WorldWideScience

Sample records for reflective clinical supervision

  1. Reflecting reflection in supervision

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    associated with reflection and an exploration of alternative conceptions that view reflection within the context of settings which have a more group- and team-based orientation. Drawing on an action research project on health care supervision, the paper questions whether we should reject earlier views...... of reflection, rehabilitate them in order to capture broader connotations or move to new ways of regarding reflection that are more in keeping with not only reflective but also emotive, normative and formative views on supervision. The paper presents a critical perspective on supervision that challenge...... the current reflective paradigm I supervision and relate this to emotive, normative and formative views supervision. The paper is relevant for Nordic educational research into the supervision and guidance...

  2. Psychiatric nursing menbers' reflections on participating in group-based clinical supervision

    DEFF Research Database (Denmark)

    Buus, Niels; Angel, Sanne; Traynor, Michael

    2011-01-01

    This paper is a report of an interview study exploring psychiatric hospital nursing staff members' reflections on participating in supervision. Clinical supervision is a pedagogical process designed to direct, develop, and support clinical nurses. Participation rates in clinical supervision...... they influence participation rates. Twenty-two psychiatric hospital nursing staff members were interviewed with a semistructured interview guide. Interview transcripts were interpreted by means of Ricoeur's hermeneutic method. The respondents understood clinical supervision to be beneficial, but with very...

  3. Clinical supervision reflected in a Danish DPCCQ sample

    DEFF Research Database (Denmark)

    Nielsen, Jan; Jacobsen, Claus Haugaard

    Core Questionnaire (DPCCQ) has only few questions on supervision. To rectify this limitation, a recent Danish version of the DPCCQ included two new sections on supervision, one focusing on supervisees and another on supervisors and their supervisory training. This paper presents our initial findings...... on giving and receiving clinical supervision as reported by therapists in Denmark. Method: Currently, the Danish sample consists of 350 clinical psychologist doing psychotherapy who completed DPCCQ. Data are currently being prepared for statistical analysis. Results: This paper will focus primarily...... on describing the amount and type of supervision received and given by the sample. Findings from these descriptive statistics will be compared within the sample across demographic parameters such as age and sex, and professional characteristics such as career level, theoretical preferences, type of clients...

  4. Reflections on the supervised relationship and interaction in nursing clinical training

    Directory of Open Access Journals (Sweden)

    Inês Alves da Rocha e Silva Rocha

    2013-05-01

    Full Text Available This reflection fits into the area of Clinical Supervision in Nursing focusing on relationships that the student develops during clinical training. It seems that in clinical training the student not only learns but also consolidates verbal, procedural and attitudinal contents. The relationship established with peers, teachers and tutors will contribute to their professional identity. It is underlined the importance of the contribution of clinical supervision for the development of a reflective thinking in students in Portugal, as highlighted here, which influences the changes in nursing practices, as well as ensuring the quality and safety of the care provided. The characteristics that the tutor must have to improve the development of the students are also explained as well as the possible solutions for the existing limitations of clinical training contexts.

  5. Collage work as a medium for guided reflection in the clinical supervision relationship.

    Science.gov (United States)

    Williams, B

    2000-05-01

    This paper identifies the value of one form of art as a means of enhancing communication and developing self expression. The medium of magazine picture collage is described with explanation of its application in the clinical supervision setting where it is used as a trigger for reflective questioning to clarify issues, examine perceptions and facilitate learning from experience. The assembly of magazine pictures as a collage allows metaphorical representation of events and influences through which the supervisee can 'see' their situation from different perspectives. This medium is used as a starting point for discussion in the supervision setting where reflective questioning by the supervisor is framed around the collage images in order to clarify relationships of the issues presented and the personal meanings and values of these to the supervisee. This method is offered as a means of supporting existing systems of supervision not a replacement for these and is perceived to be of particular value in situations where facilitation of expression by means other than dialogue alone is felt to be required in order to move the supervision process forward and enhance personal learning from this.

  6. Broadening the "ports of entry" for speech-language pathologists: a relational and reflective model for clinical supervision.

    Science.gov (United States)

    Geller, Elaine; Foley, Gilbert M

    2009-02-01

    To offer a framework for clinical supervision in speech-language pathology that embeds a mental health perspective within the study of communication sciences and disorders. Key mental health constructs are examined as to how they are applied in traditional versus relational and reflective supervision models. Comparisons between traditional and relational and reflective approaches are outlined, with reference to each mental health construct and the developmental level of the supervisee. Three stages of supervisee development are proposed based on research from various disciplines, including nursing, psychology, speech-language pathology, social work, and education. Each developmental stage is characterized by shifts or changes in the supervisee's underlying assumptions, beliefs, and patterns of behavior. This article makes the case that both the cognitive and affective dimensions of the supervisor-supervisee relationship need to be addressed without minimizing the necessary development of discipline-specific expertise. The developmental stages outlined in this paradigm can be used to understand supervisees' patterns of change and growth over time, as well as to create optimal learning environments that match their developmental level and knowledge base.

  7. Re-thinking reflection in supervision

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    The paper presents a socio-cultural perspective on supervision in professional education, which challenges the current reflective paradigm and move the debate on reflection in supervision in professional education and learning towards a recognition of context, power dynamics and ideological...... of reflective practice has been formalized by regulatory bodies as a way to develop the professionalism of both individual professional practitioners as students through continuing professional developmental processes. Consequently, reflection is often used as a `tool´ for personal and professional development...... al., 2010). This conceptual paper presents a critical, socio-cultural perspective on the current paradigm or dogma of reflective practice within supervision in professional education and learning. The purpose I to challenge the dogma and critically to analyze and move the debate on reflection...

  8. Resistance to group clinical supervision

    DEFF Research Database (Denmark)

    Buus, Niels; Delgado, Cynthia; Traynor, Michael

    2018-01-01

    This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has traditiona......This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has...... traditionally been theorized as a supervisee's maladaptive coping with anxiety in the supervision process. The aim of the present study was to examine resistance to group clinical supervision by interviewing nurses who did not participate in supervision. In 2015, we conducted semistructured interviews with 24...... Danish mental health nursing staff members who had been observed not to participate in supervision in two periods of 3 months. Interviews were audio-recorded and subjected to discourse analysis. We constructed two discursive positions taken by the informants: (i) 'forced non-participation', where...

  9. Clinical Supervision in Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    2011-01-01

    Core Questionnaire (DPCCQ) has only few questions on supervision. To rectify this limitation, a recent Danish version of the DPCCQ included two new sections on supervision, one focusing on supervisees and another on supervisors and their supervisory training. This paper presents our initial findings...

  10. Guidelines for enhancing clinical supervision: research ...

    African Journals Online (AJOL)

    ... toesighouding behels, maar dat hulle nie die noodsaaklikheid om reflektiewe leer toe te pas tydens die proses van kliniese toesighouding aangedui het nie. Keywords: Clinical supervision, Reflective thinking and learning, Support, Guidance (Health SA Gesondheid: interdisciplinary research journal: 2003 8(4): 12-23) ...

  11. Measurement Development in Reflective Supervision: History, Methods, and Next Steps

    Science.gov (United States)

    Tomlin, Angela M.; Heller, Sherryl Scott

    2016-01-01

    This issue of the "ZERO TO THREE" journal provides a snapshot of the current state of measurement of reflective supervision within the infant-family field. In this article, the authors introduce the issue by providing a brief history of the development of reflective supervision in the field of infant mental health, with a specific focus…

  12. Supporting Early Childhood Practitioners through Relationship-Based, Reflective Supervision

    Science.gov (United States)

    Bernstein, Victor J.; Edwards, Renee C.

    2012-01-01

    Reflective supervision is a relationship-based practice that supports the professional development of early childhood practitioners. Reflective supervision helps practitioners cope with the intense feelings and stress that are generated when working with at-risk children and families. It allows them to focus on the purpose and goals of the program…

  13. Developing a manual for strengthening mental health nurses' clinical supervision

    DEFF Research Database (Denmark)

    Buus, Niels; Cassedy, Paul; Gonge, Henrik

    2013-01-01

    In this article, we report findings from a study aimed at developing the content and implementation of a manual for a research-based intervention on clinical supervision of mental health nursing staff. The intervention was designed to strengthen already existing supervision practices through...... educational preparation for supervision and systematic reflection on supervision. The intervention consists of three sessions and was implemented on two groups of mental health hospital staff. We present an outline of the manual and explain how the trial sessions made us adjust the preliminary manual....... The effects of implementing the manual will subsequently be analysed in an independent randomised controlled trial....

  14. Effective use of technology in clinical supervision

    Directory of Open Access Journals (Sweden)

    Priya Martin

    2017-06-01

    Full Text Available Clinical supervision is integral to continuing professional development of health professionals. With advances in technology, clinical supervision too can be undertaken using mediums such as videoconference, email and teleconference. This mode of clinical supervision is termed as telesupervision. While telesupervision could be useful in any context, its value is amplified for health professionals working in rural and remote areas where access to supervisors within the local work environment is often diminished. While telesupervision offers innovative means to undertake clinical supervision, there remain gaps in the literature in terms of its parameters of use in clinical practice. This article outlines ten evidence-informed, practical tips stemming from a review of the literature that will enable health care stakeholders to use technology effectively and efficiently while undertaking clinical supervision. By highlighting the “how to” aspect, telesupervision can be delivered in the right way, to the right health professional, at the right time.

  15. Reflections on Supervision and Culture: What Difference Does Difference Make?

    Science.gov (United States)

    Acker, Sandra

    2011-01-01

    For this commentary, the author went back and read most of her own writings on graduate education. Having only just retired but still working with supervisees and doing research, she reflects on supervision and culture. She has four questions for authors and readers: (1) What is supervision?; (2) What are the implications of "sameness" and…

  16. Providing effective supervision in clinical neuropsychology.

    Science.gov (United States)

    Stucky, Kirk J; Bush, Shane; Donders, Jacobus

    2010-01-01

    A specialty like clinical neuropsychology is shaped by its selection of trainees, educational standards, expected competencies, and the structure of its training programs. The development of individual competency in this specialty is dependent to a considerable degree on the provision of competent supervision to its trainees. In clinical neuropsychology, as in other areas of professional health-service psychology, supervision is the most frequently used method for teaching a variety of skills, including assessment, report writing, differential diagnosis, and treatment. Although much has been written about the provision of quality supervision in clinical and counseling psychology, very little published guidance is available regarding the teaching and provision of supervision in clinical neuropsychology. The primary focus of this article is to provide a framework and guidance for the development of suggested competency standards for training of neuropsychological supervisors, particularly at the residency level. In this paper we outline important components of supervision for neuropsychology trainees and suggest ways in which clinicians can prepare for supervisory roles. Similar to Falender and Shafranske (2004), we propose a competency-based approach to supervision that advocates for a science-informed, formalized, and objective process that clearly delineates the competencies required for good supervisory practice. As much as possible, supervisory competencies are related to foundational and functional competencies in professional psychology, as well as recent legislative initiatives mandating training in supervision. It is our hope that this article will foster further discussion regarding this complex topic, and eventually enhance training in clinical neuropsychology.

  17. "The Fly on the Wall" Reflecting Team Supervision.

    Science.gov (United States)

    Prest, Layne E.; And Others

    1990-01-01

    Adapts reflecting team concept, a practical application of constructivist ideas, for use in group supervision. Evolving model includes a focus on the unique "fly on the wall" perspective of the reflecting team. Trainees are introduced to a multiverse of new ideas and perspectives in a context which integrates some of the most challenging…

  18. How Do I Know That My Supervision Is Reflective? Identifying Factors and Validity of the Reflective Supervision Rating Scale

    Science.gov (United States)

    Gallen, Robert T.; Ash, Jordana; Smith, Conner; Franco, Allison; Willford, Jennifer A.

    2016-01-01

    Reflective supervision and consultation (RS/C) is often defined as a "relationship for learning"(Fenichel, 1992, p.9). As such, measurement tools should include the perspective of each participant in the supervisory relationship when assessing RS/C fidelity, delivery quality, and the supervisee's experience. The Reflective Supervision…

  19. Self-reflection in cognitive behavioural therapy and supervision.

    Science.gov (United States)

    Prasko, Jan; Mozny, Petr; Novotny, Miroslav; Slepecky, Milos; Vyskocilova, Jana

    2012-12-01

    Supervision is a basic part of training and ongoing education in cognitive behavioural therapy. Self-reflection is an important part of supervision. The conscious understanding of one's own emotions, feelings, thoughts, and attitudes at the time of their occurrence, and the ability to continuously follow and recognize them are among the most important abilities of both therapists and supervisors. The objective of this article is to review aspects related to supervision in cognitive behavioural therapy and self-reflection in the literature. This is a narrative review. A literature review was performed using the PubMed, SciVerse Scopus, and Web of Science databases; additional references were found through bibliography reviews of relevant articles published prior to July 2011. The databases were searched for articles containing the following keywords: cognitive behavioural therapy, self-reflection, therapeutic relationship, training, supervision, transference, and countertransference. The review also includes information from monographs referred to by other reviews. We discuss conceptual aspects related to supervision and the role of self-reflection. Self-reflection in therapy is a continuous process which is essential for the establishment of a therapeutic relationship, the professional growth of the therapist, and the ongoing development of therapeutic skills. Recognizing one's own emotions is a basic skill from which other skills necessary for both therapy and emotional self-control stem. Therapists who are skilled in understanding their inner emotions during their encounters with clients are better at making decisions, distinguishing their needs from their clients' needs, understanding transference and countertransference, and considering an optimal response at any time during a session. They know how to handle their feelings so that these correspond with the situation and their response is in the client's best interest. The ability to self-reflect increases the

  20. Supporting Placement Supervision in Clinical Exercise Physiology

    Science.gov (United States)

    Sealey, Rebecca M.; Raymond, Jacqueline; Groeller, Herb; Rooney, Kieron; Crabb, Meagan; Watt, Kerrianne

    2015-01-01

    The continued engagement of the professional workforce as supervisors is critical for the sustainability and growth of work-integrated learning activities in university degrees. This study investigated factors that influence the willingness and ability of clinicians to continue to supervise clinical exercise physiology work-integrated learning…

  1. Exploring Organizational Barriers to Strengthening Clinical Supervision of Psychiatric Nursing Staff

    DEFF Research Database (Denmark)

    Gonge, Henrik; Buus, Niels

    2016-01-01

    This article reports findings from a longitudinal controlled intervention study of 115 psychiatric nursing staff. The twofold objective of the study was: (a) To test whether the intervention could increase clinical supervision participation and effectiveness of existing supervision practices, and...... in the experienced effectiveness of supervision. It is concluded that organizational support is an imperative for implementation of clinical supervision......., and (b) To explore organizational constraints to implementation of these strengthened practices. Questionnaire responses and registration of participation in clinical supervision were registered prior and subsequent to the intervention consisting of an action learning oriented reflection on staff......'s existing clinical supervision practices. Major organizational changes in the intervention group during the study period obstructed the implementation of strengthened clinical supervision practices, but offered an opportunity for studying the influences of organizational constraints. The main findings were...

  2. Informal sources of supervision in clinical training.

    Science.gov (United States)

    Farber, Barry A; Hazanov, Valery

    2014-11-01

    Although formal, assigned supervision is a potent source of learning and guidance for psychotherapy trainees, many beginning psychotherapists use other, informal sources of supervision or consultation for advice and support. Results of an online survey of beginning trainees (N = 146) indicate that other than their formally assigned supervisor, trainees most often consult with colleagues in their program, their own psychotherapist, and their significant other; that they're most likely to seek these other sources of help when they're feeling stuck or feel they've made a clinical mistake; that they do so because they need extra reassurance and suggestions; that they feel the advice given from these sources is helpful; and that they don't especially regret sharing this information. Several case examples are used to illustrate these points. Discussing clinical material with informal sources is, apparently, a great deal more common than typically acknowledged, and as such, has implications for training programs (including discussions of ethics) and formal supervision. © 2014 Wiley Periodicals, Inc.

  3. Clinical Supervision of International Supervisees: Suggestions for Multicultural Supervision

    Science.gov (United States)

    Lee, Ahram

    2018-01-01

    An increase of international students in various settings has been noted in a range of disciplines including counseling and other mental health professions. The author examined the literature on international counseling students related to their experiences in counseling training, particularly in supervision. From the counseling literature, five…

  4. Is it possible to strengthen psychiatric nursing staff's clinical supervision?

    DEFF Research Database (Denmark)

    Gonge, Henrik; Buus, Niels

    2015-01-01

    AIM: To test the effects of a meta-supervision intervention in terms of participation, effectiveness and benefits of clinical supervision of psychiatric nursing staff. BACKGROUND: Clinical supervision is regarded as a central component in developing mental health nursing practices, but the evidence...... an intervention group (n = 40) receiving the meta-supervision in addition to attending usual supervision or to a control group (n = 43) attending usual supervision. METHODS: Self-reported questionnaire measures of clinical supervision effectiveness and benefits were collected at base line in January 2012...... and at follow-up completed in February 2013. In addition, a prospective registration of clinical supervision participation was carried out over 3 months subsequent to the intervention. RESULTS: The main result was that it was possible to motivate staff in the intervention group to participate significantly more...

  5. Supervision for superheroes: the case for reflective professional supervision for senior doctors.

    Science.gov (United States)

    Austin, Helen

    2016-05-06

    The practice of medicine is inherently stressful with regular exposure to trauma and the distress of others. There is a culture in medicine that doctors should not be affected by such things, although it is well recognised that doctors have higher rates of depression, anxiety, suicide, and substance abuse than the general public. Reflective professional supervision is a forum where the complexities of the interpersonal interactions that underpin the provision of healthcare can be explored in a supportive and confidential setting. It is argued that this is a process that should continue for the duration of a doctor's career, with potential benefits including enhanced job satisfaction and resilience, better workplace communication and improved interpersonal skills.

  6. Overcoming difficult conversations in clinical supervision

    Directory of Open Access Journals (Sweden)

    Williams B

    2016-06-01

    Conversations Workshop can improve the clinical supervisor–student relationship as well as build general difficult conversation capacity for a range of stakeholders in clinical settings. Keywords: clinical, education, supervision, communication

  7. Who attends clinical supervision? The uptake of clinical supervision by hospital nurses.

    Science.gov (United States)

    Koivu, Aija; Hyrkäs, Kristiina; Saarinen, Pirjo Irmeli

    2011-01-01

    The aim of the present study was to identify which nurses decide to participate in clinical supervision (CS) when it is provided for all nursing staff. Clinical supervision is available today for health care providers in many organisations. However, regardless of evidence showing the benefits of CS, some providers decide not to participate in the sessions. A baseline survey on work and health issues was conducted in 2003 with a 3-year follow-up of the uptake of CS by the respondents. Background characteristics and perceptions of work and health were compared between medical and surgical nurses who had undertaken CS (n=124) and their peers who decided not to undertake it (n=204). Differences in the perceptions of work and dimensions of burnout were found between the two groups. Nurses attracted to CS form a distinctive group in the unit, standing out as self-confident, committed and competent professionals supported by empowering and fair leadership. Facilitating clinical supervision for committed and innovative nurses may be seen as part of the empowering leadership of the nurse manager. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  8. "Unscrambling what's in your head": A mixed method evaluation of clinical supervision for midwives.

    Science.gov (United States)

    Love, Bev; Sidebotham, Mary; Fenwick, Jennifer; Harvey, Susan; Fairbrother, Greg

    2017-08-01

    As a strategy to promote workforce sustainability a number of midwives working in one health district in New South Wales, Australia were trained to offer a reflective model of clinical supervision. The expectation was that these midwives would then be equipped to facilitate clinical supervision for their colleagues with the organisational aim of supporting professional development and promoting emotional well-being. To identify understanding, uptake, perceptions of impact, and the experiences of midwives accessing clinical supervision. Mixed Methods. In phase one 225 midwives were invited to complete a self-administered survey. Descriptive and inferential statistics were used to analyse the data. In phase two 12 midwives were interviewed. Thematic analysis was used to deepen understanding of midwives' experiences of receiving clinical supervision. Sixty percent of midwives responding in phase one had some experience of clinical supervision. Findings from both phases were complementary with midwives reporting a positive impact on their work, interpersonal skills, situational responses and career goals. Midwives described clinical supervision as a formal, structured and confidential space for 'safe reflection' that was valued as an opportunity for self-care. Barriers included misconceptions, perceived work related pressures and a sense that taking time out was unjustifiable. Education, awareness raising and further research into reflective clinical supervision, to support emotional well-being and professional midwifery practice is needed. In addition, health organisations need to design, implement and evaluate strategies that support the embedding of clinical supervision within midwives' clinical practice. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  9. The reflective meta-dialogue in psycho-dynamic supervision

    DEFF Research Database (Denmark)

    Frølund, Lone; Nielsen, Jan

    2009-01-01

    the therapeutic practice in the supervision. The mutual relations and processes between therapeutic practice and supervision will be illustrated by the so-called mirror axes, which play an important part in the transformation from learning to integrated experience. We will focus on the relationship...

  10. Clinical supervision, is it mutually beneficial

    International Nuclear Information System (INIS)

    Adams, E.J.

    2000-01-01

    Full text: Clinical education in Nuclear Medicine is essential for student learning as it enables them to develop knowledge and competence and put theory into practice. While the benefit to the student is clear, the clinical education experience should be mutually beneficial. The role of the clinical supervisor involves teaching, role modelling, management and assessment. It could be assumed that the Supervisor would find the teaching role leading to increased knowledge; role modelling leading to increased reflection which improves practice; management skills being enhanced and assessment improving critical evaluation skills. The aim of this study was to assess the perceived benefits of taking on the role of a clinical supervisor. Clinical Supervisors participating in the Nuclear Medicine program were surveyed. Questions were grouped into three main categories - professional, interpersonal and communication. A Likert scale was used to assess perceived level of benefit and open-ended questions were included to obtain additional understanding of Supervisors' perceptions. Results from the survey indicate that 64% of supervisors felt an increase in work satisfaction by taking students, 68% agreed their level of performance was improved and 61% agreed that it deepened their understanding of Nuclear Medicine. It is concluded that respondents perceived a positive benefit to areas within the role of Clinical Supervisor. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  11. Implementing a sustainable clinical supervision model for Isles nurses in Orkney.

    Science.gov (United States)

    Hall, Ian

    2018-03-02

    The Isles Network of Care (INOC) community nurses work at the extreme of the remote and rural continuum, working mostly as lone practitioners. Following the development of sustainable clinical supervision model for Isles nurses in Orkney, clinical supervision was found to improve both peer support and governance for this group of isolated staff. A literature overview identified the transition of clinical supervision in general nursing over 24 years from 'carrot' to 'stick'. The study included a questionnaire survey that was sent to the 2017 Queen's Nursing Institute Scotland cohort to elicit information about the nurses' experience of clinical supervision. The survey found that 55% provide supervision and 40% receive it. Health board encouragement of its use was found to be disappointingly low at 40%. The INOC nurses were surveyed about the new peer-support (restorative) model, which relies on video-conference contact to allow face to face interaction between isolated isles nurses. Feedback prompted a review of clinical supervision pairings, and the frequency and methods of meeting. The need for supervisor training led to agreement with the Remote and Rural Health Education Alliance to provide relevant support. The perceived benefits of supervision included increased support and reflection, and improved relationships with isolated colleagues.

  12. Demystifying the reflective clinical journal

    International Nuclear Information System (INIS)

    Milinkovic, Danielle; Field, Nikki

    2005-01-01

    Student learning on clinical placement is a complex issue and cannot be defined solely by just doing things. Reflection during clinical practice is essential if the student is going to learn from the experience. Therefore it is important for educators to include as part of clinical education programs learning strategies that encourage reflection. The reflective clinical journal is an educational tool that is employed by the School of Medical Radiation Sciences at the University of Sydney to encourage reflection of undergraduate radiation therapy students whilst on clinical placement. This discussion paper explores the key concepts of reflection and the reflective clinical journal. Due to the paucity of information about this issue in radiation therapy the literature reviewed is from across all areas of the health sciences

  13. Clinical supervision of nursing students: challenges and alternatives ...

    African Journals Online (AJOL)

    Clinical supervision is described as a formal process of professional learning support in the clinical practice. The goal of clinical practice is to prepare nursing students develop and apply the necessary theoretical and empirical knowledge and skills in order for them to practice as safely and effectively as professional nurses.

  14. Clinical linguistics: conversational reflections.

    Science.gov (United States)

    Crystal, David

    2013-04-01

    This is a report of the main points I made in an informal "conversation" with Paul Fletcher and the audience at the 14th ICPLA conference in Cork. The observations arose randomly, as part of an unstructured 1-h Q&A, so they do not provide a systematic account of the subject, but simply reflect the issues which were raised by the conference participants during that time.

  15. Resistance to group clinical supervision: A semistructured interview study of non-participating mental health nursing staff members.

    Science.gov (United States)

    Buus, Niels; Delgado, Cynthia; Traynor, Michael; Gonge, Henrik

    2018-04-01

    This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has traditionally been theorized as a supervisee's maladaptive coping with anxiety in the supervision process. The aim of the present study was to examine resistance to group clinical supervision by interviewing nurses who did not participate in supervision. In 2015, we conducted semistructured interviews with 24 Danish mental health nursing staff members who had been observed not to participate in supervision in two periods of 3 months. Interviews were audio-recorded and subjected to discourse analysis. We constructed two discursive positions taken by the informants: (i) 'forced non-participation', where an informant was in favour of supervision, but presented practical reasons for not participating; and (ii) 'deliberate rejection', where an informant intentionally chose to not to participate in supervision. Furthermore, we described two typical themes drawn upon by informants in their positioning: 'difficulties related to participating in supervision' and 'limited need for and benefits from supervision'. The findings indicated that group clinical supervision extended a space for group discussion that generated or accentuated anxiety because of already-existing conflicts and a fundamental lack of trust between group members. Many informants perceived group clinical supervision as an unacceptable intrusion, which could indicate a need for developing more acceptable types of post-registration clinical education and reflective practice for this group. © 2017 Australian College of Mental Health Nurses Inc.

  16. Reflective questioning in management education : lessons from supervising thesis projects

    NARCIS (Netherlands)

    Seggelen-Damen, van I.C.M.; Romme, A.G.L.

    2014-01-01

    Reflective questioning is a critical activity in management learning and education. This article describes research on the nature of reflective questioning in groups of management students working on final MSc projects. Drawing on content analysis of recorded meetings, we identify the following key

  17. Supervising away from home: clinical, cultural and professional challenges.

    Science.gov (United States)

    Abramovitch, Henry; Wiener, Jan

    2017-02-01

    This paper explores some challenges of supervising clinical work of trainees, known as 'routers', who live in countries with diverse cultural, social and political traditions, and the analysts who travel to supervise them. It is written as an evolving dialogue between the authors, who explore together the effects of their own culture of origin, and in particular the legacy and values of their own training institutes on the styles and models of analytic supervision. Their dialogue is framed around the meaning of home and experiences of homesickness for analysts working away from home in an interactive field of strangeness in countries where analytical psychology is a relatively new discipline. The authors outline the findings from their own qualitative survey, where other supervisors working abroad, and those they have supervised, describe their experiences and their encounters with difference. The dialogue ends with both authors discussing what they have learned about teaching and supervising abroad, the implications for more flexible use of Jungian concepts, and how such visits have changed their clinical practice in their home countries. © 2017, The Society of Analytical Psychology.

  18. Utilizing Motivational Interviewing to Address Resistant Behaviors in Clinical Supervision

    Science.gov (United States)

    Wahesh, Edward

    2016-01-01

    Motivational interviewing is presented as an approach to address resistant behaviors in clinical supervision. A case example is used to illustrate the process in which the relational and technical elements of motivational interviewing can be applied to supervisee resistance. Implications for supervisors and researchers are discussed.

  19. A systematic review of clinical supervision evaluation studies in nursing.

    Science.gov (United States)

    Cutcliffe, John R; Sloan, Graham; Bashaw, Marie

    2018-02-15

    According to the international, extant literature published during the last 20 years or so, clinical supervision (CS) in nursing is now a reasonably common phenomenon. Nevertheless, what appears to be noticeably 'thin on the ground' in this body of literature are empirical evaluations of CS, especially those pertaining to client outcomes. Accordingly, the authors undertook a systematic review of empirical evaluations of CS in nursing to determine the state of the science. Adopting the approach documented by Stroup et al. (JAMA, 283, 2000, 2008), the authors searched for reports of evaluation studies of CS in nursing - published during the years 1995 to 2015. Keywords for the search were 'clinical supervision', 'evaluation', 'efficacy', 'nursing', and combinations of these keywords. Electronic databases used were CINAHL, MEDLINE, PsychLIT, and the British Nursing Index. The research evidence from twenty-eight (28) studies reviewed is presented, outlining the main findings with an overview of each study presented. The following broad themes were identified and are each discussed in the study: narrative/anecdotal accounts of positive outcomes for clinical supervision, narrative/anecdotal accounts of negative outcomes for clinical supervision, empirical positive outcomes reported by supervisee, and empirical findings showing no effect by supervisee. © 2018 Australian College of Mental Health Nurses Inc.

  20. A National Survey of School Counselor Supervision Practices: Administrative, Clinical, Peer, and Technology Mediated Supervision

    Science.gov (United States)

    Perera-Diltz, Dilani M.; Mason, Kimberly L.

    2012-01-01

    Supervision is vital for personal and professional development of counselors. Practicing school counselors (n = 1557) across the nation were surveyed to explore current supervision practices. Results indicated that 41.1% of school counselors provide supervision. Although 89% receive some type of supervision, only 10.3% of school counselors receive…

  1. Clinical Supervision in Undergraduate Nursing Students: A Review of the Literature

    Science.gov (United States)

    Franklin, Natasha

    2013-01-01

    The concept of clinical supervision to facilitate the clinical education environment in undergraduate nursing students is well discussed within the literature. Despite the many models of clinical supervision described within the literature there is a lack of clear guidance and direction which clinical supervision model best suits the clinical…

  2. Effects of coaching supervision, mentoring supervision and abusive supervision on talent development among trainee doctors in public hospitals: moderating role of clinical learning environment.

    Science.gov (United States)

    Subramaniam, Anusuiya; Silong, Abu Daud; Uli, Jegak; Ismail, Ismi Arif

    2015-08-13

    Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital. A questionnaire-based critical survey was conducted among trainee doctors undergoing housemanship at six public hospitals in the Klang Valley, Malaysia. Prior permission was obtained from the Ministry of Health Malaysia to conduct the research in the identified public hospitals. The survey yielded 355 responses. The results were analysed using SPSS 20.0 and SEM with AMOS 20.0. The findings of this research indicate that coaching and mentoring supervision are positively associated with talent development, and that there is no significant relationship between abusive supervision and talent development. The findings also support the moderating role of clinical learning environment on the relationships between coaching supervision-talent development, mentoring supervision-talent development and abusive supervision-talent development among public hospital trainee doctors. Overall, the proposed model indicates a 26 % variance in talent development. This study provides an improved understanding on the role of the supervisory styles (coaching and mentoring supervision) on facilitating talent development among public hospital trainee doctors. Furthermore, this study extends the literature to better

  3. Using Skype to support remote clinical supervision for health professionals delivering a sustained maternal early childhood programme: a phenomenographical study.

    Science.gov (United States)

    Bruce, Tracey; Byrne, Fiona; Kemp, Lynn

    2018-02-01

    Skype technology was implemented by the Australian Maternal Early Childhood Sustained Home-visiting (MECSH) Support Service as a tool for the remote provision of clinical supervision for clinicians working in the MECSH program in Seoul, South Korea. To gain a better understanding of the processes underpinning sustainable delivery of remote clinical supervision using digital technologies. A phenomenographical study. Recorded notes and reflections on each supervision session, noting exemplars and characteristics of the experience were read and re-read to derive the characterizations of the experience. The experience has provided learnings in three domains: (1) the processes in using Skype; (2) supervisory processes; and (3) language translation, including managing clarity of, and time for translation. Skype has potential for use in remote provision of clinical supervision, including where translation is required. Further research evaluating the benefit of telesupervision from supervisor and supervisee perspectives is necessary to determine if it is a sustainable process.

  4. The importance, impact and influence of group clinical supervision for graduate entry nursing students.

    Science.gov (United States)

    Sheppard, Fiona; Stacey, Gemma; Aubeeluck, Aimee

    2018-01-01

    This paper will report on an evaluation of group clinical supervision (CS) facilitated for graduate entry nursing (GEN) students whilst on clinical placement. The literature suggests educational forums which enable GEN students to engage in critical dialogue, promote reflective practice and ongoing support are an essential element of GEN curricula. The model of supervision employed was informed by Proctor's three function interactive CS model and Inskipp and Proctor's Supervision Alliance. Both emphasise the normative, formative and restorative functions of CS as task areas within an overarching humanistic supervisory approach. The three-function model informed the design of a questionnaire which intended to measure their importance, impact and influence through both structured and open-ended questions. Findings suggest the restorative function of supervision is most valued and is facilitated in an environment where humanistic principles of non-judgement, empathy and trust are clearly present. Also the opportunity to learn from others, consider alternative perspectives and question personal assumptions regarding capability and confidence are a priority for this student group. It is suggested that the restorative function of CS should be prioritised within future developments and models which view this function as a key purpose of CS should be explored. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review.

    Science.gov (United States)

    Alfonsson, Sven; Parling, Thomas; Spännargård, Åsa; Andersson, Gerhard; Lundgren, Tobias

    2018-05-01

    Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists' competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists' competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists' competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.

  6. The development of peer reflective supervision amongst nurse educator colleagues: An action research project.

    Science.gov (United States)

    Bulman, C; Forde-Johnson, C; Griffiths, A; Hallworth, S; Kerry, A; Khan, S; Mills, K; Sharp, P

    2016-10-01

    This action research study developed the use of peer reflective supervision (PRS) amongst eight nurse educators contributing to an undergraduate Adult Nursing programme at a UK University. During the academic year (2013-14), nurse educator co-researchers met for an introductory workshop and then met regularly in pairs to facilitate each other's reflection. This provided an opportunity for nurse educators to reflect on identified issues linked to their role with a facilitative peer. Educators met three additional times in a Reflexive Learning Group (RLG), to gather data on their use of PRS. Audio-recordings from the RLGs were transcribed and analysed using Norton's (2009) thematic analysis framework. Co-researchers iteratively validated the data and an external validation group critically viewed the evidence. Overall, seven themes were generated from the three research cycles. These were: PRS as a Valuable Affirming Experience; Time Issues; Facilitation- Support, Trust and Challenge; Developing a Flexible 'Toolbox'; To Write or Not to Write; Drawing on Literature; and Requirement for Action. Findings add new evidence regarding use of a flexible toolbox of resources to develop reflection and offer practical guidance on the development of PRS. Nurse educators often experienced similar concerns, and a facilitative supervision structure allowed co-researchers to positively explore these. Recognition of work pressures and requirement for time and space for reflection was highlighted, particularly regarding writing, and exploring the literature, to develop critical analysis of experiences. The importance of action as part of the reflective process was emphasised. Co-researchers reported positive personal change as well as the opportunity to highlight issues through their reflection for further action within the organisation. The study adds constructive evidence for the use of reflection to explore professional work, make sense of experiences and develop positive action

  7. Effectiveness of clinical supervision of physiotherapists: a survey.

    Science.gov (United States)

    Snowdon, David A; Millard, Geraldine; Taylor, Nicholas F

    2015-04-01

    Limited literature exists on the practice of clinical supervision (CS) of professional physiotherapists despite current Australian safety and quality health standards stating that CS is to be provided to all physiotherapists. The aim of the present study was to evaluate the effectiveness of CS of physiotherapists working in an Australian public health service. CS was measured using the allied health-specific 26-item modified Manchester Clinical Supervision Scale (MCSS-26). Subscales of the MCSS-26 were summed for three domain scores (normative, restorative and formative) and a total score was calculated, which was compared with the reported threshold score of 73 for effective supervision. Sixty registered physiotherapists (response rate 92%), working for a large metropolitan public health service, with six different site locations, completed the survey. The mean (± s.d.) total MCSS-26 score was 71.0 ± 14.3 (95% confidence interval (CI) 67.4-74.6). Hospital site was the only variable that had a significant effect on total MCSS-26 score (P=0.005); there was no effect for supervisor or supervisee experience, or hospital setting (acute vs subacute). Physiotherapists scored a significantly lower mean percentage MCSS-26 score on the normative domain compared with the restorative domain (mean difference 7.8%; 95% CI 2.9-12.7; P=0.002) and the formative domain (mean difference 9.6%; 95% CI 6.3-13.0; P<0.001). Of the two subscales that form the normative domain, 'finding time' had a significantly lower mean percentage MCSS-26 score than 'importance/value of CS' (mean difference 35.4%; 95% CI 31.3-39.4; P<0.001). Within this publicly funded physiotherapy department there was uncertainty about the effectiveness of CS, with more than half the physiotherapists rating their supervision as less than effective, suggesting there is opportunity for improvement in the practice of physiotherapy CS. Physiotherapists scored lowest in the normative domain, indicating that they found it

  8. Digital communication to support clinical supervision: considering the human factors.

    Science.gov (United States)

    Mather, Carey; Marlow, Annette; Cummings, Elizabeth

    2013-01-01

    During the last three years the School of Nursing and Midwifery at the University of Tasmania has used a needs assessment survey to explore the needs of organizations and nursing professionals that facilitate and clinically supervise Bachelor of Nursing students in the workplace. Findings from the survey indicated that staff at healthcare organizations wanted a communication strategy that was easily accessible by clinicians who supervised students during work integrated learning placements. In particular they wanted to receive timely information related to the role and function of supervisors in practice. The development of the digital strategy to strengthen the development of a community of practice between the University, organizations, facilities and clinical supervisors was identified as the key method of improving communication. Blogging and micro blogging were selected as methods of choice for the implementation of the digital strategy because they were easy to set up, use and enable equity of access to geographically dispersed practitioners in urban and rural areas. Change champions were identified to disseminate information about the strategy within their workplaces. Although clinicians indicated electronic communication as their preferred method, there were a number of human factors at a systems and individual level identified to be challenges when communicating with clinical supervisors who were based off-campus. Information communication technology policies and embedded culture towards social presence were impediments to using this approach in some organizations. Additionally, it was found that it is necessary for this group of clinicians to be educated about using digital methods to undertake their role as clinical supervisors in their varied clinical practice environments.

  9. Reflections in the clinical practice.

    Science.gov (United States)

    Borrell-Carrió, F; Hernández-Clemente, J C

    2014-03-01

    The purpose of this article is to analyze some models of expert decision and their impact on the clinical practice. We have analyzed decision-making considering the cognitive aspects (explanatory models, perceptual skills, analysis of the variability of a phenomenon, creating habits and inertia of reasoning and declarative models based on criteria). We have added the importance of emotions in decision making within highly complex situations, such as those occurring within the clinical practice. The quality of the reflective act depends, among other factors, on the ability of metacognition (thinking about what we think). Finally, we propose an educational strategy based on having a task supervisor and rectification scenarios to improve the quality of medical decision making. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  10. How medical residents perceive the quality of supervision provided by attending doctors in the clinical setting

    NARCIS (Netherlands)

    Busari, Jamiu O.; Weggelaar, Nielske M.; Knottnerus, Andrieke C.; Greidanus, Petra-Marie; Scherpbier, Albert J. J. A.

    2005-01-01

    The supervision of medical residents is a key responsibility of attending doctors in the clinical setting. Most attending doctors, however, are unfamiliar with the principles of effective supervision. Although inconsistent, supervision has been shown to be both important and effective for the

  11. Heading off boundary problems: clinical supervision as risk management.

    Science.gov (United States)

    Walker, R; Clark, J J

    1999-11-01

    The effective management of risk in clinical practice includes steps to limit harm to clients resulting from ethical violations or professional misconduct. Boundary problems constitute some of the most damaging ethical violations. The authors propose an active use of clinical supervision to anticipate and head off possible ethical violations by intervening when signs of boundary problems appear. The authors encourage a facilitative, Socratic method, rather than directive approaches, to help supervisees maximize their learning about ethical complexities. Building on the idea of a slippery slope, in which seemingly insignificant acts can lead to unethical patterns of behavior, the authors discuss ten cues to potential boundary problems, including strong feelings about a client; extended sessions with clients; gift giving between clinician and client; loans, barter, and sale of goods; clinician self-disclosures; and touching and sex. The authors outline supervisory interventions to be made when the cues are detected.

  12. Model for investigating the benefits of clinical supervision in psychiatric nursing

    DEFF Research Database (Denmark)

    Gonge, Henrik; Buus, Niels

    2011-01-01

    with the effectiveness of clinical supervision, as measured by the Manchester Clinical Supervision Scale (MCSS). Furthermore, MCSS scores were associated with benefits, such as increased job satisfaction, vitality, rational coping and less stress, emotional exhaustion, and depersonalization. Multivariate analyses......The objective of this study was to test a model for analysing the possible benefits of clinical supervision. The model suggested a pathway from participation to effectiveness to benefits of clinical supervision, and included possible influences of individual and workplace factors. The study sample...

  13. Nurse supervisors' actions in relation to their decision-making style and ethical approach to clinical supervision.

    Science.gov (United States)

    Berggren, Ingela; Severinsson, Elisabeth

    2003-03-01

    The aim of the study was to explore the decision-making style and ethical approach of nurse supervisors by focusing on their priorities and interventions in the supervision process. Clinical supervision promotes ethical awareness and behaviour in the nursing profession. A focus group comprised of four clinical nurse supervisors with considerable experience was studied using qualitative hermeneutic content analysis. The essence of the nurse supervisors' decision-making style is deliberations and priorities. The nurse supervisors' willingness, preparedness, knowledge and awareness constitute and form their way of creating a relationship. The nurse supervisors' ethical approach focused on patient situations and ethical principles. The core components of nursing supervision interventions, as demonstrated in supervision sessions, are: guilt, reconciliation, integrity, responsibility, conscience and challenge. The nurse supervisors' interventions involved sharing knowledge and values with the supervisees and recognizing them as nurses and human beings. Nurse supervisors frequently reflected upon the ethical principle of autonomy and the concept and substance of integrity. The nurse supervisors used an ethical approach that focused on caring situations in order to enhance the provision of patient care. They acted as role models, shared nursing knowledge and ethical codes, and focused on patient related situations. This type of decision-making can strengthen the supervisees' professional identity. The clinical nurse supervisors in the study were experienced and used evaluation decisions as their form of clinical decision-making activity. The findings underline the need for further research and greater knowledge in order to improve the understanding of the ethical approach to supervision.

  14. What influences palliative care nurses in their choice to engage in or decline clinical supervision?

    Science.gov (United States)

    Puffett, Nick; Perkins, Paul

    2017-11-02

    Clinical supervision (CS) has been around since the early 1990s in the UK and has been endorsed by government and professional bodies. Levels of engagement range from 18% to 85%. To investigate what influences palliative care nurses in their choice to engage in or decline clinical supervision. A qualitative study was undertaken in an inpatient hospice in England and employed two focus groups to compare the views of participants and non-participants in CS. Data were audio recorded and transcribed verbatim by the researchers and analysed using systematic text condensation. Palliative care nurses all used informal team support for 'in the moment' support. Some engaged in formal CS to reflect 'on action' and to challenge practice. Nurses reported a lack of clarity regarding CS but, once this was overcome and engagement with CS was established, it led to changes in practice, identification of training needs and team building. The option of choice between group and individual supervision was found to be important. Group supervision led to enhanced understanding of group members which also led to team building, individual sessions were useful for individual issues. Protected time was essential for staff to be able to engage in CS. Staff who worked in larger teams reported higher levels of engagement, whereas a small team reported less need due to more informal team support. These findings are positive as they illuminate the importance of choice for support. Nurses need to be aware of their options for support and ultimately how this support affects the care they provide. The Palliative Care Nurse's Model of Support was developed, which shows the effects of each choice and how this may lead to team-building.

  15. Competencies to enable learning-focused clinical supervision: a thematic analysis of the literature.

    Science.gov (United States)

    Pront, Leeanne; Gillham, David; Schuwirth, Lambert W T

    2016-04-01

    Clinical supervision is essential for development of health professional students and widely recognised as a significant factor influencing student learning. Although considered important, delivery is often founded on personal experience or a series of predetermined steps that offer standardised behavioural approaches. Such a view may limit the capacity to promote individualised student learning in complex clinical environments. The objective of this review was to develop a comprehensive understanding of what is considered 'good' clinical supervision, within health student education. The literature provides many perspectives, so collation and interpretation were needed to aid development and understanding for all clinicians required to perform clinical supervision within their daily practice. A comprehensive thematic literature review was carried out, which included a variety of health disciplines and geographical environments. Literature addressing 'good' clinical supervision consists primarily of descriptive qualitative research comprising mostly small studies that repeated descriptions of student and supervisor opinions of 'good' supervision. Synthesis and thematic analysis of the literature resulted in four 'competency' domains perceived to inform delivery of learning-focused or 'good' clinical supervision. Domains understood to promote student learning are co-dependent and include 'to partner', 'to nurture', 'to engage' and 'to facilitate meaning'. Clinical supervision is a complex phenomenon and establishing a comprehensive understanding across health disciplines can influence the future health workforce. The learning-focused clinical supervision domains presented here provide an alternative perspective of clinical supervision of health students. This paper is the first step in establishing a more comprehensive understanding of learning-focused clinical supervision, which may lead to development of competencies for clinical supervision. © 2016 John Wiley

  16. Healthcare students' evaluation of the clinical learning environment and supervision - a cross-sectional study.

    Science.gov (United States)

    Pitkänen, Salla; Kääriäinen, Maria; Oikarainen, Ashlee; Tuomikoski, Anna-Maria; Elo, Satu; Ruotsalainen, Heidi; Saarikoski, Mikko; Kärsämänoja, Taina; Mikkonen, Kristina

    2018-03-01

    The purpose of clinical placements and supervision is to promote the development of healthcare students´ professional skills. High-quality clinical learning environments and supervision were shown to have significant influence on healthcare students´ professional development. This study aimed to describe healthcare students` evaluation of the clinical learning environment and supervision, and to identify the factors that affect these. The study was performed as a cross-sectional study. The data (n = 1973) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale during the academic year 2015-2016 from all healthcare students (N = 2500) who completed their clinical placement at a certain university hospital in Finland. The data were analysed using descriptive statistics and binary logistic regression analysis. More than half of the healthcare students had a named supervisor and supervision was completed as planned. The students evaluated the clinical learning environment and supervision as 'good'. The students´ readiness to recommend the unit to other students and the frequency of separate private unscheduled sessions with the supervisor were the main factors that affect healthcare students` evaluation of the clinical learning environment and supervision. Individualized and goal-oriented supervision in which the student had a named supervisor and where supervision was completed as planned in a positive environment that supported learning had a significant impact on student's learning. The clinical learning environment and supervision support the development of future healthcare professionals' clinical competence. The supervisory relationship was shown to have a significant effect on the outcomes of students' experiences. We recommend the planning of educational programmes for supervisors of healthcare students for the enhancement of supervisors' pedagogical competencies in supervising students in

  17. Nursing leadership from the perspective of clinical group supervision: a paradoxical practice.

    Science.gov (United States)

    Bondas, Terese

    2010-05-01

    Increase understanding of nursing leadership in group clinical supervision (CS). Leadership in CS has received little interest besides the theories in use and administrative CS. Hermeneutic interpretation of written narratives of 24 clinical nurse supervisors. Continuity in structuring, story and mission and reflection in group and leadership processes and theories of nursing and caring characterize leadership in CS. Leadership by inhibiting and creating fear, inapproachability and indistinctiveness were patterns in content brought to CS. Supervision when leadership was involved illuminated a reflexive change in focus from leadership to nursing care, from particular experiences to nursing and caring science, and from the unfamiliar to the well known and the well known to the unknown. Continuity and reflective changes using nursing and caring theories seem to be core ideas of nursing leadership from the perspective of CS. The poles of separation and communion show opposites of nursing leadership as it is illuminated in CS. The findings add knowledge to Bondas' theory of caritative leadership. CS is a reflexive practice of support and guidance that seems to have an impact on the trajectory of nursing care and staff development using nursing and caring theories.

  18. The Views of Educational Supervisors on Clinical Supervision

    Science.gov (United States)

    Kayikçi, Kemal; Yilmaz, Ozan; Sahin, Ahmet

    2017-01-01

    Contemporary educational supervision expresses democratic and leadership focused supervisory approach which consists of collaboration, trust, sharing and improving. The aims of the study are to investigate the answer of how current teacher supervision in Turkey is conducted according to the views of educational supervisors, and to unearth what the…

  19. Clinical Supervision of Substance Abuse Counselors: Current and Preferred Practices.

    Science.gov (United States)

    Culbreth, John R.

    1999-01-01

    Reports on a national survey of substance abuse counselors (N=134) to learn their current and preferred supervision practices. Results suggests that substance abuse counselor are receiving supervision similar to other counselors. No preference was indicated for the sex of the supervisor, nor for the 12-step recovery experience. Counselors did…

  20. Distance Supervision in Rehabilitation Counseling: Ethical and Clinical Considerations

    Science.gov (United States)

    Lund, Emily M.; Schultz, Jared C.

    2015-01-01

    Background: The use of technology-mediated distance supervision is a rapidly growing area in rehabilitation counseling and other fields. Distance supervision has both tremendous potential and notable challenges to address, including questions of ethics and evidence. Purpose: This article examines both the ethical and nonethical principles that…

  1. Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods.

    Science.gov (United States)

    Powell, David J.

    A case is made for professionalism in clinical training as substance abuse counseling becomes a unique field. Part 1, "Principles," includes: (1) "A Historical Review of Supervision"; (2) "A Working Definition of Supervision"; (3) "Leadership Principles for Supervisors" and; (4) "Traits of an Effective Clinical Supervisor." Part 2, "Models,"…

  2. The experience of clinical supervision for nurses and healthcare assistants in a secure adolescent service: Affecting service improvement.

    Science.gov (United States)

    McCarron, R H; Eade, J; Delmage, E

    2018-04-01

    WHAT IS KNOWN ON THE SUBJECT?: Regular and effective clinical supervision for mental health nurses and healthcare assistants (HCAs) is an important tool in helping to reduce stress and burnout, and in ensuring safe, effective and high-quality mental health care. Previous studies of clinical supervision within secure mental health environments have found both a low availability of clinical supervision, and a low level of staff acceptance of its value, particularly for HCAs. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: In previous studies, the understanding shown by HCAs and nurses around the benefits of clinical supervision may have been limited by the methods used. This study was specifically designed to help them best express their views. In contrast to previous studies, both nurses and HCAs showed a good understanding of the function and value of clinical supervision. Significant improvements in the experience of, and access to, clinical supervision for nurses and HCAs working in secure mental health services may be achieved by raising staff awareness, demonstrating organizational support and increasing monitoring of clinical supervision. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Organizations should consider reviewing their approach to supervision to include raising staff awareness, multidisciplinary supervision, group supervision, and recording and tracking of supervision rates. Organizations should be mindful of the need to provide effective clinical supervision to HCAs as well as nurses. Introduction Studies have found a low availability and appreciation of clinical supervision, especially for healthcare assistants (HCAs). Qualitative research is needed to further understand this. Aims Increase understanding of nurses' and HCAs' experiences of, and access to, clinical supervision. Identify nurses' and HCAs' perceptions of the value and function of clinical supervision. Assess how interventions affect staff's experiences of clinical supervision. Methods In

  3. "They put you on your toes": Physical Therapists' Perceived Benefits from and Barriers to Supervising Students in the Clinical Setting.

    Science.gov (United States)

    Davies, Robyn; Hanna, Elizabeth; Cott, Cheryl

    2011-01-01

    To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students. In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach. Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision. Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff.

  4. The Learning Process of Supervisees Who Engage in the Reflecting Team Model within Group Supervision: A Grounded Theory Inquiry

    Science.gov (United States)

    Pender, Rebecca Lynn

    2012-01-01

    In recent years, counselor educators have begun to incorporate the use of the reflecting team process with the training of counselors. Specifically, the reflecting team has been used in didactic courses (Cox, 2003; Landis & Young, 1994; Harrawood, Wilde & Parmanand, 2011) and in supervision (Cox, 1997; Prest, Darden, & Keller, 1990;…

  5. Essential processes for cognitive behavioral clinical supervision: Agenda setting, problem-solving, and formative feedback.

    Science.gov (United States)

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

    2015-06-01

    Clinical supervision should be a proactive and considered endeavor, not a reactive one. To that end, supervisors should choose supervision processes that are driven by theory, best available research, and clinical experience. These processes should be aimed at helping trainees develop as clinicians. We highlight 3 supervision processes we believe should be used at each supervision meeting: agenda setting, encouraging trainee problem-solving, and formative feedback. Although these are primarily cognitive-behavioral skills, they can be helpful in combination with other supervision models. We provide example dialogue from supervision exchanges, and discuss theoretical and research support for these processes. Using these processes not only encourages trainee development but also models for them how to use the same processes and approaches with clients. (c) 2015 APA, all rights reserved).

  6. [Analysis of interventions designed to improve clinical supervision of student nurses in Benin].

    Science.gov (United States)

    Otti, André; Pirson, Magali; Piette, Danielle; Coppieters T Wallant, Yves

    2017-12-05

    The absence of an explicit and coherent conception of the articulation between theory and practice in the reform of nursing training in Benin has resulted in poor quality clinical supervision of student nurses. The objective of this article is to analyze two interventions designed to improve the quality of supervision. A student welcome booklet developed by means of a consultative and provocative participatory approach was tested with twelve student nurses versus a control group. Content analysis of the data collected by individual semi-directed interviews and during two focus groups demonstrated the value of this tool. Student nurses were also taught to use to training diaries inspired by the ?experiential learning? Training diaries were analysed using a grid based on the descriptive elements of the five types of Scheepers training diaries (2008). According to the student nurses, the welcome booklet provided them with structured information to be used as a reference during their training and a better understanding of their teachers, and allowed them to situate the resources of the training course with a lower level of stress. Fifty-eight per cent of the training diaries were are mosaics, reflecting the reflective practice and self-regulated learning of student nurses. This activity also promoted metacognitive dialogue with their supervisors. The student welcome booklet appeared to facilitate integration of student nurses into the clinical setting and promoted professional and organizational socialization. The training diary improved the quality of clinical learning by repeated reflective observation of student nurses and helped to maintain permanent communication with the supervisors.

  7. Evaluation of psychology practitioner competence in clinical supervision.

    Science.gov (United States)

    Gonsalvez, Craig J; Crowe, Trevor P

    2014-01-01

    There is a growing consensus favouring the development, advancement, and implementation of a competency-based approach for psychology training and supervision. There is wide recognition that skills, attitude-values, and relationship competencies are as critical to a psychologist's competence as are knowledge capabilities, and that these key competencies are best measured during placements, leaving the clinical supervisor in an unparalleled position of advantage to provide formative and summative evaluations on the supervisee's progression towards competence. Paradoxically, a compelling body of literature from across disciplines indicates that supervisor ratings of broad domains of competence are systematically compromised by biases, including leniency error and halo effect. The current paper highlights key issues affecting summative competency evaluations by supervisors: what competencies should be evaluated, who should conduct the evaluation, how (tools) and when evaluations should be conducted, and process variables that affect evaluation. The article concludes by providing research recommendations to underpin and promote future progress and by offering practice recommendations to facilitate a more credible and meaningful evaluation of competence and competencies.

  8. Clinical Supervision of Mental Health Professionals Serving Youth: Format and Microskills.

    Science.gov (United States)

    Bailin, Abby; Bearman, Sarah Kate; Sale, Rafaella

    2018-03-21

    Clinical supervision is an element of quality assurance in routine mental health care settings serving children; however, there is limited scientific evaluation of its components. This study examines the format and microskills of routine supervision. Supervisors (n = 13) and supervisees (n = 20) reported on 100 supervision sessions, and trained coders completed observational coding on a subset of recorded sessions (n = 57). Results indicate that microskills shown to enhance supervisee competency in effectiveness trials and experiments were largely absent from routine supervision, highlighting potential missed opportunities to impart knowledge to therapists. Findings suggest areas for quality improvement within routine care settings.

  9. A cross-cultural comparison of clinical supervision in South Korea and the United States.

    Science.gov (United States)

    Son, Eunjung; Ellis, Michael V

    2013-06-01

    We investigated similarities and differences in clinical supervision in two cultures: South Korea and the United States The study had two parts: (1) a test of the cross-cultural equivalence of four supervision measures; and (2) a test of two competing models of cultural differences in the relations among supervisory style, role difficulties, supervisory working alliance, and satisfaction with supervision. Participants were 191 South Korean and 187 U.S. supervisees currently engaged in clinical supervision. The U.S. measures demonstrated sufficient measurement equivalence for use in South Korea. Cultural differences moderated the relations among supervisory styles, role difficulties, supervisory working alliance, and supervision satisfaction. Specifically, the relations among these variables were significantly stronger for U.S. than for South Korean supervisees. Implications for theory, research, and practice were discussed.

  10. Learning outcomes using video in supervision and peer feedback during clinical skills training

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein; Toftgård, Rie Castella; Nørgaard, Cita

    supervision of clinical skills (formative assessment). Demonstrations of these principles will be presented as video podcasts during the session. The learning outcomes of video supervision and peer-feedback were assessed in an online questionnaire survey. Results Results of the supervision showed large self......Objective New technology and learning principles were introduced in a clinical skills training laboratory (iLab). The intension was to move from apprenticeship to active learning principles including peer feedback and supervision using video. The objective of this study was to evaluate student...... learning outcomes in a manual skills training subject using video during feedback and supervision. Methods The iLab classroom was designed to fit four principles of teaching using video. Two of these principles were (a) group work using peer-feedback on videos produced by the students and, (b) video...

  11. Working with Conflict in Clinical Supervision: Wise Supervisors' Perspectives

    Science.gov (United States)

    Nelson, Mary Lee; Barnes, Kristin L.; Evans, Amelia L.; Triggiano, Patrick J.

    2008-01-01

    Eight female and 4 male supervisors identified by professional peers as highly competent were interviewed about experiences of conflict in supervision and their dependable strategies for managing it. Highly competent supervisors were open to conflict and interpersonal processing, willing to acknowledge shortcomings, developmentally oriented, and…

  12. Psychiatric hospital nursing staff's experiences of participating in group-based clinical supervision:

    DEFF Research Database (Denmark)

    Buus, Niels; Angel, Sanne; Traynor, Michael

    2010-01-01

    Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....

  13. Transfer of communication skills training from workshop to workplace: the impact of clinical supervision.

    Science.gov (United States)

    Heaven, Cathy; Clegg, Jenny; Maguire, Peter

    2006-03-01

    Recent studies have recognised that the communication skills learned in the training environment are not always transferred back into the clinical setting. This paper reports a study which investigated the potential of clinical supervision in enhancing the transfer process. A randomised controlled trial was conducted involving 61 clinical nurse specialists. All attended a 3-day communication skills training workshop. Twenty-nine were then randomised to 4 weeks of clinical supervision, aimed at facilitating transfer of newly acquired skills into practice. Assessments, using real and simulated patients, were carried out before the course, immediately after the supervision period and 3 months later. Interviews were rated objectively using the Medical Interview Aural Rating Scale (MIARS) to assess nurses' ability to use key skills, respond to patient cues and identify patient concerns. Assessments with simulated patients showed that the training programme was extremely effective in changing competence in all three key areas. However, only those who experienced supervision showed any evidence of transfer. Improvements were found in the supervised groups' use of open questions, negotiation and psychological exploration. Whilst neither group facilitated more disclosure of cues or concerns, those in the experimental group responded more effectively to the cues disclosed, reduced their distancing behaviour and increasing their exploration of cues. The study has shown that whilst training enhances skills, without intervention, it may have little effect on clinical practice. The potential role of clinical supervision as one way of enhancing the clinical effectiveness of communication skills training programmes has been demonstrated. PRACTISE IMPLICATIONS: This study raises questions about the effectiveness of training programmes which do not incorporate a transfer element, and provides evidence to support the need for clinical supervision for clinical nurse specialist.

  14. Baccalaureate nursing students' perceptions of learning and supervision in the clinical environment.

    Science.gov (United States)

    Dimitriadou, Maria; Papastavrou, Evridiki; Efstathiou, Georgios; Theodorou, Mamas

    2015-06-01

    This study is an exploration of nursing students' experiences within the clinical learning environment (CLE) and supervision provided in hospital settings. A total of 357 second-year nurse students from all universities in Cyprus participated in the study. Data were collected using the Clinical Learning Environment, Supervision and Nurse Teacher instrument. The dimension "supervisory relationship (mentor)", as well as the frequency of individualized supervision meetings, were found to be important variables in the students' clinical learning. However, no statistically-significant connection was established between successful mentor relationship and team supervision. The majority of students valued their mentor's supervision more highly than a nurse teacher's supervision toward the fulfillment of learning outcomes. The dimensions "premises of nursing care" and "premises of learning" were highly correlated, indicating that a key component of a quality clinical learning environment is the quality of care delivered. The results suggest the need to modify educational strategies that foster desirable learning for students in response to workplace demands. © 2014 Wiley Publishing Asia Pty Ltd.

  15. Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care.

    Science.gov (United States)

    Hyrkäs, Kristiina; Appelqvist-Schmidlechner, Kaija; Haataja, Riina

    2006-08-01

    This paper reports a study to determine how supervisees' backgrounds and surrounding infrastructure predict the efficacy of clinical supervision among Finnish nursing staff, their job satisfaction, levels of burnout and perceptions of the quality of care. Several studies have described the effects of clinical supervision, but few have focused on evaluating it. Until recently, no studies have examined how clinical supervision evaluations are related to supervisees' backgrounds, surrounding infrastructure or respondents' levels of burnout, job satisfaction and perceptions of the quality of care. The survey involved supervisees completing a range of standardized and validated evaluation measures. The respondents were identified from 12 regional, central and university hospitals across Finland (n = 799). The data collection took place from October 2000 to February 2001. The evaluations varied statistically significantly and were associated with statistically significant variations in the respondents' backgrounds. Clinical supervision infrastructure was also strongly related to evaluation scores. Supervisees' age, education, gender, employment status, area of specialty, working hours, work experience and experience as a supervisor were statistically significant predictors for evaluations of the efficacy of clinical supervision. These evaluations of clinical supervision were also found to predict the respondents' job satisfaction, levels of burnout and assessments of good nursing. Nursing staff, especially those who have over 10 years' work experience, work in general care, have a nursing diploma, are non-tenured, work part-time and work 24-hour rotating shifts can benefit from clinical supervision. However, resources need to be invested in supervisor education and nursing staff need to be encouraged to start working in both supervisor and supervisee roles because of the positive effects on job satisfaction and quality of care.

  16. Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review.

    Science.gov (United States)

    Snowdon, David A; Leggat, Sandra G; Taylor, Nicholas F

    2017-11-28

    To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience. Seventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience. Clinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health

  17. Competition and safety as reflected in the legislation concerning technical supervision - are they incompatible

    International Nuclear Information System (INIS)

    Roth, H.A.

    1986-01-01

    The author discusses the conflicts between competition and safety in the legislation on technical supervision, the requirements on specific sectors, and the consequences of the concentration of the functions of technical supervision in the hands of the Technical Supervisory Board (TUEV). The demand to give more room for competition is found to have no legal basis in fundamental law. It therefore rests with the legislator to concert the one with the other. (orig./HP) [de

  18. Clinical supervision of nurses working with patients with borderline personality disorder.

    Science.gov (United States)

    Bland, Ann R; Rossen, Eileen K

    2005-06-01

    Some nurses describe individuals diagnosed with borderline personality disorder (BPD) as among the most challenging and difficult patients encountered in their practice. As a result, the argument has been made for nursing staff to receive clinical supervision to enhance therapeutic effectiveness and treatment outcomes for individuals with BPD. Formal clinical supervision can focus on the stresses of working in a demanding environment within the work place and enable nurses to accept accountability for their own practice and development (Pesut & Herman, 1999). A psychiatric-mental health clinical nurse specialist can provide individual and/or group supervision for the nursing staff, including education about patient dynamics, staff responses, and treatment team decisions. A clinical nurse specialist also can provide emotional support to nursing staff, which enhances job satisfaction, as they struggle to maintain professional therapeutic behavior with these individuals.

  19. Model for investigating the benefits of clinical supervision in psychiatric nursing: a survey study.

    Science.gov (United States)

    Gonge, Henrik; Buus, Niels

    2011-04-01

    The objective of this study was to test a model for analysing the possible benefits of clinical supervision. The model suggested a pathway from participation to effectiveness to benefits of clinical supervision, and included possible influences of individual and workplace factors. The study sample was 136 nursing staff members in permanent employment on nine general psychiatric wards and at four community mental health centres at a Danish psychiatric university hospital. Data were collected by means of a set of questionnaires. Participation in clinical supervision was associated with the effectiveness of clinical supervision, as measured by the Manchester Clinical Supervision Scale (MCSS). Furthermore, MCSS scores were associated with benefits, such as increased job satisfaction, vitality, rational coping and less stress, emotional exhaustion, and depersonalization. Multivariate analyses indicated that certain individual and workplace factors were related to subscales of the MCSS, as well as some of the benefits. The study supported the suggested model, but methodological limitations apply. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  20. Quality of clinical supervision as perceived by attending doctors in university and district teaching hospitals.

    Science.gov (United States)

    Busari, Jamiu O; Koot, Bart G

    2007-10-01

    Attending doctors (ADs) play important roles in the supervision of specialist registrars. Little is known, however, about how they perceive the quality of their supervision in different teaching settings. We decided to investigate whether there is any difference in how ADs perceive the quality of their supervision in university teaching hospital (UTH) and district teaching hospital (DTH) settings. We used a standardised questionnaire to investigate the quality of supervision as perceived by ADs. Fifteen items reflecting good teaching ability were measured on a 5-point Likert scale (1-5: never-always). We investigated for factors that influenced the perceived quality of supervision using Likert scale items (1-5: totally disagree-totally agree) and open-ended questionnaires. A total of 83 ADs (UTH: 51; DTH: 32) were eligible to participate in the survey. Of these, 43 (52%) returned the questionnaire (UTH: 25; DTH: 18). There was no difference in the overall mean of the 15 items between the UTH (3.67, standard deviation [SD] 0.35) and DTH (3.73, SD 0.31) ADs. Attending doctors in the DTH group rated themselves better at 'teaching technical skills' (mean 3.50, SD 0.70), compared with their UTH counterparts (mean 3.0, SD 0.76) (P = 0.03). Analysis of variance of the overall means revealed no significant difference between the different hospital settings. The results suggest that teaching hospital environments do not influence how ADs perceive the quality of their supervision. Lack of time for teaching was perceived as responsible for poor supervision. Other factors found to influence AD perceptions of good supervision included effective teaching skills, communication skills and provision of feedback.

  1. Nursing supervision for care comprehensiveness

    Directory of Open Access Journals (Sweden)

    Lucieli Dias Pedreschi Chaves

    Full Text Available ABSTRACT Objective: To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. Method: A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Results: Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Final considerations: Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks.

  2. Using clinical supervision to improve the quality and safety of patient care: a response to Berwick and Francis.

    Science.gov (United States)

    Tomlinson, Jonathon

    2015-06-11

    After widely publicised investigations into excess patient deaths at Mid Staffordshire hospital the UK government commissioned reports from Robert Francis QC and Professor Don Berwick. Among their recommendations to improve the quality and safety of patient care were lifelong learning, professional support and 'just culture'. Clinical supervision is in an excellent position to support these activities but opportunities are in danger of being squeezed out by regulatory and managerial demands. Doctors who have completed their training are responsible for complex professional judgements for which narrative supervision is particularly helpful. With reference to the literature and my own practice I propose that all practicing clinicians should have regular clinical supervision. Clinical supervision has patient-safety and the quality of patient care as its primary purposes. After training is completed, doctors may practice for the rest of their career without any clinical supervision, the implication being that the difficulties dealt with in clinical supervision are no longer difficulties, or are better dealt with some other way. Clinical supervision is sufficiently flexible to be adapted to the needs of experienced clinicians as its forms can be varied, though its functions remain focused on patient safety, good quality clinical care and professional wellbeing. The evidence linking clinical supervision to the quality and safety of patient care reveals that supervision is most effective when its educational and supportive functions are separated from its managerial and evaluative functions. Among supervision's different forms, narrative-based-supervision is particularly useful as it has been developed for clinicians who have completed their training. It provides ways to explore the complexity of clinical judgements and encourages doctors to question one another's authority in a supportive culture. To be successful, supervision should also be professionally led and

  3. PERMIT PROCEDURE OF ESTHABLISMENT AND SUPERVISION OF NURSING CLINIC IN BANTUL REGENCY

    Directory of Open Access Journals (Sweden)

    Nasrullah Nasrullah

    2012-12-01

    Full Text Available As one of the health professions, nurse normally does no have independent authority to conduct medical practice. However, according to several regulations, nurse has a chance to establish and run his/her own nursing clinic. So far, there are six individual nursing clinics have been operated in Bantul Regency. By utilizing empirical research method with legislation approach, this research aims at finding out the importance and the permit procedure to establish nursing clinic as well as to know the supervision means used by the government upon the operated nursing clinic in Bantul Regency. This research proved that nursing clinics have given beneficial advantages on the society as whole. Meanwhile, to operate a nursing clinic a nurse has to be granted a Nursing Practice Permit Letter (Surat Izin Praktik Perawat/SIPP from the government. Finally, the nursing clinic is supervised by the Health Bureau by means of supervision and control program.Keywords: nursing practice, nursing clinic, Nursing Practice Permit Letter, supervision and control program

  4. Self-care assessment as an indicator for clinical supervision in nursing

    Directory of Open Access Journals (Sweden)

    Sílvia Marlene Monteiro Teixeira

    2016-06-01

    Full Text Available Objective: to evaluate the needs of clinical supervision for nurses to assess the degree of dependence on self-care and planning of nursing interventions. Methods: analytical study, cross-cutting nature, collecting data from a sample of 110 patients. Results: it was shown the differences in the identification of the degree of dependence between registers and experts, as well as the selection of operations for each self-care and failures to the original assessment of the filling level (no evaluation self-care/no identification of the degree of dependence. Conclusion: there were gaps in the nursing process; they have proposed strategies such as clinical supervision sessions, training, case studies, protocols and guidance documents, to be included in a clinical supervision in nursing model.

  5. Clinical trial quality: From supervision to collaboration and beyond.

    Science.gov (United States)

    Meeker-O'Connell, Ann; Glessner, Coleen

    2018-02-01

    Over the past decade, clinical trial quality has evolved from an after-the-fact, reactive activity to one focused on the important work of evidence generation from well-designed trials. This article explores the role the Clinical Trials Transformation Initiative has played in advancing quality as a core element of clinical trial design, through project work that initially focused on monitoring but evolved into a holistic, prospective, and comprehensive quality by design approach to clinical trial design and conduct.

  6. Genetic Counseling Supervisors' Self-Efficacy for Select Clinical Supervision Competencies.

    Science.gov (United States)

    Finley, Sabra Ledare; Veach, Pat McCarthy; MacFarlane, Ian M; LeRoy, Bonnie S; Callanan, Nancy

    2016-04-01

    Supervision is a primary instructional vehicle for genetic counseling student clinical training. Approximately two-thirds of genetic counselors report teaching and education roles, which include supervisory roles. Recently, Eubanks Higgins and colleagues published the first comprehensive list of empirically-derived genetic counseling supervisor competencies. Studies have yet to evaluate whether supervisors possess these competencies and whether their competencies differ as a function of experience. This study investigated three research questions: (1) What are genetic counselor supervisors' perceptions of their capabilities (self-efficacy) for a select group of supervisor competencies?, (2) Are there differences in self-efficacy as a function of their supervision experience or their genetic counseling experience, and 3) What training methods do they use and prefer to develop supervision skills? One-hundred thirty-one genetic counselor supervisors completed an anonymous online survey assessing demographics, self-efficacy (self-perceived capability) for 12 goal setting and 16 feedback competencies (Scale: 0-100), competencies that are personally challenging, and supervision training experiences and preferences (open-ended). A MANOVA revealed significant positive effects of supervision experience but not genetic counseling experience on participants' self-efficacy. Although mean self-efficacy ratings were high (>83.7), participant comments revealed several challenging competencies (e.g., incorporating student's report of feedback from previous supervisors into goal setting, and providing feedback about student behavior rather than personal traits). Commonly preferred supervision training methods included consultation with colleagues, peer discussion, and workshops/seminars.

  7. Reflective Process in Play Therapy: A Practical Model for Supervising Counseling Students

    Science.gov (United States)

    Allen, Virginia B.; Folger, Wendy A.; Pehrsson, Dale-Elizabeth

    2007-01-01

    Counselor educators and other supervisors, who work with graduate student counseling interns utilizing Play Therapy, should be educated, grounded, and trained in theory, supervision, and techniques specific to Play Therapy. Unfortunately, this is often not the case. Therefore, a three step model was created to assist those who do not have specific…

  8. Supervising Snowsport Activities: A Reflection upon Legislation, Policies, Guidelines and Practice

    Science.gov (United States)

    Dickson, Tracey J.; Terwiel, F. Anne

    2013-01-01

    This paper explores on-snow supervision in school-based snowsport excursions by investigating snowsport participation and safety data and relevant legislation and policies that form the framework for practice. Snowsports may present a more complex environment for managing of participants than many other outdoor environments and provide a valuable…

  9. Training with O (Observing) and T (Treatment) Teams in Live Supervision: Reflections in the Looking Glass.

    Science.gov (United States)

    Roberts, Janine; And Others

    1989-01-01

    Describes process that six counselor trainees and two supervisors used with treatment and observation teams to examine their own coevolution as a therapeutic system using the Milan model of family therapy and Ericksonian hypnotherapy. Concludes with a discussion of advantages and pitfalls of this type of dual supervision. (Author/ABL)

  10. Changes in Emotion Work at Interdisciplinary Conferences Following Clinical Supervision in a Palliative Outpatient Ward

    DEFF Research Database (Denmark)

    Nordentoft, Helle Merete

    2008-01-01

    In this article, I describe changes in emotion work at weekly interdisciplinary conferences in a palliative1 outpatient ward following clinical supervision (CS). I conceive emotions as constantly negotiated in interaction, and I researched the similarity between how this is done during CS and at ...... conclude that CS enhances professional development and may prevent burnout in palliative care....

  11. On being supervised: getting value from a clinical supervisor and making the relationship work when it is not.

    Science.gov (United States)

    Parker, Stephen; Suetani, Shuichi; Motamarri, Balaji

    2017-12-01

    The importance of clinical supervision is emphasised in psychiatric training programs. Despite this, the purpose and processes of supervision are often poorly defined. There is limited guidance available for trainees about their role in making supervision work. This paper considers the nature of supervision in psychiatric training and provides practical advice to help supervisees take active steps to make supervision work. In obtaining value from supervision, the active role of the supervisee in seeking feedback, finding value in criticism and building autonomy is emphasised. Additionally, the importance of exploring what value a supervisor can offer and maintaining realistic expectations is considered. Trainees can benefit from taking an active role in planning and managing their supervision to maximise their learning.

  12. “They put you on your toes”: Physical Therapists' Perceived Benefits from and Barriers to Supervising Students in the Clinical Setting

    Science.gov (United States)

    Hanna, Elizabeth; Cott, Cheryl

    2011-01-01

    ABSTRACT Purpose: To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students. Method: In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach. Results: Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision. Conclusions: Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff. PMID:22379263

  13. Residents' Ratings of Their Clinical Supervision and Their Self-Reported Medical Errors: Analysis of Data From 2009.

    Science.gov (United States)

    Baldwin, DeWitt C; Daugherty, Steven R; Ryan, Patrick M; Yaghmour, Nicholas A; Philibert, Ingrid

    2018-04-01

    Medical errors and patient safety are major concerns for the medical and medical education communities. Improving clinical supervision for residents is important in avoiding errors, yet little is known about how residents perceive the adequacy of their supervision and how this relates to medical errors and other education outcomes, such as learning and satisfaction. We analyzed data from a 2009 survey of residents in 4 large specialties regarding the adequacy and quality of supervision they receive as well as associations with self-reported data on medical errors and residents' perceptions of their learning environment. Residents' reports of working without adequate supervision were lower than data from a 1999 survey for all 4 specialties, and residents were least likely to rate "lack of supervision" as a problem. While few residents reported that they received inadequate supervision, problems with supervision were negatively correlated with sufficient time for clinical activities, overall ratings of the residency experience, and attending physicians as a source of learning. Problems with supervision were positively correlated with resident reports that they had made a significant medical error, had been belittled or humiliated, or had observed others falsifying medical records. Although working without supervision was not a pervasive problem in 2009, when it happened, it appeared to have negative consequences. The association between inadequate supervision and medical errors is of particular concern.

  14. Rethinking attitudes to student clinical supervision and patient care: a change management success story.

    Science.gov (United States)

    O'Keefe, Maree; Wade, Victoria; McAllister, Sue; Stupans, Ieva; Miller, Jennifer; Burgess, Teresa; LeCouteur, Amanda; Starr, Linda

    2014-08-30

    The aim of this project was to explore the process of change in a busy community dental clinic following a team development intervention designed to improve the management of student supervision during clinical placements. An action research model was used. Seven members of a community dental clinic team (three dentists, two dental therapists, one dental assistant and the clinic manager), together with the university clinical placement supervisor participated in the team development intervention. The intervention consisted of two profiling activities and associated workshops spread six months apart. These activities focused on individual work preferences and overall team performance with the aim of improving the functioning of the clinic as a learning environment for dental students. Evaluation data consisted of 20 participant interviews, fourteen hours of workplace observation and six sets of field notes. Following initial thematic analysis, project outcomes were re-analysed using activity theory and expansive learning as a theoretical framework. At project commencement students were not well integrated into the day-to-day clinic functioning. Staff expressed a general view that greater attention to student supervision would compromise patient care. Following the intervention greater clinical team cohesion and workflow changes delivered efficiencies in practice, enhanced relationships among team members, and more positive attitudes towards students. The physical layout of the clinic and clinical workloads were changed to achieve greater involvement of all team members in supporting student learning. Unexpectedly, these changes also improved clinic functioning and increased the number of student placements available. In navigating the sequential stages of the expansive learning cycle, the clinical team ultimately redefined the 'object' of their activity and crossed previously impervious boundaries between healthcare delivery and student supervision with benefits to

  15. Clinical learning environment and supervision of international nursing students: A cross-sectional study.

    Science.gov (United States)

    Mikkonen, Kristina; Elo, Satu; Miettunen, Jouko; Saarikoski, Mikko; Kääriäinen, Maria

    2017-05-01

    Previously, it has been shown that the clinical learning environment causes challenges for international nursing students, but there is a lack of empirical evidence relating to the background factors explaining and influencing the outcomes. To describe international and national students' perceptions of their clinical learning environment and supervision, and explain the related background factors. An explorative cross-sectional design was used in a study conducted in eight universities of applied sciences in Finland during September 2015-May 2016. All nursing students studying English language degree programs were invited to answer a self-administered questionnaire based on both the clinical learning environment, supervision and nurse teacher scale and Cultural and Linguistic Diversity scale with additional background questions. Participants (n=329) included international (n=231) and Finnish (n=98) nursing students. Binary logistic regression was used to identify background factors relating to the clinical learning environment and supervision. International students at a beginner level in Finnish perceived the pedagogical atmosphere as worse than native speakers. In comparison to native speakers, these international students generally needed greater support from the nurse teacher at their university. Students at an intermediate level in Finnish reported two times fewer negative encounters in cultural diversity at their clinical placement than the beginners. To facilitate a successful learning experience, international nursing students require a sufficient level of competence in the native language when conducting clinical placements. Educational interventions in language education are required to test causal effects on students' success in the clinical learning environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Twelve tips on how to set up postgraduate training via remote clinical supervision

    DEFF Research Database (Denmark)

    Wearne, Susan; Dornan, Tim; Teunissen, Pim W.

    2013-01-01

    Doctors-in-training can now be supervised remotely by specialist clinicians using information and communication technology. This provides an intermediate stage of professional development between on-site supervision and independent medical practice. Remote supervision could increase training capa...

  17. Implementation of Instructional Supervision in Secondary School ...

    African Journals Online (AJOL)

    Science, Technology and Arts Research Journal ... Supervision is critical in the development of any educational program in both developed and ... Clinical Supervision, Collegial Supervision, Self-directive supervision, Informal Supervision etc.

  18. Training the Millennial learner through experiential evolutionary scaffolding: implications for clinical supervision in graduate education programs.

    Science.gov (United States)

    Venne, Vickie L; Coleman, Darrell

    2010-12-01

    They are the Millennials--Generation Y. Over the next few decades, they will be entering genetic counseling graduate training programs and the workforce. As a group, they are unlike previous youth generations in many ways, including the way they learn. Therefore, genetic counselors who teach and supervise need to understand the Millennials and explore new ways of teaching to ensure that the next cohort of genetic counselors has both skills and knowledge to represent our profession well. This paper will summarize the distinguishing traits of the Millennial generation as well as authentic learning and evolutionary scaffolding theories of learning that can enhance teaching and supervision. We will then use specific aspects of case preparation during clinical rotations to demonstrate how incorporating authentic learning theory into evolutionary scaffolding results in experiential evolutionary scaffolding, a method that potentially offers a more effective approach when teaching Millennials. We conclude with suggestions for future research.

  19. The effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model.

    Science.gov (United States)

    Maddineshat, Maryam; Hashemi, Mitra; Besharati, Reza; Gholami, Sepideh; Ghavidel, Fatemeh

    2018-01-01

    Clinical experience associated with the fear and anxiety of nursing students in the psychiatric unit. Mental health nursing instructors find it challenging to teach nursing students to deal with patients with mental disorders in an environment where they need to provide patient teaching and clinical decision-making based on evidence and new technology. To measure the effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model evaluation in the psychiatry unit of Imam Reza Hospital, Bojnurd, Iran. This cross-sectional study was carried out from 2011 to 2016 on 76 nursing students from a university as part of a clinical mental health course in two semesters. The students were selected by a non-probable convenient sampling method. After completing their clinical education, each student responded to checklist questions based on the four-level Kirkpatrick's model evaluation and open questions relating to clinical supervision. Finally, all data was analyzed using the SPSS version 16. The students have evaluated clinical supervision as a useful approach, and appreciated the instructor's supportive behavior during teaching and imparting clinical skills. This has made them feel relaxed at the end of the clinical teaching course. In addition, in the evaluation through Kirkpatrick's model, more than 70% of the students have been satisfied with the method of conducting the teaching and average score of nursing students' attitude toward mental health students: Their mean self-confidence score was 18.33±1.69, and the mean score of their performance in the study was evaluated to be 93.74±5.3 from 100 points. The results of clinical mental health teaching through clinical supervision and Kirkpatrick's model evaluation show that the satisfaction, self-esteem, attitude, and skill of nursing students are excellent, thereby portraying the effectiveness of clinical teaching. But this program still needs to be reformed. To

  20. A review of the literature to inform a best-practice clinical supervision model for midwifery students in Australia.

    Science.gov (United States)

    McKellar, Lois; Graham, Kristen

    2017-05-01

    Effective clinical supervision in midwifery programs leading to registration is essential to ensure that students can provide safe and competent woman centred care by the completion of their program. A number of different clinical supervision models exist in Australia and internationally, with varying levels of support and facilitation of student learning opportunities. In Australia, midwifery students must achieve specified learning outcomes and midwifery practice requirements to be eligible to register as a midwife. Identifying a best practice clinical supervision model for Australian midwifery students is therefore a priority for all key stakeholders, particularly education and maternity care providers. The aim of this literature review was to explore different types of clinical supervision models in order to develop and implement a best practice model in midwifery education programs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Quality of clinical supervision and counselor emotional exhaustion: the potential mediating roles of organizational and occupational commitment.

    Science.gov (United States)

    Knudsen, Hannah K; Roman, Paul M; Abraham, Amanda J

    2013-01-01

    Counselor emotional exhaustion has negative implications for treatment organizations as well as the health of counselors. Quality clinical supervision is protective against emotional exhaustion, but research on the mediating mechanisms between supervision and exhaustion is limited. Drawing upon data from 934 counselors affiliated with treatment programs in the National Institute on Drug Abuse's Clinical Trials Network (CTN), this study examined commitment to the treatment organization and commitment to the counseling occupation as potential mediators of the relationship between quality clinical supervision and emotional exhaustion. The final ordinary least squares (OLS) regression model, which accounted for the nesting of counselors within treatment organizations, indicated that these two types of commitment were plausible mediators of the association between clinical supervision and exhaustion. Higher quality clinical supervision was strongly correlated with commitment to the treatment organization as well as commitment to the occupation of SUD counseling. These findings suggest that quality clinical supervision has the potential to yield important benefits for counselor well-being by strengthening ties to both their employing organization as well the larger treatment field, but longitudinal research is needed to establish these causal relationships. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Experiences of registered nurses who supervise international nursing students in the clinical and classroom setting: an integrative literature review.

    Science.gov (United States)

    Newton, Louise; Pront, Leeanne; Giles, Tracey M

    2016-06-01

    To examine the literature reporting the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Nursing education relies on clinical experts to supervise students during classroom and clinical education, and the quality of that supervision has a significant impact on student development and learning. Global migration and internationalisation of nursing education have led to increasing numbers of registered nurses supervising international nursing students. However, a paucity of relevant literature limits our understanding of these experiences. An integrative literature review. Comprehensive database searches of CINAHL, Informit, PubMed, Journals@Ovid, Findit@flinders and Medline were undertaken. Screening of 179 articles resulted in 10 included for review. Appraisal and analysis using Whittemore and Knafl's (Journal of Advanced Nursing, 52, 2005, 546) five stage integrative review recommendations was undertaken. This review highlighted some unique challenges for registered nurses supervising international nursing students. Identified issues were, a heightened sense of responsibility, additional pastoral care challenges, considerable time investments, communication challenges and cultural differences between teaching and learning styles. It is possible that these unique challenges could be minimised by implementing role preparation programmes specific to international nursing student supervision. Further research is needed to provide an in-depth exploration of current levels of preparation and support to make recommendations for future practice, education and policy development. An awareness of the specific cultural learning needs of international nursing students is an important first step to the provision of culturally competent supervision for this cohort of students. There is an urgent need for education and role preparation for all registered nurses supervising international nursing

  3. Students Perceptions on the quality of clinical supervision among the 12 affiliated hospital of Medical Faculty of UNISSULA

    Directory of Open Access Journals (Sweden)

    Dian Apriliana Rahmawatie

    2011-12-01

    Design and Methods: This study involved 181 students of clinical internship of the year 2003, 2004 and 2005 of medical faculty of Islamic Sultan Agung University having the clinical rotation at the stage of surgery, obsgyn, pediatrics, internal medicine, ENT, neurology, dermatology and venerology, psychiatry, across the affiliated hospitals. The subject were divided into groups based on the hospital they were placed. Clinical Teaching Effectiveness Instrument (CTEI adapted in bahasa Indonesia was used. The Descriptive and Kruskal-Wallis test were applied for the data analysis. Results: Means of the effectiveness of clinical supervision for 12 affiliated hospitals ranged from 3.25 to 4.02. Kruskal-Wallis test resulted in the value of Chi-S=13.32 and p=0.27. Conclusion: Over all the clinical supervision for the 12 affiliated hospitals is perceived good and shows no significant difference. However the practice of clinical supervision varies among the hospitals (Sains Medika, 3(2:135-149.

  4. Test-retest reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale.

    Science.gov (United States)

    Gustafsson, Margareta; Blomberg, Karin; Holmefur, Marie

    2015-07-01

    The Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale evaluates the student nurses' perception of the learning environment and supervision within the clinical placement. It has never been tested in a replication study. The aim of the present study was to evaluate the test-retest reliability of the CLES + T scale. The CLES + T scale was administered twice to a group of 42 student nurses, with a one-week interval. Test-retest reliability was determined by calculations of Intraclass Correlation Coefficients (ICCs) and weighted Kappa coefficients. Standard Error of Measurements (SEM) and Smallest Detectable Difference (SDD) determined the precision of individual scores. Bland-Altman plots were created for analyses of systematic differences between the test occasions. The results of the study showed that the stability over time was good to excellent (ICC 0.88-0.96) in the sub-dimensions "Supervisory relationship", "Pedagogical atmosphere on the ward" and "Role of the nurse teacher". Measurements of "Premises of nursing on the ward" and "Leadership style of the manager" had lower but still acceptable stability (ICC 0.70-0.75). No systematic differences occurred between the test occasions. This study supports the usefulness of the CLES + T scale as a reliable measure of the student nurses' perception of the learning environment within the clinical placement at a hospital. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Does clinical supervision of health professionals improve patient safety? A systematic review and meta-analysis.

    Science.gov (United States)

    Snowdon, David A; Hau, Raphael; Leggat, Sandra G; Taylor, Nicholas F

    2016-09-01

    To determine whether clinical supervision (CS) of health professionals improves patient safety. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. Thirty-two studies across three health professions [medicine (n = 29), nursing (n = 2) and paramedicine (n = 1)] were selected. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Risk ratios (RR) were calculated for patient safety outcomes of mortality, complications, adverse events, reoperation following initial surgery, conversion to more invasive surgery and readmission to hospital. Results of meta-analyses provided low-quality evidence that supervision of medical professionals reduced the risk of mortality (RR 0.76, 95% CI 0.60-0.95, I(2) = 76%) and supervision of medical professionals and paramedics reduced the risk of complications (RR 0.69, 95% CI 0.53-0.89, I(2) = 76%). Due to a high level of statistical heterogeneity, sub-group analyses were performed. Sub-group analyses provided moderate-quality evidence that direct supervision of surgery significantly reduced the risk of mortality (RR 0.68, 95% CI 0.50-0.93, I(2) = 33%) and direct supervision of medical professionals conducting non-surgical invasive procedures significantly reduced the risk of complications (RR 0.33, 95% CI 0.24-0.46, I(2) = 0%). CS was associated with safer surgery and other invasive procedures for medical practitioners. There was a lack of evidence about the relationship between CS and safer patient care for non-medical health professionals. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. The Clinical Learning Spiral: A Model to Develop Reflective Practitioners.

    Science.gov (United States)

    Stockhausen, Lynette

    1994-01-01

    The Clinical Learning Spiral incorporates reflective processes into undergraduate nursing education. It entails successive cycles of four phases: preparative (briefing, planning), constructive (practice development), reflective (debriefing), and reconstructive (planning for change and commitment to action). (SK)

  7. A case study exploring the experience of resilience-based clinical supervision and its influence on care towards self and others among student nurses

    Directory of Open Access Journals (Sweden)

    Gemma Stacey

    2017-11-01

    Full Text Available Background: Healthcare organisations are increasingly recognising their responsibility to support the wellbeing of nurses as a result of the accumulative demands of their role. Resilience-based clinical supervision is a newly developed intervention that encourages practitioners to pay attention and apply reasoning to behaviours and responses to emotive scenarios through a process of stress alleviation and prevention. Aims: To evaluate an intervention aimed at supporting pre-registration nursing students to develop resilience-based competencies that enable them to regulate their response to stress and monitor their own wellbeing using mindfulness, reflective discussion and positive reframing. Method: Case study methodology was used to explore how the characteristics associated with the expression and maintenance of resilience have been influenced by the intervention. Data were collected through focus groups at three timepoints with students and at the end of the intervention period with supervision facilitators, and then analysed by pattern matching to theoretical propositions. Findings: Participants expressed positive experiences of resilience-based clinical supervision. Their perception of the importance of self-care increased and their commitment to caring for others was maintained. They continued to demonstrate competencies of self-care six months after qualifying as nurses, despite the complexities of the workplace. As qualified nurses, participants recognised the implications of limited time and resources on the quality of care they were able to provide to patients, but they externalised this as organisational failings as opposed to personal inadequacy, and worked around such constraints where possible to maintain personal standards. Conclusion: Resilience-based clinical supervision has the potential to support healthcare practitioners in developing resilience-based competencies that allow them to recognise and attend to workplace stressors

  8. [Added value of family practitioners' supervision of junior doctors in a walk-in clinic].

    Science.gov (United States)

    Perdrix, J; Gubser, R; Gilgien, W; Bischoff, T

    2011-05-18

    The pending workforce crisis in family medicine has triggered various initiatives. This article describes the PMU-FLON walk-in clinic, a project of the Institute of General Medicine University of Lausanne. The working conditions in this clinic are close to that of a family practice. Doctors in training are supervised by family doctors who work part-time in the clinic. The objective is to improve training in the various fields of family medicine, from technical skills (improving optimal use of diagnostic tools), to integrating patients' requests in a more global patient-centered approach. This new educational model allows doctors in training to benefit from the specific approaches of different trainers. It will contribute to promoting quality family medicine in the future.

  9. Reflective journaling for clinical judgment development and evaluation.

    Science.gov (United States)

    Lasater, Kathie; Nielsen, Ann

    2009-01-01

    Reflective journaling is a strategy used often in clinical education to gain insight into students' clinical thinking; however, studies indicate that students may benefit from guided reflections. Numerous tools have been used to structure student reflection with varying results. This article describes the outcomes from using the Guide for Reflection based on Tanner's Clinical Judgment Model. The Lasater Clinical Judgment Rubric, created from the Model, is used to evaluate development of clinical judgment and provides language to communicate about clinical thinking with students. Senior immersion course competencies, also developed with language from Tanner's Clinical Judgment Model,offer a comprehensive package that fosters students' clinical judgment development, faculty-student communication about clinical judgment, and evaluation of students' clinical thinking.

  10. An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education.

    Science.gov (United States)

    McLean, Gillian

    2015-12-01

    CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered. © The Author(s) 2015.

  11. Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Bendix Tom

    2010-02-01

    Full Text Available Abstract Background Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Nordic Walking - power walking using ski poles - is a popular and fast growing type of exercise in Northern Europe that has been shown to improve cardiovascular metabolism. Until now, no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to back pain. Methods A total of 151 patients with low back and/or leg pain of greater than eight weeks duration were recruited from a hospital based outpatient back pain clinic. Patients continuing to have pain greater than three on the 11-point numeric rating scale after a multidisciplinary intervention were included. Fifteen patients were unable to complete the baseline evaluation and 136 patients were randomized to receive A Nordic walking supervised by a specially trained instructor twice a week for eight weeks B One-hour instruction in Nordic walking by a specially trained instructor followed by advice to perform Nordic walking at home as much as they liked for eight weeks or C Individual oral information consisting of advice to remain active and about maintaining the daily function level that they had achieved during their stay at the backcenter. Primary outcome measures were pain and disability using the Low Back Pain Rating Scale, and functional limitation further assessed using the Patient Specific Function Scale. Furthermore, information on time off work, use of medication, and concurrent treatment for their low back pain was collected. Objective measurements of physical activity levels for the supervised and unsupervised Nordic walking groups were performed using accelerometers. Data were analyzed on an intention-to-treat basis. Results No mean differences were found between the three groups in

  12. Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial

    Science.gov (United States)

    2010-01-01

    Background Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Nordic Walking - power walking using ski poles - is a popular and fast growing type of exercise in Northern Europe that has been shown to improve cardiovascular metabolism. Until now, no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to back pain. Methods A total of 151 patients with low back and/or leg pain of greater than eight weeks duration were recruited from a hospital based outpatient back pain clinic. Patients continuing to have pain greater than three on the 11-point numeric rating scale after a multidisciplinary intervention were included. Fifteen patients were unable to complete the baseline evaluation and 136 patients were randomized to receive A) Nordic walking supervised by a specially trained instructor twice a week for eight weeks B) One-hour instruction in Nordic walking by a specially trained instructor followed by advice to perform Nordic walking at home as much as they liked for eight weeks or C) Individual oral information consisting of advice to remain active and about maintaining the daily function level that they had achieved during their stay at the backcenter. Primary outcome measures were pain and disability using the Low Back Pain Rating Scale, and functional limitation further assessed using the Patient Specific Function Scale. Furthermore, information on time off work, use of medication, and concurrent treatment for their low back pain was collected. Objective measurements of physical activity levels for the supervised and unsupervised Nordic walking groups were performed using accelerometers. Data were analyzed on an intention-to-treat basis. Results No mean differences were found between the three groups in relation to any of the outcomes

  13. Comparing minimally supervised home-based and closely supervised gym-based exercise programs in weight reduction and insulin resistance after bariatric surgery: A randomized clinical trial.

    Science.gov (United States)

    Kaviani, Sara; Dadgostar, Haleh; Mazaherinezhad, Ali; Adib, Hanie; Solaymani-Dodaran, Masoud; Soheilipour, Fahimeh; Hakiminezhad, Mahdi

    2017-01-01

    Background: Effectiveness of various exercise protocols in weight reduction after bariatric surgery has not been sufficiently explored in the literature. Thus, in the present study, we aimed at comparing the effect of minimally supervised home-based and closely supervised gym-based exercise programs on weight reduction and insulin resistance after bariatric surgery. Methods: Females undergoing gastric bypass surgery were invited to participate in an exercise program and were randomly allocated into 2 groups using a random number generator in Excel. They were either offered a minimally supervised home-based (MSHB) or closely supervised gym-based (CSGB) exercise program. The CSGB protocol constitutes 2 weekly training sessions under ACSM guidelines. In the MSHB protocol, the participants received a notebook containing a list of recommended aerobic and resistance exercises, a log to record their activity, and a schedule of follow-up phone calls and clinic visits. Both groups received a pedometer. We measured their weight, BMI, lipid profile, FBS, and insulin level at baseline and at 20 weeks after the exercises, the results of which were compared using t test or Mann-Whitney U test at the end of the study. All the processes were observed by 1 senior resident in sport medicine. Results: A total of 80 patients were recruited who were all able to complete our study (MSHB= 38 and CSGB= 42). The baseline comparison revealed that the 2 groups were similar. The mean change (reduction) in BMI was slightly better in CSGB (8.61 95% CI 7.76-9.45) compared with the MSHB (5.18 95% CI 3.91-6.46); p< 0.01. However, the 2 groups did not have a statistically significant difference in the amount of change in the other factors including FBS and Homa.ir. Conclusion: As we expected a non-inferiority result, our results showed that both MSHB and CSGB exercise methods are somewhat equally effective in improving lipid profile and insulin resistance in the 2 groups, but a slightly better

  14. Peer group reflection helps clinical teachers to critically reflect on their teaching.

    Science.gov (United States)

    Boerboom, Tobias B B; Jaarsma, Debbie; Dolmans, Diana H J M; Scherpbier, Albert J J A; Mastenbroek, Nicole J J M; Van Beukelen, Peter

    2011-01-01

    Student evaluations can help clinical teachers to reflect on their teaching skills and find ways to improve their teaching. Studies have shown that the mere presentation of student evaluations is not a sufficient incentive for teachers to critically reflect on their teaching. We evaluated and compared the effectiveness of two feedback facilitation strategies that were identical except for a peer reflection meeting. In this study, 54 clinical teachers were randomly assigned to two feedback strategies. In one strategy, a peer reflection was added as an additional step. All teachers completed a questionnaire evaluating the strategy that they had experienced. We analysed the reflection reports and the evaluation questionnaire. Both strategies stimulated teachers to reflect on feedback and formulate alternative actions for their teaching practice. The teachers who had participated in the peer reflection meeting showed deeper critical reflection and more concrete plans to change their teaching. All feedback strategies were considered effective by the majority of the teachers. Strategies with student feedback and self-assessment stimulated reflection on teaching and helped clinical teachers to formulate plans for improvement. A peer reflection meeting seemed to enhance reflection quality. Further research should establish whether it can have lasting effects on teaching quality.

  15. Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: a questionnaire survey.

    Science.gov (United States)

    Sundler, Annelie J; Björk, Maria; Bisholt, Birgitta; Ohlsson, Ulla; Engström, Agneta Kullén; Gustafsson, Margareta

    2014-04-01

    The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized. The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models. A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire. In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (ppedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship. The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere. © 2013.

  16. RELATIONAL NEEDS OF THE THERAPIST: COUNTERTRANSFERENCE, CLINICAL WORK AND SUPERVISION. BENEFITS AND DISRUPTIONS IN PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    Lindsay Stewart

    2010-02-01

    Full Text Available Relational needs are the emotional needs which underlie our social connectedness and help sustain and nurture our attachments to others. In doing psychotherapy, therapists must be attuned not only to the needs of the client, but also to their own relational needs. Through self awareness and knowledge of healthy and appropriate boundaries, therapists can ensure the best interest of the client is kept foremost. In this article, the influence of the therapist’s own relational needs in the psychotherapy process is examined in terms of the possible benefits and disruptions to the client’s emotional growth. This is discussed in the context of the Integrative Psychotherapy model based on the core concepts of inquiry, involvement and attunement. Clinical supervision is seen as an important part of working through counter-transference.

  17. One state's effort to improve recruitment, retention, and practice through multifaceted clinical supervision interventions.

    Science.gov (United States)

    Collins-Camargo, Crystal; Sullivan, Dana J; Washeck, Bonnie; Adams, Jeff; Sundet, Paul

    2009-01-01

    The professional literature has described the critical role child welfare supervisors play in the recruitment and retention (R&R) of a competent workforce and in practice enhancement to produce positive outcomes for children and families. Building on findings from a federally funded demonstration project related to implementation of clinical supervision in the child welfare setting, this article provides a description of a comprehensive approach to achievement of these outcomes: an integrated implementation of an employee selection protocol, 360-degree evaluation and employee development planning, and peer consultation and support groups for supervisors. An outline of the evaluation designed to assess relative effectiveness of each component on organizational culture, staff R&R, and practice is provided.

  18. Clinical supervision and nursing students' professional competence: support-seeking behaviour and the attachment styles of students and mentors.

    Science.gov (United States)

    Moked, Zahava; Drach-Zahavy, Anat

    2016-02-01

    To examine whether the interdependent attachment style of students is positively related to their support-seeking behaviour during supervision and whether their over-dependent and counter-dependent attachment styles are negatively related to it. Second, to determine whether the mentors' attachment styles moderate the relationship between the students' support-seeking behaviours and their professional competence, such that this relationship is stronger when supervisors are characterized by higher independent attachment style. The mentor-student encounter during nursing clinical supervision is expected to create a supportive environment aimed at promoting support-seeking behaviours and subsequent positive supervision outcomes. Bowlby's attachment theory suggests that the three attachment styles - independent, counter-dependent and over-dependent - may have implications for clinical supervision. A correlative-prospective study. One hundred and seventy-eight students and 66 clinical mentors completed questionnaires at the beginning and end of a clinical supervision session during 2012-2013. Results demonstrated that high compared with low independent nursing students tended to seek less support. Second, students who seek less support evaluated their professional competence as higher than students who seek more support. Third, mentor's counter-dependent attachment style moderated the relationship between students' support-seeking behaviour and their professional competencies. The results allude to the detrimental meaning of support-seeking in the eyes of nursing students. Results can guide administrators in promoting supervision processes that are compatible with the students' independent learning style, while also preventing the negative implications of autonomic learning. Furthermore, as mentors' counter-dependent attachment style can hinder students' support-seeking, attachment styles should be considered in the selection of mentors. © 2015 John Wiley & Sons Ltd.

  19. Effective Clinical Supervision in Substance Use Disorder Treatment Programs and Counselor Job Performance.

    Science.gov (United States)

    Rothrauff-Laschober, Tanja C; Eby, Lillian Turner de Tormes; Sauer, Julia B

    2013-01-01

    When mental health counselors have limited and/or inadequate training in substance use disorders (SUDs), effective clinical supervision (ECS) may advance their professional development. The purpose of the current study was to investigate whether ECS is related to the job performance of SUD counselors. Data were obtained in person via paper-and-pencil surveys from 392 matched SUD counselor-clinical supervisor dyads working in 27 SUD treatment organizations across the United States. ECS was rated by counselors and measured with five multi-item scales (i.e., sponsoring counselors' careers, providing challenging assignments, role modeling, accepting/confirming counselors' competence, overall supervisor task proficiency). Clinical supervisors rated counselors' job performance, which was measured with two multi-item scales (i.e., task performance, performance within supervisory relationship). Using mixed-effects models, we found that most aspects of ECS are related to SUD counselor job performance. Thus, ECS may indeed enhance counselors' task performance and performance within the supervisory relationship, and, as a consequence, offset limited formal SUD training.

  20. Counterbalancing clinical supervision and independent practice: case studies in learning thoracic epidural catheter insertion.

    Science.gov (United States)

    Johnson, T

    2010-12-01

    Thoracic epidural catheter placement is an example of a demanding and high-risk clinical skill that junior anaesthetists need to learn by experience and under the supervision of consultants. This learning is known to present challenges that require further study. Ten consultant and 10 trainee anaesthetists in a teaching hospital were interviewed about teaching and learning this skill in the operating theatre, and a phenomenological analysis of their experience was performed. Trainee participation was limited by time pressure, lack of familiarity with consultants, and consultants' own need for clinical experience. There was a particular tension between safe and effective consultant practice and permitting trainees' independence. Three distinct stages of participation and assistance were identified from reports of ideal practice: early (part-task or basic procedure, consultant always present giving instruction and feedback), middle (independent practice with straightforward cases without further instruction), and late (skill extension and transfer). Learning assistance provided by consultants varied, but it was often not matched to the trainees' stages of learning. Negotiation of participation and assistance was recognized as being useful, but it did not happen routinely. There are many obstacles to trainees' participation in thoracic epidural catheter insertion, and learning assistance is not matched to need. A more explicit understanding of stages of learning is required to benefit the learning of this and other advanced clinical skills.

  1. Clinical learning environment and supervision: experiences of Norwegian nursing students - a questionnaire survey.

    Science.gov (United States)

    Skaalvik, Mari Wolff; Normann, Hans Ketil; Henriksen, Nils

    2011-08-01

    To measure nursing students' experiences and satisfaction with their clinical learning environments. The primary interest was to compare the results between students with respect to clinical practice in nursing homes and hospital wards. Clinical learning environments are important for the learning processes of nursing students and for preferences for future workplaces. Working with older people is the least preferred area of practice among nursing students in Norway. A cross-sectional design. A validated questionnaire was distributed to all nursing students from five non-randomly selected university colleges in Norway. A total of 511 nursing students completed a Norwegian version of the questionnaire, Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale in 2009. Data including descriptive statistics were analysed using the Statistical Program for the Social Sciences. Factor structure was analysed by principal component analysis. Differences across sub-groups were tested with chi-square tests and Mann-Whitney U test for categorical variables and t-tests for continuous variables. Ordinal logistic regression analysis of perceptions of the ward as a good learning environment was performed with supervisory relationships and institutional contexts as independent variables, controlling for age, sex and study year. The participating nursing students with clinical placements in nursing homes assessed their clinical learning environment significantly more negatively than those with hospital placements on nearby all sub-dimensions. The evidence found in this study indicates that measures should be taken to strengthen nursing homes as learning environments for nursing students. To recruit more graduated nurses to work in nursing homes, actions to improve the learning environment are needed. © 2011 Blackwell Publishing Ltd.

  2. Good supervision and PBL

    DEFF Research Database (Denmark)

    Otrel-Cass, Kathrin

    This field study was conducted at the Faculty of Social Sciences at Aalborg University with the intention to investigate how students reflect on their experiences with supervision in a PBL environment. The overall aim of this study was to inform about the continued work in strengthening supervision...... at this faculty. This particular study invited Master level students to discuss: • How a typical supervision process proceeds • How they experienced and what they expected of PBL in the supervision process • What makes a good supervision process...

  3. A Content Analysis of 10 Years of Clinical Supervision Articles in Counseling

    Science.gov (United States)

    Bernard, Janine M.; Luke, Melissa

    2015-01-01

    This content analysis follows Borders's (2005) review of counseling supervision literature and includes 184 counselor supervision articles published over the past 10 years. Articles were coded as representing 1 of 3 research types or 1 of 3 conceptual types. Articles were then analyzed for main topics producing 11 topic categories.

  4. Quality of clinical supervision as perceived by attending doctors in university and district teaching hospitals

    NARCIS (Netherlands)

    Busari, Jamiu O.; Koot, Bart G.

    2007-01-01

    Attending doctors (ADs) play important roles in the supervision of specialist registrars. Little is known, however, about how they perceive the quality of their supervision in different teaching settings. We decided to investigate whether there is any difference in how ADs perceive the quality of

  5. Impact of Group Clinical Supervision on Patient Education Process: A Comprehensive Assessment of Patients, Staff, and Organization Dimensions

    Directory of Open Access Journals (Sweden)

    Afsaneh Jafari Moghadam

    2018-04-01

    Full Text Available Background: The most important barriers to patient education are nurses’ poor motivation and training, and poor quality of managerial supervision. Clinical supervision could be a powerful tool for overcoming these barriers. However, the associated patient, staff, and organization-related outcomes still require further research. Aim: The present study aimed to evaluate the patient-, staff-, and organization-related outcomes of group clinical supervision with the goal of improving patient education. Method: This quasi-experimental study was conducted on 35 nurses and mothers of 94 children admitted to the surgery and nephrology wards of Dr. Sheikh Hospital, Mashhad, Iran, in 2016. A 3-month clinical supervision program consisting of support, education, feedback, and facilitation stages was implemented with the assistance of education facilitators. The data were collected using the questionnaire of patient’s satisfaction with nurses’ education, Herzberg’s job motivation questionnaire, and the checklists of nurses’ education performance and quality of education documentation. Data analysis was performed by Mann-Whitney U test, Fisher’s exact test, and independent-t test in SPSS, version 14. Results: The mean ages of the nurses, patients, and mothers were 30.3±6.7, 5.2±3.8, and 32.2±6.2, respectively. Mann-Whitney U test showed a significant improvement in patients’ satisfaction with nurses’ education performance (P

  6. Reflective journal writing: how it promotes reflective thinking in clinical nursing education: a students' perspective.

    Science.gov (United States)

    Kok, J; Chabeli, M M

    2002-08-01

    According to the outcomes-based education and training system of education (OBET) in the country and the South African Nursing Council, education should focus on "creating" reflective learners and practitioners. This article seeks to determine the effectiveness of reflective journal writing in promoting the reflective thinking of learners in clinical nursing education and to validate the guidelines described in a bigger study on how to facilitate reflective thinking using reflective journal writing. A qualitative, contextual, explorative, descriptive research design was used to determine the learners' perceptions on whether reflective journal writing did promote their higher-level thinking skills during the six-month placement in a psychiatric clinical practice using the reflective diaries. From a population of seventeen fourth-year students, six volunteered to participate in a focus group interview. The data was analysed by means of the descriptive method of open coding of Tesch (in Creswell, 1994:154-156). Positive and negative results from the perceptions of the participants and a literature review served as a basis for deducing and describing guidelines for the effective use of reflective journal writing in promoting reflective thinking in clinical nursing education. The positive perception was the development of problem-solving skills attained through reflection by using analytical critical thinking, synthesis and the evaluation of situations. Self-evaluation leading to intellectual growth and self-awareness indicated a positive perception. Negative perceptions were that reflective journal writing is time consuming, content based with a lack of clear expectations from the teacher, and distrust of students about the information written. Guba's model of ensuring trustworthiness in qualitative research as described in Krefting (1991:215-222) was employed. It is concluded that reflective journal writing in clinical nursing education does promote reflective

  7. The Pedagogical Reflection Model - an educational perspective on clinical decisions

    DEFF Research Database (Denmark)

    Voergaard Poulsen, Bettina; Vibholm Persson, Stine; Skriver, Mette

    Clinical decision-making is important in patient-centred nursing, which is known in nursing education and research (1) The Pedagogical Reflection Model (PRM) can provide a framework that supports students’ decision-making in patient-specific situations. PRM is based on the assumption that clinical......) The aims of this study were to explore how nurse students and clinical supervisors use PRM as method to reflect before, during and after PRM guidance in relation to clinical decisions in the first year of clinical practice...... decision-making needs to take into account; 1) clinical experiences, 2) the perspective of the patient, 3) clinical observations and investigations, 4) knowledge about patients experiences of being a patient and ill, 5) medical knowledge about diseases, and 6) the organizational framework (2,3,4)(Figure 1...

  8. Clinical judgment in reflective journals of prelicensure nursing students.

    Science.gov (United States)

    Bussard, Michelle E

    2015-01-01

    Clinical judgment is an essential skill needed by RNs. Employers expect new graduate nurses to enter the work-force with established clinical judgment skills. Therefore, nurse educators must ensure that prelicensure nursing students develop clinical judgment before graduation. This qualitative, interpretive description study reviewed the reflective journals of 30 prelicensure nursing students who participated in four progressive high-fidelity simulation (HFS) scenarios during a medical-surgical nursing course. Eight themes were identified in the reflective journals: (a) expectations about the patient, (b) recognition of a focused assessment, (c) interpretation of medications, laboratory data, and diagnostics, (d) communication with the patient, (e) collaboration and interprofessionalism, (f) prioritizing interventions, (g) skillfulness with interventions, and (h) incorporation of skills and information into real patient situations. This study indicated that reflective journaling following progressive HFS scenarios may be an effective teaching-learning strategy to assist prelicensure nursing students in the development of clinical judgment. Copyright 2015, SLACK Incorporated.

  9. Remotely-Supervised Transcranial Direct Current Stimulation (tDCS for Clinical Trials: Guidelines for Technology and Protocols

    Directory of Open Access Journals (Sweden)

    Leigh E Charvet

    2015-03-01

    Full Text Available The effect of transcranial direct current stimulation (tDCS is cumulative. Treatment protocols typically require multiple consecutive sessions spanning weeks or months. However, traveling to clinic for a tDCS session can present an obstacle to subjects and their caregivers. With modified devices and headgear, tDCS treatment can be administered remotely under clinical supervision, potentially enhancing recruitment, throughput, and convenience. Here we propose standards and protocols for clinical trials utilizing remotely-supervised tDCS with the goal of providing safe, reproducible and well-tolerated stimulation therapy outside of the clinic. The recommendations include: 1 training of staff in tDCS treatment and supervision, 2 assessment of the user’s capability to participate in tDCS remotely, 3 ongoing training procedures and materials including assessments of the user and/or caregiver, 4 simple and fail-safe electrode preparation techniques and tDCS headgear, 5 strict dose control for each session, 6 ongoing monitoring to quantify compliance (device preparation, electrode saturation/placement, stimulation protocol, with corresponding corrective steps as required, 7 monitoring for treatment-emergent adverse effects, 8 guidelines for discontinuation of a session and/or study participation including emergency failsafe procedures tailored to the treatment population’s level of need. These guidelines are intended to provide a minimal level of methodological rigor for clinical trials seeking to apply tDCS outside a specialized treatment center. We outline indication-specific applications (Attention Deficit Hyperactivity Disorder, Depression, Multiple Sclerosis, Palliative Care following these recommendations that support a standardized framework for evaluating the tolerability and reproducibility of remote-supervised tDCS that, once established, will allow for translation of tDCS clinical trials to a greater size and range of patient populations.

  10. Researching online supervision

    DEFF Research Database (Denmark)

    Bengtsen, Søren S. E.; Mathiasen, Helle

    2014-01-01

    Online supervision and the use of digital media in supervisory dialogues is a fast increasing practice in higher education today. However, the concepts in our pedagogical repertoire often reflect the digital tools used for supervision purposes as either a prolongation of the face-to-face contact...

  11. Kollegial supervision

    DEFF Research Database (Denmark)

    Andersen, Ole Dibbern; Petersson, Erling

    Publikationen belyser, hvordan kollegial supervision i en kan organiseres i en uddannelsesinstitution......Publikationen belyser, hvordan kollegial supervision i en kan organiseres i en uddannelsesinstitution...

  12. How do we know what makes for "best practice" in clinical supervision for psychological therapists? A content analysis of supervisory models and approaches.

    Science.gov (United States)

    Simpson-Southward, Chloe; Waller, Glenn; Hardy, Gillian E

    2017-11-01

    Clinical supervision for psychotherapies is widely used in clinical and research contexts. Supervision is often assumed to ensure therapy adherence and positive client outcomes, but there is little empirical research to support this contention. Regardless, there are numerous supervision models, but it is not known how consistent their recommendations are. This review aimed to identify which aspects of supervision are consistent across models, and which are not. A content analysis of 52 models revealed 71 supervisory elements. Models focus more on supervisee learning and/or development (88.46%), but less on emotional aspects of work (61.54%) or managerial or ethical responsibilities (57.69%). Most models focused on the supervisee (94.23%) and supervisor (80.77%), rather than the client (48.08%) or monitoring client outcomes (13.46%). Finally, none of the models were clearly or adequately empirically based. Although we might expect clinical supervision to contribute to positive client outcomes, the existing models have limited client focus and are inconsistent. Therefore, it is not currently recommended that one should assume that the use of such models will ensure consistent clinician practice or positive therapeutic outcomes. There is little evidence for the effectiveness of supervision. There is a lack of consistency in supervision models. Services need to assess whether supervision is effective for practitioners and patients. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Best practices in nursing homes. Clinical supervision, management, and human resource practices.

    Science.gov (United States)

    Dellefield, Mary Ellen

    2008-07-01

    Human resource practices including supervision and management are associated with organizational performance. Evidence supportive of such an association in nursing homes is found in the results of numerous research studies conducted during the past 17 years. In this article, best practices related to this topic have been culled from descriptive, explanatory, and intervention studies in a range of interdisciplinary research journals published between 1990 and 2007. Identified best practices include implementation of training programs on supervision and management for licensed nurses, certified nursing assistant job enrichment programs, implementation of consistent nursing assignments, and the use of electronic documentation. Organizational barriers and facilitators of these best practices are described. Copyright 2009, SLACK Incorporated.

  14. Nepalese undergraduate nursing students' perceptions of the clinical learning environment, supervision and nurse teachers: A questionnaire survey.

    Science.gov (United States)

    Nepal, Bijeta; Taketomi, Kikuko; Ito, Yoichi M; Kohanawa, Masashi; Kawabata, Hidenobu; Tanaka, Michiko; Otaki, Junji

    2016-04-01

    Clinical practice enables nursing students to acquire essential professional skills, but little is known about nursing students' perceptions of the clinical learning environment (CLE) in Nepal. To examine Nepalese nursing students' perceptions regarding the CLE and supervision. A cross-sectional questionnaire design was used. Government and private hospitals in Nepal where the undergraduate nursing college students undertook their clinical practice. Students with clinical practice experience were recruited from years 2-4 of the B.Sc. nursing program in Nepal (n=350). The final sample comprised 263 students. A self-administered questionnaire including demographic characteristics, latest clinical practice site, and general satisfaction was administered February-March 2014. The previously validated Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was used in the questionnaire. The analytical approach used exploratory factor analysis, assessments of the scale and sub-dimension reliability, correlations of factors between scale sub-dimensions, and multiple regression analysis. Students' practicum satisfaction level at government hospitals was significantly higher than those at private hospitals (prelationship between satisfaction and pedagogical atmosphere (ppedagogical atmosphere. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Reflection in the training of nurses in clinical practice settings

    DEFF Research Database (Denmark)

    Schumann Scheel, Linda; Peters, Micah D J; Meinertz Møbjerg, Anna Christine

    2017-01-01

    REVIEW QUESTION/OBJECTIVE: This scoping review will seek to find answers for the following questions which will focus on the use of reflection in the education of nurses in clinical settings:The review will also extract and map data regarding: i) what outcomes have been found in relation to the use...... (e.g. first or second year undergraduate nursing students etc.); and v) barriers/challenges to the use of reflection approaches/tools. Additional details may also be extracted and mapped during the process of the scoping review and this will be explained in the final scoping review report....

  16. A Slovenian version of the "clinical learning environment, supervision and nurse teacher scale (Cles+T)" and its comparison with the Croatian version.

    Science.gov (United States)

    Žvanut, Boštjan; Lovrić, Robert; Kolnik, Tamara Štemberger; Šavle, Majda; Pucer, Patrik

    2018-02-26

    Nursing clinical learning environments are particularly important for the achievement of good practice in clinical training of student nurses, and thus, for the nursing competence development. Hence, it is important to have an instrument consisting of reliable and valid criteria for assessing the clinical learning environment, applicable in different contexts, and translated in the respondents mother tongue. The goal of the present research was to test the reliability and validity of the Slovenian version of the "Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale", and to compare it with the Croatian version. The data was collected between 10 March and 10 June 2015 at four Slovenian institutions, where nursing BSc study programmes are performed. The final sample consisted of 232 students (response rate 68.8%): 81.9% were females and 18.1% males, average age was 23. The translated instrument in Slovenian language resulted as reliable and valid, it reflects the expected five factors of the original version despite some minor problems in the factor structure and in test-retest. The most important difference between the Slovenian and Croatian version is in the factor structure regarding the implementation of roles in clinical learning environment. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Social construction : discursive perspective towards supervision

    OpenAIRE

    Naujanienė, Rasa

    2010-01-01

    The aim of publication is to discuss the development of supervision theory in relation with social and social work theory and practice. Main focus in the analysis is done to social constructionist ideas and its’ relevance to supervision practice. The development of supervision is related with supervision practice. Starting in 19th century supervision from giving practical advices supervision came to 21st century as dialog based on critical and philosophical reflection. Different theory and pr...

  18. A clinical trial of supervised exercise for adult inpatients with acute myeloid leukemia (AML) undergoing induction chemotherapy☆

    Science.gov (United States)

    Alibhai, Shabbir M.H.; O’Neill, Sara; Fisher-Schlombs, Karla; Breunis, Henriette; Brandwein, Joseph M.; Timilshina, Narhari; Tomlinson, George A.; Klepin, Heidi D.; Culos-Reed, S. Nicole

    2013-01-01

    Patients with acute myeloid leukemia (AML) receiving induction chemotherapy (IC) were enrolled in a supervised exercise intervention to determine safety, feasibility, and efficacy. Physical fitness measures, quality of life (QOL) and fatigue were assessed using standardized measures at baseline, post-induction, and post first consolidation. Retention was excellent, the intervention was safe, and efficacy estimates suggested benefits in physical fitness and QOL outcomes. Exercise is a safe, promising intervention for improving fitness and QOL in this patient population. These results provide a foundation for a randomized trial to better understand the impact of exercise during IC on clinically important outcomes. PMID:22726923

  19. A clinical trial of supervised exercise for adult inpatients with acute myeloid leukemia (AML) undergoing induction chemotherapy.

    Science.gov (United States)

    Alibhai, Shabbir M H; O'Neill, Sara; Fisher-Schlombs, Karla; Breunis, Henriette; Brandwein, Joseph M; Timilshina, Narhari; Tomlinson, George A; Klepin, Heidi D; Culos-Reed, S Nicole

    2012-10-01

    Patients with acute myeloid leukemia (AML) receiving induction chemotherapy (IC) were enrolled in a supervised exercise intervention to determine safety, feasibility, and efficacy. Physical fitness measures, quality of life (QOL) and fatigue were assessed using standardized measures at baseline, post-induction, and post first consolidation. Retention was excellent, the intervention was safe, and efficacy estimates suggested benefits in physical fitness and QOL outcomes. Exercise is a safe, promising intervention for improving fitness and QOL in this patient population. These results provide a foundation for a randomized trial to better understand the impact of exercise during IC on clinically important outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Supervision Experiences of Professional Counselors Providing Crisis Counseling

    Science.gov (United States)

    Dupre, Madeleine; Echterling, Lennis G.; Meixner, Cara; Anderson, Robin; Kielty, Michele

    2014-01-01

    In this phenomenological study, the authors explored supervision experiences of 13 licensed professional counselors in situations requiring crisis counseling. Five themes concerning crisis and supervision were identified from individual interviews. Findings support intensive, immediate crisis supervision and postlicensure clinical supervision.

  1. The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial.

    Science.gov (United States)

    Tousignant, Michel; Corriveau, Hélène; Roy, Pierre-Michel; Desrosiers, Johanne; Dubuc, Nicole; Hébert, Réjean; Tremblay-Boudreault, Valérie; Beaudoin, Audrée-Jeanne

    2012-01-01

    To assess some fall-related clinical variables (balance, gait, fear of falling, functional autonomy, self-actualization and self-efficacy) that might explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program. The participants (152 older adults over 65 who were admitted to a geriatric day hospital program) were randomly assigned to either a supervised Tai Chi group or the usual physiotherapy. The presence of the clinical variables related to falls was evaluated before the intervention (T1), immediately after (T2), and 12 months after the end of the intervention (T3). Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls. For both groups, most variables followed the same pattern, i.e. showed significant improvement with the intervention between T1 and T2, and followed by a statistically significant decrease at the T3 evaluation. However, self-efficacy was the only variable that improved solely with the Tai Chi intervention (p = 0.001). The impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance, gait and fear of falling. It appeared to be related to an increase of general self-efficacy, a phenomenon which is not seen in the conventional physiotherapy program.

  2. Reflections

    Directory of Open Access Journals (Sweden)

    Joanne Embree

    2001-01-01

    Full Text Available Ideally, editorials are written one to two months before publication in the Journal. It was my turn to write this one. I had planned to write the first draft the evening after my clinic on Tuesday, September 11. It didn't get done that night or during the next week. Somehow, the topic that I had originally chosen just didn't seem that important anymore as I, along my friends and colleagues, reflected on the changes that the events of that day were likely to have on our lives.

  3. Mobilization with movement and kinesiotaping compared with a supervised exercise program for painful shoulder: results of a clinical trial.

    Science.gov (United States)

    Djordjevic, Olivera C; Vukicevic, Danijela; Katunac, Ljiljana; Jovic, Stevan

    2012-07-01

    The purpose of this study was to compare the efficacy of Mobilization with Movement (MWM) and kinesiotaping (KT) techniques with a supervised exercise program in participants with patients with shoulder pain. Twenty subjects with shoulder pain were included if subjects were diagnosed by the referring physician with either rotator cuff lesion with impingement syndrome or impingement shoulder syndrome. Participants were randomly assigned to 1 of 2 groups after clinical and radiologic assessment: group 1 was treated with MWM and KT techniques, whereas group 2 was treated with a supervised exercise program. The main outcome measures were active pain-free shoulder abduction and flexion tested on days 0, 5, and 10. Improvement in active pain-free shoulder range of motion was significantly higher in the group treated with MWM and KT. Repeated-measures analysis of variance indicated significant effects of treatment, time, and treatment×time interaction. This study suggests that MWM and KT may be an effective and useful treatment in range of motion augmentation of subjects with rotator cuff lesion and impingement syndrome or impingement shoulder syndrome. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  4. Quality assurance of the clinical learning environment in Austria: Construct validity of the Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T scale).

    Science.gov (United States)

    Mueller, Gerhard; Mylonas, Demetrius; Schumacher, Petra

    2018-04-21

    Within nursing education, the clinical learning environment is of a high importance in regards to the development of competencies and abilities. The organization, atmosphere, and supervision in the clinical learning environment are only a few factors that influence this development. In Austria there is currently no valid instrument available for the evaluation of influencing factors. The aim of the study was to test the construct validity with principal component analysis as well as the internal consistency of the German Clinical Learning Environment, Supervision and Teacher Scale (CLES+T scale) in Austria. The present validation study has a descriptive-quantitative cross-sectional design. The sample consisted of 385 nursing students from thirteen training institutions in Austria. The data collection was carried out online between March and April 2016. Starting with a polychoric correlation matrix, a parallel analysis with principal component extraction and promax rotation was carried out due to the ordinal data. The exploratory ordinal factor analysis supported a four-component solution and explained 73% of the total variance. The internal consistency of all 25 items reached a Cronbach's α of 0.95 and the four components ranged between 0.83 and 0.95. The German version of the CLES+T scale seems to be a useful instrument for identifying potential areas of improvement in clinical practice in order to derive specific quality measures for the practical learning environment. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Adaptation and validation of the instrument Clinical Learning Environment and Supervision for medical students in primary health care

    Directory of Open Access Journals (Sweden)

    Eva Öhman

    2016-12-01

    Full Text Available Abstract Background Clinical learning takes place in complex socio-cultural environments that are workplaces for the staff and learning places for the students. In the clinical context, the students learn by active participation and in interaction with the rest of the community at the workplace. Clinical learning occurs outside the university, therefore is it important for both the university and the student that the student is given opportunities to evaluate the clinical placements with an instrument that allows evaluation from many perspectives. The instrument Clinical Learning Environment and Supervision (CLES was originally developed for evaluation of nursing students’ clinical learning environment. The aim of this study was to adapt and validate the CLES instrument to measure medical students’ perceptions of their learning environment in primary health care. Methods In the adaptation process the face validity was tested by an expert panel of primary care physicians, who were also active clinical supervisors. The adapted CLES instrument with 25 items and six background questions was sent electronically to 1,256 medical students from one university. Answers from 394 students were eligible for inclusion. Exploratory factor analysis based on principal component methods followed by oblique rotation was used to confirm the adequate number of factors in the data. Construct validity was assessed by factor analysis. Confirmatory factor analysis was used to confirm the dimensions of CLES instrument. Results The construct validity showed a clearly indicated four-factor model. The cumulative variance explanation was 0.65, and the overall Cronbach’s alpha was 0.95. All items loaded similarly with the dimensions in the non-adapted CLES except for one item that loaded to another dimension. The CLES instrument in its adapted form had high construct validity and high reliability and internal consistency. Conclusion CLES, in its adapted form, appears

  6. Supervised Learning

    Science.gov (United States)

    Rokach, Lior; Maimon, Oded

    This chapter summarizes the fundamental aspects of supervised methods. The chapter provides an overview of concepts from various interrelated fields used in subsequent chapters. It presents basic definitions and arguments from the supervised machine learning literature and considers various issues, such as performance evaluation techniques and challenges for data mining tasks.

  7. How Supervisor Experience Influences Trust, Supervision, and Trainee Learning: A Qualitative Study.

    Science.gov (United States)

    Sheu, Leslie; Kogan, Jennifer R; Hauer, Karen E

    2017-09-01

    Appropriate trust and supervision facilitate trainees' growth toward unsupervised practice. The authors investigated how supervisor experience influences trust, supervision, and subsequently trainee learning. In a two-phase qualitative inductive content analysis, phase one entailed reviewing 44 internal medicine resident and attending supervisor interviews from two institutions (July 2013 to September 2014) for themes on how supervisor experience influences trust and supervision. Three supervisor exemplars (early, developing, experienced) were developed and shared in phase two focus groups at a single institution, wherein 23 trainees validated the exemplars and discussed how each impacted learning (November 2015). Phase one: Four domains of trust and supervision varying with experience emerged: data, approach, perspective, clinical. Early supervisors were detail oriented and determined trust depending on task completion (data), were rule based (approach), drew on their experiences as trainees to guide supervision (perspective), and felt less confident clinically compared with more experienced supervisors (clinical). Experienced supervisors determined trust holistically (data), checked key aspects of patient care selectively and covertly (approach), reflected on individual experiences supervising (perspective), and felt comfortable managing clinical problems and gauging trainee abilities (clinical). Phase two: Trainees felt the exemplars reflected their experiences, described their preferences and learning needs shifting over time, and emphasized the importance of supervisor flexibility to match their learning needs. With experience, supervisors differ in their approach to trust and supervision. Supervisors need to trust themselves before being able to trust others. Trainees perceive these differences and seek supervision approaches that align with their learning needs.

  8. Comparison of Effectiveness of Supervised Exercise Program and Cyriax Physiotherapy in Patients with Tennis Elbow (Lateral Epicondylitis): A Randomized Clinical Trial

    Science.gov (United States)

    Viswas, Rajadurai; Ramachandran, Rejeeshkumar; Korde Anantkumar, Payal

    2012-01-01

    Objective. To compare the effectiveness of supervised exercise program and Cyriax physiotherapy in the treatment of tennis elbow (lateral epicondylitis). Design. Randomized clinical trial. Setting. Physiotherapy and rehabilitation centre. Subjects. This study was carried out with 20 patients, who had tennis elbow (lateral epicondylitis). Intervention. Group A (n = 10) had received supervised exercise program. Group B (n = 10) was treated with Cyriax physiotherapy. All patients received three treatment sessions per week for four weeks (12 treatment sessions). Outcome measures. Pain was evaluated using a visual analogue scale (VAS), and functional status was evaluated by completion of the Tennis Elbow Function Scale (TEFS) which were recorded at base line and at the end of fourth week. Results. Both the supervised exercise program and Cyriax physiotherapy were found to be significantly effective in reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in greater improvement in comparison to those who received Cyriax physiotherapy. Conclusion. The results of this clinical trial demonstrate that the supervised exercise program may be the first treatment choice for therapist in managing tennis elbow. PMID:22629225

  9. Comparison of Effectiveness of Supervised Exercise Program and Cyriax Physiotherapy in Patients with Tennis Elbow (Lateral Epicondylitis: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Rajadurai Viswas

    2012-01-01

    Full Text Available Objective. To compare the effectiveness of supervised exercise program and Cyriax physiotherapy in the treatment of tennis elbow (lateral epicondylitis. Design. Randomized clinical trial. Setting. Physiotherapy and rehabilitation centre. Subjects. This study was carried out with 20 patients, who had tennis elbow (lateral epicondylitis. Intervention. Group A (=10 had received supervised exercise program. Group B (=10 was treated with Cyriax physiotherapy. All patients received three treatment sessions per week for four weeks (12 treatment sessions. Outcome measures. Pain was evaluated using a visual analogue scale (VAS, and functional status was evaluated by completion of the Tennis Elbow Function Scale (TEFS which were recorded at base line and at the end of fourth week. Results. Both the supervised exercise program and Cyriax physiotherapy were found to be significantly effective in reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in greater improvement in comparison to those who received Cyriax physiotherapy. Conclusion. The results of this clinical trial demonstrate that the supervised exercise program may be the first treatment choice for therapist in managing tennis elbow.

  10. Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services.

    Science.gov (United States)

    Alleyne, Jo; Jumaa, Mansour Olawale

    2007-03-01

    The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, 'Our Health, Our Care, Our Say' and the recent proposals from the article 'Modernising Nursing Career', to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop 'actionable knowledge'. Group clinical supervision was not practised in this study as a form of 'therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and

  11. Nursing supervision for care comprehensiveness.

    Science.gov (United States)

    Chaves, Lucieli Dias Pedreschi; Mininel, Vivian Aline; Silva, Jaqueline Alcântara Marcelino da; Alves, Larissa Roberta; Silva, Maria Ferreira da; Camelo, Silvia Helena Henriques

    2017-01-01

    To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks. refletir a supervisão de enfermagem como instrumento gerencial do enfermeiro para integralidade do cuidado, considerando suas potencialidades e limitações no cenário atual. estudo reflexivo baseado na formulação discursiva sobre a supervisão de enfermagem, apresentando conceitos e enfoques teóricos e/ou práticos. limitações no exercício da supervisão estão relacionadas à organização dos serviços de saúde embasada no modelo funcional e clínico de atenção, assim como possíveis lacunas no processo de formação do enfermeiro e sobrecarga de trabalho. Quanto às potencialidades, destaca-se a supervisão como instrumento de articulação de ações assistenciais e gerenciais, que pode favorecer integralidade da atenção, estimular atitudes de cooperação e colaboração em equipe, além da corresponsabilização e promoção da educação no trabalho. supervisão de enfermagem pode contribuir para fortalecimento da integralidade do cuidado, pressupondo reflexão cont

  12. Instructional Supervision and Its Relationship with Professional Development: Perception of Private and Government Secondary School Teachers in Addis Ababa

    Science.gov (United States)

    Tesfaw, T. A.; Hofman, R. H.

    2012-01-01

    (Purpose) The purpose of this study is to examine the existing perceptions and preferences of teachers toward instructional supervision, more specifically on the actual and ideal use of selected instructional supervisory approaches (such as clinical supervision, peer coaching, cognitive coaching, mentoring, reflective coaching, teaching…

  13. The Strategic Impact of Clinical Practice Guidelines in Nursing on the Managerial Function of Supervision

    Directory of Open Access Journals (Sweden)

    Jose Antonio Vinagre Romero

    2013-10-01

    Full Text Available Clinical practice guidelines in nursing (CPG-N are tools that allow the necessary knowledge that frequently remains specialist-internalised to be made explicit. These tools are a complement to risk adjustment systems (RAS, reinforcing their effectiveness and permitting a rationalisation of healthcare costs. This theoretical study defends the importance of building and using CPG-Ns as instruments to support the figure of the nursing supervisor in order to optimise the implementation of R&D and hospital quality strategies, enabling clinical excellence in nursing processes and cost-efficient reallocation of economic resources through their linear integration with SARs.

  14. Applicability of supervised discriminant analysis models to analyze astigmatism clinical trial data.

    Science.gov (United States)

    Sedghipour, Mohammad Reza; Sadeghi-Bazargani, Homayoun

    2012-01-01

    In astigmatism clinical trials where more complex measurements are common, especially in nonrandomized small sized clinical trials, there is a demand for the development and application of newer statistical methods. The source data belonged to a project on astigmatism treatment. Data were used regarding a total of 296 eyes undergoing different astigmatism treatment modalities: wavefront-guided photorefractive keratectomy, cross-cylinder photorefractive keratectomy, and monotoric (single) photorefractive keratectomy. Astigmatism analysis was primarily done using the Alpins method. Prior to fitting partial least squares regression discriminant analysis, a preliminary principal component analysis was done for data overview. Through fitting the partial least squares regression discriminant analysis statistical method, various model validity and predictability measures were assessed. The model found the patients treated by the wavefront method to be different from the two other treatments both in baseline and outcome measures. Also, the model found that patients treated with the cross-cylinder method versus the single method didn't appear to be different from each other. This analysis provided an opportunity to compare the three methods while including a substantial number of baseline and outcome variables. Partial least squares regression discriminant analysis had applicability for the statistical analysis of astigmatism clinical trials and it may be used as an adjunct or alternative analysis method in small sized clinical trials.

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

    NARCIS (Netherlands)

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

    2015-01-01

    Although competency-based education is well established in health care education, research shows that the competencies do not always match the reality of clinical workplaces. Therefore, there is a need to design feasible and evidence-based competency frameworks that fit the workplace reality. This

  16. Mutual assumptions and facts about nondisclosure among clinical supervisors and students in group supervision

    DEFF Research Database (Denmark)

    Nielsen, Geir Høstmark; Skjerve, Jan; Jacobsen, Claus Haugaard

    2009-01-01

    In the two preceding papers of this issue of Nordic Psychology the authors report findings from a study of nondisclosure among student therapists and clinical supervisors. The findings were reported separately for each group. In this article, the two sets of findings are held together and compared......, so as to draw a picture of mutual assumptions and facts about nondisclosure among students and supervisors....

  17. Evaluating students' perception of their clinical placements - testing the clinical learning environment and supervision and nurse teacher scale (CLES + T scale) in Germany.

    Science.gov (United States)

    Bergjan, Manuela; Hertel, Frank

    2013-11-01

    Clinical nursing education in Germany has not received attention in nursing science and practice for a long time, as it often seems to be a more or less "formalized appendix" of nursing education. Several development projects of clinical education taking place are mainly focused on the qualification of clinical preceptors. However, the clinical context and its influence on learning processes have still not been sufficiently investigated. The aim of this study was the testing of a German version of the clinical learning environment and supervision and nurse teacher scale (CLES + T scale). The sample of the pilot study consists of first-, second- and third-year student nurses (n=240) of a university nursing school from January to March 2011. Psychometric testing of the instrument is carried out by selected methods of classical testing theories using SPPS 19. The results show transferability of all subcategories of the CLES + T scale in the non-academic nursing education system of a university hospital in Germany, without the teacher scale. The strongest factor is "supervisory relationship". The German version of the CLES + T scale may help to evaluate and compare traditional and new models in clinical nursing education. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Whither Supervision?

    OpenAIRE

    Duncan Waite

    2006-01-01

    This paper inquires if the school supervision is in decadence. Dr. Waite responds that the answer will depend on which perspective you look at it. Dr. Waite suggests taking in consideration three elements that are related: the field itself, the expert in the field (the professor, the theorist, the student and the administrator), and the context. When these three elements are revised, it emphasizes that there is not a consensus about the field of supervision, but there are coincidences related...

  19. Supervised methods for detection and segmentation of tissues in clinical lumbar MRI.

    Science.gov (United States)

    Ghosh, Subarna; Chaudhary, Vipin

    2014-10-01

    Lower back pain (LBP) is widely prevalent all over the world and more than 80% of the people suffer from LBP at some point of their lives. Moreover, a shortage of radiologists is the most pressing cause for the need of CAD (computer-aided diagnosis) systems. Automatic localization and labeling of intervertebral discs from lumbar MRI is the first step towards computer-aided diagnosis of lower back ailments. Subsequently, for diagnosis and characterization (quantification and localization) of abnormalities like disc herniation and stenosis, a completely automatic segmentation of intervertebral discs and the dural sac is extremely important. Contribution of this paper towards clinical CAD systems is two-fold. First, we propose a method to automatically detect all visible intervertebral discs in clinical sagittal MRI using heuristics and machine learning techniques. We provide a novel end-to-end framework that outputs a tight bounding box for each disc, instead of simply marking the centroid of discs, as has been the trend in the recent past. Second, we propose a method to simultaneously segment all the tissues (vertebrae, intervertebral disc, dural sac and background) in a lumbar sagittal MRI, using an auto-context approach instead of any explicit shape features or models. Past work tackles the lumbar segmentation problem on a tissue/organ basis, and which tend to perform poorly in clinical scans due to high variability in appearance. We, on the other hand, train a series of robust classifiers (random forests) using image features and sparsely sampled context features, which implicitly represent the shape and configuration of the image. Both these methods have been tested on a huge clinical dataset comprising of 212 cases and show very promising results for both disc detection (98% disc localization accuracy and 2.08mm mean deviation) and sagittal MRI segmentation (dice similarity indices of 0.87 and 0.84 for the dural sac and the inter-vertebral disc, respectively

  20. Applicability of supervised discriminant analysis models to analyze astigmatism clinical trial data

    Directory of Open Access Journals (Sweden)

    Sedghipour MR

    2012-09-01

    Full Text Available Mohammad Reza Sedghipour,1 Homayoun Sadeghi-Bazargani2,31Nikoukari Ophthalmology University Hospital, Tabriz, Iran; 2Department of Statistics and Epidemiology, Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Public Health Sciences, Karolinska Institute, Stockholm, SwedenBackground: In astigmatism clinical trials where more complex measurements are common, especially in nonrandomized small sized clinical trials, there is a demand for the development and application of newer statistical methods.Methods: The source data belonged to a project on astigmatism treatment. Data were used regarding a total of 296 eyes undergoing different astigmatism treatment modalities: wavefront-guided photorefractive keratectomy, cross-cylinder photorefractive keratectomy, and monotoric (single photorefractive keratectomy. Astigmatism analysis was primarily done using the Alpins method. Prior to fitting partial least squares regression discriminant analysis, a preliminary principal component analysis was done for data overview. Through fitting the partial least squares regression discriminant analysis statistical method, various model validity and predictability measures were assessed.Results: The model found the patients treated by the wavefront method to be different from the two other treatments both in baseline and outcome measures. Also, the model found that patients treated with the cross-cylinder method versus the single method didn't appear to be different from each other. This analysis provided an opportunity to compare the three methods while including a substantial number of baseline and outcome variables.Conclusion: Partial least squares regression discriminant analysis had applicability for the statistical analysis of astigmatism clinical trials and it may be used as an adjunct or alternative analysis method in small sized clinical trials.Keywords: astigmatism, regression, partial least squares regression

  1. Reflections on Clinical Learning in Novice Speech-Language Therapy Students

    Science.gov (United States)

    Hill, Anne E.; Davidson, Bronwyn J.; Theodoros, Deborah G.

    2012-01-01

    Background: Reflective practice is reported to enhance clinical reasoning and therefore to maximize client outcomes. The inclusion of targeted reflective practice in academic programmes in speech-language therapy has not been consistent, although providing opportunities for speech-language therapy students to reflect during their clinical practice…

  2. Preparing supervisors to provide safeguarding supervision for healthcare staff.

    Science.gov (United States)

    Smikle, Marcia

    2017-11-28

    This paper outlines why experienced supervisors at a London healthcare provider received skills training so they could offer safeguarding supervision to front-line colleagues with case management responsibilities for vulnerable children and young people. It examines how supervisors use the main functions of supervision and a cycle of reflection in clinical practice with supervisees. As well as the professional issues encountered by supervisors in relation to the benefits, the challenges of providing supervision and the action required to make safeguarding supervision a part of the organisational culture are also explored. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  3. The effectiveness of telemedicine-delivered opioid agonist therapy in a supervised clinical setting.

    Science.gov (United States)

    Eibl, Joseph K; Gauthier, Graham; Pellegrini, David; Daiter, Jeffery; Varenbut, Michael; Hogenbirk, John C; Marsh, David C

    2017-07-01

    Opioid use disorder has been declared a public health crisis across North America and opioid agonist therapy (OAT) is the standard of care for these patients. Despite the increasing adoption of telemedicine as a delivery method for OAT, its effectiveness has not yet been evaluated against traditional in-person treatment. This study compared treatment outcomes for in-person versus telemedicine-delivered OAT. We conducted a non-randomized cohort comparison study using an administrative database for patients who commenced OAT between 2011 and 2012 across 58 clinic sites in the province of Ontario, Canada. Patients were stratified by primary treatment modality as being: in-person (telemedicine), mixed (25-75% by telemedicine), or via telemedicine (>75% appointments by telemedicine). The primary outcome was continuous retention in treatment as defined by one year of uninterrupted therapy, based on pharmacy dosing records. A total of 3733 OAT initiating patients were identified. Patients treated via telemedicine were more likely to be retained in therapy than patients treated in-person (n=1590; aOR=1.27; 95% CI 1.14-1.41; pTelemedicine patients demonstrated a retention rate of 50% at one year whereas in-person patients were retained at a rate of 39%. The mixed group also had higher likelihood of retention than the in-person group (n=418; aOR=1.26; 95% CI 1.08-1.47; p=0.001) and had a retention rate of 47% at one year. Telemedicine may be an effective alternative to delivering in person OAT, and it has the potential to expand access to care in rural, remote, and urban regions. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  4. Whither Supervision?

    Directory of Open Access Journals (Sweden)

    Duncan Waite

    2006-11-01

    Full Text Available This paper inquires if the school supervision is in decadence. Dr. Waite responds that the answer will depend on which perspective you look at it. Dr. Waite suggests taking in consideration three elements that are related: the field itself, the expert in the field (the professor, the theorist, the student and the administrator, and the context. When these three elements are revised, it emphasizes that there is not a consensus about the field of supervision, but there are coincidences related to its importance and that it is related to the improvement of the practice of the students in the school for their benefit. Dr. Waite suggests that the practice on this field is not always in harmony with what the theorists affirm. When referring to the supervisor or the skilled person, the author indicates that his or her perspective depends on his or her epistemological believes or in the way he or she conceives the learning; that is why supervision can be understood in different ways. About the context, Waite suggests that there have to be taken in consideration the social or external forces that influent the people and the society, because through them the education is affected. Dr. Waite concludes that the way to understand the supervision depends on the performer’s perspective. He responds to the initial question saying that the supervision authorities, the knowledge on this field, the performers, and its practice, are maybe spread but not extinct because the supervision will always be part of the great enterprise that we called education.

  5. Video games use patterns and parenteral supervision in a clinical sample of Hispanic adolescents 13-17 years old.

    Science.gov (United States)

    Colón-de Martí, Luz N; Rodríguez-Figueroa, Linnette; Nazario, Lelis L; Gutiérrez, Roberto; González, Alexis

    2012-01-01

    Video games have become a popular entertainment among adolescents. Although some video games are educational, there are others with high content of violence and the potential for other harmful effects. Lack of appropriate supervision of video games use during adolescence, a crucial stage of development, may lead to serious behavioral consequences in some adolescents. There is also concern about time spent playing video games and the subsequent neglect of more developmentally appropriate activities, such as completing academic tasks. Self-administered questionnaires were used to assess video game use patterns and parental supervision among 55 adolescent patients 13-17 years old (mean age 14.4 years; 56.4% males) and their parents. Parental supervision /monitoring of the adolescents video games use was not consistent and gender related differences were found regarding their video game use. Close to one third (32%) of the participants reported video game playing had interfered with their academic performance. Parents who understood video games rating system were more likely to prohibit their use due to rating. These findings underscore the need for clear and consistently enforced rules and monitoring of video games use by adolescents. Parents need to be educated about the relevance of their supervision, video games content and rating system; so they will decrease time playing and exposure to potentially harmful video games. It also supports the relevance of addressing supervision, gender-based parental supervisory styles, and patterns of video games use in the evaluation and treatment of adolescents.

  6. Evaluation of the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision: An embedded evaluation

    Directory of Open Access Journals (Sweden)

    Khorasani Parvaneh

    2016-08-01

    Full Text Available Background and Objective: Currently, patient education has been considered in medical centers. Clinical provision, which is one of the legal tools with training-support dimensions, can evaluate the consistency between the implemented procedures and the planned ones. This study aimed to evaluate the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision. Materials and Methods: This longitudinal, embedded study was conducted during 2013-2015 in three stages of designing, implementation, and evaluation of the supervision program using randomized convenience sampling on 786 monitoring units (medical records of patients being discharged at Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. In the designing stage, the checklists for supervision of recording patient education and consistency of patient perception with the recorded trainings and the patient satisfaction questionnaire were designed and their valididty and reliability were established. In the implementation stage, structure of the monitoring program was designed with the cooperation of eight supervisors. During 12 months, 2333 checklists and questionnaires were completed at the time of hospital discharge in the evaluation stage. Data analysis was performed in SPSS, version 18, using One-way ANOVA. Results: After 12 months of embedded evaluation, the mean score of recording patient education was 88.5±21.75, and the mean scores of patient satisfaction with the training process and consistency between patients’ perception and the recorded trainings were 47.17±21.48 and 73±25.13, respectively. The mean scores of recording patient training and consistency between patients’ perception and the recorded trainings had an increasing trend (P<0.001, while the mean score of patient satisfaction reduced (P<0.001. Conclusion: The results of clinical supervision during

  7. Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial

    DEFF Research Database (Denmark)

    Hartvigsen, Jan; Morsø, Lars; Bendix, Tom

    2010-01-01

    BACKGROUND: Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Nordic Walking - power walking using ski poles...... - is a popular and fast growing type of exercise in Northern Europe that has been shown to improve cardiovascular metabolism. Until now, no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to back pain. METHODS: A total of 151 patients with low back and/or leg...... pain of greater than eight weeks duration were recruited from a hospital based outpatient back pain clinic. Patients continuing to have pain greater than three on the 11-point numeric rating scale after a multidisciplinary intervention were included. Fifteen patients were unable to complete...

  8. Online supervision at the university

    DEFF Research Database (Denmark)

    Bengtsen, Søren Smedegaard; Jensen, Gry Sandholm

    2015-01-01

    supervision proves unhelpful when trying to understand how online supervision and feedback is a pedagogical phenomenon in its own right, and irreducible to the face-to-face context. Secondly we show that not enough attention has been given to the way different digital tools and platforms influence...... pedagogy we forge a new concept of “format supervision” that enables supervisors to understand and reflect their supervision practice, not as caught in the physical-virtual divide, but as a choice between face-to-face and online formats that each conditions the supervisory dialogue in their own particular...

  9. Implementation of a Contingency Management-Based Intervention in a Community Supervision Setting: Clinical Issues and Recommendations

    Science.gov (United States)

    Trotman, Adria J.; Taxman, Faye S.

    2011-01-01

    A cognitive-behaviorally based substance abuse treatment program was implemented within a community supervision setting. This program included a goals group that used a contingency management component and included the probation agent as a part of the treatment. In this article, the authors describe the contingency management component of the…

  10. Reflective blogs in clinical education to promote critical thinking in dental hygiene students.

    Science.gov (United States)

    Wetmore, Ann O'Kelley; Boyd, Linda D; Bowen, Denise M; Pattillo, Robin E

    2010-12-01

    One challenge facing dental hygiene, as well as dental, education is to identify clinical teaching strategies promoting critical thinking and clinical reasoning. These skills are crucial elements in the practice of dental hygiene. A two-group design (intervention, n=28, and control, n=30) assessed first-year dental hygiene students using pre-and post-Health Science Reasoning Test (HSRT) scores to evaluate the effect of reflective blogging on critical thinking skills. A reflective blog rubric, based on Mezirow's levels of reflection, determined if reflective blogging increased the level of reflection for dental hygiene students. The results suggest within this nonprobability sample that reflective blogging did not produce a significant change in students' HSRT scores (p>0.05). However, analyses of reflective blog rubric scores demonstrated statistically significant improvements (pcritical thinking.

  11. Supervision Experiences of New Professional School Counselors

    Science.gov (United States)

    Bultsma, Shawn A.

    2012-01-01

    This qualitative study examined the supervision experiences of 11 new professional school counselors. They reported that their supervision experiences were most often administrative in nature; reports of clinical and developmental supervision were limited to participants whose supervisors were licensed as professional counselors. In addition,…

  12. A Qualitative Inquiry into Nursing Students’ Experience of Facilitating Reflection in Clinical Setting

    Directory of Open Access Journals (Sweden)

    Shahnaz Karimi

    2017-01-01

    Full Text Available Background and Aim. Reflection is known as a skill that is central to nursing students’ professional development. Due to the importance and the role of reflection in clinical areas of nursing, it is important to know how to achieve it. However, nursing trainers face the challenge of how to help their students to improve reflection in clinical settings. The aim of this study was to investigate the nursing students’ experiences of facilitating reflection during clinical practice. This qualitative study was conducted by qualitative content analysis approach. Twenty nursing students during the second to eighth semester of their educational program were selected for participation using purposive sampling. Data were collected through in-depth semistructured interviews. The interview was transcribed verbatim, and qualitative content analysis was used to analyze the data. From the data analysis, four main themes were extracted. Motivation to reflect, complex experiences, efficient trainer, and effective relations were four main themes obtained from study that, in interaction with each other, had facilitating roles in students’ reflective process on experiences. The findings revealed that the nursing students’ reflection in clinical settings is effective in personal and professional level. Reflection of nursing students depends on motivational and educational factors and these factors increase the quality of care in patients. Furthermore, nursing educators need to create nurturing climate as well as supporting reflective behaviors of nursing students.

  13. On the Science of Consciousness: Epistemological Reflections and Clinical Implications.

    Science.gov (United States)

    Facco, Enrico; Lucangeli, Daniela; Tressoldi, Patrizio

    Consciousness has been one of the most important and tantalizing issues ever since the origin of philosophy and medicine. The concept of consciousness and the so-called "hard problem" (i.e., the mind-brain relationship) are highly complex topics that have yet to be elucidated, involving the realms of both science and philosophy with profound epistemological implications. In the lively debate on the foundations of the science of consciousness there are several potential biases of an essentially philosophical nature, such as those related to the paradigm and axioms adopted, and the ostensible logical contradiction between monism and dualism. Their origin dates back largely to Descartes' thinking and the birth of the new sciences as a compromise with the Inquisition, but they have been handed down through the Enlightenment and Positivism. A proper investigation of consciousness and the world of subjectivity demands a careful reflection on the paradigm of scientific medicine to identify possible flaws and overcome the limits of the mechanistic-reductionist approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. [Clinical ethics consultation - an integrative model for practice and reflection].

    Science.gov (United States)

    Reiter-Theil, Stella

    2008-07-01

    Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.

  15. Promoting self-reflection in clinical practice among Chinese nursing undergraduates in Hong Kong.

    Science.gov (United States)

    Ip, Wan Yim; Lui, May H; Chien, Wai Tong; Lee, Iris F; Lam, Lai Wah; Lee, Diana T

    2012-06-01

    This study evaluated the effect of a structured education programme on improving the self-reflection skills of Chinese nursing undergraduates in managing clinical situations. Johns' Structured Reflection Model was used as a framework for the development of the education programme. Thirty-eight nursing undergraduates attended a 3-hour interactive workshop on reflective skills and were encouraged to practise the skills learned under the guidance of a nurse instructor during their 4-week clinical practicum. The findings indicated that the programme was helpful in improving the undergraduates' reflective skills though only a few of them reached the highest level as critical reflectors. Some undergraduates identified time constraints and the lack of a trusting relationship with their nurse instructor as barriers to their reflective learning. The findings may help nurse educators develop education programmes with structured learning strategies to promote nursing undergraduates' self-refection in clinical practice.

  16. [Validity and Reliability of the Korean Version Scale of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale (CLES+T)].

    Science.gov (United States)

    Kim, Sun Hee; Yoo, So Yeon; Kim, Yae Young

    2018-02-01

    This study was conducted to evaluate the validity and reliability of the Korean version of the clinical learning environment, supervision and nurse teacher evaluation scale (CLES+T) that measures the clinical learning environment and the conditions associated with supervision and nurse teachers. The English CLES+T was translated into Korean with forward and back translation. Survey data were collected from 434 nursing students who had more than four days of clinical practice in Korean hospitals. Internal consistency reliability and construct validity using confirmatory and exploratory factor analysis were conducted. SPSS 20.0 and AMOS 22.0 programs were used for data analysis. The exploratory factor analysis revealed seven factors for the thirty three-item scale. Confirmatory factor analysis supported good convergent and discriminant validities. The Cronbach's alpha for the overall scale was .94 and for the seven subscales ranged from .78 to .94. The findings suggest that the 33-items Korean CLES+T is an appropriate instrument to measure Korean nursing students'clinical learning environment with good validity and reliability. © 2018 Korean Society of Nursing Science.

  17. Exploring Prospective Teachers’ Reflections in the Context of Conducting Clinical Interviews

    Directory of Open Access Journals (Sweden)

    Rukiye Didem Taylan

    2018-04-01

    Full Text Available This study investigated prospective mathematics teachers’ reflections on the experience of designing and conducting one-to-one clinical interviews with middle school students in the context of an elective course on use of video in teacher learning. Prospective teachers were asked to write about weaknesses and strengths in student understanding as well as their own performance as an interviewer in terms of asking questions and responding to student thinking in their reflections on conducting clinical interviews. Furthermore, prospective teachers were also asked to reflect on what they would do differently in order to conduct better clinical interviews. Nature of prospective teachers’ reflections were analyzed by using existing frameworks (through constructs of reflection-on-action and reflection-for-action and by using thematic analysis. Results of data analyses revealed that prospective teachers had more difficulties in providing meaningful reflection-for-action which was related to alternative decisions and planning for future similar interviews. Thematic analysis results revealed prospective teachers’ learning were grouped under three categories: conducting clinical interviews as part of being a teacher, complexity of conducting clinical interviews, and personal theories about middle school students. There are implications for both teacher learning and research.

  18. Development of reflective judgement in the pre-doctoral dental clinical curriculum.

    Science.gov (United States)

    Boyd, L D

    2008-08-01

    When dental students begin patient care in the clinical curriculum, they are required to move from the well-defined problems of the classroom to the more ambiguous and real life problems encountered in the context of patient care in the clinical setting. This change in learning environment requires development of reflective thinking. Reflective thinking refers to the process of thinking about uncertainty or ill-defined problems. King and Kitchener refer to the outcome of the reflective thinking process as reflective judgement. The purpose of this study was to explore the development of reflective judgement in the initial phase of the clinical curriculum. This exploratory study used a case study approach with qualitative methods. A convenience sample of third year predoctoral dental students (n = 16) volunteered to participate in writing a clinic journal and semi-structured interviews at three time points over a time period of one year. Student compliance in writing clinical journals was poor; therefore the qualitative data was primarily gathered from interview transcripts. The qualitative interview data were analysed using a coding scheme based on King and Kitchener's Reflective Judgement Model of Intellectual Development. The Cronbach alpha was 0.76 for reliability of the coding scheme. Based on the analysis of interview data, the there was an average growth in reflective judgement over the year from Stage 4.89 to 5.59 for an overall change of +0.70. Additional research is needed to explore the growth in reflective judgement over the final year of the clinical curriculum as well as to identify the most effective educational strategies to facilitate growth in reflective judgment.

  19. Journaling and dialogue pairs to promote reflection in clinical nursing education.

    Science.gov (United States)

    Van Horn, Rita; Freed, Shirley

    2008-01-01

    This research focused on the use of writing to increase reflection and problem solving in the clinical setting. Two groups of associate degree students provided clinical care and maintained journals, answering a series of focused questions. One group of students worked as individuals in the clinical setting; the other consisted of students working in pairs. There were significant differences between levels of reflection of students who worked in pairs and those who were not paired. Three major themes were found in students' journals: emotions, connections between theory and practice, and learning.

  20. Effect of Granulocyte-Macrophage Colony-Stimulating Factor With or Without Supervised Exercise on Walking Performance in Patients With Peripheral Artery Disease: The PROPEL Randomized Clinical Trial.

    Science.gov (United States)

    McDermott, Mary M; Ferrucci, Luigi; Tian, Lu; Guralnik, Jack M; Lloyd-Jones, Donald; Kibbe, Melina R; Polonsky, Tamar S; Domanchuk, Kathryn; Stein, James H; Zhao, Lihui; Taylor, Doris; Skelly, Christopher; Pearce, William; Perlman, Harris; McCarthy, Walter; Li, Lingyu; Gao, Ying; Sufit, Robert; Bloomfield, Christina L; Criqui, Michael H

    2017-12-05

    Benefits of granulocyte-macrophage colony-stimulating factor (GM-CSF) for improving walking ability in people with lower extremity peripheral artery disease (PAD) are unclear. Walking exercise may augment the effects of GM-CSF in PAD, since exercise-induced ischemia enhances progenitor cell release and may promote progenitor cell homing to ischemic calf muscle. To determine whether GM-CSF combined with supervised treadmill exercise improves 6-minute walk distance, compared with exercise alone and compared with GM-CSF alone; to determine whether GM-CSF alone improves 6-minute walk more than placebo and whether exercise improves 6-minute walk more than an attention control intervention. Randomized clinical trial with 2 × 2 factorial design. Participants were identified from the Chicago metropolitan area and randomized between January 6, 2012, and December 22, 2016, to 1 of 4 groups: supervised exercise + GM-CSF (exercise + GM-CSF) (n = 53), supervised exercise + placebo (exercise alone) (n = 53), attention control  + GM-CSF (GM-CSF alone) (n = 53), attention control + placebo (n = 51). The final follow-up visit was on August 15, 2017. Supervised exercise consisted of treadmill exercise 3 times weekly for 6 months. The attention control consisted of weekly educational lectures by clinicians for 6 months. GM-CSF (250 μg/m2/d) or placebo were administered subcutaneously (double-blinded) 3 times/wk for the first 2 weeks of the intervention. The primary outcome was change in 6-minute walk distance at 12-week follow-up (minimum clinically important difference, 20 m). P values were adjusted based on the Hochberg step-up method. Of 827 persons evaluated, 210 participants with PAD were randomized (mean age, 67.0 [SD, 8.6] years; 141 [67%] black, 82 [39%] women). One hundred ninety-five (93%) completed 12-week follow-up. At 12-week follow-up, exercise + GM-CSF did not significantly improve 6-minute walk distance more than

  1. Self-Reflection of Video-Recorded High-Fidelity Simulations and Development of Clinical Judgment.

    Science.gov (United States)

    Bussard, Michelle E

    2016-09-01

    Nurse educators are increasingly using high-fidelity simulators to improve prelicensure nursing students' ability to develop clinical judgment. Traditionally, oral debriefing sessions have immediately followed the simulation scenarios as a method for students to connect theory to practice and therefore develop clinical judgment. Recently, video recording of the simulation scenarios is being incorporated. This qualitative, interpretive description study was conducted to identify whether self-reflection on video-recorded high-fidelity simulation (HFS) scenarios helped prelicensure nursing students to develop clinical judgment. Tanner's clinical judgment model was the framework for this study. Four themes emerged from this study: Confidence, Communication, Decision Making, and Change in Clinical Practice. This study indicated that self-reflection of video-recorded HFS scenarios is beneficial for prelicensure nursing students to develop clinical judgment. [J Nurs Educ. 2016;55(9):522-527.]. Copyright 2016, SLACK Incorporated.

  2. The effect of education and supervised exercise vs. education alone on the time to total hip replacement in patients with severe hip osteoarthritis. A randomized clinical trial protocol.

    Science.gov (United States)

    Jensen, Carsten; Roos, Ewa M; Kjærsgaard-Andersen, Per; Overgaard, Søren

    2013-01-14

    The age- and gender-specific incidence of total hip replacement surgery has increased over the last two decades in all age groups. Recent studies indicate that non-surgical interventions are effective in reducing pain and disability, even at later stages of the disease when joint replacement is considered. We hypothesize that the time to hip replacement can be postponed in patients with severe hip osteoarthritis following participation in a patient education and supervised exercise program when compared to patients receiving patient education alone. A prospective, blinded, parallel-group multi-center trial (2 sites), with balanced randomization [1:1]. Patients with hip osteoarthritis and an indication for hip replacement surgery, aged 40 years and above, will be consecutively recruited and randomized into two treatment groups. The active treatment group will receive 3 months of supervised exercise consisting of 12 sessions of individualized, goal-based neuromuscular training, and 12 sessions of intensive resistance training plus patient education (3 sessions). The control group will receive only patient education (3 sessions). The primary end-point for assessing the effectiveness of the intervention is 12 months after baseline. However, follow-ups will also be performed once a year for at least 5 years. The primary outcome measure is the time to hip replacement surgery measured on a Kaplain-Meier survival curve from time of inclusion. Secondary outcome measures are the five subscales of the Hip disability and Osteoarthritis Outcome Score, physical activity level (UCLA activity score), and patient's global perceived effect. Other measures include pain after exercise, joint-specific adverse events, exercise adherence, general health status (EQ-5D-5L), mechanical muscle strength and performance in physical tests. A cost-effectiveness analysis will also be performed. To our knowledge, this is the first randomized clinical trial comparing a patient education plus

  3. Comparison of a prepCheck-supported self-assessment concept with conventional faculty supervision in a pre-clinical simulation environment.

    Science.gov (United States)

    Wolgin, M; Grabowski, S; Elhadad, S; Frank, W; Kielbassa, A M

    2018-03-25

    This study aimed to evaluate the educational outcome of a digitally based self-assessment concept (prepCheck; DentsplySirona, Wals, Austria) for pre-clinical undergraduates in the context of a regular phantom-laboratory course. A sample of 47 third-year dental students participated in the course. Students were randomly divided into a prepCheck-supervised (self-assessment) intervention group (IG; n = 24); conventionally supervised students constituted the control group (CG; n = 23). During the preparation of three-surface (MOD) class II amalgam cavities, each IG participant could analyse a superimposed 3D image of his/her preparation against the "master preparation" using the prepCheck software. In the CG, several course instructors performed the evaluations according to pre-defined assessment criteria. After completing the course, a mandatory (blinded) practical examination was taken by all course participants (both IG and CG students), and this assessment involved the preparation of a MOD amalgam cavity. Then, optical impressions by means of a CEREC-Omnicam were taken to digitalize all examination preparations, followed by surveying and assessing the latter using prepCheck. The statistical analysis of the digitalized samples (Mann-Whitney U test) revealed no significant differences between the cavity dimensions achieved in the IG and CG (P = .406). Additionally, the sum score of the degree of conformity with the "master preparation" (maximum permissible 10% of plus or minus deviation) was comparable in both groups (P = .259). The implemented interactive digitally based, self-assessment learning tool for undergraduates appears to be equivalent to the conventional form of supervision. Therefore, such digital learning tools could significantly address the ever-increasing student to faculty ratio. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. A combined hands-on teaching programme and clinical pathway focused on pleural ultrasound and procedure supervision transforms pleural procedure outcomes.

    Science.gov (United States)

    Edwards, Timothy; Cook, Alistair; Salamonsen, Matthew; Bashirzadeh, Farzad; Fielding, David

    2017-11-01

    Management of pleural effusions is a common diagnostic and management problem. We reviewed the outcomes from pleural procedures after the instigation of pleural effusion management guidelines, focusing on pleural ultrasound and a hands-on teaching programme followed by procedure supervision that enabled many operators to perform such procedures. This is a retrospective analysis of all procedures performed for pleural effusions on medical patients. Outcomes were assessed prior to the instigation of pleural effusion management guidelines (pleural pathway) and hands-on teaching (January 2010 to June 2011) and following these interventions (January 2012 to June 2013). A total of 171 procedures involving 129 patients (pre-pathway group) and 146 procedures involving 115 patients (post-pathway group) was analysed. The rate of complications prior to the pleural pathway was 22.2% (38 of 171 procedures). Following the pathway, the rate of complications declined to 7.5% (11 of 146 procedures, P < 0.003). The use of pleural ultrasound increased dramatically (72.5 vs 90.2%). The number of patients who underwent repeated procedures (defined as ≥3) reduced dramatically (21 vs 7, P < 0.01). This improvement occurred using many supervised operators who completed the hands-on teaching programme (n = 32) and followed the pleural pathway (127 of 146 procedures). The instigation of a clinical pathway focused on the use of bedside pleural ultrasound, and teaching of drainage techniques with procedure supervision vastly improved patient outcomes. This not only allowed better quality of care for patients, it also provided the acquisition of new skills to medical staff, not limiting these skills to specialised staff. © 2017 Royal Australasian College of Physicians.

  5. Variations on a Theme by Kolb: A New Perspective for Understanding Counseling and Supervision.

    Science.gov (United States)

    Abbey, David S.; And Others

    1985-01-01

    An analysis of clinical dialogue between client and counselor and between counselor-in-training and supervisor is used to demonstrate that effective counseling and supervision demands that Kolb's four modes of experience (concrete experience, reflective observation, abstract conceptualization, and active experimentation) must be available to the…

  6. Security system signal supervision

    International Nuclear Information System (INIS)

    Chritton, M.R.; Matter, J.C.

    1991-09-01

    This purpose of this NUREG is to present technical information that should be useful to NRC licensees for understanding and applying line supervision techniques to security communication links. A review of security communication links is followed by detailed discussions of link physical protection and DC/AC static supervision and dynamic supervision techniques. Material is also presented on security for atmospheric transmission and video line supervision. A glossary of security communication line supervision terms is appended. 16 figs

  7. Relationship between reflection ability and clinical performance: a cross-sectional and retrospective-longitudinal correlational cohort study in midwifery.

    Science.gov (United States)

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

    2015-01-01

    increasingly, reflection is highlighted as integral to core practice competencies but empirical research into the relationship between reflection and performance in the clinical workplace is scarce. this study investigated the relationship between reflection ability and clinical performance. we designed a cross-sectional and a retrospective-longitudinal cohort study. Data from first, second and third year midwifery students were collected to study the variables 'clinical performance' and 'reflection ability'. Data were analysed with SPSS for Windows, Release 20.0. Descriptive statistics, Pearson׳s Product Moment Correlation Coefficients (r) and r² values were computed to investigate associations between the research variables. the results showed a moderate observed correlation between reflection ability and clinical performance scores. When adopting a cross-sectional perspective, all correlation values were significant (p0.6). The results based on the retrospective-longitudinal data set explained a moderate proportion of the variance after correction for attenuation. Finally, the results indicate that 'reflection ability' scores of earlier years are significant related with 'clinical performance' scores of subsequent years. These results suggest that (1) reflection ability is linked to clinical performance; (2) that written reflections are an important, but not the sole way to assess professional competence and that (3) reflection is a contributor to clinical performance improvement. the data showed a moderate but significant relationship between 'reflection ability' and 'clinical performance' scores in clinical practice of midwifery students. Reflection therefore seems an important component of professional competence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Learning With Reflection: Practices in an Osteopathic Surgery Clinical Clerkship Through an Online Module.

    Science.gov (United States)

    Lewis, Kadriye O; Farber, Susan; Chen, Haiqin; Peska, Don N

    2015-11-01

    The value of reflective practices has gained momentum in osteopathic medical education. However, the use of reflective pedagogies has not been explored in the larger context of medical course delivery and design, to the authors' knowledge. To determine the types of reflection demonstrated by osteopathic medical students on an online discussion board and to explore differences in discussion engagement caused by the use of a reflective learning self-assessment tool. Using a mixed-method approach, reflection processes in an osteopathic surgery clinical clerkship online module were investigated in third-year osteopathic medical students. Discussion board messages were captured and coded. Both manual coding techniques and automated interrogation using NVivo9 (a computer program) for qualitative data were applied. Correlations of scores across 4 case-based discussion tasks and scores for self-reflection were computed as quantitative data. Twenty-eight students were included. Four main types of reflection (ie, content, contextual, dialogic, and personal) along with corresponding differentiated subthemes for each type of case-based discussion board group message were identified. Group collaboration revealed insights about the reflection process itself and also about the evidence of collective efforts, group engagements, and intragroup support among students. Student preparation revealed that students' metacognition was triggered when they judged their own contributions to group work. Challenges in completing readings and meeting deadlines were related to the students' long work hours. Reflective practices are essential to the practice of osteopathic medicine and medical education. Curricula can promote the development of reflective skills by integrating these deliberate practices in educational activities.

  9. The relative contributions of social cognition and self-reflectiveness to clinical insight in enduring schizophrenia.

    Science.gov (United States)

    Béland, Sophie; Lepage, Martin

    2017-12-01

    Poor clinical insight represents a major barrier to recovery in schizophrenia. Research suggests that higher-order social cognitive abilities such as theory of mind (TOM) and metacognition contribute to levels of clinical insight. However, few studies have examined whether social cognitive abilities other than TOM are related to clinical insight. Moreover, to date, no investigation has attempted to determine whether the contribution of metacognitive ability to clinical insight can be differentiated from the contribution of higher-order social cognition, despite their conceptual similarity. Therefore, the purpose of this study was to examine the relative contribution of different social cognitive abilities, as well as metacognition, to clinical insight in a large sample of 139 enduring schizophrenia patients, and controlling for established predictors of clinical insight. Hierarchical regression analyses were used to evaluate the portion of variance explained by 3 social cognitive abilities: emotion recognition, TOM, and affective empathy, and the metacognitive ability of self-reflectiveness. Clinical insight levels were assessed using the Schedule for the Assessment of Insight-Expanded version. Results indicated that affective empathy and self-reflectiveness are the strongest predictors of clinical insight. These results provide insights on the development of targeted interventions for improving clinical insight in this population. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Transition from Clinical Manager to University Lecturer: A Self-Reflective Case Study

    Science.gov (United States)

    Oldland, Elizabeth

    2011-01-01

    This paper is a case study exploring the author's use of reflective practice to facilitate the transition in role from a clinical manager with teaching responsibilities in a critical care unit to university lecturer. The similarities and differences in the roles with respect to learner characteristics, teaching contexts and effective teaching…

  11. Cultural Humility in Psychotherapy Supervision.

    Science.gov (United States)

    Hook, Joshua N; Watkins, C Edward; Davis, Don E; Owen, Jesse; Van Tongeren, Daryl R; Ramos, Marciana J

    2016-01-01

    As a core component of multicultural orientation, cultural humility can be considered an important attitude for clinical supervisees to adopt and practically implement. How can cultural humility be most meaningfully incorporated in supervision? In what ways can supervisors stimulate the development of a culturally humble attitude in our supervisees? We consider those questions in this paper and present a model for addressing cultural humility in clinical supervision. The primary focus is given to two areas: (a) modeling and teaching of cultural humility through interpersonal interactions in supervision, and (b) teaching cultural humility through outside activities and experiences. Two case studies illustrating the model are presented, and a research agenda for work in this area is outlined.

  12. Reflective Practice in the Clinical Setting: A Multi-Institutional Qualitative Study of Pediatric Faculty and Residents.

    Science.gov (United States)

    Plant, Jennifer; Li, Su-Ting T; Blankenburg, Rebecca; Bogetz, Alyssa L; Long, Michele; Butani, Lavjay

    2017-11-01

    To explore when and in what form pediatric faculty and residents practice reflection. From February to June 2015, the authors conducted focus groups of pediatric faculty and residents at the University of California, Davis; Stanford University; and the University of California, San Francisco, until thematic saturation occurred. Transcripts were analyzed based on Mezirow's and Schon's models of reflection, using the constant comparative method associated with grounded theory. Two investigators independently coded transcripts and reconciled codes to develop themes. All investigators reviewed the codes and developed a final list of themes through consensus. Through iterative discussions, investigators developed a conceptual model of reflection in the clinical setting. Seventeen faculty and 20 residents from three institutions participated in six focus groups. Five themes emerged: triggers of reflection, intrinsic factors, extrinsic factors, timing, and outcome of reflection. Various triggers led to reflection; whether a specific trigger led to reflection depended on intrinsic and extrinsic factors. When reflection occurred, it happened in action or on action. Under optimal conditions, this reflection was goal and action directed and became critical reflection. In other instances, this process resulted in unproductive rumination or acted as an emotional release or supportive therapy. Participants reflected in clinical settings, but did not always explicitly identify it as reflection or reflect in growth-promoting ways. Strategies to enhance critical reflection include developing knowledge and skills in reflection, providing performance data to inform reflection, creating time and space for safe reflection, and providing mentorship to guide the process.

  13. SAFETY: an integrated clinical reasoning and reflection framework for undergraduate nursing students.

    Science.gov (United States)

    Hicks Russell, Bedelia; Geist, Melissa J; House Maffett, Jenny

    2013-01-01

    Nurse educators can no longer focus on imparting to students knowledge that is merely factual and content specific. Activities that provide students with opportunities to apply concepts in real-world scenarios can be powerful tools. Nurse educators should take advantage of student-patient interactions to model clinical reasoning and allow students to practice complex decision making throughout the entire curriculum. In response to this change in nursing education, faculty in a pediatric course designed a reflective clinical reasoning activity based on the SAFETY template, which is derived from the National Council of State Boards of Nursing RN practice analysis. Students were able to prioritize key components of nursing care, as well as integrate practice issues such as delegation, Health Insurance Portability and Accountability Act violations, and questioning the accuracy of orders. SAFETY is proposed as a framework for integration of content knowledge, clinical reasoning, and reflection on authentic professional nursing concerns. Copyright 2012, SLACK Incorporated.

  14. Narrative thematic analysis of baccalaureate nursing students' reflections: critical thinking in the clinical education context.

    Science.gov (United States)

    Naber, Jessica L; Hall, Joanne; Schadler, Craig Matthew

    2014-09-01

    This study sought to identify characteristics of clinically situated critical thinking in nursing students' reflections, originally part of a study guided by Richard Paul's model of critical thinking. Nurses are expected to apply critical thinking in all practice situations to improve health outcomes, including patient safety and satisfaction. In a previous study, Paul's model of critical thinking was used to develop questions for reflective writing assignments. Within that study, 30 nursing students completed six open-ended narratives of nurse-patient clinical encounters during an 8-week period. Improvements were seen in critical thinking scores after the intervention. This article reports the qualitative analysis of the content of six open-ended narratives. Six overarching themes were identified and combined into a tentative conceptual model. Faculty's understanding of the characteristics of critical thinking in the context of clinical education will help them to teach and evaluate students' progress and competencies for future practice.

  15. Learning from clinical placement experience: Analysing nursing students' final reflections in a digital storytelling activity.

    Science.gov (United States)

    Paliadelis, Penny; Wood, Pamela

    2016-09-01

    This paper reports on the learning potential of a reflective activity undertaken by final year nursing students, in which they were asked to recount two meaningful events that occurred during their clinical placements over the duration of their 3-year nursing degree program and reflect on how these events contributed to their learning to become beginning level Registered Nurses (RNs). This descriptive qualitative study gathered narratives from 92 students as individual postings in an online forum created within the University's learning management system. An analysis of the students' reflections are the focus of this paper particularly in relation to the value of reflecting on the identified events. Four themes emerged that clearly highlight the way in which these students interpreted and learned from both positive and negative clinical experiences, their strong desire to fit into their new role and their ability to re-imagine how they might respond to clinical events when they become Registered Nurses. The findings of this study may contribute to developing nursing curricula that better prepares final year students for the realities of practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. New developments in technology-assisted supervision and training: a practical overview.

    Science.gov (United States)

    Rousmaniere, Tony; Abbass, Allan; Frederickson, Jon

    2014-11-01

    Clinical supervision and training are now widely available online. In this article, three of the most accessible and widely adopted new developments in clinical supervision and training technology are described: Videoconference supervision, cloud-based file sharing software, and clinical outcome tracking software. Partial transcripts from two online supervision sessions are provided as examples of videoconference-based supervision. The benefits and limitations of technology in supervision and training are discussed, with an emphasis on supervision process, ethics, privacy, and security. Recommendations for supervision practice are made, including methods to enhance experiential learning, the supervisory working alliance, and online security. © 2014 Wiley Periodicals, Inc.

  17. Does Reflective Learning with Feedback Improve Dental Students' Self-Perceived Competence in Clinical Preparedness?

    Science.gov (United States)

    Ihm, Jung-Joon; Seo, Deog-Gyu

    2016-02-01

    The value of dental students' self-assessment is often debated. The aim of this study was to explore whether reflective learning with feedback enabled dental students to more accurately assess their self-perceived levels of preparedness on dental competencies. Over 16 weeks, all third- and fourth-year students at a dental school in the Republic of Korea took part in clinical rotations that incorporated reflective learning and feedback. Following this educational intervention, they were asked to assess their perceptions of their clinical competence. The results showed that the students reported feeling most confident about performing periodontal treatment (mean 7.1 on a ten-point scale) and least confident about providing orthodontic care (mean 5.6). The fourth-year students reported feeling more confident on all the competencies than the third-year students. Their self-perceived competence in periodontal treatment and oral medicine significantly predicted the instructors' clinical evaluations. This study offered insights into determining if structured reflective learning with effective feedback helps to increase dental students' self-perceived level of clinical preparedness.

  18. Improving supervision: a team approach.

    Science.gov (United States)

    1993-01-01

    This issue of "The Family Planning Manager" outlines an interactive team supervision strategy as a means of improving family planning service quality and enabling staff to perform to their maximum potential. Such an approach to supervision requires a shift from a monitoring to a facilitative role. Because supervisory visits to the field are infrequent, the regional supervisor, clinic manager, and staff should form a team to share ongoing supervisory responsibilities. The team approach removes individual blame and builds consensus. An effective team is characterized by shared leadership roles, concrete work problems, mutual accountability, an emphasis on achieving team objectives, and problem resolution within the group. The team supervision process includes the following steps: prepare a visit plan and schedule; meet with the clinic manager and staff to explain how the visit will be conducted; supervise key activity areas (clinical, management, and personnel); conduct a problem-solving team meeting; conduct a debriefing meeting with the clinic manager; and prepare a report on the visit, including recommendations and follow-up plans. In Guatemala's Family Planning Unit, teams identify problem areas on the basis of agreement that a problem exists, belief that the problem can be solved with available resources, and individual willingness to accept responsibility for the specific actions identified to correct the problem.

  19. Mentoring, coaching and supervision

    OpenAIRE

    McMahon, Samantha; Dyer, Mary; Barker, Catherine

    2016-01-01

    This chapter considers the purpose of coaching, mentoring and supervision in early childhood eduaction and care. It examines a number of different approaches and considers the key skills required for effective coaching, mentoring and supervision.

  20. Optimal preventive bank supervision

    OpenAIRE

    Belhaj, Mohamed; Klimenko, Nataliya

    2012-01-01

    Early regulator interventions into problem banks is one of the key suggestions of Basel Committee on Banking Supervision. However, no guidance is given on their design. To fill this gap, we outline an incentive-based preventive supervision strategy that eliminates bad asset management in banks. Two supervision techniques are combined: temporary regulatory administration and random audits. Our design ensures good management without excessive supervision costs, through a gradual adjustment of...

  1. Variation in Clinical Placement Supervisors' Conceptions of and Approaches to Supervision in a Veterinary Internship Programme

    Science.gov (United States)

    van Gelderen, Ingrid; Matthew, Susan M.; Hendry, Graham D.; Taylor, Rosanne

    2018-01-01

    Good teaching that supports final year students' learning in clinical placements is critical for students' successful transition from an academic environment to professional practice. Final year internship programmes are designed to encourage student-centred approaches to teaching and deep approaches to learning, but the extent to which clinical…

  2. School, Supervision and Adolescent-Sensitive Clinic Care: Combination Social Protection and Reduced Unprotected Sex Among HIV-Positive Adolescents in South Africa.

    Science.gov (United States)

    Toska, Elona; Cluver, Lucie D; Boyes, Mark E; Isaacsohn, Maya; Hodes, Rebecca; Sherr, Lorraine

    2017-09-01

    Social protection can reduce HIV-risk behavior in general adolescent populations, but evidence among HIV-positive adolescents is limited. This study quantitatively tests whether social protection is associated with reduced unprotected sex among 1060 ART-eligible adolescents from 53 government facilities in South Africa. Potential social protection included nine 'cash/cash-in-kind' and 'care' provisions. Analyses tested interactive/additive effects using logistic regressions and marginal effects models, controlling for covariates. 18 % of all HIV-positive adolescents and 28 % of girls reported unprotected sex. Lower rates of unprotected sex were associated with access to school (OR 0.52 95 % CI 0.33-0.82 p = 0.005), parental supervision (OR 0.54 95 % CI 0.33-0.90 p = 0.019), and adolescent-sensitive clinic care (OR 0.43 95 % CI 0.25-0.73 p = 0.002). Gender moderated the effect of adolescent-sensitive clinic care. Combination social protection had additive effects amongst girls: without any provisions 49 % reported unprotected sex; with 1-2 provisions 13-38 %; and with all provisions 9 %. Combination social protection has the potential to promote safer sex among HIV-positive adolescents, particularly girls.

  3. A Supervision of Solidarity

    Science.gov (United States)

    Reynolds, Vikki

    2010-01-01

    This article illustrates an approach to therapeutic supervision informed by a philosophy of solidarity and social justice activism. Called a "Supervision of Solidarity", this approach addresses the particular challenges in the supervision of therapists who work alongside clients who are subjected to social injustice and extreme marginalization. It…

  4. Legislation and supervision

    International Nuclear Information System (INIS)

    1998-01-01

    In this part next aspects are described: (1) Legislative and supervision-related framework (reviews of structure of supervisory bodies; legislation; state supervision in the nuclear safety area, and state supervision in the area of health protection against radiation are given); (2) Operator's responsibility

  5. Nurse educators’ perceptions on facilitating reflective thinking in clinical nursing education

    Directory of Open Access Journals (Sweden)

    Mary Chabeli

    2004-11-01

    Full Text Available This article seeks to publish the results of nurse educators with regard to how reflective thinking of learners can be facilitated in clinical nursing education. Opsomming Hierdie artikel beoog om die resultate van verpleeg-opvoeders met betrekking tot hoe reflektiewe denke van leerders in kliniese verpleegonderwys gefasiliteer kan word, te publiseer. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  6. Researching the Parallel Process in Supervision and Psychotherapy

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    Reflects upon how to do process research in supervision and in the parallel process. A single case study is presented illustrating how a study on parallel process can be carried out.......Reflects upon how to do process research in supervision and in the parallel process. A single case study is presented illustrating how a study on parallel process can be carried out....

  7. Effects of reflection on clinical decision-making of intensive care unit nurses.

    Science.gov (United States)

    Razieh, Shahrokhi; Somayeh, Ghafari; Fariba, Haghani

    2018-07-01

    Nurses are one of the most influential factors in overcoming the main challenges faced by health systems throughout the world. Every health system should, hence, empower nurses in clinical judgment and decision-making skills. This study evaluated the effects of implementing Tanner's reflection method on clinical decision-making of nurses working in an intensive care unit (ICU). This study used an experimental, pretest, posttest design. The setting was the intensive care unit of Amin Hospital Isfahan, Iran. The convenience sample included 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). This clinical trial was performed on 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). The nurses were selected by census sampling and randomly allocated to either the case or the control group. Data were collected using a questionnaire containing demographic characteristics and the clinical decision-making scale developed by Laurie and Salantera (NDMI-14). The questionnaire was completed before and one week after the intervention. The data were analyzed using SPSS 21.0. The two groups were not significantly different in terms of the level and mean scores of clinical decision-making before the intervention (P = 0.786). Based on the results of independent t-test, the mean score of clinical decision-making one week after the intervention was significantly higher in the case group than in the control group (P = 0.009; t = -2.69). The results of Mann Whitney test showed that one week after the intervention, the nurses' level of clinical decision-making in the case group rose to the next level (P = 0.001). Reflection could improve the clinical decision-making of ICU nurses. It is, thus, recommended to incorporate this method into the nursing curriculum and care practices. Copyright © 2018. Published by Elsevier Ltd.

  8. Logic Learning Machine and standard supervised methods for Hodgkin's lymphoma prognosis using gene expression data and clinical variables.

    Science.gov (United States)

    Parodi, Stefano; Manneschi, Chiara; Verda, Damiano; Ferrari, Enrico; Muselli, Marco

    2018-03-01

    This study evaluates the performance of a set of machine learning techniques in predicting the prognosis of Hodgkin's lymphoma using clinical factors and gene expression data. Analysed samples from 130 Hodgkin's lymphoma patients included a small set of clinical variables and more than 54,000 gene features. Machine learning classifiers included three black-box algorithms ( k-nearest neighbour, Artificial Neural Network, and Support Vector Machine) and two methods based on intelligible rules (Decision Tree and the innovative Logic Learning Machine method). Support Vector Machine clearly outperformed any of the other methods. Among the two rule-based algorithms, Logic Learning Machine performed better and identified a set of simple intelligible rules based on a combination of clinical variables and gene expressions. Decision Tree identified a non-coding gene ( XIST) involved in the early phases of X chromosome inactivation that was overexpressed in females and in non-relapsed patients. XIST expression might be responsible for the better prognosis of female Hodgkin's lymphoma patients.

  9. [Possibilities of supervision in medical practice].

    Science.gov (United States)

    Lönnqvist, Jouko

    2014-01-01

    In supervision, a doctor examines in interaction with the supervisor her/his work, work role and collaborative relationships with the aim to develop herself/himself and the associated work community. In clinical supervision, a doctor's way of acting in interactive relationships with the patients is examined through patient cases, based on the doctor's own experience. Supervision can be used to strengthen the physician identity, clarify the work role, assimilate and delve into clinical work, support professional development and working career, manage one's own work and coping at work, develop collaboration and team work, and support the work of medical directors.

  10. Student Reflection Papers on a Global Clinical Experience: A Qualitative Study.

    Science.gov (United States)

    Margolis, Carmi Z; Rohrbaugh, Robert M; Tsang, Luisa; Fleischer, Jennifer; Graham, Mark J; Kellett, Anne; Hafler, Janet P

    Many of the 70,000 graduating US medical students [per year] have reported participating in a global health activity at some stage of medical school. This case study design provided a method for understanding the student's experience that included student's learning about culture, health disparities, exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a flexible, personalized experience. We need to understand the student's experience in order to help design appropriate curricular experiences [and valid student assessment]. Our research aim was to analyze medical student reflection papers to understand how they viewed their Global Clinical Experience (GCE). A qualitative case study design was used to analyze student reflection papers. All 28 students who participated in a GCE from 2008-2010 and in 2014-2015 and submitted a reflection paper on completion of the GCE were eligible to participate in the study. One student did not submit a reflection paper and was not included in the study. All 27 papers were coded by paragraph for reflection and for themes. System of Care/Range of Care was mentioned most often, Aids to Adjustment Process was mentioned least. The theme, "Diseases," referred to any mention of a disease in the reflection papers, and 44 diseases were mentioned in the papers. The analysis for depth of reflection yielded the following data: Observation, 81/248 paragraphs; Observation and Interpretation, 130/248 paragraphs; and Observation, Interpretation, and Suggestions for change, 36/248 paragraphs; 9 reflection papers contained 27 separate accounts of a transformational experience. This study provided a method for understanding the student's experience that included student's learning about culture, health disparities, and exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a

  11. Reflections on Self-Reflection: Contemplating Flawed Self-Judgments in the Clinic, Classroom, and Office Cubicle.

    Science.gov (United States)

    Dunning, David; Heath, Chip; Suls, Jerry M

    2018-03-01

    We reflect back on our 2004 monograph reviewing the implications of faulty self-judgment for health, education, and the workplace. The review proved popular, no doubt because the importance of accurate self-assessment is best reflected in just how broad the literature is that touches on this topic. We discuss opportunities and challenges to be found in the future study of self-judgment accuracy and error, and suggest that designing interventions aimed at improving self-judgments may prove to be a worthwhile but complex and nuanced task.

  12. Novel Paths to Relevance: How Clinical Ethics Committees Promote Ethical Reflection.

    Science.gov (United States)

    Magelssen, Morten; Pedersen, Reidar; Førde, Reidun

    2016-09-01

    How may clinical ethics committees (CECs) inspire ethical reflection among healthcare professionals? How may they deal with organizational ethics issues? In recent years, Norwegian CECs have attempted different activites that stretch or go beyond the standard trio of education, consultation, and policy work. We studied the novel activities of Norwegian CECs by examining annual reports and interviewing CEC members. Through qualitative analysis we identified nine categories of novel CEC activities, which we describe by way of examples. In light of the findings, we argue that some novel working methods may be well suited to promote ethical reflection among clinicians, and that the CEC may be a suitable venue for discussing issues of organizational ethics.

  13. Self-Reflected Well-Being via a Smartphone App in Clinical Medical Students: Feasibility Study.

    Science.gov (United States)

    Berryman, Elizabeth K; Leonard, Daniel J; Gray, Andrew R; Pinnock, Ralph; Taylor, Barry

    2018-03-07

    Well-being in medical students has become an area of concern, with a number of studies reporting high rates of clinical depression, anxiety, burnout, and suicidal ideation in this population. The aim of this study was to increase awareness of well-being in medical students by using a smartphone app. The primary objective of this study was to determine the validity and feasibility of the Particip8 app for student self-reflected well-being data collection. Undergraduate medical students of the Dunedin School of Medicine were recruited into the study. They were asked to self-reflect daily on their well-being and to note what experiences they had encountered during that day. Qualitative data were also collected both before and after the study in the form of focus groups and "free-text" email surveys. All participants consented for the data collected to be anonymously reported to the medical faculty. A total of 29 participants (69%, 20/29 female; 31%, 9/29 male; aged 21-30 years) were enrolled, with overall median compliance of 71% at the study day level. The self-reflected well-being scores were associated with both positive and negative experiences described by the participants, with most negative experiences associated with around 20% lower well-being scores for that day; the largest effect being "receiving feedback that was not constructive or helpful," and the most positive experiences associated with around 20% higher scores for that day. The study of daily data collection via the Particip8 app was found to be feasible, and the self-reflected well-being scores showed validity against participant's reflections of experiences during that day. ©Elizabeth K Berryman, Daniel J Leonard, Andrew R Gray, Ralph Pinnock, Barry Taylor. Originally published in JMIR Medical Education (http://mededu.jmir.org), 07.03.2018.

  14. Shame, the scourge of supervision

    Directory of Open Access Journals (Sweden)

    Valérie Perret

    2017-07-01

    • How can the supervisor deal with it? My motivation in writing this article is born from my personal experience with shame. It inhibited my thinking, my spontaneity, my creativity, and therefore limited my personal and professional development. Freeing myself allowed me to recover liberty, energy and legitimacy. I gained in professional competence and assertiveness within my practice as supervisor. My purpose in writing this article is that we, as supervisors, reflect together on how we look at the process of shame in our supervision sessions.  Citation - APA format: Perret, V. (2017. Shame, the scourge of supervision. International Journal of Transactional Analysis Research & Practice, 8(2, 41-48.

  15. Supervision in banking industry

    OpenAIRE

    Šmída, David

    2012-01-01

    The aim of submitted thesis Supervision in banking is to define the nature and the importance of banking supervision, to justify its existence and to analyze the applicable mechanisms while the system of banking regulation and supervision in this thesis is primarily examined in the European context, with a focus on the Czech Republic. The thesis is divided into five main chapters. The first chapter is devoted to the financial system and the importance of banks in this system, it defines the c...

  16. MULTIPERIOD BANKING SUPERVISION

    OpenAIRE

    KARL-THEODOR EISELE; PHILIPPE ARTZNER

    2013-01-01

    This paper is based on a general method for multiperiod prudential supervision of companies submitted to hedgeable and non-hedgeable risks. Having treated the case of insurance in an earlier paper, we now consider a quantitative approach to supervision of commercial banks. The various elements under supervision are the bank’s current amount of tradeable assets, the deposit amount, and four flow processes: future trading risk exposures, deposit flows, flows of loan repayments and of deposit re...

  17. Rethinking Educational Supervision

    OpenAIRE

    Burhanettin DÖNMEZ; Kadir BEYCİOĞLU

    2009-01-01

    The history of educational (school) supervision has been influenced by the history of the interaction of intellectual movements in politics, society, philosophy and industrial movements. The purpose of this conceptual and theoretical study is to have a brief look at the concept of educational supervision with related historical developments in the field. The paper also intends to see the terms and issues critically, and to conceptualize some issues associated with educational supervision in...

  18. Evaluering af kollegial supervision

    DEFF Research Database (Denmark)

    Petersen, Anne Line Bjerre Folsgaard; Bager, Lene Tortzen; Jørgensen, Mette Eg

    2015-01-01

    Videoen er en evaluering af arbejdet med en metodisk tilgang til kollegial supervision på VIA Ergoterapeutuddannelsen gennem et par år. Evalueringen sætter fokus på selve metoden, der er anvendt til kollegial supervision. Derudover er der fokus på erfaringer og udbytte af at arbejde systematisk med...... kollegial supervision blandt undervisere på VIA Ergoterapeutuddannelsen....

  19. Collective academic supervision

    DEFF Research Database (Denmark)

    Nordentoft, Helle Merete; Thomsen, Rie; Wichmann-Hansen, Gitte

    2013-01-01

    Supervision of students is a core activity in higher education. Previous research on student supervision in higher education focus on individual and relational aspects in the supervisory relationship rather than collective, pedagogical and methodical aspects of the planning of the supervision...... process. This article fills these gaps by discussing potentials and challenges in “Collective Academic Supervision”, a model for supervision at the Master of Education in Guidance at Aarhus University in Denmark. The pedagogical rationale behind the model is that students’ participation and learning...

  20. A Difficult Journey: Reflections on Driving and Driving Cessation From a Team of Clinical Researchers.

    Science.gov (United States)

    Liddle, Jacki; Gustafsson, Louise; Mitchell, Geoffrey; Pachana, Nancy A

    2017-02-01

    Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches, the team has explored quality of life and participation outcomes related to driving and nondriving for older people and has developed interventions to improve outcomes after driving cessation. The team members represent occupational therapists, medical practitioners, and clinical and neuropsychologists. While building the evidence base for driving- and driving cessation-related clinical practice, the researchers have also had first-hand experiences of interruptions to their own or parents' driving; involvement of older family members in road crashes; and provision of support during family members' driving assessment and cessation. This has led to reflection on their understandings and re-evaluation and refocusing of their perspectives in driving cessation research. This work will share the narratives of the authors and note their developing perspectives and foci within research as well as their clinical practice. Personal reflections have indicated the far-reaching implications for older drivers and family members of involvement in road crashes: the potential for interruptions to driving as a time for support and future planning and the conflicting and difficult roles of family members within the driving cessation process. Overall the lived, personal experience of the authors has reinforced the complex nature of driving and changes to driving status for the driver and their support team and the need for further research and support. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Intuitive expertise in ICT graduate supervision

    Directory of Open Access Journals (Sweden)

    Jill Jameson

    2002-12-01

    Full Text Available Intuitive expertise in the application of advanced interdisciplinary facilitation is the subject of this personal reflection on the graduate supervisory style of Professor David Squires in computers in education. This single-case reflective study examines the characteristics of effective supervision observed during masters and doctoral supervision at King's College in the years 1990-9. Interdisciplinarity in ICT graduate studies particularly requires a fluency of supervisory expertise in enabling supervisees to combine multiple complex perspectives from a number of fields of knowledge. Intuitive combinatory aspects of supervision are highlighted in this reflection on the role carried out by an academic expert in facilitating student success. This is examined from a perspective incorporating affective as well as intellectual elements, informed by characteristics identified in professional sports and performing arts coaching/mentoring. Key characteristics comprising a model of intuitive expertise in ICT graduate supervision were outlined. The resultant portrait aims to complement existing literature on graduate supervision, with reference to the field of ICTI computers in education relating to student hypermedia composition.

  2. Exploratory study of the characteristics of feedback in the reflective dialogue group given to medical students in a clinical clerkship

    Directory of Open Access Journals (Sweden)

    Chin-Chen Wen

    2015-02-01

    Full Text Available Purpose: Structured narrative reflective writing combined with guided feedback is an efficient teaching method for enhancing medical students’ reflective capacity. However, what kinds of feedback offered and reflection presented in a reflective group remain unclear. The aim of this study was to investigate the characteristics of feedback in a reflective dialogue group. Methods: Fifth-year medical students on a monthly interval rotation at the pediatric department of a medical center in eastern Taiwan during the 2012 academic year completed their reflective writing regarding patient and family psychosocial issues, and were subsequently debriefed in a 2-h group discussion session to receive feedback from a clinical tutor and peers. Content analysis was conducted to explore the characteristics of feedback and reflection presented in the reflective dialogue. The evaluative questionnaire regarding the benefits of reflection with others was administrated following the group session. Results: Forty students participated in five reflective groups and 108 psychosocial issues were discussed and identified. The tutor played an initiating role in the group discussion by providing six equal feedback types involving exploring new knowledge, initiating advanced discussion, highlighting the issues, and encouraging the students. The students provided eight types of feedback that involved a substantial deep discussion on psychosocial issues and action plans based on the complex interactive ecological network of clinical encounters. Each student attained 1.25 times the depth or breadth of reflection after receiving feedback and experienced the benefits of reflection with others. Conclusion: Through structured narrative reflective writing combined with pluralistic group discussion with a tutor and peers, the medical students had time to think deeply and broadly about psychosocial issues among patients and their family members. Facilitative feedback providing new

  3. Evolution in banking supervision

    OpenAIRE

    Edward J. Stevens

    2000-01-01

    Banking supervision must keep pace with technical innovations in the banking industry. The international Basel Committee on Banking Supervision currently is reviewing public comments on its proposed new method for judging whether a bank maintains enough capital to absorb unexpected losses. This Economic Commentary explains how existing standards became obsolete and describes the new plan.

  4. Forskellighed i supervision

    DEFF Research Database (Denmark)

    Petersen, Birgitte; Beck, Emma

    2009-01-01

    Indtryk og tendenser fra den anden danske konference om supervision, som blev holdt på Københavns Universitet i oktober 2008......Indtryk og tendenser fra den anden danske konference om supervision, som blev holdt på Københavns Universitet i oktober 2008...

  5. Networks of Professional Supervision

    Science.gov (United States)

    Annan, Jean; Ryba, Ken

    2013-01-01

    An ecological analysis of the supervisory activity of 31 New Zealand school psychologists examined simultaneously the theories of school psychology, supervision practices, and the contextual qualities that mediated participants' supervisory actions. The findings indicated that the school psychologists worked to achieve the supervision goals of…

  6. The relevance of clinical ethnography: reflections on 10 years of a cultural consultation service.

    Science.gov (United States)

    Dominicé Dao, Melissa; Inglin, Sophie; Vilpert, Sarah; Hudelson, Patricia

    2018-01-11

    Training health professionals in culturally sensitive medical interviewing has been widely promoted as a strategy for improving intercultural communication and for helping clinicians to consider patients' social and cultural contexts and improve patient outcomes. Clinical ethnography encourages clinicians to explore the patient's explanatory model of illness, recourse to traditional and alternative healing practices, healthcare expectations and social context, and to use this information to negotiate a mutually acceptable treatment plan. However, while clinical ethnographic interviewing skills can be successfully taught and learned, the "real-world" context of medical practice may impose barriers to such patient-centered interviewing. Creating opportunities for role modeling and critical reflection may help overcome some of these barriers, and contribute to improved intercultural communication in healthcare. We report and reflect on a retrospective analysis of 10 years experience with a "cultural consultation service" (CCS) whose aim is to provide direct support to clinicians who encounter intercultural difficulties and to model the usefulness of clinical ethnographic interviewing for patient care. We analyzed 236 cultural consultation requests in order to identify key patient, provider and consultation characteristics, as well as the cross cultural communication challenges that motivate health care professionals to request a cultural consultation. In addition, we interviewed 51 clinicians about their experience and satisfaction with the CCS. Requests for cultural consultations tended to involve patient care situations with complex social, cultural and medical issues. All patients had a migration background, two-thirds spoke French less than fluently. In over half the cases, patients had a high degree of social vulnerability, compromising illness management. Effective communication was hindered by language barriers and undetected or underestimated patient

  7. Engaging nurses in patient care: clinical reflection by a student nurse.

    Science.gov (United States)

    Bail, Kasia Siobhan

    2007-01-01

    I stood by, the endless student nurse observer, as a woman (let's call her Joan) was transferred by trolley from the helicopter into emergency following an acute period of respiratory distress. Two nurses from the department were present for hand-over, and three ambulance persons brought her in. Joan's condition appeared stable, as far as I could tell; her bed was at a ninety-degree angle and her oxygen-assisted breathing was very laboured, but she seemed aware of her immediate surroundings. Joan traveled on the helicopter trolley into the emergency ward, was transferred to an emergency bed, the necessary tubes and wires were re-organised, her hand-over was verbalised and the personal weekends of the treating team were discussed amongst themselves. To my increasing frustration, not one staff member looked Joan in the eye, said hello, or did anything to acknowledge her presence as anything other than another technical detail. This paper was inspired by this incident viewed as a nursing student in the emergency department. The clinical reflection that developed around this particular incident was how easily care by nurses could be limited to the physical needs of the patient. This paper is premised on the clinical reflection that engagement by nurses with patients is necessary for optimal patient care. The literature was reviewed, and the concept of 'engagement' was used to refer to the actual connection of one person to another via honest care and dedicated communication. I suggest, with literary support, that this lack of engagement extends from the inability of the nurse to provide sufficient care to fulfill the needs of the patient. The current mismatch between duty and ability for nurses is cited as being due to an increasing number of stressors. Major stressors include a lack of support from senior staff; insufficient staff; having too much work and too little time, and the inability to meet patients' needs (McNeely 1996). Accumulated stress has detrimental

  8. Non-invasive detection of periodontal disease using diffuse reflectance spectroscopy: a clinical study

    Science.gov (United States)

    Prasanth, Chandra Sekhar; Betsy, Joseph; Subhash, Narayanan; Jayanthi, Jayaraj L.; Prasanthila, Janam

    2012-03-01

    In clinical diagnostic procedures, gingival inflammation is considered as the initial stage of periodontal breakdown. This is often detected clinically by bleeding on probing as it is an objective measure of inflammation. Since conventional diagnostic procedures have several inherent drawbacks, development of novel non-invasive diagnostic techniques assumes significance. This clinical study was carried out in 15 healthy volunteers and 25 patients to demonstrate the applicability of diffuse reflectance (DR) spectroscopy for quantification and discrimination of various stages of inflammatory conditions in periodontal disease. The DR spectra of diseased lesions recorded using a point monitoring system consisting of a tungsten halogen lamp and a fiber-optic spectrometer showed oxygenated hemoglobin absorption dips at 545 and 575 nm. Mean DR spectra on normalization shows marked differences between healthy and different stages of gingival inflammation. Among the various DR intensity ratios investigated, involving oxy Hb absorption peaks, the R620/R575 ratio was found to be a good parameter of gingival inflammation. In order to screen the entire diseased area and its surroundings instantaneously, DR images were recorded with an EMCCD camera at 620 and 575 nm. We have observed that using the DR image intensity ratio R620/R575 mild inflammatory tissues could be discriminated from healthy with a sensitivity of 92% and specificity of 93%, and from moderate with a sensitivity of 83% and specificity of 96%. The sensitivity and specificity obtained between moderate and severe inflammation are 82% and 76% respectively.

  9. Reflective THz and MR imaging of burn wounds: a potential clinical validation of THz contrast mechanisms

    Science.gov (United States)

    Bajwa, Neha; Nowroozi, Bryan; Sung, Shijun; Garritano, James; Maccabi, Ashkan; Tewari, Priyamvada; Culjat, Martin; Singh, Rahul; Alger, Jeffry; Grundfest, Warren; Taylor, Zachary

    2012-10-01

    Terahertz (THz) imaging is an expanding area of research in the field of medical imaging due to its high sensitivity to changes in tissue water content. Previously reported in vivo rat studies demonstrate that spatially resolved hydration mapping with THz illumination can be used to rapidly and accurately detect fluid shifts following induction of burns and provide highly resolved spatial and temporal characterization of edematous tissue. THz imagery of partial and full thickness burn wounds acquired by our group correlate well with burn severity and suggest that hydration gradients are responsible for the observed contrast. This research aims to confirm the dominant contrast mechanism of THz burn imaging using a clinically accepted diagnostic method that relies on tissue water content for contrast generation to support the translation of this technology to clinical application. The hydration contrast sensing capabilities of magnetic resonance imaging (MRI), specifically T2 relaxation times and proton density values N(H), are well established and provide measures of mobile water content, lending MRI as a suitable method to validate hydration states of skin burns. This paper presents correlational studies performed with MR imaging of ex vivo porcine skin that confirm tissue hydration as the principal sensing mechanism in THz burn imaging. Insights from this preliminary research will be used to lay the groundwork for future, parallel MRI and THz imaging of in vivo rat models to further substantiate the clinical efficacy of reflective THz imaging in burn wound care.

  10. Experimental and clinical evaluation of a noninvasive reflectance pulse oximeter sensor.

    Science.gov (United States)

    Takatani, S; Davies, C; Sakakibara, N; Zurick, A; Kraenzler, E; Golding, L R; Noon, G P; Nose, Y; DeBakey, M E

    1992-10-01

    The objective of this study was to evaluate a new reflectance pulse oximeter sensor. The prototype sensor consists of 8 light-emitting diode (LED) chips (4 at 665 nm and 4 at 820 nm) and a photodiode chip mounted on a single substrate. The 4 LED chips for each wavelength are spaced at 90-degree intervals around the substrate and at an equal radial distance from the photodiode chip. An optical barrier between the photodiode and LED chips prevents a direct coupling effect between them. Near-infrared LEDs (940 nm) in the sensor warm the tissue. The microthermocouple mounted on the sensor surface measures the temperature of the skin-sensor interface and maintains it at a present level by servoregulating the current in the 940-nm LEDs. An animal study and a clinical study were performed. In the animal study, 5 mongrel dogs (weight, 10-20 kg) were anesthetized, mechanically ventilated, and cannulated. In each animal, arterial oxygen saturation (SaO2) was measured continuously by a standard transmission oximeter probe placed on the dog's earlobe and a reflectance oximeter sensor placed on the dog's tongue. In the first phase of the experiment, signals from the reflectance sensor were recorded while the dog was immersed in ice water until its body temperature decreased to 30 degrees C. In the second phase, the animal's body temperature was normal, and the oxygen content of the ventilator was varied to alter the SaO2. In the clinical study, 18 critically ill patients were monitored perioperatively with the prototype reflectance sensor. The first phase of the study investigated the relationship between local skin temperature and the accuracy of oximeter readings with the reflectance sensor. Each measurement was taken at a high saturation level as a function of local skin temperature. The second phase of the study compared measurements of oxygen saturation by a reflectance oximeter (SpO2[r]) with those made by a co-oximeter (SaO2[IL]) and a standard transmission oximeter (Sp

  11. How well do clinical pain assessment tools reflect pain in infants?

    Science.gov (United States)

    Slater, Rebeccah; Cantarella, Anne; Franck, Linda; Meek, Judith; Fitzgerald, Maria

    2008-06-24

    Pain in infancy is poorly understood, and medical staff often have difficulty assessing whether an infant is in pain. Current pain assessment tools rely on behavioural and physiological measures, such as change in facial expression, which may not accurately reflect pain experience. Our ability to measure cortical pain responses in young infants gives us the first opportunity to evaluate pain assessment tools with respect to the sensory input and establish whether the resultant pain scores reflect cortical pain processing. Cortical haemodynamic activity was measured in infants, aged 25-43 wk postmenstrual, using near-infrared spectroscopy following a clinically required heel lance and compared to the magnitude of the premature infant pain profile (PIPP) score in the same infant to the same stimulus (n = 12, 33 test occasions). Overall, there was good correlation between the PIPP score and the level of cortical activity (regression coefficient = 0.72, 95% confidence interval [CI] limits 0.32-1.11, p = 0.001; correlation coefficient = 0.57). Of the different PIPP components, facial expression correlated best with cortical activity (regression coefficient = 1.26, 95% CI limits 0.84-1.67, p free.

  12. Learning pathways during clinical placement of physiotherapy students: a Malaysian experience of using learning contracts and reflective diaries

    Directory of Open Access Journals (Sweden)

    Ayiesah Ramli

    2013-07-01

    Full Text Available Purpose: Learning contracts and reflective diaries are educational tools that have been recently introduced to physiotherapy students from Malaysia during clinical education. It is unclear how students perceive the experience of using a learning contract and reflective diary. This study explores the learning pathways of the students after using a learning contract and a reflective diary for the first time in their clinical placement. Methods: A total of 26 final-year physiotherapy students completed a learning contract and a reflective diary during clinical placements. Two researchers explored the data qualitatively by the thematic content analysis method using NVivo. Results: A total of four and six main learning themes were identified from the data of the students through a learning contract and reflective diary. Conclusion: These learning themes reflected the views of the students about what they have considered to be important learning pathways during their clinical placements. They give valuable insights into the experiences and opinions of students during their clinical education process, which should be useful for enhancing teaching and learning methods in physiotherapy education.

  13. Supervision som undervisningsform i voksenspecialundervisningen

    DEFF Research Database (Denmark)

    Kristensen, René

    2000-01-01

    Supervision som undervisningsform i voksenspecialundervisningen. Procesarbejde i undervisning af voksne.......Supervision som undervisningsform i voksenspecialundervisningen. Procesarbejde i undervisning af voksne....

  14. Supervised Convolutional Sparse Coding

    KAUST Repository

    Affara, Lama Ahmed

    2018-04-08

    Convolutional Sparse Coding (CSC) is a well-established image representation model especially suited for image restoration tasks. In this work, we extend the applicability of this model by proposing a supervised approach to convolutional sparse coding, which aims at learning discriminative dictionaries instead of purely reconstructive ones. We incorporate a supervised regularization term into the traditional unsupervised CSC objective to encourage the final dictionary elements to be discriminative. Experimental results show that using supervised convolutional learning results in two key advantages. First, we learn more semantically relevant filters in the dictionary and second, we achieve improved image reconstruction on unseen data.

  15. Rethinking Educational Supervision

    Directory of Open Access Journals (Sweden)

    Burhanettin DÖNMEZ

    2009-08-01

    Full Text Available The history of educational (school supervision has been influenced by the history of the interaction of intellectual movements in politics, society, philosophy and industrial movements. The purpose of this conceptual and theoretical study is to have a brief look at the concept of educational supervision with related historical developments in the field. The paper also intends to see the terms and issues critically, and to conceptualize some issues associated with educational supervision in practice. In the paper, the issues are discussed and a number of suggestions are addressed for debate.

  16. Structured learning and self-reflection: strategies to decrease anxiety in the psychiatric mental health clinical nursing experience.

    Science.gov (United States)

    Ganzer, Christine Anne; Zauderer, Cheryl

    2013-01-01

    The purpose of this qualitative study was to test a teaching-learning strategy to help nursing students decrease stress and anxiety that may be brought about by the psychiatric mental health clinical experience. Undergraduate nursing students are known to experience affective stress prior to their first psychiatric mental health clinical practicum. A stressful learning environment can affect the success of the student's clinical performance. Thirty nursing students participated in this study. A structured preclinical workshop combined with self-reflection provided insight into students' perceptions of the psychiatric mental health clinical experience. Overall, students reported that participating in the teaching-learning strategy and self-reflection helped mitigate Combining structured learning with self-reflection is a useful tool for helping nursing students increase self-awareness and ease anxiety that may interfere with learning.

  17. Group Supervision Attitudes: Supervisory Practices Fostering Resistance to Adoption of Evidence-Based Practices

    Science.gov (United States)

    Brooks, Charles T.; Patterson, David A.; McKiernan, Patrick M.

    2012-01-01

    The focus of this study was to qualitatively evaluate worker's attitudes about clinical supervision. It is believed that poor attitudes toward clinical supervision can create barriers during supervision sessions. Fifty-one participants within a social services organization completed an open-ended questionnaire regarding their clinical supervision…

  18. 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

    Science.gov (United States)

    Maxwell, Tim

    2013-01-01

    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…

  19. Supervised Convolutional Sparse Coding

    KAUST Repository

    Affara, Lama Ahmed; Ghanem, Bernard; Wonka, Peter

    2018-01-01

    coding, which aims at learning discriminative dictionaries instead of purely reconstructive ones. We incorporate a supervised regularization term into the traditional unsupervised CSC objective to encourage the final dictionary elements

  20. Supervision and group dynamics

    DEFF Research Database (Denmark)

    Hansen, Søren; Jensen, Lars Peter

    2004-01-01

     An important aspect of the problem based and project organized study at Aalborg University is the supervision of the project groups. At the basic education (first year) it is stated in the curriculum that part of the supervisors' job is to deal with group dynamics. This is due to the experience...... that many students are having difficulties with practical issues such as collaboration, communication, and project management. Most supervisors either ignore this demand, because they do not find it important or they find it frustrating, because they do not know, how to supervise group dynamics...... as well as at Aalborg University. The first visible result has been participating supervisors telling us that the course has inspired them to try supervising group dynamics in the future. This paper will explore some aspects of supervising group dynamics as well as, how to develop the Aalborg model...

  1. Supervision af psykoterapi

    DEFF Research Database (Denmark)

    SUPERVISION AF PSYKOTERAPI indtager en central position i uddannelsen og udviklingen af psykoterapeuter. Trods flere lighedspunkter med psykoterapi, undervisning og konsultation er psykoterapisupervision et selvstændigt virksomhedsområde. Supervisor må foruden at være en trænet psykoterapeut kende...... supervisionens rammer og indplacering i forhold til organisation og samfund. En række kapitler drejer sig om supervisors opgaver, roller og kontrolfunktion, supervision set fra supervisandens perspektiv samt betragtninger over relationer og processer i supervision. Der drøftes fordele og ulemper ved de...... forskellige måder, hvorpå en sag kan fremlægges. Bogens første del afsluttes med refleksioner over de etiske aspekter ved psykoterapisupervision. Bogens anden del handler om de særlige forhold, der gør sig gældende ved supervision af en række specialiserede behandlingsformer eller af psykoterapi med bestemte...

  2. Psykoterapi og supervision

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    2014-01-01

    Kapitlet beskriver supervisionen funktioner i forhold til psykoterapi. Supervision af psykoterapi henviser i almindelighed til, at en psykoterapeut konsulterer en ofte mere erfaren kollega (supervisor) med henblik på drøftelse af et konkret igangværende psykoterapeutisk behandlingsforløb. Formålet...... er at fremme denne fagpersons (psykoterapeutens) faglige udvikling samt sikre kvaliteten af behandlingen.kan defineres som i. Der redegøres for, hvorfor supervision er vigtig del af psykoterapeutens profession samt vises, hvorledes supervision foruden den faglige udvikling også er vigtigt redskab i...... psykoterapiens kvalitetssikring. Efter at have drøftet nogle etiske forhold ved supervision, fremlægges endelig nogle få forskningsresultater vedr. psykoterapisupervision af danske psykologer....

  3. How well do clinical pain assessment tools reflect pain in infants?

    Directory of Open Access Journals (Sweden)

    Rebeccah Slater

    2008-06-01

    Full Text Available Pain in infancy is poorly understood, and medical staff often have difficulty assessing whether an infant is in pain. Current pain assessment tools rely on behavioural and physiological measures, such as change in facial expression, which may not accurately reflect pain experience. Our ability to measure cortical pain responses in young infants gives us the first opportunity to evaluate pain assessment tools with respect to the sensory input and establish whether the resultant pain scores reflect cortical pain processing.Cortical haemodynamic activity was measured in infants, aged 25-43 wk postmenstrual, using near-infrared spectroscopy following a clinically required heel lance and compared to the magnitude of the premature infant pain profile (PIPP score in the same infant to the same stimulus (n = 12, 33 test occasions. Overall, there was good correlation between the PIPP score and the level of cortical activity (regression coefficient = 0.72, 95% confidence interval [CI] limits 0.32-1.11, p = 0.001; correlation coefficient = 0.57. Of the different PIPP components, facial expression correlated best with cortical activity (regression coefficient = 1.26, 95% CI limits 0.84-1.67, p < 0.0001; correlation coefficient = 0.74 (n = 12, 33 test occasions. Cortical pain responses were still recorded in some infants who did not display a change in facial expression.While painful stimulation generally evokes parallel cortical and behavioural responses in infants, pain may be processed at the cortical level without producing detectable behavioural changes. As a result, an infant with a low pain score based on behavioural assessment tools alone may not be pain free.

  4. [Ethics in clinical research: contextualizing and reductionist problem definitions, forms of ethical reflection and some particular implications].

    Science.gov (United States)

    Roelcke, Volker

    2003-12-01

    The present paper starts off with a short outline of issues, conflicts, and goals of ethical reflection about clinical research. It is then argued that non-reductionist, patient-centred ethics should critically reflect on medically preformed problem definitions, ways of problem solution, and evaluations. The shortcomings of such preformed perceptions and interpretations are illustrated using the examples of dementia research, and the complexities of the notion of risk. A more comprehensive approach including the perceptions, interpretations, and evaluations of the patients' perspective necessitates a form of ethical reflection which takes into account the social and cultural contexts of clinical research, and which therefore relies on concepts and methods of the cultural sciences (in particular history, sociology, and cultural anthropology). The decision for a reductionist, or for a contextualising mode of ethical reflection represents in itself a value decision and needs to be explicitly justified.

  5. Does the MUNIX Method Reflect Clinical Dysfunction in Amyotrophic Lateral Sclerosis: A Practical Experience.

    Science.gov (United States)

    Gawel, Malgorzata; Kuzma-Kozakiewicz, Magdalena

    2016-05-01

    The aim of our study was to assess the usefulness of the MUNIX method in reflecting the clinical dysfunction in patients with amyotrophic lateral sclerosis (ALS), as well as to assess an intra-rater reproducibility of MUNIX. The study group consisted of a total of 15 ALS patients. The mean age of symptoms onset was 55 years, and the mean disease duration was 10 months. The muscle strength and patients' functional status were assessed according to the Medical Research Council (MRC) and by ALS functional rating scale revised (ALSFRS-R), respectively. The MUNIX was performed in 6 muscles: abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps brachii (BB), tibial anterior (TA), extensor digitorum brevis (EDB), and abductor hallucis (AH), unilaterally, at a less affected side. Both muscle-specific and global MRC and MUNIX scores were calculated. In 11 patients, the study protocol was repeated at least twice every 3 months. An additional testing of the intra-rater reliability was performed at the first visit.There were no significant differences between MUNIX test and re-test values in the APB, ADM, BB, TA, EDB, and AH muscles (P >0.05). The highest variability of the test-retest values was found in the BB muscle (7.53%). Although there was a significant test-retest difference in the global MUNIX score (P = 0.02), the variability of the results was as low as 1.26%. The MUNIX value correlated with the muscle-specific MRC score in ABP, ADM, TA, EDB and AH (P <0.05), and the global MUNIX values correlated with global MRC scores (P <0.05). There was also a significant correlation between the global MUNIX score and the clinical dysfunction measured by the ALSFRS-R scale (P <0.05). The global MUNIX showed a higher monthly decline (4.3%) as compared with ALFRS-R (0.7%) and the MRC global score (0.5%).This study confirms that the MUNIX method is a sensitive, reliable, and accurate tool reflecting both motor dysfunction and disease progression in ALS

  6. An integrated model for the effects of self-reflection and clinical experiential learning on clinical nursing performance in nursing students: A longitudinal study.

    Science.gov (United States)

    Pai, Hsiang-Chu

    2016-10-01

    The use of clinical simulation in undergraduate nursing programs in Taiwan has gradually increased over the past 5years. Previous research has shown that students' experience of anxiety during simulated laboratory sessions influences their self-reflection and learning effectiveness. Thus, further study that tracks what influences students' clinical performance in actual clinical sites is vital. The aim of the study is to develop an integrated model that considers the associations among anxiety, self-reflection, and learning effectiveness and to understand how this model applies to student nurses' clinical performance while on clinical placement. This study used a correlational and longitudinal study design. The 80 nursing students, who ranged in age from 19 to 21 (mean=20.38, SD=0.56), were recruited from a nursing school in southern Taiwan. Data were collected during three phases of implementation using four questionnaires. During the first phase, the State-Trait Anxiety Inventory (STAI), Simulation Learning Effectiveness Scale (SLES), and Self-Reflection and Insight Scale (SRIS) were used after students completed the simulation course in the school simulation laboratory. Nursing students also completed the Holistic Nursing Competence Scale at 2months (Phase 2) and 4months (Phase 3) after clinical practice experience. In Phase 3, students again completed the STAI and SRIS. Partial least squares (PLS), a structural equation modeling (SEM) procedure, was used to test the research model. The findings showed that: (1) at the start of the simulation laboratory, anxiety had a significant negative effect on students' simulation learning effectiveness (SLE; β=-0.14, pself-reflection with insight (SRI; β=-0.52, pSelf-reflection also had a significant positive effect on simulation learning effectiveness (β=0.37, pself-reflection and insight also had a significant positive effect on nursing competence during the first 2months of practice in a clinical site (β=0.13; β=0

  7. The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment.

    Science.gov (United States)

    Dorsey, Shannon; Pullmann, Michael D; Kerns, Suzanne E U; Jungbluth, Nathaniel; Meza, Rosemary; Thompson, Kelly; Berliner, Lucy

    2017-11-01

    Supervisors are an underutilized resource for supporting evidence-based treatments (EBTs) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT-relevant functions.

  8. Review of Beyond the reflection: The role of the mirror paradigm in clinical practice.

    Science.gov (United States)

    Zelnick, Lawrence

    2008-12-01

    Reviews the book, Beyond the reflection: The role of the mirror paradigm in clinical practice by Paulina Kernberg, Bernadette Buhl-Nielsen, and Lina Normandin (see record 2007-00911-000). This modestly presented volume overflows with insight and new ways of looking at the mirroring experience for children and adolescents. Kernberg and her collaborators present the rich history of the image, metaphor, and pervasive role of the mirror in human experience; they carefully describe the "subjective experience of wonder, admiration, and an objective dimension of truth" in the mirror paradigm (2006, p. xv). For the psychotherapist, Kernberg's work provides a rich resource; the review of past and current research and theorizing about the mirroring function of mothers and primary caregivers is thorough and up-to-date with the most recent advances in neuroscience, attachment theory, and infant research. From Freud to Lacan, from Winnicott to Stern, and from Schore to Gergely, Kernberg presents a sweeping exposition of the various images of the mirror. This volume is worthwhile if only for its presentation of this body of recent research. But there is so much more to be found here. While this is not the first time that Kernberg has presented us with her work with mirror observation and interviews (Kernberg, 1984, 1987), this volume integrates the research about early mother- child experience, and the mirroring paradigm in the psychoanalytic theories about child development, with the phenomenology of child and adolescent psychotherapy. The clinician will find a useful application of the theory to clinical practice and diagnosis that is hard to find in the literature. Beebe and Lachmann (2002) have accomplished this integration between infant research and adult treatment, but Kernberg's application of her research and the demonstrated correlation between the findings of mirror experience, attachment histories, and clinical experience is a rare and welcome addition to the

  9. The vision in supervision: transference-countertransference dynamics and disclosure in the supervision relationship.

    Science.gov (United States)

    Coburn, W J

    1997-01-01

    The centrality of the supervision experience in the development of the supervisee's personal and professional capacities is addressed. The supervision relationship and process are explored in light of the potential effects of transference-countertransference configurations of supervisor and supervisee. Parallels between supervision and treatment are highlighted. The importance of developing and utilizing the capacity for reflectivity is reviewed, as is the impact of supervisee nondisclosure to supervisor. The direct use of countertransference experiences in the context of supervision is explored, and the centrality of self-disclosure is highlighted. It is recommended that supervisor and supervisee remain receptive to exploring these experiences in the service of developing a shared subjective sense of the patient, of increasing the supervisee's capacity to treat his or her patient, and of providing the supervisee with a novel, growth-enhancing relationship.

  10. Perspectives on Medical Students’ Reflections on Ethical Dilemmas during their Clinical Stay. Oral Presentation, COMET Conference in Aalborg, Denmark

    DEFF Research Database (Denmark)

    Gormsen, Lise Kirstine; Søndergaard, Sara; Hoffmann, Tine

    Work-in- progress Roundtable: Title: What ethical problems are out there? – a study of medical students’ reflexive writing about ethical dilemmas in the clinic. Authors: Lise Gormsen, MD, MHH, PhD., Institute of Clinical Medicine, Aarhus University, Denmark Jane Ege Møller, MA, PhD., Center...... Kristina Øgendahl Beeck, Medical student, Aarhus University, Denmark Corresponding and presenting author: Lise Gormsen, MD, MHH, Ph.D, Institute of Clinical Medicine, Aarhus University, Incuba/Skejby, building 2 Palle Juul-Jensens Boulevard 82, 8200 Aarhus N Denmark Phone: +45 23981599 Email: lise...... reflect themselves. Furthermore the material is ‘ negatively biased’ - the students write about the unsolved dilemmas. Conclusion: Reflective texts can be seen as data material that contains valuable knowledge, both concerning modes of reflection AND what types of ethical dilemmas that is a part...

  11. Self-Supervised Dynamical Systems

    Science.gov (United States)

    Zak, Michail

    2003-01-01

    Some progress has been made in a continuing effort to develop mathematical models of the behaviors of multi-agent systems known in biology, economics, and sociology (e.g., systems ranging from single or a few biomolecules to many interacting higher organisms). Living systems can be characterized by nonlinear evolution of probability distributions over different possible choices of the next steps in their motions. One of the main challenges in mathematical modeling of living systems is to distinguish between random walks of purely physical origin (for instance, Brownian motions) and those of biological origin. Following a line of reasoning from prior research, it has been assumed, in the present development, that a biological random walk can be represented by a nonlinear mathematical model that represents coupled mental and motor dynamics incorporating the psychological concept of reflection or self-image. The nonlinear dynamics impart the lifelike ability to behave in ways and to exhibit patterns that depart from thermodynamic equilibrium. Reflection or self-image has traditionally been recognized as a basic element of intelligence. The nonlinear mathematical models of the present development are denoted self-supervised dynamical systems. They include (1) equations of classical dynamics, including random components caused by uncertainties in initial conditions and by Langevin forces, coupled with (2) the corresponding Liouville or Fokker-Planck equations that describe the evolutions of probability densities that represent the uncertainties. The coupling is effected by fictitious information-based forces, denoted supervising forces, composed of probability densities and functionals thereof. The equations of classical mechanics represent motor dynamics that is, dynamics in the traditional sense, signifying Newton s equations of motion. The evolution of the probability densities represents mental dynamics or self-image. Then the interaction between the physical and

  12. In vivo inflammation mapping of periodontal disease based on diffuse reflectance spectral imaging: a clinical study

    Science.gov (United States)

    Prasanth, Chandra Sekhar; Betsy, Joseph; Jayanthi, Jayaraj L.; Nisha, Unni G.; Prasantila, Janam; Subhash, Narayanan

    2013-02-01

    Since conventional techniques using periodontal probes have inherent drawbacks in the diagnosis of different grades of gingival inflammation, development of noninvasive screening devices becomes significant. Diffuse reflectance (DR) spectra recorded with white light illumination is utilized to detect periodontal inflammation from the oxygenated hemoglobin absorption ratio R620/R575. A multispectral imaging system is utilized to record narrow-band DR images at 575 and 620 nm from the anterior sextant of the gingivia of 15 healthy volunteers and 25 patients (N=40). An experienced periodontist assesses the level of gingival inflammation at each site through periodontal probing and assigns diagnosis as healthy, mild, moderate, or severe inflammation. The DR image ratio R620/R575 computed for each pixel (8-μm resolution) from the monochrome images is pseudo-color-mapped to identify gingival inflammation sites. The DR image ratio values at each site are compared with clinical diagnosis to estimate the specificity and sensitivity of the DR imaging technique in inflammation mapping. The high diagnostic accuracy is utilized to detect underlying inflammation in six patients with a previous history of periodontitis.

  13. Inspiring Reflections

    DEFF Research Database (Denmark)

    Muchie, Mammo

    2011-01-01

    A numberof Chris Freeman's colleagues were asked to reflect on what they thought describes his life and work in a few words. Some of the colleagues replied including former SPRU students that were taught or supervised by Chris Freeman. Their views on what they thought were Chris Freeman's defining...... life is not free from fluctuations, cycles, disruptions, crises and destructions both human and ecological. Innovation research ought to position itself to address environmental, financial and economic crises. The third is innovation research for development by addressing not only poverty erdaication...

  14. BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

    Science.gov (United States)

    Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

    2017-03-01

    Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs. © 2017 Michigan Association for Infant Mental Health.

  15. Intelligent multivariate process supervision

    International Nuclear Information System (INIS)

    Visuri, Pertti.

    1986-01-01

    This thesis addresses the difficulties encountered in managing large amounts of data in supervisory control of complex systems. Some previous alarm and disturbance analysis concepts are reviewed and a method for improving the supervision of complex systems is presented. The method, called multivariate supervision, is based on adding low level intelligence to the process control system. By using several measured variables linked together by means of deductive logic, the system can take into account the overall state of the supervised system. Thus, it can present to the operators fewer messages with higher information content than the conventional control systems which are based on independent processing of each variable. In addition, the multivariate method contains a special information presentation concept for improving the man-machine interface. (author)

  16. Portable instrument that integrates irradiation with fluorescence and reflectance spectroscopies during clinical photodynamic therapy of cutaneous disease

    Science.gov (United States)

    Cottrell, W. J.; Oseroff, A. R.; Foster, T. H.

    2006-06-01

    We report a portable clinical instrument for delivering photodynamic therapy (PDT) while performing noninvasive spectroscopic monitoring in vivo. Using an off-surface probe, the instrument delivers the treatment beam to a user-defined field on the skin and performs reflectance and fluorescence spectroscopies at two regions within this field. The instrument is being used to monitor photosensitizer fluorescence photobleaching, fluorescent photoproduct kinetics, blood volume, and hemoglobin oxygen saturation during a pilot clinical trial of 5-aminolevulinic acid-PDT treatment of superficial basal cell carcinoma (BCC). Protoporphyrin IX and photoproduct fluorescence excited by the 633nm PDT treatment laser is collected between 655 and 800nm. During a series of brief treatment interruptions at programable time points, white light reflectance spectra between 475 and 800nm are acquired. Fluorescence spectra are corrected for the effects of absorption and scattering, informed by the reflectance measurements, and then decomposed into known fluorophore contributions in real time using a robust singular value decomposition fitting routine. Reflectance spectra additionally provide information on blood volume and hemoglobin oxygen saturation. Monitoring blood oxygenation and implicit dose metrics such as photosensitizer photobleaching during PDT allows the improved interpretation of clinical results and is helping to guide the treatment protocol for an anticipated low-irradiance PDT clinical trial of BCC.

  17. A "safe space" for learning and reflection: one school's design for continuity with a peer group across clinical clerkships.

    Science.gov (United States)

    Chou, Calvin L; Johnston, C Bree; Singh, Bobby; Garber, Jonathan D; Kaplan, Elizabeth; Lee, Kewchang; Teherani, Arianne

    2011-12-01

    The value of continuity in medical education, particularly during clerkships, is increasingly recognized. Previous clerkship-based models have described changes that emphasize continuity in patient care, learner supervision, and curriculum. The creation of continuous student peer groups can foster interactions that enhance mutual support through uncomfortable professional transitions during the clerkship years. Here, the authors describe a third-year clerkship model based at the San Francisco Veterans Affairs (VA) Medical Center called VA Longitudinal Rotations (VALOR), designed explicitly to establish a supportive learning environment for small peer groups.Seven groups of medical students (42 total) completed VALOR across three academic years between 2007 and 2009. On clerkships during VALOR, one hour per week was designated for faculty-facilitated sessions amongst peer groups. Students' perceptions of peer group support and overall program satisfaction were determined with immediate post surveys and focus groups at the end of VALOR, and with follow-up surveys 5 to 27 months after completing VALOR. Students strongly valued several elements of VALOR peer groups, including support through clerkship challenges, meeting for facilitated reflection, and appreciating patient experiences across the continuum of care. Students' appreciation for their peer group experiences persisted well after the conclusion of VALOR. VALOR students performed the same as or better than traditional clerkship students on knowledge and skill-based outcomes. The authors demonstrate that their third-year clerkship program using peer groups has built supportive learning networks and facilitated reflection, allowing students to develop critical professional skills. Student communication around patient care was also feasible and highly valued.

  18. Kontraktetablering i supervision

    DEFF Research Database (Denmark)

    Mortensen, Karen Vibeke; Jacobsen, Claus Haugaard

    2007-01-01

    Kapitlet behandler kontraktetablering i supervision, et element, der ofte er blevet negligeret eller endog helt forbigået ved indledningen af supervisionsforløb. Sikre aftaler om emner som tid, sted, procedurer for fremlæggelse, fortrolighed, ansvarsfordeling og evaluering skaber imidlertid trygh...

  19. Man-machine supervision

    International Nuclear Information System (INIS)

    Montmain, J.

    2005-01-01

    Today's complexity of systems where man is involved has led to the development of more and more sophisticated information processing systems where decision making has become more and more difficult. The operator task has moved from operation to supervision and the production tool has become indissociable from its numerical instrumentation and control system. The integration of more and more numerous and sophisticated control indicators in the control room does not necessary fulfill the expectations of the operation team. It is preferable to develop cooperative information systems which are real situation understanding aids. The stake is not the automation of operators' cognitive tasks but the supply of a reasoning help. One of the challenges of interactive information systems is the selection, organisation and dynamical display of information. The efficiency of the whole man-machine system depends on the communication interface efficiency. This article presents the principles and specificities of man-machine supervision systems: 1 - principle: operator's role in control room, operator and automation, monitoring and diagnosis, characteristics of useful models for supervision; 2 - qualitative reasoning: origin, trends, evolutions; 3 - causal reasoning: causality, causal graph representation, causal and diagnostic graph; 4 - multi-points of view reasoning: multi flow modeling method, Sagace method; 5 - approximate reasoning: the symbolic numerical interface, the multi-criteria decision; 6 - example of application: supervision in a spent-fuel reprocessing facility. (J.S.)

  20. Etiske betragtninger ved supervision

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard; Agerskov, Kirsten

    2007-01-01

    Kapitlet præsenterer nogle etiske betragtninger ved supervision. Mens der længe har eksisteret etiske retningslinjer for psykoterapeutisk arbejde, har der overraskende nok manglet tilsvarende vejledninger på supervisionsområdet. Det betyder imidlertid ikke, at de ikke er relevante. I kapitlet gøres...

  1. Effectiveness of Group Supervision versus Combined Group and Individual Supervision.

    Science.gov (United States)

    Ray, Dee; Altekruse, Michael

    2000-01-01

    Investigates the effectiveness of different types of supervision (large group, small group, combined group, individual supervision) with counseling students (N=64). Analyses revealed that all supervision formats resulted in similar progress in counselor effectiveness and counselor development. Participants voiced a preference for individual…

  2. Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: clinical feasibility and integration as an adjunct therapy.

    Science.gov (United States)

    Hoermann, Simon; Ferreira Dos Santos, Luara; Morkisch, Nadine; Jettkowski, Katrin; Sillis, Moran; Devan, Hemakumar; Kanagasabai, Parimala S; Schmidt, Henning; Krüger, Jörg; Dohle, Christian; Regenbrecht, Holger; Hale, Leigh; Cutfield, Nicholas J

    2017-07-01

    New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. We evaluated components of the therapeutic intervention, from the patients' and the therapists' points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. The results showed that the combination and application of the Berlin Protocol for Mirror Therapy together with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for Rehabilitation Computerised Mirror Therapy is feasible for clinical use Augmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient setting Virtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation.

  3. The effect of education and supervised exercise vs. education alone on the time to total hip replacement in patients with severe hip osteoarthritis. A randomized clinical trial protocol

    DEFF Research Database (Denmark)

    Jensen, Carsten; Roos, Ewa M.; Kjærsgaard-Andersen, Per

    2013-01-01

    Background: The age- and gender-specific incidence of total hip replacement surgery has increased over the last two decades in all age groups. Recent studies indicate that non-surgical interventions are effective in reducing pain and disability, even at later stages of the disease when joint...... will receive 3 months of supervised exercise consisting of 12 sessions of individualized, goal-based neuromuscular training, and 12 sessions of intensive resistance training plus patient education (3 sessions). The control group will receive only patient education (3 sessions). The primary end...... measures are the five subscales of the Hip disability and Osteoarthritis Outcome Score, physical activity (UCLA activity score), and patient’s global perceived effect. Other measures include pain after exercise, joint-specific adverse events, exercise adherence, general health status (EQ-5D-5L), mechanical...

  4. Fostering Dental Students' Academic Achievements and Reflection Skills Through Clinical Peer Assessment and Feedback.

    Science.gov (United States)

    Tricio, Jorge A; Woolford, Mark J; Escudier, Michael P

    2016-08-01

    Peer assessment is increasingly being encouraged to enhance dental students' learning. The aim of this study was to evaluate the educational impact in terms of academic achievements and reflective thinking of a formative prospective peer assessment and feedback protocol. Volunteer final-year dental students at King's College London Dental Institute, UK, received training on peer assessment, peer feedback, and self-reflection. At the beginning (baseline) and end (resultant) of the 2012-13 academic year, 86 students (55% of the year group) completed a reflection questionnaire (RQ). Sixty-eight of those students used a modified Direct Observation of Procedural Skills (DOPS) as a framework for peer assessment and peer feedback during a complete academic year. End-of-year, high-stakes examination grades and RQ scores from the participants and nonparticipants were statistically compared. The participants completed 576 peer DOPS. Those 22 students who peer assessed each other ≥10 times exhibited highly statistically significant differences and powerful positive effect sizes in their high-stakes exam grades (p=0.0001, d=0.74) and critical reflection skills (p=0.005, d=1.41) when compared to those who did not assess one another. Furthermore, only the same 22 students showed a statistically significant increase and positive effect size in their critical reflection skills from baseline to resultant (p=0.003, d=1.04). The results of this study suggest that the protocol used has the potential to impact dental students' academic and reflection skills, provided it is practiced in ten or more peer encounters and ensuring peer feedback is provided followed by self-reflection.

  5. Perceptions of student nurses on the writing of reflective journals as a means for personal, professional and clinical learning development

    Directory of Open Access Journals (Sweden)

    Hazel T. Mahlanze

    2017-10-01

    Full Text Available Background: Reflective journals are used by the students to voice their views on the daily activities during clinical placement. Reflective journals are aimed at helping the student to observe and record as many facts about daily practice as the student finds relevant. Reflective journal writing can therefore be used as a tool to evaluate that clinical learning is actually taking place and what challenges students are experiencing which may influence their learning. Findings by Harris (2006:460–461 are encouraging that through journaling students will develop ability to identify and analyse their difficulties, make suggestions for solving problems and ask and pursue questions on their own. Some of the participants confirmed improved values clarification, self-valuing and personal growth. Bulman & Schutz (2008:172 recommends journal writing for recording processes the student observe, copy and internalize in her journey towards professional development. Objectives: This study aimed to determine student nurses' perceptions of reflective journal writing as a means for personal, professional development and clinical learning development. Method: A quantitative and descriptive survey was conducted in September 2013. Forty participants were recruited from second year student nurses of a University of Technology in uMgungundlovu District of KwaZulu-Natal. Purposive convenience sampling strategy was used. A structured questionnaire was designed by the researcher from literature reviewed. The questionnaire was piloted and modified, then used after permission had been granted by the Ethics Committee of the university concerned. The Statistical Package for Social Sciences (SPSS 17 programme was used for data analysis. Results: Results indicated that the participants generally experienced writing of reflective journals to be a valuable tool enhancing personal development, professional growth and clinical learning. A significant number (n = 24

  6. The future endocrine patient. Reflections on the future of clinical endocrinology

    NARCIS (Netherlands)

    S.W.J. Lamberts (Steven); J.A. Romijn (Johannes); W.M. Wiersinga (Wilmar)

    2003-01-01

    textabstractIn recent years the future position of clinical endocrinology has been extensively discussed by Western European endocrine societies. Clinical endocrinology seems to suffer from being too intellectual, generating too little income, and lacking too few spectacular

  7. Experiences of Supervision at Practice Placement Sites

    Directory of Open Access Journals (Sweden)

    Lesley Diack

    2014-01-01

    Full Text Available Background. Whilst placement supervision and clinical education programmes are of significant value in shaping the behaviours of undergraduate healthcare students, appropriate provisions which are efficacious to the learner are somewhat lacking, particularly for students studying on UK MPharm programmes. Objectives. To explore and explain the value of placement supervision to the personal development and employability of undergraduate pharmacy students. Methods. Students participated in a week long community pharmacy pilot programme, a result of a collaborative effort between the School of Pharmacy and Life Sciences and a small consortium of community pharmacies. Students and stakeholders were asked to evaluate their experiences via separate questionnaires which had been developed to elicit views and attitudes. Key Findings. Feedback from students and stakeholders towards the experience was overwhelmingly positive with multiple benefits being reported. Of particular prominence was the emphasis in student feedback on the value of placement supervision to their professional and personal development. Findings were indicative of a development in clinical practice proficiencies, core skills, and improvement in decision-making practice. Conclusions. The benefits of clinical supervision to the professional and personal development of MPharm students are well documented, although attracting professional pharmacy supervisors is proving a problematic task for educational providers in the UK.

  8. Effect of UV irradiation on cutaneous cicatrices: a randomized, controlled trial with clinical, skin reflectance, histological, immunohistochemical and biochemical evaluations.

    Science.gov (United States)

    Due, Eva; Rossen, Kristian; Sorensen, Lars Tue; Kliem, Anette; Karlsmark, Tonny; Haedersdal, Merete

    2007-01-01

    The aim of this study was to examine the effect of ultraviolet (UV) irradiation on human cutaneous cicatrices. In this randomized, controlled study, dermal punch biopsy wounds served as a wound healing model. Wounds healed by primary or second intention and were randomized to postoperative solar UV irradiation or to no UV exposure. Evaluations after 5 and 12 weeks included blinded clinical assessments, skin reflectance measurements, histology, immunohistochemistry, and biochemical analyses of the N-terminal propeptide from procollagen-1, hydroxyproline, hydroxylysine, and proline. Twelve weeks postoperatively, UV-irradiated cicatrices healing by second intention: (i) were significantly pointed out as the most disfiguring; (ii) obtained significantly higher scores of colour, infiltration and cicatrix area; and (iii) showed significantly higher increase in skin-reflectance measurements of skin-pigmentation vs. non-irradiated cicatrices. No histological, immunohistochemical or biochemical differences were found. In conclusion, postoperative UV exposure aggravates the clinical appearance of cicatrices in humans.

  9. The technical supervision interface

    CERN Document Server

    Sollander, P

    1998-01-01

    The Technical Control Room (TCR) is currently using 30 different applications for the remote supervision of the technical infrastructure at CERN. These applications have all been developed with the CERN made Uniform Man Machine Interface (UMMI) tools built in 1990. However, the visualization technology has evolved phenomenally since 1990, the Technical Data Server (TDS) has radically changed our control system architecture, and the standardization and the maintenance of the UMMI applications have become important issues as their number increases. The Technical Supervision Interface is intended to replace the UMMI and solve the above problems. Using a standard WWW-browser for the display, it will be inherently multi-platform and hence available for control room operators, equipment specialists and on-call personnel.

  10. What characterizes Norwegian nursing students’ reflective journals during clinical placement in an African country?

    Directory of Open Access Journals (Sweden)

    Olav Johannes Hovland

    2015-01-01

    Conclusion: The students predominantly expressed strong personal emotions and described their hosts in a judgemental and, in many cases, critical manner, often in comparison with Norwegian conditions. A stronger focus on cultural competence in preparing students for exchange programmes may decrease their level of criticism and negative judgement, and affect the level of reflection in their journals.

  11. Improving Banking Supervision

    OpenAIRE

    Mayes, David G.

    1998-01-01

    This paper explains how banking supervision within the EU, and in Finland in particular, can be improved by the implementation of greater market discipline and related changes. Although existing EU law, institutions, market structures and practices of corporate governance restrict the scope for change, substantial improvements can be introduced now while there is a window of opportunity for change. The economy is growing H5ly and the consequences of the banking crises of the early 1990s have ...

  12. Supervision in Firms

    OpenAIRE

    Vafaï , Kouroche

    2012-01-01

    URL des Documents de travail : http://centredeconomiesorbonne.univ-paris1.fr/bandeau-haut/documents-de-travail/; Documents de travail du Centre d'Economie de la Sorbonne 2012.84 - ISSN : 1955-611X; To control, evaluate, and motivate their agents, firms employ supervisors. As shown by empirical investigations, biased evaluation by supervisors linked to collusion is a persistent feature of firms. This paper studies how deceptive supervision affects agency relationships. We consider a three-leve...

  13. Reflective action assessment with a prospective clinical problem solving tool in the context of rehabilitation medicine: an illustrative case study.

    Science.gov (United States)

    Kellett, David; Mpofu, Elias; Madden, Richard

    2013-06-01

    This study describes a case formulation approach applying a prospective ICF derived clinical tool to assess rehabilitation needs for a community dwelling stroke survivor with care from an outpatient rehabilitation medicine clinic. Case history data on the person were assessed for rehabilitation management planning using a prospective tool to interlink current with projected future functional status in everyday settings. Implicit assessment with reflective action informed decision points at each stage of the rehabilitation process. As a result of reflective action using the prospective tool, rehabilitation management led to significant changes in client participation after limitations to mobility and self care were mapped to the living conditions of the stroke survivor. The context sensitive rehabilitative plan resulted in higher subjective health-related quality of life in the stroke survivor and significant other and enhanced their capacity for participation. Reflective action informed assessment applying ICF concepts to clinical problem solving resulted in positive gains in health-related quality of life in a stroke survivor.

  14. Ethics in education supervision

    Directory of Open Access Journals (Sweden)

    Fatma ÖZMEN

    2008-06-01

    Full Text Available Supervision in education plays a crucial role in attaining educational goals. In addition to determining the present situation, it has a theoretical and practical function regarding the actions to be taken in general and the achievement of teacher development in particular to meet the educational goals in the most effective way. For the education supervisors to act ethically in their tasks while achieving this vital mission shall facilitate them to build up trust, to enhance the level of collaboration and sharing, thus it shall contribute to organizational effectiveness. Ethics is an essential component of educational supervision. Yet, it demonstrates rather vague quality due to the conditions, persons, and situations. Therefore, it is a difficult process to develop the ethical standards in institutions. This study aims to clarify the concept of ethics, to bring up its importance, and to make recommendations for more effective supervisions from the aspect of ethics, based on the literature review, some research results, and sample cases reported by teachers and supervisors.

  15. Group supervision for general practitioners

    DEFF Research Database (Denmark)

    Galina Nielsen, Helena; Sofie Davidsen, Annette; Dalsted, Rikke

    2013-01-01

    AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long-establish......AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long...... considered important prerequisites for disclosing and discussing professional problems. CONCLUSION: The results of this study indicate that participation in a supervision group can be beneficial for maintaining and developing GPs' skills in dealing with patients with mental health problems. Group supervision...... influenced other areas of GPs' professional lives as well. However, more studies are needed to assess the impact of supervision groups....

  16. General Practitioner (GP) trainees' experience of a '1-h protected supervision model' given during psychiatry placements in the United Kingdom.

    Science.gov (United States)

    Thomas, Gareth; McNeill, Helen

    2018-01-05

    Background A '1-hour protected supervision model' is well established for Psychiatry trainees. This model is also extended to GP trainees who are on placement in psychiatry. To explore the experiences of the '1-hour protected supervision model' for GP trainees in psychiatry placements in the UK. Methods Using a mixed methods approach, an anonymous online questionnaire was sent to GP trainees in the North West of England who had completed a placement in Psychiatry between February and August 2015. Results Discussing clinical cases whilst using the e-portfolio was the most useful learning event in this model. Patient care can potentially improve if a positive relationship develops between trainee/supervisor, which is impacted by the knowledge of this model at the start of the placement. Trainees found that clinical pressures were impacting on the occurrence of supervision. Conclusion The model works best when both GP trainees and their supervisors understand the model. The most frequently used and educationally beneficial aspect for GP trainees in psychiatry is the exploration of clinical cases using the learning portfolio as an educational tool. For effective delivery of this model of supervision, organisations must reflect on the balance between service delivery and allowing the supervisor and trainee adequate time for it to occur.

  17. Peer Assisted Learning and Blogging: A Strategy to Promote Reflective Practice during Clinical Fieldwork

    Science.gov (United States)

    Ladyshewsky, Richard K.; Gardner, Peter

    2008-01-01

    The use of peer assisted learning in clinical education is explored in this case study. Groups of undergraduate physiotherapy students were structured into communities of practice during the second half of their clinical fieldwork program. They collaborated online in an asynchronous manner, using information communications technology (blogs) and…

  18. The future endocrine patient. Reflections on the future of clinical endocrinology

    NARCIS (Netherlands)

    Lamberts, S. W. J.; Romijn, J. A.; Wiersinga, W. M.

    2003-01-01

    In recent years the future position of clinical endocrinology has been extensively discussed by Western European endocrine societies. Clinical endocrinology seems to suffer from being too intellectual, generating too little income, and lacking too few spectacular interventions. In this manuscript we

  19. The supervisor as gender analyst: feminist perspectives on group supervision and training.

    Science.gov (United States)

    Schoenholtz-Read, J

    1996-10-01

    Supervision and training groups have advantages over dyadic supervision and training that include factors to promote group learning and interaction within a sociocultural context. This article focuses on the gender aspects of group supervision and training. It provides a review of feminist theoretical developments and presents their application to group supervision and training in the form of eight guidelines that are illustrated by clinical examples.

  20. Helen Flanders Dunbar, John Dewey, and clinical pragmatism: reflections on method in psychosomatic medicine and bioethics.

    Science.gov (United States)

    Hart, Curtis W

    2002-01-01

    This article outlines the method utilized by physicians and major figures in the founding of Clinical Pastoral Education, Helen Flanders Dunbar, in her work of 1943, Psychosomatic Diagnosis, and relates it to the currently evolving approach in bioethics known as clinical pragmatism. It assesses Dewey's influence on both Dunbar in psychosomatic medicine and clinical pragmatism in bioethics, and illustrates the breadth of influence of the school of philosophical thought known as pragmatism with which Dewey's name and those of William James and Charles Sanders Pierce are most often identified.

  1. Reflections on clinical expertise and silent know-how in voice therapy

    DEFF Research Database (Denmark)

    Iwarsson, Jenny

    2014-01-01

    The concept of ‘clinical expertise’ is described as a part of evidence-based practice (EBP) together with ‘external scientific evidence’ and ‘patient values and perspectives’. However, clinical expertise in the management of voice disorders has not been described or discussed in much detail....... The expertise seems to consist partly of silent know-how that, from the outside, may seem improperly related to the personality of the speech-language pathologist or exclusively dependent on the number of years in the field. In this paper, it is suggested that clinical expertise in voice therapy consists...

  2. The Value of Clinical Jazz: Teaching Critical Reflection on, in, and Toward Action.

    Science.gov (United States)

    Casapulla, Sharon; Longenecker, Randall; Beverly, Elizabeth A

    2016-05-01

    Clinical Jazz is a small-group strategy in medical education designed to develop interpersonal skills and improve doctor-patient and interprofessional relationships. The purpose of this study was to explore medical students' and faculty facilitators' perceived value of Clinical Jazz. We conducted a modified Nominal Group Process with participating medical students (n=21), faculty facilitators (n=5), and research team members (n=3). Students and faculty facilitators independently answered the question, "What do you value about Clinical Jazz?" We then conducted content and thematic analyses on the resulting data. Three themes emerged during analysis: (1) students and faculty appreciated the opportunity to learn and practice a thoughtful and structured process for problem solving, (2) students and faculty valued the safety of the group process in sharing a diversity of perspectives on topics in medicine, and (3) students and faculty acknowledged the importance of addressing real and challenging problems that are rarely addressed in formal lectures and other planned small-group settings. Clinical Jazz provides students and faculty with the opportunity to address the hidden and/or informal curriculum in medical education, while providing a safe space and time to solve important clinical and interprofessional problems.

  3. Expanding the "ports of entry" for speech-language pathologists: a relational and reflective model for clinical practice.

    Science.gov (United States)

    Geller, Elaine; Foley, Gilbert M

    2009-02-01

    To outline an expanded framework for clinical practice in speech-language pathology. This framework broadens the focus on discipline-specific knowledge and infuses mental health constructs within the study of communication sciences and disorders, with the objective of expanding the potential "ports or points of entry" (D. Stern, 1995) for clinical intervention with young children who are language impaired. Specific mental health constructs are highlighted in this article. These include relationship-based learning, attachment theory, working dyadically (the client is the child and parent), reflective practice, transference-countertransference, and the use of self. Each construct is explored as to the way it has been applied in traditional and contemporary models of clinical practice. The underlying premise in this framework is that working from a relationally based and reflective perspective augments change and growth in both client and parent(s). The challenge is for speech-language pathologists to embed mental health constructs within their discipline-specific expertise. This leads to paying attention to both observable aspects of clients' behaviors as well as their internal affective states.

  4. Reflection and learning in clinical nursing education mediated by ePortfolio

    DEFF Research Database (Denmark)

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

    2015-01-01

    This paper reports on an investigation into learning mediated by the elective elements of an electronic portfolio (ePortfolio) designed to facilitate four learning styles. The design takes a phenomenological-hermeneutic approach. The setting was a ten-week clinical course in Basic Nursing...

  5. Adapting Objective Structured Clinical Examinations to Assess Social Work Students' Performance and Reflections

    Science.gov (United States)

    Bogo, Marion; Regehr, Cheryl; Logie, Carmen; Katz, Ellen; Mylopoulos, Maria; Regehr, Glenn

    2011-01-01

    The development of standardized, valid, and reliable methods for assessment of students' practice competence continues to be a challenge for social work educators. In this study, the Objective Structured Clinical Examination (OSCE), originally used in medicine to assess performance through simulated interviews, was adapted for social work to…

  6. Methodological Reflections on the Contribution of Qualitative Research to the Evaluation of Clinical Ethics Support Services.

    Science.gov (United States)

    Wäscher, Sebastian; Salloch, Sabine; Ritter, Peter; Vollmann, Jochen; Schildmann, Jan

    2017-05-01

    This article describes a process of developing, implementing and evaluating a clinical ethics support service intervention with the goal of building up a context-sensitive structure of minimal clinical-ethics in an oncology department without prior clinical ethics structure. Scholars from different disciplines have called for an improvement in the evaluation of clinical ethics support services (CESS) for different reasons over several decades. However, while a lot has been said about the concepts and methodological challenges of evaluating CESS up to the present time, relatively few empirical studies have been carried out. The aim of this article is twofold. On the one hand, it describes a process of development, modifying and evaluating a CESS intervention as part of the ETHICO research project, using the approach of qualitative-formative evaluation. On the other hand, it provides a methodological analysis which specifies the contribution of qualitative empirical methods to the (formative) evaluation of CESS. We conclude with a consideration of the strengths and limitations of qualitative evaluation research with regards to the evaluation and development of context sensitive CESS. We further discuss our own approach in contrast to rather traditional consult or committee models. © 2017 John Wiley & Sons Ltd.

  7. Weakly Supervised Dictionary Learning

    Science.gov (United States)

    You, Zeyu; Raich, Raviv; Fern, Xiaoli Z.; Kim, Jinsub

    2018-05-01

    We present a probabilistic modeling and inference framework for discriminative analysis dictionary learning under a weak supervision setting. Dictionary learning approaches have been widely used for tasks such as low-level signal denoising and restoration as well as high-level classification tasks, which can be applied to audio and image analysis. Synthesis dictionary learning aims at jointly learning a dictionary and corresponding sparse coefficients to provide accurate data representation. This approach is useful for denoising and signal restoration, but may lead to sub-optimal classification performance. By contrast, analysis dictionary learning provides a transform that maps data to a sparse discriminative representation suitable for classification. We consider the problem of analysis dictionary learning for time-series data under a weak supervision setting in which signals are assigned with a global label instead of an instantaneous label signal. We propose a discriminative probabilistic model that incorporates both label information and sparsity constraints on the underlying latent instantaneous label signal using cardinality control. We present the expectation maximization (EM) procedure for maximum likelihood estimation (MLE) of the proposed model. To facilitate a computationally efficient E-step, we propose both a chain and a novel tree graph reformulation of the graphical model. The performance of the proposed model is demonstrated on both synthetic and real-world data.

  8. Supervised Transfer Sparse Coding

    KAUST Repository

    Al-Shedivat, Maruan

    2014-07-27

    A combination of the sparse coding and transfer learn- ing techniques was shown to be accurate and robust in classification tasks where training and testing objects have a shared feature space but are sampled from differ- ent underlying distributions, i.e., belong to different do- mains. The key assumption in such case is that in spite of the domain disparity, samples from different domains share some common hidden factors. Previous methods often assumed that all the objects in the target domain are unlabeled, and thus the training set solely comprised objects from the source domain. However, in real world applications, the target domain often has some labeled objects, or one can always manually label a small num- ber of them. In this paper, we explore such possibil- ity and show how a small number of labeled data in the target domain can significantly leverage classifica- tion accuracy of the state-of-the-art transfer sparse cod- ing methods. We further propose a unified framework named supervised transfer sparse coding (STSC) which simultaneously optimizes sparse representation, domain transfer and classification. Experimental results on three applications demonstrate that a little manual labeling and then learning the model in a supervised fashion can significantly improve classification accuracy.

  9. Advanced Music Therapy Supervision Training

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2009-01-01

    supervision training excerpts live in the workshop will be offered. The workshop will include demonstrating a variety of supervision methods and techniques used in A) post graduate music therapy training programs b) a variety of work contexts such as psychiatry and somatic music psychotherapy. The workshop......The presentation will illustrate training models in supervision for experienced music therapists where transference/counter transference issues are in focus. Musical, verbal and body related tools will be illustrated from supervision practice by the presenters. A possibility to experience small...

  10. Learning Dynamics in Doctoral Supervision

    DEFF Research Database (Denmark)

    Kobayashi, Sofie

    investigates learning opportunities in supervision with multiple supervisors. This was investigated through observations and recording of supervision, and subsequent analysis of transcripts. The analyses used different perspectives on learning; learning as participation, positioning theory and variation theory....... The research illuminates how learning opportunities are created in the interaction through the scientific discussions. It also shows how multiple supervisors can contribute to supervision by providing new perspectives and opinions that have a potential for creating new understandings. The combination...... of different theoretical frameworks from the perspectives of learning as individual acquisition and a sociocultural perspective on learning contributed to a nuanced illustration of the otherwise implicit practices of supervision....

  11. Child Rights and Clinical Bioethics: Historical Reflections on Modern Medicine and Ethics.

    Science.gov (United States)

    Brosco, Jeffrey P

    2016-01-01

    Why might pediatric bioethicists in the United States reject the U.N. Convention on the Rights of the Child (CRC) as a framework for resolving ethical issues? The essays in this issue present arguments and counterarguments regarding the usefulness of the CRC in various clinical and research cases. But underlying this debate are two historical factors that help explain the seeming paradox of pediatric bioethicists' arguing against child's rights. First, the profession of clinical bioethics emerged in the 1970s as one component of modern medicine's focus on improving health through the application of technologically sophisticated treatments. The everyday work of U.S. bioethicists thus usually involves emerging technologies or practices in clinical or laboratory settings; the articles of the CRC, in contrast, seem better suited to addressing broad policy issues that affect the social determinants of health. Second, U.S. child health policy veered away from a more communitarian approach in the early 20th century for reasons of demography that were reinforced by ideology and concerns about immigration. The divide between clinical medicine and public health in the United States, as well as the relatively meager social safety net, are not based on a failure to recognize the rights of children. Indeed, there is some historical evidence to suggest that "rights language" has hindered progress on child health and well-being in the United States. In today's political climate, efforts to ensure that governments pledge to treat children in accordance with their status as human beings (a child right's perspective) are less likely to improve child health than robust advocacy on behalf of children's unique needs, especially as novel models of health-care financing emerge.

  12. The Flipped Classroom for pre-clinical dental skills teaching - a reflective commentary.

    Science.gov (United States)

    Crothers, A J; Bagg, J; McKerlie, R

    2017-05-12

    A Flipped Classroom method for teaching of adult practical pre-clinical dental skills was introduced to the BDS curriculum in Glasgow during the 2015/2016 academic session. This report provides a commentary of the first year of employing this method - from the identification of the need to optimise teaching resources, through the planning, implementation and development of the method, with an early indication of performance.

  13. Bridging the reductive and the synthetic: some reflections on the clinical implications of synchronicity.

    Science.gov (United States)

    Connolly, Angela

    2015-04-01

    When Jung introduced the concepts of synchronicity and the psychoid unconscious, he expanded analytical psychology into decidedly uncanny territory. Despite the early interest shown by Freud, anomalous phenomena such as telepathy have become a taboo subject in psychoanalysis. Today, however, there is an increasing interest in thought transference and synchronicity, thus opening the way for a fruitful exchange between different psychoanalytical schools on their clinical implications. I propose to examine some of the ambiguities of Jung's thinking, to clarify how we define synchronicity, the relationship between synchronicities and parapsychological events, and their clinical significance. At the present moment, we are still unsure if such events should be considered as normal and a way of facilitating individuation, or as an indication of psychopathology in the patient or in the analyst, just as we are uncertain about the particular characteristics of the intersubjective field that can lead to synchronicities. Making use of the typology of mind-matter correlations presented by Atmanspacher and Fach, and the distinction they draw between acategorial and non-categorial states of mind, I will use two clinical vignettes to illustrate the different states of mind in analyst and analysand that can lead to synchronicities. In particular I will focus on the relationship between analytical reverie and synchronicity. © 2015, The Society of Analytical Psychology.

  14. Public Supervision over Private Relationships : Towards European Supervision Private Law?

    NARCIS (Netherlands)

    Cherednychenko, O.O.

    2014-01-01

    The rise of public supervision over private relationships in many areas of private law has led to the development of what, in the author’s view, could be called ‘European supervision private law’. This emerging body of law forms part of European regulatory private law and is made up of

  15. Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

    Science.gov (United States)

    Braverman, Genna; Bereknyei Merrell, Sylvia; Bruce, Janine S; Makoul, Gregory; Schillinger, Erika

    2016-11-01

    Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis. We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter. Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

  16. Update on the clinical features and natural history of Wolf-Hirschhorn (4p-) syndrome: experience with 87 patients and recommendations for routine health supervision.

    Science.gov (United States)

    Battaglia, Agatino; Filippi, Tiziana; Carey, John C

    2008-11-15

    Wolf-Hirschhorn syndrome (WHS) is a well-known multiple congenital anomalies/mental retardation syndrome, firstly described in 1961 by Cooper and Hirschhorn. Its frequency is estimated as 1/50,000-1/20,000 births, with a female predilection of 2:1. The disorder is caused by partial loss of material from the distal portion of the short arm of chromosome 4 (4p16.3), and is considered a contiguous gene syndrome. No single gene deletions or intragenic mutations have been shown to confer the full WHS phenotype. Since the disorder was brought to the attention of geneticists, many additional cases have been published. Only in 1999, however, were the first data on the natural history brought to the attention of the medical community. The purpose of the present study is to help delineate in more detail and over a longer period of time, the natural history of WHS, in order to establish appropriate health supervision and anticipatory guidance for individuals with this disorder. We have collected information on 87 patients diagnosed with WHS (54 females and 33 males) both in USA and Italy. Age at first observation ranged between newborn and 17 years. Twenty patients have been followed from 4 months to 23 years. The deletion proximal breakpoint varied from 4p15.32 to 4p16.3, and, by FISH, was terminal and included both WHSCR. Deletion was detected by standard cytogenetics in 44/87 (50.5%) patients, whereas FISH was necessary in the other 43 (49.5%). Array-CGH analysis at 1 Mb resolution was performed in 34/87 patients, and, in 15/34 (44%), showed an unbalanced translocation leading to both a 4p monosomy and a partial trisomy for another chromosome arm. Six more patients had been previously shown to have an unbalanced translocation by karyotype analysis or FISH with a WHS-specific probe. Sixty-five of 87 patients had an apparent pure, de novo, terminal deletion; and 1/87 a tandem duplication of 4p16.1p16.3 associated with 4p16.3pter deletion. Age at diagnosis varied between 7

  17. Clinical neurological examination vs electrophysiological studies: Reflections from experiences in occupational medicine

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis

    2015-01-01

    a diagnosis requires the identification of the responsible pathology and the involved tissues and structures. Consequently, improved diagnostic approaches are needed. This editorial discusses the potentials of using the clinical neurologic examination in patients with upper limb complaints related to work....... It is argued that a simple but systematic physical approach permits the examiner to frequently identify patterns of neurological findings that suggest nerve afflictions and their locations, and that electrophysiological studies are less likely to identify pathology. A diagnostic algorithm for the physical...... assessment is provided to assist the clinician. Failure to include representative neurological items in the physical examination may result in patients being misinterpreted, misdiagnosed and mistreated....

  18. [Mobbing, coping and narcisism: reflections in the light of a clinical experience].

    Science.gov (United States)

    Ziliotto, G

    2008-01-01

    The term "mobbing" has today erroneously come to be a huge general recepticle for all the conflicts and interpersonal problems breaking out in the work environment. The author, who collaborates as clinical psychologist in an anti-mobbing network, shows that frequently events at work and personality structures are closely connected. In particular, attention to the modes of coping becomes a fundamental aspect for the diagnosis of mobbing. If psychic distress has gradually moved from a neurotic basis to a more preponderantly narcissistic pathology, the author underlines that precisely narcissistic pathologies may be correlated to the vast container of mobbing.

  19. Online supervision at the university - A comparative study of supervision on student assignments face-to-face and online

    Directory of Open Access Journals (Sweden)

    Søren Smedegaard Bengtsen

    2015-09-01

    Full Text Available Through an empirical study of supervision on student assignments at the university across face-to-face and online settings, we show firstly the limiting implications of traditional dichotomies between face-to-face and online supervision. Secondly we show that more attention must be given to the way different digital tools influence the supervisory dialogue. These findings illustrate a form of ‘torn pedagogy’; that online tools and platforms destabilize and tear traditional understandings of supervision pedagogy apart. Also we forge a new concept of “format supervision” that enables supervisors to understand and reflect their supervision practice as a deliberate choice between face-to-face and online formats.

  20. Online supervision at the university - A comparative study of supervision on student assignments face-to-face and online

    Directory of Open Access Journals (Sweden)

    Søren Smedegaard Bengtsen

    2015-02-01

    Full Text Available Through an empirical study of supervision on student assignments at the university across face-to-face and online settings, we show firstly the limiting implications of traditional dichotomies between face-to-face and online supervision. Secondly we show that more attention must be given to the way different digital tools influence the supervisory dialogue. These findings illustrate a form of ‘torn pedagogy’; that online tools and platforms destabilize and tear traditional understandings of supervision pedagogy apart. Also we forge a new concept of “format supervision” that enables supervisors to understand and reflect their supervision practice as a deliberate choice between face-to-face and online formats.

  1. Portable (handheld) clinical device for quantitative spectroscopy of skin, utilizing spatial frequency domain reflectance techniques

    Science.gov (United States)

    Saager, Rolf B.; Dang, An N.; Huang, Samantha S.; Kelly, Kristen M.; Durkin, Anthony J.

    2017-09-01

    Spatial Frequency Domain Spectroscopy (SFDS) is a technique for quantifying in-vivo tissue optical properties. SFDS employs structured light patterns that are projected onto tissues using a spatial light modulator, such as a digital micromirror device. In combination with appropriate models of light propagation, this technique can be used to quantify tissue optical properties (absorption, μa, and scattering, μs', coefficients) and chromophore concentrations. Here we present a handheld implementation of an SFDS device that employs line (one dimensional) imaging. This instrument can measure 1088 spatial locations that span a 3 cm line as opposed to our original benchtop SFDS system that only collects a single 1 mm diameter spot. This imager, however, retains the spectral resolution (˜1 nm) and range (450-1000 nm) of our original benchtop SFDS device. In the context of homogeneous turbid media, we demonstrate that this new system matches the spectral response of our original system to within 1% across a typical range of spatial frequencies (0-0.35 mm-1). With the new form factor, the device has tremendously improved mobility and portability, allowing for greater ease of use in a clinical setting. A smaller size also enables access to different tissue locations, which increases the flexibility of the device. The design of this portable system not only enables SFDS to be used in clinical settings but also enables visualization of properties of layered tissues such as skin.

  2. Clinical performance - a reflection of damage accumulation in ceramic dental crowns

    Energy Technology Data Exchange (ETDEWEB)

    Rekow, D.E. [Univ. of Medicine and Dentistry of New Jersey, Newark, NJ (United States). Dept. of Orthodontics; Thompson, V.P. [Univ. of Medicine and Dentistry of New Jersey, Newark, NJ (United States). New Jersey Dental School

    2001-07-01

    All-ceramic dental crowns have tremendous appeal for patients - their esthetics nearly match those of natural teeth. Unfortunately, the most esthetic materials are brittle and, consequently, are vulnerable to damage relating to shaping which is exacerbated during cyclic loading during normal chewing. Clinical performance of all-ceramic dental prostheses are directly dependent on damage introduced during fabrication and during fatigue loading associated with function. The accumulation of damage results in unacceptably high failure rates (where failure is defined as a complete fracture requiring replacement of the prosthesis). The relation between shaping damage and fatigue damage on clinical performance of all-ceramic dental crowns was investigated. Materials used commercially for all-ceramic crowns and investigated in this study included a series of different microstructures of machinable glass ceramics (Corning), aluminas and porcelains (Vita Zahnfabrik), and zirconia (Norton). As monolithic materials, strong, tough, fatigue-resistant materials are not sufficiently esthetic for crowns. Crowns fabricated from monolithic esthetic materials have high failure rates. Layering ceramics could provide acceptable strength through management of damage accumulation. (orig.)

  3. Reflections on Hip Fracture Recovery From Older Adults Enrolled in a Clinical Trial

    Directory of Open Access Journals (Sweden)

    Sarah Stott-Eveneshen MA

    2017-03-01

    Full Text Available This study describes patients’ perspectives on recovery during participation in a randomized controlled trial that tested a postoperative hip fracture management program (B4 Clinic, compared with usual care, on mobility. Semistructured qualitative interviews were conducted with 50 older adults with hip fracture (from both groups twice over 12 months. A total of 32 women (64% and 18 men (36% participated in the study with a mean age at baseline of 82 (range = 65-98 years. A total of 40 participants reported recovery goals at some point during their recovery from hip fracture but only 18 participants realized their goals within 12 months. Recovering mobility, returning to prefracture activities, and obtaining stable health were the most commonly reported goals. Participants described good social support, access to physiotherapy, and positive perspective as most important to recovery. These factors were influenced by participants’ knowledge, resources, and monthly contact with study staff (perceived as a form of social support. The most frequently reported barriers to participants’ recovery were the onset of complications, pain, and limited access to physiotherapy. Potential implications of these findings include design and modification of new or preexisting fracture programs, prioritizing patient engagement and enhanced knowledge for future clinical research in hip fracture recovery.

  4. Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision.

    Science.gov (United States)

    Rakovshik, Sarah G; McManus, Freda; Vazquez-Montes, Maria; Muse, Kate; Ougrin, Dennis

    2016-03-01

    To investigate the effect of Internet-based training (IBT), with and without supervision, on therapists' (N = 61) cognitive-behavioral therapy (CBT) skills in routine clinical practice. Participants were randomized into 3 conditions: (1) Internet-based training with use of a consultation worksheet (IBT-CW); (2) Internet-based training with CBT supervision via Skype (IBT-S); and (3) "delayed-training" controls (DTs), who did not receive the training until all data collection was completed. The IBT participants received access to training over a period of 3 months. CBT skills were evaluated at pre-, mid- and posttraining/wait using assessor competence ratings of recorded therapy sessions. Hierarchical linear analysis revealed that the IBT-S participants had significantly greater CBT competence at posttraining than did IBT-CW and DT participants at both the mid- and posttraining/wait assessment points. There were no significant differences between IBT-CW and the delayed (no)-training DTs. IBT programs that include supervision may be a scalable and effective method of disseminating CBT into routine clinical practice, particularly for populations without ready access to more-traditional "live" methods of training. There was no evidence for a significant effect of IBT without supervision over a nontraining control, suggesting that merely providing access to IBT programs may not be an effective method of disseminating CBT to routine clinical practice. (c) 2016 APA, all rights reserved).

  5. An Eight-Eyed Version of Hawkins and Shohet's Clinical Supervision Model: The Addition of the Cognitive Analytic Therapy Concept of the "Observing Eye/I" as the "Observing Us"

    Science.gov (United States)

    Darongkamas, Jurai; John, Christopher; Walker, Mark James

    2014-01-01

    This paper proposes incorporating the concept of the "observing eye/I", from cognitive analytic therapy (CAT), to Hawkins and Shohet's seven modes of supervision, comprising their transtheoretical model of supervision. Each mode is described alongside explicit examples relating to CAT. This modification using a key idea from CAT (in…

  6. New hybrid reflectance optical pulse oximetry sensor for lower oxygen saturation measurement and for broader clinical application

    Science.gov (United States)

    Nogawa, Masamichi; Ching, Chong Thong; Ida, Takeyuki; Itakura, Keiko; Takatani, Setsuo

    1997-06-01

    A new reflectance pulse oximeter sensor for lower arterial oxygen saturation (Sa)2) measurement has been designed and evaluated in animals prior to clinical trials. The new sensor incorporates ten light emitting diode chips for each wavelength of 730 and 880 nm mounted symmetrically and at the radial separation distance of 7 mm around a photodiode chip. The separation distance of 7 mm was chosen to maximize the ratio of the pulsatile to the average plethysmographic signal level at each wavelength. The 730 and 880 wavelength combination was determined to obtain a linear relationship between the reflectance ratio of the 730 and 880 nm wavelengths and Sa)2. In addition to these features of the sensor, the Fast Fourier Transform method was employed to compute the pulsatile and average signal level at each wavelength. The performance of the new reflectance pulse oximeter sensor was evaluated in dogs in comparison to the 665/910 nm sensor. As predicted by the theoretical simulation based on a 3D photon diffusion theory, the 730/880 nm sensor demonstrated an excellent linearity over the SaO2 range from 100 to 30 percent. For the SaO2 range between 100 and 70 percent, the 665/910 and 730/880 sensors showed the standard error of around 3.5 percent and 2.1 percent, respectively, in comparison to the blood samples. For the range between 70 and 30 percent, the standard error of the 730/880 nm sensor was only 2.7 percent, while that of the 665/910 nm sensor was 9.5 percent. The 730/880 sensor showed improved accuracy for a wide range of SaO2 particularly over the range between 70 and 30 percent. This new reflectance sensor can provide noninvasive measurement of SaO2 accurately over the wide saturation range from 100 to 30 percent.

  7. Accreditation to supervise research

    International Nuclear Information System (INIS)

    Mauclaire, Laurent

    2003-01-01

    After a recall of his academic research works, an indication of all his publications and of his teaching and research supervising activities, and a summary of his scientific activity, the author proposes an overview of his research works which addressed the study of radio-tracers for nuclear medicine, and the study of the 2,6 dimethyl beta cyclodextrin. These both topics are then more precisely presented and discussed. For the first one, the author notably studied iodine radiochemistry, and the elaboration of new compounds for dopamine recapturing visualization (development of radio-pharmaceutical drug marked with technetium). For the second one, the author reports the use of modified cyclodextrins for the transport of lipophilic radio-tracers

  8. Medical supervision of radiation workers

    International Nuclear Information System (INIS)

    Santani, S.B.; Nandakumar, A.N.; Subramanian, G.

    1982-01-01

    The basic elements of an occupational medical supervision programme for radiation workers are very much the same as those relevant to other professions with some additional special features. This paper cites examples from literature and recommends measures such as spot checks and continuance of medical supervision even after a radiation worker leaves this profession. (author)

  9. Tværfaglig supervision

    DEFF Research Database (Denmark)

    Tværfaglig supervision dækker over supervision af forskellige faggrupper. Det er en kompleks disciplin der stiller store krav tl supervisor. Bogens første del præsenterer fire faglige supervisionsmodeller: En almen, en psykodynamisk, en kognitiv adfærdsterapeutisk og en narrativ. Anden del...

  10. Assessment of Counselors' Supervision Processes

    Science.gov (United States)

    Ünal, Ali; Sürücü, Abdullah; Yavuz, Mustafa

    2013-01-01

    The aim of this study is to investigate elementary and high school counselors' supervision processes and efficiency of their supervision. The interview method was used as it was thought to be better for realizing the aim of the study. The study group was composed of ten counselors who were chosen through purposeful sampling method. Data were…

  11. Reflections on the theoretical contributions and clinical applications of parental insightfulness.

    Science.gov (United States)

    Lieberman, Alicia F

    2018-06-01

    This paper outlines the theoretical antecedents that contextualize parental insightfulness and examines this concept's value in assessing parental functioning and in monitoring treatment progress with parents and young children who experience mental health and relationship problems. As a concept, parental insightfulness provides a much-needed bridge linking important aspects of attachment theory with their psychoanalytic origins, including early contributions that conceptualize parenting as a developmental process that furthers the unfolding capacities of the adult self. The paper examines the compatibility between the dimensions of parental insightfulness and the criteria for a healthy adult sense of self. The empirical body of knowledge generated by the concept of parental insightfulness is briefly reviewed as the basis for using the concept as a valuable tool for the empirical exploration of intrapsychic, interpersonal, and clinical processes in parents and their children.

  12. Microalbuminuria reflects a generalized transvascular albumin leakiness in clinically healthy subjects

    DEFF Research Database (Denmark)

    Jensen, J S; Borch-Johnsen, K; Jensen, G

    1995-01-01

    1. In epidemiological studies microalbuminuria, i.e. slightly elevated urinary albumin excretion rate, predicts increased atherosclerotic vascular morbidity and mortality. This study aimed to test the hypothesis that microalbuminuria in clinically healthy subjects is associated with a systemic...... transvascular albumin leakiness. In animal experiments the outflux of albumin and lipids to the arterial wall are highly correlated, and both are elevated in atherosclerosis. 2. All participants were recruited at random from a population-based epidemiological study, where the upper decile of urinary albumin...... excretion rate was 6.6 micrograms/min. Twenty-seven patients with persistent microalbuminuria (urinary albumin excretion rate 6.6-150 micrograms/min), and 56 age- and sex-matched control subjects with persistent normoalbuminuria (UAER

  13. Supervision Duty of School Principals

    Directory of Open Access Journals (Sweden)

    Kürşat YILMAZ

    2009-04-01

    Full Text Available Supervision by school administrators is becoming more and more important. The change in the roles ofschool administrators has a great effect on that increase. At present, school administrators are consideredmore than as technical directors, but as instructional leaders. This increased the importance of schooladministrators’ expected supervision acts. In this respect, the aim of this study is to make a conceptualanalysis about school administrators’ supervision duties. For this reason, a literature review related withsupervision and contemporary supervision approaches was done, and the official documents concerningsupervision were examined. As a result, it can be said that school administrators’ supervision duties havebecome very important. And these duties must certainly be carried out by school administrators.

  14. Mobile physician reporting of clinically significant events-a novel way to improve handoff communication and supervision of resident on call activities.

    Science.gov (United States)

    Nabors, Christopher; Peterson, Stephen J; Aronow, Wilbert S; Sule, Sachin; Mumtaz, Arif; Shah, Tushar; Eskridge, Etta; Wold, Eric; Stallings, Gary W; Burak, Kathleen Kelly; Goldberg, Randy; Guo, Gary; Sekhri, Arunabh; Mathew, George; Khera, Sahil; Montoya, Jessica; Sharma, Mala; Paudel, Rajiv; Frishman, William H

    2014-12-01

    Reporting of clinically significant events represents an important mechanism by which patient safety problems may be identified and corrected. However, time pressure and cumbersome report entry procedures have discouraged the full participation of physicians. To improve the process, our internal medicine training program developed an easy-to-use mobile platform that combines the reporting process with patient sign-out. Between August 25, 2011, and January 25, 2012, our trainees entered clinically significant events into i-touch/i-phone/i-pad based devices functioning in wireless-synchrony with our desktop application. Events were collected into daily reports that were sent from the handoff system to program leaders and attending physicians to plan for rounds and to correct safety problems. Using the mobile module, residents entered 31 reportable events per month versus the 12 events per month that were reported via desktop during a previous 6-month study period. Advances in information technology now permit clinically significant events that take place during "off hours" to be identified and reported (via handoff) to next providers and to supervisors via collated reports. This information permits hospital leaders to correct safety issues quickly and effectively, while attending physicians are able to use information gleaned from the reports to optimize rounding plans and to provide additional oversight of trainee on call patient management decisions.

  15. [The interaction in clinical nursing education: reflections on care of the person with hypertension].

    Science.gov (United States)

    Araújo-Girão, Ana L; Martins de Oliveira, Glória Y; Gomes, Emiliana B; Parente-Arruda, Lidyane; Aires de Freitas, Consuelo H

    2015-01-01

    To identify the knowledge and attitudes about self-care in health among users who received clinical nursing education for hypertension based on the level of knowledge and attitudes of the hypertensive patient through interactive care interventions with patients and relatives in the therapeutic context, with the goal of developing health education. This study represents action research with a qualitative approach on hypertensive patients hospitalized for stroke. Hypertension as a risk factor is most strongly associated with the development of this health problem. Participants were interviewed about their knowledge about the illness before and after the realization of individualized health education activities on the basis of the theory of symbolic interactionism. It was found that the respondents, after participating in the educational process, demonstrated a broader knowledge of hypertension, which motivated them to seek changes in habits that could improve their quality of life. Through the use of symbolic interactionism, health education proved to be a strategy for empowerment and autonomy of the hypertensive subject with respect to their treatment and can be integrated into nursing care.

  16. Paediatric renal length measurements from ultrasound and DMSA scans: does clinical practice reflect theoretical normal values?

    International Nuclear Information System (INIS)

    Que, L.; Rutland, M.D.; Hassan, I.M.

    1999-01-01

    Full text: Renal length measurement is a routine part of ultrasound examination in children and those results are plotted on a normogram style graph, so that each child's results are compared to a normal range (mean ± 2 S.D.). Renal length measurements from the posterior oblique views of dimercaptosuccinic acid (DMSA) scans in our department have not always correlated well with the ultrasound measurements on the same patients. Renal lengths from the DMSA scans of 120 patients with apparently normal kidneys were recorded and used to generate a normogram of renal length at different ages (0.5-7 years). This DMSA normogram was compared to the ultrasound (US) normogram used in the Paediatric Radiology Department, and it showed slight differences in renal lengths (3-8 mm), but that the US normogram had smaller coefficients of variation (US = 6.6%, NM 8.3%), implying a 'tighter' normal range. 39 of these patients had DMSA and ultrasound measurements of renal length within 3 months, and these were studied first by calculating the mean and CV values for different age groups, and then by plotting individual renal lengths on the appropriate normograms. The measured data produced much greater variability in the ultrasound measurements than the DTPA measurements, and the individual points produced 4/78 (5.1%) abnormal results for DMSA, but 21/78 (26.9%) abnormal results for ultrasound. Thus, in routine clinical use, using patients with apparently normal kidneys, ultrasound was unable to match the 'normal range' set by their current normogram, but the nuclear medicine showed 5.1% of values outside the normal (DMSA) range, which was completely appropriate for a range of ± 2 standard deviations

  17. Manual physical therapy and exercise versus supervised home exercise in the management of patients with inversion ankle sprain: a multicenter randomized clinical trial.

    Science.gov (United States)

    Cleland, Joshua A; Mintken, Paul E; McDevitt, Amy; Bieniek, Melanie L; Carpenter, Kristin J; Kulp, Katherine; Whitman, Julie M

    2013-01-01

    Randomized clinical trial. To compare the effectiveness of manual therapy and exercise (MTEX) to a home exercise program (HEP) in the management of individuals with an inversion ankle sprain. An in-clinic exercise program has been found to yield similar outcomes as an HEP for individuals with an inversion ankle sprain. However, no studies have compared an MTEX approach to an HEP. Patients with an inversion ankle sprain completed the Foot and Ankle Ability Measure (FAAM) activities of daily living subscale, the FAAM sports subscale, the Lower Extremity Functional Scale, and the numeric pain rating scale. Patients were randomly assigned to either an MTEX or an HEP treatment group. Outcomes were collected at baseline, 4 weeks, and 6 months. The primary aim (effects of treatment on pain and disability) was examined with a mixed-model analysis of variance. The hypothesis of interest was the 2-way interaction (group by time). Seventy-four patients (mean ± SD age, 35.1 ± 11.0 years; 48.6% female) were randomized into the MTEX group (n = 37) or the HEP group (n = 37). The overall group-by-time interaction for the mixed-model analysis of variance was statistically significant for the FAAM activities of daily living subscale (Pankle sprains. Registered at clinicaltrials.gov (NCT00797368). Therapy, level 1b-.

  18. Making clinical case-based learning in veterinary medicine visible: analysis of collaborative concept-mapping processes and reflections.

    Science.gov (United States)

    Khosa, Deep K; Volet, Simone E; Bolton, John R

    2014-01-01

    The value of collaborative concept mapping in assisting students to develop an understanding of complex concepts across a broad range of basic and applied science subjects is well documented. Less is known about students' learning processes that occur during the construction of a concept map, especially in the context of clinical cases in veterinary medicine. This study investigated the unfolding collaborative learning processes that took place in real-time concept mapping of a clinical case by veterinary medical students and explored students' and their teacher's reflections on the value of this activity. This study had two parts. The first part investigated the cognitive and metacognitive learning processes of two groups of students who displayed divergent learning outcomes in a concept mapping task. Meaningful group differences were found in their level of learning engagement in terms of the extent to which they spent time understanding and co-constructing knowledge along with completing the task at hand. The second part explored students' and their teacher's views on the value of concept mapping as a learning and teaching tool. The students' and their teacher's perceptions revealed congruent and contrasting notions about the usefulness of concept mapping. The relevance of concept mapping to clinical case-based learning in veterinary medicine is discussed, along with directions for future research.

  19. Reflections on Ethics and Humanity in Pediatric Neurology: the Value of Recognizing Ethical Issues in Common Clinical Practice.

    Science.gov (United States)

    Ronen, Gabriel M; Rosenbaum, Peter L

    2017-05-01

    Our goals in this reflection are to (i) identify the ethical dimensions inherent in any clinical encounter and (ii) bring to the forefront of our pediatric neurology practice the myriad of opportunities to explore and learn from these ethical questions. We highlight specifically Beauchamp and Childress's principles of biomedical ethics. We use the terms ethics in common clinical practice and an ethical lens to remind people of the ubiquity of ethical situations and the usefulness of using existing ethical principles to analyze and resolve difficult situations in clinical practice. We start with a few common situations with which many of us tend to struggle. We describe what we understand as ethics and how and why developments in technology, novel potential interventions, policies, and societal perspectives challenge us to think about and debate ethical issues. Individual patients are not a singular population; each patient has their own unique life situations, culture, goals, and expectations that need to be considered with a good dose of humanity and humility. We believe that using an ethical lens-by which we mean making an explicit effort to identify and consider these issues openly-will help us to achieve this goal in practice, education, and research.

  20. Supervision of professionals: Interdependency between embodied experiences and professional knowledge

    Directory of Open Access Journals (Sweden)

    Aud Marie Øien

    2015-11-01

    Full Text Available Social work counsellors, exposed to hardships of clients’ lives, might, over time, experience strain as bodily reactions of muscle tension and pain. Within the framework of improving professional practice, the aim was to explore meanings attached to moving and breathing by studying the influence of supervision, encompassing experiences and reflections on bodily exercises, and reflection on challenging professional experiences. Action research of interdisciplinary supervision for seven counsellors, based on observations, field notes, reflection notes, and a focus group interview, was carried out. Data were analysed across participants within sessions and over time to compare meaning variations. The counsellors’ change of experiences were identified as phases: What is in it for me, not knowing what to perceive, attention as basis for knowing how to move, experiencing and creating connections, and knowing oneself better. Adjusted to change of experiences, supervisors encouraged counsellors to give attention to, become aware of, and relieve and explore muscle tension and breathing restrictions to contexts of meaning. Supervision based on movement opened access to personal learning. Supervision as approaches of movements and reflections contributed to increased self-knowledge in professional social work practices. Based on ability to perceive and relieve muscle tension and flow of breathing, the approach might be a potential for professionals to handle challenging situations. The findings, related to the lived body, encompass appearances of new meanings and new uses to experiences of muscular tension and flow of breathing.

  1. Joint influences of individual and work unit abusive supervision on ethical intentions and behaviors: a moderated mediation model.

    Science.gov (United States)

    Hannah, Sean T; Schaubroeck, John M; Peng, Ann C; Lord, Robert G; Trevino, Linda K; Kozlowski, Steve W J; Avolio, Bruce J; Dimotakis, Nikolaos; Doty, Joseph

    2013-07-01

    We develop and test a model based on social cognitive theory (Bandura, 1991) that links abusive supervision to followers' ethical intentions and behaviors. Results from a sample of 2,572 military members show that abusive supervision was negatively related to followers' moral courage and their identification with the organization's core values. In addition, work unit contexts with varying degrees of abusive supervision, reflected by the average level of abusive supervision reported by unit members, moderated relationships between the level of abusive supervision personally experienced by individuals and both their moral courage and their identification with organizational values. Moral courage and identification with organizational values accounted for the relationship between abusive supervision and followers' ethical intentions and unethical behaviors. These findings suggest that abusive supervision may undermine moral agency and that being personally abused is not required for abusive supervision to negatively influence ethical outcomes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  2. Local supervision of solariums

    International Nuclear Information System (INIS)

    2004-01-01

    In Norway, new regulations on radiation protection and application of radiation came into force on the first of January 2004. Local authorities may now perform the supervision of solariums. There are over 500 solar studios in Norway, with over 5000 solariums accessible to the public. An unknown number of solariums are in private homes, on workplaces, and in hotels and fitness studios. Norway currently has the highest frequency of skin cancer in Europe. The frequency of mole cancer has increased sixfold during the last 30 years, and 200 people die each year of this type of cancer. The Nordic cancer registers estimate that 95 per cent of the skin cancer incidences would have been avoided by limiting sunbathing. It is unknown how many cases are due to the use of solariums. But several studies indicate increased risk of mole cancer caused by solariums. It was found in previous inspection of 130 solariums that only 30 per cent had correct tubes and lamps. Only one solarium satisfied all the requirements of the regulations. But this has since improved. With the new regulations, all solarium businesses offering cosmetic solariums for sale, renting out or use have an obligation to submit reports to the Radiation Protection Authority

  3. BRONCHIAL ASTHMA SUPERVISION AMONG TEENAGERS

    Directory of Open Access Journals (Sweden)

    N.M. Nenasheva

    2008-01-01

    Full Text Available The article highlights the results of the act test based bronchial asthma supervision evaluation among teenagers and defines the interrelation of the objective and subjective asthma supervision parameters. The researchers examined 214 male teenagers aged from 16 to 18, suffering from the bronchial asthma, who were sent to the allergy department to verify the diagnosis. Bronchial asthma supervision evaluation was assisted by the act test. The research has showed that over a half (56% of teenagers, suffering from mild bronchial asthma, mention its un control course, do not receive any adequate pharmacotherapy and are consequently a risk group in terms of the bronchial asthma exacerbation. Act test results correlate with the functional indices (fev1, as well as with the degree of the bronchial hyperresponsiveness, which is one of the markers of an allergic inflammation in the lower respiratory passages.Key words: bronchial asthma supervision, act test, teenagers.

  4. The effectiveness of banking supervision

    OpenAIRE

    Davis, EP; Obasi, U

    2009-01-01

    Banking supervision is an essential aspect of modern financial systems, seeking crucially to monitor risk-taking by banks so as to protect depositors, the government safety net and the economy as a whole against systemic bank failure and its consequences. In this context, this paper seeks to explore the relationship between risk indicators for individual banks and the different approaches to banking supervision adopted around the world. This is the first work to make use of the currently avai...

  5. Deconstructing Risk Management in Psychotherapy Supervision.

    Science.gov (United States)

    Kroll, Jerome; Radden, Jennifer

    2017-12-01

    In the ongoing controversy over how much regulation and standardization to impose on clinical practice and research, it is not surprising that the activity of psychotherapy supervision should be swept up in the drive for uniformity. The managers amongst us want to regulate and institutionalize all aspects of practice. In opposition, many clinicians resist the relentless march toward the safety of uniformity travel alongside managerial imposition of regulations. Psychotherapy supervision's method of a close apprenticeship relationship between supervisor and trainee and its focus on the process and ethics of professional interaction stand at the humanistic core of what is otherwise becoming an increasingly mechanistic model of providing care to persons with mental illness. Our commentary picks up on these themes as it reviews the work by Mehrtens et al about strengthening awareness of liability in psychiatry residency training programs. We argue that the practice of psychiatry is overburdened by documentation requirements. In imposing further record-keeping on psychotherapy supervision, we lose much more than we gain. We recommend that the supervisory process focus on the characterological virtues essential to functioning as an ethical therapist. We also argue that self-protective rules place restraints on possibilities for imaginative insights and innovations in psychotherapy. © 2017 American Academy of Psychiatry and the Law.

  6. Metabolite profiling identifies candidate markers reflecting the clinical adaptations associated with Roux-en-Y gastric bypass surgery.

    Directory of Open Access Journals (Sweden)

    David M Mutch

    Full Text Available BACKGROUND: Roux-en-Y gastric bypass (RYGB surgery is associated with weight loss, improved insulin sensitivity and glucose homeostasis, and a reduction in co-morbidities such as diabetes and coronary heart disease. To generate further insight into the numerous metabolic adaptations associated with RYGB surgery, we profiled serum metabolites before and after gastric bypass surgery and integrated metabolite changes with clinical data. METHODOLOGY AND PRINCIPAL FINDINGS: Serum metabolites were detected by gas and liquid chromatography-coupled mass spectrometry before, and 3 and 6 months after RYGB in morbidly obese female subjects (n = 14; BMI = 46.2+/-1.7. Subjects showed decreases in weight-related parameters and improvements in insulin sensitivity post surgery. The abundance of 48% (83 of 172 of the measured metabolites changed significantly within the first 3 months post RYGB (p<0.05, including sphingosines, unsaturated fatty acids, and branched chain amino acids. Dividing subjects into obese (n = 9 and obese/diabetic (n = 5 groups identified 8 metabolites that differed consistently at all time points and whose serum levels changed following RYGB: asparagine, lysophosphatidylcholine (C18:2, nervonic (C24:1 acid, p-Cresol sulfate, lactate, lycopene, glucose, and mannose. Changes in the aforementioned metabolites were integrated with clinical data for body mass index (BMI and estimates for insulin resistance (HOMA-IR. Of these, nervonic acid was significantly and negatively correlated with HOMA-IR (p = 0.001, R = -0.55. CONCLUSIONS: Global metabolite profiling in morbidly obese subjects after RYGB has provided new information regarding the considerable metabolic alterations associated with this surgical procedure. Integrating clinical measurements with metabolomics data is capable of identifying markers that reflect the metabolic adaptations following RYGB.

  7. 20 CFR 656.21 - Supervised recruitment.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Supervised recruitment. 656.21 Section 656.21... Supervised recruitment. (a) Supervised recruitment. Where the Certifying Officer determines it appropriate, post-filing supervised recruitment may be required of the employer for the pending application or...

  8. Educational Supervision Appropriate for Psychiatry Trainee's Needs

    Science.gov (United States)

    Rele, Kiran; Tarrant, C. Jane

    2010-01-01

    Objective: The authors studied the regularity and content of supervision sessions in one of the U.K. postgraduate psychiatric training schemes (Mid-Trent). Methods: A questionnaire sent to psychiatry trainees assessed the timing and duration of supervision, content and protection of supervision time, and overall quality of supervision. The authors…

  9. A SURVEY OF SEMI-SUPERVISED LEARNING

    OpenAIRE

    Amrita Sadarangani *, Dr. Anjali Jivani

    2016-01-01

    Semi Supervised Learning involves using both labeled and unlabeled data to train a classifier or for clustering. Semi supervised learning finds usage in many applications, since labeled data can be hard to find in many cases. Currently, a lot of research is being conducted in this area. This paper discusses the different algorithms of semi supervised learning and then their advantages and limitations are compared. The differences between supervised classification and semi-supervised classific...

  10. Reflections on clinical practice whilst developing a portfolio of evidence: Perceptions of undergraduate nursing students in the Western Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Victoire Ticha

    2015-12-01

    Full Text Available Background: In order to develop clinical judgement, nurses should be encouraged to become analytical and critical thinkers. Development of a portfolio of evidence (PoE of reflection on clinical experiences is one of the strategies that can be used to enhance analytical and critical thinking amongst nursing students. Students’ perceptions of the process are important in order to encourage their reflective practice. PoE compilation at a school of nursing at a university in the Western Cape includes evidence of students’ clinical learning which they present in a portfolio. The students are expected to reflect on their clinical learning experiences and include these reflections in their portfolios. Objective: To describe the perceptions of fourth-year nursing students regarding reflective practice whilst compiling their PoEs. Method: A qualitative design was used to explore the perceptions of registered fourth-year nursing students with regard to their reflective practice whilst compiling their PoEs. Purposive sampling was used for selection of participants. Three focus group discussions were held, each consisting of six to eight participants. Data saturation was reached during the third meeting. Tesch’s method of data analysis was used. Results: Findings revealed that reflection enabled the learners to gain experience and identify challenges related to the expected events and tasks carried out at the hospitals and in the classroom whilst developing their PoE. Conclusion: The compilation of a PoE was a good teaching and learning strategy, and the skills, experience and knowledge that the participants in this study acquired boosted their self-esteem, confidence and critical thinking. Reflection also assisted in self-directed learning.

  11. Group supervision in a private setting: Practice and method for theory and practice in psychotherapy

    Directory of Open Access Journals (Sweden)

    Graziana Mangiacavallo

    2015-05-01

    Full Text Available The report aims to tell the experience of a supervision group in a private setting. The group consists of professional psychotherapists driven by the more experienced practitioner, who shares a clinical reasoning on psychotherapy with younger colleagues. The report aims to present the supervision group as a methode and to showcase its features. The supervision group becomes a container of professional experiences that speak of the new way of doing psychotherapy. 

  12. Human semi-supervised learning.

    Science.gov (United States)

    Gibson, Bryan R; Rogers, Timothy T; Zhu, Xiaojin

    2013-01-01

    Most empirical work in human categorization has studied learning in either fully supervised or fully unsupervised scenarios. Most real-world learning scenarios, however, are semi-supervised: Learners receive a great deal of unlabeled information from the world, coupled with occasional experiences in which items are directly labeled by a knowledgeable source. A large body of work in machine learning has investigated how learning can exploit both labeled and unlabeled data provided to a learner. Using equivalences between models found in human categorization and machine learning research, we explain how these semi-supervised techniques can be applied to human learning. A series of experiments are described which show that semi-supervised learning models prove useful for explaining human behavior when exposed to both labeled and unlabeled data. We then discuss some machine learning models that do not have familiar human categorization counterparts. Finally, we discuss some challenges yet to be addressed in the use of semi-supervised models for modeling human categorization. Copyright © 2013 Cognitive Science Society, Inc.

  13. Supervision Vs Education Quality in Primary Education

    Directory of Open Access Journals (Sweden)

    Jhoel Ruber Mota Fonseca

    2016-11-01

    Full Text Available This article has as objective to interpret the voices of teachers supervising vs quality of education in primary education, as today, supervision entails progress and improvement in the performance of the duties of teachers in the learning environment is therefore, that through this content conflicts present information to achieve changes within educational institutions towards organizational efficiency and under supplied. In it, a qualitative paradigmatic approach as a methodological foundation that allows us to interpret educational supervision through delos social actors which is made up of managers, teachers and supervisors in the context of primary education, established likewise was necessary to collect the information through direct observation technique using as an interview script whose implementation was key informants comprised of a primary teacher education, a supervisor and from this the researcher, thus achieving the corresponding analysis according to the information provided for each, which allowed the development of argumentative skills teachers, establishing rules and procedures that provide guidelines for creating answers to the problem. For with following aims determined in the investigation, vital agents that help teachers to be highly competent in their daily practice, using teaching strategies that will enable success in the classroom, whose purpose is the achievement orientation and optimization in the process of teaching and student learning. In this sense, a reflection about the role it should play the supervisor to achieve educational quality is performed, demonstrating spaces mediation, integration, participation and collaboration with respect to the performance of the master whose aim is to be efficient and effective in its educational work of the educational system.

  14. Challenges for Better thesis supervision.

    Science.gov (United States)

    Ghadirian, Laleh; Sayarifard, Azadeh; Majdzadeh, Reza; Rajabi, Fatemeh; Yunesian, Masoud

    2014-01-01

    Conduction of thesis by the students is one of their major academic activities. Thesis quality and acquired experiences are highly dependent on the supervision. Our study is aimed at identifing the challenges in thesis supervision from both students and faculty members point of view. This study was conducted using individual in-depth interviews and Focus Group Discussions (FGD). The participants were 43 students and faculty members selected by purposive sampling. It was carried out in Tehran University of Medical Sciences in 2012. Data analysis was done concurrently with data gathering using content analysis method. Our data analysis resulted in 162 codes, 17 subcategories and 4 major categories, "supervisory knowledge and skills", "atmosphere", "bylaws and regulations relating to supervision" and "monitoring and evaluation". This study showed that more attention and planning in needed for modifying related rules and regulations, qualitative and quantitative improvement in mentorship training, research atmosphere improvement and effective monitoring and evaluation in supervisory area.

  15. The efficiency of government supervision

    International Nuclear Information System (INIS)

    Paetzold, H.

    1992-01-01

    In 1970, fires as events initiating plant failure were included in the accident analyses of nuclear power plant design concepts. In the meantime, they have been expressed in more precise terms and incorporated into the bodies of nuclear technical rules and regulations. Following a suggestion by the Baden-Wuerttemberg State Ministry for the Environment, the efficiency of government supervision has been examined for the example of fire protection measures or the site of Phillipsburg with one BWR and one PWR plant in operation. The result of the examination indicated that pragmatic approaches and the establishment of key areas of supervision could further enhance the efficiency of government supervision under Section 19 of the German Atomic Energy Act and achieve improvements in plant safety. (orig.) [de

  16. ECB Banking Supervision and beyond

    OpenAIRE

    Lannoo, Karel

    2014-01-01

    With publication of the results of its Comprehensive Assessment at the end of October 2014, the European Central Bank has set the standard for its new mandate as supervisor. But this was only the beginning. The heavy work started in early November, with the day-to-day supervision of the 120 most significant banks in the eurozone under the Single Supervisory Mechanism. The centralisation of the supervision in the eurozone will pose a number of challenges for the ECB in the coming months and ye...

  17. Man-machine supervision; Supervision homme-machine

    Energy Technology Data Exchange (ETDEWEB)

    Montmain, J. [CEA Valrho, Dir. de l' Energie Nucleaire (DEN), 30 - Marcoule (France)

    2005-05-01

    Today's complexity of systems where man is involved has led to the development of more and more sophisticated information processing systems where decision making has become more and more difficult. The operator task has moved from operation to supervision and the production tool has become indissociable from its numerical instrumentation and control system. The integration of more and more numerous and sophisticated control indicators in the control room does not necessary fulfill the expectations of the operation team. It is preferable to develop cooperative information systems which are real situation understanding aids. The stake is not the automation of operators' cognitive tasks but the supply of a reasoning help. One of the challenges of interactive information systems is the selection, organisation and dynamical display of information. The efficiency of the whole man-machine system depends on the communication interface efficiency. This article presents the principles and specificities of man-machine supervision systems: 1 - principle: operator's role in control room, operator and automation, monitoring and diagnosis, characteristics of useful models for supervision; 2 - qualitative reasoning: origin, trends, evolutions; 3 - causal reasoning: causality, causal graph representation, causal and diagnostic graph; 4 - multi-points of view reasoning: multi flow modeling method, Sagace method; 5 - approximate reasoning: the symbolic numerical interface, the multi-criteria decision; 6 - example of application: supervision in a spent-fuel reprocessing facility. (J.S.)

  18. Supervisory Behaviors That Reflect Reality: A Diversified Supervision Model.

    Science.gov (United States)

    Uzat, Rodney R. J.

    This paper clarifies exactly what "culture" and "change" mean to the educational system and why these terms are so important to the health, survival, and instructional improvement of educational organizations. Educational leaders must accept the fact that crafting a change-friendly, change-embracing organizational culture for continuous…

  19. The mediating effect of self-reflection and learning effectiveness on clinical nursing performance in nursing students: A follow-up study.

    Science.gov (United States)

    Pai, Hsiang-Chu; Ko, Hui-Ling; Eng, Cheng-Joo; Yen, Wen-Jiuan

    The effectiveness of simulation learning and the effects of anxiety in the simulated situation have been understudied. In addition, research on the association between learning effectiveness and students' clinical care performance in the hospital setting is very limited in Taiwan. The aim of this study is to examine the mediating effect of self-reflection and simulation learning effectiveness on the clinical nursing performance of nursing students. A Prospective, longitudinal, and correlational design was used. The study was conducted from December 2014 to July 2015. Participants were 293 nursing students in southern Taiwan. A structural model was specified and tested using partial least squares structural equation modeling to examine the relationships between the variables. The results revealed that the model was robust in terms of its measurement quality (reliability, validity, and goodness of fit), with the data's explaining 38.3% of variance in nursing competence. As self-reflection and learning effectiveness were added into the structural model, the effect of anxiety on nursing competence was still significant, but the regression coefficient (β) estimate of -0.41 (pself-reflection and learning effectiveness mediated the relationship between anxiety and nursing competence. Nursing competence was negatively affected by anxiety and positively affected by self-reflection (β=0.49, pself-reflection and learning effectiveness, which then decreases the effect of anxiety on nursing competence and further promotes students' clinical care ability. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Mental health nursing and the problematic of supervision as a confessional act.

    Science.gov (United States)

    Banks, D; Clifton, A V; Purdy, M J; Crawshaw, P

    2013-09-01

    Mental health nurses frequently draw on self-disclosure practices within their working relationships. These 'confessional' acts can in turn be predicated on traditional assumptions of moral authority exercised by more senior colleagues. More broadly, attention has been drawn to the increasing significance of 'technologies of the self' inside neo-liberal regimes of governance. Through various forms of self-disclosure people are obliged 'to speak the truth about themselves'. By publically declaring themselves as 'fit for purpose' nurses are required to be reflexive, self-monitoring individuals, capable of constructing their own identities and biographies, and guided by expert knowledges. In this way, risk becomes a form of governance, as the individuals continually find themselves balancing risks and opportunities. Foucault's insights into the importance of 'care of the self' and 'surveillance of the self' to systems of social order and governance, such as mental health services, are significant in identifying nursing as a potential form of confessional practice. 'Reflective practice' and 'clinical supervision' are therefore 'technologies', functioning as 'modes of surveillance', and as 'confessional practices'. So 'clinical supervision' may be understood as part of a process of 'governance' that does not necessarily empower nurses, but can act to guide, correct and modify ways in which they conduct themselves. © 2012 John Wiley & Sons Ltd.

  1. Making the Invisible Visible: Understanding Social Processes within Multicultural Internship Supervision

    Science.gov (United States)

    Proctor, Sherrie L.; Rogers, Margaret R.

    2013-01-01

    Despite a clear need, few resources exist to guide field-based multicultural internship supervision practices in school psychology. This article draws on literature from counseling and clinical psychology and related disciplines to ground and define multicultural internship supervision within the context of school psychology professional practice.…

  2. Adequate supervision for children and adolescents.

    Science.gov (United States)

    Anderst, James; Moffatt, Mary

    2014-11-01

    Primary care providers (PCPs) have the opportunity to improve child health and well-being by addressing supervision issues before an injury or exposure has occurred and/or after an injury or exposure has occurred. Appropriate anticipatory guidance on supervision at well-child visits can improve supervision of children, and may prevent future harm. Adequate supervision varies based on the child's development and maturity, and the risks in the child's environment. Consideration should be given to issues as wide ranging as swimming pools, falls, dating violence, and social media. By considering the likelihood of harm and the severity of the potential harm, caregivers may provide adequate supervision by minimizing risks to the child while still allowing the child to take "small" risks as needed for healthy development. Caregivers should initially focus on direct (visual, auditory, and proximity) supervision of the young child. Gradually, supervision needs to be adjusted as the child develops, emphasizing a safe environment and safe social interactions, with graduated independence. PCPs may foster adequate supervision by providing concrete guidance to caregivers. In addition to preventing injury, supervision includes fostering a safe, stable, and nurturing relationship with every child. PCPs should be familiar with age/developmentally based supervision risks, adequate supervision based on those risks, characteristics of neglectful supervision based on age/development, and ways to encourage appropriate supervision throughout childhood. Copyright 2014, SLACK Incorporated.

  3. Supervision af psykoterapi via Skype

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard; Grünbaum, Liselotte

    2011-01-01

    that although face-to-face meetings are to be preferred, today’s technology means that supervision via videoconference like Skype™ is better than just being acceptable. Thus, it offers a good alternative to face-to-face encounters, and in certain ways it even seems to boost the growth of the supervisees...

  4. Line supervision of alarm communications

    International Nuclear Information System (INIS)

    Chritton, M.R.

    1991-01-01

    The objective of this paper is to explain the role and application of alarm communication link supervision in security systems such as for nuclear facilities. The vulnerabilities of the various types of alarm communication links will be presented. Throughout the paper, an effort has been made to describe only those technologies commercially available and to avoid speculative theoretical solutions

  5. Consultative Instructor Supervision and Evaluation

    Science.gov (United States)

    Lee, William W.

    2010-01-01

    Organizations vary greatly in how they monitor training instructors. The methods used in monitoring vary greatly. This article presents a systematic process for improving instructor skills that result in better teaching and better learning, which results in better-prepared employees for the workforce. The consultative supervision and evaluation…

  6. Ethical reflection and psychotherapy.

    Science.gov (United States)

    Vyskocilová, Jana; Prasko, Jan

    2013-01-01

    Theories of ethics and ethical reflection may be applied to both theory and practice in psychotherapy. There is a natural affinity between ethics and psychotherapy. Psychotherapy practice is concerned with human problems, dilemmas and emotions related to both one's own and other people's values. Ethics is also concerned with dilemmas in human thinking and with how these dilemmas reflect other individuals' values. Philosophical reflection itself is not a sufficient basis for the ethics of psychotherapy but it may aid in exploring attitudes related to psychotherapy, psychiatry and health care. PubMed, Web of Science and Scopus databases were searched for articles containing the keywords "psychotherapy", "ethics", "therapeutic relationship" and "supervision". The search was conducted by repeating the terms in various combinations without language or time restrictions. Also included were data from monographs cited in reviews. The resulting text is a review with conclusions concerning ethical aspects of psychotherapy. The ability to behave altruistically, sense for justice and reciprocity and mutual help are likely to be genetically determined as dispositions to be later developed by upbringing or to be formed or deformed by upbringing. Early experiences lead to formation of ethical attitudes which are internalized and then applied to both one's own and other people's behavior. Altruistic behavior has a strong impact on an individual's health and its acceptance may positively influence the pathophysiological mechanisms underlying numerous diseases. Ethical theory and reflection, however, may be applied to both theory and practice of psychotherapy in a conscious, targeted and thoughtful manner. In everyday practice, psychotherapists and organizations must necessarily deal with conscious conflicts between therapeutic possibilities, clients' wishes, their own as well as clients' ideas and the real world. Understanding one's own motives in therapy is one of the aims of a

  7. Applying Information Processing Theory to Supervision: An Initial Exploration

    Science.gov (United States)

    Tangen, Jodi L.; Borders, L. DiAnne

    2017-01-01

    Although clinical supervision is an educational endeavor (Borders & Brown, [Borders, L. D., 2005]), many scholars neglect theories of learning in working with supervisees. The authors describe 1 learning theory--information processing theory (Atkinson & Shiffrin, 1968, 1971; Schunk, 2016)--and the ways its associated interventions may…

  8. Effect of high-dose ginsenoside complex (UG0712 supplementation on physical performance of healthy adults during a 12-week supervised exercise program: A randomized placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Eon Sook Lee

    2018-04-01

    Full Text Available Background: Ginseng has been used as an ergogenic agent, although evidence for its effectiveness is weak. A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the effect of a ginsenoside complex (UG0712 on changes in exercise performance. Methods: Sedentary individuals (n=117 were randomly assigned into one of three groups: low-dose ginsenoside supplementation (100 mg/d, n=39, high-dose ginsenoside supplementation (500 mg/d, n=39, or a placebo group (500 mg/d, n=39. All participants underwent a supervised 12-wk aerobic and resistance exercise training course. To assess the effects of supplementation on physical performance, maximal oxygen consumption (VO2max, anaerobic threshold (AT, lactic acid, and muscle strength of the dominant knee were measured at baseline, every visit, and after the training program. Results: Both ginsenoside groups showed significant increases in VO2max and muscular strength during exercise training. There were no definite changes in AT and lactic acid levels over time. After exercise training, there were definite differences in the VO2max (28.64.9 to 33.7±4.9 ml/kg/min in high-dose group vs. 30.4±6.7 to 32.8±6.6 ml/kg/min in placebo, p=0.029 and AT (19.3±4.2 to 20.9±3.5 ml/kg/min in high-dose group vs. 20.0±5.1 to 20.0±4.9 ml/kg/min in placebo, p=0.038 between the high-dose ginsenoside and placebo groups. However, there was no difference in VO2max between the low-dose ginsenoside and placebo groups (p=0.254. There were no differences in muscular strength during exercise training among the three groups. Conclusion: High-dose ginsenoside supplementation (UG0712 augmented the improvement of aerobic capacity by exercise training. Keywords: cardiopulmonary exercise test, ginsenoside, Panax ginseng, randomized controlled trial

  9. How current Clinical Practice Guidelines for low back pain reflect Traditional Medicine in East Asian Countries: a systematic review of Clinical Practice Guidelines and systematic reviews.

    Directory of Open Access Journals (Sweden)

    Hyun-Woo Cho

    Full Text Available OBJECTIVES: The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs and evidence from current systematic reviews and meta-analyses (SR-MAs and to analyze the impact of this gap on present CPGs. METHODS: We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. RESULTS: Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54% mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure. However, the CPGs did not recommend acupuncture (or acupressure. Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (subacute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (subacute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. CONCLUSIONS: The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system.

  10. Multi combined Adlerian supervision in Counseling

    OpenAIRE

    Gungor, Abdi

    2017-01-01

    For counselor professional and counselor education, supervision is an important process, in which more experienced professional helps and guides less experienced professional. To provide an effective and beneficial supervision, various therapy, development, or process based approaches and models have been developed. In addition, different eclectic models integrating more than one model have been developed. In this paper, as a supervision model, multi combined Adlerian supervision model is pro...

  11. Multicultural Supervision: What Difference Does Difference Make?

    Science.gov (United States)

    Eklund, Katie; Aros-O'Malley, Megan; Murrieta, Imelda

    2014-01-01

    Multicultural sensitivity and competency represent critical components to contemporary practice and supervision in school psychology. Internship and supervision experiences are a capstone experience for many new school psychologists; however, few receive formal training and supervision in multicultural competencies. As an increased number of…

  12. Moment constrained semi-supervised LDA

    DEFF Research Database (Denmark)

    Loog, Marco

    2012-01-01

    This BNAIC compressed contribution provides a summary of the work originally presented at the First IAPR Workshop on Partially Supervised Learning and published in [5]. It outlines the idea behind supervised and semi-supervised learning and highlights the major shortcoming of many current methods...

  13. Skærpet bevidsthed om supervision

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2002-01-01

    This article presents a historical survey of the initiatives which have taken place in european music therapy towards developing a deeper consciousness about supervision. Supervision as a disciplin in music therapy training, as a maintenance of music therapy profession and as a postgraduate...... training for examined music therapists. Definitions are presented and methods developed by working groups in european music therapy supervision are presented....

  14. Methods of Feminist Family Therapy Supervision.

    Science.gov (United States)

    Prouty, Anne M.; Thomas, Volker; Johnson, Scott; Long, Janie K.

    2001-01-01

    Presents three supervision methods which emerged from a qualitative study of the experiences of feminist family therapy supervisors and the therapists they supervised: the supervision contract, collaborative methods, and hierarchical methods. Provides a description of the participants' experiences of these methods and discusses their fit with…

  15. 20 CFR 655.30 - Supervised recruitment.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Supervised recruitment. 655.30 Section 655.30... Workers) § 655.30 Supervised recruitment. (a) Supervised recruitment. Where an employer is found to have... failed to adequately conduct recruitment activities or failed in any obligation of this part, the CO may...

  16. 28 CFR 2.91 - Supervision responsibility.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Supervision responsibility. 2.91 Section 2.91 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS District of Columbia Code: Prisoners and Parolees § 2.91 Supervision responsibility. (a) Pursuan...

  17. Postgraduate research supervision in a socially distributed ...

    African Journals Online (AJOL)

    Postgraduate supervision is a higher education practice with a long history. Through the conventional "apprenticeship" model postgraduate supervision has served as an important vehicle of intellectual inheritance between generations. However, this model of supervision has come under scrutiny as a consequence of the ...

  18. 32 CFR 727.11 - Supervision.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Supervision. 727.11 Section 727.11 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL LEGAL ASSISTANCE § 727.11 Supervision. The Judge Advocate General will exercise supervision over all legal assistance activities in the Department of the Navy. Subject to the...

  19. 17 CFR 166.3 - Supervision.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Supervision. 166.3 Section 166.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION CUSTOMER PROTECTION RULES § 166.3 Supervision. Each Commission registrant, except an associated person who has no supervisory duties, must diligently supervise the handling b...

  20. Optimistic semi-supervised least squares classification

    DEFF Research Database (Denmark)

    Krijthe, Jesse H.; Loog, Marco

    2017-01-01

    The goal of semi-supervised learning is to improve supervised classifiers by using additional unlabeled training examples. In this work we study a simple self-learning approach to semi-supervised learning applied to the least squares classifier. We show that a soft-label and a hard-label variant ...

  1. Supervision of execution of dismantling; Supervision de ejecucion de desmantelamiento

    Energy Technology Data Exchange (ETDEWEB)

    Canizares, J.

    2015-07-01

    Enresa create and organizational structure that covers various areas involved in effective control of Decommissioning Project. One area is the Technical Supervision of Works Decommissioning Project, as Execution Department dependent Technical Management. In the structure, Execution Department acts as liaison between the project, disciplines involved in developing and specialized companies contracted work to achieve your intended target. Equally important is to ensure that such activities are carried out correctly, according to the project documentation. (Author)

  2. Processes that Inform Multicultural Supervision: A Qualitative Meta-Analysis.

    Science.gov (United States)

    Tohidian, Nilou B; Quek, Karen Mui-Teng

    2017-10-01

    As the fields of counseling and psychotherapy have become more cognizant that individuals, couples, and families bring with them a myriad of diversity factors into therapy, multicultural competency has also become a crucial component in the development of clinicians during clinical supervision and training. We employed a qualitative meta-analysis to provide a detailed and comprehensive description of similar themes identified in primary qualitative studies that have investigated supervisory practices with an emphasis on diversity. Findings revealed six meta-categories, namely: (a) Supervisor's Multicultural Stances; (b) Supervisee's Multicultural Encounters; (c) Competency-Based Content in Supervision; (d) Processes Surrounding Multicultural Supervision; (e) Culturally Attuned Interventions; and (f) Multicultural Supervisory Alliance. Implications for practice are discussed. © 2017 American Association for Marriage and Family Therapy.

  3. The complexities of power in feminist multicultural psychotherapy supervision.

    Science.gov (United States)

    Arczynski, Alexis V; Morrow, Susan L

    2017-03-01

    The goal of the present study was to understand how current feminist multicultural supervisors understand and implement their feminist multicultural principles into clinical supervision. We addressed this aim by answering the following research question: How do self-identified feminist multicultural psychotherapy supervisors conceptualize and practice feminist supervision that is explicitly multicultural? The perspectives of 14 participant supervisors were obtained by using semistructured initial interviews, follow-up interviews, and feedback interviews and were investigated via a feminist constructivist grounded theory design and analysis. Most participants identified as counseling psychologists (n = 12), women (n = 11) and temporarily able-bodied (n = 11); but they identified with diverse racial/ethnic, sexual, spiritual/religious, generational, and nationality statuses. A 7-category empirical framework emerged that explained how the participants anticipated and managed power in supervision. The core category, the complexities of power in supervision, explained how participants conceptualized power in supervisory relationships. The 6 remaining categories were bringing history into the supervision room, creating trust through openness and honesty, using a collaborative process, meeting shifting developmental (a)symmetries, cultivating critical reflexivity, and looking at and counterbalancing the impact of context. Limitations of the study, implications for research, and suggestions to use the theoretical framework to transform supervisory practice and training are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Application of Contingency Theories to the Supervision of Student Teachers.

    Science.gov (United States)

    Phelps, Julia D.

    1985-01-01

    This article examines selected approaches to student teacher supervision within the context of contingency theory. These include authentic supervision, developmental supervision, and supervision based on the student's level of maturity. (MT)

  5. “Sacred Work”: Reflections on the Professional and Personal Impact of an Interdisciplinary Palliative Oncology Clinical Experience by Social Work Learners

    Directory of Open Access Journals (Sweden)

    Alyssa A. Middleton

    2018-02-01

    Full Text Available This study explored the impact of an oncology palliative care clinical experience with older adults on social work learners. A three-member research team conducted a qualitative content analysis of reflective writings. 27 Master of Science in Social Work students enrolled in an interprofessional palliative oncology curriculum and completed a reflective writing assignment to summarize the clinical scenario, analyze the patient/family care provided, and describe the impact of the experience. Using a constant comparison approach based on grounded theory, the research team analyzed the reflections to come to consensus related to the overall impact of the experience. Two overarching themes (professional and personal impact and 11 subthemes (appreciation of interdisciplinary teams, recognition of clinical skills of other disciplines, insight into clinical skills of the social worker, perception of palliative care, embracing palliative care principles, centrality of communication, importance of social support, family as the unit of care, countertransference, conflict between personal values and patient/family values, and emotional reactions were identified. Experiential learning opportunities for social work learners in interprofessional palliative care build appreciation for and skills in applying palliative care principles including teamwork, symptom control, and advanced care planning along with a commitment to embrace these principles in future practice.

  6. Evaluation of professional supervision in Aotearoa/New Zealand: An interprofessional study.

    Science.gov (United States)

    Davys, Allyson Mary; O'Connell, Michael; May, Janet; Burns, Beverley

    2017-06-01

    The evaluation of professional supervision has been a focus for discussion in the supervision literature over past decades. A review of the literature in this area, however, suggests that evaluation has been differently defined, variously addressed, and a range of outcomes reported. The present study reports the findings of the first stage of a three-stage study of evaluation in professional supervision in Aotearoa/New Zealand. Experienced practitioners from the four professions of counselling, mental health nursing, psychology, and social work were interviewed to explore how evaluation in professional supervision is understood and actioned in practice. Twenty four semistructured interviews were conducted with supervisees, supervisors, and managers from each of the identified professions. The findings from these interviews indicate that a majority of participants applied some form of evaluation to their supervision arrangement. These evaluations, however, did not reflect an overarching organizational or professional culture of formal evaluation, but rather, an individualized ad-hoc process initiated by one or both of the participants (supervisor and supervisee). These evaluations focussed predominantly on the process, rather than the outcomes, of supervision. While many respondents expressed interest in a formal process for evaluating supervision, a number of concerns were also raised. These concerns included a lack of evaluation skills and resource, the potential for formal evaluation to have a negative impact on the supervision relationship, the importance of maintaining the boundaries of confidentiality, and a wariness regarding the possible use of any information gathered. © 2016 Australian College of Mental Health Nurses Inc.

  7. BANKING SUPERVISION IN EUROPEAN UNION

    Directory of Open Access Journals (Sweden)

    Lavinia Mihaela GUȚU

    2013-10-01

    Full Text Available The need for prudential supervision imposed to banks by law arises from the action that banking market’s basic factors have. Therefore, it is about banks’ role in economy. The normal functioning of banks in all their important duties maintains the stability of banking system. Further, the stability of the entire economy depends on the stability of the banking system. Under conditions of imbalance regarding treasury or liquidity, banks are faced with unmanageable crisis and the consequences can be fatal. To ensure long-term stability of the banking system, supervisory regulations were constituted in order to prevent banks focusing on achieving rapidly high profits and protect the interests of depositors. Starting from this point, this paper will carry out a study on existing models of supervision in the European Union’s Member States. A comparison between them will support identifying the advantages and disadvantages of each of them.

  8. Declarative modeling for process supervision

    International Nuclear Information System (INIS)

    Leyval, L.

    1989-01-01

    Our work is a contribution to computer aided supervision of continuous processes. It is inspired by an area of Artificial Intelligence: qualitative physics. Here, supervision is based on a model which continuously provides operators with a synthetic view of the process; but this model is founded on general principles of control theory rather than on physics. It involves concepts such as high gain or small time response. It helps in linking temporally the evolution of various variables. Moreover, the model provides predictions of the future behaviour of the process, which allows action advice and alarm filtering. This should greatly reduce the famous cognitive overload associated to any complex and dangerous evolution of the process

  9. A model for dealing with parallel processes in supervision

    Directory of Open Access Journals (Sweden)

    Lilja Cajvert

    2011-03-01

    Supervision in social work is essential for successful outcomes when working with clients. In social work, unconscious difficulties may arise and similar difficulties may occur in supervision as parallel processes. In this article, the development of a practice-based model of supervision to deal with parallel processes in supervision is described. The model has six phases. In the first phase, the focus is on the supervisor’s inner world, his/her own reflections and observations. In the second phase, the supervision situation is “frozen”, and the supervisees are invited to join the supervisor in taking a meta-perspective on the current situation of supervision. The focus in the third phase is on the inner world of all the group members as well as the visualization and identification of reflections and feelings that arose during the supervision process. Phase four focuses on the supervisee who presented a case, and in phase five the focus shifts to the common understanding and theorization of the supervision process as well as the definition and identification of possible parallel processes. In the final phase, the supervisee, with the assistance of the supervisor and other members of the group, develops a solution and determines how to proceed with the client in treatment. This article uses phenomenological concepts to provide a theoretical framework for the supervision model. Phenomenological reduction is an important approach to examine and to externalize and visualize the inner words of the supervisor and supervisees. Een model voor het hanteren van parallelle processen tijdens supervisie Om succesvol te zijn in de hulpverlening aan cliënten, is supervisie cruciaal in het sociaal werk. Tijdens de hulpverlening kunnen impliciete moeilijkheden de kop opsteken en soortgelijke moeilijkheden duiken soms ook op tijdens supervisie. Dit worden parallelle processen genoemd. Dit artikel beschrijft een op praktijkervaringen gebaseerd model om dergelijke parallelle

  10. BANKING SUPERVISION IN EUROPEAN UNION

    OpenAIRE

    Lavinia Mihaela GUȚU; Vasile ILIE

    2013-01-01

    The need for prudential supervision imposed to banks by law arises from the action that banking market’s basic factors have. Therefore, it is about banks’ role in economy. The normal functioning of banks in all their important duties maintains the stability of banking system. Further, the stability of the entire economy depends on the stability of the banking system. Under conditions of imbalance regarding treasury or liquidity, banks are faced with unmanageable crisis and the consequences ca...

  11. Medical supervision of radiation workers

    International Nuclear Information System (INIS)

    1968-01-01

    The first part of this volume describes the effects of radiation on living organism, both at the overall and at the molecular level. Special attention is paid to the metabolism and toxicity of radioactivity substances. The second part deals with radiological exposure, natural, medical and occupational. The third part provides data on radiological protection standards, and the fourth part addresses the health supervision of workers exposed to ionizing radiation, covering both physical and medical control.

  12. Coupled Semi-Supervised Learning

    Science.gov (United States)

    2010-05-01

    Additionally, specify the expected category of each relation argument to enable type-checking. Subsystem components and the KI can benefit from methods that...confirm that our coupled semi-supervised learning approaches can scale to hun- dreds of predicates and can benefit from using a diverse set of...organization yes California Institute of Technology vegetable food yes carrots vehicle item yes airplanes vertebrate animal yes videoGame product yes

  13. Supervision of execution of dismantling

    International Nuclear Information System (INIS)

    Canizares, J.

    2015-01-01

    Enresa create and organizational structure that covers various areas involved in effective control of Decommissioning Project. One area is the Technical Supervision of Works Decommissioning Project, as Execution Department dependent Technical Management. In the structure, Execution Department acts as liaison between the project, disciplines involved in developing and specialized companies contracted work to achieve your intended target. Equally important is to ensure that such activities are carried out correctly, according to the project documentation. (Author)

  14. District nurses' experience of supervising nursing students in primary health care: A pre- and post-implementation questionnaire study.

    Science.gov (United States)

    Bos, Elisabeth; Löfmark, Anna; Törnkvist, Lena

    2009-11-01

    Nursing students go through clinical supervision in primary health care settings but district nurses' (DNs) circumstances when supervising them are only briefly described in the literature. The aim of this study was to investigate DNs experience of supervising nursing students before and after the implementation of a new supervision model. Ninety-eight (74%) DNs answered a questionnaire before and 84 (65%) after implementation of the new supervision model. The study showed that DNs in most cases felt that conditions for supervision in the workplace were adequate. But about 70% lacked training for the supervisory role and 20% had no specialist district nurse training. They also experienced difficulty in keeping up-to-date with changes in nurse education programmes, in receiving support from the university and from their clinic managers, and in setting aside time for supervision. Improvements after the implementation of a new model chiefly concerned organisation; more DNs stated that one person had primary responsibility for students' clinical practice, that information packages for supervisors and students were available at the health care centres, and that conditions were in place for increasing the number of students they supervised. DNs also stated that supervisors and students benefited from supervision by more than one supervisor. To conclude, implementation of a new supervision model resulted in some improvements.

  15. Semi-supervised sparse coding

    KAUST Repository

    Wang, Jim Jing-Yan; Gao, Xin

    2014-01-01

    Sparse coding approximates the data sample as a sparse linear combination of some basic codewords and uses the sparse codes as new presentations. In this paper, we investigate learning discriminative sparse codes by sparse coding in a semi-supervised manner, where only a few training samples are labeled. By using the manifold structure spanned by the data set of both labeled and unlabeled samples and the constraints provided by the labels of the labeled samples, we learn the variable class labels for all the samples. Furthermore, to improve the discriminative ability of the learned sparse codes, we assume that the class labels could be predicted from the sparse codes directly using a linear classifier. By solving the codebook, sparse codes, class labels and classifier parameters simultaneously in a unified objective function, we develop a semi-supervised sparse coding algorithm. Experiments on two real-world pattern recognition problems demonstrate the advantage of the proposed methods over supervised sparse coding methods on partially labeled data sets.

  16. Semi-supervised sparse coding

    KAUST Repository

    Wang, Jim Jing-Yan

    2014-07-06

    Sparse coding approximates the data sample as a sparse linear combination of some basic codewords and uses the sparse codes as new presentations. In this paper, we investigate learning discriminative sparse codes by sparse coding in a semi-supervised manner, where only a few training samples are labeled. By using the manifold structure spanned by the data set of both labeled and unlabeled samples and the constraints provided by the labels of the labeled samples, we learn the variable class labels for all the samples. Furthermore, to improve the discriminative ability of the learned sparse codes, we assume that the class labels could be predicted from the sparse codes directly using a linear classifier. By solving the codebook, sparse codes, class labels and classifier parameters simultaneously in a unified objective function, we develop a semi-supervised sparse coding algorithm. Experiments on two real-world pattern recognition problems demonstrate the advantage of the proposed methods over supervised sparse coding methods on partially labeled data sets.

  17. Evaluation of a 2 to 1 peer placement supervision model by physiotherapy students and their educators.

    Science.gov (United States)

    Alpine, Lucy M; Caldas, Francieli Tanji; Barrett, Emer M

    2018-04-02

    The objective of the study was to investigate student and practice educator evaluations of practice placements using a structured 2 to 1 supervision and implementation model. Cross-sectional pilot study set in clinical sites providing placements for physiotherapy students in Ireland. Students and practice educators completing a 2.1 peer placement between 2013 and 2015 participated. A self-reported questionnaire which measured indicators linked to quality assured placements was used. Three open-ended questions captured comments on the benefits and challenges associated with the 2 to 1 model. Ten students (10/20; 50% response rate) and 10 practice educators (10/10; 100% response rate) responded to the questionnaire. Student responses included four pairs of students and one student from a further two pairs. There was generally positive agreement with the questionnaire indicating that placements using the 2 to 1 model were positively evaluated by participants. There were no significant differences between students and practice educators. The main benefits of the 2 to 1 model were shared learning experiences, a peer supported environment, and the development of peer evaluation and feedback skills by students. A key component of the model was the peer scripting process which provided time for reflection, self-evaluation, and peer review. 2 to 1 placements were positively evaluated by students and educators when supported by a structured supervision model. Clear guidance to students on the provision of peer feedback and support for educators providing feedback to two different students is recommended.

  18. Real-time in vivo tissue characterization with diffuse reflectance spectroscopy during transthoracic lung biopsy: a clinical feasibility study

    NARCIS (Netherlands)

    Spliethoff, Jarich; Prevoo, Warner; Meier, Mark A.J.; de Jong, Jeroen; Evers, Daniel; Evers, Daniel J.; Sterenborg, Hendricus J.C.M.; Lucassen, Gerald; Lucassen, Gerald W.; Hendriks, Benno H.W.; Ruers, Theo J.M.

    2016-01-01

    Purpose: This study presents the first in vivo real-time tissue characterization during image-guided percutaneous lung biopsies using diffuse reflectance spectroscopy (DRS) sensing at the tip of a biopsy needle with integrated optical fibers. Experimental Design: Tissues from 21 consented patients

  19. Clinical system model for monitoring the physiological status of jaundice by extracting bilirubin components from skin diffuse reflectance spectra

    Science.gov (United States)

    Kumar, Alla S.; Clark, Joseph; Beyette, Fred R., Jr.

    2009-02-01

    Neonatal jaundice is a medical condition which occurs in newborns as a result of an imbalance between the production and elimination of bilirubin. The excess bilirubin in the blood stream diffuses into the surrounding tissue leading to a yellowing of the skin. As the bilirubin levels rise in the blood stream, there is a continuous exchange between the extra vascular bilirubin and bilirubin in the blood stream. Exposure to phototherapy alters the concentration of bilirubin in the vascular and extra vascular regions by causing bilirubin in the skin layers to be broken down. Thus, the relative concentration of extra vascular bilirubin is reduced leading to a diffusion of bilirubin out of the vascular region. Diffuse reflectance spectra from human skin contains physiological and structural information of the skin and nearby tissue. A diffuse reflectance spectrum must be captured before and after blanching in order to isolate the intravascular and extra vascular bilirubin. A new mathematical model is proposed with extra vascular bilirubin concentration taken into consideration along with other optical parameters in defining the diffuse reflectance spectrum from human skin. A nonlinear optimization algorithm has been adopted to extract the optical properties (including bilirubin concentration) from the skin reflectance spectrum. The new system model and nonlinear algorithm have been combined to enable extraction of Bilirubin concentrations within an average error of 10%.

  20. The use of reflective journaling as a learning strategy during the clinical rotations of students from the faculty of health sciences: An action-research study.

    Science.gov (United States)

    Ruiz-López, Montserrat; Rodriguez-García, Marta; Villanueva, Purificación-González; Márquez-Cava, Montserrat; García-Mateos, Mónica; Ruiz-Ruiz, Beatriz; Herrera-Sánchez, Esteban

    2015-10-01

    Reflective practice contributes significantly to the assimilation of knowledge in undergraduate health students. Reflective journals constitute a learning strategy that promotes student reflection during clinical practice. The overall aim of the study was to explore teachers' perceptions and experiences regarding the use of reflective clinical journals as a learning tool for students in order to improve the implementation of clinical journal writing in all the Health Science degrees offered by our University. A qualitative research study was performed using the Action-Research method. Students studying various degrees at our Health Faculty were considered for this study (Nursing Physiotherapy, and Physiotherapy and Physical Activity and Sport Science). Data were collected using triangulation of document analysis (102 student journals and 12 teacher journals, together with the teachers' responses to the student's journals) and transcripts from 2 discussion groups (1 student discussion group and 1 teacher discussion group). Data analysis was performed based on the constant comparative method using ATLAS.ti version 6.2 software. Four qualitative themes emerged from the data: the journal as a teaching strategy; building a relationship of trust between the tutor and the student; the role of the teacher and the world of emotions. Several recommendations for supporting clinical journal writing were identified: an informative meeting should be arranged with students; written guidelines should be provided; a personal interview with the student is recommended at the start of the activity; feedback should be offered over short time periods; teachers should provide constructive feedback; and students should adopt a free writing approach, or be guided by very open questions. Finally, it is important that students be familiarized with the assessment criteria. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Nursing students' evaluation of a new feedback and reflection tool for use in high-fidelity simulation - Formative assessment of clinical skills. A descriptive quantitative research design.

    Science.gov (United States)

    Solheim, Elisabeth; Plathe, Hilde Syvertsen; Eide, Hilde

    2017-11-01

    Clinical skills training is an important part of nurses' education programmes. Clinical skills are complex. A common understanding of what characterizes clinical skills and learning outcomes needs to be established. The aim of the study was to develop and evaluate a new reflection and feedback tool for formative assessment. The study has a descriptive quantitative design. 129 students participated who were at the end of the first year of a Bachelor degree in nursing. After highfidelity simulation, data were collected using a questionnaire with 19 closed-ended and 2 open-ended questions. The tool stimulated peer assessment, and enabled students to be more thorough in what to assess as an observer in clinical skills. The tool provided a structure for selfassessment and made visible items that are important to be aware of in clinical skills. This article adds to simulation literature and provides a tool that is useful in enhancing peer learning, which is essential for nurses in practice. The tool has potential for enabling students to learn about reflection and developing skills for guiding others in practice after they have graduated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Paediatric trainee supervision: management changes and perceived education value.

    Science.gov (United States)

    van den Boom, Mirjam; Pinnock, Ralph; Weller, Jennifer; Reed, Peter; Shulruf, Boaz

    2012-07-01

    Supervision in postgraduate training is an under-researched area. We measured the amount, type and effect of supervision on patient care and perceived education value in a general paediatric service. We designed a structured observation form and questionnaire to document the type, duration and effect of supervision on patient management and perceived education value. Most supervision occurred without the paediatrician confirming the trainee's findings. Direct observation of the trainee was rare. Management was changed in 30% of patients seen on the inpatient ward round and in 42% of the patients discussed during the chart reviews but not seen by the paediatrician. Management was changed in 48% of the cases when the paediatrician saw the patient with the trainee in outpatients but in only 21% of patients when the patient was but not seen. Changes made to patient management, understanding and perceived education value, differed between inpatient and out patient settings. There was more impact when the paediatrician saw the patient with the trainee in outpatients; while for inpatients, the opposite was true. Trainees rated the value of the supervision more highly than their supervisors did. Trainees' comments on what they learnt from their supervisor related almost exclusively to clinical knowledge rather than professional behaviours. We observed little evidence of supervisors directly observing trainees and trainees learning professional behaviours. A review of supervisory practices to promote more effective learning is needed. Communicating to paediatricians the value their trainees place on their input could have a positive effect on their engagement in supervision. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  3. Critical reflections on a visit to an inner-city primary health care clinic in Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Louis S. Jenkins

    2017-07-01

    Conclusion: Brazil has made massive progress in providing universal health coverage over the last 20 years. South Africa, with not too dissimilar challenges, is embarking on this road more recently. The lessons learnt at clinic and community level in this inner-city clinic could be very useful for similar settings in South Africa and other countries.

  4. A Model for Art Therapy-Based Supervision for End-of-Life Care Workers in Hong Kong.

    Science.gov (United States)

    Potash, Jordan S; Chan, Faye; Ho, Andy H Y; Wang, Xiao Lu; Cheng, Carol

    2015-01-01

    End-of-life care workers and volunteers are particularly prone to burnout given the intense emotional and existential nature of their work. Supervision is one important way to provide adequate support that focuses on both professional and personal competencies. The inclusion of art therapy principles and practices within supervision further creates a dynamic platform for sustained self-reflection. A 6-week art therapy-based supervision group provided opportunities for developing emotional awareness, recognizing professional strengths, securing collegial relationships, and reflecting on death-related memories. The structure, rationale, and feedback are discussed.

  5. A qualitative investigation of the nature of "informal supervision" among therapists in training.

    Science.gov (United States)

    Coren, Sidney; Farber, Barry A

    2017-11-29

    This study investigated how, when, why, and with whom therapists in training utilize "informal supervision"-that is, engage individuals who are not their formally assigned supervisors in significant conversations about their clinical work. Participants were 16 doctoral trainees in clinical and counseling psychology programs. Semi-structured interviews were conducted and analyzed using the Consensual Qualitative Research (CQR) method. Seven domains emerged from the analysis, indicating that, in general, participants believe that informal and formal supervision offer many of the same benefits, including validation, support, and reassurance; freedom and safety to discuss doubts, anxieties, strong personal reactions to patients, clinical mistakes and challenges; and alternative approaches to clinical interventions. However, several differences also emerged between these modes of learning-for example, formal supervision is seen as more focused on didactics per se ("what to do"), whereas informal supervision is seen as providing more of a "holding environment." Overall, the findings of this study suggest that informal supervision is an important and valuable adjunctive practice by which clinical trainees augment their professional competencies. Recommendations are proposed for clinical practice and training, including the need to further specify the ethical boundaries of this unique and essentially unregulated type of supervision.

  6. Supervision of sunbeds in Finland

    International Nuclear Information System (INIS)

    Visuri, R.

    2003-01-01

    Sunbeds emitting ultraviolet radiation (UV radiation) are used for cosmetic tanning. UV radiation incontrovertibly causes skin diseases such as skin cancer and eye diseases. UV exposure from natural sun should be moderate and from sunbeds it should be avoided. The aim of the supervision of sunbeds and tanning facilities is to ensure that they comply with valid safety requirements. The basis for the requirements is that acute effects such as sunburns will not occur and the yearly UV dose would not increase excessively. (orig.)

  7. Supervision of sunbeds in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Visuri, R. [Radiation and Nuclear Safety Authority, Non-ionizing Radiation Laboratory, Helsinki (Finland)

    2003-06-01

    Sunbeds emitting ultraviolet radiation (UV radiation) are used for cosmetic tanning. UV radiation incontrovertibly causes skin diseases such as skin cancer and eye diseases. UV exposure from natural sun should be moderate and from sunbeds it should be avoided. The aim of the supervision of sunbeds and tanning facilities is to ensure that they comply with valid safety requirements. The basis for the requirements is that acute effects such as sunburns will not occur and the yearly UV dose would not increase excessively. (orig.)

  8. Nurses' perceptions of the impact of Team-Based Learning participation on learning style, team behaviours and clinical performance: An exploration of written reflections.

    Science.gov (United States)

    Oldland, Elizabeth; Currey, Judy; Considine, Julie; Allen, Josh

    2017-05-01

    Team-Based Learning (TBL) is a teaching strategy designed to promote problem solving, critical thinking and effective teamwork and communication skills; attributes essential for safe healthcare. The aim was to explore postgraduate student perceptions of the role of TBL in shaping learning style, team skills, and professional and clinical behaviours. An exploratory descriptive approach was selected. Critical care students were invited to provide consent for the use for research purposes of written reflections submitted for course work requirements. Reflections of whether and how TBL influenced their learning style, teamwork skills and professional behaviours during classroom learning and clinical practice were analysed for content and themes. Of 174 students, 159 participated. Analysis revealed three themes: Deep Learning, the adaptations students made to their learning that resulted in mastery of specialist knowledge; Confidence, in knowledge, problem solving and rationales for practice decisions; and Professional and Clinical Behaviours, including positive changes in their interactions with colleagues and patients described as patient advocacy, multidisciplinary communication skills and peer mentorship. TBL facilitated a virtuous cycle of feedback encouraging deep learning that increased confidence. Increased confidence improved deep learning that, in turn, led to the development of professional and clinical behaviours characteristic of high quality practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Current Risk Management Practices in Psychotherapy Supervision.

    Science.gov (United States)

    Mehrtens, Ilayna K; Crapanzano, Kathleen; Tynes, L Lee

    2017-12-01

    Psychotherapy competence is a core skill for psychiatry residents, and psychotherapy supervision is a time-honored approach to teaching this skill. To explore the current supervision practices of psychiatry training programs, a 24-item questionnaire was sent to all program directors of Accreditation Council for Graduate Medical Education (ACGME)-approved adult psychiatry programs. The questionnaire included items regarding adherence to recently proposed therapy supervision practices aimed at reducing potential liability risk. The results suggested that current therapy supervision practices do not include sufficient management of the potential liability involved in therapy supervision. Better protections for patients, residents, supervisors and the institutions would be possible with improved credentialing practices and better documentation of informed consent and supervision policies and procedures. © 2017 American Academy of Psychiatry and the Law.

  10. Novice supervisee's experiences of what is good and bad psychotherapy supervision

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard; Pedersen, Lene Tanggaard

    2007-01-01

    This paper presents a qualitative study of novice supervisee’s experiences of good and bad supervisory experiences and on how this change as the supervisees gain more experience. Novice psychotherapists rate supervision as the most important element in their acquisition of professional skills...... was conducted as a series of semi structured qualitative research interviews with 7 student therapist 2 month after their first clinical experience in a university clinic setting. The subjects were re-interviewed when they had almost a year of clinical experience and supervision. The interviews were...... thematically focusing on the experience of specific good and bad supervisory experiences. Also included were the importance of peers in the supervision group and the organisational setting of the supervision. After analysing each individuals experience all individual experiences were examined until patterns...

  11. Abusive Supervision Scale Development in Indonesia

    OpenAIRE

    Wulani, Fenika; Purwanto, Bernadinus M; Handoko, Hani

    2014-01-01

    The purpose of this study was to develop a scale of abusive supervision in Indonesia. The study was conducted with a different context and scale development method from Tepper’s (2000) abusive supervision scale. The abusive supervision scale from Tepper (2000) was developed in the U.S., which has a cultural orientation of low power distance. The current study was conducted in Indonesia, which has a high power distance. This study used interview procedures to obtain information about superviso...

  12. Human Supervision of Multiple Autonomous Vehicles

    Science.gov (United States)

    2013-03-22

    AFRL-RH-WP-TR-2013-0143 HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES Heath A. Ruff Ball...REPORT TYPE Interim 3. DATES COVERED (From – To) 09-16-08 – 03-22-13 4. TITLE AND SUBTITLE HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES 5a...Supervision of Multiple Autonomous Vehicles To support the vision of a system that enables a single operator to control multiple next-generation

  13. Semi-supervised clustering methods.

    Science.gov (United States)

    Bair, Eric

    2013-01-01

    Cluster analysis methods seek to partition a data set into homogeneous subgroups. It is useful in a wide variety of applications, including document processing and modern genetics. Conventional clustering methods are unsupervised, meaning that there is no outcome variable nor is anything known about the relationship between the observations in the data set. In many situations, however, information about the clusters is available in addition to the values of the features. For example, the cluster labels of some observations may be known, or certain observations may be known to belong to the same cluster. In other cases, one may wish to identify clusters that are associated with a particular outcome variable. This review describes several clustering algorithms (known as "semi-supervised clustering" methods) that can be applied in these situations. The majority of these methods are modifications of the popular k-means clustering method, and several of them will be described in detail. A brief description of some other semi-supervised clustering algorithms is also provided.

  14. Semi-supervised clustering methods

    Science.gov (United States)

    Bair, Eric

    2013-01-01

    Cluster analysis methods seek to partition a data set into homogeneous subgroups. It is useful in a wide variety of applications, including document processing and modern genetics. Conventional clustering methods are unsupervised, meaning that there is no outcome variable nor is anything known about the relationship between the observations in the data set. In many situations, however, information about the clusters is available in addition to the values of the features. For example, the cluster labels of some observations may be known, or certain observations may be known to belong to the same cluster. In other cases, one may wish to identify clusters that are associated with a particular outcome variable. This review describes several clustering algorithms (known as “semi-supervised clustering” methods) that can be applied in these situations. The majority of these methods are modifications of the popular k-means clustering method, and several of them will be described in detail. A brief description of some other semi-supervised clustering algorithms is also provided. PMID:24729830

  15. Academicians and Neurologic Physical Therapy Residents Partner to Expand Clinical Reflection Using the SOLO Taxonomy: A Novel Approach.

    Science.gov (United States)

    Pinto Zipp, Genevieve; Maher, Catherine; Donnelly, Erin; Fritz, Brian; Snowdon, Lauren

    2016-01-01

    Creating curriculums that develop physical therapy (PT) students into evidenced-based, critically reflective, entry-level practitioners is one of the primary goals for PT programs. Academic faculty partnering with neurologic residency programs to design learning environments that capitalize upon the strengths of both can create insightful educational experiences for students during their didactic training. These partnerships support the development of critical thinking skills and provide mentorship for residents transitioning from their role as a clinician to that of an educator. Using the SOLO (structure of observed learning outcomes) taxonomy as a framework for developing learning experiences, Seton Hall University neurologic academic faculty and program directors from the Kessler Institute for Rehabilitation Residency in Neurologic Physical Therapy have built a partnership that seeks to develop critical reflection skills in both the neurologic resident and entry-level PT students. While integration of residents into entry-level PT curriculum may not be novel, we believe that utilizing the SOLO model within this partnership is unique. This paper describes the partnership and learning experiences rooted in the SOLO taxonomy theoretical framework and discusses perceived benefits of this learning experience across professional health science programs.

  16. Abusive Supervision and Subordinate Performance : Instrumentality Considerations in the Emergence and Consequences of Abusive Supervision

    NARCIS (Netherlands)

    Walter, Frank; Lam, Catherine K.; van der Vegt, Geert; Huang, X.; Miao, Q.

    Drawing from moral exclusion theory, this article examines outcome dependence and interpersonal liking as key boundary conditions for the linkage between perceived subordinate performance and abusive supervision. Moreover, it investigates the role of abusive supervision for subordinates' subsequent,

  17. Processos clínicos em Núcleos de Apoio à Saúde da Família / NASF: estágio supervisionado Procesos clínicos en Núcleos de Apoyo a la Salud de la Familia (NASF: pasantía supervisionada Clinical processes in Family Health Care Center: supervised training course

    Directory of Open Access Journals (Sweden)

    Tales Vilela Santeiro

    2012-01-01

    intervención supervisada, en trámite desde 2011. En la realidad retratada, actividades de enseñanza y aprendizaje en Psicología clínica en sus interfaces con la salud pública han ocurrido entre distintas demandas: las de los usuarios, comprendidos como singulares y representantes del entorno social, y las de la formación en Psicología, comprimidas entre imperativos vinculados a las políticas públicas de enseñanza superior y de salud pública. Hay ponderaciones sobre el costo emocional que se les impone a los practicantes en busca de identidad profesional en ese contexto. Articular distintas necesidades permanece como un desafío a ser vivido y constantemente reflexionado por profesionales y estudiantes de Psicología clínica.The connection between psychology and public health has become narrowed in recent years, aiming at the consolidation of the profession in its commitments to the Brazilian reality. This article discusses the role of the integration of clinical psychology to Family Health Care Centers (NASFs, equipments of the Brazilian Unified Health System. Focused discussions result from supervised training courses developed by students from a public university in a small town in the interior of the Midwest. The activities take place on 5 NASFs and account for 16 weeks of theoretical and supervised intervention per semester, which have been ongoing since 2011. In the reality portrayed, teaching and learning in clinical psychology interfaced with public health have occurred between different demands: the users', understood as individuals and social environment representatives, and those of training in Psychology, compressed into imperatives linked to public policies on higher education and public health. There are considerations about the emotional cost that arises for the trainees who seek professional identity in this context. Articulating distinct needs remains a challenge to be faced and constantly reflected by professionals and clinical psychology

  18. Toward an Appropriate Point-of-Care Ultrasound Curriculum: A Reflection of the Clinical Practice in South Africa

    Directory of Open Access Journals (Sweden)

    Daniël Jacobus van Hoving

    2016-03-01

    Conclusions: This study indicates a mismatch between the current point-of-care ultrasound curriculum and the clinical burden of disease experienced. Disease burden, disease impact, technical difficulty of ultrasound applications, and logistical barriers need to be incorporated when considering a change in the curriculum to make it more appropriate for the South African setting.

  19. Empirical study of supervised gene screening

    Directory of Open Access Journals (Sweden)

    Ma Shuangge

    2006-12-01

    Full Text Available Abstract Background Microarray studies provide a way of linking variations of phenotypes with their genetic causations. Constructing predictive models using high dimensional microarray measurements usually consists of three steps: (1 unsupervised gene screening; (2 supervised gene screening; and (3 statistical model building. Supervised gene screening based on marginal gene ranking is commonly used to reduce the number of genes in the model building. Various simple statistics, such as t-statistic or signal to noise ratio, have been used to rank genes in the supervised screening. Despite of its extensive usage, statistical study of supervised gene screening remains scarce. Our study is partly motivated by the differences in gene discovery results caused by using different supervised gene screening methods. Results We investigate concordance and reproducibility of supervised gene screening based on eight commonly used marginal statistics. Concordance is assessed by the relative fractions of overlaps between top ranked genes screened using different marginal statistics. We propose a Bootstrap Reproducibility Index, which measures reproducibility of individual genes under the supervised screening. Empirical studies are based on four public microarray data. We consider the cases where the top 20%, 40% and 60% genes are screened. Conclusion From a gene discovery point of view, the effect of supervised gene screening based on different marginal statistics cannot be ignored. Empirical studies show that (1 genes passed different supervised screenings may be considerably different; (2 concordance may vary, depending on the underlying data structure and percentage of selected genes; (3 evaluated with the Bootstrap Reproducibility Index, genes passed supervised screenings are only moderately reproducible; and (4 concordance cannot be improved by supervised screening based on reproducibility.

  20. Danish clinical databases: An overview

    DEFF Research Database (Denmark)

    Green, Anders

    2011-01-01

    Clinical databases contain data related to diagnostic procedures, treatments and outcomes. In 2001, a scheme was introduced for the approval, supervision and support to clinical databases in Denmark.......Clinical databases contain data related to diagnostic procedures, treatments and outcomes. In 2001, a scheme was introduced for the approval, supervision and support to clinical databases in Denmark....

  1. 28 CFR 810.1 - Supervision contact requirements.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Supervision contact requirements. 810.1 Section 810.1 Judicial Administration COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA COMMUNITY SUPERVISION: ADMINISTRATIVE SANCTIONS § 810.1 Supervision contact requirements. If you are an offender under supervision by th...

  2. Supervised Object Class Colour Normalisation

    DEFF Research Database (Denmark)

    Riabchenko, Ekatarina; Lankinen, Jukka; Buch, Anders Glent

    2013-01-01

    . In this work, we develop a such colour normalisation technique, where true colours are not important per se but where examples of same classes have photometrically consistent appearance. This is achieved by supervised estimation of a class specic canonical colour space where the examples have minimal variation......Colour is an important cue in many applications of computer vision and image processing, but robust usage often requires estimation of the unknown illuminant colour. Usually, to obtain images invariant to the illumination conditions under which they were taken, color normalisation is used...... in their colours. We demonstrate the effectiveness of our method with qualitative and quantitative examples from the Caltech-101 data set and a real application of 3D pose estimation for robot grasping....

  3. Self-supervised dynamical systems

    International Nuclear Information System (INIS)

    Zak, Michail

    2004-01-01

    A new type of dynamical systems which capture the interactions via information flows typical for active multi-agent systems is introduced. The mathematical formalism is based upon coupling the classical dynamical system (with random components caused by uncertainties in initial conditions as well as by Langevin forces) with the corresponding Liouville or the Fokker-Planck equations describing evolution of these uncertainties in terms of probability density. The coupling is implemented by information-based supervising forces which fundamentally change the patterns of probability evolution. It is demonstrated that the probability density can approach prescribed attractors while exhibiting such patterns as shock waves, solitons and chaos in probability space. Applications of these phenomena to information-based neural nets, expectation-based cooperation, self-programmed systems, control chaos using terminal attractors as well as to games with incomplete information, are addressed. A formal similarity between the mathematical structure of the introduced dynamical systems and quantum mechanics is discussed

  4. School Counselor Perceptions of Administrative Supervision Practices

    Science.gov (United States)

    Eddings, Geoffrey Creighton

    2012-01-01

    This study examined the perceptions of school counselors regarding administrative supervision practices in K-12 public schools in South Carolina. Specifically, the goal was to gain insight into how school counselors view current building-level supervision practices in relation to Pajak's Twelve Dimensions of Supervisory Practice, as well as how…

  5. Wellness Model of Supervision: A Comparative Analysis

    Science.gov (United States)

    Lenz, A. Stephen; Sangganjanavanich, Varunee Faii; Balkin, Richard S.; Oliver, Marvarene; Smith, Robert L.

    2012-01-01

    This quasi-experimental study compared the effectiveness of the Wellness Model of Supervision (WELMS; Lenz & Smith, 2010) with alternative supervision models for developing wellness constructs, total personal wellness, and helping skills among counselors-in-training. Participants were 32 master's-level counseling students completing their…

  6. Applying Services Marketing Principles to Postgraduate Supervision

    Science.gov (United States)

    Dann, Stephen

    2008-01-01

    Purpose: The paper aims to describe the application of two key service quality frameworks for improving the delivery of postgraduate research supervision. The services quality frameworks are used to identify key areas of overlap between services marketing practice and postgraduate supervision that can be used by the supervisor to improve research…

  7. Ethical Issues in the Conduct of Supervision.

    Science.gov (United States)

    Sherry, Patrick

    1991-01-01

    Uses American Psychological Association code of ethics to understand ethical issues present in the conduct of supervision. Discusses ethical issues of responsibility, client and supervisee welfare, confidentiality, competency, moral and legal standards, public statements, and professional relationships in relation to supervision. (Author/NB)

  8. State Radiation Protection Supervision and Control

    International Nuclear Information System (INIS)

    2003-01-01

    Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 2002 is presented

  9. Framing doctoral supervision as formative assessment

    DEFF Research Database (Denmark)

    Kobayashi, Sofie

    Doctoral supervision has been described through a number of models useful for understanding different aspects of supervision. None of these are all-encompassing, but each emphasizes a particular perspective, like the relationship, personal vs. structural support, process vs. product orientation. ...

  10. State Radiation Protection Supervision and Control

    CERN Document Server

    2002-01-01

    Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 2002 is presented.

  11. State Supervision and Control of Radiation Protection

    CERN Document Server

    2001-01-01

    Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 1999-2001 is presented.

  12. 32 CFR 631.3 - Supervision.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Supervision. 631.3 Section 631.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS ARMED FORCES DISCIPLINARY CONTROL BOARDS AND OFF-INSTALLATION LIAISON AND OPERATIONS General § 631.3 Supervision. The following will...

  13. 19 CFR 146.3 - Customs supervision.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Customs supervision. 146.3 Section 146.3 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) FOREIGN TRADE ZONES General Provisions § 146.3 Customs supervision. (a) Assignment of Customs officers. Customs officers will be...

  14. 21 CFR 640.62 - Medical supervision.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Medical supervision. 640.62 Section 640.62 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.62 Medical supervision. A qualified licensed physician shall be on the...

  15. Asco 2044 nuclear power plant: supervision

    International Nuclear Information System (INIS)

    Sabartes, J.

    2010-01-01

    Good supervision constitutes an efficient barrier to avoid the errors caused by inadequate work practices. In this sense, it is necessary to strengthen supervision to make sure that the work is carried out with adequate human performance, tending to avoid error and providing safety quality and efficiency at work. (Author).

  16. 48 CFR 836.572 - Government supervision.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Government supervision. 836.572 Section 836.572 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 836.572 Government supervision. The contracting officer shal...

  17. Teacher Supervision Practices and Principals' Characteristics

    Science.gov (United States)

    April, Daniel; Bouchamma, Yamina

    2015-01-01

    A questionnaire was used to determine the individual and collective teacher supervision practices of school principals and vice-principals in Québec (n = 39) who participated in a research-action study on pedagogical supervision. These practices were then analyzed in terms of the principals' sociodemographic and socioprofessional characteristics…

  18. 19 CFR 19.34 - Customs supervision.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Customs supervision. 19.34 Section 19.34 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CUSTOMS WAREHOUSES, CONTAINER STATIONS AND CONTROL OF MERCHANDISE THEREIN Space Bonded for the Storage of Wheat § 19.34 Customs supervision. Port...

  19. 28 CFR 551.32 - Staff supervision.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Staff supervision. 551.32 Section 551.32 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MISCELLANEOUS Inmate Organizations § 551.32 Staff supervision. (a) The Warden shall appoint a staff member as the institution's Inmate Organization Manager (IO...

  20. 32 CFR 552.65 - Command supervision.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Command supervision. 552.65 Section 552.65 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Solicitation on Military Reservations § 552.65 Command supervision. (a) All insurance...

  1. 36 CFR 25.3 - Supervision; suspensions.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Supervision; suspensions. 25.3 Section 25.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR NATIONAL MILITARY PARKS; LICENSED GUIDE SERVICE REGULATIONS § 25.3 Supervision; suspensions. (a) The guide service will operate under the direction...

  2. 40 CFR 35.935-8 - Supervision.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Supervision. 35.935-8 Section 35.935-8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.935-8 Supervision. In the case of any project involving Step 3,...

  3. 19 CFR 111.28 - Responsible supervision.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Responsible supervision. 111.28 Section 111.28 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.28 Responsible supervision. (a) General. Every individual broker...

  4. The Perceived Effectiveness of Supervision In Cognitive Behavioral Therapy Training

    Directory of Open Access Journals (Sweden)

    Erkan Kuru

    2016-12-01

    Full Text Available Psychotherapy is a general name for the problem solving techniques to address mental disorders or struggles through verbal interaction. Cognitive Behavioral Therapy (CBT is one of the leading approaches in psychotherapy field. The first aim of this study; to evaluate the contribution of theoretical and supervision trainings perceived by mental health professionals to their CBT skills and personal development. The second one was to evaluate the CBT training process in psychotherapy training. To this end, 54 mental health professionals who agree to participate the study were given questionnaires each consisting of 18 items. This questionnaire was created by three supervisors who have been certified by the Academy of Cognitive Therapy (ACT. Mean duration of work as a mental health professional were 7.6 years. Mean duration of using psychotherapy in their clinical practice were 4,8 years. Mean duration of application of CBT as a psychotherapy modality were 3,2 years. Mean durations of theoretical and supervision trainings the participants had participated were 55,4 hours and 69,1 respectively. Seventy-nine point six of the participants reported that the theoretical training had contributed to their CBT practice at “quite” to “too much” levels. Fifty-nine point two of the participants reported that the same training contributed to their personal development at “quiet” to “too much” levels. For the supervision traning these perceived contributions were 92,6 % and 70,4% respectively. That the therapists reported high degree of satisfaction with the theoretical and supervision trainings they need to accomplish is promising about the psychotherapy training in Turkey. Besides, results of this study suggests that although theoretical training is of perceived value, supervision has been perceived as had given extra contribution. [JCBPR 2016; 5(3.000: 119-124

  5. Detection of precancerous lesions in the oral cavity using oblique polarized reflectance spectroscopy: a clinical feasibility study

    Science.gov (United States)

    Bailey, Maria J.; Verma, Nishant; Fradkin, Leonid; Lam, Sylvia; MacAulay, Calum; Poh, Catherine; Markey, Mia K.; Sokolov, Konstantin

    2017-06-01

    We developed a multifiber optical probe for oblique polarized reflectance spectroscopy (OPRS) in vivo and evaluated its performance in detection of dysplasia in the oral cavity. The probe design allows the implementation of a number of methods to enable depth resolved spectroscopic measurements including polarization gating, source-detector separation, and differential spectroscopy; this combination was evaluated in carrying out binary classification tasks between four major diagnostic categories: normal, benign, mild dysplasia (MD), and severe dysplasia (SD). Multifiber OPRS showed excellent performance in the discrimination of normal from benign, MD, SD, and MD plus SD yielding sensitivity/specificity values of 100%/93%, 96%/95%, 100%/98%, and 100%/100%, respectively. The classification of benign versus dysplastic lesions was more challenging with sensitivity and specificity values of 80%/93%, 71%/93%, and 74%/80% in discriminating benign from SD, MD, and SD plus MD categories, respectively; this challenge is most likely associated with a strong and highly variable scattering from a keratin layer that was found in these sites. Classification based on multiple fibers was significantly better than that based on any single detection pair for tasks dealing with benign versus dysplastic sites. This result indicates that the multifiber probe can perform better in the detection of dysplasia in keratinized tissues.

  6. Nuclear safety culture and nuclear safety supervision

    International Nuclear Information System (INIS)

    Chai Jianshe

    2013-01-01

    In this paper, the author reviews systematically and summarizes up the development process and stage characteristics of nuclear safety culture, analysis the connotation and characteristics of nuclear safety culture, sums up the achievements of our country's nuclear safety supervision, dissects the challenges and problems of nuclear safety supervision. This thesis focused on the relationship between nuclear safety culture and nuclear safety supervision, they are essential differences, but there is a close relationship. Nuclear safety supervision needs to introduce some concepts of nuclear safety culture, lays emphasis on humanistic care and improves its level and efficiency. Nuclear safety supervision authorities must strengthen nuclear safety culture training, conduct the development of nuclear safety culture, make sure that nuclear safety culture can play significant roles. (author)

  7. Um modelo de supervisão clínica na formação do estudante de psicologia: a experiência da UFC A model of clinical supervision in the formation of psychology students: the UFC experience

    Directory of Open Access Journals (Sweden)

    Mônica Teles Tavora

    2002-06-01

    Full Text Available Este trabalho apresenta um modelo de supervisão que tem por objetivo promover o crescimento pessoal e técnico de terapeutas iniciantes. Embora os princípios gerais da Abordagem Centrada na Pessoa e da Socionomia (referencial psicodramático sejam os pilares da metodologia de supervisão desenvolvida no estágio clínico do Curso de Psicologia da Universidade Federal do Ceará, a proposta é ampla o suficiente para ser aplicada em treinamentos de orientações humanistas em geral. A utilização da Socionomia no trabalho em grupo pressupõe uma aprendizagem compartilhada na qual cada participante é promotor de seu próprio crescimento e dos demais.This work presents a supervision model with the objective of promoting the personal and technical growth of new therapists. Although the general principles of the Person-Centered Approach and Socionomy (psychodrama referential are pillars of the supervision methodology developed in a clinical training of the Psychology curriculum at the Federal University of Ceará, the proposal is flexible enough to be applied to humanist orientation training in general. The use of Socionomy in group sessions presupposes shared learning where each participant is the promoter of his own as well as the growth of others.

  8. [Strategic thinking: a possibility of systematization of nursing supervision].

    Science.gov (United States)

    Servo, M L

    2001-07-01

    This is a study of strategic thinking as a possibility for systematization of nursing supervision. It is a perspective of collective reflection, aiming an effective intervention of nursing, without losing sight of the characteristics inherent to structures and dynamics of social relationships. It shows the need of a technical-political action of nursing staff, associating actions with ideas and acts of the wish to know, looking for construct/reconstruct practices and alternatives of change. A space of democracy that searches the change of social relationships seeking for mutual understanding, although only to verify disagreement in the end.

  9. Tumor DNA in cerebral spinal fluid reflects clinical course in a patient with melanoma leptomeningeal brain metastases

    Science.gov (United States)

    Li, Yingmei; Pan, Wenying; Connolly, Ian D.; Reddy, Sunil; Nagpal, Seema

    2017-01-01

    Cerebral spinal fluid (CSF) from brain tumor patients contains tumor cellular and cell-free DNA (cfDNA), which provides a less-invasive and routinely accessible method to obtain tumor genomic information. In this report, we used droplet digital PCR to test mutant tumor DNA in CSF of a patient to monitor the treatment response of metastatic melanoma leptomeningeal disease (LMD). The primary melanoma was known to have a BRAFV600E mutation, and the patient was treated with whole brain radiotherapy and BRAF inhibitors. We collected 9 CSF samples over 6 months. The mutant cfDNA fraction gradually decreased from 53 % (time of diagnosis) to 0 (time of symptom alleviation) over the first 6 time points. Three months after clinical improvement, the patient returned with severe symptoms and the mutant cfDNA was again detected in CSF at high levels. The mutant DNA fraction corresponded well with the patient’s clinical response. We used whole exome sequencing to examine the mutation profiles of the LMD tumor DNA in CSF before therapeutic response and after disease relapse, and discovered a canonical cancer mutation PTENR130* at both time points. The cellular and cfDNA revealed similar mutation profiles, suggesting cfDNA is representative of LMD cells. This study demonstrates the potential of using cellular or cfDNA in CSF to monitor treatment response for LMD. PMID:26961773

  10. Globalisation as we enter the 21st century: reflections and directions for nursing education, science, research and clinical practice.

    Science.gov (United States)

    Davidson, Patricia M; Meleis, Afaf; Daly, John; Douglas, Marilyn Marty

    2003-10-01

    The events of September 11th, 2001 in the United States and the Bali bombings of October 2002 are chastening examples of the entangled web of the religious, political, health, cultural and economic forces we experience living in a global community. To view these forces as independent, singular, linearly deterministic entities of globalisation is irrational and illogical. Understanding the concept of globalisation has significant implications not only for world health and international politics, but also the health of individuals. Depending on an individual's political stance and world-view, globalisation may be perceived as an emancipatory force, having the potential to bridge the chasm between rich and poor or, in stark contrast, the very essence of the divide. It is important that nurses appreciate that globalisation does not pertain solely to the realms of economic theory and world politics, but also that it impacts on our daily nursing practice and the welfare of our patients. Globalisation and the closer interactions of human activity that result, have implications for international governance, policy and theory development as well as nursing education, research and clinical practice. Nurses, individually and collectively, have the political power and social consciousness to influence the forces of globalisation to improve health for all. This paper defines and discusses globalisation in today's world and its implications for contemporary nursing education, science, research and clinical practice.

  11. Mucin pattern reflects the origin of the adenocarcinoma in Barrett's esophagus: a retrospective clinical and laboratorial study

    Directory of Open Access Journals (Sweden)

    Corbett Carlos

    2009-03-01

    Full Text Available Abstract Background Mucin immunoexpression in adenocarcinoma arising in Barrett's esophagus (BE may indicate the carcinogenesis pathway. The aim of this study was to evaluate resected specimens of adenocarcinoma in BE for the pattern of mucins and to correlate to the histologic classification. Methods Specimens were retrospectively collected from thirteen patients who underwent esophageal resection due to adenocarcinoma in BE. Sections were scored for the grade of intestinal metaplasia. The tissues were examined by immunohistochemistry for MUC2 and MUC5AC antibodies. Results Eleven patients were men. The mean age was 61 years old (varied from 40 to 75 years old. The tumor size had a mean of 4.7 ± 2.3 cm, and the extension of BE had a mean of 7.7 ± 1.5 cm. Specialized epithelium with intestinal metaplasia was present in all adjacent mucosas. Immunohistochemistry for MUC2 showed immunoreactivity in goblet cells, while MUC5AC was extensively expressed in the columnar gastric cells, localizing to the surface epithelium and extending to a variable degree into the glandular structures in BE. Tumors were classified according to the mucins in gastric type in 7/13 (MUC5AC positive and intestinal type in 4/13 (MUC2 positive. Two tumors did not express MUC2 or MUC5AC proteins. The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047. Conclusion Barrett's esophagus adenocarcinoma shows either gastric or intestinal type pattern of mucin expression. The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.

  12. Empathic concern and professional characteristics associated with clinical empathy in French general practitioners.

    Science.gov (United States)

    Lelorain, Sophie; Sultan, Serge; Zenasni, Franck; Catu-Pinault, Annie; Jaury, Philippe; Boujut, Emilie; Rigal, Laurent

    2013-03-01

    Clinical empathy, i.e. the ability of physicians to adopt patient perspective, is an essential component of care, which depends in part on empathic concern, i.e. compassionate emotions felt for others. However, too much empathic concern can be challenging for physicians. Aim of this study was to examine physician practice characteristics that could explain clinical empathy beyond empathic concern. We were also interested in testing whether professional reflective activities, such as Balint group attendance or clinical supervision, might make clinical empathy less dependent on empathic concern. A total of 295 French general practitioners (response rate of 37%) completed self-reported questionnaires on empathic concern and clinical empathy, using the Toronto empathy questionnaire (TEQ) and the Jefferson scale of physician empathy (JSPE), respectively. We also recorded information on their professional practice: professional experience, duration of consultations, and participation in Balint groups or being a clinical supervisor. Hierarchical regression analyses were carried out with clinical empathy as dependent variable. Empathic concern was an important component of clinical empathy variance. The physician practice characteristics 'consultation length' and 'being a Balint attendee or a supervisor,' but not 'clinical experience' made a significant and unique contribution to clinical empathy beyond that of empathic concern. Participating to one reflective activity (either Balint group attendance or clinical supervision) made clinical empathy less dependent on empathic concern. Working conditions such as having enough consultation time and having the opportunity to attend a professional reflective activity support the maintenance of clinical empathy without the burden of too much empathic concern.

  13. The Reflective Learning Continuum: Reflecting on Reflection

    Science.gov (United States)

    Peltier, James W.; Hay, Amanda; Drago, William

    2005-01-01

    The importance of reflection to marketing educators is increasingly recognized. However, there is a lack of empirical research that considers reflection within the context of both the marketing and general business education literature. This article describes the use of an instrument that can be used to measure four identified levels of a…

  14. A review of supervised machine learning applied to ageing research.

    Science.gov (United States)

    Fabris, Fabio; Magalhães, João Pedro de; Freitas, Alex A

    2017-04-01

    Broadly speaking, supervised machine learning is the computational task of learning correlations between variables in annotated data (the training set), and using this information to create a predictive model capable of inferring annotations for new data, whose annotations are not known. Ageing is a complex process that affects nearly all animal species. This process can be studied at several levels of abstraction, in different organisms and with different objectives in mind. Not surprisingly, the diversity of the supervised machine learning algorithms applied to answer biological questions reflects the complexities of the underlying ageing processes being studied. Many works using supervised machine learning to study the ageing process have been recently published, so it is timely to review these works, to discuss their main findings and weaknesses. In summary, the main findings of the reviewed papers are: the link between specific types of DNA repair and ageing; ageing-related proteins tend to be highly connected and seem to play a central role in molecular pathways; ageing/longevity is linked with autophagy and apoptosis, nutrient receptor genes, and copper and iron ion transport. Additionally, several biomarkers of ageing were found by machine learning. Despite some interesting machine learning results, we also identified a weakness of current works on this topic: only one of the reviewed papers has corroborated the computational results of machine learning algorithms through wet-lab experiments. In conclusion, supervised machine learning has contributed to advance our knowledge and has provided novel insights on ageing, yet future work should have a greater emphasis in validating the predictions.

  15. Content analysis of resident evaluations of faculty anesthesiologists: supervision encompasses some attributes of the professionalism core competency.

    Science.gov (United States)

    Dexter, Franklin; Szeluga, Debra; Hindman, Bradley J

    2017-05-01

    Anesthesiology departments need an instrument with which to assess practicing anesthesiologists' professionalism. The purpose of this retrospective analysis of the content of a cohort of resident evaluations of faculty anesthesiologists was to investigate the relationship between a clinical supervision scale and the multiple attributes of professionalism. From July 1, 2013 to the present, our department has utilized the de Oliveira Filho unidimensional nine-item supervision scale to assess the quality of clinical supervision of residents provided by our anesthesiologists. The "cohort" we examined included all 13,664 resident evaluations of all faculty anesthesiologists from July 1, 2013 through December 31, 2015, including 1,387 accompanying comments. Words and phrases associated with the core competency of professionalism were obtained from previous studies, and the supervision scale was analyzed for the presence of these words and phrases. The supervision scale assesses some attributes of anesthesiologists' professionalism as well as patient care and procedural skills and interpersonal and communication skills. The comments that residents provided with the below-average supervision scores included attributes of professionalism, although numerous words and phrases related to professionalism were not present in any of the residents' comments. The de Oliveira Filho clinical supervision scale includes some attributes of anesthesiologists' professionalism. The core competency of professionalism, however, is multidimensional, and the supervision scale and/or residents' comments did not address many of the other established attributes of professionalism.

  16. Supervising the uncanny: the play within the play.

    Science.gov (United States)

    Leader, Carol

    2015-11-01

    The writer offers a combined experience in analysis and the performing arts to explore uncanny aspects of the unconscious subtext of the patient's inner drama; subtext which can remain hidden from view in supervision. Freud and Jung's understanding of uncanny experience is considered together with a painting from medieval alchemy and Matte Blanco's conceptions concerning the symmetrical nature of unconscious process. Theatre and the work of the theatre director and actor in approaching the multidimensional aspects of a play are then introduced. Finally clinical case material from group supervision demonstrates how the 'theatre of therapy' and the work of the supervisory couple and group promote the emergence of a more authentic conscious asymmetrical response to the patient's 'script' that can break the 'spell' of the transference/countertransference relationship. This in turn brings meaning to the underlying and implicit 'stage directions' that the patient has been unconsciously communicating. © 2015, The Society of Analytical Psychology.

  17. Utilizing technological innovations to enhance psychotherapy supervision, training, and outcomes.

    Science.gov (United States)

    Barnett, Jeffrey E

    2011-06-01

    Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. Specific ethical challenges and pitfalls are discussed and recommendations are made for the ethical use of these technologies. Additionally, innovative practices from the seven articles in the special section that follows are highlighted and reviewed. These articles present a number of innovations that can take psychotherapy training, research, supervision, and treatment forward toward increased effectiveness. Recommendations for integrating these innovations into ongoing practices are provided and for additional research to build on the important work of the authors in this special section are provided.

  18. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

    LENUS (Irish Health Repository)

    Phelan, Dermot

    2012-11-01

    In asymptomatic subjects B-type natriuretic peptide (BNP) is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM) alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS) and peripheral serum from patients with low (n = 14) and high BNP (n = 27). Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001). CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008), CITP (r = 0.35, p = 0.03) and PIIINP (r = 0.35, p = 0.001), and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002), IL-6 (r = 0.35, p = 0.04), and IL-8 (r = 0.54, p<0.001). The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007), TNF-α (3.2±0.5 versus 3.7±1.1, p = 003), IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02) and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04), and greater left ventricular mass index (97±20 versus 118±26 g\\/m(2), p = 0.03) and left atrial volume index (18±2 versus 21±4, p = 0.008). Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.

  19. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

    Directory of Open Access Journals (Sweden)

    Dermot Phelan

    Full Text Available In asymptomatic subjects B-type natriuretic peptide (BNP is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS and peripheral serum from patients with low (n = 14 and high BNP (n = 27. Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001. CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008, CITP (r = 0.35, p = 0.03 and PIIINP (r = 0.35, p = 0.001, and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002, IL-6 (r = 0.35, p = 0.04, and IL-8 (r = 0.54, p<0.001. The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007, TNF-α (3.2±0.5 versus 3.7±1.1, p = 003, IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02 and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04, and greater left ventricular mass index (97±20 versus 118±26 g/m(2, p = 0.03 and left atrial volume index (18±2 versus 21±4, p = 0.008. Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.

  20. Effect of reflective practice education on self-reflection, insight, and reflective thinking among experienced nurses: a pilot study.

    Science.gov (United States)

    Asselin, Marilyn E; Fain, James A

    2013-01-01

    A mixed-method study was conducted to determine whether nurses' participation in a reflective practice continuing education program using a structured reflection model makes a difference in nurses' self-reflection, insight, and reflective thinking about clinical practice situations. Findings suggested that use of structured reflection using question cues, written narratives, and peer-facilitated reflection increased nurses' engagement in self-reflection and enhanced reflective thinking in practice. Including reflective practice education in novice orientation and preceptor training may be beneficial.

  1. Working with chronic and relentless self-hatred, self-harm and existential shame: a clinical study and reflections.

    Science.gov (United States)

    Austin, Sue

    2016-02-01

    This paper is the first of a two-part series which explores some of the theoretical and experiential reference points that have emerged in my work with people whose relationship to their body and/or sense of self is dominated by self-hatred and (what Hultberg describes as) existential shame. The first paper focuses on self-hatred and the second paper focuses on shame. This first paper is structured around vignettes taken from a 14-year analysis with a woman who was bulimic, self-harmed and repeatedly described herself as 'feeling like a piece of shit'. It draws together elements of Jung's concepts of the complex and symbol, and Laplanche's enigmatic signifier to focus on experiences of 'inner otherness' around which we are unconsciously organized. It also brings Jung's understanding that emotion is the chief source of consciousness into conversation with Laplanche's approach to the transference which is that by being aware that they do not 'know', the analyst provides a 'hollow' in which the patient's analytic process can evolve. These combinations of ideas are linked speculatively to emerging understandings of the neuroscience of perception and throughout the paper clinical material is used to illustrate these discussions. © 2016, The Society of Analytical Psychology.

  2. A Phenomenological Exploration of the Experiences of Master's Level Counselor Trainees in Expressive Arts Group Supervision

    Science.gov (United States)

    Rossi, Martha Howe

    2010-01-01

    Expressive arts group supervision is the use of music, stories, movement, poetry or prose, role-play or psychodrama, art, guided imagery, or play to help trainees develop reflective skills (Wilkins, 1995), express thoughts and feelings (Knill, Levine & Levine, 2005; Lahad, 2000), develop new perspectives (Gladding, 2005), increase communication…

  3. Academic Rigor or Academic Rigor Mortis? Supervising Dissertations Is Serious Business

    Science.gov (United States)

    Wright, Robin Redmon

    2017-01-01

    This reflection considers the importance of and responsibility to graduate research supervision through an examination of a published dissertation that has had significant influence on the country's current immigration debate. The author exhorts both graduate students and adult education faculty to insist on clearly stated theoretical and…

  4. "EXHALE": exercise as a strategy for rehabilitation in advanced stage lung cancer patients: a randomized clinical trial comparing the effects of 12 weeks supervised exercise intervention versus usual care for advanced stage lung cancer patients

    DEFF Research Database (Denmark)

    Quist, Morten; Langer, SW; Rørth, Mikael

    2013-01-01

    BACKGROUND: Lung cancer is the leading cause of cancer death in North America and Western Europe. Patients with lung cancer in general have reduced physical capacity, functional capacity, poor quality of life and increased levels of anxiety and depression. Intervention studies indicate that physi......BACKGROUND: Lung cancer is the leading cause of cancer death in North America and Western Europe. Patients with lung cancer in general have reduced physical capacity, functional capacity, poor quality of life and increased levels of anxiety and depression. Intervention studies indicate...... that physical training can address these issues. However, there is a lack of decisive evidence regarding the effect of physical exercise in patients with advanced lung cancer. The aim of this study is to evaluate the effects of a twelve weeks, twice weekly program consisting of: supervised, structured training...... in a group of advanced lung cancer patients (cardiovascular and strength training, relaxation). METHODS/DESIGN: A randomized controlled trial will test the effects of the exercise intervention in 216 patients with advanced lung cancer (non-small cell lung cancer (NSCLC) stage IIIb-IV and small cell lung...

  5. Study and development of equipment supervision technique system and its management software for nuclear electricity production

    International Nuclear Information System (INIS)

    Zhang Liying; Zou Pingguo; Zhu Chenghu; Lu Haoliang; Wu Jie

    2008-01-01

    The equipment supervision technique system, which standardized the behavior of supervision organizations in planning and implementing of equipment supervision, is built up based on equipment supervision technique documents, such as Quality Supervision Classifications, Special Supervision Plans and Supervision Guides. Furthermore, based on the research, the equipment supervision management information system is developed by Object Oriented Programming, which consists of supervision information, supervision technique, supervision implementation, quality statistics and analysis module. (authors)

  6. Supervision and inspection plans of plants activities

    International Nuclear Information System (INIS)

    Feijoo, J. P.

    2009-01-01

    Any idea of hierarchization between supervisor and supervised in inspection and supervision activities should necessarily be dismissed, and the independence of the supervisor when executing has tasks should be guaranteed. The inspection and supervision program enable the detection and resolution of materials and human problems alike. In addition, they are a solution to anticipate potential problems in the future, which results in a very significant reduction of industrial accidents and human errors, as well as better use and upkeep of equipment. With these programs we improve our management and our work, and without a doubt they help to strengthen the safety culture in Cofrentes Nuclear Power Plant. (Author)

  7. Clinical instability of breast cancer markers is reflected in long-term in vitro estrogen deprivation studies

    International Nuclear Information System (INIS)

    Milosevic, Jelena; Klinge, Johanna; Borg, Anna-Lena; Foukakis, Theodoros; Bergh, Jonas; Tobin, Nicholas P

    2013-01-01

    Long-term estrogen deprivation models are widely employed in an in vitro setting to recapitulate the hormonal milieu of breast cancer patients treated with endocrine therapy. Despite the wealth information we have garnered from these models thus far, a comprehensive time-course analysis of the estrogen (ER), progesterone (PR), and human epidermal growth factor 2 (HER-2/neu) receptors on the gene and protein level, coupled with expression array data is currently lacking. We aimed to address this knowledge gap in order to enhance our understanding of endocrine therapy resistance in breast cancer patients. ER positive MCF7 and BT474 breast cancer cells were grown in estrogen depleted medium for 10 months with the ER negative MDA-MB-231 cell line employed as control. ER, PR and HER-2/neu expression were analysed at defined short and long-term time points by immunocytochemistry (ICC), and quantitative real-time RT-PCR (qRT-PCR). Microarray analysis was performed on representative samples. MCF7 cells cultured in estrogen depleted medium displayed decreasing expression of ER up to 8 weeks, which was then re-expressed at 10 months. PR was also down-regulated at early time points and remained so for the duration of the study. BT474 cells generally displayed no changes in ER during the first 8 weeks of deprivation, however its expression was significantly decreased at 10 months. PR expression was also down-regulated early in BT474 samples and was absent at later time points. Finally, microarray data revealed that genes and cell processes down-regulated in both cell lines at 6 weeks overlapped with those down-regulated in aromatase inhibitor treated breast cancer patients. Our data demonstrate that expression of ER, PR, and cell metabolic/proliferative processes are unstable in response to long-term estrogen deprivation in breast cancer cell lines. These results mirror recent clinical findings and again emphasize the utility of LTED models in translational research

  8. Reflective photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Lentine, Anthony L.; Nielson, Gregory N.; Cruz-Campa, Jose Luis; Okandan, Murat; Goeke, Ronald S.

    2018-03-06

    A photovoltaic module includes colorized reflective photovoltaic cells that act as pixels. The colorized reflective photovoltaic cells are arranged so that reflections from the photovoltaic cells or pixels visually combine into an image on the photovoltaic module. The colorized photovoltaic cell or pixel is composed of a set of 100 to 256 base color sub-pixel reflective segments or sub-pixels. The color of each pixel is determined by the combination of base color sub-pixels forming the pixel. As a result, each pixel can have a wide variety of colors using a set of base colors, which are created, from sub-pixel reflective segments having standard film thicknesses.

  9. Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

    Directory of Open Access Journals (Sweden)

    Weiland Tracey J

    2010-11-01

    Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

  10. Social constructionism and supervision: experiences of AAMFT supervisors and supervised therapists.

    Science.gov (United States)

    Hair, Heather J; Fine, Marshall

    2012-10-01

    A phenomenological research process was used to investigate the supervision experience for supervisors and therapists when supervisors use a social constructionist perspective. Participants of the one-to-one interviews were six AAMFT Approved Supervisors and six therapists providing counseling to individuals, couples and families. The findings suggest supervisors were committed to their self-identified supervision philosophy and intentionally sought out congruence between epistemology and practice. The shared experience of therapists indicates they associated desirable supervision experiences with their supervisors' social constructionist perspective. Our findings also indicated that supervisors' and therapists' understanding of social constructionism included the more controversial concepts of agency and extra-discursiveness. This research has taken an empirical step in the direction of understanding what the social constructionist supervision experience is like for supervisors and therapists. Our findings suggest a linkage between epistemology and supervision practice and a satisfaction with the supervision process. © 2012 American Association for Marriage and Family Therapy.

  11. Using a Mixed Model to Explore Evaluation Criteria for Bank Supervision: A Banking Supervision Law Perspective

    Science.gov (United States)

    Tsai, Sang-Bing; Chen, Kuan-Yu; Zhao, Hongrui; Wei, Yu-Min; Wang, Cheng-Kuang; Zheng, Yuxiang; Chang, Li-Chung; Wang, Jiangtao

    2016-01-01

    Financial supervision means that monetary authorities have the power to supervise and manage financial institutions according to laws. Monetary authorities have this power because of the requirements of improving financial services, protecting the rights of depositors, adapting to industrial development, ensuring financial fair trade, and maintaining stable financial order. To establish evaluation criteria for bank supervision in China, this study integrated fuzzy theory and the decision making trial and evaluation laboratory (DEMATEL) and proposes a fuzzy-DEMATEL model. First, fuzzy theory was applied to examine bank supervision criteria and analyze fuzzy semantics. Second, the fuzzy-DEMATEL model was used to calculate the degree to which financial supervision criteria mutually influenced one another and their causal relationship. Finally, an evaluation criteria model for evaluating bank and financial supervision was established. PMID:27992449

  12. Using a Mixed Model to Explore Evaluation Criteria for Bank Supervision: A Banking Supervision Law Perspective.

    Directory of Open Access Journals (Sweden)

    Sang-Bing Tsai

    Full Text Available Financial supervision means that monetary authorities have the power to supervise and manage financial institutions according to laws. Monetary authorities have this power because of the requirements of improving financial services, protecting the rights of depositors, adapting to industrial development, ensuring financial fair trade, and maintaining stable financial order. To establish evaluation criteria for bank supervision in China, this study integrated fuzzy theory and the decision making trial and evaluation laboratory (DEMATEL and proposes a fuzzy-DEMATEL model. First, fuzzy theory was applied to examine bank supervision criteria and analyze fuzzy semantics. Second, the fuzzy-DEMATEL model was used to calculate the degree to which financial supervision criteria mutually influenced one another and their causal relationship. Finally, an evaluation criteria model for evaluating bank and financial supervision was established.

  13. Objective evaluation by reflectance spectrophotometry can be of clinical value for the verification of blanching/non blanching erythema in the sacral area.

    Science.gov (United States)

    Sterner, Eila; Fossum, Bjöörn; Berg, Elisabeth; Lindholm, Christina; Stark, André

    2014-08-01

    Early detection of non blanching erythema (pressure ulcer category I) is necessary to prevent any further skin damage. An objective method to discriminate between blanching/non blanching erythema is presently not available. The purpose of this investigation was to explore if a non invasive objective method could differentiate between blanching/non blanching erythema in the sacral area of patients undergoing hip fracture surgery. Seventy-eight patients were included. The sacral area of all patients was assessed using (i) conventional finger-press test and (ii) digital reading of the erythema index assessed with reflectance spectrophotometry. The patients were examined at admission and during 5 days postsurgery. Reflectance spectrophotometry measurements proved able to discriminate between blanching/non blanching erythema. The reliability, quantified by the intra-class correlation coefficient, was excellent between repeated measurements over the measurement period, varying between 0·82 and 0·96, and a significant change was recorded in the areas from day 1 to day 5 (P < 0·0001). The value from the reference point did not show any significant changes over the same period (P = 0·32). An objective method proven to identify early pressure damage to tissue can be a valuable tool in clinical practice. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  14. Weakly supervised classification in high energy physics

    International Nuclear Information System (INIS)

    Dery, Lucio Mwinmaarong; Nachman, Benjamin; Rubbo, Francesco; Schwartzman, Ariel

    2017-01-01

    As machine learning algorithms become increasingly sophisticated to exploit subtle features of the data, they often become more dependent on simulations. This paper presents a new approach called weakly supervised classification in which class proportions are the only input into the machine learning algorithm. Using one of the most challenging binary classification tasks in high energy physics — quark versus gluon tagging — we show that weakly supervised classification can match the performance of fully supervised algorithms. Furthermore, by design, the new algorithm is insensitive to any mis-modeling of discriminating features in the data by the simulation. Weakly supervised classification is a general procedure that can be applied to a wide variety of learning problems to boost performance and robustness when detailed simulations are not reliable or not available.

  15. Abusive Supervision Scale Development in Indonesia

    Directory of Open Access Journals (Sweden)

    Fenika Wulani

    2014-02-01

    Full Text Available The purpose of this study was to develop a scale of abusive supervision in Indonesia. The study was conducted with a different context and scale development method from Tepper’s (2000 abusive supervision scale. The abusive supervision scale from Tepper (2000 was developed in the U.S., which has a cultural orientation of low power distance. The current study was conducted in Indonesia, which has a high power distance. This study used interview procedures to obtain information about supervisor’s abusive behavior, and it was also assessed by experts. The results of this study indicated that abusive supervision was a 3-dimensional construct. There were anger-active abuse (6 items, humiliation-active abuse (4 items, and passive abuse (15 items. These scales have internal reliabilities of 0.947, 0.922, and 0.845, in sequence.

  16. The Cryogenic Supervision System in NSRRC

    CERN Document Server

    Li, Hsing-Chieh; Chiou, Wen-Song; Hsiao, Feng-Zone; Tsai, Zong-Da

    2005-01-01

    The helium cryogenic system in NSRRC is a fully automatic PLC system using the Siemens SIMATIC 300 controller. Modularization in both hardware and software makes it easy in the program reading, the system modification and the problem debug. Based on the Laview program we had developed a supervision system taking advantage of the Internet technology to get system's real-time information in any place. The functions of this supervision system include the real-time data accessing with more than 300 digital/analog signals, the data restore, the history trend display, and the human machine interface. The data is accessed via a Profibus line connecting the PLC system and the supervision system with a maximum baud rate 1.5 Mbit/s. Due to this supervision system, it is easy to master the status of the cryogenic system within a short time and diagnose the problem.

  17. Weakly supervised classification in high energy physics

    Energy Technology Data Exchange (ETDEWEB)

    Dery, Lucio Mwinmaarong [Physics Department, Stanford University,Stanford, CA, 94305 (United States); Nachman, Benjamin [Physics Division, Lawrence Berkeley National Laboratory,1 Cyclotron Rd, Berkeley, CA, 94720 (United States); Rubbo, Francesco; Schwartzman, Ariel [SLAC National Accelerator Laboratory, Stanford University,2575 Sand Hill Rd, Menlo Park, CA, 94025 (United States)

    2017-05-29

    As machine learning algorithms become increasingly sophisticated to exploit subtle features of the data, they often become more dependent on simulations. This paper presents a new approach called weakly supervised classification in which class proportions are the only input into the machine learning algorithm. Using one of the most challenging binary classification tasks in high energy physics — quark versus gluon tagging — we show that weakly supervised classification can match the performance of fully supervised algorithms. Furthermore, by design, the new algorithm is insensitive to any mis-modeling of discriminating features in the data by the simulation. Weakly supervised classification is a general procedure that can be applied to a wide variety of learning problems to boost performance and robustness when detailed simulations are not reliable or not available.

  18. Qualification of organizations for independent technical supervision

    International Nuclear Information System (INIS)

    1981-04-01

    The requirements are established on trial for the qualification of an organization as an independent technical supervision organization in nuclear facilities, in activities related with quality assurance programs. (I.C.R.) [pt

  19. Oceans apart, yet connected: Findings from a qualitative study on professional supervision in rural and remote allied health services.

    Science.gov (United States)

    Ducat, Wendy; Martin, Priya; Kumar, Saravana; Burge, Vanessa; Abernathy, LuJuana

    2016-02-01

    Improving the quality and safety of health care in Australia is imperative to ensure the right treatment is delivered to the right person at the right time. Achieving this requires appropriate clinical governance and support for health professionals, including professional supervision. This study investigates the usefulness and effectiveness of and barriers to supervision in rural and remote Queensland. As part of the evaluation of the Allied Health Rural and Remote Training and Support program, a qualitative descriptive study was conducted involving semi-structured interviews with 42 rural or remote allied health professionals, nine operational managers and four supervisors. The interviews explored perspectives on their supervision arrangements, including the perceived usefulness, effect on practice and barriers. Themes of reduced isolation; enhanced professional enthusiasm, growth and commitment to the organisation; enhanced clinical skills, knowledge and confidence; and enhanced patient safety were identified as perceived outcomes of professional supervision. Time, technology and organisational factors were identified as potential facilitators as well as potential barriers to effective supervision. This research provides current evidence on the impact of professional supervision in rural and remote Queensland. A multidimensional model of organisational factors associated with effective supervision in rural and remote settings is proposed identifying positive supervision culture and a good supervisor-supervisee fit as key factors associated with effective arrangements. © 2015 Commonwealth of Australia. Australian Journal of Rural Health published by Wiley Publishing Asia Pty Ltd. on behalf of National Rural Health Alliance Inc.

  20. Is banking supervision central to central banking?

    OpenAIRE

    Joe Peek; Eric S. Rosengren; Geoffrey M. B. Tootell

    1997-01-01

    Whether central banks should play an active role in bank supervision and regulation is being debated both in the United States and abroad. While the Bank of England has recently been stripped of its supervisory responsibilities and several proposals in the United States have advocated removing bank supervision from the Federal Reserve System, other countries are considering enhancing central bank involvement in this area. Many of the arguments for and against these proposals hinge on the effe...

  1. The LHC string2 supervision system

    CERN Document Server

    Mayya, Y S; Sicard, Claude Henri

    2002-01-01

    This paper describes the implementation of the supervision system for the LHC Prototype Full-Cell also known as String 2. The supervision application is based on a commercial package targeted to industrial controls, but because of the complexity and the specifics of such a system, integration with custom components is necessary in order to merge the industrial requirements with the specificity of the accelerator controls.

  2. Nuclear safety legislation and supervision in China

    International Nuclear Information System (INIS)

    Zhang Shiguan

    1991-02-01

    The cause for the urgent need of nuclear safety legislation and supervision in China is firstly described, and then a brief introduction to the basic principle and guideline of nuclear safety is presented. Finally the elaboration on the establishment of nuclear safety regulatory system, the enactment of a series of regulations and safety guides, and the implementation of licencing, nuclear safety supervision and research for ensuring the safety of nuclear energy, since the founding of the National Nuclear Safety Administration, are introduced

  3. The efficacy of early initiated, supervised, progressive resistance training compared to unsupervised, home-based exercise after unicompartmental knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, Peter Bo; Bogh, Søren B; Kierkegaard, Signe

    2017-01-01

    OBJECTIVE: To examine if supervised progressive resistance training was superior to home-based exercise in rehabilitation after unicompartmental knee arthroplasty. DESIGN: Single blinded, randomized clinical trial. SETTING: Surgery, progressive resistance training and testing was carried out...

  4. On psychoanalytic supervision as signature pedagogy.

    Science.gov (United States)

    Watkins, C Edward

    2014-04-01

    What is signature pedagogy in psychoanalytic education? This paper examines that question, considering why psychoanalytic supervision best deserves that designation. In focusing on supervision as signature pedagogy, I accentuate its role in building psychoanalytic habits of mind, habits of hand, and habits of heart, and transforming theory and self-knowledge into practical product. Other facets of supervision as signature pedagogy addressed in this paper include its features of engagement, uncertainty, formation, and pervasiveness, as well as levels of surface, deep, and implicit structure. Epistemological, ontological, and axiological in nature, psychoanalytic supervision engages trainees in learning to do, think, and value what psychoanalytic practitioners in the field do, think, and value: It is, most fundamentally, professional preparation for competent, "good work." In this paper, effort is made to shine a light on and celebrate the pivotal role of supervision in "making" or developing budding psychoanalysts and psychoanalytic psychotherapists. Now over a century old, psychoanalytic supervision remains unparalleled in (1) connecting and integrating conceptualization and practice, (2) transforming psychoanalytic theory and self-knowledge into an informed analyzing instrument, and (3) teaching, transmitting, and perpetuating the traditions, practice, and culture of psychoanalytic treatment.

  5. Doctoral learning: a case for a cohort model of supervision and support

    Directory of Open Access Journals (Sweden)

    Naydene de Lange

    2011-01-01

    Full Text Available We document the efforts of the faculty of education of a large research-oriented university in supporting doctoral learning. The development of a space for doctoral learning is in line with the need to develop a community of researchers in South Africa. We describe the historical origins of this cohort model of doctoral supervision and support, draw on literature around doctoral learning, and analyse a cohort of doctoral students' evaluation of the seminarsoverthree years. The findings indicate that the model has great value in developing scholarship and reflective practice in candidates, in providing support and supervision, and in sustaining students towards the completion of their doctorates.

  6. Contributions for the supervision of social programs with a focus on the family

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Aguilera Campos

    2007-04-01

    Full Text Available This article explores the following factors of intervention: the professional composition of the social programs aimed at families, the new focus on the family in social policies and supervision by multi-disciplinary teams. It is based on an analysis of recent federal programs: the Integral Family Attention Program and the Family Health Program. It reviews the supervision without presenting a strictly theoretical approach or a list of field procedures. The family is considered as a social institution undergoing a permanent change of formats and meanings that require reflection and the continuous education of social professionals.

  7. Opportunities to Learn Scientific Thinking in Joint Doctoral Supervision

    Science.gov (United States)

    Kobayashi, Sofie; Grout, Brian W.; Rump, Camilla Østerberg

    2015-01-01

    Research into doctoral supervision has increased rapidly over the last decades, yet our understanding of how doctoral students learn scientific thinking from supervision is limited. Most studies are based on interviews with little work being reported that is based on observation of actual supervision. While joint supervision has become widely…

  8. 28 CFR 2.207 - Supervision reports to Commission.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Supervision reports to Commission. 2.207 Section 2.207 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS District of Columbia Supervised Releasees § 2.207 Supervision reports to Commission. A...

  9. Evaluation of the Effectiveness of Postgraduate General Medicine Training by Objective Structured Clinical Examination—Pilot Study and Reflection on the Experiences of Kaohsiung Medical University Hospital

    Directory of Open Access Journals (Sweden)

    Jer-Chia Tsai

    2008-12-01

    Full Text Available Objective structured clinical examination (OSCE is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1 residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five-point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self-evaluation on performance by examinees revealed significantly lower global ratings on post-course OSCE (4.14 ± 0.80 vs. 3.68 ± 0.66; p < 0.02. Surveys from tutors and standardized patients (SPs completed at pre- and post-course OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 ± 0.17 vs. 4.0 ± 0.12, nonsignificant. However, a survey of the examinees completed at preand post-course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 ± 0.09 vs. 3.7 ± 0.18; p < 0.05. Qualitative information revealed that tutors and SPs remarked that PGY1 residents' medical knowledge performance was satisfactory but their clinical reasoning performance, communication skills (giving bad news and self-confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a

  10. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

    Science.gov (United States)

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    educational value. The caseload can be so great that inadequate reflective time is left for learning based on clinical experiences. In addition, supervision is often vaguely defined and discontinuous. Medical malpractice data indicate that resident physicians are frequently named in lawsuits, most often for lack of supervision. The recommendations are: The ACGME should adjust resident physicians workload requirements to optimize educational value. Resident physicians as well as faculty should be involved in work redesign that eliminates nonessential and noneducational activity from resident physician dutiesMechanisms should be developed for identifying in real time when a resident physician's workload is excessive, and processes developed to activate additional providersTeamwork should be actively encouraged in delivery of patient care. Historically, much of medical training has focused on individual knowledge, skills, and responsibility. As health care delivery has become more complex, it will be essential to train resident and attending physicians in effective teamwork that emphasizes collective responsibility for patient care and recognizes the signs, both individual and systemic, of a schedule and working conditions that are too demanding to be safeHospitals should embrace the opportunities that resident physician training redesign offers. Hospitals should recognize and act on the potential benefits of work redesign, eg, increased efficiency, reduced costs, improved quality of care, and resident physician and attending job satisfactionAttending physicians should supervise all hospital admissions. Resident physicians should directly discuss all admissions with attending physicians. Attending physicians should be both cognizant of and have input into the care patients are to receive upon admission to the hospitalInhouse supervision should be required for all critical care services, including emergency rooms, intensive care units, and trauma services. Resident physicians

  11. Multicultural supervision: lessons learned about an ongoing struggle.

    Science.gov (United States)

    Christiansen, Abigail Tolhurst; Thomas, Volker; Kafescioglu, Nilufer; Karakurt, Gunnur; Lowe, Walter; Smith, William; Wittenborn, Andrea

    2011-01-01

    This article examines the experiences of seven diverse therapists in a supervision course as they wrestled with the real-world application of multicultural supervision. Existing literature on multicultural supervision does not address the difficulties that arise in addressing multicultural issues in the context of the supervision relationship. The experiences of six supervisory candidates and one mentoring supervisor in addressing multicultural issues in supervision are explored. Guidelines for conversations regarding multicultural issues are provided. © 2011 American Association for Marriage and Family Therapy.

  12. Supervision of radiation environment management of nuclear facilities

    International Nuclear Information System (INIS)

    Luo Mingyan

    2013-01-01

    Through literature and documents, the basis, content and implementation of the supervision of radiation environment management of nuclear facilities were defined. Such supervision was extensive and complicated with various tasks and overlapping duties, and had large social impact. Therefore, it was recommend to make further research on this supervision should be done, clarify and specify responsibilities of the executor of the supervision so as to achieve institutionalization, standardization and routinization of the supervision. (author)

  13. Personal Reflections

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education. Personal Reflections. Articles in Resonance – Journal of Science Education. Volume 6 Issue 3 March 2001 pp 90-93 Personal Reflections. Why did I opt for Career in Science? Jayant V Narlikar · More Details Fulltext PDF. Volume 9 Issue 8 August 2004 pp 89-89 ...

  14. Reflection groups

    International Nuclear Information System (INIS)

    Eggermont, G.

    2006-01-01

    In 2005, PISA organised proactive meetings of reflection groups on involvement in decision making, expert culture and ethical aspects of radiation protection.All reflection group meetings address particular targeted audiences while the output publication in book form is put forward

  15. Reflection ciphers

    DEFF Research Database (Denmark)

    Boura, Christina; Canteaut, Anne; Knudsen, Lars Ramkilde

    2017-01-01

    study the necessary properties for this coupling permutation. Special care has to be taken of some related-key distinguishers since, in the context of reflection ciphers, they may provide attacks in the single-key setting.We then derive some criteria for constructing secure reflection ciphers...

  16. Attending Physician Remote Access of the Electronic Health Record and Implications for Resident Supervision: A Mixed Methods Study.

    Science.gov (United States)

    Martin, Shannon K; Tulla, Kiara; Meltzer, David O; Arora, Vineet M; Farnan, Jeanne M

    2017-12-01

    Advances in information technology have increased remote access to the electronic health record (EHR). Concurrently, standards defining appropriate resident supervision have evolved. How often and under what circumstances inpatient attending physicians remotely access the EHR for resident supervision is unknown. We described a model of attending remote EHR use for resident supervision, and quantified the frequency and magnitude of use. Using a mixed methods approach, general medicine inpatient attendings were surveyed and interviewed about their remote EHR use. Frequency of use and supervisory actions were quantitatively examined via survey. Transcripts from semistructured interviews were analyzed using grounded theory to identify codes and themes. A total of 83% (59 of 71) of attendings participated. Fifty-seven (97%) reported using the EHR remotely, with 54 (92%) reporting they discovered new clinical information not relayed by residents via remote EHR use. A majority (93%, 55 of 59) reported that this resulted in management changes, and 54% (32 of 59) reported making immediate changes by contacting cross-covering teams. Six major factors around remote EHR use emerged: resident, clinical, educational, personal, technical, and administrative. Attendings described resident and clinical factors as facilitating "backstage" supervision via remote EHR use. In our study to assess attending remote EHR use for resident supervision, attendings reported frequent remote use with resulting supervisory actions, describing a previously uncharacterized form of "backstage" oversight supervision. Future work should explore best practices in remote EHR use to provide effective supervision and ultimately improve patient safety.

  17. Quantifying Reflection

    DEFF Research Database (Denmark)

    Alcock, Gordon Lindsay

    2013-01-01

    ´ These are all based on Blooms taxonomy and levels of competence and form a major part of individual student and group learning portfolios. Key Words :Project-Based learning, Reflective Portfolios, Self assessment, Defining learning gains, Developing learning strategies , Reflections on and for learning....... It contrasts the students’ self-assessment in a range of ‘product’ skills such as Revit, Structural Design, Mathematics of construction, Technical Installations; as well as ‘process’ competencies such as ‘Working in a team’, Sharing knowledge, Maintaining a portfolio and Reflecting ON learning and FOR learning......This paper documents 1st semester student reflections on “learning to learn” in a team-based PBL environment with quantitative and qualitative student reflective feedback on the learning gains of 60 Architectural Technology and Construction Management students at VIA University College, Denmark...

  18. Yearning for the Vastness of the Sea: Reflections and Commentary on Professional Training in Hypnosis.

    Science.gov (United States)

    Baker, Elgan L

    2017-01-01

    Educational programs are a major focus of most professional hypnosis societies. Many of these programs rely on traditional curricula and teaching strategies with variable success. The articles in this special issue examine and critique these training models and suggest innovative approaches to professional education with an emphasis on more uniform course content and goals and more dynamic and effective educational processes. A convergence of themes is noted and examined including the need to continue to expand the acceptance and utilization of clinical hypnosis, the importance of attending to broader clinical competence beyond hypnosis skills, the need for faculty development and evaluation, and the imperative that course content reflects academic rigor and contemporary science as well as providing for demonstration and supervised clinical practice. These themes are explicated for the development of new training paradigms and for continued programs in the field of clinical hypnosis.

  19. Asco 2044 nuclear power plant: supervision; Central nuclear Asco 2044: supervision

    Energy Technology Data Exchange (ETDEWEB)

    Sabartes, J.

    2010-07-01

    Good supervision constitutes an efficient barrier to avoid the errors caused by inadequate work practices. In this sense, it is necessary to strengthen supervision to make sure that the work is carried out with adequate human performance, tending to avoid error ande provinding safety quality and efficiency at work. (Author).

  20. Ensemble learning with trees and rules: supervised, semi-supervised, unsupervised

    Science.gov (United States)

    In this article, we propose several new approaches for post processing a large ensemble of conjunctive rules for supervised and semi-supervised learning problems. We show with various examples that for high dimensional regression problems the models constructed by the post processing the rules with ...

  1. Self-reported needs for improving the supervision competence of PhD supervisors from the medical sciences in Denmark

    Directory of Open Access Journals (Sweden)

    Rie Raffing

    2017-10-01

    Full Text Available Abstract Background Quality of supervision is a major predictor for successful PhD projects. A survey showed that almost all PhD students in the Health Sciences in Denmark indicated that good supervision was important for the completion of their PhD study. Interestingly, approximately half of the students who withdrew from their program had experienced insufficient supervision. This led the Research Education Committee at the University of Copenhagen to recommend that supervisors further develop their supervision competence. The aim of this study was to explore PhD supervisors’ self-reported needs and wishes regarding the content of a new program in supervision, with a special focus on the supervision of PhD students in medical fields. Methods A semi-structured interview guide was developed, and 20 PhD supervisors from the Graduate School of Health and Medical Sciences at the Faculty of Health and Medical Sciences at the University of Copenhagen were interviewed. Empirical data were analysed using qualitative methods of analysis. Results Overall, the results indicated a general interest in improved competence and development of a new supervision programme. Those who were not interested argued that, due to their extensive experience with supervision, they had no need to participate in such a programme. The analysis revealed seven overall themes to be included in the course. The clinical context offers PhD supervisors additional challenges that include the following sub-themes: patient recruitment, writing the first article, agreements and scheduled appointments and two main groups of students, in addition to the main themes. Conclusions The PhD supervisors reported the clear need and desire for a competence enhancement programme targeting the supervision of PhD students at the Faculty of Health and Medical Sciences. Supervision in the clinical context appeared to require additional competence. Trial registration The Scientific Ethical Committee

  2. Self-reported needs for improving the supervision competence of PhD supervisors from the medical sciences in Denmark.

    Science.gov (United States)

    Raffing, Rie; Jensen, Thor Bern; Tønnesen, Hanne

    2017-10-23

    Quality of supervision is a major predictor for successful PhD projects. A survey showed that almost all PhD students in the Health Sciences in Denmark indicated that good supervision was important for the completion of their PhD study. Interestingly, approximately half of the students who withdrew from their program had experienced insufficient supervision. This led the Research Education Committee at the University of Copenhagen to recommend that supervisors further develop their supervision competence. The aim of this study was to explore PhD supervisors' self-reported needs and wishes regarding the content of a new program in supervision, with a special focus on the supervision of PhD students in medical fields. A semi-structured interview guide was developed, and 20 PhD supervisors from the Graduate School of Health and Medical Sciences at the Faculty of Health and Medical Sciences at the University of Copenhagen were interviewed. Empirical data were analysed using qualitative methods of analysis. Overall, the results indicated a general interest in improved competence and development of a new supervision programme. Those who were not interested argued that, due to their extensive experience with supervision, they had no need to participate in such a programme. The analysis revealed seven overall themes to be included in the course. The clinical context offers PhD supervisors additional challenges that include the following sub-themes: patient recruitment, writing the first article, agreements and scheduled appointments and two main groups of students, in addition to the main themes. The PhD supervisors reported the clear need and desire for a competence enhancement programme targeting the supervision of PhD students at the Faculty of Health and Medical Sciences. Supervision in the clinical context appeared to require additional competence. The Scientific Ethical Committee for the Capital Region of Denmark. Number: H-3-2010-101, date: 2010.09.29.

  3. A qualitative inquiry into the challenges and complexities of research supervision: viewpoints of postgraduate students and faculty members.

    Science.gov (United States)

    Yousefi, Alireza; Bazrafkan, Leila; Yamani, Nikoo

    2015-07-01

    The supervision of academic theses at the Universities of Medical Sciences is one of the most important issues with several challenges. The aim of the present study is to discover the nature of problems and challenges of thesis supervision in Iranian universities of medical sciences. The study was conducted with a qualitative method using conventional content analysis approach. Nineteen faculty members, using purposive sampling, and 11 postgraduate medical sciences students (Ph.D students and residents) were selected on the basis of theoretical sampling. The data were gathered through semi-structured interviews and field observations in Shiraz and Isfahan universities of medical sciences from September 2012 to December 2014. The qualitative content analysis was used with a conventional approach to analyze the data. While experiencing the nature of research supervision process, faculties and the students faced some complexities and challenges in the research supervision process. The obtained codes were categorized under 4 themes Based on the characteristics; included "contextual problem", "role ambiguity in thesis supervision", "poor reflection in supervision" and "ethical problems". The result of this study revealed that there is a need for more attention to planning and defining the supervisory, and research supervision. Also, improvement of the quality of supervisor and students relationship must be considered behind the research context improvement in research supervisory area.

  4. Recommendations for an update of the 2010 European regulatory guideline on clinical investigation of medicinal products used in the treatment of osteoarthritis and reflections about related clinically relevant outcomes: expert consensus statement.

    Science.gov (United States)

    Reginster, J-Y; Reiter-Niesert, S; Bruyère, O; Berenbaum, F; Brandi, M-L; Branco, J; Devogelaer, J-P; Herrero-Beaumont, G; Kanis, J; Maggi, S; Maheu, E; Richette, P; Rizzoli, R; Cooper, C

    2015-12-01

    The European Society on Clinical and Economic aspects of Osteoporosis and Osteoarthritis (ESCEO) organised a working group to evaluate the need for updating the current European guideline on clinical investigation of drugs used in the treatment of osteoarthritis (OA). Areas of potential attention were identified and the need for modifications, update or clarification was examined. Proposals were then developed based on literature reviews and through a consensus process. It was agreed that the current guideline overall still reflects the current knowledge in OA, although two possible modifications were identified. The first relates to the number and timing of measurements required as primary endpoints during clinical trials of symptom-relieving drugs, either drugs with rapid onset of action or slow acting drugs. The suggested modifications are intended to take into consideration the time related clinical need and expected time response to these drugs - i.e., a more early effect for the first category in addition to the maintenance of effect, a more continuous benefit over the long-term for the latter - in the timing of assessments. Secondly, values above which a benefit over placebo should be considered clinically relevant were considered. Based on literature reviews, the most consensual values were determined for primary endpoints of both symptom-relieving drugs (i.e., pain intensity on a visual analogue scale (VAS)) and disease-modifying drugs (i.e., radiographic joint-space narrowing). This working document might be considered by the European regulatory authorities in a future update of the guideline for the registration of drugs in OA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Supervised hub-detection for brain connectivity

    DEFF Research Database (Denmark)

    Kasenburg, Niklas; Liptrot, Matthew George; Reislev, Nina Linde

    2016-01-01

    , but can smooth discriminative signals in the population, degrading predictive performance. We present a novel hub-detection optimized for supervised learning that both clusters network nodes based on population level variation in connectivity and also takes the learning problem into account. The found......A structural brain network consists of physical connections between brain regions. Brain network analysis aims to find features associated with a parameter of interest through supervised prediction models such as regression. Unsupervised preprocessing steps like clustering are often applied...... hubs are a low-dimensional representation of the network and are chosen based on predictive performance as features for a linear regression. We apply our method to the problem of finding age-related changes in structural connectivity. We compare our supervised hub-detection (SHD) to an unsupervised hub...

  6. Semi-supervised Learning for Phenotyping Tasks.

    Science.gov (United States)

    Dligach, Dmitriy; Miller, Timothy; Savova, Guergana K

    2015-01-01

    Supervised learning is the dominant approach to automatic electronic health records-based phenotyping, but it is expensive due to the cost of manual chart review. Semi-supervised learning takes advantage of both scarce labeled and plentiful unlabeled data. In this work, we study a family of semi-supervised learning algorithms based on Expectation Maximization (EM) in the context of several phenotyping tasks. We first experiment with the basic EM algorithm. When the modeling assumptions are violated, basic EM leads to inaccurate parameter estimation. Augmented EM attenuates this shortcoming by introducing a weighting factor that downweights the unlabeled data. Cross-validation does not always lead to the best setting of the weighting factor and other heuristic methods may be preferred. We show that accurate phenotyping models can be trained with only a few hundred labeled (and a large number of unlabeled) examples, potentially providing substantial savings in the amount of the required manual chart review.

  7. Effect of denoising on supervised lung parenchymal clusters

    Science.gov (United States)

    Jayamani, Padmapriya; Raghunath, Sushravya; Rajagopalan, Srinivasan; Karwoski, Ronald A.; Bartholmai, Brian J.; Robb, Richard A.

    2012-03-01

    Denoising is a critical preconditioning step for quantitative analysis of medical images. Despite promises for more consistent diagnosis, denoising techniques are seldom explored in clinical settings. While this may be attributed to the esoteric nature of the parameter sensitve algorithms, lack of quantitative measures on their ecacy to enhance the clinical decision making is a primary cause of physician apathy. This paper addresses this issue by exploring the eect of denoising on the integrity of supervised lung parenchymal clusters. Multiple Volumes of Interests (VOIs) were selected across multiple high resolution CT scans to represent samples of dierent patterns (normal, emphysema, ground glass, honey combing and reticular). The VOIs were labeled through consensus of four radiologists. The original datasets were ltered by multiple denoising techniques (median ltering, anisotropic diusion, bilateral ltering and non-local means) and the corresponding ltered VOIs were extracted. Plurality of cluster indices based on multiple histogram-based pair-wise similarity measures were used to assess the quality of supervised clusters in the original and ltered space. The resultant rank orders were analyzed using the Borda criteria to nd the denoising-similarity measure combination that has the best cluster quality. Our exhaustive analyis reveals (a) for a number of similarity measures, the cluster quality is inferior in the ltered space; and (b) for measures that benet from denoising, a simple median ltering outperforms non-local means and bilateral ltering. Our study suggests the need to judiciously choose, if required, a denoising technique that does not deteriorate the integrity of supervised clusters.

  8. ERA Ranger tailings corridor review. Supervising Scientist report 154

    International Nuclear Information System (INIS)

    Merz, S.K.

    2000-01-01

    Sinclair Knight Merz (SKM) were commissioned by the Office of the Supervising Scientist on 25 May 2000 to undertake a review and complete a report on the tailings corridor at the ERA Ranger Mine. The objective of the study was to undertake an 'as is' and to some extent historic and look ahead, review of the corridor system sufficient to: assess the current suitability of key aspects of the design; assess the suitability of current operating, maintenance and system development regimes and responsibilities; and record any recommended actions or further investigations arising out of the review; in order to ensure the adequacy of the design, operation and maintenance. The scope of the study report was limited to the corridor itself, its associated sump and sump contents discharge and the branch corridors carrying pipelines to Pit 1. A representative report contents was discussed and agreed with the Office of the Supervising Scientist prior to commencement of the study and this is included as appendix A to this report. The originally agreed content is, with only minor amendment, reflected in this report. The study methodology comprised a review and assessment by SKM of the design of the existing system and current operations documentation and information obtained from investigations on site and discussions with ERA site personnel. Whilst, a number of modifications affecting the corridor are recommended for further consideration, the main findings of the report relate to operating and maintenance practices which should be adopted for the remainder of the mine/mill life

  9. Improved Anomaly Detection using Integrated Supervised and Unsupervised Processing

    Science.gov (United States)

    Hunt, B.; Sheppard, D. G.; Wetterer, C. J.

    There are two broad technologies of signal processing applicable to space object feature identification using nonresolved imagery: supervised processing analyzes a large set of data for common characteristics that can be then used to identify, transform, and extract information from new data taken of the same given class (e.g. support vector machine); unsupervised processing utilizes detailed physics-based models that generate comparison data that can then be used to estimate parameters presumed to be governed by the same models (e.g. estimation filters). Both processes have been used in non-resolved space object identification and yield similar results yet arrived at using vastly different processes. The goal of integrating the results of the two is to seek to achieve an even greater performance by building on the process diversity. Specifically, both supervised processing and unsupervised processing will jointly operate on the analysis of brightness (radiometric flux intensity) measurements reflected by space objects and observed by a ground station to determine whether a particular day conforms to a nominal operating mode (as determined from a training set) or exhibits anomalous behavior where a particular parameter (e.g. attitude, solar panel articulation angle) has changed in some way. It is demonstrated in a variety of different scenarios that the integrated process achieves a greater performance than each of the separate processes alone.

  10. EEM{sup TM} wireless supervision

    Energy Technology Data Exchange (ETDEWEB)

    Bilic, H. [Ericsson-Nikola Tesla d.d. Zagreb (Croatia)

    2000-07-01

    By adding the GSM network to the communication level of Energy Management systems, energy operating centres (EOC) can offer wireless access to the supervised equipment. Furthermore EOC can profit from rapid service development in the GSM networks. With implementation of GPRS to the GSM network EOC can instantly offer wireless access to external IP based networks such as Internet and corporate Intranets. The author describes architecture and key characteristic of Ericsson EnergyMaster{sup TM} (EEM{sup TM}) system for Energy Management, how and where to implement wireless supervision, wireless access to IP addresses and also how to implement new services provided by the GSM network. (orig.)

  11. Availability analysis of supervised protective systems

    International Nuclear Information System (INIS)

    Kontoleon, N.; Kontoleon, J.M.; Chrysochoides, N.G.

    1975-01-01

    The behaviour in time of a nuclear reactor supervised protective system is modelled mathematically by a Markov process, continuous in time and with three discrete states. Failure and repair rates are assumed to be exponentially distributed. An analytical expression of system availability as a function of failure and repair rates as well as the inspection intervals and duration is derived. An optimization problem is then discussed in order to maximize system availability with respect to imposed cost constraints. Finally, an example of a supervised protective system with short inactive times is given, which may be found in many practical situations of modern protective systems. (author)

  12. Supervision af psykologkandidater i privat praksis

    DEFF Research Database (Denmark)

    Petersen, Birgitte

    et litteratur review over relevante temaer i supervisionslitteraturen samt overvejelser om læring i supervision. Afhandlingens empiriske resultater vil blive belyst og diskuteret med udgangspunkt i tilsvarende fænomener i supervisionslitteraturen. Resultaterne af undersøgelsen viser, at der er en...... række vigtige elementer ved supervision, der skal være opfyldt, hvis den skal opleves som udviklende og lærerig af praksiskandidaterne. Det er elementer som kontraktetablering, rådgivning og teoretisk refleksion, en tydelig teoretisk referenceramme samt støtte og anerkendelse fra supervisor. Det...

  13. The triadic intersubjective matrix in supervision: the use of disclosure to work through painful affects.

    Science.gov (United States)

    Brown, Lawrence J; Miller, Martin

    2002-08-01

    The use of the psychoanalyst's subjective reactions as a tool to better understand his/her patient has been a central feature of clinical thinking in recent decades. While there has been much discussion and debate about the analyst's use of countertransference in individual psychoanalysis, including possible disclosure of his/her feelings to the patient, the literature on supervision has been slower to consider such matters. The attention to parallel processes in supervision has been helpful in appreciating the impact of affects arising in either the analyst/patient or the supervisor/analyst dyads upon the analytic treatment and its supervision. This contribution addresses the ways in which overlapping aspects of the personalities of the supervisor, analyst and patient may intersect and create resistances in the treatment. That three-way intersection, described here as the triadic intersubjective matrix, is considered inevitable in all supervised treatments. A clinical example from the termination phase of a supervised analysis of an adolescent is offered to illustrate these points. Finally, the question of self-disclosure as an aspect of the supervisory alliance is also discussed.

  14. Supervision and inspection plans of plants activities; Plan de inspeccion y supervision de actividades en planta

    Energy Technology Data Exchange (ETDEWEB)

    Feijoo, J. P.

    2009-07-01

    Any idea of hierarchization between supervisor and supervised in inspection and supervision activities should necessarily be dismissed, and the independence of the supervisor when executing has tasks should be guaranteed. The inspection and supervision program enable the detection and resolution of materials and human problems alike. In addition, they are a solution to anticipate potential problems in the future, which results in a very significant reduction of industrial accidents and human errors, as well as better use and upkeep of equipment. With these programs we improve our management and our work, and without a doubt they help to strengthen the safety culture in Cofrentes Nuclear Power Plant. (Author)

  15. Reflectance Modeling

    Science.gov (United States)

    Smith, J. A.; Cooper, K.; Randolph, M.

    1984-01-01

    A classical description of the one dimensional radiative transfer treatment of vegetation canopies was completed and the results were tested against measured prairie (blue grama) and agricultural canopies (soybean). Phase functions are calculated in terms of directly measurable biophysical characteristics of the canopy medium. While the phase functions tend to exhibit backscattering anisotropy, their exact behavior is somewhat more complex and wavelength dependent. A Monte Carlo model was developed that treats soil surfaces with large periodic variations in three dimensions. A photon-ray tracing technology is used. Currently, the rough soil surface is described by analytic functions and appropriate geometric calculations performed. A bidirectional reflectance distribution function is calculated and, hence, available for other atmospheric or canopy reflectance models as a lower boundary condition. This technique is used together with an adding model to calculate several cases where Lambertian leaves possessing anisotropic leaf angle distributions yield non-Lambertian reflectance; similar behavior is exhibited for simulated soil surfaces.

  16. 23 CFR 635.105 - Supervising agency.

    Science.gov (United States)

    2010-04-01

    ... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.105 Supervising agency. (a) The STD has responsibility... work with its own forces or by contract; provided the following conditions are met and the Division... compliance with subpart B of this part. (2) When the work is to be performed under a contract awarded by a...

  17. The Spiritual Genogram in Training and Supervision.

    Science.gov (United States)

    Frame, Marsha Wiggins

    2001-01-01

    Describes the spiritual genogram, a blueprint of family members' multigenerational religious and spiritual affiliations, events, and conflicts. Used as a tool in both training and supervision, the spiritual genogram enables students and supervisees to make sense of their own religious and spiritual heritage and to explore the ways in which their…

  18. Magazine Picture Collage in Group Supervision

    Science.gov (United States)

    Shepard, Blythe C.; Guenette, Francis L.

    2010-01-01

    A magazine picture collage activity was used with three female counsellor education students as a vehicle to support them in processing their experience as counsellors in training. The use of magazine picture collage in group supervision is described, and the benefits and challenges are presented. The collages served as jumping-off points for…

  19. Theory of Multiple Intelligences at Teacher Supervision

    Directory of Open Access Journals (Sweden)

    İzzet Döş

    2012-07-01

    Full Text Available This study aims to determine views of teachers and supervisors related to the multiple intelligences in students’ learning that they took into consideration in the evaluation of teachers during lesson supervision. The study was conducted with 5 supervisors who work at Kahramanmaraş provincial directorate of national education and 10 teachers who work at primary schools in the centre of Kahramanmaraş in 2011-2012 year. Data was gathered with the help of interview form consisting of five open-ended questions. In the analysis of the data content analysis which is one of the qualitative research methods. According to the results of the analysis, it has been found that usage of multiple intelligences theory in the evaluation students’ learning during supervision enabled them to evaluate students’ learning in a more detailed way. It also made it possible for the supervisors to examine supervision evaluations at different levels. It was also mentioned that supervisions made according to multiple intelligence theory has some limitations.

  20. Research Supervision: The Research Management Matrix

    Science.gov (United States)

    Maxwell, T. W.; Smyth, Robyn

    2010-01-01

    We briefly make a case for re-conceptualising research project supervision/advising as the consideration of three inter-related areas: the learning and teaching process; developing the student; and producing the research project/outcome as a social practice. We use this as our theoretical base for an heuristic tool, "the research management…