Current status of clinical education in paramedic programs: a descriptive research project.

PubMed

Grubbs, K C

1997-01-01

Development of competence in exercising therapeutic judgment skills represents the goal of clinical education. Time (clock hours) is not a valid predictor of attainment of competence in paramedic clinical education. Quantity of patient contact experiences facilitates development of judgment skills, and offers a valid measure of progress toward competence. This project uses national survey data from accredited programs to describe the availability and accessibility of patient contact experiences within paramedic clinical education. Data from this local program supplements the national survey results. The components of clinical judgment are enumerated, and strategies to teach and evaluate clinical judgment skills are discussed.

An innovation in physician training: the Clinical Scholars Program.

PubMed

Shuster, A L; Cluff, L E; Haynes, M A; Hook, E W; Rogers, D E

1983-02-01

The Robert Wood Johnson Foundation Clinical Scholars Program was developed to allow selected physician clinicians to acquire certain skills which are not part of the usual physician's repertoire. Begun in 1969 with support from the Carnegie Corporation and the Commonwealth Fund, funding has been provided since 1973 by the Robert Wood Johnson Foundation. By June 1981, 309 physicians had completed their training as clinical scholars, and a majority were pursuing careers in academic medicine. This paper recounts the factors and forces which led to the initiation and development of the program, its successes and failures, the problems faced, the achievements of clinical scholar alumni, and the program's current status.

Faculty development activities in family medicine: in search of innovation.

PubMed

Lawrence, Elizabeth A; Oyama, Oliver N

2013-01-01

To describe the Accreditation Council for Graduate Medical Education's (ACGME) faculty development requirements, explore the range of faculty development activities and support currently used by family medicine residencies to meet these requirements, and describe one innovative approach to satisfy this need. An electronic survey of faculty development activities and support offered to faculty by residency programs was sent to a random sample of 40 medical school and community based family medicine residency programs across the United States. Data were examined using t-tests, Fisher's exact tests, and Analysis of Variance. Faculty development, beyond traditional clinical CME, was strongly encouraged or required by a large proportion of the sample (73%). Only 58% of programs reported having discussed the ACGME's faculty development component areas (clinical, educational, administrative, leadership, research, and behavioral). In each component area except the "clinical" area, the absence of discussing the ACGME component areas with residency faculty was associated with fewer faculty development activities and support being offered by the program. These results, although preliminary, suggest that family medicine residency programs may value and encourage faculty development. The majority of programs use traditional activities and strategies such as CME, faculty meetings, faculty conferences and workshops; and a smaller number of programs are exploring the utility of mentoring programs, faculty discussion groups, and technology based learning systems. The challenge is to develop faculty development activities tailored to individual program and faculty needs and resources.

Doctoral programs to train future leaders in clinical and translational science.

PubMed

Switzer, Galen E; Robinson, Georgeanna F W B; Rubio, Doris M; Fowler, Nicole R; Kapoor, Wishwa N

2013-09-01

Although the National Institutes of Health (NIH) has made extensive investments in educational programs related to clinical and translational science (CTS), there has been no systematic investigation of the number and characteristics of PhD programs providing training to future leaders in CTS. The authors undertook to determine the number of institutions that, having had received NIH-funded Clinical and Translational Science Awards (CTSAs), currently had or were developing PhD programs in CTS; to examine differences between programs developed before and after CTSA funding; and to provide detailed characteristics of new programs. In 2012, CTS program leaders at the 60 CTSA-funded institutions completed a cross-sectional survey focusing on four key domains related to PhD programs in CTS: program development and oversight; students; curriculum and research; and milestones. Twenty-two institutions had fully developed PhD programs in CTS, and 268 students were earning PhDs in this new field; 13 institutions were planning PhD programs. New programs were more likely to have fully developed PhD competencies and more likely to include students in medical school, students working only on their PhD, students working on a first doctoral degree, and students working in T1 translational research. They were less likely to include physicians and students working in clinical or T2 research. Although CTS PhD programs have similarities, they also vary in their characteristics and management of students. This may be due to diversity in translational science itself or to the relative infancy of CTS as a discipline.

Doctoral Programs to Train Future Leaders in Clinical and Translational Science

PubMed Central

Switzer, Galen E.; Robinson, Georgeanna F.W.B.; Rubio, Doris M.; Fowler, Nicole R.; Kapoor, Wishwa N.

2013-01-01

Purpose Although the National Institutes of Health (NIH) has made extensive investments in educational programs related to clinical and translational science (CTS), there has been no systematic investigation of the number and characteristics of PhD programs providing training to future leaders in CTS. The authors undertook to determine the number of institutions that, having had received NIH-funded Clinical and Translational Science Awards (CTSAs), currently had or were developing PhD programs in CTS; to examine differences between programs developed before and after CTSA funding; and to provide detailed characteristics of new programs. Method In 2012, CTS program leaders at the 60 CTSA-funded institutions completed a cross-sectional survey focusing on four key domains related to PhD programs in CTS: program development and oversight; students; curriculum and research; and milestones. Results Twenty-two institutions had fully developed PhD programs in CTS, and 268 students were earning a PhD in this new field; 13 institutions were planning a PhD program. New programs were more likely to have fully developed PhD competencies and more likely to include students in medical school, students working only on their PhD, students working on a first doctoral degree, and students working in T1 translational research. They were less likely to include physicians and students working in clinical or T2 research. Conclusions Although CTS PhD programs have similarities, they also vary in their characteristics and management of students. This may be due to diversity in translational science itself or to the relative infancy of CTS as a discipline. PMID:23899901

A structural equation model on the attributes of a skills enhancement program affecting clinical competence of pre-graduate nursing students.

PubMed

Rebueno, Ma Carina D R; Tiongco, Dyan Dee D; Macindo, John Rey B

2017-02-01

Clinical competence remains an issue in nursing and has received greater emphasis than academic competence. Although skill enhancement programs are recommended and beneficial, there is limited evidence on its influence on the clinical competence of pre-graduate nursing students. This study explored the attributes of a skills enhancement program that affect the perceived clinical competence of pre-graduate nursing students. A cross-sectional study was conducted in a private higher education institution in the Philippines from April to May 2016. A total of 245 pre-graduate nursing students participated and completed a three-part survey composed of the respondent's robotfoto, the Skills Enhancement Program Questionnaire, and the Clinical Competence Questionnaire. Factor analysis explicated the attributes of the skills enhancement program while structural equation modeling and path analysis analyzed the variables' relationship. Findings showed that a skills enhancement program has 4 attributes: supportive clinical instructor, comprehensive orientation, formative goals and objectives, and conducive learning environment. Although all attributes of the program positively affected clinical competence, a supportive clinical instructor had the strongest influence on all clinical competency dimensions. A skills enhancement program that has a supportive clinical instructor, comprehensive orientation, formative goals and objectives, and conducive learning environment facilitates clinical competency development among pre-graduate nursing students. This knowledge provides momentum for nursing educators to review and refine their skills and the existing design of their skills enhancement program to further develop clinical competency among pre-graduate nursing students. Copyright © 2016 Elsevier Ltd. All rights reserved.

Coordination of Scheduling Clinical Externship or Clinical Practice Experiences for Students in Physical Therapy Educational Programs.

ERIC Educational Resources Information Center

Patterson, Robert K.; Kass, Susan H.

A project to coordinate the scheduling of allied health occupations students for clinical practice or externship experiences in Southeast Florida is described. A model clinical facility utilization and time schedule matrix was developed for four programs: the physical therapy programs at Florida International University (FIU) and the University of…

Program evaluation of a model to integrate internationally educated health professionals into clinical practice

PubMed Central

2013-01-01

Background The demand for health professionals continues to increase, partially due to the aging population and the high proportion of practitioners nearing retirement. The University of British Columbia (UBC) has developed a program to address this demand, by providing support for internationally trained Physiotherapists in their preparation for taking the National Physiotherapy competency examinations. The aim was to create a program comprised of the educational tools and infrastructure to support internationally educated physiotherapists (IEPs) in their preparation for entry to practice in Canada and, to improve their pass rate on the national competency examination. Methods The program was developed using a logic model and evaluated using program evaluation methodology. Program tools and resources included educational modules and curricular packages which were developed and refined based on feedback from clinical experts, IEPs and clinical physical therapy mentors. An examination bank was created and used to include test-enhanced education. Clinical mentors were recruited and trained to provide clinical and cultural support for participants. Results The IEP program has recruited 124 IEPs, with 69 now integrated into the Canadian physiotherapy workforce, and more IEPs continuing to apply to the program. International graduates who participated in the program had an improved pass rate on the national Physiotherapy Competency Examination (PCE); participation in the program resulted in them having a 28% (95% CI, 2% to 59%) greater possibility of passing the written section than their counterparts who did not take the program. In 2010, 81% of all IEP candidates who completed the UBC program passed the written component, and 82% passed the clinical component. Conclusion The program has proven to be successful and sustainable. This program model could be replicated to support the successful integration of other international health professionals into the workforce. PMID:24119470

Training oncology and palliative care clinical nurse specialists in psychological skills: evaluation of a pilot study.

PubMed

Clark, Jane E; Aitken, Susan; Watson, Nina; McVey, Joanne; Helbert, Jan; Wraith, Anita; Taylor, Vanessa; Catesby, Sarah

2015-06-01

National guidelines in the United Kingdom recommend training Clinical Nurse Specialists in psychological skills to improve the assessment and intervention with psychological problems experienced by people with a cancer diagnosis (National Institute for Health and Clinical Excellence, 2004). This pilot study evaluated a three-day training program combined with supervision sessions from Clinical Psychologists that focused on developing skills in psychological assessment and intervention for common problems experienced by people with cancer. Questionnaires were developed to measure participants' levels of confidence in 15 competencies of psychological skills. Participants completed these prior to the program and on completion of the program. Summative evaluation was undertaken and results were compared. In addition, a focus group interview provided qualitative data of participants' experiences of the structure, process, and outcomes of the program. Following the program, participants rated their confidence in psychological assessment and skills associated with providing psychological support as having increased in all areas. This included improved knowledge of psychological theories, skills in assessment and intervention and accessing and using supervision appropriately. The largest increase was in providing psycho-education to support the coping strategies of patients and carers. Thematic analysis of interview data identified two main themes including learning experiences and program enhancements. The significance of the clinical supervision sessions as key learning opportunities, achieved through the development of a community of practice, emerged. Although this pilot study has limitations, the results suggest that a combined teaching and supervision program is effective in improving Clinical Nurse Specialists' confidence level in specific psychological skills. Participants' experiences highlighted suggestions for refinement and development of the program. Opportunities for further research and developments in this area are discussed.

A change roadmap towards research paradigm in low-resource countries: retinoblastoma model in Egypt.

PubMed

Alfaar, Ahmad Samir; Nour, Radwa; Bakry, Mohamed Sabry; Kamal, Mohamed; Hassanain, Omneya; Labib, Rania M; Rashed, Wafaa M; Elzomor, Hossam; Alieldin, Adel; Taha, Hala; Zaghloul, Mohamed Saad; Ezzat, Sameera; AboElnaga, Sherif

2017-02-01

Research on childhood diseases represents a great global challenge. This challenge is maximized in both childhood cancer disciplines and developing world. In this paper, we aim at describing our institution experience in starting a structured childhood cancer research program in one of the developing countries in a short time based on philanthropic efforts. We used retinoblastoma as an example for what was conducted in this program. Starting in 2008, this program included improving clinical practice and its related supporting services besides developing new research services that both complement the clinical activities and pave the way towards creating a research foundation in the country. Results included developing hospital standard treatment protocols, developing national clinical trials, joining international consortia for childhood cancers clinical trials, developing data collection tools and real-time analytics, establishing a biobanking facility, and developing highly qualified team for conducting clinical, epidemiologic, and translational research studies. Moreover, this effort resulted in improving both clinical practice and patients' awareness nationally. This model can be used for other startup facilities that aim at finding answers for their national health problems in low-resource setting.

Shyness Clinic: A Social Development Program for Adolescents and Young Adults.

ERIC Educational Resources Information Center

Barrow, John; Hayashi, Judy

1980-01-01

Shyness clinic groups were offered in a university counseling center. The program focused on anxiety management, assertiveness in social relationships, and development of conversational skills. Participants improved in social skills and ability to manage anxiety. (Author)

The Evaluation of a Clinical Development Unit Leadership Preparation Program by Focus Group Interviews--Part I: Positive Aspects. Part II: Negative Aspects.

ERIC Educational Resources Information Center

Greenwood, Jennifer; Parsons, Myra

2002-01-01

Focus group evaluations of a training program for nurses leading clinical development units focused on research-based practice found that leadership and strategic skills were developed. However, participants had insufficient time to assimilate knowledge or develop mentoring relationships and needed more help developing research-receptive culture…

Emerging Roles for Pharmacists in Clinical Implementation of Pharmacogenomics

PubMed Central

Owusu-Obeng, Aniwaa; Weitzel, Kristin W.; Hatton, Randy C.; Staley, Benjamin J.; Ashton, Jennifer; Cooper-Dehoff, Rhonda M.; Johnson, Julie A.

2014-01-01

Pharmacists are uniquely qualified to play essential roles in the clinical implementation of pharmacogenomics. However, specific responsibilities and resources needed for these roles have not been defined. We describe roles for pharmacists that emerged in the clinical implementation of genotype-guided clopidogrel therapy in the University of Florida Health Personalized Medicine Program, summarize preliminary program results, and discuss education, training, and resources needed to support such programs. Planning for University of Florida Health Personalized Medicine Program began in summer 2011 under leadership of a pharmacist, with clinical launch in June 2012 of a clopidogrel-CYP2C19 pilot project aimed at tailoring antiplatelet therapies for patients undergoing percutaneous coronary intervention and stent placement. More than 1000 patients were genotyped in the pilot project in year 1. Essential pharmacist roles and responsibilities that developed and/or emerged required expertise in pharmacy informatics (development of clinical decision support in the electronic medical record), medication safety, medication-use policies and processes, development of group and individual educational strategies, literature analysis, drug information, database management, patient care in targeted areas, logistical issues in genetic testing and follow-up, research and ethical issues, and clinical precepting. In the first 2 years of the program (1 year planning and 1 year postimplementation), a total of 14 different pharmacists were directly and indirectly involved, with effort levels ranging from a few hours per month, to 25–30% effort for the director and associate director, to nearly full-time for residents. Clinical pharmacists are well positioned to implement clinical pharmacogenomics programs, with expertise in pharmacokinetics, pharmacogenomics, informatics, and patient care. Education, training, and practice-based resources are needed to support these roles and to facilitate the development of financially sustainable pharmacist-led clinical pharmacogenomics practice models. PMID:25220280

Evaluating an australian emergency nurse practitioner candidate training program.

PubMed

Plath, Sharyn J; Wright, Mary; Hocking, Julia

2017-11-01

Nurse Practitioners (NPs) receive core clinical training at master's level, with their employer providing the opportunity to upskill in clinical and procedural competencies. It is increasingly recognised that this generic education requires supplementary training for operating effectively within a specific clinical environment. In this paper we describe a pilot program designed to train Australian NP Candidates to work effectively within the Emergency Department Fast Track model of care. The training program consisted of a 12-month period: four hours in-house training per week over two semesters, running concurrently with the NP candidate's University semesters, and 3 months' clinical practice to consolidate. The training team defined milestones for Semesters one and two, and developed a case review form to assess application of the candidate's knowledge in new clinical situations, as well as check for gaps in understanding. A clinical skills guide was developed for the candidate to work toward, and a comprehensive assessment was carried out at two time points in the training program. Feedback was obtained from the mentors and the candidate at the end point of the training program, and has been used to refine the program for 2017. This in-house training program provided specialised, evidence-based training for the emergency department environment, resulting in development of the nurse practitioner candidate as a high functioning team member. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

Clinical veterinary education: insights from faculty and strategies for professional development in clinical teaching.

PubMed

Lane, India F; Strand, Elizabeth

2008-01-01

Missing in the recent calls for accountability and assurance of veterinary students' clinical competence are similar calls for competence in clinical teaching. Most clinician educators have no formal training in teaching theory or method. At the University of Tennessee College of Veterinary Medicine (UTCVM), we have initiated multiple strategies to enhance the quality of teaching in our curriculum and in clinical settings. An interview study of veterinary faculty was completed to investigate the strengths and weaknesses of clinical education; findings were used in part to prepare a professional development program in clinical teaching. Centered on principles of effective feedback, the program prepares participants to organize clinical rotation structure and orientation, maximize teaching moments, improve teaching and participation during formal rounds, and provide clearer summative feedback to students at the end of a rotation. The program benefits from being situated within a larger college-wide focus on teaching improvement. We expect the program's audience and scope to continue to expand.

Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

PubMed

Cohen, Benita E; Gregory, David

2009-01-01

Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

Challenges in Measuring Benefit of Clinical Research Training Programs--the ASH Clinical Research Training Institute Example.

PubMed

Sung, Lillian; Crowther, Mark; Byrd, John; Gitlin, Scott D; Basso, Joe; Burns, Linda

2015-12-01

The American Society of Hematology developed the Clinical Research Training Institute (CRTI) to address the lack of training in patient-oriented research among hematologists. As the program continues, we need to consider metrics for measuring the benefits of such a training program. This article addresses the benefits of clinical research training programs. The fundamental and key components are education and mentorship. However, there are several other benefits including promotion of collaboration, job and advancement opportunities, and promotion of work-life balance. The benefits of clinical research training programs need to be measured so that funders and society can judge if they are worth the investment in time and resources. Identification of elements that are important to program benefit is essential to measuring the benefit of the program as well as program planning. Future work should focus on the constructs which contribute to benefits of clinical research training programs such as CRTI.

Competency-Based Assessment for Clinical Supervisors: Design-Based Research on a Web-Delivered Program

PubMed Central

Williams, Lauren Therese; Grealish, Laurie; Jamieson, Maggie

2015-01-01

Background Clinicians need to be supported by universities to use credible and defensible assessment practices during student placements. Web-based delivery of clinical education in student assessment offers professional development regardless of the geographical location of placement sites. Objective This paper explores the potential for a video-based constructivist Web-based program to support site supervisors in their assessments of student dietitians during clinical placements. Methods This project was undertaken as design-based research in two stages. Stage 1 describes the research consultation, development of the prototype, and formative feedback. In Stage 2, the program was pilot-tested and evaluated by a purposeful sample of nine clinical supervisors. Data generated as a result of user participation during the pilot test is reported. Users’ experiences with the program were also explored via interviews (six in a focus group and three individually). The interviews were transcribed verbatim and thematic analysis conducted from a pedagogical perspective using van Manen’s highlighting approach. Results This research succeeded in developing a Web-based program, “Feed our Future”, that increased supervisors’ confidence with their competency-based assessments of students on clinical placements. Three pedagogical themes emerged: constructivist design supports transformative Web-based learning; videos make abstract concepts tangible; and accessibility, usability, and pedagogy are interdependent. Conclusions Web-based programs, such as Feed our Future, offer a viable means for universities to support clinical supervisors in their assessment practices during clinical placements. A design-based research approach offers a practical process for such Web-based tool development, highlighting pedagogical barriers for planning purposes. PMID:25803172

Work Experience Program at a Metropolitan Paediatric Hospital: Assisting Rural and Metropolitan Allied Health Professionals Exchange Clinical Skills.

ERIC Educational Resources Information Center

Parkin, Ann E.; McMahon, Sandra; Upfield, Nancy; Copley, Jodie; Hollands, Karen

2001-01-01

A clinical experience program provided 29 rural Australian allied health professionals with experience in pediatric clinical areas and opportunities to share clinical knowledge and develop networks with metropolitan peers. Questionnaires and focus groups indicated that networking, clinical skills, knowledge, confidence, and awareness of rural…

Financial management challenges for general hospital psychiatry 2001.

PubMed

Goldberg, R J

2001-01-01

Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability.

Improving clinical and translational research training: a qualitative evaluation of the Atlanta Clinical and Translational Science Institute KL2-mentored research scholars program

PubMed Central

Comeau, Dawn L; Escoffery, Cam; Freedman, Ariela; Ziegler, Thomas R; Blumberg, Henry M

2017-01-01

A major impediment to improving the health of communities is the lack of qualified clinical and translational research (CTR) investigators. To address this workforce shortage, the National Institutes of Health (NIH) developed mechanisms to enhance the career development of CTR physician, PhD, and other doctoral junior faculty scientists including the CTR-focused K12 program and, subsequently, the KL2-mentored CTR career development program supported through the Clinical and Translational Science Awards (CTSAs). Our evaluation explores the impact of the K12/KL2 program embedded within the Atlanta Clinical and Translational Science Institute (ACTSI), a consortium linking Emory University, Morehouse School of Medicine and the Georgia Institute of Technology. We conducted qualitative interviews with program participants to evaluate the impact of the program on career development and collected data on traditional metrics (number of grants, publications). 46 combined K12/KL2 scholars were supported between 2002 and 2016. 30 (65%) of the 46 K12/KL2 scholars are women; 24 (52%) of the trainees are minorities, including 10 (22%) scholars who are members of an underrepresented minority group. Scholars reported increased research skills, strong mentorship experiences, and positive impact on their career trajectory. Among the 43 scholars who have completed the program, 39 (91%) remain engaged in CTR and received over $89 000 000 as principal investigators on federally funded awards. The K12/KL2 funding provided the training and protected time for successful career development of CTR scientists. These data highlight the need for continued support for CTR training programs for junior faculty. PMID:27591319

Success of a Faculty Development Program for Teachers at the Mayo Clinic

PubMed Central

Lee, Staci M.; Lee, Mark C.; Reed, Darcy A.; Halvorsen, Andrew J.; Berbari, Elie F.; McDonald, Furman S.; Beckman, Thomas J.

2014-01-01

Background There has been limited research on the improvement of underperforming clinical teachers. Objective To determine whether a faculty development program could improve the evaluations of clinical teachers in an internal medicine residency program. Methods A total of 123 teachers completed faculty development at the Mayo Clinic from 2009 to 2012. The faculty enhancement and education development program (FEED) consists of 6 interactive, small group, 2-hour sessions taught by experienced Mayo Clinic faculty over 1 year. These sessions address the following competencies: asking questions, diagnosing learners, giving feedback, using teaching frameworks, recognizing learning styles, and providing clinical supervision. Resident-of-faculty Mayo teaching effectiveness (MTE) scores have previously demonstrated content, internal structure, and criterion validity. Teachers were grouped into the top 80% or the bottom 20%, according to baseline MTE scores. Mixed linear models were used to compare these groups regarding changes in MTE scores after completion of FEED. Results were adjusted for teacher age, sex, medical specialty, academic rank, and teaching awards. Results For all participants combined, the adjusted MTE scores (mean; standard error) improved from baseline (3.80; 0.04) to completion of FEED (3.93; 0.04; P < .001). However, the bottom 20% had a significantly greater improvement in scores than the top 80% (score-change difference  =  0.166, P < .001). Conclusions We describe a low-intensity faculty development intervention that benefited all clinical teachers, but was particularly effective for underperforming teachers in internal medicine. The approach may be suitable for adoption or adaptation in other graduate medical education programs. PMID:26140122

Development, implementation and evaluation of a clinical research engagement and leadership capacity building program in a large Australian health care service.

PubMed

Misso, Marie L; Ilic, Dragan; Haines, Terry P; Hutchinson, Alison M; East, Christine E; Teede, Helena J

2016-01-14

Health professionals need to be integrated more effectively in clinical research to ensure that research addresses clinical needs and provides practical solutions at the coal face of care. In light of limited evidence on how best to achieve this, evaluation of strategies to introduce, adapt and sustain evidence-based practices across different populations and settings is required. This project aims to address this gap through the co-design, development, implementation, evaluation, refinement and ultimately scale-up of a clinical research engagement and leadership capacity building program in a clinical setting with little to no co-ordinated approach to clinical research engagement and education. The protocol is based on principles of research capacity building and on a six-step framework, which have previously led to successful implementation and long-term sustainability. A mixed methods study design will be used. Methods will include: (1) a review of the literature about strategies that engage health professionals in research through capacity building and/or education in research methods; (2) a review of existing local research education and support elements; (3) a needs assessment in the local clinical setting, including an online cross-sectional survey and semi-structured interviews; (4) co-design and development of an educational and support program; (5) implementation of the program in the clinical environment; and (6) pre- and post-implementation evaluation and ultimately program scale-up. The evaluation focuses on research activity and knowledge, attitudes and preferences about clinical research, evidence-based practice and leadership and post implementation, about their satisfaction with the program. The investigators will evaluate the feasibility and effect of the program according to capacity building measures and will revise where appropriate prior to scale-up. It is anticipated that this clinical research engagement and leadership capacity building program will enable and enhance clinically relevant research to be led and conducted by health professionals in the health setting. This approach will also encourage identification of areas of clinical uncertainty and need that can be addressed through clinical research within the health setting.

Developing a Peer Mentorship Program to Increase Competence in Clinical Supervision in Clinical Psychology Doctoral Training Programs.

PubMed

Foxwell, Aleksandra A; Kennard, Beth D; Rodgers, Cynthia; Wolfe, Kristin L; Cassedy, Hannah F; Thomas, Anna

2017-12-01

Supervision has recently been recognized as a core competency for clinical psychologists. This recognition of supervision as a distinct competency has evolved in the context of an overall focus on competency-based education and training in health service psychology, and has recently gained momentum. Few clinical psychology doctoral programs offer formal training experiences in providing supervision. A pilot peer mentorship program (PMP) where graduate students were trained in the knowledge and practice of supervision was developed. The focus of the PMP was to develop basic supervision skills in advanced clinical psychology graduate students, as well as to train junior doctoral students in fundamental clinical and practical skills. Advanced doctoral students were matched to junior doctoral students to gain experience in and increase knowledge base in best practices of supervision skills. The 9-month program consisted of monthly mentorship meetings and three training sessions. The results suggested that mentors reported a 30% or more shift from the category of not competent to needs improvement or competent, in the following supervision competencies: theories of supervision, improved skill in supervision modalities, acquired knowledge in supervision, and supervision experience. Furthermore, 50% of the mentors reported that they were not competent in supervision experience at baseline and only 10% reported that they were not competent at the end of the program. Satisfaction data suggested that satisfaction with the program was high, with 75% of participants indicating increased knowledge base in supervision, and 90% indicating that it was a positive addition to their training program. This program was feasible and acceptable and appears to have had a positive impact on the graduate students who participated. Students reported both high satisfaction with the program as well as an increase in knowledge base and experience in supervision skills.

New Round of Studies Begin in Phase 0/I/II Cancer Prevention Clinical Trials Program | Division of Cancer Prevention

Cancer.gov

The NCI Division of Cancer Prevention’s Phase 0/I/II Cancer Prevention Clinical Trials Program, also known as the Consortia for Early Phase Prevention Trials, is beginning a new round of studies in the effort toward systematic early clinical development of promising preventive agents for people at increased risk of developing cancer. |

Keeping Clinicians in Clinical Research: The Clinical Research/Reproductive Scientist Training Program

PubMed Central

Armstrong, Alicia Y.; DeCherney, Alan; Leppert, Phyllis; Rebar, Robert; Maddox, Yvonne T.

2009-01-01

In recent years the need for translational and clinical research has increased while the number of physicians involved in clinical research has diminished. There is clearly a need for formalized academic training in the quantitative and methodological principles of clinical research in reproductive medicine. The Clinical Research/Reproductive Scientist Training Program (CREST), a program supported by the National Institute of Child Health and Human Development, the Clinical Research Training Program (CRTP) at Duke University, and the American Society for Reproductive Medicine,(ASRM) meets this existing need. In addition, this program is specifically designed for physicians in private or academic clinical practice in reproductive medicine. Innovative programs such as CREST encourage the practicing physician to engage in clinical research while maintaining an active role in clinical practice. Participants in the program receive didactic on-line training from the CRTP, attend intensive weekend seminars at the National Institutes of Health (NIH) and CREST seminars at the annual meeting of ASRM. Successful participants in the program receive a Certificate in Clinical Research from the CRTP. The program’s goal is to provide practicing physicians with the tools and research credentials that will facilitate collaborations with investigators involved in large clinical trials. PMID:19144332

Design and implementation of population-based specialty care programs.

PubMed

Botts, Sheila R; Gee, Michael T; Chang, Christopher C; Young, Iris; Saito, Logan; Lyman, Alfred E

2017-09-15

The development, implementation, and scaling of 3 population-based specialty care programs in a large integrated healthcare system are reviewed, and the role of clinical pharmacy services in ensuring safe, effective, and affordable care is highlighted. The Kaiser Permanente (KP) integrated healthcare delivery model allows for rapid development and expansion of innovative population management programs involving pharmacy services. Clinical pharmacists have assumed integral roles in improving the safety and effectiveness of high-complexity, high-cost care for specialty populations. These roles require an appropriate practice scope and are supported by an advanced electronic health record with disease registries and electronic surveillance tools for care-gap identification. The 3 specialty population programs described were implemented to address variation or unrecognized gaps in care for at-risk specialty populations. The Home Phototherapy Program has leveraged internal partnerships with clinical pharmacists to improve access to cost-effective nonpharmacologic interventions for psoriasis and other skin disorders. The Multiple Sclerosis Care Program has incorporated clinical pharmacists into neurology care in order to apply clinical guidelines in a systematic manner. The KP SureNet program has used clinical pharmacists and data analytics to identify opportunities to prevent drug-related adverse outcomes and ensure timely follow-up. Specialty care programs improve quality, cost outcomes, and the patient experience by appropriating resources to provide systematic and targeted care to high-risk patients. KP leverages an integration of people, processes, and technology to develop and scale population-based specialty care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Combining a clinical ladder and performance appraisal system as a reward strategy: the EXCEL clinical ladder program.

PubMed

Moe, J K; Lonowski, L R; Yancer, D A

1994-09-01

In response to the dramatic changes occurring in health care today and a desire to reward professional nurses for clinical behaviors that would be valued in the future, Bergan Mercy Medical Center (BMMC) has developed an innovative clinical ladder/performance appraisal system. The BMMC EXCEL Clinical Ladder program, which is based on the developmental model of Patricia Benner, is a competency-based system that uniquely combines a clinical ladder and performance appraisal system. The program is clinically focused and contains optional components in which registered nurses (RNs) can receive additional credit for participation in professional growth and leadership activities. Nurses document examples of their practice through nursing narratives that describe actual clinical situations. The development and implementation processes, challenges encountered, and recommendations for alternative approaches to the implementation of such a unique system are discussed.

[Development of clinical trial education program for pharmaceutical science students through small group discussion and role-playing using protocol].

PubMed

Imakyure, Osamu; Shuto, Hideki; Nishikawa, Fumi; Hagiwara, Yoshifuka; Inoue, Sachiko; Koyanagi, Taeko; Hirakawa, Masaaki; Kataoka, Yasufumi

2010-08-01

The acquirement of basic knowledge of clinical trials and professional attitude in their practices is a general instructional objective in the Model Core Curriculum for Pharmaceutical Education. Unfortunately, the previous program of clinical trial education was not effective in the acquirement of a professional attitude in their practices. Then, we developed the new clinical trial education program using protocol through small group discussion (SGD) and roll-playing. Our program consists of 7 steps of practical training. In step 1, the students find some problems after presentation of the protocol including case and prescription. In step 2, they analyse the extracted problems and share the information obtained in SGD. In steps 3 and 5, five clinical case scenarios are presented to the students and they discuss which case is suitable for entry to the clinical trial or which case corresponds to the discontinuance criteria in the present designed protocol. In steps 4 and 6, the roll-playing is performed by teachers and students as doctors and clinical research coordinators (CRC) respectively. Further, we conducted a trial practice based on this program for the students. In the student's self-evaluation into five grades, the average score of the skill acquisition level in each step was 3.8-4.7 grade. Our clinical trial education program could be effective in educating the candidates for CRC or clinical pharmacists.

A Paradigm Shift toward Evidence-Based Clinical Practice: Developing a Performance Assessment

ERIC Educational Resources Information Center

Wentworth, Nancy; Erickson, Lynnette B.; Lawrence, Barbara; Popham, J. Aaron; Korth, Byran

2009-01-01

The Clinical Practice Assessment System (CPAS), developed in response to teacher preparation program accreditation requirements, represents a paradigm shift of one university toward data-based decision-making in teacher education programs. The new assessment system is a scale aligned with INTASC Standards, which allows for observation and…

Understanding the scholarly writing development of nurses enrolled in U.S. clinical doctoral programs.

PubMed

Shellenbarger, Teresa; Hunker, Diane F; Gazza, Elizabeth A

2015-01-01

Faculty teaching nurses enrolled in clinical doctoral programs need to understand the process of student scholarly writing development so that students can be prepared to share knowledge and communicate effectively in scholarly formats. A hermeneutic phenomenological study that sought to understand the scholarly writing development of nurses enrolled in a clinical doctoral program was conducted. Findings from interviews with six Doctor of Nursing Practice students revealed three themes: learning throughout life, influence of emotions, and getting through the gate. Based upon these findings, recommendations for further development of doctoral student writing are suggested so that students can disseminate their knowledge in a scholarly manner, improve practice, and contribute to the profession. © 2014 Wiley Periodicals, Inc.

Second language learning in a family nurse practitioner and nurse midwifery diversity education project.

PubMed

Kelley, Frances J; Klopf, Maria Ignacia

2008-10-01

To describe the Clinical Communication Program developed to integrate second language learning (L2), multimedia, Web-based technologies, and the Internet in an advanced practice nursing education program. Electronic recording devices as well as audio, video editing, Web design, and programming software were used as tools for developing L2 scenarios for practice in clinical settings. The Clinical Communication Program offers opportunities to support both students and faculty members to develop their linguistic and cultural competence skills to serve better their patients, in general, and their students who speak a language other than English, in particular. The program provided 24 h on-demand access for using audio, video, and text exercises via the Internet. L2 education for healthcare providers includes linguistic (listening, speaking, reading, and writing) experiences as well as cultural competence and practices inside and outside the classroom environment as well as online and offline the Internet realm.

Introduction to a Special Issue of the Journal of Immunological Methods: Building global resource programs to support HIV/AIDS clinical trial studies.

PubMed

Sanchez, Ana M; Denny, Thomas N; O'Gorman, Maurice

2014-07-01

This Special Issue of the Journal of Immunological Methods includes 16 manuscripts describing quality assurance activities related to virologic and immunologic monitoring of six global laboratory resource programs that support international HIV/AIDS clinical trial studies: Collaboration for AIDS Vaccine Discovery (CAVD); Center for HIV/AIDS Vaccine Immunology (CHAVI); External Quality Assurance Program Oversight Laboratory (EQAPOL); HIV Vaccine Trial Network (HVTN); International AIDS Vaccine Initiative (IAVI); and Immunology Quality Assessment (IQA). The reports from these programs address the many components required to develop comprehensive quality control activities and subsequent quality assurance programs for immune monitoring in global clinical trials including: all aspects of processing, storing, and quality assessment of PBMC preparations used ubiquitously in HIV clinical trials, the development and optimization of assays for CD8 HIV responses and HIV neutralization, a comprehensive global HIV virus repository, and reports on the development and execution of novel external proficiency testing programs for immunophenotyping, intracellular cytokine staining, ELISPOT and luminex based cytokine measurements. In addition, there are articles describing the implementation of Good Clinical Laboratory Practices (GCLP) in a large quality assurance laboratory, the development of statistical methods specific for external proficiency testing assessment, a discussion on the ability to set objective thresholds for measuring rare events by flow cytometry, and finally, a manuscript which addresses a framework for the structured reporting of T cell immune function based assays. It is anticipated that this series of manuscripts covering a wide range of quality assurance activities associated with the conduct of global clinical trials will provide a resource for individuals and programs involved in improving the harmonization, standardization, accuracy, and sensitivity of virologic and immunologic testing. Copyright © 2014 Elsevier B.V. All rights reserved.

The Influence of the Art of Clinical Supervision Program on Nurses' Knowledge and Attitude About Working With Students.

PubMed

Russell, Kylie; Alliex, Selma; Gluyas, Heather

The Art of Clinical Supervision program was developed, implemented, and evaluated to determine nursing staff knowledge of and attitudes toward nursing students and the clinical supervision thereof. A key point of the program was the inclusion of strategies to promote one's attitude toward working with students. A mixed methods approach of surveys, online reflections, and interviews was used to determine the program's effect. The findings highlighted a positive impact on participants' self-knowledge and attitudes toward students and student clinical supervision.

State-of-the-science of patient navigation as a strategy for enhancing minority clinical trial accrual.

PubMed

Ghebre, Rahel G; Jones, Lovell A; Wenzel, Jennifer A; Martin, Michelle Y; Durant, Raegan W; Ford, Jean G

2014-04-01

Patient navigation programs are emerging that aim to address disparities in clinical trial participation among medically underserved populations, including racial/ethnic minorities. However, there is a lack of consensus on the role of patient navigators within the clinical trial process as well as outcome measures to evaluate program effectiveness. A review of the literature was conducted of PubMed, Medline, CINHAL, and other sources to identify qualitative and quantitative studies on patient navigation in clinical trials. The search yielded 212 studies, of which only 12 were eligible for this review. The eligible studies reported on the development of programs for patient navigation in cancer clinical trials, including training and implementation among African Americans, American Indians, and Native Hawaiians. A low rate of clinical trial refusal (range, 4%-6%) was reported among patients enrolled in patient navigation programs. However, few studies reported on the efficacy of patient navigation in increasing clinical treatment trial enrollment. Outcome measures are proposed to assist in developing and evaluating the efficacy and/or effectiveness of patient navigation programs that aim to increase participation in cancer clinical trials. Future research is needed to evaluate the efficacy of patient navigators in addressing barriers to clinical trial participation and increasing enrollment among medically underserved cancer patients. © 2014 American Cancer Society.

State-of-the-Science of Patient Navigation as a Strategy for Enhancing Minority Clinical Trial Accrual

PubMed Central

Ghebre, Rahel G.; Jones, Lovell A.; Wenzel, Jennifer; Martin, Michelle Y.; Durant, Raegan; Ford, Jean G.

2014-01-01

Background Patient navigation programs are emerging, that aim to address disparities in clinical trial participation among medically underserved populations, including racial/ethnic minorities. However, there is a lack of consensus on the role of patient navigators within the clinical trial process, as well as outcome measures to evaluate program effectiveness. Methods A review of the literature was conducted of PubMed, Medline, CINHAL, and other sources to identify qualitative and quantitative studies on patient navigation in clinical trials. The search yielded 212 studies, of which only 12 were eligible for this review. Results The eligible studies reported on development of programs for patient navigation in cancer clinical trials, including training and implementation among African American, American Indian and Native Hawaiians. Low clinical trial refusal, 4% to 6%, was reported among patients enrolled in patient navigation program. However, few studies reported on the efficacy of patient navigation on increasing clinical treatment trial enrollment. Conclusion Outcome measures are proposed to assist in developing and evaluating the efficacy and/or effectiveness of patient navigation programs that aim to increase participation in cancer clinical trials. Future research is needed to evaluate the efficacy of patient navigators in addressing barriers to clinical trial participation and increasing enrollment among medically underserved cancer patients. PMID:24643650

Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

PubMed Central

Lin, Chia-Der; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh; Lee, Cheng-Chun

2015-01-01

Introduction Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements. Methods A redesigned clinical mentoring program was launched in a medical center according to previous theoretical and practical studies on clinical training workplaces, including the elements of mentor qualifications, positive and active enhancers for mentor–mentee relationship building, the timing of mentoring performance evaluation, and financial and professional incentives. A four-wave web survey was conducted, comprising one evaluation of the former mentoring program and three evaluations of the redesigned clinical mentoring program. Sixty-four fifth-year medical students in clerkships who responded to the first wave and to at least two of the three following waves were included in the study. A structured and validated questionnaire encompassing 15 items on mentor performance and the personal characteristics of the clerks was used. Mixed linear models were developed for repeated measurements and to adjust for personal characteristics. Results The results revealed that the redesigned mentoring program improved the mentors’ performance over time for most evaluated items regarding professional development and personal support provided to the mentees. Conclusions Our findings serve as an improved framework for the role of the institution and demonstrate how institutional policies, programs, and structures can shape a clinical mentoring program. We recommend the adoption of mentorship schemes for other cohorts of medical students and for different learning and training stages involved in becoming a physician. PMID:26384479

[The use of systematic review to develop a self-management program for CKD].

PubMed

Lee, Yu-Chin; Wu, Shu-Fang Vivienne; Lee, Mei-Chen; Chen, Fu-An; Yao, Yen-Hong; Wang, Chin-Ling

2014-12-01

Chronic kidney disease (CKD) has become a public health issue of international concern due to its high prevalence. The concept of self-management has been comprehensively applied in education programs that address chronic diseases. In recent years, many studies have used self-management programs in CKD interventions and have investigated the pre- and post-intervention physiological and psychological effectiveness of this approach. However, a complete clinical application program in the self-management model has yet to be developed for use in clinical renal care settings. A systematic review is used to develop a self-management program for CKD. Three implementation steps were used in this study. These steps include: (1) A systematic literature search and review using databases including CEPS (Chinese Electronic Periodical Services) of Airiti, National Digital Library of Theses and Dissertations in Taiwan, CINAHL, Pubmed, Medline, Cochrane Library, and Joanna Briggs Institute. A total of 22 studies were identified as valid and submitted to rigorous analysis. Of these, 4 were systematic literature reviews, 10 were randomized experimental studies, and 8 were non-randomized experimental studies. (2) Empirical evidence then was used to draft relevant guidelines on clinical application. (3) Finally, expert panels tested the validity of the draft to ensure the final version was valid for application in practice. This study designed a self-management program for CKD based on the findings of empirical studies. The content of this program included: design principles, categories, elements, and the intervention measures used in the self-management program. This program and then was assessed using the content validity index (CVI) and a four-point Liker's scale. The content validity score was .98. The guideline of self-management program to CKD was thus developed. This study developed a self-management program applicable to local care of CKD. It is hoped that the guidelines developed in this study offer a reference for clinical caregivers to improve their healthcare practices.

Effective Strategies for Global Health Research, Training and Clinical Care: A Narrative Review

PubMed Central

Walker, Rebekah J.; Campbell, Jennifer A.; Egede, Leonard E.

2015-01-01

The purpose of this narrative review was to synthesize the evidence on effective strategies for global health research, training and clinical care in order to identify common structures that have been used to guide program development. A Medline search from 2001 to 2011 produced 951 articles, which were reviewed and categorized. Thirty articles met criteria to be included in this review. Eleven articles discussed recommendations for research, 8 discussed training and 11 discussed clinical care. Global health program development should be completed within the framework of a larger institutional commitment or partnership. Support from leadership in the university or NGO, and an engaged local community are both integral to success and sustainability of efforts. It is also important for program development to engage local partners from the onset, jointly exploring issues and developing goals and objectives. Evaluation is a recommended way to determine if goals are being met, and should include considerations of sustainability, partnership building, and capacity. Global health research programs should consider details regarding the research process, context of research, partnerships, and community relationships. Training for global health should involve mentorship, pre-departure preparation of students, and elements developed to increase impact. Clinical care programs should focus on collaboration, sustainability, meeting local needs, and appropriate process considerations. PMID:25716404

The Role of Research in Advanced Dental Education.

ERIC Educational Resources Information Center

Profitt, William R.; Vig, Peter S.

1980-01-01

Even though research is an integral part of quality advanced dental programs, many dental departments with postdoctoral programs lack faculty and other resources for research productivity. Programs to produce clinical faculty with research training are called for through the development of clinical research centers. (JSR)

Animal Resource Program | Center for Cancer Research

Cancer.gov

CCR Animal Resource Program The CCR Animal Resource Program plans, develops, and coordinates laboratory animal resources for CCR’s research programs. We also provide training, imaging, and technology development in support of moving basic discoveries to the clinic. The ARP Office:

Animal Resource Program | Center for Cancer Research

Cancer.gov

CCR Animal Resource Program The CCR Animal Resource Program plans, develops, and coordinates laboratory animal resources for CCR’s research programs. We also provide training, imaging, and technology development in support of moving basic discoveries to the clinic. The ARP Manager:

Clinical Investigator Development Program | Center for Cancer Research

Cancer.gov

The Center for Cancer Research (CCR), a division of the National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), is pleased to announce its annual call for applications for the Clinical Investigator Development Program (CIDP). This is an exciting training opportunity intended for physicians interested in dedicating

Biomedical research, development, and engineering at the Johns Hopkins University Applied Physics Laboratory. Annual report 1 October 1978-30 September 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The Medical Institutions of The Johns Hopkins University and The Johns Hopkins University Applied Physics Laboratory have developed a vigorous collaborative program of biomedical research, development, and systems engineering. An important objective of the program is to apply the expertise in engineering, the physical sciences, and systems analysis acquired by APL in defense and space research and development to problems of medical research and health care delivery. This program has grown to include collaboration with many of the clinical and basic science departments of the medical divisions. Active collaborative projects exist in ophthalmology, neurosensory research and instrumentation development, cardiovascular systems,more » patient monitoring, therapeutic and rehabilitation systems, clinical information systems, and clinical engineering. This application of state-of-the-art technology has contributed to advances in many areas of basic medical research and in clinical diagnosis and therapy through improvement of instrumentation, techniques, and basic understanding.« less

Clinical ladder program implementation: a project guide.

PubMed

Ko, Yu Kyung; Yu, Soyoung

2014-11-01

This article describes the development of a clinical ladder program (CLP) implementation linked to a promotion system for nurses. The CLP task force developed criteria for each level of performance and a performance evaluation tool reflecting the self-motivation of the applicant for professional development. One year after implementation, the number of nurses taking graduate courses increased, and 7 nurses were promoted to nurse manager positions.

A Master of Science Degree in (Clinical) Pharmacology at the University of the Pacific

ERIC Educational Resources Information Center

Shirachi, Donald Y.; Jones, Judith K.

1976-01-01

A prototype program leading to a clinically-oriented Master of Science degree in pharmacology is described. It differs from a clinical residency program, does not give a wide clinical medicine exposure, and is heavily oriented towards pharmacology and research, thereby developing students with scientific perspectives who can work as consultants.…

Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

PubMed

Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda

2016-01-01

The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

Impact of computer-based treatment planning software on clinical judgment of dental students for planning prosthodontic rehabilitation

PubMed Central

Deshpande, Saee; Chahande, Jayashree

2014-01-01

Purpose Successful prosthodontic rehabilitation involves making many interrelated clinical decisions which have an impact on each other. Self-directed computer-based training has been shown to be a very useful tool to develop synthetic and analytical problem-solving skills among students. Thus, a computer-based case study and treatment planning (CSTP) software program was developed which would allow students to work through the process of comprehensive, multidisciplinary treatment planning for patients in a structured and logical manner. The present study was aimed at assessing the effect of this CSTP software on the clinical judgment of dental students while planning prosthodontic rehabilitation and to assess the students’ perceptions about using the program for its intended use. Methods A CSTP software program was developed and validated. The impact of this program on the clinical decision making skills of dental graduates was evaluated by real life patient encounters, using a modified and validated mini-CEX. Students’ perceptions about the program were obtained by a pre-validated feedback questionnaire. Results The faculty assessment scores of clinical judgment improved significantly after the use of this program. The majority of students felt it was an informative, useful, and innovative way of learning and they strongly felt that they had learnt the logical progression of planning, the insight into decision making, and the need for flexibility in treatment planning after using this program. Conclusion CSTP software was well received by the students. There was significant improvement in students’ clinical judgment after using this program. It should thus be envisaged fundamentally as an adjunct to conventional teaching techniques to improve students’ decision making skills and confidence. PMID:25170288

Physician leadership development at Cleveland Clinic: a brief review.

PubMed

Christensen, Terri; Stoller, James K

2016-06-01

We aim to describe the rationale for and spectrum of leadership development programs, highlighting experience at a large healthcare institution (Cleveland Clinic, Cleveland, Ohio, USA). Developing leaders is a universal priority to sustain organizational success. In health care, significant challenges of ensuring quality and access and making care affordable are widely shared internationally and demand effective physician leadership. Yet, leadership competencies differ from clinical and scientific competencies and features of selecting and training physicians-who have been called "heroic lone healers" -often conspire against physicians being effective leaders or followers. Thus, developing leadership competencies in physicians is critical.Leadership development programs have been signature features of successful organizations and various Australian organizations offer such training (e.g. The Australian Leadership Foundation and the University of South Australia), but relatively few health care organizations have adopted the practice of offering such training, both in Australia and elsewhere. As a United States example of one such integrated program, the Cleveland Clinic, a large, closed-staff physician-led group practice in Cleveland, Ohio has offered physician leadership training for over 15 years. This paper describes the rationale, structure, and some of the observed impacts associated with this program. © The Royal Australian and New Zealand College of Psychiatrists 2016.

A Framework of Operating Models for Interdisciplinary Research Programs in Clinical Service Organizations

ERIC Educational Resources Information Center

King, Gillian; Currie, Melissa; Smith, Linda; Servais, Michelle; McDougall, Janette

2008-01-01

A framework of operating models for interdisciplinary research programs in clinical service organizations is presented, consisting of a "clinician-researcher" skill development model, a program evaluation model, a researcher-led knowledge generation model, and a knowledge conduit model. Together, these models comprise a tailored, collaborative…

Developing clinical leadership capability.

PubMed

Pintar, Kristi A; Capuano, Terry A; Rosser, Gwendolyn D

2007-01-01

Nursing facilities must be committed to ongoing leadership development and to developing and retaining their staff in the increasingly competitive healthcare market. In this article, the authors share the processes involved in creating a focused small group approach to developing clinical leaders. Programmatic approaches to development, clarity of needs of those targeted for development, individual development plans, external expertise partnerships, and small group session dynamics are discussed. Applications of the process and lessons learned from the program will benefit others in their efforts to enhance organization succession planning, leadership development, group learning, and program administration.

Understanding the challenges of integrating scientists and clinical teachers in psychiatry education: findings from an innovative faculty development program.

PubMed

Martimianakis, Maria Athina Tina; Hodges, Brian D; Wasylenki, Donald

2009-01-01

Medical schools and departments of psychiatry around the world face challenges in integrating science with clinical teaching. This project was designed to identify attitudes toward the integration of science in clinical teaching and address barriers to collaboration between scientists and clinical teachers. The authors explored the interactions of 20 faculty members (10 scientists and 10 clinical teachers) taking part in a 1-year structured faculty development program, based on a partnership model, designed to encourage collaborative interaction between scientists and clinical teachers. Data were collected before, during, and after the program using participant observations, surveys, participant diaries, and focus groups. Qualitative data were analyzed iteratively using the method of meaning condensation, and further informed with descriptive statistics generated from the pre- and postsurveys. Scientists and clinicians were strikingly unfamiliar with each other's worldviews, work experiences, professional expectations, and approaches to teaching. The partnership model appeared to influence integration at a social level, and led to the identification of departmental structural barriers that aggravate the divide between scientists and clinical teachers. Issues related to the integration of social scientists in particular emerged. Creating a formal program to encourage interaction of scientists and clinical teachers provided a forum for identifying some of the barriers associated with the collaboration of scientists and clinical teachers. Our data point to directions for organizational structures and faculty development that support the integration of scientists from a wide range of disciplines with their clinical faculty colleagues.

Effects of an experiential learning program on the clinical reasoning and critical thinking skills of occupational therapy students.

PubMed

Coker, Patty

2010-01-01

This study examined the effects of participation in a 1-week, experiential, hands-on learning program on the critical thinking and clinical reasoning skills of occupational therapy students. A quasi-experimental, nonrandomized pre- and post-test design was used with a sample of 25 students. The students had completed three semesters of didactic lecture coursework in a master's level OT educational program prior to participation in a hands-on therapy program for children with hemiplegic cerebral palsy. Changes in critical thinking and clinical reasoning skills were evaluated using the following dependent measures: Self-Assessment of Clinical Reflection and Reasoning (SACRR) and the California Critical Thinking Skills Test (CCTST). Changes in pretest and posttest scores on the SACRR and the CCTST were statistically significant (p>0.05) following completion of the experiential learning program. This study supports the use of hands-on learning to develop clinical reasoning and critical thinking skills in healthcare students, who face ever more diverse patient populations upon entry-level practice. Further qualitative and quantitative investigations are needed to support the results of this study and determine which components of experiential learning programs are essential for developing clinical reasoning and critical thinking skills in future allied health professionals.

Clinically speaking: A communication skills program for students from non-English speaking backgrounds.

PubMed

Miguel, Caroline San; Rogan, Fran; Kilstoff, Kathleen; Brown, Di

2006-09-01

This paper reports on the design, delivery and evaluation of an innovative oral communication skills program for first year students in a Bachelor of Nursing degree at an Australian university. This program was introduced in 2004 to meet the needs of first year undergraduate students from non-English speaking backgrounds who had experienced difficulties with spoken English while on clinical placement. The program consisted of early identification of students in need of communication development, a series of classes incorporated into the degree program to address students' needs, followed by a clinical placement block. This paper describes the structure of the program, discusses some of the major problems encountered by students in the clinical setting and presents some of the teaching strategies used to address these problems. Evaluations of the program suggest that students' communication skills and confidence improved, resulting in a more positive clinical experience for the majority of students.

Comparing oncology clinical programs by use of innovative designs and expected net present value optimization: Which adaptive approach leads to the best result?

PubMed

Parke, Tom; Marchenko, Olga; Anisimov, Vladimir; Ivanova, Anastasia; Jennison, Christopher; Perevozskaya, Inna; Song, Guochen

2017-01-01

Designing an oncology clinical program is more challenging than designing a single study. The standard approaches have been proven to be not very successful during the last decade; the failure rate of Phase 2 and Phase 3 trials in oncology remains high. Improving a development strategy by applying innovative statistical methods is one of the major objectives of a drug development process. The oncology sub-team on Adaptive Program under the Drug Information Association Adaptive Design Scientific Working Group (DIA ADSWG) evaluated hypothetical oncology programs with two competing treatments and published the work in the Therapeutic Innovation and Regulatory Science journal in January 2014. Five oncology development programs based on different Phase 2 designs, including adaptive designs and a standard two parallel arm Phase 3 design were simulated and compared in terms of the probability of clinical program success and expected net present value (eNPV). In this article, we consider eight Phase2/Phase3 development programs based on selected combinations of five Phase 2 study designs and three Phase 3 study designs. We again used the probability of program success and eNPV to compare simulated programs. For the development strategies, we considered that the eNPV showed robust improvement for each successive strategy, with the highest being for a three-arm response adaptive randomization design in Phase 2 and a group sequential design with 5 analyses in Phase 3.

Outcomes assessment of dental hygiene clinical teaching workshops.

PubMed

Wallace, Juanita S; Infante, Taline D

2008-10-01

Faculty development courses related to acquiring clinical teaching skills in the health professions are limited. Consequently, the Department of Dental Hygiene at the University of Texas Health Science Center at San Antonio conducted a series of clinical teaching workshops to address clinical teaching methodology. The goal of these workshops was to promote a problem-solving learning atmosphere for dental hygiene faculty to acquire and share sound clinical teaching strategies. To determine the value of the annual workshops on clinical teaching and evaluation, a web-based qualitative program assessment was developed using software by Survey Tracker. Four open-ended questions were designed to elicit perceptions regarding what significant changes in teaching strategies were achieved, what barriers or challenges were encountered in making these changes, and what strategies were used to overcome the barriers. The assessment was sent to dental hygiene educators representing thirty-eight dental hygiene programs who had participated in two or more of these workshops. Twenty-eight programs provided collective responses to the questions, and the narrative data were analyzed, using a qualitative methodology. Responses revealed that programs had made productive changes to their clinical education curricula and the information gained from the workshops had a positive effect on clinical teaching.

The feasibility, perceived satisfaction, and value of using synchronous webinars to educate clinical research professionals on reporting adverse events in clinical trials: a report from the Children's Oncology Group.

PubMed

Borgerson, Dawn; Dino, Jennifer

2012-01-01

Clinical research professionals are faced with decreased funding and increased workloads; innovative methods of professional development programs are necessary to accommodate these factors. This study evaluated the feasibility, perceived satisfaction, and value of using webinars to educate clinical research professionals on reporting adverse events commonly experienced in pediatric oncology clinical trials. The setting incorporated synchronous web-based educational technology. Constructivist learning provides the theoretical framework for this study. Participants evaluated the professional development program at 2 time points: (a) at the conclusion and (b) 4 to 6 weeks afterward, using survey method. Synchronous webinars were both economical and effective in educating clinical research professionals across institutional sites. Participants reported exceptionally high levels of satisfaction with the accessibility, scope, quality, and interactivity of the professional development program. The vast majority of participants reported that the education would assist with reporting adverse events in pediatric oncology clinical trials and this perception persisted into clinical practice. Although the results of this study were intended to guide future educational efforts of the Children's Oncology Group, they may also apply to other cooperative groups.

Development of an interprofessional program for cardiovascular prevention in primary care: A participatory research approach

PubMed Central

Goudreau, Johanne; Hudon, Éveline; Lussier, Marie-Thérèse; Bareil, Céline; Duhamel, Fabie; Lévesque, Lise; Turcotte, Alain; Lalonde, Gilles

2014-01-01

Background: The chronic care model provides a framework for improving the management of chronic diseases. Participatory research could be useful in developing a chronic care model–based program of interventions, but no one has as yet offered a description of precisely how to apply the approach. Objectives: An innovative, structured, multi-step participatory process was applied to select and develop (1) chronic care model–based interventions program to improve cardiovascular disease prevention that can be adapted to a particular regional context and (2) a set of indicators to monitor its implementation. Methods: Primary care clinicians (n = 16), administrative staff (n = 2), patients and family members (n = 4), decision makers (n = 5), researchers, and a research coordinator (n = 7) took part in the process. Additional primary care actors (n = 26) validated the program. Results: The program targets multimorbid patients at high or moderate risk of cardiovascular disease with uncontrolled hypertension, dyslipidemia or diabetes. It comprises interprofessional follow-up coordinated by case-management nurses, in which motivated patients are referred in a timely fashion to appropriate clinical and community resources. The program is supported by clinical tools and includes training in motivational interviewing. A set of 89 process and clinical indicators were defined. Conclusion: Through a participatory process, a contextualized interventions program to optimize cardiovascular disease prevention and a set of quality indicators to monitor its implementation were developed. Similar approach might be used to develop other health programs in primary care if program developers are open to building on community strengths and priorities. PMID:26770705

Five-year review of an international clinical research-training program

PubMed Central

Suemoto, Claudia Kimie; Ismail, Sherine; Corrêa, Paulo César Rodrigues Pinto; Khawaja, Faiza; Jerves, Teodoro; Pesantez, Laura; Germani, Ana Claudia Camargo Gonçalves; Zaina, Fabio; dos Santos, Augusto Cesar Soares; de Oliveira Ferreira, Ricardo Jorge; Singh, Priyamvada; Paulo, Judy Vicente; Matsubayashi, Suely Reiko; Vidor, Liliane Pinto; Andretta, Guilherme; Tomás, Rita; Illigens, Ben MW; Fregni, Felipe

2015-01-01

The exponential increase in clinical research has profoundly changed medical sciences. Evidence that has accumulated in the past three decades from clinical trials has led to the proposal that clinical care should not be based solely on clinical expertise and patient values, and should integrate robust data from systematic research. As a consequence, clinical research has become more complex and methods have become more rigorous, and evidence is usually not easily translated into clinical practice. Therefore, the instruction of clinical research methods for scientists and clinicians must adapt to this new reality. To address this challenge, a global distance-learning clinical research-training program was developed, based on collaborative learning, the pedagogical goal of which was to develop critical thinking skills in clinical research. We describe and analyze the challenges and possible solutions of this course after 5 years of experience (2008–2012) with this program. Through evaluation by students and faculty, we identified and reviewed the following challenges of our program: 1) student engagement and motivation, 2) impact of heterogeneous audience on learning, 3) learning in large groups, 4) enhancing group learning, 5) enhancing social presence, 6) dropouts, 7) quality control, and 8) course management. We discuss these issues and potential alternatives with regard to our research and background. PMID:25878518

Five-year review of an international clinical research-training program.

PubMed

Suemoto, Claudia Kimie; Ismail, Sherine; Corrêa, Paulo César Rodrigues Pinto; Khawaja, Faiza; Jerves, Teodoro; Pesantez, Laura; Germani, Ana Claudia Camargo Gonçalves; Zaina, Fabio; Dos Santos, Augusto Cesar Soares; de Oliveira Ferreira, Ricardo Jorge; Singh, Priyamvada; Paulo, Judy Vicente; Matsubayashi, Suely Reiko; Vidor, Liliane Pinto; Andretta, Guilherme; Tomás, Rita; Illigens, Ben Mw; Fregni, Felipe

2015-01-01

The exponential increase in clinical research has profoundly changed medical sciences. Evidence that has accumulated in the past three decades from clinical trials has led to the proposal that clinical care should not be based solely on clinical expertise and patient values, and should integrate robust data from systematic research. As a consequence, clinical research has become more complex and methods have become more rigorous, and evidence is usually not easily translated into clinical practice. Therefore, the instruction of clinical research methods for scientists and clinicians must adapt to this new reality. To address this challenge, a global distance-learning clinical research-training program was developed, based on collaborative learning, the pedagogical goal of which was to develop critical thinking skills in clinical research. We describe and analyze the challenges and possible solutions of this course after 5 years of experience (2008-2012) with this program. Through evaluation by students and faculty, we identified and reviewed the following challenges of our program: 1) student engagement and motivation, 2) impact of heterogeneous audience on learning, 3) learning in large groups, 4) enhancing group learning, 5) enhancing social presence, 6) dropouts, 7) quality control, and 8) course management. We discuss these issues and potential alternatives with regard to our research and background.

The development and evaluation of online stories to enhance clinical learning experiences across health professions in rural Australia.

PubMed

Paliadelis, Penny Susan; Stupans, Leva; Parker, Vicki; Piper, Donella; Gillan, Pauline; Lea, Jackie; Jarrott, Helen Mary; Wilson, Rhonda; Hudson, Judith N; Fagan, Anthea

2015-01-01

Clinical placement learning experiences are integral to all health and medical curricula as a means of integrating theory into practice and preparing graduates to deliver safe, high-quality care to health consumers. A growing challenge for education providers is to access sufficient clinical placements with experienced supervisors who are skilled at maximising learning opportunities for students. This paper reports on the development and evaluation of an innovative online learning program aimed at enhancing student and clinical supervisors' preparedness for effective workplace-based learning. The evidence-based learning program used 'story-telling' as the learning framework. The stories, which were supported by a range of resources, aimed to engage the learners in understanding student and supervisor responsibilities, as well as the expectations and competencies needed to support effective learning in the clinical environment. Evaluation of this program by the learners and stakeholders clearly indicated that they felt authentically 'connected' with the characters in the stories and developed insights that suggested effective learning had occurred.

Improving diabetic foot care in a nurse-managed safety-net clinic.

PubMed

Peterson, Joann M; Virden, Mary D

2013-05-01

This article is a description of the development and implementation of a Comprehensive Diabetic Foot Care Program and assessment tool in an academically affiliated nurse-managed, multidisciplinary, safety-net clinic. The assessment tool parallels parameters identified in the Task Force Foot Care Interest Group of the American Diabetes Association's report published in 2008, "Comprehensive Foot Examination and Risk Assessment." Review of literature, Silver City Health Center's (SCHC) 2009 Annual Report, retrospective chart review. Since the full implementation of SCHC's Comprehensive Diabetic Foot Care Program, there have been no hospitalizations of clinic patients for foot-related complications. The development of the Comprehensive Diabetic Foot Assessment tool and the implementation of the Comprehensive Diabetic Foot Care Program have resulted in positive outcomes for the patients in a nurse-managed safety-net clinic. This article demonstrates that quality healthcare services can successfully be developed and implemented in a safety-net clinic setting. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

Geropsychology training in a specialist geropsychology doctoral program.

PubMed

Qualls, Sara Honn; Segal, Daniel L; Benight, Charles C; Kenny, Michael P

2005-01-01

The first PhD specialty program in Geropsychology that launched in fall, 2004 at CU-Colorado Springs is described. Consistent with a scientist-practitioner model, the curriculum sequence builds systematically from basic to complex knowledge and skills across the domains of scientific psychology, research methodology, general clinical, geropsychology science, and clinical geropsychology. Practicum experiences also build skills in core clinical competencies needed by geropsychologists, including assessment, psychotherapy, neuropsychological evaluations, caregiver consultation and counseling, health psychology, and outreach/prevention. Research mentoring prepares students with the skills needed to conduct independent research useful to the clinical practice of geropsychology. Challenges faced in the process of developing the program include the development of a training clinic, balancing specialty and generalized training, building a specialty culture while maintaining faculty integration, attracting faculty and students during a start-up phase, and defining an identity within the field. The mental health services center that was launched to meet training needs while addressing a services niche in the community contributes substantially to the essence of this program, and is described in some detail. Future opportunities and challenges include program funding, heavy demands of specialty training on top of generalist training, maintaining congruence between expectations of clinical and non-clinical faculty, providing interdisciplinary experience, and expansion of practicum opportunities.

Starting a Health Professions Education Graduate Program

ERIC Educational Resources Information Center

Hansman, Catherine A.

2018-01-01

This chapter is a case story of the evolution of the Master of Education in Health Professions Education (MEHPE), a collaborative graduate program developed by the Adult Learning and Development program at Cleveland State University and the Cleveland Clinic.

Clinical skill development for community pharmacists.

PubMed

Barnette, D J; Murphy, C M; Carter, B L

1996-09-01

The importance of establishing clinical pharmacy services in the community cannot be understated in light of current challenges to the traditional dispensing role as the primary service of the community pharmacist. Advancements in automated dispensing technology and declining prescription fee reimbursement are rapidly forcing pharmacists to seek alternative sources of revenue. Providing pharmaceutical care is a viable option to increase customer loyalty job satisfaction, and reimbursement. To support the development of clinical services, academic institutions are forming partnerships with individual community practitioners to overcome perceived educational and training barriers. The authors describe the design and development of two unique clinical skill development programs at the University of Illinois at Chicago. This paper also outlines the patient focused services that the participants have established upon completing the training. These programs successfully enhanced participants' therapeutic knowledge base and facilitated development of the clinical skills necessary for direct patient care.

Implementation of an intraoperative clinical experience for senior level baccalaureate nursing students.

PubMed

Mott, Jason

2012-04-01

Perioperative nursing is a specialty that has been eliminated from many nursing education programs. With the loss of perioperative clinical experiences, the number of students pursuing a career in perioperative nursing after graduation has declined. A faculty member at one Midwestern school of nursing developed and implemented a perioperative clinical experience for senior-level baccalaureate nursing students in a critical care nursing course. This program, developed with the assistance of four local hospitals and the college of nursing, included an eight-hour OR orientation and 56 clinical hours. Students were placed in the OR under preceptor guidance and supervision. Feedback from evaluations was positive and provided recommendations for improving the program, in particular, to allow more clinical hours and more hands-on experience for the students. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Survey of Clinical Pharmacology Programs in U.S. and Canadian Medical Schools.

ERIC Educational Resources Information Center

And Others; Fisher, James W.

1980-01-01

A survey is reported that was undertaken by the Association for Medical School Pharmacology to assess the status of developing clinical pharmacology programs in medical schools in the United States and Canada and to determine why some schools have been unable to mount such programs. Survey questions are included. (Author/JMD)

The development of a community and home-based chronic care management program for older adults.

PubMed

Cooper, Jennifer; McCarter, Kathryn A

2014-01-01

The objective of this paper was to evaluate a chronic care management program piloted by a visiting nurses association. Desired outcomes were to increase nurses' knowledge of self-management of chronic conditions and improve patient self-efficacy and clinical measures. The program provided educational development for nurses and piloted encounters with patients with chronic conditions targeting community health nurses for a chronic care professional (CCP) certification and invited 300 faith community nurses to an education program on chronic condition(s). Thirteen patients with chronic condition(s) were enrolled. Chronic care professional modules were used to increase nurses' knowledge and were measured by successful completion of a certification exam. Faith community nurses participated in an education program and completed a posttest to measure knowledge of content. Patient improvement in self-management was measured by pre- and postintervention self-efficacy scores and clinical measures. Seventeen nurses successfully completed the exam, and 38 faith community nurses participated in the program and completed the posttest. Three patients showed improvement in self-efficacy scores and eight in clinical measures. The educational development of community nurses prepared them to provide effective encounters to improve self-efficacy and clinical outcomes for older adults with chronic conditions. © 2013 Wiley Periodicals, Inc.

Assuring Quality Control of Clinical Education in Multiple Clinical Affiliates.

ERIC Educational Resources Information Center

Davis, Judith A.

A plan was developed to assure equivalency of clinical education among the medical laboratory technician (MLT) programs affiliated with Sandhills Community College. The plan was designed by faculty to monitor the quality of clinical courses offered by the clinical affiliates. The major strategies were to develop competencies, slide/tape modules, a…

The National Institute of Dental Research Clinical Dental Staff Fellowship.

ERIC Educational Resources Information Center

Baum, Bruce J.; And Others

1988-01-01

A program in one of the National Institutes of Health offers clinical training fellowships as a means of training potential dental school faculty by providing both unique clinical skills and high-quality research experience. The program was developed in response to a perceived need for change in academic dentistry. (MSE)

Observation of clinical teaching: interest in a faculty development program for surgeons.

PubMed

Peyre, Sarah E; Frankl, Susan E; Thorndike, Mary; Breen, Elizabeth M

2011-01-01

Observation of clinical teaching is a powerful tool to develop faculty teaching skills. However, the process of being observed can be intimidating for any educator. Our aim is to assess interest in an Observation of Teaching Program within an academic surgical department. An electronic survey asking faculty to indicate interest in participation in a faculty development program that consists of a peer, expert, and/or cross-disciplinary physician observation of teaching was used. Faculty members were also asked whether they would like to observe other faculty as part of a peer-review track. The results were compiled for descriptive statistical analysis. Electronic survey. In all, 46 faculty, all of whom have assigned medical student and resident teaching responsibilities, were introduced to the Observation of Teaching Program and surveyed on their interest in participating. A total of 87% (40/46) of faculty responded after 2 e-mails and 75% (30/40) indicated interest in the Observation of Teaching Program. All faculty who responded positively indicated interest in expert review (30/30), 90% (27/30) in peer review, 87% (26/30) in surgeon review, and 83% (25/30) in cross-disciplinary physician review. A total of 48% (19/40) indicated interest in observing others. Of those who were not interested in the Observation of Teaching Program, restrictions on time (4/10), not enough clinical care responsibilities (2/10), not wanting to be watched (2/10), and program did not seem effective (1/10) were cited as reasons for not participating. Surgical faculty are interested in being observed and receiving feedback about their clinical teaching by experts, peers, colleagues, and cross-disciplinary physicians. Professional development programs for surgeons should consider observation as a teaching methodology. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A clinical ladder for occupational health nurses.

PubMed

Lang, Yolanda C

2010-06-01

Occupational health nurses must have a growing, expanding knowledge base to remain current in practice. The American Board for Occupational Health Nurses, Inc. encourages advancement with the availability of certification examinations. Health care centers support clinical advancement programs for bedside nurses. Nurses who continue their education either through a degree program or via continuing education or certification advance up the clinical ladder, receiving a higher salary, recognition from their peers, and perhaps even financial assistance to continue climbing, yet occupational health nurses do not have their own clinical advancement ladder. This article examines the steps necessary to develop a clinical ladder and presents a clinical ladder specific to occupational health nursing developed by the author. Copyright 2010, SLACK Incorporated.

Development of a Post-Graduate Year 2 Pharmacy Residency in Clinical Pharmacogenetics

PubMed Central

Hoffman, James M.; Gammal, Roseann S.; Relling, Mary V.; Crews, Kristine R.

2017-01-01

Purpose The structure and development of an innovative clinical pharmacogenetics post-graduate year 2 (PGY2) ASHP-accredited residency program is described. Summary The advent of the era of genomics has left practitioners wondering how to interpret the data obtained from sequencing and genotyping patients. In order to train the next leaders in the area of implementing pharmacogenetics, St. Jude Children’s Research Hospital established the first accredited residency program in clinical pharmacogenetics. The 12-month long PGY2 residency was created in accordance with the ASHP standards for advanced practice residencies. The resident learns to optimize patient outcomes through the expert provision of evidence-based, patient-centered precision medicine as an integral part of an interdisciplinary team. The resident gains hands-on experience in a dynamic environment regarding all aspects of running a clinical pharmacogenetics service. Since the first resident graduated in 2012, the program has graduated one resident each year. Conclusion To fill a need for pharmacists trained in pharmacogenetics, an innovative PGY2 residency in clinical pharmacogenetics was successfully developed. Upon completion of the program, residents are equipped with the clinical skills and necessary experience to drive precision medicine forward and lead the implementation of pharmacogenetics in various healthcare settings. PMID:28274984

The Clinical Quality Fellowship Program: Developing Clinical Quality Leadership in the Greater New York Region.

PubMed

Bhalla, Rohit; Jalon, Hillary S; Ryan, Lorraine

The Institute of Medicine has noted that a key factor underlying patient safety problems in the United States is a paucity of quality and safety training programs for clinicians. The Greater New York Hospital Association and United Hospital Fund created the Clinical Quality Fellowship Program (CQFP) to develop quality improvement leaders in the New York region. The goals of this article are to describe the CQFP's structure and curriculum, program participants' perceived value, improvement projects, and career paths. Eighty-seven participants completed the CQFP from 2010 to 2014. Among program participants completing self-assessment evaluations, significant improvements were observed across all quality improvement skill areas. Capstone project categories included inpatient efficiency, transitional care, and hospital infection. Fifty-six percent of participants obtained promotions following program completion. A training program emphasizing diverse curricular elements, varied learning approaches, and applied improvement projects increased participants' self-perceived skills, generated diverse improvement initiatives, and was associated with career advancement.

Comprehensive Opportunities for Research and Teaching Experience (CORTEX): A mentorship program.

PubMed

Zuzuárregui, José Rafael P; Hohler, Anna D

2015-06-09

We developed a program to promote medical student interest in pursuing a career in neurology. This program focuses on medical student mentorship. It also offers opportunities in teaching and clinical research in order to provide students with marketable skills for an academic career in neurology. Through this program, students are provided with guidance in developing a fourth-year clerkship schedule and an application package for residency programs. Students are involved and mentored in clinical research. Opportunities are also provided for students to teach their peers, with sessions focusing on examination preparation. Since the implementation of this program in 2010, the number of students entering into the field of neurology from our institution significantly increased from 14 students between 2006 and 2010, to 30 students between 2011 and 2014 (p < 0.05). Medical student research productivity increased from 7 publications during 2006-2010, to 22 publications, 14 poster presentations, and a book chapter after implementation of this program in 2010 (p < 0.05). In this mentoring program, students are prepared for residency application and provided with research and teaching opportunities. Students develop a highly desirable academic skill set for residency and have matched at top-ranked institutions. This program has been successful in improving student productivity in clinical research and garnering student interest in neurology. © 2015 American Academy of Neurology.

Development and Application of a Computer Simulation Program to Enhance the Clinical Problem-Solving Skills of Students.

ERIC Educational Resources Information Center

Boh, Larry E.; And Others

1987-01-01

A project to (1) develop and apply a microcomputer simulation program to enhance clinical medication problem solving in preclerkship and clerkship students and (2) perform an initial formative evaluation of the simulation is described. A systematic instructional design approach was used in applying the simulation to the disease state of rheumatoid…

The Development of a Postgraduate Orthopaedic Manual Therapy Residency Program in Nairobi, Kenya.

PubMed

Cunningham, Shala; Jackson, Richard; Muli, Daniel Kangutu; McFelea, Joni

2017-01-01

There are very few opportunities for long-term, comprehensive postgraduate education in developing countries because of fiscal and human resource constraints. Therefore, physiotherapists have little opportunity following graduation to advance their skills through the improvement of clinical reasoning and treatment planning and application. To address the need for sustainable advanced instruction in physiotherapy within the country, a postgraduate Residency program was initiated in Nairobi, Kenya in 2012. The mission of the program is to graduate advanced orthopedic practitioners who can lead their communities and local profession in the advancement of clinical care and education. Since its inception, six cohorts have been initiated for a total of 90 resident participants. In addition, six program graduates are being trained to continue the Residency program and are serving as teaching assistants for the on campus modules. This training will result in a self-sustaining program by 2020. The manual therapy Residency education model allowed for advancement of the participating physiotherapists professional development utilizing evidence-based practice. This was done without altering the current education system within the country, or accessing expensive equipment. The Residency program was developed and established with the cooperation of a local education institution and a non-profit corporation in the United States. This collaboration has facilitated the advancement of orthopedic clinical standards in the country and will, hopefully, one day serve an as a template for future programs.

Taxonomy for Education and Training in Clinical Neuropsychology: past, present, and future.

PubMed

Sperling, Scott A; Cimino, Cynthia R; Stricker, Nikki H; Heffelfinger, Amy K; Gess, Jennifer L; Osborn, Katie E; Roper, Brad L

2017-07-01

Historically, the clinical neuropsychology training community has not clearly or consistently defined education or training opportunities. The lack of consistency has limited students' and trainees' ability to accurately assess and compare the intensity of neuropsychology-specific training provided by programs. To address these issues and produce greater 'truth in advertising' across programs, CNS, with SCN's Education Advisory Committee (EAC), ADECN, AITCN, and APPCN constructed a specialty-specific taxonomy, namely, the Taxonomy for Education and Training in Clinical Neuropsychology. The taxonomy provides consensus in the description of training offered by doctoral, internship, and postdoctoral programs, as well as at the post-licensure stage. Although the CNS approved the taxonomy in February 2015, many programs have not adopted its language. Increased awareness of the taxonomy and the reasons behind its development and structure, as well as its potential benefits, are warranted. In 2016, a working group of clinical neuropsychologists from the EAC and APPCN, all authors of this manuscript, was created and tasked with disseminating information about the taxonomy. Group members held regular conference calls, leading to the generation of this manuscript. This manuscript is the primary byproduct of the working group. Its purpose is to (1) outline the history behind the development of the taxonomy, (2) detail its structure and utility, (3) address the expected impact of its adoption, and (4) call for its adoption across training programs. This manuscript outlines the development and structure of the clinical neuropsychology taxonomy and addresses the need for its adoption across training programs.

[Introduction of a Clinical Research Experience Program in Hospital Practical Training for Pharmacy Students and Its Evaluation].

PubMed

Takahashi, Katsuyuki; Suda, Yasuki; Kawaguchi, Hiroshi; Nakamura, Yasutaka; Kawabata, Shiho; Kawakami, Noriko; Nishikawa, Takeshi; Nagayama, Katsuya

2015-01-01

Long-term clinical training based on a model core curriculum was conducted to nurture highly competent pharmacists in the clinical field. Pharmacists' responsibilities are expanding, and a system has been developed to help pharmacists gain accreditation, identify specialties, and improve their training. However, this system requires research competency. Therefore clinical research should be considered a part of clinical training to encourage high competency among pharmacists. Because the model core curriculum does not include a section on clinical research. Osaka City University Hospital introduced a hands-on clinical research experience program and evaluated its usefulness. A significant improvement in the level of knowledge and awareness of clinical research was seen among students who underwent the clinical research experience program. In addition, the level of student satisfaction was higher. These findings suggest that a clinical research experience program may be useful to nurture a greater awareness of clinical research and knowledge acquisition among pharmacists.

Enhancing Therapeutic Gains: Examination of Fidelity to the Model for the Intensive Mental Health Program

ERIC Educational Resources Information Center

Randall, Camille J.; Biggs, Bridget K.

2008-01-01

Given that the development of treatment fidelity assessment protocol is an integral but too frequently ignored aspect of clinical trials for psychological treatments, the Intensive Mental Health Program (IMHP) sought to build fidelity activities into training, program evaluation, and clinical recordkeeping from the outset of a 3 year study period.…

Unpacking the Clinical and Participatory Dimensions of the Trump Math-Teacher-Residency-Program

ERIC Educational Resources Information Center

Imanuel-Noy, Dalia; Wagner, Tili

2016-01-01

The research presents a Residency Math teacher education program that has been developed in Israel in search of transforming initial teacher preparation on the Clinical-Participatory continuum. It is a "multi-phase" mixed-method research aiming to present the clinical and participatory dimensions of the TMR: the way in which they are…

Clinical decision-making among new graduate nurses attending residency programs in Saudi Arabia.

PubMed

Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

2016-02-01

This study examined the impact of residency programs on clinical decision-making of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. This descriptive study employed a convenience sample (N=98) of new graduate nurses from three hospitals in Saudi Arabia. A self-administered questionnaire was used to collect data. Clinical decision-making skills were measured using the Clinical Decision Making in Nursing Scale. Descriptive statistics, independent t-tests, and multiple linear regression analysis were utilized to examine the effect of residency programs on new graduate nurses' clinical decision-making skills. On average, resident nurses had significantly higher levels of clinical decision-making skills than non-residents (t=23.25, p=0.000). Enrollment in a residency program explained 86.9% of the variance in total clinical decision making controlling for age and overall grade point average. The findings of this study support evidence in the nursing literature conducted primarily in the US and Europe that residency programs have a positive influence on new graduate nurses' clinical decision-making skills. This is the first study to examine the impact of residency programs on clinical decision-making among new Saudi graduate nurses who completed a residency program. The findings of this study underscore the need for the development and implementation of residency programs for all new nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

Using the Behavior Change Technique Taxonomy v1 to conceptualize the clinical content of Breaking Free Online: a computer-assisted therapy program for substance use disorders.

PubMed

Dugdale, Stephanie; Ward, Jonathan; Hernen, Jan; Elison, Sarah; Davies, Glyn; Donkor, Daniel

2016-07-22

In recent years, research within the field of health psychology has made significant progress in terms of advancing and standardizing the science of developing, evaluating and reporting complex behavioral change interventions. A major part of this work has involved the development of an evidence-based Behavior Change Technique Taxonomy v1 (BCTTv1), as a means of describing the active components contained within such complex interventions. To date, however, this standardized approach derived from health psychology research has not been applied to the development of complex interventions for the treatment of substance use disorders (SUD). Therefore, this paper uses Breaking Free Online (BFO), a computer-assisted therapy program for SUD, as an example of how the clinical techniques contained within such an intervention might be mapped onto the BCTTv1. The developers of BFO were able to produce a full list of the clinical techniques contained within BFO. Exploratory mapping of the BCTTv1 onto the clinical content of the BFO program was conducted separately by the authors of the paper. This included the developers of the BFO program and psychology professionals working within the SUD field. These coded techniques were reviewed by the authors and any discrepancies in the coding were discussed between all authors until an agreement was reached. The BCTTv1 was mapped onto the clinical content of the BFO program. At least one behavioral change technique was found in 12 out of 16 grouping categories within the BCTTv1. A total of 26 out of 93 behavior change techniques were identified across the clinical content of the program. This exploratory mapping exercise has identified the specific behavior change techniques contained within BFO, and has provided a means of describing these techniques in a standardized way using the BCTTv1 terminology. It has also provided an opportunity for the BCTTv1 mapping process to be reported to the wider SUD treatment community, as it may have real utility in the development and evaluation of other psychosocial and behavioral change interventions within this field.

The summer institute in clinical dental research methods: still going and growing after twenty years.

PubMed

Derouen, Timothy A; Wiesenbach, Carol

2012-11-01

The first Summer Institute in Clinical Dental Research Methods, a faculty development program at the University of Washington, was offered in the summer of 1992 for sixteen participants. The primary objective of the program was to give clinical faculty members in dentistry an introduction to and an understanding of the fundamental principles and methods used in good clinical research. In the twentieth offering of the institute in 2011, there were thirty-five participants, and over the twenty institutes, there has been a cumulative total of 463 participants who have come from thirty U.S. states as well as forty-three countries outside the United States. The curriculum has expanded from the initial offering of biostatistics, clinical epidemiology, behavioral research methods, and ethics in clinical research to now include clinical trials, grantsmanship, data analysis, an elective in molecular biology, and a team project that provides participants with hands-on experience in research proposal development as members of an interdisciplinary team. Enrollment has doubled since the first year, yet exit evaluations of the program content have remained consistently high (rated as very good to excellent). One of the indicators of program quality is that at least 50 percent of recent participants indicated that they attended because the program was recommended by colleagues who had attended. There seems to be an ever-increasing pool of dental faculty members who are eager to learn more about clinical research methodology through the institute despite the intensive demands of full-time participation in a six-week program.

The Development of an HIV Training Program for Nurse Practitioners.

PubMed

McGee, Kara S; Relf, Michael; Harmon, James L

2016-01-01

Responding to a national need for a new workforce of HIV care providers as the first generation of providers decrease their practices or retire, the Duke University School of Nursing, with funding from the Health Resources and Services Administration, developed and implemented a program to train nurse practitioners (NP) to assume the full spectrum of primary care services needed by people living with HIV infection and various co-morbidities. The 12-credit program includes course work in HIV-related epidemiology; pathogenesis; psychosocial, political, ethical, and legal issues; and pharmacology and clinical management. Students complete 392 hours of HIV-specific clinical practice in addition to clinical hours required of all NP students. The program is the only distance-based program of its kind in the United States. Online didactic instruction is complemented by campus-based sessions with interprofessional faculty. We describe the 5 overarching goals that frame the program, and challenges and progress toward achieving those goals. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Clinical services provided by staff pharmacists in a community hospital.

PubMed

Garrelts, J C; Smith, D F

1990-09-01

A program for developing staff pharmacists' clinical skills and documenting pharmacists' clinical interventions in a large community teaching hospital is described. A coordinator hired in 1984 to develop clinical pharmacy services began a didactic and experiential program for baccalaureate-level staff pharmacists. Fourteen educational modules are supplemented by journal and textbook articles and small-group discussions of clinical cases, and the clinical coordinator provides individual training on the patient-care units for each pharmacist. Monitoring of clinical pharmacy services began in June 1987; each intervention provided by a pharmacist is recorded on a specially designed form. A target-drug program is used to document cost avoidance achieved through clinical services. Information collected through these monitoring activities is used to educate the pharmacy staff, shared with the pharmacy and therapeutics committee, and used to monitor prescribing patterns of individual physicians. The data are used in the hospital's productivity-monitoring system. All pharmacists who were on staff in 1984 have completed the educational modules, and all new employees are in the process. Since monitoring began, the number of clinical interventions has averaged 2098 per month. Cost avoidance has averaged $9306 per month. Over a five-year period, the development of staff pharmacists' clinical services raised the level of professional practice, produced substantial cost avoidance, and increased the number of pharmacist interventions in medication use.

Practitioner perspectives on extended clinical placement programs in optometry.

PubMed

Bentley, Sharon A; Cartledge, Amy; Guest, Daryl J; Cappuccio, Skye; Woods, Craig A

2016-05-01

Some universities are looking to provide a more diverse range of clinical learning experiences through extended clinical placement programs. This approach will potentially have a significant impact on practitioners. The aim of this study was to conduct a national survey of optometrists to ascertain their perspectives on participating in extended clinical placement programs. Members of Optometry Australia were invited to participate in a survey conducted during June and July 2014. A total of 268 practitioners participated (six per cent of registered Australian optometrists): 159 were predominantly employees or locums and 109 were owners or managers who identified as the key representative of a practice or organisation for the purpose of this survey. Almost two-thirds (65 per cent) of participants, who were employees or locums were supportive of extended clinical placement programs. Among this group, females were more likely to be supportive than males (p = 0.033). In comparison, just over one-third (34 per cent) of participants who were key decision-makers were supportive, with 30 per cent possibly supportive and 36 per cent not supportive. Among key decision-makers, males were more likely to be supportive (p = 0.009). The top three perceived advantages of supervising a student were: opportunity to mentor early career development, opportunity to give back to the profession and future recruitment. The top three perceived disadvantages were: burden on time, decrease in number of patients examined and burden on support staff. Suggested incentives for supervising students were credit for continuing professional development and financial remuneration. There appears to be moderate support for extended clinical placement programs; however, there are incentives that might engage a larger proportion of the profession in the future. These findings can inform the development of effective and sustainable clinical training programs for optometry students. Additionally, the findings might be used as evidence to seek Government support for clinical placement training in optometry. © 2016 Optometry Australia.

The NCI Community Oncology Research Program: what every clinician needs to know.

PubMed

McCaskill-Stevens, Worta; Lyss, Alan P; Good, Marge; Marsland, Thomas; Lilenbaum, Rogerio

2013-01-01

Research in the community setting is essential for the translation of advances in cancer research into practice and improving cancer care for all populations. The National Cancer Institute is proposing a new community-based program, NCI Community Oncology Research Program (NCORP), which is the alignment of two existing programs, the Community Clinical Oncology Program, Minority-Based Community Clinical Oncology Program, and their Research Bases, and the National Cancer Institute's Community Cancer Centers Program. NCROP will support cancer control, prevention, treatment, and screening clinical trials and expand its research scope to include cancer care delivery research. Cancer disparities research will be integrated into studies across the continuum of NCORP research. Input from current NCI-funded community investigators provides critical insight into the challenges faced by oncology practices within various organizational structures. Furthermore, these investigators identify the resources, both administrative and clinical, that will be required in the community setting to support cancer care delivery research and to meet the requirements for a new generation of clinical research. The American Society for Clinical Oncology (ASCO) has initiated a forum to focus on the conduct of clinical research in the community setting. Resources are being developed to help practices in managing cancer care in community settings.

Enhancing moral agency: clinical ethics residency for nurses.

PubMed

Robinson, Ellen M; Lee, Susan M; Zollfrank, Angelika; Jurchak, Martha; Frost, Debra; Grace, Pamela

2014-09-01

One antidote to moral distress is stronger moral agency-that is, an enhanced ability to act to bring about change. The Clinical Ethics Residency for Nurses, an educational program developed and run in two large northeastern academic medical centers with funding from the Health Resources and Services Administration, intended to strengthen nurses' moral agency. Drawing on Improving Competencies in Clinical Ethics Consultation: An Education Guide, by the American Society for Bioethics and Humanities, and on the goals of the nursing profession, CERN sought to change attitudes, increase knowledge, and develop skills to act on one's knowledge. One of the key insights the faculty members brought to the design of this program is that knowledge of clinical ethics is not enough to develop moral agency. In addition to lecture-style classes, CERN employed a variety of methods based in adult learning theory, such as active application of ethics knowledge to patient scenarios in classroom discussion, simulation, and the clinical practicum. Overwhelmingly, the feedback from the participants (sixty-seven over three years of the program) indicated that CERN achieved transformative learning. © 2014 by The Hastings Center.

Enablers and barriers in delivery of a cancer exercise program: the Canadian experience

PubMed Central

Mina, D. Santa; Petrella, A.; Currie, K.L.; Bietola, K.; Alibhai, S.M.H.; Trachtenberg, J.; Ritvo, P.; Matthew, A.G.

2015-01-01

Background Exercise is an important therapy to improve well-being after a cancer diagnosis. Accordingly, cancer-exercise programs have been developed to enhance clinical care; however, few programs exist in Canada. Expansion of cancer-exercise programming depends on an understanding of the process of program implementation, as well as enablers and barriers to program success. Gaining knowledge from current professionals in cancer-exercise programs could serve to facilitate the necessary understanding. Methods Key personnel from Canadian cancer-exercise programs (n = 14) participated in semistructured interviews about program development and delivery. Results Content analysis revealed 13 categories and 15 subcategories, which were grouped by three organizing domains: Program Implementation, Program Enablers, and Program Barriers. ■ Program Implementation (5 categories, 8 subcategories) included Program Initiation (clinical care extension, research project expansion, program champion), Funding, Participant Intake (avenues of awareness, health and safety assessment), Active Programming (monitoring patient exercise progress, health care practitioner involvement, program composition), and Discharge and Follow-up Plan.■ Program Enablers (4 categories, 4 subcategories) included Patient Participation (personalized care, supportive network, personal control, awareness of benefits), Partnerships, Advocacy and Support, and Program Characteristics.■ Program Barriers (4 categories, 3 subcategories) included Lack of Funding, Lack of Physician Support, Deterrents to Participation (fear and shame, program location, competing interests), and Disease Progression and Treatment. Conclusions Interview results provided insight into the development and delivery of cancer-exercise programs in Canada and could be used to guide future program development and expansion in Canada. PMID:26715869

The clinician's guide to composing effective business plans.

PubMed

Ettinger, Alan B; Blondell, Catherine

2011-01-01

In today's challenging healthcare environment, clinicians need to understand the fundamentals of financial analysis, which are the underpinnings of their clinical programs, especially when seeking administrative support for new initiatives. The business plan for new clinical program initiatives is composed of diverse elements such as the mission statement, market and competitive analyses, operations plan, and financial analysis. Armed with a basic knowledge of financial analysis of clinical programs, as well as forward-looking analysis of an initiative's added value, the healthcare provider can work much more effectively with administration in developing or creating new healthcare program initiatives.

Twenty-five years of accomplishments of the College of American Pathologists Q-probes program for clinical pathology.

PubMed

Howanitz, Peter J; Perrotta, Peter L; Bashleben, Christine P; Meier, Frederick A; Ramsey, Glenn E; Massie, Larry W; Zimmerman, Roberta L; Karcher, Donald S

2014-09-01

During the past 25 years, the College of American Pathologists' (CAP) Q-Probes program has been available as a subscription program to teach laboratorians how to improve the quality of clinical laboratory services. To determine the accomplishments of the CAP Q-Probes program. We reviewed Q-Probes participant information, study data and conclusions, author information, and program accomplishments. During this time 117 Q-Probes clinical pathology studies were conducted by 54 authors and coauthors, 42,899 laboratories enrolled from 24 countries, 98 peer-reviewed publications occurred and were cited more than 1600 times, and the studies were featured 59 times in CAP Today. The most frequent studies (19) focused on turnaround times for results or products at specific locations (emergency department, operating room, inpatients, outpatients), specific diseases (acute myocardial infarction, urinary tract), availability for specific events such as morning rounds or surgery, a specific result (positive blood cultures), and a method on how to use data for improvement (stat test outliers). Percentile ranking of study participants with better performance provided benchmarks for each study with attributes statistically defined that influenced improved performance. Other programs, such as an ongoing quality improvement program (Q-Tracks), a laboratory competency assessment program, a pathologist certification program, and an ongoing physician practice evaluation program (Evalumetrics), have been developed from Q-Probes studies. The CAP's Q-Probes program has made significant contributions to the medical literature and has developed a worldwide reputation for improving the quality of clinical pathology services worldwide.

Addiction Competencies in the 2009 CACREP Clinical Mental Health Counseling Program Standards

ERIC Educational Resources Information Center

Lee, Tiffany K.; Craig, Stephen E.; Fetherson, Bianca T. L.; Simpson, C. Dennis

2013-01-01

The Council for Accreditation of Counseling and Related Educational Programs developed addiction competencies for clinical mental health counseling students. This article highlights these competencies, provides an overview of current addiction training, and describes methods to integrate addiction education into curricula.

From Survivor to Thriver: A Pilot Study of an Online Program for Rape Victims

PubMed Central

Littleton, Heather; Buck, Katherine; Rosman, Lindsey; Grills-Taquechel, Amie

2013-01-01

Approximately 15% to 20% of women have been victims of rape and close to a third report current rape-related PTSD or clinically significant depression or anxiety. Unfortunately, very few distressed rape victims seek formal help. This suggests a need to develop alternative ways to assist the many distressed victims of sexual violence. Online treatment programs represent a potentially important alternative strategy for reaching such individuals. The current paper describes a pilot evaluation of an online, therapist-facilitated, self-paced cognitive behavioral program for rape victims. Five college women with current rape-related PTSD were recruited to complete the From Survivor to Thriver (S to T) program in a lab setting over the course of 7 weeks. After completing the program, 4 participants reported clinically significant reductions in PTSD symptoms and no longer met criteria for PTSD. All participants reported clinically significant reductions in vulnerability fears and 4 reported significant reductions in negative trauma-related cognitions. Implications of the results for further development of the S to T program and how clinicians could utilize this program in treating rape-related PTSD are discussed. PMID:24009410

Clinical software development for the Web: lessons learned from the BOADICEA project

PubMed Central

2012-01-01

Background In the past 20 years, society has witnessed the following landmark scientific advances: (i) the sequencing of the human genome, (ii) the distribution of software by the open source movement, and (iii) the invention of the World Wide Web. Together, these advances have provided a new impetus for clinical software development: developers now translate the products of human genomic research into clinical software tools; they use open-source programs to build them; and they use the Web to deliver them. Whilst this open-source component-based approach has undoubtedly made clinical software development easier, clinical software projects are still hampered by problems that traditionally accompany the software process. This study describes the development of the BOADICEA Web Application, a computer program used by clinical geneticists to assess risks to patients with a family history of breast and ovarian cancer. The key challenge of the BOADICEA Web Application project was to deliver a program that was safe, secure and easy for healthcare professionals to use. We focus on the software process, problems faced, and lessons learned. Our key objectives are: (i) to highlight key clinical software development issues; (ii) to demonstrate how software engineering tools and techniques can facilitate clinical software development for the benefit of individuals who lack software engineering expertise; and (iii) to provide a clinical software development case report that can be used as a basis for discussion at the start of future projects. Results We developed the BOADICEA Web Application using an evolutionary software process. Our approach to Web implementation was conservative and we used conventional software engineering tools and techniques. The principal software development activities were: requirements, design, implementation, testing, documentation and maintenance. The BOADICEA Web Application has now been widely adopted by clinical geneticists and researchers. BOADICEA Web Application version 1 was released for general use in November 2007. By May 2010, we had > 1200 registered users based in the UK, USA, Canada, South America, Europe, Africa, Middle East, SE Asia, Australia and New Zealand. Conclusions We found that an evolutionary software process was effective when we developed the BOADICEA Web Application. The key clinical software development issues identified during the BOADICEA Web Application project were: software reliability, Web security, clinical data protection and user feedback. PMID:22490389

Clinical software development for the Web: lessons learned from the BOADICEA project.

PubMed

Cunningham, Alex P; Antoniou, Antonis C; Easton, Douglas F

2012-04-10

In the past 20 years, society has witnessed the following landmark scientific advances: (i) the sequencing of the human genome, (ii) the distribution of software by the open source movement, and (iii) the invention of the World Wide Web. Together, these advances have provided a new impetus for clinical software development: developers now translate the products of human genomic research into clinical software tools; they use open-source programs to build them; and they use the Web to deliver them. Whilst this open-source component-based approach has undoubtedly made clinical software development easier, clinical software projects are still hampered by problems that traditionally accompany the software process. This study describes the development of the BOADICEA Web Application, a computer program used by clinical geneticists to assess risks to patients with a family history of breast and ovarian cancer. The key challenge of the BOADICEA Web Application project was to deliver a program that was safe, secure and easy for healthcare professionals to use. We focus on the software process, problems faced, and lessons learned. Our key objectives are: (i) to highlight key clinical software development issues; (ii) to demonstrate how software engineering tools and techniques can facilitate clinical software development for the benefit of individuals who lack software engineering expertise; and (iii) to provide a clinical software development case report that can be used as a basis for discussion at the start of future projects. We developed the BOADICEA Web Application using an evolutionary software process. Our approach to Web implementation was conservative and we used conventional software engineering tools and techniques. The principal software development activities were: requirements, design, implementation, testing, documentation and maintenance. The BOADICEA Web Application has now been widely adopted by clinical geneticists and researchers. BOADICEA Web Application version 1 was released for general use in November 2007. By May 2010, we had > 1200 registered users based in the UK, USA, Canada, South America, Europe, Africa, Middle East, SE Asia, Australia and New Zealand. We found that an evolutionary software process was effective when we developed the BOADICEA Web Application. The key clinical software development issues identified during the BOADICEA Web Application project were: software reliability, Web security, clinical data protection and user feedback.

Faculty development to enhance humanistic teaching and role modeling: a collaborative study at eight institutions.

PubMed

Branch, William T; Chou, Calvin L; Farber, Neil J; Hatem, David; Keenan, Craig; Makoul, Gregory; Quinn, Mariah; Salazar, William; Sillman, Jane; Stuber, Margaret; Wilkerson, LuAnn; Mathew, George; Fost, Michael

2014-09-01

There is increased emphasis on practicing humanism in medicine but explicit methods for faculty development in humanism are rare. We sought to demonstrate improved faculty teaching and role modeling of humanistic and professional values by participants in a multi-institutional faculty development program as rated by their learners in clinical settings compared to contemporaneous controls. Blinded learners in clinical settings rated their clinical teachers, either participants or controls, on the previously validated 10-item Humanistic Teaching Practices Effectiveness (HTPE) questionnaire. Groups of 7-9 participants at 8 academic medical centers completed an 18-month faculty development program. Participating faculty were chosen by program facilitators at each institution on the basis of being promising teachers, willing to participate in the longitudinal faculty development program. Our 18-month curriculum combined experiential learning of teaching skills with critical reflection using appreciative inquiry narratives about their experiences as teachers and other reflective discussions. The main outcome was the aggregate score of the ten items on the questionnaire at all institutions. The aggregate score favored participants over controls (P = 0.019) independently of gender, experience on faculty, specialty area, and/or overall teaching skills. Longitudinal, intensive faculty development that employs experiential learning and critical reflection likely enhances humanistic teaching and role modeling. Almost all participants completed the program. Results are generalizable to other schools.

Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.

PubMed

Heinen, Maud M; Bartholomew, L Kay; Wensing, Michel; van de Kerkhof, Peter; van Achterberg, Theo

2006-05-01

The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology. We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a needs-assessment. A multidisciplinary project group of health care workers and patients was involved in all five IM steps; formulating proximal program objectives, selecting methods and strategies, producing program components, planning for adoption and implementation and planning for evaluation. Several systematic literature reviews and original studies were performed to support this process. Social Cognitive Theory was selected as the main theory behind the program 'Lively Legs' and was combined with elements of Goal-Setting Theory, the precaution adoption model and motivational interviewing. The program is conducted through health counseling by dermatology nurses and was successfully pre-tested. Also, an implementation and evaluation plan were made. Intervention mapping helped us to succeed in developing a lifestyle program with clear goals and methods, operational strategies and materials and clear procedures. Coaching leg ulcer patients towards adherence with compression therapy and healthy lifestyles should be taken on without delay. Systematic development of lifestyle programs for other patient groups should be encouraged.

Development of a residency program in radiation oncology physics: an inverse planning approach.

PubMed

Khan, Rao F H; Dunscombe, Peter B

2016-03-08

Over the last two decades, there has been a concerted effort in North America to organize medical physicists' clinical training programs along more structured and formal lines. This effort has been prompted by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) which has now accredited about 90 residency programs. Initially the accreditation focused on standardized and higher quality clinical physics training; the development of rounded professionals who can function at a high level in a multidisciplinary environment was recognized as a priority of a radiation oncology physics residency only lately. In this report, we identify and discuss the implementation of, and the essential components of, a radiation oncology physics residency designed to produce knowledgeable and effective clinical physicists for today's safety-conscious and collaborative work environment. Our approach is that of inverse planning, by now familiar to all radiation oncology physicists, in which objectives and constraints are identified prior to the design of the program. Our inverse planning objectives not only include those associated with traditional residencies (i.e., clinical physics knowledge and critical clinical skills), but also encompass those other attributes essential for success in a modern radiation therapy clinic. These attributes include formal training in management skills and leadership, teaching and communication skills, and knowledge of error management techniques and patient safety. The constraints in our optimization exercise are associated with the limited duration of a residency and the training resources available. Without compromising the knowledge and skills needed for clinical tasks, we have successfully applied the model to the University of Calgary's two-year residency program. The program requires 3840 hours of overall commitment from the trainee, of which 7%-10% is spent in obtaining formal training in nontechnical "soft skills".

Postgraduate general dentistry residency: a clinical model.

PubMed

Gowan, J

1995-01-01

Dental graduates today are expected to be knowledgeable in many more areas than their predecessors. Changing technology and increased competition require entering the dental profession with more experience and skills. One approach to achieving this skill level is a postgraduate general dentistry residency in a clinical setting during the year following dental school graduation (PGY1). The clinical residency provides new dentists with additional hands-on training and reinforces classroom learning. HealthPartners was selected as a clinical rotation for residents in the advanced general dentistry program at the University of Minnesota Dental School. The program provides dental graduates in PGY1 training in all areas of practice. The HealthPartners rotation is highly unique. It is a staff model HMO with a clinical, multi-specialty setting. Today, HealthPartners--a Minnesota-based healthcare organization--has 116,000 members with prepaid dental benefits. Residents trained in the program develop increased skills in all areas of dental practice. In addition, they develop a good working knowledge in the basic sciences. Methods of instruction include didactic training in the form of seminars, lectures, and clinical training in HealthPartners' dental clinics.

The first competency-based higher education programme for midwives in the South Asian region--Pakistan.

PubMed

Jan, Rafat; Lakhani, Arusa; Kaufman, Karyn; Karimi, Sadia

2016-02-01

Midwives in Pakistan and the South Asian region who complete a diploma program face many challenges for career growth and development. The absence of higher education in professional midwifery in the region has contributed to general non-acceptance and invisibility of midwifery. In response to the interest, Aga Khan University (AKU) developed bachelors program in midwifery based on the Global Standards for Midwifery Education developed by the International Confederation of Midwives (ICM) with the vision to equip midwives to provide full-scope practice, develop confidence to practice midwifery independently, become clinical leaders and contribute to the future of midwifery. The final curriculum had a balance of theory and clinical practice in order to develop a high level of clinical competence that would meet the ICM standards and guidelines. The two year bachelors program is currently in progress. The first cohort of 21 midwives graduated in 2014 and a second cohort was enrolled in 2015. There is a planning for a future graduate program in midwifery to prepare individuals for leadership roles in practice, teaching, maternal-child health provision and policy making through a master's degree in midwifery. Copyright © 2015 Elsevier Ltd. All rights reserved.

Standardized patients in audiology: a proposal for a new method of evaluating clinical competence.

PubMed

Dinsmore, Brooke Freeman; Bohnert, Carrie; Preminger, Jill E

2013-05-01

While accrediting organizations require AuD programs to provide evidence that their students are able to demonstrate knowledge and competencies in specific content areas, there are no generally accepted mechanisms for the assessment and the measurement of these proficiencies. We propose that AuD programs consider developing standardized patient (SP) cases in order to develop consistent summative assessment programs within and across universities. The purpose of this article is to provide a framework for establishing SP programs to evaluate competencies in AuD students by detailing the history of SP cases and their use, developing a rationale for this method of assessment, and outlining the steps for writing and implementing SP cases. Literature review. SPs have been used to assess clinical competence in medical students for over 50 yr. The prevalence of SP assessment in allied health professions (e.g., dentistry, psychology, pharmacy) has increased over the last two decades but has only gained a limited following in audiology. SP assessment has been implemented in medical education using the Objective Structured Clinical Examination, a multistation, timed exam that uses fictional cases to assess students' clinical abilities. To date, only one published report has been completed that evaluates the use of SPs to assess clinical abilities in audiology students. This article expands upon the work of English et al (2007) and their efforts to use SPs to evaluate counseling abilities. To this end, we describe the steps necessary to write a case, procedures to determine performance requirements, and the need to develop remediation plans. As an example, we include a case that we have developed in order to evaluate vestibular assessment and patient communication skills. Utilizing SP assessment in audiology education would provide useful means to evaluate competence in a uniform way. Future research is necessary to develop reliable and valid cases that may be implemented across programs. This article aims to serve as a call to audiology programs to begin developing and reporting these cases. Once these are established we can begin to use SP cases for summative assessment. American Academy of Audiology.

Addressing challenges of training a new generation of clinician-innovators through an interdisciplinary medical technology design program: Bench-to-Bedside.

PubMed

Loftus, Patrick D; Elder, Craig T; D'Ambrosio, Troy; Langell, John T

2015-01-01

Graduate medical education has traditionally focused on training future physicians to be outstanding clinicians with basic and clinical science research skills. This focus has resulted in substantial knowledge gains, but a modest return on investment based on direct improvements in clinical care. In today's shifting healthcare landscape, a number of important challenges must be overcome to not only improve the delivery of healthcare, but to prepare future physicians to think outside the box, focus on and create healthcare innovations, and navigate the complex legal, business and regulatory hurdles of bringing innovation to the bedside. We created an interdisciplinary and experiential medical technology design competition to address these challenges and train medical students interested in moving new and innovative clinical solutions to the forefront of medicine. Medical students were partnered with business, law, design and engineering students to form interdisciplinary teams focused on developing solutions to unmet clinical needs. Over the course of six months teams were provided access to clinical and industry mentors, $500 prototyping funds, development facilities, and non-mandatory didactic lectures in ideation, design, intellectual property, FDA regulatory requirements, prototyping, market analysis, business plan development and capital acquisition. After four years of implementation, the program has supported 396 participants, seen the development of 91 novel medical devices, and launched the formation of 24 new companies. From our perspective, medical education programs that develop innovation training programs and shift incentives from purely traditional basic and clinical science research to also include high-risk innovation will see increased student engagement in improving healthcare delivery and an increase in the quality and quantity of innovative solutions to medical problems being brought to market.

THE ADAPTATION FOR GROUP CLASSROOM USE OF CLINICAL TECHNIQUES FOR TEACHING BRAIN-INJURED CHILDREN.

ERIC Educational Resources Information Center

NOVACK, HARRY S.

THIS STUDY SOUGHT TO DEVELOP A PUBLIC SCHOOL PROGRAM FOR BRAIN-INJURED CHILDREN OF AVERAGE OR LOW AVERAGE INTELLECTUAL POTENTIAL. THE OBJECTIVES WERE--(1) TO COLLECT CLINICAL TUTORING TECHNIQUES BEING USED, (2) TO CLASSIFY CLINICAL TUTORIAL METHODS IN A FRAMEWORK USEFUL FOR DEVELOPING TECHNIQUES FOR GROUP TEACHING, (3) TO ADOPT CLINICAL TUTORIAL…

Hunter disease eClinic: interactive, computer-assisted, problem-based approach to independent learning about a rare genetic disease.

PubMed

Al-Jasmi, Fatma; Moldovan, Laura; Clarke, Joe T R

2010-10-25

Computer-based teaching (CBT) is a well-known educational device, but it has never been applied systematically to the teaching of a complex, rare, genetic disease, such as Hunter disease (MPS II). To develop interactive teaching software functioning as a virtual clinic for the management of MPS II. The Hunter disease eClinic, a self-training, user-friendly educational software program, available at the Lysosomal Storage Research Group (http://www.lysosomalstorageresearch.ca), was developed using the Adobe Flash multimedia platform. It was designed to function both to provide a realistic, interactive virtual clinic and instantaneous access to supporting literature on Hunter disease. The Hunter disease eClinic consists of an eBook and an eClinic. The eClinic is the interactive virtual clinic component of the software. Within an environment resembling a real clinic, the trainee is instructed to perform a medical history, to examine the patient, and to order appropriate investigation. The program provides clinical data derived from the management of actual patients with Hunter disease. The eBook provides instantaneous, electronic access to a vast collection of reference information to provide detailed background clinical and basic science, including relevant biochemistry, physiology, and genetics. In the eClinic, the trainee is presented with quizzes designed to provide immediate feedback on both trainee effectiveness and efficiency. User feedback on the merits of the program was collected at several seminars and formal clinical rounds at several medical centres, primarily in Canada. In addition, online usage statistics were documented for a 2-year period. Feedback was consistently positive and confirmed the practical benefit of the program. The online English-language version is accessed daily by users from all over the world; a Japanese translation of the program is also available. The Hunter disease eClinic employs a CBT model providing the trainee with realistic clinical problems, coupled with comprehensive basic and clinical reference information by instantaneous access to an electronic textbook, the eBook. The program was rated highly by attendees at national and international presentations. It provides a potential model for use as an educational approach to other rare genetic diseases.

[Educational model to develop trustworthy professional activities].

PubMed

Hamui-Sutton, Alicia; Varela-Ruiz, Margarita; Ortiz-Montalvo, Armando; Torruco-García, Uri

2015-01-01

The reorganization of the national health system (SNS), enforces reflection and transformation on medical education in clinical contexts. The study presents an educational model to develop entrusted professionals activities (MEDAPROC) to train human resources in health with reliable knowledge, skills and attitudes to work in the shifting scenario of the SNS. The paper discusses international and national documents on skills in medicine. Based on the analysis of 8 domains, 50 skills and 13 entrusted professional activities (RPA) proposed by the Association of the American Medical College (AAMC) we propose a curriculum design, with the example of the undergraduate program of Gynecology and Obstetrics, with the intention to advance to internship and residency in a continuum that marks milestones and clinical practices. The pedagogical design of MEDAPROC was developed within three areas: 1) proposal of the AAMC; 2) curricular content of programs in pre and postgraduate education 3) organization of the daily agenda with academic mechanisms to develop the competencies, cover program items and develop clinical practice in deliberate learning activities, as well as milestones. The MEDAPROC offers versatility, student mobility and curricular flexibility in a system planed by academic units in diverse clinical settings.

Behavioral Medicine Training in Postdoctoral Dental Education.

ERIC Educational Resources Information Center

Lockhart, Peter B.; And Others

1992-01-01

Carolinas Medical Center (North Carolina) initiated a behavioral training program for general practice dental residents to develop skills in handling patient anxiety/stress, obesity, and depression. The program includes monthly seminars, a clinical rotation in behavioral medicine with additional related seminars, and a month-long clinical rotation…

The Computer-Based Writing Program: A Clinical Teaching Experience for Education Interns to Develop Professional Knowledge and Skills in Effective Instructional Writing Practices

ERIC Educational Resources Information Center

Painter, Diane D.

2016-01-01

The four-week university-sponsored summer Computer-based Writing (CBW) Program directed by the head of a special education initial teacher licensure program gave teaching interns opportunities to work with young struggling writers in a supervised clinical setting to address keyboarding skills, writing conventions and knowledge and application of…

75 FR 73104 - Clinical Development Programs for Sedation Products; Request for Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-29

... sedation claims? Would dose-escalation comparative trial designs be useful in studying sedation products? 5... understanding the physiology of sedation and clinical trial design issues related to the development of sedation... to procedural and intensive care unit (ICU) sedation, as well as associated clinical trial design...

Interventions to support and develop clinician-researcher leadership in one health district.

PubMed

Fry, Margaret; Dombkins, Anthony

2017-07-10

Purpose Clinical leadership, researcher capacity and a culture of clinical inquiry are needed in the clinical workforce. The purpose of this paper is to report on a program which was used to develop and support clinicians to explore practice, implement innovation, translate evidence and build researcher capacity. Design/methodology/approach This pragmatic paper presents a case study of a nursing and midwifery clinician-researcher development program. The multi-site, multi-modal program focused on education, mentoring and support, communication networks, and clinician-university partnerships strategies to build workforce capacity and leadership. Findings Over 2,000 staff have been involved in the program representing a range of health disciplines. The study day program has been delivered to 500 participants with master classes having over 1,500 attendees. The research mentor program has demonstrated that participants increased their confidence for research leadership roles and are pursuing research and quality assurance projects. Communication strategies improved the visibility of nursing and midwifery. Research limitations/implications This case study was conducted in one health district, which may not have relevance to other geographical areas. The small numbers involved in the research mentor program need to be considered when reviewing the findings. Practical implications The program has been a catalyst for developing a research culture, clinical leadership and research networks that strengthen workforce capacity. Building researcher skills in the workforce will better support quality healthcare and the examination of everyday practice. Social implications Building a culture of healthcare that is based on inquiry and evidence-based practice will lead to more appropriate and consistent healthcare delivery. Consumers have the right to expect health clinicians will challenge everyday practice and have the skills and capability to translate or generate best evidence to underpin professional and service delivery. Originality/value This paper provides strategies for building workforce researcher capacity and capability. The program provides opportunity for building research networks and role modeling the value and importance of research to practice and quality improvement.

Development and evaluation of a learner-centered educational summer camp program on soft skills for baccalaureate nursing students.

PubMed

Lau, Ying; Wang, Wenru

2014-01-01

The objectives were to develop a learner-centered educational camp program for nursing students and to evaluate 4 areas of soft skills, communication ability, clinical interaction, interpersonal relationships, and social problem solving, before and after the program. The results showed that the summer camp program was effective in improving nursing students' soft skills.

Teen Pregnancy and School-Based Health Clinics. A Family Research Report.

ERIC Educational Resources Information Center

Mosbacker, Barrett

To combat the problem of teenage pregnancy, public health clinics have made birth control counseling and free contraceptives available to minors and many public schools have implemented sex education programs. Despite the development and implementation of these programs, teenage sexual activity and pregnancy have increased. The increase in…

DriveWise: An Interdisciplinary Hospital-Based Driving Assessment Program

ERIC Educational Resources Information Center

O'Connor, Margaret G.; Kapust, Lissa R.; Hollis, Ann M.

2008-01-01

Health care professionals working with the elderly have opportunities through research and clinical practice to shape public policy affecting the older driver. This article describes DriveWise, an interdisciplinary hospital-based driving assessment program developed in response to clinical concerns about the driving safety of individuals with…

Illinois Occupational Skill Standards: Clinical Laboratory Science/Biotechnology Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended to serve as a guide for workforce preparation program providers, details the Illinois Occupational Skill Standards for clinical laboratory occupations programs. The document begins with a brief overview of the Illinois perspective on occupational skill standards and credentialing, the process used to develop the…

Development and Progression of a Model: Prospective Research Compliance Monitoring

ERIC Educational Resources Information Center

Fedor, Carol; Ferrazzano Yaussy, Cristina; Cola, Philip A.

2008-01-01

Recent trends in Human Research Protection Programs (HRPPs) have contributed to the rising emphasis on prospective monitoring of clinical research and education programs. Therefore, internal efforts and resources to monitor investigator compliance and site performance have become an important focus in the conduct of clinical research. Once the…

Athletic Training: Instructors Perceived Preparedness for Teaching in an Athletic Training Education Program

ERIC Educational Resources Information Center

Rooney, Kevin F.

2013-01-01

Athletic trainers work in clinical settings such as secondary schools, colleges and universities, sports medicine clinics, professional sports, hospitals, and other healthcare environments. However, with the rapid expansion of athletic training education programs (ATEP) over the years, another role for the athletic trainer has developed, the…

School-Based Health Clinics: An Analysis of the Johns Hopkins Study. Research Developments.

ERIC Educational Resources Information Center

Demsko, Tobin W.

School-based health clinics, adolescent pregnancy prevention programs offering comprehensive health services, represent the latest initiative to reduce the incidence of teenage pregnancy. Researchers at Johns Hopkins University designed and administered a pregnancy prevention program which offered sexuality education and family planning services…

Development and implementation of a competency-based clinical evaluation tool for midwifery education.

PubMed

Woeber, Kate

2018-07-01

The learning goals and evaluation strategies of competency-based midwifery programs must be explicit and well-defined. In the US, didactic learning is evaluated through a standardized certification examination, but standardized clinical competence evaluation is lacking. The Midwifery Competency Assessment Tool (MCAT) has been adapted from the International Confederation of Midwives' (ICM) "Essential Competencies" and from the American College of Nurse-Midwives' (ACNM) "Core Competencies", with student self-evaluation based on Benner's Novice-to-Expert theory. The MCAT allows for the measurement and monitoring of competence development in all domains of full-scope practice over the course of the midwifery program. Strengths of the MCAT are that it provides clear learning goals and performance evaluations for students, ensures and communicates content mapping across a curriculum, and highlights strengths and gaps in clinical opportunities at individual clinical sites and for entire programs. Challenges of the MCAT lie in balancing the number of competency items to be measured with the tedium of form completion, in ensuring the accuracy of student self-evaluation, and in determining "adequate" competence achievement when particular clinical opportunities are limited. Use of the MCAT with competency-based clinical education may facilitate a more standardized approach to clinical evaluation, as well as a more strategic approach to clinical site development and use. Copyright © 2018 Elsevier Ltd. All rights reserved.

The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives.

PubMed

Leibowitz, Scott F; Spack, Norman P

2011-10-01

Few interdisciplinary treatment programs that tend to the needs of youth with gender nonconforming behaviors, expressions, and identities exist in academic medical centers with formal residency training programs. Despite this, the literature provides evidence that these youth have higher rates of poor psychosocial adjustment and suicide attempts. This article explores the logistical considerations involved in developing a specialized interdisciplinary service to these gender minority youth in accordance with the existing treatment guidelines.Demographic data will be presented and treatment issues will be explored. The impact that a specialized interdisciplinary treatment program has on clinical expansion, research development, education and training, and community outreach initiatives is discussed.

Yearning for the Vastness of the Sea: Reflections and Commentary on Professional Training in Hypnosis.

PubMed

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.

A Process and Programming Design to Develop Virtual Patients for Medical Education

PubMed Central

McGee, James B.; Wu, Martha

1999-01-01

Changes in the financing and delivery of healthcare in our nation's teaching hospitals have diminished the variety and quality of a medical student's clinical training. The Virtual Patient Project is a series of computer-based, multimedia, clinical simulations, designed to fill this gap. After the development of a successful prototype and obtaining funding for a series of 16 cases, a method to write and produce many virtual patients was created. Case authors now meet with our production team to write and edit a movie-like script. This script is converted into a design document which specifies the clinical aspects, teaching points, media production, and interactivity of each case. The program's code was modularized, using object-oriented techniques, to allow for the variations in cases and for team programming. All of the clinical and teaching content is stored in a database, that allows for faster and easier editing by many persons simultaneously.

Association of American Indian Physicians

MedlinePlus

... Scholars Program This program of the Robert Wood Johnson Foundation is a leadership development opportunity for practitioners ... for Clinical Scholars program supported by Robert Wood Johnson Foundation will open in January 2018. https://t. ...

The Pharmacogenomics Research Network Translational Pharmacogenetics Program: Outcomes and Metrics of Pharmacogenetic Implementations Across Diverse Healthcare Systems.

PubMed

Luzum, J A; Pakyz, R E; Elsey, A R; Haidar, C E; Peterson, J F; Whirl-Carrillo, M; Handelman, S K; Palmer, K; Pulley, J M; Beller, M; Schildcrout, J S; Field, J R; Weitzel, K W; Cooper-DeHoff, R M; Cavallari, L H; O'Donnell, P H; Altman, R B; Pereira, N; Ratain, M J; Roden, D M; Embi, P J; Sadee, W; Klein, T E; Johnson, J A; Relling, M V; Wang, L; Weinshilboum, R M; Shuldiner, A R; Freimuth, R R

2017-09-01

Numerous pharmacogenetic clinical guidelines and recommendations have been published, but barriers have hindered the clinical implementation of pharmacogenetics. The Translational Pharmacogenetics Program (TPP) of the National Institutes of Health (NIH) Pharmacogenomics Research Network was established in 2011 to catalog and contribute to the development of pharmacogenetic implementations at eight US healthcare systems, with the goal to disseminate real-world solutions for the barriers to clinical pharmacogenetic implementation. The TPP collected and normalized pharmacogenetic implementation metrics through June 2015, including gene-drug pairs implemented, interpretations of alleles and diplotypes, numbers of tests performed and actionable results, and workflow diagrams. TPP participant institutions developed diverse solutions to overcome many barriers, but the use of Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines provided some consistency among the institutions. The TPP also collected some pharmacogenetic implementation outcomes (scientific, educational, financial, and informatics), which may inform healthcare systems seeking to implement their own pharmacogenetic testing programs. © 2017, The American Society for Clinical Pharmacology and Therapeutics.

A programmable rules engine to provide clinical decision support using HTML forms.

PubMed

Heusinkveld, J; Geissbuhler, A; Sheshelidze, D; Miller, R

1999-01-01

The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser.

Use of an Information Retrieval Service in an Obstetrics/Gynecology Residency Program.

ERIC Educational Resources Information Center

And Others; Gunning, John E.

1980-01-01

A program that uses the clinical librarian as a member of the patient care team has been developed by an obstetrics and gynecology department of a university medical center to keep faculty and hospital house staff knowledgeable about current developments and research. Program objectives, methodology, costs, evaluation, and information utilization…

A Text-Computer Assisted Instruction Program as a Viable Alternative for Continuing Education in Laboratory Medicine.

ERIC Educational Resources Information Center

Bruce, A. Wayne

1986-01-01

Describes reasons for developing combined text and computer assisted instruction (CAI) teaching programs for delivery of continuing education to laboratory professionals, and mechanisms used for developing a CAI program on method evaluation in the clinical laboratory. Results of an evaluation of the software's cost effectiveness and instructional…

Preparing Bilingual Speech-Language Pathologists: The Development of an Innovative Master's Degree Program.

ERIC Educational Resources Information Center

Wright-Harp, Wilhelmina; Munoz, Emma

2000-01-01

This paper describes the two-year master's degree program for speech-language pathologists with a specialization in bilingualism (Spanish/English) developed at the University of the District of Columbia. First, the article describes the program's curriculum, clinical practicum, recruitment, and retention activities. It then discusses the student…

John Tracy Clinic Correspondence Learning Program for Parents of Preschool Deaf-Blind Children. Teacher's Guide.

ERIC Educational Resources Information Center

Thielman, Virginia B.; And Others

The teacher's guide outlines lessons from a correspondence learning program for parents of preschool deaf blind children. Learning steps and objectives are listed for eight areas covered by the program: communication, gross motor development, fine motor development, eating, sleeping, toilet training, dressing/undressing, and personal hygiene.…

Developability assessment of clinical drug products with maximum absorbable doses.

PubMed

Ding, Xuan; Rose, John P; Van Gelder, Jan

2012-05-10

Maximum absorbable dose refers to the maximum amount of an orally administered drug that can be absorbed in the gastrointestinal tract. Maximum absorbable dose, or D(abs), has proved to be an important parameter for quantifying the absorption potential of drug candidates. The purpose of this work is to validate the use of D(abs) in a developability assessment context, and to establish appropriate protocol and interpretation criteria for this application. Three methods for calculating D(abs) were compared by assessing how well the methods predicted the absorption limit for a set of real clinical candidates. D(abs) was calculated for these clinical candidates by means of a simple equation and two computer simulation programs, GastroPlus and an program developed at Eli Lilly and Company. Results from single dose escalation studies in Phase I clinical trials were analyzed to identify the maximum absorbable doses for these compounds. Compared to the clinical results, the equation and both simulation programs provide conservative estimates of D(abs), but in general D(abs) from the computer simulations are more accurate, which may find obvious advantage for the simulations in developability assessment. Computer simulations also revealed the complex behavior associated with absorption saturation and suggested in most cases that the D(abs) limit is not likely to be achieved in a typical clinical dose range. On the basis of the validation findings, an approach is proposed for assessing absorption potential, and best practices are discussed for the use of D(abs) estimates to inform clinical formulation development strategies. Copyright © 2012 Elsevier B.V. All rights reserved.

Anatomy and history of an external quality assessment program for interpretative comments in clinical biochemistry.

PubMed

Vasikaran, Samuel D

2015-05-01

The provision of clinical interpretation of results, either verbally or in the printed report, may be considered an integral part of clinical biochemistry diagnostic service. Proficiency testing or external quality assessment (EQA) of such activity may be useful in education, training, continuing professional development and ensuring the quality of such service. Details of the Patient Report Comments Program (RPCProgram) developed by the Royal College of Pathologists of Australasia (RCPA) Chemical Pathology Quality Assurance Programs Pty Ltd (QAP) is described in this review. The program is aimed at pathologists, clinical scientists and trainees. Registered participants are provided a report with case details and a set of clinical biochemistry results at monthly intervals and submit an interpretative comment for the report. Comments received are broken up into components that are translated into common key phrases. An expert panel evaluates the key phrases, classifies them according to appropriateness and drafts a suggested comment, a case summary and a rationale, which are included in a summary report returned to participants. There is considerable diversity in the quality of interpretative comments received from participants of the PRCProgram. The primary purpose of EQA of interpretative commenting is educational self-assessment, and they are recognized as a continuing professional development activity. Whilst there is some evidence for the utility of interpretative comments in improving patient outcomes, evidence for the utility of EQA in improving quality of comments is awaited. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Mentoring in Clinical-Translational Research: A Study of Participants in Master's Degree Programs.

PubMed

McGinn, Aileen P; Lee, Linda S; Baez, Adriana; Zwanziger, Jack; Anderson, Karl E; Seely, Ellen W; Schoenbaum, Ellie

2015-12-01

Research projects in translational science are increasingly complex and require interdisciplinary collaborations. In the context of training translational researchers, this suggests that multiple mentors may be needed in different content areas. This study explored mentoring structure as it relates to perceived mentoring effectiveness and other characteristics of master's-level trainees in clinical-translational research training programs. A cross-sectional online survey of recent graduates of clinical research master's program was conducted. Of 73 surveys distributed, 56.2% (n = 41) complete responses were analyzed. Trainees were overwhelmingly positive about participation in their master's programs and the impact it had on their professional development. Overall the majority (≥75%) of trainees perceived they had effective mentoring in terms of developing skills needed for conducting clinical-translational research. Fewer trainees perceived effective mentoring in career development and work-life balance. In all 15 areas of mentoring effectiveness assessed, higher rates of perceived mentor effectiveness was seen among trainees with ≥2 mentors compared to those with solo mentoring (SM). In addition, trainees with ≥2 mentors perceived having effective mentoring in more mentoring aspects (median: 14.0; IQR: 12.0-15.0) than trainees with SM (median: 10.5; IQR: 8.0-14.5). Results from this survey suggest having ≥2 mentors may be beneficial in fulfilling trainee expectations for mentoring in clinical-translational training. © 2015 Wiley Periodicals, Inc.

Comorbidity of Deployment-Related Posttraumatic Disorders and Their Treatment with Cognitive-Behavioral Group

DTIC Science & Technology

2011-04-01

traumatised soldiers will be presented in this article . Initial experiences with the group therapy program will be discussed. 15. SUBJECT TERMS 16...clinical impression and the SCID-II questionnaire (Structurel Clinical Interview for DSM-IV1) for personality disorders. 89% showed clinical evidence...group therapy, newly developed in Berlin, for traumatised soldiers will be presented in this article . Initial experiences with the group therapy program

[Strive, plan and reach the "Summit": the Faculty Development Program at the Ruth & Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology].

PubMed

Castel, Orit Cohen; Nave, Rachel; Ganor, Margalit; Hasson-Gilad, Dalia R; Brika, Riva

2010-04-01

In recent years, faculty development has turned into a central component of medical education and a primary instrument in qualifying physicians to be teachers and educators. The faculty development program at the Ruth & Bruce Rappaport Faculty of Medicine ("Summit" program) was established in order to improve teaching of the clinical professions, to create a community of medical teachers and educators and to develop leadership in medical education within the Faculty of Medicine. This article aims to describe the design, implementation and evaluation of the faculty development program in the Technion's Faculty of Medicine. The program was designed for a group of 20 clinical teachers, of various clinical professions, who had gained at least one year of undergraduate teaching experience and wished to develop a career in medical education. The program included seven monthly, eight-hour meetings throughout the academic year. Learning was based on small group discussions, interactive exercises, role-plays and simulations, self-directed reading and reflective writing. At the end of the final meeting, participants completed an evaluation form. Seventeen of the 20 participants (85%) graduated and received certificates. Learners' overall satisfaction was high. Graduates expressed high motivation to practice medical education within the Faculty of Medicine and reported that they gained new knowledge in medical education and skills regarding various aspects of teaching and learning, such as formulation of learning objectives, designing role plays, and providing effective feedback. The "Summit" program is an innovative initiative in the field of medical education in Israel. The program had a significant impact on participants' knowledge, teaching skills and attitudes. In order to ensure implementation of the acquired tools and skills, its shortterm and long-term effects on teaching behavior and the learning climate have yet to be demonstrated. In addition, it is necessary to check if the program affected the faculty as an organization, promoted changes in curricula, teaching and evaluation methods.

Expanding clinical medical training opportunities at the University of Nairobi: adapting a regional medical education model from the WWAMI program at the University of Washington.

PubMed

Child, Mara J; Kiarie, James N; Allen, Suzanne M; Nduati, Ruth; Wasserheit, Judith N; Kibore, Minnie W; John-Stewart, Grace; Njiri, Francis J; O'Malley, Gabrielle; Kinuthia, Raphael; Norris, Tom E; Farquhar, Carey

2014-08-01

A major medical education need in Sub-Saharan Africa includes expanding clinical training opportunities to develop health professionals. Medical education expansion is a complicated process that requires significant investment of financial and human resources, but it can also provide opportunities for innovative approaches and partnerships. In 2010, the U.S. President's Emergency Plan for AIDS Relief launched the Medical Education Partnership Initiative to invest in medical education and health system strengthening in Africa. Building on a 30-year collaborative clinical and research training partnership, the University of Nairobi in Kenya developed a pilot regional medical education program modeled on the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) medical education program at the University of Washington in the United States. The University of Nairobi adapted key elements of the WWAMI model to expand clinical training opportunities without requiring major capital construction of new buildings or campuses. The pilot program provides short-term clinical training opportunities for undergraduate students and recruits and trains clinical faculty at 14 decentralized training sites. The adaptation of a model from the Northwestern United States to address medical education needs in Kenya is a successful transfer of knowledge and practices that can be scaled up and replicated across Sub-Saharan Africa.

Exploring international clinical education in US-based programs: identifying common practices and modifying an existing conceptual model of international service-learning.

PubMed

Pechak, Celia M; Black, Jill D

2014-02-01

Increasingly physical therapist students complete part of their clinical training outside of their home country. This trend is understudied. The purposes of this study were to: (1) explore, in depth, various international clinical education (ICE) programs; and (2) determine whether the Conceptual Model of Optimal International Service-Learning (ISL) could be applied or adapted to represent ICE. Qualitative content analysis was used to analyze ICE programs and consider modification of an existing ISL conceptual model for ICE. Fifteen faculty in the United States currently involved in ICE were interviewed. The interview transcriptions were systematically analyzed by two researchers. Three models of ICE practices emerged: (1) a traditional clinical education model where local clinical instructors (CIs) focus on the development of clinical skills; (2) a global health model where US-based CIs provide the supervision in the international setting, and learning outcomes emphasized global health and cultural competency; and (3) an ICE/ISL hybrid where US-based CIs supervise the students, and the foci includes community service. Additionally the data supported revising the ISL model's essential core conditions, components and consequence for ICE. The ICE conceptual model may provide a useful framework for future ICE program development and research.

Peer tutoring program for academic success of returning nursing students.

PubMed

Bryer, Jennifer

2012-01-01

High attrition rates among students in associate degree nursing programs are a concern for faculty, administrators, and students. Programs offering academic and emotional support for students at risk for failing a clinical course may decrease attrition rates and improve academic performance. A peer tutoring program was developed for returning nursing students who were unsuccessful in a previous clinical course. Peer tutors met with returning students weekly to review course work, complete case studies and practice NCLEX questions. Trusting, supportive relationships developed among students and a significant increase in grades was noted at the end of the course for 79% of students. Implementation of peer tutoring was beneficial for returning students, tutors, and the nursing program and may be valuable in other courses where academic achievement is a concern.

Ticagrelor for the treatment of atherosclerotic disease: insights from the PARTHENON clinical development program.

PubMed

Held, Peter; Himmelmann, Anders; Ditmarsch, Marc

2016-07-01

Ticagrelor (P2Y12 receptor antagonist) is presently indicated for preventing atherothrombotic events in patients with acute coronary syndrome and patients with a history of myocardial infarction. The PARTHENON clinical development program comprises five randomized, controlled, cardiovascular, indication-seeking outcome studies, aiming to evaluate ticagrelor across the spectrum of patients with atherothrombotic disease. Results of two large-scale trials support a benefit for ticagrelor in patients with acute coronary syndrome (PLATO; ClinicalTrials.gov: NCT00391872) and in patients with a history of myocardial infarction (PEGASUS-TIMI 54; ClinicalTrials.gov: NCT01225562). Ongoing trials will provide information on the efficacy and safety of ticagrelor in patients with acute ischemic stroke or transient ischemic attack (SOCRATES; ClinicalTrials.gov: NCT01994720), peripheral artery disease (EUCLID; ClinicalTrials.gov: NCT01732822) and coronary artery disease in patients with Type 2 diabetes mellitus (THEMIS: ClinicalTrials.gov: NCT01991795).

Demonstration of SLUMIS: a clinical database and management information system for a multi organ transplant program.

PubMed Central

Kurtz, M.; Bennett, T.; Garvin, P.; Manuel, F.; Williams, M.; Langreder, S.

1991-01-01

Because of the rapid evolution of the heart, heart/lung, liver, kidney and kidney/pancreas transplant programs at our institution, and because of a lack of an existing comprehensive database, we were required to develop a computerized management information system capable of supporting both clinical and research requirements of a multifaceted transplant program. SLUMIS (ST. LOUIS UNIVERSITY MULTI-ORGAN INFORMATION SYSTEM) was developed for the following reasons: 1) to comply with the reporting requirements of various transplant registries, 2) for reporting to an increasing number of government agencies and insurance carriers, 3) to obtain updates of our operative experience at regular intervals, 4) to integrate the Histocompatibility and Immunogenetics Laboratory (HLA) for online test result reporting, and 5) to facilitate clinical investigation. PMID:1807741

Using Simulation in a Psychiatric Mental Health Nurse Practitioner Doctoral Program.

PubMed

Calohan, Jess; Pauli, Eric; Combs, Teresa; Creel, Andrea; Convoy, Sean; Owen, Regina

The use and effectiveness of simulation with standardized patients in undergraduate and graduate nursing education programs is well documented. Simulation has been primarily used to develop health assessment skills. Evidence supports using simulation and standardized patients in psychiatric-mental health nurse practitioner (PMHNP) programs is useful in developing psychosocial assessment skills. These interactions provide individualized and instantaneous clinical feedback to the student from faculty, peers, and standardized patients. Incorporating simulation into advanced practice psychiatric-mental health nursing curriculum allows students to develop the necessary requisite skills and principles needed to safely and effectively provide care to patients. There are no documented standardized processes for using simulation throughout a doctor of nursing practice PMHNP curriculum. The purpose of this article is to describe a framework for using simulation with standardized patients in a PMHNP curriculum. Students report high levels of satisfaction with the simulation experience and believe that they are more prepared for clinical rotations. Faculty feedback indicates that simulated clinical scenarios are a method to ensure that each student experiences demonstrate a minimum standard of competency ahead of clinical rotations with live patients. Initial preceptor feedback indicates that students are more prepared for clinical practice and function more independently than students that did not experience this standardized clinical simulation framework. Published by Elsevier Inc.

[Use of evidence in heath policies and programs contributions of the instituto nacional de salud].

PubMed

Gutierrez, Ericson L; Piazza, Marina; Gutierrez-Aguado, Alfonso; Hijar, Gisely; Carmona, Gloria; Caballero, Patricia; Reyes, Nora; Canelo, Carlos; Aparco, Juan Pablo; Tejada, Romina A; Bolaños-Díaz, Rafael; Saravia, Silvia; Gozzer, Ernesto

2016-01-01

This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.

Mentoring interdisciplinary research teams for the study of sex and gender differences in health and disease.

PubMed

Miller, Virginia M; Bahn, Rebecca S

2013-09-01

Initiatives to hasten the translation of basic science discoveries to clinical care have necessitated the development of new approaches to interdisciplinary collaboration and training of future investigators. This has been nowhere more important than in the study of sex differences with implications for extension into areas of gender medicine. Clearly, gaining better understanding of the role that sex and gender play in health and disease is essential to the implementation of truly individualized medicine. This case report will describe our experiences in developing the Mayo Clinic Building Interdisciplinary Research Programs in Women's Health (BIRCWH) program, an interdisciplinary research and training program in women's health and sex and gender differences. We identify both our successes and the barriers we have encountered in order that others who are developing similar programs might benefit from our experiences.

A practical approach to competency assessment.

PubMed

Claflin, N

1997-01-01

Assessing clinical performance is difficult. Members of the Nursing Service Clinical Practice Committee at the Carl T. Hayden Veterans Affairs Medical Center in Phoenix developed a comprehensive program of competency assessment based on performance measures. This article describes the committee's process of developing and implementing the program and includes a blueprint for competency assessment and selected performance measures for all nursing staff who provide patient care. The approach to competency assessment includes performance measures specific to patients' ages.

Clinical Trial Assessment of Infrastructure Matrix Tool to Improve the Quality of Research Conduct in the Community.

PubMed

Dimond, Eileen P; Zon, Robin T; Weiner, Bryan J; St Germain, Diane; Denicoff, Andrea M; Dempsey, Kandie; Carrigan, Angela C; Teal, Randall W; Good, Marjorie J; McCaskill-Stevens, Worta; Grubbs, Stephen S; Dimond, Eileen P; Zon, Robin T; Weiner, Bryan J; St Germain, Diane; Denicoff, Andrea M; Dempsey, Kandie; Carrigan, Angela C; Teal, Randall W; Good, Marjorie J; McCaskill-Stevens, Worta; Grubbs, Stephen S

2016-01-01

Several publications have described minimum standards and exemplary attributes for clinical trial sites to improve research quality. The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) developed the clinical trial Best Practice Matrix tool to facilitate research program improvements through annual self-assessments and benchmarking. The tool identified nine attributes, each with three progressive levels, to score clinical trial infrastructural elements from less to more exemplary. The NCCCP sites correlated tool use with research program improvements, and the NCI pursued a formative evaluation to refine the interpretability and measurability of the tool. From 2011 to 2013, 21 NCCCP sites self-assessed their programs with the tool annually. During 2013 to 2014, NCI collaborators conducted a five-step formative evaluation of the matrix tool. Sites reported significant increases in level-three scores across the original nine attributes combined (P<.001). Two specific attributes exhibited significant change: clinical trial portfolio diversity and management (P=.0228) and clinical trial communication (P=.0281). The formative evaluation led to revisions, including renaming the Best Practice Matrix as the Clinical Trial Assessment of Infrastructure Matrix (CT AIM), expanding infrastructural attributes from nine to 11, clarifying metrics, and developing a new scoring tool. Broad community input, cognitive interviews, and pilot testing improved the usability and functionality of the tool. Research programs are encouraged to use the CT AIM to assess and improve site infrastructure. Experience within the NCCCP suggests that the CT AIM is useful for improving quality, benchmarking research performance, reporting progress, and communicating program needs with institutional leaders. The tool model may also be useful in disciplines beyond oncology.

Systematic Clinical Reasoning in Physical Therapy (SCRIPT): Tool for the Purposeful Practice of Clinical Reasoning in Orthopedic Manual Physical Therapy.

PubMed

Baker, Sarah E; Painter, Elizabeth E; Morgan, Brandon C; Kaus, Anna L; Petersen, Evan J; Allen, Christopher S; Deyle, Gail D; Jensen, Gail M

2017-01-01

Clinical reasoning is essential to physical therapist practice. Solid clinical reasoning processes may lead to greater understanding of the patient condition, early diagnostic hypothesis development, and well-tolerated examination and intervention strategies, as well as mitigate the risk of diagnostic error. However, the complex and often subconscious nature of clinical reasoning can impede the development of this skill. Protracted tools have been published to help guide self-reflection on clinical reasoning but might not be feasible in typical clinical settings. This case illustrates how the Systematic Clinical Reasoning in Physical Therapy (SCRIPT) tool can be used to guide the clinical reasoning process and prompt a physical therapist to search the literature to answer a clinical question and facilitate formal mentorship sessions in postprofessional physical therapist training programs. The SCRIPT tool enabled the mentee to generate appropriate hypotheses, plan the examination, query the literature to answer a clinical question, establish a physical therapist diagnosis, and design an effective treatment plan. The SCRIPT tool also facilitated the mentee's clinical reasoning and provided the mentor insight into the mentee's clinical reasoning. The reliability and validity of the SCRIPT tool have not been formally studied. Clinical mentorship is a cornerstone of postprofessional training programs and intended to develop advanced clinical reasoning skills. However, clinical reasoning is often subconscious and, therefore, a challenging skill to develop. The use of a tool such as the SCRIPT may facilitate developing clinical reasoning skills by providing a systematic approach to data gathering and making clinical judgments to bring clinical reasoning to the conscious level, facilitate self-reflection, and make a mentored physical therapist's thought processes explicit to his or her clinical mentor. © 2017 American Physical Therapy Association

A Model for Determining Information Diffusion in a Family Planning Program

ERIC Educational Resources Information Center

Jackson, Audrey R.

1972-01-01

Knowledge of the existence of birth control clinics is seen as a function of proximity to clinics, friendliness of neighborhood, and propensity to discuss birth control with neighbors. A conceptual model is developed to illustrate variables contributing to the diffusion of birth control information in a public health family planning program.…

Developing Mentorship Skills in Clinical Faculty: A Best Practices Approach to Supporting Beginning Teachers

ERIC Educational Resources Information Center

Hall, Dara M.; Hughes, Michelle A.; Thelk, Amy D.

2017-01-01

Effective mentoring programs help to recruit new teachers and improve teacher retention rates (e.g. Ingersoll & Strong, 2011, Rideout & Windle, 2010). Many school districts require mentoring programs for new teachers; however, they do not always have the resources to prepare their teachers to mentor beginning teachers. Clinical faculty…

Open-source approaches for the repurposing of existing or failed candidate drugs: learning from and applying the lessons across diseases

PubMed Central

Allarakhia, Minna

2013-01-01

Repurposing has the objective of targeting existing drugs and failed, abandoned, or yet-to-be-pursued clinical candidates to new disease areas. The open-source model permits for the sharing of data, resources, compounds, clinical molecules, small libraries, and screening platforms to cost-effectively advance old drugs and/or candidates into clinical re-development. Clearly, at the core of drug-repurposing activities is collaboration, in many cases progressing beyond the open sharing of resources, technology, and intellectual property, to the sharing of facilities and joint program development to foster drug-repurposing human-capacity development. A variety of initiatives under way for drug repurposing, including those targeting rare and neglected diseases, are discussed in this review and provide insight into the stakeholders engaged in drug-repurposing discovery, the models of collaboration used, the intellectual property-management policies crafted, and human capacity developed. In the case of neglected tropical diseases, it is suggested that the development of human capital be a central aspect of drug-repurposing programs. Open-source models can support human-capital development through collaborative data generation, open compound access, open and collaborative screening, preclinical and possibly clinical studies. Given the urgency of drug development for neglected tropical diseases, the review suggests elements from current repurposing programs be extended to the neglected tropical diseases arena. PMID:23966771

Open-source approaches for the repurposing of existing or failed candidate drugs: learning from and applying the lessons across diseases.

PubMed

Allarakhia, Minna

2013-01-01

Repurposing has the objective of targeting existing drugs and failed, abandoned, or yet-to-be-pursued clinical candidates to new disease areas. The open-source model permits for the sharing of data, resources, compounds, clinical molecules, small libraries, and screening platforms to cost-effectively advance old drugs and/or candidates into clinical re-development. Clearly, at the core of drug-repurposing activities is collaboration, in many cases progressing beyond the open sharing of resources, technology, and intellectual property, to the sharing of facilities and joint program development to foster drug-repurposing human-capacity development. A variety of initiatives under way for drug repurposing, including those targeting rare and neglected diseases, are discussed in this review and provide insight into the stakeholders engaged in drug-repurposing discovery, the models of collaboration used, the intellectual property-management policies crafted, and human capacity developed. In the case of neglected tropical diseases, it is suggested that the development of human capital be a central aspect of drug-repurposing programs. Open-source models can support human-capital development through collaborative data generation, open compound access, open and collaborative screening, preclinical and possibly clinical studies. Given the urgency of drug development for neglected tropical diseases, the review suggests elements from current repurposing programs be extended to the neglected tropical diseases arena.

Implementation of a fall screening program in a high risk of fracture population.

PubMed

Ritchey, Katherine; Olney, Amanda; Shofer, Jane; Phelan, Elizabeth A; Matsumoto, Alvin M

2017-10-31

Fall prevention is an important way to prevent fractures in person with osteoporosis. We developed and implemented a fall screening program in the context of routine osteoporosis care. This program was found to be feasible and showed that a significant proportion of persons with osteoporosis are at risk of falling. Falls are the most common cause of fracture in persons with osteoporosis. However, osteoporosis care rarely includes assessment and prevention of falling. We thus sought to assess the feasibility of a fall screening and management program integrated into routine osteoporosis care. The program was developed and offered to patients with osteoporosis or osteopenia seen at an outpatient clinic between May 2015 and May 2016. Feasibility was measured by physical therapist time required to conduct screening and ease of integrating the screening program into the usual clinic workflow. Self-report responses and mobility testing were conducted to describe the fall and fracture risk profile of osteoporosis patients screened. Effects on fall-related care processes were assessed via chart abstraction of patient participation in fall prevention exercise. Of the 154 clinic patients who presented for a clinic visit, 68% met screening criteria and completed in two thirds of persons. Screening was completed in a third of the time typically allotted for traditional PT evaluations and did not interfere with clinic workflow. Forty percent of those screened reported falling in the last year, and over half had two or more falls in the past year. Over half reported a balance or lower extremity impairment, and over 40% were below norms on one or more performance tests. Most patients who selected a group exercise fall prevention program completed all sessions while only a quarter completed either supervised or independent home-based programs. Implementation of a fall risk screening program in an outpatient osteoporosis clinic appears feasible. A substantial proportion of people with osteoporosis screened positive for being at risk of falling, justifying integration of fall prevention into routine osteoporosis care.

Clinical Reasoning: Survey of Teaching Methods, Integration, and Assessment in Entry-Level Physical Therapist Academic Education.

PubMed

Christensen, Nicole; Black, Lisa; Furze, Jennifer; Huhn, Karen; Vendrely, Ann; Wainwright, Susan

2017-02-01

Although clinical reasoning abilities are important learning outcomes of physical therapist entry-level education, best practice standards have not been established to guide clinical reasoning curricular design and learning assessment. This research explored how clinical reasoning is currently defined, taught, and assessed in physical therapist entry-level education programs. A descriptive, cross-sectional survey was administered to physical therapist program representatives. An electronic 24-question survey was distributed to the directors of 207 programs accredited by the Commission on Accreditation in Physical Therapy Education. Descriptive statistical analysis and qualitative content analysis were performed. Post hoc demographic and wave analyses revealed no evidence of nonresponse bias. A response rate of 46.4% (n=96) was achieved. All respondents reported that their programs incorporated clinical reasoning into their curricula. Only 25% of respondents reported a common definition of clinical reasoning in their programs. Most respondents (90.6%) reported that clinical reasoning was explicit in their curricula, and 94.8% indicated that multiple methods of curricular integration were used. Instructor-designed materials were most commonly used to teach clinical reasoning (83.3%). Assessment of clinical reasoning included practical examinations (99%), clinical coursework (94.8%), written examinations (87.5%), and written assignments (83.3%). Curricular integration of clinical reasoning-related self-reflection skills was reported by 91%. A large number of incomplete surveys affected the response rate, and the program directors to whom the survey was sent may not have consulted the faculty members who were most knowledgeable about clinical reasoning in their curricula. The survey construction limited some responses and application of the results. Although clinical reasoning was explicitly integrated into program curricula, it was not consistently defined, taught, or assessed within or between the programs surveyed-resulting in significant variability in clinical reasoning education. These findings support the need for the development of best educational practices for clinical reasoning curricula and learning assessment. © 2017 American Physical Therapy Association

Development and Implementation of a Peer Mentoring Program for Early Career Gerontological Faculty

PubMed Central

Bryant, Ashley Leak; Brody, Ab; Perez, Adriana; Shillam, Casey; Edelman, Linda S.; Bond, Stewart M.; Foster, Victoria; Siegel, Elena

2016-01-01

Purpose In conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), the Hartford Gerontological Nursing Leaders (HGNL) developed and executed a program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of the HGNL. The purpose of this article is to describe key strategies used to develop and execute the mentoring program and to present the formative and summative program evaluation. Design The program was launched in January 2011 with seven peer mentor and mentee matches. In June 2012, the peer mentoring committee solicited feedback on the development of the peer mentoring program and changes were made for the subsequent cohorts. Findings An additional 12 matches were made in the following 2 years (2012 and 2013), for a total of 31 matches to date. We have learned several key lessons from our three cohorts regarding how to structure, implement, and carefully evaluate a peer mentoring program. Conclusions Informal evaluation of our peer mentoring program noted several challenges for both peer mentors and mentees. Having knowledge of and addressing those challenges may increase the overall quality and effectiveness of peer mentoring programs and, in turn, benefit academic nursing by strengthening the faculty workforce. Clinical Relevance Findings from development and implementation of a peer mentoring program for gerontological faculty could lead to new and adaptable programs in a variety of clinical and education settings. PMID:25808927

Training in interprofessional collaboration: pedagogic innovation in family medicine units.

PubMed

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-04-01

A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Based on adult learning theories, the program was divided into 3 phases--preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program's pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training.

Health Care Workforce Development in Rural America: When Geriatrics Expertise Is 100 Miles Away

ERIC Educational Resources Information Center

Tumosa, Nina; Horvath, Kathy J.; Huh, Terri; Livote, Elayne E.; Howe, Judith L.; Jones, Lauren Ila; Kramer, B. Josea

2012-01-01

The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics…

Development and Pilot Evaluation of a Psychosocial Intervention Program for Patients with Age-Related Macular Degeneration

ERIC Educational Resources Information Center

Birk, Tanja; Hickl, Susanne; Wahl, Hans-Werner; Miller, Daniel; Kammerer, Annette; Holz, Frank; Becker, Stefanie; Volcker, Hans E.

2004-01-01

Purpose: The psychosocial needs of patients suffering from severe visual loss associated with advanced age-related macular degeneration (ARMD) are generally ignored in the clinical routine. The aim of this study was to develop and evaluate a psychosocial intervention program for ARMD patients. This intervention program was based on six modules…

Increasing the ranks of academic researchers in mental health: a multisite approach to postdoctoral fellowship training.

PubMed

O'Hara, Ruth; Cassidy-Eagle, Erin L; Beaudreau, Sherry A; Eyler, Lisa T; Gray, Heather L; Giese-Davis, Janine; Hubbard, Jeffrey; Yesavage, Jerome A

2010-01-01

This report highlights the use of multisite training for psychiatry and psychology postdoctoral fellows developing careers in academic clinical research in the field of mental health. The objective is to describe a model of training for young investigators to establish independent academic clinical research careers, including (1) program structure and eligibility, (2) program goals and development of a multisite curriculum, (3) use of technology for implementing the program across multiple sites, and (4) advantages and challenges of this multisite approach. In 2000, in collaboration with the Veterans Affairs (VA) Mental Illness Research, Education and Clinical Centers (MIRECCs), the VA Office of Academic Affiliations launched the Special Fellowship Program in Advanced Psychiatry and Psychology. Each of the 10 currently participating VA sites across the United States is affiliated with a MIRECC and an academic medical institution. In the first five years of this fellowship program, 83 fellows (34 psychiatrists and 49 psychologists) have participated. The success of this multisite approach is evidenced by the 58 fellows who have already graduated from the program: 70% have entered academic clinical research positions, and over 25 have obtained independent extramural grant support from the VA or the National Institutes of Health. Multisite training results in a greater transfer of knowledge and capitalizes on the nationwide availability of experts, creating unique networking and learning opportunities for trainees. The VA's multisite fellowship program plays a valuable role in preparing substantial numbers of psychiatry and psychology trainees for a range of academic clinical research and leadership positions in the field of mental health.

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

PubMed

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

2011-02-01

Pediatric residency practices face the challenge of providing both behavioral health (BH) training for pediatricians and psychosocial care for children. The University of Rochester School of Medicine and Dentistry and Rochester General Hospital developed a joint training program and continuity clinic infrastructure in which pediatric residents and postdoctoral psychology fellows train and practice together. The integrated program provides children access to BH care in a primary care setting and gives trainees the opportunity to integrate collaborative BH care into their regular practice routines. During 1998-2008, 48 pediatric residents and 8 psychology fellows trained in this integrated clinical environment. The program's accomplishments include longevity, faculty and fiscal stability, sustained support from pediatric leadership and community payers, the development in residents and faculty of greater comfort in addressing BH problems and collaborating with BH specialists, and replication of the model in two other primary care settings. In addition to quantitative program outcomes data, the authors present a case example that illustrates how the integrated program works and achieves its goals. They propose that educating residents and psychology trainees side by side in collaborative BH care is clinically and educationally valuable and potentially applicable to other settings. A companion report published in this issue provides results from a study comparing the perceptions of pediatric residents whose primary care continuity clinic took place in this integrated setting with those of residents from the same pediatric residency who had their continuity clinic training in a nonintegrated setting.

42 CFR 121.9 - Designated transplant program requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.9 Designated transplant program...) Has immediate access to microbiology, clinical chemistry, histocompatibility testing, radiology, and...

42 CFR 121.9 - Designated transplant program requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.9 Designated transplant program...) Has immediate access to microbiology, clinical chemistry, histocompatibility testing, radiology, and...

42 CFR 121.9 - Designated transplant program requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... RESOURCES DEVELOPMENT ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK § 121.9 Designated transplant program...) Has immediate access to microbiology, clinical chemistry, histocompatibility testing, radiology, and...

Hunter disease eClinic: interactive, computer-assisted, problem-based approach to independent learning about a rare genetic disease

PubMed Central

2010-01-01

Background Computer-based teaching (CBT) is a well-known educational device, but it has never been applied systematically to the teaching of a complex, rare, genetic disease, such as Hunter disease (MPS II). Aim To develop interactive teaching software functioning as a virtual clinic for the management of MPS II. Implementation and Results The Hunter disease eClinic, a self-training, user-friendly educational software program, available at the Lysosomal Storage Research Group (http://www.lysosomalstorageresearch.ca), was developed using the Adobe Flash multimedia platform. It was designed to function both to provide a realistic, interactive virtual clinic and instantaneous access to supporting literature on Hunter disease. The Hunter disease eClinic consists of an eBook and an eClinic. The eClinic is the interactive virtual clinic component of the software. Within an environment resembling a real clinic, the trainee is instructed to perform a medical history, to examine the patient, and to order appropriate investigation. The program provides clinical data derived from the management of actual patients with Hunter disease. The eBook provides instantaneous, electronic access to a vast collection of reference information to provide detailed background clinical and basic science, including relevant biochemistry, physiology, and genetics. In the eClinic, the trainee is presented with quizzes designed to provide immediate feedback on both trainee effectiveness and efficiency. User feedback on the merits of the program was collected at several seminars and formal clinical rounds at several medical centres, primarily in Canada. In addition, online usage statistics were documented for a 2-year period. Feedback was consistently positive and confirmed the practical benefit of the program. The online English-language version is accessed daily by users from all over the world; a Japanese translation of the program is also available. Conclusions The Hunter disease eClinic employs a CBT model providing the trainee with realistic clinical problems, coupled with comprehensive basic and clinical reference information by instantaneous access to an electronic textbook, the eBook. The program was rated highly by attendees at national and international presentations. It provides a potential model for use as an educational approach to other rare genetic diseases. PMID:20973983

A distributed model: redefining a robust research subject advocacy program at the Harvard Clinical and Translational Science Center.

PubMed

Winkler, Sabune J; Cagliero, Enrico; Witte, Elizabeth; Bierer, Barbara E

2014-08-01

The Harvard Clinical and Translational Science Center ("Harvard Catalyst") Research Subject Advocacy (RSA) Program has reengineered subject advocacy, distributing the delivery of advocacy functions through a multi-institutional, central platform rather than vesting these roles and responsibilities in a single individual functioning as a subject advocate. The program is process-oriented and output-driven, drawing on the strengths of participating institutions to engage local stakeholders both in the protection of research subjects and in advocacy for subjects' rights. The program engages stakeholder communities in the collaborative development and distributed delivery of accessible and applicable educational programming and resources. The Harvard Catalyst RSA Program identifies, develops, and supports the sharing and distribution of expertise, education, and resources for the benefit of all institutions, with a particular focus on the frontline: research subjects, researchers, research coordinators, and research nurses. © 2014 Wiley Periodicals, Inc.

The BRIGHTEN program: implementation and evaluation of a program to bridge resources of an interdisciplinary geriatric health team via electronic networking.

PubMed

Emery, Erin E; Lapidos, Stan; Eisenstein, Amy R; Ivan, Iulia I; Golden, Robyn L

2012-12-01

To demonstrate the feasibility of the BRIGHTEN Program (Bridging Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking), an interdisciplinary team intervention for assessing and treating older adults for depression in outpatient primary and specialty medical clinics. The BRIGHTEN team collaborates "virtually" to review patient assessment results, develop a treatment plan, and refer to appropriate team members for follow-up care. Older adults in 9 academic medical center clinics and 2 community-based clinics completed screening forms for symptoms of depression and anxiety. Those with positive screens engaged in comprehensive assessment with the BRIGHTEN Program Coordinator; the BRIGHTEN virtual team provided treatment recommendations based on the results of assessment. A collaborative treatment plan was developed with each participant, who was then connected to appropriate services. Two thousand four hundred twenty-two older adults were screened in participating clinics over a 40-month period. Eight hundred fifty-nine older adults screened positive, and 150 elected to enroll in BRIGHTEN. From baseline to 6 months, significant improvements were found in depression symptoms (Geriatric Depression Scale, p < .01) and general mental health (SF-12 Mental Component, p < .01). The BRIGHTEN Program demonstrated that an interdisciplinary virtual team linked with outpatient medical clinics can be an effective, nonthreatening, and seamless approach to enable older adults to access treatment for depression.

Managing a palliative oncology program: the role of a business plan.

PubMed

Walsh, D; Gombeski, W R; Goldstein, P; Hayes, D; Armour, M

1994-02-01

Today's health-care environment demands that palliative-care programs operate in a businesslike manner. This report summarizes the business plan and the process followed to develop the Palliative Care Program at the Cleveland Clinic Foundation (CCF). The benefits generated from this effort and the lessons learned that may be helpful to other program managers are described. By disciplining itself to focus on financial, marketing, and operational issues, the Palliative Care Program is in a better position to advance its clinical services within the organization and in its market area, and can thereby serve its patients more effectively.

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

PubMed

Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B

2018-03-01

The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies.

An American Clinical Training Program for Spanish Nutrition Support Pharmacists: A Three-Year Experience

PubMed Central

Dickerson, Roland N.; Martinez, Eva M.; Fraile, M. Carmen; Giménez, Josefina; Calvo, M. Victoria

2015-01-01

A clinical nutrition support pharmacist training program, in collaboration with the Spanish Foundation of Hospital Pharmacy, Spanish Society of Clinical Nutrition, Abbott Nutrition International, University of Tennessee, College of Pharmacy and Regional One Health, is described. Nutrition support pharmacists from Spain were selected to participate in a one-month training program with an experienced board-certified nutrition support pharmacist faculty member within an interdisciplinary nutrition support team environment in the U.S. Participants were expected to actively engage in an advanced clinical practice role with supervision. Clinical activities included daily intensive patient monitoring, physical assessment, critical evaluation of the patient and development of an appropriate treatment plan for patients receiving either enteral or parenteral nutrition therapy. Upon successful completion of the training program, participants were anticipated to incorporate these techniques into their current practice in Spain and to train other pharmacists to function in an advanced clinical role independently or within an interdisciplinary nutrition support team environment. PMID:28975899

A programmable rules engine to provide clinical decision support using HTML forms.

PubMed Central

Heusinkveld, J.; Geissbuhler, A.; Sheshelidze, D.; Miller, R.

1999-01-01

The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser. Images Figure 1 PMID:10566470

New non-invasive automatic cough counting program based on 6 types of classified cough sounds.

PubMed

Murata, Akira; Ohota, Nao; Shibuya, Atsuo; Ono, Hiroshi; Kudoh, Shoji

2006-01-01

Cough consisting of an initial deep inspiration, glottal closure, and an explosive expiration accompanied by a sound is one of the most common symptoms of respiratory disease. Despite its clinical importance, standard methods for objective cough analysis have yet to be established. We investigated the characteristics of cough sounds acoustically, designed a program to discriminate cough sounds from other sounds, and finally developed a new objective method of non-invasive cough counting. In addition, we evaluated the clinical efficacy of that program. We recorded cough sounds using a memory stick IC recorder in free-field from 2 patients and analyzed the intensity of 534 recorded coughs acoustically according to time domain. First we squared the sound waveform of recorded cough sounds, which was then smoothed out over a 20 ms window. The 5 parameters and some definitions to discriminate the cough sounds from other noise were identified and the cough sounds were classified into 6 groups. Next, we applied this method to develop a new automatic cough count program. Finally, to evaluate the accuracy and clinical usefulness of this program, we counted cough sounds collected from another 10 patients using our program and conventional manual counting. And the sensitivity, specificity and discriminative rate of the program were analyzed. This program successfully discriminated recorded cough sounds out of 1902 sound events collected from 10 patients at a rate of 93.1%. The sensitivity was 90.2% and the specificity was 96.5%. Our new cough counting program can be sufficiently useful for clinical studies.

Clinical biochemistry education in Spain.

PubMed

Queraltó, J M

1994-12-31

Clinical biochemistry in Spain was first established in 1978 as an independent specialty. It is one of several clinical laboratory sciences specialties, together with haematology, microbiology, immunology and general laboratory (Clinical analysis, análisis clinicos). Graduates in Medicine, Pharmacy, Chemistry and Biological Sciences can enter post-graduate training in Clinical Chemistry after a nation-wide examination. Training in an accredited Clinical Chemistry department is 4 years. A national committee for medical and pharmacist specialties advises the government on the number of trainees, program and educational units accreditation criteria. Technical staff includes nurses and specifically trained technologists. Accreditation of laboratories is developed at different regional levels. The Spanish Society for Clinical Biochemistry and Molecular Pathology (SECQ), the national representative in the IFCC, has 1600 members, currently publishes a scientific journal (Química Clinica) and a newsletter. It organizes a continuous education program, a quality control program and an annual Congress.

Nursing faculty preparedness for clinical teaching.

PubMed

Suplee, Patricia Dunphy; Gardner, Marcia; Jerome-D'Emilia, Bonnie

2014-03-01

Nursing faculty who teach in clinical settings face complex situations requiring evidence-based educational and evaluative strategies, yet many have had limited preparation for these tasks. A convenience sample of 74 nursing faculty participated in a survey about clinical teaching in prelicensure nursing programs. Most faculty developed teaching skills through conferences (57%), orientation at their educational institution (53%), or exposure in graduate school (38%). Thirty-one percent reported having no preparation for clinical teaching. Faculty felt least prepared to manage students with learning, physical, or emotional disabilities and incivility. Twenty-six percent had no preparation for evaluating students in the clinical setting, and only 17% had worked with a faculty mentor. Few evidence-based teaching strategies were used by the faculty. These findings indicate gaps exist in the preparation of clinical faculty. Graduate education, comprehensive orientation programs, and continuing professional development may help to ensure faculty are effective in managing and evaluating student learning. Copyright 2014, SLACK Incorporated.

Development of a residency program in radiation oncology physics: an inverse planning approach

PubMed Central

Dunscombe, Peter B.

2016-01-01

Over the last two decades, there has been a concerted effort in North America to organize medical physicists’ clinical training programs along more structured and formal lines. This effort has been prompted by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) which has now accredited about 90 residency programs. Initially the accreditation focused on standardized and higher quality clinical physics training; the development of rounded professionals who can function at a high level in a multidisciplinary environment was recognized as a priority of a radiation oncology physics residency only lately. In this report, we identify and discuss the implementation of, and the essential components of, a radiation oncology physics residency designed to produce knowledgeable and effective clinical physicists for today's safety‐conscious and collaborative work environment. Our approach is that of inverse planning, by now familiar to all radiation oncology physicists, in which objectives and constraints are identified prior to the design of the program. Our inverse planning objectives not only include those associated with traditional residencies (i.e., clinical physics knowledge and critical clinical skills), but also encompass those other attributes essential for success in a modern radiation therapy clinic. These attributes include formal training in management skills and leadership, teaching and communication skills, and knowledge of error management techniques and patient safety. The constraints in our optimization exercise are associated with the limited duration of a residency and the training resources available. Without compromising the knowledge and skills needed for clinical tasks, we have successfully applied the model to the University of Calgary's two‐year residency program. The program requires 3840 hours of overall commitment from the trainee, of which 7%–10% is spent in obtaining formal training in nontechnical “soft skills”. PACS number(s): 01.40 Di, 01.40.gb, 87.10‐e PMID:27074469

Treating Tobacco Dependence: Development of a Smoking Cessation Treatment Program for Outpatient Mental Health Clinics

ERIC Educational Resources Information Center

Gulliver, Suzy Bird; Wolfsdorf, Barbara A.; Morissette, Sandra Baker

2004-01-01

Response to smoking cessation treatment programs sharply decreases when applied to smokers with psychiatric comorbidities. Consequently, the development of smoking cessation treatments that address the needs of psychiatric patients is greatly needed. The primary purpose of this article is to detail the process of development of an empirically…

Developing a Postbasic Gerontology Program for International Learners: Considerations for the Process.

ERIC Educational Resources Information Center

Bolan, Christine M.

2003-01-01

Chilean and Canadian schools of nursing collaborated in the development of 13 self-paced print modules in gerontology with web-based components. A 6-week preceptored clinical experience followed completion of the theory portion to support learner mastery of program outcomes. The curriculum was developed using a creative, systematic approach that…

Enhancing Research Capacity for Global Health: Evaluation of a Distance-Based Program for International Study Coordinators

ERIC Educational Resources Information Center

Wilson, Lynda Law; Rice, Marti; Jones, Carolynn T.; Joiner, Cynthia; LaBorde, Jennifer; McCall, Kimberly; Jester, Penelope M.; Carter, Sheree C.; Boone, Chrissy; Onwuzuligbo, Uzoma; Koneru, Alaya

2013-01-01

Introduction: Due to the increasing number of clinical trials conducted globally, there is a need for quality continuing education for health professionals in clinical research manager (CRM) roles. This article describes the development, implementation, and evaluation of a distance-based continuing education program for CRMs working outside the…

An Exploration of a Community-Based LEGO® Social-Skills Program for Youth with Autism Spectrum Disorder

ERIC Educational Resources Information Center

MacCormack, Jeffrey W. H.; Matheson, Ian A.; Hutchinson, Nancy L.

2015-01-01

Clinical interventions have been effective at increasing social skills of youth with autism spectrum disorder (ASD). However, generalization of those skills to non-clinical environments is often low. To reduce this generalization gap, community-based programs have been designed to help youth develop social skills in naturalistic settings. This…

Zero to Three: Bulletin of the National Center for Clinical Infant Programs. Volume IX, Nos. 1-5, September, 1988-June, 1989.

ERIC Educational Resources Information Center

Zero to Three, 1989

1989-01-01

Five bulletins of the National Center for Clinical Infant Programs provide articles with the following titles and authors: "Motor Control as a Resource for Adaptive Coping" (G. Gordon Williamson et al.); "Fostering Emotional and Social Development in Infants with Disabilities" (Stanley Greenspan); "Dramatic Responses in a…

In Progress: Reports of New Approaches in Medical Education. Annual, Peer-Reviewed Collection of Reports on Innovative Approaches to Medical Education.

ERIC Educational Resources Information Center

Anderson, M. Brownell, Ed.

1997-01-01

Provides summary reports of 81 innovative approaches to medical education in the areas of program management and assessment, admission and student-support programs, computer applications, preclinical and clinical course integration, development of professional skills and values, introduction to clinical medicine, community-based experiences,…

Training in interprofessional collaboration

PubMed Central

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-01-01

Abstract Problem addressed A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. Objective of the program The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Program description Based on adult learning theories, the program was divided into 3 phases—preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program’s pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. Conclusion The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training. PMID:22611607

[Development and effects of emotional intelligence program for undergraduate nursing students: mixed methods research].

PubMed

Lee, Oi Sun; Gu, Mee Ock

2014-12-01

This study was conducted to develop and test the effects of an emotional intelligence program for undergraduate nursing students. The study design was a mixed method research. Participants were 36 nursing students (intervention group: 17, control group: 19). The emotional intelligence program was provided for 4 weeks (8 sessions, 20 hours). Data were collected between August 6 and October 4, 2013. Quantitative data were analyzed using Chi-square, Fisher's exact test, t-test, repeated measure ANOVA, and paired t-test with SPSS/WIN 18.0. Qualitative data were analyzed using content analysis. Quantitative results showed that emotional intelligence, communication skills, resilience, stress coping strategy, and clinical competence were significantly better in the experimental group compared to the control group. According to the qualitative results, the nursing students experienced improvement in emotional intelligence, interpersonal relationships, and empowerment, as well as a reduction in clinical practice stress after participation in the emotional intelligence program. Study findings indicate that the emotional intelligence program for undergraduate nursing students is effective and can be recommended as an intervention for improving the clinical competence of undergraduate students in a nursing curriculum.

PubMed Central

Côté, L.; Clavet, D.; St-Hilaire, S.; Vaillancourt, C.; Blondeau, F.; Martineau, B.

1999-01-01

PROBLEM ADDRESSED: In addition to clinical instruction, residents need "people" skills that will enable them to deal with all sorts of patients in difficult clinical situations. We planned a series of 12 seminars to teach these skills to first-year residents. OBJECTIVES OF PROGRAM: To ask relevant questions typical of the patient-centred approach; with empathy and respect, to encourage patients to express their emotions; to become more aware of one's own emotions and reactions in one's work as a physician; to negotiate with patients, taking into account both the patient's agenda and one's own. MAIN COMPONENTS OF PROGRAM: Clinical problems drawn from a list of situations likely to involve difficult contact with patients were used to achieve program objectives. Various teaching methods (discussion, brief presentation, practical demonstration, role play) were used during the four stages of skills development: information, demonstration, practice, and feedback. Various tools were used to test the program. CONCLUSION: Proper planning requires ongoing exploration of objectives, content, teaching methods, and evaluation. This discussion of the teaching principles applied in planning our seminars might inspire others to develop similar programs. PMID:10349069

The intersection of antimicrobial stewardship and microbiology: educating the next generation of health care professionals.

PubMed

O'Donnell, Lauren A; Guarascio, Anthony J

2017-01-01

With the alarming rise of antibiotic resistance, clinical professionals are called upon to manage antibiotic therapies using the most relevant and recent clinical and laboratory data. To this end, antimicrobial stewardship (AMS) programs aim to reduce unnecessary or suboptimal use of antibiotics while maximizing outcomes for the patient. For AMS programs to succeed, the active participation of clinical professionals at all levels of patient care is required. Although programs exist to train established clinicians in AMS, there is a paucity of literature on how and when to integrate AMS concepts and skills in pre-clinical and clinical coursework. Here, we discuss the crucial microbiology concepts and proficiencies that are necessary for building and supporting an AMS program. We provide recommendations for key points to include in clinical curricula in order to develop the necessary microbiology interpretation skills to participate in AMS. The influence of AMS programs on local organism susceptibility patterns is emphasized. The importance of antibiograms, rapid diagnostic testing and the practical interpretations of microbiology laboratory reporting are discussed in regard to prioritization in clinical curricula. We also review the current literature on instructional strategies for introducing AMS into clinical programs, and propose concepts that should be included in didactic coursework in order to provide a foundation for AMS education. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Impact of Practice-Based Instruction on Graduate Programs in the Pharmaceutical Sciences.

ERIC Educational Resources Information Center

Schumacher, Gerald E.

1979-01-01

A practice- and science-based program of graduate education and scholarship for pharmaceutical science is proposed. Recommendations include the elimination of weak graduate programs, increased industrial support, and development of the clinical scientist. (SF)

Creating an institutional resource for research education and career development: a novel model from Oregon Clinical and Translational Research Institute.

PubMed

Morris, Cynthia D; McCracken, Karen; Samuels, Mary; Orwoll, Eric

2014-06-01

We have created an education and career development program within the CTSA structure at OHSU that serves the entire institution. We believe that this is unusual in scope among CTSA programs and has contributed to an increase in career development funding and research skills among fellows and faculty. While the key element is the institutional scope, important elements include: Tailoring programs of emphasis to points of inflection on the career pathway. Minimizing barriers to education by creating a flexible, tuition-free program. An integrated one-stop education and career development approach. An institutional program for career development award applicants as well as recipients. This career development program was developed within the context of a midsize health science university but the overall strategy may be applied to other CTSAs to simplify and reduce costs of education program development.

Education and training for medicines development, regulation, and clinical research in emerging countries

PubMed Central

Kerpel-Fronius, Sandor; Rosenkranz, Bernd; Allen, Elizabeth; Bass, Rolf; Mainard, Jacques D.; Dodoo, Alex; Dubois, Dominique J.; Hela, Mandisa; Kern, Steven; Massud, Joao; Silva, Honorio; Whitty, Jeremy

2015-01-01

The aim of this satellite workshop held at the 17th World Congress of Basic and Clinical Pharmacology (WCP2014) was to discuss the needs, optimal methods and practical approaches for extending education and teaching of medicines development, regulation, and clinical research to Low and Middle Income Countries (LMICs). It was generally agreed that, for efficiently treating the rapidly growing number of patients suffering from non-communicable diseases, modern drug therapy has to become available more widely and with a shorter time lag in these countries. To achieve this goal many additional experts working in medicines development, regulation, and clinical research have to be trained in parallel. The competence-oriented educational programs designed within the framework of the European Innovative Medicine Initiative-PharmaTrain (IMI-PhT) project were developed with the purpose to cover these interconnected fields. In addition, the programs can be easily adapted to the various local needs, primarily due to their modular architecture and well defined learning outcomes. Furthermore, the program is accompanied by stringent quality assurance standards which are essential for providing internationally accepted certificates. Effective cooperation between international and local experts and organizations, the involvement of the industry, health care centers and governments is essential for successful education. The initiative should also support the development of professional networks able to manage complex health care strategies. In addition it should help establish cooperation between neighboring countries for jointly managing clinical trials, as well as complex regulatory and ethical issues. PMID:25926798

Radiation therapy and PD-1/PD-L1 blockade: the clinical development of an evolving anticancer combination.

PubMed

Gong, Jun; Le, Thang Q; Massarelli, Erminia; Hendifar, Andrew E; Tuli, Richard

2018-06-04

Several inhibitors of programmed cell death-1 (PD-1) and programmed death ligand-1 (PD-L1) have been approved as a form of immunotherapy for multiple cancers. Ionizing radiation therapy (RT) has been shown to enhance the priming and effector phases of the antitumor T-cell response rendering it an attractive therapy to combine with PD-1/PD-L1 inhibitors. Preclinical data support the rational combination of the 2 modalities and has paved way for the clinical development of the combination across a spectrum of cancers. In this review, we highlight the preclinical and clinical development of combined RT and PD-1/PD-L1 blockade to date. In addition to a comprehensive evaluation of available safety and efficacy data, we discuss important points of consideration in clinical trial design for this promising combination.

Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study.

PubMed

Goodrich, David E; Buis, Lorraine R; Janney, Adrienne W; Ditty, Megan D; Krause, Christine W; Zheng, Kai; Sen, Ananda; Strecher, Victor J; Hess, Michael L; Piette, John D; Richardson, Caroline R

2011-06-24

Regular participation in physical activity can prevent many chronic health conditions. Computerized self-management programs are effective clinical tools to support patient participation in physical activity. This pilot study sought to develop and evaluate an online interface for primary care providers to refer patients to an Internet-mediated walking program called Stepping Up to Health (SUH) and to monitor participant progress in the program. In Phase I of the study, we recruited six pairs of physicians and medical assistants from two family practice clinics to assist with the design of a clinical interface. During Phase II, providers used the developed interface to refer patients to a six-week pilot intervention. Provider perspectives were assessed regarding the feasibility of integrating the program into routine care. Assessment tools included quantitative and qualitative data gathered from semi-structured interviews, surveys, and online usage logs. In Phase I, 13 providers used SUH and participated in two interviews. Providers emphasized the need for alerts flagging patients who were not doing well and the ability to review participant progress. Additionally, providers asked for summary views of data across all enrolled clinic patients as well as advertising materials for intervention recruitment. In response to this input, an interface was developed containing three pages: 1) a recruitment page, 2) a summary page, and 3) a detailed patient page. In Phase II, providers used the interface to refer 139 patients to SUH and 37 (27%) enrolled in the intervention. Providers rarely used the interface to monitor enrolled patients. Barriers to regular use of the intervention included lack of integration with the medical record system, competing priorities, patient disinterest, and physician unease with exercise referrals. Intention-to-treat analyses showed that patients increased walking by an average of 1493 steps/day from pre- to post-intervention (t = (36) = 4.13, p < 0.01). Providers successfully referred patients using the SUH provider interface, but were less willing to monitor patient compliance in the program. Patients who completed the program significantly increased their step counts. Future research is needed to test the effectiveness of integrating SUH with clinical information systems over a longer evaluation period.

The Alzheimer's Prevention Initiative Generation Program: Evaluating CNP520 Efficacy in the Prevention of Alzheimer's Disease.

PubMed

Lopez Lopez, C; Caputo, A; Liu, F; Riviere, M E; Rouzade-Dominguez, M-L; Thomas, R G; Langbaum, J B; Lenz, R; Reiman, E M; Graf, A; Tariot, P N

2017-01-01

Alzheimer's disease pathology begins decades before the onset of clinical symptoms. This provides an opportunity for interventional clinical trials to potentially delay or prevent the onset of cognitive impairment or dementia. CNP520 (a beta-site-amyloid precursor protein-cleaving enzyme inhibitor) is in clinical development for the treatment of preclinical Alzheimer's disease under the Alzheimer's Prevention Initiative Generation Program. The Alzheimer's Prevention Initiative is a public-private partnership intended to accelerate the evaluation of Alzheimer's disease prevention therapies. The Generation Program comprises two pivotal phase II/III studies with similar designs to assess the efficacy and safety of investigational treatments in a cognitively unimpaired population at increased risk for developing Alzheimer's disease based on age and apolipoprotein E (APOE) genotype (i.e., presence of the APOE ε4 allele). The program has been designed to maximize benefit to Alzheimer's disease research. Generation Study 1 (NCT02565511) and Generation Study 2 (NCT03131453) are currently enrolling; their key features are presented here.

Translating learning into practice

PubMed Central

Armson, Heather; Kinzie, Sarah; Hawes, Dawnelle; Roder, Stefanie; Wakefield, Jacqueline; Elmslie, Tom

2007-01-01

PROBLEM ADDRESSED The need for effective and accessible educational approaches by which family physicians can maintain practice competence in the face of an overwhelming amount of medical information. OBJECTIVE OF PROGRAM The practice-based small group (PBSG) learning program encourages practice changes through a process of small-group peer discussion—identifying practice gaps and reviewing clinical approaches in light of evidence. PROGRAM DESCRIPTION The PBSG uses an interactive educational approach to continuing professional development. In small, self-formed groups within their local communities, family physicians discuss clinical topics using prepared modules that provide sample patient cases and accompanying information that distils the best evidence. Participants are guided by peer facilitators to reflect on the discussion and commit to appropriate practice changes. CONCLUSION The PBSG has evolved over the past 15 years in response to feedback from members and reflections of the developers. The success of the program is evidenced in effect on clinical practice, a large and increasing number of members, and the growth of interest internationally. PMID:17872876

Improving Medical Students' Application of Knowledge and Clinical Decision-Making Through a Porcine-Based Integrated Cardiac Basic Science Program.

PubMed

Stott, Martyn Charles; Gooseman, Michael Richard; Briffa, Norman Paul

2016-01-01

Despite the concerted effort of modern undergraduate curriculum designers, the ability to integrate basic sciences in clinical rotations is an ongoing problem in medical education. Students and newly qualified doctors themselves report worry about the effect this has on their clinical performance. There are examples in the literature to support development of attempts at integrating such aspects, but this "vertical integration" has proven to be difficult. We designed an expert-led integrated program using dissection of porcine hearts to improve the use of cardiac basic sciences in clinical medical students' decision-making processes. To our knowledge, this is the first time in the United Kingdom that an animal model has been used to teach undergraduate clinical anatomy to medical students to direct wider application of knowledge. Action research methodology was used to evaluate the local curriculum and assess learners needs, and the agreed teaching outcomes, methods, and delivery outline were established. A total of 18 students in the clinical years of their degree program attended, completing precourse and postcourse multichoice questions examinations and questionnaires to assess learners' development. Student's knowledge scores improved by 17.5% (p = 0.01; students t-test). Students also felt more confident at applying underlying knowledge to decision-making and diagnosis in clinical medicine. An expert teacher (consultant surgeon) was seen as beneficial to students' understanding and appreciation. This study outlines how the development of a teaching intervention using porcine-based methods successfully improved both student's knowledge and application of cardiac basic sciences. We recommend that clinicians fully engage with integrating previously learnt underlying sciences to aid students in developing decision-making and diagnostic skills as well as a deeper approach to learning. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program

PubMed Central

Antinori, Andrea; Arendt, Gabriele; Grant, Igor; Letendre, Scott; Chair; Muñoz-Moreno, Jose A.; Eggers, Christian; Brew, Bruce; Brouillette, Marie-Josée; Bernal-Cano, Francisco; Carvalhal, Adriana; Christo, Paulo Pereira; Cinque, Paola; Cysique, Lucette; Ellis, Ronald; Everall, Ian; Gasnault, Jacques; Husstedt, Ingo; Korten, Volkan; Machala, Ladislav; Obermann, Mark; Ouakinin, Silvia; Podzamczer, Daniel; Portegies, Peter; Rackstraw, Simon; Rourke, Sean; Sherr, Lorraine; Streinu-Cercel, Adrian; Winston, Alan; Wojna, Valerie; Yazdanpannah, Yazdan; Arbess, Gordon; Baril, Jean-Guy; Begovac, Josip; Bergin, Colm; Bonfanti, Paolo; Bonora, Stefano; Brinkman, Kees; Canestri, Ana; Cholewińska-Szymańska, Graźyna; Chowers, Michal; Cooney, John; Corti, Marcelo; Doherty, Colin; Elbirt, Daniel; Esser, Stefan; Florence, Eric; Force, Gilles; Gill, John; Goffard, Jean-Christophe; Harrer, Thomas; Li, Patrick; de Kerckhove, Linos Van; Knecht, Gaby; Matsushita, Shuzo; Matulionyte, Raimonda; McConkey, Sam; Mouglignier, Antoine; Oka, Shinichi; Penalva, Augusto; Riesenberg, Klaris; Sambatakou, Helen; Tozzi, Valerio; Vassallo, Matteo; Wetterberg, Peter; Drapato, Alicia Wiercińska

2013-01-01

Many practical clinical questions regarding the management of human immunodeficiency virus (HIV)–associated neurocognitive disorder (HAND) remain unanswered. We sought to identify and develop practical answers to key clinical questions in HAND management. Sixty-six specialists from 30 countries provided input into the program, which was overseen by a steering committee. Fourteen questions were rated as being of greatest clinical importance. Answers were drafted by an expert group based on a comprehensive literature review. Sixty-three experts convened to determine consensus and level of evidence for the answers. Consensus was reached on all answers. For instance, good practice suggests that all HIV patients should be screened for HAND early in disease using standardized tools. Follow-up frequency depends on whether HAND is already present or whether clinical data suggest risk for developing HAND. Worsening neurocognitive impairment may trigger consideration of antiretroviral modification when other causes have been excluded. The Mind Exchange program provides practical guidance in the diagnosis, monitoring, and treatment of HAND. PMID:23175555

Indigenous health: designing a clinical orientation program valued by learners.

PubMed

Huria, Tania; Palmer, Suetonia; Beckert, Lutz; Lacey, Cameron; Pitama, Suzanne

2017-10-05

Indigenous health programs are seen as a curriculum response to addressing health disparities and social accountability. Several interrelated teaching approaches to cultural competency curricula have been recommended, however evidence of the impact of these on learner outcomes including engagement and self-reported competencies is limited. We aimed to explore undergraduate medical student perspectives of an indigenous health orientation program to inform curriculum strategies that promote learning and development of clinical skills. We analyzed quantitative and qualitative student evaluations (n = 602) of a three-day immersed indigenous health orientation program between 2006 and 2014 based on Likert-scale responses and open-text comments. We conducted a thematic analysis of narrative student experiences (n = 426). Overall, 509 of 551 respondents (92%) rated the indigenous health orientation program as extremely or highly valuable and most (87%) reported that the course strongly increased their interest in indigenous health. The features of the clinical course that enhanced value for learners included situated learning (learning environment; learning context); teaching qualities (enthusiasm and passion for Māori health; role-modelling); curriculum content (re-presenting Māori history; exploring Māori beliefs, values and practices; using a Māori health framework in clinical practice); teaching methodologies (multiple teaching methods; simulated patient interview); and building relationships with peers (getting to know the student cohort; developing professional working relationships). Undergraduate medical students valued an indigenous health program delivered in an authentic indigenous environment and that explicitly reframed historical notions of indigenous health to contextualize learning. Content relevant to clinical practice, faculty knowledge, and strengthened peer interactions combined to build learner confidence and self-reported indigenous health competencies. These findings suggest empirical evidence to support a curriculum approach to indigenous health teaching that enhances clinical learning.

Expanding Clinical Medical Training Opportunities at the University of Nairobi: Adapting a Regional Medical Education Model from the WWAMI Program at the University of Washington

PubMed Central

Child, Mara J.; Kiarie, James N.; Allen, Suzanne M.; Nduati, Ruth; Wasserheit, Judith N.; Kibore, Minnie W.; John-Stewart, Grace; Njiri, Francis J.; O'Malley, Gabrielle; Kinuthia, Raphael; Norris, Tom E.; Farquhar, Carey

2014-01-01

A major medical education need in Sub-Saharan Africa includes expanding clinical training opportunities to develop health professionals. Medical education expansion is a complicated process that requires significant investment of financial and human resources, but it can also provide opportunities for innovative approaches and partnerships. In 2010, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) launched the Medical Education Partnership Initiative to invest in medical education and health system strengthening in Africa. Building on a 30-year collaborative clinical and research training partnership, the University of Nairobi in Kenya developed a pilot regional medical education program modeled on the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) medical education program at the University of Washington in the United States. The University of Nairobi adapted key elements of the WWAMI model to expand clinical training opportunities without requiring major capital construction of new buildings or campuses. The pilot program provides short-term clinical training opportunities for undergraduate students and recruits and trains clinical faculty at 14 decentralized training sites. The adaptation of a model from the Northwestern United States to address medical education needs in Kenya is a successful transfer of knowledge and practices that can be scaled up and replicated across Sub-Saharan Africa. PMID:25072575

Implementation of a new advanced graduate education program in oral implantology.

PubMed

Gallucci, German O; Weber, Hans Peter; Kalenderian, Elsbeth

2012-10-01

The academic program for the Harvard School of Dental Medicine's Advanced Graduate Program in Oral Implantology is based on scientific evidence applied to educational quality, translational research, patient care, and service. The objective of the program is to enable highly motivated individuals with proven scholarship and excellence in patient care to achieve academic leadership in the clinical and scientific fields of implant dentistry and tissue regeneration. A detailed curriculum describing the academic program, as well as a business plan (which included a management plan describing the organizational structure, financial implications, and market forces) and implementation and communication plans, were developed before moving forward. With careful academic and business planning, the result was a vibrant implant program, in which all placements and restorations of implants are coordinated with regard to practice management. The program is integrated into the existing clinical care model and has been financially self-sustaining from its inception. Six students have participated in the last two years. On average, each student performed seventy-nine procedures on twenty-nine patients, generating over $46,000 in production. The curriculum includes didactics, hands-on clinical learning, and research activities. Research is a critical component as well. The results demonstrate that the time taken to develop a detailed curriculum and business plan for a new academic program, which anticipated and resolved potential barriers to success, was instrumental in the successful implementation of an oral implantology residency program.

Clinical Supervision Skills: Managing the Clinical Environment. Health Occupations Clinical Teacher Education Series for Secondary and Post-Secondary Educators.

ERIC Educational Resources Information Center

Shea, Mary Lou; And Others

This learning module, which is part of a staff development program for health occupations clinical instructors, discusses the process of managing the physical clinical environment and students' experiences within the clinical environment. It includes learning activities dealing with various aspects of managing the physical environment and student…

Crossing the chasm: information technology to biomedical informatics.

PubMed

Fahy, Brenda G; Balke, C William; Umberger, Gloria H; Talbert, Jeffery; Canales, Denise Niles; Steltenkamp, Carol L; Conigliaro, Joseph

2011-06-01

Accelerating the translation of new scientific discoveries to improve human health and disease management is the overall goal of a series of initiatives integrated in the National Institutes of Health (NIH) "Roadmap for Medical Research." The Clinical and Translational Science Award (CTSA) program is, arguably, the most visible component of the NIH Roadmap providing resources to institutions to transform their clinical and translational research enterprises along the goals of the Roadmap. The CTSA program emphasizes biomedical informatics as a critical component for the accomplishment of the NIH's translational objectives. To be optimally effective, emerging biomedical informatics programs must link with the information technology platforms of the enterprise clinical operations within academic health centers.This report details one academic health center's transdisciplinary initiative to create an integrated academic discipline of biomedical informatics through the development of its infrastructure for clinical and translational science infrastructure and response to the CTSA mechanism. This approach required a detailed informatics strategy to accomplish these goals. This transdisciplinary initiative was the impetus for creation of a specialized biomedical informatics core, the Center for Biomedical Informatics (CBI). Development of the CBI codified the need to incorporate medical informatics including quality and safety informatics and enterprise clinical information systems within the CBI. This article describes the steps taken to develop the biomedical informatics infrastructure, its integration with clinical systems at one academic health center, successes achieved, and barriers encountered during these efforts.

[The Italian instrument evaluating the nursing students clinical learning quality].

PubMed

Palese, Alvisa; Grassetti, Luca; Mansutti, Irene; Destrebecq, Anne; Terzoni, Stefano; Altini, Pietro; Bevilacqua, Anita; Brugnolli, Anna; Benaglio, Carla; Dal Ponte, Adriana; De Biasio, Laura; Dimonte, Valerio; Gambacorti, Benedetta; Fasci, Adriana; Grosso, Silvia; Mantovan, Franco; Marognolli, Oliva; Montalti, Sandra; Nicotera, Raffaela; Randon, Giulia; Stampfl, Brigitte; Tollini, Morena; Canzan, Federica; Saiani, Luisa; Zannini, Lucia

2017-01-01

. The Clinical Learning Quality Evaluation Index for nursing students. The Italian nursing programs, the need to introduce tools evaluating the quality of the clinical learning as perceived by nursing students. Several tools already exist, however, several limitations suggesting the need to develop a new tool. A national project aimed at developing and validating a new instrument capable of measuring the clinical learning quality as experience by nursing students. A validation study design was undertaken from 2015 to 2016. All nursing national programs (n=43) were invited to participate by including all nursing students attending regularly their clinical learning. The tool developed based upon a) literature, b) validated tools already established among other healthcare professionals, and c) consensus expressed by experts and nursing students, was administered to the eligible students. 9606 nursing in 27 universities (62.8%) participated. The psychometric properties of the new instrument ranged from good to excellent. According to the findings, the tool consists in 22 items and five factors: a) quality of the tutorial strategies, b) learning opportunities; c) safety and nursing care quality; d) self-direct learning; e) quality of the learning environment. The tool is already used. Its systematic adoption may support comparison among settings and across different programs; moreover, the tool may also support in accrediting new settings as well as in measuring the effects of strategies aimed at improving the quality of the clinical learning.

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

PubMed Central

Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M.; Golden, Sherita Hill

2013-01-01

Background Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes Overall the average patient-day–weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives. PMID:22649859

Implementing and evaluating a multicomponent inpatient diabetes management program: putting research into practice.

PubMed

Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M; Golden, Sherita Hill

2012-05-01

Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. CONCEPTUAL MODEL COMPONENTS: The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staffwhile incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Overall the average patient-day-weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives.

Long-term outcomes of the New Jersey nurse faculty preparation program scholars.

PubMed

Gerolamo, Angela M; Conroy, Kara; Roemer, Grace; Holmes, Aline; Salmond, Susan; Polakowski, Jennifer

Rising concerns over the capacity of nursing education to prepare enough nurses to meet population demand have received national attention. The Robert Wood Johnson Foundation implemented the New Jersey Nursing Initiative Faculty Preparation Program to address nursing workforce issues in New Jersey. This paper describes program and scholar outcomes and provides recommendations for nurse faculty development. This descriptive study uses data from scholar surveys and interviews with grantees. Findings suggest that a faculty preparation program that targets doctoral students and includes financial support, socialization to the faculty role, and formal education courses produces graduates who maintain a career in nursing education for up to three years after program completion. However, most master's-level students who also received formal preparation in nursing education were employed in clinical practice. Program developers must carefully consider the design of programs that integrate faculty preparation and advanced clinical training for master's-level students. Copyright © 2017 Elsevier Inc. All rights reserved.

Postdoctoral Fellow | Center for Cancer Research

Cancer.gov

The Laboratory of Tumor Immunology and Biology (LTIB) functions as a multidisciplinary and interdisciplinary translational research programmatic effort with the goal of developing novel immunotherapies for cancer. The LTIB strategic plan focuses on the development of novel immunotherapeutics for human cancer, not only as monotherapies, but more importantly, in combination with other immune-mediating modalities, and other conventional or experimental therapies, as part of an immuno-oncology programmatic effort. Within this effort are several research groups, a clinical trials group, and multiple collaborations with intramural and extramural scientific and clinical investigators and with investigators in the private sector. The program takes advantage of the uniqueness of the NCI intramural program in that it spans high-risk basic discovery research in immunology, genomics and tumor biology, through preclinical translational research, to paradigm-shifting clinical trials. Focus is placed on the design and development of novel "off-the-shelf" recombinant immunotherapeutics that can be used in clinical studies at numerous institutions. A major strength of the program is the rapid translation of preclinical studies to hypothesis-generating clinical trials. We are looking for postdoctoral fellows interested in learning immunology and immunotherapy, as well as those postdoctoral fellows with a background and/or interest in experimental pathology.  The position is available immediately. The appointment duration is up to 5 years. Stipends are commensurate with education and experience.

Randomization in cancer clinical trials: permutation test and development of a computer program.

PubMed Central

Ohashi, Y

1990-01-01

When analyzing cancer clinical trial data where the treatment allocation is done using dynamic balancing methods such as the minimization method for balancing the distribution of important prognostic factors in each arm, conservativeness occurs if such a randomization scheme is ignored and a simple unstratified analysis is carried out. In this paper, the above conservativeness is demonstrated by computer simulation, and the development of a computer program that carries out permutation tests of the log-rank statistics for clinical trial data where the allocation is done by the minimization method or a stratified permuted block design is introduced. We are planning to use this program in practice to supplement a usual stratified analysis and model-based methods such as the Cox regression. The most serious problem in cancer clinical trials in Japan is how to carry out the quality control or data management in trials that are initiated and conducted by researchers without support from pharmaceutical companies. In the final section of this paper, one international collaborative work for developing international guidelines on data management in clinical trials of bladder cancer is briefly introduced, and the differences between the system adopted in US/European statistical centers and the Japanese system is described. PMID:2269216

Returning nurses to the workforce: developing a fast track back program.

PubMed

Burns, Helen K; Sakraida, Teresa J; Englert, Nadine C; Hoffmann, Rosemary L; Tuite, Patricia; Foley, Susan M

2006-01-01

Fast Track Back: Re-entry into Nursing Practice program. Describes the development, implementation, and evaluation of a state-of-the-art re-entry program facilitating the return of licensed nonpracticing RNs to the workforce through a quality education program that retools them for the workforce in the areas of pharmacology, skill development using the latest technology, practice standards, and nursing issues. The program consists of didactic content taught via classroom, Internet, skills laboratory, and high fidelity human simulated technology and a clinical component. The program is a mechanism that enables re-entry nurses to improve skills and competencies necessary to practice in today's healthcare environment.

Recommendations for the Improved Effectiveness and Reporting of Telemedicine Programs in Developing Countries: Results of a Systematic Literature Review.

PubMed

Khanal, Sumesh; Burgon, Joseph; Leonard, Saoirse; Griffiths, Matthew; Eddowes, Lucy A

2015-11-01

A lack of decisive evidence on the impact of telemedicine on financial and clinical outcomes has not prohibited significant investment in developing countries. Understanding characteristics that facilitate effective telemedicine programs is required to allow telemedicine to be used to its full potential. This systematic review aimed to identify organizational, technological, and financial features of successful telemedicine programs providing direct clinical care in developing countries. Databases were searched, and the results were reviewed systematically according to predefined inclusion/exclusion criteria. Information on location(s), measure of success, and organizational, technological, and financial characteristics were extracted. This review was impeded by inadequate program reporting, and so a concise checklist was developed to aid improved reporting, enabling future reviews to identify key characteristics of effective programs. This systematic review identified 46 articles reporting 36 programs that fulfilled the inclusion/exclusion criteria. Programs were distributed globally, including regional, national, and international programs. Technological modalities included synchronous technology, real-time teleconsultations, and asynchronous technology. Program integration with existing systems and twinning of international institutions were identified as factors enabling program success. Other factors included simple and easy-to-use technology, ability to reduce the burden on healthcare professionals, and technology able to maintain functionality in challenging environmental circumstances. Reports describing effectiveness and costs were limited. This systematic review identified key factors associated with telemedicine program success. However, inconsistencies in reporting represent an obstacle to establishment of successful programs in developing countries by limiting the application of previous experiences. Adhering to the guidelines suggested here may allow more quantitative assessments of effectiveness and impact for future programs.

Training the next generation of research mentors: the University of California, San Francisco, Clinical & Translational Science Institute Mentor Development Program.

PubMed

Feldman, Mitchell D; Huang, Laurence; Guglielmo, B Joseph; Jordan, Richard; Kahn, James; Creasman, Jennifer M; Wiener-Kronish, Jeanine P; Lee, Kathryn A; Tehrani, Ariane; Yaffe, Kristine; Brown, Jeanette S

2009-06-01

Mentoring is a critical component of career development and success for clinical translational science research faculty. Yet few programs train faculty in mentoring skills. We describe outcomes from the first two faculty cohorts who completed a Mentor Development Program (MDP) at UCSF. Eligibility includes having dedicated research time, expertise in a scientific area and a desire to be a lead research mentor. A post-MDP survey measured the program's impact on enhancement of five key mentoring skills, change in the Mentors-in-Training (MIT) self-rated importance of being a mentor to their career satisfaction, and overall confidence in their mentoring skills. Since 2007, 29 MITs participated in and 26 completed the MDP. Only 15% of the MITs reported any previous mentor training. Overall, 96% of MITs felt that participation in the MDP helped them to become better mentors. A majority reported a significant increase in confidence in mentoring skills and most reported an increased understanding of important mentoring issues at UCSF. MITs reported increased confidence in overall and specific mentoring skills after completion of the MDP. The MDP can serve as a model for other institutions to develop the next generation of clinical-translational research mentors.

[Implementing the "last mile" program in new nurse clinical education].

PubMed

Wang, Yu-Hsin; Jane, Sui-Whi; Fan, Jun-Yu; Chou, Shieu-Ming

2013-06-01

The shortage of working nurses has made Taiwan's low nursing retention rate a critical issue in domestic healthcare. Main reasons for new nurses leaving their jobs include high pressure, overtime work, heavy workload, interpersonal relationship problems with colleagues, and inadequate support from administrators. In response, nursing educators designed the "last mile" program to improve the hands-on competence of nursing students with the goal of increasing post-graduation retention rates. This article introduces the last mile program in its present form and discusses the challenges faced in transitioning the program from the classroom into the clinical training environment. The authors suggest establishing a challenge test prior to implementing the last mile program, recruiting role-model preceptors, adjusting training program / project budgets, and developing partnerships between nursing educators and clinicians to enhance the clinical competence of new nurses and ultimately increase professional nurse retention rates, competence, and accountability.

Development of a diabetes care management curriculum in a family practice residency program.

PubMed

Nuovo, Jim; Balsbaugh, Thomas; Barton, Sue; Davidson, Ellen; Fox-Garcia, Jane; Gandolfo, Angela; Levich, Bridget; Seibles, Joann

2004-01-01

Improving the quality of care for patients with chronic illness has become a high priority. Implementing training programs in disease management (DM) so the next generation of physicians can manage chronic illness more effectively is challenging. Residency training programs have no specific mandate to implement DM training. Additional barriers at the training facility include: 1) lack of a population-based perspective for service delivery; 2) weak support for self-management of illness; 3) incomplete implementation due to physician resistance or inertia; and 4) few incentives to change practices and behaviors. In order to overcome these barriers, training programs must take the initiative to implement DM training that addresses each of these issues. We report the implementation of a chronic illness management curriculum based on the Improving Chronic Illness Care (ICIC) Model. Features of this process included both patient care and learner objectives. These were: development of a multidisciplinary diabetes DM team; development of a patient registry; development of diabetes teaching clinics in the family practice center (nutrition, general management classes, and one-on-one teaching); development of a group visit model; and training the residents in the elements of the ICIC Model, ie, the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Barriers to implementing these curricular changes were: the development of a patient registry; buy-in from faculty, residents, clinic leadership, staff, and patients for the chronic care model; the ability to bill for services and maintain clinical productivity; and support from the health system key stakeholders for sustainability. Unique features of each training site will dictate differences in emphasis and structure; however, the core principles of the ICIC Model in enhancing self-management may be generalized to all sites.

Development of a relational database to capture and merge clinical history with the quantitative results of radionuclide renography.

PubMed

Folks, Russell D; Savir-Baruch, Bital; Garcia, Ernest V; Verdes, Liudmila; Taylor, Andrew T

2012-12-01

Our objective was to design and implement a clinical history database capable of linking to our database of quantitative results from (99m)Tc-mercaptoacetyltriglycine (MAG3) renal scans and export a data summary for physicians or our software decision support system. For database development, we used a commercial program. Additional software was developed in Interactive Data Language. MAG3 studies were processed using an in-house enhancement of a commercial program. The relational database has 3 parts: a list of all renal scans (the RENAL database), a set of patients with quantitative processing results (the Q2 database), and a subset of patients from Q2 containing clinical data manually transcribed from the hospital information system (the CLINICAL database). To test interobserver variability, a second physician transcriber reviewed 50 randomly selected patients in the hospital information system and tabulated 2 clinical data items: hydronephrosis and presence of a current stent. The CLINICAL database was developed in stages and contains 342 fields comprising demographic information, clinical history, and findings from up to 11 radiologic procedures. A scripted algorithm is used to reliably match records present in both Q2 and CLINICAL. An Interactive Data Language program then combines data from the 2 databases into an XML (extensible markup language) file for use by the decision support system. A text file is constructed and saved for review by physicians. RENAL contains 2,222 records, Q2 contains 456 records, and CLINICAL contains 152 records. The interobserver variability testing found a 95% match between the 2 observers for presence or absence of ureteral stent (κ = 0.52), a 75% match for hydronephrosis based on narrative summaries of hospitalizations and clinical visits (κ = 0.41), and a 92% match for hydronephrosis based on the imaging report (κ = 0.84). We have developed a relational database system to integrate the quantitative results of MAG3 image processing with clinical records obtained from the hospital information system. We also have developed a methodology for formatting clinical history for review by physicians and export to a decision support system. We identified several pitfalls, including the fact that important textual information extracted from the hospital information system by knowledgeable transcribers can show substantial interobserver variation, particularly when record retrieval is based on the narrative clinical records.

Combat Wound Initiative program.

PubMed

Stojadinovic, Alexander; Elster, Eric; Potter, Benjamin K; Davis, Thomas A; Tadaki, Doug K; Brown, Trevor S; Ahlers, Stephen; Attinger, Christopher E; Andersen, Romney C; Burris, David; Centeno, Jose; Champion, Hunter; Crumbley, David R; Denobile, John; Duga, Michael; Dunne, James R; Eberhardt, John; Ennis, William J; Forsberg, Jonathan A; Hawksworth, Jason; Helling, Thomas S; Lazarus, Gerald S; Milner, Stephen M; Mullick, Florabel G; Owner, Christopher R; Pasquina, Paul F; Patel, Chirag R; Peoples, George E; Nissan, Aviram; Ring, Michael; Sandberg, Glenn D; Schaden, Wolfgang; Schultz, Gregory S; Scofield, Tom; Shawen, Scott B; Sheppard, Forest R; Stannard, James P; Weina, Peter J; Zenilman, Jonathan M

2010-07-01

The Combat Wound Initiative (CWI) program is a collaborative, multidisciplinary, and interservice public-private partnership that provides personalized, state-of-the-art, and complex wound care via targeted clinical and translational research. The CWI uses a bench-to-bedside approach to translational research, including the rapid development of a human extracorporeal shock wave therapy (ESWT) study in complex wounds after establishing the potential efficacy, biologic mechanisms, and safety of this treatment modality in a murine model. Additional clinical trials include the prospective use of clinical data, serum and wound biomarkers, and wound gene expression profiles to predict wound healing/failure and additional clinical patient outcomes following combat-related trauma. These clinical research data are analyzed using machine-based learning algorithms to develop predictive treatment models to guide clinical decision-making. Future CWI directions include additional clinical trials and study centers and the refinement and deployment of our genetically driven, personalized medicine initiative to provide patient-specific care across multiple medical disciplines, with an emphasis on combat casualty care.

[E-learning : an effective and necessary complement to the postgraduate training].

PubMed

Galland-Decker, Coralie; Gachoud, David; Monti, Matteo

2016-11-23

The evolution of modern medicine largely influenced the development of new postgraduate training programs, which requirements are more engaging and constraining. Time dedicated to education more and more often comes into competition with the resident's clinical and administrative activities. In this context, E-learning could be an interesting solution, if used complementary to the classical training which does not further overload the clinical activity. By focusing on the recognition of clinical images, and interpretation of functional tests, we target some well known knowledge gaps of our trainees. Our program allows every participant to be exposed to some important, prototypical or rare situations, independent of the clinical exposure. The quality of our program is ensured by the collaboration with several specialty departments of our hospital.

Further development of pharmacy student-facilitated diabetes management clinics.

PubMed

Nuffer, Wesley; McCollum, Marianne; Ellis, Samuel L; Turner, Christopher J

2012-04-10

To further develop and evaluate a diabetes disease state management (DSM) program that provided direct patient care responsibilities to advanced pharmacy practice experience (APPE) students as members of healthcare teams. Nine new clinics and 3 established sites that provide self-care management education to patients with diabetes were established and maintained in rural Colorado pharmacies and supported by students in APPE training for 48 weeks per year. The 12 clinics provided 120 APPE student placements in 2010-2011. Students' perceptions of their experiences were positive. Patients who completed the student-supported diabetes self-management education program had improvements in blood glucose, blood pressure, and lipid values. Twelve diabetes DSM clinics provided direct patient care opportunities to APPE students working as part of healthcare teams while expanding healthcare resources in underserved communities in Colorado.

Establishing a successful clinical research program.

PubMed

Scoglio, Daniele; Fichera, Alessandro

2014-06-01

Clinical research (CR) is a natural corollary to clinical surgery. It gives an investigator the opportunity to critically review their results and develop new strategies. This article covers the critical factors and the important components of a successful CR program. The first and most important step is to build a dedicated research team to overcome time constraints and enable a surgical practice to make CR a priority. With the research team in place, the next step is to create a program on the basis of an original idea and new clinical hypotheses. This often comes from personal experience supported by a review of the available evidence. Randomized controlled (clinical) trials are the most stringent way of determining whether a cause-effect relationship exists between the intervention and the outcome. In the proper setting, translational research may offer additional avenues allowing clinical application of basic science discoveries.

HIV drug resistance early warning indicators in cohorts of individuals starting antiretroviral therapy between 2004 and 2009: World Health Organization global report from 50 countries.

PubMed

Bennett, Diane E; Jordan, Michael R; Bertagnolio, Silvia; Hong, Steven Y; Ravasi, Giovanni; McMahon, James H; Saadani, Ahmed; Kelley, Karen F

2012-05-01

The World Health Organization developed a set of human immunodeficiency virus drug resistance (HIVDR) early warning indicators (EWIs) to assess antiretroviral therapy clinic and program factors associated with HIVDR. EWIs are monitored by abstracting data routinely recorded in clinical records, and the results enable clinics and program managers to identify problems that should be addressed to minimize preventable emergence of HIVDR in clinic populations. As of June 2011, 50 countries monitored EWIs, covering 131 686 patients initiating antiretroviral treatment between 2004 and 2009 at 2107 clinics. HIVDR prevention is associated with patient care (appropriate prescribing and patient monitoring), patient behavior (adherence), and clinic/program management efforts to reduce treatment interruptions (follow up, retention on first-line ART, procurement and supply management of antiretroviral drugs). EWIs measure these factors and the results have been used to optimize patient and population treatment outcomes.

Clinical Epidemiology of Urban Violence: Responding to Children Exposed to Violence in Ten Communities

ERIC Educational Resources Information Center

Harpaz-Rotem, Ilan; Murphy, Robert A.; Berkowitz, Steven; Marans, Steven; Rosenheck, Robert A.

2007-01-01

This study explores the clinical epidemiology of children's exposure to violence as addressed by a program in which mental health clinicians work with law-enforcement agents in 10 U.S. cities. Data were collected on all participants contacted by the Child Development Community Policing Program (N = 7,313 individuals involved in 2,466 community…

A Competency-Based Clinical Chemistry Course for the Associate Degree Medical Laboratory Technician Graduate in a Medical Technology Baccalaureate Program.

ERIC Educational Resources Information Center

Buccelli, Pamela

Presented is a project that developed a competency-based clinical chemistry course for associate degree medical laboratory technicians (MLT) in a medical technology (MT) baccalaureate program. Content of the course was based upon competencies expected of medical technologists at career-entry as defined in the statements adopted in 1976 by the…

Student Perceptions of Effective Clinical Teaching Characteristics in Dental Hygiene Programs in Northeastern States

ERIC Educational Resources Information Center

Bearor, Dawn E.

2012-01-01

The clinical education component provided to dental hygiene students is an essential part of their development as competent practitioners. Instructor approaches to clinical teaching are therefore critical in providing quality clinical learning experiences. This study sought to identify dental hygiene students' perceptions of "best" and…

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic

PubMed Central

Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B.

2016-01-01

Background: The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. Objectives: A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. Study Design/Methods: This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. Results: The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. Conclusions: This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies. PMID:29444602

A review of standardized patients in clinical education: Implications for speech-language pathology programs.

PubMed

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

2010-06-01

The use of standardized patients has been reported as a viable addition to traditional models of professional practice education in medicine, nursing and allied health programs. Educational programs rely on the inclusion of work-integrated learning components in order to graduate competent practitioners. Allied health programs world-wide have reported increasing difficulty in attaining sufficient traditional placements for students within the workplace. In response to this, allied health professionals are challenged to be innovative and problem-solving in the development and maintenance of clinical education placements and to consider potential alternative learning opportunities for students. Whilst there is a bank of literature describing the use of standardized patients in medicine and nursing, reports of its use in speech-language pathology clinical education are limited. Therefore, this paper aims to (1) provide a review of literature reporting on the use of standardized patients within medical and allied health professions with particular reference to use in speech-language pathology, (2) discuss methodological and practical issues involved in establishing and maintaining a standardized patient program and (3) identify future directions for research and clinical programs using standardized patients to build foundation clinical skills such as communication, interpersonal interaction and interviewing.

Development and implementation of an automated quantitative film digitizer quality control program

NASA Astrophysics Data System (ADS)

Fetterly, Kenneth A.; Avula, Ramesh T. V.; Hangiandreou, Nicholas J.

1999-05-01

A semi-automated, quantitative film digitizer quality control program that is based on the computer analysis of the image data from a single digitized test film was developed. This program includes measurements of the geometric accuracy, optical density performance, signal to noise ratio, and presampled modulation transfer function. The variability of the measurements was less than plus or minus 5%. Measurements were made on a group of two clinical and two laboratory laser film digitizers during a trial period of approximately four months. Quality control limits were established based on clinical necessity, vendor specifications and digitizer performance. During the trial period, one of the digitizers failed the performance requirements and was corrected by calibration.

The business of palliative medicine--Part 3: The development of a palliative medicine program in an academic medical center.

PubMed

Nelson, Kristine A; Walsh, Declan

2003-01-01

Palliative medicine is the total continuing care of patients with cancer. Most resources for cancer care focus on curative attempts while often ignoring the symptoms created by the disease and its treatment. Attempts at curative treatment of the malignancy must be coupled with pain and symptom relief psychosocial and spiritual care, and support for the patient and family extending from the time of diagnosis through the bereavement period. To accomplish this important goal, we must establish comprehensive palliative medicine programs in cancer centers throughout the world. These programs must include education, research, and patient care and must work through an interdisciplinary team. The Cleveland Clinic Foundation palliative medicine program (PMP) is composed of a primary inpatient service, consult service, outpatient clinic, hospice homecare, and cancer homecare services. In this article, we describe the structure and development of the program and suggest future avenues for growth.

Reaching new heights: development of the emergency department nurse practitioner fellowship program.

PubMed

Varghese, Jane R; Silvestri, Antonette; Lopez, Patricia

2012-01-01

With nationwide resident shortages and decreasing resident shifts, and legislation decreasing resident work hours, the nurse practitioners (NPs) have been called upon to expand their scope of practice to encompass patients with immediate and critical conditions and to perform quick procedures. Most pediatric NP (PNP) programs do not have formal training for NP students to work in a pediatric emergency department (ED). Senior ED NPs in collaboration with an NP educator developed a comprehensive clinical program to prepare a general PNP student to practice in an ED. The fellowship committee, met with 3 local university PNP program directors. The fellowship program targeted highly motivated individuals with an interest in working in a pediatric ED at the completion of their program as recruits for the position. Based on positive feedback, there has been overwhelming support and acceptance from the ED attending physicians, the NPs in the specialty clinics, as well as the ED staff regarding the new NP fellowship role. The NP fellow experienced less stress transitioning from student to NP. The development of the fellowship program is a step forward in the future training of NPs. The structured fellowship will hopefully facilitate a seamless transition from student to NP.

Doctor of nursing practice program development: reengineering health care.

PubMed

Wall, Barbra M; Novak, Julie C; Wilkerson, Sharon A

2005-09-01

In this article, we describe the developmental process of a Doctor of Nursing Practice (DNP) program that uses interdisciplinary resources to create unique DNP curriculum opportunities. Other schools may benefit from this experience in the development of their own DNP programs. The program delivers an innovative curriculum from post-baccalaureate to doctorate, emphasizing health care engineering and interdisciplinary collaboration among faculty, hospitals, community leaders, and policymakers. This DNP program is uniquely situated to provide leadership in solving complex clinical problems through its partnership with the Regenstrief Center for Healthcare Engineering, the School of Pharmacy, the Homeland Security Institute, and the Center on Aging and the Life Course. Doctoral coursework, interdisciplinary collaboration, health care engineering/systems approaches, and new knowledge result in uniquely qualified providers. Post-baccalaureate students complete the university's Adult Nurse Practitioner program or its developing Pediatric Nurse Practitioner program during the first 2 years of the 4-year curriculum. A total of 83 post-baccalaureate credit hours include 1,526 hours of supervised clinical practice, a health policy residency, and cognate residencies in an area of specialization. The seven core competencies recommended by the American Association of Colleges of Nursing are incorporated into the curriculum.

The Systems Approach to Functional Job Analysis. Task Analysis of the Physician's Assistant: Volume II--Curriculum and Phase I Basic Core Courses and Volume III--Phases II and III--Clinical Clerkships and Assignments.

ERIC Educational Resources Information Center

Wake Forest Univ., Winston Salem, NC. Bowman Gray School of Medicine.

This publication contains a curriculum developed through functional job analyses for a 24-month physician's assistant training program. Phase 1 of the 3-phase program is a 6-month basic course program in clinical and bioscience principles and is required of all students regardless of their specialty interest. Phase 2 is a 6 to 10 month period of…

[Laboratory medicine in the obligatory postgraduate clinical training system--common clinical training program in the department of laboratory medicine in our prefectural medical university hospital].

PubMed

Okamoto, Yasuyuki

2003-04-01

I propose a postgraduate common clinical training program to be provided by the department of laboratory medicine in our prefectural medical university hospital. The program has three purposes: first, mastering basic laboratory tests; second, developing the skills necessary to accurately interpret laboratory data; third, learning specific techniques in the field of laboratory medicine. For the first purpose, it is important that medical trainees perform testing of their own patients at bedside or in the central clinical laboratory. When testing at the central clinical laboratory, instruction by expert laboratory technicians is helpful. The teaching doctors in the department of laboratory medicine are asked to advise the trainees on the interpretation of data. Consultation will be received via interview or e-mail. In addition, the trainees can participate in various conferences, seminars, and meetings held at the central clinical laboratory. Finally, in order to learn specific techniques in the field of laboratory medicine, several special courses lasting a few months will be prepared. I think this program should be closely linked to the training program in internal medicine.

Adolescent bariatric surgery program characteristics: the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study experience.

PubMed

Michalsky, Marc P; Inge, Thomas H; Teich, Steven; Eneli, Ihuoma; Miller, Rosemary; Brandt, Mary L; Helmrath, Michael; Harmon, Carroll M; Zeller, Meg H; Jenkins, Todd M; Courcoulas, Anita; Buncher, Ralph C

2014-02-01

The number of adolescents undergoing weight loss surgery (WLS) has increased in response to the increasing prevalence of severe childhood obesity. Adolescents undergoing WLS require unique support, which may differ from adult programs. The aim of this study was to describe institutional and programmatic characteristics of centers participating in Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS), a prospective study investigating safety and efficacy of adolescent WLS. Data were obtained from the Teen-LABS database, and site survey completed by Teen-LABS investigators. The survey queried (1) institutional characteristics, (2) multidisciplinary team composition, (3) clinical program characteristics, and (4) clinical research infrastructure. All centers had extensive multidisciplinary involvement in the assessment, pre-operative education, and post-operative management of adolescents undergoing WLS. Eligibility criteria and pre-operative clinical and diagnostic evaluations were similar between programs. All programs have well-developed clinical research infrastructure, use adolescent-specific educational resources, and maintain specialty equipment, including high weight capacity diagnostic imaging equipment. The composition of clinical team and institutional resources is consistent with current clinical practice guidelines. These characteristics, coupled with dedicated research staff, have facilitated enrollment of 242 participants into Teen-LABS. © 2013 Published by Elsevier Inc.

Adolescent Bariatric Surgery Program Characteristics: The Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study Experience

PubMed Central

Michalsky, M.P.; Inge, T.H.; Teich, S.; Eneli, I.; Miller, R.; Brandt, M.L.; Helmrath, M.; Harmon, C.M.; Zeller, M.H.; Jenkins, T.M.; Courcoulas, A.; Buncher, C.R.

2013-01-01

Background The number of adolescents undergoing weight loss surgery (WLS) has increased in response to the increasing prevalence of severe childhood obesity. Adolescents undergoing WLS require unique support, which may differ from adult programs. The aim of this study was to describe institutional and programmatic characteristics of centers participating in Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS), a prospective study investigating safety and efficacy of adolescent WLS. Methods Data were obtained from the Teen-LABS database and site survey completed by Teen-LABS investigators. The survey queried (1) institutional characteristics, (2) multidisciplinary team composition, (3) clinical program characteristics, and (4) clinical research infrastructure. Results All centers had extensive multidisciplinary involvement in the assessment, preoperative education and post-operative management of adolescents undergoing WLS. Eligibility criteria, pre-operative clinical and diagnostic evaluations were similar between programs. All programs have well developed clinical research infrastructure, use adolescent-specific educational resources, and maintain specialty equipment, including high weight capacity diagnostic imaging equipment. Conclusions The composition of clinical team and institutional resources are consistent with current clinical practice guidelines. These characteristics, coupled with dedicated research staff, have facilitated enrollment of 242 participants into Teen-LABS. PMID:24491361

Clinical Informatics Fellowship Programs: In Search of a Viable Financial Model: An open letter to the Centers for Medicare and Medicaid Services.

PubMed

Lehmann, C U; Longhurst, C A; Hersh, W; Mohan, V; Levy, B P; Embi, P J; Finnell, J T; Turner, A M; Martin, R; Williamson, J; Munger, B

2015-01-01

In the US, the new subspecialty of Clinical Informatics focuses on systems-level improvements in care delivery through the use of health information technology (HIT), data analytics, clinical decision support, data visualization and related tools. Clinical informatics is one of the first subspecialties in medicine open to physicians trained in any primary specialty. Clinical Informatics benefits patients and payers such as Medicare and Medicaid through its potential to reduce errors, increase safety, reduce costs, and improve care coordination and efficiency. Even though Clinical Informatics benefits patients and payers, because GME funding from the Centers for Medicare and Medicaid Services (CMS) has not grown at the same rate as training programs, the majority of the cost of training new Clinical Informaticians is currently paid by academic health science centers, which is unsustainable. To maintain the value of HIT investments by the government and health care organizations, we must train sufficient leaders in Clinical Informatics. In the best interest of patients, payers, and the US society, it is therefore critical to find viable financial models for Clinical Informatics fellowship programs. To support the development of adequate training programs in Clinical Informatics, we request that the Centers for Medicare and Medicaid Services (CMS) issue clarifying guidance that would allow accredited ACGME institutions to bill for clinical services delivered by fellows at the fellowship program site within their primary specialty.

Surgical clinical correlates in anatomy: design and implementation of a first-year medical school program.

PubMed

Haubert, Lisa M; Jones, Kenneth; Moffatt-Bruce, Susan D

2009-01-01

Medical students state the need for a clinically oriented anatomy class so to maximize their learning experience. We hypothesize that the first-year medical students, who take the Surgical Clinical Correlates in Anatomy program, will perform better than their peers in their anatomy course, their surgical clerkships and ultimately choose surgical residencies. We designed and recently implemented this program for first-year medical students. It consisted of General Surgical Knowledge, Orthopedic Surgery, Plastic Surgery, Urology, Cardiothoracic Surgery, General Surgery, Vascular Surgery, and Ear, Nose, and Throat (ENT) sessions. Each session had defined learning objectives and interactive cadaveric operations performed by faculty members and students. The program was elective and had 25 participants randomly chosen. An evaluative questionnaire was completed before and after the program. Comparative analysis of the questionnaires, first-year anatomy examination results, clinical surgical rotation scores, and residency match results will be completed. The positive opinions of surgeons increased for all medical students from the pre-evaluation to the post-evaluation, and there was a greater increase in positive opinions for our participants. Our participants also had the highest average overall for all combined anatomy examinations. A need exists among medical students to develop a clinically correlated anatomy program that will maximize their learning experience, improve their performance and allow them to make moreinformed career choices. The recent implementation of this Surgical Clinical Correlates in Anatomy program fulfills this need.

Gaining Control of Occupational Injury and Illness in the U.S. Navy Civilian Work Force

DTIC Science & Technology

1990-01-16

caring for the back. Also monitored by the supervisor is a work -hardening program developed by the clinic physical therapist and physician that... development of a work -hardening program for the returning injured employee to ensure a safe re-entry to the workplace. e. "Green Table" and Medical...physical therapist work closely in developing effective programs for the treatment of occupational injuries. Having an onsite physical therapist available

DHEW Research, Service, and Training Programs in Hearing, Speech, and Language: A Summary of Areas of Interest, Funding Mechanisms, Review Processes, and Information Sources.

ERIC Educational Resources Information Center

Kaplan, Harriet, Comp.; Lloyd, Lyle L., Comp.

Programs of agencies within the Department of Health, Education, and Welfare that support research, training, and clinical service projects in hearing, speech, and language development are reviewed. Information on each program usually includes areas of communication development and disorders specific to each agency; the funding mechanism used by…

An innovative portfolio of research training programs for medical students.

PubMed

Zier, Karen; Wyatt, Christina; Muller, David

2012-12-01

Medical student education continues to evolve, with an increasing emphasis on evidence-based decision making in clinical settings. Many schools are introducing scholarly programs to their curriculum in order to foster the development of critical thinking and analytic skills, encourage self-directed learning, and develop more individualized learning experiences. In addition, participation in rigorous scholarly projects teaches students that clinical care and research should inform each other, with the goal of providing more benefit to patients and society. Physician-scientists, and physicians who have a better appreciation of science, have the potential to be leaders in the field who will deliver outstanding clinical care, contribute new knowledge, and educate their patients.

[Development and Evaluation of a Self-Reflection Program for Intensive Care Unit Nurses Who Have Experienced the Death of Pediatric Patients].

PubMed

Kang, Hyun Ju; Bang, Kyung Sook

2017-06-01

This study aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness. The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program. Participants were 38 nurses who had experienced the death of pediatric patients (experimental group=15, control group=23); they were recruited using convenience sampling. The self-reflection program was provided over 6 weeks (6 sessions). Data were collected from April to August, 2014 and analyzed using t-tests and content analysis. The quantitative results showed that changes in personal growth (t=-6.33, p<.001) and burnout scores (z=-2.76, p=.005) were better in the experimental group compared to the control group. The qualitative results exhibited two themes, namely "personal growth" and "professional growth", and ten sub-themes. The self-reflection program developed by this study was effective in helping nurses who had experienced the death of pediatric patients to achieve personal growth through self-reflection, and it was confirmed that the program can be applied in a realistic clinical nursing setting. Furthermore, it can be recommended as an intervention program for clinical nurses. © 2017 Korean Society of Nursing Science

Learning through vulnerability: a mentor-mentee experience.

PubMed

Jones, Kohar; Reis, Shmuel

2010-01-01

The following essay, drawn from the journals and work notebook of a family medicine resident and a visiting clinical mentor, chronicles their work together in an Advanced Clinical Mentoring program. This program included afternoons of direct clinical observation immediately followed by feedback sessions. In addition to addressing specific professional issues, such as time management, limiting patient encounters, agenda matching, and the One-Minute Preceptor model, the authors developed personally as they opened themselves to learning and growing as a clinician and a teacher.

A Descriptive Study of Nursing Peer-Review Programs in US Magnet® Hospitals.

PubMed

Roberts, Holli; Cronin, Sherill Nones

2017-04-01

The goal of this study was to assess the types of nursing peer review (NPR) programs in US Magnet® organizations. The 2 most predominant models of NPR programs in the literature are performance evaluation and clinical peer review. The literature on clinical peer review is primarily descriptive, outlining structures and anecdotal outcomes. Participants from hospitals holding Magnet recognition were selected using a stratified random-sampling method. A survey developed by the researchers assessed the presence of NPR. If clinical NPR was in place, program design, evaluation measurements, and barriers were explored. Findings suggest wide variability in NPR models. More than one-third of the respondents conduct peer evaluation as the only mechanism of NPR. Most hospitals with a clinical peer-review program reported a case review structure and process measurements not supported by data. The variations noted in this study suggest more research is needed to measure the effectiveness of NPR models and associated outcomes.

Developing a Management Curriculum for a Cytotechnology Training Program.

ERIC Educational Resources Information Center

Miller, Maureen E.

This study reviewed the literature in the field of health care management, particularly that which pertains to the management of the clinical laboratory. The research cited should help cytotechnology educators in planning a management curriculum and developing program objectives to train cytotechnologists in management. The report is an annotated…

Leveraging Big Data in Pediatric Development Programs: Proceedings From the 2016 American College of Clinical Pharmacology Annual Meeting Symposium.

PubMed

Mulugeta, Lily Yeruk; Yao, Lynne; Mould, Diane; Jacobs, Brian; Florian, Jeffrey; Smith, Brian; Sinha, Vikram; Barrett, Jeffrey S

2018-01-10

This article discusses the use of big data in pediatric drug development. The article covers key topics discussed at the ACCP annual meeting symposium in 2016 including the extent to which big data or real-world data can inform clinical trial design and substitute for efficacy and safety data typically obtained in clinical trials. The current states of use, opportunities, and challenges with the use of big data in future pediatric drug development are discussed. © 2018 American Society for Clinical Pharmacology and Therapeutics.

Complementary and alternative medicine. Integrative medicine: business risks and opportunities.

PubMed

Berndtson, K

1998-01-01

Much of the buzz over integrative medicine is well deserved. The opportunities seem to outweigh the risks, but superior management skills are needed to guide these programs through adolescence into clinical and business maturity. By carefully considering the staffing, team building, compensation methods, marketing, and program evaluation and development issues explored in this article, health care and physician executives should be able to steer between the rocks on their way to integrative medicine decisions that are right for their organizations. Many claim that integrative medicine has the potential to reshape health care delivery in a more patient-centered direction. While this may be true, such programs must prove themselves from financial and clinical operational perspectives in order to achieve this potential. Luminary clinical skills are not enough to guarantee the survival of such programs--a strong clinical base of expertise in alternative therapies is a key success factor. As with any health care venture, there are no substitutes for clinical excellence or sound management.

Evaluation of clinical practice guidelines.

PubMed Central

Basinski, A S

1995-01-01

Compared with the current focus on the development of clinical practice guidelines the effort devoted to their evaluation is meagre. Yet the ultimate success of guidelines depends on routine evaluation. Three types of evaluation are identified: evaluation of guidelines under development and before dissemination and implementation, evaluation of health care programs in which guidelines play a central role, and scientific evaluation, through studies that provide the scientific knowledge base for further evolution of guidelines. Identification of evaluation and program goals, evaluation design and a framework for evaluation planning are discussed. PMID:7489550

Milestones: Critical Elements in Clinical Informatics Fellowship Programs

PubMed Central

Lehmann, Christoph U.; Munger, Benson

2016-01-01

Summary Background Milestones refer to points along a continuum of a competency from novice to expert. Resident and fellow assessment and program evaluation processes adopted by the ACGME include the mandate that programs report the educational progress of residents and fellows twice annually utilizing Milestones developed by a specialty specific ACGME working group of experts. Milestones in clinical training programs are largely unmapped to specific assessment tools. Residents and fellows are mainly assessed using locally derived assessment instruments. These assessments are then reviewed by the Clinical Competency Committee which assigns and reports trainee ratings using the specialty specific reporting Milestones. Methods and Results The challenge and opportunity facing the nascent specialty of Clinical Informatics is how to optimally utilize this framework across a growing number of accredited fellowships. The authors review how a mapped milestone framework, in which each required sub-competency is mapped to a single milestone assessment grid, can enable the use of milestones for multiple uses including individualized learning plans, fellow assessments, and program evaluation. Furthermore, such a mapped strategy will foster the ability to compare fellow progress within and between Clinical Informatics Fellowships in a structured and reliable fashion. Clinical Informatics currently has far less variability across programs and thus could easily utilize a more tightly defined set of milestones with a clear mapping to sub-competencies. This approach would enable greater standardization of assessment instruments and processes across programs while allowing for variability in how those sub-competencies are taught. Conclusions A mapped strategy for Milestones offers significant advantages for Clinical Informatics programs. PMID:27081414

What should we teach the teachers? Identifying the learning priorities of clinical supervisors.

PubMed

Bearman, Margaret; Tai, Joanna; Kent, Fiona; Edouard, Vicki; Nestel, Debra; Molloy, Elizabeth

2018-03-01

Clinicians who teach are essential for the health workforce but require faculty development to improve their educational skills. Curricula for faculty development programs are often based on expert frameworks without consideration of the learning priorities as defined by clinical supervisors themselves. We sought to inform these curricula by highlighting clinical supervisors own requirements through answering the research question: what do clinical supervisors identify as relative strengths and areas for improvement in their teaching practice? This mixed methods study employed a modified version of the Maastricht Clinical Teaching Questionnaire (mMCTQ) which included free-text reflections. Descriptive statistics were calculated and content analysis was conducted on textual comments. 481 (49%) of 978 clinical supervisors submitted their mMCTQs and associated reflections for the research study. Clinical supervisors self-identified relatively strong capability with interpersonal skills or attributes and indicated least capability with assisting learners to explore strengths, weaknesses and learning goals. The qualitative category 'establishing relationships' was the most reported strength with 224 responses. The qualitative category 'feedback' was the most reported area for improvement, with 151 responses. Key areas for curricular focus include: improving feedback practices; stimulating reflective and agentic learning; and managing the logistics of a clinical education environment. Clinical supervisors' self-identified needs provide a foundation for designing engaging and relevant faculty development programs.

Year-End Clinic Handoffs: A National Survey of Academic Internal Medicine Programs.

PubMed

Phillips, Erica; Harris, Christina; Lee, Wei Wei; Pincavage, Amber T; Ouchida, Karin; Miller, Rachel K; Chaudhry, Saima; Arora, Vineet M

2017-06-01

While there has been increasing emphasis and innovation nationwide in training residents in inpatient handoffs, very little is known about the practice and preparation for year-end clinic handoffs of residency outpatient continuity practices. Thus, the latter remains an identified, yet nationally unaddressed, patient safety concern. The 2014 annual Association of Program Directors in Internal Medicine (APDIM) survey included seven items for assessing the current year-end clinic handoff practices of internal medicine residency programs throughout the country. Nationwide survey. All internal medicine program directors registered with APDIM. Descriptive statistics of programs and tools used to formulate a year-end handoff in the ambulatory setting, methods for evaluating the process, patient safety and quality measures incorporated within the process, and barriers to conducting year-end handoffs. Of the 361 APDIM member programs, 214 (59%) completed the Transitions of Care Year-End Clinic Handoffs section of the survey. Only 34% of respondent programs reported having a year-end ambulatory handoff system, and 4% reported assessing residents for competency in this area. The top three barriers to developing a year-end handoff system were insufficient overlap between graduating and incoming residents, inability to schedule patients with new residents in advance, and time constraints for residents, attendings, and support staff. Most internal medicine programs do not have a year-end clinic handoff system in place. Greater attention to clinic handoffs and resident assessment of this care transition is needed.

Sarilumab for the treatment of rheumatoid arthritis.

PubMed

Cooper, Simon

2016-01-01

Simon Cooper has >18 years of global experience in the pharmaceutical industry. He joined Sanofi in July 2014 as the Vice President, Global Project Head. In his current position at Sanofi, Dr Cooper is responsible for the clinical development of sarilumab and the worldwide submission in rheumatoid arthritis. He joined Sanofi after serving as the Global Program Medical Director at Novartis since 2012. In this role, Dr Cooper acted as the clinical lead for secukinumab psoriasis submission. Prior to Novartis, Dr Cooper held various posts at Human Genome Sciences, USA, including Executive Director of Clinical Research, Senior Director of Clinical Research and Director of Clinical Research. During his tenure at Human Genome Sciences, USA, Dr Cooper was involved in the submission of belimumab leading to its approval for SLE, and was responsible for its subsequent clinical development program. Dr Cooper has also previously held positions at MedImmune Ltd, UK, Roche, Napp Pharmaceutical Research Ltd, Wyeth Research and Medeval Ltd. In these roles, his responsibilities ranged from medical oversight of clinical trials to medical support for commercial, medical affairs and business development. He received a Bachelor of Medicine and Bachelor of Surgery from University of Newcastle upon Tyne Medical School.

Implementation of new clinical programs in the VHA healthcare system: the importance of early collaboration between clinical leadership and research.

PubMed

Wu, R Ryanne; Kinsinger, Linda S; Provenzale, Dawn; King, Heather A; Akerly, Patricia; Barnes, Lottie K; Datta, Santanu K; Grubber, Janet M; Katich, Nicholas; McNeil, Rebecca B; Monte, Robert; Sperber, Nina R; Atkins, David; Jackson, George L

2014-12-01

Collaboration between policy, research, and clinical partners is crucial to achieving proven quality care. The Veterans Health Administration has expended great efforts towards fostering such collaborations. Through this, we have learned that an ideal collaboration involves partnership from the very beginning of a new clinical program, so that the program is designed in a way that ensures quality, validity, and puts into place the infrastructure necessary for a reliable evaluation. This paper will give an example of one such project, the Lung Cancer Screening Demonstration Project (LCSDP). We will outline the ways that clinical, policy, and research partners collaborated in design, planning, and implementation in order to create a sustainable model that could be rigorously evaluated for efficacy and fidelity. We will describe the use of the Donabedian quality matrix to determine the necessary characteristics of a quality program and the importance of the linkage with engineering, information technology, and clinical paradigms to connect the development of an on-the-ground clinical program with the evaluation goal of a learning healthcare organization. While the LCSDP is the example given here, these partnerships and suggestions are salient to any healthcare organization seeking to implement new scientifically proven care in a useful and reliable way.

The Afya Bora Fellowship: An Innovative Program Focused on Creating an Interprofessional Network of Leaders in Global Health.

PubMed

Green, Wendy M; Farquhar, Carey; Mashalla, Yohana

2017-09-01

Most current health professions education programs are focused on the development of clinical skills. As a result, they may not address the complex and interconnected nature of global health. Trainees require relevant clinical, programmatic, and leadership skills to meet the challenges of practicing in an increasingly globalized environment. To develop health care leaders within sub-Saharan Africa, the Afya Bora Consortium developed a one-year fellowship for medical doctors and nurses. Fellows from nine institutions in the United States and sub-Saharan Africa participate in 12 learning modules focused on leadership development and program management. Classroom-based training is augmented with an experiential apprenticeship component. Since 2011, 100 fellows have graduated from the program. During their apprenticeships, fellows developed projects beneficial to their development and to host organizations. The program has developed fellows' skills in leadership, lent expertise to local organizations, and built knowledge in local contexts. Most fellows have returned to their countries of origin, thus building local capacity. U.S.-based fellows examine global health challenges from regional perspectives and learn from sub-Saharan African experts and peers. The Consortium provides ongoing support to alumni through career development awards and alumni network engagement with current and past fellow cohorts. The Consortium expanded from its initial network of five countries to six and continues to seek opportunities for geographical and institutional expansion.

Development and Validation of a Primary Care-Based Family Health History and Decision Support Program (MeTree)

PubMed Central

Orlando, Lori A.; Buchanan, Adam H.; Hahn, Susan E.; Christianson, Carol A.; Powell, Karen P.; Skinner, Celette Sugg; Chesnut, Blair; Blach, Colette; Due, Barbara; Ginsburg, Geoffrey S.; Henrich, Vincent C.

2016-01-01

INTRODUCTION Family health history is a strong predictor of disease risk. To reduce the morbidity and mortality of many chronic diseases, risk-stratified evidence-based guidelines strongly encourage the collection and synthesis of family health history to guide selection of primary prevention strategies. However, the collection and synthesis of such information is not well integrated into clinical practice. To address barriers to collection and use of family health histories, the Genomedical Connection developed and validated MeTree, a Web-based, patient-facing family health history collection and clinical decision support tool. MeTree is designed for integration into primary care practices as part of the genomic medicine model for primary care. METHODS We describe the guiding principles, operational characteristics, algorithm development, and coding used to develop MeTree. Validation was performed through stakeholder cognitive interviewing, a genetic counseling pilot program, and clinical practice pilot programs in 2 community-based primary care clinics. RESULTS Stakeholder feedback resulted in changes to MeTree’s interface and changes to the phrasing of clinical decision support documents. The pilot studies resulted in the identification and correction of coding errors and the reformatting of clinical decision support documents. MeTree’s strengths in comparison with other tools are its seamless integration into clinical practice and its provision of action-oriented recommendations guided by providers’ needs. LIMITATIONS The tool was validated in a small cohort. CONCLUSION MeTree can be integrated into primary care practices to help providers collect and synthesize family health history information from patients with the goal of improving adherence to risk-stratified evidence-based guidelines. PMID:24044145

Development and Clinical Outcomes of a Dialectical Behavior Therapy Clinic

ERIC Educational Resources Information Center

Lajoie, Travis; Sonkiss, Joshua; Rich, Anne

2011-01-01

Objective: The authors describe the first 6 months of a dialectical behavior therapy (DBT) clinic operated by trainees in a general adult psychiatry residency program. The purpose of this report is to provide a model for the creation and maintenance of a formalized resident DBT clinic. Methods: Residents participated in the DBT clinic, attended a…

78 FR 31945 - Clinical Development Programs for Opioid Conversion; Public Workshop; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-28

... gaps in existing knowledge regarding equianalgesic opioid conversion in clinical practice, to develop a... organization as well as the total number of participants based on space limitations. Registrants will receive... be based on space availability. If registration reaches maximum capacity, FDA will post a notice...

77 FR 10758 - Submission for OMB Review; Comment Request; Application for Collaboration With the NIH Center for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-23

... programs delivering assay development, screening, hit to lead chemistry, lead optimization, chemical biology studies, drug development capabilities, expertise, and clinical/regulatory resources in a collaborative environment with the goal of moving promising therapeutics into human clinical trials. NCTT uses...

Supervision and autonomy of ophthalmology residents in the outpatient Clinic in the United States: a survey of ACGME-accredited programs.

PubMed

Singman, Eric L; Srikumaran, Divya; Green, Laura; Tian, Jing; McDonnell, Peter

2017-06-26

The development and demonstration of incremental trainee autonomy is required by the ACGME. However, there is scant published research concerning autonomy of ophthalmology residents in the outpatient clinic setting. This study explored the landscape of resident ophthalmology outpatient clinics in the United States. A link to an online survey using the QualtricsTM platform was emailed to the program directors of all 115 ACGME-accredited ophthalmology programs in the United States. Survey questions explored whether resident training programs hosted a continuity clinic where residents would see their own patients, and if so, the degree of faculty supervision provided therein. Metrics such as size of the resident program, number of faculty and clinic setting were also recorded. Correlations between the degree of faculty supervision and other metrics were explored. The response rate was 94%; 69% of respondents indicated that their trainees hosted continuity clinics. Of those programs, 30% required a faculty member to see each patient treated by a resident, while 42% expected the faculty member to at least discuss (if not see) each patient. All programs expected some degree of faculty interaction based upon circumstances such as the level of training of the resident or complexity of the clinical situation. 67% of programs that tracked the contribution of the clinic to resident surgical caseloads reported that these clinics provided more than half of the resident surgical volumes. More ¾ of resident clinics were located in urban settings. The degree of faculty supervision did not correlate to any of the other metrics evaluated. The majority of ophthalmology resident training programs in the United States host a continuity clinic located in an urban environment where residents follow their own patients. Furthermore, most of these clinics require supervising faculty to review both the patients seen and the medical documentation created by the resident encounters. The different degrees of faculty supervision outlined by this survey might provide a useful guide presuming they can be correlated with validated metrics of educational quality. Finally, this study could provide an adjunctive resource to current international efforts to standardize ophthalmic residency education.

New Cancer Immunotherapy Agents in Development: a report from an associated program of the 31stAnnual Meeting of the Society for Immunotherapy of Cancer, 2016.

PubMed

Adusumilli, Prasad S; Cha, Edward; Cornfeld, Mark; Davis, Thomas; Diab, Adi; Dubensky, Thomas W; Evans, Elizabeth; Grogan, Jane L; Irving, Bryan A; Leidner, Rom S; Olwill, Shane A; Soon-Shiong, Patrick; Triebel, Frederic; Tuck, David; Bot, Adrian; Dansey, Roger D; Drake, Charles G; Freeman, Gordon J; Ibrahim, Ramy; Patel, Salil; Chen, Daniel S

2017-01-01

This report is a summary of 'New Cancer Immunotherapy Agents in Development' program, which took place in association with the 31st Annual Meeting of the Society for Immunotherapy of Cancer (SITC), on November 9, 2016 in National Harbor, Maryland. Presenters gave brief overviews of emerging clinical and pre-clinical immune-based agents and combinations, before participating in an extended panel discussion with multidisciplinary leaders, including members of the FDA, leading academic institutions and industrial drug developers, to consider topics relevant to the future of cancer immunotherapy.

Developing an Interdisciplinary, Team-Based Quality Improvement Leadership Training Program for Clinicians: The Partners Clinical Process Improvement Leadership Program.

PubMed

Rao, Sandhya K; Carballo, Victoria; Cummings, Brian M; Millham, Frederick; Jacobson, Joseph O

Although there has been tremendous progress in quality improvement (QI) education for students and trainees in recent years, much less has been published regarding the training of active clinicians in QI. The Partners Clinical Process Improvement Leadership Program (CPIP) is a 6-day experiential program. Interdisciplinary teams complete a QI project framed by didactic sessions, interactive exercises, case-based problem sessions, and a final presentation. A total of 239 teams composed of 516 individuals have graduated CPIP. On completion, participant satisfaction scores average 4.52 (scale 1-5) and self-reported understanding of QI concepts improved. At 6 months after graduation, 66% of survey respondents reported sustained QI activity. Three opportunities to improve the program have been identified: (1) increasing faculty participation through online and tiered course offerings, (2) integrating the faculty-focused program with the trainee curriculum, and (3) developing a postgraduate curriculum to address the challenges of sustained improvement.

A comparative study of interprofessional education in global health care

PubMed Central

Herath, Chulani; Zhou, Yangfeng; Gan, Yong; Nakandawire, Naomie; Gong, Yanghong; Lu, Zuxun

2017-01-01

Abstract Background: The World Health Organization (WHO) and its partners identify interprofessional (IP) collaboration in education and practice as an innovative strategy that plays an important role in mitigating the global health workforce crisis. Evidence on the practice of global health level in interprofessional education (IPE) is scarce and hampered due to the absence of aggregate information. Therefore, this systematic review was conducted to examine the incidences of IPE and summarize the main features about the IPE programs in undergraduate and postgraduate education in developed and developing countries. Methods: The PubMed, Embase, Web of Science, and Google Scholar were searched from their inception to January 31, 2016 for relevant studies regarding the development of IPE worldwide, IPE undergraduate and postgraduate programs, IP interaction in health education, IPE content, clinical placements, and teaching methods. Countries in which a study was conducted were classified as developed and developing countries according to the definition by the United Nations (UN) in 2014. Results: A total of 65 studies from 41 countries met our inclusion criteria, including 45 studies from 25 developed countries and 20 studies from 16 developing countries. Compared with developing countries, developed countries had more IPE initiatives. IPE programs were mostly at the undergraduate level. Overall, the university was the most common academic institution that provided IPE programs. The contents of the curricula were mainly designed to provide IP knowledge, skills, and values that aimed at developing IP competencies. IPE clinical placements were typically based in hospitals, community settings, or both. The didactic and interactive teaching methods varied significantly within and across universities where they conducted IPE programs. Among all health care disciplines, nursing was the discipline that conducted most of the IPE programs. Conclusion: This systematic review illustrated that the IPE programs vary substantially across countries. Many countries, especially the academic institutions are benefiting from the implementation of IPE programs. There is a need to strengthen health education policies at global level aiming at initiating IPE programs in relevant institutions. PMID:28930816

Integrating interdisciplinary pain management into primary care: development and implementation of a novel clinical program.

PubMed

Dorflinger, Lindsey M; Ruser, Christopher; Sellinger, John; Edens, Ellen L; Kerns, Robert D; Becker, William C

2014-12-01

The aims of this study were to develop and implement an interdisciplinary pain program integrated in primary care to address stakeholder-identified gaps. Program development and evaluation project utilizing a Plan-Do-Study-Act (PDSA) approach to address the identified problem of insufficient pain management resources within primary care. A large Healthcare System within the Veterans Health Administration, consisting of two academically affiliated medical centers and six community-based outpatients clinics. An interprofessional group of stakeholders participated in a Rapid Process Improvement Workshop (RPIW), a consensus-building process to identify systems-level gaps and feasible solutions and obtain buy-in. Changes were implemented in 2012, and in a 1-year follow-up, we examined indicators of engagement in specialty and multimodal pain care services as well as patient and provider satisfaction. In response to identified barriers, RPIW participants proposed and outlined two readily implementable, interdisciplinary clinics embedded within primary care: 1) the Integrated Pain Clinic, providing in-depth assessment and triage to targeted resources; and 2) the Opioid Reassessment Clinic, providing assessment and structured monitoring of patients with evidence of safety, efficacy, or misuse problems with opioids. Implementation of these programs led to higher rates of engagement in specialty and multimodal pain care services; patients and providers reported satisfaction with these services. Our PDSA cycle engaged an interprofessional group of stakeholders that recommended introduction of new systems-based interventions to better integrate pain resources into primary care to address reported barriers. Early data suggest improved outcomes; examination of additional outcomes is planned. Wiley Periodicals, Inc.

Assessing the Effectiveness of a School-Based Dental Clinic on the Oral Health of Children Who Lack Access to Dental Care: A Program Evaluation

ERIC Educational Resources Information Center

Carpino, Rachel; Walker, Mary P.; Liu, Ying; Simmer-Beck, Melanie

2017-01-01

This program evaluation examines the effectiveness of a school-based dental clinic. A repeated-measures design was used to longitudinally examine secondary data from participants (N = 293). Encounter intensity was developed to normalize data. Multivariate analysis of variance and Kruskal-Wallis test were used to investigate the effect of encounter…

Clinical Assessment in Mathematics: Learning the Craft.

ERIC Educational Resources Information Center

Hunting, Robert P.; Doig, Brian A.

1997-01-01

Discusses a professional development program called Clinical Approaches to Mathematics Assessment. Argues for the advanced training of mathematics teachers who understand knowledge construction processes of students; can use clinical tools for evaluating a student's unique mathematical "fingerprint"; and can create or adapt problems, tasks, or…

The Wright Institute Sanctuary Project: Development and Proposed Evaluation of a Graduate Training Program Providing Clinical Services to Asylum Seekers in the Bay Area

ERIC Educational Resources Information Center

Padilla, Brenda Lisa

2012-01-01

This study highlights the development of a graduate training program at The Wright Institute in Berkeley, CA, which provides assessment services for undocumented immigrants seeking asylum. This program focuses on the needs of a general asylum seeking population, with a specific relevance to some of the populations that may be served in the…

An academic nursing clinic's financial survival.

PubMed

Holman, E J; Branstetter, E

1997-01-01

The authors suggest that academic institutions build business-oriented policies and practices into the development of any nurse-run clinic to set the stage for financial independence when special or development funding ends. One university-affiliated program that provides 4,000 to 5,000 annual visits drastically changed its strategies when threatened with closure after free rent and other subsidies were withdrawn. The growing emphasis on ambulatory care roles for nurses at all levels makes such clinics critical to the success of the broad-based curricula of nursing education programs, as well as the clinic's value to communities they serve. Funding difficulties frequently threaten the existence of such nurse-run clinics once the initial grant funding is no longer available. This has caused a new emphasis on running such clinics in a business-wise manner. Among the strategies initiated were: direct full-pay at the time of service; a realistic business management plan; aggressive planned marketing; contracts and agreements with other agencies; obtaining provider status with selected HMOs.

Huddle-coaching: a dynamic intervention for trainees and staff to support team-based care.

PubMed

Shunk, Rebecca; Dulay, Maya; Chou, Calvin L; Janson, Susan; O'Brien, Bridget C

2014-02-01

Many outpatient clinics where health professionals train will transition to a team-based medical home model over the next several years. Therefore, training programs need innovative approaches to prepare and incorporate trainees into team-based delivery systems. To address this need, educators at the San Francisco Veterans Affairs (VA) Medical Center included trainees in preclinic team "huddles," or briefing meetings to facilitate care coordination, and developed an interprofessional huddle-coaching program for nurse practitioner students and internal medicine residents who function as primary providers for patient panels in VA outpatient primary care clinics. The program aimed to support trainees' partnerships with staff and full participation in the VA's Patient Aligned Care Teams. The huddle-coaching program focuses on structuring the huddle process via scheduling, checklists, and designated huddle coaches; building relationships among team members through team-building activities; and teaching core skills to support collaborative practice. A multifaceted evaluation of the program showed positive results. Participants rated training sessions and team-building activities favorably. In interviews, trainees valued their team members and identified improvements in efficiency and quality of patient care as a result of the team-based approach. Huddle checklists and scores on the Team Development Measure indicated progress in team processes and relationships as the year progressed. These findings suggest that the huddle-coaching program was a worthwhile investment in trainee development that also supported the clinic's larger mission to deliver team-based, patient-aligned care. As more training sites shift to team-based care, the huddle-coaching program offers a strategy for successfully incorporating trainees.

Characteristics of the original patient navigation programs to reduce disparities in the diagnosis and treatment of breast cancer.

PubMed

Vargas, Roberto B; Ryan, Gery W; Jackson, Catherine A; Rodriguez, Rian; Freeman, Harold P

2008-07-15

Patient navigation is an intervention developed to reduce disparities in cancer care that is being widely replicated and receiving considerable support for demonstration projects and research to test its effectiveness. In the current study, the authors present an in-depth descriptive analysis of the original patient navigation programs to inform current and future program development. A qualitative multistakeholder case study using interviews and site visits of the first patient navigation site and 2 sites subsequently developed by the leadership of the original site were evaluated. At these sites, patient navigation is a system, as opposed to a person, comprised primarily of navigators and directors that work together to remove barriers and facilitate access in a well-defined course of care; navigators were from the community or were culturally similar to the patient population served but were also paid employees of the clinical care site with detailed knowledge of the clinical course patients must traverse to complete care plans. Directors had administrative authority over the clinical facility and social capital across institutions, and communicated regularly and openly with navigators to implement system level changes to remove barriers to care. Contextual factors such as policies supporting breast cancer care also influenced the implementation of these programs. The first patient navigation programs combined community and culturally sensitive care-coordination with aspects of disease management programs to reduce racial, ethnic, and poverty-driven disparities in care. Future efforts to replicate and evaluate patient navigation should take into account these unique aspects of the original patient navigation programs. (c) 2008 American Cancer Society.

Rapid Development and Distribution of Mobile Media-Rich Clinical Practice Guidelines Nationwide in Colombia.

PubMed

Flórez-Arango, José F; Sriram Iyengar, M; Caicedo, Indira T; Escobar, German

2017-01-01

Development and electronic distribution of Clinical Practice Guidelines production is costly and challenging. This poster presents a rapid method to represent existing guidelines in auditable, computer executable multimedia format. We used a technology that enables a small number of clinicians to, in a short period of time, develop a substantial amount of computer executable guidelines without programming.

Preemptive clinical pharmacogenetics implementation: current programs in five US medical centers.

PubMed

Dunnenberger, Henry M; Crews, Kristine R; Hoffman, James M; Caudle, Kelly E; Broeckel, Ulrich; Howard, Scott C; Hunkler, Robert J; Klein, Teri E; Evans, William E; Relling, Mary V

2015-01-01

Although the field of pharmacogenetics has existed for decades, practioners have been slow to implement pharmacogenetic testing in clinical care. Numerous publications describe the barriers to clinical implementation of pharmacogenetics. Recently, several freely available resources have been developed to help address these barriers. In this review, we discuss current programs that use preemptive genotyping to optimize the pharmacotherapy of patients. Array-based preemptive testing includes a large number of relevant pharmacogenes that impact multiple high-risk drugs. Using a preemptive approach allows genotyping results to be available prior to any prescribing decision so that genomic variation may be considered as an inherent patient characteristic in the planning of therapy. This review describes the common elements among programs that have implemented preemptive genotyping and highlights key processes for implementation, including clinical decision support.

Early experiences of accredited clinical informatics fellowships.

PubMed

Longhurst, Christopher A; Pageler, Natalie M; Palma, Jonathan P; Finnell, John T; Levy, Bruce P; Yackel, Thomas R; Mohan, Vishnu; Hersh, William R

2016-07-01

Since the launch of the clinical informatics subspecialty for physicians in 2013, over 1100 physicians have used the practice and education pathways to become board-certified in clinical informatics. Starting in 2018, only physicians who have completed a 2-year clinical informatics fellowship program accredited by the Accreditation Council on Graduate Medical Education will be eligible to take the board exam. The purpose of this viewpoint piece is to describe the collective experience of the first four programs accredited by the Accreditation Council on Graduate Medical Education and to share lessons learned in developing new fellowship programs in this novel medical subspecialty. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Assessing the impact of innovative training of family physicians for the patient-centered medical home.

PubMed

Carney, Patricia A; Eiff, M Patrice; Saultz, John W; Lindbloom, Erik; Waller, Elaine; Jones, Samuel; Osborn, Jamie; Green, Larry

2012-03-01

New approaches to enhance access in primary care necessitate change in the model for residency education. To describe instrument design, development and testing, and data collection strategies for residency programs, continuity clinics, residents, and program graduates participating in the Preparing the Personal Physician for Practice (P(4)) project. We developed and pilot-tested surveys to assess demographic characteristics of residents, clinical and operational features of the continuity clinics and educational programs, and attitudes about and implementation status of Patient Centered Medical Home (PCMH) characteristics. Surveys were administered annually to P(4) residency programs since the project started in 2007. Descriptive statistics were used to profile data from the P(4) baseline year. Most P(4) residents were non-Hispanic white women (60.7%), married or partnered, attended medical school in the United States and were the first physicians in their families to attend medical school. Nearly 85% of residency continuity clinics were family health centers, and about 8% were federally qualified health centers. The most likely PCMH features in continuity clinics were having an electronic health record and having fully secure remote access available; both of which were found in more than 50% of continuity clinics. Approximately one-half of continuity clinics used the electronic health record for safety projects, and nearly 60% used it for quality-improvement projects. We created a collaborative evaluation model in all 14 P(4) residencies. Successful implementation of new surveys revealed important baseline features of residencies and residents that are pertinent to studying the effects of new training models for the PCMH.

Prelicensure Baccalaureate Nursing Students' Perceptions of Their Development of Clinical Reasoning.

PubMed

Herron, Elizabeth K; Sudia, Tanya; Kimble, Laura P; Davis, Alison H

2016-06-01

Establishing a strong foundation for the development of clinical reasoning in nursing students is essential to ensure safe and effective patient care. This study explored prelicensure baccalaureate nursing students' perceptions of their development of clinical reasoning, as well as their perceptions of how it is taught. In this phenomenological study, individual semistructured interviews were conducted to gather data related to participants' perceptions of their development of clinical reasoning. Data were analyzed using procedural steps delineated by Giorgi. Data analysis revealed three main themes: Instructor Characteristics, Importance of Clinical Reasoning, and Best Place to Learn Clinical Reasoning. Students recognized how clinical reasoning enhances safe and effective clinical practice and indicated the clinical arena was the most beneficial environment in which to learn clinical reasoning. Understanding students' perceptions of learning benefits nurse educators in planning nursing program curricula to enhance and facilitate the development of clinical reasoning. [J Nurs Educ. 2016;55(6):329-335.]. Copyright 2016, SLACK Incorporated.

Crossing the Chasm: Information Technology to Biomedical Informatics

PubMed Central

Fahy, Brenda G.; Balke, C. William; Umberger, Gloria H.; Talbert, Jeffery; Canales, Denise Niles; Steltenkamp, Carol L.; Conigliaro, Joseph

2011-01-01

Accelerating the translation of new scientific discoveries to improve human health and disease management is the overall goal of a series of initiatives integrated in the National Institutes of Health (NIH) “Roadmap for Medical Research.” The Clinical and Translational Research Award (CTSA) program is, arguably, the most visible component of the NIH Roadmap providing resources to institutions to transform their clinical and translational research enterprises along the goals of the Roadmap. The CTSA program emphasizes biomedical informatics as a critical component for the accomplishment of the NIH’s translational objectives. To be optimally effective, emerging biomedical informatics programs must link with the information technology (IT) platforms of the enterprise clinical operations within academic health centers. This report details one academic health center’s transdisciplinary initiative to create an integrated academic discipline of biomedical informatics through the development of its infrastructure for clinical and translational science infrastructure and response to the CTSA mechanism. This approach required a detailed informatics strategy to accomplish these goals. This transdisciplinary initiative was the impetus for creation of a specialized biomedical informatics core, the Center for Biomedical Informatics (CBI). Development of the CBI codified the need to incorporate medical informatics including quality and safety informatics and enterprise clinical information systems within the CBI. This paper describes the steps taken to develop the biomedical informatics infrastructure, its integration with clinical systems at one academic health center, successes achieved, and barriers encountered during these efforts. PMID:21383632

Antimicrobial formulary management: meeting the challenge in the community hospital.

PubMed

Rush, D R

1991-01-01

We established a casework approach to develop an antibiotic formulary for a large community hospital. The program consists of a combination of comprehensive clinical and administrative strategies designed to reduce antimicrobial expenditures and improve the quality of antibiotic prescribing. Strategies included a background document summarizing each pharmacologic group of antimicrobial drugs and formulary preferences, presentations to medical and surgical departments, development of drug use evaluation strategies that complement the development of the formulary, and a monitoring program for nonformulary antibiotic use. The development of a customized microbiologic/antibiotic susceptibility report card specific to the institution's inpatient and outpatient microflora was an integral part of the program. This tool also allowed for the continuous compilation of comparison data and development of prescribing tips. Predetermined criteria were established providing physicians with microorganism susceptibility reports and preferred treatment alternatives linked to pharmacoeconomic concerns. These strategies can be implemented with or without direct clinical pharmacotherapy specialist involvement at the individual patient care level.

Developing Orthopaedic Trauma Capacity in Uganda: Considerations From the Uganda Sustainable Trauma Orthopaedic Program.

PubMed

OʼHara, Nathan N; OʼBrien, Peter J; Blachut, Piotr A

2015-10-01

Uganda, like many low-income countries, has a tremendous volume of orthopaedic trauma injuries. The Uganda Sustainable Trauma Orthopaedic Program (USTOP) is a partnership between the University of British Columbia and Makerere University that was initiated in 2007 to reduce the consequences of neglected orthopaedic trauma in Uganda. USTOP works with local collaborators to build orthopaedic trauma capacity through clinical training, skills workshops, system support, technology development, and research. USTOP has maintained a multidisciplinary approach to training, involving colleagues in anaesthesia, nursing, rehabilitation, and sterile reprocessing. Since the program's inception, the number of trained orthopaedic surgeons practicing in Uganda has more than doubled. Many of these newly trained surgeons provide clinical care in the previously underserved regional hospitals. The program has also worked with collaborators to develop several technologies aimed at reducing the cost of providing orthopaedic care without compromising quality. As orthopaedic trauma capacity in Uganda advances, USTOP strives to continually evolve and provide relevant support to colleagues in Uganda.

Electronic Health Record Design and Implementation for Pharmacogenomics: a Local Perspective

PubMed Central

Peterson, Josh F.; Bowton, Erica; Field, Julie R.; Beller, Marc; Mitchell, Jennifer; Schildcrout, Jonathan; Gregg, William; Johnson, Kevin; Jirjis, Jim N; Roden, Dan M.; Pulley, Jill M.; Denny, Josh C.

2014-01-01

Purpose The design of electronic health records (EHR) to translate genomic medicine into clinical care is crucial to successful introduction of new genomic services, yet there are few published guides to implementation. Methods The design, implemented features, and evolution of a locally developed EHR that supports a large pharmacogenomics program at a tertiary care academic medical center was tracked over a 4-year development period. Results Developers and program staff created EHR mechanisms for ordering a pharmacogenomics panel in advance of clinical need (preemptive genotyping) and in response to a specific drug indication. Genetic data from panel-based genotyping were sequestered from the EHR until drug-gene interactions (DGIs) met evidentiary standards and deemed clinically actionable. A service to translate genotype to predicted drug response phenotype populated a summary of DGIs, triggered inpatient and outpatient clinical decision support, updated laboratory records, and created gene results within online personal health records. Conclusion The design of a locally developed EHR supporting pharmacogenomics has generalizable utility. The challenge of representing genomic data in a comprehensible and clinically actionable format is discussed along with reflection on the scalability of the model to larger sets of genomic data. PMID:24009000

Move to the head of the class: developing staff nurses as teachers.

PubMed

Donner, Carol L; Levonian, Catherine; Slutsky, Phyllis

2005-01-01

Nurses, while clinical experts in their specific fields, rarely have an opportunity to learn and practice teaching skills needed in an educator role. Clinical experts experience anxiety when asked to make the transition from a clinical environment to the teaching role. This article describes a 4-hour program developed to train nurses to become teachers. Adult learning principles, learning styles, and curriculum development were included to demonstrate the skills necessary to help nurses become proficient teachers.

Clinical Needs Finding: Developing the Virtual Experience, A Case Study

PubMed Central

Mittal, Vaishali; Thompson, Megan; Altman, Stuart M; Taylor, Peter; Summers, Alexander; Goodwin, Kelsey; Louie, Angelique Y

2013-01-01

We describe an innovative program at the University of California, Davis for students to engage in clinical needs finding. Using a team-based approach, students participated in clinical rotations to observe firsthand the needs of clinicians at the university affiliated medical center. The teams were asked to develop documentary-style videos to capture key experiences that would allow future viewers to use the videos as “virtual” clinical rotations. This was conceived as a strategy to allow students in prohibitively large classes, or students in programs at institutions without associated medical or veterinary school programs, to experience clinical rotations and perform needs assessments. The students' perspectives on the experience as well as instructor analysis of best practices for this type of activity are presented and discussed. We found that the internship experience was valuable to the students participating, by not only introducing the practice of needs finding but for increasing the students' confidence in the practice of engineering design and their ability to work independently. The videos produced were of such high quality that instructors from other institutions have requested copies for instructional use. Virtual clinical rotations through video experiences may provide a reasonable substitute for students who do not have the ability to participate in rotations in person. PMID:23483373

Comprehensive computerized diabetes registry. Serving the Cree of Eeyou Istchee (eastern James Bay).

PubMed Central

Dannenbaum, D.; Verronneau, M.; Torrie, J.; Smeja, H.; Robinson, E.; Dumont, C.; Kovitch, I.; Webster, T.

1999-01-01

PROBLEM BEING ADDRESSED: Diabetes is rapidly evolving as a major health concern in the Cree population of eastern James Bay (Eeyou Istchee). The Cree Board of Health and Social Services of James Bay (CBHSSJB) diabetes registry was the initial phase in the development of a comprehensive program for diabetes in this region. OBJECTIVE OF PROGRAM: The CBHSSJB diabetes registry was developed to provide a framework to track the prevalence of diabetes and the progression of diabetic complications. The database will also identify patients not receiving appropriate clinical and laboratory screening for diabetic complications, and will provide standardized clinical flow sheets for routine patient management. MAIN COMPONENTS OF PROGRAM: The CBHSSJB diabetes registry uses a system of paper registration forms and clinical flow sheets kept in the nine community clinics. Information from these sheets is entered into a computer database annually. The flow sheets serve as a guideline for appropriate management of patients with diabetes, and provide a one-page summary of relevant clinical and laboratory information. CONCLUSIONS: A diabetes registry is vital to follow the progression of diabetes and diabetic complications in the region served by the CBHSSJB. The registry system incorporates both a means for regional epidemiologic monitoring of diabetes mellitus and clinical tools for managing patients with the disease. PMID:10065310

University of Connecticut School of Allied Health Professions: Program Evaluation for the 1979-1980 Academic Year.

ERIC Educational Resources Information Center

Rovezzi-Carroll, Susan

The vocational curricular evaluation model (MCC) developed by the Division of Planning and Development at the Metropolitan Community College Administration Center is used to evaluate the University of Connecticut's School of Allied Health Professions. The three undergraduate programs focused on are physical therapy, clinical dietetics and medical…

Educational Leadership on the Social Frontier: Developing Promise Neighborhoods in Urban and Tribal Settings

ERIC Educational Resources Information Center

Miller, Peter; Wills, Nathan; Scanlan, Martin

2013-01-01

We examined how the federal Promise Neighborhoods program shapes leadership networks and objectives in diverse tribal and urban settings. The program calls for diverse stakeholders to provide families with resources such as parenting workshops, childcare, preschool, health clinics, and other social services that affect learning and development. We…

Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials

PubMed Central

Bekelman, Justin E.; Deye, James A.; Vikram, Bhadrasain; Bentzen, Soren M.; Bruner, Deborah; Curran, Walter J.; Dignam, James; Efstathiou, Jason A.; FitzGerald, T. J.; Hurkmans, Coen; Ibbott, Geoffrey S.; Lee, J. Jack; Merchant, Timothy E.; Michalski, Jeff; Palta, Jatinder R.; Simon, Richard; Ten Haken, Randal K.; Timmerman, Robert; Tunis, Sean; Coleman, C. Norman; Purdy, James

2012-01-01

Background In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute (NCI) sponsored a two day workshop to examine the challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. Lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities like proton beam therapy, and the international harmonization of clinical trial QA. Results Four recommendations were made: 1) Develop a tiered (and more efficient) system for radiotherapy QA and tailor intensity of QA to clinical trial objectives. Tiers include (i) general credentialing, (ii) trial specific credentialing, and (iii) individual case review; 2) Establish a case QA repository; 3) Develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and 4) Explore the feasibility of consolidating clinical trial QA in the United States. Conclusion Radiotherapy QA may impact clinical trial accrual, cost, outcomes and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based. PMID:22425219

Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

PubMed

Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

2014-07-01

The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

Role of conceptual models in a physical therapy curriculum: application of an integrated model of theory, research, and clinical practice.

PubMed

Darrah, Johanna; Loomis, Joan; Manns, Patricia; Norton, Barbara; May, Laura

2006-11-01

The Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada, recently implemented a Master of Physical Therapy (MPT) entry-level degree program. As part of the curriculum design, two models were developed, a Model of Best Practice and the Clinical Decision-Making Model. Both models incorporate four key concepts of the new curriculum: 1) the concept that theory, research, and clinical practice are interdependent and inform each other; 2) the importance of client-centered practice; 3) the terminology and philosophical framework of the World Health Organization's International Classification of Functioning, Disability, and Health; and 4) the importance of evidence-based practice. In this article the general purposes of models for learning are described; the two models developed for the MPT program are described; and examples of their use with curriculum design and teaching are provided. Our experiences with both the development and use of models of practice have been positive. The models have provided both faculty and students with a simple, systematic structured framework to organize teaching and learning in the MPT program.

CURRENT CONCEPTS OF PLYOMETRIC EXERCISE.

PubMed

Davies, George; Riemann, Bryan L; Manske, Robert

2015-11-01

As knowledge regarding rehabilitation science continues to increase, exercise programs following musculoskeletal athletic injury continue to evolve. Rehabilitation programs have drastically changed, especially in the terminal phases of rehabilitation, which include performance enhancement, development of power, and a safe return to activity. Plyometric exercise has become an integral component of late phase rehabilitation as the patient nears return to activity. Among the numerous types of available exercises, plyometrics assist in the development of power, a foundation from which the athlete can refine the skills of their sport. Therefore, the purpose of this clinical commentary is to provide an overview of plyometrics including: definition, phases, the physiological, mechanical and neurophysiological basis of plyometrics, and to describe clinical guidelines and contraindications for implementing plyometric programs.

Teaching Translational Research to Medical Students: The New York University School of Medicine's Master's of Science in Clinical Investigation Dual-Degree Program.

PubMed

Gillman, Jennifer; Pillinger, Michael; Plottel, Claudia S; Galeano, Claudia; Maddalo, Scott; Hochman, Judith S; Cronstein, Bruce N; Gold-von Simson, Gabrielle

2015-12-01

To develop the next generation of translational investigators, New York University School of Medicine (NYUSOM) and the NYU-NYC Health and Hospitals Corporation Clinical and Translational Science Institute (NYU-HHC CTSI) developed the Master's of Science in Clinical Investigation dual-degree (MD/MSCI) program. This 5-year program dedicates 1 year to coursework and biomedical research, followed by a medical school/research overlap year, to prepare students for academic research careers. This paper details the MD/MSCI program's curriculum and approach to mentorship, describes the research/professional interests of students, and reports student productivity. In the first 4 years of the program (2010-2014) 20 students were matriculated; 7 (35%) were women, and 12 (60%) research projects were in surgical specialties. To date, 14 students have applied to residency, and half pursued surgical residency programs. Our students have produced 68 accepted abstracts, 15 abstracts in submission, 38 accepted papers, and 24 papers in submission. Despite the time-limited nature of this program, additional training in research design and implementation has promoted a high level of productivity. We conclude that dual-degree training in medicine and translational research is feasible for medical students and allows for meaningful participation in valuable projects. Follow-up is warranted to evaluate the academic trajectory of these students. © 2015 Wiley Periodicals, Inc.

Teaching Translational Research to Medical Students: The New York University School of Medicine's Master's of Science in Clinical Investigation Dual‐Degree Program

PubMed Central

Pillinger, Michael; Plottel, Claudia S.; Galeano, Claudia; Maddalo, Scott; Hochman, Judith S.; Cronstein, Bruce N.; Gold‐von Simson, Gabrielle

2015-01-01

Abstract To develop the next generation of translational investigators, New York University School of Medicine (NYUSOM) and the NYU‐NYC Health and Hospitals Corporation Clinical and Translational Science Institute (NYU‐HHC CTSI) developed the Master's of Science in Clinical Investigation dual‐degree (MD/MSCI) program. This 5‐year program dedicates 1 year to coursework and biomedical research, followed by a medical school/research overlap year, to prepare students for academic research careers. This paper details the MD/MSCI program's curriculum and approach to mentorship, describes the research/professional interests of students, and reports student productivity. In the first 4 years of the program (2010–2014) 20 students were matriculated; 7 (35%) were women, and 12 (60%) research projects were in surgical specialties. To date, 14 students have applied to residency, and half pursued surgical residency programs. Our students have produced 68 accepted abstracts, 15 abstracts in submission, 38 accepted papers, and 24 papers in submission. Despite the time‐limited nature of this program, additional training in research design and implementation has promoted a high level of productivity. We conclude that dual‐degree training in medicine and translational research is feasible for medical students and allows for meaningful participation in valuable projects. Follow‐up is warranted to evaluate the academic trajectory of these students. PMID:26365704

Creating the Action Model for High Risk Infant Follow Up Program in Iran.

PubMed

Heidarzadeh, Mohammad; Jodiery, Behzad; Mirnia, Kayvan; Akrami, Forouzan; Hosseini, Mohammad Bagher; Heidarabadi, Seifollah; HabibeLahi, Abbas

2013-11-01

Intervention in early childhood development as one of the social determinants of health, is important for reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow up program in Iran. This study was carreid out to design high risk infants follow up care program with the practical aim of creating an model action for whole country, in 2012. This qualitative study has been done by the Neonatal Department of the Deputy of Public Health in cooperation with Pediatrics Health Research Center of Tabriz University of Medical Sciences, Iran. After study of international documents, consensus agreement about adapted program for Iran has been accomplished by focus group discussion and attended Delphi agreement technique. After compiling primary draft included evidence based guidelines and executive plan, 14 sessions including expert panels were hold to finalize the program. After finalizing the program, high risk infants follow up care service package has been designed in 3 chapters: Evidence based clinical guidelines; eighteen main clinical guidelines and thirteen subsidiaries clinical guidelines, executive plan; 6 general, 6 following up and 5 backup processes. Education program including general and especial courses for care givers and follow up team, and family education processes. We designed and finalized high risk infants follow up care service package. It seems to open a way to extend it to whole country.

The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs.

PubMed

Griffin, Brenda; Bushby, Philip A; McCobb, Emily; White, Sara C; Rigdon-Brestle, Y Karla; Appel, Leslie D; Makolinski, Kathleen V; Wilford, Christine L; Bohling, Mark W; Eddlestone, Susan M; Farrell, Kelly A; Ferguson, Nancy; Harrison, Kelly; Howe, Lisa M; Isaza, Natalie M; Levy, Julie K; Looney, Andrea; Moyer, Michael R; Robertson, Sheilah Ann; Tyson, Kathy

2016-07-15

As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.

Feasibility and acceptability of a novel, computerized screening and brief intervention (SBI) for alcohol and sweetened beverage use in pregnancy.

PubMed

Nayak, Madhabika B; Korcha, Rachael A; Kaskutas, Lee A; Kaskustas, Lee A; Avalos, Lyndsay A

2014-11-25

Recommended screening and brief intervention (SBI) for alcohol use during pregnancy is impeded by high patient loads and limited resources in public health settings. We evaluated the feasibility, acceptability and validity of a new self-administered, single-session, bilingual, computerized Screening and Brief Intervention (SBI) program for alcohol and sugar sweetened beverage (SSB) use in pregnancy. We developed and tested the computerized SBI program at a public health clinic with 290 pregnant women. Feasibility, acceptability, and validity measures were included in the program which had several modules, including those on demographics, health and beverage use. Time to complete the program and user experience items were used to determine program feasibility and acceptability. Validity analyses compared proportions of prenatal alcohol use identified by the program versus in-person screening by clinic staff. Most program users (87%, n = 251) completed the entire program; 91% (n = 263) completed the key screening and brief intervention modules. Most users also completed the program in ten to fifteen minutes. Program users reported that the program was easy to use (97%), they learned something new (88%), and that they would share what they learned with others (83%) and with their doctors or clinic staff (76%). Program acceptability did not differ by age, education, or type of beverage intervention received. The program identified alcohol use in pregnancy among 21% of users, a higher rate than the 13% (p < .01) found via screening by clinic staff. Computerized Screening and Brief Intervention for alcohol and SSB use in public health clinics is feasible and acceptable to English and Spanish speaking pregnant women and can efficiently identify prenatal alcohol use.

CE: Original Research: Creating an Evidence-Based Progression for Clinical Advancement Programs.

PubMed

Burke, Kathleen G; Johnson, Tonya; Sites, Christine; Barnsteiner, Jane

2017-05-01

: Background: The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant. Using an evidence-based approach and building on the competencies identified by the IOM and QSEN, a team of experts at an academic health system developed eight competency domains and 186 related knowledge, skills, and attitudes (KSAs) for professional nursing practice. The aim of our study was to validate the eight identified competencies and 186 related KSAs and determine their developmental progression within a clinical advancement program. Using the Delphi technique, nursing leadership validated the newly identified competency domains and KSAs as essential to practice. Clinical experts from 13 Magnet-designated hospitals with clinical advancement programs then participated in Delphi rounds aimed at reaching consensus on the developmental progression of the 186 KSAs through four levels of clinical advancement. Two Delphi rounds resulted in consensus by the expert participants. All eight competency domains were determined to be essential at all four levels of clinical practice. At the novice level of practice, the experts identified a greater number of KSAs in the domains of safety and patient- and family-centered care. At more advanced practice levels, the experts identified a greater number of KSAs in the domains of professionalism, teamwork, technology and informatics, and continuous quality improvement. Incorporating the eight competency domains and the 186 KSAs into a framework for clinical advancement programs will likely result in more clearly defined role expectations; enhance accountability; and elevate and promote nursing practice, thereby improving clinical outcomes and quality of care. With their emphasis on quality and safety, the eight competency domains also offer a framework for enhancing position descriptions, performance evaluations, clinical recognition, initial and ongoing competency assessment programs, and orientation and residency programs.

Development of a Design for Evaluation of the Podiatric Medicine Training Grant Program. Final Report and Executive Summary.

ERIC Educational Resources Information Center

American Association of Colleges of Podiatric Medicine, Washington, DC.

Information is presented on an evaluation design for a federal program, the Podiatric Medicine Training Grant Program. The program supports the clinical training of third- and fourth-year podiatric medical students in underserved areas. Background information is provided on: the supply and distribution of health professionals and podiatrists in…

Adding Value through Program Integration: A Kayaking Model (Rental, Retail, Repair, Clinics and Outings).

ERIC Educational Resources Information Center

Poff, Raymond

Outdoor programs can offset initial investment costs in services and products by developing integrated program areas. The experience of Outdoors Unlimited, a recently created kayaking program at Brigham Young University (Utah), is provided as a model. The purchase of 11 kayaks for rental was followed by the introduction of retail sales, repair…

What Should We Teach the Teachers? Identifying the Learning Priorities of Clinical Supervisors

ERIC Educational Resources Information Center

Bearman, Margaret; Tai, Joanna; Kent, Fiona; Edouard, Vicki; Nestel, Debra; Molloy, Elizabeth

2018-01-01

Clinicians who teach are essential for the health workforce but require faculty development to improve their educational skills. Curricula for faculty development programs are often based on expert frameworks without consideration of the learning priorities as defined by clinical supervisors themselves. We sought to inform these curricula by…

An Evaluation of the Development of MFT Competencies and the Influence of the Supervisory Relationship

ERIC Educational Resources Information Center

Burke, Jay Evan

2017-01-01

Practicum training is an essential part of The Chicago School of Professional Psychology (TCSPP) Marriage and Family Therapy (MFT) Master's degree program, and the cornerstone for preparing students for clinical practice. To characterize the development across clinical competency areas, the current study examined midpoint and final evaluation data…

Developing a More Inclusive Curriculum: Revising Courses in Psychotherapy.

ERIC Educational Resources Information Center

Chambliss, Catherine

In many respects clinical psychology has been more sensitive than most to issues related to gender, but many glaring problems remain to be addressed. In the clinical realm of psychology it is especially important to frame more inclusive conceptualizations of adjustment. Ursinus College developed a college-wide program aimed at greater integration…

Humanistic psychotherapy research 1990-2015: from methodological innovation to evidence-supported treatment outcomes and beyond.

PubMed

Angus, Lynne; Watson, Jeanne Cherry; Elliott, Robert; Schneider, Kirk; Timulak, Ladislav

2015-01-01

Over the past 25 years, humanistic psychotherapy (HP) researchers have actively contributed to the development and implementation of innovative practice-informed research measures and coding systems. Qualitative and quantitative research findings, including meta-analyses, support the identification of HP approaches as evidence-based treatments for a variety of psychological conditions. Implications for future psychotherapy research, training, and practice are discussed in terms of addressing the persistent disjunction between significant HP research productivity and relatively low support for HP approaches in university-based clinical training programs, funding agencies, and government-supported clinical guidelines. Finally, specific recommendations are provided to further enhance and expand the impact of HP research for clinical training programs and the development of treatment guidelines.

Using multimedia for patient information--a program about nocturnal enuresis.

PubMed

Evans, J H; Collier, J; Crook, I; Garrud, P; Harris, P; MacKinlay, D R; Redsell, S A

1998-05-01

To identify the information needs of children with nocturnal enuresis, and to design, produce and evaluate an interactive computer program to provide this information. The program was developed over an 18-month period using information provided by children, parents and professionals, and was evaluated in a hospital-based enuresis clinic in 65 children. Usability and knowledge gained were also evaluated in 43 healthy children aged 8-10 years attending a local inner-city primary school. An interactive program about nocturnal enuresis was developed, which runs on a personal computer and uses sound, voice, cartoon drawings and animation in a modular design. Knowledge scores increased in clinic attendees and in schoolchildren after using the program (Wilcoxon matched pairs test, P < 0.001). This improvement was maintained when the program was re-tested 6-10 months later. This interactive computer program holds children's attention and increases their understanding of enuresis. Interactive multimedia may be useful to complement the information provided by health professionals. This method of communication may be particularly useful for children with a low level of literacy.

Implementation of a pharmacy residency in a Veterans Affairs community-based outpatient clinic.

PubMed

Phillips, Beth Bryles; Williams, Kim C

2012-05-15

The implementation of an innovative ambulatory care pharmacy residency program at a Veterans Affairs (VA) outpatient clinic is described. Community-based outpatient clinics (CBOCs) are a largely underutilized resource for pharmacy residency training. Through a collaboration of the University of Georgia College of Pharmacy in Athens and Charlie Norwood VA Medical Center in Augusta, a postgraduate year 2 (PGY2) pharmacy residency program was established at the CBOC in Athens. The program graduated its first resident in 2009; components of training included (1) disease state management at an anticoagulation clinic and a newly created disease state-focused pharmacotherapy clinic, (2) participation in the planning and implementation of a new lipid management service, (3) a variety of didactic, laboratory, and experiential teaching activities at the college of pharmacy, and (4) management experiences such as completing requests for nonformulary medications, management of drug shortages, adverse drug reaction reporting, and participation in meetings of local and regional VA pharmacy and therapeutics committees. The demonstrated value of the ongoing program led to position upgrades for two CBOC clinical pharmacists and the addition of a clinical faculty member, enabling the program to offer additional learning experiences and preceptorship opportunities. A PGY2 ambulatory care residency program established in a CBOC provided a novel practice setting for the resident, helped improve patient care and pharmacy student education, and assisted in the professional development of preceptors and providers at the training site.

Perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a RN-to-BSN program.

PubMed

Hsiao, Chiu-Yueh; Lee, Shu-Hsin; Chen, Suh-Jen; Lin, Shu-Chin

2013-08-01

Advances in genetics have had a profound impact on health care. Yet, many nurses, as well as other health care providers, have limited genetic knowledge and feel uncomfortable integrating genetics into their practice. Very little is known about perceived genetic knowledge and clinical comfort among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program. To examine perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program and to assess how genetics has been integrated into their past and current nursing programs. The study also sought to examine correlations among perceived knowledge, integration of genetics into the nursing curriculum, and clinical comfort with genetics. A descriptive, cross-sectional study. Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program were recruited. A total of 190 of 220 nurses returned the completed survey (86.36% response rate). Descriptive statistics and the Pearson product-moment correlation were used for data analysis. Most nurses indicated limited perceived knowledge and clinical comfort with genetics. Curricular hours focused on genetics in a current nursing program were greater than those in past nursing programs. The use of genetic materials, attendance at genetic workshops and conferences, and clinically relevant genetics in nursing practice significantly related with perceived knowledge and clinical comfort with genetics. However, there were no correlations between prior genetic-based health care, perceived knowledge, and clinical comfort with genetics. This study demonstrated the need for emphasizing genetic education and practice to ensure health-related professionals become knowledgeable about genetic information. Given the rapidly developing genetic revolution, nurses and other health care providers need to utilize genetic discoveries to optimize health outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.

The financial impact of a clinical academic practice partnership.

PubMed

Greene, Mary Ann; Turner, James

2014-01-01

New strategies to provide clinical experiences for nursing students have caused nursing schools and hospitals to evaluate program costs. A Microsoft Excel model, which captures costs and associated benefits, was developed and is described here. The financial analysis shows that the Clinical Academic Practice Program framework for nursing clinical education, often preferred by students, can offer financial advantages to participating hospitals and schools of nursing. The model is potentially a tool for schools of nursing to enlist hospitals and to help manage expenses of clinical education. Hospitals may also use the Hospital Nursing Unit Staffing and Expense Worksheet in planning staffing when students are assigned to units and the cost/benefit findings to enlist management support.

An innovative approach to accelerated baccalaureate education.

PubMed

Walker, Charles; Tilley, Donna Scott; Lockwood, Suzanne; Walker, Mary Beth

2008-01-01

This article highlights novelties and innovations that were successfully incorporated in the development and ongoing refinement of an accelerated nursing program for second-degree students. Using a reflective practice framework, program coordinators deliberately crafted incoming classes through constrained optimization, modified the clinical rotation model, reduced waste through efficient use of faculty and other resources, integrated clinical course work to promote contextual learning, introduced four semester themes to mitigate an obsession with content among faculty and students, and employed student-centered pedagogies that valued the depth and breadth of students' prior experiences. Program outcomes are also discussed.

Translational leadership: new approaches to team development.

PubMed

Harrigan, Rosanne C; Emery, Lori M

2010-01-01

Little is known about how to develop collaborative multidisciplinary research teams. Following a comprehensive needs assessment, we developed a curriculum-based, multi-disciplinary, didactic and experiential Translational Leadership training program grounded in adult learning theory. In addition, we constructed collaborative clinical/translational research experiences for trainees to enhance clinical/translational research skills. KEY PROGRAMMATIC ELEMENTS AND PRELIMINARY FINDINGS: This 15-week Translational Leadership program was generated based on the following premises. Academic translational leadership teams should partner and collaborate, customize, make the program relevant to the culture, create a common language, use the best resources, and establish measurable goals for success. Development of effective collaborative research teams is essential to the management of successful translational research teams. Development of these skills in addition to cultural humility will provide the best infrastructure and human capital committed to the resolution of health disparities. Effective translational research teams are more comfortable with the component team members and the communities where they implement their protocols. Our participants highly valued the diverse experiences from this program; several have succeeded in leading community-based research teams. Our Translational Leadership program offers essential skills using adult learning theory for translational researchers who become capable of leading and participating in translational research teams. We believe including community members in the training of translational research programs is an important asset. The multidisciplinary approach develops skills that are also of significant use to the community and its acceptance of responsibility for its own health.

Mentoring Early-Career Faculty Researchers Is Important-But First "Train the Trainer".

PubMed

Sood, Akshay; Tigges, Beth; Helitzer, Deborah

2016-12-01

It has long been known that mentoring is critical to the success of junior faculty researchers. The controlled intervention study by Libby et al published in this issue of Academic Medicine demonstrates that institutional investment in a mentored research career development program for early-career faculty investigators provided significant long-term gains in grant productivity. Academic institutions hoping to replicate this program's success by launching similar mentoring programs for their junior faculty investigators will, however, find that the Achilles' heel lies in the scarcity of skilled research mentors and the relative lack of attention to and recognition of the importance of a supportive institutional climate for mentoring. It is essential, therefore, to begin by developing programs to "train the trainer" as well as programs and policies to support mentors. As a recent trial at 16 Clinical and Translational Science Award institutions demonstrated, competency-based, structured research mentor training can improve mentors' skills.In this Commentary, the authors offer a comprehensive two-pronged framework for mentor development with elements that address both individual mentoring competencies and the institutional climate for mentoring. The framework depicts the gaps, activities, and outcomes that a mentor development program can address. Activities directed at changing the institutional climate related to mentor development should complement training activities for individual mentors. The authors propose that employing this framework's approach to mentor development will lead to the desired impact: to increase the competence, productivity, and retention of a diverse clinical and translational research workforce.

Using a Quasi-Experimental Research Design to Assess Knowledge in Continuing Medical Education Programs

ERIC Educational Resources Information Center

Markert, Ronald J.; O'Neill, Sally C.; Bhatia, Subhash C.

2003-01-01

Introduction: The objectives of continuing medical education (CME) programs include knowledge acquisition, skill development, clinical reasoning and decision making, and health care outcomes. We conducted a yearlong medical education research study in which knowledge acquisition in our CME programs was assessed. Method: A randomized…

An Antibiotic Resource Program for Students of the Health Professions.

ERIC Educational Resources Information Center

Tritz, Gerald J.

1986-01-01

Provides a description of a computer program developed to supplement instruction in testing of antibiotics on clinical isolates of microorganisms. The program is a simulation and database for interpretation of experimental data designed to enhance laboratory learning and prepare future physicians to use computerized diagnostic instrumentation and…

Leadership Training Program for Medical Staff in Belgium

ERIC Educational Resources Information Center

Claes, Neree; Brabanders, Valérie

2016-01-01

Today healthcare is facing many challenges in a volatile, uncertain, complex and ambiguous environment. There is a need to develop strong leaders who can cope with these challenges. This article describes the process of a leadership training program for healthcare professionals in Belgium (named "Clinical Leadership Program" or…

Assessing Competencies in a Master of Science in Clinical Research Program: The Comprehensive Competency Review.

PubMed

Robinson, Georgeanna F W B; Moore, Charity G; McTigue, Kathleen M; Rubio, Doris M; Kapoor, Wishwa N

2015-12-01

Competencies in Master of Science Clinical Research programs are becoming increasingly common. However, students and programs can only benefit fully from competency-based education if students' competence is formally assessed. Prior to a summative assessment, students must have at least one formative, formal assessment to be sure they are developing competence appropriate for their stage of training. This paper describes the comprehensive competency review (CCR), a milestone for MS students in Clinical Research at the University of Pittsburgh's Institute for Clinical Research Education. The CCR involves metacognitive reflection of the student's learning as a whole, written evidence of each competency, a narrative explaining the choice of evidence for demonstrating competencies, and a meeting in which two faculty members review the evidence and solicit further oral evidence of competence. CCRs allow for individualized feedback at the midpoint in degree programs, providing students with confidence that they will have the means and strategies to develop competence in all areas by the summative assessment of competence at their thesis defense. CCRs have also provided programmatic insight on the need for curricular revisions and additions. These benefits outweigh the time cost on the part of students and faculty in the CCR process. © 2015 Wiley Periodicals, Inc.

Assessing Competencies in a Master of Science in Clinical Research Program: The Comprehensive Competency Review

PubMed Central

Moore, Charity G.; McTigue, Kathleen M.; Rubio, Doris M.; Kapoor, Wishwa N.

2015-01-01

Abstract Competencies in Master of Science Clinical Research programs are becoming increasingly common. However, students and programs can only benefit fully from competency‐based education if students’ competence is formally assessed. Prior to a summative assessment, students must have at least one formative, formal assessment to be sure they are developing competence appropriate for their stage of training. This paper describes the comprehensive competency review (CCR), a milestone for MS students in Clinical Research at the University of Pittsburgh's Institute for Clinical Research Education. The CCR involves metacognitive reflection of the student's learning as a whole, written evidence of each competency, a narrative explaining the choice of evidence for demonstrating competencies, and a meeting in which two faculty members review the evidence and solicit further oral evidence of competence. CCRs allow for individualized feedback at the midpoint in degree programs, providing students with confidence that they will have the means and strategies to develop competence in all areas by the summative assessment of competence at their thesis defense. CCRs have also provided programmatic insight on the need for curricular revisions and additions. These benefits outweigh the time cost on the part of students and faculty in the CCR process. PMID:26332763

Teaching efficacy of nurses in clinical practice education: A cross-sectional study.

PubMed

Kim, Eun-Kyeung; Shin, Sujin

2017-07-01

Clinical nurses play a vital role in clinical practice education; thus, it is necessary to help clinical nurses have teaching efficacy through the development and application of systematic education programs. To identify nurses' teaching efficacy for clinical education and analyze the influencing factors of teaching efficacy. The study used a cross-sectional design. We used a convenience sample of 263 nurses from two hospitals. Teaching efficacy, general characteristics, and perception of clinical practice education were collected via self-reported questionnaires. Teaching efficacy was measured using Hwang's (2006) questionnaire, while perception of clinical practice education was measured using the Clinical Nurse Teacher Survey developed by Nishioka et al. (2014). Participants completed the questionnaire directly. The collected data were then analyzed using descriptive statistics, t-tests, ANOVAs, and multiple regression analysis with PASW Statistics 18.0. The mean total score of teaching efficacy was 72.5 (range 21-105). The leadership for students subscale had the highest score (3.56±0.59). The factors influencing teaching efficacy were length of clinical career (β=0.26, p<0.001) and perceptions of work satisfaction (β=0.20, p=.005), clinical supervisory relationship (β=0.18, p=.010), and nursing at the hospital ward (β=0.13, p=.029). Altogether, these variables explained 28% of the variance in teaching efficacy in nurses. Based on these results, nursing educators might need to develop greater confidence in their knowledge and enhance control of their teaching strategies. Nursing schools and hospitals might need to provide greater support and educational opportunities to nurse clinical practice instructors. Furthermore, constructing a system of cooperation between these colleges and educational hospitals, developing programs to enhance teaching efficacy, and identifying the clinical instructor's role are all necessary to promote clinical practice education. Copyright © 2017. Published by Elsevier Ltd.

The Vanderbilt Professional Nursing Practice Program, part 3: managing an advancement process.

PubMed

Steaban, Robin; Fudge, Mitzie; Leutgens, Wendy; Wells, Nancy

2003-11-01

Consistency of performance standards across multiple clinical settings is an essential component of a credible advancement system. Our advancement process incorporates a central committee, composed of nurses from all clinical settings within the institution, to ensure consistency of performance in inpatient, outpatient, and procedural settings. An analysis of nurses advanced during the first 18 months of the program indicates that performance standards are applicable to nurses in all clinical settings. The first article (September 2003) in this 3-part series described the foundation for and the philosophical background of the Vanderbilt Professional Nursing Practice Program (VPNPP), the career advancement program underway at Vanderbilt University Medical Center. Part 2 described the development of the evaluation tools used in the VPNPP, the implementation and management of this new system, program evaluation, and improvements since the program's inception. The purpose of this article is to review the advancement process, review the roles of those involved in the process, and to describe outcomes and lessons learned.

GME Concentrations: A Collaborative Interdisciplinary Approach to Learner-Driven Education.

PubMed

Nagler, Alisa; Chudgar, Saumil M; Rudd, Mariah; Whicker, Shari A; Gagliardi, Jane P; Narayan, Aditee; Heflin, Mitchell T; Gordon, David C; Andolsek, Kathryn M

2015-09-01

Graduate medical education (GME) programs may struggle to provide the knowledge, skills, and experiences necessary to meet trainee career interests and goals beyond a clinical focus. Sponsoring institutions can partner with programs to deliver content not included in typical clinical experiences of GME programs. To perform a needs assessment and to develop, implement, and measure acceptability and feasibility of an institution-wide GME Concentrations curriculum. In response to the needs assessment, GME leadership developed 4 concentrations: (1) Resident-as-Teacher; (2) Patient Safety and Quality Improvement; (3) Law, Ethics, and Health Policy; and (4) Leaders in Medicine. We formed advisory committees that developed curricula for each concentration, including didactics, experiential learning, and individual project mentoring. Participants completed pre- and postassessments. We assessed feasibility and evaluated participant presentations and final projects. Over the course of 3 years, 91 trainees (of approximately 1000 trainees each year) from 36 GME programs (of 82 accredited programs) have participated in the program. The number of participants has increased each year, and 22 participants have completed the program overall. Cost for each participant is estimated at $500. Participant projects addressed a variety of education and health care areas, including curriculum development, quality improvement, and national needs assessments. Participants reported that their GME Concentrations experience enhanced their training and fostered career interests. The GME Concentrations program provides a feasible, institutionally based approach for educating trainees in additional interest areas. Institutional resources are leveraged to provide and customize content important to participants' career interests beyond their specialty.

Academic Medical Product Development: An Emerging Alliance of Technology Transfer Organizations and the CTSA

PubMed Central

Everts, Maaike; Heller, Caren; Burke, Christine; Hafer, Nathaniel; Steele, Scott

2014-01-01

Abstract To bring the benefits of science more quickly to patient care, the NIH National Center Advancing Translational Sciences (NCATS) supports programs that enhance the development, testing, and implementation of new medical products and procedures. The NCATS clinical and translational science award (CTSA) program is central to that mission; creating an academic home for clinical and translational science and supporting those involved in the discovery and development of new health‐related inventions. The technology transfer Offices (TTO) of CTSA‐funded universities can be important partners in the development process; facilitating the transfer of medical research to the commercial sector for further development and ultimately, distribution to patients. The Aggregating Intellectual Property (IP) Working Group (AWG) of the CTSA public private partnerships key function committee (PPP‐KFC) developed a survey to explore how CTSA‐funded institutions currently interface with their respective TTOs to support medical product development. The results suggest a range of relationships across institutions; approximately half have formal collaborative programs, but only a few have well‐connected programs. Models of collaborations are described and provided as examples of successful CTSA/TTO partnerships that have increased the value of health‐related inventions as measured by follow‐on funding and industry involvement; either as a consulting partner or licensee. PMID:24945893

Academic medical product development: an emerging alliance of technology transfer organizations and the CTSA.

PubMed

Rose, Lynn M; Everts, Maaike; Heller, Caren; Burke, Christine; Hafer, Nathaniel; Steele, Scott

2014-12-01

To bring the benefits of science more quickly to patient care, the NIH National Center Advancing Translational Sciences (NCATS) supports programs that enhance the development, testing, and implementation of new medical products and procedures. The NCATS clinical and translational science award (CTSA) program is central to that mission; creating an academic home for clinical and translational science and supporting those involved in the discovery and development of new health-related inventions. The technology transfer Offices (TTO) of CTSA-funded universities can be important partners in the development process; facilitating the transfer of medical research to the commercial sector for further development and ultimately, distribution to patients. The Aggregating Intellectual Property (IP) Working Group (AWG) of the CTSA public private partnerships key function committee (PPP-KFC) developed a survey to explore how CTSA-funded institutions currently interface with their respective TTOs to support medical product development. The results suggest a range of relationships across institutions; approximately half have formal collaborative programs, but only a few have well-connected programs. Models of collaborations are described and provided as examples of successful CTSA/TTO partnerships that have increased the value of health-related inventions as measured by follow-on funding and industry involvement; either as a consulting partner or licensee. © 2014 Wiley Periodicals, Inc.

When children have children: the teen pregnancy predicament.

PubMed

Carter, D M; Felice, M E; Rosoff, J; Zabin, L S; Beilenson, P L; Dannenberg, A L

1994-01-01

Despite developments in contraceptive technology and changes in societal norms, adolescent pregnancy remains a key issue for politicians, social scientists, health care providers, and educators. The adolescent's access to contraception and abortion services continues to spark legal debate. The implications of research call for the development of innovative programs to address larger issues, such as poverty and limited access to health care, in the management and prevention of adolescent pregnancies. Clinical interventions, such as school-linked clinics to provide contraception and prenatal care programs to reduce perinatal morbidity, have varied in their approaches and their subsequent success.

Selected options supporting use of the group embedded figures test in modeling achievement in clinical laboratory science programs.

PubMed

Powell, M E

1995-01-01

To identify, in light of predicted future shortages of allied-health personnel, student and curricular characteristics of clinical laboratory science (CLS) programs relevant to recruitment and retention at the baccalaureate level. Not applicable. Not applicable. Options for modeling achievement in CLS programs are developed, and designs and procedures for clarifying procedural questions are considered in a context of delivery of instruction for specialized curricula and skill development. Considerable attention is given to the potential for using the Group Embedded Figures Test (GEFT) in modeling, advising, designing curricula, and monitoring quality improvement of programs and graduates. Not applicable. Supporting evidence is supplied from the literature for options in developing an appropriate model for examining those salient variables known to have linkages to achievement. An argument is presented for better understanding of antecedent variables affecting achievement and retention of CLS students. In addition, a case is made for development of an appropriate model examining variables identified in the literature as being linked to achievement. Dynamic models based on these considerations should be developed chronologically from entry through graduation with emphasis on growth at year-end milestones.

Understanding the Challenges of Integrating Scientists and Clinical Teachers in Psychiatry Education: Findings from an Innovative Faculty Development Program

ERIC Educational Resources Information Center

Martimianakis, Maria Athina; Hodges, Brian D.; Wasylenki, Donald

2009-01-01

Objective: Medical schools and departments of psychiatry around the world face challenges in integrating science with clinical teaching. This project was designed to identify attitudes toward the integration of science in clinical teaching and address barriers to collaboration between scientists and clinical teachers. Methods: The authors explored…

Clinical Computer Applications in Mental Health

PubMed Central

Greist, John H.; Klein, Marjorie H.; Erdman, Harold P.; Jefferson, James W.

1982-01-01

Direct patient-computer interviews were among the earliest applications of computing in medicine. Yet patient interviewing and other clinical applications have lagged behind fiscal/administrative uses. Several reasons for delays in the development and implementation of clinical computing programs and their resolution are discussed. Patient interviewing, clinician consultation and other applications of clinical computing in mental health are reviewed.

The Wrong Tool for the Job: Diabetes Public Health Programs and Practice Guidelines

PubMed Central

López, Andrea; Black, Karen; Schillinger, Dean

2011-01-01

We surveyed state diabetes programs to determine whether they develop and disseminate diabetes guidelines. We found they largely disseminate clinical practice guidelines developed from subspecialty organizations, do not prioritize among the many recommendations contained in diabetes guidelines, and have not adapted guidelines to focus on population rather than individual health. An opportunity exists for state diabetes control programs to better align guidelines with public health goals. PMID:21852653

Incorporating development of a patient-reported outcome instrument in a clinical drug development program: examples from a heart failure program.

PubMed

Wiklund, Ingela; Anatchkova, Milena; Oko-Osi, Hafiz; von Maltzahn, Robyn; Chau, Dina; Malik, Fady I; Patrick, Donald L; Spertus, John; Teerlink, John R

2016-09-15

Patient-reported outcome (PRO) measures can be used to support label claims if they adhere to US Food & Drug Administration guidance. The process of developing a new PRO measure is expensive and time-consuming. We report the results of qualitative studies to develop new PRO measures for use in clinical trials of omecamtiv mecarbil (a selective, small molecule activator of cardiac myosin) for patients with heart failure (HF), as well as the lessons learned from the development process. Concept elicitation focus groups and individual interviews were conducted with patients with HF to identify concepts for the instrument. Cognitive interviews with HF patients were used to confirm that no essential concepts were missing and to assess patient comprehension of the instrument and items. During concept elicitation, the most frequently reported HF symptoms were shortness of breath, tiredness, fluid retention, fatigue, dizziness/light-headedness, swelling, weight fluctuation, and trouble sleeping. Two measures were developed based on the concepts: the Heart Failure Symptom Diary (HF-SD) and the Heart Failure Impact Scale (HFIS). Findings from cognitive interviews suggested that the items in the HF-SD and HFIS were relevant and well understood by patients. Multiple iterations of concept elicitation and cognitive interviews were needed based on FDA request for a broader patient population in the qualitative study. Lessons learned from the omecamtiv mecarbil PRO/clinical development program are discussed, including challenges of qualitative studies, patient recruitment, expected and actual timelines, cost, and engagement with various stakeholders. Development of a new PRO measure to support a label claim requires significant investment and early planning, as demonstrated by the omecamtiv mecarbil program.

Enhancing Insights into Pulmonary Vascular Disease through a Precision Medicine Approach. A Joint NHLBI-Cardiovascular Medical Research and Education Fund Workshop Report.

PubMed

Newman, John H; Rich, Stuart; Abman, Steven H; Alexander, John H; Barnard, John; Beck, Gerald J; Benza, Raymond L; Bull, Todd M; Chan, Stephen Y; Chun, Hyung J; Doogan, Declan; Dupuis, Jocelyn; Erzurum, Serpil C; Frantz, Robert P; Geraci, Mark; Gillies, Hunter; Gladwin, Mark; Gray, Michael P; Hemnes, Anna R; Herbst, Roy S; Hernandez, Adrian F; Hill, Nicholas S; Horn, Evelyn M; Hunter, Kendall; Jing, Zhi-Cheng; Johns, Roger; Kaul, Sanjay; Kawut, Steven M; Lahm, Tim; Leopold, Jane A; Lewis, Greg D; Mathai, Stephen C; McLaughlin, Vallerie V; Michelakis, Evangelos D; Nathan, Steven D; Nichols, William; Page, Grier; Rabinovitch, Marlene; Rich, Jonathan; Rischard, Franz; Rounds, Sharon; Shah, Sanjiv J; Tapson, Victor F; Lowy, Naomi; Stockbridge, Norman; Weinmann, Gail; Xiao, Lei

2017-06-15

The Division of Lung Diseases of the NHLBI and the Cardiovascular Medical Education and Research Fund held a workshop to discuss how to leverage the anticipated scientific output from the recently launched "Redefining Pulmonary Hypertension through Pulmonary Vascular Disease Phenomics" (PVDOMICS) program to develop newer approaches to pulmonary vascular disease. PVDOMICS is a collaborative, protocol-driven network to analyze all patient populations with pulmonary hypertension to define novel pulmonary vascular disease (PVD) phenotypes. Stakeholders, including basic, translational, and clinical investigators; clinicians; patient advocacy organizations; regulatory agencies; and pharmaceutical industry experts, joined to discuss the application of precision medicine to PVD clinical trials. Recommendations were generated for discussion of research priorities in line with NHLBI Strategic Vision Goals that include: (1) A national effort, involving all the stakeholders, should seek to coordinate biosamples and biodata from all funded programs to a web-based repository so that information can be shared and correlated with other research projects. Example programs sponsored by NHLBI include PVDOMICS, Pulmonary Hypertension Breakthrough Initiative, the National Biological Sample and Data Repository for PAH, and the National Precision Medicine Initiative. (2) A task force to develop a master clinical trials protocol for PVD to apply precision medicine principles to future clinical trials. Specific features include: (a) adoption of smaller clinical trials that incorporate biomarker-guided enrichment strategies, using adaptive and innovative statistical designs; and (b) development of newer endpoints that reflect well-defined and clinically meaningful changes. (3) Development of updated and systematic variables in imaging, hemodynamic, cellular, genomic, and metabolic tests that will help precisely identify individual and shared features of PVD and serve as the basis of novel phenotypes for therapeutic interventions.

Prevention of Posttraumatic Contractures with Ketotifen (PERK)

DTIC Science & Technology

2016-10-01

the Peer Reviewed Orthopaedic Research Program (PRORP) Clinical Trial Award (CTA), W81XWH-16-PRORP-CTA, was submitted. Database development and Pre...and Safety Months Identify database and partner – Clinical Research Unit 1-2 Completed Develop Case Report Forms, consent forms 6-12 Case...report forms completed, consent forms pending – 80% completed Develop database and multicenter submission process 12-18 In progress, 30% completed

Leading by Success: Impact of a Clinical & Translational Research Infrastructure Program to Address Health Inequities

PubMed Central

Shiramizu, Bruce; Shambaugh, Vicki; Petrovich, Helen; Seto, Todd B.; Ho, Tammy; Mokuau, Noreen; Hedges, Jerris R.

2016-01-01

Building research infrastructure capacity to address clinical and translational gaps has been a focus of funding agencies and foundations. Clinical and Translational Sciences Awards, Research Centers in Minority Institutions Infrastructure for Clinical and Translational Research (RCTR) and the Institutional Development Award Infrastructure for Clinical and Translational Research funded by United States (US) government to fund clinical translational research programs have existed for over a decade to address racial and ethnic health disparities across the US. While the impact on the nation’s health can’t be made in a short period, assessment of a program’s impact could be a litmus test to gauge its effectiveness at the institution and communities. We report the success of a Pilot Project Program in the University of Hawaii RCTR Award in advancing careers of emerging investigators and community collaborators. Our findings demonstrated that the investment has a far-reaching impact on engagement with community-based research collaborators, career advancement of health disparities investigators, and favorable impacts on health policy. PMID:27797013

Model Development for A University-Based Learning Disability Clinic.

ERIC Educational Resources Information Center

Martin, Larry L.; And Others

The report presents a model for appraisal and individualized educational programing for learning disabled children at the School of Education, Auburn University, Alabama. Descriptions by clinic staff of visitations to exemplary models and a summary of a regional conference on learning disabilities introduce the report. The clinic model is…

Assessment of a Novel Point-of-Care Ultrasound Curriculum's Effect on Competency Measures in Family Medicine Graduate Medical Education.

PubMed

Bornemann, Paul

2017-06-01

Point-of-care ultrasound has been shown to decrease the use of expensive diagnostic studies and improve quality outcome measures. Currently, there is a large desire for training in family medicine residencies, but very few programs have established curricula. We sought to develop a family medicine residency curriculum and evaluate it with tools we developed. We wanted our curriculum to be easy to adopt by other residency programs, even if they did not have many well-trained ultrasound faculty. We developed a curriculum in the form of a 4-week rotation in a family medicine residency program. It consisted of self-study videos, hands-on training, and image review. We followed residents in postgraduate years 1 to 3 over a 12-month period. We developed tools, including a knowledge exam, to test image interpretation and clinical decision making, an observed structured clinical exam to assess scanning skills, and a survey to assess perceptions of point-of-care ultrasound in family medicine. The assessments were administered before and after each resident's rotation. Seventeen residents completed the rotation. The average knowledge test score improved significantly, from 62 to 84%. The average observed structured clinical exam scores also improved significantly, from 41 to 85%. The average perception survey scores improved slightly from 4.4 to 4.6. We developed a point-of-care ultrasound curriculum for family medicine residency programs that improves measures of resident attitude, skills, and knowledge. This curriculum can be adopted by residency programs with few faculty members who are experienced in ultrasound. © 2017 by the American Institute of Ultrasound in Medicine.

Case Study: Clinical Governance as an Approach to Improve Maternal and Newborn Health in 22 Hospitals in Indonesia.

PubMed

Amelia, Dwirani; Suhowatsky, Stephanie; Baharuddin, Mohammad; Tholandi, Maya; Hyre, Anne; Sethi, Reena

Clinical governance is a concept used to improve management, accountability and the provision of quality healthcare. An approach to strengthen clinical governance as a means to improve the quality of maternal and newborn care in Indonesia was developed by the Expanding Maternal and Neonatal Survival (EMAS) Program. This case study presents findings and lessons learned from EMAS program experience in 22 hospitals where peer-to-peer mentoring supported staff in strengthening clinical governance from 2012-2015. Efforts resulted in improved hospital preparedness and significantly increased the odds of facility-level coverage for three evidence-based maternal and newborn healthcare interventions.

Developing an understanding of research-based nursing pedagogy among clinical instructors: a qualitative study.

PubMed

Zakari, Nazik M A; Hamadi, Hanadi Y; Salem, Olfat

2014-11-01

Effective instruction is imperative to the learning process of clinical nursing instructors. Faculty members are required to provide high-quality teaching and training by using new ways of teaching pedagogical methods to clinical instructors, which have transformed pedagogies from an exclusive clinical model to a holistic model. The purpose of this study was to explore clinical instructors' use of planning, implementation, feedback loops, and reflection frameworks to apply research-based teaching and to examine the pedagogy used during field experience. Data for the qualitative study were obtained from twenty purposefully sampled clinical teachers (n=20) via lists of questioned instructional practices and discussions, semi-structured interviews, observational notes, field notes, and written reflections. Data were analyzed by using a triangulation method to ensure trustworthiness, credibility, and reliability. Three main themes emerged regarding the use of research-based teaching strategies: the need for learning about research-based pedagogy, support mechanisms to implement innovative teaching strategies, and transitioning from nursing student to nursing clinical instructors. It has been well documented that the nursing profession faces a serious shortage of nursing faculty, impacting the quality of clinical teaching. Developing clinical instructor programs to give students opportunities to select instructor pathways, focusing on knowledge promoting critical thinking and life-long professional development, is essential. Nursing colleges must collaborate by using a partnership model to achieve competency in planning, implementation, feedback loops, and reflection. Applying research-based clinical teaching requires the development of programs that integrate low-fidelity simulation and assisted instruction through the use of computers in Nursing Colleges. Copyright © 2014 Elsevier Ltd. All rights reserved.

Antimicrobial stewardship programs: interventions and associated outcomes.

PubMed

Patel, Dimple; Lawson, Wendy; Guglielmo, B Joseph

2008-04-01

Guidelines regarding antimicrobial stewardship programs recommend an infectious diseases-trained physician and an infectious diseases-trained pharmacist as core members. Inclusion of clinical microbiologists, infection-control practitioners, information systems experts and hospital epidemiologists is considered optimal. Recommended stewardship interventions include prospective audit and intervention, formulary restriction, education, guideline development, clinical pathway development, antimicrobial order forms and the de-escalation of therapy. The primary outcome associated with these interventions has been the associated cost savings; however, few published investigations have taken into account the overall cost of the intervention. Over the past 5 years, there has been an increased focus upon interventions intended to decrease bacterial resistance or reduce superinfection, including infections associated with Clostridium difficile colitis. Few programs have been associated with a reduction in antimicrobial drug adverse events. Antimicrobial stewardship programs are becoming increasingly associated with clear benefits and will be integral in the in-patient healthcare setting.

Mass media approaches to reducing cardiovascular disease risk.

PubMed Central

Bellicha, T; McGrath, J

1990-01-01

A key function of a basic and clinical biomedical research organization is to communicate the findings of clinical investigations so that people may apply the results to improve their health and well-being. To help communicate results from cardiovascular disease research, the National Heart, Lung, and Blood Institute has established a series of national health education programs. The authors describe a model for two of the five programs and discuss the role of communication media in supporting national goals for education programs. The research basis for the programs is reviewed, together with the process by which the Institute develops information materials for mass media, notably public service announcements. A description of two national health education campaigns, hypertension and cholesterol, illustrates how market research is used to identify appropriate target audiences, develop messages, and select channels of communication. Lessons learned about the role of mass media in a national health education campaign are summarized. PMID:2113682

Postpartum depression: a chronicle of health policy development.

PubMed

Glasser, Saralee

2010-01-01

The current report presents an example of the path taken from identification of a public health problem at the primary health service level, to conducting research documenting the scope of the problem and nature of the risk factors, disseminating the findings, and fostering development and application of relevant policy. The example presented is the case of postpartum depression, an issue with bio-psycho-social implications. Public health nurses identified the problem, prompting epidemiological research. The findings encouraged the Ministry of Health (MOH) to conduct a pilot program for screening and early intervention among pregnant and postpartum women reporting depressive symptoms. Based on the results of the pilot program, the MOH is expanding the program to all Mother-Child Health (MCH) clinics. Israel?s largest Health Maintenance Organization has followed suit and is including this program in its own clinics. This Israeli experience may serve as an instructive example of a locally identified problem evolving into a national policy.

DEVELOPMENT OF AN EMERGENCY NURSING TRAINING CURRICULUM IN GHANA

PubMed Central

Bell, Sue Anne; Oteng, Rockefeller; Redman, Richard; Lapham, Jeremy; Bam, Victoria; Dzomecku, Veronica; Yakubu, Jamila; Tagoe, Nadia; Donkor, Peter

2014-01-01

The formal provision of emergency health care is a developing specialty in many sub-Saharan African countries, including Ghana. While emergency medicine training programs for physicians are on the rise, there are few established training programs for emergency nurses. The results of a unique collaboration are described between a university in the United States, a Ghanaian university and a Ghanaian teaching hospital that has developed an emergency nursing diploma program. The expected outcomes of this training program include: a) an innovative, interdisciplinary, team-based clinical training model b) a unique and low-resource emergency nursing curriculum and c) a comprehensive and sustainable training program to increase in-country retention of nurses. PMID:24631161

Development and application of course-embedded assessment system for program outcome evaluation in the Korean nursing education: A pilot study.

PubMed

Park, Jee Won; Seo, Eun Ji; You, Mi-Ae; Song, Ju-Eun

2016-03-01

Program outcome evaluation is important because it is an indicator for good quality of education. Course-embedded assessment is one of the program outcome evaluation methods. However, it is rarely used in Korean nursing education. The study purpose was to develop and apply preliminarily a course-embedded assessment system to evaluate one program outcome and to share our experiences. This was a methodological study to develop and apply the course-embedded assessment system based on the theoretical framework in one nursing program in South Korea. Scores for 77 students generated from the three practicum courses were used. The course-embedded assessment system was developed following the six steps suggested by Han's model as follows. 1) One program outcome in the undergraduate program, "nursing process application ability", was selected and 2) the three clinical practicum courses related to the selected program outcome were identified. 3) Evaluation tools including rubric and items were selected for outcome measurement and 4) performance criterion, the educational goal level for the program, was established. 5) Program outcome was actually evaluated using the rubric and evaluation items in the three practicum courses and 6) the obtained scores were analyzed to identify the achievement rate, which was compared with the performance criterion. Achievement rates for the selected program outcome in adult, maternity, and pediatric nursing practicum were 98.7%, 100%, and 66.2% in the case report and 100% for all three in the clinical practice, and 100%, 100%, and 87% respectively for the conference. These are considered as satisfactory levels when compared with the performance criterion of "at least 60% or more". Course-embedded assessment can be used as an effective and economic method to evaluate the program outcome without running an integrative course additionally. Further studies to develop course-embedded assessment systems for other program outcomes in nursing education are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing Clinical Trial-Associated Workload in Community-Based Research Programs Using the ASCO Clinical Trial Workload Assessment Tool.

PubMed

Good, Marjorie J; Hurley, Patricia; Woo, Kaitlin M; Szczepanek, Connie; Stewart, Teresa; Robert, Nicholas; Lyss, Alan; Gönen, Mithat; Lilenbaum, Rogerio

2016-05-01

Clinical research program managers are regularly faced with the quandary of determining how much of a workload research staff members can manage while they balance clinical practice and still achieve clinical trial accrual goals, maintain data quality and protocol compliance, and stay within budget. A tool was developed to measure clinical trial-associated workload, to apply objective metrics toward documentation of work, and to provide clearer insight to better meet clinical research program challenges and aid in balancing staff workloads. A project was conducted to assess the feasibility and utility of using this tool in diverse research settings. Community-based research programs were recruited to collect and enter clinical trial-associated monthly workload data into a web-based tool for 6 consecutive months. Descriptive statistics were computed for self-reported program characteristics and workload data, including staff acuity scores and number of patient encounters. Fifty-one research programs that represented 30 states participated. Median staff acuity scores were highest for staff with patients enrolled in studies and receiving treatment, relative to staff with patients in follow-up status. Treatment trials typically resulted in higher median staff acuity, relative to cancer control, observational/registry, and prevention trials. Industry trials exhibited higher median staff acuity scores than trials sponsored by the National Institutes of Health/National Cancer Institute, academic institutions, or others. The results from this project demonstrate that trial-specific acuity measurement is a better measure of workload than simply counting the number of patients. The tool was shown to be feasible and useable in diverse community-based research settings. Copyright © 2016 by American Society of Clinical Oncology.

Yoga for Youth in Pain

PubMed Central

Evans, Subhadra; Moieni, Mona; Sternlieb, Beth; Tsao, Jennie C.I; Zeltzer, Lonnie K.

2012-01-01

Children, adolescents, and young adults do not typically feature in clinics, studies, and mainstream notions of chronic pain. Yet many young people experience debilitating pain for extended periods of time. Chronic pain in these formative years may be especially important to treat in order for young patients to maintain life tasks and to prevent protracted disability. The Pediatric Pain Program at the University of California, Los Angeles, is a multidisciplinary treatment program designed for young people with chronic pain and their families. We offer both conventional and complementary medicine to treat the whole individual. This article describes the work undertaken in the clinic and our newly developed Yoga for Youth Research Program. The clinical and research programs fill a critical need to provide service to youth with chronic pain and to scientifically study one of the more popular complementary treatments we offer, Iyengar yoga. PMID:22864296

Ten-year NEDO BVAD development program: moving forward to the clinical arena.

PubMed

Motomura, Tadashi; Okubo, Hisashi; Oda, Takeshi; Ogawa, Daisuke; Okahisa, Toshiya; Igo, Stephen; Shinohara, Toshiyuki; Yamamoto, Yoshiro; Noguchi, Chikaya; Ishizuka, Tsukasa; Okamoto, Eiji; Nosé, Yukihiko

2006-01-01

Since 1995, the Baylor Group has been developing a totally implantable NEDO BVAD system. This 10-year program was completed in March 2005, and preparation for clinical trials is underway. This article summarizes the entire 10-year NEDO program and describes the strategy for clinical trials. The project aimed to achieve: (1) dual centrifugal pumps with the ability of full biventricular support, (2) a compact system implantable into small adults, (3) a totally implantable system with transcutaneous energy transmission system (TETS), (4) a durable system with a lifetime of over 5 years, and (5) a system free of thrombus and with minimal hemolysis. The final goals are to complete preclinical system evaluations and commence the clinical trials in the near future. In vitro studies have demonstrated a pump capacity of over 8.5 l/min and an Index of Hemolysis of <0.004 g/100 l. The pump-bearing life expectancy was over 5 years. To date, eight pumps endured in vivo studies of over 3 months without complications, including thromboembolic events. The in vitro endurance studies of eight pumps are longer than 1 year. There were no mechanical malfunctions or pump failure. A stepwise clinical trial is being planned: Step1, a wearable BVAD/VAD will be clinically studied; Step 2, the BVAD/VAD will be implanted intracorporeally without TETS; and, Step 3, a totally implantable system will be clinically evaluated. The NEDO BVAD system has completed preclinical testing. Clinical trial preparation is underway.

Diagnosis of retinal detachments by a tele-ophthalmology screening program.

PubMed

McCord, Sarah A; Lynch, Mary G; Maa, April Y

2018-01-01

In 2015, a tele-ophthalmology program was undertaken at the Atlanta Veterans Affairs Medical Center to provide screening eye care for veterans in their primary care clinics. Though this program was developed as a screening tool, the availability of these services in primary care clinics has enabled triage of certain acute eye complaints. These case reports describe two patients who were diagnosed with retinal detachments through this program, although their primary care providers had triaged them as requiring non-urgent referrals to the eye clinic. Although many patients are seen for acute ocular complaints in primary care clinics and emergency departments, providers in such settings may lack the ability to adequately examine eyes and thus triage ocular complaints. These cases demonstrate the ability of tele-ophthalmology to assist in diagnosing urgent ocular conditions in primary care clinics. Though tele-ophthalmology has been accepted in some parts of the world, in the United States of America it remains widely underutilized. These cases highlight the ability of tele-ophthalmology to close the gap in acute eye care coverage that exists in the USA, most prominently in rural regions.

LISP as an Environment for Software Design: Powerful and Perspicuous

PubMed Central

Blum, Robert L.; Walker, Michael G.

1986-01-01

The LISP language provides a useful set of features for prototyping knowledge-intensive, clinical applications software that is not found In most other programing environments. Medical computer programs that need large medical knowledge bases, such as programs for diagnosis, therapeutic consultation, education, simulation, and peer review, are hard to design, evolve continually, and often require major revisions. They necessitate an efficient and flexible program development environment. The LISP language and programming environments bullt around it are well suited for program prototyping. The lingua franca of artifical intelligence researchers, LISP facllitates bullding complex systems because it is simple yet powerful. Because of its simplicity, LISP programs can read, execute, modify and even compose other LISP programs at run time. Hence, it has been easy for system developers to create programming tools that greatly speed the program development process, and that may be easily extended by users. This has resulted in the creation of many useful graphical interfaces, editors, and debuggers, which facllitate the development of knowledge-intensive medical applications.

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

PubMed

Hicks, Frank D; Rosenberg, Lisa

2016-01-01

The need to educate nurses at the graduate level and provide them with a different skill set that broadens their view of health and nursing is clearly articulated by the American Association of Colleges of Nursing. Consequently, the role of the clinical nurse leader (CNL) was born. Responding to the need for providing a highly educated and credentialed professional at the bedside, Rush University College of Nursing made the bold move to phase out baccalaureate education and enact a prelicensure, master's entry CNL program. Although there is a clear need for this type of graduate, there is little in the literature to provide guidance to institutions that wish to develop this type of program. This paper describes the factors that came into play in making that decision, the process of curriculum development and implementation, the challenges encountered in implementing this type of program, and the outcomes that the program has evidenced since its inception. Copyright © 2016 Elsevier Inc. All rights reserved.

Preemptive Clinical Pharmacogenetics Implementation: Current programs in five United States medical centers

PubMed Central

Dunnenberger, Henry M.; Crews, Kristine R.; Hoffman, James M.; Caudle, Kelly E.; Broeckel, Ulrich; Howard, Scott C.; Hunkler, Robert J.; Klein, Teri E.; Evans, William E.; Relling, Mary V.

2015-01-01

Although the field of pharmacogenetics has existed for decades, the implementation of, pharmacogenetic testing in clinical care has been slow. There are numerous publications, describing the barriers to clinical implementation of pharmacogenetics. Recently, several freely, available resources have been developed to help address these barriers. In this review we, discuss current programs that use preemptive genotyping to optimize the pharmacotherapy of, patients. Array-based preemptive testing includes a large number of relevant pharmacogenes, that impact multiple high-risk drugs. Using a preemptive approach allows genotyping results to, be available prior to any prescribing decision so that genomic variation may be considered as, an inherent patient characteristic in the planning of therapy. This review describes the common, elements among programs that have implemented preemptive genotyping and highlights key, processes for implementation, including clinical decision support. PMID:25292429

A semi-automated tool for treatment plan-quality evaluation and clinical trial quality assurance

NASA Astrophysics Data System (ADS)

Wang, Jiazhou; Chen, Wenzhou; Studenski, Matthew; Cui, Yunfeng; Lee, Andrew J.; Xiao, Ying

2013-07-01

The goal of this work is to develop a plan-quality evaluation program for clinical routine and multi-institutional clinical trials so that the overall evaluation efficiency is improved. In multi-institutional clinical trials evaluating the plan quality is a time-consuming and labor-intensive process. In this note, we present a semi-automated plan-quality evaluation program which combines MIMVista, Java/MATLAB, and extensible markup language (XML). More specifically, MIMVista is used for data visualization; Java and its powerful function library are implemented for calculating dosimetry parameters; and to improve the clarity of the index definitions, XML is applied. The accuracy and the efficiency of the program were evaluated by comparing the results of the program with the manually recorded results in two RTOG trials. A slight difference of about 0.2% in volume or 0.6 Gy in dose between the semi-automated program and manual recording was observed. According to the criteria of indices, there are minimal differences between the two methods. The evaluation time is reduced from 10-20 min to 2 min by applying the semi-automated plan-quality evaluation program.

Participatory action research: involving students in parent education.

PubMed

Fowler, Cathrine; Wu, Cynthia; Lam, Winsome

2014-01-01

Competition for scarce clinical placements has increased requiring new and innovative models to be developed to meet the growing need. A participatory action research project was used to provide a community nursing clinical experience of involvement in parent education. Nine Hong Kong nursing students self-selected to participate in the project to implement a parenting program called Parenting Young Children in a Digital World. Three project cycles were used: needs identification, skills development and program implementation. Students were fully involved in each cycle's planning, action and reflection phase. Qualitative and quantitative data were collected to inform the project. The overall outcome of the project was the provision of a rich and viable clinical placement experience that created significant learning opportunities for the students and researchers. This paper will explore the student's participation in this PAR project as an innovative clinical practice opportunity. Copyright © 2013 Elsevier Ltd. All rights reserved.

Promoting Bedside Nurse-Led Research Through a Dedicated Neuroscience Nursing Research Fellowship.

PubMed

Stutzman, Sonja; Olson, DaiWai; Supnet, Charlene; Harper, Caryn; Brown-Cleere, Shelley; McCulley, Becky; Goldberg, Mark

2016-12-01

We hypothesized that nurses would benefit from the fellowship model traditionally used to engage physicians in clinical research. The Neuroscience Nursing Research Center (NNRC) fellowship program was created as a model for engaging nurses at all levels of clinical practice to become active in clinical research. The NNRC was established in 2013 as a novel approach to promote bedside nurses as primary investigators in clinical research. The NNRC developed 4 pathways to nursing research success: research fellowship, student-nurse internship, didactic training, and research consultation. Fellows have enrolled more than 900 participants in 14 studies. Nurses have presented more than 20 abstracts at 12 conferences and submitted 11 manuscripts for publication. The NNRC has provided research training to more than 150 nurses. The NNRC program is successful in engaging nurses in research. It shows promise to continue to develop nursing research that is applicable to clinicians and thus improve patient care.

Integration of Ancillary Data for Improved Clinical Use: A Prototype within the VA's DHCP

PubMed Central

Andrews, Robert D.

1989-01-01

The Department of Veterans Affairs' (VA) Decentralized Hospital Computer Program (DHCP) is composed of several clinical modules that provide for the clinical information needs of their respective ancillary services. Using information from multiple ancillary packages is sometimes cumbersome. A prototype is being developed aimed at integrating ancillary data by storing clinical data oriented to the patient so that there is easy interaction of data from multiple services. A set of program utilities provide for user-defined functions of reporting, queries, entry, and decision support. Information can be used to monitor quality of care by providing feedback in the form of reports, reminders, and bulletins. Initial testing has indicated the prototype's design and implementation are feasible (in terms of space requirements, speed, and ease of use) in both outpatient and inpatient environments. The design and development of this prototype are described.

Effectiveness of a Clinic-Based Early Literacy Program in Changing Parent-Child Early Literacy Habits.

PubMed

Fricke, Jonathan; Navsaria, Dipesh; Mahony, Karin

2016-12-01

Reach Out and Read (ROR) improves children's development and kindergarten readiness by encouraging parents to routinely share books with their children. Primary care providers give age-appropriate books and anticipatory guidance on reading at each well-child visit. This study evaluated parent attitudes and behaviors of early literacy related to ROR participation in Wisconsin clinics. A survey of early literacy attitudes and behaviors was administered to parents of children ages 6 months to 5 years in 36 Wisconsin clinics. Ten clinics were established ROR sites (intervention group) and 26 clinics had applied to become ROR programs but had not yet initiated the program (control group). Parents at clinics with ROR programs were more likely to read with a child under the age of 6 months (OR=1.58, 95% CI, 1.05-2.38). Other literacy metrics trended toward improvement but none reached statistical significance. Paradoxically, the odds of parents reporting reading as a bedtime habit were decreased among those who participated in ROR. Our study finds mixed support of the effectiveness of ROR outside of academic settings. The apparent discrepancy between these results and those from national studies on ROR may be related to differences in respondent demographics and educational attainment or differences in program implementation and fidelity. We believe that the results will become clearer with future study as clinics are prospectively evaluated over time rather than being compared to non-ROR clinics in a cross-sectional snapshot.

[An experience applying the teaching strategies of cooperative learning and creative thinking in a mental-health nursing practicum for undergraduates at a technical college].

PubMed

Huang, Yu-Hsien; Lin, Mei-Feng; Ho, Hsueh-Jen; Chang, Lu-Na; Chen, Shiue

2015-04-01

Lack of knowledge and experience is prevalent in undergraduate students who are taking their clinical practicum for mental-health nursing. This issue negatively affects the learning process. This article shares an experience of implementing a practicum-teaching program. This program was developed by the authors to facilitate the cooperative learning and clinical care competence of students. A series of multidimensional teaching activities was designed by integrating the strategies of peer cooperation and creative thinking to promote group and individual learning. Results indicate that the program successfully encouraged the students to participate more actively in the learning process. Additionally, the students demonstrated increased competence in empathetic caring toward patients, stronger friendship relationships with peers, and improved self-growth. The authors hope this teaching program provides a framework to increase the benefits for students of participating in clinical practicums and provides a teaching reference for clinical instructors.

Programming for physicians: A free online course.

PubMed

Kubben, Pieter L

2016-01-01

This article is an introduction for clinical readers into programming and computational thinking using the programming language Python. Exercises can be done completely online without any need for installation of software. Participants will be taught the fundamentals of programming, which are necessarily independent of the sort of application (stand-alone, web, mobile, engineering, and statistical/machine learning) that is to be developed afterward.

Flight crew health stabilization program

NASA Technical Reports Server (NTRS)

Wooley, B. C.; Mccollum, G. W.

1975-01-01

The flight crew health stabilization program was developed to minimize or eliminate the possibility of adverse alterations in the health of flight crews during immediate preflight, flight, and postflight periods. The elements of the program, which include clinical medicine, immunology, exposure prevention, and epidemiological surveillance, are discussed briefly. No crewmember illness was reported for the missions for which the program was in effect.

Enhancing Research Capacity for Global Health: Evaluation of a Distance-Based Program for International Study Coordinators

PubMed Central

Wilson, Lynda Law; Rice, Marti; Jones, Carolynn T.; Joiner, Cynthia; LaBorde, Jennifer; McCall, Kimberly; Jester, Penelope M; Carter, Sheree C.; Boone, Chrissy; Onwuzuligbo, Uzoma; Koneru, Alaya

2013-01-01

Introduction Due to the increasing number of clinical trials conducted globally, there is a need for quality continuing education for health professionals in clinical research manager (CRM) roles. This paper describes the development, implementation, and evaluation of a distance-based continuing education program for CRMs working outside the United States. Methods A total of 692 applications were received from CRMs in 50 countries. Of these, 166 were admitted to the program in two cohorts. The program, taught online and in English, included four required and one optional course. Course materials were also provided as hard copies and on CDs. A pretest/posttest design was used to evaluate the outcome of the program in terms of changes in knowledge, participants’ capacity-building activities at their research sites; and participant and supervisor perceptions of program impact. Results Participants demonstrated significant improvements in knowledge about clinical research, rated course content and teaching strategies positively, and identified the opportunity for interactions with international peers as a major program strength. Challenges for participants were limited time to complete assignments and erratic internet access. Participants offered capacity building programs to 5061 individuals at their research sites. Supervisors indicated that they would recommend the program and perceived the program improved CRM effectiveness and site research capacity. Findings Results suggest that this type of continuing education program addresses a growing need for education of CRMs working in countries that have previously had limited involvement with global clinical trials. PMID:23512562

Creating value-added linkages through creative programming: a partnership for nursing education.

PubMed

Caldwell, Linda M; Luke, Gerri; Tenofsky, Linda M

2007-01-01

Academic and clinical institutions can effectively collaborate to deliver programs that enhance the educational level of the nursing staff. Creative programming, which offers flexibility and convenience, and a reasonable cost are key elements in the success of a program. Open communication and mutual recognition and respect of the talents, abilities, and values of all developers of the program are essential factors in effective collaborations leading to successful partnerships. Although clear expectations and clarity of functions are important once the partnership has developed, flexibility and a desire to "own" both the problems and the successes of a program are crucial to success.

Development of the Champlain primary care cardiovascular disease prevention and management guideline

PubMed Central

Montoya, Lorraine; Liddy, Clare; Hogg, William; Papadakis, Sophia; Dojeiji, Laurie; Russell, Grant; Akbari, Ayub; Pipe, Andrew; Higginson, Lyall

2011-01-01

Abstract Problem addressed A well documented gap remains between evidence and practice for clinical practice guidelines in cardiovascular disease (CVD) care. Objective of program As part of the Champlain CVD Prevention Strategy, practitioners in the Champlain District of Ontario launched a large quality-improvement initiative that focused on increasing the uptake in primary care practice settings of clinical guidelines for heart disease, stroke, diabetes, and CVD risk factors. Program description The Champlain Primary Care CVD Prevention and Management Guideline is a desktop resource for primary care clinicians working in the Champlain District. The guideline was developed by more than 45 local experts to summarize the latest evidence-based strategies for CVD prevention and management, as well as to increase awareness of local community-based programs and services. Conclusion Evidence suggests that tailored strategies are important when implementing specific practice guidelines. This article describes the process of creating an integrated clinical guideline for improvement in the delivery of cardiovascular care. PMID:21673196

Development and pilot evaluation of Native CREST-a Cancer Research Experience and Student Training program for Navajo undergraduate students.

PubMed

Hughes, Christine A; Bauer, Mark C; Horazdovsky, Bruce F; Garrison, Edward R; Patten, Christi A; Petersen, Wesley O; Bowman, Clarissa N; Vierkant, Robert A

2013-03-01

The Mayo Clinic Cancer Center and Diné College received funding for a 4-year collaborative P20 planning grant from the National Cancer Institute in 2006. The goal of the partnership was to increase Navajo undergraduates' interest in and commitment to biomedical coursework and careers, especially in cancer research. This paper describes the development, pilot testing, and evaluation of Native CREST (Cancer Research Experience and Student Training), a 10-week cancer research training program providing mentorship in a Mayo Clinic basic science or behavioral cancer research lab for Navajo undergraduate students. Seven Native American undergraduate students (five females, two males) were enrolled during the summers of 2008-2011. Students reported the program influenced their career goals and was valuable to their education and development. These efforts may increase the number of Native American career scientists developing and implementing cancer research, which will ultimately benefit the health of Native American people.

Development and Pilot Evaluation of Native CREST – a Cancer Research Experience and Student Training Program for Navajo Undergraduate Students

PubMed Central

Hughes, Christine A.; Bauer, Mark C.; Horazdovsky, Bruce F.; Garrison, Edward R.; Patten, Christi A.; Petersen, Wesley O.; Bowman, Clarissa N.; Vierkant, Robert A.

2012-01-01

The Mayo Clinic Cancer Center and Diné College received funding for a 4-year collaborative P20 planning grant from the National Cancer Institute in 2006. The goal of the partnership was to increase Navajo undergraduates’ interest in and commitment to biomedical coursework and careers, especially in cancer research. This paper describes the development, pilot testing and evaluation of Native CREST (Cancer Research Experience & Student Training), a 10-week cancer research training program providing mentorship in a Mayo Clinic basic science or behavioral cancer research lab for Navajo undergraduate students. Seven Native American undergraduate students (5 females, 2 males) were enrolled during the summers of 2008 - 2011. Students reported the program influenced their career goals and was valuable to their education and development. These efforts may increase the number of Native American career scientists developing and implementing cancer research, which will ultimately benefit the health of Native American people. PMID:23001889

Using intervention mapping to promote the receipt of clinical preventive services among women with physical disabilities.

PubMed

Suzuki, Rie; Peterson, Jana J; Weatherby, Amanda V; Buckley, David I; Walsh, Emily S; Kailes, June Isaacson; Krahn, Gloria L

2012-01-01

This article describes the development of Promoting Access to Health Services (PATHS), an intervention to promote regular use of clinical preventive services by women with physical disabilities. The intervention was developed using intervention mapping (IM), a theory-based logical process that incorporates the six steps of assessment of need, preparation of matrices, selection of theoretical methods and strategies, program design, program implementation, and evaluation. The development process used methods and strategies aligned with the social cognitive theory and the health belief model. PATHS was adapted from the workbook Making Preventive Health Care Work for You, developed by a disability advocate, and was informed by participant input at five points: at inception through consultation by the workbook author, in conceptualization through a town hall meeting, in pilot testing with feedback, in revision of the curriculum through an advisory group, and in implementation by trainers with disabilities. The resulting PATHS program is a 90-min participatory small-group workshop, followed by structured telephone support for 6 months.

Easing student transition to graduate nurse: a SIMulated Professional Learning Environment (SIMPLE) for final year student nurses.

PubMed

Liaw, Sok Ying; Koh, Yiwen; Dawood, Rabiah; Kowitlawakul, Yanika; Zhou, Wentao; Lau, Siew Tiang

2014-03-01

Preparing nursing students for making the transition to graduate nurse is crucial for entry into practice. Final year student nurses at the National University of Singapore (NUS) are required to undergo a consolidated clinical practice to prepare them for their transition to graduate nurse. To describe the development, implementation and evaluation of a simulation program known as SIMulated Professional Learning Environment (SIMPLE) in preparing the final year student nurses for their clinical practicum in transition to graduate nurse practice. A set of simulation features and best practices were used as conceptual framework to develop and implement the simulation program. 94 final year student nurses participated in the 15-hour SIMPLE program that incorporated multiple simulation scenarios based on actual ward clinical practices. Pre and post-tests were conducted to assess the students' preparedness for their clinical practice in transition to graduate nurse practice. The students also completed a satisfaction questionnaire and open questions to evaluate their simulation experiences. The student nurses demonstrated a significant improvement (t=12.06, p<0.01) on post-test score (mean=117.21, SD=15.17) from pre-test score (mean=97.86, SD=15.08) for their perceived preparedness towards their clinical practicum in transition to graduate nurse practice. They were highly satisfied with their simulation learning. Themes emerged from the comments on the most valuable aspects of the SIMPLE program and ways to improve the program. The study provided evidences on the effectiveness of the SIMPLE program in enhancing the students' preparedness for their transition to graduate nurse practice. A key success of the SIMPLE program was the used of simulation strategy and the involvement of practicing nurses that closely linked the students with the realities of current nursing practice to prepare them for the role of staff nurses. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comprehensive Hearing Aid Intervention at a Free Subspecialty Clinic.

PubMed

Wertz, Aileen P; Mannarelli, Gregory; Shuman, Andrew G; McKean, Erin L

2017-09-01

Providing a model of a comprehensive free audiologic program may assist other health care professionals in developing their own similar program. To describe the structure, feasibility, and outcomes of a free subspecialty clinic providing hearing aids to develop a paradigm for other programs interested in implementing similar projects. A retrospective case series was conducted from September 1, 2013, through March 31, 2016. In a partnership between a free independent clinic for indigent patients and an academic medical center, 54 indigent patients were referred to the clinic for audiograms. A total of 50 of these patients had results of audiograms available for review and were therefore included in the study; 34 of these 50 patients were determined to be eligible for hearing aid fitting based on audiometric results. Free audiometric testing, hearing aid fitting, and hearing aid donation. The number of hearing aids donated, number of eligible patients identified, number of patients fitted with hearing aids, and work effort (hours) and start-up costs associated with implementation of this program were quantified. A total of 54 patients (31 women [57.4%] and 23 men [42.6%]; median age, 61 years; range, 33-85 years) had audiograms performed, and 84 hearing aids were donated to the program. The patients were provided with free audiograms, hearing aid molds, and hearing aid programming, as well as follow-up appointments to ensure continued proper functioning of their hearing aids. Since 2013, a total of 34 patients have been determined to be eligible for the free program and were offered hearing aid services. Of these, 20 patients (59%) have been fitted or are being fitted with free hearing aids. The value of services provided is estimated to be $2260 per patient. It is feasible to provide free, comprehensive audiologic care, including hearing aids and fitting, in a well-established, free clinic model. The opportunity for indigent patients to use hearing aids at minimal personal cost is a major step forward in improving access to high-quality care.

Implementing residential treatment for prison inmates with mental illness.

PubMed

O'Connor, Frederica W; Lovell, David; Brown, Linda

2002-10-01

There is evidence that mentally ill offenders (MIOs) in prisons commit more infractions, serve longer sentences, and are more likely to be victimized than inmates who are not mentally ill. Humanistic and prison management interests are served if intervention programs minimize symptoms and promote coping and other functional skills. A collaborative agreement was established between Washington State Department of Corrections and a consortium of University of Washington faculty to mutually develop a prison-based program of clinical management and psychoeducation for MIOs. The resulting program is described, along with rationale, planning processes, implementation, and initial evaluation. Most aspects of the planned program are in place. Clinical and behavioral progress by inmates following program participation has been documented. Issues concerning treatment program implementation in prisons are discussed. Copyright 2002, Elsevier Science (USA). All rights reserved.

An Exploration of the Relationship between Clinical Decision-Making Ability and Educational Preparation among New Graduate Nurses

ERIC Educational Resources Information Center

Blount, Kamilah V.

2013-01-01

This study examined the impact of accelerated nursing direct entry master's programs on the development of clinical decision-making skills of new graduate nurses that completed the Performance Based Development System (PBDS) assessment during the study period of 2008-2012 at a healthcare organization. Healthcare today is practiced in a…

Challenges in reducing dengue burden; diagnostics, control measures and vaccines.

PubMed

Lam, Sai Kit

2013-09-01

Dengue is a major public health concern worldwide, with the number of infections increasing globally. The illness imposes the greatest economic and human burden on developing countries that have limited resources to deal with the scale of the problem. No cure for dengue exists; treatment is limited to rehydration therapy, and with vector control strategies proving to be relatively ineffective, a vaccine is an urgent priority. Despite the numerous challenges encountered in the development of a dengue vaccine, several vaccine candidates have shown promise in clinical development and it is believed that a vaccination program would be at least as cost-effective as current vector control programs. The lead candidate vaccine is a tetravalent, live attenuated, recombinant vaccine, which is currently in Phase III clinical trials. Vaccine introduction is a complex process that requires consideration and is discussed here. This review discusses the epidemiology, burden and pathogenesis of dengue, as well as the vaccine candidates currently in clinical development.

Instituting parent education practices in the neonatal intensive care unit: an administrative case report of practice evaluation and statewide action.

PubMed

Dusing, Stacey C; Van Drew, Catherine M; Brown, Shaaron E

2012-07-01

Infants born preterm are at high risk of developmental disabilities and benefit from early developmental intervention programs. Physical therapists with neonatal expertise are ideally suited to educate parents about ways to support their infant's development in the first months of life. However, administrative policies are needed to support the therapist in providing adequate parent education in the neonatal intensive care unit (NICU). This administrative case report describes the process used by a team of neonatal therapists to evaluate clinical practice, determine the need for change, and develop and implement a new parent education program in the NICU. Physical therapy parent education practices were evaluated in an academic medical center with a 36-bed, level-3 NICU. Physical therapists with neonatal expertise covered multiple units within the hospital each day. A series of focus groups, a small descriptive study, and staff discussion were used to evaluate parent education practices in this academic medical center. A new parent education program was developed based on data collected and literature to improve clinical care. The new parent education model was implemented over the course of several months using overlapping initiatives. Administrative support for the change was developed through collaboration, open communication, and presentation of clinical data. In addition, this hospital-based program contributed to the development of a statewide initiative to educate parents of preterm infants about the importance of supporting development in the first months of life. A collaborative and data-driven approach to evaluating parent education practices supported the development of a new parent education practice while acknowledging the need to meet staff productivity standards and provide excellent care throughout the hospital.

Instituting Parent Education Practices in the Neonatal Intensive Care Unit: An Administrative Case Report of Practice Evaluation and Statewide Action

PubMed Central

Van Drew, Catherine M.; Brown, Shaaron E.

2012-01-01

Background and Purpose Infants born preterm are at high risk of developmental disabilities and benefit from early developmental intervention programs. Physical therapists with neonatal expertise are ideally suited to educate parents about ways to support their infant's development in the first months of life. However, administrative policies are needed to support the therapist in providing adequate parent education in the neonatal intensive care unit (NICU). This administrative case report describes the process used by a team of neonatal therapists to evaluate clinical practice, determine the need for change, and develop and implement a new parent education program in the NICU. Case Description Physical therapy parent education practices were evaluated in an academic medical center with a 36-bed, level-3 NICU. Physical therapists with neonatal expertise covered multiple units within the hospital each day. A series of focus groups, a small descriptive study, and staff discussion were used to evaluate parent education practices in this academic medical center. A new parent education program was developed based on data collected and literature to improve clinical care. Outcomes The new parent education model was implemented over the course of several months using overlapping initiatives. Administrative support for the change was developed through collaboration, open communication, and presentation of clinical data. In addition, this hospital-based program contributed to the development of a statewide initiative to educate parents of preterm infants about the importance of supporting development in the first months of life. Discussion A collaborative and data-driven approach to evaluating parent education practices supported the development of a new parent education practice while acknowledging the need to meet staff productivity standards and provide excellent care throughout the hospital. PMID:22466024

Gesture-Controlled Interface for Contactless Control of Various Computer Programs with a Hooking-Based Keyboard and Mouse-Mapping Technique in the Operating Room

PubMed Central

Park, Ben Joonyeon; Jang, Taekjin; Choi, Jong Woo; Kim, Namkug

2016-01-01

We developed a contactless interface that exploits hand gestures to effectively control medical images in the operating room. We developed an in-house program called GestureHook that exploits message hooking techniques to convert gestures into specific functions. For quantitative evaluation of this program, we used gestures to control images of a dynamic biliary CT study and compared the results with those of a mouse (8.54 ± 1.77 s to 5.29 ± 1.00 s; p < 0.001) and measured the recognition rates of specific gestures and the success rates of tasks based on clinical scenarios. For clinical applications, this program was set up in the operating room to browse images for plastic surgery. A surgeon browsed images from three different programs: CT images from a PACS program, volume-rendered images from a 3D PACS program, and surgical planning photographs from a basic image viewing program. All programs could be seamlessly controlled by gestures and motions. This approach can control all operating room programs without source code modification and provide surgeons with a new way to safely browse through images and easily switch applications during surgical procedures. PMID:26981146

Gesture-Controlled Interface for Contactless Control of Various Computer Programs with a Hooking-Based Keyboard and Mouse-Mapping Technique in the Operating Room.

PubMed

Park, Ben Joonyeon; Jang, Taekjin; Choi, Jong Woo; Kim, Namkug

2016-01-01

We developed a contactless interface that exploits hand gestures to effectively control medical images in the operating room. We developed an in-house program called GestureHook that exploits message hooking techniques to convert gestures into specific functions. For quantitative evaluation of this program, we used gestures to control images of a dynamic biliary CT study and compared the results with those of a mouse (8.54 ± 1.77 s to 5.29 ± 1.00 s; p < 0.001) and measured the recognition rates of specific gestures and the success rates of tasks based on clinical scenarios. For clinical applications, this program was set up in the operating room to browse images for plastic surgery. A surgeon browsed images from three different programs: CT images from a PACS program, volume-rendered images from a 3D PACS program, and surgical planning photographs from a basic image viewing program. All programs could be seamlessly controlled by gestures and motions. This approach can control all operating room programs without source code modification and provide surgeons with a new way to safely browse through images and easily switch applications during surgical procedures.

Longitudinal Ultrasound Education Track Curriculum Implemented Within an Emergency Medicine Residency Program.

PubMed

Boulger, Creagh; Adams, Daniel Z; Hughes, Daralee; Bahner, David P; King, Andrew

2017-06-01

Emergency Medicine residency programs offer ultrasound-focused curricula to address Accreditation Council for Graduate Medical Education (ACGME) milestones. Although some programs offer advanced clinical tracks in ultrasound, no standard curriculum exists. We sought to establish a well-defined ultrasound track curriculum to allow interested residents to develop advanced clinical skills and scholarship within this academic niche. The curriculum involves a greater number of clinical scans, ultrasound-focused scholarly and quality improvement projects, enhanced faculty-driven ultrasound focused didactics, and participation at a national ultrasound conference to receive certification. Successful ultrasound scholarly tracks can provide residents with the potential to obtain fellowships or competency beyond ACGME requirements. © 2017 by the American Institute of Ultrasound in Medicine.

Enhancing nurses' ethical practice: development of a clinical ethics program.

PubMed

McDaniel, C

1998-06-01

There is increasing attention paid to ethics under managed care; however, few clinical-based ethics programs are reported. This paper reports the assessment and outcomes of one such program. A quasi-experimental research design with t-tests is used to assess the outcome differences between participants and control groups. There are twenty nurses in each; they are assessed for comparability. Differences are predicted on two outcomes using reliable and valid measures: nurses' time with their patients in ethics discussions, and nurses' opinions regarding their clinical ethics environments. Results reveal a statistically significant difference (p <.05) between the two groups, with modest positive change in the participants. Additional exploratory analyses are reported on variables influential in health care services.

Development and Characterization of Reference Materials for Genetic Testing: Focus on Public Partnerships.

PubMed

Kalman, Lisa V; Datta, Vivekananda; Williams, Mickey; Zook, Justin M; Salit, Marc L; Han, Jin Yeong

2016-11-01

Characterized reference materials (RMs) are needed for clinical laboratory test development and validation, quality control procedures, and proficiency testing to assure their quality. In this article, we review the development and characterization of RMs for clinical molecular genetic tests. We describe various types of RMs and how to access and utilize them, especially focusing on the Genetic Testing Reference Materials Coordination Program (Get-RM) and the Genome in a Bottle (GIAB) Consortium. This review also reinforces the need for collaborative efforts in the clinical genetic testing community to develop additional RMs.

Clinic-Based Mobile Health Decision Support to Enhance Adult Epilepsy Self-Management: An Intervention Mapping Approach.

PubMed

Shegog, Ross; Begley, Charles E

2017-01-01

Epilepsy is a neurological disorder involving recurrent seizures. It affects approximately 5 million people in the U.S. To optimize their quality of life people with epilepsy are encouraged to engage in self-management (S-M) behaviors. These include managing their treatment (e.g., adhering to anti-seizure medication and clinical visit schedules), managing their seizures (e.g., responding to seizure episodes), managing their safety (e.g., monitoring and avoiding environmental seizure triggers), and managing their co-morbid conditions (e.g., anxiety, depression). The clinic-based Management Information Decision Support Epilepsy Tool (MINDSET) is a decision-support system founded on theory and empirical evidence. It is designed to increase awareness by adult patients (≥18 years) and their health-care provider regarding the patient's epilepsy S-M behaviors, facilitate communication during the clinic visit to prioritize S-M goals and strategies commensurate with the patient's needs, and increase the patient's self-efficacy to achieve those goals. The purpose of this paper is to describe the application of intervention mapping (IM) to develop, implement, and formatively evaluate the clinic-based MINDSET prototype and in developing implementation and evaluation plans. Deliverables comprised a logic model of the problem (IM Step 1); matrices of program objectives (IM Step 2); a program planning document comprising scope, sequence, theory-based methods, and practical strategies (IM Step 3); a functional MINDSET program prototype (IM Step 4); plans for implementation (IM Step 5); and evaluation (IM Step 6). IM provided a logical and systematic approach to developing and evaluating clinic-based decision support toward epilepsy S-M.

Evaluation of a continuing professional development training program for physicians and physician assistants in hospitals in Laos based on the Kirkpatrick model

PubMed Central

2016-01-01

Purpose: Medical professionals from Korea and Laos have been working together to develop a continuing professional development training program covering the major clinical fields of primary care. This study aimed to evaluate the effectiveness of the program from 2013 to 2014 using the Kirkpatrick model. Methods: A questionnaire was used to evaluate the reaction of the trainees, and the trainers assessed the level of trainees’ performance at the beginning and the end of each clinical section. The transfer (behavioral change) of the trainees was evaluated through the review of medical records written by the trainees before and after the training program. Results: The trainees were satisfied with the training program, for which the average score was 4.48 out of 5.0. The average score of the trainees’ performance at the beginning was 2.39 out of 5.0, and rose to 3.88 at the end of each section. The average score of the medical records written before the training was 2.92 out of 5.0, and it rose to 3.34 after the training. The number of patient visits to the district hospitals increased. Conclusion: The continuing professional development training program, which was planned and implemented with the full engagement and responsibility of Lao health professionals, proved to be effective. PMID:27246494

Implementing a School-Located Vaccination Program in Denver Public Schools.

PubMed

Shlay, Judith C; Rodgers, Sarah; Lyons, Jean; Romero, Scott; Vogt, Tara M; McCormick, Emily V

2015-08-01

School-located vaccination (SLV) offers an opportunity to deliver vaccines to students, particularly those without a primary care provider. This SLV program offered 2 clinics at each of 20 elementary schools (influenza vaccine) and 3 clinics at each of 7 middle/preschool-eighth-grade schools (adolescent platform plus catch-up vaccines) during the 2009-2010 and 2010-2011 school years. Established programmatic processes for immunization delivery in an outreach setting were used. Billing and vaccine inventory management processes were developed. Vaccines from the federal Vaccines for Children program were used for eligible students. Third-party payers were billed for insured students; parents were not billed for services. The proportion of enrolled students who received at least 1 dose of vaccine increased from year 1 to year 2 (elementary: 28% to 31%; middle: 12% to 19%). Issues identified and addressed included program planning with partners, development and implementation of billing processes, development of a solution to adhere to the Family Educational Rights and Privacy Act requirements, development and utilization of an easy-to-comprehend consent form, and implementation of standard work procedures. This SLV program offered an alternative approach for providing vaccinations to students outside of the primary care setting. To be successful, ongoing partnerships are needed. © 2015, American School Health Association.

Implementation of a scalable, web-based, automated clinical decision support risk-prediction tool for chronic kidney disease using C-CDA and application programming interfaces.

PubMed

Samal, Lipika; D'Amore, John D; Bates, David W; Wright, Adam

2017-11-01

Clinical decision support tools for risk prediction are readily available, but typically require workflow interruptions and manual data entry so are rarely used. Due to new data interoperability standards for electronic health records (EHRs), other options are available. As a clinical case study, we sought to build a scalable, web-based system that would automate calculation of kidney failure risk and display clinical decision support to users in primary care practices. We developed a single-page application, web server, database, and application programming interface to calculate and display kidney failure risk. Data were extracted from the EHR using the Consolidated Clinical Document Architecture interoperability standard for Continuity of Care Documents (CCDs). EHR users were presented with a noninterruptive alert on the patient's summary screen and a hyperlink to details and recommendations provided through a web application. Clinic schedules and CCDs were retrieved using existing application programming interfaces to the EHR, and we provided a clinical decision support hyperlink to the EHR as a service. We debugged a series of terminology and technical issues. The application was validated with data from 255 patients and subsequently deployed to 10 primary care clinics where, over the course of 1 year, 569 533 CCD documents were processed. We validated the use of interoperable documents and open-source components to develop a low-cost tool for automated clinical decision support. Since Consolidated Clinical Document Architecture-based data extraction extends to any certified EHR, this demonstrates a successful modular approach to clinical decision support. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials-Report of the National Cancer Institute Work Group on Radiotherapy Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bekelman, Justin E., E-mail: bekelman@uphs.upenn.edu; Deye, James A.; Vikram, Bhadrasain

2012-07-01

Purpose: In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute sponsored a 2-day workshop to examine challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods and Materials: Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. The lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities such asmore » proton beam therapy, and the international harmonization of clinical trial QA. Results: Four recommendations were made: (1) to develop a tiered (and more efficient) system for radiotherapy QA and tailor the intensity of QA to the clinical trial objectives (tiers include general credentialing, trial-specific credentialing, and individual case review); (2) to establish a case QA repository; (3) to develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and (4) to explore the feasibility of consolidating clinical trial QA in the United States. Conclusion: Radiotherapy QA can affect clinical trial accrual, cost, outcomes, and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based.« less

Redesigning radiotherapy quality assurance: opportunities to develop an efficient, evidence-based system to support clinical trials--report of the National Cancer Institute Work Group on Radiotherapy Quality Assurance.

PubMed

Bekelman, Justin E; Deye, James A; Vikram, Bhadrasain; Bentzen, Soren M; Bruner, Deborah; Curran, Walter J; Dignam, James; Efstathiou, Jason A; FitzGerald, T J; Hurkmans, Coen; Ibbott, Geoffrey S; Lee, J Jack; Merchant, Thomas E; Michalski, Jeff; Palta, Jatinder R; Simon, Richard; Ten Haken, Randal K; Timmerman, Robert; Tunis, Sean; Coleman, C Norman; Purdy, James

2012-07-01

In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute sponsored a 2-day workshop to examine challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. The lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities such as proton beam therapy, and the international harmonization of clinical trial QA. Four recommendations were made: (1) to develop a tiered (and more efficient) system for radiotherapy QA and tailor the intensity of QA to the clinical trial objectives (tiers include general credentialing, trial-specific credentialing, and individual case review); (2) to establish a case QA repository; (3) to develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and (4) to explore the feasibility of consolidating clinical trial QA in the United States. Radiotherapy QA can affect clinical trial accrual, cost, outcomes, and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based. Copyright © 2012 Elsevier Inc. All rights reserved.

Design and Implementation of a postgraduate curriculum to support Ethiopia's first emergency medicine residency training program: the Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM).

PubMed

Meshkat, Nazanin; Teklu, Sisay; Hunchak, Cheryl

2018-04-06

To design and implement an emergency medicine (EM) postgraduate training curriculum to support the establishment of the first EM residency program at Addis Ababa University (AAU). In response to the Ethiopian Federal Ministry of Health mandate to develop EM services in Ethiopia, University of Toronto EM faculty were invited to develop and deliver EM content and expertise for the first EM postgraduate residency training program at AAU. The Toronto Addis Ababa Academic Collaboration-EM (TAAAC-EM) used five steps of a six-step approach to guide curriculum development and implementation: 1. Problem identification and general needs assessment, 2. Targeted needs assessment using indirect methods (interviews and site visits of the learners and learning environment), 3. Defining goals and objectives, 4. Choosing educational strategies and curriculum map development and 5. The needs assessment identified a learning environment with appropriate, though limited, resources for the implementation of an EM residency program. A lack of educational activities geared towards EM practice was identified, specifically of active learning techniques (ALTs) such as bedside teaching, simulation and procedural teaching. A curriculum map was devised to supplement the AAU EM residency program curriculum. The TAAAC-EM curriculum was divided into three distinct streams: clinical, clinical epidemiology and EM administration. The clinical sessions were divided into didactic and ALTs including practical/procedural and simulation sessions, and bedside teaching was given a strong emphasis. Implementation is currently in its seventh year, with continuous monitoring and revisions of the curriculum to meet evolving needs. We have outlined the design and implementation of the TAAAC-EM curriculum; an evaluation of this curriculum is currently underway. As EM spreads as a specialty throughout Africa and other resource-limited regions, this model can serve as a working guide for similar bi-institutional educational partnerships seeking to develop novel EM postgraduate training programs.

A survey of residents' experience with patient safety and quality improvement concepts in radiation oncology.

PubMed

Spraker, Matthew B; Nyflot, Matthew; Hendrickson, Kristi; Ford, Eric; Kane, Gabrielle; Zeng, Jing

The safety and quality of radiation therapy have recently garnered increased attention in radiation oncology (RO). Although patient safety guidelines expect physicians and physicists to lead clinical safety and quality improvement (QI) programs, trainees' level of exposure to patient safety concepts during training is unknown. We surveyed active medical and physics RO residents in North America in February 2016. Survey questions involved demographics and program characteristics, exposure to patient safety topics, and residents' attitude regarding their safety education. Responses were collected from 139 of 690 (20%) medical and 56 of 248 (23%) physics RO residents. More than 60% of residents had no exposure or only informal exposure to incident learning systems (ILS), root cause analysis, failure mode and effects analysis (FMEA), and the concepts of human factors engineering. Medical residents had less exposure to FMEA than physics residents, and fewer medical than physics residents felt confident in leading FMEA in clinic. Only 27% of residents felt that patient safety training was adequate in their program. Experiential learning through practical workshops was the most desired educational modality, preferred over web-based learning. Residents training in departments with ILS had greater exposure to patient safety concepts and felt more confident leading clinical patient safety and QI programs than residents training in departments without an ILS. The survey results show that most residents have no or only informal exposure to important patient safety and QI concepts and do not feel confident leading clinical safety programs. This represents a gaping need in RO resident education. Educational programs such as these can be naturally developed as part of an incident learning program that focuses on near-miss events. Future research should assess the needs of RO program directors to develop effective RO patient safety and QI training programs. Copyright © 2016 American Society of Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Optometric Grand Rounds.

ERIC Educational Resources Information Center

Townsend, John C.; Selvin, Gerald J.

1988-01-01

A clinical program developed for Veterans Administration optometry residents and rotating Southern California College of Optometry interns consisted of clinical patient examination followed by case discussion, a formal lecture corresponding to the ocular and systemic diseases presented in the examination, and student testing. (MSE)

The Diabetes Management Education Program in South Texas: An Economic and Clinical Impact Analysis.

PubMed

Kash, Bita A; Lin, Szu-Hsuan; Baek, Juha; Ohsfeldt, Robert L

2017-01-01

Diabetes is a major chronic disease that can lead to serious health problems and high healthcare costs without appropriate disease management and treatment. In the United States, the number of people diagnosed with diabetes and the cost for diabetes treatment has dramatically increased over time. To improve patients' self-management skills and clinical outcomes, diabetes management education (DME) programs have been developed and operated in various regions. This community case study explores and calculates the economic and clinical impacts of expanding a model DME program into 26 counties located in South Texas. The study sample includes 355 patients with type 2 diabetes and a follow-up hemoglobin A1c level measurement among 1,275 individuals who participated in the DME program between September 2012 and August 2013. We used the Gilmer's cost differentials model and the United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine methodology to predict 3-year healthcare cost savings and 10-year clinical benefits of implementing a DME program in the selected 26 Texas counties. Changes in estimated 3-year cost and the estimated treatment effect were based on baseline hemoglobin A1c level. An average 3-year reduction in medical treatment costs per program participant was $2,033 (in 2016 dollars). The total healthcare cost savings for the 26 targeted counties increases as the program participation rate increases. The total projected cost saving ranges from $12 million with 5% participation rate to $185 million with 75% participation rate. A 10-year outlook on additional clinical benefits associated with the implementation and expansion of the DME program at 60% participation is estimated to result in approximately 4,838 avoided coronary heart disease cases and another 392 cases of avoided strokes. The implementation of this model DME program in the selected 26 counties would contribute to substantial healthcare cost savings and clinical benefits. Organizations that provide DME services may benefit from reduction in medical treatment costs and improvement in clinical outcomes for populations with diabetes.

Development of an Individualized Yoga Intervention to Address Fatigue in Hospitalized Children Undergoing Intensive Chemotherapy.

PubMed

Diorio, Caroline; Celis Ekstrand, Amanda; Hesser, Tanya; O'Sullivan, Cathy; Lee, Michelle; Schechter, Tal; Sung, Lillian

2016-09-01

Purpose Fatigue is an important problem in children receiving intensive chemotherapy and hematopoietic stem cell transplantation (HSCT). Exercise may be an effective intervention for fatigue. Individualized yoga represents an ideal intervention because it can be tailored according to an individual child's needs. Little is known about how to structure a standardized yoga program for intensivelytreated children. Therefore, this study describes the development of a yoga program and an approach to monitoring sessions suitable for hospitalized children receiving intensive chemotherapy or HSCT. Methods The yoga program was designed to increase mobility in hospitalized children and to provide children with relaxation techniques that could be used independently in a variety of environments. The program was founded on 4 key tenets: safety, adaptability, environmental flexibility, and appeal to children. We also developed quality and consistency assurance procedures. Results A menu format with a fixed structure was selected for the yoga program. Each yoga session contained up to 6 sections: breathing exercises, warmup exercises, yoga poses, balancing poses, cool-down poses, and final relaxation. Yoga instructors selected specific yoga poses for each session from a predetermined list organized by intensity level (low, moderate, or high). Monitoring procedures were developed using videotaping and multirater adjudication. Conclusion We created a standardized yoga program and an approach to monitoring that are now ready for incorporation in clinical trials. Future work should include the adaptation of the program to different pediatric populations and clinical settings. © The Author(s) 2016.

New Clinical Faculty Training Program: Transforming Practicing Dentists into Part-Time Dental Faculty Members.

PubMed

Adams, Brooke N; Kirkup, Michele L; Willis, Lisa H; Reifeis, Paul E

2017-06-01

At Indiana University School of Dentistry, a New Clinical Faculty Training (NCFT) program was created with the primary goals of informing new part-time faculty members of clinical policies and assessment guidelines and thus developing qualified and satisfied faculty members. The aim of this study was to determine if participation in the training program improved the participants' satisfaction and competence in comparison to their colleagues who did not participate in the program. Two cohorts were compared: a control group of part-time faculty members who did not receive formal training when they were hired (n=21; response rate 58.3%); and the intervention group, who had participated in the NCFT program (n=12; response rate 80%). A survey of faculty members in the control group gathered information on their experiences when initially hired, and a pretest was administered to measure their knowledge of clinical policies. After the control group was given an overview of the program, their feedback was collected through post surveys, and a posttest identical to the pretest was given that found statistically significant increases on questions one (p=0.003) and four (p=0.025). In February 2014, 15 new faculty members participated in the pilot implementation of the NCFT program. Of those 15, 12 (the intervention group) completed follow-up surveys identical to the pre survey used with the control group. Statistically significant differences were found for the factors clinical teaching (p=0.005) and assessment training (p=0.008) with better responses for the NCFT group. These results suggest that participation in the program was associated with improved clinical teaching knowledge and job satisfaction.

Creating the Action Model for High Risk Infant Follow Up Program in Iran

PubMed Central

Heidarzadeh, Mohammad; Jodiery, Behzad; Mirnia, Kayvan; Akrami, Forouzan; Hosseini, Mohammad Bagher; Heidarabadi, Seifollah; HabibeLahi, Abbas

2013-01-01

Abstract Background Intervention in early childhood development as one of the social determinants of health, is important for reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow up program in Iran. This study was carreid out to design high risk infants follow up care program with the practical aim of creating an model action for whole country, in 2012. Methods This qualitative study has been done by the Neonatal Department of the Deputy of Public Health in cooperation with Pediatrics Health Research Center of Tabriz University of Medical Sciences, Iran. After study of international documents, consensus agreement about adapted program for Iran has been accomplished by focus group discussion and attended Delphi agreement technique. After compiling primary draft included evidence based guidelines and executive plan, 14 sessions including expert panels were hold to finalize the program. Results After finalizing the program, high risk infants follow up care service package has been designed in 3 chapters: Evidence based clinical guidelines; eighteen main clinical guidelines and thirteen subsidiaries clinical guidelines, executive plan; 6 general, 6 following up and 5 backup processes. Education program including general and especial courses for care givers and follow up team, and family education processes. Conclusion We designed and finalized high risk infants follow up care service package. It seems to open a way to extend it to whole country. PMID:26171344

Clinical Supervision of Athletic Training Students at Colleges and Universities Needs Improvement

PubMed Central

Weidner, Thomas G.; Pipkin, Jennifer

2002-01-01

Objectives: To assess the type and amount of clinical supervision athletic training students received during clinical education. Design and Setting: An online survey was conducted with a questionnaire developed specifically for this study. Subjects: Head athletic trainers from National Collegiate Athletic Association Division I (28), Division II (34), and Division III institutions (30). Thirty-four represented Commission on the Accreditation of Allied Health Education Programs-accredited athletic training education programs, 20 represented athletic training programs in Joint Review Commission on Athletic Training candidacy, and 35 offered the internship route. Measurements: Descriptive statistics were computed. Three sets of chi-square analyses were completed to assess associations among athletic training students with first-responder qualifications, program and institution characteristics, certified athletic trainer medical coverage of moderate- and increased-risk sports, and clinical supervision. A trend analysis of students' class standing and time spent in different types of clinical supervision was also completed. The alpha level was set at < .05. Results: Most of the athletic training students (83.7%), particularly in accredited programs, had first-responder qualifications. More than half of the head athletic trainers (59.8%) indicated that athletic training students were authorized to provide medical care coverage without supervision. A minimal amount of medical care coverage of moderate- and increased-risk sports was unsupervised. No significant difference between the size of the education or athletic program and type and amount of clinical supervision was noted. Freshman athletic training students spent more time in direct clinical supervision and less time in unsupervised experience, but the opposite was true for senior students. Conclusions: Athletic training students are being utilized beyond appropriate clinical supervision and the scope of clinical education. Future research should employ methods using nonparticipant observation of clinical instructors' supervision of students as well as students' own perceptions of their clinical supervision. PMID:12937552

The Impact of Clinical Experiences from Athletic Training Student and Preceptor Perspectives

ERIC Educational Resources Information Center

Benes, Sarah S.; Mazerolle, Stephanie M.; Bowman, Thomas G.

2014-01-01

Context: Clinical education is an integral part of athletic training programs. This is where students should develop their professional identities and become socialized into the profession. Understanding the student and preceptor perspectives of the impact that clinical experiences have on students can provide valuable insight into this aspect of…

Certified Registered Nurse Anesthetists: Relationship between Educator Development and Self-Efficacy toward Clinical Teaching

ERIC Educational Resources Information Center

Pipkin, Jessica Monique

2015-01-01

A high-demand is placed on healthcare providers to be educators during student clinical training evolutions. Certified registered nurse anesthesia clinical educators (CRNACEs) affiliated with nurse anesthesia education programs (NAEPs) in the United States face the complex duality of assuming the combined role of teacher and anesthesia provider.…

New evidence-based adaptive clinical trial methods for optimally integrating predictive biomarkers into oncology clinical development programs

PubMed Central

Beckman, Robert A.; Chen, Cong

2013-01-01

Predictive biomarkers are important to the future of oncology; they can be used to identify patient populations who will benefit from therapy, increase the value of cancer medicines, and decrease the size and cost of clinical trials while increasing their chance of success. But predictive biomarkers do not always work. When unsuccessful, they add cost, complexity, and time to drug development. This perspective describes phases 2 and 3 development methods that efficiently and adaptively check the ability of a biomarker to predict clinical outcomes. In the end, the biomarker is emphasized to the extent that it can actually predict. PMID:23489587

Assessing Clinical Trial–Associated Workload in Community-Based Research Programs Using the ASCO Clinical Trial Workload Assessment Tool

PubMed Central

Hurley, Patricia; Woo, Kaitlin M.; Szczepanek, Connie; Stewart, Teresa; Robert, Nicholas; Lyss, Alan; Gönen, Mithat; Lilenbaum, Rogerio

2016-01-01

Purpose: Clinical research program managers are regularly faced with the quandary of determining how much of a workload research staff members can manage while they balance clinical practice and still achieve clinical trial accrual goals, maintain data quality and protocol compliance, and stay within budget. A tool was developed to measure clinical trial–associated workload, to apply objective metrics toward documentation of work, and to provide clearer insight to better meet clinical research program challenges and aid in balancing staff workloads. A project was conducted to assess the feasibility and utility of using this tool in diverse research settings. Methods: Community-based research programs were recruited to collect and enter clinical trial–associated monthly workload data into a web-based tool for 6 consecutive months. Descriptive statistics were computed for self-reported program characteristics and workload data, including staff acuity scores and number of patient encounters. Results: Fifty-one research programs that represented 30 states participated. Median staff acuity scores were highest for staff with patients enrolled in studies and receiving treatment, relative to staff with patients in follow-up status. Treatment trials typically resulted in higher median staff acuity, relative to cancer control, observational/registry, and prevention trials. Industry trials exhibited higher median staff acuity scores than trials sponsored by the National Institutes of Health/National Cancer Institute, academic institutions, or others. Conclusion: The results from this project demonstrate that trial-specific acuity measurement is a better measure of workload than simply counting the number of patients. The tool was shown to be feasible and useable in diverse community-based research settings. PMID:27006354

A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions.

PubMed

Dunne, Tom; Bishop, Lisa; Avery, Susan; Darcy, Stephen

2017-05-01

The majority of adult mental health and substance use (MH&SU) conditions emerge in adolescence. Prevention, diagnosis, and treatment programs targeting this age group have a unique opportunity to significantly impact the well-being of the future generation of adults. At the same time, youth are reluctant to seek treatment and have high rates of dropout from interventions. An emphasis on youth engagement in prevention and treatment interventions for MH&SU results in better health outcomes for those youth. This literature review was undertaken to evaluate opportunities to improve youth engagement in MH&SU programs. The intent was to determine best practices in the field that combined community-level improvement in clinical outcomes with proven strategies in engagement enhancement to inform program development at a local level. The results discuss 40 studies, reviews, and program reports demonstrating effective youth engagement. These have been grouped into six themes based on the underlying engagement mechanism: youth participation in program development, parental relationships, technology, the health clinic, school, and social marketing. A broad range of tools are discussed that intervention developers can leverage to improve youth engagement in prevention or treatment programs. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

[Development of a multimedia learning DM diet education program using standardized patients and analysis of its effects on clinical competency and learning satisfaction for nursing students].

PubMed

Hyun, Kyung Sun; Kang, Hyun Sook; Kim, Won Ock; Park, Sunhee; Lee, Jia; Sok, Sohyune

2009-04-01

The purpose of this study was to develop a multimedia learning program for patients with diabetes mellitus (DM) diet education using standardized patients and to examine the effects of the program on educational skills, communication skills, DM diet knowledge and learning satisfaction. The study employed a randomized control posttest non-synchronized design. The participants were 108 third year nursing students (52 experimental group, 56 control group) at K university in Seoul, Korea. The experimental group had regular lectures and the multimedia learning program for DM diet education using standardized patients while the control group had regular lectures only. The DM educational skills were measured by trained research assistants. The students who received the multimedia learning program scored higher for DM diet educational skills, communication skills and DM diet knowledge compared to the control group. Learning satisfaction of the experimental group was higher than the control group, but statistically insignificant. Clinical competency was improved for students receiving the multimedia learning program for DM diet education using standardized patients, but there was no statistically significant effect on learning satisfaction. In the nursing education system there is a need to develop and apply more multimedia materials for education and to use standardized patients effectively.

Nuts and bolts of running a pulmonary embolism response team: results from an organizational survey of the National PERT™ Consortium members.

PubMed

Barnes, Geoffrey; Giri, Jay; Courtney, D Mark; Naydenov, Soophia; Wood, Todd; Rosovsky, Rachel; Rosenfield, Kenneth; Kabrhel, Christopher

2017-08-01

Pulmonary embolism response teams (PERT) are developing rapidly to operationalize multi-disciplinary care for acute pulmonary embolism patients. Our objective is to describe the core components of PERT necessary for newly developing programs. An online organizational survey of active National PERT™ Consortium members was performed between April and June 2016. Analysis, including descriptive statistics and Kruskal-Wallis tests, was performed on centers self-reporting a fully operational PERT program. The survey response rate was 80%. Of the 31 institutions that responded (71% academic), 19 had fully functioning PERT programs. These programs were run by steering committees (17/19, 89%) more often than individual physicians (2/19, 11%). Most PERT programs involved 3-5 different specialties (14/19, 74%), which did not vary based on hospital size or academic affiliation. Of programs using multidisciplinary discussions, these occurred via phone or conference call (12/18, 67%), with a minority of these utilizing 'virtual meeting' software (2/12, 17%). Guidelines for appropriate activations were provided at 16/19 (84%) hospitals. Most PERT programs offered around-the-clock catheter-based or surgical care (17/19, 89%). Outpatient follow up usually occurred in personal physician clinics (15/19, 79%) or dedicated PERT clinics (9/19, 47%), which were only available at academic institutions. PERT programs can be implemented, with similar structures, at small and large, community and academic medical centers. While all PERT programs incorporate team-based multi-disciplinary care into their core structure, several different models exist with varying personnel and resource utilization. Understanding how different PERT programs impact clinical care remains to be investigated.

Cost savings in a hospital clinical laboratory with a pay-for-performance incentive program for supervisors.

PubMed

Winkelman, J W; Aitken, J L; Wybenga, D R

1991-01-01

A pay-for-performance incentive program for clinical laboratory supervisors was developed and implemented at Brigham and Women's Hospital (Boston, Mass). It provides monetary rewards to personnel who directly produce cost savings in their area of responsibility. This reward system is new to the hospital laboratory but is commonly used in industry. Substantial true cost savings over and above previously established stringent budgets were achieved, 11% of which was returned to first-line supervisors in the form of a bonus. The program expanded the scope of professionalism for supervisors to include fiscal management.

Development of a Student Mentored Research Program between a Complementary and Alternative Medicine University and a Traditional, Research Intensive University

PubMed Central

Sullivan, Barbara M.; Furner, Sylvia E.; Cramer, Gregory D.

2014-01-01

The global need to develop clinician-scientists capable of using research in clinical practice, translating research knowledge into practice, and carrying out research that affects the quality, efficacy, and efficiency of health care is well-documented. The complementary and alternative medicine (CAM) professions embrace the call to develop physician-researchers to carry out translational and applied research for CAM modalities. CAM universities face unique challenges when implementing research training compared to traditional, research intensive (TRI) universities and medical centers where the majority of medical research is carried out. The authors present the development and outcomes of a mentored research program (MRP) between a CAM and a TRI institution, the National University of Health Sciences and the University of Illinois at Chicago School of Public Health, between 2006 and 2012. CAM pre-doctoral students engaged in a full-immersion semester at the TRI, including didactic courses and active research with a TRI faculty research mentor. Half of the participating doctor of chiropractic (DC) students continued on to PhD programs and half established integrative medicine, primary care clinical careers. Establishing rigorous criteria for mentors and mentees, communicating expectations, developing solid relationships between the mentor, mentee, and home school advisor, responding quickly to impediments, and providing adequate support from CAM and TRI investigators were key to the MRP success. To sustain research opportunities, coordinated degree programs for the DC and master of public health (DC/MPH) and master of clinical and translational research (DC/MS CTS) were established. PMID:24988423

Development of a comprehensive and sustainable gynecologic oncology training program in western Kenya, a low resource setting.

PubMed

Rosen, Barry; Itsura, Peter; Tonui, Philip; Covens, Alan; van Lonkhuijzen, Luc; Orang'o, Elkanah Omenge

2017-08-01

To provide information on the development of a gynecologic oncology training program in a low-resource setting in Kenya. This is a review of a collaboration between Kenyan and North American physicians who worked together to develop a gynecologic oncology training in Kenya. We review the published data on the increase of cancer incidence in sub-Saharan Africa and outline the steps that were taken to develop this program. The incidence of cervical cancer in Kenya is very high and is the leading cause of cancer mortality in Kenya. WHO identifies cancer as a new epidemic affecting countries in sub-Saharan Africa. In Kenya, a country of 45 million, there is limited resources to diagnose and treat cancer. In 2009 in western Kenya, at Moi University there was no strategy to manage oncology in the Reproductive Health department. There was only 1 gynecologic oncologists in Kenya in 2009. A collaboration between Canadian and Kenya physicians resulted in development of a gynecologic oncology clinical program and initiation of fellowship training in Kenya. In the past 4 years, five fellows have graduated from a 2 year fellowship training program. Integration of data collection on all the patients as part of this program provided opportunities to do clinical research and to acquire peer reviewed grants. This is the first recognized fellowship training program in sub-Saharan Africa outside of South Africa. It is an example of a collaborative effort to improve women's health in a low-resource country. This is a Kenyan managed program through Moi University. These subspecialty trained doctors will also provide advice that will shape health care policy and provide sustainable expertise for women diagnosed with a gynecologic cancer.

The impact of Masters education in manual and manipulative therapy and the 'knowledge acquisition model'.

PubMed

Perry, Jo; Green, Ann; Harrison, Karen

2011-06-01

This study aimed to explore the professional and personal impact that a clinical Masters program of manipulative therapy education had on the lives of individuals who had undertaken the course and was a follow-on study of participants' career pathways following Masters education (Green et al., 2008). Seven graduates from the program took part in a focus group. The narrative data obtained was independently verified prior to two researchers conducting a systematic, thematic content analysis. Three key themes were identified and the 'knowledge acquisition model' developed. Findings revealed that studying at Master's level is a 'life changing' and rewarding experience that develops individuals in three key domains; professionally, personally and intellectually. During Masters education students described a journey of multi-compartmental development whereby their knowledge-base was challenged and their existing cognitive framework deconstructed. Progression through the program resulted in the development of a new, clearer framework for thinking and understanding that extended, universally, into all aspects of their lives; clinically, managerially, emotionally, politically and intellectually. Participants also described two cultures for career progression in the UK National Health Service (NHS). Findings could help students considering undertaking Masters level education, employers and clinical mentors of these practitioners and academic educators. Copyright © 2010 Elsevier Ltd. All rights reserved.

Training the Trainer: Developing Educators for Continuing Professional Education.

ERIC Educational Resources Information Center

Canellos, Harriete; Medio, Franklin J.; Mozlin, Rochelle; Perry, Claudia A.

2000-01-01

Describes a program at the State University of New York College of Optometry targeted at training younger clinical faculty who wish to become involved in continuing professional education. Covers the program's purpose and the institution's experiences with implementation. (DB)

Technology Development Resources | Resources | CDP

Cancer.gov

The Cancer Diagnosis Program strives to improve the diagnosis and assessment of cancer by effectively moving new scientific knowledge into clinical practice. This national program stimulates, coordinates and funds resources and research for the development of innovative in vitro diagnostics, novel diagnostic technologies and appropriate human specimens in order to better characterize cancers and allow improved medical decision making and evaluation of response to treatment.

Long-Term Maternal Effects of Early Childhood Intervention: Findings from the Infant Health and Development Program (IHDP)

ERIC Educational Resources Information Center

Martin, Anne; Brooks-Gunn, Jeanne; Klebanov, Pamela; Buka, Stephen L.; McCormick, Marie C.

2008-01-01

The Infant Health and Development Program (IHDP) was a randomized clinical trial of early intervention services for low birth weight, premature infants. Mothers and infants received services for 3 years beginning at neonatal discharge. At the intervention's conclusion, mothers in the intervention group who had lighter (less than 2001 g) birth…

Integrating risk minimization planning throughout the clinical development and commercialization lifecycle: an opinion on how drug development could be improved

PubMed Central

Morrato, Elaine H; Smith, Meredith Y

2015-01-01

Pharmaceutical risk minimization programs are now an established requirement in the regulatory landscape. However, pharmaceutical companies have been slow to recognize and embrace the significant potential these programs offer in terms of enhancing trust with health care professionals and patients, and for providing a mechanism for bringing products to the market that might not otherwise have been approved. Pitfalls of the current drug development process include risk minimization programs that are not data driven; missed opportunities to incorporate pragmatic methods and market-based insights, outmoded tools and data sources, lack of rapid evaluative learning to support timely adaption, lack of systematic approaches for patient engagement, and questions on staffing and organizational infrastructure. We propose better integration of risk minimization with clinical drug development and commercialization work streams throughout the product lifecycle. We articulate a vision and propose broad adoption of organizational models for incorporating risk minimization expertise into the drug development process. Three organizational models are discussed and compared: outsource/external vendor, embedded risk management specialist model, and Center of Excellence. PMID:25750537

[Effects of practical training to increase motivation for learning and related factors].

PubMed

Yamaguchi, Takumi; Akiyama, Shinji; Sagara, Hidenori; Tanaka, Akihiro; Miyauchi, Yoshirou; Araki, Hiroaki; Shibata, Kazuhiko; Izushi, Fumio; Namba, Hiroyuki

2014-01-01

Under the six-year pharmaceutical education system that was initiated in April 2006, students who had completed the course in March 2012 became the first graduates. The six-year system encourages students to develop a well-rounded personality, a deep sense of ethics, knowledge required for health care professionals, abilities to identify and solve problems, and practical skills required in clinical settings, as well as basic knowledge and skills. Under the new education system based on the "pharmaceutical education model core curriculums" and "practical training model core curriculums", general pharmaceutical education is implemented in each college, and five-month practical training is conducted in clinical settings. Clinical tasks experienced by students for the first time are expected to significantly influence their motivation to learn and future prospects. In the present survey research, students who had completed practical training evaluated the training program, and correspondence and logistic regression analyses of the results were conducted to examine the future effects and influences of the training on the students. The results suggest that the students viewed the practical training program positively. In addition, clinical experience during the training sessions not only influenced their decisions on future careers, but also significantly increased their motivation to learn. Furthermore, their motivation for learning was increased most by the enthusiasm of pharmacists who advised them in clinical settings, rather than the training program itself. To improve pharmaceutical clinical learning, it is important to develop teaching and working environments for pharmacists in charge of advising students in clinical training.

A Novel Program Trains Community‐Academic Teams to Build Research and Partnership Capacity

PubMed Central

Brown, Jen; LeBailly, Susan; McGee, Richard; Bayldon, Barbara; Huber, Gail; Kaleba, Erin; Lowry, Kelly Walker; Martens, Joseph; Mason, Maryann; Nuñez, Abel

2013-01-01

Abstract The Community‐Engaged Research Team Support (CERTS) program was developed and tested to build research and partnership capacity for community‐engaged research (CEnR) teams. Led by the Northwestern University Clinical and Translational Sciences Institute (NUCATS), the goals of CERTS were: (1) to help community‐academic teams build capacity for conducting rigorous CEnR and (2) to support teams as they prepare federal grant proposal drafts. The program was guided by an advisory committee of community and clinical partners, and representatives from Chicago's Clinical and Translational Science Institutes. Monthly workshops guided teams to write elements of NIH‐style research proposals. Draft reviewing fostered a collaborative learning environment and helped teams develop equal partnerships. The program culminated in a mock‐proposal review. All teams clarified their research and acquired new knowledge about the preparation of NIH‐style proposals. Trust, partnership collaboration, and a structured writing strategy were assets of the CERTS approach. CERTS also uncovered gaps in resources and preparedness for teams to be competitive for federally funded grants. Areas of need include experience as principal investigators, publications on study results, mentoring, institutional infrastructure, and dedicated time for research. PMID:23751028

Programming for physicians: A free online course

PubMed Central

Kubben, Pieter L.

2016-01-01

This article is an introduction for clinical readers into programming and computational thinking using the programming language Python. Exercises can be done completely online without any need for installation of software. Participants will be taught the fundamentals of programming, which are necessarily independent of the sort of application (stand-alone, web, mobile, engineering, and statistical/machine learning) that is to be developed afterward. PMID:27127694

Institute for Molecular Medicine Research Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Phelps, Michael E

2012-12-14

The objectives of the project are the development of new Positron Emission Tomography (PET) imaging instrumentation, chemistry technology platforms and new molecular imaging probes to examine the transformations from normal cellular and biological processes to those of disease in pre-clinical animal models. These technology platforms and imaging probes provide the means to: 1. Study the biology of disease using pre-clinical mouse models and cells. 2. Develop molecular imaging probes for imaging assays of proteins in pre-clinical models. 3. Develop imaging assays in pre-clinical models to provide to other scientists the means to guide and improve the processes for discovering newmore » drugs. 4. Develop imaging assays in pre-clinical models for others to use in judging the impact of drugs on the biology of disease.« less

Meeting the Needs of Underserved Patients in Western Kenya by Creating the Next Generation of Global Health Pharmacists.

PubMed

Miller, Monica L; Karwa, Rakhi; Schellhase, Ellen M; Pastakia, Sonak D; Crowe, Susie; Manji, Imran; Jakait, Beatrice; Maina, Mercy

2016-03-25

Objective. To describe a novel training model used to create a sustainable public health-focused pharmacy residency based in Kenya and to describe the outcomes of this training program on underserved populations. Design. The postgraduate year 2 residency was designed to expose trainees to the unique public health facets of inpatient, outpatient, and community-based care delivery in low and middle-income countries. Public health areas of focus included supply chain management, reproductive health, pediatrics, HIV, chronic disease management, and teaching. Assessment. The outcomes of the residency were assessed based on the number of new clinical programs developed by residents, articles and abstracts written by residents, and resident participation in grant writing. To date, six residents from the United States and eight Kenyan residents have completed the residency. Eleven sustainable patient care services have been implemented as a result of the residency program. Conclusion. This pharmacy residency training model developed accomplished pharmacists in public health pharmacy, with each residency class expanding funding and clinical programming, contributing to curriculum development, and creating jobs.

The business of emergency medicine: a nonclinical curriculum proposal for emergency medicine residency programs.

PubMed

Falvo, Thomas; McKniff, Sueanne; Smolin, Gregory; Vega, David; Amsterdam, James T

2009-09-01

Over the course of their postgraduate medical education, physicians are expected not only to acquire an extensive knowledge of clinical medicine and sound procedural skills, but also to develop competence in their other professional roles as communicator, collaborator, mediator, manager, teacher, and patient advocate. Although the need for physicians to develop stronger service delivery skills is well recognized, residency programs may underemphasize formal training in nonclinical proficiencies. As a result, graduates can begin their professional careers with an incomplete understanding of the operation of health care systems and how to utilize system resources in the manner best suited to their patients' needs. This article proposes the content, educational strategy, and needs assessment for an academic program entitled The Business of Emergency Medicine (BOEM). Developed as an adjunct to the (predominantly) clinical content of traditional emergency medicine (EM) training programs, BOEM is designed to enhance the existing academic curricula with additional learning opportunities by which EM residents can acquire a fundamental understanding of the nonclinical skills of their specialty. (c) 2009 by the Society for Academic Emergency Medicine.

Renewable Energy for Rural Health Clinics (Energia Removable para Centros de Salud Rurales)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jimenez, A. C.; Olson, K.

This guide provides a broad understanding of the technical, social, and organizational aspects of health clinic electrification, especially through the use of renewable energy sources. It is intended to be used primarily by decision makers within governments or private agencies to accurately assess their health clinic's needs, select appropriate and cost-effective technologies to meet those needs, and to put into place effective infrastructure to install and maintain the hardware. This is the first in a series of rural applications guidebooks that the National Renewable Energy Laboratory (NREL) Village Power Program is commissioning to couple commercial renewable systems with rural applications.more » The guidebooks are complemented by NREL's Village Power Program's development activities, international pilot projects, and visiting professionals program. For more information on the NREL Village Power Program, visit the Renewables for Sustainable Village Power web site at http://www.rsvp.nrel .gov/rsvp/.« less

GME Concentrations: A Collaborative Interdisciplinary Approach to Learner-Driven Education

PubMed Central

Nagler, Alisa; Chudgar, Saumil M.; Rudd, Mariah; Whicker, Shari A.; Gagliardi, Jane P.; Narayan, Aditee; Heflin, Mitchell T.; Gordon, David C.; Andolsek, Kathryn M.

2015-01-01

Background Graduate medical education (GME) programs may struggle to provide the knowledge, skills, and experiences necessary to meet trainee career interests and goals beyond a clinical focus. Sponsoring institutions can partner with programs to deliver content not included in typical clinical experiences of GME programs. Objective To perform a needs assessment and to develop, implement, and measure acceptability and feasibility of an institution-wide GME Concentrations curriculum. Methods In response to the needs assessment, GME leadership developed 4 concentrations: (1) Resident-as-Teacher; (2) Patient Safety and Quality Improvement; (3) Law, Ethics, and Health Policy; and (4) Leaders in Medicine. We formed advisory committees that developed curricula for each concentration, including didactics, experiential learning, and individual project mentoring. Participants completed pre- and postassessments. We assessed feasibility and evaluated participant presentations and final projects. Results Over the course of 3 years, 91 trainees (of approximately 1000 trainees each year) from 36 GME programs (of 82 accredited programs) have participated in the program. The number of participants has increased each year, and 22 participants have completed the program overall. Cost for each participant is estimated at $500. Participant projects addressed a variety of education and health care areas, including curriculum development, quality improvement, and national needs assessments. Participants reported that their GME Concentrations experience enhanced their training and fostered career interests. Conclusions The GME Concentrations program provides a feasible, institutionally based approach for educating trainees in additional interest areas. Institutional resources are leveraged to provide and customize content important to participants' career interests beyond their specialty. PMID:26457150

Hospital Guidelines for Diabetes Management and the Joint Commission-American Diabetes Association Inpatient Diabetes Certification.

PubMed

Arnold, Pamela; Scheurer, Danielle; Dake, Andrew W; Hedgpeth, Angela; Hutto, Amy; Colquitt, Caroline; Hermayer, Kathie L

2016-04-01

The Joint Commission Advanced Inpatient Diabetes Certification Program is founded on the American Diabetes Association's Clinical Practice Recommendations and is linked to the Joint Commission Standards. Diabetes currently affects 29.1 million people in the USA and another 86 million Americans are estimated to have pre-diabetes. On a daily basis at the Medical University of South Carolina (MUSC) Medical Center, there are approximately 130-150 inpatients with a diagnosis of diabetes. The program encompasses all service lines at MUSC. Some important features of the program include: a program champion or champion team, written blood glucose monitoring protocols, staff education in diabetes management, medical record identification of diabetes, a plan coordinating insulin and meal delivery, plans for treatment of hypoglycemia and hyperglycemia, data collection for incidence of hypoglycemia, and patient education on self-management of diabetes. The major clinical components to develop, implement, and evaluate an inpatient diabetes care program are: I. Program management, II. Delivering or facilitating clinical care, III. Supporting self-management, IV. Clinical information management and V. performance measurement. The standards receive guidance from a Disease-Specific Care Certification Advisory Committee, and the Standards and Survey Procedures Committee of the Joint Commission Board of Commissioners. The Joint Commission-ADA Advanced Inpatient Diabetes Certification represents a clinical program of excellence, improved processes of care, means to enhance contract negotiations with providers, ability to create an environment of teamwork, and heightened communication within the organization. Published by Elsevier Inc.

Community-based dental education: history, current status, and future.

PubMed

Formicola, Allan J; Bailit, Howard L

2012-01-01

This article examines the history, current status, and future direction of community-based dental education (CBDE). The key issues addressed include the reasons that dentistry developed a different clinical education model than the other health professions; how government programs, private medical foundations, and early adopter schools influenced the development of CBDE; the societal and financial factors that are leading more schools to increase the time that senior dental students spend in community programs; the impact of CBDE on school finances and faculty and student perceptions; and the reasons that CBDE is likely to become a core part of the clinical education of all dental graduates.

Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

PubMed

Linggi, A; Pelham, L D

1986-09-01

A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.

Development of an emergency nursing training curriculum in Ghana.

PubMed

Bell, Sue Anne; Oteng, Rockefeller; Redman, Richard; Lapham, Jeremy; Bam, Victoria; Dzomecku, Veronica; Yakubu, Jamila; Tagoe, Nadia; Donkor, Peter

2014-10-01

The formal provision of emergency health care is a developing specialty in many sub-Saharan African countries, including Ghana. While emergency medicine training programs for physicians are on the rise, there are few established training programs for emergency nurses. The results of a unique collaboration are described between a university in the United States, a Ghanaian university and a Ghanaian teaching hospital that has developed an emergency nursing diploma program. The expected outcomes of this training program include: (a) an innovative, interdisciplinary, team-based clinical training model, (b) a unique and low-resource emergency nursing curriculum and (c) a comprehensive and sustainable training program to increase in-country retention of nurses. Copyright © 2014 Elsevier Ltd. All rights reserved.

The portfolio approach to competency-based assessment at the Cleveland Clinic Lerner College of Medicine.

PubMed

Dannefer, Elaine F; Henson, Lindsey C

2007-05-01

Despite the rapid expansion of interest in competency-based assessment, few descriptions of assessment systems specifically designed for a competency-based curriculum have been reported. The purpose of this article is to describe the design of a portfolio approach to a comprehensive, competency-based assessment system that is fully integrated with the curriculum to foster an educational environment focused on learning. The educational design goal of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University was to create an integrated educational program-curriculum and instructional methods, student assessment processes, and learning environment-to prepare medical students for success in careers as physician investigators. The first class in the five-year program matriculated in 2004. To graduate, a student must demonstrate mastery of nine competencies: research, medical knowledge, communication, professionalism, clinical skills, clinical reasoning, health care systems, personal development, and reflective practice. The portfolio provides a tool for collecting and managing multiple types of assessment evidence from multiple contexts and sources within the curriculum to document competence and promote reflective practice skills. This article describes how the portfolio was developed to provide both formative and summative assessment of student achievement in relation to the program's nine competencies.

Using electronic clinical practice audits as needs assessment to produce effective continuing medical education programming.

PubMed

Klein, Doug; Staples, John; Pittman, Carmen; Stepanko, Cheryl

2012-01-01

The traditional needs assessment used in developing continuing medical education programs typically relies on surveying physicians and tends to only capture perceived learning needs. Instead, using tools available in electronic medical record systems to perform a clinical audit on a physician's practice highlights physician-specific practice patterns. The purpose of this study was to test the feasibility of implementing an electronic clinical audit needs assessment process for family physicians in Canada. A clinical audit of 10 preventative care interventions and 10 chronic disease interventions was performed on family physician practices in Alberta, Canada. The physicians used the results from the audit to produce personalized learning needs, which were then translated into educational programming. A total of 26 family practices and 4489 patient records were audited. Documented completion rates for interventions ranged from 13% for ensuring a patient's tetanus vaccine is current to 97% of pregnant patients receiving the recommended prenatal vitamins. Electronic medical record-based needs assessments may provide a better basis for developing continuing medical education than a more traditional survey-based needs assessment. This electronic needs assessment uses the physician's own patient outcome information to assist in determining learning objectives that reflect both perceived and unperceived needs.

Bridging the gap between primary care and the cancer system

PubMed Central

Sisler, Jeffrey; McCormack-Speak, Pat

2009-01-01

ABSTRACT PROBLEM BEING ADDRESSED Patient care is poorly coordinated between family physicians and the cancer system and the working relationships are not strong. OBJECTIVE OF PROGRAM To improve integration of patient care and communication between FPs and cancer specialists; enhance FPs’ knowledge of cancer and the cancer system; and promote the role of primary care within the cancer care system. PROGRAM DESCRIPTION The Uniting Primary Care and Oncology (UPCON) Network of CancerCare Manitoba has created partnerships with 12 primary care clinics in Winnipeg, Man, by providing the following: access to the provincial electronic medical record for cancer; small group continuing professional development for a “lead physician” from each clinic to make him or her the local cancer resource; educational outreach to all clinic staff; and changes within CancerCare Manitoba to highlight the role of FPs. CONCLUSION Lead physicians are appreciated by their clinic colleagues, and these FPs are the main users of the cancer electronic medical record. A strong cancer continuing professional development program has been implemented and a voice for primary care has been created within the agency. The UPCON Network is now expanding throughout Manitoba. PMID:19282538

Managing complex processing of medical image sequences by program supervision techniques

NASA Astrophysics Data System (ADS)

Crubezy, Monica; Aubry, Florent; Moisan, Sabine; Chameroy, Virginie; Thonnat, Monique; Di Paola, Robert

1997-05-01

Our objective is to offer clinicians wider access to evolving medical image processing (MIP) techniques, crucial to improve assessment and quantification of physiological processes, but difficult to handle for non-specialists in MIP. Based on artificial intelligence techniques, our approach consists in the development of a knowledge-based program supervision system, automating the management of MIP libraries. It comprises a library of programs, a knowledge base capturing the expertise about programs and data and a supervision engine. It selects, organizes and executes the appropriate MIP programs given a goal to achieve and a data set, with dynamic feedback based on the results obtained. It also advises users in the development of new procedures chaining MIP programs.. We have experimented the approach for an application of factor analysis of medical image sequences as a means of predicting the response of osteosarcoma to chemotherapy, with both MRI and NM dynamic image sequences. As a result our program supervision system frees clinical end-users from performing tasks outside their competence, permitting them to concentrate on clinical issues. Therefore our approach enables a better exploitation of possibilities offered by MIP and higher quality results, both in terms of robustness and reliability.

The research program coordinator: an example of effective management.

PubMed

Merry, Lisa; Gagnon, Anita J; Thomas, Julia

2010-01-01

Careers in clinical research management are increasingly common. Despite nurses' important role in clinical research, their status as research professionals is underrecognized. In this article, we describe the role of a "program coordinator" (PC) in the context of a complex research program on migration and reproductive health. The PC role expands beyond the usual role of a research coordinator because he or she is involved in all aspects of the program of research and his or her responsibilities include research, education, clinical, and administration components. He or she ensures optimal organization and continuity across several studies and ensures ethical and scientific standards are applied for each individual study. His or her clinical knowledge assures data are accurate and subjects are safe. In addition, he or she assists with applying for funding, the maintenance of research partnerships, and dissemination of research findings; he or she supports students' learning and completes all regulatory aspects related to the program of research. Key to the PC role is relationship building and the application of Good Clinical Practice principles. The advanced role of a PC also warrants opportunities for professional development and a competitive salary. A PC is an effective approach for research management and a natural role for professional nurse. Copyright 2010 Elsevier Inc. All rights reserved.

Application of a contextual instructional framework in a continuing professional development training program for physiotherapists in Rwanda.

PubMed

Dunleavy, Kim; Chevan, Julia; Sander, Antoinette P; Gasherebuka, Jean Damascene; Mann, Monika

2018-06-01

Continuing professional development is an important component of capacity building in low resource countries. The purpose of this case study is to describe the use of a contextual instructional framework to guide the processes and instructional design choices for a series of continuing professional development courses for physiotherapists in Rwanda. Four phases of the project are described: (1) program proposal, needs assessment and planning, (2) organization of the program and instructional design, (3) instructional delivery and (4) evaluation. Contextual facilitating factors and needs informed choices in each phase. The model resulted in delivery of continuing professional development to the majority of physiotherapists in Rwanda (n = 168, 0.48 rural/0.52 urban) with participants reporting improvement in skills and perceived benefit for their patients. Environmental and healthcare system factors resulted in offering the courses in rural and urban areas. Content was developed and delivered in partnership with Rwandan coinstructors. Based on the domestic needs identified in early courses, the program included advocacy and leadership activities, in addition to practical and clinical instruction. The contextual factors (environment, healthcare service organization, need for rehabilitation and status and history of the physiotherapy profession) were essential for project and instructional choices. Facilitating factors included the established professional degree and association, continuing professional development requirements, a core group of active professionals and an existing foundation from other projects. The processes and contextual considerations may be useful in countries with established professional-level education but without established postentry-level training. Implications for Rehabilitation Organizations planning continuing professional development programs may benefit from considering the context surrounding training when planning, designing and developing instruction. The surrounding context including the environment, the organization of healthcare services, the population defined need for rehabilitation, and the domestic status and history of the physiotherapy profession, is important for physiotherapy projects in countries with lower resources. Facilitating factors in low resource countries such as an established professional degree and association, continuing professional development requirements, a core group of active professionals and an existing foundation from other projects impact the success of projects. Methods that may be useful for relevance, dissemination and consistency include involvement of in-country leaders and instructors and attendance in multiple courses with consistent themes. Rehabilitation professionals in low resource countries may benefit from continuing professional development courses that emphasize practical skills, and clinical reasoning, accompanied by clinical mentoring and directed coaching that encourages knowledge transfer to the clinical setting. Active learning approaches and multiple progressive courses provide opportunities to develop peer support through professional communities of practice.

Development of a Hampton University Program for Novel Breast Cancer Imaging and Therapy Research

DTIC Science & Technology

2013-04-01

intracavitary brachytherapy procedures during laboratory pre-clinical imaging and dosimetry equipment testing, calibration and data processing, in collaboration... electronics and detector instrumentation development; 4) breast phantom construction and implantation; 5) laboratory pre-clinical device testing...such as the ionization chamber, diode, radiographic verification 6 films and thermoluminescent dosimeters ( TLD ) but the scintillator fiber detectors

Development of Guidelines Related to Riverside Community College Nursing Student Mandatory Assignment to AIDS Patients in the Clinical Setting.

ERIC Educational Resources Information Center

Kross, Carolyn Sue

The purpose of this study was to develop Associate Degree nursing program guidelines for Riverside Community College (RCC), in California, regarding mandatory nursing student assignment to Acquired Immune Deficiency Syndrome (AIDS) patients, and student refusal of such assignments in a clinical setting. During the 1990 fall semester, RCC's Nursing…

Leveraging model-informed approaches for drug discovery and development in the cardiovascular space.

PubMed

Dockendorf, Marissa F; Vargo, Ryan C; Gheyas, Ferdous; Chain, Anne S Y; Chatterjee, Manash S; Wenning, Larissa A

2018-06-01

Cardiovascular disease remains a significant global health burden, and development of cardiovascular drugs in the current regulatory environment often demands large and expensive cardiovascular outcome trials. Thus, the use of quantitative pharmacometric approaches which can help enable early Go/No Go decision making, ensure appropriate dose selection, and increase the likelihood of successful clinical trials, have become increasingly important to help reduce the risk of failed cardiovascular outcomes studies. In addition, cardiovascular safety is an important consideration for many drug development programs, whether or not the drug is designed to treat cardiovascular disease; modeling and simulation approaches also have utility in assessing risk in this area. Herein, examples of modeling and simulation applied at various stages of drug development, spanning from the discovery stage through late-stage clinical development, for cardiovascular programs are presented. Examples of how modeling approaches have been utilized in early development programs across various therapeutic areas to help inform strategies to mitigate the risk of cardiovascular-related adverse events, such as QTc prolongation and changes in blood pressure, are also presented. These examples demonstrate how more informed drug development decisions can be enabled by modeling and simulation approaches in the cardiovascular area.

A Faculty Development Program can result in an improvement of the quality and output in medical education, basic sciences and clinical research and patient care.

PubMed

Dieter, Peter Erich

2009-07-01

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International.The traditional teacher- and discipline-centred curriculum was displaced by a student-centred, interdisciplinary and integrative curriculum, which has been named Dresden Integrative Patient/Problem-Oriented Learning (DIPOL). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany.The students play a very important strategic role in all processes. They are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. The Faculty Development program, including a reform in medical education, the establishment of the Quality Management program and the certification, resulted in an improvement of the quality and output of medical education and was accompanied in an improvement of the quality and output of basic sciences and clinical research and interdisciplinary patient care.

Case Definitions for Conditions Identified by Newborn Screening Public Health Surveillance.

PubMed

Sontag, Marci K; Sarkar, Deboshree; Comeau, Anne M; Hassell, Kathryn; Botto, Lorenzo D; Parad, Richard; Rose, Susan R; Wintergerst, Kupper A; Smith-Whitley, Kim; Singh, Sikha; Yusuf, Careema; Ojodu, Jelili; Copeland, Sara; Hinton, Cynthia F

2018-01-01

Newborn screening (NBS) identifies infants with rare conditions to prevent death or the onset of irreversible morbidities. Conditions on the Health and Human Services Secretary's Recommended Uniform Screening Panel have been adopted by most state NBS programs, providing a consistent approach for identification of affected newborns across the United States. Screen-positive newborns are identified and referred for confirmatory diagnosis and follow-up. The designation of a clinically significant phenotype precursor to a clinical diagnosis may vary between clinical specialists, resulting in diagnostic variation. Determination of disease burden and birth prevalence of the screened conditions by public health tracking is made challenging by these variations. This report describes the development of a core group of new case definitions, along with implications, plans for their use, and links to the definitions that were developed by panels of clinical experts. These definitions have been developed through an iterative process and are piloted in NBS programs. Consensus public health surveillance case definitions for newborn screened disorders will allow for consistent categorization and tracking of short- and long-term follow-up of identified newborns at the local, regional, and national levels.

Case Definitions for Conditions Identified by Newborn Screening Public Health Surveillance

PubMed Central

Sontag, Marci K.; Sarkar, Deboshree; Comeau, Anne M.; Hassell, Kathryn; Botto, Lorenzo D.; Parad, Richard; Rose, Susan R.; Wintergerst, Kupper A.; Smith-Whitley, Kim; Singh, Sikha; Yusuf, Careema; Ojodu, Jelili; Copeland, Sara; Hinton, Cynthia F.

2018-01-01

Newborn screening (NBS) identifies infants with rare conditions to prevent death or the onset of irreversible morbidities. Conditions on the Health and Human Services Secretary’s Recommended Uniform Screening Panel have been adopted by most state NBS programs, providing a consistent approach for identification of affected newborns across the United States. Screen-positive newborns are identified and referred for confirmatory diagnosis and follow-up. The designation of a clinically significant phenotype precursor to a clinical diagnosis may vary between clinical specialists, resulting in diagnostic variation. Determination of disease burden and birth prevalence of the screened conditions by public health tracking is made challenging by these variations. This report describes the development of a core group of new case definitions, along with implications, plans for their use, and links to the definitions that were developed by panels of clinical experts. These definitions have been developed through an iterative process and are piloted in NBS programs. Consensus public health surveillance case definitions for newborn screened disorders will allow for consistent categorization and tracking of short- and long-term follow-up of identified newborns at the local, regional, and national levels.

An integrated educational model for continuing nurse education.

PubMed

Duff, Beverley; Gardner, Glenn; Osborne, Sonya

2014-01-01

This paper reports on the development and evaluation of an integrated clinical learning model to inform ongoing education for surgical nurses. The research aim was to evaluate the effectiveness of implementing a Respiratory Skills Update (ReSKU) education program, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment. Continuous development and integration of technological innovations and research in the healthcare environment mandate the need for continuing education for nurses. Despite an increased worldwide emphasis on this, there is scant empirical evidence of program effectiveness. A quasi experimental pre test, post test non-equivalent control group design evaluated the impact of the ReSKU program on surgical nurses' clinical practice. The 2008 study was conducted in a 400 bed regional referral public hospital and was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group's reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful reflection, was a powerful educational strategy to enhance competency and capability in clinicians. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Quality Control Specialist | Center for Cancer Research

Cancer.gov

Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Institute of Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and blood diseases and conditions; parasitic infections; rheumatic and inflammatory diseases; and rare and neglected diseases. CMRP’s collaborative approach to clinical research and the expertise and dedication of staff to the continuation and success of the program’s mission has contributed to improving the overall standards of public health on a global scale. The Clinical Monitoring Research Program (CMRP) provides analytical experience to work on innovative T-cell therapy for cancer treatment, and responsible for development and execution of analytical assays for generation lot release assays and product CoAs in support of the National Cancer Institute’s (NCI’s), Center for Cancer Research (CCR), Surgery Branch (SB). KEY ROLES/RESPONSIBILITIES-THIS POSITION IS CONTINGENT UPON FUNDING APPROVAL Collaborates on the development of templates and processes to enhance the performance of the program Provides organizational and document support including preparation of documents (spreadsheets, web pages, written narrative, meeting minutes) and timely communication with committee and working group members through email contact and websites Establishes, implements and maintains standardized processes and assess performance to make recommendations for improvement Prepares technical reports, abstracts, presentations and program correspondence concerning assigned projects through research and analysis of information relevant to government policy, regulations and other relevant data Monitors all assigned programs for compliance Facilitates communication through all levels of staff by functioning as a liaison between internal departments, senior management, and the customer Attends weekly meetings to discuss upcoming events, tasks, special projects and implementation plans Develops and implements procedures/programs to ensure effective and efficient business and operational processes Identifies potential bottlenecks in the upcoming development process and works with all team members and senior management to resolve them Analyzes and tracks initiatives and contracts Coordinates and reviews daily operations and logistics, including purchasing and shipping of miscellaneous equipment, lab and office supplies to ensure compliance with appropriate government regulations Aids in measuring, monitoring, problem solving, and reporting of research, operational and business issues Reviews operational requirements for development of or changes to staffing Perform all tasks associated with the manufacture of clinical product (vector or cell) Cross-trains on SOPs and procedures required to support both vector and cell production Follows batch records and SOPs Executes GMP runs in close collaboration with Process Development and Quality Assurance and Quality Control groups Assists in the development of SOPs, batch records, deviations and change controls Troubleshoots processing and equipment issues Participates in investigations regarding out of specifications/trend (OOS/OOT) results; addresses and manages deviations to manufacturing procedures

[Consumer involvement in the Disease Management Guideline for Asthma--a background report].

PubMed

Senger, Sylvia; Lelgemann, Monika; Kopp, Ina

2006-01-01

In the past clinical guidelines were mainly developed by experts and in everyday clinical practice almost exclusively used by clinical experts, while issues that were relevant from the patients' (consumers') point of view tended to be neglected. But then, the majority of patient information has not been perceptibly connected to clinical guidelines. Connecting the development of clinical guidelines with the development of patient information publications would make good sense for both products, though. On the one hand, evidence-based treatment guidelines could be made available to the actual target group of the clinical care process--i.e. the patients or consumers--and on the other hand, patient experiences and competencies (social evidence) might inform the production of guidelines. Such a procedure demands the cooperation of clinical experts and patients. So far there are no generally accepted methods in Germany for the practical implementation of consumer involvement on both the organizational and content level with the aim of involving patients in the development process of guidelines as well as the production of the respective patient information versions. Such a methodology shall be established as part of the National Program for Disease Management Guidelines. For the first time in this program, patient involvement is being exercised within the scope of the National Disease Management Guideline for Asthma (NDM Asthma). Here, patients are involved in the NDM development process by providing the opportunity to comment on the consented guideline draft and to participate in the translation of the NDM Asthma into a patient version. The present paper is a background report describing the current state of work and indicating consequences for some future developments.

The Development and Implementation of a Model for Evaluating Clinical Specialty Education Programs.

ERIC Educational Resources Information Center

McLean, James E.; And Others

A new method for evaluating cancer education programs, using an external/internal evaluation team is outlined. The internal program staff are required to collect the data, arrange for a site visit, provide access to personnel, and make available other information requested by the evaluators. The external team consists of a dentist with oncological…

Tonsillitis

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Hoarseness

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Sinusitis

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Cholesteatoma

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Developing leadership competencies among medical trainees: five-year experience at the Cleveland Clinic with a chief residents' training course.

PubMed

Farver, Carol F; Smalling, Susan; Stoller, James K

2016-10-01

Challenges in healthcare demand great leadership. In response, leadership training programs have been developed within academic medical centers, business schools, and healthcare organizations; however, we are unaware of any well-developed programs for physicians-in-training. To address this gap, we developed a two-day leadership development course for chief residents (CRs) at the Cleveland Clinic, framed around the concept of emotional intelligence. This paper describes our five-year experience with the CRs leadership program. Since inception, 105 CRs took the course; 81 (77%) completed before-and-after evaluations. Participants indicated that they had relatively little prior knowledge of the concepts that were presented and that the workshop greatly enhanced their familiarity with leadership competencies. Qualitative analysis of open-ended responses indicated that attendees valued the training, especially in conflict resolution and teamwork, and indicated specific action plans for applying these skills. Furthermore, the workshop spurred some participants to express plans to learn more about leadership competencies. This study extends prior experience in offering an emotional intelligence-based leadership workshop for CRs. Though the program is novel, further research is needed to more fully understand the impact of leadership training for CRs and for the institutions and patients they serve. © The Royal Australian and New Zealand College of Psychiatrists 2016.

The development of a diversity mentoring program for faculty and trainees: A program at the Brown Clinical Psychology Training Consortium

PubMed Central

de Dios, Marcel A.; Kuo, Caroline; Hernandez, Lynn; Clark, Uraina S.; Wenze, Susan J.; Boisseau, Christina L.; Hunter, Heather L.; Reddy, Madhavi K.; Tolou-Shams, Marina; Zlotnick, Caron

2013-01-01

There is a critical need for increasing the diversity representation among clinicians and researchers in academic medicine, including departments of psychiatry and psychology. Mentorship of under-represented groups has been identified as an important way to remediate diversity-related barriers in the field. This paper outlines the early development and pilot implementation of a diversity mentorship program at Brown University. In an effort to inform and guide future diversity programs, we discuss the challenges faced in creating the program, the successes experienced during the first year, and the future directions undertaken as a means for improving the program. PMID:25346563

Pulmonary Testing Laboratory Computer Application

PubMed Central

Johnson, Martin E.

1980-01-01

An interactive computer application reporting patient pulmonary function data has been developed by Washington, D.C. VA Medical Center staff. A permanent on-line data base of patient demographics, lung capacity, flows, diffusion, arterial blood gases and physician interpretation is maintained by a minicomputer at the hospital. A user oriented application program resulted from development in concert with the clinical users. Rapid program development resulted from employing a newly developed time saving technique that has found wide application at other VA Medical Centers. Careful attention to user interaction has resulted in an application program requiring little training and which has been satisfactorily used by a number of clinicians.

Establishing an endovascular carotid stent program.

PubMed

Raabe, Rod; Chong, Brian

2004-12-01

FDA approval of carotid stent and distal protection devices has transformed carotid artery stenting (CAS) from an investigational procedure to a practical application. Recent approval by the Center for Medicare Services (CMS) has ensured that CAS will be a part of everyday practice throughout the country. To establish a competitive endovascular carotid stent program, one needs to develop an effective strategy. The key to success is substance and service. A high-quality clinical program with excellent communication between the patient and referring physician is essential. You must first get access to the patient by establishing a clinical practice. As a radiologist, you have the advantage of gaining access by identifying appropriate patients through noninvasive vascular labs, CTA, and MRA. An algorithm-driven evaluation and treatment protocol with good pre- and postoperative care, along with a quality assurance program, will ensure that your carotid stent program has substance and delivers optimal service. With good planning, you will have a firm clinical foundation for treatment of carotid artery stenosis in your community. Putting all of the ingredients together will ensure a successful carotid endovascular program.

Teaching and clinical educator competency: bringing two worlds together.

PubMed

Robinson, Cathy P

2009-01-01

More sessional clinical educators are being employed in educational institutions today than ever before. Also identified in the literature are issues affecting sessional clinical educators' ability to develop and maintain educator competency. Using the definition of educator competency by the National League for Nursing (NLN 2005a), explored in this paper are ways of increasing sessional clinical educator competency, such as orientation and mentorship programs to support student learning in clinical environments. Approaches in the form of theoretical models designed to evaluate clinical educator competency are examined. A new Sessional Clinical Educator Competency (SCEC) Framework is offered to provide direction for implementing strategies to develop and evaluate sessional clinical educator competency. Suggested is that the SCEC framework could be useful for educational administrators and sessional clinical educators to assess clinical educator competency.

Non-Categorical Preschool Model Program.

ERIC Educational Resources Information Center

Bolen, Jacqueline M.; And Others

Special education teachers at the graduate level developed a model noncategorical preschool program for five normal or severely handicapped children which incorporated parent training and behavioral research. The staff assumed such tasks as designing classroom/clinic/observation areas, arranging for materials, training parents, and attending…

Service, training, mentorship: first report of an innovative education-support program to revitalize primary care social service in Chiapas, Mexico.

PubMed

Van Wieren, Andrew; Palazuelos, Lindsay; Elliott, Patrick F; Arrieta, Jafet; Flores, Hugo; Palazuelos, Daniel

2014-01-01

The Mexican mandatory year of social service following medical school, or pasantía, is designed to provide a safety net for the underserved. However, social service physicians (pasantes) are typically unpracticed, unsupervised, and unsupported. Significant demotivation, absenteeism, and underperformance typically plague the social service year. Compañeros en Salud (CES) aimed to create an education-support package to turn the pasantía into a transformative learning experience. CES recruited pasantes to complete their pasantía in CES-supported Ministry of Health clinics in rural Chiapas. The program aims to: 1) train pasantes to more effectively deliver primary care, 2) expose pasantes to central concepts of global health and social medicine, and 3) foster career development of pasantes. Program components include supportive supervision, on-site mentorship, clinical information resources, monthly interactive seminars, and improved clinic function. We report quantitative and qualitative pasante survey data collected from February 2012 to August 2013 to discuss strengths and weaknesses of this program and its implications for the pasante workforce in Mexico. Pasantes reported that their medical knowledge, and clinical and leadership skills all improved during the CES education-support program. Most pasantes felt the program had an overall positive effect on their career goals and plans, although their self-report of preparedness for the Mexican residency entrance exam (ENARM) decreased during the social service year. One hundred percent reported they were satisfied with the CES-supported pasantía experience and wished to help the poor and underserved in their careers. Education-support programs similar to the CES program may encourage graduating medical students to complete their social service in underserved areas, improve the quality of care provided by pasantes, and address many of the known shortcomings of the pasantía. Additional efforts should focus on developing a strategy to expand this education-support model so that more pasantes throughout Mexico can experience a transformative, career-building, social service year.

NIH Career Development Awards in Clinical and Translational Science Award institutions: distinguishing characteristics of top performing sites.

PubMed

Guerrero, Lourdes R; Nakazono, Terry; Davidson, Pamela L

2014-12-01

To identify and disseminate the organizational characteristics of "top performing" National Institute of Health (NIH) Clinical and Translational Science Awards (CTSA) institutions in regards to career development, using the number of new K awards received per year to rank institutions and comparing these with non-CTSA institutions. The authors analyzed the organizational characteristics of all 61 CTSA institutions from 2006 to 2013 using the American Association of Medical Colleges Organizational Characteristics Database and K Award funding details using NIH RePORT. Five of the "top 10 performing" institutions are in the western region, and six out of the ten are public schools. Three of the "top 10 performing" institutions receive most of their K awards through two funding mechanisms-the K08 (mentored clinical scientist research award) and K23 (mentored patient-oriented research career development awards). Notably, these three institutions lack a KL2 program. The CTSA network of institutions is committed to developing the next generation of physician scientists in order to meet the pressing health needs of society. Educators and evaluators within this network may need to provide training to junior investigators beyond the traditional KL2 programs in order to advance their career development as physician scientists and clinical translational researchers. © 2014 Wiley Periodicals, Inc.

Describing a residency program developed for newly graduated nurse practitioners employed in retail health settings.

PubMed

Thabault, Paulette; Mylott, Laura; Patterson, Angela

2015-01-01

Retail health clinics are an expanding health care delivery model and an emerging new practice site for nurse practitioners (NPs). Critical thinking skills, clinical competence, interprofessional collaboration, and business savvy are necessary for successful practice in this highly independent and autonomous setting. This article describes a pilot residency partnership program aimed at supporting new graduate NP transition to practice, reducing NP turnover, and promoting academic progression. Eight new graduate NPs were recruited to the pilot and paired with experienced clinical NP preceptors for a 12-month program that focused on increasing clinical and business competence in the retail health setting. The residency program utilized technology to facilitate case conferences and targeted Webinars to enhance learning and peer-to-peer sharing and support. An on-line doctoral-level academic course that focused on interprofessional collaboration in health care, population health, and business concepts was offered. Both NPs and preceptors were highly satisfied with the academic-service residency program between MinuteClinic and Northeastern University School of Nursing in Boston, MA. New NPs particularly valued the preceptor model, the clinical case conferences, and business Webinars. Because their priority was in gaining clinical experience and learning the business acumen relevant to managing the processes of care, they did not feel ready for the doctoral course and would have preferred to take later in their practice. The preceptors valued the academic course and felt that it enhanced their precepting and leadership skills. At the time of this article, 6 months post completion of the residency program, there has been no turnover. Our experience supports the benefits for residency programs for newly graduated NPs in retail settings. The model of partnering with academia by offering a course within a service organization's educational programs can enable academic progression. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving Metabolic and Cardiovascular Health at an Early Psychosis Intervention Program in Vancouver, Canada

PubMed Central

Fredrikson, Diane H.; Boyda, Heidi N.; Tse, Lurdes; Whitney, Zachary; Pattison, Mark A.; Ott, Fred J.; Hansen, Laura; Barr, Alasdair M.

2014-01-01

Psychotic disorders most commonly appear during the late teenage years and early adulthood. A focused and rapid clinical response by an integrated health team can help to improve the quality of life of the patient, leading to a better long-term prognosis. The Vancouver Coastal Health early psychosis intervention program covers a catchment area of approximately 800,000 people in the cities of Vancouver and Richmond, Canada. The program provides a multidisciplinary approach to supporting patients under the age of 30 who have recently experienced first-break psychosis. The program addresses the needs of the treatment environment, medication, and psychological therapies. A critical part of this support includes a program to specifically improve patients’ physical health. Physical health needs are addressed through a two-pronged, parallel approach. Patients receive routine metabolic health assessments during their first year in the program, where standard metabolic parameters are recorded. Based on the results of clinical interviews and laboratory tests, specific actionable interventions are recommended. The second key strategy is a program that promotes healthy lifestyle goal development. Patients work closely with occupational therapists to develop goals to improve cardiometabolic health. These programs are supported by an active research environment, where patients are able to engage in studies with a focus on improving their physical health. These studies include a longitudinal evaluation of the effects of integrated health coaching on maintaining cardiometabolic health in patients recently admitted to the program, as well as a clinical study that evaluates the effects of low versus higher metabolic risk antipsychotic drugs on central adiposity. An additional pharmacogenomic study is helping to identify genetic variants that may predict cardiometabolic changes following treatment with antipsychotic drugs. PMID:25249985

Characteristics of Volunteer Coaches in a Clinical Process Improvement Program.

PubMed

Morley, Katharine E; Barysauskas, Constance M; Carballo, Victoria; Kalibatas, Orinta; Rao, Sandhya K; Jacobson, Joseph O; Cummings, Brian M

The Partners Clinical Process Improvement Leadership Program provides quality improvement training for clinicians and administrators, utilizing graduates as volunteer peer coaches for mentorship. We sought to understand the factors associated with volunteer coach participation and gain insight into how to improve and sustain this program. Review of coach characteristics from course database and survey of frequent coaches. Out of 516 Partners Clinical Process Improvement Leadership Program graduates from March 2010 to June 2015, 117 (23%) individuals volunteered as coaches. Sixty-one (52%) individuals coached once, 31 (27%) coached twice, and 25 (21%) coached 3 or more times. There were statistically significant associations between coaching and occupation (P = .005), Partners Clinical Process Improvement Leadership Program course taken (P = .001), and course location (P = .007). Administrators were more likely to coach than physicians (odds ratio: 1.75, P = .04). Reasons for volunteering as a coach included further development of skills, desire to stay involved with program, and enjoying mentoring. Reasons for repeated coaching included maintaining quality improvement skills, expanding skills to a wider variety of projects, and networking. A peer graduate volunteer coach model is a viable strategy for interprofessional quality improvement mentorship. Strategies that support repeat coaching and engage clinicians should be promoted to ensure an experienced and diversified group of coaches.

Effects of an Art-Based Curriculum on Clinical Trials Attitudes and Breast Cancer Prevention Knowledge

ERIC Educational Resources Information Center

Herman, Patricia M.; Larkey, Linda K.

2006-01-01

Although Latinos now comprise the largest minority in the U.S. population, they continue to be seriously underrepresented in clinical trials. A nonrandomized controlled study of an innovative community-developed clinical trial and breast cancer education program targeting Latinas tested whether use of an art-based curriculum could increase…

Integrating Preclinical and Clinical Oral Diagnosis and Radiology.

ERIC Educational Resources Information Center

Rhodus, Nelson L.; Brand, John W.

1988-01-01

A program providing second-year dental students with early experience in direct patient contact in an oral diagnosis/oral radiology clinic was well received by both students and faculty and was found to develop desirable skills and qualities in the students participating. (MSE)

The CTSA Consortium's Catalog of Assets for Translational and Clinical Health Research (CATCHR)

PubMed Central

Mapes, Brandy; Basford, Melissa; Zufelt, Anneliese; Wehbe, Firas; Harris, Paul; Alcorn, Michael; Allen, David; Arnim, Margaret; Autry, Susan; Briggs, Michael S.; Carnegie, Andrea; Chavis‐Keeling, Deborah; De La Pena, Carlos; Dworschak, Doris; Earnest, Julie; Grieb, Terri; Guess, Marilyn; Hafer, Nathaniel; Johnson, Tesheia; Kasper, Amanda; Kopp, Janice; Lockie, Timothy; Lombardo, Vincetta; McHale, Leslie; Minogue, Andrea; Nunnally, Beth; O'Quinn, Deanna; Peck, Kelly; Pemberton, Kieran; Perry, Cheryl; Petrie, Ginny; Pontello, Andria; Posner, Rachel; Rehman, Bushra; Roth, Deborah; Sacksteder, Paulette; Scahill, Samantha; Schieri, Lorri; Simpson, Rosemary; Skinner, Anne; Toussant, Kim; Turner, Alicia; Van der Put, Elaine; Wasser, June; Webb, Chris D.; Williams, Maija; Wiseman, Lori; Yasko, Laurel; Pulley, Jill

2014-01-01

Abstract The 61 CTSA Consortium sites are home to valuable programs and infrastructure supporting translational science and all are charged with ensuring that such investments translate quickly to improved clinical care. Catalog of Assets for Translational and Clinical Health Research (CATCHR) is the Consortium's effort to collect and make available information on programs and resources to maximize efficiency and facilitate collaborations. By capturing information on a broad range of assets supporting the entire clinical and translational research spectrum, CATCHR aims to provide the necessary infrastructure and processes to establish and maintain an open‐access, searchable database of consortium resources to support multisite clinical and translational research studies. Data are collected using rigorous, defined methods, with the resulting information made visible through an integrated, searchable Web‐based tool. Additional easy‐to‐use Web tools assist resource owners in validating and updating resource information over time. In this paper, we discuss the design and scope of the project, data collection methods, current results, and future plans for development and sustainability. With increasing pressure on research programs to avoid redundancy, CATCHR aims to make available information on programs and core facilities to maximize efficient use of resources. PMID:24456567

Mindfulness-Based Cognitive Approach for Seniors (MBCAS): Program Development and Implementation.

PubMed

Zellner Keller, Brigitte; Singh, Nirbhay N; Winton, Alan S W

2014-01-01

A number of cognitive interventions have been developed to enhance cognitive functioning in the growing population of the elderly. We describe the Mindfulness-Based Cognitive Approach for Seniors (MBCAS), a new training program designed especially for seniors. It was conceived in the context of self-development for seniors who wish to enhance their relationship with their inner and outer selves in order to navigate their aging process more easily and fluently. Physical and psychosocial problems related to aging, as well as some temporal issues, were taken into account in developing this program. Unlike clinically oriented mindfulness-based programs, which are generally delivered during an 8-week period, the MBCAS training program is presented over a period of 8 months. The main objectives of this program are to teach seniors to observe current experiences with nonjudgmental awareness, to identify automatic behaviors or reactions to current experiences that are potentially nonadaptive, and to enhance and reinforce positive coping with typical difficulties that they face in their daily lives. Details of the program development and initial implementation are presented, with suggestions for evaluating the program's effectiveness.

Swallowing Trouble

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Pediatric Sinusitis

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Deviated Septum

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Sinus Surgery

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Mouth Sores

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Nose Surgery

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Stuffy Nose

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A clinical database management system for improved integration of the Veterans Affairs Hospital Information System.

PubMed

Andrews, R D; Beauchamp, C

1989-12-01

The Department of Veterans Affairs (VA) Decentralized Hospital Computer Program (DHCP) contains data modules derived from separate ancillary services (e.g., Lab, Pharmacy and Radiology). It is currently difficult to integrate information between the modules. A prototype is being developed aimed at integrating ancillary data by storing clinical data oriented to the patient so that there is easy interaction of data from multiple services. A set of program utilities provides for user-defined functions of decision support, queries, and reports. Information can be used to monitor quality of care by providing feedback in the form of reports, and reminders. Initial testing has indicated the prototype's design and implementation are feasible (in terms of space requirements, speed, and ease of use) in outpatient and inpatient settings. The design, development, and clinical use of this prototype are described.

Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors.

PubMed

Langenau, Erik E; Zhang, Xiuyuan; Roberts, William L; DeChamplain, Andre F; Boulet, John R

2012-01-01

High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC) were conducted to determine consistency across different specialties. Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered 'important' or 'extremely important' to assess: sterile technique (93.8%), advanced cardiovascular life support (ACLS) (91.1%), basic life support (BLS) (90.0%), interpretation of electrocardiogram (89.4%) and blood gas (88.7%). Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later) and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%), sterile technique (67.2%), BLS (68.9%), ACLS (65.9%) and phlebotomy (63.5%). Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the first year of residency training or later. Gathering data from residency program directors provides support for developing new assessment tools in high-stakes licensing examinations.

Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors

PubMed Central

Langenau, Erik E.; Zhang, Xiuyuan; Roberts, William L.; DeChamplain, Andre F.; Boulet, John R.

2012-01-01

Background High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC) were conducted to determine consistency across different specialties. Results Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%), advanced cardiovascular life support (ACLS) (91.1%), basic life support (BLS) (90.0%), interpretation of electrocardiogram (89.4%) and blood gas (88.7%). Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later) and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%), sterile technique (67.2%), BLS (68.9%), ACLS (65.9%) and phlebotomy (63.5%). Discussion Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the first year of residency training or later. Conclusions Gathering data from residency program directors provides support for developing new assessment tools in high-stakes licensing examinations. PMID:22833698

Quality Assurance Through Quality Improvement and Professional Development in the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Siegl, Elvira J.; Miller, Jacqueline W.; Khan, Kris; Harris, Susan E.

2015-01-01

Quality assurance (QA) is the process of providing evidence that the outcome meets the established standards. Quality improvement (QI), by contrast, is the act of methodically developing ways to meet acceptable quality standards and evaluating current processes to improve overall performance. In the case of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), the desired outcome is the delivery of quality health care services to program clients. The NBCCEDP provides professional development to ensure that participating providers have current knowledge of evidence-based clinical standards regarding breast and cervical cancer screening and diagnosis and are monitoring women with abnormal screening results for timely follow-up. To assess the quality of clinical care provided to NBCCEDP clients, performance data are collected by NBCCEDP grantees and compared against predetermined Centers for Disease Control and Prevention (CDC) benchmarks known as Data Quality Indicator Guides. In this article, the authors describe 1) the development and use of indicators for QI in the NBCCEDP and 2) the professional development activities implemented to improve clinical outcomes. QA identifies problems, whereas QI systematically corrects them. The quality of service delivery and improved patient outcomes among NBCCEDP grantees has enhanced significantly because of continuous monitoring of performance and professional development. By using QA, NBCCEDP grantees can maximize the quality of patient screening, diagnostic services, and follow-up. Examples of grantee activities to maintain quality of care are also described in this report. PMID:25099901

Assessing program efficiency: a time and motion study of the Mental Health Emergency Care - Rural Access Program in NSW Australia.

PubMed

Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell

2014-07-31

The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas.

Promoting diversity through program websites: A multicultural content analysis of school psychology program websites.

PubMed

Smith, Leann V; Blake, Jamilia J; Graves, Scott L; Vaughan-Jensen, Jessica; Pulido, Ryne; Banks, Courtney

2016-09-01

The recruitment of culturally and linguistically diverse students to graduate programs is critical to the overall growth and development of school psychology as a field. Program websites serve as an effective recruitment tool for attracting prospective students, yet there is limited research on how school psychology programs use their websites to recruit diverse students. The purpose of this study was to evaluate whether school psychology program websites include sufficient levels of diversity-related content critical for attracting diverse applicants. The website content of 250 professional psychology programs (165 school psychology training programs and 85 clinical and counseling psychology programs) were examined for the presence of themes of diversity and multiculturalism that prospective racially/ethnically and linguistically diverse students deem important for selecting a graduate program. Results indicated that school psychology programs had less diversity-related content on their program's website relative to clinical and counseling psychology programs.' Implications for improving recruitment of racially/ethnically and linguistically diverse students through websites are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Mandatory communication training of all employees with patient contact.

PubMed

Ammentorp, Jette; Graugaard, Lars Toke; Lau, Marianne Engelbrecht; Andersen, Troels Præst; Waidtløw, Karin; Kofoed, Poul-Erik

2014-06-01

In 2010 a communication program that included mandatory communication skills training for all employees with patient contact was developed and launched at a large regional hospital in Denmark. We describe the communication program, the implementation process, and the initial assessment of the process to date. The cornerstone of the program is a communication course based on the Calgary Cambridge Guide and on the experiences of several efficacy and effectiveness studies conducted at the same hospital. The specific elements of the program are described in steps and a preliminary assessment based on feedback from the departments will be presented. The elements of the communication program are as follows: (1) education of trainers; (2) courses for health professionals employed in clinical departments; (3) education of new staff; (4) courses for health professionals in service departments; and (5) maintenance of communication skills. Thus far, 70 of 86 staff have become certified trainers and 17 of 18 departments have been included in the program. Even though the communication program is resource-intensive and competes with several other development projects in the clinical departments, the experiences of the staff and the managers are positive and the program continues as planned. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Diagnostics Research and Development Resources | Resources | CDP

Cancer.gov

The Cancer Diagnosis Program strives to improve the diagnosis and assessment of cancer by effectively moving new scientific knowledge into clinical practice. This national program stimulates, coordinates and funds resources and research for the development of innovative in vitro diagnostics, novel diagnostic technologies and appropriate human specimens in order to better characterize cancers and allow improved medical decision making and evaluation of response to treatment.

Service and Science in Times of Crisis: Developing, Planning, and Implementing a Clinical Research Program for Children Traumatically Bereaved after 9/11

ERIC Educational Resources Information Center

Goodman, Robin F.; Brown, Elissa J.

2008-01-01

September 11, 2001 was a tragedy unparalleled in the United States, resulting in the largest number of parentally bereaved children from a single terrorist incident. The event necessitated swift and sensitive development of programs to meet the needs of bereaved children and their families, and it offered a rare opportunity to investigate the…

From the bush to the big smoke--development of a hybrid urban community based medical education program in the Northern Territory, Australia.

PubMed

Morgan, S; Smedts, A; Campbell, N; Sager, R; Lowe, M; Strasser, S

2009-01-01

The Northern Territory (NT) of Australia is a unique setting for training medical students. This learning environment is characterised by Aboriginal health and an emphasis on rural and remote primary care practice. For over a decade the NT Clinical School (NTCS) of Flinders University has been teaching undergraduate medical students in the NT. Community based medical education (CBME) has been demonstrated to be an effective method of learning medicine, particularly in rural settings. As a result, it is rapidly gaining popularity in Australia and other countries. The NTCS adopted this model some years ago with the implementation of its Rural Clinical School; however, urban models of CBME are much less well developed than those in rural areas. There is considerable pressure to better incorporate CBME into medical student teaching environment, particularly because of the projected massive increase in student numbers over the next few years. To date, the community setting of urban Darwin, the NT capital city, has not been well utilised for medical student training. In 2008, the NTCS enrolled its first cohort of students in a new hybrid CBME program based in urban Darwin. This report describes the process and challenges involved in development of the program, including justification for a hybrid model and the adaptation of a rural model to an urban setting. Relationships were established and formalised with key partners and stakeholders, including GPs and general practices, Aboriginal medical services, community based healthcare providers and other general practice and community organisations. Other significant issues included curriculum development and review, development of learning materials and the establishment of robust evaluation methods. Development of the CBME model in Darwin posed a number of key challenges. Although the experience of past rural programs was useful, a number of distinct differences were evident in the urban setting. Change leadership and inter-professional collaboration were key strengths in the implementation and ongoing evaluation of the program. The program will provide important information about medical student training in urban community settings, and help inform other clinical schools considering the adoption of similar models.

Creating a "culture of research" in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program.

PubMed

Dimond, Eileen P; St Germain, Diane; Nacpil, Lianne M; Zaren, Howard A; Swanson, Sandra M; Minnick, Christopher; Carrigan, Angela; Denicoff, Andrea M; Igo, Kathleen E; Acoba, Jared D; Gonzalez, Maria M; McCaskill-Stevens, Worta

2015-06-01

The value of community-based cancer research has long been recognized. In addition to the National Cancer Institute's Community Clinical and Minority-Based Oncology Programs established in 1983, and 1991 respectively, the National Cancer Institute established the National Cancer Institute Community Cancer Centers Program in 2007 with an aim of enhancing access to high-quality cancer care and clinical research in the community setting where most cancer patients receive their treatment. This article discusses strategies utilized by the National Cancer Institute Community Cancer Centers Program to build research capacity and create a more entrenched culture of research at the community hospitals participating in the program over a 7-year period. To facilitate development of a research culture at the community hospitals, the National Cancer Institute Community Cancer Centers Program required leadership or chief executive officer engagement; utilized a collaborative learning structure where best practices, successes, and challenges could be shared; promoted site-to-site mentoring to foster faster learning within and between sites; required research program assessments that spanned clinical trial portfolio, accrual barriers, and outreach; increased identification and use of metrics; and, finally, encouraged research team engagement across hospital departments (navigation, multidisciplinary care, pathology, and disparities) to replace the traditionally siloed approach to clinical trials. The health-care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors (e.g. institutional review board reviews, physician interest, and trial availability). The National Cancer Institute Community Cancer Centers Program sites, as program participants, had access to the required resources and support to develop and implement the strategies described. Metrics are an important component yet often challenging to identify and collect. The model requires a strong emphasis on outreach that challenges hospitals to improve and expand their reach, particularly into underrepresented populations and catchment areas. These efforts build on trust and a referral pipeline within the community which take time and significant commitment to establish. The National Cancer Institute Community Cancer Centers Program experience provides a relevant model to broadly address creating a culture of research in community hospitals that are increasingly networked via systems and consortiums. The strategies used align well with the National Cancer Institute-American Society of Clinical Oncology Accrual Symposium recommendations for patient-/community-, physician-/provider-, and site-/organizational-level approaches to clinical trials; they helped sites achieve organizational culture shifts that enhanced their cancer research programs. The National Cancer Institute Community Cancer Centers Program hospitals reported that the strategies were challenging to implement yet proved valuable as they provided useful metrics for programmatic assessment, planning, reporting, and growth. While focused on oncology trials, these concepts may be useful within other disease-focused research as well. © The Author(s) 2015.

Supplementing Resident Research Funding Through a Partnership With Local Industry.

PubMed

Skube, Steven J; Arsoniadis, Elliot G; Jahansouz, Cyrus; Novitsky, Sherri; Chipman, Jeffrey G

2018-01-17

To develop a model for the supplementation of resident research funding through a resident-hosted clinical immersion with local industry. Designated research residents hosted multiple groups of engineers and business professionals from local industry in general surgery-focused clinical immersion weeks. The participants in these week-long programs are educated about general surgery and brought to the operating room to observe a variety of surgeries. This study was performed at the University of Minnesota, in Minneapolis, Minnesota, at a tertiary medical center. Ten designated research residents hosted general surgery immersion programs. Fifty-seven engineers and business professionals from 5 different local biomedical firms have participated in this program. General surgery research residents (in collaboration with the University of Minnesota's Institute for Engineering in Medicine) have hosted 9 clinical immersion programs since starting the collaborative in 2015. Immersion participant response to the experiences was very positive. Two full-time resident research positions can be funded annually through participation in this program. With decreasing funding available for surgical research, particularly resident research, innovative ways to fund resident research are needed. The general surgery clinical immersion program at the University of Minnesota has proven its value as a supplement for resident research funding and may be a sustainable model for the future. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Closing the gap between science and practice: the need for professional leadership.

PubMed

Eagle, Kim A; Garson, Arthur J; Beller, George A; Sennett, Cary

2003-01-01

Major opportunity exists to better align clinical science and clinical practice. To do so will require efforts not only to develop clinical practice guidelines, but to facilitate their application in practice. The American College of Cardiology operates a program to develop and assess the effectiveness of tools that facilitate the application of guidelines in practice. Here we review what we have learned about the process of guideline implementation, lay out the major research questions that need to be addressed, and argue that professional societies play a critical role in moving from guideline development to application.

Creating trauma-informed correctional care: a balance of goals and environment

PubMed Central

Miller, Niki A.; Najavits, Lisa M.

2012-01-01

Background Rates of posttraumatic stress disorder and exposure to violence among incarcerated males and females in the US are exponentially higher than rates among the general population; yet, abrupt detoxification from substances, the pervasive authoritative presence and sensory and environmental trauma triggers can pose a threat to individual and institutional stability during incarceration. Objective The authors explore the unique challenges and promises of trauma-informed correctional care and suggest strategies for administrative support, staff development, programming, and relevant clinical approaches. Method A review of literature includes a comparison of gendered responses, implications for men's facilities, and the compatibility of trauma recovery goals and forensic programming goals. Results Trauma-informed care demonstrates promise in increasing offender responsivity to evidence-based cognitive behavioral programming that reduces criminal risk factors and in supporting integrated programming for offenders with substance abuse and co-occurring disorders. Conclusions Incorporating trauma recovery principles into correctional environments requires an understanding of criminal justice priorities, workforce development, and specific approaches to screening, assessment, and programming that unify the goals of clinical and security staff. PMID:22893828

Perspectives in medical education 7. Observations on clinical training at a "US-style" residency program at Teine Keijinkai Hospital in Sapporo, Japan.

PubMed

Rao, R Harsha

2009-06-01

The residency program at Teine Keijinkai Hospital in Sapporo has successfully implemented a training philosophy that is focused on the development of clinical skills and critical thinking in Japanese residents. Several elements contribute to its success. The first and foremost is visionary physician leadership, beginning with the pioneers who implemented the philosophy, and continuing through the current leadership, which has sustained the original vision. A close second is the administrative and financial commitment to invest in producing more clinically accomplished Japanese physicians, long before that need was officially recognized. Third is the program's explicit aim of adhering to international norms by requiring three years of training, promulgating a benevolent, not paternalistic teaching philosophy and encouraging an interactive and interrogatory learning ethic. Fourth is the year-round presence of a US-trained Physician-in-Residence, to sustain the focus on clinical skills and international norms. Fifth is a long-term relationship with the Internal Medicine Training Program at the University of Pittsburgh, providing a conduit for ongoing academic exchange and programmatic advice. Last, but not least, is its avowed intention of being viewed as an "American-style program" with a preference for English fluent applicants, which acts as a magnet for trainees motivated to acquire clinical skills and competencies, with an eye to future training in the US. All these elements contribute to the program's unique focus on teaching clinical skills and critical thinking. Others who are striving with varying degrees of success to implement a similar philosophy in Japan may benefit from studying its example.

Translation of an Evidence-Based Tailored Childhood Injury Prevention Program

PubMed Central

Weaver, Nancy L.; Williams, Janice; Jacobsen, Heather A.; Botello-Harbaum, Maria; Glasheen, Cristie; Noelcke, Elizabeth; Nansel, Tonja R.

2008-01-01

This article describes the process of translating Safe n’ Sound, a computer-based program for parents of young children, for a general clinic environment. Safe n’ Sound is designed to reduce the risk of unintentional childhood injuries, the leading cause of death among children older than 1 year in the United States. The evidence-based program produces tailored information for parents and their healthcare provider about burns, falls, poisoning, drowning, suffocations, choking prevention, and car safety. To offer Safe n’ Sound to a broader audience, we translated the program from the form used for efficacy testing to a stand-alone application. Notable steps in this translation included (1) conducting an organizational assessment to determine the needs of the clinic staff and feasibility of implementation, (2) modifying the program to reduce length, prioritize risk areas, and update content, (3) repackaging the program to minimize cost and space requirements, and (4) developing promotional and instructional materials. Factors contributing to the success of this effort include strong collaborative partnerships, the relative advantage of Safe n’ Sound over traditional materials, the modifiable design of the program, and the support of the clinic staff and providers. Challenges and areas for future work are discussed. PMID:18287925

An official American Thoracic Society policy statement: pay-for-performance in pulmonary, critical care, and sleep medicine.

PubMed

Kahn, Jeremy M; Scales, Damon C; Au, David H; Carson, Shannon S; Curtis, J Randall; Dudley, R Adams; Iwashyna, Theodore J; Krishnan, Jerry A; Maurer, Janet R; Mularski, Richard; Popovich, John; Rubenfeld, Gordon D; Sinuff, Tasnim; Heffner, John E

2010-04-01

Pay-for-performance is a model for health care financing that seeks to link reimbursement to quality. The American Thoracic Society and its members have a significant stake in the development of pay-for-performance programs. To develop an official ATS policy statement addressing the role of pay-for-performance in pulmonary, critical care and sleep medicine. The statement was developed by the ATS Health Policy Committee using an iterative consensus process including an expert workshop and review by ATS committees and assemblies. Pay-for-performance is increasingly utilized by health care purchasers including the United States government. Published studies generally show that programs result in small but measurable gains in quality, although the data are heterogeneous. Pay-for-performance may result in several negative consequences, including the potential to increase costs, worsen health outcomes, and widen health disparities, among others. Future research should be directed at developing reliable and valid performance measures, increasing the efficacy of pay-for-performance programs, minimizing negative unintended consequences, and examining issues of costs and cost-effectiveness. The ATS and its members can play a key role in the design and evaluation of these programs by advancing the science of performance measurement, regularly developing quality metrics alongside clinical practice guidelines, and working with payors to make performance improvement a routine part of clinical practice. Pay-for-performance programs will expand in the coming years. Pulmonary, critical care and sleep practitioners can use these programs as an opportunity to partner with purchasers to improve health care quality.

A Hospital Clinic Early Intervention Program.

ERIC Educational Resources Information Center

Simser, Judith I.; Steacie, Pamela

1993-01-01

The Aural Habilitation Program of Children's Hospital of Eastern Ontario (Canada) provides weekly, individualized aural habilitation sessions for parents of young children with hearing impairments and offers guidance in creating a listening, learning environment in the home. Strategies for developing parents' skills and confidence are described.…

Evaluation through research of a three-track career ladder program for registered nurses.

PubMed

Korman, Carol; Eliades, Aris Beoglos

2010-01-01

A descriptive study design was employed to survey registered nurse participants in a career ladder program comprising of three tracks: clinical, education, and management. Findings indicate that participation allows nurses of varying education preparation and roles to demonstrate professional development. Implications for staff development include efficacy of the online survey technique, provision of a reliable tool to evaluate a career ladder, and evaluation of a career ladder that includes the staff development educator.

Center to Advance Palliative Care palliative care clinical care and customer satisfaction metrics consensus recommendations.

PubMed

Weissman, David E; Morrison, R Sean; Meier, Diane E

2010-02-01

Data collection and analysis are vital for strategic planning, quality improvement, and demonstration of palliative care program impact to hospital administrators, private funders and policymakers. Since 2000, the Center to Advance Palliative Care (CAPC) has provided technical assistance to hospitals, health systems and hospices working to start, sustain, and grow nonhospice palliative care programs. CAPC convened a consensus panel in 2008 to develop recommendations for specific clinical and customer metrics that programs should track. The panel agreed on four key domains of clinical metrics and two domains of customer metrics. Clinical metrics include: daily assessment of physical/psychological/spiritual symptoms by a symptom assessment tool; establishment of patient-centered goals of care; support to patient/family caregivers; and management of transitions across care sites. For customer metrics, consensus was reached on two domains that should be tracked to assess satisfaction: patient/family satisfaction, and referring clinician satisfaction. In an effort to ensure access to reliably high-quality palliative care data throughout the nation, hospital palliative care programs are encouraged to collect and report outcomes for each of the metric domains described here.

Using an imaginary scrapbook for neurolinguistic programming in the aftermath of a clinical depression: a case history.

PubMed

Hossack, A; Standidge, K

1993-04-01

We employed neurolinguistic programming (NLP) principles to develop a positive self-identity in an elderly male patient in England recovering from clinical depression. This novel technique encouraged recall of intrinsically rewarding past experiences. Each experience was conceptualized in an image and compiled chronologically in an imaginary book, providing continuity to what were chaotic and fragmented recollections during the immediate postdepressive stage. The patient's anxiety and depression were alleviated and his own functional goals largely realized.

Flexible Reporting of Clinical Data

PubMed Central

Andrews, Robert D.

1987-01-01

Two prototype methods have been developed to aid in the presentation of relevant clinical data: 1) an integrated report that displays results from a patient's computer-stored data and also allows manual entry of data, and 2) a graph program that plots results of multiple kinds of tests. These reports provide a flexible means of displaying data to help evaluate patient treatment. The two methods also explore ways of integrating the display of data from multiple components of the Veterans Administration's (VA) Decentralized Hospital Computer Program (DHCP) database.

Improving Warfarin Management Within the Medical Home: A Health-System Approach.

PubMed

Rose, Anne E; Robinson, Erin N; Premo, Joan A; Hauschild, Lori J; Trapskin, Philip J; McBride, Ann M

2017-03-01

Anticoagulation clinics have been considered the optimal strategy for warfarin management with demonstrated improved patient outcomes through increased time in therapeutic international normalized ratio (INR) range, decreased critical INR values, and decreased anticoagulation-related adverse events. However, not all health systems are able to support a specialized anticoagulation clinic or may see patient volume exceed available anticoagulation clinic resources. The purpose of this study was to utilize an anticoagulation clinic model to standardize warfarin management in a primary care clinic setting. A warfarin management program was developed that included standardized patient assessment, protocolized warfarin-dosing algorithm, and electronic documentation and reporting tools. Primary care clinics were targeted for training and implementation of this program. The warfarin management program was applied to over 2000 patients and implemented at 39 clinic sites. A total of 160 nurses and 15 pharmacists were trained on the program. Documentation of warfarin dose and date of the next INR increased from 70% to 90% (P <.0001), documentation occurring within 24 hours of the INR result increased from 75% to 87% (P <.0001), and monitoring the INR at least every 4 weeks increased from 71% to 83% (P <.0001) per patient encounter. Time in therapeutic INR range improved from 65% to 75%. Incorporating a standardized approach to warfarin management in the primary care setting significantly improves warfarin-related documentation and time in therapeutic INR range. Copyright © 2016 Elsevier Inc. All rights reserved.

Cochlear-Meningitis Vaccination

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Find an ENT

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Smell and Taste

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Voice and Aging

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Tongue-Tie (Ankyloglossia)

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Tonsils and Adenoids

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Pediatric Thyroid Cancer

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Fine Needle Aspiration

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Ear Plastic Surgery

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Ears and Altitude

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About Your Voice

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Evaluation of a case-based urology learning program.

PubMed

Mishra, Kirtishri; Snow-Lisy, Devon C; Ross, Jonathan; Goldfarb, David A; Goldman, Howard; Campbell, Steven C

2013-12-01

To address the challenges that today's trainees encounter, such as information overload and reduced immersion in the field, and recognizing their preference for novel educational resources, an electronic case-based urology learning program was developed. Each case was designed to illustrate the basic principles of the disease process and the fundamentals of evaluation and management using the Socratic method, recapitulating a prototypical patient encounter. A 21-question survey was developed after review of published reports of classroom and clinical learning environment surveys. The target group was 2 pilot urology training programs (the Cleveland Clinic and University Hospitals-Case Medical Center). The responses were entirely anonymous. A total of 32 trainees participated (8 fellows and 24 residents), representing a 53% response rate. Most trainees (79%) were able to process cases within an average of ≤ 10 minutes. Of the trainees, 91% reported referring back to particular cases for patient care, to review for examinations, or for studying. Most trainees believed a case-based urology learning program would be a potentially important resource for clinical practice (69%) and for preparing for the in-service (63%) or board (69%) examinations. Most trainees believed the program met its goals of illustrating the basics principles of the disease process (88%), outlining the fundamentals of evaluation and management (94%), and improving the trainees' knowledge base (91%). An electronic case-based urology learning program is feasible and useful and stimulates learning at all trainee levels. Copyright © 2013 Elsevier Inc. All rights reserved.

Training competent and effective Primary Health Care Workers to fill a void in the outer islands health service delivery of the Marshall Islands of Micronesia.

PubMed

Keni, Bhalachandra H

2006-12-15

Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities. In an effort to remedy the effectiveness of health care delivery to these islands, a program to train mid-level health care workers (Hospital Assistants) was developed and implemented by the Ministry of Health in conjunction with the hospital in Majuro, the capital city of the Marshall Islands. A physician instructor with experience and expertise in primary health care in these regions conducted the program. The curriculum included training in basic health science, essentials of endemic disorders and their clinical management appropriate to the outer islands. Emphasis was given to prevention and health promotion as well as to the curative aspects. For clinical observation, the candidates were assigned to clinical departments of the Majuro hospital for 1 year during their training, as assistants to the nursing staff. This paper discusses the details of the training, the modalities used to groom the candidates, and an assessment of the ultimate effectiveness of the program. Out of 16 boys who began training, 14 candidates were successful in completing the program. In 1998 a similar program was conducted exclusively for women under the auspices of Asian Development Bank funding, hence women were not part of this program. For developing countries of the Pacific, appropriately trained human resources are an essential component of economic progress, and the health workforce is an important part of human resources for sustainable progress and development.

Training competent and effective Primary Health Care Workers to fill a void in the outer islands health service delivery of the Marshall Islands of Micronesia

PubMed Central

Keni, Bhalachandra H

2006-01-01

Background Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities. In an effort to remedy the effectiveness of health care delivery to these islands, a program to train mid-level health care workers (Hospital Assistants) was developed and implemented by the Ministry of Health in conjunction with the hospital in Majuro, the capital city of the Marshall Islands. Methods A physician instructor with experience and expertise in primary health care in these regions conducted the program. The curriculum included training in basic health science, essentials of endemic disorders and their clinical management appropriate to the outer islands. Emphasis was given to prevention and health promotion as well as to the curative aspects. For clinical observation, the candidates were assigned to clinical departments of the Majuro hospital for 1 year during their training, as assistants to the nursing staff. This paper discusses the details of the training, the modalities used to groom the candidates, and an assessment of the ultimate effectiveness of the program. Results Out of 16 boys who began training, 14 candidates were successful in completing the program. In 1998 a similar program was conducted exclusively for women under the auspices of Asian Development Bank funding, hence women were not part of this program. Conclusion For developing countries of the Pacific, appropriately trained human resources are an essential component of economic progress, and the health workforce is an important part of human resources for sustainable progress and development. PMID:17173693

Program development and defining characteristics of returning military in a VA Polytrauma Network Site.

PubMed

Lew, Henry L; Poole, John H; Vanderploeg, Rodney D; Goodrich, Gregory L; Dekelboum, Sharon; Guillory, Sylvia B; Sigford, Barbara; Cifu, David X

2007-01-01

The conflicts in Iraq and Afghanistan have resulted in a new generation of combat survivors with complex physical injuries and emotional trauma. This article reports the initial implementation of the Polytrauma Network Site (PNS) clinic, which is a key component of the Department of Veterans Affairs (VA) Polytrauma System of Care and serves military personnel returning from combat. The PNS clinic in Palo Alto, California, is described to demonstrate the VA healthcare system's evolving effort to meet the clinical needs of this population. We summarize the following features of this interdisciplinary program: (1) sequential assessment, from initial traumatic brain injury screening throughout our catchment area to evaluation by the PNS clinic team, and (2) clinical evaluation results for the first 62 clinic patients. In summary, this population shows a high prevalence of postconcussion symptoms, posttraumatic stress, poor cognitive performance, head and back pain, auditory and visual symptoms, and problems with dizziness or balance. An anonymous patient feedback survey, which we used to fine-tune the clinic process, reflected high satisfaction with this new program. We hope that the lessons learned at one site will enhance the identification and treatment of veterans with polytrauma across the country.

Continuous glucose monitoring technology for personal use: an educational program that educates and supports the patient.

PubMed

Evert, Alison; Trence, Dace; Catton, Sarah; Huynh, Peter

2009-01-01

The purpose of this article is to describe the development and implementation of an educational program for the initiation of real-time continuous glucose monitoring (CGM) technology for personal use, not 3-day CGMS diagnostic studies. The education program was designed to meet the needs of patients managing their diabetes with either diabetes medications or insulin pump therapy in an outpatient diabetes education center using a team-based approach. Observational research, complemented by literature review, was used to develop an educational program model and teaching strategies. Diabetes educators, endocrinologists, CGM manufacturer clinical specialists, and patients with diabetes were also interviewed for their clinical observations and experience. The program follows a progressive educational model. First, patients learn in-depth about real-time CGM technology by attending a group presensor class that provides detailed information about CGM. This presensor class facilitates self-selection among patients concerning their readiness to use real-time CGM. If the patient decides to proceed with real-time CGM use, CGM initiation is scheduled, using a clinic-centered protocol for both start-up and follow-up. Successful use of real-time CGM involves more than just patient enthusiasm or interest in a new technology. Channeling patient interest into a structured educational setting that includes the benefits and limitations of real-time CGM helps to manage patient expectations.

Innovation in organ transplantation: A meeting report.

PubMed

Fishman, Jay A; Greenwald, Melissa

2018-05-09

This workshop targeted opportunities to stimulate transformative innovation in organ transplantation. Participants reached consensus regarding the following: (1) Mechanisms are needed to improve the coordination of policy and oversight activities, given overlapping responsibilities for transplantation and clinical investigation among federal agencies. Innovative clinical trials span traditional administrative boundaries and include stakeholders with diverse interests. Participants identified the need for a governmental interagency working group to coordinate nationwide transplant-related activities. (2) Improvements are required in clinical metrics for transplantation, with alignment of performance goals across transplantation organizations and any development of data requirements being consistent with those goals. Database coordination among clinical centers, organ procurement organizations, regulatory agencies, and payers would facilitate research and better inform policy. New data requirements should provide actionable insights into clinical performance. (3) Innovative research seen as potentially adversely affecting Program-Specific Reports may reduce centers' participation. Cutting-edge research requires mitigation of risk-aversive behaviors created by reporting of clinical outcomes data. Participants proposed a new review process in advance of implementation of clinical trials to guide "carve-outs" of transplant center outcomes data from Program-Specific Reports. Clinical transplantation will be advanced by the development of a shared and comprehensive research agenda to facilitate coordination of research and policy. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

Clinical Assessment of Family Caregivers in Dementia.

ERIC Educational Resources Information Center

Rankin, Eric D.; And Others

1992-01-01

Evaluated development of integrated family assessment inventory based on Double ABCX and Circumplex models of family functioning and its clinical utility with 121 primary family caregivers from cognitive disorders program. Proposed model predicted significant proportion of variance associated with caregiver stress and strain. Several aspects of…