[The role of the nurse in the field of public health]

OBJECTIVE

Identify the role of public health nurses and differentiate it from that of community care nurses in the context of Catalonia, through the experiences and perspectives of professionals in the field of public health.

METHOD

Descriptive phenomenological qualitative study. Fourteen interviews were conducted with key informants, from the field of public health and community care, selected by i purposive sampling. Content analysis using thematic methodology, creation of categories from the triangulation of results.

RESULTS

The professional competencies and functions performed by nursing in the field of public health are analysed. Most of the specific functions were the ones related to "care" and the "global vision" of health. The indeterminacy of functions and roles, related to gender inequality, leads to a low recognition of the profession and a lack of appropriateness of the professional category, reflected in a low presence of nurses in management positions in public health. Although some competencies are shared with the family and community nurse, there are also differences.

CONCLUSIONS

This study sheds light on the role of public health nursing, often overlooked. It is urgent to define public health nurses role and functions, in order to avoid inequalities and increase their recognition.

[Practical considerations for implementing health outcomes measurement projects within a healthcare organization: Delphi Expert Consensus Study]

INTRODUCTION

Measuring health outcomes and costs per patient is an essential element of value-based healthcare (VBHC). The aim of the study was to generate expert consensus on the activities required to implement it.

METHODS

A two-round modified Delphi study with healthcare professionals, quality and clinical management methodologists and managers with academic and/or practical experience in outcome measurement projects. A median equal to or greater than 4 and a relative interquartile range (RIQR) equal to or greater than 25% were established as consensus criteria.

RESULTS

Consensus was obtained on 91% of the items (N=74/81). In terms of feasibility, the items that received the highest score and consensus were the existence of data protection guarantees (median=5; mean=4.8; RIQR=0%), the vision and motivation of healthcare professionals (median=5; mean=4.7; RIQR=20%), the existence and availability of ICT tools (or systems) for data recording (median=5; mean=4.5; RIQR=20%), and having sufficient funding to undertake the project (median=5; mean=4.2; RIQR=20%). The most highly rated factors adding complexity were the number of units or departments involved in the care process for the clinical condition (median=5; mean=4.4; RIQR=20%), having an accepted set of monitoring indicators for the condition (median=5; mean=4.4; RIQR=20%), and the involvement of several levels of care in the project (median=5; mean=4.3; RIQR=20%).

CONCLUSIONS

We describe practical aspects for the application of systematic outcomes measurement in routine clinical practice. These results can serve as a tool for prioritising, sizing, resource planning, and estimating implementation costs.

The assessment of medical competencies

OBJECTIVE

To describe the most widely used tools in the assessment of medical competencies, analyse their prevalence of use, their advantages and disadvantages and propose an appropriate model for our context.

METHODS

We conducted a narrative review of articles from MEDLINE, following the PRISM protocol, and analysed a total of 62 articles.

RESULTS

The assessment of competencies is heterogeneous, especially in the educational and professional settings. The specific and technical competencies acquired during university education are mainly assessed using the objective structured clinical assessment. In the professional setting, core competencies are assessed using the 360° technique.

CONCLUSIONS

We need a rigorous empiric comparison of the efficiency of the tools according to the type of competency. We propose a competency management model for the «undergraduate/graduate/active professional» continuum, whose goal is to improve training and professional practice and thereby increase the quality of patient care.

[Public health competencies and contents in Spanish university degree programmes of Veterinary Medicine]

OBJECTIVE

To reach a consensus among public health faculty from various Spanish universities about the core public health competencies that should be integrated into the Veterinary Medicine degree training.

METHODS

The 3rd Forum of University Professors of Public Health was held at the School of Veterinary Medicine of the University of Cordoba (12-13 January 2016). Forty-two university professors and lecturers from nine Spanish universities with veterinary degrees participated in the forum. They were divided into five working groups during three working sessions to identify and classify core public health competencies for the Veterinary Medicine degree, propose public health contents for the identified competencies and organize such contents in thematic blocks. The results were discussed in different plenary sessions.

RESULTS

The highest number of core competencies was identified in the activities related to the following public health functions: «Assessment of the population's health needs» and «Developing health policies». The final programme included basic contents organized into five units: 1) Fundamentals of public health; 2) Study and research in public health; 3) Production, animal health and environment; 4) Food security; and 5) Health education.

CONCLUSIONS

The public health core competencies and contents identified in this Forum may be considered as a starting point to update public health training programmes for future veterinary professionals.

[Education in our time: competency or aptitude? The case for medicine. Part I]

This paper begins with a statement: It is necessary to characterize the respective society to be able to understand the education's core. Distinctive features of the present-day world lead us to define it as the ruin of a civilization based on limitless financial gain, where education has a passive quality, responsible of maintaining the status quo as well as preserving the degrading attributes of actual societies: individualism, passivity, competitiveness, consumerism and high vulnerability to control and manipulation. About the dilemma: competency or aptitude, these are not synonyms but concepts pertaining radically different approaches to the practice and understanding of education. Competency represents the actual tendencies of passive education, where knowledge is just about acquiring information. Aptitude refers to participatory education, described in the second part of this essay. The passive education is present in the professional competencies model, specified in terms of curricula, profiles, levels, school activities, evaluation, concept of progress and social consequences. This paradigm does not foster real progress-defined as the primacy of values sustaining spiritual, intellectual and moral development but as an "accomplice" of the civilization's collapse.

[Public health competencies and contents in Spanish undergraduate medical degrees]

OBJECTIVE

To reach a consensus among public health faculty from various Spanish universities about the core public health competencies that should be integrated into undergraduate medical degrees.

METHODS

The 2nd Forum of University Teachers was held at the Rey Juan Carlos University (Madrid, 11-12 December 2014). Twenty-four university professors and lecturers from 19 Spanish universities imparting medical degrees participated in the forum. They were distributed in three working groups during three working sessions. In the first session, they were asked to identify and classify core public health competencies for medical degrees. In the second, they were asked to propose public health contents for the identified competencies. In the third session, the participants organized these contents in thematic blocks. The results were discussed in distinct plenary sessions.

RESULTS

The highest number of core competencies was identified in the activities related to the public health functions «Assessment of the population's health needs» and «Developing health policies». The final programme included basic contents organised into five units: Concept of health, public health and its determinants; Epidemiology and health research; Determinants and health problems; Strategies, interventions and policies; and health systems, clinical and healthcare management.

CONCLUSIONS

The public health core competencies and contents identified in this Forum may be considered as a starting point to improve and update public health training programmes for future medical professionals.

[Delphi study to identify the management skills of nursing executives]

OBJECTIVE

To determine and update the skills map for the position of Nurse Administrator in hospitals and Primary Care.

METHOD

An observational, descriptive, cross-sectional study based on a Delphi technique was conducted in hospital and Primary Care settings. Two nominal groups with 15 nurses each were used to define the contents of the questionnaire 0 in the Delphi technique. All nurses registered in the professional associations of Alicante, Castellón and Valencia were invited to participate. The results of the Delphi study was submitted to factor analysis to identify the set of skills and, subsequently, compare them with the offer of post-graduate course in colleges and universities during the 2014-15 academic year.

RESULTS

Forty-five competences were extracted during the Nominal groups. In total, 705 nurses replied to the first wave in the Delphi Technique, and 394 in the second (response rate of 56%). Factorial analysis grouped the skills chosen into 10 factors: managing people, conflict management, independent learning, ethics, emotional balance, commitment, self-discipline, continuous improvement, critical-thinking, and innovation. Four skills groups identified in this study (emotional balancing, commitment, self-discipline and courage) were not usually included in the post-graduate courses

CONCLUSIONS

The nurse administrator skills should be related to relational and ethical behaviour. The training offer of the post-graduate courses must be reoriented.

[Consensus on competencies for advanced nursing practice in Spain]

INTRODUCTION

There is a lack of international consensus on the exact definition and core competencies of advanced practice nursing (APN) roles, a problem particularly acute in our national context due to the lack of APN role development, which has a significantly short history in our country. The main objective of this paper was the delineation of the competence framework for Advanced Practice Nurses in our national context based on expert consensus through the Delphi method

METHOD

Based on a preliminary literature review process, a conglomerate of 17 domains of competence (clusters of related competencies) were identified. This initial set was revised, refined and validated by a group of expert panellists on the subject (clinicians, researchers, managers, and teachers) through successive rounds in search of a suitable consensus on each of the various proposed items

RESULTS

The results helped to establish a solid foundation in the form of a skills map that could identify those sets of more specific competencies for advanced practice roles, regardless of regulatory and professional practice context, identifying domains such as Research and Evidence Based Practice, Clinical and Professional Leadership, or Care Management

DISCUSSION

This set of skills related to advanced practice roles in our environment can delineate competency standards common to this level of nursing practice, and serve as a reference for policy development, a review of roles, or the establishment of academic profiles.

[Public health competencies and contents in pharmacy degree programs in Spanish universities]

OBJECTIVE

To identify public health core competencies and contents in pharmacy degrees at a meeting of public health lecturers in pharmacy degrees from various public and private universities.

METHODS

The first Meeting of the Forum of University Teaching Staff in Pharmacy Degrees was held at the Faculty of Medicine in the Complutense University, Madrid, Spain on the 19(th) and 20(th) of November 2013. The meeting was attended by 17 lecturers. Participants brought their own teaching programs and were given two previous studies on public health competencies for analysis of public health contents and competencies in pharmacy degrees. Working groups were formed and the results were shared.

RESULTS

The highest number of core competencies was identified in the following functions: "Assessment of the population's health needs" and "Developing health policies". The final program included basic contents organized into 8 units: Concept of Public Health, Demography, Epidemiological Method, Environment and Health, Food Safety, Epidemiology of Major Health Problems, Health Promotion and Education, and Health Planning and Management.

CONCLUSIONS

Representation of almost all the Spanish Pharmacy Faculties and the consensus reached in the description of competences and program contents will greatly improve the quality of teaching in this area.