WorldWideScience

Sample records for clinical education setting

  1. Selection and Evaluation Guidelines for Clinical Education Settings in Athletic Training.

    Science.gov (United States)

    Weidner, Thomas G.; Laurent, Tim

    2001-03-01

    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.

  2. Selection and Evaluation Guidelines for Clinical Education Settings in Athletic Training.

    Science.gov (United States)

    Weidner, Thomas G.; Laurent, Tim

    2001-03-01

    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. PMID:12937517

  3. Educational Preparation for the Clinic Job Setting: Clinical Athletic Trainers' Perspectives

    Science.gov (United States)

    Schilling, Jim; Combs, Martha

    2011-01-01

    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. Importance and Applicability of Approved Clinical Instructor Standards and Criteria to Certified Athletic Trainers in Different Clinical Education Settings

    OpenAIRE

    Weidner, Thomas G.; Henning, Jolene M.

    2005-01-01

    Context: For optimal clinical education of athletic training students, Clinical Instructor Educators and program directors need to proactively select, train, and evaluate their Approved Clinical Instructors (ACIs).

  5. Help-Seeking Behaviors among Athletic Training Students in the Clinical Education Setting: A Pilot Study

    Science.gov (United States)

    Nakajima, Mikiko Aoyagi; Freesemann, Keith W.

    2013-01-01

    Context: Help-seeking is an important self-regulating and proactive strategy that prepares students to be successful learners. It is particularly important in the clinical education setting, in which students must actively engage in learning. Objective: To determine both the type of help-seeking behaviors used by athletic training students in the…

  6. Education leadership in the clinical health care setting: A framework for nursing education development.

    Science.gov (United States)

    Mockett, Lynda; Horsfall, Janine; O'Callaghan, Wendy

    2006-12-01

    This paper describes how a new framework for clinical nursing education was introduced at Counties Manukau District Health Board (CMDHB), New Zealand. The project was initiated in response to the significant legislative and post registration nursing education changes within New Zealand. The journey of change has been a significant undertaking, and has required clear management, strong leadership, perseverance and understanding of the organisation's culture. The approach taken to managing the change had four stages, and reflects various change management models. The first stage, the identification process, identified the impetus for change. Creating the vision is the second stage and identified what the change would look like within the organisation. To ensure success and to guide the process of change a realistic and sustainable vision was developed. Implementing the vision was the third stage, and discusses the communication and pilot phase of implementing the nursing education framework. Stage four, embedding the vision, explores the process and experiences of changing an education culture and embedding the vision into an organisation. The paper concludes by discussing the importance of implementing robust, consistent, strategic and collaborative processes - that reflect and evaluate best educational nursing practice. PMID:19040908

  7. Athletic Training Students in the College/ University Setting and the Scope of Clinical Education

    OpenAIRE

    Weidner, Thomas G.; Noble, Gary L; Pipkin, Jennifer B

    2006-01-01

    Context: Athletic training education programs must provide the proper type and amount of clinical supervision in order for athletic training students to obtain appropriate clinical education and to meet Board of Certification examination requirements.

  8. Interprofessional education and practice guide No. 5: Interprofessional teaching for prequalification students in clinical settings.

    Science.gov (United States)

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

    2016-05-01

    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. PMID:27152536

  9. Interprofessional education and practice guide No. 5: Interprofessional teaching for prequalification students in clinical settings.

    Science.gov (United States)

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

    2016-05-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Moore Ainsley E

    2010-12-01

    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.

  11. Teaching Reflective Practice in Practice Settings: Students' Perceptions of Their Clinical Educators

    Science.gov (United States)

    Trede, Franziska; Smith, Megan

    2012-01-01

    Reflective practice in practice settings can enhance practice knowledge, self-assessment and lifelong learning, develop future practice capability and professional identity, and critically appraise practice traditions rather than reproduce them. The inherent power imbalance between student and educator runs the risk for the reflective practice…

  12. The primary care clinic as a setting for continuing medical education: program description.

    Science.gov (United States)

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

    2000-11-14

    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.

  13. Opening Options: Making Field Education Work in a Private Practice Clinic Setting

    Science.gov (United States)

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

    2011-01-01

    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…

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

    Directory of Open Access Journals (Sweden)

    Debra Nestel

    2014-01-01

    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.

  15. AMTA Monograph Series - Effective Clinical Practice in Music Therapy Early Childhood and School Age Educational Settings

    Science.gov (United States)

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

    2006-01-01

    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…

  16. 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

    Science.gov (United States)

    Brewster, Marnie; Wylie, Kevan R.

    2008-01-01

    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…

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

    Directory of Open Access Journals (Sweden)

    Andrea Pokorná

    2016-07-01

    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.

  18. Setting Goals for Achievement in Physical Education Settings

    Science.gov (United States)

    Baghurst, Timothy; Tapps, Tyler; Kensinger, Weston

    2015-01-01

    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…

  19. Bullying in Early Educational Settings

    Science.gov (United States)

    Kirves, Laura; Sajaniemi, Nina

    2012-01-01

    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…

  20. 34 CFR 104.34 - Educational setting.

    Science.gov (United States)

    2010-07-01

    ... Preschool, Elementary, and Secondary Education § 104.34 Educational setting. (a) Academic setting. A... 34 Education 1 2010-07-01 2010-07-01 false Educational setting. 104.34 Section 104.34 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF...

  1. [Midwifery clinical practicum education].

    Science.gov (United States)

    Kao, Chien-Huei; Gau, Meei-Ling

    2013-06-01

    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.

  2. 7 CFR 15b.23 - Educational setting.

    Science.gov (United States)

    2010-01-01

    ... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Preschool, Elementary, Secondary, Adult, and Extension Education § 15b.23 Educational setting. (a) Academic setting. A recipient to which this subpart applies shall educate, or shall provide for the education of each qualified handicapped person in...

  3. 45 CFR 605.34 - Educational setting.

    Science.gov (United States)

    2010-10-01

    ... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Preschool, Elementary, and Secondary Education § 605.34 Educational setting. (a) Academic setting. A recipient to which this subpart applies shall educate, or shall provide for the education of, each qualified...

  4. 45 CFR 84.34 - Educational setting.

    Science.gov (United States)

    2010-10-01

    ... HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Preschool, Elementary, and Secondary Education § 84.34 Educational setting. (a) Academic setting. A recipient to which this subpart applies shall educate, or shall provide for the education of, each qualified handicapped person in...

  5. Re-Setting Music Education's "Default Settings"

    Science.gov (United States)

    Regelski, Thomas A.

    2013-01-01

    This paper explores the effects and problems of one highly influential default setting of the "normal style template" of music education and proposes some alternatives. These do not require abandoning all traditional templates for school music. But re-setting the default settings does depend on reconsidering the promised function of…

  6. The communication process in clinical settings.

    Science.gov (United States)

    Mathews, J J

    1983-01-01

    The communication of information in clinical settings is fraught with problems despite avowed common aims of practitioners and patients. Some reasons for the problematic nature of clinical communication are incongruent frames of reference about what information ought to be shared, sociolinguistic differences and social distance between practitioners and patients. Communication between doctors and nurses is also problematic, largely due to differences in ideology between the professions about what ought to be communicated to patients about their illness and who is ratified to give such information. Recent social changes, such as the Patient Bill of Rights and informed consent which assure access to information, and new conceptualizations of the nurse's role, warrant continued study of the communication process especially in regard to what constitutes appropriate and acceptable information about a patient's illness and who ought to give such information to patients. The purpose of this paper is to outline characteristics of communication in clinical settings and to provide a literature review of patient and practitioner interaction studies in order to reflect on why information exchange is problematic in clinical settings. A framework for presentation of the problems employs principles from interaction and role theory to investigate clinical communication from three viewpoints: (1) the level of shared knowledge between participants; (2) the effect of status, role and ideology on transactions; and (3) the regulation of communication imposed by features of the institution. PMID:6359453

  7. Educational Needs in the Psychiatric Setting.

    Science.gov (United States)

    Sluckin, Andy; Hanna, Bob

    1991-01-01

    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…

  8. Goal-setting in clinical medicine.

    Science.gov (United States)

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

    1999-07-01

    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.

  9. 2010 Federal STEM Education Inventory Data Set

    Data.gov (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.

  10. Ethnographic nexus analysis in clinical nursing education

    DEFF Research Database (Denmark)

    Kjær, Malene

    2016-01-01

    Purpose;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...... practice in the health care settings.Findings;The paper contributes with insights into the field of clinical nursing education, gained through a thorough methodological framework of nexus analysis as an ethnographic way to conduct research in education and grasp the various multimodal social actions...

  11. Educational technologies as ways set of educational process realization

    OpenAIRE

    Kadirbayeva R. I.

    2013-01-01

    Various approaches to educational technology definition can be summarized as set of implementation ways of curricula and the training programs, representing system of forms, methods and the tutorials, providing achievement of the educational purposes. Information educational technologies arise when using means of information equipment. Information technologies bring opportunity and need of change of the educational process model: transition from reproductive training – "modulation" of knowled...

  12. Mentoring in the clinical setting: Process, issues and challenges

    Directory of Open Access Journals (Sweden)

    Sivalingam Nalliah

    2012-01-01

    Full Text Available Mentoring in academic medicine requires thetrained mentor to commit time, purpose and dedicationfor the personal and professional development of threecategories of protégés or mentees i.e. medical students,the clinician-trainee and the clinical-educator.Conventionally, assigned mentors monitor the progressof the first two categories of personnel as their careerpathway is clearly defined. On the other hand theclinician–educator in academic medicine could be ascientist or a career clinician expected to contribute tomedical education activities and research. The clinicianeducatorhas grown in complexity as he multitasks inproviding clinical care, assists in delivering the medicalcurriculum and is expected to do research and publish.Although there is dearth of research in mentoring theclinician-educator, it is clear that mentored clinicaleducatorsare more productive by way of scientificpublications. Trained mentors are expected to identifythe needs of the mentee with regards to the level of hiscareer development and his aptitude to move up theacademic ladder, successfully nurturing the maturationprocess. Processes of mentoring in the clinical setting,attributes of the successful mentor and facilitating thementee in overcoming challenges in academic medicineare discussed.

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

    Directory of Open Access Journals (Sweden)

    Burciul Barry

    2010-12-01

    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

    Science.gov (United States)

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

    2015-01-01

    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. Clinical health informatics education for a 21st Century World.

    Science.gov (United States)

    Liaw, Siaw Teng; Gray, Kathleen

    2010-01-01

    This chapter gives an educational overview of: * health informatics competencies in medical, nursing and allied clinical health professions * health informatics learning cultures and just-in-time health informatics training in clinical work settings * major considerations in selecting or developing health informatics education and training programs for local implementation * using elearning effectively to meet the objectives of health informatics education. PMID:20407180

  16. Becoming conscious of learning and nursing in clinical settings

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... 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....

  17. Clinical oncology in resource-limited settings

    OpenAIRE

    Buonaguro, Franco M.; Gueye, Serigne N; Wabinga, Henry R; Ngoma, Twalib A.; Vermorken, Jan B; Mbulaiteye, Sam M

    2013-01-01

    Infectious Agents and Cancer is introducing a new section of Clinical Oncology with the main objective of stimulating debate through articles published in the section. Infectious diseases have been the major causes of morbidity and mortality in human populations, and have dominated the medical approach to clinical and public health. Successful efforts to control mortality from acute infections have paved the way for chronic, mostly indolent, infections to become major causes of morbidity. Can...

  18. Interprofessional clinical education: clinicians' views on the importance of leadership.

    Science.gov (United States)

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

    2012-01-01

    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. Boundary Crossings and Violations in Clinical Settings

    Directory of Open Access Journals (Sweden)

    V K Aravind

    2012-01-01

    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.

  20. Dabigatran: patient management in specific clinical settings.

    Science.gov (United States)

    Kyrle, Paul Alexander; Binder, Konrad; Eichinger, Sabine; Függer, Reinhold; Gollackner, Bernd; Hiesmayr, J Michael; Huber, Kurt; Lang, Wielfried; Perger, Peter; Quehenberger, Peter; Roithinger, Franz X; Schmaldienst, Sabine; Weltermann, Ansgar; Domanovits, Hans

    2014-09-01

    Dabigatran, a direct thrombin inhibitor, is licensed for the prevention of venous thromboembolism after knee and hip replacement, the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation and for the treatment of acute venous thromboembolism. As dabigatran has a favourable benefit-risk profile, it is being increasingly used. Dabigatran differs from vitamin K antagonists as regards its pharmacological characteristics and its impact on certain laboratory tests, and also in the lack of a direct antagonist that can reverse dabigatran-induced anticoagulation. In emergency settings such as acute bleeding, emergency surgery, acute coronary syndrome, thrombolysis for ischaemic stroke or overdosing, specific strategies are required. A working group of experts from various disciplines has developed strategies for the management of dabigatran-treated patients in emergency settings. PMID:25138549

  1. 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.

    Directory of Open Access Journals (Sweden)

    Jonathan Eldredge

    2007-12-01

    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

  2. The Necessity of Ethical Education for Clinical Nurses in Japan

    OpenAIRE

    Adachi,Miyuki; Miyabayashi,Ikuko; Miyawaki,Mihoko

    2000-01-01

    In complex and diversified clinical settings, social needs for patients' rights are increasingly demanded. Although clinical nurses have not received systematic ethics education, they will face ethical problems on a daily basis. To solve these problems, we are required to offer ethics education to clinical nurses. We have conducted a seminar on ethics for clinical nurses at Tottori University Hospital. The purpose of this study is to clarify the current status of nursing ethics. Sixty-six cli...

  3. Prospective Lymphedema Surveillance in a Clinic Setting.

    Science.gov (United States)

    Chance-Hetzler, Janet; Armer, Jane; Van Loo, Maggie; Anderson, Blake; Harris, Robin; Ewing, Rebecca; Stewart, Bob

    2015-01-01

    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). PMID:26308061

  4. Prospective Lymphedema Surveillance in a Clinic Setting

    Directory of Open Access Journals (Sweden)

    Janet Chance-Hetzler

    2015-08-01

    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.

  5. Nursing students’ perspectives on clinical education

    OpenAIRE

    MOHAMMAD REZA HEIDARI; REZA NOROUZADEH

    2015-01-01

    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...

  6. Education for healthcare clinical support workers.

    Science.gov (United States)

    Lewis, Robin; Kelly, Shona

    2015-12-01

    This article reviews the current situation regarding the provision of education and training for healthcare clinical support workers (HCSWs). In the UK, there has been an increasing reliance on unqualified clinical support staff to provide a significant proportion of the direct patient care in all healthcare settings. HCSWs routinely undertake several nursing activities that were traditionally the responsibility of nursing students or junior staff nurses. There is a need for an urgent review of the training of healthcare support staff. A 'tick box' approach to training, with an emphasis on classroom-based or on-the-job learning, makes it difficult for HCSWs to integrate theory into practice, and supports a transactional approach to caring rather than a relational approach to caregiving. Lessons from the educational experiences of other healthcare groups should be applied to the training of HCSWs. An immersive, participatory teaching and learning strategy is one approach that could be used. PMID:26647705

  7. Empowerment Philosophies and Practices in Business and Educational Settings.

    Science.gov (United States)

    Kaczmarek, Patricia

    1994-01-01

    Provides an overview of empowerment philosophies and practices in business and educational settings. Role changes for empowerment are discussed, and resistance factors regarding empowerment are described for each setting. (four references) (LRW)

  8. 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...

  9. Using Video Ethnography in Clinical Nurse Education

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... video ethnography and interaction analysis the authors show how the participants involved understand and act within the everyday encounters and situations in the hospital. The micro ethnographic analysis in this article shows how interaction between participants involved in the complex setting takes...

  10. "Set the Pace": Nutrition Education DVD for Head Start Parents

    Science.gov (United States)

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

    2013-01-01

    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.)

  11. Setting priorities and selecting topics for clinical practice guidelines.

    OpenAIRE

    Battista, R N; Hodge, M J

    1995-01-01

    Setting priorities and selecting topics are important steps in guidelines development, but they have received relatively little attention to date. Responses from a survey of guidelines stakeholders in Canada suggest that the health burden of a clinical condition on the population is an important factor in priority setting. Economic considerations, cast as either costs of treatment to the health care system or the economic burden of illness to society, are given varying importance by different...

  12. Democracy and Teacher Education: Setting Priorities

    Science.gov (United States)

    Goodman, Jesse H.

    2009-01-01

    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…

  13. Mind-Sets and Equitable Education

    Science.gov (United States)

    Dweck, Carol S.

    2010-01-01

    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'…

  14. Crisis Management's New Role in Educational Settings

    Science.gov (United States)

    Gainey, Barbara S.

    2009-01-01

    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…

  15. DESIGN AND IMPLEMENTATION OF A SOLAR ENERGY EDUCATIONAL SET

    OpenAIRE

    İbrahim SEFA; DEMİRTAŞ, Mehmet; Ramazan BAYINDIR

    2007-01-01

    In this study, an educational tool which can be used to obtain electrical energy from solar energy has been designed and implemented. The obtained energy can be used both for direct current and alternating current. Moreover, the energy can be charged into an accumulator group on request. Several experiments related to obtaining electrical energy from solar energy, storing the energy and conversion systems are prepared on the developed educational set. The educational set presented in this pap...

  16. Effectiveness of Child Psychoanalytic Psychotherapy in a Clinical Outpatient Setting

    Science.gov (United States)

    Deakin, Elisabeth Kuhn; Tiellet Nunes, Maria Lucia

    2009-01-01

    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…

  17. Doctoral Clinical Geropsychology Training in a Primary Care Setting

    Science.gov (United States)

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

    2005-01-01

    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,…

  18. Baccalaureate Nursing Students' Communication Process in the Clinical Setting.

    Science.gov (United States)

    Kotecki, Catherine Nuss

    2002-01-01

    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…

  19. The geriatric minimum data set for clinical trials (GMDS).

    NARCIS (Netherlands)

    Kan, G Abellan Van; Sinclair, A.; Andrieu, S.; Olde Rikkert, M.G.M.; Gambassi, G.; Vellas, B.

    2008-01-01

    BACKGROUND: To overcome the weak evidence base coming from often poor and insufficient clinical research in older people, a minimum data set to achieve harmonisation is highly advisable. This will lead to uniform nomenclature and to the standardisation of the assessment tools. Our primary objective

  20. Peer assisted learning in the clinical setting: an activity systems analysis.

    Science.gov (United States)

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

    2015-08-01

    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.

  1. Challenges Associated With Using Large Data Sets for Quality Assessment and Research in Clinical Settings.

    Science.gov (United States)

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

    2015-08-01

    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.

  2. Transitioning Pharmacogenomics into the Clinical Setting: Training Future Pharmacists.

    Science.gov (United States)

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

    2016-01-01

    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 educational intervention, including personal genotyping, was feasible, and positively enhanced students' reflections, and attitudes toward

  3. Violence Experienced By Nursing Students in Clinical Practice Settings

    Directory of Open Access Journals (Sweden)

    Meltem KÜRTÜNCÜ

    2013-01-01

    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. Estimating the re-identification risk of clinical data sets

    Directory of Open Access Journals (Sweden)

    Dankar Fida

    2012-07-01

    Full Text Available Abstract Background De-identification is a common way to protect patient privacy when disclosing clinical data for secondary purposes, such as research. One type of attack that de-identification protects against is linking the disclosed patient data with public and semi-public registries. Uniqueness is a commonly used measure of re-identification risk under this attack. If uniqueness can be measured accurately then the risk from this kind of attack can be managed. In practice, it is often not possible to measure uniqueness directly, therefore it must be estimated. Methods We evaluated the accuracy of uniqueness estimators on clinically relevant data sets. Four candidate estimators were identified because they were evaluated in the past and found to have good accuracy or because they were new and not evaluated comparatively before: the Zayatz estimator, slide negative binomial estimator, Pitman’s estimator, and mu-argus. A Monte Carlo simulation was performed to evaluate the uniqueness estimators on six clinically relevant data sets. We varied the sampling fraction and the uniqueness in the population (the value being estimated. The median relative error and inter-quartile range of the uniqueness estimates was measured across 1000 runs. Results There was no single estimator that performed well across all of the conditions. We developed a decision rule which selected between the Pitman, slide negative binomial and Zayatz estimators depending on the sampling fraction and the difference between estimates. This decision rule had the best consistent median relative error across multiple conditions and data sets. Conclusion This study identified an accurate decision rule that can be used by health privacy researchers and disclosure control professionals to estimate uniqueness in clinical data sets. The decision rule provides a reliable way to measure re-identification risk.

  5. Benefits of Teacher "Connections" in Stressful Educational Settings

    Science.gov (United States)

    Stanley, A. Quinn

    2011-01-01

    Findings from this investigation suggest that spirituality is a vital component for teacher and student success in high stress educational settings. The study investigated how experienced teachers of violent students maintained teacher efficacy through stress management in four schools in one state within the USA. Most educators consider working…

  6. Conceptualizing Mathematics as Discourse in Different Educational Settings

    Science.gov (United States)

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

    2015-01-01

    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…

  7. Setting the Stage: Global Competition in Higher Education

    Science.gov (United States)

    Bagley, Sylvia S.; Portnoi, Laura M.

    2014-01-01

    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…

  8. Manual Linear Movements to Assess Spasticity in a Clinical Setting

    Science.gov (United States)

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

    2013-01-01

    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

  9. Evaluation of a novel electronic genetic screening and clinical decision support tool in prenatal clinical settings.

    Science.gov (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

    2014-07-01

    "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.

  10. Clinical Traumatic Brain Injury in the Preclinical Setting.

    Science.gov (United States)

    Berkner, Justin; Mannix, Rebekah; Qiu, Jianhua

    2016-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability for people under 45 years of age. Clinical TBI is often the result of disparate forces resulting in heterogeneous injuries. Preclinical modeling of TBI is a vital tool for studying the complex cascade of metabolic, cellular, and molecular post-TBI events collectively termed secondary injury. Preclinical models also provide an important platform for studying therapeutic interventions. However, modeling TBI in the preclinical setting is challenging, and most models replicate only certain aspects of clinical TBI. This chapter details the most widely used models of preclinical TBI, including the controlled cortical impact, fluid percussion, blast, and closed head models. Each of these models replicates particular critical aspects of clinical TBI. Prior to selecting a preclinical TBI model, it is important to address what aspect of human TBI is being sought to evaluate. PMID:27604710

  11. Order sets utilization in a clinical order entry system.

    Science.gov (United States)

    Cowden, Daniel; Barbacioru, Catalin; Kahwash, Eiad; Saltz, Joel

    2003-01-01

    An order set is a predefined template that has been utilized in the standard care of hospitals for many years. While in the past, it took the form of pen and paper, today, it is, indeed, electronic. Within order sets are distinct ordering patterns that may yield fruitful results for clinicians and informaticians, alike. Protocols like there electronic counterpart, order sets, provide an 'indication' identifying the clinical scenario of the patient's condition when the ordering event occurred. This 'indication' is rarely captured by individual orders, and provides difficult challenges to developers of information systems. While mandating an 'indication' be entered for every medication or lab order makes the job much more tasking on the physician provider, it is appealing to researchers and accountants. We have attempted to bypasses that consideration by identifying ordering patterns that predict diagnostic related codes (DRGs) and diagnostic codes which would greatly facilitate the information gathering process and still provide a flexible and user friendly physician interface. PMID:14728324

  12. Community-Based Clinical Education Programs.

    Science.gov (United States)

    Bailit, Howard

    1999-01-01

    This "theme" issue offers 17 articles all on the subject of dentistry education programs sponsored by the Macy project, a 24-month effort to assess the feasibility of "community-based clinical dental education." Following an introduction, articles are grouped into those concerning problems (financing dental education, public financing of dental…

  13. Clinical Legal Education Models: Recommended Assessment Regimes

    OpenAIRE

    Riette (MA) du Plessis

    2015-01-01

    Clinical legal education (CLE) forms part of the LLB curriculum at most South African Universities. There are many similarities in the approach to CLE, but often also many differences. The clinical models of four South African university law clinics are reviewed in an effort to find suitable models. It is indicated that formulating a mission for the law clinic will have a direct impact on the clinical model chosen. The integration of CLE courses into the core curriculum of the law school will...

  14. Clinical decision making of nurses working in hospital settings.

    Science.gov (United States)

    Bjørk, Ida Torunn; Hamilton, Glenys A

    2011-01-01

    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.

  15. 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: ida.blystad@lio.se; 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)

    2012-12-15

    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.

  16. Transitioning Pharmacogenomics into the Clinical Setting: Training Future Pharmacists

    Science.gov (United States)

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

    2016-01-01

    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

  17. Undergraduate peer-assisted learning in the clinical setting.

    Science.gov (United States)

    Zentz, Suzanne E; Kurtz, Christine P; Alverson, Elise M

    2014-03-01

    Peer-assisted learning was implemented at a private university. Senior nursing students were assigned to assist sophomores during their fundamentals clinical experience. The aim of this study was to evaluate the effectiveness of peer-assisted learning in the clinical setting and to ascertain students' perceptions of fulfilling the roles of the professional nurse. During a 2-year period, 342 students participated in peer-assisted learning. Major outcomes identified by sophomores were reduced anxiety and increased confidence. A major benefit for seniors was reflection on their professional development, which strengthened their confidence and facilitated transition into the role of professional nurse. Future research should examine the impact of diversity and learning styles on this strategy and faculty perception of peer-assisted learning at achieving learning outcomes and relieving faculty burden. This study supports peer-assisted learning as an effective teaching strategy for learning nursing skills and implementing the roles of the professional nurse. PMID:24512330

  18. Becoming conscious of learning and nursing in clinical settings

    DEFF Research Database (Denmark)

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

    2015-01-01

    -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....

  19. [Screening of sexually transmitted diseases in clinical and non-clinical settings in Salvador, Bahia, Brazil].

    Science.gov (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

    2006-02-01

    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.

  20. Nursing students’ perspectives on clinical education

    Directory of Open Access Journals (Sweden)

    MOHAMMAD REZA HEIDARI

    2015-01-01

    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.

  1. Integrative Nursing: Application of Principles Across Clinical Settings

    Directory of Open Access Journals (Sweden)

    Mary Jo Kreitzer

    2015-04-01

    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.

  2. Adapting Formal Education Materials for Out-of-School Settings

    Science.gov (United States)

    Smith, Denise A.; Gibbons, H.

    2006-12-01

    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.

  3. Continuing Education Instrumentation Training in Clinical Chemistry.

    Science.gov (United States)

    LeBlanc, Jacqueline; Frankel, Saundra

    1980-01-01

    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)

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

    Directory of Open Access Journals (Sweden)

    Shah M

    2013-09-01

    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.

  5. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions.

    Science.gov (United States)

    Hunter, Sharyn; Arthur, Carol

    2016-05-01

    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. PMID:27235568

  6. Feedback in clinical education: untying the Gordian knot.

    Science.gov (United States)

    Weinstein, Debra F

    2015-05-01

    Feedback is essential to clinical education, especially in the era of competencies, milestones, and entrustable professional activities. It is, however, an area where medical educators often fall short. Although educational leaders and faculty supervisors provide feedback in a variety of clinical settings, surveys show important gaps in medical student and resident satisfaction with the feedback received, suggesting lost opportunities to identify performance problems as well as to help each learner reach his or her greatest potential.In this issue of Academic Medicine, Telio and colleagues extend the empirically validated concept of a "therapeutic alliance" to propose the "educational alliance" as a framework for enhancing feedback in medical education. They highlight the importance of source credibility, which depends on the teacher-learner relationship and alignment of values, the teacher's understanding of the learner's role and goals, the teacher's direct observation of the learner, and the learner's perception of the teacher's good intentions. The author of this Commentary suggests that the educational alliance framework should prompt medical educators to reconsider feedback and explore opportunities for optimizing it. Most medical schools and graduate medical education programs are not designed in a way that supports the education alliance model, but the Commentary author offers suggestions for cultivating educational alliances, including rethinking supervisor selection criteria. Such interventions should be combined with ongoing faculty development and efforts to improve coaching and mentoring for students, residents, and fellows. Untying the Gordian knot of effective feedback will require innovative approaches, exchange of successful strategies, and continued research. PMID:25406602

  7. Clinical Decision Making of Nurses Working in Hospital Settings

    Directory of Open Access Journals (Sweden)

    Ida Torunn Bjørk

    2011-01-01

    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.

  8. Digital breast tomosynthesis (DBT): initial experience in a clinical setting

    International Nuclear Information System (INIS)

    Background: Digital breast tomosynthesis (DBT) is a promising new technology. Some experimental clinical studies have shown positive results, but the future role and indications of this new technique, whether in a screening or clinical setting, need to be evaluated. Purpose: To compare digital mammography and DBT in a side-by-side feature analysis for cancer conspicuity, and to assess whether there is a potential additional value of DBT to standard state-of-the-art conventional imaging work-up with respect to detection of additional malignancies. Material and Methods: The study had ethics committee approval. A total of 129 women underwent 2D digital mammography including supplementary cone-down and magnification views and breast ultrasonography if indicated, as well as digital breast tomosynthesis. The indication for conventional imaging in the clinical setting included a palpable lump in 30 (23%), abnormal mammographic screening findings in 54 (42%), and surveillance in 45 (35%) of the women. The women were examined according to present guidelines, including spot-magnification views, ultrasonography, and needle biopsies, if indicated. The DBT examinations were interpreted several weeks after the conventional imaging without knowledge of the conventional imaging findings. In a later session, three radiologists performed a side-by-side feature analysis for cancer conspicuity in a sample of 50 cases. Results: State-of-the-art conventional imaging resulted in needle biopsy of 45 breasts, of which 20 lesions were benign and a total of 25 cancers were diagnosed. The remaining 84 women were dismissed with a normal/definitely benign finding and without indication for needle biopsy. The subsequent DBT interpretation found suspicious findings in four of these 84 women, and these four women had to be called back for repeated work-up with knowledge of the tomosynthesis findings. These delayed work-ups resulted in two cancers (increasing the cancer detection by 8%) and two

  9. The Impact of Postmodernism on The UAE Educational Setting

    Science.gov (United States)

    Sarsar, Nasreddine

    2007-01-01

    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…

  10. The Impact of Technology on Relationships in Educational Settings

    Science.gov (United States)

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

    2012-01-01

    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…

  11. Adapting Law-Related Education to Juvenile Justice Settings.

    Science.gov (United States)

    Curd-Larkin, Mary C.

    1987-01-01

    Notes that juvenile justice systems are increasingly turning to law-related education (LRE) programs as a means of providing youths with some of the skills and knowledge which might deter continued delinquent behavior. Describes issues which must be addressed when implementing LRE in juvenile justice settings. (JDH)

  12. Mathematics Education and Language Diversity: A Dialogue across Settings

    Science.gov (United States)

    Phakeng, Mamokgethi Setati; Moschkovich, Judit N.

    2013-01-01

    This article shares the authors' views on language-diversity issues in research in mathematics education. Described are tensions, questions, and myths that they have regularly faced as researchers. They use similarities and differences in two settings (multilingual classrooms in South Africa and U.S. mathematics classrooms with Latino/a…

  13. [Analysis of an intercultural clinical practice in a judicial setting].

    Science.gov (United States)

    Govindama, Yolande

    2007-01-01

    This article analyses an intercultural clinical practice in a legal setting from an anthropological and psychoanalytical perspective, demonstrating necessary reorganizations inherent to the framework. The culture of the new country and its founding myth being implicit to the judicial framework, the professional intervening introduces psychoanalytical references particularly totemic principles and the symbolic father by making genealogy, a universal object of transmission as guarantee of fundamental taboos of humanity. The metacultural perspective in this approach integrates ethnopsychoanalytical principles put forth by Devereux as well as the method although this latter has been adapted to the framework. This approach allows to re-question Devereux's ethnopsychoanalytical principles by opening the debate on the perspective of a psychoanalytical as well as psychiatric. PMID:18253668

  14. Can Critical Management Education Be Critical in a Formal Higher Educational Setting?

    Science.gov (United States)

    Choo, Kok Leong

    2007-01-01

    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…

  15. Utilising Medicare annual wellness visits to implement interprofessional education in the primary care setting.

    Science.gov (United States)

    Irons, Brian; Evans, Lance; Bogschutz, Renee; Panasci, Kathryn; Sun, Grace

    2016-07-01

    Interprofessional education (IPE) is an important component of healthcare professional curriculum in order to optimally prepare students for their roles as part of the healthcare team. Integrating IPE activities into direct patient care in the primary care clinic setting can help improve perceptions and student understanding of other healthcare professionals' responsibilities in this ever-evolving practice setting. This report describes the implementation of an interprofessional clinic including a variety of healthcare professionals and students in the context of the Medicare Annual Wellness Visits (AWV). Design of the clinic and general roles of the professionals in optimising preventive care are described. Student perceptions of IPE and their knowledge of other healthcare professionals were also surveyed. Student knowledge of other professionals mildly improved. Student perception of actual cooperation and interprofessional interaction statistically improved, while perception of interprofessional learning slightly worsened. Utilising Medicare AWVs can be a way for various professionals to improve IPE in the primary care setting. PMID:27219719

  16. A Clinical Librarian-Nursing Partnership to Bridge Clinical Practice and Research in an Oncology Setting.

    Science.gov (United States)

    Ginex, Pamela K; Hernandez, Marisol; Vrabel, Mark

    2016-09-01

    Nurses today work in practice settings where the expectation is to "draw upon the best evidence to provide the care most appropriate to each patient" (Olsen, Goolsby, & McGinnis, 2009, p. 10) while caring for patients with high acuity in highly specialized settings. Within the nursing profession, the Magnet Recognition Program® advocates for exemplary professional practice and the generation of new knowledge through research and clinical innovation. Nurses working in a clinical setting are often the best resource to identify important clinical questions and gaps in practice, but a lack of resources presents challenges to nurses in fully developing their questions and identifying the most appropriate methods to answer them. These challenges often fall into three broad categories: individual nurse characteristics, organizational characteristics, and environmental characteristics (Dobbins, Ciliska, Cockerill, Barnsley, & DiCenso, 2002). Creating a dedicated partnership between nurses and library staff is one method that can overcome these challenges to use existing resources and support nurses who are asking and answering important clinical questions (DePalma, 2005; Vrabel, 2005). 
. PMID:27541547

  17. The application of persuasive technology to educational settings

    DEFF Research Database (Denmark)

    Mintz, Joseph; Aagaard, Morten

    2012-01-01

    in the domain of health promotion. We present a mainly theoretical consideration of how persuasive technology could be used in educational contexts, particularly in school settings. We consider how persuasive technology design may need to be modified to meet the needs of complex educational settings. We propose......Persuasive technology is a sub-discipline of Human–Computer Interaction that has emerged within the last 10 years, and which has generated increasing interest in the application of persuasion to systems design. Most applications have to date been developed in commercial contexts, as well...... four design principles for the use of persuasive technology in instructional design, including credibility and Kairos. We derive these from theoretical considerations, as well as from our experience with the HANDS project, which has developed a mobile persuasive application for positive behaviour...

  18. Setting up a Legal Clinic in Hong Kong: progress and challenges

    OpenAIRE

    Cheung, ETM

    2010-01-01

    Clinical legal education has in recent decades become a well established part of legal education provided by universities globally. However, Hong Kong is lagging behind. The Faculty of Law, University of Hong Kong, has long foreseen the desirability of introducing clinical elements into our various education programmes so as to expose students to the practical side of the law. In 2005-06, the Faculty considered that it was time to take the development of clinical legal education a step furthe...

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

    Directory of Open Access Journals (Sweden)

    María Pilar Teruel Melero

    2009-04-01

    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.

  20. Physician judgment in clinical settings: methodological influences and cognitive performance.

    Science.gov (United States)

    Dawson, N V

    1993-07-01

    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.

  1. Prevalence of Sarcopenia and Associated Outcomes in the Clinical Setting.

    Science.gov (United States)

    Peterson, Sarah J; Braunschweig, Carol A

    2016-02-01

    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.

  2. Ethical practice and clinical legal education

    OpenAIRE

    Duncan, N. J.

    2005-01-01

    This article is designed to explore a variety of ways in which clinical methods can achieve the goals of educators and the professions in the preparation of student lawyers. In particular I intend to show how clinical methods assist in the development of: - a deeper understanding of the law, and the law in context; - general transferable skills; - legal professional skills; - a sound values basis for ethical practice. In addition, I hope to show that there are ways of using cli...

  3. 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;

    2010-01-01

    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....

  4. Identifying elders with neuropsychiatric problems in a clinical setting

    Directory of Open Access Journals (Sweden)

    Shilpa Sadanand

    2013-01-01

    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

  5. Peer-Assisted Learning in the Athletic Training Clinical Setting

    OpenAIRE

    Henning, Jolene M.; Weidner, Thomas G.; Jones, James

    2006-01-01

    Context: Athletic training educators often anecdotally suggest that athletic training students enhance their learning by teaching their peers. However, peer-assisted learning (PAL) has not been examined within athletic training education in order to provide evidence for its current use or as a pedagogic tool.

  6. Special Education Teachers' Experiences Supporting and Supervising Paraeducators: Implications for Special and General Education Settings

    Science.gov (United States)

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

    2016-01-01

    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…

  7. DNA barcoding in diverse educational settings: five case studies

    Science.gov (United States)

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

    2016-01-01

    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

  8. DNA barcoding in diverse educational settings: five case studies.

    Science.gov (United States)

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

    2016-09-01

    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

  9. DNA barcoding in diverse educational settings: five case studies.

    Science.gov (United States)

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

    2016-09-01

    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'.

  10. Cost of dry eye treatment in an Asian clinic setting.

    Directory of Open Access Journals (Sweden)

    Samanthila Waduthantri

    Full Text Available OBJECTIVES: To estimate the cost and patterns of expenditure of dry eye treatment. METHODOLOGY: We retrieved data on the type and cost of dry eye treatment in Singapore National Eye Centre from pharmacy and clinic inventory databases over a 2 year period (2008-2009 retrospectively. According to the type of treatment, data were sorted into 7 groups; meibomien gland disease (MGD treatment, preservative free lubricant eye drops, preserved lubricant eye drops, lubricant ointments and gels, cyclosporine eye drops, oral supplements and non-pharmacological treatments/procedures. Each recorded entry was considered as one patient episode (PE. Comparisons in each group between two years were carried out using Pearson Chi-Square test. Significance level was set at alpha  =  0.05. RESULTS: Cost data from 54,052 patients were available for analysis. Total number of recorded PEs was 132,758. Total annual expenditure on dry eye treatment for year 2008 and 2009 were US$1,509,372.20 and US$1,520,797.80 respectively. Total expenditure per PE in year 2008 and 2009 were US$22.11 and US$23.59 respectively. From 2008 to 2009, there was a 0.8% increase in total annual expenditure and 6.69% increase in expenditure per PE. Pharmacological treatment attributes to 99.2% of the total expenditure with lubricants accounting for 79.3% of the total pharmacological treatment expenditure. Total number of units purchased in preservative free lubricants, cyclosporine eye drops and MGD therapy have increased significantly (p<0.001 whereas number of units purchased in preserved lubricants and ointments/gels have reduced significantly (p<0.001 from 2008 to 2009. CONCLUSION: Dry eye imposes a significant direct burden to health care expenditure even without considering indirect costs. Health care planners should be aware that these direct costs appear to increase over the time and more so for particular types of medications. Given the limitations of socio-economic data, true

  11. Eportfolio and learning styles in clinical nursing education

    DEFF Research Database (Denmark)

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

    2015-01-01

    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 participa...... 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.......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...... on practice and one´s own learning process. The principal initiators were emotional involvement in clinical nursing, consciousness of learning through writing; ponder over practice, and a confident and constructive student-preceptor relationship. Inhibitors were vulnerability, a preconception that one learns...

  12. Eportfolio and learning styles in clinical nursing education

    DEFF Research Database (Denmark)

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

    2015-01-01

    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 participa...... one learns 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.......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...... on practice and one´s own learning process. The principal initiators were emotional involvement in clinical nursing, consciousness of learning through writing; ponder over practice, and a confident and constructive student-preceptor relationship. Inhibitors were vulnerability, a preconception that...

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

    Science.gov (United States)

    Sanderson, Helena; Lea, Jacqueline

    2012-11-01

    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. Significance of subjective memory complaints in the clinical setting

    NARCIS (Netherlands)

    D. Silva; M. Guerreiro; C. Faria; J. Maroco; B.A. Schmand; A. de Mendonça

    2014-01-01

    Objective: The clinical significance of subjective memory complaints in the elderly participants, particularly regarding liability of subsequent progression to dementia, has been controversial. In the present study, we tested the hypothesis that severity or type of subjective memory complaints repor

  15. Clinical Decision Making of Nurses Working in Hospital Settings

    OpenAIRE

    Ida Torunn Bjørk; Hamilton, Glenys A.

    2011-01-01

    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 d...

  16. 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;

    2010-01-01

    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 ...... clinical departments and the leadership skills of clinical consultants responsible for education.......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...

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

    OpenAIRE

    Scherpbier Albert JJ; Mortensen Lene S; Malling Bente; Ringsted Charlotte

    2010-01-01

    Abstract Background 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. Methods The study was a trans-sectional correlation study. The educational clim...

  18. A balancing act: a phenomenological exploration of medical students' experiences of using mobile devices in the clinical setting

    Science.gov (United States)

    Rashid-Doubell, F; Mohamed, S; Elmusharaf, K; O'Neill, C S

    2016-01-01

    Objective The aims of this study were to describe the experiences of senior students using mobile devices in a clinical setting while learning and interacting with clinical teachers, patients and each other, and to identify challenges that facilitated or impeded the use of such devices in the hospital. Design Interpretative phenomenology was chosen to guide our enquiry. Semi-structured interviews were conducted to examine the experiences of five senior medical students using mobile devices in the clinical setting. Setting and participants Senior medical students at an international medical school in the Middle East. Results Three main themes emerged from the data analysis: learning; professional identity and transitioning from student to doctor. The findings showed that using mobile devices in the clinical area as a learning tool was not a formalised process. Rather, it was opportunistic learning at the bedside and on occasion a source of distraction from clinical teaching. Students needed to negotiate relationships between themselves, the clinical teacher and patients in order to ensure that they maintained an acceptable professional image. Participants experienced and negotiated the change from student to doctor making them mindful of using their devices at the bedside. Conclusions Mobile devices are part of daily life for a medical student and there is a need to adapt medical education in the clinical setting, to allow the students to use their devices in a sensitive manner. PMID:27142860

  19. 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.

    2008-01-01

    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

  20. Clinical Guide to Music Therapy in Physical Rehabilitation Settings

    Science.gov (United States)

    Wong, Elizabeth

    2004-01-01

    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…

  1. A Review of Body Dysmorphic Disorder and Its Presentation in Different Clinical Settings

    OpenAIRE

    Mufaddel, Amir; Osman, Ossama T.; Almugaddam, Fadwa; Jafferany, Mohammad

    2013-01-01

    Objective: Body dysmorphic disorder (BDD) is a relatively common psychiatric disorder characterized by preoccupations with perceived defects in physical appearance. This review aimed to explore epidemiology, clinical features, comorbidities, and treatment options for BDD in different clinical settings.

  2. Early Childhood Educators' Preferences and Perceptions Regarding Outdoor Settings as Learning Environments

    Science.gov (United States)

    Ernst, Julie

    2014-01-01

    In the context of encouraging the use of natural outdoor settings for educational experiences with young children, survey research using photographs of outdoor settings was conducted to explore in-service early childhood educators' preferences and perceptions regarding outdoor settings and the educational opportunities and resource needs they…

  3. Estimating the re-identification risk of clinical data sets

    OpenAIRE

    Dankar Fida; El Emam Khaled; Neisa Angelica; Roffey Tyson

    2012-01-01

    Abstract Background De-identification is a common way to protect patient privacy when disclosing clinical data for secondary purposes, such as research. One type of attack that de-identification protects against is linking the disclosed patient data with public and semi-public registries. Uniqueness is a commonly used measure of re-identification risk under this attack. If uniqueness can be measured accurately then the risk from this kind of attack can be managed. In practice, it is often not...

  4. Effect of “diagnosis threat” in clinical setting

    OpenAIRE

    Fresson, Megan; Dardenne, Benoît; Meulemans, Thierry

    2014-01-01

    Objective. When reminded of their neurological history, mild traumatic brain injured (TBI) students underperform on neuropsychological tests (Suhr & Gunstad, 2002). To date, this “diagnosis threat” (DT) phenomenon has mainly been studied with a non-clinical and high-functioning population (university students). The aim of this study was twofold: to study this phenomenon with neurological patients and to examine the mechanisms responsible for underperformance. Method. Patients (18-55 years-old...

  5. Bioethics for clinicians: 25. Teaching bioethics in the clinical setting

    OpenAIRE

    McKneally, Martin F.; Peter A Singer

    2001-01-01

    BIOETHICS IS NOW TAUGHT IN EVERY CANADIAN MEDICAL SCHOOL. Canada needs a cadre of teachers who can help clinicians learn bioethics. Our purpose is to encourage clinician teachers to accept this important responsibility and to provide practical advice about teaching bioethics to clinicians as an integral part of good clinical medicine. We use 5 questions to focus the discussion: Why should I teach? What should I teach? How should I teach? How should I evaluate? How should I learn?

  6. Promoting Client Goal Ownership in a Clinical Setting

    OpenAIRE

    Laura H. VanPuymbrouck OTR/L

    2014-01-01

    Effective goal setting involves collaboration between the client and therapist and is an important component of occupational therapy practice. However, encouraging involvement and collaboration does not necessarily guarantee that client goals are incorporated into the treatment plan. The purpose of this innovative treatment program was to determine if providing a client with a venue for goal identification, documentation, and maintenance might impact participation and satisfaction in a day re...

  7. An eight-year clinic experience with clozapine use in a Parkinson's disease clinic setting.

    Directory of Open Access Journals (Sweden)

    Nawaz Hack

    Full Text Available BACKGROUND: To examine our eight year clinic-based experience in a Parkinson's disease expert clinical care center using clozapine as a treatment for refractory psychosis in Parkinson's disease (PD. METHODS: The study was a retrospective chart review which covered eight years of clozapine registry use. Statistical T-tests, chi-square, correlations and regression analysis were used to analyze treatment response for potential associations of age, disease duration, and Hoehn & Yahr (H&Y score, and degree of response to clozapine therapy. RESULTS: There were 36 participants included in the analysis (32 PD, 4 parkinsonism-plus. The characteristics included 30.6% female, age 45-87 years (mean 68.3±10.15, disease duration of 17-240 months (mean 108.14±51.13 and H&Y score of 2 to 4 (mean 2.51±0.51. The overall retention rate on clozapine was 41% and the most common reasons for discontinuation were frequent blood testing (28%, nursing home (NH placement (11% and leucopenia (8%. Responses to clozapine across the cohort were: complete (33%, partial (33%, absent (16%, and unknown (16%. Age (r = -0.36, p0.05. CONCLUSIONS: This single-center experience highlights the challenges associated with clozapine therapy in PD psychosis. Frequent blood testing remains a significant barrier for clozapine, even in patients with therapeutic benefit. Surprisingly, all patients admitted to a NH discontinued clozapine due to logistical issues of administration and monitoring within that setting. Consideration of the barriers to clozapine therapy will be important to its use and to its continued success in an outpatient setting.

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

    Directory of Open Access Journals (Sweden)

    Kannikar Kongbunkiat

    2015-06-01

    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.

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

    LENUS (Irish Health Repository)

    Collins, I M

    2012-03-02

    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.

  10. Music Therapy with Traumatized Refugees in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Jaap Orth

    2005-07-01

    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.

  11. Promoting Client Goal Ownership in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Laura H. VanPuymbrouck OTR/L

    2014-04-01

    Full Text Available Effective goal setting involves collaboration between the client and therapist and is an important component of occupational therapy practice. However, encouraging involvement and collaboration does not necessarily guarantee that client goals are incorporated into the treatment plan. The purpose of this innovative treatment program was to determine if providing a client with a venue for goal identification, documentation, and maintenance might impact participation and satisfaction in a day rehabilitation setting. Responses to a study satisfaction survey (Ss were taken at baseline and immediately postintervention from the experimental (N = 11 and control (N = 10 groups and attendance rates were compared between groups. Semi-structured post- intervention interviews were used to obtain qualitative feedback of the intervention. Minimal differences between the control and experimental group were found on the quantitative measures. However, unanticipated results to components were identified. Qualitative findings suggested that both patients and therapists felt the intervention created positive outcomes. This innovative program approach outlines basic strategies therapists can employ to provide a venue for client goal ownership focusing on client goal identification, client goal documentation, and client goal maintenance. While results do not support increases in self-efficacy, further research to explore the role of client-owned goals is suggested.

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

    Directory of Open Access Journals (Sweden)

    Rogers William H

    2008-01-01

    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

  13. The educational theory underpinning a clinical workbook for VERT

    International Nuclear Information System (INIS)

    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.

  14. A Lifestyle Medicine Clinic in a Community Pharmacy Setting

    Directory of Open Access Journals (Sweden)

    Thomas L. Lenz, PharmD, MA, PAPHS

    2010-01-01

    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.

  15. Conceptual framework for facilitating reflective practice by nurses in the clinical setting

    OpenAIRE

    Lucia Nelumbu; Louise Pretorius

    2015-01-01

    Problems or incidents occurring in clinical settings are often seen as indicators of poor nursing care and even indicators of a lack of reflective practice skills. This paper presents the description of the conceptual framework to facilitate reflective practice for registered nurses in clinical settings. It focuses on the characteristics of the agent (lecturer as a facilitator) and recipients (registered nurses), the context of the clinical practice, the procedures for the facilitation of ref...

  16. Single-Sex Education in Public School Settings

    Science.gov (United States)

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

    2013-01-01

    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…

  17. View the Zoo! Evaluation of Visual Communication in an Outdoor Educational Setting.

    Science.gov (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…

  18. Clinical application driven physiology in biomedical engineering laboratory course education.

    Science.gov (United States)

    Schmidt, Robert

    2005-01-01

    An innovative biomedical engineering (BME) laboratory course was developed to integrate wireless biotechnology with a hands on learning approach. In recent years the need for biomedical engineers in research and industry has increased dramatically. This requires novel strategies for training BME students in both engineering principles and clinical applications. BME students should be prepared with an appropriate skill set for real-world problems. BME education requires hands on learning with cutting edge technology to produce students ready to solve clinical problems in both research and industry. Including a wide range of BME clinical and rehabilitation applications increases student interest. A wide range of BME laboratories was designed to encompass both the basics of physiological signals and how to effectively utilize them in clinical applications. These clinical application interfaces are critical for students to understand how physiological signals may be manipulated to extract meaningful benefits for various medical disorders and rehabilitation needs. The biomedical engineering laboratory course presented in this paper was implemented and evaluated at several universities. Utilizing a virtual environment for practical applications bridges the gap between fundamentals and real world designs. PMID:17282190

  19. Expansive learning in the university setting: the case for simulated clinical experience.

    Science.gov (United States)

    Haigh, Jacquelyn

    2007-03-01

    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].

  20. Does the "Negro" "Still" Need Separate Schools? Single-Sex Educational Settings as Critical Race Counterspaces

    Science.gov (United States)

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

    2014-01-01

    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…

  1. Ethical problems in pediatrics: what does the setting of care and education show us?

    Directory of Open Access Journals (Sweden)

    Guedert Jucélia

    2012-03-01

    Full Text Available Abstract Background Pediatrics ethics education should enhance medical students' skills to deal with ethical problems that may arise in the different settings of care. This study aimed to analyze the ethical problems experienced by physicians who have medical education and pediatric care responsibilities, and if those problems are associated to their workplace, medical specialty and area of clinical practice. Methods A self-applied semi-structured questionnaire was answered by 88 physicians with teaching and pediatric care responsibilities. Content analysis was performed to analyze the qualitative data. Poisson regression was used to explore the association of the categories of ethical problems reported with workplace and professional specialty and activity. Results 210 ethical problems were reported, grouped into five areas: physician-patient relationship, end-of-life care, health professional conducts, socioeconomic issues and health policies, and pediatric teaching. Doctors who worked in hospitals as well as general and subspecialist pediatricians reported fewer ethical problems related to socioeconomic issues and health policies than those who worked in Basic Health Units and who were family doctors. Conclusions Some ethical problems are specific to certain settings: those related to end-of-life care are more frequent in the hospital settings and those associated with socioeconomic issues and public health policies are more frequent in Basic Health Units. Other problems are present in all the setting of pediatric care and learning and include ethical problems related to physician-patient relationship, health professional conducts and the pediatric education process. These findings should be taken into consideration when planning the teaching of ethics in pediatrics. Trial registration This research article didn't reports the results of a controlled health care intervention. The study project was approved by the Institutional Ethical Review

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

    Directory of Open Access Journals (Sweden)

    Scherpbier Albert JJ

    2010-09-01

    Full Text Available Abstract Background 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. Methods The study was a trans-sectional correlation study. The educational climate was investigated by a survey among all doctors (specialists and trainees in the departments. Leadership skills of the consultants responsible for education were measured by multi-source feedback scores from heads of departments, peer consultants, and trainees. Results Doctors from 42 clinical departments representing 21 specialties participated. The response rate of the educational climate investigation was moderate 52% (420/811, Response rate was high in the multisource-feedback process 84.3% (420/498. The educational climate was scored quite high mean 3.9 (SD 0.3 on a five-point Likert scale. Likewise the leadership skills of the clinical consultants responsible for education were considered good, mean 5.4 (SD 0.6 on a seven-point Likert scale. There was no significant correlation between the scores concerning the educational climate and the scores on leadership skills, r = 0.17 (p = 0.29. Conclusions This study found no relation between the educational climate and the leadership skills of the clinical consultants responsible for postgraduate medical education in clinical departments with the instruments used. Our results indicate that consultants responsible for education are in a weak position to influence the educational climate in the clinical department. Further studies are needed to explore, how heads of departments and other factors related to the clinical organisation could influence the educational climate.

  3. Patients' experiences of dental implant placement for treatment of partial edentulism in a student clinic setting.

    Science.gov (United States)

    Seferli, Jotta; Michelin, Mattias; Klinge, Björn; Wettergren, Lena

    2014-01-01

    The aim of this study was to evaluate patients' experiences of oral implant surgery when performed in a student clinic setting and the potential impact on patients'daily life. Patient selection was carried out during a round, to which undergraduate students in semester 9 and 10 could bring patients that they considered eligible for one or two implants. Partial edentulous patients that fulfilled the inclusion criteria for implant installation at the student's clinic were consequently enrolled to implant surgery with either Astra Tech or 3i implants. The same surgeon accomplished all implant installations and the students were involved in the treatment, initially by assisting during the surgery and subsequently by performing the prosthetic restoration. After the surgery, a study-specific questionnaire was sent to patients for evaluation of discomfort, pain during the surgical procedure and postoperative symptoms. Thirty-six patients were included in the study, 30 patients answered the questionnaire (response rate 83%). When retrospectively assessed, more than half of the patients (60%) perceived discomfort in the course of the implant surgery and 29% reported pain during the surgical procedure. Impact on daily living and postoperative symptoms were rarely reported (most common were pain, swelling and difficulties with chewing) and had a short duration when they occurred. Based on the results of this study conducted at a student's clinic, the impact of implant surgery on daily living appears to be small. However, it is noteworthy that the perception of discomfort and pain during the surgical procedure was frequently reported. Continued research is recommended to expose the patient's experiences of implant surgery in an educational context as well as in general dental practice. PMID:25102718

  4. Medical simulation-based education improves medicos' clinical skills

    OpenAIRE

    Wang, Zhaoming; Liu, Qiaoyu; Wang, Hai

    2012-01-01

    Clinical skill is an essential part of clinical medicine and plays quite an important role in bridging medicos and physicians. Due to the realities in China, traditional medical education is facing many challenges. There are few opportunities for students to practice their clinical skills and their dexterities are generally at a low level. Medical simulation-based education is a new teaching modality and helps to improve medicos' clinical skills to a large degree. Medical simulation-based edu...

  5. Educational Technology Research in Postsecondary Settings: Promise, Problems, and Prospects

    Science.gov (United States)

    Hannafin, Michael; Orrill, Chandra; Kim, Hyeonjin; Kim, Minchi

    2005-01-01

    While educational technology applications in higher education have grown dramatically during the past 20 years, significant disagreements exist as to their effectiveness and impact. Advocates and critics tend to advance competing positions, but little evidence of technology's impact derived through disciplined inquiry has been presented in support…

  6. Inclusive Education Setting in Southwestern Nigeria: Myth or Reality?

    Science.gov (United States)

    Oluremi, Fareo Dorcas

    2015-01-01

    Researches from developed and developing countries found that there were problems affecting the inclusive education in Nigeria. Hence, there is need to determine the challenges facing the schools where inclusive education is being implemented, and what could be done to improve the programme. The study showed that essential facilities and materials…

  7. 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

    2012-01-01

    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.

  8. Interprofessional student clinics: an economic evaluation of collaborative clinical placement education.

    Science.gov (United States)

    Haines, Terry P; Kent, Fiona; Keating, Jennifer L

    2014-07-01

    Interprofessional student clinics can be used to create clinical education placements for health professional students in addition to traditional hospital-based placements and present an opportunity to provide interprofessional learning experiences in a clinical context. To date, little consideration has been given in research literature as to whether such clinics are economically viable for a university to run. We conducted an economic evaluation based upon data generated during a pilot of an interprofessional student clinic based in Australia. Cost-minimization analyses of the student clinic as opposed to traditional profession-specific clinical education in hospitals were conducted from university, Commonwealth Government, state government and societal perspectives. Cost data gathered during the pilot study and market prices were used where available, while $AUD currency at 2011 values were used. Per student day of clinical education, the student clinic cost an additional $289, whereas the state government saved $49 and the Commonwealth Government saved $66. Overall, society paid an additional $175 per student day of clinical education using the student clinic as opposed to conventional hospital-based placements, indicating that traditional hospital-based placements are a cost-minimizing approach overall for providing clinical education. Although interprofessional student clinics have reported positive patient and student learning outcomes, further research is required to determine if these benefits can justify the additional cost of this model of education. Considerations for clinic sustainability are proposed. PMID:24417539

  9. Comparison of Clinical Teaching by Residents and Attending Physicians in Inpatient and Lecture Settings.

    Science.gov (United States)

    Bergen, Merlynn R.; And Others

    1993-01-01

    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.…

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

    NARCIS (Netherlands)

    Stolker, J.J.

    2002-01-01

    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,

  11. A Comparison of Work-Exacerbated Asthma Cases from Clinical and Epidemiological Settings

    OpenAIRE

    Henneberger, Paul K; Xiaoming Liang; Catherine Lemière

    2013-01-01

    BACKGROUND: Clinical and epidemiological studies commonly use different case definitions in different settings when investigating work-exacerbated asthma (WEA). These differences are likely to impact characteristics of the resulting WEA cases.OBJECTIVES: To investigate this issue by comparing two groups of WEA cases, one identified using an intensive clinical evaluation and another that fulfilled epidemiological criteria.METHODS: A total of 53 clinical WEA cases had been referred for suspecte...

  12. Case Study: Learner Physiotherapists' Perceptions of Clinical Education.

    Science.gov (United States)

    Harris, Duncan; Naylor, Sandra

    1992-01-01

    Describes a study conducted in the United Kingdom to discover what processes learner physiotherapists experience in clinical education and whether their experience is comparable to that of other students in medical professions. The need for feedback is addressed, and the role of the clinical educator is discussed. A form for student assessment is…

  13. Physical Education at Preschools: The Meaning of "Physical Education" to Practitioners at Three Preschool Settings in Scotland

    Science.gov (United States)

    McEvilly, Nollaig; Verheul, Martine; Atencio, Matthew

    2015-01-01

    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…

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

    Science.gov (United States)

    Ezhilarasu, Punitha

    2012-01-01

    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. Co-Designing Mobile Apps to Assist in Clinical Nursing Education: A Study Protocol.

    Science.gov (United States)

    O'Connor, Siobhan; Andrews, Tom

    2016-01-01

    Mobile applications (apps) to train health professionals is gaining momentum as the benefits of mobile learning (mLearning) are becoming apparent in complex clinical environments. However, most educational apps are generic, off-the-shelf pieces of software that do not take into consideration the unique needs of nursing students. The proposed study will apply a user-centred design process to create a tailored mobile app for nursing students to learn and apply clinical skills in practice. The app will be piloted and evaluated to understand how nursing students use mobile technology in clinical settings to support their learning and educational needs. PMID:27332433

  16. Collecting Behavioral Data in General Education Settings: A Primer for Behavioral Data Collection

    Science.gov (United States)

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

    2011-01-01

    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…

  17. Prevention of Bullying in Early Educational Settings: Pedagogical and Organisational Factors Related to Bullying

    Science.gov (United States)

    Repo, Laura; Sajaniemi, Nina

    2015-01-01

    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…

  18. CFD Data Sets on the WWW for Education and Testing

    Science.gov (United States)

    Globus, Al; Lasinski, T. A. (Technical Monitor)

    1995-01-01

    The Numerical Aerodynamic Simulation (NAS) Systems Division at NASA Ames Research Center has begun the development of a Computational Fluid Dynamics (CFD) data set archive on the World Wide Web (WWW) at URL http://www.nas.nasa.gov/NAS/DataSets/. Data sets are integrated with related information such as research papers, metadata, visualizations, etc. In this paper, four classes of users are identified and discussed: students, visualization developers, CFD practitioners, and management. Bandwidth and security issues are briefly reviewed and the status of the archive as of May 1995 is examined. Routine network distribution of data sets is likely to have profound implications for the conduct of science. The exact nature of these changes is subject to speculation, but the ability for anyone to examine the data, in addition to the investigator's analysis, may well play an important role in the future.

  19. Understanding facilitators and barriers to reengineering the clinical research enterprise in community-based practice settings.

    Science.gov (United States)

    Kukafka, Rita; Allegrante, John P; Khan, Sharib; Bigger, J Thomas; Johnson, Stephen B

    2013-09-01

    Solutions are employed to support clinical research trial tasks in community-based practice settings. Using the IT Implementation Framework (ITIF), an integrative framework intended to guide the synthesis of theoretical perspectives for planning multi-level interventions to enhance IT use, we sought to understand the barriers and facilitators to clinical research in community-based practice settings preliminary to implementing new informatics solutions for improving clinical research infrastructure. The studies were conducted in practices within the Columbia University Clinical Trials Network. A mixed-method approach, including surveys, interviews, time-motion studies, and observations was used. The data collected, which incorporates predisposing, enabling, and reinforcing factors in IT use, were analyzed according to each phase of ITIF. Themes identified in the first phase of ITIF were 1) processes and tools to support clinical trial research and 2) clinical research peripheral to patient care processes. Not all of the problems under these themes were found to be amenable to IT solutions. Using the multi-level orientation of the ITIF, we set forth strategies beyond IT solutions that can have an impact on reengineering clinical research tasks in practice-based settings. Developing strategies to target enabling and reinforcing factors, which focus on organizational factors, and the motivation of the practice at large to use IT solutions to integrate clinical research tasks with patient care processes, is most challenging. The ITIF should be used to consider both IT and non-IT solutions concurrently for reengineering of clinical research in community-based practice settings. PMID:23806363

  20. International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271.

    Science.gov (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

    2016-08-01

    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 (country differences were evident in all the neurocognitive test scores (p < 0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive 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.

  1. Learners with Disabilities in an Inclusive Education Setting in Nigeria: Implications for Administrators

    Science.gov (United States)

    Eskay, Michael; Oboegbulem, Angie

    2013-01-01

    Education in an inclusive setting appears to be a concept in this 21st century. This concept is beginning to gain recognition in the field of education. Children with and without disabilities are gradually being educated together in large scale societies. This is because most large scale countries have begun to recognize, appreciate, and accept…

  2. Educational Goal-Setting in a Native-Canadian Community.

    Science.gov (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…

  3. Accommodations in Homeschool Settings for Children with Special Education Needs

    Science.gov (United States)

    Stoudt, Patricia Koelsch

    2012-01-01

    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…

  4. Scoring Los Angeles Landscapes: Environmental Education in an Urban Setting.

    Science.gov (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. Designing Multimedia for Ecological Tourism in an Educational Setting.

    Science.gov (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…

  6. Social Responsibility in a Historical and Educational Setting

    Science.gov (United States)

    Jevons, F. R.

    1973-01-01

    Scientists must try hard to make themselves understood by a wider public, remember that science is not infallible and social issues are not always clear, and should develop sympathetic understanding of other people's views. A broad educational background is needed for science students to aid in accomplishment of these goals. (DF)

  7. Clinical Immersion and Biomedical Engineering Design Education: "Engineering Grand Rounds".

    Science.gov (United States)

    Walker, Matthew; Churchwell, André L

    2016-03-01

    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.

  8. Clinical Immersion and Biomedical Engineering Design Education: "Engineering Grand Rounds".

    Science.gov (United States)

    Walker, Matthew; Churchwell, André L

    2016-03-01

    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. PMID:26857015

  9. Use of Big-Screen Films in Multiple Childbirth Education Classroom Settings

    OpenAIRE

    Kaufman, Tamara

    2010-01-01

    Although two recent films, Orgasmic Birth and Pregnant in America, were intended for the big screen, they can also serve as valuable teaching resources in multiple childbirth education settings. Each film conveys powerful messages about birth and today's birthing culture. Depending on a childbirth educator's classroom setting (hospital, birthing center, or home birth environment), particular portions in each film, along with extra clips featured on the films' DVDs, can enhance an educator's c...

  10. Developing an empirical base for clinical nurse specialist education.

    Science.gov (United States)

    Stahl, Arleen M; Nardi, Deena; Lewandowski, Margaret A

    2008-01-01

    This article reports on the design of a clinical nurse specialist (CNS) education program using National Association of Clinical Nurse Specialists (NACNS) CNS competencies to guide CNS program clinical competency expectations and curriculum outcomes. The purpose is to contribute to the development of an empirical base for education and credentialing of CNSs. The NACNS CNS core competencies and practice competencies in all 3 spheres of influence guided the creation of clinical competency grids for this university's practicum courses. This project describes the development, testing, and application of these clinical competency grids that link the program's CNS clinical courses with the NACNS CNS competencies. These documents guide identification, tracking, measurement, and evaluation of the competencies throughout the clinical practice portion of the CNS program. This ongoing project will continue to provide data necessary to the benchmarking of CNS practice competencies, which is needed to evaluate the effectiveness of direct practice performance and the currency of graduate nursing education. PMID:18438164

  11. Internal Medicine Residents’ Perceptions of Team-Based Care and its Educational Value in the Continuity Clinic: A Qualitative Study

    OpenAIRE

    Soones, TN; O Brien, BC; Julian, KA

    2015-01-01

    © 2015, Society of General Internal Medicine. BACKGROUND : In order to teach residents how to work in interprofessional teams, educators in graduate medical education are implementing team-based care models in resident continuity clinics. However, little is known about the impact of interprofessional teams on residents’ education in the ambulatory setting. OBJECTIVE: To identify factors affecting residents’ experience of team-based care within continuity clinics and the impact of these teams ...

  12. The Impact of the Clinical Medical Librarian on Medical Education.

    Science.gov (United States)

    Sarkis, Jeanne; Hamburger, Stephen

    1981-01-01

    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)

  13. Critical thinking in clinical nurse education: application of Paul's model of critical thinking.

    Science.gov (United States)

    Andrea Sullivan, E

    2012-11-01

    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.

  14. Clinical and no-clinical setting specificities in first session short-term psychotherapy psychodrama group.

    Science.gov (United States)

    Drakulić, Aleksandra Mindoljević

    2011-03-01

    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. PMID:21661367

  15. Clinical and no-clinical setting specificities in first session short-term psychotherapy psychodrama group.

    Science.gov (United States)

    Drakulić, Aleksandra Mindoljević

    2011-03-01

    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.

  16. Using Large Data Sets to Study College Education Trajectories

    Science.gov (United States)

    Oseguera, Leticia; Hwang, Jihee

    2014-01-01

    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…

  17. Galantamine treatment in Alzheimer's disease: response and long-term outcome in a routine clinical setting

    Directory of Open Access Journals (Sweden)

    Wallin ÅK

    2011-09-01

    Full Text Available Åsa K Wallin, Carina Wattmo, Lennart MinthonClinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, SwedenBackground: In the absence of long-term, placebo-controlled studies of cholinesterase inhibitors in Alzheimer's disease (AD, analysis of the results of open-label trials becomes crucial. This study aimed to explore the three-year effects of galantamine treatment, as well as subgroups of response and adherence to treatment.Methods: Two hundred and eighty patients with a clinical diagnosis of AD were included in the prospective, open-label, multicenter Swedish Alzheimer Treatment Study, and received galantamine treatment. Efficacy measures included cognitive tests, ie, the Mini-Mental State Examination (MMSE and Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-cog, functional rating (Instrumental Activities of Daily Living Scale [IADL], and global rating. Assessments were carried out before treatment and every six months for a period of three years. K-means cluster analysis was used to identify response subgroups.Results: After three years of treatment, the mean change from baseline was 2.6 points in MMSE and 5.6 points in ADAS-cog scores. Globally, half of the patients improved or remained unchanged for two years. Cluster analysis identified two response clusters. Cluster 1 included patients with low ability in ADAS-cog and IADL scores at baseline. Even though the patients in cluster 1 were older and less educated, they responded better at six months compared with patients in cluster 2. Cluster 2 included patients with better ADAS-cog and IADL scores at baseline. Patients in cluster 2 had a higher frequency of the APOE ε4 allele, a slower pretreatment progression rate, and remained in the study longer than those in cluster 1. Three-year completers (n = 129, 46% received higher doses of galantamine compared with dropouts.Conclusion: AD patients who received long-term galantamine treatment were

  18. Establishing research in a palliative care clinical setting: perceived barriers and implemented strategies.

    Science.gov (United States)

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

    2014-02-01

    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.

  19. Operationalizing NIMH Research Domain Criteria (RDoC) in naturalistic clinical settings.

    Science.gov (United States)

    Sharp, Carla; Fowler, J Christopher; Salas, Ramiro; Nielsen, David; Allen, Jon; Oldham, John; Kosten, Thomas; Mathew, Sanjay; Madan, Alok; Frueh, B Christopher; Fonagy, Peter

    2016-01-01

    Recently, the National Institute of Mental Health (NIMH) introduced the Research Domain Criteria (RDoC) initiative to address two major challenges facing the field of psychiatry: (1) the lack of new effective personalized treatments for psychiatric disorders, and (2) the limitations associated with categorically defined psychiatric disorders. Although the potential of RDoC to revolutionize personalized psychiatric medicine and psychiatric nosology has been acknowledged, it is unclear how to implement RDoC in naturalistic clinical settings as part of routine outcomes research. In this article, the authors present the major RDoC principles and then show how these principles are operationalized in The Menninger Clinic's McNair Initiative for Neuroscience Discovery-Menninger & Baylor College of Medicine (MIND-MB) study. The authors discuss how RDoC-informed outcomes-based assessment in clinical settings can transform personalized clinical care through multimodal treatments. PMID:27583809

  20. Role Models and Teachers: medical students perception of teaching-learning methods in clinical settings, a qualitative study from Sri Lanka

    OpenAIRE

    Jayasuriya-Illesinghe, Vathsala; Nazeer, Ishra; Athauda, Lathika; Perera, Jennifer

    2016-01-01

    Background Medical education research in general, and those focusing on clinical settings in particular, have been a low priority in South Asia. This explorative study from 3 medical schools in Sri Lanka, a South Asian country, describes undergraduate medical students’ experiences during their final year clinical training with the aim of understanding the teaching-learning experiences. Methods Using qualitative methods we conducted an exploratory study. Twenty eight graduates from 3 medical s...

  1. Clinical Pharmacy Education in a Dental Pharmacy

    Science.gov (United States)

    Helling, Dennis K.; Walker, John A.

    1978-01-01

    A clinical pharmacy training program for undergraduate students developed at the University of Iowa provides conjoint training of pharmacy and dental students in the clinic areas and pharmacy at the College of Dentistry. (LBH)

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

    Directory of Open Access Journals (Sweden)

    Chipchase Lucinda S

    2012-11-01

    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. Nursing Challenges in Motivating Nursing Students through Clinical Education: A Grounded Theory Study

    OpenAIRE

    Hanifi Nasrin; Parvizy Soroor; Joolaee Soodabeh

    2012-01-01

    Nurses are the first role models for students in clinical settings. They can have a significant role on students' motivation. The purpose of this study was to explore the understanding of nursing students and instructors concerning the role of nurses in motivating nursing students through clinical education. The sampling was first started purposefully and continued with theoretical sampling. The study collected qualitative data through semistructured and interactive interviews with 16 nursing...

  4. INTENTION TO USE M-LEARNING IN HIGHER EDUCATION SETTINGS

    Directory of Open Access Journals (Sweden)

    Jorge Brantes Ferreira

    2014-09-01

    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.

  5. [How to Understand "Clinical Ethics" and "Research Ethics" in Clinical Settings--Incorporation of IRB, REC, and CEC in Hospital Organizations].

    Science.gov (United States)

    Ita, Koichiro

    2016-02-01

    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.

  6. [How to Understand "Clinical Ethics" and "Research Ethics" in Clinical Settings--Incorporation of IRB, REC, and CEC in Hospital Organizations].

    Science.gov (United States)

    Ita, Koichiro

    2016-02-01

    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. PMID:27311285

  7. USHER SYNDROME IN EDUCATIONAL SETTINGS: INDIGENOUS IDENTIFICATION STRATEGIES DEVELOPED IN INDIA

    Directory of Open Access Journals (Sweden)

    Gnanathicam Victoria NAOMI

    2013-09-01

    Full Text Available Introduction:most teachers of hearing and visually impaired children in India have to learn more about the prevalence and characteristics of Usher Syndrome. Keeping in mind the need to address this neglected population, the present study was designed and executed in South India.Goals:the goals of the study were to identify students with Usher Syndrome in educational settings using indigenous techniques, and to develop and describe a protocol for identifying these students.Methodology:seven hundred hearing impaired students studying in residential and inclusive schools in four districts of the State Tamil Nadu were screened using tools which included screening for distance and near vision, field of vision, dark adaptation, glare and contrast sensitivity.Results:ten students between the age of 14- 20 were found to be at risk of having Usher Syndrome. Finally, 6 subjects who had a diagnosis of retinitis pigmentosa were clinically identified with Usher Syndrome.Conclusion:these identification strategies will assist special education and rehabilitation pro­fess­ionals in recognizing symptoms of Usher Synd­rome so that they will be able to refer these children for diagnostic and supportive services.

  8. Implementation of responsiveness to intervention in early education settings.

    Science.gov (United States)

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

    2009-05-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Liu Wen-hua

    2012-10-01

    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.

  10. The use of standardized clients in research in the veterinary clinical setting.

    Science.gov (United States)

    Nogueira Borden, Leandra J; Adams, Cindy L; Ladner, Lynda D

    2008-01-01

    This article describes the first use of undisclosed standardized clients (SCs) for research in the veterinary clinical setting. The study described here used SCs to investigate veterinarian-client communication during euthanasia discussions. Use of this methodology allowed us to avoid several ethical and logistical challenges associated with gathering observational data on sensitive subject matter. In medicine, standardized patients (SPs) are used extensively in teaching, medical school examinations, and licensing examinations. Increasingly, SPs are being used in research to evaluate physicians' performance in the clinical setting, including assessment of physician-patient communication. Several veterinary schools have recently introduced SCs for teaching and evaluation of student veterinarians. Until now, however, SCs have not been used for research in the veterinary clinical setting. Two cases were designed to reflect common reasons for discussion of euthanasia in private practice. A random sample of 32 consenting veterinarians in southern Ontario saw each case. Appointments were audio-recorded and analyzed using a communication assessment tool adapted from human medicine. At the end of each appointment, the SC disclosed his or her identity and both veterinarian and SC completed questionnaires to describe their perceptions of the communication that took place. This article describes in detail the use of SCs in this study, including case design, training, preparation for visits, use of animal patients, and challenges faced. The use of SCs was shown to be a feasible method of assessing veterinarian-client communication in the clinical setting. PMID:19066360

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

    Directory of Open Access Journals (Sweden)

    Giovanni Castellini, PhD, MD

    2016-09-01

    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.

  12. Refining Video Game Use Questionnaires for Research and Clinical Application: Detection of Problematic Response Sets

    Science.gov (United States)

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

    2012-01-01

    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…

  13. 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.

    2007-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Joseph ML

    2015-07-01

    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

  15. International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271.

    Science.gov (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

    2016-08-01

    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 (memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive 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. PMID:26733457

  16. Perceived educational needs of women entrepreneurs in a business incubator setting

    OpenAIRE

    Heath, William J.

    1995-01-01

    The focus of this study was to examine the past educational experiences women entrepreneurs had that related to the operation of their businesses in an incubator setting. The study also examined educational needs not adequately addressed for women entrepreneurs in this setting. Data were gathered by participant interview methods using a qualitative research approach. Twenty subjects were selected for individual interviews. They were located through personal contact upon reco...

  17. Influences on classification accuracy of exam sets: an example from vocational education and training

    OpenAIRE

    Hubregtse, M.; Eggen, T.J.H.M.; Veldkamp, B.P.

    2012-01-01

    Classification accuracy of single exams is well studied in the educational measurement literature. However, when making important decisions, such as certification decisions, one usually uses several exams: an exam set. This chapter elaborates on classification accuracy of exam sets. This is influenced by the shape of the ability distribution, the height of the standards, and the possibility for compensation. This is studied using an example from vocational education and training (VET). The cl...

  18. The attributes of an effective teacher differ between the classroom and the clinical setting.

    Science.gov (United States)

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

    2016-10-01

    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 < 0.001 and 0.12 [0.01, 0.23], p = 0.03, respectively). The variables associated with effectiveness of classroom and clinical teachers differ, suggesting context specificity in teaching effectiveness ratings. Context specificity may be explained by differences in the exposure that learners have to teachers in the classroom versus clinical setting-so that raters in the clinical setting may base ratings upon observed behaviours rather than stereotype data. Alternatively, since subjective ratings of teaching effectiveness inevitably incorporate learners' context-specific needs, the attributes that make a teacher effective in one context may not meet the needs of learners in a different context. PMID:26891679

  19. Evaluation of Online Education about Diabetes Management in the School Setting

    Science.gov (United States)

    Bachman, Jean A.; Hsueh, Kuei-Hsiang

    2008-01-01

    There are a variety of initiatives to provide education to improve the quality of care for children with diabetes in the school setting. This study piloted and evaluated an online continuing education program for school nurses about diabetes management for children in schools using current practice principles. The evaluation determined if…

  20. A Comprehensive Approach to Hazing Prevention in Higher Education Settings. Working Paper

    Science.gov (United States)

    Langford, Linda

    2008-01-01

    The Higher Education Center's 2002 publication "Preventing Violence and Promoting Safety in Higher Education Settings: Overview of a Comprehensive Approach," outlines a framework for addressing a broad array of violence issues in college and university communities. This document outlines specific considerations in applying this approach to the…

  1. An Investigation of the Self-Regulation Components Students Employ in the Physical Education Setting

    Science.gov (United States)

    Kermarrec, Gilles; Todorovich, John; Fleming, David

    2004-01-01

    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…

  2. The Use of Instructional and Motivational Self-Talk in Setting up a Physical Education Lesson

    Science.gov (United States)

    Zourbanos, Nikos

    2013-01-01

    The main purpose of this article is to provide guidelines to physical educators for setting up a self-talk program during their lesson. The article briefly presents definitions of self-talk and research findings in sport and physical education to highlight the important benefits of positive self-talk in enhancing task performance. It also provides…

  3. Barker's Behavior Setting Theory: A Useful Conceptual Framework for Research on Educational Administration.

    Science.gov (United States)

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

    1985-01-01

    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)

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

    DEFF Research Database (Denmark)

    Mintz, Joseph; Aagaard, Morten

    2010-01-01

    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....

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

    OpenAIRE

    Mintz, Joseph; Aagaard, Morten

    2010-01-01

    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.

  6. Strengthening Clinical Preparation: The Holy Grail of Teacher Education

    Science.gov (United States)

    Darling-Hammond, Linda

    2014-01-01

    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…

  7. Clinical risk and depression (continuing education credit).

    Science.gov (United States)

    Sharkey, S

    1997-01-22

    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.

  8. Learning with Nature and Learning from Others: Nature as Setting and Resource for Early Childhood Education

    Science.gov (United States)

    MacQuarrie, Sarah; Nugent, Clare; Warden, Claire

    2015-01-01

    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…

  9. Influences on classification accuracy of exam sets: an example from vocational education and training

    NARCIS (Netherlands)

    Hubregtse, M.; Eggen, T.J.H.M.; Eggen, T.J.H.M.; Veldkamp, B.P.

    2012-01-01

    Classification accuracy of single exams is well studied in the educational measurement literature. However, when making important decisions, such as certification decisions, one usually uses several exams: an exam set. This chapter elaborates on classification accuracy of exam sets. This is influenc

  10. Military Curriculum Materials for Vocational and Technical Education. Builders School, Ceramic Tile Setting 3-9.

    Science.gov (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…

  11. Graduate Leaders in Early Childhood Education and Care Settings, the Practitioner Perspective

    Science.gov (United States)

    Davis, Geraldine

    2014-01-01

    Since 2006, UK policy has identified a professionalisation agenda for staff working in early childhood education and care settings. This has included the development of graduate leaders with a specific purpose to lead improvements in these settings by leading change, and hence improving outcomes for children. This article reports on findings from…

  12. How Stable are Temperaments in the Clinical Setting: A Pilot Study

    Science.gov (United States)

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

    2016-01-01

    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

  13. Priority setting in family change and clinical practice: the Family FIRO Model.

    Science.gov (United States)

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

    1991-06-01

    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.

  14. Transforming the Academic Faculty Perspective in Graduate Medical Education to Better Align Educational and Clinical Outcomes.

    Science.gov (United States)

    Wong, Brian M; Holmboe, Eric S

    2016-04-01

    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. PMID:26703412

  15. Genetic counsellors in Sweden: their role and added value in the clinical setting.

    Science.gov (United States)

    Pestoff, Rebecka; Ingvoldstad, Charlotta; Skirton, Heather

    2016-03-01

    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.

  16. "A golden opportunity": Exploring interprofessional learning and practice in rural clinical settings.

    Science.gov (United States)

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

    2015-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    George Q. Daley

    2016-06-01

    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.

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

    Science.gov (United States)

    Daley, George Q; Hyun, Insoo; Apperley, Jane F; Barker, Roger A; Benvenisty, Nissim; Bredenoord, Annelien L; Breuer, Christopher K; Caulfield, Timothy; Cedars, Marcelle I; Frey-Vasconcells, Joyce; Heslop, Helen E; Jin, Ying; Lee, Richard T; McCabe, Christopher; Munsie, Megan; Murry, Charles E; Piantadosi, Steven; Rao, Mahendra; Rooke, Heather M; Sipp, Douglas; Studer, Lorenz; Sugarman, Jeremy; Takahashi, Masayo; Zimmerman, Mark; Kimmelman, Jonathan

    2016-06-14

    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. PMID:27185282

  19. "How could neuroimaging be helpful in the assessment of Dementia in a clinical setting? "

    OpenAIRE

    Malakouti K; Gaviria M

    2002-01-01

    This study was conducted to evaluate how neuroimaging procedures (MRI, SPECT) could be used in clinical setting for diagnosis of dementia.Forty out of 94 patients suspected of having a diagnosis of dementia, referred to Radiology Department for consecutive neuroimaging procedures, were selected. Patients’ medical records reviewed anda retrospective diagnosis was reached according to DSM-IV for Alzheimer’s disease (AD) and NINDS-AINS for vascular dementia (VaD). Mann-Whitney, fisher’s exact te...

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

    OpenAIRE

    Elvis Siprián Castro Alzate; Karen Aguía Rojas; Leidy Vanessa Linares Murcia; Laura Yanquén Castro; Vanessa Reyes Villanueva

    2016-01-01

    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...

  1. 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: lucasalvolini@alice.it; 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)

    2008-03-15

    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.

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

    Directory of Open Access Journals (Sweden)

    ALIREZA ESTEGHAMATI

    2016-04-01

    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

  3. Nursing preceptors' experiences of two clinical education models.

    Science.gov (United States)

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

    2014-08-01

    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. PMID:24512652

  4. Utilization of fecal occult blood test in the acute hospital setting and its impact on clinical management and outcomes

    Science.gov (United States)

    Mosadeghi, S; Ren, H; Catungal, J; Yen, I; Liu, B; Wong, RJ; Bhuket, T

    2016-01-01

    Background: Despite lack of evidence supporting the use of fecal occult blood test (FOBT) in the acute hospital setting, FOBT is commonly used in the inpatient setting for reasons other than colorectal cancer (CRC) screening. Aims: To evaluate practice trends in utilizing FOBT on inpatients and its impact on affecting clinical management and outcomes. Materials and Methods: A cross-sectional study of consecutive adult patients undergoing FOBT from January 1, 2011 to December 31, 2011 during an acute medical admission at a large urban safety net hospital was performed. Indications for FOBT, and the impact of FOBT results on endoscopic procedures performed and clinical outcomes were assessed. The number of inpatient endoscopic procedures before and after discontinuing inpatient FOBT was also assessed. Results: A total of 207 inpatient FOBTs were performed in 2011. The most common reason cited for FOBT was anemia (36%, n = 74) followed by gastrointestinal (GI) bleeding (27%, n = 55). Interestingly, 23% (n = 47) of the patients undergoing inpatient FOBT had overt GI bleeding. As expected, patients with positive FOBT were significantly more likely to undergo endoscopic examinations (P < 0.01). After discontinuing the availability of inpatient FOBT, patients were less likely to undergo endoscopic examinations [odds ratio (OR) 0.80, 95% confidence interval (CI) 0.75-0.85]. Conclusion: Inappropriate utilization of FOBT in the inpatient setting is common, even when the indication does not support its use. Setting limitations on inpatient FOBT may reduce the inappropriate utilization of inpatient FOBT. Quality improvement initiatives are needed to educate clinicians on the appropriate use of FOBT, which is primarily for average risk CRC screening. PMID:27089107

  5. Twenty years of the Journal of Clinical Psychology in Medical Settings: we hope you will enjoy the show.

    Science.gov (United States)

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

    2014-03-01

    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.

  6. Safety of telemental healthcare delivered to clinically unsupervised settings: a systematic review.

    Science.gov (United States)

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

    2010-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Henrard Jean-Claude

    2009-04-01

    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.

  8. Education and counseling in the methadone treatment setting improves knowledge of viral hepatitis.

    Science.gov (United States)

    Larios, Sandra E; Masson, Carmen L; Shopshire, Michael S; Hettema, Jennifer; Jordan, Ashly E; McKnight, Courtney; Young, Christopher; Khalili, Mandana; Seewald, Randy M; Min, Albert; Hengl, Nicholas; Sorensen, James L; Des Jarlais, Don C; Perlman, David C

    2014-04-01

    The aim of this study was to evaluate the effectiveness of an educational method of providing viral hepatitis education for methadone maintenance patients. Four hundred forty participants were randomly assigned to either a control or a motivationally-enhanced viral hepatitis education and counseling intervention. Viral hepatitis A (HAV), B (HBV), and C (HCV) knowledge tests were administered at baseline, following each of two education sessions (post-education), and at a 3-month follow-up assessment. Results indicated a significant increase in knowledge of HAV, HBV, and HCV over time. No differences were found in knowledge between the intervention groups in knowledge acquisition regarding any of the hepatitis viruses suggesting that a motivational interviewing style may not augment hepatitis knowledge beyond standard counseling. A two-session viral hepatitis education intervention effectively promotes hepatitis knowledge and can be integrated in methadone treatment settings. PMID:24462241

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

    DEFF Research Database (Denmark)

    Illeris, Helene

    2009-01-01

    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......  New, experimental educational settings such as ‘art laboratories', ‘digital workshops' and ‘theme-based tours' are important to the processes of change towards more inclusive practices, which have been initiated in many Danish art galleries. While traditional gallery education was constructed...... 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...

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

    Directory of Open Access Journals (Sweden)

    Karen E. Hamilton

    2005-09-01

    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

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

    Directory of Open Access Journals (Sweden)

    Shirwaikar A

    2015-12-01

    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.

  12. Simulation-based medical education in clinical skills laboratory

    OpenAIRE

    Akaike, Masashi; Fukutomi, Miki; Nagamune, Masami; Fujimoto, Akiko; Tsuji, Akiko; Ishida, Kazuko; Iwata, Takashi

    2012-01-01

    Clinical skills laboratories have been established in medical institutions as facilities for simulation-based medical education (SBME). SBME is believed to be superior to the traditional style of medical education from the viewpoint of the active and adult learning theories. SBME can provide a learning cycle of debriefing and feedback for learners as well as evaluation of procedures and competency. SBME offers both learners and patients a safe environment for practice and error. In a full-env...

  13. Andragogy in clinical medicine: implications for medical educators

    Directory of Open Access Journals (Sweden)

    Dr. Geetha Mani

    2014-03-01

    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.

  14. Preparing culturally and linguistically diverse nursing students for clinical practice in the health care setting.

    Science.gov (United States)

    Harvey, Theresa; Robinson, Carolyn; Frohman, Rena

    2013-07-01

    The number of culturally and linguistically diverse (CALD) students seeking enrollment in higher education courses in Western countries where English is the predominant language has grown considerably in the past decade, especially in undergraduate health care courses. When enrolled in nursing courses, students are required to complete clinical placements. Such experiences can create significant challenges for CALD students where language, cultural differences, and interpretation of cultural norms complicate the learning process. To assist CALD nursing students to transition successfully, an extracurricular integrated curriculum program was developed and implemented at a university in Queensland, Australia. The program is a series of interactive workshops based on the principles of caring pedagogy and student-centered learning. The program applies strategies that combine small-group discussions with peers, role-plays, and interactions with final-year nursing student volunteers. Evaluation of the program suggests it has assisted most of the students surveyed to be successful in their clinical studies. PMID:23721071

  15. Simulation-based medical education in clinical skills laboratory.

    Science.gov (United States)

    Akaike, Masashi; Fukutomi, Miki; Nagamune, Masami; Fujimoto, Akiko; Tsuji, Akiko; Ishida, Kazuko; Iwata, Takashi

    2012-01-01

    Clinical skills laboratories have been established in medical institutions as facilities for simulation-based medical education (SBME). SBME is believed to be superior to the traditional style of medical education from the viewpoint of the active and adult learning theories. SBME can provide a learning cycle of debriefing and feedback for learners as well as evaluation of procedures and competency. SBME offers both learners and patients a safe environment for practice and error. In a full-environment simulation, learners can obtain not only technical skills but also non-technical skills, such as leadership, team work, communication, situation awareness, decision-making, and awareness of personal limitations. SBME is also effective for integration of clinical medicine and basic medicine. In addition, technology-enhanced simulation training is associated with beneficial effects for outcomes of knowledge, skills, behaviors, and patient-related outcomes. To perform SBME, effectively, not only simulators including high-fidelity mannequin-type simulators or virtual-reality simulators but also full-time faculties and instructors as professionals of SBME are essential in a clinical skills laboratory for SBME. Clinical skills laboratory is expected to become an integrated medical education center to achieve continuing professional development, integrated learning of basic and clinical medicine, and citizens' participation and cooperation in medical education. PMID:22449990

  16. Evaluating cognitive impairment in the clinical setting: practical screening and assessment tools.

    Science.gov (United States)

    Valcour, Victor G

    2011-12-01

    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.

  17. The objectivity of the Autism Diagnostic Observation Schedule (ADOS) in naturalistic clinical settings.

    Science.gov (United States)

    Zander, Eric; Willfors, Charlotte; Berggren, Steve; Choque-Olsson, Nora; Coco, Christina; Elmund, Anna; Moretti, Åsa Hedfors; Holm, Anette; Jifält, Ida; Kosieradzki, Renata; Linder, Jenny; Nordin, Viviann; Olafsdottir, Karin; Poltrago, Lina; Bölte, Sven

    2016-07-01

    The Autism Diagnostic Observation Schedule (ADOS) is a first-choice diagnostic tool in autism spectrum disorder (ASD). Excellent interpersonal objectivity (interrater reliability) has been demonstrated for the ADOS under optimal conditions, i.e., within groups of highly trained "research reliable" examiners in research setting. We investigated the spontaneous interrater reliability among clinically trained ADOS users across multiple sites in clinical routine. Forty videotaped administrations of the ADOS modules 1-4 were rated by five different raters each from a pool of in total 15 raters affiliated to 13 different clinical sites. G(q,k) coefficients (analogous to intraclass correlations), kappas (ĸ) and percent agreement (PA) were calculated. The median interrater reliability for items across the four modules was G(q,k) = .74-.83, with the single ADOS items ranging from .23 to .94. G(q,k) for total scores was .85-.92. For diagnostic classification (ASD/non-spectrum), PA was 64-82 % and Fleiss' ĸ .19-.55. Objectivity was lower for pervasive developmental disorder not otherwise specified and non-spectrum diagnoses as compared to autism. Interrater reliabilities of the ADOS items and domain totals among clinical users across multiple sites were in the same range as previously reported for research reliable users, while the one for diagnostic classification was lower. Differences in sample characteristics, rater skills and statistics compared with previous studies are discussed. Findings endorse the objectivity of the ADOS in naturalistic clinical settings, but also pinpoint its limitations and the need and value of adequate and continuous rater training. PMID:26584575

  18. Creating an optical spectroscopy system for use in a primary care clinical setting (Conference Presentation)

    Science.gov (United States)

    Eshein, Adam; Nguyen, The-Quyen; Radosevich, Andrew J.; Gould, Bradley; Wu, Wenli; Konda, Vani; Yang, Leslie W.; Koons, Ann; Feder, Seth; Valuckaite, Vesta; Roy, Hemant K.; Backman, Vadim

    2016-03-01

    While there are a plethora of in-vivo spectroscopic techniques that have demonstrated the ability to detect a number of diseases in research trials, very few techniques have successfully become a fully realized clinical technology. This is primarily due to the stringent demands on a clinical device for widespread implementation. Some of these demands include: simple operation requiring minimal or no training, safe for in-vivo patient use, no disruption to normal clinic workflow, tracking of system performance, warning for measurement abnormality, and meeting all FDA guidelines for medical use. Previously, our group developed a fiber optic probe-based optical sensing technique known as low-coherence enhanced backscattering spectroscopy (LEBS) to quantify tissue ultrastructure in-vivo. Now we have developed this technique for the application of prescreening patients for colonoscopy in a primary care (PC) clinical setting. To meet the stringent requirements for a viable medical device used in a PC clinical setting, we developed several novel components including an automated calibration tool, optical contact sensor for signal acquisition, and a contamination sensor to identify measurements which have been affected by debris. The end result is a state-of-the-art medical device that can be realistically used by a PC physician to assess a person's risk for harboring colorectal precancerous lesions. The pilot study of this system shows great promise with excellent stability and accuracy in identifying high-risk patients. While this system has been designed and optimized for our specific application, the system and design concepts are universal to most in-vivo fiber optic based spectroscopic techniques.

  19. 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

    2012-02-01

    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.

  20. Feedback on students' clinical reasoning skills during fieldwork education

    OpenAIRE

    de Beer, Marianne; Mårtensson, Lena

    2015-01-01

    Background/aim Feedback on clinical reasoning skills during fieldwork education is regarded as vital in occupational therapy students' professional development. The nature of supervisors' feedback however, could be confirmative and/or corrective and corrective feedback could be with or without suggestions on how to improve. The aim of the study was to evaluate the impact of supervisors' feedback on final-year occupational therapy students' clinical reasoning skills through comparing the natur...

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

    OpenAIRE

    Shirwaikar A

    2015-01-01

    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 edu...

  2. Haemophilia in a real-world setting: the value of clinical experience in data collection.

    Science.gov (United States)

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

    2016-02-01

    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.

  3. Haemophilia in a real-world setting: the value of clinical experience in data collection.

    Science.gov (United States)

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

    2016-02-01

    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. PMID:26809546

  4. Singapore Meeting of Education Research Associations Sets the Stage for Establishing a World Education Research Association

    Science.gov (United States)

    Educational Researcher, 2009

    2009-01-01

    This article discusses a meeting of education research associations from around the world which achieved a major goal toward establishing a World Education Research Association (WERA) in Singapore on November 24-25, 2008. At the meeting, representatives reaffirmed a commitment to establish WERA and finalized several key documents for its…

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

    OpenAIRE

    Friddah R. Mathevula; Lunic B. Khoza

    2013-01-01

    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 ans...

  6. [Clinical pharmacy practice education in master's course of Meijo University in affiliation with medical school].

    Science.gov (United States)

    Matsuba, Kazuhisa

    2009-08-01

    In 2003, Meijo University has developed a new program to train students in master's degree in the field of clinical practice. This new curriculum has three big pillars of educational goal: Problem-Based Learning (PBL), communication skill and clinical pharmacy practice training. Before exposing students to clinical training, they must learn first how to solve various patients' problems through PBL and enhance their communication skill. To provide a clinical environment, education and training, the Faculty of Pharmacy cooperated with the School of Medicine of Fujita Health University. Master's students together with other members of the healthcare team observe patient's disease state and most especially monitor pharmacotherapy. At first, students will be trained for a month at the pharmacy division and experience one week-nursing job. Next, they will be trained at the clinical divisions such as General Internal Medicine, Cardiology, Endocrinology, Gastroenterology, Respiratory Medicine, Hematology, Chemotherapy, Gastroenterological Surgery, Psychiatry, and Emergency Unit. Students rotate three-month training on four clinical divisions during one year. The head physicians of the medical department hold concurrent post as professors and share responsibility with the pharmacy faculty in training the students. To have its venue where students, faculty and physicians conduct their discussion on clinical cases, a pharmacy satellite seminar class room was set up at Fujita Health University hospital. Through this, pharmacy students and faculty had more opportunities to exchange knowledge on medicine and pharmacy. Master's students are expected to acquire professionalism, ethical knowledge and pharmaceutical care skills through the clinical pharmacy practice program. PMID:19652496

  7. Educating Educators: Perceptions of Preceptors and Clinical Education Coordinators Regarding Training at a Division II Athletic Training Program

    Science.gov (United States)

    Bomar, Renae Ellen; Mulvihill, Thalia

    2016-01-01

    Context: Clinical experiences give the student athletic trainer the opportunity to relate and apply didactic information to a real-world setting. During these experiences student athletic trainers are supervised by certified, licensed health care providers working in a variety of settings (e.g., hospital, physical therapy clinic, doctor's office).…

  8. Balancing patient care and student education: learning to deliver bad news in an optometry teaching clinic.

    Science.gov (United States)

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

    2009-05-01

    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.

  9. Nursing Challenges in Motivating Nursing Students through Clinical Education: A Grounded Theory Study

    Directory of Open Access Journals (Sweden)

    Hanifi Nasrin

    2012-01-01

    Full Text Available Nurses are the first role models for students in clinical settings. They can have a significant role on students’ motivation. The purpose of this study was to explore the understanding of nursing students and instructors concerning the role of nurses in motivating nursing students through clinical education. The sampling was first started purposefully and continued with theoretical sampling. The study collected qualitative data through semistructured and interactive interviews with 16 nursing students and 4 nursing instructors. All interviews were recorded, transcribed, and analyzed using grounded theory approach. One important pattern emerged in this study was the “concerns of becoming a nurse,” which itself consisted of three categories: “nurses clinical competency,” “nurses as full-scale mirror of the future,” and “Monitoring and modeling through clinical education” (as the core variable. The findings showed that the nurses’ manners of performance as well as the profession’s prospect have a fundamental role in the process of formation of motivation through clinical education. Students find an insight into the nursing profession by substituting themselves in the place of a nurse, and as result, are or are not motivated towards the clinical education.

  10. The effect of nursing staff on student learning in the clinical setting.

    Science.gov (United States)

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

    2016-06-01

    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. PMID:27275914

  11. The effect of nursing staff on student learning in the clinical setting.

    Science.gov (United States)

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

    2016-06-01

    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.

  12. Clinical Studies in the Second Line Setting of Advanced Pancreatic Cancer: Are We Making Any Progress?

    Directory of Open Access Journals (Sweden)

    Vassilios S Ramfidis

    2012-07-01

    Full Text Available Despite the enormous advances in clinical research in oncology, the prognosis of pancreatic carcinoma remains poor. Thetherapeutic options in this type of cancer are very limited, with modest results at present. In the 2012 American Society of Clinical Oncology (ASCO Annual Meeting, four interesting trials on the second line treatment of pancreatic cancer were presented. The first study (Abstract #4017 with a phase II design suggested that maintenance therapy with sunitinib, after a complete course of standard first line treatment, was feasible and effective while the second phase I/II study (Abstract #4034 evaluated the role of trabedersen, an agent that inhibits TGF-β2 expression. Finally, the efficacy and toxicity of lapatinib combined with either FOLFOX (Abstract #e14533 or capecitabine (Abstract #e14569 were examined in the second line setting of pancreatic cancer.

  13. The attributes of an effective teacher differ between the classroom and the clinical setting.

    Science.gov (United States)

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

    2016-10-01

    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 stereotype data. Alternatively, since subjective ratings of teaching effectiveness inevitably incorporate learners' context-specific needs, the attributes that make a teacher effective in one context may not meet the needs of learners in a different context.

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

    Directory of Open Access Journals (Sweden)

    Friddah R. Mathevula

    2013-06-01

    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

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

    Directory of Open Access Journals (Sweden)

    Rasova K

    2012-10-01

    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

  16. Professional competencies in health sciences education: from multiple intelligences to the clinic floor.

    Science.gov (United States)

    Lane, India F

    2010-03-01

    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.

  17. Professional competencies in health sciences education: from multiple intelligences to the clinic floor.

    Science.gov (United States)

    Lane, India F

    2010-03-01

    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. PMID:19585247

  18. Clinical and Applied Experience in Rehabilitation Counselor Education

    Science.gov (United States)

    Tschopp, Molly K.; Chronister, Julie A.

    2008-01-01

    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…

  19. Computer-Assisted Law Instruction: Clinical Education's Bionic Sibling

    Science.gov (United States)

    Henn, Harry G.; Platt, Robert C.

    1977-01-01

    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.…

  20. Functional Standards for Didactic and Clinical Optometric Education.

    Science.gov (United States)

    Optometric Education, 1998

    1998-01-01

    Outlines the functional standards for didactic and clinical optometric education adopted by the Association of Schools and Colleges of Optometry, including specific abilities in the areas of: observation; communication; sensory and motor coordination; intellectual-conceptual, integrative, and quantitative skills; and behavioral and social…

  1. Salmonella prevalence among reptiles in a Zoo education setting

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...

  2. STUDENTS' SELF-ASSESSMENT IN PRE-CLINICAL AND CLINICAL EDUCATION OF PROSTHETIC DENTISTRY

    Directory of Open Access Journals (Sweden)

    Dimiter Kirov

    2014-09-01

    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.

  3. The use of blogging in tertiary healthcare educational settings to enhance reflective learning in nursing leadership.

    Science.gov (United States)

    Levine, Theodora C

    2014-01-01

    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.

  4. The use of blogging in tertiary healthcare educational settings to enhance reflective learning in nursing leadership.

    Science.gov (United States)

    Levine, Theodora C

    2014-01-01

    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. PMID:25407971

  5. 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)

    杨伟吉

    2014-01-01

    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 .

  6. Objective Structured Clinical Examinations Provide Valid Clinical Skills Assessment in Emergency Medicine Education

    OpenAIRE

    Wallenstein, Joshua; Ander, Douglas

    2015-01-01

    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 ev...

  7. Opportunities to Participate and Teacher Interactions in Coed versus Single-Gender Physical Education Settings

    Science.gov (United States)

    Hannon, James C.; Ratliffe, Thomas

    2007-01-01

    The idea that single-gender physical education settings may result in a higher number of interactions with teachers and participation opportunities for female students has gained a considerable amount of attention in recent years. The purpose of this study was to compare high school aged females and males opportunities to participate and interact…

  8. Chlamydia screening strategies and outcomes in educational settings: a systematic review.

    Science.gov (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

    2014-03-01

    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. PMID:24521724

  9. Re-Setting the Concentration Levels of Students in Higher Education: An Exploratory Study

    Science.gov (United States)

    Burke, Lisa A.; Ray, Ruth

    2008-01-01

    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…

  10. Outcomes of a Behavioral Education Model for Children with Autism in a Mainstream School Setting

    Science.gov (United States)

    Grindle, Corinna F.; Hastings, Richard P.; Saville, Maria; Hughes, J. Carl; Huxley, Kathleen; Kovshoff, Hanna; Griffith, Gemma M.; Walker-Jones, Elin; Devonshire, Katherine; Remington, Bob

    2012-01-01

    The authors report 1-year outcomes for 11 children (3-7 years) with autism who attended an "Applied Behavior Analysis (ABA) classroom" educational intervention in a mainstream school setting. The children learned new skills by the end of 1 year and learned additional skills during a 2nd year. Group analysis of standardized test outcomes (IQ and…

  11. Integrated Educational and Mental Health Services within a Day Treatment Setting.

    Science.gov (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…

  12. 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.

    2009-01-01

    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

  13. 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.

    2009-01-01

    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

  14. A Critical Appraisal of Four Approaches Which Support Teachers' Problem-Solving within Educational Settings

    Science.gov (United States)

    Bennett, Sue; Monsen, Jeremy J.

    2011-01-01

    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…

  15. The Evidence for Student-Focused Motivational Interviewing in Educational Settings: A Review of the Literature

    Science.gov (United States)

    Snape, Laura; Atkinson, Cathy

    2016-01-01

    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,…

  16. Expectations, Realizations, and Approval of Tablet Computers in an Educational Setting

    Science.gov (United States)

    Hassan, Mamdouh; Geys, Benny

    2016-01-01

    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…

  17. Physical Activity Levels in Coeducational and Single-Gender High School Physical Education Settings

    Science.gov (United States)

    Hannon, James; Ratliffe, Thomas

    2005-01-01

    The purpose of this study was to investigate the effects of coeducational (coed) and single-gender game-play settings on the activity levels of Caucasian and African American high school physical education students. Students participated in flag football, ultimate Frisbee, and soccer units. Classes were as follows: there were two coed classes, two…

  18. Guatemala Project: The Traditional Laundering Place as a Non-Formal Health Education Setting

    Science.gov (United States)

    Colle, Royal D.

    1977-01-01

    Describes a nonformal adult education project designed to improve the health and nutrition of rural Guatemalan residents through the use of a traditional setting--the pila (an outdoor laundering place found throughout Guatemala), a modern medium (audio cassette and cassette player), and content which was a combination of modern and indigenous. (SH)

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

    Science.gov (United States)

    PACER Center, 2005

    2005-01-01

    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.…

  20. Validation of Virtual Learning Team Competencies for Individual Students in a Distance Education Setting

    Science.gov (United States)

    Topchyan, Ruzanna; Zhang, Jie

    2014-01-01

    The purpose of this study was twofold. First, the study aimed to validate the scale of the Virtual Team Competency Inventory in distance education, which had initially been designed for a corporate setting. Second, the methodological advantages of Exploratory Structural Equation Modeling (ESEM) framework over Confirmatory Factor Analysis (CFA)…

  1. The Use of Weblogs in Higher Education Settings: A Review of Empirical Research

    Science.gov (United States)

    Sim, Jeffrey Wee Sing; Hew, Khe Foon

    2010-01-01

    "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…

  2. Education level inequalities and transportation injury mortality in the middle aged and elderly in European settings

    NARCIS (Netherlands)

    Borrell, C; Plasencia, A; Huisman, M; Costa, G; Kunst, A; Andersen, O; Bopp, M; Borgan, JK; Deboosere, P; Glickman, M; Gadeyne, S; Minder, C; Regidor, E; Spadea, T; Valkonen, T; Mackenbach, JP

    2005-01-01

    Objective: To study the differential distribution of transportation injury mortality by educational level in nine European settings, among people older than 30 years, during the 1990s. Methods: Deaths of men and women older than 30 years from transportation injuries were studied. Rate differences an

  3. Examining Practice for Educating Culturally and Linguistically Diverse Exceptional Populations in Middle School Inclusive Settings

    Science.gov (United States)

    O'Keeffe, Suzanne Becker

    2012-01-01

    This dissertation examined the relationship between instructional practice in the classroom and current theory when educating culturally and linguistically diverse exceptional (CLDE) middle school students in inclusive settings. Participants for this study were chosen using community nomination and data were collected using classroom observation.…

  4. Informal Music Education: The Nature of a Young Child's Engagement in an Individual Piano Lesson Setting

    Science.gov (United States)

    Kooistra, Lauren

    2016-01-01

    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;…

  5. 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.

    2009-01-01

    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

  6. Leading Teams of Higher Education Administrators: Integrating Goal Setting, Team Role, and Team Life Cycle Theories

    Science.gov (United States)

    Posthuma, Richard; Al-Riyami, Said

    2012-01-01

    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…

  7. A Multi-Educational Approach to Improving Teacher Skills with Special Needs Preschoolers in Group Settings.

    Science.gov (United States)

    Ellis, Mickie

    The practicum developed and implemented an inservice teacher education program to improve services to exceptional children in group settings based on a newly developed resource manual, two workshop series, and observation/evaluation of teachers in their classes on a bimonthly basis over a period of 8 months. Eighty-nine preschool teachers…

  8. Development of EFL Writing over Three Years in Secondary Education: CLIL and Non-CLIL Settings

    Science.gov (United States)

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

    2015-01-01

    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…

  9. An Application of the Shewart Time Series Design in an Educational Setting.

    Science.gov (United States)

    1977

    A time series procedure, the Shewart Technique, was used in an educational setting with eight academically deficient students to increase the percent of assignments completed. Ss were given mediation training and behavior contracts. The Shewart Technique was found to be useful in providing a formative analysis for intervention. (Tables and graphs…

  10. 77 FR 41431 - Proposed Collection; Comment Request: Impact of Clinical Research Training and Medical Education...

    Science.gov (United States)

    2012-07-13

    ... 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...

  11. Education in Environmental Chemistry: Setting the Agenda and Recommending Action. A Workshop Report Summary

    Science.gov (United States)

    Zoller, Uri

    2005-08-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Kotecha A

    2015-10-01

    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

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

    Directory of Open Access Journals (Sweden)

    S-Farzad Mohammadi

    2013-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Court JH

    2015-04-01

    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

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

    Science.gov (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. Dressing-related trauma: clinical sequelae and resource utilization in a UK setting

    Directory of Open Access Journals (Sweden)

    Charlesworth B

    2014-04-01

    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

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

    Directory of Open Access Journals (Sweden)

    Santosh Ramdurg

    2013-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Julia L Finkelstein

    2015-01-01

    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

  19. Injection drug users' perspectives on placing HIV prevention and other clinical services in pharmacy settings.

    Science.gov (United States)

    Lutnick, Alexandra; Case, Patricia; Kral, Alex H

    2012-04-01

    In their role as a source of sterile syringes, pharmacies are ideally situated to provide additional services to injection drug users (IDUs). Expanding pharmacy services to IDUs may address the low utilization rates of healthcare services among this population. This qualitative study of active IDUs in San Francisco explored perspectives on proposed health services and interventions offered in pharmacy settings, as well as facilitators and barriers to service delivery. Eleven active IDUs participated in one-on-one semistructured interviews at a community field site and at a local syringe exchange site between February and May 2010. Results revealed that most had reservations about expanding services to pharmacy settings, with reasons ranging from concerns about anonymity to feeling that San Francisco already offers the proposed services in other venues. Of the proposed health services, this group of IDUs prioritized syringe access and disposal, clinical testing and vaccinations, and provision of methadone. Pharmacists' and pharmacy staff's attitudes were identified as a major barrier to IDUs' comfort with accessing services. The findings suggest that although IDUs would like to see some additional services offered within pharmacy settings, this is contingent upon pharmacists and their staff receiving professional development trainings that cultivate sensitivity towards the needs and experiences of IDUs. PMID:22231488

  20. Using SOLO to Evaluate an Educational Virtual Environment in a Technology Education Setting

    Science.gov (United States)

    Padiotis, Ioannis; Mikropoulos, Tassos A.

    2010-01-01

    The present research investigates the contribution of an interactive educational virtual environment on milk pasteurization to the learning outcomes of 40 students in a technical secondary school using SOLO taxonomy. After the interaction with the virtual environment the majority of the students moved to higher hierarchical levels of understanding…

  1. Key components of financial-analysis education for clinical nurses.

    Science.gov (United States)

    Lim, Ji Young; Noh, Wonjung

    2015-09-01

    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.

  2. Teaching during clinical practice: strategies and techniques used by preceptors in nursing education.

    Science.gov (United States)

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

    2009-07-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Pereira J.C.R.

    2004-01-01

    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.

  4. The Effectiveness of Peer Taught Group Sessions of Physiotherapy Students within the Clinical Setting: A Quasi-Experimental Study

    Science.gov (United States)

    Scott, Dee; Jelsma, Jennifer

    2014-01-01

    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…

  5. The Quality of Care Provided to Women with Urinary Incontinence in Two Clinical Settings

    Science.gov (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.

    2016-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Jean-Claude Mbanya

    2009-10-01

    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.

  7. A comparison of effectiveness of hepatitis B screening and linkage to care among foreign-born populations in clinical and nonclinical settings.

    Science.gov (United States)

    Chandrasekar, Edwin; Kaur, Ravneet; Song, Sharon; Kim, Karen E

    2015-01-01

    Hepatitis B (HBV) is an urgent, unmet public health issue that affects Asian Americans disproportionately. Of the estimated 1.2 million living with chronic hepatitis B in USA, more than 50% are of Asian ethnicity, despite the fact that Asian Americans constitute less than 6% of the total US population. The Centers for Disease Control and Prevention recommends HBV screening of persons who are at high risk for the disease. Yet, large numbers of Asian Americans have not been diagnosed or tested, in large part because of perceived cultural and linguistic barriers. Primary care physicians are at the front line of the US health care system, and are in a position to identify individuals and families at risk. Clinical settings integrated into Asian American communities, where physicians are on staff and wellness care is emphasized, can provide testing for HBV. In this study, the Asian Health Coalition and its community partners conducted HBV screenings and follow-up linkage to care in both clinical and nonclinical settings. The nonclinic settings included health fair events organized by churches and social services agencies, and were able to reach large numbers of individuals. Twice as many Asian Americans were screened in nonclinical settings than in health clinics. Chi-square and independent samples t-test showed that participants from the two settings did not differ in test positivity, sex, insurance status, years of residence in USA, or education. Additionally, the same proportion of individuals found to be infected in the two groups underwent successful linkage to care. Nonclinical settings were as effective as clinical settings in screening for HBV, as well as in making treatment options available to those who tested positive; demographic factors did not confound the similarities. Further research is needed to evaluate if linkage to care can be accomplished equally efficiently on a larger scale. PMID:25609976

  8. Human thermoregulation and measurement of body temperature in exercise and clinical settings.

    Science.gov (United States)

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

    2008-04-01

    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.

  9. Clinical and Educational Gaps in Diagnosis of Nail Disorders.

    Science.gov (United States)

    Hare, Anna Q; Rich, Phoebe

    2016-07-01

    Dermatologists care for skin, hair, and nails, yet many dermatologists find nail disorders challenging. Practice gaps in knowledge, skill, and attitude in clinical practice and resident education are sometimes impediments to timely medical and surgical diagnosis of nail disorders. Limited resident exposure to diagnosis and management of complicated nail disorders and lack of experience performing diagnostic and surgical procedures impairs progress toward surmounting these gaps. PMID:27363883

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

    Directory of Open Access Journals (Sweden)

    Matthew Trendowski

    2015-01-01

    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.

  11. 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

    2015-01-01

    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.

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

    LENUS (Irish Health Repository)

    O'Donnell, N

    2012-01-01

    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.

  13. [Reflections on the clinical reports «minimum data set»].

    Science.gov (United States)

    Prieto de Paula, J M; Franco Hidalgo, S

    2012-02-01

    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.

  14. Diagnostic tests for influenza and other respiratory viruses: determining performance specifications based on clinical setting.

    Science.gov (United States)

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

    2010-06-01

    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.

  15. National Priority Setting of Clinical Practice Guidelines Development for Chronic Disease Management.

    Science.gov (United States)

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

    2015-12-01

    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.

  16. Violence prevention in schools and other community settings: the pediatrician as initiator, educator, collaborator, and advocate.

    Science.gov (United States)

    Wilson-Brewer, R; Spivak, H

    1994-10-01

    Attention to the problem of youth violence has resulted in a proliferation of violence prevention and intervention strategies. Examined in this paper are those strategies that can be categorized as educational, environmental/technological, and recreational. In the educational category are conflict resolution and mediation, crime prevention and law-related education, handgun violence education, life skills training, self-esteem development, public education, and media education. The environmental/technological category covers a range of strategies: metal detectors, school police, concrete barriers, dress codes, and safe corridor programs, among others. The rather broad recreational category is based upon the importance of physical activity as an outlet for stress and anger and as a component of a multicomponent program. Multi-intervention programs are described as well as some of the major gaps in current violence prevention programming. The suggested role of the pediatrician in violence prevention efforts is described as both initiator and collaborator, as counselor, and as advocate. Because of their great credibility with respect to issues related to children and youth, pediatricians can influence not only parents in their contacts with them in the health care setting, but also school administrators and community leaders. Pediatricians have access to the media, and they can speak to the issue in public forums as well. Furthermore, pediatricians can join existing community efforts to determine ways in which violence prevention and intervention strategies can be incorporated into agency activities. PMID:7936888

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

    Directory of Open Access Journals (Sweden)

    Helen M. Seeley

    2010-06-01

    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.

  18. ART Adherence Measurement in Non-Clinical Settings in South India

    Science.gov (United States)

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

    2016-01-01

    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

  19. Expectations, Realizations, and Approval of Tablet Computers in an Educational Setting

    OpenAIRE

    Hassan, Mamdouh; Geys, Benny

    2016-01-01

    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 i) high expectations (ex ante) can undermine the approval ratings of new technologies (ex post); and ii) individuals’ post-implementation evaluations are more likely to ...

  20. USHER SYNDROME IN EDUCATIONAL SETTINGS: INDIGENOUS IDENTIFICATION STRATEGIES DEVELOPED IN INDIA

    OpenAIRE

    NAOMI Gnanathicam Victoria; HEMAMBIGAI Chandran

    2015-01-01

    Introduction:most teachers of hearing and visually impaired children in India have to learn more about the prevalence and characteristics of Usher Syndrome. Keeping in mind the need to address this neglected population, the present study was designed and executed in South India.Goals:the goals of the study were to identify students with Usher Syndrome in educational settings using indigenous techniques, and to develop and describe a protocol for identifying these students.Methodology:seven hu...

  1. Promoting Gender Equality in Educational Settings: The Role of Computer Supported Cooperative Learning

    OpenAIRE

    ZSIGMOND, Istvan

    2015-01-01

    New media makes possible new forms of collaboration and interaction in educational settings. Group-based instructional methods, as collaborative and cooperative learning can be mediated by specific computer-based applications and methods.In this article arguments are presented for differentiating collaborative and cooperative learning methods on offline and computer-mediated environments as well. In comparison to CSCL (Computer Supported Collaborative Learning), there is a well-established ne...

  2. Non-challenging education and teacher control as factors for marginalization of students in diverse settings

    OpenAIRE

    Wedin, Åsa

    2015-01-01

    This article discusses teachers’ attitudes towards immigrant students in poor settings and the effect these attitudes have on organization of education on classroom level. It draws on results from two ethnographic studies where some primary school classes in Sweden were followed with participant observation and interviews as main research methods. The article focuses on classroom activities and teachers’ attitudes towards immigrant students and students with low socio-economic status. In the ...

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

    Directory of Open Access Journals (Sweden)

    Andrew Fitzgerald

    2016-06-01

    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.

  4. The relationship between cultural competence education and increasing diversity in nursing schools and practice settings.

    Science.gov (United States)

    Pacquiao, Dula

    2007-01-01

    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.

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

    DEFF Research Database (Denmark)

    Pontoppidan, Birgitte Schou

    2010-01-01

    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...... this approach, first year student teachers in a science & technology class developed teacher knowledge (as aspects of PCK). The study identifies an example using Co-Re and PaPeR as a Resource Folio to show where evidence of developing teacher knowledge is seen. This didactical approach turns the traditional...... 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...

  6. How different can you be and still survive? Homogeneity and difference in clinical nursing education.

    Science.gov (United States)

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

    2004-01-01

    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.

  7. Enacting a Vision for a Master's Entry Clinical Nurse Leader Program: Rethinking Nursing Education.

    Science.gov (United States)

    Hicks, Frank D; Rosenberg, Lisa

    2016-01-01

    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. PMID:26802590

  8. Enacting a Vision for a Master's Entry Clinical Nurse Leader Program: Rethinking Nursing Education.

    Science.gov (United States)

    Hicks, Frank D; Rosenberg, Lisa

    2016-01-01

    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.

  9. 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

    2016-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Marilyn Svejda

    2012-01-01

    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.

  11. 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

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

    Science.gov (United States)

    Montgomery, Madeline C.; Oldenburg, Catherine E.; Nunn, Amy S.; Mena, Leandro; Anderson, Peter; Liegler, Teri; Mayer, Kenneth H.; Patel, Rupa; Almonte, Alexi; Chan, Philip A.

    2016-01-01

    Background 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. Methods 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. Results 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. Conclusion In this clinical PrEP program, adherence was high

  13. Human papillomavirus testing by self-sampling: assessment of accuracy in an unsupervised clinical setting

    Science.gov (United States)

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

    2007-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Giuseppe Carrus

    2012-01-01

    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

  15. Leadership Readiness for Flexibility and Mobility: The 4th Dimensions on Situational Leadership Styles in Educational Settings

    Science.gov (United States)

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

    2014-01-01

    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…

  16. Undergraduate dental education in New Zealand: 2007-2009 final-year student feedback on clinical learning environments.

    Science.gov (United States)

    Anderson, Vivienne R; Rich, Alison M; Seymour, Gregory J

    2011-09-01

    Dental education is a unique form of health professional education. This is because the clinical training component largely occurs within the dental school and involves students carrying out irreversible patient interventions early in their education. Perhaps not surprisingly, previous research indicates that dental education (and particularly the clinical component) is stressful for many students. In their responses to an annual clinical learning environment survey, final-year Bachelor of Dental Surgery (BDS) students at the University of Otago have suggested that teaching staff play a key role in mitigating or compounding stressors associated with students' clinical work. In 2007-2009 questionnaire responses, students identified the kinds of staff feedback which they found constructive or unhelpful while working in patient clinic settings, described their responses to feedback received, and identified ways in which students' clinical learning experiences might be improved. This paper outlines 2007-2009 University of Otago Faculty of Dentistry clinical learning environment survey findings, and relates these to the literature on effective teaching and clinical teaching. It then describes programmatic changes and research initiatives developed in response to student feedback. PMID:21957835

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

    Directory of Open Access Journals (Sweden)

    Elvis Siprián Castro Alzate

    2016-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Theron AJ

    2013-11-01

    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

  19. Cultural brokerage: Creating linkages between voices of lifeworld and medicine in cross-cultural clinical settings.

    Science.gov (United States)

    Lo, Ming-Cheng Miriam

    2010-09-01

    Culturally competent healthcare has emerged as a policy solution to racial and ethnic health disparities in the United States. Current research indicates that patient-centered care is a central component of culturally competent healthcare, and a rich literature exists on how to elicit patients' lifeworld voices through open-ended questions, sensitive communication skills, and power-sharing interaction styles. But it remains largely unclear how doctors create linkages between cultures of medicine and lifeworld as two sets of incongruent meaning systems. Without such linkages, a doctor lacks the cultural tool to incorporate her patient's assumptions or frameworks into the voice of medicine, rendering it difficult to (at least partially) expand and transform the latter from within. This study explores how doctors perform this bridging work, conceptualized as cultural brokerage, on the job. Cultural brokerage entails mutual inclusion of different sets of schemas or frameworks with which people organize their meanings and information. Based on 24 in-depth interviews with primary care physicians in Northern California, this study inductively documents four empirical mechanisms of cultural brokerage: 'translating between health systems', 'bridging divergent images of medicine', 'establishing long-term relationships', and 'working with patients' relational networks'. Furthermore, the study argues that cultural brokerage must be understood as concrete 'cultural labor', which involves specific tasks and requires time and resources. I argue that the performance of cultural brokerage work is embedded in the institutional contexts of the clinic and therefore faces two macro-level constraints: the cultural ideology and the political economy of the American healthcare system. PMID:20801996

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

    Directory of Open Access Journals (Sweden)

    Alban Koci

    2015-01-01

    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.

  1. Educating residents in behavioral health care and collaboration: integrated clinical training of pediatric residents and psychology fellows.

    Science.gov (United States)

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

    2011-02-01

    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.

  2. Incorporating Experiential Learning Techniques to Improve Self-Efficacy in Clinical Special Care Dentistry Education.

    Science.gov (United States)

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

    2015-09-01

    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

  3. Incorporating Experiential Learning Techniques to Improve Self-Efficacy in Clinical Special Care Dentistry Education.

    Science.gov (United States)

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

    2015-09-01

    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

  4. Simulation-based education for building clinical teams

    Directory of Open Access Journals (Sweden)

    Marshall Stuart

    2010-01-01

    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.

  5. Blood transcriptomic markers for major depression: from animal models to clinical settings.

    Science.gov (United States)

    Redei, Eva E; Mehta, Neha S

    2015-05-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2014-02-15

    ''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.)

  7. How to protect incompetent clinical research subjects involved in critical care or emergency settings.

    Science.gov (United States)

    Zamperetti, Nereo; Piccinni, Mariassunta; Bellomo, Rinaldo; Citerio, Giuseppe; Mistraletti, Giovanni; Gristina, Giuseppe; Giannini, Alberto

    2016-04-01

    Clinical research is an essential component of medical activity, and this is also true in intensive care. Adequate information and consent are universally considered necessary for the protection of research subjects. However, in emergency situations, the majority of critical patients are unable to consent and a valid legal representative is often unavailable. The situation is even more complex in Italy, where the relevant legislation fails to specify how investigators should manage research in emergency or critical care setting when it involves incompetent patients who do not have an appointed legal representative. While special measures for the protection of incompetent subjects during emergency research are necessary, not allowing such research at all dooms critically ill patients to receive non-evidence-based treatments without the prospect of improvement. The recently-issued EU Regulation n. 536/2014 will probably help shed light on this situation. Indeed, it specifically addresses the issue of "research in emergency situations" and introduces detailed rules aimed at protecting patients while allowing research. In this article, we argue that obtaining informed consent during emergency research on incompetent subjects in unrealistic, and that in most cases substituted judgment on the part of a proxy carries major flaws. Strict criteria in evaluating the risk-benefit ratio of proposed intervention and a careful evaluation of the trial by a local or national Research Ethics Committee are perhaps the most practicable solution. PMID:26154445

  8. Know how to teach me: Setting up an inclusive classroom: A study on preparing teachers for inclusive education in India

    OpenAIRE

    Srivastava, Meenakshi

    2016-01-01

    Education For All has been an important objective in the Millennium development goals which were set internationally. The goals aim at making all children attending school irrespective of gender, ethnicity, socioeconomic status or special educational needs (SEN). In developing countries providing education to all children is a big challenge because many children are not attending school. This especially counts for children with special educational needs. The general aim of the current study w...

  9. LITERARY CLINIC: GLOBAL LITERATURES AND ENGLISH TEACHER EDUCATION IN BRAZIL

    Directory of Open Access Journals (Sweden)

    Malia Spofford XAVIER

    2014-06-01

    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.

  10. Science Education in the Early Childhood & Special Education Setting: An Analysis of Science Education Across Lake Washington, Bellevue & Seattle School Districts

    Science.gov (United States)

    Coffin, Tara B.

    This survey based research illustrates science education in the early childhood setting, specifically across Lake Washington, Seattle and Bellevue Public School Districts, with a lens on programs serving children with special needs. Taking current best practice into consideration, this research compares the amount of time that teachers currently spend teaching their students science across these settings, with recommendations urging educators to expose their students to the scientific inquiry process early and often. Additionally, the results of this survey align with findings regarding teacher self-efficacy in the area of science, demonstrating that educators who have a science background and/or have received professional development opportunities in the area of science, are likely to teach science more often and lead higher quality lessons. The survey results also demonstrate that the provision of curriculum and training opportunities are indicative of a community that supports science education, and therefore predictive of the amount and quality of science education that students in an early childhood setting receive.

  11. Classroom to clinic: incorporating adolescent spiritual/faith assessment into nurse practitioner education & practice.

    Science.gov (United States)

    Haley, Janice M

    2014-01-01

    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.

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

    OpenAIRE

    Sarah M. Westberg, Pharm.D.; Kathrine Beeksma, R.N.

    2010-01-01

    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, includ...

  13. [Planning nursing teaching: educational purposes and clinical competence].

    Science.gov (United States)

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

    2009-06-01

    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. PMID:19655664

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

    Directory of Open Access Journals (Sweden)

    Carolina FERNÁNDEZ-SALINERO MIGUEL

    2014-07-01

    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.

  15. 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

    Directory of Open Access Journals (Sweden)

    Maria Luiza Segatto

    2011-09-01

    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

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

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    Kikuchi Toshiaki

    2010-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Effects of ostracism and sex on alcohol consumption in a clinical laboratory setting.

    Science.gov (United States)

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

    2015-09-01

    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.

  19. Preliminary Validation of Angle-Independent Myocardial Elastography Using MR Tagging in a Clinical Setting

    Science.gov (United States)

    Lee, Wei-Ning; Qian, Zhen; Tosti, Christina L.; Brown, Truman R.; Metaxas, Dimitris N.; Konofagou, Elisa E.

    2014-01-01

    Myocardial Elastography (ME), a radio-frequency (RF) based speckle tracking technique, was employed in order to image the entire two-dimensional (2D) transmural deformation field in full view, and validated against tagged Magnetic Resonance Imaging (tMRI) in normal as well as reperfused (i.e., treated myocardial infarction (MI)) human left ventricles. RF ultrasound and tMRI frames were acquired at the papillary muscle level in 2D short-axis (SA) views at nominal frame rates of 136 (fps; real time) and 33 fps (electrocardiogram (ECG)-gated), respectively. In ultrasound, in-plane, 2D (lateral and axial) incremental displacements were iteratively estimated using one-dimensional (1D) cross-correlation and recorrelation techniques in a 2D search with a 1D matching kernel. In tMRI, cardiac motion was estimated by a template-matching algorithm on a 2D grid-shaped mesh. In both ME and tMRI, cumulative 2D displacements were estimated and then used to estimate 2D Lagrangian finite systolic strains, from which polar (i.e., radial and circumferential) strains, namely angle-independent measures, were further obtained through coordinate transformation. Principal strains, which are angle-independent and less centroid-dependent than polar strains, were also computed and imaged based on the 2D finite strains with a previously established strategy. Both qualitatively and quantitatively, angle-independent ME is shown to be capable of 1) estimating myocardial deformation in good agreement with tMRI estimates in a clinical setting and of 2) differentiating abnormal from normal myocardium in a full left-ventricular view. Finally, the principal strains are suggested to be an alternative diagnostic tool of detecting cardiac disease with the characteristics of their reduced centroid dependence. PMID:18952364

  20. Effects of ostracism and sex on alcohol consumption in a clinical laboratory setting.

    Science.gov (United States)

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

    2015-09-01

    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. PMID:25642585

  1. An Evaluation on Medical Students' Satisfaction with Clinical Education and its Effective Factors

    Directory of Open Access Journals (Sweden)

    Vahid Ziaee

    2004-05-01

    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.

  2. LGBTQ Inclusion in Educator Preparation: Getting Ready for Gender and Sexual Diversity in Secondary School Settings

    Science.gov (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.

  3. Service user involvement in pre-registration mental health nurse education classroom settings: a review of the literature.

    Science.gov (United States)

    Terry, J

    2012-11-01

    Service user involvement in pre-registration nurse education is now a requirement, yet little is known about how students engage with users in the classroom, how such initiatives are being evaluated, how service users are prepared themselves to teach students, or the potential influence on clinical practice. The aim of this literature review was to bring together published articles on service user involvement in classroom settings in pre-registration mental health nurse education programmes, including their evaluations. A comprehensive review of the literature was carried out via computer search engines and the Internet, as well as a hand search of pertinent journals and references. This produced eight papers that fitted the inclusion criteria, comprising four empirical studies and four review articles, which were then reviewed using a seven-item checklist. The articles revealed a range of teaching and learning strategies had been employed, ranging from exposure to users' personal stories, to students being required to demonstrate awareness of user perspectives in case study presentations, with others involving eLearning and assessment skills initiatives. This review concludes that further longitudinal research is needed to establish the influence of user involvement in the classroom over time. PMID:22296494

  4. Ideological and political education for clinical graduates on the basis of medical characteristics

    Directory of Open Access Journals (Sweden)

    Yun-chuan JING

    2014-09-01

    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.

  5. Techniques for identifying the applicability of new information management technologies in the clinical setting: an example focusing on handheld computers.

    OpenAIRE

    Sittig, D. F.; Jimison, H. B.; Hazlehurst, B. L.; Churchill, B. E.; Lyman, J. A.; Mailhot, M. F.; Quick, E. A.; Simpson, D A

    2000-01-01

    This article describes techniques and strategies used to judge the potential applicability of new information management technologies in the clinical setting and to develop specific design recommendations for new features and services. We focus on a project carried out to identify the potential uses of handheld computers (i.e., the Palm Pilot or a small WinCE-based device) in the ambulatory practice setting. We found that the potential for a robust handheld computing device to positively affe...

  6. The two-component model of memory development, and its potential implications for educational settings.

    Science.gov (United States)

    Sander, Myriam C; Werkle-Bergner, Markus; Gerjets, Peter; Shing, Yee Lee; Lindenberger, Ulman

    2012-02-15

    We recently introduced a two-component model of the mechanisms underlying age differences in memory functioning across the lifespan. According to this model, memory performance is based on associative and strategic components. The associative component is relatively mature by middle childhood, whereas the strategic component shows a maturational lag and continues to develop until young adulthood. Focusing on work from our own lab, we review studies from the domains of episodic and working memory informed by this model, and discuss their potential implications for educational settings. The episodic memory studies uncover the latent potential of the associative component in childhood by documenting children's ability to greatly improve their memory performance following mnemonic instruction and training. The studies on working memory also point to an immature strategic component in children whose operation is enhanced under supportive conditions. Educational settings may aim at fostering the interplay between associative and strategic components. We explore possible routes towards this goal by linking our findings to recent trends in research on instructional design. PMID:22682913

  7. Nursing Students' Opinion on the Use of Smartphone Applications (Apps) in Clinical Education and Training: A Study Protocol.

    Science.gov (United States)

    O'Connor, Siobhan; Andrews, Tom

    2016-01-01

    Nurse educators are exploring different mobile technologies to provide additional support to nursing students in clinical practice. However, the view of nursing students on the use of smartphone applications (apps) to enhance clinical education has not been explored. This proposed study will use a self-reported questionnaire to examine the opinions of nursing students on the current and potential use of smartphone apps when training in clinical settings. Descriptive and inferential statistics will be performed on the quantitative data. Qualitative data from open ended questions will be thematically analysed using the framework approach. This will be the first study to examine the use of smartphone apps as a support in clinical teaching from a students' perspective. Their opinion is vital if the right mobile technology is to be designed and implemented. PMID:27332464

  8. Psychometric properties of the Postgraduate Hospital Educational Environment Measure in an Iranian hospital setting

    Directory of Open Access Journals (Sweden)

    Shahrzad Shokoohi

    2014-08-01

    Full Text Available Background: Students’ perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic – especially as instruments developed and tested in one culture are translated for use in another. Materials and method: This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results: Overall internal consistency of the translated measure was good (a=0.94. Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion: The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide.

  9. A comparison of effectiveness of hepatitis B screening and linkage to care among foreign-born populations in clinical and nonclinical settings

    Directory of Open Access Journals (Sweden)

    Chandrasekar E

    2015-01-01

    Full Text Available Edwin Chandrasekar,1 Ravneet Kaur,1 Sharon Song,1 Karen E Kim2 1Asian Health Coalition, Chicago, IL, USA; 2Division of the Biological Sciences and Office of Community Engagement and Cancer Disparities, University of Chicago, Chicago, IL, USA Abstract: Hepatitis B (HBV is an urgent, unmet public health issue that affects Asian Americans disproportionately. Of the estimated 1.2 million living with chronic hepatitis B in USA, more than 50% are of Asian ethnicity, despite the fact that Asian Americans constitute less than 6% of the total US population. The Centers for Disease Control and Prevention recommends HBV screening of persons who are at high risk for the disease. Yet, large numbers of Asian Americans have not been diagnosed or tested, in large part because of perceived cultural and linguistic barriers. Primary care physicians are at the front line of the US health care system, and are in a position to identify individuals and families at risk. Clinical settings integrated into Asian American communities, where physicians are on staff and wellness care is emphasized, can provide testing for HBV. In this study, the Asian Health Coalition and its community partners conducted HBV screenings and follow-up linkage to care in both clinical and nonclinical settings. The nonclinic settings included health fair events organized by churches and social services agencies, and were able to reach large numbers of individuals. Twice as many Asian Americans were screened in nonclinical settings than in health clinics. Chi-square and independent samples t-test showed that participants from the two settings did not differ in test positivity, sex, insurance status, years of residence in USA, or education. Additionally, the same proportion of individuals found to be infected in the two groups underwent successful linkage to care. Nonclinical settings were as effective as clinical settings in screening for HBV, as well as in making treatment options available to

  10. The role of ultrasound simulators in education: an investigation into sonography student experiences and clinical mentor perceptions.

    Science.gov (United States)

    Gibbs, Vivien

    2015-11-01

    Simulation as an effective pedagogy is gaining momentum at all levels of health care education. Limited research has been undertaken on the role of simulated learning in health care and further evaluation is needed to explore the quality of learning opportunities offered, and their effectiveness in the preparation of students for clinical practice. This study was undertaken to explore ways of integrating simulation-based learning into sonography training to enhance clinical preparation. A qualitative study was undertaken, using interviews to investigate the experiences of a group of sonography students after interacting with an ultrasound simulator. The perceptions of their clinical mentors on the effectiveness of this equipment to support the education and development of sonographers were also explored. The findings confirm that ultrasound simulators provide learning opportunities in an unpressurised environment, which reduces stress for the student and potential harm to patients. Busy clinical departments acknowledge the advantages of opportunities for students to acquire basic psychomotor skills in a classroom setting, thereby avoiding the inevitable reduction in patient throughput which results from clinical training. The limitations of simulation equipment to support the development of the full range of clinical skills required by sonographers were highlighted and suggestions made for more effective integration of simulation into the teaching and learning process. Ultrasound simulators have a role in sonography education, but continued research needs to be undertaken in order to develop appropriate strategies to support students, educators and mentors to effectively integrate this methodology. PMID:27433260

  11. Food Safety Education Using an Interactive Multimedia Kiosk in a WIC Setting: Correlates of Client Satisfaction and Practical Issues

    Science.gov (United States)

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

    2010-01-01

    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.…

  12. The usefulness of holotranscobalamin in predicting vitamin B12 status in different clinical settings.

    Science.gov (United States)

    Herrmann, Wolfgang; Obeid, Rima; Schorr, Heike; Geisel, Jürgen

    2005-02-01

    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.

  13. Skills, Positional Good or Social Closure? The Role of Education across Structural-Institutional Labour Market Settings

    Science.gov (United States)

    van de Werfhorst, Herman G.

    2011-01-01

    A theoretical approach is formulated that connects various theories of why education has an effect on labour market outcomes with institutional settings in which such theories provide the most likely mechanism. Three groups of mechanisms are distinguished: education as an indicator of productive skills, as a positional good and as a means for…

  14. Know how to teach me: Setting up an inclusive classroom : A study on preparing teachers for inclusive education in India

    NARCIS (Netherlands)

    Srivastava, Meenakshi

    2016-01-01

    Education For All has been an important objective in the Millennium development goals which were set internationally. The goals aim at making all children attending school irrespective of gender, ethnicity, socioeconomic status or special educational needs (SEN). In developing countries providing ed

  15. Missouri Educator Perceptions on the Use of Smartphones/Cell Phones in a Secondary School Setting: Their Relationship to Instruction

    Science.gov (United States)

    Birch, Christopher

    2012-01-01

    This mixed methods study evaluated the differences in the perceptions of educators in the state of Missouri on cell phone use in the classroom setting and its relationship to instruction. Specifically, this study analyzed the difference in perceptions and relationships that exist among educators (teachers and counselors) and administrators in…

  16. Predicting Acceptance and Popularity in Early Adolescence as a Function of Hearing Status, Gender, and Educational Setting

    Science.gov (United States)

    Wolters, Nina; Knoors, Harry E. T.; Cillessen, Antonius H. N.; Verhoeven, Ludo

    2011-01-01

    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 education. Acceptance varied as a function of…

  17. Diagnosing Borderline Personality Disorder: Examination of How Clinical Indicators Are Used by Professionals in the Health Setting

    Science.gov (United States)

    Treloar, Amanda Jane Commons; Lewis, Andrew J.

    2009-01-01

    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…

  18. 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

    2015-01-01

    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

  19. The role of the nurse research facilitator in building research capacity in the clinical setting.

    Science.gov (United States)

    Jamerson, Patricia A; Vermeersch, Patricia

    2012-01-01

    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.

  20. The Nonprofit Clinic at the University of Pittsburgh: Preparing Students for Transition to Professional Settings

    Science.gov (United States)

    Kearns, Kevin P.

    2014-01-01

    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.

  1. Factors that influence the clinical decision-making of rehabilitation professionals in long-term care settings.

    Science.gov (United States)

    Wainwright, Susan Flannery; McGinnis, Patricia Quinn

    2009-01-01

    The purpose of this qualitative research was to evaluate the reasoning of clinicians practicing in long-term care facilities and to explore factors influencing their professional development. Eighteen participants were recruited from eight clinical sites and included seven occupational therapists, eight physical therapists, and three speech therapists distributed across three groups relative to experience. Nonparticipant observation and videotape of therapist-patient interactions were used in semi-structured interviews with each participant. Qualitative data analysis software was used during a process of open and axial coding, followed by thematic analysis. The facilitory and inhibitory factors that affect clinical reasoning and professional development were identified. Rehabilitation professionals in long-term care demonstrated clinical reasoning within the context of patient-centered goals. Well-developed and explicit programs for mentorship, professional development, and continuing education fostered their clinical reasoning abilities. Participants perceived that these factors were vital to achieving optimal patient outcomes. PMID:19753425

  2. The impact of drug samples on clinical recommendations in dental education.

    Science.gov (United States)

    Hujoel, Philippe P; Gillette, Jane

    2011-10-01

    The distribution of branded drug samples in an educational setting may obscure the line between an evidence-based and a marketing-based education. The aim of this study was to evaluate the impact of branded drug samples on clinical recommendations in a dental education setting. Survey respondents exposed (n=95) and unexposed (n=80) to a specific branded drug sample program containing non-patented ingredients responded to a brief questionnare on recommendations for dentinal hypersensitivity. The results showed that an exposure to the branded drug sample was associated with twelve-fold increased odds for recommending the brand name (95 percent confidence interval [CI]: 5.8-24.5; precommending the therapeutic class to which the branded drug sample belonged (95 percent CI: 1.1-6.0; p=0.02); a 66 percent reduction in odds for considering other therapeutic classes (95 percent CI: 0.18-0.63; p=0.00015); and an 84 percent reduction in considering etiology (95 percent CI: 0.08-0.35; precommendation, narrowing therapeutic thinking, and decreased consideration for removing causes. PMID:22012775

  3. 'Out of the Whirlwind': Clinical Pastoral Education and Climate Change.

    Science.gov (United States)

    Calder, Andy S; Morgan, Jan E

    2016-03-01

    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.

  4. Preparing Dedicated Education Unit Staff Nurses for the Role of Clinical Teacher.

    Science.gov (United States)

    Seibert, Susan A; Bonham, Elizabeth

    2016-01-01

    Dedicated Education Units optimize the expertise of staff nurses to provide clinical instruction to nursing students, thereby creating a need to prepare staff nurses for the teaching role and educate them about clinical teaching strategies. A curriculum to educate Dedicated Education Unit staff nurses in the art of clinical instruction was created to fill this gap in staff development. This article describes the development of an innovative, interactive, evidence-based curriculum to prepare Dedication Education Unit staff nurses and strengthen an academic-practice partnership. PMID:27434320

  5. Laboratory approach for diagnosis of toluene-based inhalant abuse in a clinical setting

    Directory of Open Access Journals (Sweden)

    Raka Jain

    2016-01-01

    Full Text Available The steady increase of inhalant abuse is a great challenge for analytical toxicologists. This review describes an overview of inhalant abuse including the extent of the problem, types of products abused, modes of administration, pharmacology and effects of inhalants, the role of laboratory, interpretation of laboratory results and clinical considerations. Regular laboratory screening for inhalant abuse as well as other substance abuse and health risk behaviors must be a part of standard clinical care.

  6. Gaining entry-level clinical competence outside of the acute care setting.

    Science.gov (United States)

    Lordly, Daphne; Taper, Janette

    2008-01-01

    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. PMID:18334052

  7. Stereoscopy in Astronomical Visualizations to Support Learning at Informal Education Settings

    Science.gov (United States)

    Price, Aaron; Lee, Hee-Sun

    2015-08-01

    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.

  8. Residents as teachers: Near peer learning in clinical work settings: AMEE Guide No. 106.

    Science.gov (United States)

    Ramani, Subha; Mann, Karen; Taylor, David; Thampy, Harish

    2016-07-01

    This AMEE Guide provides a framework to guide medical educators engaged in the design and implementation of "Resident as Teacher" programs. The suggested approaches are based on established models of program development: the Program Logic model to guide program design, the Dundee three-circle model to inform a systematic approach to planning educational content and the Kirkpatrick pyramid, which forms the backbone of program evaluation. The Guide provides an overview of Resident as Teacher curricula, their benefits and impact, from existing literature supplemented by insights from the authors' own experiences, all of whom are engaged in teaching initiatives at their own institutions. A conceptual description of the Program Logic model is provided, a model that highlights an outcomes-based curricular design. Examples of activities under each step of this model are described, which would allow educational leaders to structure their own program based on the scope, context, institutional needs and resources available. Emphasis is placed on a modular curricular format to not only enhance the teaching skills of residents, but also enable development of future career educators, scholars and leaders. Application of the Dundee three-circle model is illustrated to allow for a flexible curricular design that can cater to varying levels of educational needs and interests. In addition, practical advice is provided on robust assessment of outcomes, both assessment of participants and program evaluation. Finally, the authors highlight the need for congruence between the formal and hidden curriculum through explicit recognition of the value of teaching by institutions, support for development of teaching programs, encouragement of evidence-based approach to education and rewards for all levels of teachers. PMID:27071739

  9. Arbor Clinical Nutrition Updates: evidence-based clinical nutrition education using the Internet.

    Science.gov (United States)

    Helman, A D

    2005-08-01

    The Arbor Clinical Nutrition Updates (ACNU) is a weekly electronic nutrition journal for health professionals. Each issue summarises several recent clinical research papers appearing in the general medical and nutrition literature and which deal with a common nutrition topic. A commentary is added on how this research fits in with previous work, and what it all means for the practising clinician. ACNU is the world's most widely read electronic nutrition publication, with over 100,000 largely health-professional readers in 186 countries. It is published in nine languages and distributed by email without charge in both plain text and Acrobat formats. ACNU utilises a number of the Internet's unique characteristics to facilitate broad reach, currency and active reader feedback. This, together with its brevity and summarising format, helps to maintain its relevance to the nutrition education needs of health professionals, particularly those in clinical practice, and to overcome the factors most commonly reported by health professionals as obstacles to their greater adoption of evidence-based medicine. ACNU is intended to be a collaboration with the primary research journals to extend the reach of new nutrition research findings to a wider community of researchers, academics and clinicians than each journal might otherwise reach individually. As such, ACNU utilises the Internet to promote the goals of open-access publishing and evidence-based medicine. PMID:16052179

  10. 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

    2014-11-01

    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

  11. Cybersecurity in the Clinical Setting: Nurses' Role in the Expanding "Internet of Things".

    Science.gov (United States)

    Billingsley, Luanne; McKee, Shawn A

    2016-08-01

    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.

  12. Sluggish Cognitive Tempo in a Child and Adolescent Clinical Outpatient Setting.

    Science.gov (United States)

    Camprodon-Rosanas, Ester; Batlle, Santiago; Estrada-Prat, Xavier; Aceña-Díaz, Marta; Petrizan-Aleman, Araitz; Pujals, Elena; Martin-López, Luis M; Pérez-Solá, Víctor; Ribas-Fitó, Núria

    2016-09-01

    Sluggish cognitive tempo (SCT) symptoms have largely emerged from investigations of attention-deficit/hyperactivity disorder (ADHD). Recent research has demonstrated the relevance of SCT symptoms in the field of clinical child and adolescent psychiatry. The goal of this research was to study the symptoms of SCT in a clinical child and adolescent sample and to define its features and comorbid conditions. We reviewed 834 clinical records of patients referred to Child and Adolescent Mental Health Services and examined SCT symptoms and their relation with sociodemographic data, clinical diagnosis, comorbid conditions, Child Behavior Checklist dimensions, and intelligence quotient. Of the 515 patients (age range, 4 to 17 y, 62.5% male) for whom a fully completed Child Behavior Checklist for Children and Adolescents was available, 20.8% showed high levels of SCT symptoms. SCT symptoms were strongly associated with age, internalizing symptoms, learning disabilities, and ADHD inattentive subtype (ADHD-I). No significant correlations with intelligence quotient were found. We concluded that SCT symptoms are highly prevalent in a clinical sample, and that these symptoms might be related to the difficulties that some individuals have in responding to demands in their environments, such as academic or social demands, as they increase over time. PMID:27648500

  13. Female genital mutilation management in the ambulatory clinic setting: a case study and review of the literature.

    Science.gov (United States)

    Craven, Spencer; Kavanagh, Alex; Khavari, Rose

    2016-01-01

    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.

  14. Female genital mutilation management in the ambulatory clinic setting: a case study and review of the literature.

    Science.gov (United States)

    Craven, Spencer; Kavanagh, Alex; Khavari, Rose

    2016-01-01

    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

  15. Developing an outpatient wound care clinic in an acute rehabilitation setting.

    Science.gov (United States)

    Sheehan, Diane Dudas; Zeigler, Mary H

    2010-01-01

    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.

  16. Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study

    Directory of Open Access Journals (Sweden)

    Findlay-Reece Barbara

    2010-01-01

    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

  17. Vaginal Birth After Caesarean Section in Low Resource Settings: The Clinical and Ethical Dilemma.

    Science.gov (United States)

    Wanyonyi, Sikolia; Muriithi, Francis G

    2015-10-01

    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.

  18. Intentions in critical clinical settings: a study of medical students' perceptions.

    Science.gov (United States)

    Juth, Niklas; Tillberg, Therése; Lynöe, Niels

    2011-08-01

    The aim of this pilot study was to develop a realistic clinical case for identifying Knobe's asymmetric effect, ie, the tendency to ascribe intentions to a larger extent when an act is considered wrong, as well as to compare medical students at the beginning and end of their curriculum. A vignette about a critically ill 72-year-old patient in need of an operation was used, with two different outcomes: the patient dies or the patient recovers. Approximately half of the students received the 'recovery case' and half the 'death case'. The questions asked were whether it was right to perform the risky operation and whether the head of the clinic brought about the patient's death/recovery intentionally. Among students in their first term an asymmetry in response pattern was identified. This asymmetry was not found among students in their final term. The difference between term 1 and term 11 students is believed to be due to the socialisation of medical students towards clinical reasoning regarding the moral role of intentions. Although no Knobe effect could be detected among term 11 students, a related adaptation effect was detected, indicating that students at the end of their medical school also tend to adapt their ascription of intentions to their moral evaluation of the act. By using clinically relevant cases a new effect has thus been identified that might be useful when investigating experienced clinicians and their views on intentions. The cases and effect merit further investigation.

  19. Automated objective routine examination of optical quality of rigid endoscopes in a clinical setting.

    Science.gov (United States)

    Wientjes, Rens; Noordmans, Herke J; van der Eijk, Jerine A J; van den Brink, Henk

    2013-01-01

    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. PMID:23555715

  20. Setting up the On-Site Marriage and Family Therapy Clinical Training Course

    Science.gov (United States)

    Ratanasiripong, Paul; Ghafoori, Bita

    2009-01-01

    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…

  1. Web-based lifestyle management for chronic kidney disease patients in a clinical setting

    NARCIS (Netherlands)

    Nauta, Jan M.; Boog, Paul J.M. van der; Slegten, Jacqueline T.; Janssen, Ruud; Hettinga, Marike

    2013-01-01

    Maintaining a proper lifestyle is important for chronic kidney disease patients. This study investigates whether an online lifestyle diary supplementary to the support received in the outpatient clinic can help patients to get to such a lifestyle. A total of 33 participants expressed their willingne

  2. Validity of the Research Diagnostic Criteria for Temporomandibular Disorders Axis I in clinical and research settings.

    NARCIS (Netherlands)

    Steenks, M.H.; Wijer, A. de

    2009-01-01

    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

  3. Extra-intestinal amebiasis: clinical presentation in a non-endemic setting

    DEFF Research Database (Denmark)

    Thorsen, S; Rønne-Rasmussen, J; Petersen, E;

    1993-01-01

    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...

  4. Achieving Educational Goals in Neurology Ward from the Viewpoint of Clinical Clerkship at Kermanshah University of Medical Sciences in 2012

    Directory of Open Access Journals (Sweden)

    Nazanin Razazian

    2012-11-01

    Full Text Available In medical education, setting goals for clinical clerkship is the responsibility of educational groups. Taking the students' opinions into account, it is possible to study the efficacy of education in terms of learning and achieving educational goals. (1In periodontics and restorative departments of Shahed and Tehran University of Medical Sciences, it is reported that, achieving educational goals is not poss-ible (2. Also, some studies have reported the inadequacy of educational objectives in anesthesia clerkship from the viewpoint of medical students (3. In this descriptive-analytic study, 166 medical students of neurology wards at Imam Reza Hospital in Kermanshah during 2011- 2012 were selected via a survey to study the achievement rate of educational goals. We used a questionnaire to collect data. Reliability of the questionnaire (including content and face validity was obtained via consulting with ten faculty members of Kermanshah University of Medical Sciences.The mean age of the participants was 21.34 (±1.43 years. 60.5% of them were females. 3.6% were freshmen and 49.9% were sophomores. 79.5% knew the goals before the start of clinical clerkship and 76.5% took part in the justification session in which their responsibility and method of evaluation were presented. 78.3% of them received the emergency protocol of Neurology. Overall, the participants ranked the goal achievement as high (41.6%, well (45.2% and medium (23.3%. There was no statistically significantly association between achieving educational goals and age and clinical clerkship period. However, there was a statis¬tically significantly association between the increase rate of achieving educational goals and introducing the objectives at the beginning of clinical clerkship period (p=0.011, justification session at the beginning of clinical clerkship (p=0.019 being familiar with emergency protocols of Neurology (p=0.04 and the season (winter in comparison with fall and spring in

  5. Cybersecurity in the Clinical Setting: Nurses' Role in the Expanding "Internet of Things".

    Science.gov (United States)

    Billingsley, Luanne; McKee, Shawn A

    2016-08-01

    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. PMID:27467307

  6. Epidemiological study of clinical characteristics of patients with PCOS attending infertility clinic and awareness of PCOS in a rural set up

    OpenAIRE

    Shubhada Jajoo; Riju Angik

    2013-01-01

    Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age group. It is a common diagnosis in women presenting with infertility. All the dimensions of PCOS have not been completely explored. In this study we studied the clinical features of PCOS and comparing with non-PCOS infertility patients and simultaneously studied the prevalence of PCOS in infertility patients and its awareness in a rural set up. Methods: It is a prospect...

  7. Needs and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa

    Directory of Open Access Journals (Sweden)

    Jane W. Muchiri

    2012-10-01

    Full Text Available Diabetes self-management education is crucial in diabetes care. Education that is tailored to the needs of the patient is considered the most effective in improving health outcomes. Diet, a critical element of diabetes treatment, is reported as the most difficult to adhere to by both patients and health professionals. Tailored nutrition education (NE could benefit diabetic individuals with low socio-economic status, who are amongst those noted to have poor health outcomes. This qualitative interpretive phenomenological study aimed to explore and describe the NE needs of adults with type 2 diabetes mellitus to guide development of a tailored NE programme for resource-poor settings. Participants were 31 non-insulin-dependent type 2 diabetic patients (convenience sample and 10 health professionals. Focus group discussions using semi-structured questions were held with the diabetics, and open-ended self-administered questionnaires were used with the health professionals. Data analysis was done using Krueger’s framework approach. Disease-related knowledge deficits and inappropriate self-reported dietary practices, including intake of unbalanced meals, problems with food portion control and unsatisfactory intake of fruits and vegetables, were observed. Recommendations for the NE programme included topics related to the disease and others related to diet. Group education at the clinic, a competent educator and comprehensive education were indicated by the patients. Participation of family and provision of pamphlets were aspects recommended by patients and health professionals. Barriers that could impact the NE included financial constraints, food insecurity, conflict in family meal arrangements and access to appropriate foods. Support from family and health professionals and empowerment through education were identified as facilitators to following dietary recommendations by both groups of participants. Knowledge deficits, inappropriate dietary

  8. Impact of Facilitated Asynchronous Distance Education on Clinical Skills Development of International Pharmacy Graduates

    Science.gov (United States)

    Austin, Zubin; Dean, Marie Rocchi

    2006-01-01

    The use of distance education for clinical skills development in the health professions has not been extensively described, due in part to the intensive nature of the relationship between the patient and practitioner. In the context of pharmacy practice, there are specific needs to develop new vehicles for clinical skills education due to growing…

  9. Transforming Teacher Education through Clinical Practice: A National Strategy to Prepare Effective Teachers

    Science.gov (United States)

    Education Digest: Essential Readings Condensed for Quick Review, 2011

    2011-01-01

    The education of teachers in the United States needs to be turned upside down. Teacher education must shift away from emphasizing academic preparation and course work loosely linked to school-based experiences to programs fully grounded in clinical practice and interwoven with academic content and professional courses. This clinically based…

  10. Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings

    OpenAIRE

    Douglas B. Cooper, PhD; Rodney D. Vanderploeg, PhD; Patrick Armistead-Jehle, PhD; Jeffrey D. Lewis, MD, PhD; Amy O. Bowles, MD

    2014-01-01

    Cognitive difficulties are frequently reported by Operation Iraqi Freedom/Operation Enduring Freedom military personnel who sustained mild traumatic brain injuries (TBIs). The current study examined several potential factors that may contribute to self-reported cognitive difficulties in postdeployment clinical settings. Eighty-four subjects who sustained a mild or moderate TBI and reported cognitive difficulties underwent neurocognitive testing. Multiple regression analyses were used to deter...

  11. Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial

    OpenAIRE

    Charles G. Burgar, MD; Peter S. Lum, PhD; A. M. Erika Scremin, MD; Susan L. Garber, MA, OTR; H. F. Machiel Van der Loos, PhD; Deborah Kenney, MS, OTR; Peggy Shor, OTR

    2011-01-01

    This randomized, controlled, multisite Departmentof Veterans Affairs clinical trial assessed robot-assisted (RA)upper-limb therapy with the Mirror Image Movement Enabler(MIME) in the acute stroke rehabilitation setting. Hemipareticsubjects (n = 54) received RA therapy using MIME for either upto 15 hours (low-dose) or 30 hours (high-dose) or received up to15 hours of additional conventional therapy in addition to usualcare (control). The primary outcome measure was the Fugl-Meyer Assessment (F...

  12. Systematic implementation of evidence-based practice in a clinical nursing setting: a participatory action research project

    OpenAIRE

    Friesen-Storms, Jolanda; Moser, Albine; Loo, Sandra,; Beurskens, Anna; Bours, Gerrie

    2015-01-01

    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 research. Method: The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases....

  13. Female genital mutilation management in the ambulatory clinic setting: a case study and review of the literature

    OpenAIRE

    Craven, Spencer; Kavanagh, Alex; Khavari, Rose

    2016-01-01

    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 pre...

  14. Theoretical Frameworks, Methods, and Procedures for Conducting Phenomenological Studies in Educational Settings

    Directory of Open Access Journals (Sweden)

    Pelin Yüksel

    2015-01-01

    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

  15. Preparing nursing students for the future: an innovative approach to clinical education.

    Science.gov (United States)

    Nielsen, Ann E; Noone, Joanne; Voss, Heather; Mathews, Launa Rae

    2013-07-01

    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.

  16. Sharing raw data from clinical trials: what progress since we first asked "Whose data set is it anyway?".

    Science.gov (United States)

    Vickers, Andrew J

    2016-01-01

    Ten years ago, one of the first papers published in Trials was a commentary entitled "Whose data set is it anyway?" The commentary pointed out that trialists routinely refused requests for data sharing and argued that this attitude was a community standard that had no rational basis. At the time, there had been few calls for clinical trial data sharing and certainly no institutional support. Today the situation could not be more different. Numerous organizations now recommend or require raw data to be made available, including the International Committee of Medical Journal Editors, which recently proposed that clinical trial data sharing be a "condition of … publication." Furthermore, the literature is replete with papers covering an enormously wide variety of topics on data sharing. But despite a tectonic shift in attitudes, we are yet to see clinical trial data sharing become an unquestioned norm, where a researcher can readily download a data set from a trial almost as easily as they can now download a copy of the published paper. The battle over the next few years is to go beyond changing minds to ensuring that real data sets are routinely made available. PMID:27142986

  17. Integrated monitoring: Setting new standards for the next decade of clinical trial practice

    Directory of Open Access Journals (Sweden)

    Kamala Rai

    2011-01-01

    Full Text Available The new age clinical research professional is now geared toward an "integrated monitoring" approach. A number of critical activities at the site level and at the sponsor′s organization need convergence to harness rich dividends in early study start and quick close of the study. The field monitor needs full integration to ensure standard of care, train the site in protocol, select the right site, ensure regulatory support, ensure excellent project management skills, coach, support the logistics team, manage the vendor, ensure good documentation practices, develop patient recruitment and retention, lean the applicable process, as well as ensure effective site management amongst the myriad activities assigned toward developing the drug in the clinic.

  18. Effect of clinical specialist physiotherapists in orthopaedic diagnostic setting - A systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Mikkelsen, Lone Ramer; Juhl, Carsten

    2016-01-01

    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...

  19. Atrial Arrhythmias in Obstructive Sleep Apnea: Underlying Mechanisms and Implications in the Clinical Setting

    Directory of Open Access Journals (Sweden)

    David Filgueiras-Rama

    2013-01-01

    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.

  20. Effect of clinical specialist physiotherapists in orthopaedic diagnostic setting - A systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Juhl, Carsten; Mikkelsen, Lone Ramer

    2016-01-01

    on diagnostic agreement, economic costs and patient satisfaction. Methods: A systematic review was performed searching MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, PEDro and reference lists of included studies as well as previously published systematic reviews. Inclusion...... quality compared to studies with high quality. Cost analysis (n=4) showed 27-49 % cost savings for assessments performed by CSP compared to OS (n=3), and that CSP-led clinics were more expensive but also more beneficial compared to OS-led clinics (n=1). Cost savings was found in studies of mixed...... percentage wasn’t mentioned instead it was reported that patients were generally satisfied (n=1) or that satisfaction was in favour of CSP assessment (n=2). Discussion and conclusion: CSP care may be as beneficial or even better than assessment performed by OS in terms of diagnostic accuracy, economic costs...

  1. Return of individual research results and incidental findings in the clinical trials cooperative group setting.

    Science.gov (United States)

    Ferriere, Michael; Van Ness, Brian

    2012-04-01

    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.

  2. Objective Structured Clinical Examinations Provide Valid Clinical Skills Assessment in Emergency Medicine Education

    Directory of Open Access Journals (Sweden)

    Wallenstein, Joshua

    2014-12-01

    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.

  3. THE CYBERSPACE IN THE CONTINUED CLINICAL BIOCHEMISTRY EDUCATION

    Directory of Open Access Journals (Sweden)

    J.M. Martins

    2008-05-01

    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 “bioq.educacao.biz/ULAB-HC-UFPE”. 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.

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

    OpenAIRE

    Matthew Trendowski

    2015-01-01

    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 so...

  5. Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study

    OpenAIRE

    Findlay-Reece Barbara; Kania Ania; Mulkins Andrea; Verhoef Marja J; Mior Silvano

    2010-01-01

    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...

  6. Laboratory approach for diagnosis of toluene-based inhalant abuse in a clinical setting

    OpenAIRE

    Raka Jain; Arpita Verma

    2016-01-01

    The steady increase of inhalant abuse is a great challenge for analytical toxicologists. This review describes an overview of inhalant abuse including the extent of the problem, types of products abused, modes of administration, pharmacology and effects of inhalants, the role of laboratory, interpretation of laboratory results and clinical considerations. Regular laboratory screening for inhalant abuse as well as other substance abuse and health risk behaviors must be a part of standard clini...

  7. Illness Perception and Depressive Symptoms among Persons with Type 2 Diabetes Mellitus: An Analytical Cross-Sectional Study in Clinical Settings in Nepal

    Directory of Open Access Journals (Sweden)

    Suira Joshi

    2015-01-01

    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.

  8. Using quality and safety education for nurses to guide clinical teaching on a new dedicated education unit.

    Science.gov (United States)

    McKown, Terri; McKeon, Leslie; McKown, Leslie; Webb, Sherry

    2011-12-01

    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.

  9. Injection Drug Users’ Perspectives on Placing HIV Prevention and Other Clinical Services in Pharmacy Settings

    OpenAIRE

    Lutnick, Alexandra; Case, Patricia; Kral, Alex H.

    2012-01-01

    In their role as a source of sterile syringes, pharmacies are ideally situated to provide additional services to injection drug users (IDUs). Expanding pharmacy services to IDUs may address the low utilization rates of healthcare services among this population. This qualitative study of active IDUs in San Francisco explored perspectives on proposed health services and interventions offered in pharmacy settings, as well as facilitators and barriers to service delivery. Eleven active IDUs parti...

  10. Integrating learning assessment and supervision in a competency framework for clinical workplace education.

    Science.gov (United States)

    Embo, M; Driessen, E; Valcke, M; van der Vleuten, C P M

    2015-02-01

    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.

  11. A Review on the Use and Perceived Effects of Mobile Blogs on Learning in Higher Educational Settings

    OpenAIRE

    Norman, Helmi; Din, Rosseni; Nordin, Norazah; Ryberg, Thomas

    2014-01-01

    Mobile technology is affecting the way we learn and teach in higher education. An interesting mobile tool for supporting learning and instruction is by using mobile blogs or “moblogs”. This review focuses on existing studies implementing moblogs for learning purposes in higher educational settings. A total of 16 studies were selected for the review. The constant-comparative method was used to analyze the studies. Results from the data analysis indicate that the findings fall into two overarch...

  12. Prognostic and Predictive Biomarkers in Colorectal Cancer. From the Preclinical Setting to Clinical Practice.

    Science.gov (United States)

    Maurel, Joan; Postigo, Antonio

    2015-01-01

    Colorectal cancer (CRC) is the second largest cause of cancer mortality in Western countries, mostly due to metastasis. Understanding the natural history and prognostic factors in patients with metastatic CRC (mCRC) is essential for the optimal design of clinical trials. The main prognostic factors currently used in clinical practice are related to tumor behavior (e.g., white blood counts, levels of lactate dehydrogenase, levels of alkaline phosphatase) disease extension (e.g., presence of extrahepatic spread, number of organs affected) and general functional status (e.g., performance status as defined by the Eastern Cooperative Oncology Group). However, these parameters are not always sufficient to establish appropriate therapeutic strategies. First-line therapy in mCRC combines conventional chemotherapy (CHT) (e.g., FOLFOX, FOLFIRI, CAPOX) with a number of agents targeted to specific signaling pathways (TA) (e.g., panitumumab and cetuximab for cases KRAS/NRAS WT, and bevacizumab). Although the response rate to this combination regime exceeds 50%, progression of the disease is almost universal and only less than 10% of patients are free of disease at 2 years. Current clinical trials with second and third line therapy include new TA, such as tyrosin-kinase receptors inhibitors (MET, HER2, IGF-1R), inhibitors of BRAF, MEK, PI3K, AKT, mTORC, NOTCH and JAK1/JAK2, immunotherapy modulators and check point inhibitors (anti-PD-L1 and anti- PD1). Despite the identification of multiple prognostic and predictive biomarkers and signatures, it is still unclear how expression of many of these biomarkers is modulated by CHT and/or TA, thus potentially affecting response to treatment. In this review we analyzed how certain biomarkers in tumor cells and microenvironment influence the response to new TA and immune-therapies strategies in mCRC pre-treated patients. PMID:26452385

  13. Prevalence of vitreomacular adhesion: an optical coherence tomography analysis in the retina clinic setting

    Directory of Open Access Journals (Sweden)

    Reichel E

    2016-04-01

    Full Text Available Elias Reichel,1 Glenn J Jaffe,2 Srinivas R Sadda,3 Stefanie Schuman,2 Amir H Hariri,3 Keegan Skidmore,1 Jake Duker1 1Department of Ophthalmology, New England Eye Center, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, 2Duke Eye Center, Duke Reading Center, Durham, NC, 3Department of Ophthalmology, Doheny Eye Centers, University of California, Los Angeles, CA, USA Purpose: The aims of this study were to determine the prevalence of vitreomacular adhesion (VMA in a random sample of clinical patients at three US retina clinics and to assess comorbid retinal conditions, ocular diseases, prior treatment history, and other medical histories. Patients and methods: This observational, retrospective cohort study was based on patients from the Doheny Eye Centers, Duke Eye Center, and Tufts Medical Center who received a bilateral spectral domain optical coherence tomography (SD-OCT scan (one scan/eye for clinical evaluation with available medical records. The study had three phases: 1 collection of retrospective patient data; 2 review of OCT scans at a reading center to assess VMA and associated conditions; and 3 analyses and reporting of data on the prevalence of VMA, patient demographics, and comorbid conditions. Data were obtained from electronic health records and OCT grading forms. Outcome measures from bilateral SD-OCT scans and medical records included OCT evaluation of VMA and retinal comorbid conditions. Results: In 719 patients with 1,483 reviewable OCT scans, the prevalence of VMA was estimated at 14.74% (90% CI, 12.58%–16.92%. The prevalence of unilateral VMA was estimated at 12.39%, while bilateral VMA was 2.36%. In patients with VMA, 34 out of 123 eyes with VMA (27.64% also had fovea deformed by vitreomacular traction. Macular hole (MH was significantly more prevalent in VMA-diagnosed eyes versus non-VMA-diagnosed eyes (6.5% versus 1.9%; P=0.02. There was a significantly higher incidence of full-thickness MH (P=0

  14. Advancing medicine one research note at a time: the educational value in clinical case reports

    OpenAIRE

    Cabán-Martinez Alberto J; Beltrán Wilfredo F

    2012-01-01

    Abstract A case report—a brief written note that describes unique aspects of a clinical case—provides a significant function in medicine given its rapid, succinct, and educational contributions to scientific literature and clinical practice. Despite the growth of, and emphasis on, randomized clinical trials and evidenced-based medicine, case reports continue to provide novel and exceptional knowledge in medical education. The journal BMC Research Notes introduces a new “case reports” section ...

  15. Stereoscopy in Static Scientific Imagery in an Informal Education Setting: Does It Matter?

    Science.gov (United States)

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

    2014-12-01

    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.

  16. Quality Teaching in a Managerial Setting: Higher Education Challenges in Australia

    Directory of Open Access Journals (Sweden)

    Therese Demediuk

    2011-02-01

    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.

  17. Dialogue Education in the Post-Secondary Classroom: Reflecting on Dialogue Processes from Two Higher Education Settings in North America

    Science.gov (United States)

    Gunnlaugson, Olen; Moore, Janet

    2009-01-01

    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…

  18. An in vivo transcriptome data set of natural antisense transcripts from Plasmodium falciparum clinical isolates

    Directory of Open Access Journals (Sweden)

    Amit Kumar Subudhi

    2014-12-01

    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.

  19. Self-Reported Low Self-Esteem. Intervention and Follow-Up in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    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.

  20. The reliability of lung crackle characteristics in cystic fibrosis and bronchiectasis patients in a clinical setting

    International Nuclear Information System (INIS)

    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

  1. Midwifery student exposure to workplace violence in clinical settings: An exploratory study.

    Science.gov (United States)

    McKenna, Lisa; Boyle, Malcolm

    2016-03-01

    Evidence indicates that nurses regularly experience bullying within the workplace which has the potential for health and social effects, as well as worker attrition. Literature suggests that nursing students are exposed to workplace violence during clinical placements including from health professionals and mentors, however little is known about midwifery students. This study sought to examine undergraduate midwifery students' experiences of workplace violence during clinical placements. A cross-sectional approach using a paper-based survey, the Paramedic Workplace Questionnaire, was used to solicit the information. Students were exposed to workplace violence with the main act being intimidation (30%), verbal abuse (17%), physical abuse (3%), and sexual harassment (3%). In more than three-quarters of the incidents the students had some level of apprehension or were frightened as a result of the violence. Students responded to the acts of violence with changes to emotions, self-confidence, and a desire to "give up". This paper demonstrates ways in which midwifery students are vulnerable to potential workplace violence from various sources. Support mechanisms need to be developed to ensure this can be minimised. PMID:26672901

  2. Preconception Counseling and Care in the Setting of HIV: Clinical Characteristics and Comorbidities

    Directory of Open Access Journals (Sweden)

    Rupsa C. Boelig

    2015-01-01

    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. Do organizational and clinical ethics in a hospital setting need different venues?

    Science.gov (United States)

    Førde, Reidun; Hansen, Thor Willy Ruud

    2014-06-01

    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.

  4. The cost utility of a multi-disciplinary foot protection clinic (MDFPC) in an Irish hospital setting.

    LENUS (Irish Health Repository)

    Nason, G J

    2012-04-21

    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.

  5. Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (Russian Edition)

    International Nuclear Information System (INIS)

    This publication addresses the shortfall of well trained and clinically qualified medical physicists working in radiation medicine. The roles, responsibilities and clinical training requirements of medical physicists have not always been well defined or well understood by health care professionals, health authorities and regulatory agencies. To fill this gap, this publication provides recommendations for the academic education and clinical training of clinically qualified medical physicists, including recommendations for their accreditation certification and registration, along with continuous professional development. The goal is to establish criteria that support the harmonization of education and clinical training worldwide

  6. Multilingual interactions in clinical dental education: a focus on mediated interpreting.

    Science.gov (United States)

    Bridges, Susan M; Yiu, Cynthia K Y; McGrath, Colman P

    2011-01-01

    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.

  7. Patterns of clinical presentation of adult coeliac disease in a rural setting

    Directory of Open Access Journals (Sweden)

    D'Souza Charles

    2006-09-01

    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

  8. Herpes Zoster Vaccine in the Long-Term Care Setting: A Clinical and Logistical Conundrum.

    Science.gov (United States)

    Schafer, Katherine Montag; Reidt, Shannon

    2016-01-01

    Advancing age is associated with an increased risk of herpes zoster (shingles) infection and latent effects such as postherpetic neuralgia. The herpes zoster vaccine is recommended in those 60 years of age and older and has been shown to prevent both the primary disease and associated complications. While this recommendation applies to those living in long-term care facilities, there is little clinical evidence to support use in this population. Additionally, there are logistical barriers that may complicate the use of the vaccine. The article examines the evidence for vaccinating residents in long-term care facilities and discusses logistical barriers to vaccination. Pharmacists and providers may consider life expectancy and other factors when evaluating which patients should receive the vaccination. PMID:26803085

  9. Child Sexual Abuse in Early-Childhood Care and Education Settings

    Science.gov (United States)

    Briggs, Freda

    2014-01-01

    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…

  10. Acting and Reacting: Youth's Behavior in Corrupt Educational Settings

    Science.gov (United States)

    Sabic-El-Rayess, Amra

    2014-01-01

    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…

  11. Current State of Environmental Education in Mexico: A Study on Practices, Audiences, Settings, and Topics

    Science.gov (United States)

    Marcos-Iga, Jose; Shaw, William

    2011-01-01

    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…

  12. Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff

    Science.gov (United States)

    Langhan, Melissa L.; Riera, Antonio; Kurtz, Jordan C.; Schaeffer, Paula; Asnes, Andrea G.

    2015-01-01

    Objective Technologies are not always successfully implemented into practise. We elicited experiences of acute care providers with the introduction of technology and identified barriers and facilitators in the implementation process. Methods A qualitative study using one-on-one interviews among a purposeful sample of 19 physicians and nurses within ten emergency departments and intensive care units was performed. Grounded theory, iterative data analysis and the constant comparative method were used to inductively generate ideas and build theories. Results Five major categories emerged: decision-making factors, the impact on practise, technology's perceived value, facilitators and barriers to implementation. Barriers included negative experiences, age, infrequent use, and access difficulties. A positive outlook, sufficient training, support staff, and user friendliness were facilitators. Conclusions This study describes strategies implicated in the successful implementation of newly adopted technology in acute care settings. Improved implementation methods and evaluation of implementation processes are necessary for successful adoption of new technology. PMID:25367721

  13. Setting the agenda: an analysis of negotiation strategies in clinical talk.

    Science.gov (United States)

    Manning, Philip; Ray, George B

    2002-01-01

    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. PMID:12375771

  14. Clinical education - place and part for becoming a practically trained radiographer

    International Nuclear Information System (INIS)

    Full text: The aim is to present the crucial role of clinical education for becoming a practically trained radiographer. It's been put on review and analysis the role of the clinic practice and pre-graduate practice into the education of the future specialist. It's presenting in detail every component of the program for study and the contribution of every module in it - image diagnostic, nuclear medicine and radiotherapy. the clinical education lasts six semesters in real working environment. The gradual increase of working hours creates conditions for higher educational quality. Students gradually master techniques, acquire skills and precision at working in an X-ray department, nuclear medicine units and radiotherapy, master communication techniques and acquire teamwork skills. the clinical education provides professional training, quick adaptation to realization and facilitates starting a job

  15. Role of pharmacists in optimizing the use of anticancer drugs in the clinical setting

    Directory of Open Access Journals (Sweden)

    Ma CSJ

    2014-02-01

    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

  16. Evaluation of short-term nonpharmacological treatment of insomnia in a clinical setting.

    Science.gov (United States)

    Verbeek, I; Schreuder, K; Declerck, G

    1999-10-01

    Of the 86 chronic insomnia patients we treated with nonpharmacological means, 74 improved considerably. The subjective improvement was confirmed by the outcome of the sleep logs registered after 4 weeks of treatment (decrease in sleep-onset latency, wake after sleep onset, and an increase of sleep efficiency). Of the 49 patients who had used hypnotics at intake, 18 discontinued their medication and 19 considerably reduced theirs after therapy. The investigated population was characterized by high scores for anxiety, depression, and somaticization; the depression and anxiety scores were significantly higher for the hypnotics users. The percentage of nonresponders (patients who were unaffected by the treatment) was highest for the group of homemakers and for the group of patients with a low level of education. Significantly less of the nonresponders had received cognitive therapy compared with responders. The value of nonpharmacological treatment lies in the fact that it leads to a subjective improvement of sleep and to increased control over the sleep problem that the patient was experiencing. Helping the patients to obtain control over their sleep problems was our main therapeutic goal. PMID:10616231

  17. Teachers' Perceptions of Their Mentoring Role in Three Different Clinical Settings: Student Teaching, Early Field Experiences, and Entry Year Teaching

    Science.gov (United States)

    Gut, Dianne M.; Beam, Pamela C.; Henning, John E.; Cochran, Deborah C.; Knight, Rhonda Talford

    2014-01-01

    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,…

  18. East meets West: The influence of language and culture in clinical education.

    Science.gov (United States)

    Ladyshewsky, Richard

    1996-01-01

    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.

  19. Comparing of goal setting strategy with group education method to increase physical activity level: A randomized trial

    OpenAIRE

    Nasrin Jiryaee; Zahra Dana Siadat; Ahmadreza Zamani; Roya Taleban

    2015-01-01

    Background: Designing an intervention to increase physical activity is important to be based on the health care settings resources and be acceptable by the subject group. This study was designed to assess and compare the effect of the goal setting strategy with a group education method on increasing the physical activity of mothers of children aged 1 to 5. Materials and Methods: Mothers who had at least one child of 1-5 years were randomized into two groups. The effect of 1) goal-setting stra...

  20. 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

    2007-09-01

    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.

  1. Exploring the dimensions of doctor-patient relationship in clinical practice in hospital settings.

    Science.gov (United States)

    Shrivastava, Saurabh RamBiharilal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh

    2014-05-01

    The Doctor-Patient Relationship (DPR) is a complex concept in the medical sociology in which patients voluntarily approach a doctor and thus become a part of a contract in which they tends to abide with the doctor's guidance. Globally, the DPR has changed drastically over the years owing to the commercialization and privatization of the health sector. Furthermore, the dynamics of the DPR has shown a significant change because of the formulation of consumer protection acts; clauses for professional misconduct and criminal negligence; establishment of patient forums and organizations; massive expansion of the mass media sector leading to increase in health awareness among people; and changes in the status of the doctors. Realizing the importance of DPR in the final outcome and quality of life of the patient, multiple measures have been suggested to make a correct diagnosis and enhance healing. To conclude, good DPR is the crucial determinant for a better clinical outcome and satisfaction with the patients, irrespective of the socio-cultural determinants.

  2. 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)

    2013-02-15

    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.)

  3. Exploring the Dimensions of Doctor-Patient Relationship in Clinical Practice in Hospital Settings

    Directory of Open Access Journals (Sweden)

    Saurabh RamBiharilal Shrivastava

    2014-05-01

    Full Text Available The Doctor-Patient Relationship (DPR is a complex concept in the medical sociology in which patients voluntarily approach a doctor and thus become a part of a contract in which they tends to abide with the doctor’s guidance. Globally, the DPR has changed drastically over the years owing to the commercialization and privatization of the health sector. Furthermore, the dynamics of the DPR has shown a significant change because of the formulation of consumer protection acts; clauses for professional misconduct and criminal negligence; establishment of patient forums and organizations; massive expansion of the mass media sector leading to increase in health awareness among people; and changes in the status of the doctors. Realizing the importance of DPR in the final outcome and quality of life of the patient, multiple measures have been suggested to make a correct diagnosis and enhance healing. To conclude, good DPR is the crucial determinant for a better clinical outcome and satisfaction with the patients, irrespective of the socio-cultural determinants.

  4. Imagining oneself: Narrative evaluations of the professional identities of learners in a transnational higher-educational setting

    NARCIS (Netherlands)

    Haines, Kevin

    2015-01-01

    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

  5. Exploring the Social Connections in Preschool Settings between Children Labelled with Special Educational Needs and Their Peers

    Science.gov (United States)

    Parry, John

    2015-01-01

    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…

  6. Visual Communication in Transition: Designing for New Media Literacies and Visual Culture Art Education across Activities and Settings

    Science.gov (United States)

    Zuiker, Steven J.

    2014-01-01

    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…

  7. Accommodating Remedial Readers in the General Education Setting: Is Listening-while-Reading Sufficient to Improve Factual and Inferential Comprehension?

    Science.gov (United States)

    Schmitt, Ara J.; Hale, Andrea D.; McCallum, Elizabeth; Mauck, Brittany

    2011-01-01

    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…

  8. 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.

    2011-01-01

    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

  9. Case Study on the Implementation of School-Wide Positive Behavioral Interventions and Supports in an Alternative Educational Setting

    Science.gov (United States)

    Gelbar, Nicholas W.; Jaffery, Rose; Stein, Ravit; Cymbala, Heather

    2015-01-01

    School-wide positive behavior interventions and supports (SW-PBIS) can effectively reduce problem behaviors and simultaneously increase pro-social behaviors in general education settings. SW-PBIS is not a "packaged" intervention, but a framework through which schools create systemic changes for promoting expected behaviors, while also…

  10. Parent and Teacher Perceptions of Transitioning Students from a Listening and Spoken Language School to the General Education Setting

    Science.gov (United States)

    Rugg, Natalie; Donne, Vicki

    2011-01-01

    The present study examines the perception of parents and teachers towards the transition process and preparedness of students who are deaf or hard of hearing from a listening and spoken language school in the Northeastern United States to a general education setting in their home school districts. The study uses a mixed methods design with…

  11. External Insect Morphology: A Negative Factor in Attitudes toward Insects and Likelihood of Incorporation in Future Science Education Settings

    Science.gov (United States)

    Wagler, Ron; Wagler, Amy

    2012-01-01

    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…

  12. Revisiting/Revising Art and Home: (Be)Longing and Identity in Out-of-School Art Education Settings

    Science.gov (United States)

    Weida, Courtney Lee

    2011-01-01

    What does "home" mean in the context of teaching artistry and art making that happens outside of the school setting? This article examines home as a valuable context and concept for teaching artists. Kathleen Vaughan (a researcher of art education environments) has extensively considered the notion of home, defining the concept in terms of…

  13. Selecting Educational Software for Teenagers in After-School Settings: A Toolkit from the America Connects Consortium

    Science.gov (United States)

    Lara-Meloy,Teresa; Flores, Emilio; Jeffers, Laura; Llorente, Carlin; Weagle, Valerie; Burns, Melissa, Ed.; Davis-Kay, Jen, Ed.

    2004-01-01

    Educational software can be an effective way for teens to enhance their learning skills in out-of-school settings. Many software programs provide subject-specific content and tools to support conceptual learning and skills development. They allow for individual, self-paced learning experiences as well as collaborative projects. In addition,…

  14. Use of Large-Scale Data Sets to Study Educational Pathways of American Indian and Alaska Native Students

    Science.gov (United States)

    Faircloth, Susan C.; Alcantar, Cynthia M.; Stage, Frances K.

    2014-01-01

    This chapter discusses issues and challenges encountered in using large-scale data sets to study educational experiences and subsequent outcomes for American Indian and Alaska Native (AI/AN) students. In this chapter, we argue that the linguistic and cultural diversity of Native peoples, coupled with the legal and political ways in which education…

  15. Practitioners, Learning Difference and Regional and Remote Inclusive Education Settings: A Focused Analysis of the Research and Policy Literature

    Science.gov (United States)

    Hollitt, Julie A.

    2012-01-01

    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…

  16. Investigating the Experience of Outdoor and Adventurous Project Work in an Educational Setting Using a Self-Determination Framework

    Science.gov (United States)

    Sproule, John; Martindale, Russell; Wang, John; Allison, Peter; Nash, Christine; Gray, Shirley

    2013-01-01

    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…

  17. A Systematic Literature Review of Alcohol Education Programmes in Middle and High School Settings (2000-2014)

    Science.gov (United States)

    Dietrich, Timo; Rundle-Thiele, Sharyn; Schuster, Lisa; Connor, Jason P.

    2016-01-01

    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.…

  18. Conflict Resolution and Children's Behaviour: Observing and Understanding Social and Cooperative Play in Early Years Educational Settings

    Science.gov (United States)

    Broadhead, Pat

    2009-01-01

    This paper draws from continuing research into the growth of sociability and cooperation in young children. It began in the mid-1980s and has continued periodically in a range of early years educational settings across the 3-6 age range. The research has underpinned the development of an observational tool. This tool--the Social Play Continuum or…

  19. Cross-Cultural Astronomy in Informal Education Settings - Collaboration with Integrity

    Science.gov (United States)

    Maryboy, Nancy; Hawkins, I.; Begay, D.; Sakimoto, P.

    2008-05-01

    The richness of astronomical knowledge and traditions from diverse cultures can engage participants of all ages and backgrounds. We will present astronomy-focused programs for museums, planetariums, and community centers designed to enhance participation of underserved populations in celebrating the International Year of Astronomy (IYA) in 2009. We will share examples of how the indigenous astronomies from the Southwestern US and Mesoamerica can be juxtaposed with Western astronomy to enhance education efforts and understanding for all audiences. In these examples, the traditional knowledge has been highlighted and incorporated into the realm of innovative and unique multimedia resources that engage students and the public, and which often ignite a deeper and more authentic interest in western astronomy and astrophysics. We will discuss approaches to displaying the Navajo sky in a digital planetarium in a manner that is true to the Navajo worldview and that also presents images and information from Western astronomy. We will share multi-media resources that highlight the importance of solar alignments in architecture and in landscape within the context of the seasons. We will also discuss how we are exploring ways to protect the intellectual property rights of indigenous sky knowledge while making aspects of it available to the general public. Our collaboration upholds the integrity of both Western and Indigenous astronomy knowledge and research protocols, and honors indigenous languages. We will discuss collaborative and relationship-based evaluation strategies emerging from the above efforts and from a new effort, Cosmic Serpent, a professional development program to increase the capacity of museum practitioners to bridge indigenous and western science learning in informal settings. We will provide links and information to access products and programs to engage all audiences in the wonder, complexity, and beauty of our Universe. We acknowledge the generous

  20. 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;

    2015-01-01

    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...

  1. 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

    Science.gov (United States)

    Merakou, K.; Knithaki, A.; Karageorgos, G.; Theodoridis, D.; Barbouni, A.

    2015-01-01

    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…

  2. Radiology education. The evaluation and assessment of clinical competence

    International Nuclear Information System (INIS)

    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.

  3. 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

    2012-11-01

    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.

  4. 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)

    2016-05-15

    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.)

  5. Re-envisioning clinical education for nurse practitioner programs: themes from a national leaders' dialogue.

    Science.gov (United States)

    Giddens, Jean Foret; Lauzon-Clabo, Laurie; Morton, Patricia Gonce; Jeffries, Pamela; McQuade-Jones, Bambi; Ryan, Sandra

    2014-01-01

    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. PMID:24939338

  6. Epidemiological, clinical and prognostic profile of childhood acute bacterial meningitis in a resource poor setting

    Directory of Open Access Journals (Sweden)

    Bankole Peter Kuti

    2015-01-01

    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.

  7. Educational intervention to improve physician reporting of adverse drug reactions (ADRs in a primary care setting in complementary and alternative medicine

    Directory of Open Access Journals (Sweden)

    Ostermann Thomas

    2009-07-01

    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

  8. 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

    2010-07-01

    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

  9. A recently developed MRI scoring system for hand osteoarthritis: its application in a clinical setting.

    Science.gov (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

    2016-08-01

    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. PMID:27236512

  10. Talent management in the UK higher education institutions - setting a research agenda

    OpenAIRE

    Okonkwo, O

    2015-01-01

    As the changing landscape of UK higher education sector is propelling a transition towards greater competition among higher education institutions (HEIs), talent management is increasingly recognised as one of the most important human resource management issues in many of these higher education institutions. Yet, the nature of talent management in the UK HEIs has rarely been investigated. This paper evaluates the prospects of implementing talent management in the HE sector, with the aim of se...

  11. Internet-based virtual classroom and educational management software enhance students' didactic and clinical experiences in perfusion education programs.

    Science.gov (United States)

    Riley, Jeffrey B; Austin, Jon W; Holt, David W; Searles, Bruce E; Darling, Edward M

    2004-09-01

    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

  12. Internet-based virtual classroom and educational management software enhance students' didactic and clinical experiences in perfusion education programs.

    Science.gov (United States)

    Riley, Jeffrey B; Austin, Jon W; Holt, David W; Searles, Bruce E; Darling, Edward M

    2004-09-01

    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

  13. A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP in clinical settings to prevent HIV infection.

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    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

  14. Spinal manipulation in physical therapist professional degree education: A model for teaching and integration into clinical practice.

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    Flynn, Timothy W; Wainner, Robert S; Fritz, Julie M

    2006-08-01

    Spinal manipulation for low back complaints is an intervention supported by randomized clinical trials and its use recommended by clinical practice guidelines. Physical therapists in this country and internationally have used thrust spinal manipulation at much lower-than-expected rates, despite evidence supporting its efficacy for the treatment of acute low back pain (LBP). The purpose of this clinical commentary is to describe a physical therapist professional degree curriculum in thrust spinal manipulation and outline a method of monitoring ongoing student performance during the clinical education experience. Increased emphasis on evidence-based decision making and on the psychomotor skills of thrust spinal manipulation was introduced into a physical therapist professional degree curriculum. As part of ongoing student performance monitoring, physical therapy students on their first full-time (8-week) clinical education experience, collected practice pattern and outcome data on individuals with low back complaints. Eight of 18 first-year students were in outpatient musculoskeletal clinical settings and managed 61 individuals with low back complaints. Patients were seen for an average (+/-SD) of 6.2 +/- 4.0 visits. Upon initial visit the student therapists employed spinal manipulation at a rate of 36.2% and spinal mobilization at 58.6%. At the final visit, utilization of manipulation and mobilization decreased (13% and 37.8%, respectively), while the utilization of exercise interventions increased, with 75% of patients receiving some form of lumbar stabilization training. Physical therapist students used thrust spinal manipulation at rates that are more consistent with clinical practice guidelines and substantially higher then previously reported by practicing physical therapists. Education within an evidence-based framework is thought to contribute to practice behaviors and outcomes that are more consistent with best practice guidelines. PMID:16915979

  15. Experience developing national evidence-based clinical guidelines for childhood pneumonia in a low-income setting - making the GRADE?

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    Agweyu Ambrose

    2012-01-01

    Full Text Available 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 revision of the Kenyan pediatric clinical guidelines focusing on antibiotic treatment of pneumonia. Methods A team of health professionals, many with minimal prior experience conducting systematic reviews, carried out evidence synthesis for structured clinical questions. Summaries were compiled and distributed to a panel of clinicians, academicians and policy-makers to generate recommendations based on best available research evidence and locally-relevant contextual factors. Results We reviewed six eligible articles on non-severe and 13 on severe/very severe pneumonia. Moderate quality evidence suggesting similar clinical outcomes comparing amoxicillin and cotrimoxazole for non-severe pneumonia received a strong recommendation against adopting amoxicillin. The panel voted strongly against amoxicillin for severe pneumonia over benzyl penicillin despite moderate quality evidence suggesting clinical equivalence between the two and additional factors favoring amoxicillin. Very low quality evidence suggesting ceftriaxone was as effective as the standard benzyl penicillin plus gentamicin for very severe pneumonia received a strong recommendation supporting the standard treatment. Conclusions Although this exercise may have fallen short of the rigorous requirements recommended by the developers of GRADE, it was arguably an improvement on previous attempts at guideline development in low-income countries and offers valuable lessons for future similar exercises where

  16. Prescription Writing in Small Groups as a Clinical Pharmacology Educational Intervention: Perceptions of Preclerkship Medical Students.

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    James, Henry; Tayem, Yasin I Y; Al Khaja, K A J; Veeramuthu, Sindhan; Sequeira, Reginald P

    2016-08-01

    Medical students do not perform well in writing prescriptions, and the 3 variables-learner, teacher, and instructional method-are held responsible to various degrees. The objective of this clinical pharmacology educational intervention was to improve medical students' perceptions, motivation, and participation in prescription-writing sessions. The study participants were second-year medical students of the College of Medicine and Medical Sciences of the Arabian Gulf University, Bahrain. Two prescription-writing sessions were conducted using clinical case scenarios based on problems the students had studied as part of the problem-based learning curriculum. At the end of the respiratory system subunit, the training was conducted in small groups, each facilitated by a tutor. At the end of the cardiovascular system subunit, the training was conducted in a traditional large-group classroom setting. Data were collected with the help of a questionnaire at the end of each session and a focus group discussion. A majority of the students (95.3% ± 2.4%) perceived the small-group method better for teaching and learning of all aspects of prescription writing: analyzing the clinical case scenario, applying clinical pharmacology knowledge for therapeutic reasoning, using a formulary for searching relevant prescribing information, and in writing a complete prescription. Students also endorsed the small-group method for better interaction among themselves and with the tutor and for the ease of asking questions and clarifying doubts. In view of the principles of adult learning, where motivation and interaction are important, teaching and learning prescription writing in small groups deserve a serious consideration in medical curricula. PMID:26677798

  17. 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

    2009-09-01

    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.

  18. Antibiotic use and clinical outcomes in the acute setting under management by an infectious diseases acute physician versus other clinical teams: a cohort study

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    Jones, Nicola; Mistry, Vikash; Crook, Derrick; Peto, Tim; Walker, A Sarah

    2016-01-01

    Objectives To assess the magnitude of difference in antibiotic use between clinical teams in the acute setting and assess evidence for any adverse consequences to patient safety or healthcare delivery. Design Prospective cohort study (1 week) and analysis of linked electronic health records (3 years). Setting UK tertiary care centre. Participants All patients admitted sequentially to the acute medical service under an infectious diseases acute physician (IDP) and other medical teams during 1 week in 2013 (n=297), and 3 years 2012–2014 (n=47 585). Primary outcome measure Antibiotic use in days of therapy (DOT): raw group metrics and regression analysis adjusted for case mix. Secondary outcome measures 30-day all-cause mortality, treatment failure and length of stay. Results Antibiotic use was 173 vs 282 DOT/100 admissions in the IDP versus non-IDP group. Using case mix-adjusted zero-inflated Poisson regression, IDP patients were significantly less likely to receive an antibiotic (adjusted OR=0.25 (95% CI 0.07 to 0.84), p=0.03) and received shorter courses (adjusted rate ratio (RR)=0.71 (95% CI 0.54 to 0.93), p=0.01). Clinically stable IDP patients of uncertain diagnosis were more likely to have antibiotics held (87% vs 55%; p=0.02). There was no significant difference in treatment failure or mortality (adjusted p>0.5; also in the 3-year data set), but IDP patients were more likely to be admitted overnight (adjusted OR=3.53 (95% CI 1.24 to 10.03), p=0.03) and have longer length of stay (adjusted RR=1.19 (95% CI 1.05 to 1.36), p=0.007). Conclusions The IDP-led group used 30% less antibiotic therapy with no adverse clinical outcome, suggesting antibiotic use can be reduced safely in the acute setting. This may be achieved in part by holding antibiotics and admitting the patient for observation rather than prescribing, which has implications for costs and hospital occupancy. More information is needed to indicate whether any such longer admission will

  19. A Procedure for Socially Valid Goal Setting

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    Ogletree, Billy T.; Howell, Amber; Carpenter, Dale

    2005-01-01

    Goal setting poses a significant challenge for service providers in both clinical and educational settings. With today's call for services that contribute to meaningful changes in children, there is an increased need for goal-setting procedures that are socially valid. This article presents such a procedure and illustrates its use through a case…

  20. Test Anxiety and High-Stakes Test Performance between School Settings: Implications for Educators

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    von der Embse, Nathaniel; Hasson, Ramzi

    2012-01-01

    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…