Full Text Available Abstract Background As more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows. Through the Integrative Family Medicine program, a six site pilot program of a four year residency training model combining integrative medicine and family medicine training, we have developed and tested a set of competency-based evaluation tools to assess residents' skills in integrative medicine history-taking and treatment planning. This paper presents the results from the implementation of direct observation and treatment plan evaluation tools, as well as the results of two Objective Structured Clinical Examinations (OSCEs developed for the program. Methods The direct observation (DO and treatment plan (TP evaluation tools developed for the IFM program were implemented by faculty at each of the six sites during the PGY-4 year (n = 11 on DO and n = 8 on TP. The OSCE I was implemented first in 2005 (n = 6, revised and then implemented with a second class of IFM participants in 2006 (n = 7. OSCE II was implemented in fall 2005 with only one class of IFM participants (n = 6. Data from the initial implementation of these tools are described using descriptive statistics. Results Results from the implementation of these tools at the IFM sites suggest that we need more emphasis in our curriculum on incorporating spirituality into history-taking and treatment planning, and more training for IFM residents on effective assessment of readiness for change and strategies for delivering integrative medicine treatment recommendations. Focusing our OSCE assessment more narrowly on integrative medicine history-taking skills was much more effective in delineating strengths and weaknesses in our residents' performance than using the OSCE for both integrative and more basic communication competencies. Conclusion As these tools are refined further they will be of value both in improving
Cusack, Lynette; Gilbert, Sandra; Fereday, Jennifer
Successful transition to practice programs that use competency-based assessment require the involvement of all staff, especially those undertaking the preceptor role. Qualitative data were collected using interview methods. Participants were 14 newly employed nurses and 7 preceptors in the child and family community health service in South Australia. Participant narratives were recorded electronically, transcribed, and thematically analyzed using the paradigm of critical social science. Five themes were identified that describe enablers as well as barriers to applying a flexible transition to practice program using competency-based assessment. These included flexibility in the program design, flexibility on the part of preceptors, flexibility to enable recognition of previous learning, flexibility in the assessment of competencies, and flexibility in workload. To ensure successful application of a transition to practice program using competency-based assessment, preceptors must understand the flexible arrangements built into the program design and have the confidence and competence to apply them. Copyright 2013, SLACK Incorporated.
Campos-Outcalt, Doug; Jeffcott-Pera, Michelle; Carter-Smith, Pamela; Schoof, Bellinda K; Young, Herbert F
This study was conducted to document current immunization practices by family physicians. In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consisted of questions regarding the demographics of the practice, vaccines that are provided at the physicians' clinical site, whether the practice refers patients elsewhere for vaccines, and participation in the Vaccines for Children (VFC) program. The response rate was 38.5%, 31.8% after non-office-based respondents were deleted. A high proportion of respondents (80% or more) reported providing most routinely recommended child, adolescent, and adult vaccines at their practice sites. The exceptions were rotavirus vaccine for children and herpes zoster vaccine for adults., A significant proportion, however, reported referring elsewhere for some vaccines (44.1% for children and adolescent vaccines and 53.5% for adult vaccines), with the most frequent referral location being a public health department. A higher proportion of solo and 2-physician practices than larger practices reported referring patients. A lack of adequate payment was listed as the reason for referring patients elsewhere for vaccines by one-half of those who refer patients. One-half of responders do not participate in the VFC program. Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study.
Washington State Board for Community and Technical Colleges, 2014
In January 2015, thirteen Washington community colleges launched an online, competency-based business transfer degree--the first in the state's community and technical college system. This issue brief provides answers to commonly asked questions about the new competency-based degree.
Literature on the background, causes, and current prevalence of competency based programs is synthesized in this report. According to one analysis of the actual and probable costs of minimum competency testing, estimated costs for test development, test administration, bureaucratic structures, and remedial programs for students who cannot pass the…
Brightwell, Alexandra; Grant, Janet
Competency based training describes progression through training referenced to the demonstrated ability to perform certain tasks. In recent years, this has become the dominant curriculum model. We seek to examine who benefits from a competency based approach to medical education. For the regulators and service, the apparent advantage is in terms of apparent measurable accountability and flexibility. For assessors, the promise of competence based assessments in the workplace to provide a reliable and objective measurement of a trainee's performance has not been demonstrated in practice. For the doctor in training, there is very little evidence to show benefit from competency based training. Competency based training places emphasis on individual skills rather than overall learning experience thus risks diminishing the role of the trainee in the workplace. Any form of medical education that devalues workplace based learning will ultimately harm the profession and, in turn, patient care.
Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B
A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of
Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those provided for in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN. The procedures to be followed are available in the Admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S ...
Quality management systems in nuclear medicine are vital to a high level of nuclear medicine (NM) practice. Trained and competent staffs are essential for achieving high standards and growth in NM. One of the key bottlenecks for NM is the shortfall in human resources, especially of radiopharmacists. There is an acute shortage in most Member States and in some countries an absence of nationally registered pharmacists with radiopharmacy experience. Most nuclear medicine facilities operate their radiopharmacies (commonly referred to as the hot laboratories) with the support of technologists and radiographers. Recent surveys have found the level of training amongst technologists to be extremely variable. Most had little or no training in hot laboratory practices. The survey also indicated the poor state of hot laboratories in many countries. Basic quality systems in the hot laboratory could be improved significantly with better training. This competency-based education manual is designed with those radiopharmacy practitioners in mind. This competency-based trainer's manual provides trainers in each of the IAEA regions with the essentials of a training programme for all radiopharmacy practitioners. The competency-based training is a two week programme followed up with three months of practice achievements. The syllabus provides a standardized approach to lectures, practical sessions, and interactive workshops focusing on critical aspects of hot laboratory practices. The trainers, with the assistance of this manual, can deliver essential skills, competencies, and underpinning knowledge to operate safely and effectively in their hot laboratory. The course focuses on simple but practical steps that could be undertaken to improve staff performance. In addition, a basic framework of quality management principles related to radiopharmacy practices is also covered. Further, the syllabus can be adapted to the particular needs and characteristics of any training centre, country
Russanti, Irma; Nurlaela, Lutfiyah; Basuki, Ismet; Munoto
Professional certification is a form of stipulation on certain competency standards provided by one professional organization to the performance of a person through assessment. For that an assessment needs to be standardized so that there exists a general standardized scale to measure competence. In the professional certification of fashion design department, an instrument of competency based assessment is essential to be developed. The purpose of this review is to know the application of competency based assessment in the field of fashion design. The literature reviews were found by journal searching with keywords competency based assessment and fashion design in Google scholar, of which was gotten over 20 journals from 2006 to 2016. Afterwards, the search of the free-downloaded e-books in libgen was conducted under competency based assessment and fashion design, which is then found some related references. The obtained literatures were used to review the definition, approach, and implementation of competency based assessment in the field of fashion design. Results show that it is important to develop an assessment sheet in the field of fashion design covering garment, apparel and embroidery sectors by patterning the criteria of performers along with the qualifications.
Ameh, Charles A; Kerr, Robert; Madaj, Barbara; Mdegela, Mselenge; Kana, Terry; Jones, Susan; Lambert, Jaki; Dickinson, Fiona; White, Sarah; van den Broek, Nynke
Healthcare provider training in Emergency Obstetric and Newborn Care (EmOC&NC) is a component of 65% of intervention programs aimed at reducing maternal and newborn mortality and morbidity. It is important to evaluate the effectiveness of this. We evaluated knowledge and skills among 5,939 healthcare providers before and after 3-5 days 'skills and drills' training in emergency obstetric and newborn care (EmOC&NC) conducted in 7 sub-Saharan Africa countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Zimbabwe) and 2 Asian countries (Bangladesh, Pakistan). Standardised assessments using multiple choice questions and objective structured clinical examination (OSCE) were used to measure change in knowledge and skills and the Improvement Ratio (IR) by cadre and by country. Linear regression was performed to identify variables associated with pre-training score and IR. 99.7% of healthcare providers improved their overall score with a median (IQR) increase of 10.0% (5.0% - 15.0%) for knowledge and 28.8% (23.1% - 35.1%) for skill. There were significant improvements in knowledge and skills for each cadre of healthcare provider and for each country (phealthcare providers working in maternity wards in both sub-Saharan Africa and Asia. Additional support and training is needed for use of the partograph as a tool to monitor progress in labour. Further research is needed to assess if this is translated into improved service delivery.
Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those stipulated in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN. The procedures to be followed are available in the Admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S VI 2.01 of ...
Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those stipulated in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN. The procedures to be followed are available in the admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S VI 2.01 of ...
Quality management systems in nuclear medicine are vital to a high level of nuclear medicine (NM) practice. Trained and competent staffs are essential for achieving high standards and growth in NM. One of the key bottlenecks for NM is the shortfall in human resources, especially of radiopharmacists. There is an acute shortage in most Member States and in some countries an absence of nationally registered pharmacists with radiopharmacy experience. Most nuclear medicine facilities operate their radiopharmacies (commonly referred to as the hot laboratories) with the support of technologists and radiographers. Recent surveys have found the level of training amongst technologists to be extremely variable. Most had little or no training in hot laboratory practices. The survey also indicated the poor state of hot laboratories in many countries. Basic quality systems in the hot laboratory could be improved significantly with better training. This competency-based education manual is designed with those radiopharmacy practitioners in mind. This competency-based trainer's manual provides trainers in each of the IAEA regions with the essentials of a training programme for all radiopharmacy practitioners. The competency-based training is a two week programme followed up with three months of practice achievements. The syllabus provides a standardized approach to lectures, practical sessions, and interactive workshops focusing on critical aspects of hot laboratory practices. The trainers, with the assistance of this manual, can deliver essential skills, competencies, and underpinning knowledge to operate safely and effectively in their hot laboratory. The course focuses on simple but practical steps that could be undertaken to improve staff performance. In addition, a basic framework of quality management principles related to radiopharmacy practices is also covered. Further, the syllabus can be adapted to the particular needs and characteristics of any training centre, country
Erlingsson, Christen L; Magnusson, Lennart; Hanson, Elizabeth
Our aim was to investigate connections between Swedish family caregivers' health and providing care for an ill relative by conducting a systematic search and synthesis of previous research. We analyzed 31 articles using first qualitative content analysis then hermeneutic analysis. Analysis resulted in three derived themes-sliding sideways into caregiving, caregiving in reciprocity, and caregiving in disintegration-and a main interpretation and conceptual model of Swedish family caregivers' health-caregiving in a sphere of beliefs. Results indicated that Swedish family caregivers' beliefs, experiences of reciprocity, or nonsupport, together with quality of interpersonal relationships and feelings of responsibility and guilt, have a profound impact on their health. These results point to the value and importance of nurses gaining an understanding of family caregivers' beliefs and experiences of reciprocity or nonsupport to effectively promote family caregivers' health.
Bazemore, Andrew; Wingrove, Peter; Peterson, Lars; Petterson, Stephen
Family physicians are increasingly incorporating other health care providers into their practice teams to better meet the needs of increasingly complex and comorbid patients. While a majority of family physicians report working with a nurse practitioner, only 21% work with a behavioral health specialist. A better understanding of optimal team composition and function in primary care is essential to realizing the promise of a patient-centered medical home and achieving the triple aim. © Copyright 2016 by the American Board of Family Medicine.
Durden, Tonia; Mincemoyer, Claudia; Crandall, Leslie; Alviz, Kit; Garcia, Aileen
High-quality family childcare (FCC) can positively influence all areas of a child's growth and development. Thus, it is important to invest in efforts to increase quality, including providing professional development to enhance the skills of those caring for children in their homes. This study explores the characteristics of FCC providers who…
Wittenberg, Elaine; Buller, Haley; Ferrell, Betty; Koczywas, Marianna; Borneman, Tami
To describe a family caregiver communication typology and demonstrate identifiable communication challenges among four caregiver types: Manager, Carrier, Partner, and Lone. Case studies based on interviews with oncology family caregivers. Each caregiver type demonstrates unique communication challenges that can be identified. Recognition of a specific caregiver type will help nurses to adapt their own communication to provide tailored support. Family-centered cancer care requires attention to the communication challenges faced by family caregivers. Understanding the challenges among four family caregiver communication types will enable nurses to better address caregiver burden and family conflict. Copyright © 2017 Elsevier Inc. All rights reserved.
Young, Richard A
The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.
Heath, Betty; Williams, Terry M.
Which method of instruction is more effective for postsecondary students: competency-based or traditional? This study reveals that the effectiveness of one method over the other depends on work experience of the student. (Author)
Presents guidelines for the development of competency-based curriculum formulated as a result of an automotive mechanics curriculum workshop. Listed are specific guidelines for content development, writing style, and illustration. (LRA)
Competency-based education (CBE) stands out at global level as the best educational practice. Indeed, CBE is supposed to improve the quality of care provided by newly graduated nurses. Yet, there is a dearth of knowledge in nursing literature regarding CBE concept's definition. CBE is implemented differently in each entity even inside the same discipline in a single country. What accounts for CBE in nursing education ? to clarify CBE concept meaning according to literature review in order to propose a definition. Wilson concept analysis method framed our literature review through two databases: CINHAL and ERIC. following the 11 Wilson techniques analysis, we identified CBE concept as a multidimensional concept clustering three dimensions : learning, teaching and assessment. nurses educators are accountable for providing performants newly graduated professional to the society. Schools should struggle for the visibility and the transparency of means they are using to accomplish their educational activities. This first attempt to understand CBE concept opens a matter of debate concerning further development and clarification of the concept. This first description of CBE concept is a step toward its identification and assessment.
Developing a competency-based training program requires the support of a strong curriculum development program. The major thrust of Arkansas Power and Light Company's competency-based curriculum development program is the identification of competencies using position task analysis data, panels, and INPO JTA data. Eight steps in the curriculum development approach provide the logic and rationale of the process: (1) establish competencies, (2) conduct competency verification, (3) develop competency tests, (4) develop curriculum, (5) develop instructional media, (6) validate curriculum and conduct field testing, (7) perform training effectiveness evaluation, and (8) revise the curriculum as needed. The processes describe how INPO JTA's and NRC procedures are cross-referenced to show that standards and requirements imposed or sanctioned by NRC and INPO are met. The competency-based approach to curriculum and training development eliminates the traditional scatterload approach to training and focuses on training to the competency. The primary benefits of competency-based training include accountability, minimal job training to meet job or position requirements, and a process to document an individual's job proficiency
Steele, Jennifer L.; Lewis, Matthew W.; Santibanez, Lucrecia; Faxon-Mills, Susannah; Rudnick, Mollie; Stecher, Brian M.; Hamilton, Laura S.
In 2011, the Bill & Melinda Gates Foundation created the Project Mastery grant program to support competency-based education initiatives in large school systems that serve a high proportion of disadvantaged youth. Competency-based education meets students where they are academically, provides students with opportunities for choice, and awards…
Ibrahim, Halah; Al Tatari, Hossam; Holmboe, Eric S
Although competency-based medical education has become the standard for physician training in the West, many developing countries have not yet adopted competency-based training. In 2009 in the United Arab Emirates, the government regulatory and operational authorities for healthcare in Abu Dhabi mandated a wide-scale reform of the emirate's postgraduate residency programs to the competency-based framework of the newly formed Accreditation Council for Graduate Medical Education-International (ACGME-I). This article briefly describes the rationale for competency-based medical education and provides an overview of the transition from traditional, time-based residency training to competency-based postgraduate medical education for the Pediatrics residency programs in Abu Dhabi. We will provide data on the initial impact of this transition on resident performance and patient outcomes in a Pediatrics residency program in an academic medical center in the United Arab Emirates.
Halsall, Viannella; Rogers, Jennifer; Witt, Jacki; Song, Sejun; Nguyen, Hoang Duc Huy; Kelly, Patricia
To provide an overview of lessons learned during the development process of an app for iOS and Android based on national recommendations for providing quality family planning services. After a review of existing apps was conducted to determine whether an app of clinical recommendations for family planning existed, a team of clinicians, training specialists, and app developers created a resource app by first drafting a comprehensive content map. A prototype of the app was then pilot tested using smart tablets by a volunteer convenience sample of women's healthcare professionals. Outcomes measured included usability, acceptability, download analytics, and satisfaction by clinicians as reported through an investigator-developed tool. Sixty-nine professionals tested a prototype of the app, and completed a user satisfaction tool. Overall, user feedback was positive, and a zoom function was added to the final version as a result of the pilot test. Within 3 months of being publicly available, the app was downloaded 677 times, with 97% of downloads occurring on smart phones, 76% downloads occurring on iOS devices, and 24% on Android devices. This trend persisted throughout the following 3 months. Clinicians with an interest in developing an app should consider a team approach to development, pilot test the app prior to wider distribution, and develop a web-based version of the app to be used by clinicians who are unable to access smart devices in their practice setting.
McCowan, Richard J.
This paper describes the theories and social factors that contributed to the development of competency-based training (CBT). These include behaviorism (Edward L. Thorndike), scientific management (Frederick Taylor), progressive education (John Dewey), and derivative theories including operant conditioning (B.F. Skinner), objectives-based…
Campbell, Craig; Silver, Ivan; Sherbino, Jonathan; Ten Cate, Olle; Holmboe, Eric S.
Competence is traditionally viewed as the attainment of a static set of attributes rather than a dynamic process in which physicians continuously use their practice experiences to "progress in competence'' toward the attainment of expertise. A competency-based continuing professional development
Background: The establishment of a credible, defensible and acceptable “formal competency based ophthalmology training curriculum for undergraduate medical and dental students” is fundamental to program recognition, monitoring and evaluation. The University of Zimbabwe College of Health Sciences (UZ-CHS) has ...
Young, Lynne; Frost, Linda J; Bigl, Julie; Clauson, Marion; McRae, Cora; Scarborough, Kathy S; Murphy, Sue; Jillings, Carol; Gillespie, Frank
In this paper, we begin by providing an overview of the Educator Pathway Project (EPP), an education infrastructure that was developed in response to emerging critical nursing workplace issues, and the related demand for enhanced workplace education. We then describe the EPP competency-based curriculum designed to prepare nurses as preceptors, mentors, and educators to lead learning with diverse learner groups. This competency-based curriculum was developed through a collaboration of nurse leaders across practice, academic, and union sectors and drew from a widely embraced curriculum development model (Iwasiw, Goldenberg, & Andrusyzyn, 2005). The goal of the curriculum was to prepare nurses through a four-level career pathway model that contextualized practice and education theory to various education-related roles and levels of experience within the practice setting. Over 1,100 nurses participated in this innovative intersectoral nursing initiative.
Nardi, Edileuza de Fátima Rosina; de Oliveira, Magda Lúcia Félix
The elderly suffering disability caused by diseases need a network of support in order to continue feeling socially active. This study aims at characterizing the social support provided to the family caregiver who looks after an elderly dependent, in Brazil. A descriptive study with qualitative approach was conducted at the municipality of Jandaia do Sul, Paraná, Brazil. Data collection was performed through semi-structured interviews with 19 primary family caregivers. Data analysis was based on Thematic Analysis. The results show that when it comes to informal sources, the reference to grown up children was mostly used, while as formal ones Unidade Básica de Saúde, the Brazilian Basic Health Unit, and the team from Programa Saúde da Familia, Brazilian Pro-Family Health Program, were referred to. However, the image of Community Health Agent was the most mentioned. Thus, it is necessary to create support nets to integrate both formal and informal systems.
Elfadil Sabeil; Azizah Bt Abdul Manaf; Zuraini Ismail; Mohamed Abas
Lack of Cyber Forensics experts is a huge challenge facing the world today. It comes due to the fancy of Cyber Forensics training or education. The multidisciplinary nature of Cyber Forensics proliferates to diverse training programmes, from a handful dayâ€Ÿs workshop to Postgraduate in Cyber Forensics. Consequently, this paper concentrates on analyzing the Cyber Forensics training programmes in terms of Competency-Based Framework. The study proves that Cyber Forensics training or education h...
I Ketut Santra
The aim of the research is improving the teaching method in entrepreneurship subject. This research adopted the competency based training (CBT) into the entrepreneurship. The major task in this research is formulated and designed the entrepreneurship competency. Entrepreneurship competency indicated by Personal, Strategic and Situational and Business competence. All of entrepreneurship competences are described into sub topic of competence. After designing and formulating the game and simulat...
Campbell, Craig; Silver, Ivan; Sherbino, Jonathan; Cate, Olle Ten; Holmboe, Eric S
Competence is traditionally viewed as the attainment of a static set of attributes rather than a dynamic process in which physicians continuously use their practice experiences to "progress in competence" toward the attainment of expertise. A competency-based continuing professional development (CPD) model is premised on a set of learning competencies that include the ability to (a) use practice information to identify learning priorities and to develop and monitor CPD plans; (b) access information sources for innovations in development and new evidence that may potentially be integrated into practice; (c) establish a personal knowledge management system to store and retrieve evidence and to select and manage learning projects; (d) construct questions, search for evidence, and record and track conclusions for practice; and (e) use tools and processes to measure competence and performance and develop action plans to enhance practice. Competency-based CPD emphasizes self-directed learning processes and promotes the role of assessment as a professional expectation and obligation. Various approaches to defining general competencies for practice require the creation of specific performance metrics to be meaningful and relevant to the lifelong learning strategies of physicians. This paper describes the assumptions, advantages, and challenges of establishing a CPD system focused on competencies that improve physician performance and the quality and safety of patient care. Implications for competency-based CPD are discussed from an individual and organizational perspective, and a model to bridge the transition from residency to practice is explored.
Priska J.R. Siagian
Full Text Available Indonesia is affected by global crisis. Increasing the number of entrepreneurs is one of many solutions to increase the economic growth in Indonesia. The number of entrepreneurs in Indonesia to leverage the economic growth is still limited. Entrepreneurs can be prepared through an Entrepreneurship Study Program. Entrepreneurship Study Program attempts to create qualified entrepreneurs who have relevant competences. In order to create a qualified entrepreneurs, the Entrepreneurial Studies Program requires a competency-based curriculum that will support the educational process and provide all the necessary to become future entrepreneurs who can survive through a global challenge. This research aims to design a competence-based curriculum for entrepreneurial study and uses Quality Function Deployment (QFD as the major tool to design the competence-based curriculum. From the QFD process, this research finds core and elective courses for the Entrepreneurship Study Program. The result shows the competences covered by the courses and sequence, credits, and teaching methods for each course. The competences prepared the potential entrepreneurs can be achieved through specific courses which can be acquired within 8 semesters.
Bromer, Juliet; Henly, Julia R.
This paper presents a qualitative investigation of the work-family support roles of a sample of 29 child care providers serving low-income families in the Chicago area (16 family, friend, and neighbor providers (FFN), 7 licensed family child care providers (FCC), and 6 center-based teachers). Providers report offering low-income parents…
Krause, Jackie; Dias, Laura Portolese; Schedler, Chris
The growth of competency-based education in an online environment requires the development and measurement of quality competency-based courses. While quality measures for online courses have been developed and standardized, they do not directly align with emerging best practices and principles in the design of quality competency-based online…
Administration for Children & Families, 2015
The director measure is intended for use with program directors in center-based, family child care, and Head Start/Early Head Start settings for children from birth through five years old. This measure asks respondents general questions about the early childhood education environment, the children enrolled in the program, and how the program…
Caspe, Margaret; Lopez, M. Elena
Today we know much more about how children learn than ever before, including the types of motivation and support they need to thrive, the ways that digital media and technology enhance their creativity, and the ways that families and educators, both within and outside of school settings, can share responsibility to facilitate new knowledge and…
Schwartz, Richard Bruce; McManus, John G; Croushorn, John; Piazza, Gina; Coule, Phillip L; Gibbons, Mark; Bollard, Glenn; Ledrick, David; Vecchio, Paul; Lerner, E Brooke
Tactical emergency medical support (TEMS) is a rapidly growing area within the field of prehospital medicine. As TEMS has grown, multiple training programs have emerged. A review of the existing programs demonstrated a lack of competency-based education. To develop educational competencies for TEMS as a first step toward enhancing accountability. As an initial attempt to establish accepted outcome-based competencies, the National Tactical Officers Association (NTOA) convened a working group of subject matter experts. This working group drafted a competency-based educational matrix consisting of 18 educational domains. Each domain included competencies for four educational target audiences (operator, medic, team commander, and medical director). The matrix was presented to the American College of Emergency Physicians (ACEP) Tactical Emergency Medicine Section members. A modified Delphi technique was utilized for the NTOA and ACEP groups, which allowed for additional expert input and consensus development. The resultant matrix can serve as the basic educational standard around which TEMS training organizations can design programs of study for the four target audiences.
Gerstenblatt, Paula; Faulkner, Monica; Lee, Ahyoung; Doan, Linh Thy; Travis, Dnika
Family child care providers contend with a number of work stressors related to the dual roles of operating a small business and providing child care in their home. Research has documented many sources of work related stress for family child care providers; however, research examining family child care providers' experiences outside of the…
Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna
In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.
Bronstein, Janet M; Felix, Holly C; Bursac, Zoran; Stewart, M Kathryn; Foushee, H Russell; Klapow, Joshua
This study examines both provider and client perceptions of the extent to which general health concerns are addressed in the context of publicly supported family planning care. A mail survey of family planning providers (n = 459) accepting Medicaid-covered clients in Arkansas and Alabama gathered data on reported actions and resource referral availability for ten categories of non-contraceptive health concerns. A telephone survey of recent family planning clients of these providers (n = 1991) gathered data on the presence of 16 health concerns and whether and how they were addressed by the family planning provider. Data were collected in 2006-2007. More than half (56%) of clients reported having one or more general health concerns. While 43% of those concerns had been discussed with the family planning providers, only 8% had been originally identified by these providers. Women with higher trust in physicians and usual sources of general health care were more likely to discuss their concerns. Of those concerns discussed, 39% were reportedly treated by the family planning provider. Similarly, over half of responding providers reported providing treatment for acute and chronic health conditions and counseling on health behaviors during family planning visits. Lack of familiarity with referral resources for uninsured clients was identified as a significant concern in the provision of care to these clients. Greater engagement by providers in identifying client health concerns and better integration of publicly supported family planning with other sources of health care for low income women could expand the existing potential for delivering preconception or general health care in these settings.
I Ketut Santra
Full Text Available The aim of the research is improving the teaching method in entrepreneurship subject. This research adopted the competency based training (CBT into the entrepreneurship. The major task in this research is formulated and designed the entrepreneurship competency. Entrepreneurship competency indicated by Personal, Strategic and Situational and Business competence. All of entrepreneurship competences are described into sub topic of competence. After designing and formulating the game and simulation the research continuing to implement the competency based training in the real class. The time consumed to implementing the CBT one semester, starting on September 2006 to early February 2007. The lesson learnt from the implementation period, the CBT could improve the student competence in Personal, Situational Strategic and Business. The three of the competencies are important for the success entrepreneur. It is a sign of application of “Kurikulum Berbasis Kompetensi”. There are many evidences to describe the achievement of the CBT in entrepreneurship subject. Firstly, physically achievement, that all of the student’s business plan could became the real business. The evidences are presented by picture of the student’s real business. Secondly theoretically achievement, that the Personal, Situational Strategic and Business competence statistically have significant relation with Business Plan even Real Business quality. The effect of the Personal, Situational Strategic and Business competence to Business Plan quality is 84.4%. and, to the Real Business quality 77.2%. The statistic’s evidence suggests that the redesign of the entrepreneurship subject is the right way. The content of the entrepreneur competence (Personal, Situational and Strategic and Business competence have impact to the student to conduct and running for own business.
Edwards, Nicole Megan
This article is intended to provide early childhood providers with a concise overview of emerging emotional development in young children (birth-5), the important role of primary caregivers, and the link between parenting, emotional development, and behavior. Specific suggestions that have been shared with urban Head Start mothers are offered,…
Chuenjitwongsa, S; Oliver, R G; Bullock, A D
The aim of undergraduate dental education is to provide competent dentists to serve societal needs and improve population oral healthcare. Competency-based education has influenced the development of dental education for decades but this term is problematic. This article explores components of competency-based undergraduate health professional education in order to help the dental profession have a better understanding of the context and purposes of undergraduate dental education. This is a discussion paper based on a wide reading of the literature on the education of health professionals with a specific focus on competency-based undergraduate education. Competence comprises an integration of knowledge, skills and attitudes indicating a capability to perform professional tasks safely and ethically. The process of becoming a competent practitioner is complex. Four characteristics of competency-based education are: curriculum components and content shaped by societal needs; focused on student-centred learning; learning achievement; and limited attention to time-based training and numerical targets. Alongside a competency-based approach, undergraduate dental education can be influenced by institutional features and external factors but these receive little consideration in the literature. Understanding competence, competency-based education, and institutional and external factors will help to improve educational quality, define roles and professional development for the dental educator, and inform further research. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T; O'Neill, Suzanne M; Rubinstein, Wendy S; Acheson, Louise S
This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6month follow-up, adjusting for age, site and practice clustering. A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (p'scommunicating at baseline and those who were not. Among participants who were not communicating at baseline, intervention participants had higher odds of communicating with family members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.
Johnston, Elizabeth; Rasmusson, Xeno; Foyil, Barbara; Shopland, Patricia
Content analysis of 35 family members stories found that sharing individualized music enhanced memory, mood and provided interactive opportunities, where family members connected and communicated with relatives who had dementia. Technology supports a positive new role for family members, who often use MP3 players (e.g. iPods), headphones,…
Swartz, Rebecca Anne; Wiley, Angela R.; A. Koziol, Natalie; Magerko, Katherine A.
Background: Family child care is commonly used in the US by families, including by those receiving child care subsidies. Psychosocial influences upon the workforce and professional development participation of family child care providers (FCCPs) have implications for the investment of public dollars that aim to improve quality and stability of…
Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T.; O'Neill, Suzanne M.; Rubinstein, Wendy S.; Acheson, Louise S.
Objective This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. Methods A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6 month follow-up, adjusting for age, site and practice clustering. Results A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (psfamily members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Conclusion Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. PMID:25901453
Drawing upon the work of Foucault and Latour, this article reflects on 25 years of critique of competence-based education and its continuing strength as a way of framing education and training. Using an example from England, it rehearses the argument from Foucault that, despite its student-centred discourse, competence-based education can be…
Wesselink, R.; Biemans, H.J.A.; Mulder, M.; Elsen, van den E.
The concept of competence is increasingly the basis for (re)designing VET. In competence-based VET academic disciplines are no longer starting points for curriculum development. Competence needed for working in practice, however, is. Competence-based learning is a dominant trend in VET in several
Maintaining nuclear competencies in the nuclear industry is a one of the most critical challenges in the near future. With the development of a number of nuclear engineering educational programmes in several States, this publication provides guidance to decision makers in Member States on a competence based approach to curricula development, presenting the established practices and associated requirements for educational programmes in this field. It is a consolidation of best practices that will ensure sustainable, effective nuclear engineering programmes, contributing to the safe, efficient and economic operation of nuclear power plants. The information presented is drawn from a variety of recognized nuclear engineering programmes around the world and contributes to the main areas that are needed to ensure a viable and robust nuclear industry
Noureldin, Yasser A; Lee, Jason Y; McDougall, Elspeth M; Sweet, Robert M
The use of simulation as an assessment tool is much more controversial than is its utility as an educational tool. However, without valid simulation-based assessment tools, the ability to objectively assess technical skill competencies in a competency-based medical education framework will remain challenging. The current literature in urologic simulation-based training and assessment uses a definition and framework of validity that is now outdated. This is probably due to the absence of awareness rather than an absence of comprehension. The following review article provides the urologic community an updated taxonomy on validity theory as it relates to simulation-based training and assessments and translates our simulation literature to date into this framework. While the old taxonomy considered validity as distinct subcategories and focused on the simulator itself, the modern taxonomy, for which we translate the literature evidence, considers validity as a unitary construct with a focus on interpretation of simulator data/scores.
Bryant, G A
Effective orientation programs should provide new RN and LPN employees with very specific performance expectations. Competency-based orientation provides such a structure. This approach not only decreases the orientee's anxiety, but it also acts as a basis for establishing competencies specific to that unit. Because the existing staff members are intimately involved in the process, socialization within the unit and cohesiveness of purpose are enhanced. Adult learning theory, educational principles, self-paced learning modules, and the use of preceptors and check-off lists are employed in this Competency-Based Orientation (CBO) program for an adult orthopaedic unit. Samples of various aspects of a CBO are included.
Merlin, Lisa R; Horak, Holli A; Milligan, Tracey A; Kraakevik, Jeff A; Ali, Imran I
Current medical educational theory encourages the development of competency-based curricula. The Accreditation Council for Graduate Medical Education's 6 core competencies for resident education (medical knowledge, patient care, professionalism, interpersonal and communication skills, practice-based learning, and systems-based practice) have been embraced by medical schools as the building blocks necessary for becoming a competent licensed physician. Many medical schools are therefore changing their educational approach to an integrated model in which students demonstrate incremental acquisition and mastery of all competencies as they progress through medical school. Challenges to medical schools include integration of preclinical and clinical studies as well as development of learning objectives and assessment measures for each competency. The Undergraduate Education Subcommittee (UES) of the American Academy of Neurology (AAN) assembled a group of neuroscience educators to outline a longitudinal competency-based curriculum in medical neuroscience encompassing both preclinical and clinical coursework. In development of this curriculum, the committee reviewed United States Medical Licensing Examination content outlines, Liaison Committee on Medical Education requirements, prior AAN-mandated core curricula for basic neuroscience and clinical neurology, and survey responses from educators in US medical schools. The newly recommended curriculum provides an outline of learning objectives for each of the 6 competencies, listing each learning objective in active terms. Documentation of experiences is emphasized, and assessment measures are suggested to demonstrate adequate achievement in each competency. These guidelines, widely vetted and approved by the UES membership, aspire to be both useful as a stand-alone curriculum and also provide a framework for neuroscience educators who wish to develop a more detailed focus in certain areas of study. © 2014 American Academy
Brownie, Sharon Mary; Thomas, Janelle
This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project’s genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers’ commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia’s current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented. PMID:25279384
Aziz, Mirette; Ahmed, Sabra; Ahmed, Boshra
To assess the attitudes of physicians providing family planning services at the public sector in Egypt about recommending intrauterine device (IUD) for family planning clients, and to identify the factors that could affect their attitudes. A descriptive cross sectional study, in which all the physicians providing family planning services in Assiut Governorate were invited to complete self-administered questionnaires. The study participants were recruited at the family planning sector monthly meetings of the 13 health directorates of Assiut Governorate, Upper Egypt. 250 physicians accepted to participate in the study. Bivariate and Multivariate regression analyses were performed to identify the most important predictors of recommending IUD to family planning clients when appropriate. Less than 50% of physicians would recommend IUD for clients with proper eligibility criteria; women younger than 20 years old (49.2%), women with history of ectopic pregnancy (34%), history of pelvic inflammatory diseases (40%) or sexually transmitted diseases (18.4%) and nulliparous women (22.8%). Receiving family planning formal training within the year preceding data collection and working in urban areas were the significant predictors of recommending IUD insertion for appropriate clients. Physicians providing family planning services in Upper Egypt have negative attitudes about recommending IUD for family planning clients. Continuous education and in-service training about the updated medical eligibility criteria, especially for physicians working in rural areas may reduce the unfounded medical restrictions for IUD use. Copyright © 2017 Elsevier B.V. All rights reserved.
Rood, S; Raquepo, M; Ladia, M A
A study in the Philippines sought to observe and describe the family planning (FP) training program in two regions. This program trains physicians, nurses, and midwives as a team and includes a Basic/Comprehensive (B/C) course in FP with didactic and practicum elements, training in interpersonal communication skills (ICS) for those who have completed with B/C course, and a Preceptors Course for those who will supervise the practicum phase of the B/C course. The study gathered specific information on 1) trainee absenteeism and drop-out rates, 2) course content and effects, 3) the trainee selection process, 4) the practicum requirement for the B/C course, and 5) service delivery values and quality of care. Data were collected through observations, questionnaires, exit interviews with clients during the practicum phase, interviews with supervisors and public officials (mayors), and focus group discussions with regional trainers. This assessment led to the following recommendations: 1) maintain the current team approach; 2) reserve basic orientation-type subjects for office-based training to allow more time for FP topics in the training programs; 3) use caution in making a switch to "competency-based" training because of the possibility that supervision is inadequate for such a training method; 4) improve scheduling; 5) enforce the prerequisites for participation in the ICS and Preceptors Courses; 6) assign only one trainee to a preceptor area during the practicum and reduce the quota of IUD insertions to reduce pressure to obtain IUD acceptors; 7) create a "model" FP clinic each time a preceptor is trained; 8) pay more attention to natural FP methods; and 9) maintain an emphasis on quality of care.
Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T
The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.
Dinther, van M.; Dochy, F.; Segers, M.; Braeken, J.
The purpose of this study was to provide insight into the interplay between student perceptions of competence-based assessment and student self-efficacy, and how this influences student learning outcomes. Results reveal that student perceptions of the form authenticity aspect and the quality
Fioroni, John J.
This document contains materials developed by a project to provide a competency-based curriculum guide for laser technology at the community college level. An abstract of the final report is included. Next, the 17 job competencies determined as necessary to meet the job description of laser technician are listed. A career ladder and qualifications…
Chyung, Seung Youn; Stepich, Donald; Cox, David
Competency-based instruction can be applied to a military setting, an academic program, or a corporate environment with a focus on producing performance-based learning outcomes. In this article, the authors provide theoretical and practical information about underlying characteristics of competencies and explain how the Department of Instructional…
Coker, Homer; Coker, Joan G.
Reference materials, slides, cassettes, books, pamphlets, materials from other states, and articles used in the Carroll County, Georgia, Competency Based Teacher Certification Project, 1973-74, are listed. Brief annotations are included for both the reference materials and articles. (MJM)
Bell, Melissa M; Newhill, Christina E
Social service professionals can face challenges in the course of providing family planning information to their clients. This article reports findings from a study that developed an original 27-item measure, the Reproductive Counseling Obstacle Scale (RCOS) designed to measure such obstacles based conceptually on Bandura's social cognitive theory (1986). We examine the reliability and factor structure of the RCOS using a sample of licensed social workers (N = 197). A 20-item revised version of the RCOS was derived using principal component factor analysis. Results indicate that barriers to discussing family planning, as measured by the RCOS, appear to be best represented by a two-factor solution, reflecting self-efficacy/interest and perceived professional obligation/moral concerns. Implications for practice and future research are discussed.
This case study considers pedagogical techniques used in family childcare to promote children's learning experiences. Data extracted from an earlier study were used to inform this examination of four family childcare providers' pedagogy. In the current study, I use socio-cultural theory and the Reggio Emilia approach to address the following…
McConkey, Roy; McConaghie, Jayne; Roberts, Paul; King, Diana
The success of family placement schemes depends largely on the recruitment of suitable people who are willing to offer placements in their own home yet little research has been undertaken of their characteristics and the reasons for their involvement. Thirty providers of family based placements to adult persons with intellectual disabilities were…
Dove, Marion; Dogba, Maman Joyce; Rodríguez, Charo
To examine the reasons why family physicians continue or discontinue providing intrapartum care in their clinical practice. Qualitative descriptive study. Two hospitals located in a multicultural area of Montreal, Que, in November 2011 to June 2012. Sixteen family physicians who were current or former providers of obstetric care. Data were collected using semistructured qualitative interviews. Thematic analysis was used to analyze the interview transcripts. Three overarching themes that help create understanding of why family doctors continue to provide obstetric care were identified: their attraction, often initiated by role models early in their careers, to practising complete continuity of care and accompanying patients in a special moment in their lives; the personal, family, and organizational pressures experienced while pursuing a family medicine career that includes obstetrics; and their ongoing reflection about continuing to practise obstetrics. The practice of obstetrics was very attractive to family physician participants whether they provided intrapartum care or decided to stop. More professional support and incentives might help keep family doctors practising obstetrics. Copyright© the College of Family Physicians of Canada.
Xue, Dongbo; Bo, Hong; Zhang, Weihui; Zhao, Song; Meng, Xianzhi; Zhang, Donghua
To induce competency-based education/developing a curriculum in the training of postgraduate students in laparoscopic surgery. This study selected postgraduate students before the implementation of competency-based education (n = 16) or after the implementation of competency-based education (n = 17). On the basis of the 5 competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, and professionalism, the research team created a developing a curriculum chart and specific improvement measures that were implemented in the competency-based education group. On the basis of the developing a curriculum chart, the assessment of the 5 comprehensive competencies using the 360° assessment method indicated that the competency-based education group's competencies were significantly improved compared with those of the traditional group (P The improvement in the comprehensive assessment was also significant compared with the traditional group (P The implementation of competency-based education/developing a curriculum teaching helps to improve the comprehensive competencies of postgraduate students and enables them to become qualified clinicians equipped to meet society's needs.
Fan, Jun-Yu; Wang, Yu Hsin; Chao, Li Fen; Jane, Sui-Whi; Hsu, Li-Ling
Competency-based education is known to improve the match between educational performance and employment opportunities. This study examined the effects of competency-based education on the learning outcomes of undergraduate nursing students. The study used a quasi-experimental design. A convenience sample of 312 second-year undergraduate nursing students from northern and southern Taiwan participated in the study. The experimental group (n=163) received competency-based education and the control group received traditional instruction (n=149) in a medical-surgical nursing course. Outcome measures included students' scores on the Objective Structured Clinical Examination, Self-Evaluated Core Competencies Scale, Metacognitive Inventory for Nursing Students questionnaire, and academic performance. Students who received competency-based education had significantly higher academic performance in the medical-surgical nursing course and practicum than did the control group. Required core competencies and metacognitive abilities improved significantly in the competency-based education group as compared to the control group after adjusting for covariates. Competency-based education is worth implementing and may close the gap between education and the ever-changing work environment. Copyright © 2014 Elsevier Ltd. All rights reserved.
Longo, Lianne; Slater, Serena
Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies. It is imperative health care providers strive towards increased awareness and knowledge of how culture affects the overall experience of illness and death in order to help create a mutually satisfactory care plan. Providing culturally-competent care entails the use of proper communication skills to facilitate the exploration of patient and family perspectives and allows for mutual decision making. A case study will illustrate the challenges encountered in providing culturally-competent care to a woman with brain cancer and her family. As the patient's health declined, the family entered into a state of crisis where communication between family members and health care professionals was strained; leading to conflict and sub-optimal outcomes. This paper will address the ethical dilemma of providing culturally-competent care when a patient's safety is at risk, and the nursing implications of upholding best practices in the context of differing beliefs and priorities.
Gruppen, Larry D; Burkhardt, John C; Fitzgerald, James T; Funnell, Martha; Haftel, Hilary M; Lypson, Monica L; Mullan, Patricia B; Santen, Sally A; Sheets, Kent J; Stalburg, Caren M; Vasquez, John A
Competency-based education (CBE) has been widely cited as an educational framework for medical students and residents, and provides a framework for designing educational programmes that reflect four critical features: a focus on outcomes, an emphasis on abilities, a reduction of emphasis on time-based training, and promotion of learner centredness. Each of these features has implications and potential challenges for implementing CBE. As an experiment in CBE programme design and implementation, the University of Michigan Master of Health Professions Education (UM-MHPE) degree programme was examined for lessons to be learned when putting CBE into practice. The UM-MHPE identifies 12 educational competencies and 20 educational entrustable professional activities (EPAs) that serve as the vehicle for both learning and assessment. The programme also defines distinct roles of faculty members as assessors, mentors and subject-matter experts focused on highly individualised learning plans adapted to each learner. Early experience with implementing the UM-MHPE indicates that EPAs and competencies can provide a viable alternative to traditional courses and a vehicle for rigorous assessment. A high level of individualisation is feasible but carries with it significant costs and makes intentional community building essential. Most significantly, abandoning a time-based framework is a difficult innovation to implement in a university structure that is predicated on time-based education. © 2016 John Wiley & Sons Ltd.
Walser, Sarah A; Werner-Lin, Allison; Mueller, Rebecca; Miller, Victoria A; Biswas, Sawona; Bernhardt, Barbara A
This study provides preliminary data on the process and content of returning results from exome sequencing offered to children through one of the Clinical Sequencing Exploratory Research (CSER) projects. We recorded 25 sessions where providers returned diagnostic and secondary sequencing results to families. Data interpretation utilized inductive thematic analysis. Typically, providers followed a results report and discussed diagnostic findings using technical genomic and sequencing concepts. We identified four provider processes for returning results: teaching genetic concepts; assessing family response; personalizing findings; and strengthening patient-provider relationships. Sessions should reflect family interest in medical management and next steps, and minimize detailed genomic concepts. As the scope and complexity of sequencing increase, the traditional information-laden counseling model requires revision.
Battat, Robert; Jhonson, Marc; Wiseblatt, Lorne; Renard, Cruff; Habib, Laura; Normil, Manouchka; Remillard, Brian; Brewer, Timothy F; Sacajiu, Galit
covered. We identified teaching goals covered and competencies that were missing from a CME program for rural Haitian physicians. We aim to use this analysis to provide a competency-based CME lecture series that proportionally meets local needs while following recommendations of recognized national family medicine organizations.
Lucey, Catherine R; Thibault, George E; Ten Cate, Olle
Health care systems around the world are transforming to align with the needs of 21st-century patients and populations. Transformation must also occur in the educational systems that prepare the health professionals who deliver care, advance discovery, and educate the next generation of physicians in these evolving systems. Competency-based, time-variable education, a comprehensive educational strategy guided by the roles and responsibilities that health professionals must assume to meet the needs of contemporary patients and communities, has the potential to catalyze optimization of educational and health care delivery systems. By designing educational and assessment programs that require learners to meet specific competencies before transitioning between the stages of formal education and into practice, this framework assures the public that every physician is capable of providing high-quality care. By engaging learners as partners in assessment, competency-based, time-variable education prepares graduates for careers as lifelong learners. While the medical education community has embraced the notion of competencies as a guiding framework for educational institutions, the structure and conduct of formal educational programs remain more aligned with a time-based, competency-variable paradigm.The authors outline the rationale behind this recommended shift to a competency-based, time-variable education system. They then introduce the other articles included in this supplement to Academic Medicine, which summarize the history of, theories behind, examples demonstrating, and challenges associated with competency-based, time-variable education in the health professions.
Lockyer, Jocelyn; Carraccio, Carol; Chan, Ming-Ka; Hart, Danielle; Smee, Sydney; Touchie, Claire; Holmboe, Eric S; Frank, Jason R
The meaningful assessment of competence is critical for the implementation of effective competency-based medical education (CBME). Timely ongoing assessments are needed along with comprehensive periodic reviews to ensure that trainees continue to progress. New approaches are needed to optimize the use of multiple assessors and assessments; to synthesize the data collected from multiple assessors and multiple types of assessments; to develop faculty competence in assessment; and to ensure that relationships between the givers and receivers of feedback are appropriate. This paper describes the core principles of assessment for learning and assessment of learning. It addresses several ways to ensure the effectiveness of assessment programs, including using the right combination of assessment methods and conducting careful assessor selection and training. It provides a reconceptualization of the role of psychometrics and articulates the importance of a group process in determining trainees' progress. In addition, it notes that, to reach its potential as a driver in trainee development, quality care, and patient safety, CBME requires effective information management and documentation as well as ongoing consideration of ways to improve the assessment system.
Weinberger, Steven E; Pereira, Anne G; Iobst, William F; Mechaber, Alex J; Bronze, Michael S
Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program. Challenges to competency-based education include teaching and evaluating the competencies related to practice-based learning and improvement and systems-based practice, as well as implementing a flexible time frame to achieve competencies. However, the Alliance for Academic Internal Medicine Education Redesign Task Force II does not favor reducing internal medicine training to less than 36 months as part of competency-based education. Rather, the 36-month time frame should allow for remediation to address deficiencies in achieving competencies and for diverse enrichment experiences in such areas as quality of care and practice improvement for residents who have demonstrated skills in all required competencies.
McCloy, Robert J.
This publication is a curriculum and teaching guide for preparing real estate agents in the state of West Virginia. The guide contains 30 units, or lessons. Each lesson is designed to cover three to five hours of instruction time. Competencies provided for each lesson are stated in terms of what the student should be able to do as a result of the…
Garner, Pamela W.; Parker, Tameka S.
This article describes the implementation of a service-learning project, which was infused into a child development course. The project linked family child care providers, their licensing agency, and 39 preservice teachers in a joint effort to develop a parent handbook to be used by the providers in their child care businesses and to support…
Seidman, Dominika; Weber, Shannon; Carlson, Kimberly; Witt, Jacki
Pre-exposure prophylaxis (PrEP) provides a radically different HIV prevention option for women. Not only is PrEP the first discrete, woman-controlled method that is taken in advance of exposure, but it is both safe and highly effective, offering over 90% protection if taken daily. While multiple modalities of PrEP are in development ranging from vaginal rings to injectables and implants, only PrEP with oral tenofovir/emtricitabine is currently FDA-approved. Family planning clinics provide key access points for many women to learn about and obtain PrEP. By incorporating PrEP services into family planning care, family planning providers have the opportunity to meet women's expectations, ensure women are aware of and offered comprehensive HIV prevention options, and reverse emerging disparities in PrEP access. Despite real and perceived barriers to integrating PrEP into family planning care, providing PrEP services, ranging from education to onsite provision, is not only possible but an important component of providing high-quality sexual and reproductive healthcare to women. Lessons learned from early adopters will help guide those in family planning settings initiating or enhancing PrEP services. Copyright © 2018. Published by Elsevier Inc.
The Institute for Energy and Transport of the Joint Research Centre, European Commission, developed a strategy and road map for ECVET implementation. The JRC road map for European Credit System for Vocational Education and Training (ECVET) implementation has reached the stage of Competence-Based Qualification System development. The Competence-Based Qualification System can help bridge the gap between Human Resources demand and supply in the nuclear market by structuring qualifications in small independent parts. This very specific ECVET feature of a qualification, facilitates the process of competences accumulation and the lifelong learning, mobility and flexible learning pathways. New developments are presented about the Competence-Based Qualification System development for the nuclear energy sector.
Ceclan, Mihail [European Commission, Petten (Netherlands). Inst. for Energy and Transport
The Institute for Energy and Transport of the Joint Research Centre, European Commission, developed a strategy and road map for ECVET implementation. The JRC road map for European Credit System for Vocational Education and Training (ECVET) implementation has reached the stage of Competence-Based Qualification System development. The Competence-Based Qualification System can help bridge the gap between Human Resources demand and supply in the nuclear market by structuring qualifications in small independent parts. This very specific ECVET feature of a qualification, facilitates the process of competences accumulation and the lifelong learning, mobility and flexible learning pathways. New developments are presented about the Competence-Based Qualification System development for the nuclear energy sector.
S. A. Efimova
Full Text Available Introduction. The search of the unified tools of competences measurement of vocational training institutions graduates and identification of mechanisms of interrelation of these competences with requirements of professional standards imposed to workers of various levels are brought into focus in the context of formation of National system of qualifications of the Russian Federation, introduction of the Third-generation Federal State Educational Standards and transition of professional education to the modular, and competence-based model of the organization of training. The aim of the article is to justify the content, structure and technology of competency-based assessment, as a set of interrelated activities and regulated procedures performed on the basis of the standardized interdisciplinary evaluation materials. Methodology and research methods. The present investigation is based on systematic-activity and competency-based approaches, analysis, systematization, and generalization. Results. The place of competencies, as a part of educational outcomes of vocational education programs, is justified. Critical analysis of typical methodological solutions that are typical for the modern pedagogical practices of the competency-based assessment is performed. The content and organizational design of the process of competency-based assessment is described. Scientific novelty. The conceptual apparatus of competency-based assessment is supplemented with the «sub-competence» category - component of competence, which retains all of its properties due to human activities. Factors of objects choice and methods of assessment in identifying the professional competences are proved. Practical significance. Results of the study can be used by researchers involved with assessment procedures; methodologists and teachers of professional educational organizations, training institutes, independent centers of the qualifications evaluation for the organization of
Full Text Available Objective: This study was conducted to compare the environment of families with and without substance-dependent members to investigatethe functioning of families with substance-dependent members and also provide them with appropriate treatment strategies. Method: A causative-comparative method followed by an ex post facto design was used in this study. A sample of 50-person suffering from substance-dependent disorder referring to outpatient treatment centers, located in west and east of Tehran, constituted the participants of the study. As well, another 50-person group not suffering from the disorder participated in this study as the former group’s counterpart. The participants answered the questions of environment of family scale (EFS (Moos & Moos, 1986. Findings: The results showed that there was a significant difference between two groups in dimensions of cohesion, conflict, achievement orientation, intellectual-cultural orientation, religious orientation, organization, and control whereas therewas no significant difference between the two groups in dimension of expressiveness, independency, and recreational orientation. Conclusion: The study recommendsthe authorities the application of efficient interventionist treatment strategies appropriate to the characteristics of families having drug-dependent member.
Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C
Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs
Claxton-Oldfield, Stephen; Gosselin, Natasha; Schmidt-Chamberlain, Kirsten; Claxton-Oldfield, Jane
A total of 22 family members, whose deceased loved ones had used the services of a hospice palliative care volunteer, responded to a brief survey designed to assess the importance of the different kinds of support offered to them (family members) by the volunteer, their impressions of the volunteers' personal qualities/characteristics, their general experiences with the volunteer, and their overall satisfaction with the volunteer services. The kind of support that received the highest importance rating from family members was the opportunity to take a much-needed break from the demands of caring for their loved one, closely followed by emotional support, the volunteer spending time with them, and the volunteer providing them with information. Family members rated volunteers highly on a list of qualities/characteristics that exemplify individuals who are effective in this role. In all, 85% of the family members felt that their volunteer was well trained and 95% did not feel that their or their loved one's privacy had been invaded by having a volunteer. Overall, family members were very satisfied with the volunteer support they received. Some limitations of the study are discussed.
Legacy, Jim; And Others
This competency-based curriculum unit on tree identification is one of five developed for classroom use in teaching the landscape/nursery area of horticulture. The three sections are each divided into teaching content (in a question-and-answer format) and student skills that outline steps and factors for consideration. Topics covered include…
Associated Educational Consultants, Inc., Pittsburgh, PA.
This student welding competency-based education curriculum consists of six units dealing with general areas related to trade occupations and nine units covering specific aspects of working with welding equipment and performing welding operations. Topics covered in the first six units are welding opportunities, human relations, safety, basic…
This article follows the author's previous piece on practical guidelines for the development of comprehensive competence-based education and training (Mulder, 2012). It is about the questions that have been and are still frequently asked in presentations, workshops and classes about the introduction
Sampson, Demetrios; Fytros, Demetrios
Please cite as: Sampson, D., & Fytros, D. (2008). Competence Models in Technology-enhanced Competence-based Learning. In H. H. Adelsberger, Kinshuk, J. M. Pawlowski & D. Sampson (Eds.), International Handbook on Information Technologies for Education and Training, 2nd Edition, Springer, June 2008
Sampson, Demetrios; Fytros, Demetrios
Sampson, D., & Fytros, D. (2008). Competence Based Educational Metadata for Supporting Lifelong Competence Development Programmes. In P. Diaz, Kinshuk, I. Aedo & E. Mora (Eds.), Proceedings of the 8th IEEE International Conference on Advanced Learning Technologies (ICALT 2008), pp. 288-292. July,
Hodge, Steven; Harris, Roger
Among the many critiques of competency-based approaches to education and training (CBT) is a strain which draws on Foucault's analysis of "disciplinary" power and knowledge. Foucault offered an interpretation of modern institutions, such as prisons, armies and schools, which revealed subtle mechanisms of surveillance and systems of…
Pearce, Eli M; And Others
Describes a competency-based, modular laboratory course emphasizing the synthesis and characterization of polymers and directed toward senior undergraduate and/or first-year graduate students in science and engineering. One module, free-radical polymerization kinetics by dilatometry, is included as a sample. (CS)
Huff, Sheila M.
Some issues in connection with competency-based education (CBE) and the world of work discussed by the author include the relevance of CBE programs to work, the changing attitudes of students and young workers toward work, "credentialism" or the continual upgrading of educational requirements for employment, underemployment and CBE, and others.…
Designed to meet individual needs and learning levels of high school and postsecondary students enrolled in vocational training for occupations in clothing services and production sewing, this competency-based curriculum teaches skills in alterations, dressmaking, and power sewing machine operations. Skills are organized into 13 units: Awareness…
Turney, Mildred; And Others
This task force report defines competency-based education (CBE) as a system of education designed to develop competencies in those who are products of the system. A distinction is made between CBE and performance based education (PBE) in this report. Although the American Association of Colleges for Teacher Education Committee on Performance-Based…
Nevada Univ., Las Vegas. Coll. of Education.
This document is one of ten curriculum guides developed by the Nevada Competency-Based Adult High School Diploma (CBAHSD) Project. This curriculum guide on health is divided into ten topics. The topics included are Nutrition, Reproduction, Menstruation, Contraception, Alcohol Abuse, Tobacco, Immunization, Disease, Accident Prevention, and…
The focus on competency in social work education makes the development of a competency-based curriculum critical. This article describes an approach to curriculum building taking into account the integration, coherency, and integrity of such a curriculum. A presentation of how performance outcomes are fundamental to the relationship between the…
Toohey, Susan; And Others
A literature review examined what aspects of performance should be assessed, what methods are appropriate, whether competency-based assessments should be graded, whether assessments should be done in the workplace or training institutions, and whose responsibility they are. Competence should be very broadly defined as both technical skills and as…
Sloan, Kelly; Hilley, Robert
This competency-based curriculum guide for instructing students in using computer numerically controlled (CNC) turning machines is one of a series of instructional guides for the machinist field developed in Oklahoma. Although developed jointly with Baxter Technologies Corporation and oriented toward the Baxter Vo-Tec 2000 Future Builder CNC…
Clerkin, Kris; Simon, Yvonne
This article presents a new model of education that works with employers to help their employees gain the skills and credentials needed for promotions and career mobility. Southern New Hampshire University's College for America, a competency-based education model for working adults, increases their access to, and the convenience of higher…
Le Goff, Solenn; Ristol, Santi; Estévez, José Antonio
Please, cite this publication as: Le Goff, S., Ristol, S., & Estévez, J.A. (2006). Employing Competence based Management to enhance Training Effectiveness. Proceedings of International Workshop in Learning Networks for Lifelong Competence Development, TENCompetence Conference. March 30th-31st,
Popova, Viktoria; Clougherty, R. J., Jr.
In this article, the authors report that, as the importance of competency-based learning (CBL) in higher education discourse surges, it not only further validates prior learning assessment (PLA), but it demonstrates PLA's essential nature as an important framework for assessing learning that has been acquired outside of traditional academia.…
Pediatric healthcare providers' perspectives on barriers to diabetes self-management among youth with type 1 diabetes and strategies to overcome them were explored qualitatively. Family conflict about diabetes care was viewed as a common problem, addressable by behavioral interventions to improve co...
Jacobstein, Roy; Stanley, Harriet
Contraceptive implants are extremely effective, long acting, and suitable for nearly all women-to delay, space, or limit pregnancies-and they are increasingly popular. Now, markedly reduced prices and innovative service delivery models using dedicated non-physician service providers offer a historic opportunity to help satisfy women's growing need for family planning.
Hwang, Boyoung; Luttik, Marie Louise; Dracup, Kathleen; Jaarsma, Tiny
Background: Knowledge about the potential burden for family caregivers related to the care of patients with heart failure (HF) is limited. The aims of the study were to compare the kind and amount of care provided by partners of HF patients and partners of healthy individuals and to examine the
Frith, Lucy; Blyth, Eric; Lui, Steve
What contact arrangements are established between providers and recipients of embryos using Snowflakes® Embryo Adoption Program? Contact arrangements varied considerably and were generally positively described, although some challenges were acknowledged. Reproductive technologies create new and diverse family forms, and the ways in which families created by embryo adoption are negotiated in practice have not been extensively investigated. This exploratory, mixed-methods study had two phases: (i) an online survey (open May-September 2013) and (ii) qualitative semi-structured interviews by email (conducted between 2014 and 2015), exploring participants' experiences of contact with their embryo provider or recipient. Phase I included 17 providers (14 women and 3 men) and 28 recipients (27 women and 1 man). Phase II included 8 providers (5 women and 3 men) and 12 recipients (10 women and 2 men). All participants, except one, were located in the US. This study illustrates how embryo adoption in the US, as a form of conditional donation, can operate and how the participants define and negotiate these emerging relationships. All families were open with their children about how they were conceived and early contact between recipients and providers (frequently before birth) was valued. On the whole, participants were happy with the amount and type of contact they had, and where the current contact did not involve the children, it was seen as a way of keeping the channels open for future contact when the children were older. Participants often portrayed the opportunities for contact as being in the best interests of the child. The study participants are a particular group who had chosen to either receive or give their embryos via a conditional embryo adoption agency in the US and had established contact. Therefore, this is not a representative sample of those who provide or receive embryos for family building. This embryo adoption model clearly fulfils a need; some people
Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff
A. P. Usol'tsev
Full Text Available Introduction. In the last one and a half decades in Russian education competence-based approach has widely extended. Competence-based approach arose in the 1970s in the USA and gained development for the solution of problems of professional education. During mass realization of this approach in the system of the Russian education its idea began to be emasculated and turned into own contrast gradually. As a result, the advantages of the competence-based concept were leveled down, and it lost its practical importance.The aim of the present publication is to prepare the empirical bases of competence- based approach, to open an essence of its theoretical kernel – the term "competence", to define limits of its applicability and expediency of use.Methods. Competence-based approach is considered by the author according to the general methodological structure of the scientific theory. The analysis and synthesis of theses of normative documents (Federal State Educational Standards, contents of the scientific and methodical works and scientific publications devoted to the practical application of competence-based approach are performed.Results and scientific novelty. From critical positions various definitions of competence as a key concept of competence-based approach are analysed. The general scheme of formation of competence is presented. The need of accurate localization of its content which provides speed of achievement of the required results and a possibility of their diagnostics is emphasized. The framework of application of competence-based approach is designated: it is effective if trainees are trained for performance of unambiguously described, algorithmic professional functions; it is of little use for training of specialists whose future professional activity means a big share of a productive, creative component; it is irrational in school education which is aimed at the general development, but not at early narrow
Dannefer, Elaine F; Henson, Lindsey C
Despite the rapid expansion of interest in competency-based assessment, few descriptions of assessment systems specifically designed for a competency-based curriculum have been reported. The purpose of this article is to describe the design of a portfolio approach to a comprehensive, competency-based assessment system that is fully integrated with the curriculum to foster an educational environment focused on learning. The educational design goal of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University was to create an integrated educational program-curriculum and instructional methods, student assessment processes, and learning environment-to prepare medical students for success in careers as physician investigators. The first class in the five-year program matriculated in 2004. To graduate, a student must demonstrate mastery of nine competencies: research, medical knowledge, communication, professionalism, clinical skills, clinical reasoning, health care systems, personal development, and reflective practice. The portfolio provides a tool for collecting and managing multiple types of assessment evidence from multiple contexts and sources within the curriculum to document competence and promote reflective practice skills. This article describes how the portfolio was developed to provide both formative and summative assessment of student achievement in relation to the program's nine competencies.
Shriner, Michael; Schlee, Bethanne M.; Mullis, Ronald L.; Cornille, Thomas A.; Mullis, Ann K.
Federal and State Governments provide childcare subsidies for low-income working families. This study compares the encountered issues and working environments of family home providers of subsidized and non-subsidized childcare. Questionnaires were distributed throughout a southeastern state in the United States to 548 family home childcare…
Boyd, Victoria A; Whitehead, Cynthia R; Thille, Patricia; Ginsburg, Shiphra; Brydges, Ryan; Kuper, Ayelet
Over the last two decades, competency-based frameworks have been internationally adopted as the primary educational approach in medicine. Yet competency-based medical education (CBME) remains contested in the academic literature. We look broadly at the nature of this debate to explore how it may shape scholars' understanding of CBME, and its implications for medical education research and practice. In doing so, we deconstruct unarticulated discourses and assumptions embedded in the CBME literature. We assembled an archive of literature focused on CBME. The archive dates from 1996, the publication year of the first CanMEDS Physician Competency Framework. We then conducted a Foucauldian critical discourse analysis (CDA) to delineate the dominant discourses underpinning the literature. CDA examines the intersections of language, social practices, knowledge and power relations to highlight how entrenched ways of thinking influence what can or cannot be said about a topic. Detractors of CBME have advanced an array of conceptual critiques. Proponents have often responded with a recurring discursive strategy that minimises these critiques and deflects attention from the underlying concept of the competency-based approach. As part of this process, conceptual concerns are reframed as two practical problems: implementation and interpretation. Yet the assertion that these are the construct's primary concerns was often unsupported by empirical evidence. These practices contribute to a discourse of infallibility of CBME. In uncovering the discourse of infallibility, we explore how it can silence critical voices and hinder a rigorous examination of the competency-based approach. These discursive practices strengthen CBME by constructing it as infallible in the literature. We propose re-approaching the dialogue surrounding CBME as a starting point for empirical investigation, driven by the aim to broaden scholars' understanding of its design, development and implementation in
Bergsmann, Evelyn; Schultes, Marie-Therese; Winter, Petra; Schober, Barbara; Spiel, Christiane
Competence-based teaching in higher education institutions and its evaluation have become a prevalent topic especially in the European Union. However, evaluation instruments are often limited, for example to single student competencies or specific elements of the teaching process. The present paper provides a more comprehensive evaluation concept that contributes to sustainable improvement of competence-based teaching in higher education institutions. The evaluation concept considers competence research developments as well as the participatory evaluation approach. The evaluation concept consists of three stages. The first stage evaluates whether the competencies students are supposed to acquire within the curriculum (ideal situation) are well defined. The second stage evaluates the teaching process and the competencies students have actually acquired (real situation). The third stage evaluates concrete aspects of the teaching process. Additionally, an implementation strategy is introduced to support the transfer from the theoretical evaluation concept to practice. The evaluation concept and its implementation strategy are designed for internal evaluations in higher education and primarily address higher education institutions that have already developed and conducted a competence-based curriculum. Copyright © 2015 Elsevier Ltd. All rights reserved.
Swing, Susan R
A central component of competency-based medical education is a framework of higher-order and more fundamental competencies whose purpose is to focus instruction and learning. In the language of the learning sciences, many of these competencies are complex cognitive-perceptual or cognitive-motor skills. Competency-based medical education has been criticized for being reductionistic, that is, for focusing on atomistic skills and failing to capture the essence of professional activities as manifested by complex, integrated capabilities. The value of identifying fundamental skill components is supported by theory and evidence from the learning sciences, however. Complex skills are constructed from fundamental, component skills. Proficient performance of the former is achieved as components are refined and integrated during repeated performance of the skill in a realistic context and as feedback on performance is provided. Competency-based medical education does not propose specific methods for teaching competencies. The learning and instructional sciences, however, posit a number of conditions for learning that support the acquisition of simple skills and their flexible integration into complex capabilities. Learners' motivation and self-regulation skills will also have an impact on the extent to which they engage in learning processes that result in the integration of knowledge and skills into complex competencies.
Nagunwa, Thomas; Lwoga, Edda
This paper provides the practical experience of developing an eLearning technology as a tool to implement Competency-based Medical Education (CBME) in Tanzania medical universities, with a specific focus on Muhimbili University of Health and Allied Sciences. The paper provides a background to eLearning and the early attempt to adopt it in 2006 at…
Feagan, Lori M; Fisher, Nancy J
The majority of acute care facilities have not developed policies or guidelines to facilitate family presence during cardiopulmonary resuscitation. Prior studies have shown that the personal beliefs and attitudes of hospital personnel involved in resuscitation efforts are the primary reasons family presence is not offered. This 2-phase, before/after study was conducted in a 388-bed academic trauma center, and in a 143-bed community hospital in eastern Washington State in 2008. In phase I, a convenience sample of physicians and registered nurses from both facilities were surveyed about their opinions and beliefs regarding family-witnessed resuscitation (FWR). Spearman's rho and independent t-tests were used to compare support of FWR between and within roles and practice location subgroups. In phase II of the study, clinician subgroups in the community hospital were re-surveyed following an educational program that used evidence-based information. Independent t-test and one-way ANOVA were used to compare pre and post-education mean scores of subgroups on indicators of effective teaching strategies and improved FWR support. Opinions on FWR vary within and between practice roles and locations, with the strongest variable of support being prior experience with FWR. Following FWR education, mean scores improved for survey variables chosen as indicators of FWR support and teaching effectiveness. When CPR providers are presented with FWR education, their opinion-based beliefs may be modified, decreasing barriers to family witnessed resuscitation and improving overall support of FWR as an extension of family-centered care. Copyright © 2011 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.
Ashida, Sato; Hadley, Donald W.; Goergen, Andrea F.; Skapinsky, Kaley F.; Devlin, Hillary C.; Koehly, Laura M.
Purpose: This study evaluates the role of older family members as providers of social resources within familial network systems affected by an inherited cancer susceptibility syndrome. Design and Methods: Respondents who previously participated in a study that involved genetic counseling and testing for Lynch syndrome and their family network…
Schofield, Gillian; Beek, Mary
This paper reports on a longitudinal study of children growing up in long-term foster family care. It focuses attention on the challenges for foster carers in providing a secure base for foster children in middle childhood and early adolescence, who have come predominantly from backgrounds of abuse, neglect, and psychosocial adversity. Separation and loss in the children's lives, often through multiple placements, increase the likelihood of difficulties across a range of development. These children tend to be wary, distrustful, and controlling when they enter foster placements, but need from their carers many of the caregiving qualities most commonly described as providing a secure base in infancy. This study describes a model of parenting which uses four caregiving dimensions that are consistent with attachment theory and research: promoting trust in availability, promoting reflective function, promoting self-esteem, and promoting autonomy. A fifth dimension, promoting family membership, is added, as it reflects the need for children in long-term foster family care to experience the security that comes from a sense of identity and belonging. Qualitative data from the study demonstrates the usefulness of this model as a framework for analysis, but also suggests the potential use of such a framework for working with and supporting foster carers.
Willyane de Andrade Alvarenga
Full Text Available During and after pregnancy, mothers with HIV can undergo treatment that is capable of preventing vertical transmission (VT to their babies. The purpose of this study was to analyze the experience of family members that provide care for children whose mothers have HIV, to reduce the risk of VT, with emphasis on the beginning of this trajectory. This study was based on the qualitative approach and Symbolic Interactionism was adopted as a theoretical framework. A total of 36 family members participated in the study, all of whom were carers of children aged up to 18 months and waiting for confirmation of the HIV diagnosis. Data were collected in a hospital in north-eastern Brazil, between December 2012 and February 2013, and examined by means of content analysis. Child care began during pregnancy, when the possibility of the child having HIV was expected. Some had previous experience in providing care for exposed children. Understanding the early trajectory of care will help find ways to provide better support for carers during the trajectory of diagnosis confirmation.
Dinardi, A.; Bjelde, B.; Insprucker, J.
The Falcon family of launch vehicles, developed by Space Exploration Technologies Corporation (SpaceX), are designed to provide the world's lowest cost access to orbit. Highly reliable, low cost launch services offer considerable opportunities for risk reduction throughout the life cycle of satellite programs. The significantly lower costs of Falcon 1 and Falcon 9 as compared with other similar-class launch vehicles results in a number of new business case opportunities; which in turn presents the possibility for a paradigm shift in how the satellite industry thinks about launch services.
Iowa Department of Education, 2018
In 2012 Senate File 2284 approved competency-based education (CBE). In 2013 House File 215 provided $100,000 to be used as grants to districts/schools participating in a collaborative effort toward CBE pathways for their students and a framework toward statewide implementation. The Iowa CBE Collaborative will engage in collaborative inquiry to…
Buche, Fred; Cox, Charles
A competency-based automotive mechanics curriculum was developed at Big Bend Community College (Washington) in order to provide the basis for an advanced placement procedure for high school graduates and experienced adults through a competency assessment. In order to create the curriculum, Big Bend Community College automotive mechanics…
Full Text Available To quantify the impact of service provider characteristics on young people's choice of family planning (FP service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth.A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15-24. Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP and described by six attributes (the distance between participants' home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers' attitude, availability of FP commodities and price. A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01 and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01. Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth.Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available.
Ugaz, Jorge; Leegwater, Anthony; Chatterji, Minki; Johnson, Doug; Baruwa, Sikiru; Toriola, Modupe; Kinnan, Cynthia
Private health care providers are an important source of modern contraceptives in Sub-Saharan Africa, yet they face many challenges that might be addressed through targeted training. This study measures the impact of a package of trainings and supportive supervision activities targeted to private health care providers in Lagos State, Nigeria, on outcomes including range of contraceptive methods offered, providers' knowledge and quality of counseling, recordkeeping practices, access to credit and revenue. A total of 965 health care facilities were randomly assigned to treatment and control groups. Facilities in the treatment group-but not those in the control group-were offered a training package that included a contraceptive technology update and interventions to improve counseling and clinical skills and business practices. Multivariate regression analysis of data collected through facility and mystery client surveys was used to estimate effects. The training program had a positive effect on the range of contraceptive methods offered, with facilities in the treatment group providing more methods than facilities in the control group. The training program also had a positive impact on the quality of counseling services, especially on the range of contraceptive methods discussed by providers, their interpersonal skills and overall knowledge. Facilities in the treatment group were more likely than facilities in the control group to have good recordkeeping practices and to have obtained loans. No effect was found on revenue generation. Targeted training programs can be effective tools to improve the provision of family planning services through private providers.
Sturgis, Chris; Patrick, Susan
This exploration into competency-based innovation at the school, district, and state levels suggests that competency-based pathways are a re-engineering of this nation's education system around learning--a re-engineering designed for success in which failure is no longer an option. Competency-based approaches build upon standards reforms, offering…
Misbah, Zainun; Gulikers, Judith; Maulana, Ridwan; Mulder, Martin
Competence-based education requires changing teacher roles probably affecting teacher–student interactions and student motivation. This study examines how students (N = 1469) from competence-based and less-competence-based vocational schools perceive their teachers' interpersonal behaviour and its
Charles, Lesley; Triscott, Jean; Dobbs, Bonnie; Tian, Peter George; Babenko, Oksana
The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency-based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency-based program on residents' learning and their training experience as compared to residents trained using learning objectives. The data from the 2007-2013 COE residents were used in the study, with nine and eight residents trained in the LO and CC programs, respectively. Residents' learning was measured using preceptors' evaluations of residents' skills/abilities throughout the program (118 evaluations in total). Residents' rating of training experience was measured using the Graduate's Questionnaire which residents completed after graduation. For residents' learning, overall, there was no significant difference between the two programs. However, when examined as a function of the four CanMEDS roles, there were significant increases in the CC residents' scores for two of the CanMEDS roles: Communicator/Collaborator/Manager and Scholar compared to residents in the LO program. With respect to residents' training experience, seven out of ten program components were rated by the CC residents higher than by the LO residents. The implementation of a COE CC program appears to facilitate resident learning and training experience.
de la Vara-Salazar, Elvia; Suárez-López, Leticia; Rivera, Leonor; Lazcano-Ponce, Eduardo
Family planning (FP) counseling is an essential activity to prevent unplanned pregnancies and allow a fulfilling sex life. We defined adequate counseling in FP as the counseling given to women and men of reproductive age that provided complete information about use, application, effectiveness, side effects, and contraindications. Two objectives are proposed in this study. First, we seek to analyze geographic and institutional factors associated with FP counseling in primary and secondary healthcare facilities in Mexico. Second, we seek to identify the cultural barriers that providers perceive as a limitation of the clients so that they can come to request information related to FP and that are associated with FP counseling. This cross-sectional study uses a complex, probabilistic, stratified sampling design representative at national level by institution, region and rural-urban areas. We collected 16,829 provider questionnaires at healthcare facilities. Bivariate and logistic regression analyses were performed. Providers in rural areas had a greater possibility of offering adequate counseling (OR = 2.98; 95%CI 1.18-7.53). Providers in the northern region of the country were more likely to provide adequate counseling (OR = 5.37; 95% CI 1.91-15.12). Providers whom perceive religion as a limitation for clients to come to request information about FP are less likely to provide adequate counseling (OR = 0.37; 95% CI 0.15-0.88). Physical space exclusively for the provision of FP counseling and the availability of manuals were not associated with adequate counseling. There is a need to address the social and cultural influences on the quality of counseling in these healthcare facilities. Copyright © 2018 Elsevier B.V. All rights reserved.
Full Text Available Implementation of competency-based pharmacy education (CBPE is a time-consuming, complicated process, which requires agreement on the tasks of a pharmacist, commitment, institutional stability, and a goal-directed developmental perspective of all stakeholders involved. In this article the main steps in the development of a fully-developed competency-based pharmacy curriculum (bachelor, master are described and tips are given for a successful implementation. After the choice for entering into CBPE is made and a competency framework is adopted (step 1, intended learning outcomes are defined (step 2, followed by analyzing the required developmental trajectory (step 3 and the selection of appropriate assessment methods (step 4. Designing the teaching-learning environment involves the selection of learning activities, student experiences, and instructional methods (step 5. Finally, an iterative process of evaluation and adjustment of individual courses, and the curriculum as a whole, is entered (step 6. Successful implementation of CBPE requires a system of effective quality management and continuous professional development as a teacher. In this article suggestions for the organization of CBPE and references to more detailed literature are given, hoping to facilitate the implementation of CBPE.
Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin
Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.
at the same period, staff performance were not desirable in some processes and/or sub-processes. Conclusion: This study demonstrated the educational needs of family health providers in 6 task processes and prioritized them according to their views. Regular and comprehensive educational needs assessments are required to revise staff training programs, in order to give quality services to general population.
Siebes, R C; Nijhuis, B J G; Boonstra, A M; Ketelaar, M; Wijnroks, L; Reinders-Messelink, H A; Postema, K; Vermeer, A
To examine the validity and utility of the Dutch Measure of Processes of Care for Service Providers (MPOC-SP) as a family-specific measure. A validation study. Five paediatric rehabilitation settings in the Netherlands. The MPOC-SP was utilized in a general (reflecting on services provided for all clients and clients' families) and family-specific way (filled out in reference to a particular child and his or her family). Professionals providing rehabilitation and educational services to children with cerebral palsy. For construct validity, Pearson's product-moment correlation coefficients (r ) between the scales were calculated. The ability of service providers to discriminate between general and family-specific ratings was examined by exploration of absolute difference scores. One hundred and sixteen service professionals filled out 240 family-specific MPOC-SPs. In addition, a subgroup of 81 professionals filled out a general MPOC-SP. For each professional, family-specific and general scores were paired, resulting in 151 general-family-specific MPOC-SP pairs. The construct validity analyses confirmed the scale structure: 21 items (77.8%) loaded highest in the original MPOC-SP factors, and all items correlated best and significantly with their own scale score (r 0.565 to 0.897; PService providers were able to discriminate between general and family-specific MPOC-SP item ratings. The family-specific MPOC-SP is a valid measure that can be used for individual evaluation of family-centred services and can be the impetus for family-related quality improvement.
Peter, Beate; Raskind, Wendy H.
Purpose To evaluate phenotypic expressions of speech sound disorder (SSD) in multigenerational families with evidence of familial forms of SSD. Method Members of five multigenerational families (N = 36) produced rapid sequences of monosyllables and disyllables and tapped computer keys with repetitive and alternating movements. Results Measures of repetitive and alternating motor speed were correlated within and between the two motor systems. Repetitive and alternating motor speeds increased in children and decreased in adults as a function of age. In two families with children who had severe speech deficits consistent with disrupted praxis, slowed alternating, but not repetitive, oral movements characterized most of the affected children and adults with a history of SSD, and slowed alternating hand movements were seen in some of the biologically related participants as well. Conclusion Results are consistent with a familial motor-based SSD subtype with incomplete penetrance, motivating new clinical questions about motor-based intervention not only in the oral but also the limb system. PMID:21909176
Rodriguez, Violeta J; Cook, Ryan R; Weiss, Stephen M; Peltzer, Karl; Jones, Deborah L
Patient-provider family planning discussions and preconception counseling can reduce maternal and neonatal risks by increasing adherence to provider recommendations and antiretroviral medication. However, HIV-infected women may not discuss reproductive intentions with providers due to anticipation of negative reactions and stigma. This study aimed to identify correlates of patient-provider family planning discussions among HIV-infected women in rural South Africa, an area with high rates of antenatal HIV and suboptimal rates of prevention of mother-to-child transmission (PMTCT) of HIV. Participants were N=673 pregnant HIV-infected women who completed measures of family planning discussions and knowledge, depression, stigma, intimate partner violence, and male involvement. Participants were, on average, 28 ± 6 years old, and half of them had completed at least 10-11 years of education. Most women were unemployed and had a monthly income of less than ~US$76. Fewer than half of the women reported having family planning discussions with providers. Correlates of patient-provider family planning discussions included younger age, discussions about PMTCT of HIV, male involvement, and decreased stigma ( p family planning discussions through male involvement ( b = -0.010, bias-corrected 95% confidence interval [bCI] [-0.019, -0.005]). That is, depression decreased male involvement, and in turn, male involvement increased patient-provider family planning discussions. Therefore, by decreasing male involvement, depression indirectly decreased family planning discussions. Study findings point to the importance of family planning strategies that address depression and facilitate male involvement to enhance communication between patients and providers and optimize maternal and neonatal health outcomes. This study underscores the need for longitudinal assessment of men's impact on family planning discussions both pre- and postpartum. Increasing support for provision of mental
McAloone, Timothy Charles
the object of a research exercise, to affect and observe various approaches to the teaching of design. Particular attention will be paid in this case to competencies, both initiated in the teaching and the evaluated in the students’ interpretation of the theoretical contents. The lessons learned from...... through educational curricula and research programmes. This paper presents an initiative from Denmark, showing new interpretations of industrial needs, research insights, educational ideas and identification of core innovative engineering competencies. The new Danish Master of Science engineering...... the first three years of this semester’s application and teaching to approximately 55 students per year are presented and discussed. After introducing the motivation and background for establishing the education programme, the consideration of competence-based education is described, in the context...
Ebert, Thomas J; Fox, Chris A
The Accreditation Council for Graduate Medical Education is transitioning to a competency-based system with milestones to measure progress and define success of residents. The confines of the time-based residency will be relaxed. Curriculum must be redesigned and assessments will need to be precise and in-depth. Core anesthesiology faculty will be identified and will be the "trained observers" of the residents' progress. There will be logistic challenges requiring creative management by program directors. There may be residents who achieve "expert" status earlier than the required 36 months of clinical anesthesia education, whereas others may struggle to achieve acceptable status and will require additional education time. Faculty must accept both extremes without judgment. Innovative new educational opportunities will need to be created for fast learners. Finally, it will be important that residents embrace this change. This will require programs to clearly define the specific aims and measurement endpoints for advancement and success.
Alman, Benjamin A; Ferguson, Peter; Kraemer, William; Nousiainen, Markku T; Reznick, Richard K
The current methods used to train residents to become orthopaedic surgeons are based on tradition, not evidence-based models. Educators have only a limited ability to assess trainees for competency using validated tests in various domains. The reduction in resident work hours limits the time available for clinical training, which has resulted in some calls for lengthening the training process. Another approach to address limited training hours is to focus training in a program that allows residents to graduate from a rotation based on demonstrated competency rather than on time on a service. A pilot orthopaedic residency curriculum, which uses a competency-based framework of resident training and maximizes the use of available training hours, has been designed and is being implemented.
Pedro, Akeem; Hai Chien, Pham; Park, Chan Sik
Accidents still prevail in the construction industry, resulting in injuries and fatalities all over the world. Educational programs in construction should deliver safety knowledge and skills to students who will become responsible for ensuring safe construction work environments in the future. However, there is a gap between the competencies current pedagogical approaches target, and those required for safety in practice. This study contributes to addressing this issue in three steps. Firstly, a vision for competency-based construction safety education is conceived. Building upon this, a research scheme to achieve the vision is developed, and the first step of the scheme is initiated in this study. The critical competencies required for safety education are investigated through analyses of literature, and confirmed through surveys with construction and safety management professionals. Results from the study would be useful in establishing and orienting education programs towards current industry safety needs and requirements
ten Cate, Olle
Full Text Available Since the turn of the twenty-first century, competency-based medical education (CBME has become a dominant approach to postgraduate medical education in many countries. CBME has a history dating back half a century and is rooted in general educational approaches such as outcome-based education and mastery learning. Despite controversies around the terminology and the CBME approach, important national medical regulatory bodies in Canada, the United States, and other countries have embraced CBME. CBME can be characterized as having two distinct features: a focus on specific domains of competence, and a relative independence of time in training, making it an individualized approach that is particularly applicable in workplace training. It is not the length of training that determines a person’s readiness for unsupervised practice, but the attained competence or competencies. This shift in focus makes CBME different from traditional training. In this contribution, definitions of CBME and related concepts are detailed.
The ACPSEM together with the Australian Radiation Protection Society has been working for nearly two years now on a competency based standards project for the professions of medical and health physicists. Competencies are being used increasingly in industry and the professions as a means of determining skill levels. For example, all the medical radiation technology streams have a CBS system in the final stages of development, and our engineering colleagues have completed theirs. Last year there was a draft document sent to all members asking for feedback. Following a vote of funding by both bodies, a project offect (Dr David Waggett) has been appointed, and has produced a very much improved set of competency standards covering all significant subspecialties in our profession. This workshop will detail the work done so far, and preview the draft document. A healthy discussion will be encouraged, as the project steering group will shortly be arranging the next steps in process. (author)
Full Text Available Inclusive development is mean to accommodate the marginalized people, most of whom are the poor with problem of fulfilling their need of housing. The government has tried hard to meet the need of housing by constructing rusunawa. This paper is aimed at describing about the provision and uses of rusunawa, both in cities and peri urban area by studying the cases in the City of Yogyakarta, Sleman Regency, and Bantul Regency. The study was conducted by doing observation and both structured and in-depth interviews. The research results show that rusunawa was viewed as one solutions to help low-income family in fulfilling their need of housing. In some cases in the City of Yogyakarta, rusunawa plays an important role in preventing the settlement along both sides of rivers from becoming slum areas. Rusunawa in both Regencies of Sleman and Bantul are located near the city so it is easy for the settlers to get to their workplace. The construction of rusunawa has also paid attention to the disabled by providing special facilities. The same case is providing playground for children and facilities for early education for young kids. However, there have not been special facilities for the elderly and pregnant women.
Casarett, David J; Spence, Carol; Haskins, Matthew; Teno, Joan
Job satisfaction is particularly important in the hospice industry, given the emotional and interpersonal challenges that hospice staff face in providing care to patients near the end of life and their families. However, little is known about the job satisfaction of hospice providers, or about variation in satisfaction among disciplines. Staff at participating hospices completed the Survey of Team Attitudes and Relationships (STAR) using an online user interface. The STAR has 6 domains that comprise 45 items. Results were submitted for 8,495 staff from 177 hospices in 41 states. The mean total score was 28 on a 0-100 scale (range, 0-100; interquartile range, 8-45) and hospice-level scores ranged from 15 to 44. Nonclinical staff (n = 3260) and clinical staff (n = 5235) had similar total scores (28 for both). Among clinical staff, in a mixed effects model adjusting for individual and hospice characteristics, physicians had the highest total scores (adjusted mean 42; 95% confidence interval: 35-46) compared to chaplains (30; 28-33), bereavement coordinators (27; 24-30), nurses' aides (29; 27-33); nurses (26; 28-33), and social workers (25; 23-26). There is significant variation in job satisfaction both among hospices and disciplines.
Ranse, Kristen; Bloomer, Melissa; Coombs, Maureen; Endacott, Ruth
A core component of family-centred nursing care during the provision of end-of-life care in intensive care settings is information sharing with families. Yet little is known about information provided in these circumstances. To identify information most frequently given by critical care nurses to families in preparation for and during withdrawal of life-sustaining treatment. An online cross-sectional survey. During May 2015, critical care nurses in Australia and New Zealand were invited to complete the Preparing Families for Treatment Withdrawal questionnaire. Data analysis included descriptive statistics to identify areas of information most and least frequently shared with families. Cross tabulations with demographic data were used to explore any associations in the data. From the responses of 159 critical care nurses, information related to the emotional care and support of the family was most frequently provided to families in preparation for and during withdrawal of life-sustaining treatment. Variation was noted in the frequency of provision of information across body systems and their associated physical changes during the dying process. Significant associations (p<0.05) were identified between the variables gender, nursing experience and critical care experiences and some of the information items most and least frequently provided. The provision of information during end-of-life care reflects a family-centred care approach by critical care nurses with information pertaining to emotional care and support of the family paramount. The findings of this study provide a useful framework for the development of interventions to improve practice and support nurses in communicating with families at this time. Copyright © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
Knapp, Caprice A; Madden, Vanessa L; Marcu, Mircea I
Partnering between families and their children's providers is a cornerstone of family-centered care. This study aimed to identify factors associated with family-provider partnership and determine the association between partnership and other outcome measures for children with special health care needs (CSHCN). Descriptive, bivariate, and multivariate analyses were conducted using data from the 2005-2006 National Survey of Children with Special Health Care Needs. Multivariate models showed that CSHCN who are White non-Hispanic, younger than 12, reside in households with incomes above 400% of the federal poverty level, and have a usual source of care were associated with family-provider partnership. Multivariate models showed that family-provider partnership was significantly associated with adequate insurance, early and continual screening, organized health care services, and transition preparedness. Family-provider partnership was associated with 20% fewer emergency department visits and 9% fewer school days missed. This study suggests that policies aimed at promoting family-provider partnership could increase health outcomes for CSHCN.
Stern, Lisa F; Simons, Hannah R; Kohn, Julia E; Debevec, Elie J; Morfesis, Johanna M; Patel, Ashlesha A
To describe contraceptive use among U.S. female family planning providers and to compare their contraceptive choices to the general population. We surveyed a convenience sample of female family planning providers ages 25-44 years, including physicians and advanced practice clinicians, via an internet-based survey from April to May 2013. Family planning providers were compared to female respondents ages 25-44 years from the 2011-2013 National Survey of Family Growth. A total of 488 responses were eligible for analysis; 331 respondents (67.8%) were using a contraceptive method. Providers' contraceptive use differed markedly from that of the general population, with providers significantly more likely to use intrauterine contraception, an implant, and the vaginal ring. Providers were significantly less likely to use female sterilization and condoms. There were no significant differences between providers and the general population in use of partner vasectomy or the pill. Long-acting reversible contraception (LARC) use was significantly higher among providers than in the general population (41.7% vs. 12.1%, pfamily planning providers differed significantly from the general population. These findings have implications for clinical practice, patient education, and health policy. Family planning providers report higher use of LARC than the general population. This may reflect differences in preferences and access. Providers might consider sharing these findings with patients, while maintaining patient choice and autonomy. Copyright © 2015 Elsevier Inc. All rights reserved.
Stajduhar, Kelli I; Funk, Laura; Outcalt, Linda
Family caregivers are assuming growing responsibilities in providing care to dying family members. Supporting them is fundamental to ensure quality end-of-life care and to buffer potentially negative outcomes, although family caregivers frequently acknowledge a deficiency of information, knowledge, and skills necessary to assume the tasks involved in this care. The aim of this inquiry was to explore how family caregivers describe learning to provide care to palliative patients. Secondary analysis of data from four qualitative studies (n = 156) with family caregivers of dying people. Data included qualitative interviews with 156 family caregivers of dying people. Family caregivers learn through the following processes: trial and error, actively seeking needed information and guidance, applying knowledge and skills from previous experience, and reflecting on their current experiences. Caregivers generally preferred and appreciated a supported or guided learning process that involved being shown or told by others, usually learning reactively after a crisis. Findings inform areas for future research to identify effective, individualized programs and interventions to support positive learning experiences for family caregivers of dying people.
Keisling, Bruce L; Bishop, Elizabeth A; Roth, Jenness M
Background While the MCH Leadership Competencies and family as a discipline have been required elements of Leadership Education in Neurodevelopmental and related Disabilities (LEND) programs for over a decade, little research has been published on the efficacy of either programmatic component in the development of the next generation of leaders who can advocate and care for Maternal and Child Health (MCH) populations. Objective To test the effectiveness of integrating the family discipline through implementation of parent led curricula on trainees' content knowledge, skills, and leadership development in family-centered care, according to the MCH Leadership Competencies. Methods One hundred and two long-term (≥ 300 h) LEND trainees completed a clinical and leadership training program which featured intensive parent led curricula supported by a full-time family faculty member. Trainees rated themselves on the five Basic and Advanced skill items that comprise MCH Leadership Competency 8: Family-centered Care at the beginning and conclusion of their LEND traineeship. Results When compared to their initial scores, trainees rated themselves significantly higher across all family-centered leadership competency items at the completion of their LEND traineeship. Conclusions The intentional engagement of a full-time family faculty member and parent led curricula that include didactic and experiential components are associated with greater identification and adoption by trainees of family-centered attitudes, skills, and practices. However, the use of the MCH Leadership Competencies as a quantifiable measure of program evaluation, particularly leadership development, is limited.
Nicklas, T A; Baranowski, T; Baranowski, J C; Cullen, K; Rittenberry, L; Olvera, N
Children's intakes of fruit, juice, and vegetables (FJV) do not meet the recommended minimum of five daily servings, placing them at increased risk for development of cancer and other diseases. Because children's food preferences and practices are initiated early in life (e.g., 2-5 years of age), early dietary intervention programs may have immediate nutritional benefit, as well as reduce chronic disease risk when learned healthful habits and preferences are carried into adulthood. Families and child-care settings are important social environments within which food-related behaviors among young children are developed. FJV preferences, the primary predictor of FJV consumption in children, are influenced by availability, variety, and repeated exposure. Caregivers (parents and child-care providers) can influence children's eating practices by controlling availability and accessibility of foods, meal structure, food modeling, food socialization practices, and food-related parenting style. Much remains to be learned about how these influences and practices affect the development of FJV preferences and consumption early in life.
Seidman, Dominika; Carlson, Kimberly; Weber, Shannon; Witt, Jacki; Kelly, Patricia J
The Centers for Disease Control and Prevention defines HIV prevention as a core family planning service. The HIV community identified family planning visits as key encounters for women to access preexposure prophylaxis (PrEP) for HIV prevention. No studies explore US family planning providers' knowledge of and attitudes towards PrEP. We conducted a national survey of clinicians to understand barriers and facilitators to PrEP implementation in family planning. Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed. Among 604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers (physicians, nurse practitioners, midwives or physicians assistants). Among potential prescribers, 38% correctly defined PrEP [95% confidence interval (CI): 32.5-42.8], 37% correctly stated the efficacy of PrEP (95% CI: 32.0-42.4), and 36% chose the correct HIV test after a recent exposure (95% CI: 30.6-40.8). Characteristics of those who answered knowledge questions correctly included age less than 35 years, practicing in the Northeast or West, routinely offering HIV testing, providing rectal sexually transmitted infection screening or having seen any PrEP guidelines. Even among providers in the Northeast and West, the proportion of respondents answering questions correctly was less than 50%. Thirty-six percent of respondents had seen any PrEP guidelines. Providers identified lack of training as the main barrier to PrEP implementation; 87% wanted PrEP education. To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing. US family planning providers have limited knowledge about HIV PrEP and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure that family planning clients access comprehensive HIV prevention methods
Full Text Available The paper focuses on the Tuning Russia project. It aims at providing an overview of the impact of the Tuning methodology and outcomes concerning University teaching, learning, and assessment activities. It identifies: the most relevant results and “lesson learnt” during the project; tools/concepts/experiences that involved teachers found most interesting; strengths and weaknesses; the usefulness of working with colleagues from different Russian universities; and the level of sharing of the Tuning methodology with other colleagues within participating Universities. The empirical data for the study were drawn from a qualitative questionnaire with open questions filled-in by the members of the subject area group “Social Work” involved in the Tuning Russia project. The respondents were six academic teachers from different Russian universities and two European Tuning experts. This reflection by academic teachers upon the initial implementation of the Tuning approach in Russia highlights the opportunities to explore methods of establishing and improving communities of practice in the field of competence-based higher education curriculum development. Results highlight the need to develop further work concerning both summative and formative evaluation in relation to competence-based curricula review in higher education
Desai, Mitesh; Davies, Olubanke; Menon-Johansson, Anatole; Sethi, Gulshan Cindy
Specialty trainees in genitourinary medicine (GUM) are required to attain competencies described in the GUM higher specialty training curriculum by the end of their training, but learning opportunities available may conflict with service delivery needs. In response to poor feedback on trainee satisfaction surveys, a four-year modular training programme was developed to achieve a curriculum competencies-based approach to training. We evaluated the clinical opportunities of the new programme to determine: (1) Whether opportunity cost of training to service delivery is justifiable; (2) Which competencies are inadequately addressed by direct clinical opportunities alone and (3) Trainee satisfaction. Local faculty and trainees assessed the 'usefulness' of the new modular programme to meet each curriculum competence. The annual General Medical Council (GMC) national training survey assessed trainee satisfaction. The clinical opportunities provided by the modular training programme were sufficiently useful for attaining many competencies. Trainee satisfaction as captured by the GMC survey improved from two reds pre- to nine greens post-intervention on a background of rising clinical activity in the department. The curriculum competencies-based approach to training offers an objective way to balance training with service provision and led to an improvement in GMC survey satisfaction.
The learning goals and evaluation strategies of competency-based midwifery programs must be explicit and well-defined. In the US, didactic learning is evaluated through a standardized certification examination, but standardized clinical competence evaluation is lacking. The Midwifery Competency Assessment Tool (MCAT) has been adapted from the International Confederation of Midwives' (ICM) "Essential Competencies" and from the American College of Nurse-Midwives' (ACNM) "Core Competencies", with student self-evaluation based on Benner's Novice-to-Expert theory. The MCAT allows for the measurement and monitoring of competence development in all domains of full-scope practice over the course of the midwifery program. Strengths of the MCAT are that it provides clear learning goals and performance evaluations for students, ensures and communicates content mapping across a curriculum, and highlights strengths and gaps in clinical opportunities at individual clinical sites and for entire programs. Challenges of the MCAT lie in balancing the number of competency items to be measured with the tedium of form completion, in ensuring the accuracy of student self-evaluation, and in determining "adequate" competence achievement when particular clinical opportunities are limited. Use of the MCAT with competency-based clinical education may facilitate a more standardized approach to clinical evaluation, as well as a more strategic approach to clinical site development and use. Copyright © 2018 Elsevier Ltd. All rights reserved.
Oyegbile, Yemisi Okikiade; Brysiewicz, Petra
To describe the experiences of family caregivers providing care for patients living with End-Stage Renal Disease in Nigeria BACKGROUND: Family caregiving is where an unpaid volunteer, usually a close family member, attends to the needs of a loved one with a chronic, disabling illness within the home. Much research has been conducted in the area of family caregiving in high-income countries. However, the same cannot be said for many of the low-resource, multicultural African countries. Qualitative descriptive study. This qualitative descriptive study used manifest content analysis to analyse data from semi-structured, individual interviews, with 15 purposively selected family caregivers. Two tertiary institutions providing renal care in South-Western Nigeria: the research setting for this study. Five categories were identified, and these included disconnectedness with self and others, never-ending burden, 'a fool being tossed around', obligation to care and promoting a closer relationship. Experiences associated with the caregiving of patients diagnosed with End-Stage Renal Disease evoked a number of emotions from the family caregivers, and the study revealed that caregiving imposed some burdens that are specific to low-resource countries on participants. Nurses need to engage family caregivers on disease-specific teachings that might promote understanding of the disease process and role expectation. Family caregivers may benefit from social support services. © 2016 John Wiley & Sons Ltd.
Full Text Available Violeta J Rodriguez,1 Ryan R Cook,1 Stephen M Weiss,1 Karl Peltzer,2–4 Deborah L Jones1 1Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 2HIV/AIDS/STIs and TB (HAST Research Programme, Human Sciences Research Council, Pretoria, South Africa; 3ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand; 4Department of Psychology, University of Limpopo, Turfloop, South Africa Abstract: Patient–provider family planning discussions and preconception counseling can reduce maternal and neonatal risks by increasing adherence to provider recommendations and antiretroviral medication. However, HIV-infected women may not discuss reproductive intentions with providers due to anticipation of negative reactions and stigma. This study aimed to identify correlates of patient–provider family planning discussions among HIV-infected women in rural South Africa, an area with high rates of antenatal HIV and suboptimal rates of prevention of mother-to-child transmission (PMTCT of HIV. Participants were N=673 pregnant HIV-infected women who completed measures of family planning discussions and knowledge, depression, stigma, intimate partner violence, and male involvement. Participants were, on average, 28 ± 6 years old, and half of them had completed at least 10–11 years of education. Most women were unemployed and had a monthly income of less than ~US$76. Fewer than half of the women reported having family planning discussions with providers. Correlates of patient–provider family planning discussions included younger age, discussions about PMTCT of HIV, male involvement, and decreased stigma (p < 0.05. Depression was indirectly associated with patient–provider family planning discussions through male involvement (b = −0.010, bias-corrected 95% confidence interval [bCI] [−0.019, −0.005]. That is, depression decreased male involvement, and in turn, male involvement
Ashida, Sato; Hadley, Donald W; Goergen, Andrea F; Skapinsky, Kaley F; Devlin, Hillary C; Koehly, Laura M
This study evaluates the role of older family members as providers of social resources within familial network systems affected by an inherited cancer susceptibility syndrome. Respondents who previously participated in a study that involved genetic counseling and testing for Lynch syndrome and their family network members were invited to participate in a onetime telephone interview about family communication. A total of 206 respondents from 33 families identified 2,051 social relationships (dyads). Nineteen percent of the respondents and 25% of the network members were older (≥60 years). Younger respondents (≤59 years) were more likely to nominate older network members as providers of social resources than younger members: instrumental support (odds ratio [OR] = 1.68), emotional support (OR = 1.71), help in crisis situation (OR = 2.04), and dependability when needed (OR = 2.15). Compared with younger network members, older members were more likely to be listed as encouragers of colon cancer screening by both younger (OR = 3.40) and older respondents (OR = 1.90) independent of whether support exchange occurred in the relationship. Engaging older network members in health interventions to facilitate screening behaviors and emotional well-being of younger members within families affected by inherited conditions may be beneficial. Findings can be used to empower older individuals about their important social roles in enhancing the well-being of their family members and to inform younger individuals about their older relatives' resourcefulness to facilitate positive social interactions.
Gibbons, Susanne W; Barnett, Scott D; Hickling, Edward J
This study uses data from the 2005 Department of Defense Survey of Health-Related Behaviors Among Military Personnel to examine relationships between family stress and posttraumatic stress symptoms across 4 subgroups of Operation Iraqi Freedom-deployed (i.e., war in Iraq) or Operation Enduring Freedom-deployed (i.e., war in Afghanistan) active-duty military service members. Results suggest the following: (a) the greatest positive correlation of family stressors with posttraumatic stress symptoms was found within the military health care officer group, and (b) these military health care officers differed in family stressors mediating posttraumatic stress with divorce and financial problems accounting for significant and unique portions of the variance. Implications for care of service members and their families are discussed. Published by Elsevier Inc.
Ranse, K; Bloomer, M; Coombs, M; Endacott, R
publisher: Elsevier articletitle: Family centred care before and during life-sustaining treatment withdrawal in intensive care: A survey of information provided to families by Australasian critical care nurses journaltitle: Australian Critical Care articlelink: http://dx.doi.org/10.1016/j.aucc.2016.08.006 content_type: article copyright: © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
Scheele, Fedde; Teunissen, Pim; Van Luijk, Scheltus; Heineman, Erik; Fluit, Lia; Mulder, Hanneke; Meininger, Abe; Wijnen-Meijer, Marjo; Glas, Gerrit; Sluiter, Henk; Hummel, Thalia
Medical boards around the world face the challenge of creating competency-based postgraduate training programs. Recent legislation requires that all postgraduate medical training programmes in The Netherlands be reformed. In this article the Dutch Advisory Board for Postgraduate Curriculum Development shares some of their experiences with guiding the design of specialist training programs, based on the Canadian Medical Educational Directives for Specialists (CanMEDS). All twenty-seven Dutch Medical Specialty Societies take three steps in designing a curriculum. First they divide the entire content of a specialty into logical units, so-called 'themes'. The second step is discussing, for each theme, for which tasks trainees have to be instructed, guided, and assessed. Finally, for each task an assessment method is chosen to focus on a limited number of CanMEDS roles. This leads to a three step training cycle: (i) based on their in-training assessment and practices, trainees will gather evidence on their development in a portfolio; (ii) this evidence stimulates the trainee and the supervisor to regularly reflect on a trainee's global development regarding the CanMEDS roles as well as on the performance in specific tasks; (iii) a personal development plan structures future learning goals and strategies. The experiences in the Netherlands are in line with international developments in postgraduate medical education and with the literature on workplace-based teaching and learning.
Silvia Franco da Rocha Tonhom
Full Text Available Objective To analyze the possibilities and limits of competency-based training in nursing. Method An integrative review of the literature on the subject was carried out, and an analysis was made of the results of a survey evaluating a nursing course based on areas of competency. A dialog was then established between the review and the results of the research. Results On the question of which theoretical type of competency the articles from the literature relate to, there is a predominance of the constructivist perspective, followed by the functionalist approach and the dialog-based approach. In the dialog between the literature and the research, limits and possibilities were observed in the development of a training by areas of competency. Conclusion The dialog-based approach to competency is the proposition that most approximates to the profile defined by the National Curriculum Guidelines for training in nursing, and this was also identified in the evaluation survey that was studied. However, it is found that there are aspects on better work is needed, such as: partnership between school and the workplace, the role of the teacher, the role of the student, and the process of evaluation.
Fullerton, Judith T; Thompson, Joyce B; Johnson, Peter
many articles published in the decade since promulgation of the Millennium Development Goals have acknowledged the distinct advantages to maternal and newborn health outcomes that can be achieved as a result of expanding access to skilled birth attendant (including midwifery) services. However, these advantages are often predicated on the assumption that the midwifery workforce shares a common definition and identity. Regrettably, a clear delineation of midwifery competencies is rarely addressed. A core set of midwifery competencies is essential to providing the high quality services that lead to the desirable health outcomes described in that body of research. Attribution of improved outcomes to access to midwifery cannot be made without a common understanding of a defined set of services provided to standard by the midwifery workforce across the inter-conceptional and childbearing time frame. The International Confederation of Midwives (ICM) has developed a clear list of competencies that delineate the domains of practice for the fully qualified, professional midwife. These domains frame the educational outcomes that must be conveyed within competency-based education programmes. this article explores the concept of competency-based education for midwives; first exploring the concept of competency itself, then providing examples of what is already known about competency-based approaches to curriculum design, teacher preparation, teacher support and assessment of student learning. These concepts are linked to the ICM competencies as the unifying construct for education of individuals who share a common definition and identity as midwives. © 2013 Elsevier Ltd. All rights reserved.
Marcinowicz, Ludmila; Chlabicz, Slawomir; Grebowski, Ryszard
Patient satisfaction is a complex and difficult concept to measure, thus precluding the use of exclusively quantitative methods for its description. The purpose of this survey was firstly to identify particular healthcare dimensions that determine a patient's satisfaction or dissatisfaction; and secondly to attempt to typologise the patients' responses based on their evaluation of healthcare. Using a qualitative research design, thirty-six in-depth interviews with patients of family physicians were conducted: four patients from each of 9 family practices in different regions of Poland were interviewed. The main outcome measure was factors associated with patient satisfaction/dissatisfaction. In their evaluations of their contacts with family doctors, the patients cited mostly issues concerning interpersonal relationships with the doctor. Nearly 40% of the statements referred to this aspect of healthcare, with nearly equal proportions of positive and negative comments. The second most frequent category of responses concerned contextual factors (21%) that related to conditions of medical service, with two-thirds of the evaluations being negative. Statements concerning the doctor's competencies (12.9%) and personal qualities (10.5%) were less common. To improve the quality of healthcare, family doctors should take special care to ensure the quality of their interactions with patients.
Knorth, Erik J.; Knot-Dickscheit, Jana; Thoburn, June
Recently, there has been growing interest amongst researchers, practitioners and policy-makers in approaches to understanding and ways of helping parents, children and the communities in which they live to respond to ‘families experiencing multiple problems’ (FEMPs). There is a strong need for
Ugurlu, Necla Isikdogan; Kayhan, Nilay
This study is to diagnose and evaluate children with different special needs medically and educationally and, as a result of those evaluations, to identify families' expectations, opinions and suggestions concerning the special education process, services and the functioning of special education institutions. The mothers of five children who…
Keohane, Raymond G.; Newman, Carrie E.
Describes the Employee Services Network (ESN), an employee assistance program developed within the Family and Children's Service of Richmond, Virginia. Demonstrates how a not-for-profit agency can develop, structure, and implement a program of services for the corporate community. (LLL)
A substantial proportion of American, Canadian and English preschoolers regularly participate in family child care making its quality of vital importance for the children concerned, their parents, the school system and the society in which they live. This article discusses the seven key caregiver behaviors and physical space characteristics…
Ross, Shelley; Poth, Cheryl-Anne; Donoff, Michel G; Papile, Chiara; Humphries, Paul; Stasiuk, Samantha; Georgis, Rebecca
Competency-based assessment innovations are being implemented to address concerns about the effectiveness of traditional approaches to medical training and the assessment of competence. Integrating intended users' perspectives during the piloting and refinement process of an innovation is necessary to ensure the innovation meets users' needs. Failure to do so results in no opportunity for users to influence the innovation, nor for developers to assess why an innovation works or does not work in different contexts. A qualitative participatory action research approach was used. Sixteen first-year residents participated in three focus groups and two interviews during piloting. Verbatim transcripts were analyzed individually and then across all transcripts using a constant comparison approach. The analysis revealed three key characteristics related to the impact on the residents' acceptance of the innovation as being a worthwhile investment of time and effort: access to frequent, timely, and specific feedback from preceptors. Findings were used to refine the innovation further. This study highlights the necessary conditions for assessing the success of implementation of educational innovations. Reciprocal communication between users and developers is vital. This reflects the approaches recommended in the Ottawa Consensus Statement on research in assessment published in Medical Teacher in March 2011.
Ferguson, Peter C; Caverzagie, Kelly J; Nousiainen, Markku T; Snell, Linda
The current medical education system is steeped in tradition and has been shaped by many long-held beliefs and convictions about the essential components of training. The objective of this article is to propose initiatives to overcome biases against competency-based medical education (CBME) in the culture of medical education. At a retreat of the International Competency Based Medical Education (ICBME) Collaborators group, an intensive brainstorming session was held to determine potential barriers to adoption of CBME in the culture of medical education. This was supplemented with a review of the literature on the topic. There continues to exist significant key barriers to the widespread adoption of CBME. Change in educational culture must be embraced by all components of the medical education hierarchy. Research is essential to provide convincing evidence of the benefit of CBME. The widespread adoption of CBME will require a change in the professional, institutional, and organizational culture surrounding the training of medical professionals.
Sturgis, Chris; Patrick, Susan
This exploration into competency-based innovation at the school, district, and state levels suggests that competency-based pathways are a re-engineering of this nation's education system around learning--a re-engineering designed for success in which failure is no longer viable. This discussion draws on interviews and site visits with innovators…
This article follows the author's previous piece on practical guidelines for the development of comprehensive competence-based education and training (Mulder, 2012). It is about the questions that have been and are still frequently asked in presentations, workshops and classes about the introduction of competence-based education. Here, the author…
Eaton, Paul William
This article examines the limitations and possibilities of the emerging competency-based movement in student affairs. Using complexity theory and postmodern educational theory as guiding frameworks, examination of the competency-based movement will raise questions about overapplication of competencies in graduate preparation programs and…
As the education field strives to differentiate and personalize learning to cater to each student, two related movements are gaining attention: competency-based education and blended learning. In competency-based models, students advance on the basis of mastery, rather than according to the traditional methods of counting progress in terms of time…
Gulikers, Judith T. M.; Baartman, Liesbeth K. J.; Biemans, Harm J. A.
Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers' lack of understanding of new, competence-based assessments as well as the lack of key stakeholders' involvement, hamper effective and efficient self-evaluations by teachers of innovative, competence-based assessments (CBAs). While…
Carla Raymondalexas Marchira
Full Text Available ABTRACT Many persons suffering psychotic illnesses, such as schizophrenia, are largely untreated in low income countries. In these settings, most persons with severe mental illness live with their families. Thus, families play a particular critical role in determining whether a person with a psychotic illness will receive treatment and what the quality of treatment. Psychoeducation has proven to be extremely effective in helping families develop the knowledge and skills which is necessary to help their family members. Indonesia has a national policy to integrate the management of mental health problems into the primary health care system. However, in practice, such care does not implemented effectively. A preliminary study in primary health centers in two districts of Bantul and Gunung Kidul regency, Yogyakarta province, showed that there was very little or there is not any training for health care workers on diagnosis and treatment of psychotic disorder. This study was conducted to evaluate the effectiveness of the training program for health workers in three primary health centers in Yogyakarta, Indonesia, to provide psychoeducation to family caregivers for persons with psychotic disorder. A quasi-experimental study with the approach of one group pre and posttest design was performed in this study. Fortythree health workers in 3 primary health centers in Bantul and Gunung Kidul, Yogyakarta were trained every week for a month to provide psychoeducation to family caregivers who live with psychotic disorder patient. Result showed that the baseline score of knowledge of schizophrenia among health workers in 3 primary health centers in Bantul and Gunung Kidul before training were not significantly different (p=0.162. After the psychoeducation training program there were significantly different (p=0.003 of the score of knowledge of schizophrenia among health workers in 3 primary health care centers compared with before training. For conclusion, the
Maria Silvia Guglielmin
Full Text Available The present contribution presents the discussion about the analysis carried out on family atoms that were completed in the first psychodrama group meetings carried out in all the Empower Daphne III program partner countries. The issue of the relationship with the mother is central to the aim of the project, in that we hypothesise that the mothers of victims are incapable of educating their daughters about personal autonomy in relation to men, due to the traditional culture in which they grew up in. The article presents information about the use and processing of the survey tool “Family atom ” created by Jacob Moreno and the analysis of the data that emerged in parallel to the reports sent periodically by the psychodramatists to the monitoring and analysis team. From the results three types of maternal relationships emerge (positive, negative and incongruent that enable us to confirm the initial hypothesis of this action research.
Griewatz, Jan; Simon, Melanie; Lammerding-Koeppel, Maria
Objectives: Competency-based medical education (CBME) requires factual knowledge to be practically applied together with skills and attitudes. With the National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) representing a strong official demand for competence-orientation, it is generally important to explicitly outline its characteristics and review its realisation in teacher trainings. Further requirements are given by the core competencies for medical teachers (KLM). As an example the MQ programme ("Medizindidaktische Qualifikation") in Baden-Wuerttemberg, a long established and well-accepted training, has been critically revised on this basis, concerning its suitability for the demands of CBME, its needs for adjustment and the efforts to be undertaken for its implementation. Methods: In a systematic quality management process the MQ curriculum and its organisational framing were analysed and further developed in a step-wise comprehensive approach, using the six-step cycle by Kern. The procedures included a thorough needs assessment (e.g. literature research, programme mapping), strategic decisions on structure and content, piloting and evaluation. During the process essential elements of project and change management were considered. Results: The experiences of the MQ example revealed helpful information for key factors to be considered in the pending change process any training provider will be confronted with. Guiding questions were developed related to the process phases. Our analyses showed persistent key points of proven value as stable foundation for change, as well as components needing special consideration to foster competence-oriented aims and transfer into practice: reflection, feedback, application-oriented methods and transparent competence development. These aspects have to be consciously perceived and experienced by participants. Taking this into account, we re-designed the course evidence-based. Besides
Bandiera, Glen; Lendrum, David
Controversy exists regarding the applicability of competency-based education during clinical rotations in emergency medicine (EM). Little has been written about the perceptions of front-line teachers regarding one such competency-based education paradigm, the CanMEDS framework. We undertook to determine 1) what perceptions exist among front-line teachers at two academic health science emergency departments (EDs) regarding the use of the CanMEDS roles to frame what residents should learn on ED rotations and 2) how those same teachers envision practically incorporating the CanMEDS roles into feedback provided to residents. Teachers at two sites volunteered for a semistructured focus group study. Focus groups were moderated by an experienced qualitative researcher, and verbatim transcriptions were coded by two independent reviewers. The codes were merged into final themes. The final focus group was used to further explore issues raised and test assumptions made in the preceding groups. In five focus groups involving 21 participants, the Medical Expert and Professional roles were seen as most relevant to an EM rotation, whereas the Health Advocate, Manager, Scholar, and Collaborator roles were least relevant. On further exploration, however, faculty identified highly relevant components of each role that they could envision teaching in an ED. Participants also felt that the framework helped highlight the breadth of physician competencies and provided structure for teaching and feedback. EM faculty find the CanMEDS framework helpful for structuring teaching and learning and that many elements of the roles, when defined, are feasible to integrate into a clinical rotation.
Schmied, Virginia; Fowler, Cathrine; Rossiter, Chris; Homer, Caroline; Kruske, Sue
Australia has a system of universal child and family health (CFH) nursing services providing primary health services from birth to school entry. Herein, we report on the findings of the first national survey of CFH nurses, including the ages and circumstances of children and families seen by CFH nurses and the nature and frequency of the services provided by these nurses across Australia. A national survey of CFH nurses was conducted. In all, 1098 CFH nurses responded to the survey. Over 60% were engaged in delivering primary prevention services from a universal platform. Overall, 82.8% reported that their service made first contact with families within 2 weeks of birth, usually in the home (80.7%). The proportion of respondents providing regular support to families decreased as the child aged. Services were primarily health centre based, although 25% reported providing services in other locations (parks, preschools).The timing and location of first contact, the frequency of ongoing services and the composition of families seen by nurses varied across Australian jurisdictions. Nurses identified time constraints as the key barrier to the delivery of comprehensive services. CFH nurses play an important role in supporting families across Australia. The impact of differences in the CFH nursing provision across Australia requires further investigation. What is known about the topic? Countries that offer universal well child health services demonstrate better child health and developmental outcomes than countries that do not. Australian jurisdictions offer free, universal child and family health (CFH) nursing services from birth to school entry. What does this paper add? This paper provides nation-wide data on the nature of work undertaken by CFH nurses offering universal care. Across Australia, there are differences in the timing and location of first contact, the frequency of ongoing services and the range of families seen by nurses. What are the implications for
Mulder, Hanneke; Ten Cate, Olle; Daalder, Rieneke; Berkvens, Josephine
Competency-based medical education (CBME) is increasingly dominating clinical training, but also poses questions as to its practical implementation. There is a need for practical guidelines to translate CBME to the clinical work floor. This article aims to provide a practical model, based on the concept of entrustable professional activities (EPAs) to make this translation, derived from curriculum building for physician assistants (PAs). For the training of PAs at the Utrecht University of Applied Sciences, a three-step model was developed to guide competency-based curriculum development, teaching and assessment. It includes specific guidelines for the identification, systematic description and planning of EPAs. The EPA concept appeared to be a useful tool to build competency-based clinical workplace curricula. Implementation of the curriculum requires use of trainee portfolios and progress interviews, statements of rewarded responsibility and training of supervisors. The individualised approach and flexibility that true CBME implies is brought into practice with this model. The model may also be transferred to other domains of clinical training, among which postgraduate training for medical specialties.
Moon, Sherril; Simonsen, Monica L.; Neubert, Debra A.
The purpose of this exploratory study was to survey community rehabilitation providers (CRPs) to determine their perceptions of the skills, experiences, and information that transitioning youth with developmental disabilities (DD) and their families need to access supported employment (SE) services. Supervisors of SE from 12 CRPs across one state…
Friedman, Carli; Rizzolo, Mary C.
The United States long-term services and supports system is built on largely unpaid (informal) labor. There are a number of benefits to allowing family caregivers to serve as paid personal care providers including better health and satisfaction outcomes, expanded workforces, and cost effectiveness. The purpose of this study was to examine how…
Brown, A K; O'Connor, P J; Roberts, T E; Wakefield, R J; Karim, Z; Emery, P
A competency based approach to the education of rheumatologists in musculoskeletal ultrasonography (MSK US) ensures standards are documented, transparent, accountable, and defensible, with clear benefit to all stakeholders. Specific competency outcomes will facilitate informed development of a common curriculum and structured programme of training and assessment. To determine explicit competency based learning outcomes for rheumatologists undertaking MSK US. International experts in MSK US, satisfying specific selection criteria, were asked to define the minimum standards required by a rheumatologist to be judged competent in MSK US. They reviewed 115 MSK US skills, comprising bone and soft tissue pathology, in seven joints regions of the upper and lower limbs, and rated their relative importance according to specific criteria. These data are presented as specific educational outcomes within designated competency categories. 57 expert MSK US practitioners were identified and 35 took part in this study. Ten generic core competency outcomes were recognised including physics, anatomy, technique, and interpretation. Regarding specific regional competencies, 53% (61/115) were considered "must know" core learning outcomes, largely comprising inflammatory joint/tendon/bone pathology and guided procedures; 45% (52/115) were required at an intermediate/advanced level (18/115 "should know", 34/115 "could know"), and 2% (2/115) were deemed inappropriate/unnecessary for rheumatologist ultrasonographers. This is the first study to developing a competency model for the education of rheumatologists in MSK US based on the evidence of international experts. A specific set of learning outcomes has been defined, which will facilitate future informed education and practice development and provide a blueprint for a structured rheumatology MSK US curriculum and assessment process.
Diane D. Behl
Full Text Available Telepractice to deliver remote Part C early intervention (EI services to families in their home is a rapidly-growing strategy under the Individuals with Disabilities Education Act (IDEA to meet the needs of infants and toddlers who are deaf or hard of hearing. A survey was completed within a “learning community” comprised of staff from EI programs that were implementing telepractice to learn about their specific implementation strategies and challenges they faced. Twenty-seven individuals representing 11 programs responded. The results showed great variability in hardware and software, with many raising concerns regarding security. Primary challenges reported were internet connectivity and training in skills required to deliver telepractice services. The findings from this survey were valuable in guiding future areas of investigation for the learning community and ultimately improving telepractice in the field.
Atuahene, Margaret Duah; Afari, Esther Oku; Adjuik, Martin; Obed, Samuel
Family planning services help save lives by reducing women's exposure to risks of child birth and abortion. While family planning services provide measures to prevent unintended pregnancies and time the formation of families, the acceptability and coverage is still very low worldwide. Some of the reasons for this include poor quality of service, unavailability of range of methods, fear of opposition from partners, side effects and health concerns among others.About 40 % of the world's 215,000 annual deaths in childbirth occur in the Sub-Saharan region. In Ghana, urban-rural fertility differences range from two to three children. The acceptability and coverage of family planning are still low and in the study area in particular. We sought to examine factors that contribute to low acceptability and coverage of family planning services in a sub-urban community with a design of quantitative cross-sectional. Ethical approval was given by the Ghana Health Service. Midwives and community health nurses who provide family planning services were interviewed. Exit-interview was also conducted with women receiving a variety of outpatient services. Most of the women in this study (48.7 %) were in the 25-34 age range and were either married (42.8 %) or cohabiting (40.5 %). Majority of these women (67.7 %) have middle/Junior high level of formal education with a modal parity of two. Sixty eight (68) clients were identified as current family planning users. About 6.0 % and 4.5 % were dissatisfied about auditory and visual privacy during counselling respectively. This was confirmed by providers who attributed it to inappropriate facility layout. Most of the clients (79.1 %) were not given educational materials although 88.8 % were talked to about family planning and this could be due to unavailability of these hand-outs.Though clients show satisfaction of services received, providers did not follow standard protocols with as much as 73.7 % faced with challenges in
In Finland the municipal restructuring project was launched in 2005. Its goal is to create a system that ensures high-quality municipal welfare services for everyone, continuing into the future. The main focus of this research is to examine the tension between strategic competence-based management and productivity in public welfare services. The theoretical basis covers theories regarding strategic competence-based management and productivity. To guarantee services and quality it is important to strengthen the supply of employees, competence, development, leverage, and benefits in public organizations. Leadership has a significant role in strategic competence-based management.
Finley, Joanne P
The many burdens faced by caregivers of patients with cancer are well documented. Caregivers are asked to perform procedures, make assessments, coordinate care, and communicate with healthcare providers at an increasingly complex level. A caregiver quality improvement project, in the form of a Caregiver Café, was instituted at a National Cancer Institute-designated comprehensive cancer center. . The objectives of the café are to (a) provide respite and a place for caregivers to relax and be nurtured, (b) provide a place for caregivers to meet and support each other, (c) provide answers to caregiver questions, and (d) recommend appropriate caregiver resources. . The weekly Caregiver Café is led by an advanced practice nurse, and the format varies depending on the needs of the caregivers who attend. . Caregivers have verbalized the importance of the café in helping them cope with their loved ones' cancers and treatments, and many attend on a regular basis. The Caregiver Café provides support and information and a place to get away from it all.
Rosenthal, Marjorie S; Crowley, Angela A; Curry, Leslie
To describe the perspective and strategies of family child care providers (FCCPs) to reduce children's suboptimal weight trajectories. In-person, in-depth interviews with FCCPs. Family child care homes. Seventeen FCCPs caring for children 6 weeks to 9 years old; 94% caring for children paying with a state subsidy. Strategies of FCCP to reduce children's suboptimal weight trajectories. Constant comparative method of qualitative data analysis. Family child care providers described 3 core strategies: (1) improving children's behavior, (2) engaging and educating parents, and (3) leveraging influences external to their relationship with parents to effect positive change and to avoid parental conflict. These strategies were framed within their knowledge of child development, parental communication, and community services. The findings suggest that FCCPs' role in obesity prevention may be framed within knowledge that may be commonly expected of a child care provider. Partnerships between public health policy makers and FCCP may reduce obesigenic environments by employing training and resources that link obesity prevention and child care provider expertise. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Miller, Elizabeth; McCauley, Heather L; Decker, Michele R; Levenson, Rebecca; Zelazny, Sarah; Jones, Kelley A; Anderson, Heather; Silverman, Jay G
Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers. Copyright © 2017 by the Guttmacher Institute.
Koffer Miller, Kaitlin H.; Mathew, Mary; Nonnemacher, Stacy L.; Shea, Lindsay L.
A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum…
Ghesquiere, Angela R; Pinto, Rogerio M; Rahman, Rahbel; Spector, Anya Y
Brazil has a unique mental health care system, characterized by universal coverage delivered by interdisciplinary teams both in the community and in specialized centros de atenção psicossocial (CAPS-psychosocial care centers). Provision of patient-centered mental health care is an important principle of Brazilian mental health care, but this topic has not been well-studied. We analyzed data from a cross-sectional survey of 151 community health workers (CHWs), nurses, and physicians in Santa Luzia, Minas Gerais State, Brazil. Chi-squares, t-tests and multivariate regression analyses examined differences in socio-demographics, caseload, engagement in evidence-based practices (EBPs), and transdisciplinary collaboration between providers who reported providing high levels of patient-centered mental health care and those who did not. In multivariate regression models, components of transdisciplinary collaboration were significantly associated with providers' perceptions of patient-centered mental health care (p < 0.05). CHWs were also significantly more likely to report providing patient-centered care than physicians and nurses. EBP engagement and sociodemographics were not associated with perceptions. Results suggest that training efforts to improve patient-centered mental health care in Brazil could build upon CHWs' skills and focus on transdisciplinary collaboration. Findings may inform practice in other countries with similar health care systems.
Shin, Masako T.
This English-Thai lexicon and program introduction for combination welding is one of eight documents in the Multicultural Competency-Based Vocational/Technical Curricula Series. It is intended for use in postsecondary, adult, and preservice teacher and administrator education. The first two sections provide Thai equivalencies of English…
Shin, Masako T.
This English-Thai lexicon and program introduction for automotive mechanics is one of eight documents in the Multicultural Competency-Based Vocational/Technical Curricula Series. It is intended for use in postsecondary, adult, and preservice teacher and administrator education. The first two sections provide Thai equivalencies of English…
Lerner, Jennifer Brown; Tomasello, Jenna; Brand, Betsy; Knowles, George
Afterschool and competency-based learning are increasingly emerging as student-centered, supportive learning models to prepare students for college and career. This white paper explores the intersection and relationship between these two fields, recommends ideal policy environments for implementing successful programs, provides real-world…
Medina, Melissa S.
Competency-based Education (CBE) is an educational model that allows students to learn and demonstrate their abilities at their own pace. CBE is growing in popularity in undergraduate educational programs and its role in pharmacy education in the United States (US) is under review. In comparison, medical education is utilizing competency-based approaches (such as competencies and Entrustable Professional Activities) to ensure that students possess the required knowledge, skills, and attitudes prior to graduation or program completion. The concept of competency-based approaches is growing in use in pharmacy education in the US, but the future related to aspects of this concept (e.g., mandatory Entrustable Professional Activities) is not certain. A review of pharmacy education’s evolution in the US and a comparison of competency-related terms offers insight into the future use of competency-based approaches and CBE in pharmacy education in the US through the lens of benefits and challenges. PMID:28970425
Seezink, Audrey; Poell, Rob; Kirschner, Paul A.
Seezink, A., Poell, R. F., & Kirschner, P. A. (2009). Teachers' individual action theories about competence-based education: The value of the cognitive apprenticeship model. Journal of Vocational Education & Training, 61, 203-215.
Melissa S. Medina
Full Text Available Competency-based Education (CBE is an educational model that allows students to learn and demonstrate their abilities at their own pace. CBE is growing in popularity in undergraduate educational programs and its role in pharmacy education in the United States (US is under review. In comparison, medical education is utilizing competency-based approaches (such as competencies and Entrustable Professional Activities to ensure that students possess the required knowledge, skills, and attitudes prior to graduation or program completion. The concept of competency-based approaches is growing in use in pharmacy education in the US, but the future related to aspects of this concept (e.g., mandatory Entrustable Professional Activities is not certain. A review of pharmacy education’s evolution in the US and a comparison of competency-related terms offers insight into the future use of competency-based approaches and CBE in pharmacy education in the US through the lens of benefits and challenges.
Baartman, Liesbeth; Bastiaens, Theo; Kirschner, Paul A.; Van der Vleuten, Cees
Baartman, L. K. J., Bastiaens, T. J., Kirschner, P. A., & Van der Vleuten, C. P. M. (2007). Evaluation assessment quality in competence-based education: A qualitative comparison of two frameworks. Educational Research Review, 2, 114-129.
Hepburn, Larry; Shin, Masako
This document, one of eight in a multi-cultural competency-based vocational/technical curricula series, is on food service. This program is designed to run 24 weeks and cover 15 instructional areas: orientation, sanitation, management/planning, preparing food for cooking, preparing beverages, cooking eggs, cooking meat, cooking vegetables,…
Hepburn, Larry; Shin, Masako
This document, one of eight in a multi-cultural competency-based vocational/technical curricula series, is on automotive mechanics. This program is designed to run 36 weeks and cover 10 instructional areas: the engine; drive trains--rear ends/drive shafts/manual transmission; carburetor; emission; ignition/tune-up; charging and starting;…
Poth, Aaron G; Colgrave, Michelle L; Philip, Reynold; Kerenga, Bomai; Daly, Norelle L; Anderson, Marilyn A; Craik, David J
Cyclotides are plant proteins whose defining structural features are a head-to-tail cyclized backbone and three interlocking disulfide bonds, which in combination are known as a cyclic cystine knot. This unique structural motif confers cyclotides with exceptional resistance to proteolysis. Their endogenous function is thought to be as plant defense agents, associated with their insecticidal and larval growth-inhibitory properties. However, in addition, an array of pharmaceutically relevant biological activities has been ascribed to cyclotides, including anti-HIV, anthelmintic, uterotonic, and antimicrobial effects. So far, >150 cyclotides have been elucidated from members of the Rubiaceae, Violaceae, and Cucurbitaceae plant families, but their wider distribution among other plant families remains unclear. Clitoria ternatea (Butterfly pea) is a member of plant family Fabaceae and through its usage in traditional medicine to aid childbirth bears similarity to Oldenlandia affinis, from which many cyclotides have been isolated. Using a combination of nanospray and matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) analyses, we examined seed extracts of C. ternatea and discovered cyclotides in the Fabaceae, the third-largest family of flowering plants. We characterized 12 novel cyclotides, thus expanding knowledge of cyclotide distribution and evolution within the plant kingdom. The discovery of cyclotides containing novel sequence motifs near the in planta cyclization site has provided new insights into cyclotide biosynthesis. In particular, MS analyses of the novel cyclotides from C. ternatea suggest that Asn to Asp variants at the cyclization site are more common than previously recognized. Moreover, this study provides impetus for the examination of other economically and agriculturally significant species within Fabaceae, now the largest plant family from which cyclotides have been described.
Tatla, Sandy K; Howard, Dori; Antunes Silvestre, Alda; Burnes, Stacey; Husson, Meghan; Jarus, Tal
The growing complexity of healthcare requires family and interprofessional partnerships to deliver effective care. Interprofessional coaching can enhance family-centred practice and collaboration. The purpose of this study was to explore the acceptability and feasibility of collaborative coaching training to improve family centredness within acute paediatric rehabilitation. Using a participatory action design, service providers (SPs; n = 36) underwent a 6-month coaching programme involving coaching workshops, learning triads, and tailored sessions with a licensed coach. The feasibility and acceptability of coaching on SPs' family interactions and care was explored. Measure of Processes of Care (MPOC) and MPOC-SP, a coaching skills questionnaire, and focus groups were used to evaluate the acceptability of coaching training. We found that structured coaching training was feasible and SPs reported significant improvements in their coaching skills; however, MPOC and MPOC-SP scores did not reveal significant differences. Qualitative themes indicated that clinicians are developing coaching competencies and applying these skills in clinical practice. Participants perceived that the coaching approach strengthened relationships amongst colleagues, and they valued the opportunity for interprofessional learning. Findings suggest that coaching offers promise as an approach to facilitate successful patient outcomes and improve processes of care. Preliminary findings indicate that interprofessional coaching training is acceptable, feasible, and can significantly improve SP coaching skills and improve team cohesion. Further research to study the effects of coaching on interprofessional care using validated outcome measures and to assess the impact on service delivery is recommended.
Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E
We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.
Evans, Andrea B; Hulme, Jennifer M; Nugus, Peter; Cranmer, Hilarie H; Coutu, Melanie; Johnson, Kirsten
The evaluation tool was first derived from the formerly Consortium of British Humanitarian Agencies' (CBHA; United Kingdom), now "Start Network's," Core Humanitarian Competency Framework and formatted in an electronic data capture tool that allowed for offline evaluation. During a 3-day humanitarian simulation event, participants in teams of eight to 10 were evaluated individually at multiple injects by trained evaluators. Participants were assessed on five competencies and a global rating scale. Participants evaluated both themselves and their team members using the same tool at the end of the simulation exercise (SimEx). All participants (63) were evaluated. A total of 1,008 individual evaluations were completed. There were 90 (9.0%) missing evaluations. All 63 participants also evaluated themselves and each of their teammates using the same tool. Self-evaluation scores were significantly lower than peer-evaluations, which were significantly lower than evaluators' assessments. Participants with a medical degree, and those with humanitarian work experience of one month or more, scored significantly higher on all competencies assessed by evaluators compared to other participants. Participants with prior humanitarian experience scored higher on competencies regarding operating safely and working effectively as a team member. This study presents a novel electronic evaluation tool to assess individual performance in five of six globally recognized humanitarian competency domains in a 3-day humanitarian SimEx. The evaluation tool provides a standardized approach to the assessment of humanitarian competencies that cannot be evaluated through knowledge-based testing in a classroom setting. When combined with testing knowledge-based competencies, this presents an approach to a comprehensive competency-based assessment that provides an objective measurement of competency with respect to the competencies listed in the Framework. There is an opportunity to advance the use of
Keating, Sarah B; Rutledge, Dana N; Sargent, Arlene; Walker, Polly
To address the incongruence between the expectations of nursing service and education in California, the Education Industry Interface Task Force of the California Strategic Planning Committee for Nursing developed descriptions to assist employers and educators in clearly differentiating practice and educational competencies. The completion of the Competency-Based Role Differentiation Model resulted in the need to test the model for its utility in the service setting, in education, and for career planning for nurses. Three alpha demonstration sites were selected based on representative geographical regions of California. The sites were composed of tri-partnerships consisting of a medical center, an associate degree in nursing program, and a baccalaureate nursing program. Observers rated senior students and new graduates in medical-surgical units on their behaviors in teacher and leadership care provider and care coordinator roles. The alpha demonstration study results were as expected. That is, senior students practice predominantly at a novice level in teacher and management/leadership care provider functions and new graduates practice predominately at the competent level. New graduates are more likely to take on novice and competent care coordinator roles. The CBRDM may be useful for practice and education settings to evaluate student and nurse performance, to define role expectations, and to identify the preparation necessary for the roles. It is useful for all of nursing as it continues to define its levels of practice and their relationship to on-the-job performance, curriculum development, and carrier planning.
Froelich, Larry; And Others
This curriculum for food marketing (cashier-checking) is designed to provide entry-level employment skills. It is organized into 13 units which contain one to ten competencies. A student competency sheet provided for each competency is organized into this format: unit and competency number and name, learning steps, learning activities, and…
Hardman, James R.
This program is designed to provide entry-level training to individuals (especially workers displaced from industry) who desire employment as "slot technicians" in the casino industry. The 96-hour course includes both classroom instruction and hands-on experience. Sources for direct purchase of required manuals are provided. The 13…
Azami-Aghdash, Saber; Ghojazadeh, Morteza; Aghaei, Mir Hossein; Naghavi-Behzad, Mohammad; Asgarlo, Zoleikha
In view of the recent surge in chronic disease rates and elderly population in the developing countries, there is an urgent felt need for palliative and hospice care services. The present study investigates the views and attitudes of patients and their families, physicians, nurses, healthcare administrators, and insurers regarding designing and delivering hospice care service in a middle income country. In this qualitative study, the required data was collected using semi structured interviews and was analyzed using thematic analysis. Totally 65 participants from hospitals and Tabriz University of Medical Sciences were selected purposively to achieve data saturation. Analyzing the data, five main themes (barriers, facilitators, strategies, attitudes, and service provider) were extracted. Barriers included financial issues, cultural-religious beliefs, patient and family-related obstacles, and barriers related to healthcare system. Facilitators included family-related issues, cultural-religious beliefs, as well as facilitators associated with patients, healthcare status, and benefits of hospice service. Most participants (79%) had positive attitude towards hospice care service. Participant suggested 10 ways to design and deliver effective and efficient hospice care service. They thought the presence of physicians, nurses, and psychologists and other specialists and clergy were necessary in the hospice care team. Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.
Peacock, Shelley; Duggleby, Wendy; Koop, Priscilla
Dementia is a terminal illness, and family caregivers play a vital role in providing end-of-life care to their relative. The present study begins to address the paucity of research regarding end-of-life caregiving experience with dementia. This study utilized Munhall's methodology for interpretive phenomenology. Seven women and four men were interviewed two to three times within a year of their relative's death; interviews were transcribed verbatim and hermeneutically analyzed. Findings reveal two essential aspects of end-of-life dementia caregiving: being-with and being-there. Further findings are organized according to the existential life worlds. Examination of the life worlds demonstrates that 1) spatiality provided a sense or lack of feeling welcome to provide end-of-life care; 2) temporality was an eternity or time melting away quickly, or the right or wrong time to die; 3) corporeality revealed feelings of exhaustion; and 4) relationality was felt as a closeness to others or in tension-filled relationships. An understanding from bereaved caregivers' perspectives will help healthcare practitioners better support and empathize with family caregivers. Further research is warranted that focuses on other places of death and differences in experience based on gender or relationship to the care receiver.
Lockyer, Jocelyn; Bursey, Ford; Richardson, Denyse; Frank, Jason R; Snell, Linda; Campbell, Craig
Competency-based medical education (CBME) is as important in continuing professional development (CPD) as at any other stage of a physician's career. Principles of CBME have the potential to revolutionize CPD. Transitioning to CBME-based CPD will require a cultural change to gain commitment from physicians, their employers and institutions, CPD providers, professional organizations, and medical regulators. It will require learning to be aligned with professional and workplace standards. Practitioners will need to develop the expertise to systematically examine their own clinical performance data, identify performance improvement opportunities and possibilities, and develop a plan to address areas of concern. Health care facilities and systems will need to produce data on a regular basis and to develop and train CPD educators who can work with physician groups. Stakeholders, such as medical regulatory authorities who are responsible for licensing physicians and other standard-setting bodies that credential and develop maintenance-of-certification systems, will need to change their paradigm of competency enhancement through CPD.
Rajapaksha, Ajith; Hirsch, Andrew S.
The practice of learning physics contributes to the development of many transdisciplinary skills learners are able to exercise independent of the physics discipline. However, the standard practices of physics instruction do not explicitly include the monitoring or evaluation of these skills. In a competency-based (CB) learning model, the skills (competencies) are clearly defined and evaluated. We envisioned that a CB approach, where the underlying competencies are highlighted within the instructional process, would be more suitable to teaching physics to learners with diversified disciplinary interests. A model CB course curriculum was developed and practiced at Purdue University to teach introductory college physics to learners who were majoring in the technology disciplines. The experiment took place from the spring semester in 2015 until the spring semester in 2017. The practice provided a means to monitor and evaluate a set of developmental transdisciplinary competencies that underlie the learning of force and motion concepts in classical physics. Additionally, the CB practice contributed to produce substantial physics learning outcomes among learners who were underprepared to learn physics in college.
Full Text Available The practice of learning physics contributes to the development of many transdisciplinary skills learners are able to exercise independent of the physics discipline. However, the standard practices of physics instruction do not explicitly include the monitoring or evaluation of these skills. In a competency-based (CB learning model, the skills (competencies are clearly defined and evaluated. We envisioned that a CB approach, where the underlying competencies are highlighted within the instructional process, would be more suitable to teaching physics to learners with diversified disciplinary interests. A model CB course curriculum was developed and practiced at Purdue University to teach introductory college physics to learners who were majoring in the technology disciplines. The experiment took place from the spring semester in 2015 until the spring semester in 2017. The practice provided a means to monitor and evaluate a set of developmental transdisciplinary competencies that underlie the learning of force and motion concepts in classical physics. Additionally, the CB practice contributed to produce substantial physics learning outcomes among learners who were underprepared to learn physics in college.
Kerrigan, Noreen; Akabas, Myles H; Betzler, Thomas F; Castaldi, Maria; Kelly, Mary S; Levy, Adam S; Reichgott, Michael J; Ruberman, Louise; Dolan, Siobhan M
The Albert Einstein College of Medicine (Einstein) was founded in 1955 during an era of limited access to medical school for women, racial minorities, and many religious and ethnic groups. Located in the Bronx, NY, Einstein seeks to educate physicians in an environment of state-of-the-art scientific inquiry while simultaneously fulfilling a deep commitment to serve its community by providing the highest quality clinical care. A founding principle of Einstein, the basis upon which Professor Einstein agreed to allow the use of his name, was that admission to the student body would be based entirely on merit. To accomplish this, Einstein has long used a 'holistic' approach to the evaluation of its applicants, actively seeking a diverse student body. More recently, in order to improve its ability to identify students with the potential to be outstanding physicians, who will both advance medical knowledge and serve the pressing health needs of a diverse community, the Committee on Admissions reexamined and restructured the requirements for admission. These have now been categorized as four 'Admissions Competencies' that an applicant must demonstrate. They include: 1) cocurricular activities and relevant experiences; 2) communication skills; 3) personal and professional development; and 4) knowledge. The purpose of this article is to describe the process that resulted in the introduction and implementation of this competency based approach to the admission process.
Hodgson, Jennifer L; Pelzer, Jacquelyn M; Inzana, Karen D
The implementation of competency-based curricula within the health sciences has been an important paradigm shift over the past 30 years. As a result, one of the five strategic goals recommended by the North American Veterinary Medical Education Consortium (NAVMEC) report was to graduate career-ready veterinarians who are proficient in, and have the confidence to use, an agreed-upon set of core competencies. Of the nine competencies identified as essential for veterinary graduates, seven could be classified as professional or non-technical competencies: communication; collaboration; management (self, team, system); lifelong learning, scholarship, value of research; leadership; diversity and multicultural awareness; and adaptation to changing environments. Traditionally, the professional competencies have received less attention in veterinary curricula and their assessment is often sporadic or inconsistent. In contrast, the same or similar competencies are being increasingly recognized in other health professions as essential skills and abilities, and their assessment is being undertaken with enhanced scrutiny and critical appraisal. Several challenges have been associated with the assessment of professional competencies, including agreement as to their definition and therefore their evaluation, the fact that they are frequently complex and require multiple integrative assessments, and the ability and/or desire of faculty to teach and assess these competencies. To provide an improved context for assessment of the seven professional competencies identified in the NAVMEC report, this article describes a broad framework for their evaluation as well as specific examples of how these or similar competencies are currently being measured in medical and veterinary curricula.
Birhane Sime Geressu
Full Text Available The purpose of this study is to critically examine the impact of competence based training on employability of technical and vocational college graduates in Ethiopia. Mixed methods of research design, predominantly concurrent nested strategy were employed to conduct the study. The study involved 162 instructors, 123 Level III automotive technology trainees, 87 department heads and 89 graduates, a total of 461 respondents as a sample. Moreover, 24 respondents (6 industry owners, 6 TVET college deans, 6 competence-based process owners and 6 industry trainers’ leaders were purposely selected for interview and focus group discussion. Under the study, the researcher used employability of graduates as dependent variable and competency based training as independent variable. Descriptive and inferential statistics were employed for data analysis. The study result showed that technical and vocational education and training (TVET colleges in Ethiopia have been performing below expectations in developing demand-based curriculum and implementing competence-based training in TVET colleges and industries. As a result, among the graduates nearly 50 percent are not employed in the past two years. Hence, it is recommended that constantly consulting and involving relevant stakeholders in setting study profile, identifying intended learning outcomes and strengthening competence based learning style are vital for graduates to demonstrate employability skill, knowledge and attitude into the job that consequentially lead to graduate employment.First published online: 30 November 2017
Martell, John L.
This document defines, describes usage of, and provides samples of student competency profiles being used in 17 vocational programs at Rutland Area Vocational-Technical Center in Rutland, Vermont. The profiles cover the following programs: auto body, auto mechanics, business/data processing, cabinetmaking, carpentry/masonry, culinary arts,…
Rotthoff, Thomas; Ostapczuk, Martin Stefan; de Bruin, Judith; Kröncke, Klaus-Dietrich; Decking, Ulrich; Schneider, Matthias; Ritz-Timme, Stefanie
, the MSQ correlated highly positively with DREEM (r = 0.79 and 0.80, p basis of the institution's MS. Our MSQ provides a reliable instrument to measure the learning climate with a strong focus on competencies which are increasingly considered crucial in medical education. The questionnaire thus offers additional information beyond the DREEM. Our site-specific results imply that our own faculty is not yet fully living up to its competency-based MS. In general, the MSQ might prove useful for faculty development to the increasing number of faculties seeking to measure their perceived competency orientation in a competency-based curriculum.
Newmann, Sara J; Zakaras, Jennifer M; Tao, Amy R; Onono, Maricianah; Bukusi, Elizabeth A; Cohen, Craig R; Steinfeld, Rachel; Grossman, Daniel
With high rates of unintended pregnancy in sub-Saharan Africa, integration of family planning (FP) into HIV care is being explored as a strategy to reduce unmet need for contraception. Perspectives and experiences of healthcare providers are critical in order to create sustainable models of integrated care. This qualitative study offers insight into how HIV care providers view and experience the benefits and challenges of providing integrated FP/HIV services in Nyanza Province, Kenya. Sixteen individual interviews were conducted among healthcare workers at six public sector HIV care facilities one year after the implementation of integrated FP and HIV services. Data were transcribed and analyzed qualitatively using grounded theory methods and Atlas.ti. Providers reported a number of benefits of integrated services that they believed increased the uptake and continuation of contraceptive methods. They felt that integrated services enabled them to reach a larger number of female and male patients and in a more efficient way for patients compared to non-integrated services. Availability of FP services in the same place as HIV care also eliminated the need for most referrals, which many providers saw as a barrier for patients seeking FP. Providers reported many challenges to providing integrated services, including the lack of space, time, and sufficient staff, inadequate training, and commodity shortages. Despite these challenges, the vast majority of providers was supportive of FP/HIV integration and found integrated services to be beneficial to HIV-infected patients. Providers' concerns relating to staffing, infrastructure, and training need to be addressed in order to create sustainable, cost-effective FP/HIV integrated service models.
Yu, Hao; Dick, Andrew W; Szilagyi, Peter G
Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). To examine how the growth of health care costs affected financial burden for families of CSHCN between 2001 and 2004 and to determine the extent to which health insurance coverage protected families of CSHCN against financial burden. In 2001-2004, 5196 families of CSHCN were surveyed by the national Medical Expenditure Panel Survey (MEPS). The main outcome was financial burden, defined as the proportion of family income spent on out-of-pocket (OOP) health care expenditures for all family members, including OOP costs and premiums. Family insurance coverage was classified as: (1) all members publicly insured, (2) all members privately insured, (3) all members uninsured, (4) partial coverage, and (5) a mix of public and private with no uninsured periods. An upward trend in financial burden for families of CSHCN occurred and was associated with growth of economy-wide health care costs. A multivariate analysis indicated that, given the economy-wide increase in medical costs between 2001 and 2004, a family with CSHCN was at increased risk in 2004 for having financial burden exceeding 10% of family income [odds ratio (OR) = 1.39; P financial burden exceeding 20% of family income. Over 15% of families with public insurance had financial burden exceeding 10% of family income compared with 20% of families with private insurance (P financial burden of >10% or 20% of family income than privately-insured families. Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of CSHCN.
Ashcroft, Nicki; Shelus, Victoria; Garg, Himanshu; McLarnon-Silk, Courtney; Jennings, Victoria H
CycleTel Family Advice (CFA), an SMS-based service designed to improve knowledge of fertility and family planning (FP), was delivered to over 100,000 people in India from April to August 2015. The goal of CFA was to increase knowledge on a range of reproductive health topics, e.g., the menstrual cycle, fertility, and FP, and to increase positive perceptions and use of FP. This paper focuses on the best practices and operational challenges for providing an SMS service based on the implementation experience of CFA. The implementation process for CFA was well documented, specifically program design, commercial partnerships, formative research, design of messages, and recruitment of users. The impact of CFA on knowledge, attitudes, and behaviors was assessed through phone surveys before and after message delivery. Programmatic data and phone surveys resulted in several operational findings, particularly in the areas of user behavior, partnership management, and mHealth research. While there were improvements in knowledge, there were not significant changes in FP use and couple communication. The intervention yielded insights into designing an mHealth intervention as well as the opportunities and challenges of implementing a stand-alone SMS-based service with a broad audience. Lessons learned were that (I) SMS-based interventions, without other supporting systems, may not lead to high user engagement or behavior change; (II) partnerships with private sector technical platforms can help overcome the difficult problem of marketing and outreach, but they bring limitations to user interface and dependencies on a commercial structure; (III) collecting demographic data required to provide tailored content may be a barrier to user acquisition; and (IV) while phone surveys are useful for evaluation of mHealth interventions, reaching users is challenging and response rates are low.
Lunev, Alexander; Petrova, Irina; Zaripova, Viktoria
One of the goals of higher professional education is to develop generic student competencies across a variety of disciplines that play a crucial role in education and that provide wider opportunities for graduates in finding good jobs and more chance of promotion. In this article a list of generic competencies developed in Russian universities is compared with a similar list developed by a consortium of Russian and European universities (project TUNING-RUSSIA). Then there is a second comparison with a list of competencies taken from the CDIO Syllabus. This comparison indicates the degree of similarity among the lists and the possible convergence among universities all over the world. The results are taken from a survey carried out among Russian employers, academics, and graduates. The survey asked to rate each listed competence by its importance and the degree of achieving goals in the process of the education.
Risco de Domínguez, Graciela
Competency-based education is a form of designing, developing, delivering and documenting instruction based on a set of objectives and results that have been recommended for medical education. This article describes the steps in the process of designing and implementing a competency-based curriculum at a new medical school in a Peruvian university. We present the process followed including context analysis, mission design, the professional profile, the content and organization of the curriculum as well as the evaluation and resources for the training. Finally, issues and challenges faced, as well as lessons learned are summarized.
Todsen, Tobias; Melchiors, Jacob; Charabi, Birgitte
and to establish validity evidence for an objective structured assessment of ultrasound skills (OSAUS) used for competency-based assessment. STUDY DESIGN: A prospective experimental study. METHODS: Six otolaryngologists and 11 US novices were included in a standardized test setup for which they had to perform...... and the diagnostic accuracy was found (Spearman's ρ, 0.85; P competence with good reliability, significant discrimination between US competence levels, and a strong...... correlation of assessment score to diagnostic accuracy. An OSAUS pass/fail score was established and could be used for competence-based assessment in surgeon-performed HNUS. LEVEL OF EVIDENCE: NA. Laryngoscope, 2017....
Johnson, Leigh A; Chan, Lauren M; Weese, Terri L; Busby, Lisa D; McMurry, Samuel
Members of the phlox family (Polemoniaceae) serve as useful models for studying various evolutionary and biological processes. Despite its biological importance, no family-wide phylogenetic estimate based on multiple DNA regions with complete generic sampling is available. Here, we analyze one nuclear and five chloroplast DNA sequence regions (nuclear ITS, chloroplast matK, trnL intron plus trnL-trnF intergeneric spacer, and the trnS-trnG, trnD-trnT, and psbM-trnD intergenic spacers) using parsimony and Bayesian methods, as well as assessments of congruence and long branch attraction, to explore phylogenetic relationships among 84 ingroup species representing all currently recognized Polemoniaceae genera. Relationships inferred from the ITS and concatenated chloroplast regions are similar overall. A combined analysis provides strong support for the monophyly of Polemoniaceae and subfamilies Acanthogilioideae, Cobaeoideae, and Polemonioideae. Relationships among subfamilies, and thus for the precise root of Polemoniaceae, remain poorly supported. Within the largest subfamily, Polemonioideae, four clades corresponding to tribes Polemonieae, Phlocideae, Gilieae, and Loeselieae receive strong support. The monogeneric Polemonieae appears sister to Phlocideae. Relationships within Polemonieae, Phlocideae, and Gilieae are mostly consistent between analyses and data permutations. Many relationships within Loeselieae remain uncertain. Overall, inferred phylogenetic relationships support a higher-level classification for Polemoniaceae proposed in 2000.
Lv, Yunyun; Kawasaki, Kazuhiko; Li, Jia; Li, Yanping; Bian, Chao; Huang, Yu; You, Xinxin; Shi, Qiong
The family of secretory calcium-binding phosphoproteins (SCPPs) have been considered vital to skeletal tissue mineralization. However, most previous SCPP studies focused on phylogenetically distant animals but not on those closely related species. Here we provide novel insights into the coevolution of SCPP genes and fish scales in 10 species from Otophysi . According to their scale phenotypes, these fishes can be divided into three groups, i.e., scaled, sparsely scaled, and scaleless. We identified homologous SCPP genes in the genomes of these species and revealed an absence of some SCPP members in some genomes, suggesting an uneven evolutionary history of SCPP genes in fishes. In addition, most of these SCPP genes, with the exception of SPP1 , individually form one or two gene cluster(s) on each corresponding genome. Furthermore, we constructed phylogenetic trees using maximum likelihood method to estimate their evolution. The phylogenetic topology mostly supports two subclasses in some species, such as Cyprinus carpio , Sinocyclocheilus anshuiensis , S. grahamin , and S. rhinocerous , but not in the other examined fishes. By comparing the gene structures of recently reported candidate genes, SCPP1 and SCPP5 , for determining scale phenotypes, we found that the hypothesis is suitable for Astyanax mexicanus , but denied by S. anshuiensis , even though they are both sparsely scaled for cave adaptation. Thus, we conclude that, although different fish species display similar scale phenotypes, the underlying genetic changes however might be diverse. In summary, this paper accelerates the recognition of the SCPP family in teleosts for potential scale evolution.
Yousefi, Hojatollah; Naderi, Mojgan; Daryabeigi, Reza
Stressors in the intensive care unit (ICU) impair patients' comfort, excite the stress response, and increase oxygen consumption in their body. Non-medical interventions are recommended by several studies as a treatment to improve comfort in the ICU patients. Sensory stimulation is one of the most important interventions. Since arterial blood oxygen saturation is an important index of patients' clinical and respiratory condition, this study aimed to investigate the effect of sensory stimulation provided by family on arterial blood oxygen saturation in critical care patients. This study is a clinical trial conducted on 64 patients hospitalized in the ICU wards of Al-Zahra and Kashani hospitals in Isfahan, Iran in 2012 and 2013. The patients were selected by simple sampling method and were randomly assigned to two groups (study and control). Patients' arterial blood oxygen saturations were measured 10 min before, immediately after, 10 min and 30 min after sensory stimulation in the study group, and simultaneously in the control group without any intervention. Repeated measures analysis of variance (ANOVA) showed a significant difference in the mean of arterial blood oxygen saturation levels 10 min before, immediately after, 10 min and 30 min after sensory stimulation in the study group (P 0.18). Application of sensory stimulations as a nursing and non-medical intervention by the family members improves comfort and increases the level of blood oxygen saturation in critical care patients.
Deng, Yinyue; Wu, Jien; Yin, Wenfang; Li, Peng; Zhou, Jianuan; Chen, Shaohua; He, Fei; Cai, Jun; Zhang, Lian-Hui
Diffusible signal factor (DSF) represents a new class of widely conserved quorum sensing signals, which regulates various biological functions through intra- or interspecies signaling. The previous studies identified that there is an antagonistic interaction between Xanthomonas and Bacillus species bacteria in natural ecosystem, but the detailed molecular mechanism of interspecies competition is not clear. This study showed that Xanthomonas campestris pv. campestris (Xcc) interfered with morphological transition and sporulation of Bacillus thuringiensis in mixed cultures, whereas abrogation of the DSF synthase RpfF reduced the interference. DSF inhibited B. thuringiensis cell division and sporulation through modulation of ftsZ, which encodes an important cell division protein in bacterial cells. In addition, RpfF is essential for production of six DSF-family signals in Xcc, which employ the same signaling pathways to regulate biological functions in Xcc and play similar effects on reduction of cell division, sporulation and antibiotic resistance of B. thuringiensis. Furthermore, abrogation of RpfF decreased the competitive capability of Xcc against B. thuringiensis on the surface of Chinese cabbage leaves. Our findings provide new insights into the role of DSF-family signals in interspecies competition and depict molecular mechanisms with which Xcc competes with B. thuringiensis. © 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.
José Carlos Dextre Flores
Full Text Available The interest of this paper is based on presenting the importance of educational instruction today, in general and in particular the accounting career. This, it should be noted, is part of the development trends of cognitive skills, instrumental skills and values that a person must acquire during the education period at a higher educational institution, which will allow the graduate to be competent to begin the professional practice.The complexity that is involved in the public accountant career in both their education based on international standards like the attributes to be displayed in the quality of performance, has forced higher education experts to guide newways of undertaking the education strategy. This is accomplished through the adoption of models consistent with the demands of society and the employment market. Of these, competencies education is one of the models that best contribute to the learning process, allowing at the potential accounting professional to develop skills, abilities and attitudes needed to join into the labor market successfully. In this sense, the college, university, or an academic unit faculty, school, program - they decided to adopt, provide and ensure competencies education, mustdo according to the guidelines proposed for teaching methodologies, social responsibility and the business world. Similarly, should be based on participatory action committed by students and teachers, and the respect for human values. Within this scheme, it must prioritize the humanistic education of the person in their professional projection.
Andrews, John S; Bale, James F; Soep, Jennifer B; Long, Michele; Carraccio, Carol; Englander, Robert; Powell, Deborah
The Education in Pediatrics Across the Continuum (EPAC) Study Group is developing the first competency-based, time-variable progression from undergraduate medical education (UME) to graduate medical education (GME) in the history of medical education in the United States. EPAC, an innovation project sponsored by the Association of American Medical Colleges and supported by the Josiah Macy Jr. Foundation, was developed through a collaboration between five medical schools and multiple professional organizations with an interest in undergraduate and graduate medical education. The planning and implementation process demanded cooperatively addressing practical barriers such as education requirements for licensure and developing approaches to learner assessment that provided meaningful information about competency. Each participating school now has at least three cohorts of learners participating, and the program is transitioning its first cohort of students from UME to GME based on achievement of predetermined competencies that allow this transition. Members of the first cohort of learners in this program have begun their pediatric residency training at different times beginning in late 2016, confirming the feasibility of competency-based advancement from UME to GME in pediatrics. Although there is still much to learn about the outcomes of EPAC learners' professional development in residency training and beyond, EPAC has defined an operational approach to a different path through medical school and into residency training, based on the attainment of competence.
Stephen L. Rego
Full Text Available Here, we are proposing and testing the use of literature reviews as a method to identify essential competencies for specific fields. This has implications in how educators develop and structure both traditional and competency based curricula. Our focus will be on utilizing this method to identify the most relevant and commonly used techniques in the field of regenerative medicine. This publication review method may be used to develop competency based education (CBE programs that focus on commonly utilized skills. CBE is an emerging trend in higher education that will greatly enhance student learning experiences. CBE works by providing students with field specific skills and knowledge; thus, it is imperative for educators to identify the most essential competencies in a given field. Therefore, we reason that a literature review of the techniques performed in studies published in prevalent peer reviewed journals for a given field offers an ideal method to identify and rank competencies that should be delivered to students by a respective curriculum. Here, we reviewed recent articles published on topics in the field of regenerative medicine as a proof of concept for the use of literature reviews as a guide for the development of a regenerative medicine CBE curriculum.
Treiger, Teresa M; Fink-Samnick, Ellen
The purpose of this fourth part of the COLLABORATE© article series provides an expansion and application of previously presented concepts pertaining to the COLLABORATE paradigm of professional case management practice. The model is built upon a value-driven foundation that: PRIMARY PRACTICE SETTING(S):: Applicable to all health care sectors where case management is practiced. As an industry, health care continues to evolve. Terrain shifts and new influences continually surface to challenge professional case management practice. The need for top-performing and nimble professionals who are knowledgeable and proficient in the workplace continues to challenge human resource departments. In addition to care setting knowledge, professional case managers must continually invest in their practice competence toolbox to grow skills and abilities that transcend policies and processes. These individuals demonstrate agility in framing (and reframing) their professional practice to facilitate the best possible outcomes for their clients. Therefore, the continued emphasis on practice competence conveyed through the performance management cycle is an essential ingredient to performance management focused on customer service excellence and organizational improvement. Professional case management transcends professional disciplines, educational levels, and practice settings. Business objectives continue to drive work process and priorities in many practice settings. However, competencies that align with regulatory and accreditation requirements should be the critical driver for consistent, high-quality case management practice. Although there is inherent value in what various disciplines bring to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities.
Full Text Available Background: There is limited understanding of the impact of Triple C competency-based curriculums on the preparation of residents for family practice. This paper describes a competency-based curriculum within an integrated longitudinal block design and presents preliminary evaluation data on the impact of this curriculum on preparedness for family practice. Methods: First and second year family medicine residents were surveyed as a component of a year-end program evaluation to assess the extent to which the residency program is preparing them to engage in a variety of practice domains, the likelihood that they would engage in these domains, and the extent to which this residency program is comprehensive, relevant to their development as a family physician, and promotes interprofessional practice. Results: Residents perceived themselves as prepared to engage in most practice areas and their intentions to engage in various practice domains were positively correlated to their ratings of preparedness. Ratings reflected that residents perceived this program as comprehensive and relevant to their development as a family physician and they perceived a high degree of encouragement for interprofessional practice. Conclusions: This study provides some preliminary evidence that an integrated competency-based curriculum, with an emphasis on interprofessional practice has the potential to effectively prepare residents for practice in family medicine.
This module, one of ten competency based modules developed for vocational home economics teachers, is based on a job cluster in fabric and textiles merchandising. It is designed for use with a variety of groups including grades 9-14 and adults. Focusing on the specific job title fabric and textiles salesperson, ten competencies and the student…
Lowe, Phyllis; And Others
This module, one of ten competency based modules developed for vocational home economics teachers, is based on a job cluster in the catering industry. It is designed for use with a variety of levels of learners (secondary, postsecondary, adult) in both school and non-school educational settings. Focusing on two levels of employment, food caterer…
Gulikers, J.T.M.; Baartman, L.K.J.; Biemans, H.
Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers’ lack of understanding of new, competence-based assessments as well as the lack of key stakeholders’ involvement, hamper effective and efficient self-evaluations by teachers of
Gulikers, J.T.M.; Baartman, L.; Biemans, H.J.A.
Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers’ lack of understanding of new, competence-based assessments as well as the lack of key stakeholders’ involvement, hamper effective and efficient self-evaluations by teachers of
DeWald, Janice P.; McCann, Ann L.
Describes the three-step process used to develop a competency-based curriculum at the Caruth School of Dental Hygiene (Texas A&M University). The process involved development of a competency document (detailing three domains, nine major competencies, and 54 supporting competencies), an evaluation plan, and a curriculum inventory which defined…
This competency-based module uses the Ocean County (New Jersey) Vocational-Technical Schools curriculum-infused model for infusing basic skills instruction into vocational education. The model demonstrates the relationship of vocational skills to communication, mathematics, and science. The document begins with a philosophy statement; preface; a…
Burnette, Diane M.
Although competency-based education (CBE) has existed since the early 1970s adult-focused degree programs, interest in CBE has spiked in recent years due to the increased attention on higher education affordability and accountability. This article reviews the extant literature on CBE to address the following questions: (a) What are the definitions…
Wooten, Kevin C.; Elden, Max
A competency-based degree program in human resource management was co-generated by six groups of stakeholders who synthesized competency models using group decision support software. The program focuses on core human resource processes, general business management, strategic decision making and problem solving, change management, and personal…
Oudkerk Pool, Andrea; Govaerts, Marjan J. B.; Jaarsma, Debbie A. D. C.; Driessen, Erik W.
While portfolios are increasingly used to assess competence, the validity of such portfolio-based assessments has hitherto remained unconfirmed. The purpose of the present research is therefore to further our understanding of how assessors form judgments when interpreting the complex data included in a competency-based portfolio. Eighteen…
Schellhammer, Karl Sebastian; Cuniberti, Gianaurelio
We are hereby presenting a didactic concept for an advanced lab course that focuses on the design of donor materials for organic solar cells. Its research-related and competence-based approach qualifies the students to independently and creatively apply computational methods and to profoundly and critically discuss the results obtained. The high…
Boahin, Peter; Hofman, Adriaan
In the changing global economy, employability skills increasingly are the focus of vocational education and training institutions. This paper explores the effect of academic disciplines, students' background characteristics and industry training on the acquisition of employability skills through competency-based training. A significant…
Fastré, Greet M. J.; van der Klink, Marcel R.; Amsing-Smit, Pauline; van Merriënboer, Jeroen J.
This study examined the effects of type of assessment criteria (performance-based vs. competency-based), the relevance of assessment criteria (relevant criteria vs. all criteria), and their interaction on secondary vocational education students' performance and assessment skills. Students on three programmes in the domain of nursing and care…
van der Heijde, C.M.; van der Heijden, B.I.J.M.
Employability is a critical requirement for enabling both sustained competitive advantage at the firm level and career success at the individual level. We propose a competence-based approach to employability derived from an expansion of the resource-based view of the firm. In this contribution, we
van der Heijde, C.M.; van der Heijden, Beatrice
Employability is a critical requirement for enabling both sustained competitive advantage at the firm level and career success at the individual level. We propose a competence-based approach to employability derived from an expansion of the resource-based view of the firm. In this contribution, we
Rajapaksha, Ajith; Hirsch, Andrew S.
The practice of learning physics contributes to the development of many transdisciplinary skills learners are able to exercise independent of the physics discipline. However, the standard practices of physics instruction do not explicitly include the monitoring or evaluation of these skills. In a competency-based (CB) learning model, the skills…
Book, Patricia A.
The perceived value of postsecondary education to economic competitiveness and individual success is driving innovation in higher education. Competency-based education (CBE) is the latest disruption that seeks to respond to the growing sense of national urgency to boost education attainment. The target audience generally includes those adult…
Battel-Kirk, Barbara; Van der Zanden, Gerard; Schipperen, Marielle; Contu, Paolo; Gallardo, Carmen; Martinez, Ana; Garcia de Sola, Silvia; Sotgiu, Alessandra; Zaagsma, Miriam; Barry, Margaret M.
Background: The CompHP Pan-European Accreditation Framework for Health Promotion was developed as part of the CompHP Project that aimed to develop competency-based standards and an accreditation system for health promotion practice, education, and training in Europe. Method: A phased, multiple-method approach was employed to facilitate consensus…
De Maria, Richard
This competency-based module uses the Ocean County (New Jersey) Vocational-Technical Schools curriculum-infused model for infusing basic skills instruction into vocational education. The document consists of matrices that describe the relationship of vocational skills to basic communication, mathematics, and science skills within the entrepreneur…
The purpose of this study was to explore teachers' opinions with regard to the value and process of grading within a competency based training (CBT) framework, following the introduction of a formalised grading system at a specialist Technical and Further Education centre for hospitality and tourism training The data were gathered using a 16-item…
Wouter van Rennes; Josephine Lappia
Since 2000, all Dutch Universities of Professional Education are confronted with three major renewals. The first was the European agreement to implement the Bachelor-Master system in Higher Education. The second was the strong tendence to renew eduction towards Competence Based Education. The third
Cave, Julie; And Others
This instructor's manual consists of materials for use in presenting a course in the occupational area of pharmacy aide. Included in the first part of the guide are a program master sequence; a master listing of instructional materials, equipment, and supplies; an overview of the competency-based vocational education (CBVE) system; and guidelines…
Nevada Univ., Las Vegas. Coll. of Education.
This document is one of ten curriculum guides developed by the Nevada Competency-Based Adult High School Diploma (CBAHSD) Project. This curriculum guide on American government is divided into fourteen topics. The topics included are: definition of "State"; left to right political spectrum; Dictatorship vs. Democracy; Capitalism,…
Sommaruga, L.; De Angelis, E.
A competence-based approach was applied to a blended learning on line distance training in the Euroinno EU project aimed at vocational training in building automation. The current paper describes the experience gathered during the learning process and the definition of the curriculum. A number of issues emerged during the sessions concerning…
Seezink, Audrey; Poell, Rob F.; Kirschner, Paul A.
Dutch prevocational secondary schools are reforming their educational programmes to make them more competence-based. This reform has substantial implications for the roles played by teachers. Yet, little empirical research has been conducted on teachers' processes of competence development in vocational settings. This study explores teachers'…
Kentucky State Dept. of Education, Frankfort.
This package contains instructor's guide sheets and student task assignment sheets for Modules R 1-45 of the competency-based curriculum in retailing developed for use in secondary and postsecondary schools in Kentucky. Some of the topics covered in the modules include the following: retailing--past, present, and future; retailing occupations;…
This competency-based module uses the Ocean County (New Jersey) Vocational-Technical Schools curriculum-infused model for infusing basic skills instruction into vocational education. The model demonstrates the relationship of vocational skills to communication, mathematics, and science. The document begins with a philosophy statement; preface; a…
Franks, Peter; Hay, Stephen; Mavin, Tim
Competency-based training (CBT) for pilots was formally introduced in 1999 by the Civil Aviation Safety Authority (CASA) for training leading to the issue of aeroplane private and commercial pilot licences. This initiative followed the Australian government's introduction of CBT policy for vocational and workplace training in the late 1980's.…
Butland, Mark James
Colleges facing pressures to increase student outcomes while reducing costs have shown an increasing interest in competency-based education (CBE) models. Regional accreditors created a joint policy on CBE evaluation. Two years later, through this grounded theory study, I sought to understand from experts the nature of this policy, its impact, and…
Luzerne County Community Coll., Nanticoke, PA.
The project described in this report was conducted at the Community College of Luzerne County (Pennsylvania) to develop, in conjunction with area vocational-technical schools, the second year of a competency-based curriculum in automated systems/robotics technology. During the project, a task force of teachers from the area schools and the college…
Prof. Dr. Paul A. Kirschner; Dr. Audrey Seezink; Prof. Dr. Rob F. Poell
Dutch prevocational secondary schools are reforming their educational programmes to make them more competence-based. This reform has substantial implications for the roles played by teachers. Yet, little empirical research has been conducted on teachers' processes of competence development in
The Domain Five Observation Instrument (DFOI) is a competency-based observation instrument recommended for sport leaders or researchers who wish to evaluate coaches' instructional behaviors. The DFOI includes 10 behavior categories and four timed categories that encompass 34 observable instructional benchmarks outlined in domain five of the…
Luzerne County Community Coll., Nanticoke, PA.
A project was conducted at the Community College of Luzerne County (Pennsylvania) to develop, in cooperation with area vocational-technical schools, the first year of a competency-based curriculum in laser/electro-optics technology. Existing programs were reviewed and private sector input was sought in developing the curriculum and identifying…
Mosalanejad, Leili; Shahsavari, Sakine; Sobhanian, Saeed; Dastpak, Mehdi
Background: By rapid developing of the network technology, the internet-based learning methods are substituting the traditional classrooms making them expand to the virtual network learning environment. The purpose of this study was to determine the effectiveness of virtual systems on competency-based skills of first-year nursing students.…
Dragoo, Amie; Barrows, Richard
The number of competency-based education (CBE) degree programs has increased rapidly over the past five years, yet there is little research on CBE program development. This study utilized conceptual models of higher education change and a qualitative methodology to analyze the strategies and challenges in implementing CBE business degree programs…
Singh, Tejinder; Modi, Jyoti Nath
There has been an increasing emphasis on defining outcomes of medical education in terms of performance of trainees. This is a step beyond the description of outcomes in terms of competence that encompasses mostly potential abilities rather than the actual performance. The contextual adaptations and behavior judgments of the trainees are best assessed by a program of in-training assessment. Workplace based assessment (WPBA) is one of the modalities, which assesses the trainee in authentic settings. Though Postgraduate (PG) medical training in India is said to be competency-based, most institutions do not have any formative or in-training assessment program for the same. The two cardinal elements of WPBA are direct observation and conducted in work place in addition to provision of feedback to the trainee. The WPBA conforms to the highest (Level 4: Does) of Millers pyramid and also has the potential to assess at all four levels. Some of the tools used for WPBA are: Logbooks, Clinical Encounter Cards (CEC), mini-Clinical Evaluation Exercise (mini-CEX), Case based discussions, Direct Observation of Procedural Skills (DOPS), Multisource feedback (peers, co-workers, seniors, patients) etc. These can be documented in the form of a portfolio that provides a longitudinal view of experiences and progress of the trainee. The WPBA scores high on validity and educational impact by virtue of being based on direct observation in real situation and contextual feedback. The feasibility and acceptability is enhanced by making appropriate choices of tools, advance planning, building of mutual trust, and training of assessors. Given the established benefits of WPBA in shaping clinical learning, there is an imminent need for including this mode of assessment in our clinical training programs especially PG training.
Full Text Available Introduction: Competency-based medical education (CBME presents a paradigm shift in medical training. This outcome-based education movement has triggered substantive changes across the globe. Since this transition is only beginning, many faculty members may not have experience with CBME nor a solid foundation in the grounding literature. We identify and summarize key papers to help faculty members learn more about CBME. Methods: Based on the online discussions of the 2016–2017 ALiEM Faculty Incubator program, a series of papers on the topic of CBME was developed. Augmenting this list with suggestions by a guest expert and by an open call on Twitter for other important papers, we were able to generate a list of 21 papers in total. Subsequently, we used a modified Delphi study methodology to narrow the list to key papers that describe the importance and significance for educators interested in learning about CBME. To determine the most impactful papers, the mixed junior and senior faculty authorship group used three-round voting methodology based upon the Delphi method. Results: Summaries of the five most highly rated papers on the topic of CBME, as determined by this modified Delphi approach, are presented in this paper. Major themes include a definition of core CBME themes, CBME principles to consider in the design of curricula, a history of the development of the CBME movement, and a rationale for changes to accreditation with CBME. The application of the study findings to junior faculty and faculty developers is discussed. Conclusion: We present five key papers on CBME that junior faculty members and faculty experts identified as essential to faculty development. These papers are a mix of foundational and explanatory papers that may provide a basis from which junior faculty members may build upon as they help to implement CBME programs.
Cooney, Robert; Chan, Teresa M; Gottlieb, Michael; Abraham, Michael; Alden, Sylvia; Mongelluzzo, Jillian; Pasirstein, Michael; Sherbino, Jonathan
Competency-based medical education (CBME) presents a paradigm shift in medical training. This outcome-based education movement has triggered substantive changes across the globe. Since this transition is only beginning, many faculty members may not have experience with CBME nor a solid foundation in the grounding literature. We identify and summarize key papers to help faculty members learn more about CBME. Based on the online discussions of the 2016-2017 ALiEM Faculty Incubator program, a series of papers on the topic of CBME was developed. Augmenting this list with suggestions by a guest expert and by an open call on Twitter for other important papers, we were able to generate a list of 21 papers in total. Subsequently, we used a modified Delphi study methodology to narrow the list to key papers that describe the importance and significance for educators interested in learning about CBME. To determine the most impactful papers, the mixed junior and senior faculty authorship group used three-round voting methodology based upon the Delphi method. Summaries of the five most highly rated papers on the topic of CBME, as determined by this modified Delphi approach, are presented in this paper. Major themes include a definition of core CBME themes, CBME principles to consider in the design of curricula, a history of the development of the CBME movement, and a rationale for changes to accreditation with CBME. The application of the study findings to junior faculty and faculty developers is discussed. We present five key papers on CBME that junior faculty members and faculty experts identified as essential to faculty development. These papers are a mix of foundational and explanatory papers that may provide a basis from which junior faculty members may build upon as they help to implement CBME programs.
Marchira, Carla Raymondalexas; Puspitasari, Warih Andan; Rochmawati, Ida; Mulyani, Siti
ABTRACT Many persons suffering psychotic illnesses, such as schizophrenia, are largely untreated in low income countries. In these settings, most persons with severe mental illness live with their families. Thus, families play a particular critical role in determining whether a person with a psychotic illness will receive treatment and what the quality of treatment. Psychoeducation has proven to be extremely effective in helping families develop the knowledge and skills which is necessar...
Hahn, Julie; Reilly, Patricia M; Buchanan, Teresa M
Creating a healing and healthy environment for patients, families, and staff is an ongoing challenge. As part of our hospital's Integrative Care Program, a Reiki Volunteer Program has helped to foster a caring and healing environment, providing a means for patients, family, and staff to reduce pain and anxiety and improve their ability to relax and be present. Because direct care providers manage multiple and competing needs at any given time, they may not be available to provide Reiki when it is needed. This program demonstrates that a volunteer-based program can successfully support nurses in meeting patient, family, and staff demand for Reiki services.
Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health
The Thana Resource Development and Employment Project (TRDEP), built upon the successful experience of the Grameen Bank and other nongovernmental organizations, is a comprehensive poverty alleviation scheme implemented by the government of Bangladesh and targeted to the poorest segment of Bangladeshi society. The project provides soft loans to landless poor for income-generating activities involving non-crop livelihoods and trades. The loans are granted at an 18% interest rate including a 2% charge which goes into a risk fund. The poorest of poor are eligible to receive loans as long as each borrowing unit is a self-help group comprised of five members of one family and each member of the group assumes the responsibility of paying each other member's loan. Each member of a borrowing group may receive loans in the amount of Taka 3000-5000 (US$75-125). The loans are then repayable in 50 equal installments over the course of 1 year. One member's default disqualifies all other group members from receiving future credit until the default is cleared. TRDEP borrowers have started small, successful entrepreneurial activities with their loans as capital.
Shaku, Fumio; Tsutsumi, Madoka
Decision making in terminal illness has recently received increased attention. In Japan, patients and their families typically make decisions without understanding either the severity of illness or the efficacy of life-supporting treatments at the end of life. Japanese culture traditionally directs the family to make decisions for the patient. This descriptive study examined the influence of the experiences of 391 Japanese nurses caring for dying patients and family members and how that experience changed their decision making for themselves and their family members. The results were mixed but generally supported the idea that the more experience nurses have in caring for the dying, the less likely they would choose to institute lifesupport measures for themselves and family members. The results have implications for discussions on end-of-life care. © The Author(s) 2016.
Okoye, K. R. E.; Michael, Ofonmbuk Isaac
This paper attempts to examine the concept of Competency-Based Training (CBT) as a veritable mode of delivery of Technical and Vocational Education and Training (TVET) and at the same time highlights some of the strengths and weaknesses of implementing competency-base training. The characteristics, principles and benefits of CBT were also x-rayed.…
Krause, Jackie; Dias, Laura Portolese; Schedler, Chris
While competency-based education is growing, standardized tools for evaluating the unique characteristics of course design in this domain are still under development. This preliminary research study evaluated the effectiveness of a rubric developed for assessing course design of competency-based courses in an undergraduate Information Technology…
The concern with competency-based education is not whether it is any different from the more traditional approaches but whether it is worth the considerable effort it involves. There are several aspects of a competency-based program to be considered in its evaluation. The first is whether or not there is a justifiable need for the specified…
Tate, Pamela; Klein-Collins, Rebecca
Competency-based education (CBE) is the hot new thing in higher education. While forms of CBE have been around since the 1970s, there has been a surge of interest in CBE, with more than 600 postsecondary institutions now reporting that they are either offering competency-based degree programs or are planning to do so. Similarly, institutional…
Gadagkar Sudhindra R
Full Text Available Abstract Background The completion of 19 insect genome sequencing projects spanning six insect orders provides the opportunity to investigate the evolution of important gene families, here tubulins. Tubulins are a family of eukaryotic structural genes that form microtubules, fundamental components of the cytoskeleton that mediate cell division, shape, motility, and intracellular trafficking. Previous in vivo studies in Drosophila find a stringent relationship between tubulin structure and function; small, biochemically similar changes in the major alpha 1 or testis-specific beta 2 tubulin protein render each unable to generate a motile spermtail axoneme. This has evolutionary implications, not a single non-synonymous substitution is found in beta 2 among 17 species of Drosophila and Hirtodrosophila flies spanning 60 Myr of evolution. This raises an important question, How do tubulins evolve while maintaining their function? To answer, we use molecular evolutionary analyses to characterize the evolution of insect tubulins. Results Sixty-six alpha tubulins and eighty-six beta tubulin gene copies were retrieved and subjected to molecular evolutionary analyses. Four ancient clades of alpha and beta tubulins are found in insects, a major isoform clade (alpha 1, beta 1 and three minor, tissue-specific clades (alpha 2-4, beta 2-4. Based on a Homarus americanus (lobster outgroup, these were generated through gene duplication events on major beta and alpha tubulin ancestors, followed by subfunctionalization in expression domain. Strong purifying selection acts on all tubulins, yet maximum pairwise amino acid distances between tubulin paralogs are large (0.464 substitutions/site beta tubulins, 0.707 alpha tubulins. Conversely orthologs, with the exception of reproductive tissue isoforms, show little sequence variation except in the last 15 carboxy terminus tail (CTT residues, which serve as sites for post-translational modifications (PTMs and interactions
Lindahl, Berit; Lindblad, Britt-Marie
The number of medically fragile children cared for at home is increasing; however, there are few studies about the professional support these families receive in their homes. The aim of the study was to understand the meanings that parents had about the support they received from health care professionals who offered care for their ventilator-assisted child in the family home. A phenomenological-hermeneutic method was used. Data included the narratives of five mother-father couples living in Sweden who were receiving professional support for their ventilator-assisted child. The findings indicate that receiving professional support meant being at risk of and/or exposed to the exercise of control over family privacy. The professional support system in the families' homes worked more by chance than by competent and sensible planning. In good cases, caring encounters were characterized by a mutual relationship where various occupational groups were embraced as a part of family life. The findings are discussed in light of compassionate care, exercise of power, and the importance of holistic educational programs.
Full Text Available Problems of management in aerospace manufacturing are similar to those we observe in other sectors, the main of which is the flattening of strategic management. The main reason lies in the attitude towards human resource of the organization. In the aerospace industry employs 250 thousand people, who need individual approach. The individual approach can offer competence-based approach to management. The purpose of the study is proof of the benefits of the competency approach to human resource management in context strategic management of the aerospace organization. To achieve this goal it is possible to obtain the method of comparative analysis. The article compares two approaches to personnel management. The transition to competence-based human resource management means (a a different understanding of the object of management; (b involvement in all functions of human resource management «knowledge – skills – abilities» of the employee; (c to change the approach to strategic management aerospace industry.
Arpentieva Mariam; Duvalina Olga; Braitseva Svetlana; Gorelova Irina; Rozhnova Anna
Problems of management in aerospace manufacturing are similar to those we observe in other sectors, the main of which is the flattening of strategic management. The main reason lies in the attitude towards human resource of the organization. In the aerospace industry employs 250 thousand people, who need individual approach. The individual approach can offer competence-based approach to management. The purpose of the study is proof of the benefits of the competency approach to human resource ...
Full Text Available In the past decade, health and human service educational programs have transitioned to competence-based outcomes to enhance the quality of graduating professionals. While such outcomes are a critical step in ensuring professional quality, they require curricular and pedagogical adjustments that do not fit easily within university environments. Technology has eased many problems of fit through the development of hybrid and flipped courses that allow on-campus time to be better focused on developing professional skills. This study explored the question: Can flipped delivery improve competence-based outcomes in social work practice classes? The study assessed pedagogical adjustments that integrated competence-based learning principles with flipped classroom delivery. Principles of organizing the class to maximize competence development are explored and illustrated. Improved competence development and student satisfaction were demonstrated in three flipped practice courses with a combined sample size of 269 Bachelor of Social Work (BSW and Masters of Social Work (MSW students. Researchers concluded that using flipped-classroom methods enhanced the students’ capacity to apply concepts and develop skills. In particular, the ability to receive and process feedback on applied skills was improved.
White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E
To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.
Howe, Edmund G
How might clinicians best try to retain the trust of patients and family members after clinicians oppose giving a treatment? If clinicians can maintain the trust of patients and families in these situations, this may soften what may be the greatest possible loss--the death of a loved one. I discuss what clinicians seeking to retain trust should not do--namely impose their values and reason wrongly--and introduce strategies that clinicians may use to reduce both. I present five principles that clinicians can follow to try to retain trust, with examples that illustrate each. I suggest specific interventions that clinicians can make, especially when they anticipate that a patient and/or family may, in time, want a treatment that is futile. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
Blackstock, Oni J.; Mba-Jonas, Adamma; Sacajiu, Galit M.
Disparities in the rates of unintended pregnancy have increased for low-income African American women as compared to other groups due, in part, to declining contraception use. Women obtain family planning information from diverse sources, which may ultimately influence contraceptive decision making. For this qualitative study, we conducted…
Hutchison, Lauren A; Raffin-Bouchal, Donna S; Syme, Charlotte A; Biondo, Patricia D; Simon, Jessica E
Objectives Advance care planning is the process by which people reflect upon their wishes and values for healthcare, discuss their choices with family and friends and document their wishes. Readiness represents a key predictor of advance care planning participation; however, the evidence for addressing readiness is scarce within the renal failure context. Our objectives were to assess readiness for advance care planning and barriers and facilitators to advance care planning uptake in a renal context. Methods Twenty-five participants (nine patients, nine clinicians and seven family members) were recruited from the Southern Alberta Renal Program. Semi-structured interviews were recorded, transcribed and then analyzed using interpretive description. Results Readiness for advance care planning was driven by individual values perceived by a collaborative encounter between clinicians and patients/families. If advance care planning is not valued, then patients/families and clinicians are not ready to initiate the process. Patients and clinicians are delaying conversations until "illness burden necessitates," so there is little "advance" care planning, only care planning in-the-moment closer to the end of life. Discussion The value of advance care planning in collaboration with clinicians, patients and their surrogates needs reframing as an ongoing process early in the patient's illness trajectory, distinguished from end-of-life decision making.
Full Text Available Introduction: Progress tests provide students feedback on their level of proficiency over the course of their medical studies. Peer-assisted learning and competency-based education have become increasingly important in medical education. Although progress tests have been proven to be useful as a longitudinal feedback instrument, there are currently no progress tests that have been created in cooperation with students or that focus on competency in medical education.In this study, we investigated the extent to which students can be included in the development of a progress test and demonstrated that aspects of knowledge related to competency can be represented on a competency-based progress test.Methods: A two-dimensional blueprint for 144 multiple-choice questions (MCQs covering groups of medical subjects and groups of competency areas was generated by three expert groups for developing the competency-based progress test. A total of 31 students from seven medical schools in Germany actively participated in this exercise. After completing an intensive and comprehensive training programme, the students generated and reviewed the test questions for the competency-based progress test using a separate platform of the ItemManagementSystem (IMS. This test was administered as a formative test to 469 students in a pilot study in November 2013 at eight medical schools in Germany. The scores were analysed for the overall test and differentiated according to the subject groups and competency areas.Results: A pool of more than 200 MCQs was compiled by the students for pilot use, of which 118 student-generated MCQs were used in the progress test. University instructors supplemented this pool with 26 MCQs, which primarily addressed the area of scientific skills. The post-review showed that student-generated MCQs were of high quality with regard to test statistic criteria and content. Overall, the progress test displayed a very high reliability. When the
Engelberg, Ruth A.; Downey, Lois; Kross, Erin K.; Reinke, Lynn F.; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W.; Back, Anthony L.; Curtis, J. Randall
Abstract Background: Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. Objective: To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. Methods: As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Results: Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Conclusions: Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families. PMID:24592958
Long, Ann C; Engelberg, Ruth A; Downey, Lois; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W; Back, Anthony L; Curtis, J Randall
Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.
Bampi, Giovana B; Bisso-Machado, Rafael; Hünemeier, Tábita; Gheno, Tailise C; Furtado, Gabriel V; Veliz-Otani, Diego; Cornejo-Olivas, Mario; Mazzeti, Pillar; Bortolini, Maria Cátira; Jardim, Laura B; Saraiva-Pereira, Maria Luiza
Spinocerebellar ataxia type 10 (SCA10) is an autosomal dominant neurodegenerative disorder characterized by progressive cerebellar ataxia and epilepsy. The disease is caused by a pentanucleotide ATTCT expansion in intron 9 of the ATXN10 gene on chromosome 22q13.3. SCA10 has shown a geographical distribution throughout America with a likely degree of Amerindian ancestry from different countries so far. Currently available data suggest that SCA10 mutation might have spread out early during the peopling of the Americas. However, the ancestral origin of SCA10 mutation remains under speculation. Samples of SCA10 patients from two Latin American countries were analysed, being 16 families from Brazil (29 patients) and 21 families from Peru (27 patients) as well as 49 healthy individuals from Indigenous Quechua population and 51 healthy Brazilian individuals. Four polymorphic markers spanning a region of 5.2 cM harbouring the ATTCT expansion were used to define the haplotypes, which were genotyped by different approaches. Our data have shown that 19-CGGC-14 shared haplotype was found in 47% of Brazilian and in 63% of Peruvian families. Frequencies from both groups are not statistically different from Quechua controls (57%), but they are statistically different from Brazilian controls (12%) (p Quechuas, 19-15-CGGC-14-10, is found in 50% of Brazilian and in 65% of Peruvian patients with SCA10. These findings bring valuable evidence that ATTCT expansion may have arisen in a Native American chromosome.
Full Text Available Context: The Food Safety and Standards Act have redefined the roles and responsibilities of food regulatory workforce and calls for highly skilled human resources as it involves complex management procedures. Aims: 1 Identify the competencies needed among the food regulatory workforce in India. 2 Develop a competency-based training curriculum for food safety regulators in the country. 3 Develop training materials for use to train the food regulatory workforce. Settings and Design: The Indian Institute of Public Health, Hyderabad, led the development of training curriculum on food safety with technical assistance from the Royal Society for Public Health, UK and the National Institute of Nutrition, India. The exercise was to facilitate the implementation of new Act by undertaking capacity building through a comprehensive training program. Materials and Methods: A competency-based training needs assessment was conducted before undertaking the development of the training materials. Results: The training program for Food Safety Officers was designed to comprise of five modules to include: Food science and technology, Food safety management systems, Food safety legislation, Enforcement of food safety regulations, and Administrative functions. Each module has a facilitator guide for the tutor and a handbook for the participant. Essentials of Food Hygiene-I (Basic level, II and III (Retail/ Catering/ Manufacturing were primarily designed for training of food handlers and are part of essential reading for food safety regulators. Conclusion: The Food Safety and Standards Act calls for highly skilled human resources as it involves complex management procedures. Despite having developed a comprehensive competency-based training curriculum by joint efforts by the local, national, and international agencies, implementation remains a challenge in resource-limited setting.
Mario Rueda Beltrán
Full Text Available The article gives an overview of the main arguments and characteristics attributed to the Competency-based Approach in education, so as to analyze the various definitions available and some of the proposals on the subject of teaching skills. Approaches and strategies are suggested for developing teacher-evaluation programs in the context of a generalized environment in the educational sector which is adopting the model of competencies for school reform, curriculum redesign, modifications in teaching strategies, and manners and functions of evaluation.
V. A. Gerasimova
Full Text Available By the analysis results of scientific works in the field of competence-based approach in education authors proved need of computer support of the planning and development stage of the main educational program, they developed the main educational program structure automatic formation model on the graphs basis, offered the integrated criterion of an discipline assessment and developed a strategic map of a discipline complex assessment. The executed theoretical researches are a basis for creation of the main educational program planning and development support automated system.
Jack, Barbara A; O'Brien, Mary R; Scrutton, Joyce; Baldry, Catherine R; Groves, Karen E
To explore bereaved family carers' perceptions and experiences of a hospice at home service. The increasing demand for the development of home-based end-of-life services is not confined to the western world; such services are also emerging in resource-poor countries where palliative care services are developing with limited inpatient facilities. Despite this growing trend, studies show a variety of interrelated factors, with an emphasis on the availability of informal carers and their ability to cope, which can influence whether terminally ill patients actually remain at home. A hospice at home service was developed to meet patients' and families' needs by providing individually tailored resources. A qualitative study. Data were collected by semi-structured, digitally recorded interviews from 20 family carers who had experienced the service. Interviews were transcribed verbatim and a thematic approach adopted for analysis. All participants reported a personal positive impact of the service. Family carers commented the service provided a valued presence, they felt in good hands and importantly it helped in supporting normal life. The impact of an individualised, targeted, hospice at home service using dedicated, palliative care trained, staff, is perceived positively by family carers and importantly, supportive of those with additional caring or employment commitments. The emergence of hospice at home services has resulted in more options for patients and their families, when the increased amount of care a family member has to provide in these circumstances needs to be adequately supported, with the provision of a flexible service tailored to individual needs and delivered by appropriately trained staff. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.
Pascual-Fernández, M Cristina
Informing is a process that includes many aspects and when it involves a family member at the end of life it becomes a complicated matter, not only for giving the information, but also for the mood of family members. Thus, the information should be adapted to the language and education of the patient and family. That information must be proper and suitable to the moment. To describe the aspects of information offered to relatives of patients in the end of life process in Intensive Care Units (ICU), and to determine the nursing evaluation in this process. To evaluate the professionals' attitude on this subject. An observational study conducted on nurses in pediatric and adult ICU nurses of a large public health hospital complexes in the city of Madrid. The data was collected using a questionnaire on the evaluation of care of children who died in pediatric ICU. The majority of the nurses, 71% (159), said that the information was given in a place alone with the doctor. More than half (52.4%, 118) considered that the information was sufficient/insufficient depending on the day. Significant differences were found as regards the behavior of the staff at the time of a death in (P<.01), with pediatric ICU professionals being more empathetic. ICU nurses believe that the information is appropriate for the prognosis and adapted to the patient situation. They also consider the place where the information is given and the attitude of the professionals in the end of life process are adequate. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Hinton, Ladson; Apesoa-Varano, Ester Carolina; Unützer, Jürgen; Dwight-Johnson, Megan; Park, Mijung; Barker, Judith C
The aim of this study is to describe the roles of family members in older men's depression treatment from the perspectives of older men and primary care physicians (PCPs). Cross-sectional, descriptive qualitative study conducted from 2008-2011 in primary care clinics in an academic medical center and a safety-net county teaching hospital in California's Central Valley. Participants in this study were the following: (1) 77 age ≥ 60, noninstitutionalized men with a 1-year history of clinical depression and/or depression treatment who were identified through screening in primary care clinics and (2) a convenience sample of 15 PCPs from the same recruitment sites. Semi-structured and in-depth qualitative interviews were conducted and audiotaped then transcribed and analyzed thematically. Treatment-promoting roles of family included providing an emotionally supportive home environment, promoting depression self-management and facilitating communication about depression during primary care visits. Treatment-impeding roles of family included triggering or worsening men's depression, hindering depression care during primary care visits, discouraging depression treatment and being unavailable to assist men with their depression care. Overall, more than 90% of the men and the PCPs described one or more treatment-promoting roles of family and over 75% of men and PCPs described one or more treatment-impeding roles of family. Families play important roles in older men's depression treatment with the potential to promote as well as impede care. Interventions and services need to carefully assess the ongoing roles and attitudes of family members and to tailor treatment approaches to build on the positive aspects and mitigate the negative aspects of family support. Copyright © 2014 John Wiley & Sons, Ltd.
Over one hundred children and some of their parents were infected with HIV in state hospitals in the Chimkent region in Southern Kazakhstan. After this tragedy, the Regional Department of Public Health organized social services for these families and asked the American Jewish Joint Distribution Committee (JDC) to provide them with training and…
Foth, Thomas; Holmes, Dave
Competency has become a key concept in education in general over the last four decades. This article examines the development of the competency-based movement with a particular focus on the significance it has had for nursing education. Our hypothesis is that the competency movement can only adequately be understood if it is analyzed in relation to the broad societal transformation of the last decades-often summarized under the catchword neoliberalism-and with it the emergence of managerial models for Human Resource Management (HRM) for the reorganization of social services. Classical professions, which were characterized under welfarism by an esoteric knowledge based on ethical norms, have now become marketable commodities that can be evaluated in the same way as other commodities. We want to underline that while this development is still under way, it is the concept of competency that was the decisive political instrument enabling this profound change. With the widespread implementation of competency-based education that now governs nursing knowledge, the development of a critical, oppositional perspective becomes more challenging, if not entirely impossible. We will be focusing primarily on nursing education in Canada, although we maintain that it has relevance for nursing internationally. © 2016 John Wiley & Sons Ltd.
Tekian, Ara; Watling, Christopher J; Roberts, Trudie E; Steinert, Yvonne; Norcini, John
Research indicates the importance and usefulness of feedback, yet with the shift of medical curricula toward competencies, feedback is not well understood in this context. This paper attempts to identify how feedback fits within a competency-based curriculum. After careful consideration of the literature, the following conclusions are drawn: (1) Because feedback is predicated on assessment, the assessment should be designed to optimize and prevent inaccuracies in feedback; (2) Giving qualitative feedback in the form of a conversation would lend credibility to the feedback, address emotional obstacles and create a context in which feedback is comfortable; (3) Quantitative feedback in the form of individualized data could fulfill the demand for more feedback, help students devise strategies on how to improve, allow students to compare themselves to their peers, recognizing that big data have limitations; and (4) Faculty development needs to incorporate and promote cultural and systems changes with regard to feedback. A better understanding of the role of feedback in competency-based education could result in more efficient learning for students.
Gruppen, Larry D; Ten Cate, Olle; Lingard, Lorelei A; Teunissen, Pim W; Kogan, Jennifer R
Competency-based, time-variable medical education has reshaped the perceptions and practices of teachers, curriculum designers, faculty developers, clinician educators, and program administrators. This increasingly popular approach highlights the fact that learning among different individuals varies in duration, foundation, and goal. Time variability places particular demands on the assessment data that are so necessary for making decisions about learner progress. These decisions may be formative (e.g., feedback for improvement) or summative (e.g., decisions about advancing a student). This article identifies challenges to collecting assessment data and to making assessment decisions in a time-variable system. These challenges include managing assessment data, defining and making valid assessment decisions, innovating in assessment, and modeling the considerable complexity of assessment in real-world settings and richly interconnected social systems. There are hopeful signs of creativity in assessment both from researchers and practitioners, but the transition from a traditional to a competency-based medical education system will likely continue to create much controversy and offer opportunities for originality and innovation in assessment.
Full Text Available The purpose of the present study was to examine the influence of the “Competence-based didactic units” in vocational education on students’ motivation and self-regulated learning. The sample consisted of 115 males and 133 females (n=250 who were attending secondary vocational or technical schools in Slovenia. The students were included in an experimental project that introduced a “competence- based didactic unit” (CBDU in vocational schools’ curricula. In our study, the introduction of the CBDU was used to measure changes in the motivational, cognitive, and metacognitive aspects of self-regulated learning and to examine how they were subsequently related to other students characteristists, such as gender, school performance and time spent on school work. The results show the importance of CBDUs, on the one hand, on motivational factors such as intrinsic goal orientation, task value, and self-efficacy, and, on the other hand, differences in gender and grade level. The findings are discussed in terms of how teaching strategies in vocational education can contribute to the development of individuals’ motivation.
Lehr, Bosco; Ostermann, Herwig; Schubert, Harald
As a result of more economising in German hospitals, changes evolve in organising the deployment of senior medical staff. New demands are made of senior hospital management. Leadership competencies in the training and development of physicians are of prime importance to the successful perception of managerial responsibilities. The present study investigates the actual and targeted demands of leadership made of senior medical staff in terms of how these demands are perceived. To this end, the demands of leadership were surveyed using a competence-based questionnaire and investigated with a view to potentials in professional development by way of example of the senior management of psychiatric hospitals in Germany. In all, the results show high ratings in personal performance, the greatest significance being attributed to value-oriented competence in the actual assessment of demands on leadership. Besides gender-specific differences in the actual assessments of single fields of competence, the greatest differences between the targeted and the actual demands are, in all, shown to be in the competencies of self-management and communication. Competence-based core areas in leadership can be demonstrated for the professional development of physicians and an adaptive mode of procedure deduced. Copyright © 2010. Published by Elsevier GmbH.
Estrada, John H M
Considered as an element of business discourse, the competence-based education emerges associated with processes of productive restructuring influencing the economy since 1970. These processes arise as a consequence of the crisis of the accumulation model based on mass production and consumption following the principles of taylorism and fordism. In the last decades, the State has been unable to solve the periodic crisis that afflicts late capitalism. Because of this, the State moves away from its economic mission, promotes marketing mechanisms and, in the meantime, it tries to manage the motivational crisis of the population. This challenge forces the State to take interest in the vital world of individuals trying to solve the legitimacy crisis through educational reforms that affect the world of work. The relationship between the vertiginous changes of working world and a new educational formation is explicit. This educational formation must consider (at the same time) the management capacity, learning capacity, teamwork capacity and self-training. Based on this situation, there is a direct relationship between technologic advances, the structural crisis of capitalism and work organization. Besides, the "qualification" term is replaced with "competency-based education".
Dauphinee, W Dale; Boulet, John R; Norcini, John J
Educational assessment for the health professions has seen a major attempt to introduce competency based frameworks. As high level policy developments, the changes were intended to improve outcomes by supporting learning and skills development. However, we argue that previous experiences with major innovations in assessment offer an important road map for developing and refining assessment innovations, including careful piloting and analyses of their measurement qualities and impacts. Based on the literature, numerous assessment workshops, personal interactions with potential users, and our 40 years of experience in implementing assessment change, we lament the lack of a coordinated approach to clarify and improve measurement qualities and functionality of competency based assessment (CBA). To address this worrisome situation, we offer two roadmaps to guide CBA's further development. Initially, reframe and address CBA as a measurement development opportunity. Secondly, using a roadmap adapted from the management literature on sustainable innovation, the medical assessment community needs to initiate an integrated plan to implement CBA as a sustainable innovation within existing educational programs and self-regulatory enterprises. Further examples of down-stream opportunities to refocus CBA at the implementation level within faculties and within the regulatory framework of the profession are offered. In closing, we challenge the broader assessment community in medicine to step forward and own the challenge and opportunities to reframe CBA as an innovation to improve the quality of the clinical educational experience. The goal is to optimize assessment in health education and ultimately improve the public's health.
Röhrig, R; Stausberg, J; Dugas, M
The aim of this project is to develop a catalogue of competency-based learning objectives "Medical Informatics" for undergraduate medical education (abbreviated NKLM-MI in German). The development followed a multi-level annotation and consensus process. For each learning objective a reason why a physician needs this competence was required. In addition, each objective was categorized according to the competence context (A = covered by medical informatics, B = core subject of medical informatics, C = optional subject of medical informatics), the competence level (1 = referenced knowledge, 2 = applied knowledge, 3 = routine knowledge) and a CanMEDS competence role (medical expert, communicator, collaborator, manager, health advocate, professional, scholar). Overall 42 objectives in seven areas (medical documentation and information processing, medical classifications and terminologies, information systems in healthcare, health telematics and telemedicine, data protection and security, access to medical knowledge and medical signal-/image processing) were identified, defined and consented. With the NKLM-MI the competences in the field of medical informatics vital to a first year resident physician are identified, defined and operationalized. These competencies are consistent with the recommendations of the International Medical Informatics Association (IMIA). The NKLM-MI will be submitted to the National Competence-Based Learning Objectives for Undergraduate Medical Education. The next step is implementation of these objectives by the faculties.
Ana Fernández-Aballí Altamirano
Full Text Available The neoliberalization of higher education in Spain has been consolidating through its integration process to the European Higher Education Area. In this context, competence-based curricula have become an instrument to create a model of education and citizenship in which market values override solidarity, justice and community well-being. There is, however, still room to shift the teaching-learning space. Using Freirean critical pedagogy to redefine the curriculum through the implementation of Participatory Action Research (PAR in the classroom provides a methodological approach within and despite current EHEA policies to revert the neoliberalization of higher education.
Ivey, Susan L; Laditka, Sarah B; Price, Anna E; Tseng, Winston; Beard, Renée L; Liu, Rui; Fetterman, David; Wu, Bei; Logsdon, Rebecca G
We examined experiences and concerns among caregivers of community-dwelling people with dementia from two ethnic groups. We conducted a thematic analysis of responses to the question, 'What is your life like as a caregiver?' in nine focus groups (n = 75) with Filipino and non-Hispanic White caregivers. Constant comparison methods identified themes by ethnicity. Experiences and concerns expressed across groups were related to care recipient symptoms commonly associated with dementia, including severe memory loss and behavioral changes. Participants in both ethnic groups described strategies that help them cope, such as receiving help from family and friends, receiving respite support, and participating in support groups. Filipino caregivers more often emphasized positive aspects of caregiving, whereas Whites often expressed that others do not understand the daily experiences of caregiving. Filipinos more commonly described caregivers as a 'good person' or 'saint' and emphasized that caregiving made them stronger.
Routine training is not enough: structured training in family planning and abortion improves residents' competency scores and intentions to provide abortion after graduation more than ad hoc training.
Macisaac, Laura; Vickery, Zevidah
Abortion provision remains threatened by the paucity of physicians trained to provide them. Lack of training during residency has been cited by obstetrician and gynecologist (ob-gyn) physicians as a reason for not including abortion in their practice. We administered surveys on interest, competency and intention to provide abortions to two groups of ob-gyn residents: one experiencing a new comprehensive and structured family planning rotation, and another group at our affiliate hospital's residency program receiving "ad hoc" training during their routine gynecology rotations. Surveys were anonymous and blinded to investigator. The structured family planning rotation group compared to the ad hoc group reported significantly increased competency score using a Likert scale in manual vacuum aspiration (MVA) (4.5 vs. 1; p=.003) and had a higher proportion reporting intent to provide office MVA postresidency (100% vs. 39%; p=.01) and being trained to 22.5 weeks' vs. 12 weeks' gestation (p=.005). In bivariate analysis, competency in MVA was associated with higher intentions to provide MVA after residency (p=.007). A structured rotation in family planning and abortion for obstetrics/gynecology residents results in increases in competency and intentions to provide abortion, and an association between the two. In-hospital structured training proved to be superior to ad hoc training in our affiliate institution in improving competency and intention to provide abortion after residency. Copyright © 2012 Elsevier Inc. All rights reserved.
McKinnon, Wendy; Naud, Shelly; Ashikaga, Taka; Colletti, Rose; Wood, Marie
: Providing medical management updates and long-term support to families with hereditary cancer syndromes in rural areas is a challenge. To address this, we designed a one-day retreat for BRCA1/2 carriers in our region. The retreat included educational updates about medical management, genetic privacy and discrimination, and addressed psychological and family issues. Evaluations completed at the conclusion of the retreat were overwhelmingly positive with requests for a similar event in the future. The impact of this retreat on a variety of health behaviors was assessed. Eligible participants completed questionnaires before and 6 months after the retreat. Questionnaires focused on lifestyle, cancer screening and prevention practices, psychological history and distress, decision-making regarding genetic testing, and family communication issues. For individuals who completed both the pre and post retreat questionnaires, one-half made lifestyle changes and nearly two-thirds increased cancer screening, initiated chemoprevention, completed or planned to complete preventative surgery in the future. We conclude that this type of forum provides a valuable opportunity for BRCA carriers and their families to receive updated medical information, share personal experiences, provide and receive support, as well as change health behaviors.
Evaluation of family-centred practices in the early intervention programmes for infants and young children in Singapore with Measure of Processes of Care for Service Providers and Measure of Beliefs about Participation in Family-Centred Service.
Tang, H N; Chong, W H; Goh, W; Chan, W P; Choo, S
The primary purpose of this study was to report on an evaluation of the perceptions and beliefs of service providers towards family-centred practices in 11 early intervention programmes for infants and young children in Singapore. The Measure of Processes of Care for Service Providers (MPOC-SP) and Measure of Beliefs about Participation in Family-Centred Service (MBP-FCS) were administered to 213 service providers made up of teachers, therapists, psychologists and social workers providing centre-based therapy to children with special needs who were below the age of 6 years. Exploratory factor analyses were performed with both scales. Nineteen of the 27 MPOC-SP items were retained and supported the original four-factor structure model. The exploratory factor analyses on MBP-FCS provided a less satisfactory outcome. Fourteen of the 28 items were retained and these loaded onto four factors. The two factors relating to Beliefs about benefits of FCS and Beliefs about the absence of negative outcomes from FCS failed to emerge as separate factors. Further multiple regressions indicated that more direct work with families and positive self-efficacy in implementing FCS contributed significantly to explaining service providers' positive perception towards family-centred practice in service delivery. This is the first time MPOC-SP and MBP-FCS were administered to a population in an Asian context. While MBP-FCS would benefit from further development work on its construct, MPOC-SP offered important insights into service providers' perspectives about family-centred practices that would have useful implications for professional and service development. © 2011 Blackwell Publishing Ltd.
Full Text Available This paper presents a case study of a youth organisation working with families in extreme poverty and lack of adequate housing in Chile and Mexico. It initially describes the considerable structural changes that relate to the emergence of the organisation, and then discusses how across context case study research that draws from the interpretivist interactionist tradition was employed. In the main body it presents interventions that aim to provide families with temporary accommodation, social support, education, micro-credit opportunities, and legal support. The paper aims to contribute to a discussion concerning wider insights to be gained from context-specific approaches in working with families. The article highlights the need for policy and practice that approaches families as complex, dynamic and context specific entities that are re-configured through their networks and interpersonal interactions, and are subject to particular plays of power relations. Furthermore, it argues for practice that fosters family agency that is based on recognition of strengths, emotional and cognitive aspects of decision making as well as nurturing of hope.
Fok, Mark C; Wong, Roger Y
Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference value for difference from pre-curriculum based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT
Vadaparampil, S. T.; Malo, T.; Cruz, C. D. L.; Christie, J.; Vadaparampil, S. T.
BRCA genetic test results provide important information to manage cancer risk for patients and their families. Little is known on the communication of genetic test results by mutation status with family members and physicians in the oncology care setting. As part of a longitudinal study evaluating the impact of genetic counseling and testing among recently diagnosed breast cancer patients, we collected patients' self-reported patterns of disclosure. Descriptive statistics characterized the sample and determined the prevalence of disclosure of BRCA test results to family members and physicians. Of 100 patients who completed the baseline and the 6-month followup survey, 77 reported pursuing testing. The majority shared test results with female first-degree relatives; fewer did with males. Participants were more likely to share results with oncologists compared to surgeons, primary care physicians, or other specialty physicians. These findings suggest that while breast cancer patients may communicate results to at-risk female family members and their medical oncologist, they may need education and support to facilitate communication to other first-degree relatives and providers
Ruiz, Yumary; Matos, Sergio; Kapadia, Smiti; Islam, Nadia; Cusack, Arthur; Kwong, Sylvia; Trinh-Shevrin, Chau
Despite the importance of community health workers (CHWs) in strategies to reduce health disparities and the call to enhance their roles in research, little information exists on how to prepare CHWs involved in community-academic initiatives (CAIs). Therefore, the New York University Prevention Research Center piloted a CAI-CHW training program. We applied a core competency framework to an existing CHW curriculum and bolstered the curriculum to include research-specific sessions. We employed diverse training methods, guided by adult learning principles and popular education philosophy. Evaluation instruments assessed changes related to confidence, intention to use learned skills, usefulness of sessions, and satisfaction with the training. Results demonstrated that a core competency-based training can successfully affect CHWs' perceived confidence and intentions to apply learned content, and can provide a larger social justice context of their role and work. This program demonstrates that a core competency-based framework coupled with CAI-research-specific skill sessions (1) provides skills that CAI-CHWs intend to use, (2) builds confidence, and (3) provides participants with a more contextualized view of client needs and CHW roles.
Leonard, Rosemary; Horsfall, Debbie; Rosenberg, John; Noonan, Kerrie
Although there is ample evidence of the risk to carers from the burden of caring, there is also evidence that a caring network can relieve the burden on the principal carer, strengthen community relationships, and increase 'Death Literacy' in the community. There is often an assumption that, in caring networks, family and service providers are central and friends and community are marginal. We examined whether this is the case in practice using SNA. To identify the relative positioning of family, friends, community, and service providers in caring networks. In interviews with carers (N = 23) and focus groups with caring networks (N = 13) participants were asked to list the people in the caring network and rate the strength of their relationships to them (0 no relationship to 3 strong relationship). SNA in UCInet was used to map the networks, examine density (number and strength of relationships) across time (when caring began to the present) and across relationship types (family, friends, community, and service providers) supplemented by qualitative data. The analysis revealed significant increases in the density of the networks over time. The density of relationships with friends was similar to that other family. Community and service providers had significantly lower density. Qualitative analysis revealed that often service providers were not seen as part of the networks. To avoid carer burnout, it is important not to make assumptions about where carers obtain support but work with each carer to mobilise any support that is available. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Siebes, RC; Ketelaar, M; Wijnroks, L; van Schie, PE; Nijhuis, Bianca J G; Vermeer, A; Gorter, JW
Objective: To validate the Dutch translation of the Canadian Measure of Processes of Care for Service Providers questionnaire (MPOC-SP) for use in paediatric rehabilitation settings in the Netherlands. Design: The construct validity, content validity, face validity, and reliability of the Dutch
Kealy-Bateman, Warren; Kotze, Beth; Lampe, Lisa
To provide information relevant to decision-making around the timing of attempting the centrally administered summative assessments in the Royal Australian and New Zealand College of Psychiatrists (RANZCP) 2012 Fellowship Program. We consider the new Competency-Based Fellowship Program of the RANZCP and its underlying philosophy, the trainee trajectory within the program and the role of the supervisor. The relationship between workplace-based and external assessments is discussed. The timing of attempting centrally administered summative assessments is considered within the pedagogical framework of medical competencies development. Although successful completion of all the centrally administered summative assessments requires demonstration of a junior consultant standard of competency, the timing at which this standard will most commonly be achieved is likely to vary from assessment to assessment. There are disadvantages attendant upon prematurely attempting assessments, and trainees are advised to carefully consider the requirements of each assessment and match this against their current level of knowledge and skills. Trainees and supervisors need to be clear about the competencies required for each of the external assessments and match this against the trainee's current competencies to assist in decision-making about the timing of assessments and planning for future learning. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Treiger, Teresa M; Fink-Samnick, Ellen
The purpose of this first of a three-article series is to provide context and justification for a new paradigm of case management built upon a value-driven foundation that Applicable to all health care sectors where case management is practiced. In moving forward, the one fact that rings true is there will be constant change in our industry. As the health care terrain shifts and new influences continually surface, there will be consequences for case management practice. These impacts require nimble clinical professionals in possession of recognized and firmly established competencies. They must be agile to frame (and reframe) their professional practice to facilitate the best possible outcomes for their patients. Case managers can choose to be Gumby or Pokey. This is exactly why the definition of a competency-based case management model's time has come, one sufficiently fluid to fit into any setting of care. The practice of case management transcends the vast array of representative professional disciplines and educational levels. A majority of current models are driven by business priorities rather than by the competencies critical to successful practice and quality patient outcomes. This results in a fragmented professional case management identity. While there is inherent value in what each discipline brings to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities, including a reflective clinical ladder.
Tay, Charison; Khajuria, Ankur; Gupte, Chinmay
Traditional orthopaedic training has followed an apprenticeship model whereby trainees enhance their skills by operating under guidance. However the introduction of limitations on training hours and shorter training programmes mean that alternative training strategies are required. To perform a literature review on simulation training in arthroscopy and devise a framework that structures different simulation techniques that could be used in arthroscopic training. A systematic search of Medline, Embase, Google Scholar and the Cochrane Databases were performed. Search terms included "virtual reality OR simulator OR simulation" and "arthroscopy OR arthroscopic". 14 studies evaluating simulators in knee, shoulder and hip arthroplasty were included. The majority of the studies demonstrated construct and transference validity but only one showed concurrent validity. More studies are required to assess its potential as a training and assessment tool, skills transference between simulators and to determine the extent of skills decay from prolonged delays in training. We also devised a "ladder of arthroscopic simulation" that provides a competency-based framework to implement different simulation strategies. The incorporation of simulation into an orthopaedic curriculum will depend on a coordinated approach between many bodies. But the successful integration of simulators in other areas of surgery supports a possible role for simulation in advancing orthopaedic education. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
In February 1992, the National Office of Overseas Skills Recognition funded a $150,000 research project for the development of Competency Based Standards for the professions of Medical Radiation Science (MRS). The four professions of MRS are now considered to be: Radiography, Radiation Therapy, Nuclear Medicine Science and Sonography. The four national documents have aimed at describing the performances of the MRS practitioner at entry level to the profession. Findings from survey and interviews indicate that the existing structure of the undergraduate courses should be reviewed with emphasis on: problem solving skills, theater radiography, paediatric radiography, image interpretation or radiography pathology as well as venepuncture, if accepted nationally. . 5 refs., 1 tab., 5 figs
McCabe, O Lee; Everly, George S; Brown, Lisa M; Wendelboe, Aaron M; Abd Hamid, Nor Hashidah; Tallchief, Vicki L; Links, Jonathan M
Surges in demand for professional mental health services occasioned by disasters represent a major public health challenge. To build response capacity, numerous psychological first aid (PFA) training models for professional and lay audiences have been developed that, although often concurring on broad intervention aims, have not systematically addressed pedagogical elements necessary for optimal learning or teaching. We describe a competency-based model of PFA training developed under the auspices of the Centers for Disease Control and Prevention and the Association of Schools of Public Health. We explain the approach used for developing and refining the competency set and summarize the observable knowledge, skills, and attitudes underlying the 6 core competency domains. We discuss the strategies for model dissemination, validation, and adoption in professional and lay communities.
Full Text Available Although competency has long been the major concern in ELT either in the EFL or ESL contexts, the rise of competency-based syllabus launched by the Ministry of National Education (2006 brought about significant issue among the English teachers in the country. One of the crucial issues is that how to transfer the concepts of competences into the syllabus design. Since a syllabus does not only contain a list of subject content, but also how curriculum planners (teachers reflect their understanding and belief about nature of language and of language teaching and learning, the ELT must be carried out to achieve communicative competence. Current investigation on the practices of ELT, however, indicates that English teachers are still walking in place, leaving the CC as a big slogan in their jobs.
Oudkerk Pool, Andrea; Govaerts, Marjan J B; Jaarsma, Debbie A D C; Driessen, Erik W
While portfolios are increasingly used to assess competence, the validity of such portfolio-based assessments has hitherto remained unconfirmed. The purpose of the present research is therefore to further our understanding of how assessors form judgments when interpreting the complex data included in a competency-based portfolio. Eighteen assessors appraised one of three competency-based mock portfolios while thinking aloud, before taking part in semi-structured interviews. A thematic analysis of the think-aloud protocols and interviews revealed that assessors reached judgments through a 3-phase cyclical cognitive process of acquiring, organizing, and integrating evidence. Upon conclusion of the first cycle, assessors reviewed the remaining portfolio evidence to look for confirming or disconfirming evidence. Assessors were inclined to stick to their initial judgments even when confronted with seemingly disconfirming evidence. Although assessors reached similar final (pass-fail) judgments of students' professional competence, they differed in their information-processing approaches and the reasoning behind their judgments. Differences sprung from assessors' divergent assessment beliefs, performance theories, and inferences about the student. Assessment beliefs refer to assessors' opinions about what kind of evidence gives the most valuable and trustworthy information about the student's competence, whereas assessors' performance theories concern their conceptualizations of what constitutes professional competence and competent performance. Even when using the same pieces of information, assessors furthermore differed with respect to inferences about the student as a person as well as a (future) professional. Our findings support the notion that assessors' reasoning in judgment and decision-making varies and is guided by their mental models of performance assessment, potentially impacting feedback and the credibility of decisions. Our findings also lend further
Chakraborty, Nirali M; Murphy, Caitlin; Paudel, Mahesh; Sharma, Sriju
Nepal has high unmet need for family planning and low use of intrauterine devices (IUDs). While clients' attitudes toward the IUD are known in a variety of contexts, little is known about providers' knowledge and perceptions of the IUD in developing countries. Nepal's liberal IUD service provision policies allow the opportunity to explore provider knowledge and perceptions across cadres and sectors. This research contributes to an understanding of providers' IUD perceptions in low-resource environments, and increases evidence for IUD task-sharing and private sector involvement. A questionnaire was administered to 345 nurses and auxiliary nurse midwives (ANMs) affiliated with the private Mahila Swastha Sewa (MSS) franchise, public sector, or private non-franchise sector. All providers had been trained in TCu 380A IUD insertion and removal. The questionnaire captured providers' IUD experience, knowledge, and perceived barriers to recommendation. Descriptive, multivariate linear, and multinomial logistic regression was conducted, comparing providers between cadre and sector. On average, providers answered 21.5 of 35 questions correctly, for a score of 61.4%. Providers scored the lowest on IUD medical eligibility, answering 5.9 of 14 questions correctly. Over 50% of providers were able to name the four side effects most frequently associated with the IUD; however, one-third of all providers found at least one of these side effects unacceptable. Adjusted results show that cadre does not significantly impact provider's IUD knowledge scores or side effect perceptions. Public sector affiliation was associated with higher knowledge scores regarding personal characteristic eligibility and more negative perceptions of two normal IUD side effects. IUD knowledge is significantly associated with provider's recent training and employment at multiple facilities, and side effect perceptions are significantly associated with client volume, range of family planning methods, and
Family therapy Overview Family therapy is a type of psychological counseling (psychotherapy) that can help family members improve communication and resolve conflicts. Family therapy is usually provided by a psychologist, ...
Szasz, Peter; Louridas, Marisa; Harris, Kenneth A; Grantcharov, Teodor P
Competency-based education necessitates assessments that determine whether trainees have acquired specific competencies. The evidence on the ability of internal raters (staff surgeons) to provide accurate assessments is mixed; however, this has not yet been directly explored in the operating room. This study's objective is to compare the ratings given by internal raters vs an expert external rater (independent to the training process) in the operating room. Raters assessed general surgery residents during a laparoscopic cholecystectomy for their technical and nontechnical performance. Fifteen cases were observed. There was a moderately positive correlation (r s = .618, P = .014) for technical performance and a strong positive correlation (r s = .731, P = .002) for nontechnical performance. The internal raters were less stringent for technical (mean rank 3.33 vs 8.64, P = .007) and nontechnical (mean rank 3.83 vs 8.50, P = .01) performances. This study provides evidence to help operationalize competency-based assessments. Copyright © 2016 Elsevier Inc. All rights reserved.
Ten Cate, Olle
Competency-based medical education stresses the attainment of competencies rather than the completion of fixed time in rotations. This sometimes leads to the interpretation that quantitative features of a program are of less importance, such as procedures practiced and weeks or months spent in clinical practice. An educational philosophy like "We don't require numbers of procedures completed but focus on competencies" suggests a dichotomy of either competency-based or time and procedures based education. The author argues that this dichotomy is not useful, and may even compromise education, as long as valid assessment of all relevant competencies is not possible or feasible. Requiring quantities of experiences of learners is not in contrast with competency-based education.
Desy, Janeve R; Reed, Darcy A; Wolanskyj, Alexandra P
Millennials are quickly becoming the most prevalent generation of medical learners. These individuals have a unique outlook on education and have different preferences and expectations than their predecessors. As evidenced by its implementation by the Accreditation Council for Graduate Medical Education in the United States and the Royal College of Physicians and Surgeons in Canada, competency based medical education is rapidly gaining international acceptance. Characteristics of competency based medical education can be perfectly paired with Millennial educational needs in several dimensions including educational expectations, the educational process, attention to emotional quotient and professionalism, assessment, feedback, and intended outcomes. We propose that with its attention to transparency, personalized learning, and frequent formative assessment, competency based medical education is an ideal fit for the Millennial generation as it realigns education and assessment with the needs of these 21st century learners. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Muraraneza, Claudine; Mtshali, Gloria Ntombifikile
In health professional education, the competency-based curriculum concept has been an important driver of reform in the training of competent graduates for the 21st century. In African countries, although there has been implementing it in pre-service nursing and midwifery education and the literature reports a lack of understanding of what is it on the part of the implementers. This article explores the meaning of competency based curriculum in pre-service nursing and midwifery education in Rwanda. A grounded theory approach, following Corbin and Strauss, was used. Following ethical clearance by the university ethical committee, data was collected from 17 participants through in-depth individual interviews of staff. Four categories emerged: (a) transformation, (b) tool for primary health care philosophy, (c) technological approach to education, (d) and modular system. Competency-based curriculum is confirmed as an appropriate educational tool in producing competent graduates for today and the future. Copyright © 2017 Elsevier Ltd. All rights reserved.
Mainous, Arch G; Fang, Bo; Peterson, Lars E
The Family Medicine (FM) Milestones are competency-based assessments of residents in key dimensions relevant to practice in the specialty. Residency programs use the milestones in semiannual reviews of resident performance from the time of entry into the program to graduation. Using a national sample, we investigated the relationship of FM competency-based assessments to resident progress and the complementarity of milestones with knowledge-based assessments in FM residencies. We used midyear and end-of-year milestone ratings for all FM residents in Accreditation Council for Graduate Medical Education-accredited programs during academic years 2014-2015 and 2015-2016. The milestones contain 22 items across 6 competencies. We created a summative index across the milestones. The American Board of Family Medicine database provided resident demographics and in-training examination (ITE) scores. We linked information to the milestone data. The sample encompassed 6630 FM residents. The summative milestone index increased, on average, for each cohort (postgraduate year 1 [PGY-1] to PGY-2 and PGY-2 to PGY-3) at each assessment. The correlation between the milestone index that excluded the medical knowledge milestone and ITE scores was r = .195 ( P ITE scores and composite milestone assessments were higher for residents who advanced than for those who did not. Competency-based assessment using the milestones for FM residents seems to be a viable multidimensional tool to assess the successful progression of residents.
Menon, Prema R; Stapleton, Renee D; McVeigh, Ursula; Rabinowitz, Terry
Many critically ill patients who transfer from rural hospitals to tertiary care centers (TCCs) have poor prognoses, and family members are unable to discuss patient prognosis and goals of care with TCC providers until after transfer. Our TCC conducted teleconferences prior to transfer to facilitate early family discussions. We conducted a retrospective review of these telemedicine family conferences among critically ill patients requested for transfer which occurred from December 2008 to December 2009 at our TCC. Outcomes for each patient and detailed descriptions of the conference content were obtained. We also assessed limitations and attitudes and satisfaction with this intervention among clinicians. During the 12-month period, 12 telemedicine consultations were performed. Of these patients, 10 (83%) died in the 30 days following the request for transfer. After the telemedicine consultation, 8 (67%) patients were transferred to our TCC from their respective hospitals, while 4 (33%) patients continued care at their regional hospital and did not transfer. Of the patients who transferred to TCC, 7 (88% of those transferred) returned to their community after a stay at the TCC. This study demonstrates that palliative care consultations can be provided via telemedicine for critically ill patients and that adequate preparation and technical expertise are essential. Although this study is limited by the nature of the retrospective review, it is evident that more research is needed to further assess its applicability, utility, and acceptability. © The Author(s) 2014.
Kong, Sui-Ting; Fang, Christine Meng-Sang; Lou, Vivian Weiqun
Developing culturally appropriate end-of-life care for Chinese elderly and families is not an endemic challenge for Hong Kong, but that of the Western countries with a noticeable trend of rising Chinese population. The particular development of Hong Kong healthcare system, which is currently the major provider of end-of-life care, makes Hong Kong a fruitful case for understanding the confluence of the West and the East cultures in end-of-life care practices. This study therefore aims at building our best practice to enhance the capacity of residential care homes in providing culturally appropriate end-of-life care. We conducted two phases of research, a questionnaire survey and a qualitative study, which respectively aims at (1) understanding the EoL care service demand and provision in RCHEs, including death facts and perceived barriers and challenges in providing quality end-of-life care in care homes, and (2) identifying the necessary organizational capacities for the 'relational personhood' to be sustained in the process of ageing and dying in residential care homes. Findings shed light on how to empower residential care homes with necessary environmental, structural and cultural-resource-related capacity for providing quality end-of-life care for Chinese elders and their families. Copyright © 2016 Elsevier Inc. All rights reserved.
Hopmans, Cornelis J; den Hoed, Pieter T; Wallenburg, Iris; van der Laan, Lijkckle; van der Harst, Erwin; van der Elst, Maarten; Mannaerts, Guido H H; Dawson, Imro; van Lanschot, Jan J B; Ijzermans, Jan N M
Currently, most surgical training programs are focused on the development and evaluation of professional competencies. Also in the Netherlands, competency-based training and assessment programs were introduced to restructure postgraduate medical training. The current surgical residency program is based on the Canadian Medical Education Directives for Specialists (CanMEDS) competencies and uses assessment tools to evaluate residents' competence progression. In this study, we examined the attitude of surgical residents and attending surgeons toward a competency-based training and assessment program used to restructure general surgical training in the Netherlands in 2009. In 2011, all residents (n = 51) and attending surgeons (n = 108) in 1 training region, consisting of 7 hospitals, were surveyed. Participants were asked to rate the importance of the CanMEDS competencies and the suitability of the adopted assessment tools. Items were rated on a 5-point Likert scale and considered relevant when at least 80% of the respondents rated an item with a score of 4 or 5 (indicating a positive attitude). Reliability was evaluated by calculating the Cronbach's α, and the Mann-Whitney test was applied to assess differences between groups. The response rate was 88% (n = 140). The CanMEDS framework demonstrated good reliability (Cronbach's α = 0.87). However, the importance of the competencies 'Manager' (78%) and 'Health Advocate' (70%) was undervalued. The assessment tools failed to achieve an acceptable reliability (Cronbach's α = 0.55), and individual tools were predominantly considered unsuitable for assessment. Exceptions were the tools 'in-training evaluation report' (91%) and 'objective structured assessment of technical skill' (82%). No significant differences were found between the residents and the attending surgeons. This study has demonstrated that, 2 years after the reform of the general surgical residency program, residents and attending surgeons in a large
Full Text Available Background: In Germany medical students should gain proficiency and specific skills in the vaccination field. Especially important is the efficient communication of scientific results about vaccinations to the community, in order to give professional counseling with a complete overview about therapeutic options.Aim of the project: The aim of this project is to set up a vaccination-related curriculum in the Medical Faculty at the Ludwig-Maximilians-University in Munich. The structure of the curriculum is based on the National catalogue for competency-based learning objectives in the field of vaccination (Nationaler Kompetenzbasierter Lernzielekatalog Medizin NKLM. Through this curriculum, the students will not only acquire the classical educational skills concerning vaccination in theory and practice, but they will also learn how to become independent in the decision-making process and counseling. Moreover, the students will become aware of consequences of action related to this specific topic.Methods: According to defined guidelines, an analysis was performed on courses, which are currently offered by the university. A separate analysis of the NKLM was carried out. Both analyses identified the active courses related to the topic of vaccination as well as the NKLM learning objectives. The match between the topics taught in current courses and the NKLM learning objectives identified gaps concerning the teaching of specific content. Courses were modified in order to implement the missing NKLM learning objectives.Results: These analyses identified 24 vaccination-related courses, which are currently taught at the University. Meanwhile, 35 learning objectives on vaccination were identified in the NKLM catalogue. Four of which were identified as not yet part of the teaching program. In summary, this interdisciplinary work enabled the development of a new vaccination-related curriculum, including 35 learning objectives, which are now implemented in
This competency-based module uses the Ocean County (New Jersey) Vocational-Technical Schools curriculum-infused model for infusing basic skills instruction into vocational education. The model demonstrates the relationship of vocational skills to communication, mathematics, and science. The document begins with a philosophy statement; preface; a…
Oyao, Sheila G.; Holbrook, Jack; Rannikmäe, Miia; Pagunsan, Marmon M.
This article proposes a competence-based learning framework for science teaching, applied to the study of "big ideas", in this case to the study of natural hazards and disaster risk reduction (NH&DRR). The framework focuses on new visions of competence, placing emphasis on nurturing connectedness and behavioral actions toward…
Tutlys, Vidmantas; Spöttl, Georg
Purpose: This paper aims to explore methodological and institutional challenges on application of the work-process analysis approach in the design and development of competence-based occupational standards for Lithuania. Design/methodology/approach: The theoretical analysis is based on the review of scientific literature and the analysis of…
ten Cate, Olle
Competency-based medical education stresses the attainment of competencies rather than the completion of fixed time in rotations. This sometimes leads to the interpretation that quantitative features of a program are of less importance, such as procedures practiced and weeks or months spent in
Gaudet, Cyndi H.; Annulis, Heather M.; Kmiec, John J., Jr.
This article describes an ongoing project to build a comprehensive evaluation framework for the competency-based Master of Science in Workforce Training and Development (MSWTD) program at The University of Southern Mississippi (USM). First, it discusses some trends and issues in evaluating the performance of higher education programs in the United…
Cheng, Bo; Wang, Minhong; Yang, Stephen J. H.; Kinshuk; Peng, Jun
Current endeavors to integrate competency-based learning approaches with e-learning systems designed for delivery of training to adult learners in the workplace are growing. However, academic efforts in examining learners' perceptions of, and reactions toward, this technology-delivered pedagogical innovation are limited. Drawing together…
Bergen Community Coll., Paramus, NJ.
The Associate Degree Nursing Program at Bergen Community College developed and field tested competency-based instructional modules in a program designed to allow licensed practical nurses to qualify to take the certification examination for registered nurses after a year of study. Thirteen licensed practical nurses were enrolled in the first class…
In this study, learning processes of students in competence-based Pre-Vocational Secondary Education (PVSE; in Dutch vmbo) were investigated. The study aimed at describing the relation between goal orientations, information processing strategies and the development of knowledge of these students.
Steele, Jennifer L.; Lewis, Matthew W.; Santibanez, Lucrecia; Faxon-Mills, Susannah; Rudnick, Mollie; Stecher, Brian M.; Hamilton, Laura S.
In 2011, the Bill & Melinda Gates Foundation extended grants to three educational organizations working to develop or enhance competency-based approaches in large, urbanized school systems. The grant initiative, called Project Mastery, funded the development of technology-enhanced tools, including curriculum materials and online learning…
Stewart, Richard Lee
A competency-based culinary arts food preparation curriculum for Delaware high school students with special needs was developed during a project that included the following activities: review of the state's existing culinary arts curriculum for regular education students; incumbent worker survey administered to 24 restaurant…
Velasco-Martínez, Leticia-Concepción; Tójar-Hurtado, Juan-Carlos
Competency-based learning requires making changes in the higher education model in response to current socio-educational demands. Rubrics are an innovative educational tool for competence evaluation, for both students and educators. Ever since arriving at the university systems, the application of rubrics in evaluation programs has grown…
Schaap, Harmen; De Bruijn, Elly; Van der Schaaf, Marieke; Kirschner, Paul A.
Schaap, H., De Bruijn, E., Van der Schaaf, M. F., & Kirschner, P. A. (2009). Students' personal professional theories in competence-based vocational education: the construction of personal knowledge through internalisation and socialisation. Journal of Vocational Education & Training, 61(4),
Schaap, H.; de Bruijn, E.; Van der Schaaf, M. F.; Kirschner, P. A.
Competence-based vocational education is based on a constructivist learning paradigm, where the development of students' personal professional knowledge is emphasised. However, there is a lack of insight into how students construct their own professional knowledge and what the content and nature of personal professional knowledge is. This article…
ten Cate, Olle
Competency-based medical education stresses the attainment of competencies rather than the completion of fixed time in rotations. This sometimes leads to the interpretation that quantitative features of a program are of less importance, such as procedures practiced and weeks or months spent in clinical practice. An educational philosophy like…
Tomasello, Jenna; Brand, Betsy
How can states ensure that students who are overage or under-credit (OA/UC) not only graduate high school but are prepared for college or the workforce? Competency-based education (CBE) is one emerging strategy for addressing the needs of at-risk youth. CBE can address the needs of at-risk students because it is personalized to individual…
Alhassan, Munkaila; Habib, Abdallah Mohammed
Polytechnics in Ghana view Competency Based Training (CBT) as a major intervention to the perennial constraints confronting its education and training. On the basis of this, and by government policy, a pilot programme of CBT was instituted in all the 10 polytechnics of Ghana, and was pilot tested in, at least, one department. Agricultural…
Snowden, Monique L.
In March 2013, the US Department of Education issued guidance to institutions on how to attain approval for competency-based programs under the current title IV, Higher Education Act (HEA) regulations on direct assessment programs. This article considers the graduate enrollment futures of colleges and universities that have chosen and will elect…
Busari, Jamiu O.; Verhagen, Eduard A. A.; Muskiet, Fred D.; Duits, Ashley J.
Background: The introduction of competency-based curricula in institutions situated in resource-limited environments is likely to pose new challenges for the implementation process. The St. Elisabeth Hospital (SEHOS) in Curacao, Dutch Caribbean, is affiliated to university teaching hospitals in the
Vermeulen, M.I.; Tromp, F.; Zuithoff, N.P.; Pieters, R.H.; Damoiseaux, R.A.; Kuyvenhoven, M.M.
Abstract Background: Historically, semi-structured interviews (SSI) have been the core of the Dutch selection for postgraduate general practice (GP) training. This paper describes a pilot study on a newly designed competency-based selection procedure that assesses whether candidates have the
Paul Hager and I worked on a large number of research projects and publications throughout the 1990s. The focus of this work was on developing a competency-based approach to professional education and assessment. I review this work and its impact over the years. Notwithstanding the fact that most professional associations today have a competency…
Nousiainen, Markku T; Caverzagie, Kelly J; Ferguson, Peter C; Frank, Jason R
Medical educators must prepare for a number of challenges when they decide to implement a competency-based curriculum. Many of these challenges will pertain to three key aspects of implementation: organizing the structural changes that will be necessary to deliver new curricula and methods of assessment; modifying the processes of teaching and evaluation; and helping to change the culture of education so that the CBME paradigm gains acceptance. This paper focuses on nine key considerations that will support positive change in first two of these areas. Key considerations include: ensuring that educational continuity exists amongst all levels of medical education, altering how time is used in medical education, involving CBME in human health resources planning, ensuring that competent doctors work in competent health care systems, ensuring that information technology supports CBME, ensuring that faculty development is supported, ensuring that the rights and responsibilities of the learner are appropriately balanced in the workplace, preparing for the costs of change, and having appropriate leadership in order to achieve success in implementation.
Lipp, Mitchell J; Cho, Kiyoung; Kim, Han Suk
Feedback can exert a powerful influence on learning and achievement although its effect varies. The aim of this study was to investigate the effects of three types of feedback on dental students' attitudes and confidence in a competency-based course in predoctoral orthodontics at New York University College of Dentistry. In 2013-14, all 253 third-year students in a course using test-enhanced instructional methods received written feedback on formative assessments. The type of feedback varied across three groups: pass/fail grades (PF) N=77, emoticons (EM) N=90, or written comments (WC) N=86. At the end of the course, students completed surveys that included four statements addressing their attitudes toward course instruction and confidence in their abilities. The survey response rate ranged from 75% to 100% among groups. The lowest response rate (75%) was in the PF group. In attitudes toward course instruction and confidence in their abilities, the WC group trended to more positive responses than the other groups, while the PF group trended to negative responses. On two of the four statements, the trend for the WC group was significant (95% CI). In both statements concerning attitudes toward instruction, the PF group trended to negative responses that were significant (95% CI). These results support the effectiveness of descriptive written comments over pass/fail grades or emoticons in improving dental students' confidence in their abilities and their attitudes toward instruction.
Prabawati, I.; Meirinawati; AOktariyanda, T.
Human Resources (HR) is a very important factor in an organization so that human resources are required to have the ability, skill or competence in order to be able to carry out the vision and mission of the organization. Competence includes a number of attributes attached to the individual which is a combination of knowledge, skills, and behaviors that can be used as a mean to improve performance. Concerned to the demands of human resources that should have the knowledge, skills or abilities, it is necessary to the development of human resources in public organizations. One form of human resource development is Competency-Based Training (CBT). CBT focuses on three issues, namely skills, competencies, and competency standard. There are 5 (five) strategies in the implementation of CBT, namely: organizational scanning, strategic planning, competency profiling, competency gap analysis, and competency development. Finally, through CBT the employees within the organization can reduce or eliminate the differences between existing performance with a potential performance that can improve the knowledge, expertise, and skills that are very supportive in achieving the vision and mission of the organization.
Calabria, Bianca; Clifford, Anton; Rose, Miranda; Shakeshaft, Anthony P
Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians' notions of health and wellbeing. This paper aims to describe the process of tailoring CRA and CRAFT for delivery to Aboriginal Australians, explore the perceptions of health care providers participating in the tailoring process, and their experiences of participating in CRA and CRAFT counsellor certification. Data sources included notes recorded from eight working group meetings with 22 health care providers of a drug and alcohol treatment agency and Aboriginal Community Controlled Health Service (November 2009-February 2013), and transcripts of semi-structured interviews with seven health care providers participating in CRA and CRAFT counsellor certification (May 2012). Qualitative content analysis was used to categorise working group meeting notes and interview transcripts were into key themes. Modifying technical language, reducing the number of treatment sessions, and including an option for treatment of clients in groups, were key recommendations by health care providers for improving the feasibility and applicability of delivering CRA and CRAFT to Aboriginal Australians. Health care providers perceived counsellor certification to be beneficial for developing their skills and confidence in delivering CRA and CRAFT, but identified time constraints and competing tasks as key challenges. The tailoring process resulted in Aboriginal Australian-specific CRA and CRAFT resources. The process also resulted in the training and certification of
McCauley, Mary; Head, Jennifer; Lambert, Jaki; Zafar, Shamsa; van den Broek, Nynke
Violence against women is an international public health concern and a violation of women's rights. Domestic violence can first occur, and increase in frequency and severity, during and after pregnancy. Healthcare providers have the potential to identify and support women who experience domestic violence. We sought to investigate the knowledge and perceptions of domestic violence among doctors who provide routine antenatal and postnatal care at healthcare facilities in Pakistan. In addition, we explored possible management options from policy makers, and enabling factors of and barriers to the routine screening of domestic violence. Semi-structured key informant interviews were conducted with doctors (n = 25) working in public and private hospitals and with officials involved in domestic violence policy development (n = 5) in Islamabad, Pakistan. Transcribed interviews were coded and codes grouped into categories. Thematic framework analysis was undertaken to identify emerging themes. Most doctors have a good awareness of domestic violence and a desire to help women who report domestic violence during and after pregnancy. Enabling factors included doctors' ability to build rapport and trust with women and their suggestion that further education of both healthcare providers and women would be beneficial. However, domestic violence is often perceived as a "family issue" that is not routinely discussed by healthcare providers. Lack of resources, lack of consultation time and lack of effective referral pathways or support were identified as the main barriers to the provision of quality care. Doctors and policy advisors are aware of the problem and open to screening for domestic violence during and after pregnancy. It is suggested that the provision of a speciality trained family liaison officer or healthcare provider would be beneficial. Clear referral pathways need to be established to provide quality care for these vulnerable women in Pakistan.
Nousiainen, Markku T; McQueen, Sydney A; Ferguson, Peter; Alman, Benjamin; Kraemer, William; Safir, Oleg; Reznick, Richard; Sonnadara, Ranil
Although simulation-based training is becoming widespread in surgical education and research supports its use, one major limitation is cost. Until now, little has been published on the costs of simulation in residency training. At the University of Toronto, a novel competency-based curriculum in orthopaedic surgery has been implemented for training selected residents, which makes extensive use of simulation. Despite the benefits of this intensive approach to simulation, there is a need to consider its financial implications and demands on faculty time. This study presents a cost and faculty work-hours analysis of implementing simulation as a teaching and evaluation tool in the University of Toronto's novel competency-based curriculum program compared with the historic costs of using simulation in the residency training program. All invoices for simulation training were reviewed to determine the financial costs before and after implementation of the competency-based curriculum. Invoice items included costs for cadavers, artificial models, skills laboratory labor, associated materials, and standardized patients. Costs related to the surgical skills laboratory rental fees and orthopaedic implants were waived as a result of special arrangements with the skills laboratory and implant vendors. Although faculty time was not reimbursed, faculty hours dedicated to simulation were also evaluated. The academic year of 2008 to 2009 was chosen to represent an academic year that preceded the introduction of the competency-based curriculum. During this year, 12 residents used simulation for teaching. The academic year of 2010 to 2011 was chosen to represent an academic year when the competency-based curriculum training program was functioning parallel but separate from the regular stream of training. In this year, six residents used simulation for teaching and assessment. The academic year of 2012 to 2013 was chosen to represent an academic year when simulation was used equally
Gonzalez, Nestor R; Dusick, Joshua R; Martin, Neil A
Changes in neurosurgical practice and graduate medical education impose new challenges for training programs. We present our experience providing neurosurgical residents with digital and mobile educational resources in support of the departmental academic activities. A weekly mandatory conference program for all clinical residents based on the Accreditation Council for Graduate Medical Education competencies, held in protected time, was introduced. Topics were taught through didactic sessions and case discussions. Faculty and residents prepare high-quality presentations, equivalent to peer-review leading papers or case reports. Presentations are videorecorded, stored in a digital library, and broadcasted through our Website and iTunes U. Residents received mobile tablet devices with remote access to the digital library, applications for document/video management, and interactive teaching tools. Residents responded to an anonymous survey, and performances on the Self-Assessment in Neurological Surgery examination before and after the intervention were compared. Ninety-two percent reported increased time used to study outside the hospital and attributed the habit change to the introduction of mobile devices; 67% used the electronic tablets as the primary tool to access the digital library, followed by 17% hospital computers, 8% home computers, and 8% personal laptops. Forty-two percent have submitted operative videos, cases, and documents to the library. One year after introducing the program, results of the Congress of Neurological Surgeons-Self-Assessment in Neurological Surgery examination showed a statistically significant improvement in global scoring and improvement in 16 of the 18 individual areas evaluated, 6 of which reached statistical significance. A structured, competency-based neurosurgical education program supported with digital and mobile resources improved reading habits among residents and performance on the Congress of Neurological Surgeons
Sealy, Yvette M; Zarcadoolas, Christina; Dresser, Michelle; Wedemeyer, Laura; Short, Leslie; Silver, Lynn
This paper describes the research and development of the Obesity in Children Action Kit, a paper-based chronic disease management tool of the Public Health Detailing Program (PHD) at the New York City (NYC) Department of Health and Mental Hygiene (DOHMH). It also describes PHD's process for developing the Obesity in Children detailing campaign (targeting healthcare providers working with children aged 2-18) and its results, during which the Action Kit materials were a focal point. The campaign goals were to impact healthcare provider clinical behaviors, improve the health literacy of parents and children, instigate patient-provider-parent dialogue, and change family practices to prevent obesity. Qualitative research methods consisted of healthcare provider in-depth interviews and parent focus groups to aid campaign development. Evaluation of the Obesity in Children campaign included self-reported data on uptake and usage of clinical tools and action steps of matched assessments from 237 healthcare provider initial and follow-up visits, material stock counts, and DOHMH representative qualitative visit excerpts. Key themes identified in parent focus groups were concerns about childhood diabetes and high blood pressure, awareness of cultural pressure and our "supersize" culture, frustration with family communication around overweight and obesity, lack of knowledge about food quality and portion size, economic pressures, and the availability of healthy and nutritious foods. During the Obesity in Children campaign, six representatives reached 161 practices with 1,588 one-on-one interactions, and an additional 461 contacts were made through group presentations. After these interactions, there was a significant increase in the percentage of physicians self-reported use of key recommended practices: Use of BMI percentile-for-age to assess for overweight or obesity at every visit increased from 77% to 88% (p families to set realistic goals increased from 64% to 86% (p
D'Alessandro, Donna; Kingsley, Peggy
The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.
Ni, Phang Koh; Siew Lin, Serena Koh
Maternal postpartum health is a neglected area both in research and practice. This aspect warrants more attention as the health of postpartum mothers has a considerable influence on her infant and also other family members. Social support provided by family and friends has been identified as a buffer against the many stressors faced by the women. Outcomes such as self-esteem, stress, postnatal depression, breastfeeding levels, infant care, and maternal adaptation have been studied and found to be significantly related to social support. The need to understand the role of social support provided by family and friends provide the impetus for conducting this review. The objective of this systematic review was to appraise and synthesise the best available evidence which discusses the impact of social support from family and friends on enhancing the wellbeing of postpartum women. This review includes women who were within their first year postpartum period, with any number of children, and had given birth to healthy infants. Mothers who had co-existing morbidities such as depression were excluded. Mothers from low socio-economic groups were excluded.This review considered any study that involved the provision of social support by family and/or friends. Interventions provided by peer counsellors were also considered.The six outcomes were stress, self esteem, breastfeeding levels, mental health in relation to postnatal depression, infant care and maternal adaptation.Quantitative This review considered any randomised controlled trials that examined the effectiveness of social support from family and friends on the well being of the postpartum women. As it was not likely to find RCTs on this topic, this review also considered observational studies (cohort, case control, quantitative descriptive studies such as surveys).Qualitative This review considered any interpretive studies that drew on the experiences of social support from family and friends in postpartum women
Full Text Available Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum.Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills.Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks “Movement,” “Balance” and “Contact.” The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men’s-women’s-children’s medicine, the senses, the nervous system and the mind, and general medicine which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments, block practicums, and two scientific projects.Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum
Vaižgėlienė, Eglė; Padaiga, Žilvinas; Rastenytė, Daiva; Tamelis, Algimantas; Petrikonis, Kęstutis; Fluit, Cornelia
In 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into the competency-based medical education curriculum (CBME). In 2015, we implemented the validated EFFECT questionnaire together with the EFFECT-System for quality assessment of clinical teaching in residency training. The aim of this study was to investigate the influence of characteristics of the resident (year of training) and clinical teacher (gender, age, and type of academic position) on teaching quality, as well as to assess areas for teaching quality improvement. Residents from 7 different residency study programs filled out 333 EFFECT questionnaires evaluating 146 clinical teachers. We received 143 self-evaluations of clinical teachers using the same questionnaire. Items were scored on a 6-point Likert scale. Main outcome measures were residents' mean overall (MOS), mean subdomain (MSS) and clinical teachers' self-evaluation scores. The overall comparisons of MOS and MSS across study groups and subgroups were done using Student's t test and ANOVA for trend. The intraclass correlation coefficient (ICC) was calculated in order to see how residents' evaluations match with self-evaluations for every particular teacher. To indicate areas for quality improvement items were analyzed subtracting their mean score from the respective (sub)domain score. MOS for domains of "role modeling", "task allocation", "feedback", "teaching methodology" and "assessment" valued by residents were significantly higher than those valued by teachers (Pevaluation questionnaires were rated significantly higher by residents in role modeling subdomains (Phigher than the female teachers (Phigher (Pevaluations of clinical teachers are influenced by teachers' age, gender, year of residency training, type of teachers' academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers
Lutz, Kristina; Yazdani, Arjang; Ross, Douglas
Competency-based medical education is becoming increasingly prevalent and is likely to be mandated by the Royal College in the near future. The objective of this study was to define the core technical competencies that should be possessed by plastic surgery residents as they transition into their senior (presently postgraduate year 3) years of training. A list of potential core competencies was generated using a modified Delphi method that included the investigators and 6 experienced, academic plastic surgeons from across Canada and the United States. Generated items were divided into 7 domains: basic surgical skills, anesthesia, hand surgery, cutaneous surgery, esthetic surgery, breast surgery, and craniofacial surgery. Members of the Delphi group were asked to rank particular skills on a 4-point scale with anchored descriptors. Item reduction resulted in a survey consisting of 48 skills grouped into the aforementioned domains. This self-administered survey was distributed to all Canadian program directors (n = 11) via e-mail for validation and further item reduction. The response rate was 100% (11/11). Using the average rankings of program directors, 26 "core" skills were identified. There was agreement of core skills across all domains except for breast surgery and esthetic surgery. Of them, 7 skills were determined to be above the level of a trainee at this stage; a further 15 skills were agreed to be important, but not core, competencies. Overall, 26 competencies have been identified as "core" for plastic surgery residents to possess as they begin their senior, on-service years. The nature of these skills makes them suitable for teaching in a formal, simulated environment, which would ensure that all plastic surgery trainees are competent in these tasks as they transition to their senior years of residency. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Kiguli, Sarah; Mubuuke, Roy; Baingana, Rhona; Kijjambu, Stephen; Maling, Samuel; Waako, Paul; Obua, Celestino; Ovuga, Emilio; Kaawa-Mafigiri, David; Nshaho, Jonathan; Kiguli-Malwadde, Elsie; Bollinger, Robert; Sewankambo, Nelson
Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non-communicable diseases, yet it has a significant shortage of health workers. Even the few health workers available may lack desired competencies required to address current and future health challenges. Reducing Uganda's disease burden and addressing health challenges requires Ugandan medical schools to produce health workers with the necessary competencies. This study describes the process which a consortium of Ugandan medical schools and the Medical Education Partnership for Equitable Services to all Ugandans (MESAU) undertook to define the required competencies of graduating doctors in Uganda and implement competency-based medical education (CBME). A retrospective qualitative study was conducted in which document analysis was used to collect data employing pre-defined checklists, in a desktop or secondary review of various documents. These included reports of MESAU meetings and workshops, reports from individual institutions as well as medical undergraduate curricula of the different institutions. Thematic analysis was used to extract patterns from the collected data. MESAU initiated the process of developing competencies for medical graduates in 2011 using a participatory approach of all stakeholders. The process involved consultative deliberations to identify priority health needs of Uganda and develop competencies to address these needs. Nine competence domain areas were collaboratively identified and agreed upon, and competencies developed in these domains. Key successes from the process include institutional collaboration, faculty development in CBME and initiating the implementation of CBME. The consortium approach strengthened institutional collaboration that led to the development of common competencies desired of all medical graduates to
Pettepher, Cathleen C; Lomis, Kimberly D; Osheroff, Neil
Physicians-in-training require skills and attitudes beyond medical knowledge in order to mature into successful clinicians. However, because assessments in pre-clerkship curricula historically have focused almost exclusively on medical knowledge, faculty contributions to early student development often have been limited. To address this challenge and enhance student progress, we re-designed our pre-clerkship curriculum to include settings in which diverse facets of student performance could be observed and fostered. Concurrently, we transitioned to an assessment strategy focused on competency-based milestones. The implementation of this strategy has allowed pre-clerkship science faculty to provide early-stage students with rich holistic feedback designed to stimulate their professional growth.
Mak, Winnie W S; Chan, Randolph C H; Yau, Sania S W
Considering the lack of existing measures on attitudes toward personal recovery and the need to acknowledge the cultural milieu in recovery attitude assessment, the present study developed and validated the Attitudes towards Recovery Questionnaire (ARQ) in a sample of people in recovery of mental illness, family carers, and mental health service providers in Hong Kong. The ARQ was developed based on existing literature and measures of recovery, and focus group discussions with various stakeholders. Findings of the multi-sample confirmatory factor analyses supported a five-factor structure: (1) resilience as a person in recovery, (2) self-appreciation and development, (3) self-direction, (4) family involvement, and (5) social ties and integration. The ARQ was positively correlated with recovery outcomes, empowerment, recovery knowledge, and recovery orientation of mental health services. As a tool for examining recovery attitudes, the ARQ informs us of the mindset across stakeholders and areas that need enhancement to facilitate the recovery process. Copyright © 2018. Published by Elsevier B.V.
Røen, Ingebrigt; Stifoss-Hanssen, Hans; Grande, Gunn; Brenne, Anne-Tove; Kaasa, Stein; Sand, Kari; Knudsen, Anne Kari
Caring for advanced cancer patients affects carers' psychological and physical health. Resilience has been defined as "the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat." The aim of this study was to explore factors promoting carer resilience, based on carers' experiences with and preferences for health care provider support. Qualitative, semi-structured, individual interviews with family carers of advanced cancer patients were performed until data saturation. The interviews were recorded, transcribed, and analyzed using systematic text condensation. Carers ( n = 14) of advanced cancer patients, not receiving curative treatment, admitted to an integrated curative and palliative care cancer outpatient clinic or to a university hospital cancer clinic, were included. 14 carers of advanced cancer patients were included; 7 men, 7 women, and mean age of 59 years; 3 were bereaved; 12 were partners; 5 had young and teenage children. Four main resilience factors were identified: (1) being seen and known by health care providers-a personal relation; (2) availability of palliative care; (3) information and communication about illness, prognosis, and death; and (4) facilitating a good carer-patient relation. Health care providers may enhance carers' resilience by a series of simple interventions. Education should address carers' support needs and resilience. Systematic assessment of carers' support needs is recommended. Further investigation is needed into how health care providers can help carers and patients communicate about death.
Full Text Available Aquaporins (AQPs are channel-forming integral membrane proteins that transport water and other small solutes across biological membranes. Despite the vital role of AQPs, to date, little is known in physic nut (Jatropha curcas L., Euphorbiaceae, an important non-edible oilseed crop with great potential for the production of biodiesel. In this study, 32 AQP genes were identified from the physic nut genome and the family number is relatively small in comparison to 51 in another Euphorbiaceae plant, rubber tree (Hevea brasiliensis Muell. Arg.. Based on the phylogenetic analysis, the JcAQPs were assigned to five subfamilies, i.e., 9 plasma membrane intrinsic proteins (PIPs, 9 tonoplast intrinsic proteins (TIPs, 8 NOD26-like intrinsic proteins (NIPs, 2 X intrinsic proteins (XIPs and 4 small basic intrinsic proteins (SIPs. Like rubber tree and other plant species, functional prediction based on the aromatic/arginine selectivity filter, Froger’s positions and specificity-determining positions showed a remarkable difference in substrate specificity among subfamilies of JcAQPs. Genome-wide comparative analysis revealed the specific expansion of PIP and TIP subfamilies in rubber tree and the specific gene loss of the XIP subfamily in physic nut. Furthermore, by analyzing deep transcriptome sequencing data, the expression evolution especially the expression divergence of duplicated HbAQP genes was also investigated and discussed. Results obtained from this study not only provide valuable information for future functional analysis and utilization of Jc/HbAQP genes, but also provide a useful reference to survey the gene family expansion and evolution in Euphorbiaceae plants and other plant species.
Tolan, Amy M; Kaji, Amy H; Quach, Chi; Hines, O Joe; de Virgilio, Christian
Program directors often struggle to determine which factors in the Electronic Residency Application Service (ERAS) application are important in the residency selection process. With the establishment of the Accreditation Council for Graduate Medical Education (ACGME) competencies, it would be important to know whether information available in the ERAS application can predict subsequent competency-based performance of general surgery residents. This study is a retrospective correlation of data points found in the ERAS application with core competency-based clinical rotation evaluations. ACGME competency-based evaluations as well as technical skills assessment from all rotations during residency were collected. The overall competency score was defined as an average of all 6 competencies and technical skills. A total of77 residents from two (one university and one community based university-affiliate) general surgery residency programs were included in the analysis. Receiving honors for many of the third year clerkships and AOA membership were associated with a number of the individual competencies. USMLE scores were predictive only of Medical Knowledge (p = 0.004). Factors associated with higher overall competency were female gender (p = 0.02), AOA (p = 0.06), overall number of honors received (p = 0.04), and honors in Ob/Gyn (p = 0.03) and Pediatrics (p = 0.05). Multivariable analysis showed honors in Ob/Gyn, female gender, older age, and total number of honors to be predictive of a number of individual core competencies. USMLE scores were only predictive of Medical Knowledge. The ERAS application is useful for predicting subsequent competency based performance in surgical residents. Receiving honors in the surgery clerkship, which has traditionally carried weight when evaluating a potential surgery resident, may not be as strong a predictor of future success. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights
Juan Carlos Revilla Castro
Full Text Available La gestión por competencias se ha convertido en los últimos treinta años en uno de los temas recurrentes cuando se habla de la gestión integral en las organizaciones del siglo xxi. Los cuatro pilares sobre los que descansa dicha gestión son la selección, la formación, la retribución y la evaluación. El objetivo del presente artículo es el análisis de uno de esos elementos clave: la evaluación por competencias. El punto de partida de esta investigación es la tendencia, en aumento, a valorar a los trabajadores tanto por sus cualificaciones como por sus actitudes, dos elementos centrales en la definición de competencia. A través del análisis de diferentes entrevistas a expertos y encargados de recursos humanos implicados en la gestión por competencias, se pretende visualizar las dificultades de encontrar elementos objetivos a los que atenerse a la hora de evaluar las competencias de los trabajadores.In the last 30 years competence-based management has become a recurring theme in the integral management of 21st-century institutions. The four pillars that support competence-based management are selection, training, remuneration and assessment. The aim of the present article is to analyse one of these key elements: competence-based assessment. The starting point of the study is the increasing tendency to assess employees on the basis not only of their qualifications but also of their attitudes, two elements that are fundamental to the definition of competence. By analyzing a variety of interviews with experts and people in charge of human resources involved in competence-based management, we aim to highlight how difficult it is to find objective elements on which to base an assessment of the competences of employees.
Full Text Available Background: Competency-based curricula define their educational goals according to profession-specific roles and competencies. Thus, this type of curricula is outcome-oriented, in contrast to the traditional German curricula, which are mainly procedure-oriented. This study investigates the new licensure legislation in Germany, mandatory for all medical faculties, to see if it allows the development of competency-based curricula.Methods: For the first step we clustered all demands to roles. In step two we transformed the procedure-oriented demands into outcome-oriented competencies, according to the 6 roles found, pursuing strictly the wording of the law.Results: Although the principal goals in the new German licensure law are outcome-oriented, namely three abilities of a certified physician, still the majority of requirements and demands remain procedure-oriented. Clustering resulted in the following six roles: medical expert, health advocate, teamworker, manager, representative of the medical profession and, life-long learner. The relevant competencies for the six roles, we could derive from the standards set by the law.Conclusion: We were able to show that the new German licensure order comprises a useful framework for the development of outcome-oriented, competency-based curricula.
Ohashi, Kota; Kayama, Makiko; Ryuuo, Shoko; Suzuki, Jun; Hayashinoshita, Yutaka; Ooka, Shiho; Matsuura, Rie
We provided home end-of-life care to a child with a brain tumor. As cases of children with malignancies who receive such care have rarely been described in Japan, we report our experience with this patient. An 11-year-old previously healthy boy was found to have a brainstem glioma in December X. The tumor was reduced by radiotherapy and chemotherapy, but relapse was noted in August X plus 1. Best supportive care alone was selected for this patient. Before the initiation of home care, we consulted a designated hospital for pediatric cancer treatment in the area and requested a case- worker from the child/home section in his resident area. As the patient was too young for long-term care insurance, we immediately applied for a physical disability certificate to augment welfare support. After the initiation of home care, swallowing function diminished markedly, but we provided guidance on dietary contents and suction, allowing continued oral ingestion by prioritizing his and his family's wishes. In January X plus 2 of the following year, his respiratory condition worsened after the development of aspiration pneumonitis, and he died at home. We advocate the establishment of a regional network so that children with brain tumors can receive end-of-life care at home.
Sakwe George Mbotake
Full Text Available The effect of globalization and the increasing demands on the job market have induced many countries in the world to introduce reforms aimed at streamlining their higher education curricula. The demand for a more flexible workforce with high skills (competencies in problem solving, team work and project management has been on the rise in recent years and the incorporation of competency-based curriculum has emerged as a necessity in the higher education sector. However, in spite of the growing popularity for the need to prepare graduates for the workplace, the actual academic culture and formative processes are yet to be tailored to address these new exigencies. The aim of this paper is to analyze in what manner competence and competence-based learning are being currently implemented in the Advanced School of Translators and Interpreters (ASTI of the University of Buea in Cameroon. Competency dashboard indicators from best practice frameworks are used to assess stakeholders’ sense-making as levers for quality assessment in translation learning. An opinion survey of 60 trainee translators and 12 instructors helped to identify factors, instructional and otherwise which promote or inhibit the success of competence-based education. The study posits that systemic and environmental issues, as well as organizational, teaching and learning, assessment, and quality assurance issues are germane to the effective implementation of generic and specific competencies. The ensuing proposals advocate for a responsive translator training and education that is more personalized and adaptive to address higher education’s challenges of access, quality, and affordability for a diverse set of students.
Nguyen Hong, Hanh
Human resource management is a pivotal part in driving a company to success. This stands true for all companies in every industry, including the currently booming technology industry. Herman IT - a Kajaani-based technology company - is planning to establish its own human resource management (HRM) department and needs of a competency-based talent management model as a guideline for its HRM. The purpose of this research is to explore Herman IT’s current talent management and compare it to a com...
My article is essentially a reflection of an experience I shared with an audience of around 80 Russian coaches in Moscow, in March this year. I was a guest of the Association of Russian Coaches, who had invited me to demonstrate a 30-minute coaching session at one of their weekly competence-based coaching supervision events. These events are organized by a volunteer working group, who have tasked themselves to develop the “Standard for the Russian Coaching Profession”. These particular events...
Vandeweghe, Laura; Moens, Ellen; Braet, Caroline; Van Lippevelde, Wendy; Vervoort, Leentje; Verbeken, Sandra
The aim of the current study is to identify strategies to promote healthy eating in young children that can be applied by caregivers, based on their own perceptions of effectiveness and feasibility. Whereas previous research mainly focused on parental influences on children's eating behavior, the growing role of other caregivers in the upbringing of children can no longer be denied. Four focus groups were conducted with three types of caregivers of post-weaning children under 6 years old: parents (n = 14), family child care providers (n = 9), and daycare assistants (n = 10). The audiotaped focus group discussions were transcribed and imported into Nvivo 10.0 for thematic analysis. The behaviors put forward by the caregivers were categorized within three broad dimensions: global influences, general behaviors, and specific feeding practices. Perceived effective strategies to promote healthy eating behavior in children included rewards, verbal encouragement, a taste-rule, sensory sensations, involvement, variation, modeling, repeated exposure, and a peaceful atmosphere. Participants mainly disagreed on the perceived feasibility of each strategy, which largely depended on the characteristics of the caregiving setting (e.g. infrastructure, policy). Based on former research and the current results, an intervention to promote healthy eating behaviors in young children should be adapted to the caregiving setting or focus on specific feeding practices, since these involve simple behaviors that are not hindered by the limitations of the caregiving setting. Due to various misconceptions regarding health-promoting strategies, clear instructions about when and how to use these strategies are necessary.
Full Text Available Abstract Background The aim of the current study is to identify strategies to promote healthy eating in young children that can be applied by caregivers, based on their own perceptions of effectiveness and feasibility. Whereas previous research mainly focused on parental influences on children’s eating behavior, the growing role of other caregivers in the upbringing of children can no longer be denied. Methods Four focus groups were conducted with three types of caregivers of post-weaning children under 6 years old: parents (n = 14, family child care providers (n = 9, and daycare assistants (n = 10. The audiotaped focus group discussions were transcribed and imported into Nvivo 10.0 for thematic analysis. The behaviors put forward by the caregivers were categorized within three broad dimensions: global influences, general behaviors, and specific feeding practices. Results Perceived effective strategies to promote healthy eating behavior in children included rewards, verbal encouragement, a taste-rule, sensory sensations, involvement, variation, modeling, repeated exposure, and a peaceful atmosphere. Participants mainly disagreed on the perceived feasibility of each strategy, which largely depended on the characteristics of the caregiving setting (e.g. infrastructure, policy. Conclusions Based on former research and the current results, an intervention to promote healthy eating behaviors in young children should be adapted to the caregiving setting or focus on specific feeding practices, since these involve simple behaviors that are not hindered by the limitations of the caregiving setting. Due to various misconceptions regarding health-promoting strategies, clear instructions about when and how to use these strategies are necessary.
Terwel, Bart W; Harinck, Fieke; Ellemers, Naomi; Daamen, Dancker D L
Public trust in organizations that are involved in the management and use of new technologies affects lay judgments about the risks and benefits associated with these technologies. In turn, judgments about risks and benefits influence lay attitudes toward these technologies. The validity of this (indirect) effect of trust on lay attitudes toward new technologies, which is referred to as the causal chain account of trust, has up till now only been examined in correlational research. The two studies reported in this article used an experimental approach to more specifically test the causal chain account of trust in the context of carbon dioxide capture and storage technology (CCS). Complementing existing literature, the current studies explicitly distinguished between two different types of trust in organizations: competence-based trust (Study 1) and integrity-based trust (Study 2). In line with predictions, results showed that the organizational position regarding CCS implementation (pro versus con) more strongly affected people's risk and benefit perceptions and their subsequent acceptance of CCS when competence-based trust was high rather than low. In contrast, the organizational position had a greater impact on people's level of CCS acceptance when integrity-based trust was low rather than high.
Wiersma, Fraukje; Berkvens, Josephine; Ten Cate, Olle
Entrustable professional activities (EPAs) were introduced as a principle for individualized physician assistant (PA) workplace curricula at the University of Applied Sciences (UAS) Utrecht in 2008. We studied how the focus on EPAs served the competency-based flexibility intention of the program. We analyzed data of those 119 students who enrolled in the program 2010 through 2013, and completed the program before April 2016. We analyzed the number of EPAs per student at start and end of the program, number changed during training and the reasons for change. Data of 101 students were suitable for evaluation. Excluded were 16 students ending the program prematurely and two with study delay. Mean number of EPAs per student at the start was 6.8 (range 4-12) and at the end 6.6 (range 3-13). On average 1.5 EPAs were altered (range 0-13). Reasons included extension of the EPA package during training (n = 10), lack of proficiency at planned moments of summative entrustment decisions (n = 9) and procedures not being suitable for PAs at closer look (n = 6). All changes resulted in a curriculum meeting the school's standards for graduation. The flexibility of the EPA concept enabled changes in the individualized curriculum of students, according to the intended competency-based nature of the educational program.
Mauricio Hernando Bedoya Hernández
Full Text Available This article is a report on the research “Care practices and family burden in families from Antioquia, Colombia, with a member diagnosed with bipolar affective disorder”. Objective: To recognize the context of the care provided to family members diagnosed with such disorder. Method: a qualitative study using the phenomenological and hermeneutic approach was done. Data were collected via in-depth interviews with the 12 families participating in the study, and a genogram was built. Results: two factors explain the increased stress and fatigue observed in family members taking care of a person with a mental condition: the first one is associated with the caregiver, and the second one, with the material and immaterial conditions of the care provided. Conclusions: (1 stress and fatigue are low when individuals willingly choose to take care of the person with a mental condition and thus define themselves as caregivers; (2 the quality and type of the bond established between the diseased person and the caregiver are strong predictors of family stress and fatigue; (3 this condition challenges the identity ofthe family and that of each one of its members.
Proscovia Namubiru Ssentamu
Full Text Available With the urge to Africanise the curriculum following colonisation, many African countries are still wary of the educational initiatives from the developed countries. However, with the clear curriculum design and development guidelines provided by various national Quality Assurance bodies, African countries need not fear migrating curricula from developed countries. Drawing from the workshop experiences, authors of this paper illustrate the steps involved in migrating, contextualising and adapting a professional field of study in a multi-institutional partnership, with particular focus on the competence-based curriculum design and development process. The process of migrating higher education (HE Administration, Leadership and Management curriculum taught at the University of Tampere (Finland to a Postgraduate Diploma in Higher Education Leadership and Management (PGDHELM curriculum at Uganda Management Institute (UMI in partnership with the Makerere University and the University of Helsinki involved undertaking a needs assessment, training of trainers and adapting the programme to the UMI context. The training of trainers provided opportunity for the trainees to reflect and generate information on the status of HE leadership and management in Uganda. The curriculum was institutionalised by aligning it to the vision, mission and profile of UMI in the context of the existing internal and external Quality Assurance frameworks. This paper underscores the importance of involving stakeholders, taking into account national and institutional requirements in all the steps when migrating an academic curriculum.
Prick, A.J.C.; de Lange, J.; Twisk, J.W.R.; Pot, A.M.
Background: Earlier research showed that multi-component dyadic interventions - including a combination of intervention strategies and addressing both the person with dementia and caregiver - have a beneficial impact on the mental and physical health of people with dementia and their family
Herbert, Carol P.
The acronym IDEALS summarizes family physicians' obligations when violence is suspected: to identify family violence; document injuries; educate families and ensure safety for victims; access resources and coordinate care; co-operate in the legal process; and provide support for families. Failure to respond reflects personal and professional experience and attitudes, fear of legal involvement, and lack of knowledge. Risks of intervention include physician burnout, physician overfunctioning, escalation of violence, and family disruption. PMID:21228987
Full Text Available Funmilayo Eniola Olopade,1 Oluwatosin Adekunle Adaramoye,2 Yinusa Raji,3 Abiodun Olubayo Fasola,4 Emiola Oluwabunmi Olapade-Olaopa5 1Department of Anatomy, 2Department of Biochemistry, 3Department of Physiology, 4Department of Oral Pathology, 5Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria Abstract: The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the “old” curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula
Priddis, Lynn E; Matacz, Rochelle; Weatherston, Deborah
This article describes findings from a project conducted in Western Australia (Mental Health Commission WA, 2015) that investigated the education and training needs of the Infant/Early Childhood Mental Health (I/ECMH) workforce. We examined international training programs and models of delivery in infant mental health, including a review of the current training available in Australia. Data collected from over 60 interviews were analyzed, and a staged delivery model for I/ECMH training and supervision that aligned with the Michigan Association for Infant Mental Health (2014) Competency Guidelines was recommended. These findings led to the purchase of the Michigan Association for Infant Mental Health (2014) for use in Western Australia. In a very short time, use of the Michigan Competency Framework by the Australian Association for Infant Mental Health West Australian Branch Incorporated has begun to change the training and education opportunities for upskilling the infant and early childhood workforce in Western Australia. It has resulted in a map to guide and develop training in the I/ECMH field for individual practitioners and professionals as well as for workplaces that will ultimately benefit Western Australian infants, young children, and their families during the perinatal period and in the early years. © 2015 Michigan Association for Infant Mental Health.
Olopade, Funmilayo Eniola; Adaramoye, Oluwatosin Adekunle; Raji, Yinusa; Fasola, Abiodun Olubayo; Olapade-Olaopa, Emiola Oluwabunmi
The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the "old" curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula successfully. The modifications to the teaching and assessment of the core basic medical science subjects have resulted in improved learning and performance at the final examinations.
Vermeulen, Margit I; Tromp, Fred; Zuithoff, Nicolaas P A; Pieters, Ron H M; Damoiseaux, Roger A M J; Kuyvenhoven, Marijke M
Abstract Background: Historically, semi-structured interviews (SSI) have been the core of the Dutch selection for postgraduate general practice (GP) training. This paper describes a pilot study on a newly designed competency-based selection procedure that assesses whether candidates have the competencies that are required to complete GP training. The objective was to explore reliability and validity aspects of the instruments developed. The new selection procedure comprising the National GP Knowledge Test (LHK), a situational judgement tests (SJT), a patterned behaviour descriptive interview (PBDI) and a simulated encounter (SIM) was piloted alongside the current procedure. Forty-seven candidates volunteered in both procedures. Admission decision was based on the results of the current procedure. Study participants did hardly differ from the other candidates. The mean scores of the candidates on the LHK and SJT were 21.9 % (SD 8.7) and 83.8% (SD 3.1), respectively. The mean self-reported competency scores (PBDI) were higher than the observed competencies (SIM): 3.7(SD 0.5) and 2.9(SD 0.6), respectively. Content-related competencies showed low correlations with one another when measured with different instruments, whereas more diverse competencies measured by a single instrument showed strong to moderate correlations. Moreover, a moderate correlation between LHK and SJT was found. The internal consistencies (intraclass correlation, ICC) of LHK and SJT were poor while the ICC of PBDI and SIM showed acceptable levels of reliability. Findings on content validity and reliability of these new instruments are promising to realize a competency based procedure. Further development of the instruments and research on predictive validity should be pursued.
Gadbury-Amyot, Cynthia C.; Holt, Lorie P.; Overman, Pamela R.; Schmidt, Colleen R.
Describes the implementation of a portfolio assessment program in the dental hygiene program at the University of Missouri School of Dentistry. Tables provide examples of program competencies and related portfolio entries, the complete scoring rubric for portfolios, and the student portfolio evaluation survey. Concludes that although portfolio…
The purpose of this Child Development Associate (CDA) training module is to provide the CDA intern with knowledge of how to use nutrition information with children and parents, as well as how to structure and carry out a nutrition program, including mealtime and food preparation activities. Objectives are presented along with suggested activities…
Solomon, Getachew Habtamu
In the human development effort, different countries are underscoring the role of technical-vocational education and training (TVET) in providing relevant knowledge and skills to improve productivity, increase access to employment opportunities and raise the standard of living. It is in
Spokane Community Coll., WA.
Developed through a grant that enabled faculty members to work together to define goals and set objectives, this curriculum guide contains course objectives for the culinary arts program at Spokane Community College in Washington. Objectives are provided for the following courses: culinary techniques and skill development (two levels),…
The purpose of this Child Development Associate (CDA) training module is to help the CDA intern increase musical experiences in his or her classroom. Objectives are presented along with suggested activities for achieving each objective, and an assessment checklist. Also provided is a study guide emphasizing the values of musical activities in the…
According to clinical-pathological correlation studies, the natural history of arrhythmogenic right ventricular dysplasia\\/cardiomyopathy is purported to progress from localized to global right ventricular dysfunction, followed by left ventricular (LV) involvement and biventricular pump failure. The inevitable focus on sudden death victims and transplant recipients may, however, have created a skewed perspective of a genetic disease. We hypothesized that unbiased representation of the spectrum of disease expression in arrhythmogenic right ventricular dysplasia\\/cardiomyopathy would require in vivo assessment of families in a genetically heterogeneous population.
Djalali, Ahmadreza; Della Corte, Francesco; Segond, Frederique; Metzger, Marie-Helene; Gabilly, Laurent; Grieger, Fiene; Larrucea, Xabier; Violi, Christian; Lopez, Cédric; Arnod-Prin, Philippe; Ingrassia, Pier L
Education and training are key elements of health system preparedness vis-à-vis chemical, biological, radiological and nuclear (CBRN) emergencies. Medical respondents need sufficient knowledge and skills to manage the human impact of CBRN events. The current study was designed to determine which competencies are needed by hospital staff when responding to CBRN emergencies, define educational needs to develop these competencies, and implement a suitable delivery method. This study was carried out from September 2014 to February 2015, using a three-step modified Delphi method. On the basis of international experiences, publications, and experts' consensus, core competencies for hospital staff - as CBRN casualty receivers - were determined, and training curricula and delivery methods were defined. The course consists of 10 domains. These are as follows: threat identification; health effects of CBRN agents; planning; hospital incident command system; information management; safety, personal protective equipment and decontamination; medical management; essential resources; psychological support; and ethical considerations. Expected competencies for each domain were defined. A blended approach was chosen. By identifying a set of core competencies, this study aimed to provide the specific knowledge and skills required by medical staff to respond to CRBN emergencies. A blended approach may be a suitable delivery method, allowing medical staff to attend the same training sessions despite different time zones and locations. The study output provides a CBRN training scheme that may be adapted and used at the European Union level.
Slade, Steve; Ross, Shelley; Lawrence, Kathrine; Archibald, Douglas; Mackay, Maria Palacios; Oandasan, Ivy F.
Abstract Objective To examine trends in family medicine training at a time when substantial pedagogic change is under way, focusing on factors that relate to extended family medicine training. Design Aggregate-level secondary data analysis based on the Canadian Post-MD Education Registry. Setting Canada. Participants All Canadian citizens and permanent residents who were registered in postgraduate family medicine training programs within Canadian faculties of medicine from 1995 to 2013. Main outcome measures Number and proportion of family medicine residents exiting 2-year and extended (third-year and above) family medicine training programs, as well as the types and numbers of extended training programs offered in 2015. Results The proportion of family medicine trainees pursuing extended training almost doubled during the study period, going from 10.9% in 1995 to 21.1% in 2013. Men and Canadian medical graduates were more likely to take extended family medicine training. Among the 5 most recent family medicine exit cohorts (from 2009 to 2013), 25.9% of men completed extended training programs compared with 18.3% of women, and 23.1% of Canadian medical graduates completed extended training compared with 13.6% of international medical graduates. Family medicine programs vary substantially with respect to the proportion of their trainees who undertake extended training, ranging from a low of 12.3% to a high of 35.1% among trainees exiting from 2011 to 2013. Conclusion New initiatives, such as the Triple C Competency-based Curriculum, CanMEDS–Family Medicine, and Certificates of Added Competence, have emerged as part of family medicine education and credentialing. In acknowledgment of the potential effect of these initiatives, it is important that future research examine how pedagogic change and, in particular, extended training shapes the care family physicians offer their patients. As part of that research it will be important to measure the breadth and uptake of
Elena Cano Garcia
Full Text Available Academic programs in Design have always faced the challenge of providing the best education in a sphere so changing as Design discipline itself. This is especially true within the current renewal of curricula derived from the implementation of the European Higher Education Area (EHEA and, to a much more general level, the adaptation of the discipline of Design to the new challenges posed by the Knowledge Society. In this context, we present the educational experience of a serious games design workshop, which has been conducted at the University of Barcelona's Design BA. This pedagogical activity emphazises on three aspects which we believe are fundamental to the current pedagogy of design: to give a more transverse view of this discipline; to value the role of Design as a means of innovation in today's Knowledge Society; and to rethink the social function of Design.
Koestner, Wolfgang; Otten, Wiebke; Kaireit, Till; Wacker, Frank K; Dettmer, Sabine
Purpose New teaching formats are required to implement competency-based teaching in radiology teaching. Therefore, we have established and evaluated two practical competency-based radiological courses. Materials and Methods The courses were held in a multimedia room with 25 computers and a professional DICOM viewer. Students were taught basic image analysis and presented clinical cases with a DICOM viewer under supervision of an instructor using desktop monitoring software. Two courses (elective course and obligatory course) were evaluated by the students (n = 160 and n = 100) and instructors (n = 9) using an anonymized online survey. Results Courses were evaluated positively by the students and instructors. From the perspective of the students, the courses increased understanding of cross-sectional anatomy (elective/obligatory course: 97 %/95 %) and radiologic findings (97 %/99 %). Furthermore, the course increased the students' interest in radiology (61 %/65 %). The students considered this way of teaching to be relevant to their future occupation (92 % of students in the obligatory course). The higher incidence of teacher-student interaction and the possibility of independent image analysis were rated positively. The majority of instructors did not observe increased distractibility due to the computers (67 %) or notice worse preparation for MC tests (56 %). However, 56 % of instructors reported greater preparation effort. Conclusion Practical competency-based radiological teaching using a DICOM viewer is a feasible innovative approach with high acceptance among students and instructors. It fosters competency-based learning as proposed by the model curriculum of the German Radiological Society (DRG) and the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). Key Points · Practical competency-based radiological teaching is highly accepted by students and instructors
Levin, Pamela F; Swider, Susan M; Breakwell, Susan; Cowell, Julia M; Reising, Virginia
The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties. © 2013 Wiley Periodicals, Inc.
María Dolores de Prada
Full Text Available This article presents the results of an action-research implementation project based on a system that weaves together five different routes to facilitate the development of competences through the use of multiple learning paths for primary and secondary teachers. The first and initial results that the article deals with relate to the experience of math teachers for ages 11 to 14. Other levels and other fields are in the process of being developed. The article deals briefly with the justification, the background and the fundamental principles that underpin the research methodology and introduces a number of elements such as the method followed by the research, the resources and the materials used as well as the results obtained at the end of the second year of this experience. It also justifies the model chosen and the criteria and strategies selected for its reliability and verification. In addition, it provides significant elements of reflection about a number of burning issues: The development of a new profile of the “teacher” in a studentcentred system and the implementation system to be followed, the importance of multiple but integrated learning paths and the relevance as well as the reflection on real cases of competence evaluation.
Wallenstein, Joshua; Heron, Sheryl; Santen, Sally; Shayne, Philip; Ander, Douglas
This study evaluated the ability of an objective structured clinical examination (OSCE) administered in the first month of residency to predict future resident performance in the Accreditation Council for Graduate Medical Education (ACGME) core competencies. Eighteen Postgraduate Year 1 (PGY-1) residents completed a five-station OSCE in the first month of postgraduate training. Performance was graded in each of the ACGME core competencies. At the end of 18 months of training, faculty evaluations of resident performance in the emergency department (ED) were used to calculate a cumulative clinical evaluation score for each core competency. The correlations between OSCE scores and clinical evaluation scores at 18 months were assessed on an overall level and in each core competency. There was a statistically significant correlation between overall OSCE scores and overall clinical evaluation scores (R = 0.48, p competencies of patient care (R = 0.49, p competencies. An early-residency OSCE has the ability to predict future postgraduate performance on a global level and in specific core competencies. Used appropriately, such information can be a valuable tool for program directors in monitoring residents' progress and providing more tailored guidance. © 2010 by the Society for Academic Emergency Medicine.
Yang, Bo; Tong, Yuting
With the rapid development of economy, the development of logistics enterprises in China is also facing a huge challenge, especially the logistics enterprises generally lack of core competitiveness, and service innovation awareness is not strong. Scholars in the process of studying the core competitiveness of logistics enterprises are mainly from the perspective of static stability, not from the perspective of dynamic evolution to explore. So the author analyzes the influencing factors and the evolution process of the core competence of logistics enterprises, using the method of system dynamics to study the cause and effect of the evolution of the core competence of logistics enterprises, construct a system dynamics model of evolution of core competence logistics enterprises, which can be simulated by vensim PLE. The analysis for the effectiveness and sensitivity of simulation model indicates the model can be used as the fitting of the evolution process of the core competence of logistics enterprises and reveal the process and mechanism of the evolution of the core competence of logistics enterprises, and provide management strategies for improving the core competence of logistics enterprises. The construction and operation of computer simulation model offers a kind of effective method for studying the evolution of logistics enterprise core competence.
Goldstein, Erika A; Maclaren, Carol F; Smith, Sherilyn; Mengert, Terry J; Maestas, Ramoncita R; Foy, Hugh M; Wenrich, Marjorie D; Ramsey, Paul G
The focus on fundamental clinical skills in undergraduate medical education has declined over the last several decades. Dramatic growth in the number of faculty involved in teaching and increasing clinical and research commitments have contributed to depersonalization and declining individual attention to students. In contrast to the close teaching and mentoring relationship between faculty and students 50 years ago, today's medical students may interact with hundreds of faculty members without the benefit of a focused program of teaching and evaluating clinical skills to form the core of their four-year curriculum. Bedside teaching has also declined, which may negatively affect clinical skills development. In response to these and other concerns, the University of Washington School of Medicine has created an integrated developmental curriculum that emphasizes bedside teaching and role modeling, focuses on enhancing fundamental clinical skills and professionalism, and implements these goals via a new administrative structure, the College system, which consists of a core of clinical teachers who spend substantial time teaching and mentoring medical students. Each medical student is assigned a faculty mentor within a College for the duration of his or her medical school career. Mentors continuously teach and reflect with students on clinical skills development and professionalism and, during the second year, work intensively with them at the bedside. They also provide an ongoing personal faculty contact. Competency domains and benchmarks define skill areas in which deepening, progressive attention is focused throughout medical school. This educational model places primary focus on the student.
Gomes, Nadirlene Pereira; Erdmann, Alacoque Lorenzini
Objective to construct a theoretical matrix based on the meanings of the interactions and actions experienced by the professionals regarding the nursing care practices and the health of women in situations of conjugal violence in the ambit of the Family Health Strategy. Methods research based in Grounded Theory. Following approval by the Research Ethics Committee, 52 professionals were interviewed in Santa Catarina, Brazil. The analysis was based on open, axial and selective codifications. Results the theoretical model was delimited based on the phenomenon "Recognizing conjugal violence as a public health problem, and the need for management of the care for the woman", which reflects the experience of the professionals in relation to care for the woman, as well as the meanings attributed to this care. Conclusions the phenomenon allows one to understand the movement of action and interaction regarding the care for the woman in a situation of conjugal violence. PMID:24553706
Nadirlene Pereira Gomes
Full Text Available OBJECTIVE: to construct a theoretical matrix based on the meanings of the interactions and actions experienced by the professionals regarding the nursing care practices and the health of women in situations of conjugal violence in the ambit of the Family Health Strategy. METHODS: research based in Grounded Theory. Following approval by the Research Ethics Committee, 52 professionals were interviewed in Santa Catarina, Brazil. The analysis was based on open, axial and selective codifications. RESULTS: the theoretical model was delimited based on the phenomenon "Recognizing conjugal violence as a public health problem, and the need for management of the care for the woman", which reflects the experience of the professionals in relation to care for the woman, as well as the meanings attributed to this care. CONCLUSIONS: the phenomenon allows one to understand the movement of action and interaction regarding the care for the woman in a situation of conjugal violence.
Gomes, Nadirlene Pereira; Erdmann, Alacoque Lorenzini
to construct a theoretical matrix based on the meanings of the interactions and actions experienced by the professionals regarding the nursing care practices and the health of women in situations of conjugal violence in the ambit of the Family Health Strategy. research based in Grounded Theory. Following approval by the Research Ethics Committee, 52 professionals were interviewed in Santa Catarina, Brazil. The analysis was based on open, axial and selective codifications. the theoretical model was delimited based on the phenomenon "Recognizing conjugal violence as a public health problem, and the need for management of the care for the woman", which reflects the experience of the professionals in relation to care for the woman, as well as the meanings attributed to this care. the phenomenon allows one to understand the movement of action and interaction regarding the care for the woman in a situation of conjugal violence.
Fang, Chengchi; Guan, Lihong; Zhong, Zaixuan; Gan, Xiaoni; He, Shunping
One of the most important events in vertebrate evolutionary history is the water-to-land transition, during which some morphological and physiological changes occurred in concert with the loss of specific genes in tetrapods. However, the molecular mechanisms underlying this transition have not been well explored. To explore vertebrate adaptation to different oxygen levels during the water-to-land transition, we performed comprehensive bioinformatics and experimental analysis aiming to investigate the NAMPT family in vertebrates. NAMPT, a rate-limiting enzyme in the salvage pathway of NAD+ biosynthesis, is critical for cell survival in a hypoxic environment, and a high level of NAMPT significantly augments oxidative stress in normoxic environments. Phylogenetic analysis showed that NAMPT duplicates arose from a second round whole-genome duplication event. NAMPTA existed in all classes of vertebrates, whereas NAMPTB was only found in fishes and not tetrapods. Asymmetric evolutionary rates and purifying selection were the main evolutionary forces involved. Although functional analysis identified several functionally divergent sites during NAMPT family evolution, in vitro experimental data demonstrated that NAMPTA and NAMPTB were functionally conserved for NAMPT enzymatic function in the NAD+ salvage pathway. In situ hybridization revealed broad NAMPTA and NAMPTB expression patterns, implying regulatory functions over a wide range of developmental processes. The morpholino-mediated knockdown data demonstrated that NAMPTA was more essential than NAMPTB for vertebrate embryo development. We propose that the retention of NAMPTB in water-breathing fishes and its loss in air-breathing tetrapods resulted from vertebrate adaptation to different oxygen levels during the water-to-land transition. © 2015 FEBS.
Jones, Jamal; Staub, Judith; Seymore, Andrew; Scott, Lancer A
Limited research has focused on the safety and security of First Responders and Receivers, including clinicians, hospital workers, public safety officials, community volunteers, and other lay personnel, during public health emergencies. These providers are, in some cases, at greater peril during large-scale disasters due to their lack of training and inadequate resources to handle major influxes of patients. Exemplified in the 1995 Tokyo sarin gas attacks and the 2008 Wenchuan earthquakes, lack of training results in poor outcomes for both patients and First Receivers. The improvement of knowledge and comfort level of First Receivers preparing for a medical disaster via an affordable, repeatable emergency preparedness training (EPT) curriculum. A 5-hour EPT curriculum was developed including nine learning objectives, 18 competencies, and 34 performance objectives. Following brief didactic and small group sessions, interprofessional teams of four to six trainees were observed in a large patient simulator designed to recreate environmentally challenging (ie, flood evacuation), multi-patient scenarios using a novel technique developed to utilize trainees as actors. Trained observers assessed successful completion of 16 individual and 18 team performance objectives. Prior to training, team members completed a 24-question knowledge assessment, a demographic survey, and a comfort level self-assessment. Following training, trainees repeated the 24 questions, self-assessment, and course assessment. One hundred ninety-five participants completed the course between November 2012 and August 2013. One hundred ninety-one (98.5%), 150 (76.9%), and 66 (33.8%) participants completed the pretest, post-test, and course assessment, respectively. The mean (SD) percentage of correct answers between the pretest and post-test increased from 46.3 (13.4) to 75.3 (12.2), P safety and security of the "Second Front.
Stickney, Carolyn A; Ziniel, Sonja I; Brett, Molly S; Truog, Robert D
To compare perceptions, goals, and expectations of health care providers and parents regarding parental participation in morning rounds and target specific areas of opportunity for educational interventions. Semistructured interviews of parents and focus groups of health care providers to learn about their experiences in, goals for, and perceived barriers to successful parental participation in morning rounds. Qualitative methods were used to analyze interview and focus group transcripts. Parents (n = 21) and health care providers (n = 24) participated in interviews and focus groups, respectively. Analyses revealed key areas of agreement between providers and parents regarding goals for rounds when parents are present, including helping parents achieve an understanding of the child's current status and plan of care. Providers and parents disagreed, however, about the nature of opportunities to ask questions. Parents additionally reported a strong desire to provide expert advice about their children and expected transparency from their care team, while providers stated that parental presence sometimes hindered frank discussions and education. Some agreement in goals for parent participation in morning rounds exists, although there are opportunities to calibrate expectations for both parents and health care providers. Solutions may involve a protocol for orienting parents to morning rounds, focusing on improving communication with parents outside of morning rounds, and the preservation of a forum for providers to have private discussions as a team. Copyright © 2014 Elsevier Inc. All rights reserved.
Stickney, Carolyn A; Ziniel, Sonja I; Brett, Molly S; Truog, Robert D
To compare the experiences and attitudes of healthcare providers and parents regarding parental participation in morning rounds, in particular to evaluate for differences in perception of parental comprehension of rounds content and parental comfort with attendance, and to identify subgroups of parents who are more likely to report comfort with attending rounds. Cross-sectional survey of 100 parents and 131 healthcare providers in a tertiary care pediatric medical/surgical intensive care unit. Descriptive statistics were used to analyze survey responses; univariate and multivariate analyses were performed to compare parent and healthcare provider responses. Of parents, 92% reported a desire to attend rounds, and 54% of healthcare providers reported a preference for parental presence. There were significant discrepancies in perception of understanding between the 2 groups, with healthcare providers much less likely to perceive that parents understood both the format (30% vs 73%, P parents. Analysis of parent surveys did not reveal characteristics correlated with increased comfort or desire to attend rounds. A majority of parents wish to participate in morning rounds, whereas healthcare provider opinions are mixed. Important discrepancies exist between parent and healthcare provider perceptions of parental comfort and comprehension on rounds, which may be important in facilitating parental presence. Copyright © 2014 Mosby, Inc. All rights reserved.
Bárbara Posse Reis Martins
Full Text Available The aim of Pharmaceutical Care programs is to improve patients' quality of life, and such programs are particularly effective in the case of chronic diseases such as hypertension. The objective of this longitudinal study was to analyze a Pharmaceutical Care model for hypertensive patients receiving care within the Family Health Strategy (FHS. All patients were being seen by an FHS team affiliated to a primary healthcare unit in Goiânia, Goiás, Brazil. Fourteen patients participated in the study, with each patient receiving six home visits during the Pharmaceutical Care. Overall, 142 drug-related problems were reported, the most common concerning the ineffectiveness of treatment (33.8%. A total of 135 pharmaceutical interventions were performed, 92.6% of which involved pharmacist-patient communication, with 48.8% of these interventions being implemented. Cardiovascular risk decreased in three patients and remained unchanged in nine. In hypertensive patients with diabetes, fasting glucose levels were reduced in six out of nine cases. The Pharmaceutical Care model proposed here was effective in detecting drug-related problems and in proposing interventions to resolve or prevent these problems. Consequently, this may have contributed towards improving clinical parameters, such as fasting glucose levels and cardiovascular risk in hypertensive patients receiving care within the FHS.
San Mateo County Office of Education, Redwood City, CA. Career Preparation Centers.
This fourth of fifteen sets of Adult Competency Education (ACE) Competency Based Job Descriptions in the ACE kit contains job descriptions for Refrigerator Mechanic and Motorcycle Repairperson. Each begins with a fact sheet that includes this information: occupational title, D.O.T. code, ACE number, career ladder, D.O.T. general educational…
Bogenschutz, Matthew; Nord, Derek; Hewitt, Amy
Turnover among direct support professionals (DSPs) in community support settings for individuals with intellectual and developmental disabilities (IDD) has been regarded as a challenge since tracking of this workforce began in the 1980s. This study utilized a group randomized controlled design to test the effects of a competency-based training…
Hoogveld, Bert; Paas, Fred; Jochems, Wim
Teachers involved in the development of competency-based higher education (CBE) are expected to fulfil a new role of instructional designer. As a consequence, they are confronted with the problem to translate abstract new curriculum principles into concrete learning tasks. Recent studies have shown
Koopman, M.; Teune, P.J.; Beijaard, D.
In the Netherlands, many Pre-Vocational Secondary Education schools are implementing elements of competence-based education. These learning environments are expected to elicit the use of deep information processing strategies and to positively influence learning outcomes. While questionnaires are
Weaver, R. Glenn; Beets, Michael W.; Turner-McGrievy, Gabrielle; Webster, Collin A.; Moore, Justin
The YMCA of the USA serves more than nine million youth in its summer day camping programs nationwide. In spring 2011, the YMCA of Columbia, SC, with support from the University of South Carolina, adopted a competency-based staff-level training approach in an attempt to align staff behaviors with the YMCA of the USA new physical activity standards…
Koopman, M.; Teune, P.J.; Jochems, W.M.G.
The preference of students in competence-based Pre-Vocational Secondary Education (PVSE) for information processing strategies and the development of their body of knowledge were measured in a study that was carried out with 31 participants. The students’ information processing strategies were
Downey, Christopher; Byrne, Jenny; Souza, Ana
This article presents a sub-set of findings from a research project describing the experience of four case study schools which have implemented a competence-based curriculum (CBC) for students in their first year of secondary education. Secondary schools are highly departmentalised environments with organisational structures based primarily around…
Dr. M. Koopman; prof dr Douwe Beijaard; Dr P.J. Teune
This study explores the psychometric properties of three instruments: a semi-structured interview, a questionnaire and a sorting task. The central question is which instrument is most suitable to investigate the goal orientations of students in competence-based Pre-Vocational Secondary Education.
Behrends, Marianne; Steffens, Sandra; Marschollek, Michael
The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) describes medical skills and attitudes without being ordered by subjects or organs. Thus, the NKLM enables systematic curriculum mapping and supports curricular transparency. In this paper we describe where learning objectives related to Medical Informatics (MI) in Hannover coincide with other subjects and where they are taught exclusively in MI. An instance of the web-based MERLIN-database was used for the mapping process. In total 52 learning objectives overlapping with 38 other subjects could be allocated to MI. No overlap exists for six learning objectives describing explicitly topics of information technology or data management for scientific research. Most of the overlap was found for learning objectives relating to documentation and aspects of data privacy. The identification of numerous shared learning objectives with other subjects does not mean that other subjects teach the same content as MI. Identifying common learning objectives rather opens up the possibility for teaching cooperations which could lead to an important exchange and hopefully an improvement in medical education. Mapping of a whole medical curriculum offers the opportunity to identify common ground between MI and other medical subjects. Furthermore, in regard to MI, the interaction with other medical subjects can strengthen its role in medical education.
Full Text Available Competence-based education refers to the integration of knowledge, skills, attitudes and interactivity as the intended outcomes of learning. It makes use of lifelong learning and lifelike tasks in realistic settings and requires the cooperation of teachers. This research was prompted by the desire to explain why collegial cooperation often seems to be problematic in schools and universities. Are there certain social structures or behavioural patterns that influence the cooperative culture in teacher communities? The research material was collected in 2013 and 2014 in Oulu, Finland. The target groups were both newly qualified and experienced vocational teachers at all educational levels (N=30. The data collection methods were open questions in interviews and questionnaires. The research approach and analysis methods were qualitative. The theoretical background is in humanistic-cognitive and experiential learning as well as in dynamic epistemic conceptions. The findings show that the prevailing model in teacher communities is individualistic, discipline-divided and course-based, especially among older teachers. The obstacles refer to teachers’ self-image and a deeply rooted fear of criticism or revelation of incompetence. The promoters of cooperation were connected to the changing practices and desire of sharing with colleagues.
Kamesh, Lavanya; Clapham, Mike; Foggensteiner, Lukas
Renal specialty medical training in the UK was reformed in August 2007, with an emphasis placed on competency-based training and the publication of a new curriculum and assessment blueprint. This model of training places additional time demands on both trainees and trainers, with implications for job planning and service delivery. We evaluated the resource requirements and impact on service delivery of implementing a high-quality training programme in renal medicine. Each trainee maintained a portfolio containing details of workplace-based assessments. The change in educational environment led to improved trainee satisfaction. The mean total consultant time involved in implementing the training programme was 0.7 programmed activities (PAs) per trainee per week in the first year, which decreased to 0.5 PAs per trainee per week in the second year. This pilot study indicates that it is possible to integrate successful and high-quality specialty training in a busy clinical environment. The model outlined could form a template for postgraduate specialist training delivery in a variety of medical specialties.
Edelweiss Vitol Gysel
Full Text Available In the context of competence-based teaching, this paper draws upon the model of Translation Competence (TC put forward by the PACTE group (2003 to establish a dialogue between cognitive-constructivist paradigms for translation teaching and the model of the Context-based Text Typology (MATTHIESSEN et al., 2007. In this theoretical environment, it proposes a model for the design of a Teaching Unit (TU for the development of the bilingual competence in would-be-translators.To this end, it explores translation as a cognitive, communicative and textual activity (HURTADO ALBIR, 2011 and considers its teaching from the translation task-based approach (HURTADO ALBIR, 1999. This approach is illustrated through the practical example of the design of a TU elaborated for the subject ‘Introduction to Specialized Translation’,part of the curricular grid of the program ‘Secretariado Executivo’ at Universidade Federal de Santa Catarina. Aspects such as the establishment of learning objectives and their alignment with the translation tasks composing the TU are addressed for this specific pedagogical situation. We argue for the development of textual competences by means of the acquisition of strategies derived from the Context-based Text Typology to solve problems arising from the translation of different text types and contextual configurations.
Wietholter, Jon P; Ponte, Charles D; Long, Dustin M
Few publications have addressed the perceptions of pharmacists and physicians regarding the value of clinical pharmacist services. A survey-based study was conducted to determine whether Internal Medicine (IM) and Family Medicine (FM) pharmacists and physicians differed in their attitudes regarding the benefits of collaboration in an acute care setting. The primary objective was to evaluate perceived differences regarding self-assessment of value between IM and FM pharmacists. The secondary objective was to evaluate perceived differences of clinical pharmacist benefit between IM and FM physicians. An eight-item questionnaire assessed the attitudes and beliefs of pharmacists and physicians regarding the value of clinical pharmacy services. Surveys were emailed and participants marked their responses using a 7-point Likert scale for each item. Demographic data and overall comments were collected from each participant. Overall, 167 surveys were completed. When comparing cumulative physician and pharmacist responses, none of the eight questions showed significant differences. Statistically significant differences were noted when comparing IM and FM clinical pharmacists on five of the eight survey items; for each of these items, FM pharmacists had more favourable perceptions than their IM counterparts. No statistically significant differences were noted when comparing responses of IM and FM physicians. This study found that FM pharmacists perceived a greater benefit regarding participation in inpatient acute care rounds when compared to their IM pharmacist counterparts. Future studies are necessary to determine if other medical specialties' perceptions of clinical pharmacy provision differ from our findings and to evaluate the rationale behind specific attitudes and behaviours. © 2016 Royal Pharmaceutical Society.
Bernabó, Jorge G; Buraschi, Jorge; Olcese, Juan; Buraschi, María; Duro, Eduardo
The strategy of curriculum planning in the majority of the Schools of Medicine has shifted, in the past years, from curriculum models based in contents to outcome oriented curricula. Coincidently the interest in defining and evaluating the clinical competences that a graduate must have has grown. In our country, and particularly in the Associated Hospitals belonging to the Unidad Regional de Enseñanza IV of the UBA School of Medicine, evidence has been gathered showing that the acquisition of clinical competences during the grade is in general insufficient. The foundations and characteristics of PREM (Programa de Requisitos Esenciales Mínimos) are described. PREM is a tool to promote the apprenticeship of abilities and necessary skills for the practice of medicine. The objective of the program is to promote the apprenticeship of a well defined list of core competences considered indispensable for a general practitioner. An outcome oriented curriculum with a clear definition of the expected knowledge, skills and attitudes of a graduate of the programme, the promotion of learning experiences centered in the practice and evaluation tools based in direct observation of the student's performance should contribute to close the gap between what the Medicine Schools traditionally teach and evaluate, and what the doctor needs to know and needs to do to perform correctly its profession.
Connecticut Birth to Three System, Hartford.
This guide for parents and service providers contains information on autistic spectrum disorder (ASD) in young children and is the product of a review of research-based programs and models and requirements of the Individuals with Disabilities Education Act. The document begins with discussion of the definition of ASD, possible causes of ASD, and…
Does access to a colorectal cancer screening website and/or a nurse-managed telephone help line provided to patients by their family physician increase fecal occult blood test uptake?: A pragmatic cluster randomized controlled trial study protocol
Full Text Available Abstract Background Fecal occult blood test screening in Canada is sub-optimal. Family physicians play a central role in screening and are limited by the time constraints of clinical practice. Patients face multiple barriers that further reduce completion rates. Tools that support family physicians in providing their patients with colorectal cancer information and that support uptake may prove useful. The primary objective of the study is to evaluate the efficacy of a patient decision aid (nurse-managed telephone support line and/or colorectal cancer screening website distributed by community-based family physicians, in improving colorectal cancer screening rates. Secondary objectives include evaluation of (disincentives to patient FOBT uptake and internet use among 50 to 74 year old males and females for health-related questions. Challenges faced by family physicians in engaging in collaborative partnerships with primary healthcare researchers will be documented. Methods/design A pragmatic, two-arm, randomized cluster controlled trial conducted in 22 community-based family practice clinics (36 clusters with 76 fee-for-service family physicians in Winnipeg, Manitoba, Canada. Each physician will enroll 30 patients attending their periodic health examination and at average risk for colorectal cancer. All physicians will follow their standard clinical practice for screening. Intervention group physicians will provide a fridge magnet to each patient that contains information facilitating access to the study-specific colorectal cancer screening decision aids (telephone help-line and website. The primary endpoint is patient fecal occult blood test completion rate after four months (intention to treat model. Multi-level analysis will include clinic, physician and patient level variables. Patient Personal Health Identification Numbers will be collected from those providing consent to facilitate analysis of repeat screening behavior. Secondary outcome
Worsley, Anthony; Wang, Wei; Sarmugam, Rani; Pham, Quynh; Februhartanty, Judhiastuty; Ridley, Stacey
The rise of the middle classes in developing countries and the associated epidemiological transition raises the importance of assessing this population group's awareness of the causes of obesity and effective weight control strategies in order to develop effective health promotion strategies. The study aimed to examine the perceptions of the causes of obesity and weight control strategies held by middle class household food providers in Melbourne, Singapore, Shanghai, Indonesia and Vietnam. An online survey was conducted in late 2013, early 2014 among 3945 respondents. Information about body weight concerns, perceived causes of obesity, effectiveness of weight control methods, demographics, self-reported height and weight, and personal values was elicited. Confirmatory factor analyses (CFA) derived nine reliable factors which were used in structural equation modelling (SEM). Two thirds of respondents were trying to change their body weight, of them, 71% were trying to lose weight. The CFA and SEM showed that demographics, region of residence, personal values and perceptions of the causes of obesity ( Unhealthy food behaviours , influences Beyond personal control and Environmental influences ) had direct and indirect associations with three weight control methods factors, named: Healthy habits, Eat less, sit less , and Dieting. Middle class food providers in the study regions share public health views of obesity causation and personal weight control. These findings could inform public health and food policies, and the design of public health interventions and communications. Further research is required among lower socio economic status (SES) populations.
Miner, Dianne Cooney
The study of the family in the Caribbean originated with European scholars who assumed the universality of the patriarchal nuclear family and the primacy of this structure to the healthy functioning of society. Matrifocal Caribbean families thus were seen as chaotic and disorganized and inadequate to perform the essential tasks of the social system. This article provides a more current discussion of the Jamaican family. It argues that its structure is the result of the agency and adaptation of its members and not the root cause of the increasing marginalization of peoples in the developing world. The article focuses on families living in poverty and how the family structure supports essential family functions, adaptations, and survival.
Brown, Erica; Coad, Jane; Staniszewska, Sophie; Hacking, Suzanne; Chesworth, Brigit; Chambers, Lizzie
Children with life limiting conditions and their families have complex needs. Evaluations must consider their views and perspectives to ensure care is relevant, appropriate and acceptable. We consulted with children, young people, their parents and local professionals to gain a more informed picture of issues affecting them prior to preparing a bid to evaluate services in the area. Multiple methods included focus groups, face-to-face and telephone interviews and participatory activities. Recordings and products from activities were analysed for content to identify areas of relevance and concern. An overarching theme from parents was ‘Why does it happen like this?’ Services did not seem designed to meet their needs. Whilst children and young people expressed ideas related to quality of environment, services and social life, professionals focused on ways of meeting the families’ needs. The theme that linked families’ concerns with those of professionals was ‘assessing individual needs’. Two questions to be addressed by the evaluation are (1) to what extent are services designed to meet the needs of children and families and (2) to what extent are children, young people and their families consulted about what they need? Consultations with families and service providers encouraged us to continue their involvement as partners in the evaluation. PMID:24270996
Williams, Lauren Therese; Grealish, Laurie; Jamieson, Maggie
Background Clinicians need to be supported by universities to use credible and defensible assessment practices during student placements. Web-based delivery of clinical education in student assessment offers professional development regardless of the geographical location of placement sites. Objective This paper explores the potential for a video-based constructivist Web-based program to support site supervisors in their assessments of student dietitians during clinical placements. Methods This project was undertaken as design-based research in two stages. Stage 1 describes the research consultation, development of the prototype, and formative feedback. In Stage 2, the program was pilot-tested and evaluated by a purposeful sample of nine clinical supervisors. Data generated as a result of user participation during the pilot test is reported. Users’ experiences with the program were also explored via interviews (six in a focus group and three individually). The interviews were transcribed verbatim and thematic analysis conducted from a pedagogical perspective using van Manen’s highlighting approach. Results This research succeeded in developing a Web-based program, “Feed our Future”, that increased supervisors’ confidence with their competency-based assessments of students on clinical placements. Three pedagogical themes emerged: constructivist design supports transformative Web-based learning; videos make abstract concepts tangible; and accessibility, usability, and pedagogy are interdependent. Conclusions Web-based programs, such as Feed our Future, offer a viable means for universities to support clinical supervisors in their assessment practices during clinical placements. A design-based research approach offers a practical process for such Web-based tool development, highlighting pedagogical barriers for planning purposes. PMID:25803172
Full Text Available Abstract Background There is increasing agreement among medical educators regarding the importance of improving the integration between public health and clinical education, understanding and implementation of epidemiological methods, and the ability to critically appraise medical literature. The Sackler School of Medicine at Tel-Aviv University revised its public health and preventive medicine curriculum, during 2013–2014, according to the competency-based medical education (CBME approach in training medical students. We describe the revised curriculum, which aimed to strengthen competencies in quantitative research methods, epidemiology, public health and preventive medicine, and health service organization and delivery. Methods We report the process undertaken to establish a relevant 6-year longitudinal curriculum and describe its contents, implementation, and continuous assessment and evaluation. Results Central competencies included: epidemiology and statistics for appraisal of the literature and implementation of research; the application of health promotion principles and health education strategies in disease prevention; the use of an evidence-based approach in clinical and public health decision making; the examination and analysis of disease trends at the population level; and knowledge of the structure of health systems and the role of the physician in these systems. Two new courses, in health promotion, and in public health, were added to the curriculum, and the courses in statistics and epidemiology were joined. Annual evaluation of each course results in continuous revisions of the syllabi as needed, while we continue to monitor the whole curriculum. Conclusions The described revision in a 6 year-medical school training curriculum addresses the currently identified needs in public health. Ongoing feedback from students, and re-evaluation of syllabus by courses teams are held annually. Analysis of student’s written feedbacks
The anesthesia training program of the Saudi Commission for health specialties has introduced a developed competency-based anesthesia residency program starting from 2015 with the utilization of the workplace-based assessment (WBA) tools, namely mini-clinical exercises (mini-CEX), direct observation of procedural skills (DOPS), and case-based discussion (CBD). This work aimed to describe the process of development of anesthesia-specific list of mini-CEX, DOPS, and CBD tools within the Saudi Arabian Anesthesia Training Programs. To introduce the main concepts of formative WBA tools and to develop anesthesia-specific applications for each of the selected WBA tools, four 1-day workshops were held at the level of major training committees at eastern (Dammam), western (Jeddah), and central (Riyadh) regions in the Kingdom were conducted. Sixty-seven faculties participated in these workshops. After conduction of the four workshops, the anesthesia-specific applications setting of mini-CEX, DOPS, and CBD tools among the 5-year levels were fully described. The level of the appropriate consultation skills was divided according to the case complexity adopted from the American Society of Anesthesiologists physical classification for adult and obstetric and pediatric patient as well as the type of the targeted anesthetic procedure. WBA anesthesia-specific lists of mini-CEX, DOPS, and CBD forms were easily incorporated first into guidelines to help the first stage of implementation of formative assessment in the Saudi Arabian Anesthesia Residency Program, and this can be helpful to replicate such program within other various training programs in Saudi Arabia and abroad.
Ash, Susan; Palermo, Claire; Gallegos, Danielle
Competency-based Education (CBE) has underpinned the education of dietitians in Australia since the first Competency Standards (CS) were published; however, little is known about how CBE has influenced dietetic practice. The aim of this paper is to explore how a CBE framework and the CS have influenced dietetic practice in Australia since 1990. A qualitative investigation explored concepts of dietetic practice. Data analysed were original interviews previously undertaken with recent graduate dietitians during 1991 (n = 26), 1998 (n = 23) and 2007 (n = 19) and seven guided discussions with dietitians and employers (n = 28) conducted in 2014 to identify themes. The DAA Competency Standards and Accreditation Manuals/Standards since 1990 were also analysed to triangulate the interview data and to investigate how the CS were interpreted. Themes identified from interviews included: (i) communicating for better care, (ii) scientific enquiry for effective practice, (iii) critical thinking and evidence-based practice and (iv) professionalism, which remained core to dietetic practice over time, but leadership, advocacy, business management and entrepreneurial skills have emerged more strongly as the scope of practice has diversified. The landscape in which dietitians' practice showed increasing complexity and clear boundaries separating professional roles were disappearing. The 2015 CS and the 2017 Accreditation Standards highlighted that competency remains a shifting construct and that professional behaviours change depending on economic and political reasons in the play of power. Accreditation policy and current standards have successfully maintained a standard of dietetic practice across a diverse country but have the potential to constrain innovation. © 2018 Dietitians Association of Australia.
Connell, Braydon; Warner, Grace; Weeks, Lori E
Background/Question: Volunteers are important in the support of frail older adults requiring palliative care, especially in rural areas. However, there are challenges associated with volunteer supports related to training, management and capacity to work in partnership with healthcare providers (HCP). This review addresses the question: What is the feasibility of a volunteer-HCP partnership to support frail older adults residing in rural areas, as they require palliative care? This integrative review identified ten articles that met the identified search criteria. Articles were appraised using the Critical Appraisal Skills Programme (CASP) checklists, designed for use across a range of quantitative and qualitative studies. Studies were drawn from international sources to understand how volunteer roles vary by culture and organization; the majority of studies were conducted in North America. Studies varied in methodology, including quantitative, qualitative and educational commentary. Identified factors that were crucial to the feasibility of volunteer-HCP partnerships in rural areas included volunteer training dynamics, relationships between volunteers and HCP, and rural environmental factors. Preliminary evidence indicates that a volunteer-HCP palliative partnership is feasible. However, training policies/procedures, volunteer-HCP relationships, and rural specific designs impact the feasibility of this partnership. Additional research is needed to further establish the feasibility of implementing these partnerships in rural settings.
Bastawrous, Marina; Gignac, Monique A; Kapral, Moira K; Cameron, Jill I
To qualitatively explore daughters' experiences with and response to holding multiple roles while providing post-stroke care to a parent. Qualitative study using a descriptive approach. Semi-structured interviewing was used. Interviews were recorded, transcribed and analyzed to develop themes. General community of a metropolitan city. Twenty-three adult daughters caring for a community-dwelling parent who had suffered a stroke. Not applicable. Not applicable. Role overload is a salient issue for daughter caregivers. This overload is best captured by the analogy of "juggling" multiple role demands and responsibilities. Two key themes suggest that role overload resulting from parent care affects daughters': 1) valued relationships (e.g. challenges develop in their relationship with children and partner); and 2) ability to participate in valued activities (e.g. reduced involvement in leisure activities and restricted employment). Future support efforts should help daughters manage the caregiving role in light of other responsibilities. This can mitigate overload-related strain in valued relationships and decreased participation in valued activities, thereby contributing to better health and well-being for daughter caregivers. © The Author(s) 2014.
... and Tests A physical exam may show fatty skin growths called xanthomas and cholesterol deposits in the eye (corneal arcus). The health care provider will ask questions about your personal and family medical history. There may be: A strong family history of ...
Cuidado de Ninos con Necesidades Especiales en el Hogar: Manual de Estrategias y Actividades para Proveedores que Cuidan Ninos en Sus Hogares (Children with Special Needs in Family Day Care Homes: A Handbook of Approaches and Activities for Family Day Care Home Providers).
de la Brosse, Beatrice
Practical information and sample teaching activities for child caregivers who work with young developmentally disabled children in family day care settings are provided in this manual. Each chapter shares a typical experience a caregiver may have with a particular child. Chapter 1 focuses on getting to know a new child, initial expectations, and…
Gonsalves, Catherine; Zaidi, Zareen
There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on 'doing the work of a physician' rather than identity formation and 'being a physician.' This study aims to understand how competency-based education impacts the development of a medical student's identity. Three ceramic models representing three core competencies 'medical knowledge,' 'patient care,' and 'professionalism' were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Students across all four years of medical school related to the 'professionalism' competency domain (50%). They reflected that 'being an empathetic physician' was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized 'professionalism' as a competency. Students perceive 'professionalism' as a competency that impacts their identity formation in the social role of 'being a doctor,' albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.
van Vendeloo, Stefan N; Brand, Paul L P; Kollen, Boudewijn J; Verheyen, Cees C P M
To evaluate the perceived quality of the learning environment, before and after introduction of competency-based postgraduate orthopedic education. From 2009 to 2014, we conducted annual surveys among Dutch orthopedic residents. The validated Dutch Residency Educational Climate Test (D-RECT, 50 items on 11 subscales) was used to assess the quality of the learning environment. Scores range from 1 (poor) to 5 (excellent). Dynamic cohort follow-up study. All Dutch orthopedic residents were surveyed during annual compulsory courses. Over the 6-year period, 641 responses were obtained (response rate 92%). Scores for "supervision" (95% CI for difference 0.06-0.28, p = 0.002) and "coaching and assessment" (95% CI 0.11-0.35, p < 0.001) improved significantly after introduction of competency-based training. There was no significant change in score on the other subscales of the D-RECT. After the introduction of some of the core components of competency-based postgraduate orthopedic education the perceived quality of "supervision" and "coaching and assessment" improved significantly. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...
Powers, Robert; Mirkovic, Nebojsa; Goldsmith-Fischman, Sharon; Acton, Thomas; Chiang, Yiwen; Huang, Yuanpeng; Ma, LiChung; Rajan, Paranji K.; Cort, John R.; Kennedy, Michael A.; Liu, Jinfeng; Rost, Burkhard; Honig, Barry; Murray, Diana; Montelione, Gaetano
The solution structure of protein AF2095 from the thermophilic archaea Archaeglobus fulgidis, a 123-residue (13.6 kDa) protein, has been determined by NMR methods. The structure of AF2095 is comprised of four a-helices and a mixed b-sheet consisting of four parallel and anti-parallel b-strands, where the a-helices sandwich the b-sheet. Sequence and structural comparison of AF2095 with proteins from Homo sapiens, Methanocaldococcus jannaschii and Sulfolobus solfataricus, reveals that AF2095 is a peptidyl-tRNA hydrolase (Pth2). This structural comparison also identifies putative catalytic residues and a tRNA interaction region for AF2095. The structure of AF2095 is also similar to the structure of protein TA0108 from archaea Thermoplasma acidophilum, which is deposited in the Protein Database but not functionally annotated. The NMR structure of AF2095 has been further leveraged to obtain good quality structural models for 55 other proteins. Although earlier studies have proposed that the Pth2 protein family is restricted to archeal and eukaryotic organisms, the similarity of the AF2095 structure to human Pth2, the conservation of key active-site residues, and the good quality of the resulting homology models demonstrate a large family of homologous Pth2 proteins that are conserved in eukaryotic, archaeal and bacterial organisms, providing novel insights in the evolution of the Pth and Pth2 enzyme families.
Family-centredness of professionals who support people with profound intellectual and multiple disabilities: validation of the Dutch 'Measure of Processes of Care for Service Providers' (MPOC-SP-PIMD).
Jansen, Suzanne L G; van der Putten, Annette A J; Post, Wendy J; Vlaskamp, Carla
A Dutch version of the 'Measure of Processes of Care for Service Providers' (MPOC-SP) was developed to determine the extent to which professionals apply the principles of family-centred care in the rehabilitation of children with physical disabilities. However, no data were available on the reliability and construct validity of this instrument when it comes to supporting people with profound intellectual and multiple disabilities (PIMD). This study aimed to validate an adapted version of the Dutch MPOC-SP for assessing the family-centred behaviours of professionals who support this group (MPOC-SP-PIMD). A total of 105 professionals took part in the study. A Mokken scale analysis was conducted to determine whether the instrument satisfied the assumptions of both monotone homogeneity and double monotonicity. Loevinger's scalability coefficient (H) was used for the scalability of the entire scale and of each item separately. Rho was calculated as a measure of the internal consistency of the scales. The analyses resulted in two scales: a nine-item scale interpreted as 'Showing Interpersonal Sensitivity', with H=.39 and rho=.76, and a seven-item scale interpreted as 'Treating People Respectfully', with H=.49 and rho=.78. A validated version of the MPOC-SP-PIMD, suitable for supporting people with PIMD, consists of a subset of two scales from the original Dutch MPOC-SP. This instrument can be used to compare the family-centredness of professionals with parent's expectations and views. This information can be used in practice to match the support to the needs of the parents and family of the child with PIMD. Copyright © 2014 Elsevier Ltd. All rights reserved.
Grosse, Susan J.
This article discusses how families can increase family togetherness and improve physical fitness. The author provides easy ways to implement family friendly activities for improving and maintaining physical health. These activities include: walking, backyard games, and fitness challenges.
Full Text Available Objetivo: Comprender las repercusiones del cuidado familiar ejercido por inmigrantes contratadas en régimen interno, en la salud de ellas mismas, de las personas mayores dependientes y de sus familias, en Sevilla. Método: Se diseñó un estudio cualitativo, utilizando entrevistas en profundidad a informantes-clave, cuidadoras inmigrantes, personas mayores dependientes y familias, y grupos de discusión de profesionales sanitarios. El estudio se realizó en Sevilla entre los años 2006 y 2008. Unidad de observación: familias con mayores dependientes a su cargo y cuidadora inmigrante interna contratada. Unidades de análisis: salud, cuidados, dependencia, género, etnia y clase social. El análisis de categorías, predeterminadas y emergentes, se realizó con QSR NUD*ISTVivo1.3. Tras llegar a la saturación, se triangularon disciplinas, investigadoras, fuentes y técnicas, para enriquecer y validar los resultados. Resultados: En la salud de las cuidadoras inmigrantes influyen, fundamentalmente, la repercusión del trabajo de cuidar y el proceso migratorio. Las relaciones interpersonales son el factor que más influye en la salud de todas las personas implicadas. Conclusiones: El cuidado familiar encargado a mujeres inmigrantes, unido al duelo migratorio, tiene importantes repercusiones en su salud. Si las relaciones interpersonales son de buen trato e igualitarias, se constituyen como factor de protección para todas las personas en contacto.Objective: To understand the effects of care within the family provided by live-in female immigrants on elderly dependents and their families and the carers themselves in Seville (Spain. Methods: We designed a qualitative study using in-depth interviews of key informants, immigrant care workers, elderly dependents and their families, and discussion groups composed of health professionals. The study was carried out in Seville between 2006 and 2008. The observation unit consisted of the families of elderly
The intrinsically disordered structural platform of the plant defence hub protein RPM1-interacting protein 4 provides insights into its mode of action in the host-pathogen interface and evolution of the nitrate-induced domain protein family.
Sun, Xiaolin; Greenwood, David R; Templeton, Matthew D; Libich, David S; McGhie, Tony K; Xue, Bin; Yoon, Minsoo; Cui, Wei; Kirk, Christopher A; Jones, William T; Uversky, Vladimir N; Rikkerink, Erik H A
Arabidopsis thaliana (At) RPM1-interacting protein 4 (RIN4), targeted by many defence-suppressing bacterial type III effectors and monitored by several resistance proteins, regulates plant immune responses to pathogen-associated molecular patterns and type III effectors. Little is known about the overall protein structure of AtRIN4, especially in its unbound form, and the relevance of structure to its diverse biological functions. AtRIN4 contains two nitrate-induced (NOI) domains and is a member of the NOI family. Using experimental and bioinformatic approaches, we demonstrate that the unbound AtRIN4 is intrinsically disordered under physiological conditions. The intrinsically disordered polypeptide chain of AtRIN4 is interspersed with molecular recognition features (MoRFs) and anchor-identified long-binding regions, potentially allowing it to undergo disorder-to-order transitions upon binding to partner(s). A poly-l-proline II structure, often responsible for protein recognition, is also identified in AtRIN4. By performing bioinformatics analyses on RIN4 homologues from different plant species and the NOI proteins from Arabidopsis, we infer the conservation of intrinsic disorder, MoRFs and long-binding regions of AtRIN4 in other plant species and the NOI family. Intrinsic disorder and MoRFs could provide RIN4 proteins with the binding promiscuity and plasticity required to act as hubs in a pivotal position within plant defence signalling cascades. © 2014 FEBS.
Provedoras e co-provedoras: mulheres-cônjuge e mulheres-chefe de família sob a precarização do trabalho e o desemprego Providers and co-providers: wives and female heads of families in unstable employment conditions and unemployment
their members, as well as changes in the role of women in the family and in society. The focus here is the character of the profiles of participation of wives and female heads of families who are providers or co-providers in their nuclear families. There has been increasing growth of the importance of the participation of these woman in the labor market, under unstable labor relationships and unemployment. At the same time, they have been taking on more significant roles in the composition of family income. Although they often hold down unstable jobs, in comparison with other members of their families, only wives and female heads of families showed increased participation and occupation between 1990 and 2003. Especially important is the segment of working wives, half of whom under unstable or informal labor relationships, who show less reduction in the proportion of non-unstable relationships during this period. The occupational profiles of members of the family groups in which these women participate are analyzed, and the families of wives and female heads of families who work and do not work were compared. The contribution of these women to the incomes of their nuclear families has softened the fall in income of their households and clearly attenuated the increasing impoverishment in the São Paulo Metropolitan Region.
Purpose There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results Students across all four years of medical school related to the ‘professionalism’ competency domain (50%). They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception. PMID:27572244
Full Text Available Purpose There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results Students across all four years of medical school related to the ‘professionalism’ competency domain (50%. They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.
Bogenschutz, Matthew; Nord, Derek; Hewitt, Amy
Turnover among direct support professionals (DSPs) in community support settings for individuals with intellectual and developmental disabilities (IDD) has been regarded as a challenge since tracking of this workforce began in the 1980s. This study utilized a group randomized controlled design to test the effects of a competency-based training intervention for DSPs on site-level turnover rates over a one year period. Results suggested that, compared with the control group, sites receiving the training intervention experienced a significant decrease in annual turnover, when multiple factors were controlled. Implications, including the importance of considering quality training as a long term organizational investment and intervention to reduce turnover, are discussed.
Andrus, Len Hughes; Fenley, Mary D.
Describes a Family Nurse Practitioner Program that has effectively improved the distribution of primary health care manpower in rural areas. Program characteristics include selection of personnel from areas of need, decentralization of clinical and didactic training sites, competency-based portable curriculum, and circuit-riding institutionally…
Puski, Athena; Hovick, Shelly; Senter, Leigha; Toland, Amanda Ewart
Deciding between increased cancer screening or prophylactic surgery and the timing of such procedures can be a difficult and complex process for women with BRCA mutations. There are gaps in our understanding of involvement of others in the decision-making process for women with BRCA mutations. This study evaluated the management decision-making process of women with BRCA mutations, focusing on the involvement of others. Grounded theory was used to analyze and code risk management decision-making information from interviews with 20 BRCA mutation carriers. Unaffected at-risk participants with a BRCA mutation, those under age 40, and those with no children described having a difficult time making risk management decisions. Physicians were an integral part of the decision-making process by providing decisional support and management recommendations. Family members and other mutation carriers filled similar yet distinct roles by providing experiential information as well as decisional and emotional support for carriers. Participants described genetic counselors as short-term providers of risk information and management recommendations. The study findings suggest that unaffected at-risk women, women under 40, and those who do not have children may benefit from additional support and information during the decision-making process. Genetic counselors are well trained to help women through this process and connect them with resources, and may be under-utilized in long-term follow-up for women with a BRCA mutation.
Full text: In Turkey, in recent years, public opinion is mostly positive towards the establishment of NPPs because electricity demand is ever-increasing with a growing population and developing economy. For peaceful nuclear energy use, Turkey ratified the NPT in 1979 and has had a safeguards agreement, and its Additional Protocol since 2001. However, Turkey has not accumulated the essential nuclear knowledge and experience until now. The present nuclear education and training programmes are not focused on nuclear safety and power technology. There is lack of competencies concerned with measuring and monitoring, instrumentation and control for a safe operation of a reactor, and other specific nuclear equipment and facilities on site. The urgent needs should be determined to commence a competency based education in which the younger generations will instill confidence to nuclear technology. In nuclear training and education programs, it should be given a priority to nuclear safety and security culture. This should be a key requirement for newcomers to nuclear technology. In this presentation, the present status of nuclear science education in Turkey is discussed briefly and the fundamental arguments are dealt to focus on competency based nuclear education. Within international community, Turkey can seek collaborations and can consider the new challenges to tackle with the present difficulties in nuclear education programmes as a newcomer country. (author
Schuwirth, Lambert; Ash, Julie
In this paper we are challenging six traditional notions about assessment that are unhelpful when designing 'assessment for learning'-programmes for competency-based education. We are arguing for the following: Reductionism is not the only way to assure rigour in high-stakes assessment; holistic judgements can be equally rigorous. Combining results of assessment parts only because they are of the same format (like different stations in an OSCE) is often not defensible; instead there must be a logically justifiable combination. Numbers describe the quality of the assessment. Therefore, manipulating the numbers is usually not the best way to improve its quality. Not every assessment moment needs to be a decision moment, disconnecting both makes combining summative and formative functions of assessment easier. Standardisation is not the only route to equity. Especially with diverse student groups tailoring is more equitable than standardisation. The most important element to standardise is the quality of the process and not the process itself. Finally, most assessment is too much focussed on detecting deficiencies and not on valuing individual student differences. In competency-based education--especially with a focus on learner orientation--this 'deficiency-model' is not as well aligned as a 'differences-model'.
Kühl, Susanne J; Toberer, Matthias; Keis, Oliver; Tolks, Daniel; Fischer, Martin R; Kühl, Michael
Background: Medical students often have a problem recognising the relevance of basic science subjects for their later professional work in the pre-clinical stage of their studies. This can lead to a lower motivation to learn biochemical content and dissatisfaction in the courses amongst the students. Alternative teaching methods such as the Inverted Classroom (IC) method can address this deficiency. The goal of this study was: to analyse the motivation and satisfaction of the students in a biochemistry seminar through the use of the e-learning-based IC method, to investigate the acceptance against the IC teaching method in biochemistry, and to compare the learning success achieved using the IC approach with that of a traditional course. We also investigated how a biochemistry course in the pre-clinical stage of a human medicine course of studies can be successfully organised according to the IC method. Furthermore, we examined the benefits of the IC method over conventional teaching formats. Method: The IC method was implemented in accordance with the guidelines of the GMA committee "New Media"  in a biochemistry seminar for two student IC intervention groups with 42 students. A part of the factual knowledge from the on-site phase in the form of teaching videos together with self-learning control tasks were provided online before the seminar for both IC intervention groups. Exporting content to the self-learning phase creates new free time in the on-site phase, during which the content can be critically considered and processed and additional competency-based learning objectives can be taught. Identical biochemistry teaching content was taught in parallel control groups (14 student groups with n=299 students), but no material was handed out beforehand for a self-learning phase. These students only received the materials after the on-site phase. Motivation and satisfaction as well as the acceptance for the teaching methods were recorded by questionnaires, the
Kühl, Susanne J.
Full Text Available Background: Medical students often have a problem recognising the relevance of basic science subjects for their later professional work in the pre-clinical stage of their studies. This can lead to a lower motivation to learn biochemical content and dissatisfaction in the courses amongst the students. Alternative teaching methods such as the Inverted Classroom (IC method can address this deficiency. The goal of this study was: We also investigated how a biochemistry course in the pre-clinical stage of a human medicine course of studies can be successfully organised according to the IC method. Furthermore, we examined the benefits of the IC method over conventional teaching formats. Method: The IC method was implemented in accordance with the guidelines of the GMA committee “New Media” in a biochemistry seminar for two student IC intervention groups with 42 students. A part of the factual knowledge from the on-site phase in the form of teaching videos together with self-learning control tasks were provided online before the seminar for both IC intervention groups. Exporting content to the self-learning phase creates new free time in the on-site phase, during which the content can be critically considered and processed and additional competency-based learning objectives can be taught. Identical biochemistry teaching content was taught in parallel control groups (14 student groups with n=299 students, but no material was handed out beforehand for a self-learning phase. These students only received the materials after the on-site phase. Motivation and satisfaction as well as the acceptance for the teaching methods were recorded by questionnaires, the acquisition of knowledge by MC exams.Results: On a Likert scale from 1 (strongly disagree to 6 (strongly agree, the students in the IC intervention groups could be seen to be much more motivated (5.53 than students in the control group (4.01. Students in the IC intervention groups also recognised the
Reforms in the Australian vocational education and training (VET) landscape have generated significant interest in the changes to the delivery and nature of formal (off-the-job) training provided by Registered Training Organisations. Existing research has provided valuable insights into the evolving role of teachers, and speculated upon the…
Marieke van der Schaaf; Paul Kirschner; Prof.Dr. Elly de Bruijn; Dr. Harmen Schaap
This article aims to provide an insight into how students construct their professional knowledge and what the content and nature of personal professional knowledge is through the concept of PPTs (personal professional theories).
Croes, M.J.G.; Feijs, L.M.G.; Chen, L.; Djajadingrat, T.; Feijs, L.M.G.; Hu, J.; Kufin, S.H.M.; Rampino, L.; Rodriguez, E.; Steffen, D.
In this demo we show the two main components of the Family Arizing system which allows parents to stay in contact with their child and, in cases of distress, provide the child with a remote comforting hug. The two components to be shown are the active necklace and the active snuggle.
Ion, Georgeta; Cano, Elena; Cabrera, Nati
This article examines an innovation in teaching-learning and assessment processes through the use of a platform called the Competency Assessment Tool (CAT). It allows for the tracking of student blogs with the objective of improving self-reflective processes and providing feedback. The experiment was carried out in six universities in Catalonia,…
... The Treatment Of MSUD The MSUD Family Support Group has provided funds to Buck Institute for its ... of the membership of the MSUD Family Support Group, research for improved treatments and potential cure was ...
The impact of facility audits, evaluation reports and incentives on motivation and supply management among family planning service providers: an interventional study in two districts in Maputo Province, Mozambique.
Vermandere, Heleen; Galle, Anna; Griffin, Sally; de Melo, Málica; Machaieie, Lino; Van Braeckel, Dirk; Degomme, Olivier
Good progress is being made towards universal access to contraceptives, however stock-outs still jeopardize progress. A seldom considered but important building block in optimizing supply management is the degree to which health workers feel motivated and responsible for monitoring supply. We explored how and to what extent motivation can be improved, and the impact this can have on avoiding stock-outs. Fifteen health facilities in Maputo Province, Mozambique, were divided into 3 groups (2 intervention groups and 1 control), and 10 monthly audits were implemented in each of these 15 facilities to collect data through examination of stock cards and stock-counts of 6 contraceptives. Based on these audits, the 2 intervention groups received a monthly evaluation report reflecting the quality of their supply management. One of these 2 groups was also awarded material incentives conditional on their performance. A Wilcoxon-Mann Whitney test was used to detect differences between the groups in the average number of stocked-out centres, while changes over time were verified through applying a Friedman test. Additionally, staff motivation was measured through interviewing health care providers of all centres at baseline, and after 5 and 10 months. To detect differences between the groups and changes over time, a Kruskal Wallis and a Wilcoxon signed-rank test were applied, respectively. Motivation reported by providers (n = 55, n = 40 and n = 39 at baseline, 1st and 2nd follow-up respectively) was high in all groups, during all rounds, and did not change over time. Facilities in the intervention groups had better supply management results (including less stock-outs) during the entire intervention period compared with those in the control group, but the difference was only significant for the group receiving both material incentives and a monthly evaluation. However, our data also suggest that supply management also improved in control facilities, receiving
The situation in the family preceding a family separation is studied here, to identify risk factors for family dissolution. Information registers covering prospective statistics about health aspects, demographic variables, family violence, self-destructive behaviour, unemployment, and the spousal...
Goldman, Joanne; Kitto, Simon; Reeves, Scott
Interprofessional collaboration is recognised as an important factor in improving patient care in intensive care units (ICUs). Competency frameworks, and more specifically interprofessional competency frameworks, are a key strategy being used to support the development of attitudes, knowledge, skills, and behaviours needed for an interprofessional approach to care. However, evidence for the application of competencies is limited. This study aimed to extend our empirically based understanding of the significance of interprofessional competencies to actual clinical practice in an ICU. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers' perspectives, behaviours, and interactions of interprofessional collaboration in a medical surgical ICU in a community teaching hospital in Canada. Approximately 160 hours of observations were undertaken and 24 semi-structured interviews with healthcare workers were conducted over a period of 6 months. Data were analysed using a directed content approach where two national competency frameworks were used to help generate an understanding of the practice of interprofessional collaboration. Healthcare professionals demonstrated numerous instances of interprofessional communication, role understandings, and teamwork in the ICU setting, which supported a number of key collaborative competencies. However, organisational factors such as pressures for discharge and patient flow, staffing, and lack of prioritisation for interprofessional learning undermined competencies designed to improve collaboration and teamwork. The findings demonstrate that interprofessional competencies can play an important role in promoting knowledge, attitudes, skills, and behaviours needed. However, competencies that promote interprofessional collaboration are dependent on a range of contextual factors that enable (or impede) individuals to actually enact these competencies.
Hasske, Eva; Beil, Michael; Keller, Katrin
Objective: The aim of the Medical Academy Waldbreitbach is to connect individual and organisational requirements in order to promote an appropriate and multi-locational development of medical competency in the face of the continuously evolving challenges of clinical practice. Integral processes in this are the reduction of organisational learning barriers and the successive integration of competency-oriented learning events in the structures of personnel and organisational development. The modular system for the further development of doctors' skills serves here as a supplementary and recommendation system for both existing curricula and those defined by regulatory organisations and professional associations. Methods: The Medical Academy's modular system has a two-dimensional structure. In addition to the axis of biography orientation, the model orients itself around issues relating to the needs of a doctor in any individual professional position, as well as with whom he comes into contact and where his primary challenges lie. In order to achieve better integration in day-to-day routine and a needs-specific orientation of content, the modular system provides a combination of "one, two or three day and two- three- or four-hour training units" depending upon the topic. The transfer of experiential knowledge with the aid of practical exercises is a central element of the didactic model. Results: Through the combined use of summative and formative assessment, the significance of a dialogue-orientated approach in both planning and in the organisational process was highlighted. In feedback discussions and quantitative evaluation sheets, participants identified in particular cross-generational knowledge sharing as a central element for the development of personal values alongside the interdisciplinary transfer of knowledge. The combination of specialist and interdisciplinary topics, for example on team processes or communication, is frequently emphasised, indicating that
Sagasser, Margaretha H; Fluit, Cornelia R M G; van Weel, Chris; van der Vleuten, Cees P M; Kramer, Anneke W M
Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study explored how supervisors made entrustment decisions based on residents' performance in a long-term family medicine training program. A qualitative nonparticipant observational study was conducted in 2014-2015 at competency-based family medicine residency programs in the Netherlands. Seven supervisor-resident pairs participated. During two days, one researcher observed first-year residents' patient encounters, debriefing sessions, and supervisor-resident educational meetings and interviewed them separately afterwards. Data were collected and analyzed using iterative, phenomenological inductive research methodology. The entrustment process developed over three phases. Supervisors based their initial entrustment on prior knowledge about the resident. In the ensuing two weeks, entrustment decisions regarding independent patient care were derived from residents' observed general competencies necessary for a range of health problems (clinical reasoning, decision making, relating to patients); medical knowledge and skills; and supervisors' intuition. Supervisors provided supervision during and after encounters. Once residents performed independently, supervisors kept reevaluating their decisions, informed by residents' overall growth in competencies rather than by adhering to a predefined set of tasks. Supervisors in family medicine residency training took a holistic approach to trust, based on general competencies, knowledge, skills, and intuition. Entrustment started before training and developed over time. Building trust is a mutual process between supervisor and resident, requiring a good working relationship.
Ahmad A. S. Al Husban
Full Text Available Higher educational systems become increasingly oriented towards the competences-based student-centered learning and outcome approach. Worldwide, these systems are focusing on the students as a whole: focusing on their dimensional, intellectual, professional, psychological, moral, and spiritual. This research was conducted in an attempt to answer the main research question: how can the architectural design courses be designed based on the required competences and how can the teaching, learning activities and assessment methods be structured and aligned in order to allow students to achieve and reach the intended learning outcomes? This research used a case study driven best practice research method to answer the research questions based on the T MEDA pilot architectural program that was implemented at the Hashemite University, Jordan. This research found that it is important for architectural education to adapt the students-centered learning method. Such approach increases the effectiveness of teaching and learning methods, enhances the design studio environment, and focuses on students’ engagement to develop their design process and product. Moreover, this research found that using different assessment methods in architectural design courses help students to develop their learning outcomes; and inform teachers about the effectiveness of their teaching process. Furthermore, the involvement of students in assessment produces effective learning and enhances their design motivation. However, applying competences-based students-centered learning and outcome approach needs more time and staff to apply. Another problem is that some instructors resist changing to the new methods or approaches because they prefer to use their old and traditional systems. The application for this method at the first time needs intensive recourses, more time, and good cooperation between different instructors and course coordinator. However, within the time this method
California Agriculture, 1994
This special issue focuses on problems and challenges confronting the California family and on research and extension efforts to provide at least partial answers. Research briefs by staff include "Challenges Confront the California Family" (state trends in poverty, divorce, single-parent families, child abuse, delinquency, teen births,…
Adult Competency Education Kit. Basic Skills in Speaking, Math, and Reading for Employment. Part H. ACE Competency Based Job Descriptions: #25--Household Appliance Mechanic; #26--Lineworker; #27--Painter Helper, Spray; #28--Painter, Brush; #29--Carpenter Apprentice.
San Mateo County Office of Education, Redwood City, CA. Career Preparation Centers.
This fifth of fifteen sets of Adult Competency Education (ACE) Competency Based Job Descriptions in the ACE kit contains job descriptions for Household Appliance Mechanic; Lineworker; Painter Helper, Spray; Painter, Brush; and Carpenter Apprentice. Each begins with a fact sheet that includes this information: occupational title, D.O.T. code, ACE…
Full Text Available There is an absence of broad-based and binding curricular requirements for structured competency-based post-graduate medical training in Germany, and thus no basis for comparing the competencies of physicians undergoing training in a medical specialty (. In response, the German Society of Primary Care Pediatrics’ working group on post-graduate education (DGAAP has identified realistic entrustable professional activities (EPAs in primary care, defined their number, scope and content, selected competency domains, specified required knowledge and skills, and described appropriate assessment methods. These guidelines are referred to as and can be accessed electronically by educators in pediatric medicine; the use and effectiveness of these guidelines are monitored by the German Association for Medical Education’s committee on post-graduate education (GMA. Teaching and training in pediatric medicine should take EPAs into consideration. To accomplish this, phases dedicated to primary care should be integrated into formal medical specialty training. Primary care pediatrics must enhance the sites where such training takes place into learning environments that prepare physicians trainees and turn the practicing specialists into mentoring educators.
Cramer, Robert J; Bryson, Claire N; Eichorst, Morgam K; Keyes, Lee N; Ridge, Brittany E
As professional psychology training programs and continuing education have moved toward competency based approaches, it has become equally important to develop uniform, evidence-based approaches for suicide risk assessment and management. The present article presents a workshop curriculum based on established core competencies in suicide risk assessment and management. Drawing on theories suicide risk formation, the workshop features an integration of didactic, process, and experiential components. We present pilot data from 2 small group workshops (n = 17): 1 from a clinical psychology doctoral program and 1 from a university counseling center. Workshop participation yielded increases in (a) the ability to recognize appropriate clinician responses to suicidal client statements, (b) self-perceptions of general capacity to interface with suicidal patients and mastery of the 10 core competencies, (c) factual knowledge concerning suicide risk assessment and management, and (d) the self-rated ability to assess and manage a suicidal patient. We discuss statistical and generalizability limitations as well as implications for future modification, implementation, and provision of this training method. © 2016 Wiley Periodicals, Inc.
Bernard, Heather; Hackbarth, Diana; Olmsted, Russell N; Murphy, Denise
Infection Preventionists have varying levels of educational preparation. Many have no prior experience in IP. The diversity makes design of professional development programs challenging. Recent surveys suggest that only about half of practicing IPs are board certified. There is an urgent need to employ competent IP's to drive improvement in patient outcomes. This is a project that utilized the APIC Competency Model to create a professional development program characterizing three career stages. Methods included a review of literature on professional development; a survey of IP competence; an assessment of job descriptions and performance evaluations; and a crosswalk of IP competencies. The professional development program includes competency - based IP job descriptions and performance evaluations for each career stage; a professional portfolio; and a toolkit for supervisors. Participants agreed that application of the model resulted in tools which are more closely aligned with current roles for IPs; and increased satisfaction and motivation with the new program. Competent and knowledgeable IP's are crucial to optimizing efficacy of IPC programs. A professional development program has the potential to guide staff orientation, improve satisfaction and retention, improve patient outcomes and promote a positive trajectory in advancing practice. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Hautz, Stefanie C; Hautz, Wolf E; Keller, Niklas; Feufel, Markus A; Spies, Claudia
In Germany, a national competence based catalogue of learning objectives in medicine (NKLM) was developed by the Society for Medical Education and the Council of Medical Faculties. As many of its international counterparts the NKLM describes the qualifications of medical school graduates. The definition of such outcome frameworks indents to make medical education transparent to students, teachers and society. The NKLM aims to amend existing lists of medical topics for assessment with learnable competencies. All outcome frameworks are structured into chapters, domains or physician roles. The definition of the scholar-role poses a number of questions such as: What distinguishes necessary qualifications of a scientifically qualified physician from those of a medical scientist? 13 outcome frameworks were identified through a systematic three-step literature review and their content compared to the scholar role in the NKLM by means of a qualitative text analysis. The three steps consist of (1) search for outcome frameworks, (2) in- and exclusion, and (3) data extraction, categorization, and validation. The results were afterwards matched with the scholar role of the NKLM. Extracted contents of all frameworks may be summarized into the components Common Basics, Clinical Application, Research, Teaching and Education, and Lifelong Learning. Compared to the included frameworks the NKLM emphasises competencies necessary for research and teaching while clinical application is less prominently mentioned. The scholar role of the NKLM differs from other international outcome frameworks. Discussing these results shall increase propagation and understanding of the NKLM and thus contribute to the qualification of future medical graduates in Germany.
Hautz, Stefanie C.
Full Text Available Background: In Germany, a national competence based catalogue of learning objectives in medicine (NKLM was developed by the Society for Medical Education and the Council of Medical Faculties. As many of its international counterparts the NKLM describes the qualifications of medical school graduates. The definition of such outcome frameworks indents to make medical education transparent to students, teachers and society. The NKLM aims to amend existing lists of medical topics for assessment with learnable competencies. All outcome frameworks are structured into chapters, domains or physician roles. The definition of the scholar-role poses a number of questions such as: What distinguishes necessary qualifications of a scientifically qualified physician from those of a medical scientist? Methods: 13 outcome frameworks were identified through a systematic three-step literature review and their content compared to the scholar role in the NKLM by means of a qualitative text analysis. The three steps consist of (1 search for outcome frameworks, (2 in- and exclusion, and (3 data extraction, categorization, and validation. The results were afterwards matched with the scholar role of the NKLM.Results: Extracted contents of all frameworks may be summarized into the components , and . Compared to the included frameworks the NKLM emphasises competencies necessary for research and teaching while clinical application is less prominently mentioned. Conclusion: The scholar role of the NKLM differs from other international outcome frameworks. Discussing these results shall increase propagation and understanding of the NKLM and thus contribute to the qualification of future medical graduates in Germany.
Patricia Jara Concha
Full Text Available El presente artículo analiza el impacto de la educación superior en la sociedad y su pertinencia en un mundo global. Discute algunas nociones de la formación de enfermería, especialmente en el postgrado, en los nuevos escenarios, para responder a un paradigma de educación-producción; y analiza críticamente tanto los componentes de un currículo con enfoque de competencias en un programa de Magíster en Enfermería, como sus implicaciones para el contexto laboral y para el de la academia. Plantea una propuesta de competencias de postgrado en tres dimensiones esenciales del saber: saber conocer, saber hacer y saber ser.We analyze the impact of higher education on the society and its fitting within a globalized world and discuss some notions regarding nursing education particularly at the graduate level in the current context driven by the education-production paradigm. We present a critical analysis of the components of a competence-based curriculum for a master of nursing program and discuss its implications for both work and academic contexts. Finally, we propose three basic competences for nursing graduate education based on three key dimensions of knowing: including to know, to know how and to know being.
tool towards children's general Bildung and more specific development of literacy competence in the first years of school, in 2007 we carried out an investigation about fiction as a part of mother-tongue teaching and the process of children's learning to read. Via the investigation and general studies...... we want to get more knowledge ablout following questions: How to define fiction which holds a personal and language "Bildung"? How to define the importance of fiction related to children's literacy competence? What kind of fiction do teachers use? How do teachers mediate fiction, how and in what...... extend do teachers make use of drawing and play activities? How to find a balance between to maintain the aesthetical and narrative methods and expressions AND gaining a literacy competence? This paper has focus on the fourth question....
.... A competency framework that is used consistently throughout the force and that focuses on the functions of leadership will help align training, development, and performance management processes...
[Interprofessional multistation practical training in the auditorium : Implementation of the national competence-based catalog of learning objectives for undergraduate medical education in the cross-sectorial area medicine of aging and the aged at the TU Dresden].
Sauer, Maik; Görnig, Matthias; Voigt, Karen; Schübel, Jeaninne; Bergmann, Antje
The German national competence-based catalogue of learning objectives for undergraduate medical education (NKLM) newly introduced in 2015, provides a variety of learning objectives, competences, as well as practical skills for the cross-sectorial area 7 "Medication of Aging and the Aged" (QB7). Against this background an interdisciplinary teaching concept to mediate all required teaching contents should be developed. Can an interdisciplinary multistation practical course in the auditorium, in which different tasks and skills are trained at each station meet the requirements of the NKLM? Evaluation by questionnaire and rating of answers on a 6-stage Likert scale. Analysis of the qualitative and quantitative evaluation results of 235 participating students and 13 lecturers in 2016. The interdisciplinary multistation practical course in the auditorium is fully compliant with the NKLM. All theoretical and practical contents and competences could be depicted. The subjective learning effect was assessed by students as good (mean = 2.66; SD = 0.94; N = 230). The available teaching time was rated as being too short in qualitative statements. The lecturers attested a high degree of interest by the students (mean = 2.15; SD = 0.86; N = 13), but criticized that the noise level was too loud. Compact, hands-on and interdisciplinary teaching concepts in the QB7 help to make the best use of human and spatial resources and convey all theoretical and practical teaching contents and competences from the NKLM; however, the planning, organization and implementation are very time-consuming.
Grover, Sandeep; Avasthi, Ajit; Shah, Sandip; Lakdawala, Bhavesh; Chakraborty, Kaustav; Nebhinani, Naresh; Kallivayalil, Roy A; Dalal, Pranob K.; Sinha, Vishal; Khairkar, Praveen; Mukerjee, Divya G.; Thara, R.; Behere, Prakash; Chauhan, Nidhi; Thirunavukarasu, M.
Aim: To study the health-care needs of the patients with severe mental disorders as perceived by their family caregivers and the treating psychiatrists. Materials and Methods: Caregivers of patients with severe mental disorders and their treating psychiatrists were assessed using Camberwell Assessment of Need-Research Version (CAN-R) scale and indigenously designed Supplementary Assessment of Needs Scale (SNAS). Results: The study included 1494 patients recruited from 15 centers. The mean nee...
Schatorjé, R.J.W.; Markopoulos, P.; Neustaedter, C.; Harrison, S.; Sellen, A.
This chapter makes the argument that intra-family communication is not an issue of connectivity anytime anywhere, but of providing communication media that are flexible and expressive allowing families to appropriate them and fit their own idiosyncratic ways of communicating with each other. We
... Staying Safe Videos for Educators Search English Español Family Meals KidsHealth / For Parents / Family Meals What's in ... even more important as kids get older. Making Family Meals Happen It can be a big challenge ...
... Spread the Word Shop AAP Find a Pediatrician Family Life Medical Home Family Dynamics Adoption & Foster Care ... Life Listen Español Text Size Email Print Share Family Arguments Page Content Article Body We seem to ...
Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, ... as heart disease, stroke, and cancer. Having a family member with a disease raises your risk, but ...
... Some have two parents, while others have a single parent. Sometimes there is no parent and grandparents raise grandchildren. Some children live in foster families, adoptive families, or in stepfamilies. Families are much ...
... Spread the Word Shop AAP Find a Pediatrician Family Life Medical Home Family Dynamics Adoption & Foster Care ... Life Listen Español Text Size Email Print Share Family Disruptions Page Content Article Body No matter how ...
Gregg, Shea C; Heffernan, Daithi S; Connolly, Michael D; Stephen, Andrew H; Leuckel, Stephanie N; Harrington, David T; Machan, Jason T; Adams, Charles A; Cioffi, William G
Limited data exist on how to develop resident leadership and communication skills during actual trauma resuscitations. An evaluation tool was developed to grade senior resident performance as the team leader during full-trauma-team activations. Thirty actions that demonstrated the Accreditation Council for Graduate Medical Education core competencies were graded on a Likert scale of 1 (poor) to 5 (exceptional). These actions were grouped by their respective core competencies on 5 × 7-inch index cards. In Phase 1, baseline performance scores were obtained. In Phase 2, trauma-focused communication in-services were conducted early in the academic year, and immediate, personalized feedback sessions were performed after resuscitations based on the evaluation tool. In Phase 3, residents received only evaluation-based feedback following resuscitations. In Phase 1 (October 2009 to April 2010), 27 evaluations were performed on 10 residents. In Phase 2 (April 2010 to October 2010), 28 evaluations were performed on nine residents. In Phase 3 (October 2010 to January 2012), 44 evaluations were performed on 13 residents. Total scores improved significantly between Phases 1 and 2 (p = 0.003) and remained elevated throughout Phase 3. When analyzing performance by competency, significant improvement between Phases 1 and 2 (p competencies (patient care, knowledge, system-based practice, practice-based learning) with the exception of "communication and professionalism" (p = 0.56). Statistically similar scores were observed between Phases 2 and 3 in all competencies with the exception of "medical knowledge," which showed ongoing significant improvement (p = 0.003). Directed resident feedback sessions utilizing data from a real-time, competency-based evaluation tool have allowed us to improve our residents' abilities to lead trauma resuscitations over a 30-month period. Given pressures to maximize clinical educational opportunities among work-hour constraints, such a model may help
Bierer, S Beth; Dannefer, Elaine F
The move toward competency-based education will require medical schools and postgraduate training programs to restructure learning environments to motivate trainees to take personal ownership for learning. This qualitative study explores how medical students select and implement study strategies while enrolled in a unique, nontraditional program that emphasizes reflection on performance and competence rather than relying on high-stakes examinations or grades to motivate students to learn and excel. Fourteen first-year medical students volunteered to participate in three, 45-minute interviews (42 overall) scheduled three months apart during 2013-2014. Two medical educators used structured interview guides to solicit students' previous assessment experiences, preferred learning strategies, and performance monitoring processes. Interviews were digitally recorded and transcribed verbatim. Participants confirmed accuracy of transcripts. Researchers independently read transcripts and met regularly to discuss transcripts and judge when themes achieved saturation. Medical students can adopt an assessment for learning mind-set with faculty guidance and implement appropriate study strategies for mastery-learning demands. Though students developed new strategies at different rates during the year, they all eventually identified study and performance monitoring strategies to meet learning needs. Students who had diverse learning experiences in college embraced mastery-based study strategies sooner than peers after recognizing that the learning environment did not reward performance-based strategies. Medical students can take ownership for their learning and implement specific strategies to regulate behavior when learning environments contain building blocks emphasized in self-determination theory. Findings should generalize to educational programs seeking strategies to design learning environments that promote self-regulated learning.
Full Text Available Objetivo: Cuantificar y caracterizar la producción científica sobre los cuidados familiares prestados por las mujeres inmigrantes. Métodos: Búsqueda, en abril de 2008, sin límite de fechas, en las principales bases de datos nacionales e internacionales: Web of Science, Current Contents Connect, ISI Proceedings, MedLine, CINAHL, PsycInfo, EMBASE, IME, ISOC y CUIDEN. Se revisaron los resúmenes y se excluyeron los que no se refirieran al objeto de estudio o no estuvieran en inglés, francés o español. De los incluidos se revisó la bibliografía para detectar otros. Se identificaron y analizaron diversas variables: tipo de artículo, tema principal, país del autor principal y año de publicación. Se realizó un análisis de contenido, utilizando como categorías los temas tratados. Resultados: Se hallaron 191 trabajos y se excluyeron 178. Los 13 analizados tratan sobre diferencias entre cuidado formal e informal (2, factores determinantes (4, necesidad epistemológica (3, beneficios de este tipo de cuidados (5, necesidad de educación para la salud/formación (4, necesidad de apoyo institucional/político (2, inmigración y salud (6, y relación cuidadoras/cuidadas (4. Hay cinco revisiones literarias, seis estudios descriptivos, una investigación cualitativa y una experiencia. Dos fueron publicados antes de 2002, ocho entre 2003 y 2005, y tres entre 2006 y 2008. La mayoría son españoles (9/13. Conclusiones: La escasez de trabajos confirma que la contratación de personas inmigrantes para el cuidado es una realidad nueva e invisible. La mayoría destaca sus beneficios. No hay patrón dominante de temas. Existe una gran diversidad metodológica y los escasos estudios analíticos podrían indicar que es una investigación incipiente. Sería necesario potenciar estudios sobre estos cuidados.Objective: To quantify and characterize the scientific production on the family care provided by immigrant women. Methods: A literature search was
Alderfer, Melissa A
Family management styles (FMSs) explain some of the complexities embedded in a family with a child who has chronic illness. The FMS typologies provide descriptions of family adjustment and management of care. These 5 distinct patterns may be valuable in tailoring and evaluating family interventions in research.
... interpreted the term, because, among the variety of services provided, family offices are in the business of...: Private Wealth Management in the Family Context, Wharton Global Family Alliance (Apr. 1, 2008), available..., management, and employment structures and arrangements employed by family offices.'' \\14\\ We have taken this...
Full Text Available In plants, SNF1-related kinase (SnRK1 responds to the availability of carbohydrates as well as to environmental stresses by down-regulating ATP consuming biosynthetic processes, while stimulating energy-generating catabolic reactions through gene expression and post-transcriptional regulation. The functional SnRK1 complex is a heterotrimer where the catalytic alpha subunit associates with a regulatory beta subunit and an activating gamma subunit. Several different metabolites as well as the hormone abscisic acid (ABA have been shown to modulate SnRK1 activity in a cell- and stimulus-type specific manner. It has been proposed that tissue- or stimulus-specific expression of adapter proteins mediating SnRK1 regulation can at least partly explain the differences observed in SnRK1 signaling. By using yeast two-hybrid and in planta bi-molecular fluorescence complementation assays we were able to demonstrate that proteins containing the domain of unknown function (DUF 581 could interact with both isoforms of the SnRK1 alpha subunit (AKIN10/11 of Arabidopsis. A structure/function analysis suggests that the DUF581 is a generic SnRK1 interaction module and co-expression with DUF581 proteins in plant cells leads to reallocation of the kinase to specific regions within the nucleus. Yeast two-hybrid analyses suggest that SnRK1 and DUF581 proteins can share common interaction partners inside the nucleus. The analysis of available microarray data implies that expression of the 19 members of the DUF581 encoding gene family in Arabidopsis is differentially regulated by hormones and environmental cues, indicating specialized functions of individual family members. We hypothesize that DUF581 proteins could act as mediators conferring tissue- and stimulus-type specific differences in SnRK1 regulation.
Seita, John R.
Family privilege is defined as "strengths and supports gained through primary caring relationships." A generation ago, the typical family included two parents and a bevy of kids living under one roof. Now, every variation of blended caregiving qualifies as family. But over the long arc of human history, a real family was a…
A paradigm shift is underway in the training of professional counselors. It involves a shift in orientation from an input-based or traditional model of training to an outcomes-based or competency-based model of training. This article provides a detailed description of both input-based and outcomes-based training and instructional methods. It…
Knafl, Kathleen A; Deatrick, Janet A; Knafl, George J; Gallo, Agatha M; Grey, Margaret; Dixon, Jane
Understanding patterns of family response to childhood chronic conditions provides a more comprehensive understanding of their influence on family and child functioning. In this paper, we report the results of a cluster analysis based on the six scales comprising the Family Management Measure (FaMM) and the resulting typology of family management. The sample of 575 parents (414 families) of children with diverse chronic conditions fell into four patterns of response (Family Focused, Somewhat Family Focused, Somewhat Condition Focused, Condition Focused) that differed in the extent family life was focused on usual family routines or the demands of condition management. Most (57%) families were in either the Family Focused or Somewhat Family Focused pattern. Patterns of family management were related significantly to family and child functioning, with families in the Family Focused and Somewhat Family Focused patterns demonstrating significantly better family and child functioning than families in the other two patterns. Copyright © 2013. Published by Elsevier Inc.
Harsha V. Patil
additional assessing tool in competency based medical education. We favor introduction of OSPE method of evaluation in our setup as it covers all domains and different aspects.
A Reflection on the Work of an Educational Psychologist in Providing Supervision for a Team of Community Based Support Workers, Supporting Families with Vulnerable Adolescents at Risk of Exclusion from School
The evolving role of the educational psychologist (EP) is discussed with an emphasis on the supervision provided for a team of support workers for vulnerable adolescents, working within a Local Service Team. This development is considered in the context of the Every Child Matters (DfES, 2004) agenda and the Farrell, Woods, Lewis, Rooney, Squire…
W.W. de Herder (Wouter)
textabstractFamilial GH-secreting tumors are seen in association with three separate hereditary clinical syndromes: multiple endocrine neoplasia type 1, Carney complex, and familial isolated pituitary adenomas.