Statewide survey to compare services provided for residents with dementia in special care units and non-special-care units

To protect the consumer, consistency is needed in what one can expect when a long-term care facility (LTCF) advertises having an Alzheimer's special care unit (SCU). Arkansas recently passed disclosure legislation, which has led to the development of criteria for licensure of SCUs. This study compared the extent to which Arkansas LTCFs, with and without SCUs, met these criteria. We conducted a statewide survey of 238 LTCFs prior to the enforcement of these regulations and will conduct the same survey following their enforcement. Of the 147 (62 percent) facilities responding, 24 (16 percent) had a SCU. None of the LTCFs with SCUs met all the state criteria. The number and quality of services provided in SCUs and non-SCUs were similar.

Rural Alabama Health Professional Training Consortium: six-year evaluation results

The Rural Alabama Health Professional Training Consortium is a rural community health center-based program that began in 1990 to provide interdisciplinary training for medical, nursing, pharmacy, dentistry, and nutrition students. After 6 years, 166 students had participated. This article discusses an evaluation of the impact of this program on these students by means of comparing pre-tests and posttests. Dentists demonstrated attitudes less favorable to locating in rural practices compared to other students. There was a significant increase in clinical competencies relevant to rural practice. Professional perceptions about working in an interdisciplinary environment were significantly lower for medical students compared to pharmacists, but their attitudes improved over time. The team concept was highly rated. Over 90% of the students thought that the program met or exceeded their expectations and would recommend it to other students, except for nurses. Over 80% of the students will consider working in a rural area on graduation, except for dentists.

Self-assessment in clinical health psychology: a model for ethical expansion of practice

Society expects autonomous professions to ensure the competency of it practitioners, and professions should facilitate the continuing education and training of its members. Given the shift from psychology as a mental health profession to that of a health profession, the authors propose a self-assessment model for the individual practitioner to gauge his or her readiness to provide professional service in expanded areas of practice. This model could also be useful to the American Psychological Association, state psychological associations, and other purveyors of continuing education programs in systematically developing postgraduate experiences. A template for self-assessment that reflects well-accepted core domains of knowledge and skills is presented.

Students' perspectives: a Canadian study of supervised pastoral education

Summarizes and analyses the findings of a research study that was commissioned and supported by CAPPE and The Churches' Council on Theological Education in Canada. Surveys students who were completing a basic unit in Supervised Pastoral Education (SPE) to identify the self-perceived effects of the unit on pastoral functioning. Utilizes qualitative and quantitative methods, focus group sessions, consultations, and a literature search to develop a questionnaire which was distributed to eligible students via the Internet. Draws several conclusions that suggest re-examination, further study or program changes, and validates the central focus of SPE basic units on self-awareness and experiential learning.

Continuing education meetings and workshops: effects on professional practice and health care outcomes

BACKGROUND

Educational meetings and printed educational materials are the two most common types of continuing education for health professionals. An important aim of continuing education is to improve professional practice so that patients can receive improved health care.

OBJECTIVES

To assess the effects of educational meetings on professional practice and health care outcomes.

SEARCH STRATEGY

We searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE (from 1966), the Research and Development Resource Base in Continuing Medical Education in January 1999 and reference lists of articles.

SELECTION CRITERIA

Randomised trials or well designed quasi-experimental studies examining the effect of continuing education meetings (including lectures, workshops, and courses) on the clinical practice of health professionals or health care outcomes.

DATA COLLECTION AND ANALYSIS

Two reviewers independently applied inclusion criteria, assessed the quality of each study, and extracted study data. We attempted to collect missing data from investigators. We conducted both qualitative and quantitative analyses.

MAIN RESULTS

Thirty-two studies were included with a total of 36 comparisons. The studies involved from 13 to 411 health professionals (total N= 2995) and were judged to be of moderate or high quality, although methods were generally poorly reported. There was substantial variation in the complexity of the targeted behaviours, baseline compliance, the characteristics of the interventions and the results. The heterogeneity of the results was best explained by differences in the interventions. For 10 comparisons of interactive workshops, there were moderate or moderately large effects in six (all of which were statistically significant) and small effects in four (one of which was statistically significant). For interventions that combined workshops and didactic presentations, there were moderate or moderately large effects in 12 comparisons (eleven of which were statistically significant) and small effects in seven comparisons (one of which was statistically significant). In seven comparisons of didactic presentations, there were no statistically significant effects, with the exception of one out of four outcome measures in one study.

REVIEWER'S CONCLUSIONS

Interactive workshops can result in moderately large changes in professional practice. Didactic sessions alone are unlikely to change professional practice.

Staying up-to-date through distance education: the radiation therapy perspective

BACKGROUND

Distance education (DE) courses are offered to medical radiation technologists (therapy) [MRT(T)] in Canada for professional development (PD).

METHODS

A survey of 300 therapists was conducted to identify potential participants and factors that can influence DE participation and learning.

RESULTS

The motivation to take PD is intrinsic, for personal growth and fulfillment, rather than to satisfy employment or provincial requirements. There is interest in DE because of its accessibility. Work constraints appear to be more restrictive than domestic ones and little support for PD is perceived from the cancer centers.

CONCLUSIONS

These findings raise implications for professional development in cancer centers that are broader than the original objective of optimizing course design.

Revolution or evolution: competency validation in Kentucky

The six-year exploration of competency by the Kentucky Board of Nursing and a number of stakeholders resulted in enactment of a change to the Kentucky nursing laws that refocused continued competency from mandatory continuing education to multiple validation options. Many questions are yet unanswered as the new continued competency validation strategies are implemented for 2001 Kentucky nurse licensure renewal.

Setting the educational agenda and curriculum for error prevention in emergency medicine

Graduate and postgraduate medical education currently teaches safety in patient care by instilling a deep sense of personal responsibility in student practitioners. To increase safety, medical education will have to begin to introduce new concepts from the "safety sciences," without losing the advantages that the values of commitment and responsibility have gained. There are two related educational goals. First, we in emergency medicine (EM) must develop a group of safety-educated practitioners who can understand and implement safe practice innovations in their clinical settings, and will be instrumental in changing our professional culture. Second, EM must develop a group of teachers and researchers who can begin to deeply understand how safety is maintained in emergency care, develop solutions that will work in emergency department settings, and pass on those insights and innovations. The specifics of what should be taught are outlined briefly. Work is currently ongoing to identify more specifically the core content that should be included in educational programs on patient safety in emergency care. Finally, careful attention will have to be paid to the way in which these principles are taught. It seems unlikely that a series of readings and didactic lectures alone will be effective. The analysis of meaningful cases, perhaps supplemented by high-fidelity simulation, seems to hold promise for more successful education in patient safety.

[Anti-HBV vaccination and continuing education of health personnel: proposal for a priority index in various hospital units]

This work defines an "hazard index of unit" for the occupational transmission of the HBV to the aim to establish the priorities in the activity of promotion of the hepatitis B vaccine turned to health personnel. It has been estimated the prevalence of the potentiality infecting for the HBV in patients coming to various unit and the cover immunization against HBV in personnel and used the incidence of exposures to biological risk, always reported to the single units, found in the within of the activity of the Committee of Control of the Hospitals infections in our hospital. The analysis evidences three areas to risk: infectious diseases, general surgery and obstetrics and gynecology.

Contextual influences on learning application in practice. An extended role for process evaluation

Although process evaluation usually ends with the program, process itself does not end. This study analyzed process or contextual influences health professionals face when returning from continuing professional education (CPE) and attempting to apply learning. Follow-up survey data were analyzed for a sample (N = 549) of physicians, nurses, counselors, and rehabilitation specialists. Contextual influences studied include resources, encouragement, support, opportunity, and authority. Logistic regression analysis found support for changes to apply training ideas was a predictor of application for the sample as a whole and for all professional groups except one. Encouragement from others was a predictor of application for rehabilitation specialists, and opportunity to apply learning was a second predictor for nurses. Sufficient resources was not a predictor in any models tested. Results indicate that the practice context can affect educational outcomes and an extended vision of process evaluation is needed to incorporate such variables in the evaluation of CPE.

Utility of a brief self-efficacy scale in clinical training program evaluation

Self-efficacy is often studied as a predictor of professional practice behaviors or as an outcome of clinical training, using brief scales with little validation. This study examines the utility of a brief self-efficacy scale in the evaluation of a clinical training program. Subjects were 119 registered dietitians who participated in diabetes training. Hypothesized relationships between self-efficacy ratings and indices of skill mastery, participation in training, and subsequent practice change were examined. Self-efficacy ratings after training correlated significantly with relevant prior experience (r = .4 and .29, p < .01) but not total experience and with knowledge post-test score (r = .21, p < .02). Self-efficacy for all 12 program objectives increased significantly after training. Post-training self-efficacy for two program objectives correlated significantly with self-reported successful practice changes related to those objectives (r = .4, p < .04 and r = .51, p < .01). The data suggest that brief self-efficacy assessments can contribute meaningfully to clinical training program evaluation.

The development of a continuous quality control programme for strict sperm morphology among sub-Saharan African laboratories

Inter-technician and between-laboratory differences, especially during the evaluation of sperm morphology, have been a major cause of concern. The study aimed to develop an intensive training programme with intervals of continuous quality control assessments for sperm morphology. Twenty andrology laboratories from sub-Saharan Africa were invited to participate in a World Health Organization Special Programme of Research, Development and Research Training in Human Reproduction semenology workshop. Following intensive training in strict sperm morphololgy evaluation, a continuous quality control programme was introduced on a quarterly basis. At baseline, the mean (+/- SD) percentage difference reported between the participants and the reference laboratory reading was 33.50 +/- 11%. After training, the mean percentage difference had decreased to 14.32 +/- 5% at 3 months and to 5.00 +/- 5% at 6 months. Pairwise comparison of the differences at each evaluation time revealed the following: Baseline differences (pre-training) differed significantly from the differences at 3 months (P = 0.0002) as well as at 6 months after training (P = 0.007). The differences at 6 months did not differ significantly from those at 3 months (P = 0.27). Training of andrology technicians as well as continuous proficiency testing can be conducted on a national and international level with the support of a referring laboratory. Global quality control measurements in andrology laboratories should become mandatory, since these results indicate that continuous quality control for laboratory technicians can be highly successful.

Program design and delivery in Canadian CME drug therapy courses

OBJECTIVE

To examine how drug therapy course directors design and deliver drug therapy courses, and whether they employ adult education principles to assure effective education.

DESIGN

Analysis of a three-part questionnaire sent to directors of drug therapy courses in Canada.

PARTICIPANTS

The questionnaire was sent to all seven directors of drug therapy courses at medical schools that are accredited continuing medical education providers.

RESULTS

All directors completed and returned the questionnaires. To decide on course content, most use feedback from previous course attendees, peer consultations, course committee member discussions and their own perceptions of learners' needs. Courses generally use conventional teacher-dominated technology rather than methods that emphasize active learner participation.

CONCLUSION

Directors of Canadian continuing medical education drug therapy courses reasonably employ adult education principles when deciding learner needs and designing teaching vehicles.

Continuing education in audiology: what do we want?

A sample of audiologists practicing in the New England states was surveyed about topics of interest for continuing education, desire to obtain a professional doctoral degree, and preferred learning modes for completing continuing education activities and doctoral education. Two hundred sixty-eight completed surveys were returned. Respondents indicated interest in a wide range of continuing education topics, with the greatest amount of interest in areas related to technology. The majority of respondents preferred to complete continuing education activities via traditional, face-to-face programming, whereas most respondents indicated interest in using both traditional and distance-learning methods to upgrade to a professional doctoral degree. Results of the survey also showed that a large proportion of audiologists are undecided about their desire to obtain a professional doctoral degree.