional in a large multidisciplinary project to improve services for head injury.Methods ‐ An action research approach was taken, with the information professional acting as co‐ordinator. Change management processes were guided by theory and evidence. The health information professional was responsible for an ongoing literature review on knowledge management (clinical and political issues, data collection and analysis (from patient records, collating and comparing data (to help develop standards, and devising appropriate dissemination strategies.Results ‐ Important elements of the health information management role proved to be 1 co‐ordination; 2 setting up mechanisms for collaborative learning through information sharing; and 3 using the theoretical frameworks (identified from the literature review to help guide implementation. The role that emerged here has some similarities to the informationist role that stresses domain knowledge, continuous learning and working in context (embedding. This project also emphasised the importance of co‐ordination, and the ability to work across traditional library information analysis (research literature discovery and appraisal and information analysis of patient data sets (the information management role.Conclusion ‐ Experience with this project indicates that health information professionals will need to be prepared to work with patient record data and synthesis of that data, design systems to co‐ordinate patient data collection, as well as critically appraise external evidence.

  9. Using the Promise of Sonodynamic Therapy in the Clinical Setting against Disseminated Cancers

    Directory of Open Access Journals (Sweden)

    Matthew Trendowski


    Full Text Available Sonodynamic therapy (SDT is a form of ultrasound therapy in which specialized chemotherapeutic agents known as sonosensitizers are administered to increase the efficacy of ultrasound-mediated preferential damage of neoplastic cells. Multiple in vitro and in vivo studies have indicated that SDT has the ability to exhibit profound physical and chemical changes on cellular structure. As supportive as the data have been, assessment of this method at the clinical level has been limited to only solid tumors. Although SDT has shown efficacy against multiple adherent neoplastic cell lines, it has also shown particular promise with leukemia-derived cell lines. Potential procedures to administer SDT to leukemia patients are heating the appendages as ultrasound is applied to these areas (Heat and Treat, using an ultrasound probe to scan the body for malignant growths (Target and Destroy, and extracorporeal blood sonication (EBS through dialysis. Each method offers a unique set of benefits and concerns that will need to be evaluated in preclinical mammalian models of malignancy before clinical examination can be considered.

  10. Diagnostic tests for influenza and other respiratory viruses: determining performance specifications based on clinical setting. (United States)

    Takahashi, Hiroshi; Otsuka, Yoshihito; Patterson, Bruce K


    The lack of sensitivity of rapid immunoassays in detecting the novel 2009 H1N1 influenza virus infection has led to recommendations on influenza diagnostic testing for clinicians treating patients as well as advising clinicians on testing decisions. Studies have also shown that rapid immunoassays for seasonal influenza virus show considerable variability in performance characteristics, based on age of patient, prevalence of disease, course of infection, and the quality of the kit used. While public health authorities are currently focused on influenza virus diagnostics, a lack of sensitivity of rapid immunoassays for other viral respiratory pathogens has been widely reported, such as the very limited value of rapid immunoassays for the detection of respiratory syncytial virus in adults. In light of the lack of sensitivity of diagnostic tests for suspected 2009 H1N1 influenza virus infection, as well as their variable performance characteristics for seasonal influenza virus, a number of recommendations have been made by public health authorities advising clinicians on the need for clinical judgment as an important part of testing and treatment decisions as well as reliance on local epidemiologic and surveillance data. With the availability of new molecular methodologies that are user-friendly and allow the front-line physician as well as hospital infection control programs to significantly improve respiratory viral diagnostics, there is a need to carefully determine the most optimal diagnostic testing methodology based on the clinical setting. This review will describe the historical, current, and changing dynamics of respiratory virus infection diagnostics.

  11. [Reflections on the clinical reports «minimum data set»]. (United States)

    Prieto de Paula, J M; Franco Hidalgo, S


    Royal Decree 1093/2010 (3 September 2010) establishes the minimum data set that the clinical reports of discharges and outpatient visits elaborated in the facilities of the National Health System should contain, among others. Until then, the Ministerial Order 221/1984, that only required the drawing up of a discharge report for patients seen in a hospital-regime health care establishment, was in force. In spite of the importance of these documents, their quality is far from that desired, especially that of the reports on visits, which, among other things, are not performed in a high percentage of the cases. Recently the Sociedad Española de Medicina Interna (SEMI) (Spanish Society of Internal Medicine), in collaboration with other scientific societies, issued some recommendations for the drawing up of the discharge reports. In this present work, a series of thoughts are made on the implications of the new decree, especially in the case of the reports of the outpatient clinics.

  12. Clinical Presentation, Aetiology, and Outcomes of Meningitis in a Setting of High HIV and TB Prevalence

    Directory of Open Access Journals (Sweden)

    Keneuoe Hycianth Thinyane


    Full Text Available Meningitis causes significant morbidity and mortality globally. The aim of this study was to study the clinical presentation, aetiology, and outcomes of meningitis among adult patients admitted to Queen Mamohato Memorial Hospital in Maseru, Lesotho, with a diagnosis of meningitis. A cross-sectional study was conducted between February and April 2014; data collected included presenting signs and symptoms, laboratory results, and clinical outcomes. Descriptive statistics were used to summarise data; association between variables was analysed using Fisher’s exact test. 56 patients were enrolled; the HIV coinfection rate was 79%. The most common presenting symptoms were altered mental status, neck stiffness, headache, and fever. TB meningitis was the most frequent diagnosis (39%, followed by bacterial (27%, viral (18%, and cryptococcal meningitis (16%. In-hospital mortality was 43% with case fatalities of 23%, 40%, 44%, and 90% for TB, bacterial, cryptococcal, and viral meningitis, respectively. Severe renal impairment was significantly associated with mortality. In conclusion, the causes of meningitis in this study reflect the high prevalence of HIV and TB in our setting. Strategies to reduce morbidity and mortality due to meningitis should include improving diagnostic services to facilitate early detection and treatment of meningitis and timely initiation of antiretroviral therapy in HIV-infected patients.

  13. Molecular-based mycobacterial identification in a clinical laboratory setting: a comparison of two methods.

    LENUS (Irish Health Repository)

    O'Donnell, N


    Many mycobacterial species are pathogenic to humans, with infection occurring worldwide. Infection with Mycobacterium tuberculosis is a well-described global phenomenon, but other mycobacterial species are increasingly shown to be the cause of both pulmonary and extrapulmonary infection and are managed differently from M. tuberculosis infection. Rapid and accurate differentiation of mycobacterial species is, therefore, critical to guide timely and appropriate therapeutic and public health management. This study evaluates two commercially available DNA strip assays, the Genotype Common Mycobacteria (CM) assay (Hain Lifescience, Nehren, Germany) and the Speed-oligo Mycobacteria assay (Vircell, Spain) for their usefulness in a clinical laboratory setting. Both assays were evaluated on 71 clinical mycobacterial isolates, previously identified using Gen-Probe AccuProbe and through a UK mycobacteriology reference laboratory, as well as 29 non-mycobacterial isolates. Concordant results were obtained for 98% of isolates using both assays. The sensitivity was 97% (95% confidence interval [CI]: 93.3-100%) for the CM assay and 98.6% (95% CI: 95.9-100%) for the Speed-oligo assay. Overall, both assays proved to be useful tools for rapid and sensitive mycobacterial species identification, although interpretation of results was easier with the CM assay. Finally, results were available within one day, compared to current identification times which range between seven days and four weeks.

  14. National Priority Setting of Clinical Practice Guidelines Development for Chronic Disease Management. (United States)

    Jo, Heui-Sug; Kim, Dong Ik; Oh, Moo-Kyung


    By November 2013, a total of 125 clinical practice guidelines (CPGs) have been developed in Korea. However, despite the high burden of diseases and the clinical importance of CPGs, most chronic diseases do not have available CPGs. Merely 83 CPGs are related to chronic diseases, and only 40 guidelines had been developed in the last 5 yr. Considering the rate of the production of new evidence in medicine and the worsening burden from chronic diseases, the need for developing CPGs for more chronic diseases is becoming increasingly pressing. Since 2011, the Korean Academy of Medical Sciences and the Korea Centers for Disease Control and Prevention have been jointly developing CPGs for chronic diseases. However, priorities have to be set and resources need to be allocated within the constraint of a limited funding. This study identifies the chronic diseases that should be prioritized for the development of CPGs in Korea. Through an objective assessment by using the analytic hierarchy process and a subjective assessment with a survey of expert opinion, high priorities were placed on ischemic heart disease, cerebrovascular diseases, Alzheimer's disease and other dementias, osteoarthritis, neck pain, chronic kidney disease, and cirrhosis of the liver.

  15. ART Adherence Measurement in Non-Clinical Settings in South India (United States)

    Kleinman, Nora J.; Manhart, Lisa E.; Mohanraj, Rani; Kumar, Shuba; Jeyaseelan, L.; Rao, Deepa; Simoni, Jane M.


    Optimal adherence to antiretroviral therapy (ART) is key to viral suppression, but may be impeded by psychosocial consequences of HIV-infection such as stigma and depression. Measures of adherence in India have been examined in clinic populations, but little is known about the performance of these measures outside clinical settings. We conducted a cross-sectional study of 151 Tamil-speaking people living with HIV/AIDS (PLHA) in India recruited through HIV support networks and compared single item measures from the Adult AIDS Clinical Trial Group (AACTG) scale, a visual analog scale (VAS), and a question on timing of last missed dose. Depression was measured using the Major Depression Inventory (MDI) and HIV-related stigma was measured using an adaptation of the Berger Stigma Scale. Mean age was 35.6 years (SD±5.9); 55.6% were male; mean MDI score was 11.9 (SD±9.1); and mean stigma score was 67.3 (SD±12.0). Self-reported perfect adherence (no missed doses) was 93.3% using the AACTG item, 87.1% using last missed dose, and 83.8% using the VAS. The measures had moderate agreement with each other (kappa 0.45 - 0.57). Depression was associated with lower adherence irrespective of adherence measure used, and remained significantly associated in multivariable analyses adjusting for age and marital status. Stigma was not associated with adherence irrespective of the measure used. The VAS captured the greatest number of potentially non-adherent individuals and may be useful for identifying PLHA in need of adherence support. Given the consistent and strong association between poorer adherence and depression, programs that jointly address adherence and mental health for PLHA in India may be more effective than programs targeting only one. PMID:25119585

  16. Standard Setting for Clinical Competence at Graduation from Medical School: A Comparison of Passing Scores across Five Medical Schools (United States)

    Boursicot, Katharine A. M.; Roberts, Trudie E.; Pell, Godfrey


    While Objective Structured Clinical Examinations (OSCEs) have become widely used to assess clinical competence at the end of undergraduate medical courses, the method of setting the passing score varies greatly, and there is no agreed best methodology. While there is an assumption that the passing standard at graduation is the same at all medical…

  17. Enacting a Vision for a Master's Entry Clinical Nurse Leader Program: Rethinking Nursing Education. (United States)

    Hicks, Frank D; Rosenberg, Lisa


    The need to educate nurses at the graduate level and provide them with a different skill set that broadens their view of health and nursing is clearly articulated by the American Association of Colleges of Nursing. Consequently, the role of the clinical nurse leader (CNL) was born. Responding to the need for providing a highly educated and credentialed professional at the bedside, Rush University College of Nursing made the bold move to phase out baccalaureate education and enact a prelicensure, master's entry CNL program. Although there is a clear need for this type of graduate, there is little in the literature to provide guidance to institutions that wish to develop this type of program. This paper describes the factors that came into play in making that decision, the process of curriculum development and implementation, the challenges encountered in implementing this type of program, and the outcomes that the program has evidenced since its inception.

  18. Human papillomavirus testing by self-sampling: assessment of accuracy in an unsupervised clinical setting (United States)

    Szarewski, Anne; Cadman, Louise; Mallett, Susan; Austin, Janet; Londesborough, Philip; Waller, Jo; Wardle, Jane; Altman, Douglas G; Cuzick, Jack


    Objectives: To compare the performance and acceptability of unsupervised self-sampling with clinician sampling for high-risk human papillomavirus (HPV) types for the first time in a UK screening setting. Setting: Nine hundred and twenty women, from two demographically different centres, attending for routine cervical smear testing Methods: Women performed an unsupervised HPV self-test. Immediately afterwards, a doctor or nurse took an HPV test and cervical smear. Women with an abnormality on any test were offered colposcopy. Results: Twenty-one high-grade and 39 low-grade cervical intraepithelial neoplasias (CINs) were detected. The sensitivity for high-grade disease (CIN2+) for the self HPV test was 81% (95% confidence interval [CI] 60–92), clinician HPV test 100% (95% CI 85–100), cytology 81% (95% CI 60–92). The sensitivity of both HPV tests to detect high- and low-grade cervical neoplasia was much higher than that of cytology (self-test 77% [95%CI 65–86], clinician test 80% [95% CI 68–88], cytology 48% [95% CI 36–61]). For both high-grade alone, and high and low grades together, the specificity was significantly higher for cytology (greater than 95%) than either HPV test (between 82% and 87%). The self-test proved highly acceptable to women and they reported that the instructions were easy to understand irrespective of educational level. Conclusions: Our results suggest that it would be reasonable to offer HPV self-testing to women who are reluctant to attend for cervical smears. This approach should now be directly evaluated among women who have been non-attenders in a cervical screening programme. PMID:17362570

  19. Care priorities- Registered Nurses' clinical daily work in municipal elderly care settings. (United States)

    Norell, Margaretha; Ziegert, Kristina; Kihlgren, Annica


    Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. In according to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure is perceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 - 2008, using a web-based form. The nurses filled in patient's type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and were attributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in south-western Sweden, who received some form of health care from a RN, or performed by non-certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient's gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation.

  20. How different can you be and still survive? Homogeneity and difference in clinical nursing education. (United States)

    Paterson, Barbara L; Osborne, Margaret; Gregory, David


    The article focuses on a component of a three-year institutional ethnography regarding the construction of cultural diversity in clinical education. Students in two Canadian schools of nursing described being a nursing student as bounded by unwritten and largely invisible expectations of homogeneity in the context of a predominant discourse of equality and cultural sensitivity. At the same time, they witnessed many incidents, both personally and those directed toward other individuals of the same culture, of clinical teachers problematizing difference and centering on difference as less than the expected norm. This complex and often contradictory experience of difference and homogeneity contributed to their construction of cultural diversity as a problem. The authors provide examples of how the perception of being different affected some students' learning in the clinical setting and their interactions with clinical teachers. They will illustrate that this occurred in the context of macro influences that shaped how both teachers and students experienced and perceived cultural diversity. The article concludes with a challenge to nurse educators to deconstruct their beliefs and assumptions about inclusivity in nursing education.

  1. Adherence to Pre-Exposure Prophylaxis for HIV Prevention in a Clinical Setting.

    Directory of Open Access Journals (Sweden)

    Madeline C Montgomery

    Full Text Available The HIV epidemic in the United States (US disproportionately affects gay, bisexual, and other men who have sex with men (MSM. Pre-exposure prophylaxis (PrEP using co-formulated tenofovir disoproxil fumarate (TDF and emtricitabine (FTC has demonstrated high efficacy in reducing HIV incidence among MSM. However, low adherence was reported in major efficacy trials and may present a substantial barrier to successful PrEP implementation. Rates of adherence to PrEP in "real-world" clinical settings in the US remain largely unknown.We reviewed demographic and clinical data for the first 50 patients to enroll in a clinical PrEP program in Providence, Rhode Island. We analyzed self-reported drug adherence as well as drug concentrations in dried blood spots (DBS from patients who attended either a three- or six-month follow-up appointment. We further assessed drug concentrations and the resistance profile of a single patient who seroconverted while taking PrEP.Of the first 50 patients to be prescribed PrEP, 62% attended a follow-up appointment at three months and 38% at six months. Of those who attended an appointment at either time point (70%, n = 35, 92% and 95% reported taking ±4 doses/week at three and six months, respectively. Drug concentrations were performed on a random sample of 20 of the 35 patients who attended a follow-up appointment. TDF levels consistent with ±4 doses/week were found in 90% of these patients. There was a significant correlation between self-reported adherence and drug concentrations (r = 0.49, p = 0.02. One patient who had been prescribed PrEP seroconverted at his three-month follow-up visit. The patient's drug concentrations were consistent with daily dosing. Population sequencing and ultrasensitive allele-specific PCR detected the M184V mutation, but no other TDF- or FTC-associated mutations, including those present as minor variants.In this clinical PrEP program, adherence was high, and self-reported drug adherence

  2. Instinctive Clinical Teaching: Erasing the Mental Boundary Between Clinical Education and Patient Care to Promote Natural Learning. (United States)

    Yang, Yih-Ming; Kim, Christopher H; Briones, Michael A; Hilinski, Joseph A; Greenwald, Michael


    Effective clinical teaching is essential in physician education, yet faculty members rarely receive formal training in clinical teaching. Formal models for training clinical educators are often tedious and require significant time and effort. Instinctive clinical teaching allows clinicians to seamlessly integrate and promote effective teaching into their clinical practice. The approach is guided by similarities between the components of Kolb's experiential learning cycle-concrete experience, reflective observation, abstract conceptualization, and active experimentation-and the elements of the patient care process-history and physical, initial assessment, differential, hypothesis, final diagnosis, management, and follow-up. Externalization of these clinical thought processes allows for inclusion of learners and promotes effective clinical teaching.

  3. Building the Clinical Bridge to Advance Education, Research, and Practice Excellence

    Directory of Open Access Journals (Sweden)

    Marilyn Svejda


    Full Text Available The University of Michigan School of Nursing and the Health System partnered to develop an undergraduate clinical education model as part of a larger project to advance clinical education, practice, and scholarship with education serving as the clinical bridge that anchors all three areas. The clinical model includes clusters of clinical units as the clinical home for four years of a student's education, clinical instruction through team mentorship, clinical immersion, special skills preparation, and student portfolio. The model was examined during a one-year pilot with junior students. Stakeholders were largely positive. Findings showed that Clinical Faculty engaged in more role modeling of teaching strategies as Mentors assumed more direct teaching used more clinical reasoning strategies. Students reported increased confidence and competence in clinical care by being integrated into the team and the Mentor's assignment. Two new full time faculty roles in the Health System support education, practice, and research.

  4. Introduction of Education Systems for Clinical Engineers in Japan

    Institute of Scientific and Technical Information of China (English)

    Jun Yoshioka; Keiko Fukuta; Hiroki Igeta; Takeshi Ifuku; Tadayuki Kawasaki


    Japanese clinical engineer (CE) is a significant and unique profession compared with other nations with its dual clinical and technology focus and national licensing. The CE system of licensing was established in May 1987 under the Clinical Engineers Act. CEs are required to complete 3 to 4 years in designated schools and pass a national examination. It is a professional medical position responsible for the operation and maintenance of life-support and non-life-support medical device systems under the direction of physicians. Currently approximately 70 educational institutes - including technical colleges and universities - provide diverse and wide-ranging curricula from engineering to various clinical disciplines to produce CEs. Since clinical practice training is mandatory as a part of institute work, an important approach for CEs is gained by working in hospitals. The comprehensive curricula and the licensing system in Japan together serve to keep the appropriate quantity and quality of CEs. The Japan Association for Clinical Engineers (JACE) was established in February 1990; one of its aims is to support improvement of CEs throughout their careers through various lectures, seminars, on-the-job trainings, workshops, and an annual member meeting. New CEs can now take advantage of video e-learning. For junior CEs, there are seminars for hyperbaric oxygen therapy, blood purification, heart-lung bypass, respiratory therapy, operating room, intensive care unit, arrhythmia and aphaeresis related devices, as well as healthcare technology management (HTM). Also, the institutes provide a leadership seminar alongside this clinical practice training. Besides the licensing process, a proper certification system for CEs is a critical element in the clinical field. This enhances the ability of CEs to engage in more extensive duties and develop specialties, as well as to provide better healthcare. Associated societies provide certification with technology qualifications in

  5. Bibliometric Analysis: Mirror Therapy as an Occupational Therapy Intervention Strategy in the Clinical Setting

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    Elvis Siprián Castro Alzate


    Full Text Available Objective: To determine the national and international scientific evidence regarding the use of mirror therapy, as an occupational therapy intervention tool in the clinical setting, in order to acquire knowledge and implement this strategy in professional practice. Materials and methods: A descriptive study was conducted in which the research strategy was held through medical subject headings (MeSH, such as “mirror neuron”, ”occupational therapy”, “physical rehabilitation” and “motor imagery”. Through the use of the bolean and combinations in five different databases were performed: Embase, Ebsco, OTseeker, Science Direct and Medline. The analysis was elaborated by establishing frequencies of different variables such as journal, country, study type and publish­ing year. Conclusions: In the evidence analysis it was found that mirror therapy is an interven­tion modality recently used by different rehabilitation professionals. Since 2004, an increase in the generation of high impact scientific evidence about this subject has been recognized, due in part to the reported effectiveness in clinical practices, mainly the treatment of health conditions secondary to stroke, limb amputations, chronic pain syndromes, and post-surgical rehabilitation. During the reviewed period, an increase in high level academic evidence was observed: 35.7 % of the analyzed publications correspond to randomized controlled trials and 42.9 % are system­atic reviews. The use of mirror therapy in occupational therapy is an intervention modality that facilitates functional rehabilitation processes, promotes independence in performing activities of daily living (adl and allows social participation and environment adaptation processes to happen.

  6. Can the anti-inflammatory activities of β2-agonists be harnessed in the clinical setting?

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    Theron AJ


    Full Text Available Annette J Theron,1,2 Helen C Steel,1 Gregory R Tintinger,1 Charles Feldman,3 Ronald Anderson1 1Medical Research Council Unit for Inflammation and Immunity, Department of Immunology, Faculty of Health Sciences, University of Pretoria, 2Tshwane Academic Division of the National Health Laboratory Service, Pretoria, 3Division of Pulmonology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa Abstract: Beta2-adrenoreceptor agonists (β2-agonists are primarily bronchodilators, targeting airway smooth muscle and providing critical symptomatic relief in conditions such as bronchial asthma and chronic obstructive pulmonary disease. These agents also possess broad-spectrum, secondary, anti-inflammatory properties. These are mediated largely, though not exclusively, via interactions with adenylyl cyclase-coupled β2-adrenoreceptors on a range of immune and inflammatory cells involved in the immunopathogenesis of acute and chronic inflammatory disorders of the airways. The clinical relevance of the anti-inflammatory actions of β2-agonists, although often effective in the experimental setting, remains contentious. The primary objectives of the current review are: firstly, to assess the mechanisms, both molecular and cell-associated, that may limit the anti-inflammatory efficacy of β2-agonists; secondly, to evaluate pharmacological strategies, several of which are recent and innovative, that may overcome these limitations. These are preceded by a consideration of the various types of β2-agonists, their clinical applications, and spectrum of anti-inflammatory activities, particularly those involving adenosine 3',5'-cyclic adenosine monophosphate-activated protein kinase-mediated clearance of cytosolic calcium, and altered gene expression in immune and inflammatory cells. Keywords: adenylyl cyclase, corticosteroids, cyclic AMP, muscarinic

  7. Nuclear medicine in the acute clinical setting: indications, imaging findings, and potential pitfalls. (United States)

    Uliel, Livnat; Mellnick, Vincent M; Menias, Christine O; Holz, Andrew L; McConathy, Jonathan


    Nuclear medicine imaging provides valuable functional information that complements information obtained with anatomic imaging techniques in the evaluation of patients with specific acute clinical manifestations. Nuclear medicine studies are most often used in conjunction with other imaging modalities and as a problem-solving tool. Under certain circumstances a nuclear medicine study may be indicated as the first-line imaging modality, as in the case of renal scintigraphy for transplant dysfunction in the early postoperative period. Nuclear imaging may be preferred when a conventional first-line study is contraindicated or when it is important to minimize radiation exposure. The portability of nuclear imaging offers particular advantages for the evaluation of critically ill patients whose clinical condition is unstable and who cannot be safely transported out of the intensive care unit. The ability to visualize physiologic and pathophysiologic processes over relatively long time periods without adding to the patient's radiation exposure contributes to the high diagnostic sensitivity of several types of nuclear medicine studies. Viewing the acquired images in the cine mode adds to the value of these studies for diagnosing and characterizing dynamic abnormalities such as intermittent internal bleeding and bile or urine leakage. In this pictorial review, the spectrum of nuclear medicine studies commonly performed in the acute care setting is reviewed according to body systems and organs, with detailed descriptions of the indications, technical considerations, findings, and potential pitfalls of each type of study. Supplemental material available at

  8. University tutorials in the setting of the European Higher Education Area: current profiles

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    Full Text Available In the new setting promoted by the European Higher Education Area, university guidance and tutorials have become more important than ever. We understand tutorials as part of the teaching responsibility in which a more personal interaction between professor and student, professor and novice teacher, or student and student is established, and whose goal is to guide learning according to the individual characteristics and learning styles of the individuals involved. Now is the time to set up guidance and tutorials systems for students –both during the training process and in their first professional steps– and for novice teachers also. Among such systems we can mention professor coaching, peer mentoring, professional tutoring in training centres or mentoring of an experienced university professor on the novice teacher.

  9. LGBTQ Inclusion in Educator Preparation: Getting Ready for Gender and Sexual Diversity in Secondary School Settings (United States)

    Hoelscher, Mary Helen

    possibilities for LGBTQ inclusion in life science educator preparation. This study, thus, is theoretical as it sets about exploring possibilities for LGBTQ inclusion across life science education curriculum by drawing from the literature about the needs of LGBT and questioning students, the small amount of scholarly work related to science teacher education, and other scholarly work that relates to preparing teachers for gender and sexual diversity in secondary settings. The second study explored possibilities for LGBTQ inclusion in science teacher education. The third study, a holistic multiple-case study, explored science teacher candidates' adoption of LGBTQ inclusion in their praxis during a science EPP (SEPP). The research questions guiding this study were: what were science TCs' commitments to LGBTQ-inclusive praxis? What were science TCs' enactments of LGBTQ-inclusive praxis? And, what supports and barriers influenced TCs' commitment to and enactment of LGBTQ-inclusive praxis during the SEPP? Understanding these commitments, enactments, and the supports and barriers to them will benefit the particular SEPP and contribute to greater understanding of the capacities and needs of science TCs as they are challenged to fully welcome and educate the diversity of learners who enter their classrooms. The set of studies concludes with a discussion of implications for EPPs and future research that may lead to the realization of a vision of classroom practices that are inclusive of LGBTQ students for the benefit of schools and communities.

  10. Educating residents in behavioral health care and collaboration: integrated clinical training of pediatric residents and psychology fellows. (United States)

    Pisani, Anthony R; leRoux, Pieter; Siegel, David M


    Pediatric residency practices face the challenge of providing both behavioral health (BH) training for pediatricians and psychosocial care for children. The University of Rochester School of Medicine and Dentistry and Rochester General Hospital developed a joint training program and continuity clinic infrastructure in which pediatric residents and postdoctoral psychology fellows train and practice together. The integrated program provides children access to BH care in a primary care setting and gives trainees the opportunity to integrate collaborative BH care into their regular practice routines. During 1998-2008, 48 pediatric residents and 8 psychology fellows trained in this integrated clinical environment. The program's accomplishments include longevity, faculty and fiscal stability, sustained support from pediatric leadership and community payers, the development in residents and faculty of greater comfort in addressing BH problems and collaborating with BH specialists, and replication of the model in two other primary care settings. In addition to quantitative program outcomes data, the authors present a case example that illustrates how the integrated program works and achieves its goals. They propose that educating residents and psychology trainees side by side in collaborative BH care is clinically and educationally valuable and potentially applicable to other settings. A companion report published in this issue provides results from a study comparing the perceptions of pediatric residents whose primary care continuity clinic took place in this integrated setting with those of residents from the same pediatric residency who had their continuity clinic training in a nonintegrated setting.

  11. Ischaemic memory imaging using metabolic radiopharmaceuticals: overview of clinical settings and ongoing investigations

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    Yoshinaga, Keiichiro [Hokkaido University Graduate School of Medicine, Department of Molecular Imaging, Sapporo (Japan); Naya, Masanao [Hokkaido University Graduate School of Medicine, Department of Cardiology, Sapporo (Japan); Shiga, Tohru; Suzuki, Eriko; Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan)


    ''Ischaemic memory'' is defined as a prolonged functional and/or biochemical alteration remaining after a particular episode of severe myocardial ischaemia. The biochemical alteration has been reported as metabolic stunning. Metabolic imaging has been used to detect the footprint left by previous ischaemic episodes evident due to delayed recovery of myocardial metabolism (persistent dominant glucose utilization with suppression of fatty acid oxidation). β-Methyl-p-[{sup 123}I]iodophenylpentadecanoic acid (BMIPP) is a single-photon emission computed tomography (SPECT) radiotracer widely used for metabolic imaging in clinical settings in Japan. In patients with suspected coronary artery disease but no previous myocardial infarction, BMIPP has shown acceptable diagnostic accuracy. In particular, BMIPP plays an important role in the identification of prior ischaemic insult in patients arriving at emergency departments with acute chest pain syndrome. Recent data also show the usefulness of {sup 123}I-BMIPP SPECT for predicting cardiovascular events in patients undergoing haemodialysis. Similarly, SPECT or PET imaging with {sup 18}F-FDG injected during peak exercise or after exercise under fasting conditions shows an increase in FDG uptake in postischaemic areas. This article will overview the roles of ischaemic memory imaging both under established indications and in ongoing investigations. (orig.)

  12. Fad diets and obesity--Part I: Measuring weight in a clinical setting. (United States)

    Moyad, Mark A


    Obesity is a recognized epidemic in many regions around the world and billions of dollars are spent each year in attempting to combat this problem. However, before a discussion of the different conventional and alternative treatments for obesity can be initiated, it is first critical to determine whether or not a certain individual is actually overweight, obese, or has an excess of adipose tissue. Therefore, a review of the various popular and unpopular measurements of obesity is needed. A variety of measurements exist such as bioelectrical impedance, body mass index (BMI), crude weight, densitometry, dual energy x-ray absorptiometry (DEXA), lean body mass (LBM), skinfold thickness, and waist-to-hip ratio (WHR). All of these measurements contain inherent advantages and disadvantages, but many of these can still be used in a clinical setting. Health professionals should acquaint themselves with these different measurements in order to take the first step in bringing attention to and potentially treating a condition that affects virtually every medical discipline.

  13. Blood transcriptomic markers for major depression: from animal models to clinical settings. (United States)

    Redei, Eva E; Mehta, Neha S


    Depression is a heterogeneous disorder and, similar to other spectrum disorders, its manifestation varies by age of onset, severity, comorbidity, treatment responsiveness, and other factors. A laboratory blood test based on specific biomarkers for major depressive disorder (MDD) and its subgroups could increase diagnostic accuracy and expedite the initiation of treatment. We identified candidate blood biomarkers by examining genome-wide expression differences in the blood of animal models representing both the genetic and environmental/stress etiologies of depression. Human orthologs of the resulting transcript panel were tested in pilot studies. Transcript abundance of 11 blood markers differentiated adolescent subjects with early-onset MDD from adolescents with no disorder (ND). A set of partly overlapping transcripts distinguished adolescent patients who had comorbid anxiety disorders from those with only MDD. In adults, blood levels of nine transcripts discerned subjects with MDD from ND controls. Even though cognitive behavioral therapy (CBT) resulted in remission of some patients, the levels of three transcripts consistently signaled prior MDD status. A coexpression network of transcripts seems to predict responsiveness to CBT. Thus, our approach can be developed into clinically valid diagnostic panels of blood transcripts for different manifestations of MDD, potentially reducing diagnostic heterogeneity and advancing individualized treatment strategies.

  14. Incorporating Experiential Learning Techniques to Improve Self-Efficacy in Clinical Special Care Dentistry Education. (United States)

    Watters, Amber L; Stabulas-Savage, Jeanine; Toppin, James D; Janal, Malvin N; Robbins, Miriam R


    The New York University College of Dentistry has introduced a clinical rotation for fourth-year dental students that focuses on treating people with special health care needs (PSN). The aim of this study was to investigate the hypothesis that clinical experience in treating patients with special health care needs during predoctoral education is associated with increased self-assessed student ability and comfort and therefore self-efficacy. The study also investigated whether other characteristics, such as prior personal or volunteer experience with this population, service-mindedness, and/or the inclination to treat underserved populations, were associated with comfort in treating PSN. A survey was used to assess changes in students' perceived knowledge, beliefs, and attitudes regarding treating PSN before and after the clinical experience for July 2012-June 2013. The survey included questions about students' service-mindedness, comfort, perceptions of abilities of PSN and educational importance of learning to treat PSN, desire for clinical experience, and future intent or interest in treating PSN. Out of 364 students invited to participate, 127 surveys were returned, for a response rate of 34.9%. The results showed statistically significant increases on six items following training: impressions about the importance of oral health among PSN, comfort in treating people with cognitive disabilities and with medical complexities, intent to treat PSN in future practice, interest in including PSN in postgraduate training, and belief that PSN could be treated in the private practice setting. These students reported preferring to learn in the clinical setting over didactic instruction. This clinical experience was associated with improved self-efficacy in treating PSN and increased intentions to treat this population in future practice. Improvements were particularly evident among those with the least prior experience with PSN and were independent of other aspects of the

  15. Simulation-based education for building clinical teams

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    Marshall Stuart


    Full Text Available Failure to work as an effective team is commonly cited as a cause of adverse events and errors in emergency medicine. Until recently, individual knowledge and skills in managing emergencies were taught, without reference to the additional skills required to work as part of a team. Team training courses are now becoming commonplace, however their strategies and modes of delivery are varied. Just as different delivery methods of traditional education can result in different levels of retention and transfer to the real world, the same is true in team training of the material in different ways in traditional forms of education may lead to different levels of retention and transfer to the real world, the same is true in team training. As team training becomes more widespread, the effectiveness of different modes of delivery including the role of simulation-based education needs to be clearly understood. This review examines the basis of team working in emergency medicine, and the components of an effective emergency medical team. Lessons from other domains with more experience in team training are discussed, as well as the variations from these settings that can be observed in medical contexts. Methods and strategies for team training are listed, and experiences in other health care settings as well as emergency medicine are assessed. Finally, best practice guidelines for the development of team training programs in emergency medicine are presented.

  16. Clinical Education, the lessons learned from practical applications - Albanian issues, East Europe and the advanced international practices on Clinical Education

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    Alban Koci


    In legal clinics, students perform various tasks just as an attorney would do in the same job position, such as doing legal research, drafting briefs and other legal documents, and interviewing clients. Many jurisdictions even allow students to appear in court on behalf of clients, even in criminal defense. Legal clinics is part of the academic law program in the most of the law faculties all over the world and it has a great impact in the community’s life. Throughout legal clinics students not only get the opportunity to be part of an important experience, but also they can be effective and help the people in need with their work. This paper aims to bring attention to the importance of clinical education in the formation of young lawyers and how one can learn from experience. There will be discussed important issues about legal clinic, the objectives and its mission, how to apply it and the benefits legal clinic brings not only for the academic area but also for the society.

  17. Analysis of risk factors linked to social educator profession in different residential settings of Alicante Province

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    Jorge Heliz Llopis


    Full Text Available One of the most important professions in the field of intervention with underage at social risk that are cared for in different residential settings is, undoubtedly, that of the social educator. In that sense, although there are many professionals involved with these underage (psychologists, social workers, psychiatrists, teachers, etc., social educators are the ones who, through the carrying out of functions specific to their profession, often work as the "front line" of action, given that they are the ones who are more in touch with the underage and therefore the most likely to be exposed to different variables that could eventually put them in a situation of risk of psycho-social problems related to their work. Hence, the task of identifying the risk variables related to the teaching profession becomes a key objective in order to prevent the occurrence of likely problems that could undermine their psychosocial health. Therefore, through this communication we intend to expose the results that we obtained with a sample of 50 educators who perform their work in different residential-type services in the province of Alicante.

  18. The Anne Frank Haven: A case of an alternative educational program in an integrative Kibbutz setting (United States)

    Ben-Peretz, Miriam; Giladi, Moshe; Dror, Yuval


    The essential features of the programme of the Anne Frank Haven are the complete integration of children from low SES and different cultural backgrounds with Kibbutz children; a holistic approach to education; and the involvement of the whole community in an "open" residential school. After 33 years, it is argued that the experiment has proved successful in absorbing city-born youth in the Kibbutz, enabling at-risk populations to reach significant academic achievements, and ensuring their continued participation in the dominant culture. The basic integration model consists of "layers" of concentric circles, in dynamic interaction. The innermost circle is the class, the learning community. The Kibbutz community and the foster parents form a supportive, enveloping circle, which enables students to become part of the outer community and to intervene in it. A kind of meta-environment, the inter-Kibbutz partnership and the Israeli educational system, influence the program through decision making and guidance. Some of the principles of the Haven — integration, community involvement, a year's induction for all new students, and open residential settings — could be useful for cultures and societies outside the Kibbutz. The real "secret" of success of an alternative educational program is the dedicated, motivated and highly trained staff.

  19. Classroom to clinic: incorporating adolescent spiritual/faith assessment into nurse practitioner education & practice. (United States)

    Haley, Janice M


    Although nursing is well grounded in the conceptualization of person as body-mind-spirit, there is little evidence that advanced practice nurses routinely address the spirit in giving patient care, especially with adolescents in the outpatient setting. The neglect of spiritual aspects of care may be related to lack of a framework, or education/incorporation into nurse practitioner preparation. This article describes one method of integrating adolescent spiritual/faith assessment into a nurse practitioner clinical course. Readings, assignments, and a grading rubric are offered.


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    Malia Spofford XAVIER


    Full Text Available Departing from the polyvalent metaphor of the “clinic,” this article discusses the results of the first phase of an English teacher education project, part of the Teaching Initiation Scholarship Program (PIBID/CAPES at a federal university in Brazil. Given the effects of globalization on language teaching and learning, the English teacher certification program needs to incorporate critical and intercultural perspectives in the reflexive dimension of the teacher education curriculum. One possible approach is the study of global English, or Anglophone, literatures utilizing a cultural studies and postcolonial theoretical framework. In accordance with recent observations by Festino (2011 and Lourenço (2011 about the importance of literatures in English for education in Brazil, I propose a multimodal and critical approach to the study of Anglophone literatures connected to teaching in basic education that also stimulates teacher reflection. This approach also seeks to illuminatethe role of English in Brazil and clarify the notion of content in English classes, as it relates to narrative. My analysis involves a triptych of literary genres from different countries: Kendal Hippolyte (poetry – St. Lucia, Chinua Achebe (novel – Nigeria, and Jhumpa Lahiri (short story – United States and India. Some strategies for transposing literary studies to the middle school English classroom in Brazil are also outlined.

  1. Brief motivational interview and educational brochure in emergency room settings for adolescents and young adults with alcohol related problems: a randomized single blind clinical trial Intervenção motivacional breve e brochura educacional em pronto-socorro para adolescentes e adultos jovens com problemas relacionados ao álcool: um ensaio clínico simples cego randomizado

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    Maria Luiza Segatto


    Full Text Available OBJECTIVE: To evaluate the effectiveness of brief motivational interviewing and an educational brochure when delivered in emergency room to reduce alcohol abuse and related problems among adolescents and young adults. METHOD: a randomized single blind clinical trial with a 3 month follow-up was carried out at three emergency rooms from October 2004 to November 2005; subjects assessed were 16-25 years old treated for alcohol related events up to 6 hours after consumption. Socio-demographic data, quantity, frequency and negative consequences of alcohol consumption, motivation to change habits and future risk preception were evaluated. Statistical analysis was performed on subjects who completed follow up (completers. ANCOVA model was used to analyze the difference between the intervention groups with statistical significance level α = 5% and Confidence Interval (CI 95%. RESULTS: 186 subjects formed the initial sample, being n = 175 included and randomized to educational brochure group (n = 88 or motivational interviewing group (n = 87. Follow-up assessment was performed in 85.2% sample. No significant difference between groups was observed. However, significant reductions (p OBJETIVO: Avaliar a efetividade da entrevista motivacional breve e de uma brochura educativa quando aplicadas em prontos-socorros para reduzir o abuso e problemas relacionados ao álcool entre os jovens. MÉTODO: Um ensaio clínico randomizado simples-cego com três meses de seguimento foi realizado em três prontos-socorros de outubro de 2004 a novembro de 2005, com indivíduos de 16-25 anos tratados por eventos relacionados ao álcool com até 6 horas após o consumo. Dados sociodemográficos, quantidade, frequência e consequências negativas, motivação para mudanças de hábitos e percepção para riscos do consumo de álcool foram avaliados. A análise estatística foi realizada em indivíduos que completaram o seguimento (completados. Modelo de ANCOVA foi utilizado

  2. Brief motivational interview and educational brochure in emergency room settings for adolescents and young adults with alcohol-related problems: a randomized single-blind clinical trial Intervenção motivacional breve e brochura educacional em pronto-socorro para adolescentes e adultos jovens com problemas relacionados ao álcool: um ensaio clínico simples-cego randomizado

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    Maria Luiza Segatto


    Full Text Available OBJECTIVE: To evaluate the effectiveness of brief motivational interviewing and an educational brochure when delivered in emergency room to reduce alcohol abuse and related problems among adolescents and young adults. METHOD: A randomized single-blind clinical trial with a three-month follow-up was carried out at three emergency rooms from October 2004 to November 2005; subjects assessed were 16-25 years old treated for alcohol related events up to 6 hours after consumption. Socio-demographic data, quantity, frequency and negative consequences of alcohol consumption, motivation to change habits and future risk perception were evaluated. Statistical analysis was performed on subjects who completed follow-up (completers. ANCOVA model was used to analyze the difference between the intervention groups with statistical significance level α = 5% and confidence interval (CI of 95%. RESULTS: 186 subjects formed the initial sample, being 175 included and randomized to the educational brochure group (n = 88 or motivational interviewing group (n = 87. Follow-up assessment was performed in 85.2% of the sample. No significant difference between groups was observed. However, significant reductions (p OBJETIVO: Avaliar a efetividade da entrevista motivacional breve e de uma brochura educativa quando aplicadas em prontos-socorros para reduzir o abuso e problemas relacionados ao álcool entre os jovens. MÉTODO: Um ensaio clínico randomizado simples-cego com três meses de seguimento foi realizado em três prontos-socorros de outubro de 2004 a novembro de 2005, com indivíduos de 16-25 anos tratados por eventos relacionados ao álcool com até 6 horas após o consumo. Dados sociodemográficos, quantidade, frequência e consequências negativas, motivação para mudanças de hábitos e percepção para riscos do consumo de álcool foram avaliados. A análise estatística foi realizada em indivíduos que completaram o seguimento (completados. Modelo de ANCOVA

  3. Integrating Peer Assisted Learning and eLearning: Using Innovative Pedagogies to Support Learning and Teaching in Higher Education Settings (United States)

    Edwards, Susan; Bone, Jane


    The paper reports the findings from a project which examined the interface between Peer Assisted Learning (PAL) and eLearning in a higher education setting. Traditional uses of ICTs in Higher Education have focused on the "transfer model" where existing face to face pedagogies have tended to be transferred to approaches to eLearning.…

  4. Food Safety Education Using an Interactive Multimedia Kiosk in a WIC Setting: Correlates of Client Satisfaction and Practical Issues (United States)

    Trepka, Mary Jo; Newman, Frederick L.; Huffman, Fatma G.; Dixon, Zisca


    Objective: To assess acceptability of food safety education delivered by interactive multimedia (IMM) in a Supplemental Nutrition Program for Women, Infants and Children Program (WIC) clinic. Methods: Female clients or caregivers (n = 176) completed the food-handling survey; then an IMM food safety education program on a computer kiosk.…

  5. Agenda Setting During Follow-Up Encounters in a University Primary Care Outpatient Clinic. (United States)

    Rey-Bellet, Sarah; Dubois, Julie; Vannotti, Marco; Zuercher, Marili; Faouzi, Mohamed; Devaud, Karen; Rodondi, Nicolas; Rodondi, Pierre-Yves


    At the beginning of the medical encounter, clinicians should elicit patients' agendas several times using open-ended questions. Little is known, however, about how many times physicians really solicit a patient's agenda during follow-up encounters. The objective was to analyze the number of agenda solicitations by physicians, of agendas initiated by physicians, and of patients' spontaneous agendas during the beginning and the entire encounter. We analyzed 68 videotaped follow-up encounters at a university primary care outpatient clinic. The number of different types of agenda setting was searched for and analyzed using negative binomial regression or logistic regression models. Physicians solicited agendas a mean ± SD of 0.8 ± 0.7 times/patient during the first 5 minutes and 1.7 ± 1.2 times/patient during the entire encounter. Physicians in 32.4% of encounters did not solicit the patient agenda, and there were never more than two physician's solicitations during the first 5 minutes. The mean number of physician's solicitations of the patients' agenda was 42% lower among female physicians during the first 5 minutes and 34% lower during the entire encounter. The number of agendas initiated by physicians was 1.2 ± 1.2/patient during the beginning and 3.2 ± 2.3/patient during the entire encounter. In 58.8% of the encounters, patients communicated their agendas spontaneously. There were twice as many patient spontaneous agendas (IRR = 2.12, p = .002) with female physicians than with males. This study showed that agenda solicitation with open-ended questions in follow-up encounters does not occur as often as recommended. There is thus a risk of missing new agendas or agendas that are important to the patient.

  6. Effects of ostracism and sex on alcohol consumption in a clinical laboratory setting. (United States)

    Bacon, Amy K; Cranford, Alexi N; Blumenthal, Heidemarie


    Drinking to cope with negative affect is a drinking pattern that leads to problematic alcohol use both in college and after graduation. Despite theory and correlational evidence to this effect, establishing a link between stress and alcohol consumption among college students in the laboratory has yielded both a limited number of studies and, at times, inconsistent results. The present study attempts to resolve these issues through investigating the effects of an ecologically relevant stressor-ostracism-on alcohol consumption in a clinical laboratory setting. Social drinking college students (N = 40; 55% female) completed a 5-min game of Cyberball and were randomly assigned either to be included or excluded in the virtual ball-toss game. The amount (in ml) of beer consumed in a subsequent mock taste test served as our primary dependent variable, with breath alcohol concentration (BrAC) as a secondary dependent variable. Results indicated that excluded participants reported a trend toward an increase in negative affect from pre- to post-Cyberball, and endorsed significantly lower self-esteem, belonging, control, and belief in a meaningful existence compared to included participants. A significant Sex × Condition effect indicated that excluded women consumed less beer than both included women and excluded men, supported by a nonsignificant trend in BrAC. Men did not differ in their consumption of beer as a result of Cyberball condition. Implications of sex and social context on alcohol use are discussed, as well as ostracism as a method for investigating relationships between social stress and alcohol use.

  7. Cognitive behavioral therapy for depression among adults in Japanese clinical settings: a single-group study

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    Kikuchi Toshiaki


    Full Text Available Abstract Background Empirical support for cognitive behavioral therapy (CBT for treating Japanese patients with major depression is lacking, therefore, a feasibility study of CBT for depression in Japanese clinical settings is urgently required. Findings A culturally adapted, 16-week manualized individual CBT program for Japanese patients with major depressive disorder was developed. A total of 27 patients with major depression were enrolled in a single-group study with the purpose of testing the feasibility of the program. Twenty six patients (96% completed the study. The mean total score on the Beck Depression Inventory-II (BDI-II for all patients (Intention-to-treat sample improved from 32.6 to 11.7, with a mean change of 20.8 (95% confidence interval: 17.0 to 24.8. Within-group effect size at the endpoint assessment was 2.64 (Cohen's d. Twenty-one patients (77.7% showed treatment response and 17 patients (63.0% achieved remission at the end of the program. Significant improvement was observed in measurement of subjective and objective depression severity (assessed by BDI-II, Quick Inventory of Depressive Symptomatology-Self Rated, and Hamilton Depression Rating Scale, dysfunctional attitude (assessed by Dysfunctional Attitude Scale, global functioning (assessed by Global Assessment of Functioning of DSM-IV and subjective well-being (assessed by WHO Subjective Well-being Inventory (all p values Conclusions Our manualized treatment comprised of a 16-week individual CBT program for major depression appears feasible and may achieve favorable treatment outcomes among Japanese patients with major depression. Further research involving a larger sample in a randomized, controlled trial design is warranted. Trial registration UMIN-CTR UMIN000002542.

  8. Practicability of hygienic wrapping of touchscreen operated mobile devices in a clinical setting.

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    Matthias Hammon

    Full Text Available BACKGROUND: To prove effectiveness of wrapping tablet computers in order to reduce microbiological contamination and to evaluate whether a plastic bag-covered tablet leads to impaired user satisfaction or touchscreen functionality. MATERIALS AND METHODS: Within a period of 11 days 115 patients were provided with a tablet computer while waiting for their magnetic resonance imaging examination. Every day the contamination of the surface of the tablet was determined before the first and after the final use. Before the device was handed over to a patient, it was enclosed in a customized single-use plastic bag, which was analyzed for bacterial contamination after each use. A questionnaire was applied to determine whether the plastic bag impairs the user satisfaction and the functionality of the touchscreen. RESULTS: Following the use by patients the outside of the plastic bags was found to be contaminated with various bacteria (657.5 ± 368.5 colony forming units/day; some of them were potentially pathogenic. In contrast, the plastic bag covered surface of the tablet was significantly less contaminated (1.7 ± 1.9 colony forming units/day. Likewise, unused plastic bags did not show any contamination. 11% of the patients reported problems with the functionality of the touchscreen. These patients admitted that they had never used a tablet or a smartphone before. CONCLUSIONS: Tablets get severely contaminated during usage in a clinical setting. Wrapping with a customized single-use plastic bag significantly reduces microbiological contamination of the device, protects patients from the acquisition of potentially pathogenic bacteria and hardly impairs the user satisfaction and the functionality of the touchscreen.

  9. Building a global health education network for clinical care and research. The benefits and challenges of distance learning tools. Lessons learned from the Hopkins Center for Clinical Global Health Education. (United States)

    Bollinger, Robert C; McKenzie-White, Jane; Gupta, Amita


    Expanding the capacity for clinical care and health research is a global priority and a global challenge. The Johns Hopkins Center for Clinical Global Health Education (CCGHE) was established in 2005 to provide access to high-quality training to health care providers in resource-limited settings. The CCGHE made a strategic decision to develop, use, and evaluate distance learning platforms to achieve its mission. In the initial years of this new program, several lessons have been learned that may be helpful to other programs considering the use of distance learning programs to expand global health clinical and research capacity.

  10. [Planning nursing teaching: educational purposes and clinical competence]. (United States)

    Dell'Acqua, Magda Cristina Queiroz; Miyadahira, Ana Maria Kazue; Ide, Cilene Aparecida Costardi


    Thinking about nursing education implies articulating this issue with the expressions of theoretical frameworks, from the perspective of a pedagogical aspect that includes both constructivism and competencies. The objective was to characterize, from a longitudinal view, the construction of care competencies that exist in the teaching plans of nursing undergraduate programs. This exploratory-descriptive study used a qualitative approach. Documentary analysis was performed on the nine teaching plans of undergraduate care subjects. The ethical-legal aspects were guaranteed, so that data was collected only after the study had been approved by the Research Ethics Committee. The data evidenced a curriculum organization centered on subjects, maintaining internal rationales that seem to resist summative organizations. Signs emerge of hardly substantial links between any previous knowledge and the strengthening of critical judgment and clinical reasoning. As proposed, the study contributed with reconsiderations for the teaching-learning process and showed the influence of constructivism on the proposal of clinical competencies.

  11. Application description and policy model in collaborative environment for sharing of information on epidemiological and clinical research data sets.

    Directory of Open Access Journals (Sweden)

    Elias César Araujo de Carvalho

    Full Text Available BACKGROUND: Sharing of epidemiological and clinical data sets among researchers is poor at best, in detriment of science and community at large. The purpose of this paper is therefore to (1 describe a novel Web application designed to share information on study data sets focusing on epidemiological clinical research in a collaborative environment and (2 create a policy model placing this collaborative environment into the current scientific social context. METHODOLOGY: The Database of Databases application was developed based on feedback from epidemiologists and clinical researchers requiring a Web-based platform that would allow for sharing of information about epidemiological and clinical study data sets in a collaborative environment. This platform should ensure that researchers can modify the information. A Model-based predictions of number of publications and funding resulting from combinations of different policy implementation strategies (for metadata and data sharing were generated using System Dynamics modeling. PRINCIPAL FINDINGS: The application allows researchers to easily upload information about clinical study data sets, which is searchable and modifiable by other users in a wiki environment. All modifications are filtered by the database principal investigator in order to maintain quality control. The application has been extensively tested and currently contains 130 clinical study data sets from the United States, Australia, China and Singapore. Model results indicated that any policy implementation would be better than the current strategy, that metadata sharing is better than data-sharing, and that combined policies achieve the best results in terms of publications. CONCLUSIONS: Based on our empirical observations and resulting model, the social network environment surrounding the application can assist epidemiologists and clinical researchers contribute and search for metadata in a collaborative environment, thus potentially

  12. Comparing the Experience of Mature-Aged and Traditional Medical Students in the Clinical Setting: A Qualitative Approach


    Jurjus, RA; Butera, G; ABDELNABI, M; Krapf, JM


    Background: Although the mean age of first year medical students is 24, an increasing number of “mature-aged” students, defined as over age 30, are entering medical school in the United States. Few studies have employed qualitative methodology to determine the experience of mature-aged medical students, especially in the clinical setting. Purpose: The purpose of this study was to employ a qualitative design to compare the experience of mature-aged and traditional medical students on clinic...

  13. An Evaluation on Medical Students' Satisfaction with Clinical Education and its Effective Factors

    Directory of Open Access Journals (Sweden)

    Vahid Ziaee


    Full Text Available Purpose: To evaluate medical students' satisfaction with clinical education during medical internship and the effects of variables in the organizational domain on satisfaction. Method: A cross-sectional descriptive analytic study in 2000 identified students' satisfaction with clinical education in medical students of Tehran University of Medical Sciences. Students' satisfaction was assessed by a modified job satisfaction questionnaire. Clinical education was classified into; outpatient, bedside and theoretical teaching. Results: Overall satisfaction with clinical education was 38.8%; outpatient and bedside teaching 52% each and theoretical education 70.8%. Overall satisfaction had a significant association with approach to common and epidemic diseases, class size, and the course planning. Conclusion: Based on the present study, we conclude that clinical education should be reevaluated in our university with the specific attention to the class size, variety of diseases and course planning considered for each session in clinical education.

  14. Ideological and political education for clinical graduates on the basis of medical characteristics

    Directory of Open Access Journals (Sweden)

    Yun-chuan JING


    Full Text Available Along with the reform of medical system, medical education in China is also undergoing great changes. Due to the special characteristics of medical education, it differs from other educational characteristics. It carries with the characteristics of clinical practice on the basis distributed learning, physical and mental development along with ages, enrollment expansion and medical requirement, and standardization training for resident doctors. So, ideological and political education of clinical graduates showed many new characteristics. First, medical ethics education is the basic step, combined with the related disciplines of medical humanity connotation. Second, flexible and diversified form of ideological and political education on the basis of medical work is necessary. Third, establish a system of ideological and political education for clinical graduates, to build up new education concept, and to develop ideological and political education activities for clinical graduates in depth.

  15. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments

    DEFF Research Database (Denmark)

    Malling, Bente Vigh; Mortensen, Lene S.; Scherpbier, Albert J J;


    The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate...

  16. Educating the Next Generation of Geoscientists: Strategies for Formal and Informal Settings (United States)

    Burrell, S.


    ENGAGE, Educating the Next Generation of Geoscientists, is an effort funded by the National Science Foundation to provide academic opportunities for members of underrepresented groups to learn geology in formal and informal settings through collaboration with other universities and science organizations. The program design tests the hypothesis that developing a culture of on-going dialogue around science issues through special guest lectures and workshops, creating opportunities for mentorship through informal lunches, incorporating experiential learning in the field into the geoscience curriculum in lower division courses, partnership-building through the provision of paid summer internships and research opportunities, enabling students to participate in professional conferences, and engaging family members in science education through family science nights and special presentations, will remove the academic, social and economic obstacles that have traditionally hindered members of underrepresented groups from participation in the geosciences and will result in an increase in geoscience literacy and enrollment. Student feedback and anecdotal evidence indicate an increased interest in geology as a course of study and increased awareness of the relevance of geology everyday life. Preliminary statistics from two years of program implementation indicate increased student comprehension of Earth science concepts and ability to use data to identify trends in the natural environment.

  17. Stereoscopy in Astronomical Visualizations to Support Learning at Informal Education Settings (United States)

    Price, Aaron; Lee, Hee-Sun


    Stereoscopy has been used in science education for 100 years. Recent innovations in low cost technology as well as trends in the entertainment industry have made stereoscopy popular among educators and audiences alike. However, experimental studies addressing whether stereoscopy actually impacts science learning are limited. Over the last decade, we have conducted a series of quasi-experimental and experimental studies on how children and adult visitors in science museums and planetariums learned about the structure and function of highly spatial scientific objects such as galaxies, supernova, etc. We present a synthesis of the results from these studies and implications for stereoscopic visualization development. The overall finding is that the impact of stereoscopy on perceptions of scientific objects is limited when presented as static imagery. However, when presented as full motion films, a significantly positive impact was detected. To conclude, we present a set of stereoscopic design principles that can help design astronomical stereoscopic films that support deep and effective learning. Our studies cover astronomical content such as the engineering of and imagery from the Mars rovers, artistic stereoscopic imagery of nebulae and a high-resolution stereoscopic film about how astronomers measure and model the structure of our galaxy.

  18. The usefulness of holotranscobalamin in predicting vitamin B12 status in different clinical settings. (United States)

    Herrmann, Wolfgang; Obeid, Rima; Schorr, Heike; Geisel, Jürgen


    Serum concentrations of homocysteine (Hcy) and methylmalonic acid (MMA) become increased in B12-deficient subjects and are therefore, considered specific markers of B12 deficiency. Serum level of holotranscobalamin (holoTC) becomes decreased before the development of the metabolic dysfunction. We investigated the usefulness of holoTC in diagnosing B12 deficiency in some clinical settings. We measured serum concentrations of holoTC, MMA, Hcy and total B12 in omnivores, vegetarians, elderly people and haemodialysis patients. Our results indicated that the incidence of holoTC vegans (76%). Low holoTC and elevated MMA were detected in 64% of the vegans and 43% of the lacto- and lacto-ovovegetarians. An elevated MMA and a low holoTC were found in subjects with total serum B12 as high as 300 pmol/L. The distribution of holoTC in elderly people was similar to that in younger adults (median holoTC 55 pmol/L in both groups). A low holoTC and an elevated MMA were found in 16% of the elderly group. An elevated MMA and a normal holoTC were found in 20% of the elderly group who had a relatively high median serum concentration of creatinine (106.1 micromol/L). Serum concentrations of holoTC in dialysis patients were considerably higher than all other groups (median 100 pmol/L). This was also associated with severely increased serum levels of MMA (median 987 nmol/L). From these results it can be concluded that serum concentration of holoTC is a much better predictor of B12 status than total B12. This was particularly evident in case of dietary B12 deficiency. Serum concentrations of holoTC as well as MMA can be affected by renal dysfunction. Elevated MMA and normal holoTC in patients with renal insufficiency may not exclude vitamin B12 deficiency. HoloTC seems not to be a promising marker in predicting B12 status in renal patients.

  19. Reliability of clinical diagnosis and laboratory testing techniques currently used for identification of canine parvovirus enteritis in clinical settings (United States)

    FAZ, Mirna; MARTÍNEZ, José Simón; QUIJANO-HERNÁNDEZ, Israel; FAJARDO, Raúl


    Canine parvovirus type 2 (CPV-2) is the main etiological agent of viral enteritis in dogs. Actually in literature, CPV-2 has been reported with clinical signs that vary from the classical disease, and immunochromatography test and PCR technique have been introduced to veterinary hospitals to confirm CPV-2 diagnosis and other infections. However, the reliability of these techniques has been poorly analyzed. In this study, we evaluated the sensitivity and specificity of veterinary clinical diagnosis, immunochromatography test and PCR technique. Our data indicate that variations in the clinical signs of CPV-2 complicate the gathering of an appropriate diagnosis; and immunochromatography test and PCR technique do not have adequate sensitivity to diagnose positive cases. PMID:27818461

  20. Clinical and corneal microbial profile of infectious keratitis in a high HIV prevalence setting in rural South Africa

    NARCIS (Netherlands)

    W. Schaftenaar (Willem); R.P.H. Peters (Remco); G.S. Baarsma (Seerp); C. Meenken (Christina); N.S. Khosa; S. Getu (Sarah); J.A. McIntyre (James); A.D.M.E. Osterhaus (Albert); G.M.G.M. Verjans (George)


    textabstractThe purpose of this investigation was to determine the clinical and corneal microbial profile of infectious keratitis in a high human immunodeficiency virus (HIV) prevalence setting in rural South Africa. Data in this cross-sectional study were collected from patients presenting with sym

  1. Systematic implementation of evidence-based practice in a clinical nursing setting : a participatory action research project

    NARCIS (Netherlands)

    Friesen-Storms, Jolanda; Moser, Albine; Loo, Sandra van der; Beurskens, Anna; Bours, Gerrie


    Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action researc

  2. Diagnosing Borderline Personality Disorder: Examination of How Clinical Indicators Are Used by Professionals in the Health Setting (United States)

    Treloar, Amanda Jane Commons; Lewis, Andrew J.


    This paper reviews the history of the recognition of borderline personality disorder as a clinical disorder, followed by a review of the contemporary practice of diagnosing borderline personality disorder in psychiatric settings. Many researchers have cautioned against the conflation of difficult patients with the diagnostic category of borderline…

  3. The role of the nurse research facilitator in building research capacity in the clinical setting. (United States)

    Jamerson, Patricia A; Vermeersch, Patricia


    With little guidance in the literature regarding best practices, clinical institutions have used different organizational models to meet the challenges of building research capacity. This article provides recommendations regarding the most productive models based on review of historical clinical research facilitation models and the results of a survey regarding extant models conducted among research facilitators who were members of the Midwest Nursing Research Society.

  4. The Nonprofit Clinic at the University of Pittsburgh: Preparing Students for Transition to Professional Settings (United States)

    Kearns, Kevin P.


    The Nonprofit Clinic at the University of Pittsburgh gives graduate students the opportunity to serve as management consultants to nonprofit organizations. This article describes the learning objectives, logistics, and outcomes of the Nonprofit Clinic. Bloom's 1956 taxonomy of learning objectives is employed to assess learning outcomes.

  5. [Advanced curriculum for clinical assessment and skill in new age pharmacist education]. (United States)

    Kiuchi, Yuji; Masuda, Yutaka; Kamei, Daisuke; Kogo, Mari; Nakamura, Akihiro


    In Showa University School of pharmacy, 7 competencies for outcome-based education were set up in 2011. We are now creating sequential curriculum in order to achieve these competencies. As a member of team medical treatment, pharmacist must share a patient's information with other members, assess each patient's condition, propose the best medication with evidence, and also check the effect of medication. Therefore, many active practices in a hospital and community and problem-based learning (PBL) tutorials are carried out in curriculum in School of Pharmacy. As a training for the future pharmacists who positively perform primary care with responsibility in community pharmacy, students study the method of clinical assessment (assessment of condition of disease from the patient's complain, and choice of appropriate proposal). Furthermore, the exercise and training of parenteral medication, physical assessment, and first aid, etc. are also taken in the curriculums as new clinical skill. The systematic and gradual interprofessional education curriculum for the team medical education has been carried out aiming at training of active members in medical team in a hospital and community. At this symposium, I will introduce these systematic advanced curriculums for the pharmacist of a new age, and to show the usefulness and learning effect.

  6. The medical educator, the discourse analyst, and the phonetician: a collaborative feedback methodology for clinical communication. (United States)

    Woodward-Kron, Robyn; Stevens, Mary; Flynn, Eleanor


    Frameworks for clinical communication assist educators in making explicit the principles of good communication and providing feedback to medical trainees. However, existing frameworks rarely take into account the roles of culture and language in communication, which can be important for international medical graduates (IMGs) whose first language is not English. This article describes the collaboration by a medical educator, a discourse analyst, and a phonetician to develop a communication and language feedback methodology to assist IMG trainees at a Victorian hospital in Australia with developing their doctor-patient communication skills. The Communication and Language Feedback (CaLF) methodology incorporates a written tool and video recording of role-plays of doctor-patient interactions in a classroom setting or in an objective structured clinical examination (OSCE) practice session with a simulated patient. IMG trainees receive verbal feedback from their hospital-based medical clinical educator, the simulated patient, and linguists. The CaLF tool was informed by a model of language in context, observation of IMG communication training, and process evaluation by IMG participants during January to August 2009. The authors provided participants with a feedback package containing their practice video (which included verbal feedback) and the completed CaLF tool.The CaLF methodology provides a tool for medical educators and language practitioners to work collaboratively with IMGs to enhance communication and language skills. The ongoing interdisciplinary collaboration also provides much-needed applied research opportunities in intercultural health communication, an area the authors believe cannot be adequately addressed from the perspective of one discipline alone.

  7. The Effect of Early Clinical Exposure Program on Attitude Change of Undergraduate Medical Students toward their preparation for Attending Clinical Setting in Internal Medicine, Surgery and Pediatrics Wards during 2013-2014

    Directory of Open Access Journals (Sweden)

    M.A. Seifrabei


    Full Text Available Introduction & Objective: This study was conducted to evaluate the effect of early clinical exposure on medical students’ attitude toward their preparation for attending clinical setting. Material & Methods: In an interventional before -after study, 52 fourth semester medical students studying at Hamadan University of medical sciences were enrolled in the study. The participants filled out a self-structured questionnaire before and after taking part in a 4 month course in three different wards including: surgery, pediatric and internal wards . The staff’s opinions about the program were also gathered. Result: Mean attitude score increased significantly after taking part in the course in these areas: satisfaction about basic science lessons (P=0.019, understanding social determinants of health (P= 0.03 and understanding clinical thinking and simple clinical skills (P= 0.01. Passing the course did not have any significant effect in communication skills and current semester scores (P.0.05 in both issues. Forty one percent of the academic staff in the mentioned wards believed in the necessity of early clinical exposure in basic science stage, 29.5% denied it's necessity and 29.5% did not express their opinions. Conclusion: It seems that despite the mean score increase of some items, early clinical exposure program doesn’t have any positive effect on the measured items. Therefore, it is recommended to change the medical education program. Sci J Hamadan Univ Med Sci . 2016; 22 (4 :323-330

  8. Understanding the digital divide in the clinical setting: the technology knowledge gap experienced by US safety net patients during teleretinal screening. (United States)

    George, Sheba; Moran, Erin; Fish, Allison; Ogunyemi, Lola


    Differential access to everyday technology and healthcare amongst safety net patients is associated with low technological and health literacies, respectively. These low rates of literacy produce a complex patient "knowledge gap" that influences the effectiveness of telehealth technologies. To understand this "knowledge gap", six focus groups (2 African-American and 4 Latino) were conducted with patients who received teleretinal screenings in U.S. urban safety-net settings. Findings indicate that patients' "knowledge gap" is primarily produced at three points: (1) when patients' preexisting personal barriers to care became exacerbated in the clinical setting; (2) through encounters with technology during screening; and (3) in doctor-patient follow-up. This "knowledge gap" can produce confusion and fear, potentially affecting patients' confidence in quality of care and limiting their disease management ability. In rethinking the digital divide to include the consequences of this knowledge gap faced by patients in the clinical setting, we suggest that patient education focus on both their disease and specific telehealth technologies deployed in care delivery.

  9. Programs and Practices for Special Education Students in Alternative Education Settings. Research to Practice Brief. Volume 6, Issue 1 (United States)

    Unruh, Deanne; Bullis, Michael; Todis, Bonnie; Waintrup, Miriam; Atkins, Trent


    This brief presents a review of alternative education programs targeting students with disabilities. Because there is no clear picture of how alternative education programs operate, specifically regarding youth with disabilities, the U.S. Department of Education's Office of Special Education Programs (OSEP) funded three grants to develop a…

  10. Relationship between clinical fieldwork educator performance and health professional students' perceptions of their practice education learning environments. (United States)

    Brown, Ted; Williams, Brett; Lynch, Marty


    The Dundee Ready Education Environment Measure, Clinical Teaching Effectiveness Instrument, and Clinical Learning Environment Inventory were completed by 548 undergraduate students (54.5% response rate) enrolled in eight health professional bachelor degree courses. Regression analysis was used to investigate the significant predictors of the Clinical Teaching Effectiveness Instrument with the Dundee Ready Education Environment Measure and Clinical Learning Environment Inventory subscales as independent variables. The results indicated that the Dundee Ready Education Environment Measure and Clinical Learning Environment Inventory Actual version subscale scores explained 44% of the total variance in the Clinical Teaching Effectiveness Instrument score. The Dundee Ready Education Environment Measure subscale Academic Self-Perception explained 1.1% of the variance in the Clinical Teaching Effectiveness Instrument score. The Clinical Learning Environment Inventory Actual subscales accounted for the following variance percentages in the Clinical Teaching Effectiveness Instrument score: personalization, 1.1%; satisfaction, 1.7%; task orientation, 5.1%; and innovation, 6.2%. Aspects of the clinical learning environment appear to be predictive of the effectiveness of the clinical teaching that students experience. Fieldwork educator performance might be a significant contributing factor toward student skill development and practitioner success.

  11. Perspective: clinical communication education in the United Kingdom: some fresh insights. (United States)

    Brown, Jo


    Clinical communication education is now part of the core curriculum of every medical school in the United Kingdom and the United States. It has emerged over 30 years because of various societal, political, and policy drivers and is supported by an impressive evidence base.For a variety of reasons, however, clinical communication has become separated from other parts of medical education and tends to be positioned in the early years of the curriculum, when students have limited experience of being in the clinical workplace and working with patients. The teachers of clinical communication, whether medical-school-based or clinically based, may not share learning goals for the subject and this may, therefore, provide a disintegrated learning experience for students.Clinical communication teachers need to inject fresh thinking into the teaching and learning of the subject to unite it with clinical practice in the authentic clinical workplace. Engaging with theories of workplace learning, which aim to overcome the theory/practice gap in vocational education, may be the way forward. The author suggests various ways that this might be achieved-for example, by situating clinical communication education throughout the whole undergraduate curriculum, by integrating the topic of clinical communication with other areas of medical education, by developing coteaching and curriculum design partnerships between medical school and clinical workplace, and by developing a greater range of postgraduate education that offers opportunities for professional development in clinical communication for qualified doctors that is complementary with what is taught in undergraduate education.

  12. Teaching and learning "on the run": ready-to-use toolkits in busy clinical settings. (United States)

    Cleary, Michelle; Walter, Garry


    Clinicians should strongly consider using toolkits in their workplaces with students on clinical placement. These toolkits could include brief quizzes, crossword puzzles, vignettes, role-playing, storytelling, or reflective activities to engage students in context-specific, collaborative learning.

  13. Theoretical Frameworks, Methods, and Procedures for Conducting Phenomenological Studies in Educational Settings

    Directory of Open Access Journals (Sweden)

    Pelin Yüksel


    Full Text Available The main purposes of phenomenological research are to seek reality from individuals’ narratives of their experiences and feelings, and to produce in-depth descriptions of the phenomenon. Phenomenological research studies in educational settings generally embody lived experience, perception, and feelings of participants about a phenomenon. This study aims to provide a general framework for researchers who are interested in phenomenological studies especially in educational setting. Additionally, the study provides a guide for researchers on how to conduct a phenomenological research and how to collect and analyze phenomenal data. The first part of the paper explains the underpinnings of the research methodology consisting of methodological framework and key phenomenological concepts. The second part provides guidance for a phenomenological research in education settings, focusing particularly on phenomenological data collection procedure and phenomenological data analysis methods.Keywords: Phenomenology, phenomenological inquiry, phenomenological data analysis Eğitim Ortamlarında Fenomenal Çalışmaları Yürütmek İçin Teorik Çerçeveler, Yöntemler ve ProsedürlerÖzFenomenolojik araştırmaların temel amacı, bireyin deneyimlerinden ve duygularından yola çıkarak belli bir fenomenan üzerinde yaptığı anlatılarında gerçeği aramak ve bu fenomenana yönelik derinlemesine açıklamalar üretmektir. Eğitim ortamlarında fenomenolojik araştırmalar genellikle araştırmaya katılanların belli bir fenomenan hakkında yaşantıları, deneyimleri, algıları ve duyguları somutlaştırmak için kullanılır. Bu çalışma, özellikle eğitim ortamlarında fenomenolojik çalışmalarla ilgilenen araştırmacılar için genel bir çerçeve sunmayı amaçlamaktadır. Ayrıca, çalışmada fenomenolojik araştırmalar için veri toplamak ve bu fenomenal verileri analiz yapmak için araştırmacılara yön gösterici bir k

  14. Gaining entry-level clinical competence outside of the acute care setting. (United States)

    Lordly, Daphne; Taper, Janette


    Traditionally, an emphasis has been placed on dietetic interns' attainment of entry-level clinical competence in acute care facilities. The perceived risks and benefits of acquiring entry-level clinical competence within long-term and acute care clinical environments were examined. The study included a purposive sample of recent graduates and dietitians (n=14) involved in an integrated internship program. Study subjects participated in in-depth individual interviews. Data were thematically analyzed with the support of data management software QSR N6. Perceived risks and benefits were associated with receiving clinical training exclusively in either environment; risks in one area surfaced as benefits in the other. Themes that emerged included philosophy of care, approach to practice, working environment, depth and breadth of experience, relationships (both client and professional), practice outcomes, employment opportunities, and attitude. Entry-level clinical competence is achievable in both acute and long-term care environments; however, attention must be paid to identified risks. Interns who consider gaining clinical competence exclusively in one area can reduce risks and better position themselves for employment in either practice area by incorporating an affiliation in the other area into their internship program.

  15. 'Out of the Whirlwind': Clinical Pastoral Education and Climate Change. (United States)

    Calder, Andy S; Morgan, Jan E


    This article traces the development of an innovative program of Clinical Pastoral Education (CPE), conducted in 2013 in Victoria, Australia. Interns were placed in environmental contexts; the program's aim was to enhance the eco-ministry identity of interns as they attended to the anxieties and concerns of people affected by ecological change, as well as listening to the cries and groans of Earth. In this sense, pastoral care acknowledges the environment and our human presence within it as of religious and spiritual concern. The theological and supervisory rationales of the program are outlined and include a careful alignment of parallel competencies with the existing objectives and standards required for accreditation. Guidelines for sacred practice in nature, place/case study and the more-than-human verbatims are described, and an illustrative example of such a verbatim is also included.

  16. Care zoning. A pragmatic approach to enhance the understanding of clinical needs as it relates to clinical risks in acute in-patient unit settings. (United States)

    Taylor, Kris; Guy, Stuart; Stewart, Linda; Ayling, Mark; Miller, Graham; Anthony, Anne; Bajuk, Anne; Brun, Jo Le; Shearer, Dianne; Gregory, Rebecca; Thomas, Matthew


    The process of risk assessment which should inform and help identify clinical needs is often seen as a tick box and task-focussed approach. While on the surface this provides a sense of security that forms have been completed, we often fail to communicate in a meaningful manner about the clinical needs identified, which would assist in supporting the care planning delivery processes. A clinical practice improvement (CPI) project implemented a care zoning framework as an evidenced-based process that provides pragmatic support to nurses who are required to continually assess, implement, and evaluate plans to address clinical need across three acute mental health inpatient settings. Risk descriptors informed by the New South Wales (NSW) Mental Health Assessment & Outcome Tools (MHAOT) criteria were developed and described in behavioural contexts in order to improve the project's reliability and translation. A pragmatic traffic light tool was used to share clinical information across three agreed care zones, red (high clinical need), amber (medium clinical need), and green (low clinical need). Additionally nurses were asked to utilise a shift review form in the context of supporting the recording of care zoning and promoting action-orientated note writing. The introduction of care zoning has enthused the nursing teams and the mental health service to adopt care zoning as a supervisory framework that increases their capacity to communicate clinical needs, share information, and gain invaluable support from one another in addressing clinical needs. This includes increased opportunities for staff to feel supported in asking for assistance in understanding and addressing complex clinical presentations.

  17. Using script theory to cultivate illness script formation and clinical reasoning in health professions education. (United States)

    Lubarsky, Stuart; Dory, Valérie; Audétat, Marie-Claude; Custers, Eugène; Charlin, Bernard


    Script theory proposes an explanation for how information is stored in and retrieved from the human mind to influence individuals' interpretation of events in the world. Applied to medicine, script theory focuses on knowledge organization as the foundation of clinical reasoning during patient encounters. According to script theory, medical knowledge is bundled into networks called 'illness scripts' that allow physicians to integrate new incoming information with existing knowledge, recognize patterns and irregularities in symptom complexes, identify similarities and differences between disease states, and make predictions about how diseases are likely to unfold. These knowledge networks become updated and refined through experience and learning. The implications of script theory on medical education are profound. Since clinician-teachers cannot simply transfer their customized collections of illness scripts into the minds of learners, they must create opportunities to help learners develop and fine-tune their own sets of scripts. In this essay, we provide a basic sketch of script theory, outline the role that illness scripts play in guiding reasoning during clinical encounters, and propose strategies for aligning teaching practices in the classroom and the clinical setting with the basic principles of script theory.

  18. Clinical care for severe influenza and other severe illness in resource-limited settings: the need for evidence and guidelines. (United States)

    Ortiz, Justin R; Jacob, Shevin T; West, T Eoin


    The 2009 influenza A (H1N1) pandemic highlighted the importance of quality hospital care of the severely ill, yet there is evidence that the impact of the 2009 pandemic was highest in low- and middle-income countries with fewer resources. Recent data indicate that death and suffering from seasonal influenza and severe illness in general are increased in resource-limited settings. However, there are limited clinical data and guidelines for the management of influenza and other severe illness in these settings. Life-saving supportive care through syndromic case management is used successfully in high-resource intensive care units and in global programs such as the Integrated Management of Childhood Illness (IMCI). While there are a variety of challenges to the management of the severely ill in resource-limited settings, several new international initiatives have begun to develop syndromic management strategies for these environments, including the World Health Organization's Integrated Management of Adult and Adolescent Illness Program. These standardized clinical guidelines emphasize syndromic case management and do not require high-resource intensive care units. These efforts must be enhanced by quality clinical research to provide missing evidence and to refine recommendations, which must be carefully integrated into existing healthcare systems. Realizing a sustainable, global impact on death and suffering due to severe influenza and other severe illness necessitates an ongoing and concerted international effort to iteratively generate, implement, and evaluate best-practice management guidelines for use in resource-limited settings.

  19. Cybersecurity in the Clinical Setting: Nurses' Role in the Expanding "Internet of Things". (United States)

    Billingsley, Luanne; McKee, Shawn A


    Nurses face growing complexity in their work. The expanding "Internet of Things" with "smart" technologies can reduce the burden. However, equipment and devices that connect to patients, the network, or to the Internet can be exploited by hackers. Nurses should be able to identify, understand, and protect against cybersecurity risks to safeguard patients. J Contin Educ Nurs. 2016;47(8):347-349.

  20. Peer Coaching as a Technique to Foster Professional Development in Clinical Ambulatory Settings


    Sekerka, Leslie E.; Chao, Jason


    Introduction: Few studies have examined how peer coaching is an eflective educational and development technique in contexts outside the clussroom. This research focused on peer coaching as a platform to study the process of professional development for physicians. The purpose was to identib perceived benefits coaches received from a coaching encounter and how this relates to their own process of professional development.

  1. Comparison of conventional ERG parameters and high-intensity A-wave analysis in a clinical setting. (United States)

    Marmor, Michael F; Serrato, Alexandra; Tzekov, Radouil


    Computational analysis of high-intensity a-waves yields direct information about the rod and cone receptor potential. However, it is not clear whether such information adds materially to the diagnostic value of the standard ERG in a routine clinical setting. We recorded both conventional ISCEV standard and computational high intensity ERG parameters from 38 patients referred to a clinical laboratory for ERG testing, and also from eight normal volunteers. The patients were grouped as: (1) macular dysfunction; (2) diffuse cone dysfunction; (3) diffuse rod-cone dysfunction. The results showed moderate variation in both conventional and computational parameters, but in general a similar pattern of normality or abnormality for both among the disease groups. There were only a few outlying subjects for which one or the other approach seemed more sensitive. We conclude that a-wave analysis is an important tool for clinical research and the study of special patients, but adding it to the standard ERG protocol does not, at our present state of knowledge, add markedly to clinical evaluations in a routine clinical setting.

  2. Acute HIV infection (AHI in a specialized clinical setting: case-finding, description of virological, epidemiological and clinical characteristics

    Directory of Open Access Journals (Sweden)

    Adriana Ammassari


    Full Text Available Introduction: Diagnosis of HIV infection during early stages is mandatory to catch up with the challenge of limiting HIV viral replication and reservoirs formation, as well as decreasing HIV transmissions by immediate cART initiation. Objectives: Aims were to describe (a virological characteristics of AHI identified, (b epidemiological and clinical factors associated with being diagnosed with AHI. Methods: Cross-sectional, retrospective study. All individuals diagnosed with AHI according to Fiebig's staging between Jan 2013 and Mar 2014 at the INMI “L. Spallanzani” were included. Serum samples reactive to a fourth generation HIV-1/2 assay (Architect HIV Ag/Ab Combo, Abbott were retested with another fourth generation assay (VIDAS DUO HIV Ultra, Biomérieux and underwent confirmation with HIV-1 WB (New Lav I Bio-Rad and/or with Geenius confirmatory assay (Bio-Rad. WHO criteria (two env products reactivity were used to establish positivity of confirmatory assays. In case of clinically suspected AHI, HIV-1 RNA (Real time, Abbott and p24 assay (VIDAS HIV P24 Bio-Rad were also performed. Avidity test was carried out, on confirmed positive samples lacking p31 reactivity, to discriminate between recent (true Fiebig V phase and late infections; to avoid possible misclassifications, clinical data were also used. Demographic, epidemiological, clinical and laboratory data are routinely, and anonymously recorded in the SENDIH and SIREA studies. Results: During the study period, we observed 483 newly HIV diagnosed individuals, of whom 40 were identified as AHI (8.3%. Fiebig classification showed: 7 stage II/III, 13 stage IV, 20 stage V. Demographic, epidemiological, and clinical characteristics of patients are shown in the Table. Overall, the study population had a median S/Co ratio at fourth generation EIA (Architect of 49.50 (IQR, 23.54–98.05: values were significantly lower in Fiebig II-IV than in Fiebig V (38.68 [IQR, 20.08–54.84] vs 75.72 [IQR

  3. Vaginal Birth After Caesarean Section in Low Resource Settings: The Clinical and Ethical Dilemma. (United States)

    Wanyonyi, Sikolia; Muriithi, Francis G


    Vaginal birth after Caesarean section (VBAC) has long been practised in low resource settings using unconventional methods. This not only poses danger to the woman and her baby, but could also have serious legal and ethical implications. The adoption of this practice has been informed by observational studies with many deficiencies; this is so despite other studies from settings in which the standard of care is much better that show that elective repeat Caesarean section (ERCS) may actually be safer than VBAC. This raises questions about whether we should insist on a dangerous practice when there are safer alternatives. We highlight some of the challenges faced in making this decision, and discuss why the fear of ERCS may not be justified after all in low resource settings. Since a reduction in rates of Caesarean section may not be applicable in these regions, because their rates are already low, the emphasis should instead be on adequate birth spacing and safer primary operative delivery.

  4. Liaison Old Age Psychiatry Service in a Medical Setting: Description of the Newcastle Clinical Service

    Directory of Open Access Journals (Sweden)

    E. B. Mukaetova-Ladinska


    Full Text Available Liaison Old Age Psychiatry services (LOAP have begun to emerge in the UK and further development of the service is supported by the latest health policies. Since qualitative and quantitative studies in this area are lacking, we have undertaken a detailed quantitative prospective review of referrals to the Newcastle LOAP to evaluate the clinical activity of the service. We report high referral rates and turnover for the LOAP service. Reasons for referral are diverse, ranging from requests for level of care and capacity assessments and transfer to other clinical services to management of behaviour, diagnosis, and treatment. We outline the value of a multidisciplinary model of LOAP activity, including the important role of the liaison nursing team, in providing a rapid response, screening, and followup of high number of clinical referrals to the service.

  5. Female genital mutilation management in the ambulatory clinic setting: a case study and review of the literature. (United States)

    Craven, Spencer; Kavanagh, Alex; Khavari, Rose


    A 31-year-old patient with obstructive voiding symptoms and apareunia in the setting of Type III female genital mutilation/cutting (FGM/C) is presented. The patient underwent ambulatory clinic defibulation to relieve her symptoms. FGM has been shown to have serious immediate complications and many chronic complications that greatly impact patients' lives. Several case series have been published describing center-specific experience with defibulation procedures for Type III FGM/C. Here, we present the treatment of a patient with Type III FGM/C in an ambulatory urology clinic in the United States.

  6. Female genital mutilation management in the ambulatory clinic setting: a case study and review of the literature (United States)

    Craven, Spencer; Kavanagh, Alex; Khavari, Rose


    A 31-year-old patient with obstructive voiding symptoms and apareunia in the setting of Type III female genital mutilation/cutting (FGM/C) is presented. The patient underwent ambulatory clinic defibulation to relieve her symptoms. FGM has been shown to have serious immediate complications and many chronic complications that greatly impact patients’ lives. Several case series have been published describing center-specific experience with defibulation procedures for Type III FGM/C. Here, we present the treatment of a patient with Type III FGM/C in an ambulatory urology clinic in the United States. PMID:27333917

  7. Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study

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    Findlay-Reece Barbara


    Full Text Available Abstract Background Integrative health care (IHC is an interdisciplinary blending of conventional medicine and complementary and alternative medicine (CAM with the purpose of enhancing patients' health. In 2006, we designed a study to assess outcomes that are relevant to people using such care. However, we faced major challenges in conducting this study and hypothesized that this might be due to the lack of a research climate in these clinics. To investigate these challenges, we initiated a further study in 2008, to explore the reasons why IHC clinics are not conducting outcomes research and to identify strategies for conducting successful in-house outcomes research programs. The results of the latter study are reported here. Methods A total of 25 qualitative interviews were conducted with key participants from 19 IHC clinics across Canada. Basic content analysis was used to identify key themes from the transcribed interviews. Results Barriers identified by participants fell into four categories: organizational culture, organizational resources, organizational environment and logistical challenges. Cultural challenges relate to the philosophy of IHC, organizational leadership and practitioner attitudes and beliefs. Participants also identified significant issues relating to their organization's lack of resources such as funding, compensation, infrastructure and partnerships/linkages. Environmental challenges such as the nature of a clinic's patient population and logistical issues such as the actual implementation of a research program and the applicability of research data also posed challenges to the conduct of research. Embedded research leadership, integration of personal and professional values about research, alignment of research activities and clinical workflow processes are some of the factors identified by participants that support IHC clinics' ability to conduct outcomes research. Conclusions Assessing and enhancing the broader

  8. Developing an outpatient wound care clinic in an acute rehabilitation setting. (United States)

    Sheehan, Diane Dudas; Zeigler, Mary H


    People with disability are at high risk for skin breakdown,which requires ongoing prevention and management. An outpatient rehabilitation wound clinic was developed to handle a variety of acute and chronic wounds for this unique population. This article describes how two advanced practice nurses proposed the idea for the wound care clinic and formulated a business plan, which was critical to successfully administering an outpatient wound care service. Essential components of the business plan included the goals, scope of service, professional practice model, benefits, rationale, marketing analysis, predicted volumes, regulatory imperatives, and financial needs.

  9. The Predictive Value of Ultrasound Learning Curves Across Simulated and Clinical Settings

    DEFF Research Database (Denmark)

    Madsen, Mette E; Nørgaard, Lone N; Tabor, Ann


    OBJECTIVES: The aim of the study was to explore whether learning curves on a virtual-reality (VR) sonographic simulator can be used to predict subsequent learning curves on a physical mannequin and learning curves during clinical training. METHODS: Twenty midwives completed a simulation-based tra......OBJECTIVES: The aim of the study was to explore whether learning curves on a virtual-reality (VR) sonographic simulator can be used to predict subsequent learning curves on a physical mannequin and learning curves during clinical training. METHODS: Twenty midwives completed a simulation...

  10. Standardization of Clinical Skill Evaluation in Physical/Occupational Therapist Education -Effects of Introduction of an Education System Using OSCE-. (United States)

    Sakurai, Hiroaki; Kanada, Yoshikiyo; Sugiura, Yoshito; Motoya, Ikuo; Yamada, Masayuki; Tomita, Masao; Naka, Toru; Teranishi, Toshio; Tanabe, Shigeo; Tsujimura, Toru; Okanishi, Tetsuo


    [Purpose] A major issue in physical/occupational therapist education is the improvement of students' clinical techniques. In this study, we introduced an education system using an Objective Structured Clinical Examination (OSCE), and made an attempt at standardization of its evaluation. [Subjects] The subjects were 227 students in the classes of 2008 to 2010 who enrolled at our university between 2004 and 2006, before the introduction of the education system using OSCE, and 221 students in the classes of 2011 to 2013 who enrolled between 2007 and 2009, after the introduction. [Methods] Performances in attitude and skills (performance in clinical training and OSCE) were compared between before and after the introduction of OSCE. OSCE results were compared between before and after clinical trainings at each OSCE Level; and the correlation of between performances in clinical training and OSCE was examined. [Results] Performances in OSCE and clinical training (attitude, skills) were improved by the introduction of the education system using OSCE, but no significant correlation was observed in the relationship between performances in OSCE and clinical training. [Conclusion] Further studies should be conducted aiming at the standardization of clinical skill evaluation in postgraduate education to establish an education system using OSCE.

  11. Stereoscopy in Static Scientific Imagery in an Informal Education Setting: Does It Matter? (United States)

    Price, C. Aaron; Lee, H.-S.; Malatesta, K.


    Stereoscopic technology (3D) is rapidly becoming ubiquitous across research, entertainment and informal educational settings. Children of today may grow up never knowing a time when movies, television and video games were not available stereoscopically. Despite this rapid expansion, the field's understanding of the impact of stereoscopic visualizations on learning is rather limited. Much of the excitement of stereoscopic technology could be due to a novelty effect, which will wear off over time. This study controlled for the novelty factor using a variety of techniques. On the floor of an urban science center, 261 children were shown 12 photographs and visualizations of highly spatial scientific objects and scenes. The images were randomly shown in either traditional (2D) format or in stereoscopic format. The children were asked two questions of each image—one about a spatial property of the image and one about a real-world application of that property. At the end of the test, the child was asked to draw from memory the last image they saw. Results showed no overall significant difference in response to the questions associated with 2D or 3D images. However, children who saw the final slide only in 3D drew more complex representations of the slide than those who did not. Results are discussed through the lenses of cognitive load theory and the effect of novelty on engagement.

  12. Quality Teaching in a Managerial Setting: Higher Education Challenges in Australia

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    Therese Demediuk


    Full Text Available Australian universities face increased challenges in a global higher education marketplace. They have responded to this competitive environment by introducing greater efficiency and accountability measures. One key measure is the quality of teaching and in particular, the delivery of student-centred teaching. However, the reforms have changed the working lives of academic teachers who now have greater reporting and administrative responsibilities with less sense of collegiality in the sector. In these circumstances, it is not clear that teaching staff will share the same perceptions of quality teaching as their institutions expect. This paper examines the utility of role theory and learning organization theory as part of a project which will examine the ways in which implicit knowledge can be made explicit and shared in the organization as part of academic teachers’ roles. The paper hypothesizes that when academics share their perceptions of good teaching, universities will benefit from a coherent set of quality teaching indicators which are aligned with their organizational cultures.

  13. Dialogue Education in the Post-Secondary Classroom: Reflecting on Dialogue Processes from Two Higher Education Settings in North America (United States)

    Gunnlaugson, Olen; Moore, Janet


    In this article, educators Olen Gunnlaugson and Janet Moore reflect on their experiences developing and facilitating two dialogue-based courses. They proceed with a brief overview of dialogue education and how they are situating their approaches to dialogue within the field of higher education and in terms of transformative learning. Each then…

  14. Extra-intestinal amebiasis: clinical presentation in a non-endemic setting

    DEFF Research Database (Denmark)

    Thorsen, S; Rønne-Rasmussen, J; Petersen, E;


    37/38 patients with reciprocal titers > or = 512 against Entamoeba histolytica in Denmark over a 5-year period were evaluated retrospectively in order to establish the clinical profile of extra-intestinal amebiasis in a non-endemic area. 24 of these had extra-intestinal amebiasis, all presenting 1...

  15. Automated objective routine examination of optical quality of rigid endoscopes in a clinical setting.

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    Rens Wientjes

    Full Text Available Rigid endoscopes degrade during clinical use due to sterilization, ionizing radiation and mechanical forces. Despite visual checks on functionality at the department of sterilization, surgeons are still confronted with suboptimal instruments as it is difficult to assess this degradation in an objective manner. To guarantee that endoscopes have sufficient optical quality for minimal invasive surgery, an experimental opto-electronic test bench has been developed in order to be used at the department of sterilization. Transmission of illumination fibres and lens contrast values are stored in a database to enable empirical criteria to reject endoscope for further clinical usage or to accept endoscopes after repair. Results of the test bench are given for an eight month period, where a trained operator performed 1599 measurements on 46 different types. Stability of the system, trends in quality of clinical endoscopes, and effect of repair or replacement were assessed. Although the period was too short to draw firm conclusions, a slow downwards trend in quality of clinically used endoscopes could be observed. Also, endoscopes generally improve in quality after repair or replacement, while endoscope replacement seems to slightly outperform endoscope repair. To optimize the measurement process, a new system is being developed requiring less user interaction and measuring more optical parameters of an endoscope. By commercializing this system, we hope that measurements at different hospitals will give improved insight which acceptance and rejection criteria to use and which factors (usage, cleaning protocol, and brands determine the economic lifetime of endoscopes.

  16. Validity of the Research Diagnostic Criteria for Temporomandibular Disorders Axis I in clinical and research settings.

    NARCIS (Netherlands)

    Steenks, M.H.; Wijer, A. de


    The lack of standardized diagnostic criteria for defining clinical subtypes of temporomandibular disorders (TMD) was the main motive to create the Research Diagnostic Criteria for TMD (RDC/TMD), which were provided to allow standardization and replication of research into the most common forms of mu

  17. Non-Beta-Lactamase-Producing Penicillin-Resistant Enterococcus faecium in a Clinical Setting

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    Daniel Eymard


    Full Text Available Six clinical isolates of Enterococcus faecium highly resistant to penicillin are reported. These strains did not produce beta-lactamase and no plasmid DNA could be detected. It is postulated that the mechanism of resistance is one or more chromosomally mediated alterations of penicillin-binding proteins.

  18. Setting up the On-Site Marriage and Family Therapy Clinical Training Course (United States)

    Ratanasiripong, Paul; Ghafoori, Bita


    The first clinical training experience or practicum for graduate students in a Marriage and Family Therapy (MFT) program is one of the most important aspects of the entire training program. After a year-long journey through textbook and classroom knowledge, students have the opportunity to finally apply their skills to real life environments with…

  19. Experience developing national evidence-based clinical guidelines for childhood pneumonia in a low-income setting - making the GRADE?


    Agweyu Ambrose; Opiyo Newton; English Mike


    Abstract Background The development of evidence-based clinical practice guidelines has gained wide acceptance in high-income countries and reputable international organizations. Whereas this approach may be a desirable standard, challenges remain in low-income settings with limited capacity and resources for evidence synthesis and guideline development. We present our experience using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for the recent revisio...

  20. Illness Perception and Depressive Symptoms among Persons with Type 2 Diabetes Mellitus: An Analytical Cross-Sectional Study in Clinical Settings in Nepal

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    Suira Joshi


    Full Text Available Background. This study aimed to assess the relationship between illness perception and depressive symptoms among persons with diabetes. Method. This was an analytical cross-sectional study conducted among 379 type 2 diabetic patients from three major clinical settings of Kathmandu, Nepal. Results. The prevalence of depressive symptoms was 44.1% (95% CI: 39.1, 49.1. Females (p<0.01, homemakers (p<0.01, 61–70 age group (p=0.01, those without formal education (p<0.01, and people with lower social status (p<0.01 had significantly higher proportion of depressive symptoms than the others. Multivariable analysis identified age (β=0.036, p=0.016, mode of treatment (β=0.9, p=0.047, no formal educational level (β=1.959, p=0.01, emotional representation (β=0.214, p<0.001, identity (β=0.196, p<0.001, illness coherence (β=-0.109, p=0.007, and consequences (β=0.093, p=0.049 as significant predictors of depressive symptoms. Conclusion. Our study demonstrated a strong relationship between illness perception and depressive symptoms among diabetic patients. Study finding indicated that persons living with diabetes in Nepal need comprehensive diabetes education program for changing poor illness perception, which ultimately helps to prevent development of depressive symptoms.

  1. Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT). (United States)

    Grieve, Sharon; Perez, Roberto Sgm; Birklein, Frank; Brunner, Florian; Bruehl, Stephen; Harden, R Norman; Packham, Tara; Gobeil, Francois; Haigh, Richard; Holly, Janet; Terkelsen, Astrid; Davies, Lindsay; Lewis, Jennifer; Thomassen, Ilona; Connett, Robyn; Worth, Tina; Vatine, Jean-Jacques; McCabe, Candida S


    Complex Regional Pain Syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS.In 2013, an international consortium of patients, clinicians, researchers and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populationsThe development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process. 'What is the clinical presentation and course of CRPS, and what factors influence it?' was agreed as the most pertinent research question that our standardised set of patient-reported outcome measures should be selected to answer. The domains encompassing the key concepts necessary to answer the research question were agreed as: pain, disease severity, participation and physical function, emotional and psychological function, self efficacy, catastrophizing and patient's global impression of change. The final core measurement set included the optimum generic or condition-specific patient-reported questionnaire outcome measures, which captured the essence of each domain, and one clinician reported outcome measure to capture the degree of severity of CRPS. The next step is to test the feasibility and acceptability of collecting outcome measure data using the core measurement set in the CRPS population internationally.

  2. Child Sexual Abuse in Early-Childhood Care and Education Settings (United States)

    Briggs, Freda


    When the author was adviser to the Australian Minister for Education for writing the national Safe Schools Framework (2003), meetings were held with early-childhood care and education administrators from all state, Catholic and independent sectors. Their unexpected message was that educators were facing new problems, those of child sexual abuse in…

  3. Acting and Reacting: Youth's Behavior in Corrupt Educational Settings (United States)

    Sabic-El-Rayess, Amra


    With its broader employability to the issues of underperformance that may emerge in educational systems internationally, this empirical study redefines and expands Albert Hirschman's theory of voice, exit, and loyalty within higher education. The article formulates a new education-embedded theoretical framework that explains reactionary…

  4. Beyond Traditional Art Education: Transformative Lifelong Learning in Community-Based Settings with Older Adults (United States)

    Lawton, Pamela Harris; La Porte, Angela M.


    Quality community-based art education programs for older adults over the age of 50 should exploit the broad range of interests and cognitive abilities of participants by utilizing adult education theory, brain research, and the best practices of adult art education programs. We consider a developing paradigm on the cognitive abilities of the…

  5. Current State of Environmental Education in Mexico: A Study on Practices, Audiences, Settings, and Topics (United States)

    Marcos-Iga, Jose; Shaw, William


    Environmental education in Mexico takes many forms and plays a wide variety of roles. Through an online survey, we addressed the need to present a wider picture on the current state of environmental education practices in Mexico: Who is engaging in environmental education practices, how important is it for their organization, who are they…

  6. Effect of clinical specialist physiotherapists in orthopaedic diagnostic setting - A systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Mikkelsen, Lone Ramer; Juhl, Carsten


    Trøstrup J1, Mikkelsen LR1, Juhl CB2 1 Center for Planlagt Kirurgi, Regionshospitalet Silkeborg 2 Forskningsenheden for Muskuloskeletal Funktion og Fysioterapi (FoF), Institut for idræt og biomekanik, Syddansk Universitet Aim: To evaluate the effectiveness of clinical assessment of patients...... with musculoskeletal complaint performed by Clinical Specialist Physiotherapists (CSP) compared to Orthopaedic Surgeons (OS) on diagnostic agreement, economic cost and patient satisfaction. Methods: A systematic review was performed by searching in MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL......), EMBASE, CINAHL, PEDro and reference lists of included studies and previously published systematic reviews. Studies evaluating 1) adults (18+) with a musculoskeletal complaint referred to orthopaedic outpatient assessment and 2) patient assessment performed by CSP were included. Studies conducted...

  7. Return of individual research results and incidental findings in the clinical trials cooperative group setting. (United States)

    Ferriere, Michael; Van Ness, Brian


    The National Cancer Institute (NCI)-funded cooperative group cancer clinical trial system develops experimental therapies and often collects samples from patients for correlative research. The cooperative group bank (CGB) system maintains biobanks with a current policy not to return research results to individuals. An online survey was created, and 10 directors of CGBs completed the surveys asking about understanding and attitudes in changing policies to consider return of incidental findings (IFs) and individual research results (IRRs) of health significance. The potential impact of the 10 consensus recommendations of Wolf et al. presented in this issue are examined. Reidentification of samples is often not problematic; however, changes to the current banking and clinical trial systems would require significant effort to fulfill an obligation of recontact of subjects. Additional resources, as well as a national advisory board would be required to standardize implementation.

  8. Atrial Arrhythmias in Obstructive Sleep Apnea: Underlying Mechanisms and Implications in the Clinical Setting

    Directory of Open Access Journals (Sweden)

    David Filgueiras-Rama


    Full Text Available Obstructive sleep apnea (OSA is a common disorder characterized by repetitive interruption of ventilation during sleep caused by recurrent upper airway collapse, which leads to intermittent hypoxia. The disorder is commonly undiagnosed despite its relationship with substantial cardiovascular morbidity and mortality. Moreover, the effects of the disorder appear to be particularly dangerous in young subjects. In the last decade, substantial clinical evidence has identified OSA as independent risk factor for both bradyarrhythmias and tachyarrhythmias. To date the mechanisms leading to such arrhythmias have not been completely understood. However, recent data from animal models and new molecular analyses have increased our knowledge of the field, which might lead to future improvement in current therapeutic strategies mainly based on continuous positive airway pressure. This paper aims at providing readers a brief and specific revision of current knowledge about the mechanisms underlying atrial arrhythmias in OSA and their clinical and therapeutic implications.

  9. Experiences with developing and implementing a virtual clinic for glaucoma care in an NHS setting


    Kotecha A; Baldwin A; Brookes J; Foster PJ


    Aachal Kotecha,1,2 Alex Baldwin,1 John Brookes,1 Paul J Foster1,2 1Glaucoma Service, Moorfields Eye Hospital National Health Service Foundation Trust, 2NIHR BRC, Moorfields Eye Hospital, NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London, UK Background: This article describes the development of a virtual glaucoma clinic, whereby technicians collect information for remote review by a consultant specialist.Design and Methods: This was a hospita...

  10. The development of clinical practice guidelines for the use of aromatherapy in a cancer setting. (United States)

    Campbell, L; Pollard, A; Roeton, C


    The need to develop guidelines for the use of aromatherapy was identified to ensure safe and appropriate use in clinical practice. Therapeutic actions and safety data were reviewed along with literature relating to nurses' use of aromatherapy. A policy was developed with the needs of the oncology patient being the foremost consideration. Methods of administration and dosage of essential oils were stipulated to address safety issues.

  11. Profile of patients attending psychogeriatric clinic in a tertiary care setting

    Directory of Open Access Journals (Sweden)

    Suresh Neethu


    Full Text Available Background: Proportion of elderly is increasing among the total population of Kerala, and mental health problems of this group are unique. Objectives: To assess the clinical and sociodemographic profile of patients attending Psychogeriatric Clinic in a tertiary care center and to study the correlation of sociodemographic and clinical variables with psychiatric diagnoses in this population. Materials and Methods: A retrospective chart review of patients, who attended the Psychogeriatric Clinic of a tertiary care center over a period of 1 year, was done. The Institutional Ethics Committee discussed and waived clearance for the review. Results: There were 85 cases with a mean age of 69.5 years (standard deviation-7.36. Majority of them were females (56.5% and belonged to low socioeconomic status (52.9%. Comorbid physical illnesses were seen in 76.5% cases. Diagnoses were made by Junior Residents in Psychiatry and confirmed by a qualified psychiatrist, as per International Classification of Diseases-10 criteria. The most common psychiatric diagnosis was organic mental disorders (24.7%, which included dementias, delirium, and organic mood disorders. This was followed by bipolar affective disorders (22.4%, schizophrenia and related disorders (20.0%, depressive and anxiety disorders (17.6% and mental and behavioral disorders due to substance use (2.4%. Occurrence of organic psychiatric disorders showed positive correlation with age (Spearman's ρ =0.253, P = 0.02 and occurrence of hypertension (ρ =0.222, P = 0.04. Conclusions: Organic psychiatric disorders are more common in elderly patients attending a tertiary care center. Comorbid physical illnesses are seen in more than three-fourths of this population. Organic psychiatric disorders are seen more commonly with increasing age and occurrence of hypertension.

  12. Longitudinal assessment of pain outcomes in the clinical setting: development of the "APOLO" electronic data capture system. (United States)

    Hassett, Afton L; Wasserman, Ronald; Goesling, Jenna; Rakovitis, Kevin; Shi, Baorong; Brummett, Chad M


    Data to fully evaluate the effectiveness of many commonly used interventions in the clinical pain management setting are inadequate. Clinical data collected for patient management often are not based on validated instruments, and this impedes the ability to conduct longitudinal research. To address these needs, modified patient intake and return visit forms were established and the Assessment of Pain Outcomes Longitudinal Electronic Data Capture system was developed. Data collection has been underway since November 22, 2010. As of December 7, 2011, 951 New Patient and 688 Return Visit forms had been entered. The forms have been well received, with less than 6.5% failing to complete at least 90% of the data requested. Accuracy of data entry is excellent, with an error rate of 1 in 11,250 potential data points. Data output converts easily to standard statistical programs. The creation of a pain outcomes database using validated measures and clinically relevant data is feasible.

  13. Is Direct Supervision in Clinical Education for Athletic Training Students Always Necessary to Enhance Student Learning? (United States)

    Scriber, Kent; Trowbridge, Cindy


    Objective: To present an alternative model of supervision within clinical education experiences. Background: Several years ago direct supervision was defined more clearly in the accreditation standards for athletic training education programs (ATEPs). Currently, athletic training students may not gain any clinical experience without their clinical…

  14. The Reliability, Validity, and Usefulness of the Objective Structured Clinical Examination (OSCE) in Dental Education (United States)

    Graham, Roseanna


    This study evaluated the reliability, validity, and educational usefulness of a comprehensive, multidisciplinary Objective Structured Clinical Examination (OSCE) in dental education. The OSCE was administered to dental students at the Columbia University College of Dental Medicine (CDM) before they entered clinical training. Participants in this…

  15. The Student-Run Clinic: A New Opportunity for Psychiatric Education (United States)

    Schweitzer, Pernilla J.; Rice, Timothy R.


    Objective: Student-run clinics are increasingly common in medical schools across the United States and may provide new opportunities for psychiatric education. This study investigates the educational impact of a novel behavioral health program focused on depressive disorders at a student-run clinic. Method: The program was assessed through chart…

  16. Exploring the Integration of Technology into Jewish Education: Multi-User Virtual Environments and Supplementary School Settings (United States)

    Sohn, Johannah Eve


    This descriptive case study explores the implementation of a multi-user virtual environment (MUVE) in a Jewish supplemental school setting. The research was conducted to present the recollections and reflections of three constituent populations of a new technology exploring constructivist education in the context of supplemental and online…

  17. Accommodating Remedial Readers in the General Education Setting: Is Listening-while-Reading Sufficient to Improve Factual and Inferential Comprehension? (United States)

    Schmitt, Ara J.; Hale, Andrea D.; McCallum, Elizabeth; Mauck, Brittany


    Word reading accommodations are commonly applied in the general education setting in an attempt to improve student comprehension and learning of curriculum content. This study examined the effects of listening-while-reading (LWR) and silent reading (SR) using text-to-speech assistive technology on the comprehension of 25 middle-school remedial…

  18. Ethnographies of Thought in Varied Settings: The Acquisition of Rich Understandings of Context and Cognition in Education. (United States)

    DelPizzo, Martha Tecca; Wolfe, Jody Messinger

    Two studies (from 1989 and 1990) are reviewed to illustrate the effectiveness and versatility of "ethnographies of thought" (as described by C. Geertz, 1983) for gaining significant understanding of the meaning perspectives of research participants and the contexts of a variety of educational settings. The methodological implications of the two…

  19. Predicting acceptance and popularity in early adolescence as a function of hearing status, gender, and educational setting

    NARCIS (Netherlands)

    Wolters, N.; Knoors, H.E.T.; Cillessen, A.H.N.; Verhoeven, L.T.W.


    This study examined associations of communicative skills, social behavior, and personality with acceptance and popularity as a function of hearing status, gender, and educational setting. Participants were 87 deaf and 672 hearing early adolescents of 52 6th grade classrooms in mainstream and special

  20. Imagining oneself: Narrative evaluations of the professional identities of learners in a transnational higher-educational setting

    NARCIS (Netherlands)

    Haines, Kevin


    This article uses a narrative approach to investigate the learning experiences of third-year medical students in a transnational higher educational setting, specifically during an elective period abroad. The students evaluate their learning experiences in an unfamiliar environment both in relation t

  1. Investigating the Experience of Outdoor and Adventurous Project Work in an Educational Setting Using a Self-Determination Framework (United States)

    Sproule, John; Martindale, Russell; Wang, John; Allison, Peter; Nash, Christine; Gray, Shirley


    The purpose of this study was to carry out a preliminary investigation to explore the use of outdoor and adventurous project work (PW) within an educational setting. Specifically, differences between the PW and normal academic school experiences were examined using a self-determination theory framework integrated with a goal orientation and…

  2. External Insect Morphology: A Negative Factor in Attitudes toward Insects and Likelihood of Incorporation in Future Science Education Settings (United States)

    Wagler, Ron; Wagler, Amy


    This study investigated if the external morphology of an insect had a negative effect on United States (US) preservice elementary teacher's attitudes toward insects and beliefs concerning the likelihood of incorporating insects into future science education settings. 270 US kindergarten through sixth grade preservice elementary teachers…

  3. Practitioners, Learning Difference and Regional and Remote Inclusive Education Settings: A Focused Analysis of the Research and Policy Literature (United States)

    Hollitt, Julie A.


    This literature review interrogates current international writing about inclusive education (IE) in regional and remote settings, with explicit reference to Australian considerations, including the emergent National Curriculum. The task of this review has been to establish the types of knowledge reported about IE in minority, marginalized and…

  4. Visual Communication in Transition: Designing for New Media Literacies and Visual Culture Art Education across Activities and Settings (United States)

    Zuiker, Steven J.


    As an example of design-based research, this case study describes and analyses the enactment of a collaborative drawing and animation studio in a Singapore secondary school art classroom. The design embodies principles of visual culture art education and new media literacies in order to organize transitions in the settings of participation and…

  5. A Review of Research on Environmental Education in Non-Traditional Settings in Turkey, 2000 and 2011 (United States)

    Erdogan, Mehmet; Usak, Muhammet; Bahar, Mehmet


    The purpose of the present study was to collect and analyze the research on environmental education in non-traditional settings in Turkey undertaken with various subjects (e.g. students, graduates and teachers) and published over the years of 2000-2011. For systematic analysis, selected data-bases and journals were scrutinized across five…

  6. A Systematic Literature Review of Alcohol Education Programmes in Middle and High School Settings (2000-2014) (United States)

    Dietrich, Timo; Rundle-Thiele, Sharyn; Schuster, Lisa; Connor, Jason P.


    Purpose: Social marketing benchmark criteria were used to understand the extent to which single-substance alcohol education programmes targeting adolescents in middle and high school settings sought to change behaviour, utilised theory, included audience research and applied the market segmentation process. The paper aims to discuss these issues.…

  7. Exploring the Social Connections in Preschool Settings between Children Labelled with Special Educational Needs and Their Peers (United States)

    Parry, John


    This paper reports on a small-scale study of the social interactions between six children labelled with special educational needs and their peers in their respective early years settings. Data from play observations, photographs and staff interviews is used to examine the dynamics of the connections that they make with other children. The position…

  8. Coping with Challenging Behaviours of Children with Autism: Effectiveness of Brief Training Workshop for Frontline Staff in Special Education Settings (United States)

    Ling, C. Y. M.; Mak, W. W. S.


    Background: The present study examined the effectiveness of three staff training elements: psychoeducation (PE) on autism, introduction of functional behavioural analysis (FBA) and emotional management (EM), on the reaction of challenging behaviours for frontline staff towards children with autism in Hong Kong special education settings. Methods:…

  9. Preparing nursing students for the future: an innovative approach to clinical education. (United States)

    Nielsen, Ann E; Noone, Joanne; Voss, Heather; Mathews, Launa Rae


    A clinical education model was developed and implemented by nursing faculty in the Oregon Consortium for Nursing Education undergraduate curriculum to improve clinical learning for preparation of nurses to practice in the 21st century. This clinical education model, developed though collaborative work by nursing practice and education representatives throughout the state, moves away from a "random access opportunity" model of clinical education reliant on "total patient care" experiences to an intentional design of clinical learning activities based on course competencies appropriate to student level. Five elements of the model were proposed: case-based, concept-based, intervention skill-based, focused direct client care and integrative experiences. Different elements are dominant in early, middle and late clinical experiences to best support the developmental level of the student. Expectations for faculty, students and clinical staff were also developed to enhance best practices in clinical learning. Preparation of clinical partners for a change in clinical learning and student accountability are essential for optimal learning. This paper provides an overview of the model with clinical application examples for each element with a particular emphasis on case-based, concept-based and integrative clinical experiences.

  10. Using quality and safety education for nurses to guide clinical teaching on a new dedicated education unit. (United States)

    McKown, Terri; McKeon, Leslie; McKown, Leslie; Webb, Sherry


    Gaps exist in health professional education versus the demands of current practice. Leveraging front-line nurses to teach students exemplary practice in a Dedicated Education Unit (DEU) may narrow this gap. The DEU is an innovative model for experiential learning, capitalizing on the expertise of staff nurses as clinical teachers. This study evaluated the effectiveness of a new academic-practice DEU in facilitating quality and safety competency achievement among students. Six clinical teachers received education in clinical teaching and use of Quality and Safety Education for Nurses (QSEN) competencies to guide acquisition of essential knowledge, skills, and attitudes for continuous health care improvement. Twelve students assigned to the six teachers completed daily logs for the 10-week practicum. Findings suggest that DEU students achieved QSEN competencies through clinical teacher mentoring in interdisciplinary collaboration, using electronic information for best practice and patient teaching, patient/family decision making, quality improvement, and resolution of safety issues.


    Directory of Open Access Journals (Sweden)

    J.M. Martins


    Full Text Available The cybernetic spaces simulate the real world with interactive multimedia. This work  has been applied since January, 2007 on the curricular student’s apprenticeship at high school and graduation, in the site “”. It has been developed to provide continuity to the technical-scientific learning of students and professionals, and also to improve their human social relations on the  labour  environment.  It’s comprises a virtual space, destined to communication and collective building of knowledge on the clinical biochemistry.   It’s about an interactive environment which allows the users registered as coordinator professor (professional  or the scientist student (trainee,  unlimited access to  posting contents (classes, texts, presentations, animations, consultations, non-synchronic discussions (on orkut, forums, e-mail and synchronic discussions (on chats, videoconferences. After a few live tutorials  about new  input in this environment, and the use of the new learning tool,  the collective building of knowledge on cyberspace begins. As a trainee’s program task, the scientist student would have to build a space of his own, under guidance and supervision of the coordinator teachers.  The cyberspace efficiency was evaluated from reports collected in February, 2008: the adherence to this  work was satisfactory, regarding this period, with 68 registered users, 870 accesses and 52 contents available on the several sections of the virtual laboratory. Our work is still being applied, and new adhesions are  happening everyday. We intend to amplify this cyber environment in order to make it a  permanent  continued education site on the health area.  From interest contracts and common knowledge,  the technological interfaces constitute an interaction, in which everyone is a potential author.  Keywords: Cyberspace, online biochemistry education, continued education.

  12. Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

    Directory of Open Access Journals (Sweden)

    Sonja E. Raaum


    Full Text Available Purpose: Smartphone technology offers a multitude of applications (apps that provide a wide range of functions for healthcare professionals. Medical trainees are early adopters of this technology, but how they use smartphones in clinical care remains unclear. Our objective was to further characterize smartphone use by medical trainees at two United States academic institutions, as well as their prior training in the clinical use of smartphones. Methods: In 2014, we surveyed 347 internal medicine and emergency medicine resident physicians at the University of Utah and Brigham and Women’s Hospital about their smartphone use and prior training experiences. Scores (0%–100% were calculated to assess the frequency of their use of general features (email, text and patient-specific apps, and the results were compared according to resident level and program using the Mann-Whitney U-test. Results: A total of 184 residents responded (response rate, 53.0%. The average score for using general features, 14.4/20 (72.2% was significantly higher than the average score for using patient-specific features and apps, 14.1/44 (33.0%, P<0.001. The average scores for the use of general features, were significantly higher for year 3–4 residents, 15.0/20 (75.1% than year 1–2 residents, 14.1/20 (70.5%, P=0.035, and for internal medicine residents, 14.9/20 (74.6% in comparison to emergency medicine residents, 12.9/20 (64.3%, P= 0.001. The average score reflecting the use of patient-specific apps was significantly higher for year 3–4 residents, 16.1/44 (36.5% than for year 1–2 residents, 13.7/44 (31.1%; P=0.044. Only 21.7% of respondents had received prior training in clinical smartphone use. Conclusion: Residents used smartphones for general features more frequently than for patient-specific features, but patient-specific use increased with training. Few residents have received prior training in the clinical use of smartphones.

  13. Self-Reported Low Self-Esteem. Intervention and Follow-Up in a Clinical Setting



    At the Research Clinic for Holistic Medicine in Copenhagen, 43 patients who presented with low or very low self-esteem were treated with psychodynamic short-term therapy complemented with bodywork. They received an average of 20 sessions at a cost of 1,600 EURO. The bodywork helped the patients to confront old emotional pain from childhood trauma repressed to the body-mind. Results showed that 60.5% recovered from low selfesteem (95% CI: 44.41–75.02%). Calculated from this, we have NNT = 1.33...

  14. [Evidence-based clinical guidelines in dental practice 6. Guidelines for clinical practice in dental education]. (United States)

    van der Sanden, W J M; Gorter, R; Tams, J


    In response to the initiatives of the Kennisinstituut Mondzorg (Institute for Knowledge Translation in Oral Care), the importance of effective education in the area of guidelines is increasing. Future dentists will, after all, be confronted with new guidelines and need to be able to integrate them in their daily practice. Various guidelines and protocols have been established within the 3 dental schools. For students and instructors, however, the motivation for these guidelines and protocols is not always sufficiently clear. In addition, the terms guideline, clinical practice guideline and protocol are used interchangeably, resulting in terminological confusion. Embedding within and coordination with theoretical education is also still limited in all programmes and it is proposed that the 3 dental schools collaborate on this issue. Finally, it is advised to replace the term 'evidence-based' with 'evidence-informed' because this indicates more clearly that other factors (patients opinion, available financial means, etc.) play a role in the final choice of treatment in a specific situation.

  15. Objective Structured Clinical Examinations Provide Valid Clinical Skills Assessment in Emergency Medicine Education

    Directory of Open Access Journals (Sweden)

    Wallenstein, Joshua


    Full Text Available Introduction: Evaluation of emergency medicine (EM learners based on observed performance in the emergency department (ED is limited by factors such as reproducibility and patient safety. EM educators depend on standardized and reproducible assessments such as the objective structured clinical examination (OSCE. The validity of the OSCE as an evaluation tool in EM education has not been previously studied. The objective was to assess the validity of a novel management-focused OSCE as an evaluation instrument in EM education through demonstration of performance correlation with established assessment methods and case item analysis. Methods: We conducted a prospective cohort study of fourth-year medical students enrolled in a required EM clerkship. Students enrolled in the clerkship completed a five-station EM OSCE. We used Pearson’s coefficient to correlate OSCE performance with performance in the ED based on completed faculty evaluations. Indices of difficulty and discrimination were computed for each scoring item. Results: We found a moderate and statistically-significant correlation between OSCE score and ED performance score [r(239 =0.40, p<0.001]. Of the 34 OSCE testing items the mean index of difficulty was 63.0 (SD =23.0 and the mean index of discrimination was 0.52 (SD =0.21. Conclusion: Student performance on the OSCE correlated with their observed performance in the ED, and indices of difficulty and differentiation demonstrated alignment with published best-practice testing standards. This evidence, along with other attributes of the OSCE, attest to its validity. Our OSCE can be further improved by modifying testing items that performed poorly and by examining and maximizing the inter-rater reliability of our evaluation instrument. [West J Emerg Med. 2015;16(1:121–126.

  16. Integrating learning assessment and supervision in a competency framework for clinical workplace education. (United States)

    Embo, M; Driessen, E; Valcke, M; van der Vleuten, C P M


    Although competency-based education is well established in health care education, research shows that the competencies do not always match the reality of clinical workplaces. Therefore, there is a need to design feasible and evidence-based competency frameworks that fit the workplace reality. This theoretical paper outlines a competency-based framework, designed to facilitate learning, assessment and supervision in clinical workplace education. Integration is the cornerstone of this holistic competency framework.

  17. Prevalence and correlates of substance use among youth living with HIV in clinical settings (United States)

    Gamarel, Kristi E.; Brown, Larry; Kahler, Christopher W.; Fernandez, M. Isabel; Bruce, Douglas; Nichols, Sharon


    Objectives The purpose of this study was to better understand the prevalence and correlates of substance use behaviors among HIV-infected adolescents in HIV care settings. Methods A cross-sectional sample of 2216 youth living with HIV (YLWH; ages 12-26) was recruited through the Adolescent Trials Network for HIV Interventions. Participants completed a one-time survey on sociodemographic factors, substance use and health behaviors. We used logistic regression models to understand the correlates of substance use outcomes. Results Overall, weekly or more frequent tobacco use was reported by 32.9% of participants, 27.5% marijuana use, and 21.3% alcohol use; and 22.5% reported any other illicit drug use. In multivariable models, young MSM had higher odds of reporting each substance use behavior, and transgender women had increased odds of marijuana and other illicit drug use. Criminal justice involvement, unstable housing, condomless sex, and suboptimal antiretroviral therapy was associated with increased risk of substance use behaviors. Conclusions Study findings highlight the need for regular screening for substance use in HIV care settings in order to improve access to and delivery of culturally competent substance use prevention and treatment services. PMID:27750182

  18. Efficacy of brief interventions in clinical care settings for persons living with HIV. (United States)

    Lightfoot, Marguerita; Rotheram-Borus, Mary Jane; Comulada, W Scott; Reddy, Vanessa S; Duan, Naihua


    Prevention of HIV transmission from patients living with HIV (PLH) is a high national priority and strategies that are easy to implement and sustain to eliminate sexual transmission acts among PLH are needed. We evaluated a brief intervention that focused primarily on the enhancing motivations and encouraging PLH to act in accordance with their values without providing the intensity of the existing evidence-based programs for PLH. Using a quasiexperimental design, six medical clinics in Los Angeles County, CA, were evaluated across three intervention conditions: 1) computerized delivery; 2) provider delivery; or 3) standard care. We examined longitudinal changes in patients' reports of the number of HIV-negative (HIV-) or serostatus-unknown sexual partners and the number of unprotected vaginal and anal sex acts. Among 566 PLH, PLH in the computerized delivery condition reported a significant decrease in the number of HIV-/unknown sexual partners compared with the provider delivery and standard care conditions and a significant decrease in the number of unprotected sex acts in comparison to the standard care condition. Computerized motivational interventions delivered in waiting rooms at medical clinics may be an efficient strategy to reduce unprotected sex acts among PLH.

  19. The reliability of lung crackle characteristics in cystic fibrosis and bronchiectasis patients in a clinical setting. (United States)

    Marques, Alda; Bruton, Anne; Barney, Anna


    Lung sounds provide useful information for assessing and monitoring respiratory patients, but standard auscultation is subjective. Computer aided lung sound analysis (CALSA) enables the quantification and characterisation of added lung sounds (e.g. crackles). At present, little is known about the reliability of these sound characteristics. Therefore, the aim of this study was to explore the reliability of crackle initial deflection width (IDW) and two-cycle deflection (2CD) in a clinical population. Fifty-four subjects (37 bronchiectasis, 17 cystic fibrosis) were recruited from out-patient clinics. Three repeated lung sound recordings were taken at seven anatomical sites with a digital stethoscope connected to a laptop computer. The intra-subject reliability of crackle IDW and 2CD was found to be 'good' to 'excellent', estimated by the analysis of variance, intraclass correlation coefficient (IDW 0.76;0.85, 2CD 0.83;0.94), Bland and Altman 95% limits of agreement (IDW -0.50;0.47 ms, 2CD -2.12;1.87 ms) and smallest real difference (IDW 0.30;0.66 ms, 2CD 1.57;2.42 ms). Crackle 2CD was found to be more reliable than IDW. It is concluded that crackle IDW and 2CD characterized by CALSA have good test-retest reliability. This technique requires further evaluation since CALSA has potential to diagnose or monitor respiratory conditions, and provide an objective physiological measure for respiratory interventions.

  20. Self-Reported Low Self-Esteem. Intervention and Follow-Up in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt


    Full Text Available At the Research Clinic for Holistic Medicine in Copenhagen, 43 patients who presented with low or very low self-esteem were treated with psychodynamic short-term therapy complemented with bodywork. They received an average of 20 sessions at a cost of 1,600 EURO. The bodywork helped the patients to confront old emotional pain from childhood trauma repressed to the body-mind. Results showed that 60.5% recovered from low selfesteem (95% CI: 44.41–75.02%. Calculated from this, we have NNT = 1.33–2.25. Almost all aspects of life improved at the same time (p < 0.01: physical health, mental health, quality of life, and ability to function in a number of important areas (partner, friends, sexually, and socially. This indicated that we had successfully induced existential healing (Antonovsky salutogenesis. The strategy of improving self-esteem can be the key to a new life for patients presenting with low quality of life, poor health (physical and/omental, and poor ability to function. The patients were strongly motivated and willing to endure strong emotional pain provoked by the therapy. The rate of recovery is comparable to the most successful interventions with psychological and psychiatric treatment. Clinical holistic treatment has many advantages: efficiency, low cost, lack of negative side effects, lasting results, lack of use of psychopharmacological drugs (often with side effects, and an important preventive dimension.

  1. Self-reported low self-esteem. Intervention and follow-up in a clinical setting. (United States)

    Ventegodt, Søren; Thegler, Suzett; Andreasen, Tove; Struve, Flemming; Enevoldsen, Lars; Bassaine, Laila; Torp, Margrethe; Merrick, Joav


    At the Research Clinic for Holistic Medicine in Copenhagen, 43 patients who presented with low or very low self-esteem were treated with psychodynamic short-term therapy complemented with bodywork. They received an average of 20 sessions at a cost of 1,600 EURO. The bodywork helped the patients to confront old emotional pain from childhood trauma repressed to the body-mind. Results showed that 60.5% recovered from low self-esteem (95% CI: 44.41-75.02%). Calculated from this, we have NNT = 1.33-2.25. Almost all aspects of life improved at the same time (p improving self-esteem can be the key to a new life for patients presenting with low quality of life, poor health (physical and/or mental), and poor ability to function. The patients were strongly motivated and willing to endure strong emotional pain provoked by the therapy. The rate of recovery is comparable to the most successful interventions with psychological and psychiatric treatment. Clinical holistic treatment has many advantages: efficiency, low cost, lack of negative side effects, lasting results, lack of use of psychopharmacological drugs (often with side effects), and an important preventive dimension.

  2. Preconception Counseling and Care in the Setting of HIV: Clinical Characteristics and Comorbidities

    Directory of Open Access Journals (Sweden)

    Rupsa C. Boelig


    Full Text Available Objective. To describe the demographic and clinical characteristics of HIV-infected individuals and HIV-affected couples who were referred for preconception counseling (PCC at a large urban US-based HIV clinic. Methods. Electronic medical records were reviewed for HIV-infected individuals and HIV-affected couples. Medical, reproductive, surgical, psychosocial, and family history data were abstracted. Univariate analyses were done. Results. There were 8 single HIV-infected women and 100 HIV-affected couples who underwent PCC. HIV-infected women were older (mean age 35 years versus 32 years, P=0.06, were more likely to smoke (23% versus 0%, P<0.01, and had more medical comorbidities (57% versus 33%, P=0.04 than HIV-uninfected women. The majority of couples were serodiscordant (77%, and of these couples, 32% had a detectable plasma viral load and 33% report inconsistent condom use. Conclusions. HIV-infected women have a number of medical and psychosocial issues, including those related to HIV that may increase the risk of adverse pregnancy outcomes and HIV perinatal and sexual transmission. PCC is an important intervention to optimize maternal management to improve perinatal outcomes and minimize transmission risks.

  3. An in vivo transcriptome data set of natural antisense transcripts from Plasmodium falciparum clinical isolates

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    Amit Kumar Subudhi


    Full Text Available Antisense transcription is pervasive among biological systems and one of the products of antisense transcription is natural antisense transcripts (NATs. Emerging evidences suggest that they are key regulators of gene expression. With the discovery of NATs in Plasmodium falciparum, it has been suggested that these might also be playing regulatory roles in this parasite. However, all the reports describing the diversity of NATs have come from parasites in culture condition except for a recent study published by us. In order to explore the in vivo diversity of NATs in P. falciparum clinical isolates, we performed a whole genome expression profiling using a strand-specific 244 K microarray that contains probes for both sense and antisense transcripts. In this report, we describe the experimental procedure and analysis thereof of the microarray data published recently in Gene Expression Omnibus (GEO under accession number GSE44921. This published data provide a wealth of information about the prevalence of NATs in P. falciparum clinical isolates from patients with diverse malaria related disease conditions. Supplementary information about the description and interpretation of the data can be found in a recent publication by Subudhi et al. in Experimental Parasitology (2014.

  4. Do organizational and clinical ethics in a hospital setting need different venues? (United States)

    Førde, Reidun; Hansen, Thor Willy Ruud


    The structure of ethics work in a hospital is complex. Professional ethics, research ethics and clinical ethics committees (CECs) are important parts of this structure, in addition to laws and national and institutional codes of ethics. In Norway all hospital trusts have a CEC, most of these discuss cases by means of a method which seeks to include relevant guidelines and laws into the discussion. In recent years many committees have received more cases which have concerned questions of principle. According to Ellen Fox and co-authors the traditional CEC model suffers from a number of weaknesses. Therefore, in their organization a separate body deals with organizational matters. In this paper, we discuss what is gained and what is lost by creating two separate bodies doing ethics consultation. We do this through an analysis of detailed minutes of CEC discussions in one CEC during a 6-year period. 30 % of all referrals concerned matters of principle. Some of these discussions originated in a dilemma related to a particular patient. Most of the discussions had some consequences within the hospital organization, for clinical practice, for adjustment of guidelines, or may have influenced national policy. We conclude that a multiprofessional CEC with law and ethics competency and patient representation may be well suited also for discussion of general ethical principles. A CEC is a forum which can help bridge the gap between clinicians and management by increasing understanding for each others' perspectives.

  5. The cost utility of a multi-disciplinary foot protection clinic (MDFPC) in an Irish hospital setting.

    LENUS (Irish Health Repository)

    Nason, G J


    BACKGROUND: Foot ulceration which may result in lower limb amputation is one of the most feared complications among patients with diabetes and the prevention of both ulceration and amputation is a major challenge facing the health service. Many studies have proposed dedicated diabetic foot teams as the future of diabetic foot care. AIMS: We aimed to quantify the cost benefit and sustainability of a multi-disciplinary foot protection clinic (MDFPC) in an Irish university hospital setting. METHODS: A dedicated bi-weekly consultant-led MDFPC including Vascular Surgery, Endocrinology, Orthopaedic Surgery, Podiatry, Orthotics and Tissue Viability was established in June 2008. RESULTS: Between 2006 and 2010, a total of 221 lower limb procedures (major\\/minor amputations and debridement) were performed. The number of major amputations decreased from 12 during the control period (2 years before the clinic) to 7 in the study period (2 years after the clinic). After costing all activity associated with the clinic, there was an overall saving of 114,063 per year associated with the introduction of the MDFPC. CONCLUSION: This is the first study in an Irish context, and one of few international studies, to demonstrate that an aggressive-coordinated approach to diabetic foot care is both cost effective and clinically efficient in reducing the burden of foot-related complications in a diabetic population.

  6. Fully automated atlas-based hippocampal volumetry for detection of Alzheimer's disease in a memory clinic setting. (United States)

    Suppa, Per; Anker, Ulrich; Spies, Lothar; Bopp, Irene; Rüegger-Frey, Brigitte; Klaghofer, Richard; Gocke, Carola; Hampel, Harald; Beck, Sacha; Buchert, Ralph


    Hippocampal volume is a promising biomarker to enhance the accuracy of the diagnosis of dementia due to Alzheimer's disease (AD). However, whereas hippocampal volume is well studied in patient samples from clinical trials, its value in clinical routine patient care is still rather unclear. The aim of the present study, therefore, was to evaluate fully automated atlas-based hippocampal volumetry for detection of AD in the setting of a secondary care expert memory clinic for outpatients. One-hundred consecutive patients with memory complaints were clinically evaluated and categorized into three diagnostic groups: AD, intermediate AD, and non-AD. A software tool based on open source software (Statistical Parametric Mapping SPM8) was employed for fully automated tissue segmentation and stereotactical normalization of high-resolution three-dimensional T1-weighted magnetic resonance images. Predefined standard masks were used for computation of grey matter volume of the left and right hippocampus which then was scaled to the patient's total grey matter volume. The right hippocampal volume provided an area under the receiver operating characteristic curve of 84% for detection of AD patients in the whole sample. This indicates that fully automated MR-based hippocampal volumetry fulfills the requirements for a relevant core feasible biomarker for detection of AD in everyday patient care in a secondary care memory clinic for outpatients. The software used in the present study has been made freely available as an SPM8 toolbox. It is robust and fast so that it is easily integrated into routine workflow.

  7. (Education For) Work Sets You Free: "Employability" and Higher Education in Former Yugoslavia and Its Successor States (United States)

    Bacevic, Jana


    Recent analyses of education policy discourses in Europe and beyond note the rise of the discourse of "employability" as a new form of regulating the relationship between universities, markets and the state. Education and labour market relationships are also considered to be one of the main aspects of postsocialist transition. This…

  8. Patterns of clinical presentation of adult coeliac disease in a rural setting

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    D'Souza Charles


    Full Text Available Abstract Background In recent years there has been increasing recognition that the pattern of presentation of coeliac disease may be changing. The classic sprue syndrome with diarrhoea and weight loss may be less common than the more subtle presentations of coeliac disease such as an isolated iron deficiency anaemia. As a result, the diagnosis of this treatable condition is often delayed or missed. Recent serologic screening tests allow non-invasive screening to identify most patients with the disease and can be applied in patients with even subtle symptoms indicative of coeliac disease. Both benign and malignant complications of coeliac disease can be avoided by early diagnosis and a strict compliance with a gluten free diet. Aim The aim of this study is to evaluate the trends in clinical presentation of patients diagnosed with adult coeliac disease. In addition, we studied the biochemical and serological features and the prevalence of associated conditions in patients with adult coeliac disease. Methods This is an observational, retrospective, cross-sectional review of the medical notes of 32 adult patients attending the specialist coeliac clinic in a district general hospital. Results Anaemia was the most common mode of presentation accounting for 66% of patients. Less than half of the patients had any of the classical symptoms of coeliac disease and 25% had none of the classical symptoms at presentation. Anti-gliadin antibodies, anti-endomysial antibody and anti-tissue transglutaminase showed 75%, 68% and 90% sensitivity respectively. In combination, serology results were 100% sensitive as screening tests for adult coeliac disease. Fifty nine percent patients had either osteoporosis or osteopenia. There were no malignant complications observed during the follow up of our patients. Conclusion Most adults with coeliac disease have a sub clinical form of the disease and iron deficiency anaemia may be its sole presenting symptom. Only a minority

  9. Educational intervention to improve physician reporting of adverse drug reactions (ADRs in a primary care setting in complementary and alternative medicine

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    Ostermann Thomas


    Full Text Available Abstract Background Recent studies have shown that adverse drug reactions (ADRs are underreported. This may be particularly true of ADRs associated with complementary and alternative medicine (CAM. Data on CAM-related ADRs, however, are sparse. Objective was to evaluate the impact of an educational intervention and monitoring programme designed to improve physician reporting of ADRs in a primary care setting. Methods A prospective multicentre study with 38 primary care practitioners specialized in CAM was conducted from January 2004 through June 2007. After 21 month all physicians received an educational intervention in terms of face-to-face training to assist them in classifying and reporting ADRs. The study centre monitored the quantity and quality of ADR reports and analysed the results. To measure changes in the ADR reporting rate, the median number of ADR reports and interquartile range (IQR were calculated before and after the educational intervention. The pre-intervention and post-intervention quality of the reports was assessed in terms of changes in the completeness of data provided for obligatory items. Interrater reliability between the physicians and the study centre was calculated using Cohen's kappa with a 95% confidence interval (CI. We used Mann Whitney U-test for testing continuous data and chi-square test was used for categorical data. The level of statistical significance was set at P Results A total of 404 ADRs were reported during the complete study period. An initial 148% increase (P = 0.001 in the number of ADR reports was observed after the educational intervention. Compared to baseline the postinterventional number of ADR reportings was statistically significant higher (P P Conclusion The results of the present study demonstrate that an educational intervention can increase physician awareness of ADRs. Participating physicians were able to incorporate the knowledge they had gained from face-to-face training into their

  10. A comparison of teaching strategies for integrating information technology into clinical nursing education. (United States)

    Elfrink, V L; Davis, L S; Fitzwater, E; Castleman, J; Burley, J; Gorney-Moreno, M J; Sullivan, J; Nichols, B; Hall, D; Queen, K; Johnson, S; Martin, A


    As health care becomes more information-intensive and diverse, there is a need to integrate information technology (IT) into clinical education. Little is known, however, about how to design instructional strategies for integrating information technology into clinical nursing education. This article outlines the instructional strategies used by faculty in five nursing programs who taught students to use a point-of-care information technology system. The article also reports students' computer acceptance and summarizes IT clinical teaching recommendations.

  11. [Thinking on controlled setting of plarebo acupuncture in clinical trial of acupuncture and moxibustion]. (United States)

    Mao, Wen-Chao; Liu, Bao-Yan; He, Li-Yun; Liu, Zhi-Shun


    Differences and relations between effects of acupuncture therapy and sham acupuncture are systematically analyzed in this article through the influential factors of acupuncture effect. And it is held that sham acupuncture effect is not exactly equal to placebo effect. The effects of both acupuncture and sham acupuncture are composed by specific effects and non-specific effects, and the differences of non-specific effects between acupunc ture and sham acupuncture can be minimized furthest with blinding and randomized method. Therefore, the difference of acupuncture and sham acupuncture treatment rests with the degree of differences of the specific effects. Only when both of the specific effect of acupuncture and the effect of acupuncture are minimized, can it be applied as the ideal placebo control. Consequently when placebo acupunture are setted up, factors such as the body condition, site of stimulation and stimulation parameters which can influence the specific effect of acupuncture should be taken into consideration to produce the relatively minimum specific effect.

  12. Safe handling and administration considerations of oral anticancer agents in the clinical and home setting. (United States)

    Lester, Joanne


    The use of hormonal, chemotherapeutic, and targeted biologic oral agents has exponentially increased since the early 2000s. Oral therapies have the advantage of persistent exposure of the cytotoxic drug to tumor cells and the tumor environment. The use of oral anticancer agents provides therapeutic drug treatment for patients with cancer in the comfort of their home or alternative settings, such as retirement homes and assisted living or extended-care facilities. Practices to ensure safe storage, handling, administration, and disposal of oral agents are necessary to prevent additional exposure of hazardous substances to the environment, professionals, patients, family members, and caretakers. Providers should consider potential barriers to adherence and compliance, and develop strategies to ensure optimal therapeutic benefit prior to initiation of oral agents.

  13. Setting the agenda: an analysis of negotiation strategies in clinical talk. (United States)

    Manning, Philip; Ray, George B


    This article analyzes the process whereby physicians and patients set the agenda for medical interviews. Applying a conversation analytic perspective to the analysis of 22 videotapes of primary care interviews at a large, urban, teaching and research hospital, a 3-stage model is developed, consisting of (a) an opening sequence, (b) an initial statement of concerns by the patient, and (c) the negotiation process. The analysis illustrates the critical function of the opening verbal exchanges, showing how patient responses to the physician's first question and subsequent queries and summaries by the physician are intricately interwoven. The interaction at the very beginning of the interview is shown to significantly alter the ensuing interaction. The analysis provides a discursive framework for analyzing problematic communication during the primary care interview.

  14. The Impact of Iterative Reconstruction on Computed Tomography Radiation Dosimetry: Evaluation in a Routine Clinical Setting.

    Directory of Open Access Journals (Sweden)

    Rachael E Moorin

    Full Text Available To evaluate the effect of introduction of iterative reconstruction as a mandated software upgrade on radiation dosimetry in routine clinical practice over a range of computed tomography examinations.Random samples of scanning data were extracted from a centralised Picture Archiving Communication System pertaining to 10 commonly performed computed tomography examination types undertaken at two hospitals in Western Australia, before and after the introduction of iterative reconstruction. Changes in the mean dose length product and effective dose were evaluated along with estimations of associated changes to annual cancer incidence.We observed statistically significant reductions in the effective radiation dose for head computed tomography (22-27% consistent with those reported in the literature. In contrast the reductions observed for non-contrast chest (37-47%; chest pulmonary embolism study (28%, chest/abdominal/pelvic study (16% and thoracic spine (39% computed tomography. Statistically significant reductions in radiation dose were not identified in angiographic computed tomography. Dose reductions translated to substantial lowering of the lifetime attributable risk, especially for younger females, and estimated numbers of incident cancers.Reduction of CT dose is a priority Iterative reconstruction algorithms have the potential to significantly assist with dose reduction across a range of protocols. However, this reduction in dose is achieved via reductions in image noise. Fully realising the potential dose reduction of iterative reconstruction requires the adjustment of image factors and forgoing the noise reduction potential of the iterative algorithm. Our study has demonstrated a reduction in radiation dose for some scanning protocols, but not to the extent experimental studies had previously shown or in all protocols expected, raising questions about the extent to which iterative reconstruction achieves dose reduction in real world clinical

  15. Comparative study of 1+PRN ranibizumab versus bevacizumab in the clinical setting

    Directory of Open Access Journals (Sweden)

    Carneiro AM


    Full Text Available Angela M Carneiro,1,2 Luis S Mendonça,1 Manuel S Falcão,1,2 Sofia L Fonseca,1 Elisete M Brandão,1 Fernando M Falcão-Reis1,21Department of Ophthalmology of Hospital de São João, Porto, Portugal; 2Faculty of Medicine of University of Porto, Porto, PortugalPurpose: We compared the efficacy of intravitreal ranibizumab and bevacizumab for treating neovascular age-related macular degeneration using an on-demand regimen.Methods: A total of 186 wet age-related macular degeneration eyes of 186 treatment-naïve patients were compared retrospectively (67 eyes treated with ranibizumab with 91 treated with bevacizumab. At baseline, mean age, best corrected visual acuity, and angiographic lesion types were similar in both groups. Best corrected visual acuity and ocular coherence tomography were evaluated.Results: Sixty eyes treated with ranibizumab and 85 eyes treated with bevacizumab completed a 12-month evaluation. At 12 months, mean best corrected visual acuity increased by +6.65 letters with ranibizumab treatment and by +5.59 with bevacizumab treatment (P = 0.64. Visual acuity improved by ≥15 letters in 15 eyes treated with ranibizumab and in 21 eyes treated with bevacizumab (P = 0.75. An overall reduction in ocular coherence tomography central thickness occurred for all time points. The mean number of injections per eye was 5.97 with ranibizumab and 5.92 with bevacizumab (P = 0.90.Conclusion: Intravitreal therapies with ranibizumab or bevacizumab have similar visual and anatomical results. These results confirm those of comparison of Age-Related Macular Degeneration Treatment Trials in as-needed cohorts in clinical practice. Randomized long-term clinical trials are necessary to examine the systemic safety of these treatments.Keywords: AMD, anti-VEGF therapy, bevacizumab, choroidal neovascularization, ranibizumab, wet AMD 

  16. Patients' Perceptions of Dehumanization of Patients in Dental School Settings: Implications for Clinic Management and Curriculum Planning. (United States)

    Raja, Sheela; Shah, Raveena; Hamad, Judy; Van Kanegan, Mona; Kupershmidt, Alexandra; Kruthoff, Mariela


    Although the importance of empathy, rapport, and anxiety/pain awareness in dentist-patient relations has been well documented, these factors continue to be an issue with patients in many dental school clinics. The aim of this study was to develop an in-depth understanding of how patients at an urban, university-affiliated medical center and its dental school's clinic experienced oral health care and to generate ideas for improving the dental school's clinical curriculum and management of the clinic. Although patient satisfaction surveys are common, in-depth patient narratives are an underutilized resource for improving dental education. In-depth qualitative interviews were conducted with 20 uninsured or underinsured dental patients at these sites, and the results were analyzed using content analysis. Major phenomena that participants discussed were the importance of empathy and good rapport with their oral health providers and provider awareness of dental pain and anxiety. Many patients also discussed feeling dehumanized during dental visits. Based on their positive and negative experiences, the participants made suggestions for how oral health professionals can successfully engage patients in treatment.

  17. Role of pharmacists in optimizing the use of anticancer drugs in the clinical setting

    Directory of Open Access Journals (Sweden)

    Ma CSJ


    Full Text Available Carolyn SJ Ma Department of Pharmacy Practice, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Honolulu, HI, USA Abstract: Oncology pharmacists, also known as oncology pharmacy specialists (OPSs have specialized knowledge of anticancer medications and their role in cancer. As essential member of the interdisciplinary team, OPSs optimize the benefits of drug therapy, help to minimize toxicities and work with patients on supportive care issues. The OPSs expanded role as experts in drug therapy extends to seven major key elements of medication management that include: selection, procurement, storage, preparation/dispensing, prescribing/dosing/transcribing, administration and monitoring/evaluation/education. As front line caregivers in hospital, ambulatory care, long-term care facilities, and community specialty pharmacies, the OPS also helps patients in areas of supportive care including nausea and vomiting, hematologic support, nutrition and infection control. This role helps the patient in the recovery phase between treatment cycles and adherence to chemotherapy treatment schedules essential for optimal treatment and outcome. Keywords: oncology pharmacist, oncology pharmacy specialist, medication management, chemotherapy

  18. A Content Analysis of Preconception Health Education Materials: Characteristics, Strategies, and Clinical-Behavioral Components (United States)

    Levis, Denise M.; Westbrook, Kyresa


    Purpose Many health organizations and practitioners in the United States promote preconception health (PCH) to consumers. However, summaries and evaluations of PCH promotional activities are limited. Design We conducted a content analysis of PCH health education materials collected from local-, state-, national-, and federal-level partners by using an existing database of partners, outreach to maternal and child health organizations, and a snowball sampling technique. Setting Not applicable. Participants Not applicable. Method Thirty-two materials were included for analysis, based on inclusion/exclusion criteria. A codebook guided coding of materials’ characteristics (type, authorship, language, cost), use of marketing and behavioral strategies to reach the target population (target audience, message framing, call to action), and inclusion of PCH subject matter (clinical-behavioral components). Results The self-assessment of PCH behaviors was the most common material (28%) to appear in the sample. Most materials broadly targeted women, and there was a near-equal distribution in targeting by pregnancy planning status segments (planners and nonplanners). “Practicing PCH benefits the baby’s health” was the most common message frame used. Materials contained a wide range of clinical-behavioral components. Conclusion Strategic targeting of subgroups of consumers is an important but overlooked strategy. More research is needed around PCH components, in terms of packaging and increasing motivation, which could guide use and placement of clinical-behavioral components within promotional materials. PMID:23286661

  19. Multilingual interactions in clinical dental education: a focus on mediated interpreting. (United States)

    Bridges, Susan M; Yiu, Cynthia K Y; McGrath, Colman P


    In clinical dental consultations in multilingual contexts, medical interpreting is often performed by the supporting staff as part of routine triadic formulations. As academic dentistry becomes increasingly internationalized, issues of language and culture add to the interactional complexity of clinical communication and education. A multivariate approach was adopted to investigate one case of multilingualism in dentistry in Asia. Collection of both survey (n = 86) and interactional data provided empirical evidence regarding language use and language demands across integrated Polyclinics. Descriptive statistics of Dental Surgery Assistant (DSA) perception data and conversation analysis (CA) of mediated interpretation indicate that, as members of the oral healthcare team, DSAs in Hong Kong are an essential resource in their role of intercultural mediators between patients and clinicians, both staff and students. Discussion of sociolinguistic notions of place-as-location and place-as-meaning supports a wider conceptualization of the role of support staff as interpreters in clinical settings. Implications are drawn for policy, curriculum and staff development.

  20. Teachers' Perceptions of Their Mentoring Role in Three Different Clinical Settings: Student Teaching, Early Field Experiences, and Entry Year Teaching (United States)

    Gut, Dianne M.; Beam, Pamela C.; Henning, John E.; Cochran, Deborah C.; Knight, Rhonda Talford


    The purpose of this study was to determine the differences in mentoring across three different clinical settings: student teaching, early field experiences, and entry year teachers. Eighteen teachers with mentoring experience in all three clinical settings were selected and interviewed. The teachers' expectations for teacher development,…

  1. Portfolio assessment and evaluation: Implications and guidelines for clinical nursing education


    M M Chabeli


    With the advent of Outcomes-Based Education in South Africa, the quality of nursing education is debatable, especially with regard to the assessment and evaluation of clinical nursing education, which is complex and renders the validity and reliability of the methods used questionable. This paper seeks to explore and describe the use of portfolio assessment and evaluation, its implications and guidelines for its effective use in nursing education. Firstly, the concepts of assessment, evaluati...

  2. An Annotated Bibliography of Current Literature Dealing with Stroke Education Programs in a Physical Rehabilitation Setting. (United States)

    Donohue, Ann Teresa

    This study makes available to nurses and other rehabilitation team members pertinent information to meet stroke patients' educational needs. The study was conducted to support the theory that those patients and families who actively participate in a stroke education program will more positively cope with the losses resulting from the disability…

  3. Legislative Agenda Setting for In-State Resident Tuition Policies: Immigration, Representation, and Educational Access (United States)

    McLendon, Michael K.; Mokher, Christine G.; Flores, Stella M.


    Few recent issues in higher education have been as contentious as that of legislation extending in-state college tuition benefits to undocumented students, initiatives now known as in-state resident tuition (ISRT) policies. Building on several strands of literature in political science and higher education studies, we analyze the effects of…

  4. Cyberbullying Experience and Gender Differences among Adolescents in Different Educational Settings (United States)

    Heiman, Tali; Olenik-Shemesh, Dorit


    Cyberbullying refers to a negative activity aimed at deliberate and repeated harm through the use of a variety of electronic media. This study examined the Internet behavior patterns and gender differences among students with learning disabilities who attended general education and special education classes, their involvement in cyberbullying, and…

  5. Incorporating Nutrition Education Classes into Food Pantry Settings: Lessons Learned in Design and Implementation (United States)

    Hardison-Moody, Annie; Bowen, Sarah; Bloom, J. Dara; Sheldon, Marissa; Jones, Lorelei; Leach, Brandi


    The project reported here evaluated the effectiveness of nutrition education at food pantries. We offer best practices for future Extension-based nutrition programming with this clientele. Three classes were offered at food pantries through the Expanded Food and Nutrition Education Program (EFNEP). Entry and exit surveys were collected for each…

  6. Current Practices in Special Education Service Delivery and Differences between Instructional Settings (United States)

    Platt, Marguerite D.


    Despite nationwide advances in special education service delivery practices, disparities exist between the educational outcomes of students with disabilities versus students without disabilities. There is often disparity in teachers' roles and instructional practices in coteaching classrooms, as well as in their pullout resource classroom…

  7. Vocational Education and Training Manager Discursive Practices at the Frontline: Alternative Possibilities in a Victorian Setting (United States)

    Foley, Annette


    This article looks at how the neoliberal reform process is affecting the professional identity of frontline managers in the Australian vocational education and training sector. The article examines how frontline managers are required to negotiate their working practices between their understandings and experiences as educators and the new…

  8. Setting Them Free: Students as Co-Producers of Honors Education (United States)

    van Gorp, Bouke; Wolfensberger, Marca V. C.; de Jong, Nelleke


    While the attractions and advantages of freedom that differentiates honors education from regular teaching are both theoretically and practically significant, the authors' experience at Utrecht University in the Netherlands has demonstrated drawbacks that need to be addressed and resolved in creating effective honors education. Freedom poses…

  9. Educators' Understandings Of, and Support For, Infant Peer Relationships in Early Childhood Settings (United States)

    Davis, Belinda; Degotardi, Sheila


    This research adopted a qualitative methodology to investigate the reported beliefs and pedagogical practices relating to infant peer relationships held by three early childhood infant educators. Thematic analysis was used to derive commonalties and differences that reflected these educators' views and practices about children's early…

  10. Test Anxiety and High-Stakes Test Performance between School Settings: Implications for Educators (United States)

    von der Embse, Nathaniel; Hasson, Ramzi


    With the enactment of standards-based accountability in education, high-stakes tests have become the dominant method for measuring school effectiveness and student achievement. Schools and educators are under increasing pressure to meet achievement standards. However, there are variables which may interfere with the authentic measurement of…

  11. General Education Teacher Perceptions of Self-Efficacy Regarding Teaching Students with Autism in Inclusion Settings (United States)

    Condrey, Jennifer H.


    With an increase in the number of children being diagnosed with Autism Spectrum Disorder comes an increase in students with autism being integrated into regular education classrooms. While general education teachers strongly support inclusion, they do not feel prepared to implement inclusion practices in their classrooms. This dissertation was…

  12. Policy Dialogue and Target Setting: Do Current Indicators of Education for All Signify Progress? (United States)

    Lewin, Keith M.


    Governments and development agencies met at Jomtien in 1990 and Dakar in 2000 and committed themselves to achieve "Education for All" (EFA). Most aid to education is now the umbrella of EFA and its associated goals, targets and indicators. This paper selects some of the indicators used for EFA and analyses their strengths and weaknesses. Gross and…

  13. Medical Evaluation Processes in Clinical settings. Qualitative Analysis through the Experience of Teachers and Students

    Directory of Open Access Journals (Sweden)

    Juan Fernando Cediel Becerra


    Full Text Available Evaluation processes in clinical practice havenot been well, being their study focused on the technical issues concerning these processes.This study tried an approach to the evaluationprocesses through the analysis of perceptionsfrom teachers and students about the methodologyof evaluation considering the teachinglearningprocesses performed in a clinicalpractice of the Medicine Program –UniversidadEl Bosque from Bogota. With this purpose weconducted interviews with teachers and studentssearching the manner in which the evaluative,learning and teaching processes are done; thenwe analyzed the perception from both agentsconcerning the way these processes are related.The interviews were categorized bath deductivelyand inductively, and then contrasted withsome current theories of learning, teaching andevaluation in medicine. The study showed thatnowadays the evaluation and, in general, theeducative processes are affected by several factorswhich are associated to the manner theprofessional practice is developed, and the educativeprocess of the current teachers. We concludedthere is no congrency between theapproach of the evaluation, mainly conductivist,and the learning and teaching strategiesmainly constructivist. This fact cause dissent inteachers and students.

  14. Review of radiological scoring methods of osteoporotic vertebral fractures for clinical and research settings

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Ling [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee21-83, CA, Rotterdam (Netherlands); Rivadeneira, Fernando [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee5-79, CA, Rotterdam (Netherlands); Ly, Felisia; Breda, Stephan J. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee21-83, CA, Rotterdam (Netherlands); Zillikens, M.C. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Department of Internal Medicine, ' s Gravendijkwal 230, CE, Rotterdam (Netherlands); Hofman, Albert [Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Uitterlinden, Andre G. [Erasmus Medical Center, Department of Internal Medicine, Rotterdam (Netherlands); Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040 Ee21-75, CA, Rotterdam (Netherlands); Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Rotterdam (Netherlands); Erasmus Medical Center, Departments of Internal Medicine and Epidemiology, P.O. Box 2040 Ee5-75B, CA, Rotterdam (Netherlands); Krestin, Gabriel P.; Oei, Edwin H.G. [Erasmus Medical Center, Department of Radiology, ' s Gravendijkwal 230, CE, Rotterdam (Netherlands)


    Osteoporosis is the most common metabolic bone disease; vertebral fractures are the most common osteoporotic fractures. Several radiological scoring methods using different criteria for osteoporotic vertebral fractures exist. Quantitative morphometry (QM) uses ratios derived from direct vertebral body height measurements to define fractures. Semi-quantitative (SQ) visual grading is performed according to height and area reduction. The algorithm-based qualitative (ABQ) method introduced a scheme to systematically rule out non-fracture deformities and diagnoses osteoporotic vertebral fractures based on endplate depression. The concordance across methods is currently a matter of debate. This article reviews the most commonly applied standardised radiographic scoring methods for osteoporotic vertebral fractures, attaining an impartial perspective of benefits and limitations. It provides image examples and discusses aspects that facilitate large-scale application, such as automated image analysis software and different imaging investigations. It also reviews the implications of different fracture definitions for scientific research and clinical practice. Accurate standardised scoring methods for assessing osteoporotic vertebral fractures are crucial, considering that differences in definition will have implications for patient care and scientific research. Evaluation of the feasibility and concordance among methods will allow establishing their benefits and limitations, and most importantly, optimise their effectiveness for widespread application. (orig.)

  15. Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting

    DEFF Research Database (Denmark)

    Johansen, Anders; Holm, Jens-Christian; Pearson, Seija


    Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children...... as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI...... circumference, growth, pubertal stage, blood pressure, neurology and skin and provide comprehensive paraclinical investigations for obesity and obesity related conditions. Treatment of obesity in children and adolescents is fully dependent on the combined effort of the entire family. This cannot...

  16. Recent developments in circulating biomarkers in Parkinson's disease: the potential use of miRNAs in a clinical setting. (United States)

    Teixeira Dos Santos, Marcia Cristina; Bell, Rosie; da Costa, Andre Nogueira


    Parkinson's disease (PD) is the second most common neurodegenerative disorder, affecting 5% of the elderly population. PD diagnosis is still based on the identification of neuromotor symptoms although nonmotor manifestations emerge years prior to diagnosis. The discovery of biomarkers at the earliest stages of PD is of extreme interest. miRNAs have been considered potential biomarkers for neurodegenerative diseases, but only a limited number have been found to be PD related. This review focuses on the current findings in the field of circulating miRNAs in PD and the challenges surrounding clinical utility and validation. We briefly describe the more established circulating biomarkers in PD and provide a more thorough review of miRNAs differentially expressed in PD. We highlight their potential for being considered as biomarkers for diagnosis while emphasizing the challenges for adequate validation of the findings and how miRNAs can be envisioned in a clinical setting satisfying regulatory bodies.

  17. Time to rethink the role of the library in educating doctors: driving information literacy in the clinical environment (United States)

    Simons, Mary R.; Morgan, Michael Kerin; Davidson, Andrew Stewart


    Question: Can information literacy (IL) be embedded into the curriculum and clinical environment to facilitate patient care and lifelong learning? Setting: The Australian School of Advanced Medicine (ASAM) provides competence-based programs incorporating patient-centred care and lifelong learning. ASAM librarians use outcomes-based educational theory to embed and assess IL into ASAM's educational and clinical environments. Methods: A competence-based IL program was developed where learning outcomes were linked to current patients and assessed with checklists. Weekly case presentations included clinicians' literature search strategies, results, and conclusions. Librarians provided support to clinicians' literature searches and assessed their presentations using a checklist. Main Results: Outcome data showed clinicians' searching skills improved over time; however, advanced MEDLINE searching remained challenging for some. Recommendations are provided. Conclusion: IL learning that takes place in context using measurable outcomes is more meaningful, is enduring, and likely contributes to patient care. Competence-based assessment drives learning in this environment. PMID:23133329

  18. Chronic disease self-management support for persons with dementia, in a clinical setting (United States)

    Ibrahim, Joseph Elias; Anderson, Laura J; MacPhail, Aleece; Lovell, Janaka Jonathan; Davis, Marie-Claire; Winbolt, Margaret


    The burden of chronic disease is greater in individuals with dementia, a patient group that is growing as the population is aging. The cornerstone of optimal management of chronic disease requires effective patient self-management. However, this is particularly challenging in older persons with a comorbid diagnosis of dementia. The impact of dementia on a person’s ability to self-manage his/her chronic disease (eg, diabetes mellitus or heart failure) varies according to the cognitive domain(s) affected, severity of impairment and complexity of self-care tasks. A framework is presented that describes how impairment in cognitive domains (attention and information processing, language, visuospatial ability and praxis, learning and memory and executive function) impacts on the five key processes of chronic disease self-management. Recognizing the presence of dementia in a patient with chronic disease may lead to better outcomes. Patients with dementia require individually tailored strategies that accommodate and adjust to the individual and the cognitive domains that are impaired, to optimize their capacity for self-management. Management strategies for clinicians to counter poor self-management due to differentially impaired cognitive domains are also detailed in the presented framework. Clinicians should work in collaboration with patients and care givers to assess a patient’s current capabilities, identify potential barriers to successful self-management and make efforts to adjust the provision of information according to the patient’s skill set. The increasing prevalence of age-related chronic illness along with a decline in the availability of informal caregivers calls for innovative programs to support self-management at a primary care level. PMID:28182172

  19. Epidemiological, clinical and prognostic profile of childhood acute bacterial meningitis in a resource poor setting

    Directory of Open Access Journals (Sweden)

    Bankole Peter Kuti


    Full Text Available Background: Childhood bacterial meningitis is a neurologic emergency that continues to kill and maims children particularly in developing countries with poor immunization coverage. Objective: This study set out to assess the hospital incidence, pattern of presentation, etiologic agents, outcome and determinants of mortality among the children admitted with bacterial meningitis at the Wesley Guild Hospital (WGH, Ilesa. Patients and Methods: We carried out a retrospective review of admitted cases of bacterial meningitis in children aged one month to 15 years at the WGH, Ilesa over a three year period by looking at the hospital records. Factors in the history and examinations were compared among survivors and those that died to determine factors significantly associated with mortality in these children. Results: Eighty-one (5.5% of the 1470 childhood admissions during the study period had bacterial meningitis. Male preponderance was observed and two-thirds of the children were infants. More cases were admitted during the wet rainy season than during the dry harmattan season. Haemophilus influenzae type B and Streptococcus pneumoniae were the leading etiologic agents and ciprofloxacin and ceftriaxone adequately cover for these organisms. Twenty-two (27.2% of the 81 children died, while 34 (42.0% survived with neurologic deficits. Children with multiple seizures, coma, neck retraction, hyponatremia, hypoglycorrhachia, turbid CSF as well as Gram positive meningitis at presentation were found to more likely to die (P < 0.05. None of these factors however independently predict mortality. Conclusion: Childhood bacterial meningitis often results in death and neurologic deficit among infants and young children admitted at the WGH, Ilesa. Children diagnosed with meningitis who in addition had multiple seizures, neck retraction and coma at presentation are at increased risk of dying.

  20. Chronic disease self-management support for persons with dementia, in a clinical setting. (United States)

    Ibrahim, Joseph Elias; Anderson, Laura J; MacPhail, Aleece; Lovell, Janaka Jonathan; Davis, Marie-Claire; Winbolt, Margaret


    The burden of chronic disease is greater in individuals with dementia, a patient group that is growing as the population is aging. The cornerstone of optimal management of chronic disease requires effective patient self-management. However, this is particularly challenging in older persons with a comorbid diagnosis of dementia. The impact of dementia on a person's ability to self-manage his/her chronic disease (eg, diabetes mellitus or heart failure) varies according to the cognitive domain(s) affected, severity of impairment and complexity of self-care tasks. A framework is presented that describes how impairment in cognitive domains (attention and information processing, language, visuospatial ability and praxis, learning and memory and executive function) impacts on the five key processes of chronic disease self-management. Recognizing the presence of dementia in a patient with chronic disease may lead to better outcomes. Patients with dementia require individually tailored strategies that accommodate and adjust to the individual and the cognitive domains that are impaired, to optimize their capacity for self-management. Management strategies for clinicians to counter poor self-management due to differentially impaired cognitive domains are also detailed in the presented framework. Clinicians should work in collaboration with patients and care givers to assess a patient's current capabilities, identify potential barriers to successful self-management and make efforts to adjust the provision of information according to the patient's skill set. The increasing prevalence of age-related chronic illness along with a decline in the availability of informal caregivers calls for innovative programs to support self-management at a primary care level.

  1. Multi-parametric MR imaging of quadriceps musculature in the setting of clinical frailty syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Melville, David M.; Sharma, Puneet; Taljanovic, Mihra S. [University of Arizona College of Medicine, Department of Medical Imaging, 1501 N. Campbell Ave., P.O. Box 245067, Tucson, AZ (United States); Mohler, Jane; Fain, Mindy; Muchna, Amy E. [University of Arizona College of Medicine, Arizona Center on Aging, Tucson, AZ (United States); Krupinski, Elizabeth [University of Arizona College of Medicine, Department of Medical Imaging, 1501 N. Campbell Ave., P.O. Box 245067, Tucson, AZ (United States); Emory University, Department of Radiology and Imaging Services, Atlanta, GA (United States)


    Frailty is a common geriatric syndrome associated with loss of skeletal muscle mass (sarcopenia) conferring an increased risk of rapid decline in health and function with increased vulnerability to adverse outcomes. The purpose of this study was to investigate the correlation between diffusion tensor, T2 and intramuscular fat content values of the quadriceps muscle group and clinical frailty status using diffusion tensor MR imaging. Subjects were recruited from the Arizona Frailty cohort composed of all females with frailty status based on the Fried criteria, including 6 non-frail and 10 pre-frail/frail adults, as well as a community sample of 11 young, healthy controls. Axial images of both thighs were obtained on a 3-T magnet with T1, T2 and diffusion tensor imaging as well as intramuscular fat analysis. Diffusion tensor and T2 values were determined by region-of-interest measurements at the proximal, mid and distal thirds of both thighs. Data were evaluated to determine differences between measured values and frailty status. The mean fractional anisotropy (FA) values in the bilateral quadriceps muscles demonstrated significant differences (F = 7.558, p = 0.0030) between the control and pre-frail/frail and non-frail and pre-frail/frail groups. There was a significant difference in mean T2 (F = 21.675, p < 0.0001) and lipid content (F = 19.266, p < 0.0001) among all three groups in the total quadriceps muscle group. The quadriceps musculature of pre-frail/frail adults demonstrated increased FA compared to young controls and non-frail adults with increasing T2 and intramuscular fat among the control, non-frail and pre-frail/frail categories. (orig.)

  2. Validation of a Cochlear Implant Patient Specific Model of the Voltage Distribution in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Waldo Nogueira


    Full Text Available Cochlear Implants (CIs are medical implantable devices that can restore the sense of hearing in people with profound hearing loss. Clinical trials assessing speech intelligibility in CI users have found large inter-subject variability. One possibility to explain the variability is the individual differences in the interface created between electrodes of the CI and the auditory nerve. In order to understand the variability, models of the voltage distribution of the electrically stimulated cochlea may be useful. With this purpose in mind, we developed a parametric model that can be adapted to each CI user based on landmarks from individual cone beam computed tomography (CBCT scans of the cochlea before and after implantation. The conductivity values of each cochlea compartment as well as the weighting factors of different grounding modes have been also parameterized. Simulations were performed modeling the cochlea and electrode positions of 12 CI users. Three models were compared with different levels of detail: A homogeneous model (HM, a non-patient specific model (NPSM and a patient specific model (PSM. The model simulations were compared with voltage distribution measurements obtained from the backward telemetry of the 12 CI users. Results show that the PSM produces the lowest error when predicting individual voltage distributions. Given a patient specific geometry and electrode positions we show an example on how to optimize the parameters of the model and how to couple it to an auditory nerve model. The model here presented may help to understand speech performance variability and support the development of new sound coding strategies for CIs.

  3. Melatonin-dopamine interactions: from basic neurochemistry to a clinical setting. (United States)

    Zisapel, N


    To review the interaction between melatonin and the dopaminergic system in the hypothalamus and striatum and its potential clinical use in dopamine-related disorders in the central nervous system. Medline-based search on melatonin-dopamine interactions in mammals. Melatonin. the hormone produced by the pineal gland at night. influences circadian and seasonal rhythms, most notably the sleep-wake cycle and seasonal reproduction. The neurochemical basis of these activities is not understood yet. Inhibition of dopamine release by melatonin has been demonstrated in specific areas of the mammalian central nervous system (hypothalamus, hippocampus, medulla-pons, and retina). Antidopaminergic activities of melatonin have been demonstrated in the striatum. Dopaminergic transmission has a pivotal role in circadian entrainment of the fetus, in coordination of body movement and reproduction. Recent findings indicate that melatonin may modulate dopaminergic pathways involved in movement disorders in humans. In Parkinson patients melatonin may, on the one hand, exacerbate symptoms (because of its putative interference with dopamine release) and, on the other, protect against neurodegeneration (by virtue of its antioxidant properties and its effects on mitochondrial activity). Melatonin appears to be effective in the treatment of tardive dyskinesia. a severe movement disorder associated with long-term blockade of the postsynaptic dopamine D2 receptor by antipsychotic drugs in schizophrenic patients. The interaction of melatonin with the dopaminergic system may play a significant role in the nonphotic and photic entrainment of the biological clock as well as in the fine-tuning of motor coordination in the striatum. These interactions and the antioxidant nature of melatonin may be beneficial in the treatment of dopamine-related disorders.

  4. Screening for Food Insecurity in Pediatric Clinical Settings: Opportunities and Barriers. (United States)

    Barnidge, Ellen; LaBarge, Gene; Krupsky, Kathryn; Arthur, Joshua


    Food insecurity is a serious health concern among children in the United States with 15.3 million children living in food insecure households. The American Academy of Pediatrics recommends that pediatricians screen for food insecurity at health maintenance visits as identifying children at risk is a crucial step in the amelioration of food insecurity. Two surveys were administered in a Midwest pediatric clinic. A cross-sectional survey was electronically distributed to pediatric providers to assess perceptions of food insecurity among patients, provider readiness to conduct food security screenings, and barriers to conducting those screenings. A cross-sectional caregiver survey was administered to assess demographics, household food security status, participation in nutrition assistance programs, and barriers to getting enough food to eat. Descriptive statistics and odds ratios were calculated. Eighty-eight percent of physicians believe that food insecurity is a challenge for some of their patients. Only 15 % of providers reported screening for food insecurity, while 80 % were willing to screen. Physicians were most concerned with knowing how to handle a positive screen. Among caregivers, 57 % screened positive for food insecurity. Those experiencing food insecurity were more likely to be non-white, participate in SNAP and to feel discomfort towards the idea of talking to a doctor or nurse about food needs. Caregivers reporting food insecurity were significantly less likely to have a personal vehicle. Effective food insecurity screening requires addressing caregiver and health provider barriers in order to increase the likelihood of identifying households most at risk.

  5. Group Patient Education: Effectiveness of a Brief Intervention in People with Type 2 Diabetes Mellitus in Primary Health Care in Greece: A Clinically Controlled Trial (United States)

    Merakou, K.; Knithaki, A.; Karageorgos, G.; Theodoridis, D.; Barbouni, A.


    This study aims to assess the impact of a brief patient group education intervention in people with type 2 diabetes mellitus. The sample, 193 people with type 2 diabetes mellitus who were patients at the diabetic clinic of a primary health care setting in Attica, was assigned to two groups, intervention (138 individuals) and control group (55…

  6. You Must Change Your Life: A Narrative and Theological Inquiry into the Experiences of Transformative Learning in Clinical Pastoral Education Students (United States)

    Jones, Logan Carroll


    The purpose of this qualitative research study is to explore and describe the experiences of transformative learning in seminary students and clergy who have participated in a Clinical Pastoral Education (CPE) residency program while providing pastoral care to patients in an acute care hospital setting. This research focuses on the affective…

  7. East meets West: The influence of language and culture in clinical education. (United States)

    Ladyshewsky, Richard


    The marketing of education in South East Asia has become big business for Australian Universities. Physiotherapy programs are not exempt from this marketing push, with increases in foreign student enrollment becoming commonplace. This raises numerous opportunities and dilemmas for those involved in physiotherapy clinical education. This action research project investigated the influence of language and culture on clinical education practices. Nine South East Asian undergraduate physiotherapy students and 11 clinical instructors were involved in this qualitative research project. A variety of issues were identified which have important ramifications for academics and clinical instructors. Cultural membership, issues of authority and respect, and language proficiency were identified as having a direct influence on the clinical education process. Strategies for dealing with these cross cultural teaching and learning challenges are discussed.

  8. Mobile technology and its use in clinical nursing education: a literature review. (United States)

    O'Connor, Siobhan; Andrews, Tom


    Nursing students face a variety of challenges to learning in clinical practice, from the theory-practice gap, to a lack of clinical supervision and the ad hoc nature of learning in clinical environments. Mobile technology is proposed as one way to address these challenges. This article comprehensively summarizes and critically reviews the available literature on mobile technology used in undergraduate clinical nursing education. It identifies the lack of clear definitions and theory in the current body of evidence; the variety of mobile devices and applications used; the benefits of mobile platforms in nursing education; and the complexity of sociotechnical factors, such as the cost, usability, portability, and quality of mobile tools, that affect their use in undergraduate clinical nursing education. Implications for nursing education and practice are outlined, and recommendations for future research are discussed.

  9. Ethnomathematics in non-formal educational settings: the Urban Boundaries project

    DEFF Research Database (Denmark)

    Pais, Alexandre; Mesquita, Mônica


    The push to marry off local and school knowledge has been a growing concern within educational sciences, particularly in mathematics education where a field of studies by the name of ethnomathematics has been producing research around the uses people do of mathematics outside school’s walls....... Notwithstanding the good will of educational agents in bringing to schools local knowledges, criticisms have been made on the sometimes naive way in which such a bridge is theorized and implemented. After a brief description of these criticisms, we present the Urban Boundaries Project as an attempt to avoid...

  10. EDUCORE project: a clinical trial, randomised by clusters, to assess the effect of a visual learning method on blood pressure control in the primary healthcare setting

    Directory of Open Access Journals (Sweden)

    Garrido-Elustondo Sofia


    Full Text Available Abstract Background High blood pressure (HBP is a major risk factor for cardiovascular disease (CVD. European hypertension and cardiology societies as well as expert committees on CVD prevention recommend stratifying cardiovascular risk using the SCORE method, the modification of lifestyles to prevent CVD, and achieving good control over risk factors. The EDUCORE (Education and Coronary Risk Evaluation project aims to determine whether the use of a cardiovascular risk visual learning method - the EDUCORE method - is more effective than normal clinical practice in improving the control of blood pressure within one year in patients with poorly controlled hypertension but no background of CVD; Methods/Design This work describes a protocol for a clinical trial, randomised by clusters and involving 22 primary healthcare clinics, to test the effectiveness of the EDUCORE method. The number of patients required was 736, all between 40 and 65 years of age (n = 368 in the EDUCORE and control groups, all of whom had been diagnosed with HBP at least one year ago, and all of whom had poorly controlled hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg. All personnel taking part were explained the trial and trained in its methodology. The EDUCORE method contemplates the visualisation of low risk SCORE scores using images embodying different stages of a high risk action, plus the receipt of a pamphlet explaining how to better maintain cardiac health. The main outcome variable was the control of blood pressure; secondary outcome variables included the SCORE score, therapeutic compliance, quality of life, and total cholesterol level. All outcome variables were measured at the beginning of the experimental period and again at 6 and 12 months. Information on sex, age, educational level, physical activity, body mass index, consumption of medications, change of treatment and blood analysis results was also recorded; Discussion The

  11. A recently developed MRI scoring system for hand osteoarthritis: its application in a clinical setting. (United States)

    Ramonda, Roberta; Favero, Marta; Vio, Stefania; Lacognata, Carmelo; Frallonardo, Paola; Belluzzi, Elisa; Campana, Carla; Lorenzin, Mariagrazia; Ortolan, Augusta; Angelini, Federico; Piccoli, Antonio; Oliviero, Francesca; Punzi, Leonardo


    This study aimed to apply the recently proposed Oslo hand osteoarthritis magnetic resonance imaging (MRI) scoring system to evaluate MRI findings in a cohort of patients affected by long-standing erosive hand osteoarthritis (EHOA). Eleven female EHOA patients (median 59 [interquartile range 62-52] years, disease duration 9.5 [interquartile range 13-3.75] years) underwent MRI (1.5 T) of the dominant hand, and synovitis, bone marrow lesions (BMLs), joint space narrowing, osteophytes, cysts, malalignment, and erosions were scored using the Oslo scoring system. Intra- and inter-reader reliability were assessed. The patients also underwent X-ray examination, and bone features were evaluated using the same scoring system. Pain and tenderness were assessed during a physical examination. Spearman's non-parametric test was used to analyze the correlations between variables. MRI intra- and inter-reader reliability were found between good and moderate for many features. No statistical differences were found between the radiographs and MRI with regard to detection of JSN, malalignment, and bone erosions. Synovitis was detected in 39.8 % of the 80 joints examined (in a mild form in 80 %), erosions were found in 51.1 %, and BMLs were identified in 20.5 and 23.9 % at the distal and the proximal side, respectively. BMLs at both the proximal and distal ends were correlated with tender joints (BML distal p = 0.0013, BML proximal p = 0.012). The presence of synovitis was correlated with tenderness (p = 0.004) and erosions at both the distal and proximal joints (p = 0.004). The presence of erosions correlated with tender joints (p < 0.01) and the mean visual analog scale (VAS) score (distal p = 0.03, proximal p = 0.01). Synovitis and BMLs were correlated with clinical symptoms in our patients affected with long-standing EHOA.

  12. A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP in clinical settings to prevent HIV infection.

    Directory of Open Access Journals (Sweden)

    Emily A Arnold

    Full Text Available BACKGROUND: A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC can reduce HIV acquisition among men who have sex with men (MSM and transgender (TG women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States. METHODS: Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time. RESULTS: Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations. CONCLUSIONS: While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that

  13. Radiology education. The evaluation and assessment of clinical competence

    Energy Technology Data Exchange (ETDEWEB)

    Hibbert, Kathryn M.; Van Deven, Teresa [The Univ. of Western Ontario, London, ON (Canada). Dept. of Medical Imaging; Chhem, Rethy K. [Medical Univ. of Vienna (Austria). Dept. of Radiology; Nagasaki Univ. (Japan). Atomic Bomb Disease Inst.; Wang, Shih-chang (eds.) [Univ. of Sydney Westmead Hospital (Australia). Dept. of Radiology; Royal Australian and New Zealand College of Radiologists, Sydney (Australia). Faculty of Radiodiagnosis


    Third volume of a trilogy devoted to radiology education and improvement of medical imaging students' learning, teaching, and scholarship. Reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education. Includes a series of rich case studies. Written by an international group of experienced educators and medical professionals. This book reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education, highlighting emerging practices and work done in the field. The sometimes conflicting assessment and evaluation needs of accreditation bodies, academic programs, trainees, and patients are carefully considered. The final section of the book examines assessment and evaluation in practice, through the development of rich case studies reflecting the implementation of a variety of approaches. This is the third book in a trilogy devoted to the scholarship of radiology education and is the culmination of an important initiative to improve medical imaging students' learning, teaching, and scholarship by bringing together experienced educators and medical professionals. The previous two books focused on the culture and the learning organizations in which our future radiologists are educated and on the application of educational principles in the education of radiologists. Here, the trilogy comes full circle: attending to the assessment and evaluation of the education of its members has much to offer back to the learning of the organization.

  14. Teachers' perceptions of the inclusion of children with hearing loss in general education settings. (United States)

    Eriks-Brophy, Alice; Whittingham, JoAnne


    A questionnaire was used to document the attitudes of 63 classroom teachers in Ottawa, Canada, toward inclusive education for students with hearing loss. The objective was to determine whether teachers had the attitudes, knowledge, and teaching skills proposed to underlie the effective inclusion of these students in regular classrooms. It was found that the teachers had favorable attitudes toward inclusion for students with hearing loss, felt confident in their ability to teach them, and were knowledgeable about the effects of hearing loss on language and learning. They also clearly indicated that their teacher education programs had insufficiently prepared them to teach these students effectively. The results highlight the need for increased emphasis on the unique educational requirements of students with hearing loss in teacher education programs, and for the provision of appropriate supports for both teachers and students to promote successful inclusion.

  15. SET Careers Program: An interactive science, engineering, and technology career education exhibit. [A brief summary report

    Energy Technology Data Exchange (ETDEWEB)

    Cole, P.R.


    The New York Hall of Science, in response to the national crisis in education and employment in science and engineering, is developing and pilot testing a unique, interactive, video-based, hypermedia series on energy-related and other science and engineering careers for middle and junior high school students. Working in collaboration with the Consortium for Mathematics and its Applications (COMAP) and the Educational Film Center (EFC), this pilot-demonstration phase will last 14 months, during which time the basic design, production, and testing of eight science and engineering career modules (video and software) will be completed and installed as an interactive educational exhibit at the New York Hall of Science. This career education package will then be distributed to other science technology centers nationwide.

  16. Re-envisioning clinical education for nurse practitioner programs: themes from a national leaders' dialogue. (United States)

    Giddens, Jean Foret; Lauzon-Clabo, Laurie; Morton, Patricia Gonce; Jeffries, Pamela; McQuade-Jones, Bambi; Ryan, Sandra


    As the need for primary care providers increases, nursing education programs face significant challenges to meet future workforce needs. A more resource-efficient approach for the clinical education of nurse practitioner students is needed. A think tank involving 20 thought leaders representing multiple disciplines was convened to discuss this issue. This article presents seven themes that emerged from this national leaders' dialog: academic practice co-design, standardized preclinical preparation, standardized student assessment, entrustable professional activities, immersive clinical experiences, interprofessional education for team-based care, and innovative education practices.

  17. Cyberbullying experience and gender differences among adolescents in different educational settings. (United States)

    Heiman, Tali; Olenik-Shemesh, Dorit


    Cyberbullying refers to a negative activity aimed at deliberate and repeated harm through the use of a variety of electronic media. This study examined the Internet behavior patterns and gender differences among students with learning disabilities who attended general education and special education classes, their involvement in cyberbullying, and the relationships among being cyberbullied, their responses, and their coping strategies. The sample consisted of 149 students with learning disabilities (LD) attending general education classes, 116 students with comorbid LD attending special education classes, and 242 typically achieving students. All the students, studying in middle and high schools, completed a self-report cyberbullying questionnaire. Findings indicate that although no significant differences emerged in the amount of surfing hours and students' expertise in the use of the Internet, students attending special education classes are more likely to be cybervictims and cyberperpetrators; girls are more likely to be cybervictims, whereas boys are more likely to be cyberperpetrators. These results contribute to our understanding of students' involvement in cyberbullying and can serve as a basis for developing preventive programs as well as intervention programs for students and for educational school teams.

  18. Internet-based virtual classroom and educational management software enhance students' didactic and clinical experiences in perfusion education programs. (United States)

    Riley, Jeffrey B; Austin, Jon W; Holt, David W; Searles, Bruce E; Darling, Edward M


    A challenge faced by many university-based perfusion education (PE) programs is the need for student clinical rotations at hospital locations that are geographically disparate from the main educational campus. The problem has been addressed through the employment of distance-learning environments. The purpose of this educational study is to evaluate the effectiveness of this teaching model as it is applied to PE. Web-based virtual classroom (VC) environments and educational management system (EMS) software were implemented independently and as adjuncts to live, interactive Internet-based audio/video transmission from classroom to classroom in multiple university-based PE programs. These Internet environments have been used in a variety of ways including: 1) forum for communication between the university faculty, students, and preceptors at clinical sites, 2) didactic lectures from expert clinicians to students assigned to distant clinical sites, 3) small group problem-based-learning modules designed to enhance students analytical skills, and 4) conversion of traditional face-to-face lectures to asynchronous learning modules. Hypotheses and measures of student and faculty satisfaction, clinical experience, and learning outcomes are proposed, and some early student feedback was collected. For curricula that emphasize both didactic and clinical education, the use of Internet-based VC and EMS software provides significant advancements over traditional models. Recognized advantages include: 1) improved communications between the college faculty and the students and clinical preceptors, 2) enhanced access to a national network of clinical experts in specialized techniques, 3) expanded opportunity for student distant clinical rotations with continued didactic course work, and 4) improved continuity and consistency of clinical experiences between students through implementation of asynchronous learning modules. Students recognize the learning efficiency of on

  19. Adopting and sustaining a Virtual Fracture Clinic model in the District Hospital setting – a quality improvement approach (United States)

    Logishetty, Kartik


    Virtual Fracture Clinics (VFCs) are an alternative to the conventional fracture clinics, to manage certain musculoskeletal injuries. This has recently been reported as a safe, cost-effective and efficient care model. As demonstrated at vanguard sites in the United Kingdom, VFCs can enhance patient care by standardising treatment and reducing outpatient appointments. This project demonstrates how a Quality Improvement approach was applied to introduce VFCs in the District General Hospital setting. We demonstrate how undertaking Process Mapping, Driver Diagrams, and Stakeholder Analysis can assist implementation. We discuss Whole Systems Measures applicable to VFCs, to consider how robust and specific data collection can progress this care model. Three Plan-Do-Study-Act cycles led to a change in practice over a 21-month period. Our target for uptake of new patients seen in VFCs within 6 months of starting was set at 50%. It increased from 0% to 56.1% soon after introduction, and plateaued at an average of 56.4% in the six-months before the end of the study period. Careful planning, frequent monitoring, and gathering feedback from a multidisciplinary team of varying seniority, were the important factors in transitioning to, and sustaining, a successful VFC model.

  20. Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program

    Directory of Open Access Journals (Sweden)

    Fennell Mary L


    Full Text Available Abstract Background In this article, we describe the National Cancer Institute (NCI Community Cancer Centers Program (NCCCP pilot and the evaluation designed to assess its role, function, and relevance to the NCI's research mission. In doing so, we describe the evolution of and rationale for the NCCCP concept, participating sites' characteristics, its multi-faceted aims to enhance clinical research and quality of care in community settings, and the role of strategic partnerships, both within and outside of the NCCCP network, in achieving program objectives. Discussion The evaluation of the NCCCP is conceptualized as a mixed method multi-layered assessment of organizational innovation and performance which includes mapping the evolution of site development as a means of understanding the inter- and intra-organizational change in the pilot, and the application of specific evaluation metrics for assessing the implementation, operations, and performance of the NCCCP pilot. The assessment of the cost of the pilot as an additional means of informing the longer-term feasibility and sustainability of the program is also discussed. Summary The NCCCP is a major systems-level set of organizational innovations to enhance clinical research and care delivery in diverse communities across the United States. Assessment of the extent to which the program achieves its aims will depend on a full understanding of how individual, organizational, and environmental factors align (or fail to align to achieve these improvements, and at what cost.