licensure medical: Topics by Science.gov

Sample records for licensure medical

American Medical Technologists' (AMT) Position on Licensure for Medical Laboratory Personnel.

ERIC Educational Resources Information Center

American Medical Technologists, Park Ridge, IL.

The American Medical Technologists organization opposes licensure for medical laboratory personnel unless there is consensus among all the groups representing generalist laboratory practitioners as to qualifications, titles, accreditation, and certification policies. Licensure is a restrictive and protectionistic measure, and American Medical…
The future of medical licensure in the United States.

PubMed

Thompson, James N

2006-12-01

Medical licensure in the United States is undergoing significant change. With calls for greater accountability and transparency, state medical boards and their membership association, the Federation of State Medical Boards (FSMB), are seeking ways to assure the public that physicians are maintaining their competence throughout the lifetime of their practice of medicine. At present, competence in cognitive, clinical, and communicative skills is regularly measured only at initial licensure. Yet, the public and policy-related organizations are demanding ongoing assessment of physicians' ability to safely and competently practice medicine. The author reports on activities that involve the FSMB and other national organizations, including the Educational Commission for Foreign Medical Graduates, in planning for a future of increased accountability and transparency of the licensing and regulatory communities that oversee the practice of medicine. He notes that topics of discussion include possible nationalization of what has been traditionally state-based licensure. He raises questions about a future that may include specialty-based licensure and greater national and even international license portability.
Contemporary issues: The pre-licensure nursing student and medication errors.

PubMed

Green, Cheryl

2018-06-01

In Modern health care, the creation of cultures of safety for patients is of the upmost importance. Impacting the institutional stabilization of health care facilities safety initiatives, is the preparation of pre-licensure nursing students to safely administer medications to patients. Therefore, preparation of the pre-licensure nursing student must be evidence-based practice focused and incorporate innovative ways to reduce the potential for medication errors. Copyright © 2018. Published by Elsevier Ltd.
Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions.

PubMed

Dyrbye, Liselotte N; West, Colin P; Sinsky, Christine A; Goeders, Lindsey E; Satele, Daniel V; Shanafelt, Tait D

2017-10-01

To determine whether state medical licensure application questions (MLAQs) about mental health are related to physicians' reluctance to seek help for a mental health condition because of concerns about repercussions to their medical licensure. In 2016, we collected initial and renewal medical licensure application forms from 50 states and the District of Columbia. We coded MLAQs related to physicians' mental health as "consistent" if they inquired only about current impairment from a mental health condition or did not ask about mental health conditions. We obtained data on care-seeking attitudes for a mental health problem from a nationally representative convenience sample of 5829 physicians who completed a survey between August 28, 2014, and October 6, 2014. Analyses explored relationships between state of employment, MLAQs, and physicians' reluctance to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their medical licensure. We obtained initial licensure applications from 51 of 51 (100%) and renewal applications from 48 of 51 (94.1%) medical licensing boards. Only one-third of states currently have MLAQs about mental health on their initial and renewal application forms that are considered consistent. Nearly 40% of physicians (2325 of 5829) reported that they would be reluctant to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their medical licensure. Physicians working in a state in which neither the initial nor the renewal application was consistent were more likely to be reluctant to seek help (odds ratio, 1.21; 95% CI, 1.07-1.37; P=.002 vs both applications consistent). Our findings support that MLAQs regarding mental health conditions present a barrier to physicians seeking help. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
State medical licensure for telemedicine and teleradiology.

PubMed

Hunter, Tim B; Weinstein, Ronald S; Krupinski, Elizabeth A

2015-04-01

Physician medical licensure is state based for historical and constitutional reasons. It may also provide the best method for guaranteeing patient protection from unqualified, incompetent, impaired, or unprofessional practitioners of medicine. However, a significant cost for physicians practicing telemedicine is having to obtain multiple state medical licenses. There is reasonable likelihood that model legislation for the practice of telemedicine across state boundaries will be passed in the next few years, providing physicians with a simpler process for license reciprocity in multiple states via interstate licensing compacts. Physicians would have to be licensed in the state in which the patient resides. Patient complaints would still be adjudicated by the medical licensing board in the state where the patient resides according applicable state legislation.
Three controversies over item disclosure in medical licensure examinations

PubMed Central

Park, Yoon Soo; Yang, Eunbae B.

2015-01-01

In response to views on public's right to know, there is growing attention to item disclosure – release of items, answer keys, and performance data to the public – in medical licensure examinations and their potential impact on the test's ability to measure competence and select qualified candidates. Recent debates on this issue have sparked legislative action internationally, including South Korea, with prior discussions among North American countries dating over three decades. The purpose of this study is to identify and analyze three issues associated with item disclosure in medical licensure examinations – 1) fairness and validity, 2) impact on passing levels, and 3) utility of item disclosure – by synthesizing existing literature in relation to standards in testing. Historically, the controversy over item disclosure has centered on fairness and validity. Proponents of item disclosure stress test takers’ right to know, while opponents argue from a validity perspective. Item disclosure may bias item characteristics, such as difficulty and discrimination, and has consequences on setting passing levels. To date, there has been limited research on the utility of item disclosure for large scale testing. These issues requires ongoing and careful consideration. PMID:26374693
Three controversies over item disclosure in medical licensure examinations.

PubMed

Park, Yoon Soo; Yang, Eunbae B

2015-01-01

In response to views on public's right to know, there is growing attention to item disclosure - release of items, answer keys, and performance data to the public - in medical licensure examinations and their potential impact on the test's ability to measure competence and select qualified candidates. Recent debates on this issue have sparked legislative action internationally, including South Korea, with prior discussions among North American countries dating over three decades. The purpose of this study is to identify and analyze three issues associated with item disclosure in medical licensure examinations - 1) fairness and validity, 2) impact on passing levels, and 3) utility of item disclosure - by synthesizing existing literature in relation to standards in testing. Historically, the controversy over item disclosure has centered on fairness and validity. Proponents of item disclosure stress test takers' right to know, while opponents argue from a validity perspective. Item disclosure may bias item characteristics, such as difficulty and discrimination, and has consequences on setting passing levels. To date, there has been limited research on the utility of item disclosure for large scale testing. These issues requires ongoing and careful consideration.
The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario.

PubMed

Yen, Wendy; Hodwitz, Kathryn; Thakkar, Niels; Martimianakis, Maria Athina Tina; Faulkner, Dan

2016-12-01

The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs) into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO's alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed.
The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario

PubMed Central

Yen, Wendy; Hodwitz, Kathryn; Thakkar, Niels; Martimianakis, Maria Athina (Tina); Faulkner, Dan

2016-01-01

The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs) into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO’s alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed. PMID:28344705
National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.

PubMed

Kinsman, Jeremiah M; Robinson, Kathy

2018-02-27

Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR). State law and scopes of practice were systematically reviewed using a multi-tiered approach to determine each state's legally-defined EMS licensure levels and their authority to administer an opioid antagonist. State law, state EMS websites, and state EMS scope of practice documents were identified and searched using Google Advanced Search with Boolean Search Strings. Initial results of the review were sent to each state office of EMS for review and comment. As of September 1, 2017, 49 states and DC authorize EMTs to administer an opioid antagonist. Among the 40 US jurisdictions (39 states and DC) that define the EMR or a comparable first responder licensure level in state law, 37 states and DC authorize their EMRs to administer an opioid antagonist. Paramedics are authorized to administer opioid antagonists in all 50 states, DC, and PR. All 49 of the US jurisdictions (48 states and DC) that define the advanced emergency medical technician (AEMT) or a comparable intermediate EMS licensure level in state law authorize their AEMTs to administer an opioid antagonist. 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited
Predicting United States Medical Licensure Examination Step 2 clinical knowledge scores from previous academic indicators.

PubMed

Monteiro, Kristina A; George, Paul; Dollase, Richard; Dumenco, Luba

2017-01-01

The use of multiple academic indicators to identify students at risk of experiencing difficulty completing licensure requirements provides an opportunity to increase support services prior to high-stakes licensure examinations, including the United States Medical Licensure Examination (USMLE) Step 2 clinical knowledge (CK). Step 2 CK is becoming increasingly important in decision-making by residency directors because of increasing undergraduate medical enrollment and limited available residency vacancies. We created and validated a regression equation to predict students' Step 2 CK scores from previous academic indicators to identify students at risk, with sufficient time to intervene with additional support services as necessary. Data from three cohorts of students (N=218) with preclinical mean course exam score, National Board of Medical Examination subject examinations, and USMLE Step 1 and Step 2 CK between 2011 and 2013 were used in analyses. The authors created models capable of predicting Step 2 CK scores from academic indicators to identify at-risk students. In model 1, preclinical mean course exam score and Step 1 score accounted for 56% of the variance in Step 2 CK score. The second series of models included mean preclinical course exam score, Step 1 score, and scores on three NBME subject exams, and accounted for 67%-69% of the variance in Step 2 CK score. The authors validated the findings on the most recent cohort of graduating students (N=89) and predicted Step 2 CK score within a mean of four points (SD=8). The authors suggest using the first model as a needs assessment to gauge the level of future support required after completion of preclinical course requirements, and rescreening after three of six clerkships to identify students who might benefit from additional support before taking USMLE Step 2 CK.
Modeling relationships between traditional preadmission measures and clinical skills performance on a medical licensure examination.

PubMed

Roberts, William L; Pugliano, Gina; Langenau, Erik; Boulet, John R

2012-08-01

Medical schools employ a variety of preadmission measures to select students most likely to succeed in the program. The Medical College Admission Test (MCAT) and the undergraduate college grade point average (uGPA) are two academic measures typically used to select students in medical school. The assumption that presently used preadmission measures can predict clinical skill performance on a medical licensure examination was evaluated within a validity argument framework (Kane 1992). A hierarchical generalized linear model tested relationships between the log-odds of failing a high-stakes medical licensure performance examination and matriculant academic and non-academic preadmission measures, controlling for student-and school-variables. Data includes 3,189 matriculants from 22 osteopathic medical schools tested in 2009-2010. Unconditional unit-specific model expected average log-odds of failing the examination across medical schools is -3.05 (se = 0.11) or 5%. Student-level estimated coefficients for MCAT Verbal Reasoning scores (0.03), Physical Sciences scores (0.05), Biological Sciences scores (0.04), uGPA(science) (0.07), and uGPA(non-science) (0.26) lacked association with the log-odds of failing the COMLEX-USA Level 2-PE, controlling for all other predictors in the model. Evidence from this study shows that present preadmission measures of academic ability are not related to later clinical skill performance. Given that clinical skill performance is an important part of medical practice, selection measures should be developed to identify students who will be successful in communication and be able to demonstrate the ability to systematically collect a medical history, perform a physical examination, and synthesize this information to diagnose and manage patient conditions.
Rhode Island Board of Medical Licensure and Discipline: Illustration of the disciplinary process as it pertains to cases involving opioid prescribing.

PubMed

McDonald, James V

Prescription-drug overuse/overdose and misuse is an important and pivotal issue to state medical boards. This is an illustration of how some cases involving overprescribing of opioids have been addressed by the Rhode Island Board of Medical Licensure and Discipline.
Principal Licensure Exams and Future Job Performance: Evidence from the School Leaders Licensure Assessment

ERIC Educational Resources Information Center

Grissom, Jason A.; Mitani, Hajime; Blissett, Richard S. L.

2017-01-01

Many states require prospective principals to pass a licensure exam to obtain an administrative license, but we know little about the potential effects of principal licensure exams on the pool of available principals or whether scores predict later job performance. We investigate the most commonly used exam, the School Leaders Licensure Assessment…
Investigation of Standardized Patient Ratings of Humanistic Competence on a Medical Licensure Examination Using Many-Facet Rasch Measurement and Generalizability Theory

ERIC Educational Resources Information Center

Zhang, Xiuyuan; Roberts, William L.

2013-01-01

Humanistic doctor-patient interaction has been measured for eight years using the Global Patient Assessment (GPA) tool in the national osteopathic clinical skills medical licensure examination. Standardized patients (SPs) apply the GPA tool to rate examinees' competence on doctor-patient communication, interpersonal skills, and professionalism.…
CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores.

PubMed

Dore, Kelly L; Reiter, Harold I; Kreuger, Sharyn; Norman, Geoffrey R

2017-05-01

Typically, only a minority of applicants to health professional training are invited to interview. However, pre-interview measures of cognitive skills predict for national licensure scores (Gauer et al. in Med Educ Online 21 2016) and subsequently licensure scores predict for performance in practice (Tamblyn et al. in JAMA 288(23): 3019-3026, 2002; Tamblyn et al. in JAMA 298(9):993-1001, 2007). Assessment of personal and professional characteristics, with the same psychometric rigour of measures of cognitive abilities, are needed upstream in the selection to health profession training programs. To fill that need, Computer-based Assessment for Sampling Personal characteristics (CASPer)-an on-line, video-based screening test-was created. In this paper, we examine the correlation between CASPer and Canadian national licensure examination outcomes in 109 doctors who took CASPer at the time of selection to medical school. Specifically, CASPer scores were correlated against performance on cognitive and 'non-cognitive' subsections of both the Medical Council of Canada Qualifying Examination (MCCQE) Parts I (end of medical school) and Part II (18 months into specialty training). Unlike most national licensure exams, MCCQE has specific subcomponents examining personal/professional qualities, providing a unique opportunity for comparison. The results demonstrated moderate predictive validity of CASPer to national licensure outcomes of personal/professional characteristics three to six years after admission to medical school. These types of disattenuated correlations (r = 0.3-0.5) are not otherwise predicted by traditional screening measures. These data support the ability of a computer-based strategy to screen applicants in a feasible, reliable test, which has now demonstrated predictive validity, lending evidence of its validation for medical school applicant selection.
The Licensure of Mental Health Counselors.

ERIC Educational Resources Information Center

Hendrikson, Leslie

With the growing number of counselors working outside of school settings, licensure of mental health counselors has become an important issue. A main problem facing counselors is the lack of a clear identity. Licensure would lead to increased professionalism and identification. Licensure is authorized by the state legislature, regulating the…
Novel licensure pathways for expeditious introduction of new tuberculosis vaccines: a discussion of the adaptive licensure concept.

PubMed

Rustomjee, Roxana; Lockhart, Stephen; Shea, Jacqueline; Fourie, P Bernard; Hindle, Zoë; Steel, Gavin; Hussey, Gregory; Ginsberg, Ann; Brennan, Michael J

2014-03-01

The ultimate goal of vaccine development is licensure of a safe and efficacious product that has a well-defined manufacturing process resulting in a high quality product. In general, clinical development and regulatory approval occurs in a linear, sequential manner: Phase 1 - safety, immunogenicity; Phase 2 - immunogenicity, safety, dose ranging and preliminary efficacy; Phase 3 - definitive efficacy, safety, lot consistency; and, following regulatory approval, Phase 4 - post-marketing safety and effectiveness. For candidate TB vaccines, where correlates of protection are not yet identified, phase 2 and 3 efficacy of disease prevention trials are, by necessity, very large. Each trial would span 2-5 years, with full licensure expected only after 1 or even 2 decades of development. Given the urgent unmet need for a new TB vaccine, a satellite discussion was held at the International African Vaccinology Conference in Cape Town, South Africa in November 2012, to explore the possibility of expediting licensure by use of an "adaptive licensure" process, based on a risk/benefit assessment that is specific to regional needs informed by epidemiology. This may be appropriate for diseases such as TB, where high rates of morbidity, mortality, particularly in high disease burden countries, impose an urgent need for disease prevention. The discussion focused on two contexts: licensure within the South African regulatory environment - a high burden country where TB vaccine efficacy trials are on-going, and licensure by the United States FDA --a well-resourced regulatory agency where approval could facilitate global licensure of a novel TB vaccine. Copyright © 2013. Published by Elsevier Ltd.
Music Teacher Licensure Candidates in the United States: A Demographic Profile and Analysis of Licensure Examination Scores

ERIC Educational Resources Information Center

Elpus, Kenneth

2015-01-01

The purpose of this study was to analyze the demographic profile of candidates seeking music teacher licensure in the United States and to understand whether performance on the Praxis II music teacher licensure tests varies systematically as a function of various demographic characteristics. Praxis II music test data and background questionnaire…
Variations by state in physician disciplinary actions by US medical licensure boards.

PubMed

Harris, John Alexander; Byhoff, Elena

2017-03-01

To investigate the variation in the rate of state medical board physician disciplinary actions between US states. Longitudinal study of state medical board physician disciplinary action rates using the US National Practitioner Data Bank and American Medical Association estimates of physician demographics across all 50 states and the District of Columbia from 2010 to 2014. Results were reliability adjusted using a multilevel logistic model controlling for year of disciplinary action, physicians per capita in each state and the rate of malpractice claims per physician in each state. From 2010 to 2014, there were a total of 5046 506 physician licensure years present. Medical boards reported a total of 21 647 disciplinary actions, of which 5137 (23.7%) were major disciplinary actions involving revocation, suspension or surrender of licence. The mean, reliability-adjusted rate of all disciplinary actions was 3.76 (95% CI 3.21 to 4.42) with a significant variation between states. State rates ranged from 2.13 (95% CI 1.86 to 2.45) to 7.93 (95% CI 6.33 to 9.93) actions per 1000 physicians. The mean rate of major disciplinary actions was 2.71 (95% CI 1.93 to 3.82), ranging from 0.64 (95% CI 0.53 to 0.76) to 2.71 (95% CI 1.93 to 3.82) actions per 1000 physicians. The correlation between the rate of major disciplinary action and minor disciplinary actions was 0.34. There is a significant, fourfold variation in the annual rate of medical board physician disciplinary action by state in the USA. When indicated, state medical boards should consider policies aimed at improving standardisation and coordination to provide consistent supervision to physicians and ensure public safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A Study of Experience Credit for Professional Engineering Licensure

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

Martin, M.A.

2003-08-11

Oak Ridge National Laboratory performed a study of experience credit for professional engineering licensure for the Department of Energy's Industrial Assessment Center (IAC) Program. One of the study's goals was to determine how state licensure boards grant experience credit for engineering licensure, particularly in regards to IAC experience and experience prior to graduation. Another goal involved passing IAC information to state licensure boards to allow the boards to become familiar with the program and determine if they would grant credit to IAC graduates. The National Council of Examiners for Engineers and Surveyors (NCEES) has adopted a document, the ''Model Law''.more » This document empowers states to create state engineering boards and oversee engineering licensure. The board can also interpret and adopt rules and regulations. The Model Law also gives a general ''process'' for engineering licensure, the ''Model Law Engineer''. The Model Law Engineer requires that an applicant for professional licensure, or professional engineering (PE) licensure, obtain a combination of formal education and professional experience and successfully complete the fundamentals of engineering (FE) and PE exams. The Model Law states that a PE applicant must obtain four years of ''acceptable'' engineering experience after graduation to be allowed to sit for the PE exam. Although the Model Law defines ''acceptable experience,'' it is somewhat open to interpretation, and state boards decide whether applicants have accumulated the necessary amount of experience. The Model Law also allows applicants one year of credit for postgraduate degrees as well as experience credit for teaching courses in engineering. The Model Law grants states the power to adopt and amend the bylaws and rules of the Model Law licensure process. It allows state boards the freedom to modify the experience requirements for professional licensure. This power has created variety in experience requirements, and
Portfolios for determining initial licensure competency.

PubMed

Chambers, David W

2004-02-01

Because attempts to improve initial licensure examinations have not been grounded in measurement theory, partial and inadequate remedies have led to a cycle of refutations, defenses and political polarization. The author reviewed the psychometric literature, focusing on high-stakes professional decisions. Editorials in the dental literature and position papers of involved organizations often use words from this literature without incorporating its fundamental concepts. The reliability of one-shot initial licensure examinations is estimated to be approximately r = .40, which is a value well under the standard for such tests in other professions. Validity has not been investigated rigorously, but the one-shot format and proposals to remove live patients certainly would reduce validity. The use of portfolios--a small number of evaluations in several realistic task domains--is a viable means of achieving psychometric standards for initial licensure decisions. Boards are charged with making valid and reliable licensure decisions, not with conducting examinations. At a minimum, they must define the competencies of beginning practitioners and establish the psychometric criteria for their decisions (neither of which are done currently). Gathering data then can be delegated to whoever is best qualified to meet these standards.
Teacher Effectiveness: An Analysis of Licensure Screens

ERIC Educational Resources Information Center

Shuls, James V.; Trivitt, Julie R.

2015-01-01

Historically, the government has sought to improve the quality of the teacher workforce by requiring certification. Teachers are among the most licensed public personnel employees in the United States. Traditionally, an education degree with a student teaching experience and passage of licensure exams were necessary for licensure. In the 1980s,…
Model Act for State Licensure of Psychologists

ERIC Educational Resources Information Center

American Psychologist, 2011

2011-01-01

As APA policy, the Model Act for State Licensure of Psychologists serves as a prototype for drafting state legislation regulating the practice of psychology. State legislatures are encouraged to use the language of this document and the policies that it espouses as the model for their own state licensure laws. Inevitably each state law will…
University Approaches to Software Copyright and Licensure Policies.

ERIC Educational Resources Information Center

Hawkins, Brian L.

Issues of copyright policy and software licensure at Drexel University that were developed during the introduction of a new microcomputing program are discussed. Channels for software distribution include: individual purchase of externally-produced software, distribution of internally-developed software, institutional licensure, and "read…
Advocating for Educational Standards in Counselor Licensure Laws

ERIC Educational Resources Information Center

Lawson, Gerard; Trepal, Heather C.; Lee, Robin W.; Kress, Victoria

2017-01-01

As the counseling profession evolves, educational standards for counselor licensure must be standardized from state to state. In this article, the authors discuss historical and current influences and present an advocacy model that has been used to standardize educational requirements in state counselor licensure laws.
Paths to Licensure: Things Physicists Should Know

NASA Astrophysics Data System (ADS)

Stewart, Gay; Stewart, John

2016-03-01

The path to licensure can be quite complicated, and can thwart a physics department's efforts to produce more and better prepared high school physics teachers. Each state has different pathways to licensure. Acronyms like CAEP and SPA are not within the normal physicist's vocabulary. Some understanding of this topic can allow physics faculty advisers to help our students so that fewer are derailed on their path to the classroom, or take a path that will leave them less well prepared if they do find themselves there. Examples of different approaches that work within state licensure systems from two different states will be presented. Physics teacher preparation efforts in both Arkansas and West Virginia have been supported in part by the Physics Teacher Education Coalition (PhysTEC).
Parental Influence on Driver Licensure in Adolescence: A Randomized Controlled Trial

PubMed Central

Mirman, Jessica H.; Curry, Allison E.; Winston, Flaura K.; Fisher Thiel, Megan C.; Pfeiffer, Melissa R.; Rogers, Rachel; Elliott, Michael R.; Durbin, Dennis R.

2017-01-01

Objective Newly licensed adolescent drivers have skill deficits that increase risk for motor vehicle crashes. Development of programs targeted to prelicensed adolescents has been hindered by concerns about encouraging overconfidence and early licensure. The study had 2 primary objectives: (a) determine whether an Internet-based intervention designed to improve parent-supervised practice (TeenDrivingPlan [TDP]) influenced adolescents’ time to licensure and parents’ perceptions of adolescents’ driving skill, expertise, and safety and (b) evaluate the association of these perceptions and practice diversity (number of different environments where practiced occurred) with time to licensure. Method A randomized controlled trial was used to compare TDP with a control condition. Participants (N = 295 parent–adolescent dyads) completed periodic surveys over 24 weeks and were subsequently followed for up to a year to determine adolescents’ licensure status. Results TDP did not influence time to licensure and did not affect parents’ perceptions of skill, expertise, and safety. Practice diversity was associated with faster licensure. A more favorable perception of adolescents’ skill in comparison to peers was associated with faster licensure. Conclusions Targeting parents’ beliefs about adolescents’ safety in relation to other road users may not be conducive to altering licensing trajectories, whereas sensitizing parents to their adolescents’ emerging skills might be more effective in promoting safe entry into licensure. PMID:27936811
An Economic Analysis of Occupational Licensure. Final Report.

ERIC Educational Resources Information Center

Rayack, Elton

To examine the hypothesis that occupational licensure is primarily a restrictive device to protect those licensed from competition, analysis focused on the licensure of non-professional occupations in Rhode Island, Massachusetts, and Connecticut, covering 36 licenses issued by the three states for 12 occupations (e.g. electricians, barbers,…
Parent and teen agreement on driving expectations prior to teen licensure.

PubMed

Hamann, Cara J; Ramirez, Marizen; Yang, Jingzhen; Chande, Vidya; Peek-Asa, Corinne

2014-01-01

To examine pre-licensure agreement on driving expectations and predictors of teen driving expectations among parent-teen dyads. Cross-sectional survey of 163 parent-teen dyads. Descriptive statistics, weighted Kappa coefficients, and linear regression were used to examine expectations about post-licensure teen driving. Teens reported high pre-licensure unsupervised driving (N = 79, 48.5%) and regular access to a car (N = 130, 81.8%). Parents and teens had low agreement on teen driving expectations (eg, after dark, κw = 0.23). Each time teens currently drove to/from school, their expectation of driving in risky conditions post-licensure increased (β = 0.21, p = .02). Pre-licensure improvement of parent-teen agreement on driving expectations are needed to have the greatest impact on preventing teens from driving in high risk conditions.
Tiered Licensure: Connecting Educator Effectiveness Policies. Ask the Team

ERIC Educational Resources Information Center

Paliokas, Kathleen

2013-01-01

Multitiered licensure structures can provide educators incentives to develop and improve their performance as they work toward advanced status. When working in tandem with compensation, career ladders, and ongoing professional learning policies, licensure can be a lever to promote educator development, advancement, and retention. Licensure…
Counseling Psychology Licensure in Taiwan: Development, Challenges, and Opportunities

ERIC Educational Resources Information Center

Wang, Li-fei; Kwan, Kwong-Liem K.; Huang, Su-Fei

2011-01-01

The development and consequences of licensure for counseling psychologists in Taiwan are presented to promote cross-cultural awareness surrounding issues in the counseling psychology profession. The national licensure statute for counseling psychologists in Taiwan was established by the Taiwanese Legislature in 2001. While the licensing system…
The costs and effectiveness of large Phase III pre-licensure vaccine clinical trials.

PubMed

Black, Steven

2015-01-01

demonstrated in efficacy trials. Notably, pre-licensure trials of pneumococcal conjugate severely underestimated their true effect and cost-effectiveness. In fact, in discussions prior to vaccine introduction in the USA for PCV7, the vaccine was said to be not cost-effective and some counseled against its introduction. In reality, following introduction, PCV7 has been shown to be highly cost-effective. In the last decade, new methods have been identified using large linked databases such as the Vaccine Safety Datalink in the USA that allow identification of an increased risk of an event within a few months of vaccine introduction and that can screen for unanticipated very rare events as well. In addition, the availability of electronic medical records and hospital discharge data in many settings allows for accurate assessment of vaccine effectiveness. Given the high financial and opportunity cost of requiring large pre-licensure safety studies, consideration could be given to 'conditional licensure' of vaccines whose delivery system is well characterized in a setting where sophisticated pharmacovigilance systems exist on the condition that such licensure would incorporate a requirement for rapid cycle and other real-time evaluations of safety and effectiveness following introduction. This would actually allow for a more complete and timely evaluation of vaccines, lower the financial barrier to development of new vaccines and thus allow a broader portfolio of vaccines to be developed and successfully introduced.
Testing Teacher Candidates: The Role of Licensure Tests in Improving Teacher Quality.

ERIC Educational Resources Information Center

Mitchell, Karen J., Ed.; Robinson, David Z., Ed.; Plake, Barbara S., Ed.; Knowles, Kaeli T., Ed.

This book examines the appropriateness and technical quality of teacher licensure tests currently in use, evaluating teacher licensure tests and examining the use of tests to hold states and institutions of higher education accountable for the quality of teacher preparation and licensure. It also suggests alternatives for developing and assessing…
24 CFR 242.8 - Standards for licensure and methods of operation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Standards for licensure and methods of operation. The Secretary shall require satisfactory evidence that the... of licensure and methods of operation for hospitals, and satisfactory assurance that such standards...
Considerations of Administrative Licensure, Provider Type, and Leadership Quality: Recommendations for Research, Policy, and Practice

ERIC Educational Resources Information Center

Hackmann, Donald G.

2016-01-01

This article reviews U.S. administrative licensure regulations, focusing on type of school leader licensure, provider types, and leadership quality. Licensure obtained through university-based and alternative routes is examined. Due to limited research on alternative school administrative licensure, regulations in medicine, psychology,…
Assessment in the context of licensure and certification.

PubMed

Norcini, John J; Lipner, Rebecca S; Grosso, Louis J

2013-01-01

Over the past 25 years, three major forces have had a significant influence on licensure and certification: the shift in focus from educational process to educational outcomes, the increasing recognition of the need for learning and assessment throughout a physician's career, and the changes in technology and psychometrics that have opened new vistas for assessment. These forces have led to significant changes in assessment for licensure and certification. To respond to these forces, licensure and certification programs have improved the ways in which their examinations are constructed, scored, and delivered. In particular, we note the introduction of adaptive testing; automated item creation, scoring, and test assembly; assessment engineering; and data forensics. Licensure and certification programs have also expanded their repertoire of assessments with the rapid development and adoption of simulation and workplace-based assessment. Finally, they have invested in research intended to validate their programs in four ways: (a) the acceptability of the program to stakeholders, (b) the extent to which stakeholders are encouraged to learn and improve, (c) the extent to which there is a relationship between performance in the programs and external measures, and (d) the extent to which there is a relationship between performance as measured by the assessment and performance in practice. Over the past 25 years, changes in licensure and certification have been driven by the educational outcomes movement, the need for lifelong learning, and advances in technology and psychometrics. Over the next 25 years, we expect these forces to continue to exert pressure for change which will lead to additional improvement and expansion in examination processes, methods of assessment, and validation research.
42 CFR 422.372 - Basis for waiver of State licensure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Provider-Sponsored Organizations § 422.372... authority to conduct business as an MA plan. (b) Basis for waiver of State licensure. Any of the following... engaged in a substantially similar business; or (ii) Required, as a condition of licensure that the...
Texas Higher Education Coordinating Board 2000 Statewide Annual Licensure Report.

ERIC Educational Resources Information Center

Texas Higher Education Coordinating Board, Austin. Div. of Community and Technical Colleges.

This report provides the licensure examination results for two-year technical associate degrees and one-year certificate programs at community and technical colleges in Texas. The Texas Higher Education Coordinating Board recognizes the success rate for licensure as an integral part of the overall success of many technical programs. The following…
A Systematic Analysis of Transition Coursework Required for Special Education Licensure

ERIC Educational Resources Information Center

Williams-Diehm, Kendra L.; Rowe, Dawn A.; Johnson, Margaret C.; Guilmeus, Jean Francois

2018-01-01

The field of secondary special education and transition has long advocated for quality training at the preservice level. However, transition-focused coursework is not required for all special education licensure programs. Licensure programs requiring this coursework do not cover all transition-related knowledge and skills needed for teachers to…

Motivating Factors of Nontraditional Post-Baccalaureate Students Pursuing Initial Teacher Licensure

ERIC Educational Resources Information Center

Bunn, Gary; Wake, Donna

2015-01-01

This study examines the motivating factors that prompted post-baccalaureate students to change careers and to pursue an initial teaching license. Researchers collected survey data from 346 nontraditional teaching candidates who were part of either an initial licensure master's degree program or a statewide nontraditional licensure program.…
Nursing Students' Intrinsic Motivation and Performance on the Licensure Examination.

PubMed

Hackney, Michele G

Unsuccessful attempts at licensure adversely affect graduates, prelicensure nursing education programs, health care agencies, and ultimately, patient safety. The purpose of this quantitative, correlational study was to investigate the relationship between nursing students' intrinsic motivation and performance on the licensure examination. Nursing students responded to 12 questions related to reasons for learning as indicators of motivation type. Results indicated no statistically significant correlations between variables.
Telemedicine: legal and licensure issues

NASA Astrophysics Data System (ADS)

Wood, Michael B.; Whelan, Leo J.

1995-10-01

The National Information Infrastructure program offers a great opportunity for the United States to capitalize on remarkable technological advancements over a broad range of applications benefiting society. One such application, telemedicine, has the potential to offer widespread access to sophisticated medical care, curtailed health care delivery costs, and homogeneous health and health-related educational opportunities. However, there are a variety of barriers to widespread application of telemedicine once the technical infrastructure of the information highway is well established and ubiquitous. These barriers include technical limitations, reimbursement issues, equipment and networking costs, and appropriate scientific studies to document efficacy and cost effectiveness. These issues may prove to be only transient disincentives which can be surmounted. Additional barriers exist, however, that may not be as readily resolved by traditional methods of analysis and more widespread practice applications. These political and regulatory obstacles will require clarification of the issues and solutions based on national consensus. It is the purpose of this discussion to amplify on these particular barriers which include licensure and tort jurisdiction.
The complementary roles of Phase 3 trials and post-licensure surveillance in the evaluation of new vaccines

PubMed Central

Lopalco, Pier Luigi; DeStefano, Frank

2015-01-01

Vaccines have led to significant reductions in morbidity and saved countless lives from many infectious diseases and are one of the most important public health successes of the modern era. Both vaccines' effectiveness and safety are keys for the success of immunisation programmes. The role of post-licensure surveillance has become increasingly recognised by regulatory authorities in the overall vaccine development process. Safety, purity, and effectiveness of vaccines are carefully assessed before licensure, but some safety and effectiveness aspects need continuing monitoring after licensure; Post-marketing activities are a necessary complement to pre-licensure activities for monitoring vaccine quality and to inform public health programmes. In the recent past, the availability of large databases together with data-mining and cross-linkage techniques have significantly improved the potentialities of post-licensure surveillance. The scope of this review is to present challenges and opportunities offered by vaccine post-licensure surveillance. While pre-licensure activities form the foundation for the development of effective and safe vaccines, post-licensure monitoring and assessment, are necessary to assure that vaccines are effective and safe when translated in real world settings. Strong partnerships and collaboration at an international level between different stakeholders is necessary for finding and optimally allocating resources and establishing robust post-licensure processes. PMID:25444788
42 CFR 416.40 - Condition for coverage-Compliance with State licensure law.

Code of Federal Regulations, 2010 CFR

2010-10-01

... licensure law. 416.40 Section 416.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM AMBULATORY SURGICAL SERVICES Specific Conditions for Coverage § 416.40 Condition for coverage—Compliance with State licensure law. The ASC must comply...
A survey of deans and ADEA activities on dental licensure issues.

PubMed

Ranney, Richard R; Haden, N Karl; Weaver, Richard W; Valachovic, Richard W

2003-10-01

A written survey on issues in clinical testing for licensure was sent to the deans of all dental schools in the United States. Response rate was 89 percent. Results indicate that administrative leaders of the country's dental schools think that third-party evaluation of graduates is appropriate, but they do not have confidence in current clinical tests for licensure. More than nine out of ten respondents indicated that change was needed in current testing procedures, and 82 percent thought the tests as currently conducted were not valid for decision purposes. Regional differences existed among the responses, with the least dissatisfaction occurring in the West. The highest-rated and most frequently mentioned reasons for dissatisfaction with clinical tests were the involvement of patients (human subjects) as currently done. Most respondents favored a national level for licensure tests, although the majority also approved of the recently enacted New York law that permits completion of a postgraduate year in an accredited program to substitute for clinical testing. Respondents indicated a belief that a national database on academic measures as compared to outcomes on clinical licensure tests would be useful, with overall grade point average or class rank as the favored academic measure. Informed by the recommendations of its representatives to the AADE-ADEA Innovative Testing and Educational Methodologies Committee and results of the survey of deans, ADEA is pursuing steps to foster change in the clinical licensure process.
The complementary roles of Phase 3 trials and post-licensure surveillance in the evaluation of new vaccines.

PubMed

Lopalco, Pier Luigi; DeStefano, Frank

2015-03-24

Vaccines have led to significant reductions in morbidity and saved countless lives from many infectious diseases and are one of the most important public health successes of the modern era. Both vaccines' effectiveness and safety are keys for the success of immunisation programmes. The role of post-licensure surveillance has become increasingly recognised by regulatory authorities in the overall vaccine development process. Safety, purity, and effectiveness of vaccines are carefully assessed before licensure, but some safety and effectiveness aspects need continuing monitoring after licensure; Post-marketing activities are a necessary complement to pre-licensure activities for monitoring vaccine quality and to inform public health programmes. In the recent past, the availability of large databases together with data-mining and cross-linkage techniques have significantly improved the potentialities of post-licensure surveillance. The scope of this review is to present challenges and opportunities offered by vaccine post-licensure surveillance. While pre-licensure activities form the foundation for the development of effective and safe vaccines, post-licensure monitoring and assessment, are necessary to assure that vaccines are effective and safe when translated in real world settings. Strong partnerships and collaboration at an international level between different stakeholders is necessary for finding and optimally allocating resources and establishing robust post-licensure processes. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Capital We Must Develop: Emotional Competence Educating Pre-Licensure Nursing Students.

PubMed

Waite, Roberta; McKinney, Nicole S

2016-01-01

Emotional competency is a skill commonly overlooked within the nursing curriculum. However, with the complexity of the health care environment and increased emphasis on team collaboration, nurse educators who focus on health promotion and technical, medical, and organizational competencies need to consider adding a focus on soft skills, such as emotional competency. This pilot study engaged 14 pre-licensure nursing students who were involved in an 18-month leadership program. Pre-post scores of the Emotional and Social Competency Inventory are described. Statistical significance was found with three core areas: emotional self-awareness, emotional self-control, and inspirational leadership.
Undergraduate educational environment, perceived preparedness for postgraduate clinical training, and pass rate on the National Medical Licensure Examination in Japan.

PubMed

Tokuda, Yasuharu; Goto, Eiji; Otaki, Junji; Jacobs, Joshua; Omata, Fumio; Obara, Haruo; Shapiro, Mina; Soejima, Kumiko; Ishida, Yasushi; Ohde, Sachiko; Takahashi, Osamu; Fukui, Tsuguya

2010-05-20

We investigated the views of newly graduating physicians on their preparedness for postgraduate clinical training, and evaluated the relationship of preparedness with the educational environment and the pass rate on the National Medical Licensure Examination (NMLE). Data were obtained from 2429 PGY-1 physicians-in-training (response rate, 36%) using a mailed cross-sectional survey. The Dundee Ready Education Environment Measure (DREEM) inventory was used to assess the learning environment at 80 Japanese medical schools. Preparedness was assessed based on 6 clinical areas related to the Association of American Medical Colleges Graduation Questionnaire. Only 17% of the physicians-in-training felt prepared in the area of general clinical skills, 29% in basic knowledge of diagnosis and management of common conditions, 48% in communication skills, 19% in skills associated with evidence-based medicine, 54% in professionalism, and 37% in basic skills required for a physical examination. There were substantial differences among the medical schools in the perceived preparedness of their graduates. Significant positive correlations were found between preparedness for all clinical areas and a better educational environment (all p < 0.01), but there were no significant associations between the pass rate on the NMLE and perceived preparedness for any clinical area, as well as pass rate and educational environment (all p > 0.05). Different educational environments among universities may be partly responsible for the differences in perceived preparedness of medical students for postgraduate clinical training. This study also highlights the poor correlation between self-assessed preparedness for practice and the NMLE.
Undergraduate educational environment, perceived preparedness for postgraduate clinical training, and pass rate on the National Medical Licensure Examination in Japan

PubMed Central

2010-01-01

Background We investigated the views of newly graduating physicians on their preparedness for postgraduate clinical training, and evaluated the relationship of preparedness with the educational environment and the pass rate on the National Medical Licensure Examination (NMLE). Methods Data were obtained from 2429 PGY-1 physicians-in-training (response rate, 36%) using a mailed cross-sectional survey. The Dundee Ready Education Environment Measure (DREEM) inventory was used to assess the learning environment at 80 Japanese medical schools. Preparedness was assessed based on 6 clinical areas related to the Association of American Medical Colleges Graduation Questionnaire. Results Only 17% of the physicians-in-training felt prepared in the area of general clinical skills, 29% in basic knowledge of diagnosis and management of common conditions, 48% in communication skills, 19% in skills associated with evidence-based medicine, 54% in professionalism, and 37% in basic skills required for a physical examination. There were substantial differences among the medical schools in the perceived preparedness of their graduates. Significant positive correlations were found between preparedness for all clinical areas and a better educational environment (all p < 0.01), but there were no significant associations between the pass rate on the NMLE and perceived preparedness for any clinical area, as well as pass rate and educational environment (all p > 0.05). Conclusion Different educational environments among universities may be partly responsible for the differences in perceived preparedness of medical students for postgraduate clinical training. This study also highlights the poor correlation between self-assessed preparedness for practice and the NMLE. PMID:20487536
Race, Gender, and Teacher Testing: How Informative a Tool Is Teacher Licensure Testing?

ERIC Educational Resources Information Center

Goldhaber, Dan; Hansen, Michael

2010-01-01

Virtually all states require teachers to undergo licensure testing before participation in the public school labor market. This article analyzes the information these tests provide about teacher effectiveness. The authors find that licensure tests have different predicative validity for student achievement by teacher race. They also find that…
Dimensionality and DIF in a Licensure Examination.

ERIC Educational Resources Information Center

Sykes, Robert C.; And Others

The sources of multidimensionality found in several different forms of a licensure examination were studied. The relationship between one source of multidimensionality, differential item functioning (DIF) (or factors producing DIF), and content characteristics was explored in an attempt to isolate aspects of training or curriculum that could…
Step up to the bar: avoiding discrimination in professional licensure.

PubMed

Appelbaum, Paul S

2015-04-01

In their efforts to protect the public from impaired professionals, licensure boards often have created special rules for applicants with mental disorders. The authorities in charge of admission to the Louisiana bar required extensive disclosure of mental health status, even if an applicant's professional functioning was not impaired. After the U.S. Department of Justice found that Louisiana's practices violated applicants' rights under the Americans with Disabilities Act, the state agreed to focus on applicants' functional impairment rather than on mental disorders. This settlement may provide a model for licensure boards in other states and for other professions, including the health professions.
42 CFR 422.400 - State licensure requirement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Organization Compliance With State Law and Preemption by Federal Law § 422.400 State licensure requirement. Except in the case of a PSO granted a waiver under subpart H of this part, each MA organization must— (a) Be licensed under State law...
The Affordances and Constraints of Special Education Initial Teacher Licensure Policy for Teacher Preparation

ERIC Educational Resources Information Center

Blanton, Linda P.; Boveda, Mildred; Munoz, Lorena R.; Pugach, Marleen C.

2017-01-01

Initial licensure polices in special education were examined to determine how these policies support or hinder reform efforts to develop teacher education programs that prepare graduates for the increasingly complex needs of diverse students. Initial special education licensure policies are described with an emphasis on the differences across…
An Analysis of State Music Education Certification and Licensure Practices in the United States

ERIC Educational Resources Information Center

May, Brittany Nixon; Willie, Karen; Worthen, Cherilyn; Pehrson, Allyssa

2017-01-01

Teacher certification and licensure practices for music educators vary by state. Enhancing music teacher educator knowledge of state music education certification and licensure practices can inform music teacher preparation and improve future music teacher quality. The purpose of this study was to compile relevant information for music educators…
The Enhanced Nurse Licensure Compact (eNLC): Unlocking Access to Nursing Care Across the Nation.

PubMed

Kappel, Dawn M

2018-05-01

Nurses, including school nurses, may reside in a state with compact licensing. On July 20, 2017, an enhanced Nurse Licensure Compact (eNLC) was enacted with implementation beginning on January 19, 2018. Nurses must be knowledgeable about the status of their state's participation in the compact licensure, both their state of residence and their state of practice. Nurses must also be knowledgeable about what is entailed in compact licensure. This brief article provides basic information about compact licensing, along with considerations about nursing delegation, for the practicing school nurse.
Passing the Leadership Test: Strategies for Success on the Leadership Licensure Exam. Second Edition

ERIC Educational Resources Information Center

Jones, Leslie; Kennedy, Eugene

2012-01-01

"Passing the Leadership Test: Strategies for Success on the Leadership Licensure Exam" is a study guide for the School Leaders Licensure Examination (SLLA.) The book presents a comprehensive, practical guide for preparing for the SLLA. It is divided into two sections: basic principles of test preparation and the ISLLC standards with implications…
Nursing regulation, the nurse licensure compact, and nurse administrators: working together for patient safety.

PubMed

Poe, Laura

2008-01-01

Maintaining the concept of states rights, boards of nursing responded to the need for removal of barriers in meeting nursing manpower needs. One mechanism to accomplish this end was the development of the Nurse Licensure Compact, a multistate nurse license structured in much the same way as driver's license compacts. Representatives of State Boards of Nursing developed model compact structure and rules which allow nurses licensed in their state of residence to practice in other participating states without having to obtain additional licenses. Monitoring of nurse licensure and disciplinary information is facilitated through Nursys (nurse system). Nurses, nurse administrators, and the public benefit from the experiences of the 23 states that have implemented the Nurse Licensure Compact.
Vehicles driven by teenagers in their first year of licensure.

PubMed

Williams, Allan F; Leaf, William A; Simons-Morton, Bruce G; Hartos, Jessica L

2006-03-01

to determine access to vehicles, vehicle ownership and its correlates, and types of vehicles driven by teenagers during their first year of licensure. About 3,500 Connecticut teenagers and their parents recruited at DMV offices participated in a study aimed at persuading parents to impose and maintain driving restrictions on their sons and daughters. Telephone interviews with teens and parents, which included questions on vehicles driven, were conducted upon licensure and at intervals throughout the year. The majority of both male and female teens owned vehicles immediately upon licensure. Family income and number of vehicles in the family were associated with early ownership. A year later 74% owned vehicles. Small cars, which provide inferior crash protection, were the most popular vehicle; the percent driving small cars increased from 36% to 42% over the year. About 25% were driving SUVs, pickups, or sports cars, which may increase crash risk for young beginners. One year after licensure, only 35% of teens were driving midsize or large passenger cars, the types of vehicles recommended for them, and about one-third of these vehicles were 10 or more years old. Owners were more likely than non-owners to drive older and smaller vehicles, to drive more miles, do more risky driving, and to have more traffic violations and crashes. Many teenagers in Connecticut were driving vehicles that rank low in crash protection or may increase crash risk. Attention to the young driver problem has been focused primarily on managing driving risks through graduated licensing systems. More attention needs to be given to the vehicles teens drive, and how decisions about vehicle type and ownership are made. Parents exert control over what vehicles their sons and daughters drive, and may benefit from information on how to make choices that better balance cost, safety, and other factors that go into these decisions.

[Private medical education in Germany].

PubMed

Schwörer, Beatrix; Wissing, Frank

2018-02-01

Through the years, a range of privately funded medical training opportunities has been established in Germany. Only a few of them operate along the German Medical Licensure Act and thus underlie quality assurance regulations in Germany. Most of the courses are a result of German hospitals cooperating with universities from other EU countries. The content of the courses and the examinations underlie the regulations of the university's home country. This article aims to give an overview of the private medical training opportunities offered in Germany and to show differences compared to state funded German medical schools. The authors discuss the opportunities of private medical training as well as its challenges and risks. Basic principles concerning finances and quality assurance of national and international private medical training are provided. Regardless of their mode of financing, the superior goal of the training, according to the German Medical Licensure Act, should always be to enable young doctors to pursue further professional training, so that they can maintain the best possible quality in patient care, research, and medical education.
42 CFR 422.400 - State licensure requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... by Federal Law § 422.400 State licensure requirement. Except in the case of a PSO granted a waiver under subpart H of this part, each MA organization must— (a) Be licensed under State law, or otherwise authorized to operate under State law, as a risk-bearing entity (as defined in § 422.2) eligible to offer...
The Use of Occupational Licensure Examination Results in Outcomes Assessment. AIR 1994 Annual Forum Paper.

ERIC Educational Resources Information Center

Bragg, Theresa A.

This paper discusses the validity of licensure examination results as an indicator of the performance of higher educational institutions. Licensure examination scores are available to departments for a variety of disciplines and analysis is best performed within the departments. The quality of feedback may dictate the usefulness of results. Using…
A Framework for Evidence-Based Licensure of Adaptive Autonomous Systems: Technical Areas

DTIC Science & Technology

2016-03-01

subjective judgments by human experts . They are design dependent, but address questions of whether the system is performing as needed, as opposed...I N S T I T U T E F O R D E F E N S E A N A L Y S E S A Framework for Evidence-Based Licensure of Adaptive Autonomous Systems : Technical Areas...and Licensure of Autonomous Systems ,” for the Air Force Research Laboratory (AFRL). The views, opinions, and findings should not be construed as
Perceived Utility of Pharmacy Licensure Examination Preparation Tools

PubMed Central

Peak, Amy Sutton; Sheehan, Amy Heck; Arnett, Stephanie

2006-01-01

Objectives To identify board examination preparation tools most commonly used by recent pharmacy graduates and determine which tools are perceived as most valuable and representative of the actual content of licensure examinations. Methods An electronic survey was sent to all 2004 graduates of colleges of pharmacy in Indiana. Participants identified which specific preparation tools were used and rated tools based on usefulness, representativeness of licensure examination, and monetary value, and provided overall recommendations to future graduates. Results The most commonly used preparation tools were the Pharmacy Law Review Session offered by Dr. Thomas Wilson at Purdue University, the Complete Review for Pharmacy, Pre-NAPLEX, PharmPrep, and the Kaplan NAPLEX Review. Tools receiving high ratings in all categories included Dr. Wilson's Pharmacy Law Review Session, Pre-NAPLEX, Comprehensive Pharmacy Review, Kaplan NAPLEX Review, and Review of Pharmacy. Conclusions Although no preparation tool was associated with a higher examination pass rate, certain tools were clearly rated higher than others by test takers. PMID:17149406
Previous Education, Sociodemographic Characteristics, and Nursing Cumulative Grade Point Average as Predictors of Success in Nursing Licensure Examinations

PubMed Central

Amankwaa, Isaac; Agyemang-Dankwah, Anabella; Boateng, Daniel

2015-01-01

Introduction. Success in the licensure examination is the only legal prerequisite to practice as a nurse in Ghana. However, a large percentage of nursing students who sit fail this examination for the first time. This study sought to unravel whether prior education, sociodemographic characteristics, and nursing Cumulative Grade Point Average (CGPA) could predict performance in the licensure examinations. Methods. The study was a descriptive cross-sectional survey conducted from November 2014 to April 2015 in the Kumasi metropolis, Ghana on 176 past nursing students. Data was collected using questionnaires and analyzed using SPSS version 22. A logistic regression model was fitted to look at the influence of the explanatory variables on the odds of passing the licensure examinations. All statistical significances were tested at p value of <0.05. Results. Majority, 56.3%, were females and 86.4% were between the ages of 25 and 31 years. Most of the students (88.6%) entered the nursing training colleges with a WASSCE qualification and 38% read general science. 73.9% passed the licensure examinations and the mean CGPA of the students was 2.89 (SD = 0.37). Sociodemographic characteristics and previous education had no influence on performance in the licensure examinations. CGPA had strong positive relationship with performance in licensure examinations (AOR = 15.27; 95% CI = 6.28, 27.11). Conclusion. Students CGPA could be a good predictor of their performance in the licensure examinations. On the other hand, students' sociodemographic and previous educational characteristics might not be important factors to consider in admitting students into the nursing training programme. PMID:26635975
Initial Teacher Licensure Testing in Tennessee: Test Validation.

ERIC Educational Resources Information Center

Bowman, Harry L.; Petry, John R.

In 1988 a study was conducted to determine the validity of candidate teacher licensure examinations for use in Tennessee under the 1984 Comprehensive Education Reform Act. The Department of Education conducted a study to determine the validity of 11 previously unvalidated or extensively revised tests for certification and to make recommendations…
Perceived risk and other predictors and correlates of teenagers' safety belt use during the first year of licensure.

PubMed

Ouimet, Marie Claude; Morton, Bruce G Simons; Noelcke, Elizabeth A; Williams, Allan F; Leaf, William A; Preusser, David F; Hartos, Jessica L

2008-03-01

Teenagers have the lowest rate of safety belt use and the highest crash rate compared to other age groups. Past studies on teenagers' belt use have mostly been cross-sectional. The first goals of this study were to examine, at licensure, teenagers' and parents' perceptions of risk of crash/injury for newly licensed teenagers when driving unbelted and teenagers' perceived and parents' intended consequences for safety belt rule violations. In addition, the comparability of these variables to other risky driving behaviors was explored. The second goal was to evaluate the importance of these variables in the prediction of teenagers' belt use during the first year of licensure, relative to other factors related to belt use, including demographics and substance use. More than 2,000 parent-teenager dyads were interviewed by telephone, parents at permit and licensure and teenagers at permit, licensure, and 3, 6, and 12 months after licensure. Approximately a third of the teenagers reported at least once at 3, 6, or 12 months post-licensure not always using their safety belt in the past week. At licensure, participants' perceived risk of safety belt non-use was high and ranked among the behaviors most related to crash/injury for newly licensed teenagers, behind driving under the influence of alcohol or drugs. Parent-imposed consequences for safety belt rule violations were not as highly rated as parent-imposed consequences for driving under the influence of alcohol or drugs. Sequential logistic regression modeled the relationship between safety belt use and perceived risk and consequences of non-use, as well as other prospective predictors assessed at permit and licensure, and driving correlates measured after licensure. Teenagers' extreme perceived risk and parents' intended sure consequences for non-use were significant prospective predictors of regular use during the first year of licensure. Other significant predictors and correlates were race (White), high school grade
Passing as White: Race, Shame, and Success in Teacher Licensure Testing Events for Black Preservice Teachers

ERIC Educational Resources Information Center

Petchauer, Emery

2015-01-01

This qualitative portraiture study explored how race becomes a conscious and salient dimension of teacher licensure exams for black preservice teachers. The findings focus on one black preservice teacher and how she identified as white on the demographic survey preceding her licensure exam due to the racialized nature of the experience and the…
A Survey of Professional Licensure Examinations in Texas.

ERIC Educational Resources Information Center

Texas Coll. and Univ. System, Austin. Coordinating Board.

A determination was made of how graduates of Texas professional education programs perform on licensure examinations in comparison with their counterparts in other states. Test scores of Texas graduates were compared with national norms and averages in other states, when available, as well as with scores of graduates of out-of-state programs who…
The case against one-shot testing for initial dental licensure.

PubMed

Chambers, David W; Dugoni, Arthur A; Paisley, Ian

2004-03-01

High-stakes testing are expected to meet standards for cost-effectiveness, fairness, transparency, high reliability, and high validity. It is questionable whether initial licensure examinations in dentistry meet such standards. Decades of piecemeal adjustments in the system have resulted in limited improvement. The essential flaw in the system is reliance on a one-shot sample of a small segment of the skills, understanding, and supporting values needed for today's professional practice of dentistry. The "snapshot" approach to testing produces inherently substandard levels of reliability and validity. A three-step alternative is proposed: boards should (1) define the competencies required of beginning practitioners, (2) establish the psychometric standards needed to make defensible judgments about candidates, and (3) base licensure decisions only on portfolios of evidence that test for defined competencies at established levels of quality.
Using Computer-Adaptive Quizzing as a Tool for National Council Licensure Examination Success.

PubMed

Pence, Jill; Wood, Felecia

This study examined the relationship between using computer-adaptive quizzing (CAQ) and first-time National Council Licensure Examination (NCLEX) success. A retrospective, descriptive, correlational design was used to analyze the relationship between use of a CAQ program and first-time NCLEX results of 194 baccalaureate graduates. Chi-square analysis suggested that there was an association between using the software and NCLEX success (p < .001, df = 1), with 16 percent of those without access compared to 1 percent with access being unsuccessful on the licensure exam. Results support using CAQ as formative preparation for the NCLEX.
Driver licensing and reasons for delaying licensure among young adults ages 18-20, United States, 2012.

PubMed

Tefft, Brian C; Williams, Allan F; Grabowski, Jurek G

2014-12-01

Motor vehicle crashes are the leading cause of death for teens and young adults in the United States. Graduated driver licensing (GDL) systems were designed to protect young novice drivers by limiting their exposure to specific risks while they gain experience driving. In the United States, most states' GDL systems only apply to new drivers younger than 18. Some experts suggest that GDL might encourage young people to wait until age 18 to obtain a license, to avoid GDL requirements, resulting in older teenagers having less driving experience and higher crash risk than they might have had without GDL. This study examined the prevalence and timing of licensure among young adults, and explored factors associated with delaying licensure among those not licensed before age 18. An online questionnaire was completed by 1,039 persons aged 18-20 years, recruited from a representative panel of United States households. Main outcome measures were acquisition of driver's license (a) within 12 months of the state minimum age for licensure, (b) before age 18. Associations of timing of licensure with demographic characteristics were assessed using multivariable logistic regression. Respondents not licensed before age 18 were asked to rate the importance of various possible reasons for delaying licensure. 54% of respondents were licensed before age 18. Blacks (37%; adjusted Prevalence Ratio 0.67, 95% Confidence Interval 0.48-0.93) and Hispanics (29%; adjusted Prevalence Ratio 0.60, 95% Confidence Interval 0.45-0.81) were less likely than non-Hispanic whites (67%) to be licensed before age 18. Lower household income was independently associated with delayed licensure (P < .001). The most common self-reported reasons for not becoming licensed sooner were not having a car, being able to get around without driving, and costs associated with driving. There was little evidence that GDL is a major contributor to delayed licensure; however, a substantial minority of young people do
Differences in young driver crash involvement in states with varying licensure practices.

PubMed

Ferguson, S A; Leaf, W A; Williams, A F; Preusser, D F

1996-03-01

Teenage driver licensing practices and the crashes of teenagers were compared in several states with differing laws and policies regarding licensure. High school seniors in Delaware, a state with laws that allow early driving and licensure, reported that they first drove on a public road, obtained a learner's permit and obtained a driver's license at younger ages than high school seniors in other northeastern states (Connecticut, New Jersey and upstate New York). State crash data indicated that Delaware and Connecticut, which allow unrestricted licensing at age 16, showed the highest rates of 16-year-old driver involvements in nonfatal and fatal injury crashes. Pennsylvania and upstate New York, which have night driving curfews for 16 year-olds, showed lower crash rates overall and much lower crash rates during their respective curfew hours. New Jersey and Nassau and Suffolk counties, where unsupervised driving by 16 year-olds is generally not allowed, showed the lowest crash rates for 16 year-olds. Graduated licensing programs that include delayed full-privilege licensure, night driving curfews, and extended periods of supervised practice driving are a possible countermeasure for the high motor vehicle crash rates of young drivers.
Roadmap for Educator Licensure Policy Addressing Data Literacy: Key Focus Areas to Ensure Quality. Data for Action

ERIC Educational Resources Information Center

Data Quality Campaign, 2014

2014-01-01

State licensure polices are meant to provide teacher preparation programs with direction about the skills teachers need to be qualified to teach, including skills to use data. This roadmap discusses the 10 key data use skills that states can include in a licensure policy with a quality focus on effective data use.
Predicting National Council Licensure Examination for Registered Nurses Performance

ERIC Educational Resources Information Center

Whitehead, Charles D.

2016-01-01

The Baccalaureate Nursing program in San Antonio, Texas experienced a decrease in National Council Licensure Examination for Registered Nurses (NCLEX-RN) on the first attempt for students graduating between 2009 and 2014 without a clear explanation for the decline. The purpose of this quantitative non-experimental correlational study was to…
Evaluating the Validity of Portfolio Assessments for Licensure Decisions

ERIC Educational Resources Information Center

Wilson, Mark; Hallam, P. J.; Pecheone, Raymond; Moss, Pamela A.

2014-01-01

This study examines one part of a validity argument for portfolio assessments of teaching practice used as an indicator of teaching quality to inform a licensure decision. We investigate the relationship among portfolio assessment scores, a test of teacher knowledge (ETS's Praxis I and II), and changes in student achievement (on…
State-Controlled Licensure and Interstate Mobility: Questions from Katrina

ERIC Educational Resources Information Center

Taylor, Carmen L.

2006-01-01

State licensure laws in speech-language pathology and audiology vary from state to state. Natural disaster displacements as well as trends in job mobility have increased the need for licensees to be able to have more fluidity in practicing from 1 state to another. Additionally, literature reviews on the history of professional licensure…
Advocating for School Psychologists in Response to the APA's Proposed "Model Act for State Licensure of Psychologists"

ERIC Educational Resources Information Center

Skalski, Anastasia Kalamaros

2009-01-01

On March 6, 2009, the APA Model Licensure Act Task Force released its second draft of the policy document known as the proposed "Model Act for State Licensure of Psychologists". This policy document serves as guidance to state legislatures for how they should set up their psychology licensing laws. The general expectations promoted in the model…
Health Manpower Credentialing: Legal Implications of Institutional Licensure. Health Manpower Policy Discussion Paper Series No.: C3.

ERIC Educational Resources Information Center

Crane, Stephen

The objective of this analysis is to outline in broad fashion the current trends and issues in the licensure of health manpower and to contrast two proposed alternative systems of credentialing that focus on licensure of health care institutions instead of individual health care providers. The argument of the analysis is that the current system of…

42 CFR 423.425 - Licensure does not substitute for or constitute certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Organization Compliance with State Law and Preemption by Federal Law § 423.425 Licensure does not substitute...
The Relationship between Teacher-Licensure Level and Gains in the Student Academic Achievement in New Mexico Public Schools

ERIC Educational Resources Information Center

Morris, Roxann Lynne

2010-01-01

Purpose, scope, and method of study: The primary purpose of this study was to examine the relationship between teacher-licensure level in the New Mexico Three Tiered Licensure (NM 3-TL) System and gains in student academic achievement in reading and mathematics in grades four and five. A secondary purpose was to determine whether student…
Career and Technical Education Administration: Requirements, Certification/Licensure, and Preparation

ERIC Educational Resources Information Center

Zirkle, Christopher J.; Jeffery, Jeremy O.

2017-01-01

The current climate of career and technical administration requirements in all 50 states was detailed and explored. An increasing number of states are not requiring specific career-technical administration certification/licensure in order to oversee secondary career and technical education (CTE) programs, with more states moving towards a general…
The Case for Licensure of Applied Behavior Analysts

PubMed Central

Dorsey, Michael F; Weinberg, Michael; Zane, Thomas; Guidi, Megan M

2009-01-01

The evolution of the field of applied behavior analysis to a practice-oriented profession has created the need to ensure that the consumers of these services are adequately protected. We review the limitations of the current board certification process and present a rationale for the establishment of licensing standards for applied behavior analysts on a state-by-state basis. Recommendations for securing the passage of a licensure bill also are discussed. PMID:22477697
The 150-Hour Requirement for CPA Licensure: One Institution's Response

ERIC Educational Resources Information Center

Larkin, Joseph M.

2014-01-01

Virtually all states now require candidates for the Certified Public Accountant (CPA) examination and subsequent licensure to have completed 150 semester hours of college education. The rationale behind this requirement is to improve the preparation of students entering the profession and to increase their chances of successful completion of the…
Crossing boundaries: a comprehensive survey of medical licensing laws and guidelines regulating the interstate practice of pathology.

PubMed

Hiemenz, Matthew C; Leung, Stanley T; Park, Jason Y

2014-03-01

In the United States, recent judicial interpretation of interstate licensure laws has found pathologists guilty of malpractice and, more importantly, the criminal practice of medicine without a license. These judgments against pathologists highlight the need for a timely and comprehensive survey of licensure requirements and laws regulating the interstate practice of pathology. For all 50 states, each state medical practice act and state medical board website was reviewed. In addition, each medical board was directly contacted by electronic mail, telephone, or US registered mail for information regarding specific legislation or guidelines related to the interstate practice of pathology. On the basis of this information, states were grouped according to similarities in legislation and medical board regulations. This comprehensive survey has determined that states define the practice of pathology on the basis of the geographic location of the patient at the time of surgery or phlebotomy. The majority of states (n=32) and the District of Columbia allow for a physician with an out-of-state license to perform limited consultation to a physician with the specific state license. Several states (n=5) prohibit physicians from consultation without a license for the specific state. Overall, these results reveal the heterogeneity of licensure requirements between states. Pathologists who either practice in multiple states, send cases to out-of-state consultants, or serve as consultants themselves should familiarize themselves with the medical licensure laws of the states from which they receive or send cases.
10 CFR 712.34 - Site Occupational Medical Director.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the nominee's relevant training, experience, and licensure, and include a curriculum vitae and a copy... his or her designee through the Manager, a written report summarizing HRP medical activity during the...
The Impact of Teacher Licensure Programs on Minority Student Achievement

ERIC Educational Resources Information Center

Duke, Rose S.

2013-01-01

This research examined the impact of teacher licensure routes, particularly those identified as either traditional or alternative on student achievement by comparing Virginia Standards of Learning (SOL) end of year scores in math and reading for minority students in grades six through eight during the period from 2005 through 2009. To compare the…
A Framework for Evidence-Based Licensure of Adaptive Autonomous Systems

DTIC Science & Technology

2016-03-01

insights gleaned to DoD. The autonomy community has identified significant challenges associated with test, evaluation verification and validation of...licensure as a test, evaluation, verification , and validation (TEVV) framework that can address these challenges. IDA found that traditional...language requirements to testable (preferably machine testable) specifications • Design of architectures that treat development and verification of
Birth-Kindergarten Licensure Graduates' Perceptions of Their Current Practices and Pre-Service Preparation Relative to Individualization Strategies for Young Children

ERIC Educational Resources Information Center

Gillis, Margaret C.

2011-01-01

The purpose of this study was to examine the current practices and pre-service preparation of recent graduates of North Carolina Birth-Kindergarten (B-K) teacher licensure programs related to individualizing curriculum and instruction for children. Participants were 142 individuals who graduated from B-K licensure programs in four-year…
The licensure exam in nursing degree courses: a survey in the four universities of the Lazio Region.

PubMed

Marchetti, A; Virgolesi, M; Pulimeno, A M L; Rocco, G; Stievano, A; Venturini, G; De Marinis, M G

2014-01-01

In recent years, the nursing licensure exam is at the centre of a national and international wide debate. This debate regards the planning of the nursing licensure exam in many Universities and the competences that this exam must certify to ensure quality, effectiveness, and ethics of nursing care from newly-graduated nurses to general public. The aim of this study was to describe the practical tests used for the licensure exam in the four Universities of the Lazio Region. The researchers analyzed the type of practical tests used and the field of competences assessed according to the degrees of performance defined by the Dublin Descriptors. The data were collected through semi-structured interviews to Presidents, Directors and Lecturers of nursing degree courses and through direct retrieval of the written texts of the licensure exam. Two researchers analyzed the practical tests. A special lecture-grid divided into three different sections to interpret the data was created. Statistical analysis was carried out by means of Epi-info 3.5.1/2008. Analysis of data showed that the most used tests were Discussion of theoretical and practical aspects in context (33.6%), followed by the Test with open and/or closed questions (23,9%). Psychomotor and relational skills tests were little used. The most valued field of competence was the cognitive one (85,5%) that assessed, above all, the storage of the concept. The ability to interpret data and solve problems was less valued. The study showed the high discrepancy in the types of tests used in the four Universities of the Lazio Region. Universities found it difficult to assess psychomotor and relational skills of the students. Most of the cognitive tests utilized omitted the evaluation of mastery of complex competences. Therefore, there is the necessity of a new planning of the nursing licensure exam to overcome these critical issues.
Impact of Professional Nursing Tutors on National Council Licensure Examination Success

ERIC Educational Resources Information Center

Mondeik, Shelly L.

2014-01-01

This mixed-methods study examined the impact of professional nursing tutors on National Council Licensure Examination (NCLEX) success. Thirty-eight nursing student success rates from Northcentral Technical College, a two year technical college in Wisconsin, were analyzed by using NCLEX pass rate information, professional tutoring logs, and a…
Quality indicators for initial licensure and discipline in nursing laws in South Korea and North Carolina.

PubMed

Kim, K K; Kjervik, D K; Foster, B

2014-03-01

The Korean regulatory framework of nursing licensure reflects that of the USA, but its content differs in some of the powers related to quality assurance. This article compares regulatory quality indicators and describes core standards in nursing regulations that are related to both initial licensure and discipline for three groups: the National Council of State Boards of Nursing, the North Carolina and the South of Korea. A descriptive, comparative law design is used to examine the differences and similarities in the quality indicators and core standards found in three documents: the National Council of State Boards of Nursing Model Act, the North Carolina Nursing Practice Act and the Korean Medical Service Act for registered nurses. The findings indicate that ten quality indicators and two standards appear in study objects. Although most of the quality indicators are common to all documents, some differences are found in terms of the scope of criminal background checks and the range of grounds for disciplinary action. These findings cannot be generalized in the USA because although the North Carolina nursing act was selected as an example of US nursing laws, nursing laws differ somewhat across states. This comparative study shows a clear opportunity to develop indicators that acknowledge the important areas of competence and good moral character and how they can improve patient safety in Korea. This study provides recommendations for Korean nursing legislative redesign and pointers for other jurisdictions to consider. © 2013 International Council of Nurses.
Continuing to Hold the Test Maker Accountable: The ISLLC Standards and the New York State School District Leadership Licensure Assessments

ERIC Educational Resources Information Center

Markson, Craig; Inserra, Albert

2014-01-01

The purpose of this study was to examine the relationship of school leadership candidates' perceptions of their level of training in the Interstate School Leaders Licensure Consortium Standards (ISLLC) with their scores on Parts I and II of the New York State School District Leader (SDL) licensure assessments. The New York State assessments were…
Issues in Psychology Licensure: Requirements, Applicant Rights, Future Trends, and Epilogue.

ERIC Educational Resources Information Center

Tentoni, Stuart C.

This paper provides an analysis of the effects of licensure for psychologists. Common requirements are reviewed. Meeting the requirements may require attention to the laws of the state in which practice is intended before finishing the doctorate. Making a graduate education dossier is recommended and an example is appended. The "Examination…
Longitudinal Analysis of Adolescent Girls' Activity Patterns: Understanding the Influence of the Transition to Licensure

PubMed Central

McDonald, Noreen C.; Merlin, Louis; Hu, Haoting; Shih, Joshu; Cohen, Deborah A.; Evenson, Kelly R.; McKenzie, Thomas L.; Rodriguez, Daniel A.

2016-01-01

The proportion of teens and young adults with driver's licenses has declined sharply in many industrialized countries including the United States. Explanations for this decline have ranged from the introduction of graduated driver licensing programs to the increase in online social interaction. We used a longitudinal cohort study of teenage girls in San Diego and Minneapolis to evaluate factors associated with licensure and whether teens' travel patterns become more independent as they aged. We found that licensure depended not only on age, but on race and ethnicity as well as variables that correlate with household income. Results also showed evidence that teen travel became more independent as teen's age, and that acquiring a license is an important part of this increased independence. However, we found limited evidence that teen's travel-activity patterns changed as a result of acquiring a driver's license. Rather, teen independence resulted in less parental chauffeuring, but little shift in travel patterns. For the larger debate on declining Millennial mobility, our results suggest the need for more nuanced attention to variation across demographic groups and consideration of the equity implications if declines in travel and licensure are concentrated in low-income and minority populations. PMID:28458769
Is the public being protected? Prevention of suboptimal medical practice through training programs and credentialing examinations.

PubMed

Tamblyn, R

1994-06-01

Governments have traditionally looked to the medical profession for leadership in health planning and have charged the profession with the responsibility of establishing and monitoring standards of medical practice. Training program accreditation and licensure/certification exams have been used as the primary methods of preventing unqualified individuals from entering medical practice. Despite the critical nature of the decision made at the time of licensure/certification, there is no information about the validity of these examinations for predicting subsequent practice and health outcome. In this article, the assumptions implicit in the current use of licensing/certifying examinations are identified, the relevant evidence is reviewed, and the implications of this evidence for current methods of measurement are discussed.
Toward Increasing Teacher Diversity: Targeting Support and Intervention for Teacher Licensure Candidates

ERIC Educational Resources Information Center

Tyler, Linda

2011-01-01

Since 2006, the National Education Association (NEA) and Educational Testing Service (ETS) have been working collaboratively to support teacher candidates in preparing for "The Praxis Series"[TM] of teacher licensure assessments, currently used in 41 states and territories. Their focus has been particularly targeted to assisting minority…
Implications of the licensure of a partially efficacious malaria vaccine on evaluating second-generation vaccines.

PubMed

Fowkes, Freya J I; Simpson, Julie A; Beeson, James G

2013-10-30

Malaria is a leading cause of morbidity and mortality, with approximately 225 million clinical episodes and >1.2 million deaths annually attributed to malaria. Development of a highly efficacious malaria vaccine will offer unparalleled possibilities for disease prevention and remains a key priority for long-term malaria control and elimination. The Malaria Vaccine Technology Roadmap's goal is to 'develop and license a first-generation malaria vaccine that has protective efficacy of more than 50%'. To date, malaria vaccine candidates have only been shown to be partially efficacious (approximately 30% to 60%). However, licensure of a partially effective vaccine will create a number of challenges for the development and progression of new, potentially more efficacious, malaria vaccines in the future. In this opinion piece we discuss the methodological, logistical and ethical issues that may impact on the feasibility and implementation of superiority, non-inferiority and equivalence trials to assess second generation malaria vaccines in the advent of the licensure of a partially efficacious malaria vaccine. Selecting which new malaria vaccines go forward, and defining appropriate methodology for assessment in logistically challenging clinical trials, is crucial. It is imperative that the scientific community considers all the issues and starts planning how second-generation malaria vaccines will advance in the advent of licensure of a partially effective vaccine.
Predictors of Retention and Passing National Council Licensure Examination for Registered Nurses

ERIC Educational Resources Information Center

Elkins, Nancy

2013-01-01

The current nursing shortage has challenged colleges to educate nurses at a faster pace than in previous times. Successful completion of the nursing programs and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam is important for the students, faculty, and nursing programs. The purpose of this retrospective…

Trends in teen driver licensure, driving patterns and crash involvement in the United States, 2006-2015.

PubMed

Shults, Ruth A; Williams, Allan F

2017-09-01

The Monitoring the Future (MTF) survey provides nationally-representative annual estimates of licensure and driving patterns among U.S. teens. A previous study using MTF data reported substantial declines in the proportion of high school seniors that were licensed to drive and increases in the proportion of nondrivers following the recent U.S. economic recession. To explore whether licensure and driving patterns among U.S. high school seniors have rebounded in the post-recession years, we analyzed MTF licensure and driving data for the decade of 2006-2015. We also examined trends in teen driver involvement in fatal and nonfatal injury crashes for that decade using data from the Fatality Analysis Reporting System and National Automotive Sampling System General Estimates System, respectively. During 2006-2015, the proportion of high school seniors that reported having a driver's license declined by 9 percentage points (11%) from 81% to 72% and the proportion that did not drive during an average week increased by 8 percentage points (44%) from 18% to 26%. The annual proportion of black seniors that did not drive was consistently greater than twice the proportion of nondriving white seniors. Overall during the decade, 17- and 18-year-old drivers experienced large declines in fatal and nonfatal injury crashes, although crashes increased in both 2014 and 2015. The MTF data indicate that licensure and driving patterns among U.S. high school seniors have not rebounded since the economic recession. The recession had marked negative effects on teen employment opportunities, which likely influenced teen driving patterns. Possible explanations for the apparent discrepancies between the MTF data and the 2014 and 2015 increases in crashes are explored. MTF will continue to be an important resource for clarifying teen driving trends in relation to crash trends and informing strategies to improve teen driver safety. Published by Elsevier Ltd.
Literacy Course Priorities and Signature Aspects of Nine Elementary Initial Licensure Programs

ERIC Educational Resources Information Center

Lenski, Susan; Ganske, Kathy; Chambers, Sandy; Wold, Linda; Dobler, Elizabeth; Grisham, Dana L.; Scales, Roya; Smetana, Linda; Wolsey, Thomas Devere; Yoder, Karen K.; Young, Janet

2013-01-01

The purpose of this article is to describe the first part of a three-phase study to learn what makes an effective elementary literacy initial licensure program. The first step was to identify how nine programs prioritized research-based literacy practices and to identify each program's unique features, which we called "signature aspects." Findings…
"Special Delivery": Case Studies in Alternative Teacher Licensure Programs for Students of Color.

ERIC Educational Resources Information Center

Hasslen, Robin; Green, Les

St. Cloud State University's Teacher of Color project provides alternate licensure for degreed individuals needing only to complete their teacher education core and subject area coursework. It offers minority students on- and off-campus programs, financial support, flexible hours, and a compressed program. Researchers examined participating…
Implications of the licensure of a partially efficacious malaria vaccine on evaluating second-generation vaccines

PubMed Central

2013-01-01

Background Malaria is a leading cause of morbidity and mortality, with approximately 225 million clinical episodes and >1.2 million deaths annually attributed to malaria. Development of a highly efficacious malaria vaccine will offer unparalleled possibilities for disease prevention and remains a key priority for long-term malaria control and elimination. Discussion The Malaria Vaccine Technology Roadmap’s goal is to 'develop and license a first-generation malaria vaccine that has protective efficacy of more than 50%’. To date, malaria vaccine candidates have only been shown to be partially efficacious (approximately 30% to 60%). However, licensure of a partially effective vaccine will create a number of challenges for the development and progression of new, potentially more efficacious, malaria vaccines in the future. In this opinion piece we discuss the methodological, logistical and ethical issues that may impact on the feasibility and implementation of superiority, non-inferiority and equivalence trials to assess second generation malaria vaccines in the advent of the licensure of a partially efficacious malaria vaccine. Conclusions Selecting which new malaria vaccines go forward, and defining appropriate methodology for assessment in logistically challenging clinical trials, is crucial. It is imperative that the scientific community considers all the issues and starts planning how second-generation malaria vaccines will advance in the advent of licensure of a partially effective vaccine. PMID:24228861
Perceptions and practices of U.S. dental schools regarding curriculum integrated format and traditional format licensure exams.

PubMed

Desai, Shamik; Allareddy, Veerasathpurush; Donoff, R Bruce; Howell, T Howard; Karimbux, Nadeem Y

2013-08-01

The dental licensure exam in the United States has evolved over the past ten years, and two formats-the traditional format and curriculum integrated format-are now available for students to satisfy licensure requirements. The objective of this study was to examine the differences and relative merits of the two formats. A twenty-five-question survey was distributed to the fifty-seven U.S. dental schools at the time. The survey included both quantitative and discrete variables and followed a strategic sequential order. The first set of questions sought to determine what type of board preparatory/mock exam each dental school offered, and the next set of questions asked which licensure exam each school formally offered. The final questions were qualitative in nature and aimed to determine the school representatives' opinions about the curriculum integrated format versus traditional format. Of the fifty-seven schools contacted, thirty-seven agreed to participate (response rate=64.9 percent). Fourteen schools reported that they administer the traditional format only and twelve administer the curriculum integrated format only, while eleven offer both. Thirty-two schools offered mock board exams to their graduating students, and twenty-four of those said their mock exams were identical in format to the actual qualifying clinical exams offered at their institution. The respondents reported no significant advantage to preparing for the curriculum integrated format examination as compared to the traditional format examination with regards to number of clock hours taken from regular curriculum time. In reporting on this study, this article provides an overview of the relative advantages and disadvantages of the two examination formats used for the dental licensure process in the United States.
Asynchronous Online Peer Assistance: Telephone Messages of Encouragement in Post Licensure Nursing Programs

ERIC Educational Resources Information Center

Melrose, Sherri; Swettenham, Steve

2012-01-01

Peer assistance activities can strengthen online learning environments. And yet, like other professional adult learners, working post licensure nurses attending university part time to upgrade their credentials may have limited interest in student-to-student interaction. Some intentionally choose asynchronous self-paced courses so they can work on…
Shall We Overcome? Self-Efficacy, Teacher Licensure Exams, and African American Preservice Teachers

ERIC Educational Resources Information Center

Petchauer, Emery

2016-01-01

This article reports findings from a 3-year qualitative study exploring the experiences of African American preservice teachers as they prepared for the Praxis "basic skills" teacher-licensure exam, a gatekeeper to many teacher-education programs. Using the construct of self-efficacy, results illustrate how students assess their Praxis…
A Short Profile of Hypnotherapy Licensure in Israel.

PubMed

Binyaminy, Binyamin; Haas, Eric J

2016-01-01

In Israel, only physicians, dentists, and psychologists who complete an accredited licensing process may practice hypnosis. This study examines the characteristics of hypnotherapists compared to nonhypnotherapists in the same discipline. All hypnotherapists in Israel were compared to nonhypnotherapist health professionals. There are more subspecialists among hypnotists, and the most common specialties were psychiatry, pediatric dentistry, and clinical psychology. These findings imply self-sorting of hypnotists as a result of the regulation in Israel. Licensure of hypnotherapists could be useful in other countries by comprehensive follow-up of all licensed hypnotists and by improving public and health professional perceptions of the field and its relevance to clinical practice.
The State of State Policies for Principal Preparation Program Approval and Candidate Licensure

ERIC Educational Resources Information Center

Anderson, Erin; Reynolds, Amy

2015-01-01

Policies for principal preparation and licensure are important levers for improving school leadership. By developing a rubric of research-based practices, this University Council of Educational Administration study aims to provide a formative tool for policy makers. Using a policy analysis frame by Roach et al., this study explores the state code,…
Acceptance of a U.S. Degree in Pharmacy for Licensure in Several Foreign Countries.

ERIC Educational Resources Information Center

Blake, Martin I.; Louie, Annie

1988-01-01

A study of the acceptability of a U.S. pharmacy degree in meeting academic requirements for licensure in Canada, France, Mexico, the Philippines, Taiwan, the United Kingdom, India, Nigeria, Egypt, and Austria suggests that citizenship, reciprocal recognition, and retraining requirements and program divergences will reduce transferability of…
Impact of Time Lapse on ASCP Board of Certification Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) Examination Scores.

PubMed

Brown, Karen A; Fenn, JoAnn P; Freeman, Vicki S; Fisher, Patrick B; Genzen, Jonathan R; Goodyear, Nancy; Houston, Mary Lunz; O'Brien, Mary Elizabeth; Tanabe, Patricia A

2015-01-01

Research in several professional fields has demonstrated that delays (time lapse) in taking certification examinations may result in poorer performance by examinees. Thirteen states and/or territories require licensure for laboratory personnel. A core component of licensure is passing a certification exam. Also, many facilities in states that do not require licensure require certification for employment or preferentially hire certified individuals. To analyze examinee performance on the American Society for Clinical Pathology (ASCP) Board of Certification (BOC) Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) certification examinations to determine whether delays in taking the examination from the time of program completion are associated with poorer performance. We obtained examination data from April 2013 through December 2014 to look for changes in mean (SD) exam scaled scores and overall pass/fail rates. First-time examinees (MLS: n = 6037; MLT, n = 3920) were divided into 3-month categories based on the interval of time between date of program completion and taking the certification exam. We observed significant decreases in mean (SD) scaled scores and pass rates after the first quarter in MLS and MLT examinations for applicants who delayed taking their examination until the second, third, and fourth quarter after completing their training programs. Those who take the ASCP BOC MLS and MLT examinations are encouraged to do so shortly after completion of their educational training programs. Delays in taking an exam are generally not beneficial to the examinee and result in poorer performance on the exam. Copyright© by the American Society for Clinical Pathology (ASCP).
A primer on medical education in the United States through the lens of a current resident physician.

PubMed

Mowery, Yvonne M

2015-10-01

Physician training and standards for medical licensure differ widely across the globe. The medical education process in the United States (US) typically involves a minimum of 11 years of formal training and multiple standardized examinations between graduating from secondary school and becoming an attending physician with full medical licensure. Students in the US traditionally enter a 4-year medical school after completing an undergraduate bachelor's degree, in contrast to most other countries where medical training begins after graduation from high school. Medical school seniors planning to practice medicine in the US must complete postgraduate clinical training, referred to as residency, within the specialty of their choosing. The duration of residency varies depending on specialty, typically lasting between 3 and 7 years. For subspecialty fields, additional clinical training is often required in the form of a fellowship. Many experts have called for changes in the medical education system to shorten medical training in the US, and reforms are ongoing in some institutions. However, physician education in the US generally remains a progression from undergraduate premedical coursework to 4 years of medical school, followed by residency training with an optional subspecialty fellowship.
A primer on medical education in the United States through the lens of a current resident physician

PubMed Central

2015-01-01

Physician training and standards for medical licensure differ widely across the globe. The medical education process in the United States (US) typically involves a minimum of 11 years of formal training and multiple standardized examinations between graduating from secondary school and becoming an attending physician with full medical licensure. Students in the US traditionally enter a 4-year medical school after completing an undergraduate bachelor’s degree, in contrast to most other countries where medical training begins after graduation from high school. Medical school seniors planning to practice medicine in the US must complete postgraduate clinical training, referred to as residency, within the specialty of their choosing. The duration of residency varies depending on specialty, typically lasting between 3 and 7 years. For subspecialty fields, additional clinical training is often required in the form of a fellowship. Many experts have called for changes in the medical education system to shorten medical training in the US, and reforms are ongoing in some institutions. However, physician education in the US generally remains a progression from undergraduate premedical coursework to 4 years of medical school, followed by residency training with an optional subspecialty fellowship. PMID:26623123
A primer on medical education in the United States through the lens of a current resident physician

PubMed Central

2015-01-01

Physician training and standards for medical licensure differ widely across the globe. The medical education process in the United States (US) typically involves a minimum of 11 years of formal training and multiple standardized examinations between graduating from secondary school and becoming an attending physician with full medical licensure. Students in the US traditionally enter a 4-year medical school after completing an undergraduate bachelor’s degree, in contrast to most other countries where medical training begins after graduation from high school. Medical school seniors planning to practice medicine in the US must complete postgraduate clinical training, referred to as residency, within the specialty of their choosing. The duration of residency varies depending on specialty, typically lasting between 3 and 7 years. For subspecialty fields, additional clinical training is often required in the form of a fellowship. Many experts have called for changes in the medical education system to shorten medical training in the US, and reforms are ongoing in some institutions. However, physician education in the US generally remains a progression from undergraduate premedical coursework to 4 years of medical school, followed by residency training with an optional subspecialty fellowship. PMID:26605316
Correction to: CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores.

PubMed

Dore, Kelly L; Reiter, Harold I; Kreuger, Sharyn; Norman, Geoffrey R

2017-12-01

In re-examining the paper "CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores" published in AHSE (22(2), 327-336), we recognized two errors of interpretation.
A Survey of Optometry Graduates to Determine Practice Patterns: Part II: Licensure and Practice Establishment Experiences.

ERIC Educational Resources Information Center

Bleimann, Robert L.; Smith, Lee W.

1985-01-01

A summary of Part II of a two-volume study of optometry graduates conducted by the Association of Schools and Colleges of Optometry is presented. Part II includes the analysis of the graduates' licensure and practice establishment experiences. (MLW)
Educational Technology in Teacher Education Programs for Initial Licensure. Statistical Analysis Report. NCES 2008-040

ERIC Educational Resources Information Center

Kleiner, Brian; Thomas, Nina; Lewis, Laurie

2007-01-01

This report presents findings from a 2006 national survey of all Title IV degree-granting 4- year postsecondary institutions on how teacher candidates within teacher education programs for initial licensure are being prepared to use educational technology once they enter the field. The "Educational Technology in Teacher Education Programs…
Veterinary Medical Education in Florida. Report and Recommendations of the Postsecondary Education Planning Commission, Report No. 3, 1987.

ERIC Educational Resources Information Center

Florida State Postsecondary Education Commission, Tallahassee.

A report on veterinary medical education in Florida and the need for veterinary care in Florida is presented. Overviews of the veterinary profession and veterinary medical education are also given, including the areas of history, careers in the field, licensure, salaries, animal disease research, accreditation, curriculum, enrollment, educational…
Assuring dental hygiene clinical competence for licensure: a national survey of dental hygiene program directors.

PubMed

Fleckner, Lucinda M; Rowe, Dorothy J

2015-02-01

To conduct a national survey of dental hygiene program directors to gain their opinions of alternative assessments of clinical competency, as qualifications for initial dental hygiene licensure. A 22 question survey, comprised of statements eliciting Likert-scale responses, was developed and distributed electronically to 341 U.S. dental hygiene program directors. Responses were tabulated and analyzed using University of California, San Francisco Qualtrics® computer software. Data were summarized as frequencies of responses to each item on the survey. The response rate was 42% (n=143). The majority of respondents (65%) agreed that graduating from a Commission on Dental Accreditation (CODA)-approved dental hygiene program and passing the national board examination was the best measure to assure competence for initial licensure. The addition of "successfully completing all program's competency evaluations" to the above core qualifications yielded a similar percentage of agreement. Most (73%) agreed that "the variability of live patients as test subjects is a barrier to standardizing the state and regional examinations," while only 29% agreed that the "use of live patients as test subjects is essential to assure competence for initial licensure." The statement that the one-time state and regional examinations have "low validity in reflecting the complex responsibilities of the dental hygienist in practice" had a high (77%) level of agreement. Most dental hygiene program directors agree that graduating from a CODA-approved dental hygiene program and passing the national board examination would ensure that a graduate has achieved clinical competence and readiness to provide comprehensive patient-centered care as a licensed dental hygienist. Copyright © 2015 The American Dental Hygienists’ Association.
Post-licensure safety surveillance for human papillomavirus-16/18-AS04-adjuvanted vaccine: more than 4 years of experience

PubMed Central

Angelo, Maria-Genalin; Zima, Julia; Tavares Da Silva, Fernanda; Baril, Laurence; Arellano, Felix

2014-01-01

Purpose To summarise post-licensure safety surveillance over more than 4 years of routine use of the human papillomavirus-16/18-AS04-adjuvanted vaccine (HPV-16/18 vaccine: Cervarix®, GlaxoSmithKline, Belgium). Methods We describe global post-licensure passive surveillance data based on routine pharmacovigilance from 18 May 2007 until 17 November 2011 and enhanced surveillance implemented during the 2-year national immunisation programme in the UK (school years 2008–2010). Results Spontaneous reports from countries worldwide showed a similar pattern for the most frequently reported adverse events after HPV-16/18 vaccination. No patterns or trends were observed for potential immune-mediated diseases after vaccination. Observed incidences of Bell's palsy and confirmed Guillain–Barré syndrome were within the expected range in the general population. Outcomes of pregnancy in women who were inadvertently exposed to HPV-16/18 vaccine during pregnancy, were in line with published reports for similar populations. Enhanced surveillance of adverse events in the UK triggered a review of cases of anaphylaxis, angioedema and syncope reports, leading to an update to the prescribing information. Conclusion Collaborative partnerships between industry and national regulatory agencies facilitated rapid notification and transfer of safety information, allowing for rapid responses in the event of a safety signal of adverse event of concern. More than 4 years of post-licensure experience may provide confidence to providers and the public about the safety profile of HPV-16/18 vaccine in routine use. The safety profile appears to be consistent with pre-licensure data reporting that HPV-16/18 vaccine has an acceptable benefit–risk profile in adolescent girls and women. PMID:24644078

An Examination of the Qatari Licensure System: Giving Voice to Educators at Government-Funded Schools

ERIC Educational Resources Information Center

Abu-Tineh, Abdullah; Sadiq, Hissa; Al-Mutawah, Fatma; Chaaban, Youmen

2017-01-01

The issue of developing a comprehensive licensure system aligned with professional standards for teachers and school leaders has received considerable attention in recent years. As part of the Qatari educational reform in recent years, teachers and school leaders are held accountable to offer quality education for all students. The current study…
History of the medical licensing examination (uieop) in Korea’s Goryeo Dynasty (918-1392)

PubMed Central

Lee, Kyung-Lock

2015-01-01

This article aims to describe the training and medical licensing system (uieop) for becoming a physician officer (uigwan) during Korea’s Goryeo Dynasty (918-1392). In the Goryeo Dynasty, although no license was necessary to provide medical services to the common people, there was a licensing examination to become a physician officer. No other national licensing system for healthcare professionals existed in Korea at that time. The medical licensing examination was administered beginning in 958. Physician officers who passed the medical licensing examination worked in two main healthcare institutions: the Government Hospital (Taeuigam) and Pharmacy for the King (Sangyakguk). The promotion and expansion of medical education differed depending on the historical period. Until the reign of King Munjong (1046-1083), medical education as a path to licensure was encouraged in order to increase the number of physician officers qualifying for licensure by examination; thus, the number of applicants sitting for the examination increased. However, in the late Goryeo Dynasty, after the officer class of the local authorities (hyangri) showed a tendency to monopolize the examination, the Goryeo government limited the examination applications by this group. The medical licensing examination was divided into two parts: medicine and ‘feeling the pulse and acupuncture’ (jugeumeop). The Goryeo Dynasty followed the Chinese Dang Dynasty’s medical system while also taking a strong interest in the Chinese Song Dynasty’s ideas about medicine. PMID:26008917
Trend of De La Salle Lipa Education Graduates' Performance in the Licensure Examination for Teachers

ERIC Educational Resources Information Center

Kalaw, Maria Theresa B.

2017-01-01

This study aimed to examine the trend of performance of De La Salle Lipa (DLSL) education graduates in the Licensure Examination for Teachers (LET). Quantitative trend analysis employed on the data collected from records officially released by the Professional Regulation Commission (PRC) for the years 2011 to 2015 revealed that the performance of…
Initial Development of Criteria for Assessing Quality of Medical Care.

ERIC Educational Resources Information Center

Ironside, Roderick A.

In 1969, the Medical School of the University of Puerto Rico (UPR) received a grant from the National Center for Health Services Research and Development (Public Health Service, HEW) to plan and conduct--as a demonstration project--a special retraining program for physicians who had failed to approve the licensure examinations of the Puerto Rico…
Medical Physicists and AAPM

NASA Astrophysics Data System (ADS)

Amols, Howard

2006-03-01

The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members are based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.
45 CFR 61.7 - Reporting licensure actions taken by Federal or State licensing and certification agencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Reporting licensure actions taken by Federal or State licensing and certification agencies. 61.7 Section 61.7 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...
45 CFR 61.7 - Reporting licensure actions taken by Federal or State licensing and certification agencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting licensure actions taken by Federal or State licensing and certification agencies. 61.7 Section 61.7 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...
45 CFR 61.7 - Reporting licensure actions taken by Federal or State licensing and certification agencies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Reporting licensure actions taken by Federal or State licensing and certification agencies. 61.7 Section 61.7 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...
Post-licensure safety surveillance for human papillomavirus-16/18-AS04-adjuvanted vaccine: more than 4 years of experience.

PubMed

Angelo, Maria-Genalin; Zima, Julia; Tavares Da Silva, Fernanda; Baril, Laurence; Arellano, Felix

2014-05-01

To summarise post-licensure safety surveillance over more than 4 years of routine use of the human papillomavirus-16/18-AS04-adjuvanted vaccine (HPV-16/18 vaccine: Cervarix®, GlaxoSmithKline, Belgium). We describe global post-licensure passive surveillance data based on routine pharmacovigilance from 18 May 2007 until 17 November 2011 and enhanced surveillance implemented during the 2-year national immunisation programme in the UK (school years 2008-2010). Spontaneous reports from countries worldwide showed a similar pattern for the most frequently reported adverse events after HPV-16/18 vaccination. No patterns or trends were observed for potential immune-mediated diseases after vaccination. Observed incidences of Bell's palsy and confirmed Guillain-Barré syndrome were within the expected range in the general population. Outcomes of pregnancy in women who were inadvertently exposed to HPV-16/18 vaccine during pregnancy, were in line with published reports for similar populations. Enhanced surveillance of adverse events in the UK triggered a review of cases of anaphylaxis, angioedema and syncope reports, leading to an update to the prescribing information. Collaborative partnerships between industry and national regulatory agencies facilitated rapid notification and transfer of safety information, allowing for rapid responses in the event of a safety signal of adverse event of concern. More than 4 years of post-licensure experience may provide confidence to providers and the public about the safety profile of HPV-16/18 vaccine in routine use. The safety profile appears to be consistent with pre-licensure data reporting that HPV-16/18 vaccine has an acceptable benefit-risk profile in adolescent girls and women. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.
Health Care Professionals' Attitudes toward Licensure, National Certification, and Continuing Education Requirements: Results of a Texas Survey.

ERIC Educational Resources Information Center

Hagus, Cheryll K.

2000-01-01

Survey responses (n=1,620) from health processionals in communications disorders, clinical laboratory science, health information management, physical therapy, and respiratory care indicated the majority support licensure and certification; 45.3% had difficulty finding accessible, relevant continuing education programs; cost and distance were…
The Effect of Licensure Type on the Policies, Practices, and Resident Composition of Florida Assisted Living Facilities

PubMed Central

Street, Debra; Burge, Stephanie; Quadagno, Jill

2009-01-01

Purpose: Most assisted living facility (ALF) residents are White widows in their mid- to late 80s who need assistance with activities of daily living (ADLs) because of frailty or cognitive decline. Yet, ALFs also serve younger individuals with physical disabilities, traumatic brain injury, or serious mental illness. We compare Florida ALFs with different licensure profiles by admission–discharge policies and resident population characteristics. Design and Methods: We use state administrative data and facility survey data from the Florida Study of Assisted Living (FSAL) to classify ALFs by licensure type and to determine how licensure influences ALF policies, practices, and resident population profiles. Results: Standard-licensed traditional ALFs primarily serve elderly White women with physical care needs and typically retain residents when their physical health deteriorates. Some ALFs that hold specialty licenses (extended congregate care and limited nursing services) offer extra physical care services and serve an older, more physically frail population with greater physical and cognitive challenges. ALFs with limited mental health (LMH) licenses serve clientele who are more racially and ethnically diverse, younger, and more likely to be men and single. LMH facilities also have a significant proportion of frail elder residents who live alongside these younger residents, including some who exhibit behavioral problems. LMH facilities also employ discharge policies that make it more difficult for frail elderly residents to age in place. Implications: These differences by facility type raise important quality of life issues for both the frail elderly individuals and assisted living residents who do not fit the conventional demographic profile. PMID:19363016
Predictors of Success on the National Council Licensure Examination for Registered Nurses among Transfer BSN Students

ERIC Educational Resources Information Center

Fortier, Mary E.

2010-01-01

This quantitative research study (N=175) examined predictors of first time success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) among transfer students in a baccalaureate degree program (BSN). The predictors were chosen after an extensive literature review yielded few studies related to this population. Benner's…
Crime, criminals, and cures: medical model revisited.

PubMed

Sampson, R J

2000-06-01

David Lykken's target article assesses the causes of crime and advocates a controversial "cure"--parental licensure. Although Lykken gets many of the facts about criminals right, ultimately the disease metaphor breaks down. Crime requires three things--motivated offenders ("criminals"), suitable targets or victims, and the absence of capable guardians to prevent the act. Typical of medical model approaches, failure to consider the convergence in time and space of the three necessary elements for crime results in a misdiagnosis. In this invited commentary, I briefly note three reasons why Lykken's cure, along with the medical model in general, is unlikely to bear fruit.
Educational Planning: Implications of the 2008 Revised Interstate School Leadership Licensure Consortium Standards for School Leaders

ERIC Educational Resources Information Center

Lindahl, Ronald A.; Beach, Robert H.

2009-01-01

On November 2, 1996, the Interstate School Leadership Licensure Consortium (ISLLC), a program of the Council of Chief State School Officers (CCSSO), adopted a set of Standards for School Leaders (CCSSO, 1996). By 2005, 41 states had adopted or adapted these Standards (Sanders & Simpson, 2005). However, after almost a decade of experience with…
Leadership Conference on Medical Education in Substance Abuse (Washington, DC, December 1-2, 2004)

ERIC Educational Resources Information Center

Office of National Drug Control Policy, 2004

2004-01-01

In December 2004, the Office of National Drug Control Policy (ONDCP) in the Executive Office of the President hosted an important Leadership Conference on Medical Education in Substance Abuse. The conference brought together leaders of private sector organizations, Federal agencies, organized medicine, and licensure and certification bodies to…
Meeting the goal of concurrent adolescent and adult licensure of HIV prevention and treatment strategies.

PubMed

Hume, Michelle; Lewis, Linda L; Nelson, Robert M

2017-12-01

The ability of adolescents to access safe and effective new products for HIV prevention and treatment is optimised by adolescent licensure at the same time these products are approved and marketed for adults. Many adolescent product development programmes for HIV prevention or treatment products may proceed simultaneously with adult phase III development programmes. Appropriately implemented, this strategy is not expected to delay licensure as information regarding product efficacy can often be extrapolated from adults to adolescents, and pharmacokinetic properties of drugs in adolescents are expected to be similar to those in adults. Finally, adolescents enrolled in therapeutic HIV prevention and treatment research can be considered adults, based on US Food and Drug Administration (FDA) regulations and the appropriate application of state law. The FDA permits local jurisdictions to apply state and local HIV/sexually transmitted infection minor treatment laws so that adolescents who are HIV-positive or at risk of contracting HIV may be enrolled in therapeutic or prevention trials without obtaining parental permission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis.

PubMed

Cant, Robyn P; Cooper, Simon J

2017-11-01

Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25-6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.
A Comparison of Traditional Test Blueprinting and Item Development to Assessment Engineering in a Licensure Context

ERIC Educational Resources Information Center

Masters, James S.

2010-01-01

With the need for larger and larger banks of items to support adaptive testing and to meet security concerns, large-scale item generation is a requirement for many certification and licensure programs. As part of the mass production of items, it is critical that the difficulty and the discrimination of the items be known without the need for…
Teacher Perceptions of the Indiana Workplace Specialist I Licensure Training Program during the 2011-2012 Academic Year

ERIC Educational Resources Information Center

Lazaros, Edward J.; Cotton, Samuel; Brown, Paul B.

2012-01-01

Alternative teacher licensure, also known as alternative teacher certification, is a growing national trend in education, and it has long been common in the field of career and technical education. Alternatively licensed teachers often enter teaching with a wealth of subject area knowledge due to their previous work experience. Mentorship programs…
The Prevalence of Multiple-Choice Testing in Registered Nurse Licensure-Qualifying Nursing Education Programs in New York State.

PubMed

Birkhead, Susan; Kelman, Glenda; Zittel, Barbara; Jatulis, Linnea

The aim of this study was to describe nurse educators' use of multiple-choice questions (MCQs) in testing in registered nurse licensure-qualifying nursing education programs in New York State. This study was a descriptive correlational analysis of data obtained from surveying 1,559 nurse educators; 297 educators from 61 institutions responded (response rate [RR] = 19 percent), yielding a final cohort of 200. MCQs were reported to comprise a mean of 81 percent of questions on a typical test. Baccalaureate program respondents were equally likely to use MCQs as associate degree program respondents (p > .05) but were more likely to report using other methods of assessing student achievement to construct course grades (p < .01). Both groups reported little use of alternate format-type questions. Respondent educators reported substantial reliance upon the use of MCQs, corroborating the limited data quantifying the prevalence of use of MCQ tests in licensure-qualifying nursing education programs.

Present Status of Medical Education in Poland

PubMed Central

Selzer, Arthur

1965-01-01

In the past few years medical education in Poland has undergone considerable change, particularly at the graduate and postgraduate levels, and has shown increasing Western influences. On the negative side, a physician who was trained in pre-war Poland and is now in the United States, noted mass production of physicians with modest clinical facilities and the preponderance of didactic lecturing over semi-individual instruction—conditions rather characteristic of most European medical schools. On the positive side were well-informed, up-to-date faculties and the thoughtful planning and organization of graduate and postgraduate medical education. The overall impression was a favorable one, but the system of schooling and of evaluation of students' work made it possible for indifferent students to progress to licensure. PMID:14288146
PRESENT STATUS OF MEDICAL EDUCATION IN POLAND.

PubMed

SELZER, A

1965-04-01

In the past few years medical education in Poland has undergone considerable change, particularly at the graduate and postgraduate levels, and has shown increasing Western influences. On the negative side, a physician who was trained in pre-war Poland and is now in the United States, noted mass production of physicians with modest clinical facilities and the preponderance of didactic lecturing over semi-individual instruction-conditions rather characteristic of most European medical schools. On the positive side were well-informed, up-to-date faculties and the thoughtful planning and organization of graduate and postgraduate medical education. The overall impression was a favorable one, but the system of schooling and of evaluation of students' work made it possible for indifferent students to progress to licensure.
Use of Curricular and Extracurricular Assessments to Predict Performance on the United States Medical Licensing Examination (USMLE) Step 1: A Multi-Year Study

ERIC Educational Resources Information Center

Gandy, Robyn A.; Herial, Nabeel A.; Khuder, Sadik A.; Metting, Patricia J.

2008-01-01

This paper studies student performance predictions based on the United States Medical Licensure Exam (USMLE) Step 1. Subjects were second-year medical students from academic years of 2002 through 2006 (n = 711). Three measures of basic science knowledge (two curricular and one extracurricular) were evaluated as predictors of USMLE Step 1 scores.…
Post-licensure rapid immunization safety monitoring program (PRISM) data characterization.

PubMed

Baker, Meghan A; Nguyen, Michael; Cole, David V; Lee, Grace M; Lieu, Tracy A

2013-12-30

The Post-Licensure Rapid Immunization Safety Monitoring (PRISM) program is the immunization safety monitoring component of FDA's Mini-Sentinel project, a program to actively monitor the safety of medical products using electronic health information. FDA sought to assess the surveillance capabilities of this large claims-based distributed database for vaccine safety surveillance by characterizing the underlying data. We characterized data available on vaccine exposures in PRISM, estimated how much additional data was gained by matching with select state and local immunization registries, and compared vaccination coverage estimates based on PRISM data with other available data sources. We generated rates of computerized codes representing potential health outcomes relevant to vaccine safety monitoring. Standardized algorithms including ICD-9 codes, number of codes required, exclusion criteria and location of the encounter were used to obtain the background rates. The majority of the vaccines routinely administered to infants, children, adolescents and adults were well captured by claims data. Immunization registry data in up to seven states comprised between 5% and 9% of data for all vaccine categories with the exception of 10% for hepatitis B and 3% and 4% for rotavirus and zoster respectively. Vaccination coverage estimates based on PRISM's computerized data were similar to but lower than coverage estimates from the National Immunization Survey and Healthcare Effectiveness Data and Information Set. For the 25 health outcomes of interest studied, the rates of potential outcomes based on ICD-9 codes were generally higher than rates described in the literature, which are typically clinically confirmed cases. PRISM program's data on vaccine exposures and health outcomes appear complete enough to support robust safety monitoring. Copyright © 2013 Elsevier Ltd. All rights reserved.
Factors and Processes That Influence E-Professionalism among Pre-Licensure Baccalaureate Nursing Students When Utilizing Social Media

ERIC Educational Resources Information Center

Skrabal, Julie

2017-01-01

There is limited research related to nursing students' social media use. Because of this, there was a need to further explore how they were using social media and their ability to maintain e-professionalism. This study discovered that pre-licensure baccalaureate nursing students are actively using multiple social media accounts on a daily basis.…
Comparison of Written and Oral Examinations in a Baccalaureate Medical-Surgical Nursing Course.

ERIC Educational Resources Information Center

Rushton, Patricia; Eggett, Dennis

2003-01-01

Of four groups of medical-surgical nurses, 55 took one final and three midterm written exams, 150 took one each (written), 45 took an oral final, 92 took both written and oral, and 47 took a written test with licensure questions and an oral final. Oral exams resulted in higher scores, more effective study habits, and increased application. (SK)
The Relationship between Rating Scales Used to Evaluate Tasks from Task Inventories for Licensure and Certification Examinations

ERIC Educational Resources Information Center

Cadle, Adrienne Woodley

2012-01-01

The first step in developing or updating a licensure or certification examination is to conduct a job or task analysis. Following completion of the job analysis, a survey validation study is performed to validate the results of the job analysis and to obtain task ratings so that an examination blueprint may be created. Psychometricians and job…
e-Professionalism: a new frontier in medical education.

PubMed

Kaczmarczyk, Joseph M; Chuang, Alice; Dugoff, Lorraine; Abbott, Jodi F; Cullimore, Amie J; Dalrymple, John; Davis, Katrina R; Hueppchen, Nancy A; Katz, Nadine T; Nuthalapaty, Francis S; Pradhan, Archana; Wolf, Abigail; Casey, Petra M

2013-01-01

This article, prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, discusses the evolving challenges facing medical educators posed by social media and a new form of professionalism that has been termed e-professionalism. E-professionalism is defined as the attitudes and behaviors that reflect traditional professionalism paradigms but are manifested through digital media. One of the major functions of medical education is professional identity formation; e-professionalism is an essential and increasingly important element of professional identity formation, because the consequences of violations of e-professionalism have escalated from academic sanctions to revocation of licensure. E-professionalism should be included in the definition, teaching, and evaluation of medical professionalism. Curricula should include a positive approach for the proper professional use of social media for learners.
[Study on the reform and improvement of the medical device registration system in China].

PubMed

Wang, Lanming

2012-11-01

Based on the theories of the Government Regulation and Administrative Licensure, aiming at the current situations of medical device registration system in China, some policy suggestions for future reform and improvement were provided as follows. (1) change the concepts of medical device registration administration. (2) perfect the regulations of medical device registration administration. (3) reform the medical device review organizational system. (4) Optimize the procedure of review and approval. (5) set up and maintain a professional team of review and approval staff. (6) reinforce the post-marketing supervision of medical devices. (7) foster and bring into play of the role of non-government organizations.
Vaccine stability study design and analysis to support product licensure.

PubMed

Schofield, Timothy L

2009-11-01

Stability evaluation supporting vaccine licensure includes studies of bulk intermediates as well as final container product. Long-term and accelerated studies are performed to support shelf life and to determine release limits for the vaccine. Vaccine shelf life is best determined utilizing a formal statistical evaluation outlined in the ICH guidelines, while minimum release is calculated to help assure adequate potency through handling and storage of the vaccine. In addition to supporting release potency determination, accelerated stability studies may be used to support a strategy to recalculate product expiry after an unintended temperature excursion such as a cold storage unit failure or mishandling during transport. Appropriate statistical evaluation of vaccine stability data promotes strategic stability study design, in order to reduce the uncertainty associated with the determination of the degradation rate, and the associated risk to the customer.
Development of new core competencies for Taiwanese Emergency Medical Technicians.

PubMed

Chang, Yu-Tung; Tsai, Kuang-Chau; Williams, Brett

2018-01-01

Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT) and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents' perspectives of the Taiwanese EMT training and education system. The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS) education system are the attitude of authorities, the licensure system, and legislation. The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of incorporating competency standards in the current skills-based curriculum. Moreover, the core-competencies gap that exists between Taiwanese EMT-1s, EMT-2s, and EMT-Paramedics and internationally recognized core competencies needs to be addressed. By identifying the key factors that potentially impact the development of the EMS education system, such as the attitude of authorities, the licensure system, and legislation, these findings will inform
Development of new core competencies for Taiwanese Emergency Medical Technicians

PubMed Central

Chang, Yu-Tung; Tsai, Kuang-Chau; Williams, Brett

2018-01-01

Objectives Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT) and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. Methods A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents’ perspectives of the Taiwanese EMT training and education system. Results The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS) education system are the attitude of authorities, the licensure system, and legislation. Conclusion The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of incorporating competency standards in the current skills-based curriculum. Moreover, the core-competencies gap that exists between Taiwanese EMT-1s, EMT-2s, and EMT-Paramedics and internationally recognized core competencies needs to be addressed. By identifying the key factors that potentially impact the development of the EMS education system, such as the attitude of authorities, the licensure system, and
An Analysis of Programmatic Variables Relating to the Pass Rates on the Licensure Examination by Practical Nurses in Tennessee Technology Centers

ERIC Educational Resources Information Center

Simpson, Janis Lee

2013-01-01

The purpose of this quantitative research study was to determine the degree to which Licensed Practical Nursing programmatic variables positively correlate with select Tennessee Technology Center institution pass rates on the licensure examination--NCLEX-PNRTM. This study investigated the relationship between the dependent variable of NCLEX-PNRTM…
Using K-12 Lessons Learned about How to Balance Accessibility and Test Security to Inform Licensure, Credentialing, and Certification Exam Policies

ERIC Educational Resources Information Center

Lazarus, Sheryl S.; van den Heuvel, Jill R.; Thurlow, Martha L.

2017-01-01

This paper explores how to balance test security and accessibility on licensure, credentialing, and certification exams. It examines K-12 test security policies related to educational assessments across states to discover lessons learned about how to meet accessibility needs of individuals with disabilities while minimizing test security risks. It…
Modeling Relationships between Traditional Preadmission Measures and Clinical Skills Performance on a Medical Licensure Examination

ERIC Educational Resources Information Center

Roberts, William L.; Pugliano, Gina; Langenau, Erik; Boulet, John R.

2012-01-01

Medical schools employ a variety of preadmission measures to select students most likely to succeed in the program. The Medical College Admission Test (MCAT) and the undergraduate college grade point average (uGPA) are two academic measures typically used to select students in medical school. The assumption that presently used preadmission…
Post-licensure safety surveillance of 23-valent pneumococcal polysaccharide vaccine in the Vaccine Adverse Event Reporting System (VAERS), 1990-2013.

PubMed

Miller, Elaine R; Moro, Pedro L; Cano, Maria; Lewis, Paige; Bryant-Genevier, Marthe; Shimabukuro, Tom T

2016-05-27

23-Valent pneumococcal polysaccharide vaccine, trade name Pneumovax(®)23 (PPSV23), has been used for decades in the Unites States and has an extensive clinical record. However, limited post-licensure safety assessment has been conducted. To analyze reports submitted to the Vaccine Adverse Event Reporting System (VAERS) following PPSV23 from 1990 to 2013 in order to characterize its safety profile. We searched the VAERS database for US reports following PPSV23 for persons vaccinated from 1990 to 2013. We assessed safety through: automated analysis of VAERS data, crude adverse event (AE) reporting rates based on PPSV23 doses distributed in the US market, clinical review of death reports and reports involving vaccine administered to pregnant women, and empirical Bayesian data mining to assess for disproportional reporting. During the study period, VAERS received 25,168 PPSV23 reports; 92% were non-serious, 67% were in females and 86% were in adults aged ≥19 years. When PPSV23 was administered alone, fever (43%), injection site erythema (28%) and injection site pain (25%) were the most commonly reported non-serious AEs in children. Injection site erythema (32%), injection site pain (27%) and injection site swelling (23%) were the most commonly reported non-serious AEs in adults. Of serious reports (2129, 8% of total), fever was most commonly reported in both children (69%) and adults (39%). There were 66 reports of death, four in children and 62 in adults. Clinical review of death reports did not reveal any concerning patterns that would suggest a causal association with PPSV23. No disproportional reporting of unexpected AEs was observed in empirical Bayesian data mining. We did not identify any new or unexpected safety concerns for PPSV23. The VAERS data are consistent with safety data from pre-licensure clinical trials and other post-licensure studies. Published by Elsevier Ltd.
Licensure strategy for pre- and post-exposure prophylaxis of biothrax vaccine: the first vaccine licensed using the FDA animal rule.

PubMed

Longstreth, Janice; Skiadopoulos, Mario H; Hopkins, Robert J

2016-12-01

The availability of a licensed anthrax vaccine that is safe, effective, and easy to administer for both pre- and post-exposure prophylaxis is critical to successfully manage and prevent potential anthrax attacks. BioThrax® (Anthrax Vaccine Adsorbed; AVA) is the only licensed anthrax vaccine in the US. Areas covered: Recent licensed improvements to BioThrax vaccine for pre-exposure prophylaxis (PrEP) have included an intramuscular (IM) five-dose schedule (in 2008) and a three-dose IM primary series at 0, 1 and 6 months (in 2012). Post-exposure prophylaxis (PEP) - three doses given subcutaneously (SC) at 0, 2, and 4 weeks - was licensed in 2015. We review the anthrax disease and vaccine literature that supported these licensure efforts. Expert commentary: This PEP licensure is the first time the FDA's Animal Rule has been used to license a vaccine. Additional improvements such as fewer vaccine doses and reduced time to protection are desirable for a PEP vaccine and are being pursued with next generation vaccine candidates.
International accreditation of ambulatory surgical centers and medical tourism.

PubMed

McGuire, Michael F

2013-07-01

The two forces that have driven the increase in accreditation of outpatient ambulatory surgery centers (ASC's) in the United States are reimbursement of facility fees by Medicare and commercial insurance companies, which requires either accreditation, Medicare certification, or state licensure, and state laws which mandate one of these three options. Accreditation of ASC's internationally has been driven by national requirements and by the competitive forces of "medical tourism." The three American accrediting organizations have all developed international programs to meet this increasing demand outside of the United States. Copyright © 2013. Published by Elsevier Inc.
The Association between Elementary Teacher Licensure Test Scores and Student Growth in Mathematics: An Analysis of Massachusetts MTEL and MCAS Tests

ERIC Educational Resources Information Center

LeGeros, Life

2013-01-01

This quasi-experimental value-added study provided evidence for the predictive validity of the Massachusetts MTEL General Curriculum Mathematics Subtest by finding an association between the licensure test results of 130 teachers and the growth of their 2640 grade 4 and 5 students. The study took advantage of a natural experiment that arose due to…
Integration and Validation in Hybrid-Online Teacher Preparation: A Case Study of Persistence in a Native American Special Education Licensure Program

ERIC Educational Resources Information Center

Patterson, Donna Rose

2013-01-01

This study explored persistence through the experience of professional studies students in a special education licensure program. The context of the study was a graduate level teacher preparation program delivered in a hybrid format of face-to-face and online learning environments. The goal of the program was to prepare teachers from a Native…

The need for national medical licensing examination in Saudi Arabia

PubMed Central

Bajammal, Sohail; Zaini, Rania; Abuznadah, Wesam; Al-Rukban, Mohammad; Aly, Syed Moyn; Boker, Abdulaziz; Al-Zalabani, Abdulmohsen; Al-Omran, Mohammad; Al-Habib, Amro; Al-Sheikh, Mona; Al-Sultan, Mohammad; Fida, Nadia; Alzahrani, Khalid; Hamad, Bashir; Al Shehri, Mohammad; Abdulrahman, Khalid Bin; Al-Damegh, Saleh; Al-Nozha, Mansour M; Donnon, Tyrone

2008-01-01

Background Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate. Discussion We are arguing for the need for a Saudi national medical licensing examination that consists of two parts: Part I (Written) which tests the basic science and clinical knowledge and Part II (Objective Structured Clinical Examination) which tests the clinical skills and attitudes. We propose this examination to be mandated as a licensure requirement for practicing medicine in Saudi Arabia. Conclusion The driving and hindering forces as well as the strengths and weaknesses of implementing the licensing examination are discussed in details in this debate. PMID:19032779
Analysis of School Leaders Licensure Assessment Content Category I-V Scores and Principal Internship Self-Assessment Scores for ISLLC Standards I-V

ERIC Educational Resources Information Center

Kelly, Michael D.

2016-01-01

This study compares School Leaders Licensure Assessment (SLLA) sub-scores with principal interns' self-assessment sub-scores (ISA) for a principal internship evaluation instrument in one educational leadership graduate program. The results of the study will be used to help establish the effectiveness of the current principal internship program,…
Individualized student advisement for preparation for the national council licensure examination for registered nurses: a community college experience.

PubMed

Anderson, Ruth M

2007-01-01

The success of faculty is, in part, measured by the success of their students. One measurement of student success is passing the National Council Licensure Examination for Registered Nurses. However, some students require assistance beyond routine class work; they require a personalized plan for studying based on individualized areas of weakness. The author reviews the process of implementing a program of individualized student advisement. Included are samples of forms that have been developed to assist in this process.
Factors associated with National Council Licensure Examination-Registered Nurse success.

PubMed

Arathuzik, D; Aber, C

1998-01-01

Identification of factors associated with National Council Licensure Examination-Registered Nurse (NCLEX-RN) success is critical at public colleges of nursing with diverse student populations. This issue was the purpose of this research study. A descriptive correlational research design was used. Seventy-nine generic senior students enrolled in an urban public university participated in the study. Several internal and external blocks to success were described by the students, including family responsibilities, emotional distress, fatigue, and financial and work burdens. Significant correlations were found between success in the NCLEX-RN and cumulative undergraduate nursing program grade point average, English as the primary language spoken at home, lack of family responsibilities or demands, lack of emotional distress, and sense of competency in critical thinking. Establishment of a comprehensive data base-including factors associated with success in the NCLEX-RN and programs of advisement, tutoring, and stress management as well as classes in study skills, test taking, and NCLEX preparation-are recommended for public colleges of nursing with diverse student populations.
Legal Issues for the Medical Director.

PubMed

Trulove, William G

2015-09-04

The nephrologist serving as medical director of a dialysis clinic must understand that the role of director is not simply an extension of being a good nephrologist. The two roles-nephrology practice and the leadership of a dialysis clinic-may be filled by a single person. However, each role contains unique tasks, requiring specific skill sets, and each role comes with inherent, associated legal risks. The medical director assumes a new level of responsibility and accountability defined by contractual obligations to the dialysis provider and by state and federal regulations. Hence, a medical director is accountable not only for providing standard-of-care treatment to his or her private practice patients dialyzed at the clinic but also for maintaining the safety of the dialysis clinic patient population and staff. Accordingly, a nephrologist serving in the role of medical director faces distinct legal risks beyond typical professional liability concerns. The medical director must also be mindful of regulatory compliance, unique avenues to licensure board complaints, and implications of careless communication habits. A thoughtful and prepared medical director can mitigate these risk exposures by understanding the sources of these challenges: contractual obligations, pertinent regulatory responsibilities, and the modern electronic communications environment. Copyright © 2015 by the American Society of Nephrology.
Legal Issues for the Medical Director

PubMed Central

2015-01-01

The nephrologist serving as medical director of a dialysis clinic must understand that the role of director is not simply an extension of being a good nephrologist. The two roles—nephrology practice and the leadership of a dialysis clinic—may be filled by a single person. However, each role contains unique tasks, requiring specific skill sets, and each role comes with inherent, associated legal risks. The medical director assumes a new level of responsibility and accountability defined by contractual obligations to the dialysis provider and by state and federal regulations. Hence, a medical director is accountable not only for providing standard-of-care treatment to his or her private practice patients dialyzed at the clinic but also for maintaining the safety of the dialysis clinic patient population and staff. Accordingly, a nephrologist serving in the role of medical director faces distinct legal risks beyond typical professional liability concerns. The medical director must also be mindful of regulatory compliance, unique avenues to licensure board complaints, and implications of careless communication habits. A thoughtful and prepared medical director can mitigate these risk exposures by understanding the sources of these challenges: contractual obligations, pertinent regulatory responsibilities, and the modern electronic communications environment. PMID:25492255
Sources of information on postgraduate medical training programs and medical specialty career resources-2006 update.

PubMed

Brazin, Lillian R

2006-01-01

This is the final biennial update listing directories, journal articles, Web sites, and general books that aid the librarian, house officer, or medical student in finding information on medical residency and fellowship programs. The World Wide Web provides the most complete and up-to-date source of information about postgraduate training programs and specialties. This update continues to go beyond postgraduate training resources to include selected Web sites and books on curriculum vitae writing, practice management, personal finances, the "Match," certification and licensure examination preparation, lifestyle issues, job hunting, and the DEA license application process. Print resources are included if they provide information not on the Internet, have features that are particularly useful, or cover too many relevant topics in depth to be covered in a journal article or on a Web site. The Internet is a major marketing tool for hospitals seeking to recruit the best and brightest physicians for their training programs. Even the smallest community hospital has a Web site.
Careers in Medical Physics and the American Association of Physicists in Medicine

NASA Astrophysics Data System (ADS)

Amols, Howard

2006-03-01

The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members is based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.
Examining Changes in Certification/Licensure Requirements and the International Medical Graduate Examinee Pool

ERIC Educational Resources Information Center

McKinley, Danette W.; Hess, Brian J.; Boulet, John R.; Lipner, Rebecca S.

2014-01-01

Changes in certification requirements and examinee characteristics are likely to influence the validity of the evidence associated with interpretations made based on test data. We examined whether changes in Educational Commission for Foreign Medical Graduates (ECFMG) certification requirements over time were associated with changes in internal…
[Medical education in a bachelors and masters system].

PubMed

Harendza, S; Guse, A H

2009-09-01

Gain of basic and applied medical knowledge and the changing demands of society with regard to medical professions are the main factors for continuous reforms in medical curricula. The Bologna Declaration of 1999 initiated the development of a unified European higher education area. A key tool for unification is the introduction of the Bachelors/Masters system. Although some European countries have adapted their medical curricula to the Bachelors/Masters system there is still debate on this issue in Germany. Some societies, e.g., the Society for Medical Education, demonstrated how the Bachelors/Masters system might be transferred to Germany. Moreover, the German Association of Medical Students already published a core curriculum compatible with the Bologna criteria. Some central elements of the Bologna Declaration have already been or could easily be integrated into the current structure of medical studies, e.g., quality assurance or a credit point transfer system. Furthermore, in the framework of the German medical licensure law, it is possible to introduce a curriculum fully compatible with the Bologna Declaration. A meaningful prerequisite would be a unified national (or European) qualification frame and catalog of learning objectives, designed according to the Bologna criteria. This should guarantee good mobility for medical students within Europe.
What's in a Teacher Test? Assessing the Relationship between Teacher Licensure Test Scores and Student STEM Achievement and Course-Taking. Working Paper 158

ERIC Educational Resources Information Center

Goldhaber, Dan; Gratz, Trevor; Theobald, Roddy

2016-01-01

We investigate the relationship between teacher licensure test scores and student test achievement and high school course-taking. We focus on three subject/grade combinations--middle school math, ninth-grade algebra and geometry, and ninth-grade biology--and find evidence that a teacher's basic skills test scores are modestly predictive of student…
Fast tracking the vaccine licensure process to control an epidemic of serogroup B meningococcal disease in New Zealand.

PubMed

Lennon, Diana; Jackson, Catherine; Wong, Sharon; Horsfall, Maraekura; Stewart, Joanna; Reid, Stewart

2009-08-15

Epidemics of serogroup B meningococcal disease are rare. Strain-specific outer membrane vesicle vaccines, which are not marketed, are the only current tool for control. A correlate of protection is ill defined, but published data suggest that measured serum bactericidal antibody levels parallel efficacy. Even infants can mount a strain-specific antibody response to a strain-specific vaccine. New Zealand's epidemic (1991-2007; peak rate [in 2001], 17.4 cases per 100,000 persons) was dominated by a single strain. After a 5-year search (1996-2001) for a manufacturer for a strain-specific outer membrane vesicle vaccine, a fast-tracked research program (2002-2004) determined the safety and immunogenicity of vaccine in infants (2 age groups: 6-10 weeks and 6-8 months), children (age, 16-24 months), and school-aged children (age, 8-12 years) after an adult trial. The vaccine was reactogenic, compared with control vaccines (meningococcal C conjugate and routine infant vaccines), but retention was high. Three vaccine doses produced antibody levels (measured by serum bactericidal assay) that were considered to be adequate for public health intervention. However, in young infants, a fourth dose was required to achieve levels equivalent to those achieved by other age groups. Provisional licensure by New Zealand's MedSafe was based on serological criteria strengthened by bridged safety data from studies of the parent outer membrane vesicle vaccine, independent assessment of manufacturing quality, and a clear plan for safety monitoring and effectiveness evaluation after licensure.
Post-licensure safety monitoring of quadrivalent human papillomavirus vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2009-2015.

PubMed

Arana, Jorge E; Harrington, Theresa; Cano, Maria; Lewis, Paige; Mba-Jonas, Adamma; Rongxia, Li; Stewart, Brock; Markowitz, Lauri E; Shimabukuro, Tom T

2018-03-20

The Food and Drug Administration (FDA) approved quadrivalent human papillomavirus vaccine (4vHPV) for use in females and males aged 9-26 years, since 2006 and 2009 respectively. We characterized reports to the Vaccine Adverse Event Reporting System (VAERS), a US spontaneous reporting system, in females and males who received 4vHPV vaccination. We searched VAERS for US reports of adverse events (AEs) following 4vHPV from January 2009 through December 2015. Signs and symptoms were coded using Medical Dictionary for Regulatory Activities (MedDRA). We calculated reporting rates and conducted empirical Bayesian data mining to identify disproportional reports. Clinicians reviewed available information, including medical records, and reports of selected pre-specified conditions. VAERS received 19,760 reports following 4vHPV; 60.2% in females, 17.2% in males, and in 22.6% sex was missing. Overall, 94.2% of reports were non-serious; dizziness, syncope and injection site reactions were commonly reported in both males and females. Headache, fatigue and nausea were commonly reported serious AEs. More than 60 million 4vHPV doses were distributed during the study period. Crude AE reporting rates were 327 reports per million 4vHPV doses distributed for all reports, and 19 per million for serious reports. Among 29 verified reports of death, there was no pattern of clustering of deaths by diagnosis, co-morbidities, age, or interval from vaccination to death. No new or unexpected safety concerns or reporting patterns of 4vHPV with clinically important AEs were detected. Safety profile of 4vHPV is consistent with data from pre-licensure trials and postmarketing safety data. Published by Elsevier Ltd.
Should Live Patient Licensing Examinations in Dentistry Be Discontinued? Two Viewpoints: Viewpoint 1: Alternative Assessment Models Are Not Yet Viable Replacements for Live Patients in Clinical Licensure Exams and Viewpoint 2: Ethical and Patient Care Concerns About Live Patient Exams Require Full Acceptance of Justifiable Alternatives.

PubMed

Chu, Tien-Min Gabriel; Makhoul, Nicholas M; Silva, Daniela Rodrigues; Gonzales, Theresa S; Letra, Ariadne; Mays, Keith A

2018-03-01

This Point/Counterpoint article addresses a long-standing but still-unresolved debate on the advantages and disadvantages of using live patients in dental licensure exams. Two contrasting viewpoints are presented. Viewpoint 1 supports the traditional use of live patients, arguing that other assessment models have not yet been demonstrated to be viable alternatives to the actual treatment of patients in the clinical licensure process. This viewpoint also contends that the use of live patients and inherent variances in live patient treatment represent the realities of daily private practice. Viewpoint 2 argues that the use of live patients in licensure exams needs to be discontinued considering those exams' ethical dilemmas of exposing patients to potential harm, as well as their lack of reliability and validity and limited scope. According to this viewpoint, the current presence of viable alternatives means that the risk of harm inherent in live patient exams can finally be eliminated and those exams replaced with other means to confirm that candidates are qualified for licensure to practice.
Continuing Medical Education, Maintenance of Certification, and Physician Reentry

PubMed Central

Luchtefeld, Martin; Kerwel, Therese G.

2012-01-01

Continuing medical education serves a central role in the licensure and certification for practicing physicians. This chapter explores the different modalities that constitute CME along with their effectiveness, including simulation and best education practices. The evolution to maintenance of certification and the requirements for both the American Board of Surgery and the American Board of Colon and Rectal Surgery are delineated. Further progress in the education of practicing surgeons is evidenced through the introduction of laparoscopic colectomy and the improvements made from the introduction of laparoscopic cholecystectomy. Finally, reentry of physicians into practice following a voluntary leave of absence, a new and challenging issue for surgeons, is also discussed. PMID:23997673
Directing Discipline: State Medical Board Responsiveness to State Legislatures.

PubMed

Lillvis, Denise F; McGrath, Robert J

2017-02-01

State medical boards are increasingly responsible for regulating medical and osteopathic licensure and professional conduct in the United States. Yet, there is great variation in the extent to which such boards take disciplinary action against physicians, indicating that some boards are more zealous regulators than others. We look to the political roots of such variation and seek to answer a simple, yet important, question: are nominally apolitical state medical boards responsive to political preferences? To address this question, we use panel data on disciplinary actions across sixty-four state medical boards from 1993 through 2006 and control for over-time changes in board characteristics (e.g., composition, independence, budgetary status), regulatory structure, and resources. We show that as state legislatures become more liberal [conservative], state boards increasingly [decreasingly] discipline physicians, especially during unified government and in the presence of highly professional legislatures. Our conclusions join others in emphasizing the importance of state medical boards and the contingent nature of political control of state regulation. In addition, we emphasize the roles that oversight capacity and strategy play in offsetting concerns regarding self-regulation of a powerful organized interest. Copyright © 2017 by Duke University Press.
What's in a Teacher Test? Assessing the Relationship between Teacher Licensure Test Scores and Student STEM Achievement and Course-Taking. CEDR Working Paper. WP #2016-11

ERIC Educational Resources Information Center

Goldhaber, Dan; Gratz, Trevor; Theobald, Roddy

2016-01-01

We investigate the relationship between teacher licensure test scores and student test achievement and high school course-taking. We focus on three subject/grade combinations-- middle school math, ninth-grade algebra and geometry, and ninth-grade biology--and find evidence that a teacher's basic skills test scores are modestly predictive of…
The fundamentals of integrating service in a post-licensure RN to BSN program.

PubMed

Washington-Brown, Linda; Ritchie, Arlene

2014-01-01

Integrating service in a post-licensure registered nurse to bachelor of science in nursing (RN to BSN) program provides licensed registered nurse (RN) students the opportunity to learn, develop, and experience different cultures while serving the community and populations in need (McKinnon & Fitzpatrick, 2012). Service to the community, integrated with academic learning can be applied in a wide variety of settings, including schools, universities, and community faith-based organizations. Academic service-learning (ASL) can involve a group of students, a classroom, or an entire school. In the RN to BSN program, the authors use a student-directed service learning approach that integrates service-learning throughout the curriculum. RN students are introduced to service-learning at program orientation prior to the start of classes and receive reinforcement and active engagement throughout the curriculum. The students and volunteer agencies receive and give benefits from the services provided and the life lessons gained through mentorship, education, and hands-on experiences.
Continuing Medical Education for Air Medical Providers: The Successes and Challenges.

PubMed

Miller, Jenna O; Thammasitboon, Satid; Hsu, Deborah C; Shah, Manish I; Minard, Charles G; Graf, Jeanine M

2016-02-01

Research has shown that patients transported by nonpediatric teams have higher rates of morbidity and mortality. There is currently a paucity of pediatric standardized ongoing medical education for emergency medical service providers, thus we aimed to develop a model curriculum to increase their knowledge regarding pediatric respiratory distress and failure. The curriculum was based on the Kolb Learning Cycle to optimize learning. Target learners were flight nurses (registered nurse) and emergency medical technicians of a private helicopter emergency transport team. The topics included were pediatric stridor, wheezing, and respiratory failure. Online modules were developed for continued spaced education. Knowledge gained from the interventions was measured by precurricular and postcurricular testing and compared with paired t tests. A linear mixed regression model was used to investigate covariates of interest. Sixty-two learners attended the workshop. Fifty-nine learners completed both precurricular and postcurricular testing. The mean increase between pretest and posttest scores was 12.1% (95% confidence interval, 9.4, 14.8; P < 0.001). Type of licensure (private emergency medical technician vs registered nurse) and number of years experience had no association with the level of knowledge gained. Learners who had greater than 1 year of pediatric transport experience scored higher on their pretests. There was no significant retention shown by those who participated in spaced education. The curriculum was associated with a short term increased knowledge regarding pediatric respiratory distress and failure for emergency helicopter transport providers and could be used as an alternative model to develop standardized ongoing medical education in pediatrics. Further work is needed to achieve knowledge retention in this learner population.
In-flight medical incapacitation and impairment of airline pilots.

PubMed

DeJohn, Charles A; Wolbrink, Alex M; Larcher, Julie G

2006-10-01

Medical incapacitation in the cockpit is rare, although it is a concern that has been the subject of several investigations over the years. With recent heightened interest in this problem, it seemed worthwhile to review all relevant scientific literature on the topic. Medline, PsychLit, the Aerospace Database, and other online databases were searched for studies of pilot in-flight medical incapacitation and impairment. The search revealed 13 articles during the years from 1968 to 2000. The studies represented several different approaches and were divided into five categories as follows: in-flight medical events, career termination, simulator data, questionnaires, and epidemiological analysis. The articles based on in-flight medical events showed that the leading causes of those episodes were myocardial infarctions, cardiac arrhythmias, and epileptic seizures. Few of the other types of studies used data from actual in-flight medical occurrences, instead relying on indirect measures such as career termination due to permanent medical grounding, loss of licensure insurance, or general epidemiological data to estimate the frequency of in-flight medical events. The reviewed studies provided only limited information on the frequency and categories of in-flight medical events and did not include incapacitation rates, making meaningful comparison between studies difficult. Future research needs to be based on actual in-flight medical events, and should be normalized to a useful denominator, such as flight time, to allow for meaningful comparison between studies.

A Just Culture Approach to Managing Medication Errors.

PubMed

Rogers, Erin; Griffin, Emily; Carnie, William; Melucci, Joseph; Weber, Robert J

2017-04-01

Medication errors continue to be a concern of health care providers and the public, in particular how to prevent harm from medication mistakes. Many health care workers are afraid to report errors for fear of retribution including the loss of professional licensure and even imprisonment. Most health care workers are silent, instead of admitting their mistake and discussing it openly with peers. This can result in further patient harm if the system causing the mistake is not identified and fixed; thus self-denial may have a negative impact on patient care outcomes. As a result, pharmacy leaders, in collaboration with others, must put systems in place that serve to prevent medication errors while promoting a "Just Culture" way of managing performance and outcomes. This culture must exist across disciplines and departments. Pharmacy leaders need to understand how to classify behaviors associated with errors, set realistic expectations, instill values for staff, and promote accountability within the workplace. This article reviews the concept of Just Culture and provides ways that pharmacy directors can use this concept to manage the degree of error in patient-centered pharmacy services.
Initiatives by the government and physician groups to improve awareness of medical ethics: Challenges in Japan

PubMed Central

MORIOKA, Yasuhiko

2012-01-01

Physicians have been required to possess high ethical standards, as medical practice is directly involved with patients' lives. Although ethics arise out of an individual's consciousness, ethical regulations imposed by the nation/government together with self-regulation by physician groups are important in the practice of ethics, for which reason countries around the world undertake various initiatives. This paper investigates physician licensure, organizations governing physician status, the role of physician groups, and the actual conditions of lifelong learning and ethics education in developed countries worldwide, in contrast with which it throws problems in the situation in Japan into relief. Organizations governing physician status, the form of medical associations, and the improvement of lifelong learning are pointed out as critical issues especially in Japan. PMID:22498978
Simulation Performance and National Council Licensure Examination for Registered Nurses Outcomes: Field Research Perspectives.

PubMed

Brackney, Dana E; Lane, Susan Hayes; Dawson, Tyia; Koontz, Angie

2017-11-01

This descriptive field study examines processes used to evaluate simulation for senior-level Bachelor of Science in Nursing (BSN) students in a capstone course, discusses challenges related to simulation evaluation, and reports the relationship between faculty evaluation of student performance and National Council Licensure Examination for Registered Nurses (NCLEX-RN) first-time passing rates. Researchers applied seven terms used to rank BSN student performance (n = 41, female, ages 22-24 years) in a senior-level capstone simulation. Faculty evaluation was correlated with students' NCLEX-RN outcomes. Students evaluated as "lacking confidence" and "flawed" were less likely to pass the NCLEX-RN on the first attempt. Faculty evaluation of capstone simulation performance provided additional evidence of student preparedness for practice in the RN role, as evidenced by the relationship between the faculty assessment and NCLEX-RN success. Simulation has been broadly accepted as a powerful educational tool that may also contribute to verification of student achievement of program outcomes and readiness for the RN role.
Development of the competency-based medical curriculum for the new Augsburg University Medical School.

PubMed

Härtl, Anja; Berberat, Pascal; Fischer, Martin R; Forst, Helmuth; Grützner, Stefanie; Händl, Thomas; Joachimski, Felix; Linné, Renate; Märkl, Bruno; Naumann, Markus; Putz, Reinhard; Schneider, Werner; Schöler, Claus; Wehler, Markus; Hoffmann, Reinhard

2017-01-01

Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum. Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden) employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills. Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung) into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks "Movement," "Balance" and "Contact." The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men's-women's-children's medicine, the senses, the nervous system and the mind, and general medicine) which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments), block practicums, and two scientific projects. Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum and the impact of the new
Development of the competency-based medical curriculum for the new Augsburg University Medical School

PubMed Central

Härtl, Anja; Berberat, Pascal; Fischer, Martin R.; Forst, Helmuth; Grützner, Stefanie; Händl, Thomas; Joachimski, Felix; Linné, Renate; Märkl, Bruno; Naumann, Markus; Putz, Reinhard; Schneider, Werner; Schöler, Claus; Wehler, Markus; Hoffmann, Reinhard

2017-01-01

Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum. Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden) employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills. Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung) into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks “Movement,” “Balance” and “Contact.” The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men’s-women’s-children’s medicine, the senses, the nervous system and the mind, and general medicine) which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments), block practicums, and two scientific projects. Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum and the
Modes of Instruction for K-12 School Leadership Candidate Coursework and Internship Preparation in the ISLLC Standards and Candidate Gender and Candidate Scores of New York State Licensure Assessments

ERIC Educational Resources Information Center

Markson, Craig

2013-01-01

The purpose of this study was to investigate the relationships between K-12 school leadership program graduates' descriptions of their coursework and internship preparedness in the Interstate School Leaders Licensure Consortium (ISLLC) Standards among three modes of instruction (online, hybrid, and face-to-face) and their scores on Parts I and II…
Licensure tests for special education teachers: how well they assess knowledge of reading instruction and mathematics.

PubMed

Stotsky, Sandra

2009-01-01

To determine the extent to which knowledge of evidence-based reading instruction and mathematics is assessed on licensure tests for prospective special education teachers, this study drew on information provided by Educational Testing Service (ETS), the American Board for Certification of Teacher Excellence, and National Evaluation Systems (now Evaluation Systems group of Pearson). It estimated the percentage of test items on phonemic awareness, phonics, and vocabulary knowledge and on mathematics content. It also analyzed descriptions of ETS's tests of "principles of teaching and learning." Findings imply that prospective special education teachers should be required to take both a dedicated test of evidence-based reading instructional knowledge, as in California, Massachusetts, and Virginia, and a test of mathematical knowledge, as in Massachusetts. States must design their own tests of teaching principles to assess knowledge of evidence-based educational theories.
The need to incorporate health information technology into physicians' education and professional development.

PubMed

Graham-Jones, Pierce; Jain, Sachin H; Friedman, Charles P; Marcotte, Leah; Blumenthal, David

2012-03-01

Nationwide, as physicians and health care systems adopt electronic health records, health information technology is becoming integral to the practice of medicine. But current medical education and professional development curricula do not systematically prepare physicians to use electronic health records and the data these systems collect. We detail how training in meaningful use of electronic health records could be incorporated into physician training, from medical school, through licensure and board certification, to continuing medical education and the maintenance of licensure and board certification. We identify six near-term opportunities for professional organizations to accelerate the integration of health information technology into their requirements.
Process-outcome interrelationship and standard setting in medical education: the need for a comprehensive approach.

PubMed

Christensen, Leif; Karle, Hans; Nystrup, Jørgen

2007-09-01

An outcome-based approach to medical education compared to a process/content orientation is currently being discussed intensively. In this article, the process and outcome interrelationship in medical education is discussed, with specific emphasis on the relation to the definition of standards in basic medical education. Perceptions of outcome have always been an integrated element of curricular planning. The present debate underlines the need for stronger focus on learning objectives and outcome assessment in many medical schools around the world. The need to maintain an integrated approach of process/content and outcome is underlined in this paper. A worry is expressed about the taxonomy of learning in pure outcome-based medical education, in which student assessment can be a major determinant for the learning process, leaving the control of the medical curriculum to medical examiners. Moreover, curricula which favour reductionism by stating everything in terms of instrumental outcomes or competences, do face a risk of lowering quality and do become a prey for political interference. Standards based on outcome alone rise unclarified problems in relationship to licensure requirements of medical doctors. It is argued that the alleged dichotomy between process/content and outcome seems artificial, and that formulation of standards in medical education must follow a comprehensive line in curricular planning.
A history and overview of the certification exam for medical dosimetrists

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

Pusey, Damien; Smith, Lisette; Zeman, Elaine M.

2005-06-30

During the last century, the creation and implementation of board certification has had a powerful impact on the medical community. Board certification has helped to shape the scope and practice of medical professionals and the care they provide, as well as to influence the way the health insurance industry sets standards for reimbursement. One profession that offers board certification to its members is medical dosimetry. The Medical Dosimetrist Certification Board exam has been administered since 1988 and its content covers a broad spectrum of information from the radiation therapy sciences. The exam has strict application requirements and is rather difficultmore » to pass. Those who pass the exam can then call themselves Certified Medical Dosimetrists. For data purposes of this study, several members of the dosimetry community were solicited to participate in a survey regarding the exam's content and history, and to provide relevant statistical data. Currently 2,177 medical dosimetrists are board certified, with an additional 1,500 estimated to be working without certification. Although board certification is not currently required to practice medical dosimetry, new legislation known as the CARE Bill could change this. The CARE Bill, if passed, would mandate nationwide compulsory licensure and/or certification for medical dosimetrists and other medical professionals who want to work in radiation-related health care. Health maintenance organizations and other insurance carriers may likewise require certification for reimbursement purposes.« less
Workplace-based assessment for vocational registration of international medical graduates.

PubMed

Lillis, Steven; Van Dyk, Valencia

2014-01-01

Medical regulatory authorities need efficient and effective methods of ensuring the competence of immigrating international medical graduates (IMGs). Not all IMGs who apply for specialist vocational registration will have directly comparable qualifications to those usually accepted. As general licensure examinations are inappropriate for these doctors, workplace-based assessment (WBA) techniques would appear to provide a solution. However, there is little published data on such outcomes. All cases of WBA (n = 81) used for vocational registration of IMGs in New Zealand between 2008 and 2013 were collated and analyzed. The successful completion rate of IMGs through the pathway was 87%. The majority (64%) undertook the year of supervised practice and the final assessment in a provincial center. For those unsuccessful in the pathway, inadequate clinical knowledge was the most common deficit found, followed by poor clinical reasoning. A WBA approach for assessing readiness of IMGs for vocational registration is feasible. The constructivist theoretical perspective of WBA has particular advantages in assessing the standard of practice for experienced practitioners working in narrow scopes than traditional methods of assessment. The majority of IMGs undertook both the clinical year and the assessment in provincial hospitals, thus providing a workforce for underserved areas. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.
Live-attenuated tetravalent dengue vaccines: The needs and challenges of post-licensure evaluation of vaccine safety and effectiveness.

PubMed

Wichmann, Ole; Vannice, Kirsten; Asturias, Edwin J; de Albuquerque Luna, Expedito José; Longini, Ira; Lopez, Anna Lena; Smith, Peter G; Tissera, Hasitha; Yoon, In-Kyu; Hombach, Joachim

2017-10-09

Since December 2015, the first dengue vaccine has been licensed in several Asian and Latin American countries for protection against disease from all four dengue virus serotypes. While the vaccine demonstrated an overall good safety and efficacy profile in clinical trials, some key research questions remain which make risk-benefit-assessment for some populations difficult. As for any new vaccine, several questions, such as very rare adverse events following immunization, duration of vaccine-induced protection and effectiveness when used in public health programs, will be addressed by post-licensure studies and by data from national surveillance systems after the vaccine has been introduced. However, the complexity of dengue epidemiology, pathogenesis and population immunity, as well as some characteristics of the currently licensed vaccine, and potentially also future, live-attenuated dengue vaccines, poses a challenge for evaluation through existing monitoring systems, especially in low and middle-income countries. Most notable are the different efficacies of the currently licensed vaccine by dengue serostatus at time of first vaccination and by dengue virus serotype, as well as the increased risk of dengue hospitalization among young vaccinated children observed three years after the start of vaccination in one of the trials. Currently, it is unknown if the last phenomenon is restricted to younger ages or could affect also seronegative individuals aged 9years and older, who are included in the group for whom the vaccine has been licensed. In this paper, we summarize scientific and methodological considerations for public health surveillance and targeted post-licensure studies to address some key research questions related to live-attenuated dengue vaccines. Countries intending to introduce a dengue vaccine should assess their capacities to monitor and evaluate the vaccine's effectiveness and safety and, where appropriate and possible, enhance their surveillance
Quality management of clinical-practical instruction for Practical Year medical students in Germany - proposal for a catalogue of criteria from the German Society of Medical Education.

PubMed

Raes, Patricia; Angstwurm, Matthias; Berberat, Pascal; Kadmon, Martina; Rotgans, Jerome; Streitlein-Böhme, Irmgard; Burckhardt, Gerhard; Fischer, Martin R

2014-01-01

Amended in 2013, the current version of the German Medical Licensure Regulation contains structural specifications that are also required of non-university institutions involved in Practical Year clinical training. The criteria are worded in relatively general terms. Furthermore, not all of the structural specifications can be readily applied to every subject area. In order to ensure commensurability in Practical Year instruction in Germany, not least in light of recently introduced Practical Year mobility, it is necessary to define consistent quality criteria for Practical Year training. The authors therefore propose a catalogue of criteria for the quality management process in Practical Year instruction facilities. In January 2014, the board of directors of the German Society for Medical Education decided to establish a committee comprised of representatives from various German medical faculties. In a process similar to the Delphi methodology, the group developed criteria for structure, process and outcome quality in Practical Year training in Germany. The criteria developed for structure, process and outcome quality apply to Practical Year training in academic teaching hospitals and university medical centres. Furthermore, modalities for review are proposed. The present catalogue of criteria is intended to contribute to the formation of a basis for the most consistent quality standards possible for Practical Year instruction in Germany.
Post-licensure safety surveillance study of routine use of tetanus toxoid, reduced diphtheria toxoid and 5-component acellular pertussis vaccine.

PubMed

Baxter, Roger; Hansen, John; Timbol, Julius; Pool, Vitali; Greenberg, David P; Johnson, David R; Decker, Michael D

2016-11-01

An observational post-licensure (Phase IV) retrospective large-database safety study was conducted at Kaiser Permanente, a US integrated medical care organization, to assess the safety of Tetanus Toxoid, Reduced Diphtheria Toxoid and 5-Component Acellular Pertussis Vaccine (Tdap5) administered as part of routine healthcare among adolescents and adults. We evaluated incidence rates of various clinical events resulting in outpatient clinic, emergency department (ED), and hospital visits during various time intervals (windows) following Tdap5 vaccination using 2 pharmacoepidemiological methods (risk interval and historic cohort) and several screening thresholds. Plausible outcomes of interest with elevated incidence rate ratios (IRRs) were further evaluated by reviewing individual patient records to confirm the diagnosis, timing (temporal relationship), alternative etiology, and other health record details to discern possible relatedness of the health events to vaccination. Overall, 124,139 people received Tdap5 vaccine from September 2005 through mid-October 2006, and 203,154 in the comparison cohort received a tetanus and diphtheria toxoid adsorbed vaccine (and no live virus vaccine) during the year prior to initiation of this study. In the outpatient, ED and hospital databases, respectively, we identified 11/26, 179/700 and 187/700 unique health outcomes with IRRs significantly >1.0. Among the same unique health outcomes in the outpatient, ED, and hospital databases, 9, 146, and 385, respectively, had IRRs significantly <1.0. Further scrutiny of the outcomes with elevated IRRs did not reveal unexpected signals of adverse outcomes related to vaccination. In conclusion, Tdap5 vaccine was found to be safe among this large population of adolescents and adults.
[From the licensure of vaccines to the recommendation of the Standing Committee on Vaccination in Germany : criteria for the assessment of benefits and risks].

PubMed

Pfleiderer, Michael; Wichmann, Ole

2015-03-01

Vaccines are among the most effective preventive measures in modern medicine and have led to a dramatic decline and-for a few diseases-even to the elimination of severely infectious diseases. There are some particularities of the risk-benefit assessment of vaccines compared with that of therapeutic drugs. These include the fact that vaccines are applied to healthy individuals with the aim of preventing an infectious disease, while therapeutic drugs are administered to sick people to cure them of an already acquired disease. The acceptable level of risk associated with the application of a vaccine is therefore much lower. In addition, high vaccination coverage can lead to population-level effects (e.g., the indirect protection of unvaccinated individuals) that can confer additional benefits to the population overall. When a marketing authorization application (MAA) for a novel vaccine is evaluated, conclusions are made regarding its quality, safety, and efficacy, and a benefit-risk assessment is carried out accordingly. In contrast, when deciding on the introduction of a new vaccine into a national immunization program or on a recommendation for a specific risk-group, the focus is shifted to considerations of how a licensed vaccine can be best used in a population (e.g., which immunization strategy is most effective in preventing deaths or hospitalizations, or in reducing treatment costs for the health care system). Stringent assessment criteria have been developed that require a robust safety analysis before a new vaccine is administered to humans for the first time in pre-licensure studies. Similarly, criteria are applied for calculating the benefit-risk ratio at the time of the licensure of a new vaccine in addition to during the entire post-licensure period. However, when deciding if and how a licensed vaccine can best be integrated into an existing immunization program, additional criteria are applied that are different, yet complementary to those applied for
The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

PubMed

Schoonover, Heather

The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.
[Quality control in medical education and continuing medical education in allergology in Germany].

PubMed

Ring, Johannes; Rakoski, Jürgen

2003-10-01

Quality control in education and training in allergology comprises activities at the different levels of the curriculum of medical schools, residency programs and postgraduate education. Unfortunately, until now allergology in Germany has not yet been regularly embedded in the medical curriculum of all medical schools. Therefore, the German Society for Allergology and Clinical Immunology (DGAI) has demanded for years that chairs and departments of allergology be introduced at every Medical Faculty in Germany. The new Medical Licensure Rules (Approbationsordnung) offer the possibility to select allergology, amongst others, as an obligatory subject in the medical state examination. Furthermore, allergological topics can now be introduced into the newly established interdisciplinary fields (Querschnittsbereiche). At the level of residency training, doctors who want to become allergists have to undergo a special curriculum in the field of allergology, formerly called additional specialisation in allergology (Zusatzbezeichnung) after having finished their board examination in an organ-related specialty subject. Following a decision of the German "Arztetag" in May 2003, this 24-months curriculum has unfortunately been reduced to 18 months. 12 months of this 18 months requirement may be fulfilled during a residency programme in either dermatovenerology, otolaryngology, internal medicine, pulmology and/or paediatrics. Compared to previous years, this results in a drastic deterioration of allergy training in Germany. The DGAI has decided to take up the fight for its improvement in both a quantitative and qualitative respect. The crucial issue is to develop quality criteria for persons as well as institutions eligible as training centres in allergology. As regards post-graduate education, the German Academy of Allergology and Environmental Medicine (Deutsche Akademie für Allergie und Umweltmedizin, DAAU) has introduced a system of certified continuing medical education (CME
Recruitment and retention of emergency medical technicians: a qualitative study.

PubMed

Patterson, P Daniel; Probst, Janice C; Leith, Katherine H; Corwin, Sara J; Powell, M Paige

2005-01-01

Emergency medical technicians (EMTs) are critical to out-of-hospital care, but maintaining staff can be difficult. The study objective was to identify factors that contribute to recruitment and retention of EMTs and paramedics. Information was drawn from three focus groups of EMT-Basic, EMT-Intermediate, and EMT-Paramedic personnel recruited from participants at an annual conference. Thoughts and feelings of EMTs and paramedics were investigated using eight questions designed to explore entry into emergency medical services, what it is like to be an EMT or paramedic, and the EMT educational process. Data were analyzed at the group level for common themes using NVivo. For a majority of respondents, emergency medical services was not a primary career path. Most respondents entered the industry as an alternate or replacement for a nursing career or as a second career following military medic service. The majority of respondents believed the job was stressful yet rewarding, and although it negatively affected their personal lives, the occupation gave them a sense of accomplishment and belonging. Respondents expressed a preference for EMT education resulting in college credit or licensure versus professional certification. Job-related stress produced by numerous factors appears to be a likely contributor to low employee retention. Recruitment and retention efforts should address study findings, incorporating key findings into educational, evaluation, and job enhancement programs.
Exploring the potential uses of value-added metrics in the context of postgraduate medical education.

PubMed

Gregory, Simon; Patterson, Fiona; Baron, Helen; Knight, Alec; Walsh, Kieran; Irish, Bill; Thomas, Sally

2016-10-01

Increasing pressure is being placed on external accountability and cost efficiency in medical education and training internationally. We present an illustrative data analysis of the value-added of postgraduate medical education. We analysed historical selection (entry) and licensure (exit) examination results for trainees sitting the UK Membership of the Royal College of General Practitioners (MRCGP) licensing examination (N = 2291). Selection data comprised: a clinical problem solving test (CPST); a situational judgement test (SJT); and a selection centre (SC). Exit data was an applied knowledge test (AKT) from MRCGP. Ordinary least squares (OLS) regression analyses were used to model differences in attainment in the AKT based on performance at selection (the value-added score). Results were aggregated to the regional level for comparisons. We discovered significant differences in the value-added score between regional training providers. Whilst three training providers confer significant value-added, one training provider was significantly lower than would be predicted based on the attainment of trainees at selection. Value-added analysis in postgraduate medical education potentially offers useful information, although the methodology is complex, controversial, and has significant limitations. Developing models further could offer important insights to support continuous improvement in medical education in future.
Post-licensure safety surveillance study of routine use of tetanus toxoid, reduced diphtheria toxoid and 5-component acellular pertussis vaccine

PubMed Central

Baxter, Roger; Hansen, John; Timbol, Julius; Pool, Vitali; Greenberg, David P.; Johnson, David R.; Decker, Michael D.

2016-01-01

ABSTRACT An observational post-licensure (Phase IV) retrospective large-database safety study was conducted at Kaiser Permanente, a US integrated medical care organization, to assess the safety of Tetanus Toxoid, Reduced Diphtheria Toxoid and 5-Component Acellular Pertussis Vaccine (Tdap5) administered as part of routine healthcare among adolescents and adults. We evaluated incidence rates of various clinical events resulting in outpatient clinic, emergency department (ED), and hospital visits during various time intervals (windows) following Tdap5 vaccination using 2 pharmacoepidemiological methods (risk interval and historic cohort) and several screening thresholds. Plausible outcomes of interest with elevated incidence rate ratios (IRRs) were further evaluated by reviewing individual patient records to confirm the diagnosis, timing (temporal relationship), alternative etiology, and other health record details to discern possible relatedness of the health events to vaccination. Overall, 124,139 people received Tdap5 vaccine from September 2005 through mid-October 2006, and 203,154 in the comparison cohort received a tetanus and diphtheria toxoid adsorbed vaccine (and no live virus vaccine) during the year prior to initiation of this study. In the outpatient, ED and hospital databases, respectively, we identified 11/26, 179/700 and 187/700 unique health outcomes with IRRs significantly >1.0. Among the same unique health outcomes in the outpatient, ED, and hospital databases, 9, 146, and 385, respectively, had IRRs significantly <1.0. Further scrutiny of the outcomes with elevated IRRs did not reveal unexpected signals of adverse outcomes related to vaccination. In conclusion, Tdap5 vaccine was found to be safe among this large population of adolescents and adults. PMID:27388557

Attitudes to proposed assessment of pharmacy skills in Korean pharmacist licensure examination.

PubMed

Kim, Joo Hee; Lee, Ju-Yeun; Lee, Young Sook; Yong, Chul-Soon; Han, Nayoung; Gwak, Hye Sun; Oh, Jungmi; Lee, Byung Koo; Lee, Sukhyang

2017-01-01

The survey aimed to obtain opinions about a proposed implementation of pharmacy skills assessment in Korean pharmacist licensure examination (KPLE). A 16-question survey was distributed electronically to 2,738 people including 570 pharmacy professors of 35 pharmacy schools, 550 preceptors from 865 practice sites and 1,618 students who graduated in 2015. The survey solicited responses concerning the adequacy of the current KPLE in assessing pharmacy knowledge/skills/attitudes, deficiencies of pharmacy skills testing in assessing the professional competencies necessary for pharmacists, plans for pharmacy skills tests in the current KPLE, and subject areas of pharmacy practice. A total of 466 surveys were returned. The current exam is not adequate for assessing skills and attitudes according to 42%-48% of respondents. Sixty percent felt that skills test is necessary to assess qualifications and professional competencies. Almost two-thirds of participants stated that testing should be implemented within 5 years. More than 60% agreed that candidates should be graduates and that written and skills test scores can be combined for pass-fail decisions. About 70% of respondents felt that the test should be less than 2 hours in duration. Over half of the respondents thought that the assessor should be a pharmacy faculty member with at least 5 years of clinical experience. Up to 70% stated that activities related to patient care were appropriate and practical for the scope of skills test. Pharmacy skills assessment was supported by the majority of respondents.
Attitudes to proposed assessment of pharmacy skills in Korean pharmacist licensure examination

PubMed Central

2017-01-01

Purpose The survey aimed to obtain opinions about a proposed implementation of pharmacy skills assessment in Korean pharmacist licensure examination (KPLE). Methods A 16-question survey was distributed electronically to 2,738 people including 570 pharmacy professors of 35 pharmacy schools, 550 preceptors from 865 practice sites and 1,618 students who graduated in 2015. The survey solicited responses concerning the adequacy of the current KPLE in assessing pharmacy knowledge/skills/attitudes, deficiencies of pharmacy skills testing in assessing the professional competencies necessary for pharmacists, plans for pharmacy skills tests in the current KPLE, and subject areas of pharmacy practice. Results A total of 466 surveys were returned. The current exam is not adequate for assessing skills and attitudes according to 42%–48% of respondents. Sixty percent felt that skills test is necessary to assess qualifications and professional competencies. Almost two-thirds of participants stated that testing should be implemented within 5 years. More than 60% agreed that candidates should be graduates and that written and skills test scores can be combined for pass-fail decisions. About 70% of respondents felt that the test should be less than 2 hours in duration. Over half of the respondents thought that the assessor should be a pharmacy faculty member with at least 5 years of clinical experience. Up to 70% stated that activities related to patient care were appropriate and practical for the scope of skills test. Conclusion Pharmacy skills assessment was supported by the majority of respondents. PMID:28352065
Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice.

PubMed

Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

2015-01-01

Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and 'black sheep'; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated.
Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

PubMed Central

Snyder, Jeremy; Crooks, Valorie A.; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

2015-01-01

Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and ‘black sheep’; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated. PMID:25865122
Medicare Program; End-Stage Renal Disease Prospective Payment System, Coverage and Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program Bid Surety Bonds, State Licensure and Appeals Process for Breach of Contract Actions, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program and Fee Schedule Adjustments, Access to Care Issues for Durable Medical Equipment; and the Comprehensive End-Stage Renal Disease Care Model. Final rule.

PubMed

2016-11-04

This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP. This rule also implements statutory requirements for bid surety bonds and state licensure for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). This rule also expands suppliers' appeal rights in the event of a breach of contract action taken by CMS, by revising the appeals regulation to extend the appeals process to all types of actions taken by CMS for a supplier's breach of contract, rather than limit an appeal for the termination of a competitive bidding contract. The rule also finalizes changes to the methodologies for adjusting fee schedule amounts for DMEPOS using information from CBPs and for submitting bids and establishing single payment amounts under the CBPs for certain groupings of similar items with different features to address price inversions. Final changes also are made to the method for establishing bid limits for items under the DMEPOS CBPs. In addition, this rule summarizes comments on the impacts of coordinating Medicare and Medicaid Durable Medical Equipment for dually eligible beneficiaries. Finally, this rule also summarizes comments received in response to a request for information related to the Comprehensive ESRD Care Model and future payment models affecting renal care.
The promise and challenge of including multimedia items in medical licensure examinations: some insights from an empirical trial.

PubMed

Shen, Linjun; Li, Feiming; Wattleworth, Roberta; Filipetto, Frank

2010-10-01

The Comprehensive Osteopathic Medical Licensing Examination conducted a trial of multimedia items in the 2008-2009 Level 3 testing cycle to determine (1) if multimedia items were able to test additional elements of medical knowledge and skills and (2) how to develop effective multimedia items. Forty-four content-matched multimedia and text multiple-choice items were randomly delivered to Level 3 candidates. Logistic regression and paired-samples t tests were used for pairwise and group-level comparisons, respectively. Nine pairs showed significant differences in either difficulty or/and discrimination. Content analysis found that, if text narrations were less direct, multimedia materials could make items easier. When textbook terminologies were replaced by multimedia presentations, multimedia items could become more difficult. Moreover, a multimedia item was found not uniformly difficult for candidates at different ability levels, possibly because multimedia and text items tested different elements of a same concept. Multimedia items may be capable of measuring some constructs different from what text items can measure. Effective multimedia items with reasonable psychometric properties can be intentionally developed.
Evolving medical service in the information age: a legal analysis of applying telemedicine programs in Taiwan.

PubMed

Wu, Hsing-Hao

2008-12-01

In the face of the information age, Internet and telecommunication technologies have been widely applied in various settings. These innovational technologies have been used in the areas of e-commerce, long distance learning programs, entertainment, e-government, and so on. In recent years, the evolution of Internet technology is also pervading the health care industry. This dramatic trend may significantly alter traditional medical practice as well as the means of delivery of health care. The idea of telemedicine is to use modern information technology as a means or platform to deliver health care service in remote areas and to manage medical information in digitalized forms. The progress of developing telemedicine, however, is rather slow. The main reason for this slow progress is not technological but rather legal. Health care providers are reluctant to promote this innovation in medical service mainly due to uncertain legal consequences and ethical concerns. Although there are many legal challenges surrounding telemedicine, this note will examine major legal issues including licensure, malpractice liability, and privacy protection. Furthermore, I will discuss the potential of applying telemedicine programs in Taiwan's National Health Insurance Program (hereinafter referred to as NHI).
An interagency collaboration to facilitate development of filovirus medical countermeasures.

PubMed

Kilgore, Nicole; Nuzum, Edwin O

2012-10-19

The Filovirus Animal Non-Clinical Group (FANG) is a US interdepartmental and interagency group established to support and facilitate the advanced development of filovirus Medical Countermeasures (MCM), both vaccines and therapeutics. It is co-led by one representative from the Department of Defense (DoD), the first author, and one from the Department of Health and Human Services (HHS), the second author. The FANG membership includes operational level program staff and Subject Matter Experts (SME) from performing organizations as well as scientific staff and program managers from DoD and HHS funding and regulatory agencies. Focus areas include animal models, assays, reagents, product manufacture and characterization, and other interagency product development issues that will support Food and Drug Administration (FDA) licensure of safe and effective filovirus MCMs. The FANG continues to develop strategies to address broadly applicable and interagency product development challenges relevant to filovirus MCM development. This paper summarizes FANG structure and accomplishments and is meant to heighten community awareness of this government-led collaborative effort.
Post-licensure safety surveillance of zoster vaccine live (Zostavax®) in the United States, Vaccine Adverse Event Reporting System (VAERS), 2006-2015.

PubMed

Miller, Elaine R; Lewis, Paige; Shimabukuro, Tom T; Su, John; Moro, Pedro; Woo, Emily Jane; Jankosky, Christopher; Cano, Maria

2018-03-26

Herpes zoster (HZ), or shingles, is caused by reactivation of varicella-zoster virus in latently infected individuals. Live-attenuated HZ vaccine (zoster vaccine live, ZVL) is approved in the United States for persons aged ≥50 years and recommended by the CDC for persons ≥60 years. We analyzed U.S. reports of adverse events (AEs) following ZVL submitted to the Vaccine Adverse Event Reporting System (VAERS), a spontaneous reporting system to monitor vaccine safety, for persons vaccinated May 1, 2006, through January 31, 2015. We conducted descriptive analysis, clinical reviews of reports with selected pre-specified conditions, and empirical Bayesian data mining. VAERS received 23,092 reports following ZVL, of which 22,120 (96%) were classified as non-serious. Of reports where age was documented (n = 18,817), 83% were in persons aged ≥60 years. Reporting rates of AEs were 106 and 4.4 per 100,000 ZVL doses distributed for all reports and serious reports, respectively. When ZVL was administered alone among persons aged ≥50 years, injection site erythema (27%), HZ (17%), injection site swelling (17%), and rash (14%) were the most commonly reported symptoms among non-serious reports; HZ (29%), pain (18%), and rash (16%) were the most commonly reported symptoms among serious reports. Six reports included laboratory evidence of vaccine-strain varicella-zoster virus (Oka/Merck strain) infection; AEs included HZ, HZ- or varicella-like illness, and local reaction with vesicles. In our review of reports of death with sufficient information to determine cause (n = 46, median age 75 years), the most common causes were heart disease (n = 28), sepsis (n = 4), and stroke (n = 3). Empirical Bayesian data mining did not detect new or unexpected safety signals. Findings from our safety review of ZVL are consistent with those from pre-licensure clinical trials and other post-licensure assessments. Transient injection-site reactions, HZ, and rashes were most frequently
An approach to integrating interprofessional education in collaborative mental health care.

PubMed

Curran, Vernon; Heath, Olga; Adey, Tanis; Callahan, Terrance; Craig, David; Hearn, Taryn; White, Hubert; Hollett, Ann

2012-03-01

This article describes an evaluation of a curriculum approach to integrating interprofessional education (IPE) in collaborative mental health practice across the pre- to post-licensure continuum of medical education. A systematic evaluation of IPE activities was conducted, utilizing a combination of evaluation study designs, including: pretest-posttest control group; one-group pre-test-post-test; and one-shot case study. Participant satisfaction, attitudes toward teamwork, and self-reported teamwork abilities were key evaluative outcome measures. IPE in collaborative mental health practice was well received at both the pre- and post-licensure levels. Satisfaction scores were very high, and students, trainees, and practitioners welcomed the opportunity to learn about collaboration in the context of mental health. Medical student satisfaction increased significantly with the introduction of standardized patients (SPs) as an interprofessional learning method. Medical students and faculty reported that experiential learning in practice-based settings is a key component of effective approaches to IPE implementation. At a post-licensure level, practitioners reported significant improvement in attitudes toward interprofessional collaboration in mental health care after participation in IPE. IPE in collaborative mental health is feasible, and mental health settings offer practical and useful learning experiences for students, trainees, and practitioners in interprofessional collaboration.
Development of a Hospital-based Massage Therapy Course at an Academic Medical Center.

PubMed

Dion, Liza J; Cutshall, Susanne M; Rodgers, Nancy J; Hauschulz, Jennifer L; Dreyer, Nikol E; Thomley, Barbara S; Bauer, Brent

2015-03-01

Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment.
Development of a Hospital-based Massage Therapy Course at an Academic Medical Center

PubMed Central

Dion, Liza J.; Cutshall, Susanne M.; Rodgers, Nancy J.; Hauschulz, Jennifer L.; Dreyer, Nikol E.; Thomley, Barbara S.; Bauer, Brent

2015-01-01

Background: Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. Methods: A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. Results: The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. Conclusions: The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment. PMID
The value of internship in graduate medical education: survey of emergency medicine residents and program directors.

PubMed

Ray, Adam M

2007-01-01

To assess the opinions of emergency medicine (EM) residents and program directors about the value of completing a nonrequired 1-year internship before entering an EM residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). An eight-question, self-administered online survey was e-mailed to EM residents who had completed a nonrequired internship before entering ACGME-accredited residency programs. A separate, six-question survey was e-mailed to program directors of ACGME-accredited programs that do not require an internship who had ever had a resident who had completed a nonrequired internship. Forty-six (27 [59%] osteopathic, 19 [41%] allopathic) of 113 residents and 40 of 124 program directors responded to the survey questions. Less than 4% of residents completed a separate nonrequired 1-year internship. The most common reason for completing a nonrequired internship was to obtain licensure by the American Osteopathic Association (19 [41%]). Most residents believed that they were more proficient with history-taking and physical examinations (38 [83%]) and procedures (34 [74%]) during the first year of residency than their colleagues who did not complete an internship, but this percentage decreased over time. The program directors had similar opinions. Most osteopathic residents who completed the internship for osteopathic licensure would not have done so if it were not required. Most (39 of 40) program directors would not recommend taking a nonrequired internship. Completing a 1-year internship before entering an EM residency program may better prepare physicians for their first year of residency in terms of basic clinical competancy, but further study is needed in this area.
Effect of first-encounter pretest on pass/fail rates of a clinical skills medical licensure examination.

PubMed

Roberts, William L; McKinley, Danette W; Boulet, John R

2010-05-01

Due to the high-stakes nature of medical exams it is prudent for test agencies to critically evaluate test data and control for potential threats to validity. For the typical multiple station performance assessments used in medicine, it may take time for examinees to become comfortable with the test format and administrative protocol. Since each examinee in the rotational sequence starts with a different task (e.g., simulated clinical encounter), those who are administered non-scored pretest material on their first station may have an advantage compared to those who are not. The purpose of this study is to investigate whether pass/fail rates are different across the sequence of pretest encounters administered during the testing day. First-time takers were grouped by the sequential order in which they were administered the pretest encounter. No statistically significant difference in fail rates was found between examinees who started with the pretest encounter and those who encountered the pretest encounter later in the sequence. Results indicate that current examination administration protocols do not present a threat to the validity of test score interpretations.
An Interagency Collaboration to Facilitate Development of Filovirus Medical Countermeasures

PubMed Central

Kilgore, Nicole; Nuzum, Edwin O.

2012-01-01

The Filovirus Animal Non-Clinical Group (FANG) is a US interdepartmental and interagency group established to support and facilitate the advanced development of filovirus Medical Countermeasures (MCM), both vaccines and therapeutics. It is co-led by one representative from the Department of Defense (DoD), the first author, and one from the Department of Health and Human Services (HHS), the second author. The FANG membership includes operational level program staff and Subject Matter Experts (SME) from performing organizations as well as scientific staff and program managers from DoD and HHS funding and regulatory agencies. Focus areas include animal models, assays, reagents, product manufacture and characterization, and other interagency product development issues that will support Food and Drug Administration (FDA) licensure of safe and effective filovirus MCMs. The FANG continues to develop strategies to address broadly applicable and interagency product development challenges relevant to filovirus MCM development. This paper summarizes FANG structure and accomplishments and is meant to heighten community awareness of this government-led collaborative effort. PMID:23202465
Survey of Older Drivers’ Experiences with Florida’s Mandatory Vision Re-Screening Law for Licensure

PubMed Central

McGwin, Gerald; McCartt, Anne T.; Braitman, Keli A.; Owsley, Cynthia

2008-01-01

Purpose To document the license renewal experiences of Florida drivers ages 80 and older who must pass a visual acuity test when renewing their driver’s license. Participants A random sample of Florida residents ages 80 and older whose driver’s licenses were scheduled to expire between January 1, 2004 and June 30, 2005 as identified by the Florida Department of Highway Safety and Motor Vehicles. Methods Study participants (n=1,242 drivers) were contacted via telephone and completed a survey regarding their experiences with the license renewal process. Results The majority (80.2%) of those eligible for license renewal reportedly attempted to do so and 88.0% succeeded the first time they tried. A large percentage of drivers (88%) who failed the vision test said they sought treatment, and 77.6% of drivers who reattempted renewal reportedly passed the test. About half of drivers who did not seek renewal said they thought they would fail the vision test. The majority of those choosing not to renew their license (99.5%) reported using transportation alternatives. Conclusions This Study suggests that the Florida vision screening re-licensure law is not a deterrent to seeking license renewal for the ≥80-year-old population. Furthermore, only a small percentage of Florida drivers ages ≥ 80 years and older reported that they failed the visual acuity screening test and were denied license renewal. PMID:18432496
Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

PubMed

Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

2017-03-01

International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.
Bibliography. Citations Obtained Through the National Library of Medicine's MEDLARS Program

ERIC Educational Resources Information Center

Journal of Medical Education, 1978

1978-01-01

Approximately 200 MEDLARS references are cited dealing with: accreditation and licensure; computers; continuing education; curriculum; educational measurement, and research and development; forensic medicine; graduate education; history; internship and residency; foreign medical education; minority groups; schools; specialism; students; teaching…
Time to Loosen the Apron Strings: Cohort-based Evaluation of a Learner-driven Remediation Model at One Medical School.

PubMed

Bierer, S Beth; Dannefer, Elaine F; Tetzlaff, John E

2015-09-01

Remediation in the era of competency-based assessment demands a model that empowers students to improve performance. To examine a remediation model where students, rather than faculty, develop remedial plans to improve performance. Private medical school, 177 medical students. A promotion committee uses student-generated portfolios and faculty referrals to identify struggling students, and has them develop formal remediation plans with personal reflections, improvement strategies, and performance evidence. Students submit reports to document progress until formally released from remediation by the promotion committee. Participants included 177 students from six classes (2009-2014). Twenty-six were placed in remediation, with more referrals occurring during Years 1 or 2 (n = 20, 76 %). Unprofessional behavior represented the most common reason for referral in Years 3-5. Remedial students did not differ from classmates (n = 151) on baseline characteristics (Age, Gender, US citizenship, MCAT) or willingness to recommend their medical school to future students (p < 0.05). Two remedial students did not graduate and three did not pass USLME licensure exams on first attempt. Most remedial students (92 %) generated appropriate plans to address performance deficits. Students can successfully design remedial interventions. This learner-driven remediation model promotes greater autonomy and reinforces self-regulated learning.
Bibliography. Citations Obtained through the National Library of Medicine's MEDLARS Program.

ERIC Educational Resources Information Center

Journal of Medical Education, 1980

1980-01-01

A bibliography from the National Library of Medicine's MEDLARS Program covers: accreditation, certification and licensure; computers; continuing education; curriculum; educational measurement; faculty; forensic medicine; history; internship and residency; medical education in other countries; minority groups, sex and age factors; and premedical…

What's the difference? Comparison of American and Japanese medical practice.

PubMed

Kitano, Masami

2007-09-01

Medical systems in the USA such as EBM., DRG., Informed Consent and Second Opinion have already been introduced into the Japanese medical system. However, some of these systems have met resistance from a part of the population due to the differences of social structures, morals and customs between the two countries. Briefly, I described the medical education and licensure, the private practice and "open hospital system" of the USA. The following 4 topics which drew great interest in Japan will be discussed. 1) CEREBRAL DEATH AND BIOETHICS: Cerebral death has been restrictively accepted as human death since the 1980's only in terms of terminal cares in clinical medicine. The rather simplified current neurological criteria for death are approved in the USA. In order for an organ transplant to take place, a potential donor must be diagnosed as brain dead. However, Japanese society has not accepted the concept of cerebral death completely because of an accident in the 1960's where an organ was improperly removed when the donor who was not in the state of brain death. Recently, more people in Japan are showing interest in Dignity and Euthanasia from the point of view of "Right to die". 2) MALPRACTICE AND LITIGATION: "To err is human" was introduced by the Institute of Medicine for Risk Management. Accidental deaths of patients under medical care ranks No.8 in total number of deaths in the USA. There are 100,000 malpractice cases in the "Lawsuit Society" of America, which is 100 times that of Japan. Furthermore, the legal fees and insurance premiums are extremely high in the US as opposed to very low in Japan. 3) HEALTH CARE INSURANCE: To reduce medical costs, the insurance companies introduced "Competitive Managed Care" which resulted in the formation of "Health Maintenance Organizations" (HMO). Furthermore, when you compare the two countries in respect to those who have health insurance, 44 million in the USA carry no health insurance, whereas in Japan, the government
Exploring the impact of mindfulness meditation training in pre-licensure and post graduate nurses.

PubMed

Sanko, Jill; Mckay, Mary; Rogers, Scott

2016-10-01

The complex, high stress, technologically laden healthcare environment compromises providers' ability to be fully present in the moment; especially during patient interactions. This "pulling away" of attention (mindlessness) from the present moment creates an environment where decision making can take place in the absence of thoughtful, deliberate engagement in the task at hand. Mindfulness, can be cultivated through a variety of mindfulness practices. Few schools of nursing or hospitals offer mindfulness training, despite study findings supporting its effectiveness in improving levels of mindfulness, and perceived connections with patients and families. A mindfulness program developed for this study and tailored to nursing was used to provide the mindfulness training. Pre and post training assessments were completed and included administration of the Freiburg Mindfulness Inventory (FMI) and the Defining Issues Test (DIT) of moral judgment version 2. A statistically significant improvement in the FMI scores p=0.003 was found. The pre-licensure group did not show a statistically significant improvement in their FMI scores pre to post training (p=0.281), however the post graduate group did (p=0.004). Statistically significant pre - post scores were found in two schemas of the DIT-2 (P [Post conventional] score, p=0.039 and N2 [Maintaining norms] score, p=0.032). Mindfulness training improves mindfulness and some aspects of ethical decision making in the groups studied as part of this project. The findings of this study are promising and further demonstrate the merits of a mindfulness practice, however aspects of mindfulness training would need to be addressed prior to launching a full scale attempt to incorporate this into a work life or some other quality improvement program. Copyright © 2016 Elsevier Ltd. All rights reserved.
75 FR 16139 - Request For Public Comment: 30-Day Proposed Information Collection: Indian Health Service Medical...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-31

... references supplied by the applicant and may include: Former employers, educational institutions, licensure... streamlined and is using information technology to make the application electronically available on the... information technology. Direct Comments to OMB: Send your written comments and suggestions regarding the...
A Plea to Reassess the Role of United States Medical Licensing Examination Step 1 Scores in Residency Selection.

PubMed

Prober, Charles G; Kolars, Joseph C; First, Lewis R; Melnick, Donald E

2016-01-01

The three-step United States Medical Licensing Examination (USMLE) was developed by the National Board of Medical Examiners and the Federation of State Medical Boards to provide medical licensing authorities a uniform evaluation system on which to base licensure. The test results appear to be a good measure of content knowledge and a reasonable predictor of performance on subsequent in-training and certification exams. Nonetheless, it is disconcerting that the test preoccupies so much of students' attention with attendant substantial costs (in time and money) and mental and emotional anguish. There is an increasingly pervasive practice of using the USMLE score, especially the Step 1 component, to screen applicants for residency. This is despite the fact that the test was not designed to be a primary determinant of the likelihood of success in residency. Further, relying on Step 1 scores to filter large numbers of applications has unintended consequences for students and undergraduate medical education curricula. There are many other factors likely to be equally or more predictable of performance during residency. The authors strongly recommend a move away from using test scores alone in the applicant screening process and toward a more holistic evaluation of the skills, attributes, and behaviors sought in future health care providers. They urge more rigorous study of the characteristics of students that predict success in residency, better assessment tools for competencies beyond those assessed by Step 1 that are relevant to success, and nationally comparable measures from those assessments that are easy to interpret and apply.
Post-licensure surveillance of quadrivalent inactivated influenza (IIV4) vaccine in the United States, Vaccine Adverse Event Reporting System (VAERS), July 1, 2013-May 31, 2015.

PubMed

Haber, Penina; Moro, Pedro L; Lewis, Paige; Woo, Emily Jane; Jankosky, Christopher; Cano, Maria

2016-05-11

Quadrivalent inactivated influenza vaccines (IIV4) were first available for use during 2013-14 influenza season for individuals aged ≥6 months. IIV4 is designed to protect against four different flu viruses; two influenza A viruses and two influenza B viruses. We searched the Vaccine Adverse Event Reporting System (VAERS) for US reports after IIV4 and trivalent inactivated influenza vaccine (IIV3) from 7/1/2013-5/31/2015. Medical records were requested for non-manufacturer reports classified as serious (i.e. death, hospitalization, prolonged hospitalization, life-threatening illness, permanent disability). The review included automated data analysis, clinical review of all serious reports, reports of special interest, and empirical Bayesian data mining. VAERS received 1,838 IIV4 reports; 512 (28%) in persons aged 6 months-17 years of which 42 (8.2%) were serious reports; 1,265 (69%) in persons aged >18 years of which 84 (6.6%) were serious reports; two in children <6 months and 59 in persons of unknown age. Injection site erythema (24%), fever (14%) and injection site swelling (17%) were the most frequent adverse events among persons aged 6 months-17 years, while injection site pain (16%), pain (15%) and pain in extremity (13%) were the most frequent among persons aged 18-64 years given the vaccine alone. Among non-death serious reports, injection site reactions, constitutional symptoms, Guillain-Barré syndrome, seizures, and anaphylaxis were the most frequently reported adverse events. Data mining detected disproportional reporting for incorrect vaccine administration with no associated adverse events. Adverse events following IIV4 reported to VAERS were similar to those following IIV3. In our review of VAERS reports, IIV4 had a similar safety profile to IIV3. Most of the reported AEs were non-serious. Our findings are consistent with data from pre-licensure studies of IIV4. Published by Elsevier Ltd.
Realization of entry-to-practice milestones by Canadians who studied medicine abroad and other international medical graduates: a retrospective cohort study.

PubMed

Mathews, Maria; Kandar, Rima; Slade, Steve; Yi, Yanqing; Beardall, Sue; Bourgeault, Ivy

2017-06-19

International medical graduates must realize a series of milestones to obtain full licensure. We examined the realization of milestones by Canadian and non-Canadian graduates of Western or Caribbean medical schools, and Canadian and non-Canadian graduates from other medical schools. Using the National IMG Database (data available for 2005-2011), we created 2 cohorts: 1) international medical graduates who had passed the Medical Council of Canada Qualifying Examination Part I between 2005 and 2010 and 2) those who had first entered a family medicine postgraduate program between 2005 and 2009, or had first entered a specialty postgraduate program in 2005 or 2006. We examined 3 entry-to-practice milestones; obtaining a postgraduate position, passing the Medical Council of Canada Qualifying Examination Part II and obtaining a specialty designation. Of the 6925 eligible graduates in cohort 1, 2144 (31.0%) had obtained a postgraduate position. Of the 1214 eligible graduates in cohort 2, 1126 (92.8%) had passed the Qualifying Examination Part II, and 889 (73.2%) had obtained a specialty designation. In multivariate analyses, Canadian graduates of Western or Caribbean medical schools (odds ratio [OR] 4.69, 95% confidence interval [CI] 3.82-5.71) and Canadian graduates of other medical schools (OR 1.49, 95% CI 1.31-1.70) were more likely to obtain a postgraduate position than non-Canadian graduates of other (not Western or Caribbean) medical schools. There was no difference among the groups in passing the Qualifying Examination Part II or obtaining a specialty designation. Canadians who studied abroad were more likely than other international medical graduates to obtain a postgraduate position; there were no differences among the groups in realizing milestones once in a postgraduate program. These findings support policies that do not distinguish postgraduate applicants by citizenship or permanent residency status before medical school. Copyright 2017, Joule Inc. or its
Use of aptitude to understand bachelor of science in nursing student attrition and readiness for the National Council Licensure Examination-Registered Nurse.

PubMed

Newton, Sarah E; Moore, Gary

2009-01-01

Attrition is a serious issue among Bachelor of Science in Nursing (BSN) students with attrition rates around 50% nationwide. To help minimize BSN student attrition, many nursing programs use commercially available standardized nursing aptitude tests as adjuncts to scholastic aptitude data, usually operationalized as pre-nursing grade point average, to select students for admission. Little is known regarding the usefulness of scholastic and nursing aptitude data for predicting long-term retention in a BSN program and readiness for the National Council Licensure Examination-Registered Nurse (NCLEX-RN). Therefore, the purpose of this study was to describe the relationships among scholastic aptitude, nursing aptitude, BSN student attrition prior to the final semester of the curriculum, and BSN student readiness for the NCLEX-RN. This study's findings, along with other findings in the literature, suggest the need for a parsimonious explanatory model of BSN student attrition that can be used to guide admission and progression policies, and ensure that students ready for the NCLEX-RN are the ones graduating from BSN programs.
78 FR 36198 - Request for Public Comment: 30-Day Proposed Information Collection: Indian Health Service Medical...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... supplied by the applicant and may include: Former employers, educational institutions, licensure and... technology to make the application electronically available on the Internet. The application may be found at... collection techniques or other forms of information technology. Send Requests for Further Information: For...
Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

PubMed Central

Huygen, Frank; Verschueren, Kristin; McCabe, Candida; Stegmann, Jens-Ulrich; Zima, Julia; Mahaux, Olivia; Van Holle, Lionel; Angelo, Maria-Genalin

2015-01-01

Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We investigated the potential CRPS signal in relation to HPV-16/18-adjuvanted vaccine (Cervarix®) by database review of CRPS cases with independent expert confirmation; a disproportionality analysis and analyses of temporality; an observed versus expected analysis using published background incidence rates; systematic reviews of aggregate safety data, and a literature review. The analysis included 17 case reports of CRPS: 10 from Japan (0.14/100,000 doses distributed) and seven from the United Kingdom (0.08/100,000). Five cases were considered by independent experts to be confirmed CRPS. Quantitative analyses did not suggest an association between CRPS and HPV-16/18-adjuvanted vaccine. Observed CRPS incidence after HPV-16/18 vaccination was statistically significantly below expected rates. Systematic database reviews using search terms varying in specificity and sensitivity did not identify new cases. No CRPS was reported during clinical development and no unexpected results found in the literature. There is not sufficient evidence to suggest an increased risk of developing CRPS following vaccination with HPV-16/18-adjuvanted vaccine. Post-licensure safety surveillance confirms the acceptable benefit-risk of HPV-16/18 vaccination. PMID:26501109
Non-Patient-Based Clinical Licensure Examination for Dentistry in Minnesota: Significance of Decision and Description of Process.

PubMed

Mills, Eric A

2016-06-01

In recent years in the United States, there has been heightened interest in offering clinical licensure examination (CLE) alternatives to the live patient-based method in dentistry. Fueled by ethical concerns of faculty members at the University of Minnesota School of Dentistry, the state of Minnesota's Board of Dentistry approved a motion in 2009 to provide two CLE options to the school's future predoctoral graduates: a patient-based one, administered by the Central Regional Dental Testing Service, and a non-patient-based one administered by the National Dental Examining Board of Canada (NDEB). The validity of the NDEB written exam and objective structured clinical exam (OSCE) has been verified in a multi-year study. Via five-option, one-best-answer, multiple-choice questions in the written exam and extended match questions with up to 15 answer options in the station-based OSCE, competent candidates are distinguished from those who are incompetent in their didactic knowledge and clinical critical thinking and judgment across all dental disciplines. The action had the additional effects of furthering participation of Minnesota Board of Dentistry members in the University of Minnesota School of Dentistry's competency-based curriculum, of involving the school's faculty in NDEB item development workshops, and, beginning in 2018, of no longer permitting the patient-based CLE option on site. The aim of this article is to describe how this change came about and its effects.
The Literature of Veterinary Medicine. CE 60.

ERIC Educational Resources Information Center

Kerker, Ann E.; Malamud, Judie

This course guide outlines the objectives and content for a professional continuing education course on the literature of veterinary medicine. Topics covered include: (1) an introduction to veterinary medicine as a discipline, including comparison with other medical sciences, veterinary medicine education, licensure, animal models, veterinary…
75 FR 43156 - Notice of Proposed Information Collection Requests

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... in the approval process would defeat the purpose of the information collection, violate State or... requirements for foreign nursing schools (National Council Licensure Examination for Registered Nurses (NCLEX... attending foreign medical and nursing schools to gather such scores. Requests for copies of the proposed...
An Approach to Integrating Interprofessional Education in Collaborative Mental Health Care

ERIC Educational Resources Information Center

Curran, Vernon; Heath, Olga; Adey, Tanis; Callahan, Terrance; Craig, David; Hearn, Taryn; White, Hubert; Hollett, Ann

2012-01-01

Objective: This article describes an evaluation of a curriculum approach to integrating interprofessional education (IPE) in collaborative mental health practice across the pre- to post-licensure continuum of medical education. Methods: A systematic evaluation of IPE activities was conducted, utilizing a combination of evaluation study designs,…
A Reference Handbook of the Texas Health Professions and their Support Personnel; The Health Professions in Texas.

ERIC Educational Resources Information Center

Texas Nurses Association.

The fields of dentistry, dietetics, medicine, medical technology, nursing, occupational therapy, pharmacy, physical therapy, and social work are defined in the handbook. The entrance requirements, educational institutions, and licensure regulations in Texas are treated for each major and allied support field. The functions or types of…
Value of post-licensure data on benefits and risks of vaccination to inform vaccine policy: The example of rotavirus vaccines.

PubMed

Parashar, Umesh D; Cortese, Margaret M; Payne, Daniel C; Lopman, Benjamin; Yen, Catherine; Tate, Jacqueline E

2015-11-27

In 1999, the first rhesus-human reassortant rotavirus vaccine licensed in the United States was withdrawn within a year of its introduction after it was linked with intussusception at a rate of ∼1 excess case per 10,000 vaccinated infants. While clinical trials of 60,000-70,000 infants of each of the two current live oral rotavirus vaccines, RotaTeq (RV5) and Rotarix (RV1), did not find an association with intussusception, post-licensure studies have documented a risk in several high and middle income countries, at a rate of ∼1-6 excess cases per 100,000 vaccinated infants. However, considering this low risk against the large health benefits of vaccination that have been observed in many countries, including in countries with a documented vaccine-associated intussusception risk, policy makers and health organizations around the world continue to support the routine use of RV1 and RV5 in national infant immunization programs. Because the risk and benefit data from affluent settings may not be directly applicable to developing countries, further characterization of any associated intussusception risk following rotavirus vaccination as well as the health benefits of vaccination is desirable for low income settings. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Ltd.. All rights reserved.
Medical Surveillance Monthly Report (MSMR). Volume 17, Number 06, June 2010

DTIC Science & Technology

2010-06-01

of vaccine safety and effi cacy trials, and advocacy for U.S. licensure of JE vaccines .9 During World War II, LTC Albert Sabin conducted pioneering...the improved safety profi le of second-generation vaccines , and the geographic spread of JE virus over the past 50 years warrant continued...control of JE, including characterization of the ecology of JEV, development of fi rst and second generation vaccines and diagnostic assays, conduct
Competency: Does High Fidelity Simulation Make a Difference?

ERIC Educational Resources Information Center

Valente, Alice M.

2010-01-01

High fidelity simulation is a well documented adjunctive teaching method in medical and nurse practitioner programs, but few studies of effectiveness on this technology on the development of competency have emphasized pre-licensure associate degree level programs. This study explored student competency in the application of the nursing process…
Career Paths of First-Year Resident Physicians: A Seven-Year Study.

ERIC Educational Resources Information Center

Langwell, Kathryn M.

1980-01-01

Information taken from the American Medical Association's Physician Masterfile on career paths of all physicians who began an initial U.S. residency in 1968 is presented. Data, presented separately for men and women residents, are included for licensure and certification, major professional activities, specialty choices, and location decisions.…
Experiences of pre-licensure or pre-registration health professional students and their educators in working with intra-professional teams: a qualitative systematic review.

PubMed

Butcher, Diane L; MacKinnon, Karen; Bruce, Anne; Gordon, Carol; Koning, Clare

2017-04-01

Inter-professional initiatives are prevalent in the healthcare landscape, requiring professionals to collaborate effectively to provide quality patient care. Little attention has been given to intra-professional relationships, where professionals within one disciplinary domain (such as degree and diploma nursing students) collaborate to provide care. New care models are being introduced where baccalaureate and diploma students of a particular discipline (such as nursing, occupational therapy, dentistry or physiotherapy) work closely together in teams to deliver care. Questions thus arise as to how students and educators learn to work on intra-professional teams. To identify and synthesize evidence regarding experiences of pre-licensure health professional students and their educators on intra-professional teams and to draw recommendations to enhance policy and/or curriculum development. Pre-licensure students and educators, focusing on regulated health professions that have had more than one point of entry into practice. Experiences of intra-professional team learning or teaching within various entry-to-practice categories of a particular health-related discipline. Eight qualitative studies were included in the review. Seven studies were descriptive in nature; one study was a critical analysis. A comprehensive search of various databases was conducted between June 2, 2015 and August 16, 2015, and repeated in March 2016. The search considered all studies reported and published from January 1, 2001 to March 7, 2016. Only studies published in English were included in this review. Included papers were of low-to-moderate quality; however, it is important to consider that post-positivist assumptions underpinned much of the primary research, which could explain why researcher positionality and/or influence on the research would not be addressed. Data were extracted using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and
Addressing the nation's physician workforce needs: The Society of General Internal Medicine (SGIM) recommendations on graduate medical education reform.

PubMed

Jackson, Angela; Baron, Robert B; Jaeger, Jeffrey; Liebow, Mark; Plews-Ogan, Margaret; Schwartz, Mark D

2014-11-01

The Graduate Medical Education (GME) system in the United States (US) has garnered worldwide respect, graduating over 25,000 new physicians from over 8,000 residency and fellowship programs annually. GME is the portal of entry to medical practice and licensure in the US, and the pathway through which resident physicians develop the competence to practice independently and further develop their career plans. The number and specialty distribution of available GME positions shapes the overall composition of our national workforce; however, GME is failing to provide appropriate programs that support the delivery of our society's system of healthcare. This paper, prepared by the Health Policy Education Subcommittee of the Society of General Internal Medicine (SGIM) and unanimously endorsed by SGIM's Council, outlines a set of recommendations on how to reform the GME system to best prepare a physician workforce that can provide high quality, high value, population-based, and patient-centered health care, aligned with the dynamic needs of our nation's healthcare delivery system. These recommendations include: accurate workforce needs assessment, broadened GME funding sources, increased transparency of the use of GME dollars, and implementation of incentives to increase the accountability of GME-funded programs for the preparation and specialty selection of their program graduates.

An Inexpensive Predictor of Student Performance on Licensure Examinations.

ERIC Educational Resources Information Center

Hyde, R. M.; And Others

1987-01-01

The construction of a comprehensive final examination over the basic medical sciences is described. Performance on the exam was a better predictor of NBME-I scores than GPA in basic science or MCAT scores and a better predictor of NBME-II scores than preclinical course performance and MCAT scores. (Author/RH)
How Often is "Often"? The Use of Imprecise Terms in Exam Items.

ERIC Educational Resources Information Center

Case, Susan M.

This study was designed to gather data on the meaning of imprecise terms from items written by physicians for their students and by test committees for national licensure and certification examinations. A total of 32 members of test committees who write examination items for various medical specialty examinations participated in the study. Each…
Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data.

PubMed

Gauer, Jacqueline L; Wolff, Josephine M; Jackson, J Brooks

2016-01-01

The purpose of this study was to determine the associations and predictive values of Medical College Admission Test (MCAT) component and composite scores prior to 2015 with U.S. Medical Licensure Exam (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, with a focus on whether students scoring low on the MCAT were particularly likely to continue to score low on the USMLE exams. Multiple linear regression, correlation, and chi-square analyses were performed to determine the relationship between MCAT component and composite scores and USMLE Step 1 and Step 2 CK scores from five graduating classes (2011-2015) at the University of Minnesota Medical School ( N =1,065). The multiple linear regression analyses were both significant ( p <0.001). The three MCAT component scores together explained 17.7% of the variance in Step 1 scores ( p< 0.001) and 12.0% of the variance in Step 2 CK scores ( p <0.001). In the chi-square analyses, significant, albeit weak associations were observed between almost all MCAT component scores and USMLE scores (Cramer's V ranged from 0.05 to 0.24). Each of the MCAT component scores was significantly associated with USMLE Step 1 and Step 2 CK scores, although the effect size was small. Being in the top or bottom scoring range of the MCAT exam was predictive of being in the top or bottom scoring range of the USMLE exams, although the strengths of the associations were weak to moderate. These results indicate that MCAT scores are predictive of student performance on the USMLE exams, but, given the small effect sizes, should be considered as part of the holistic view of the student.
Cross-Sectional Analysis of the 1039 U.S. Physicians Reported to the National Practitioner Data Bank for Sexual Misconduct, 2003-2013.

PubMed

AbuDagga, Azza; Wolfe, Sidney M; Carome, Michael; Oshel, Robert E

2016-01-01

Little information exists on U.S. physicians who have been disciplined with licensure or restriction-of-clinical-privileges actions or have had malpractice payments because of sexual misconduct. Our objectives were to: (1) determine the number of these physicians and compare their age groups' distribution with that of the general U.S. physician population; (2) compare the type of disciplinary actions taken against these physicians with actions taken against physicians disciplined for other offenses; (3) compare the characteristics and type of injury among victims of these physicians with those of victims in reports for physicians with other offenses in malpractice-payment reports; and (4) determine the percentages of physicians with clinical-privileges or malpractice-payment reports due to sexual misconduct who were not disciplined by medical boards. We conducted a cross-sectional analysis of physician reports submitted to the National Practitioner Data Bank (NPDB) from January 1, 2003, through September 30, 2013. A total of 1039 physicians had ≥ 1 sexual-misconduct-related reports. The majority (75.6%) had only licensure reports, and 90.1% were 40 or older. For victims in malpractice-payment reports, 87.4% were female, and "emotional injury only" was the predominant type of injury. We found a higher percentage of serious licensure actions and clinical-privileges revocations in sexual-misconduct-related reports than in reports for other offenses (89.0% vs 68.1%, P = < .001, and 29.3% vs 18.8%, P = .002, respectively). Seventy percent of the physicians with a clinical-privileges or malpractice-payment report due to sexual misconduct were not disciplined by medical boards for this problem. A small number of physicians were reported to the NPDB because of sexual misconduct. It is concerning that a majority of the physicians with a clinical-privileges action or malpractice-payment report due to sexual misconduct were not disciplined by medical boards for this
Driver Licensing Age and Lifestyle of 16 Year Olds.

ERIC Educational Resources Information Center

Preusser, David F.; And Others

1985-01-01

The relationship of driver licensure rate to 16-year-old lifestyles was assessed in three states: Michigan (where 56% of 16-year-olds are licensed), New York (14% licensure), and New Jersey (2% licensure). For the most part, the differences in 16-year-old licensure and mobility were not reflected in lifestyle differences. (KH)
Driving difficulties in Parkinson's disease

PubMed Central

Rizzo, Matthew; Uc, Ergun Y; Dawson, Jeffrey; Anderson, Steven; Rodnitzky, Robert

2011-01-01

Safe driving requires the coordination of attention, perception, memory, motor and executive functions (including decision-making) and self-awareness. PD and other disorders may impair these abilities. Because age or medical diagnosis alone is often an unreliable criterion for licensure, decisions on fitness to drive should be based on empirical observations of performance. Linkages between cognitive abilities measured by neuropsychological tasks, and driving behavior assessed using driving simulators, and natural and naturalistic observations in instrumented vehicles, can help standardize the assessment of fitness-to-drive. By understanding the patterns of driver safety errors that cause crashes, it may be possible to design interventions to reduce these errors and injuries and increase mobility. This includes driver performance monitoring devices, collision alerting and warning systems, road design, and graded licensure strategies. PMID:20187237
The establishment of surrogates and correlates of protection: Useful tools for the licensure of effective influenza vaccines?

PubMed Central

Ward, Brian J.; Pillet, Stephane; Charland, Nathalie; Trepanier, Sonia; Couillard, Julie; Landry, Nathalie

2018-01-01

ABSTRACT The search for a test that can predict vaccine efficacy is an important part of any vaccine development program. Although regulators hesitate to acknowledge any test as a true ‘correlate of protection’, there are many precedents for defining ‘surrogate’ assays. Surrogates can be powerful tools for vaccine optimization, licensure, comparisons between products and development of improved products. When such tests achieve ‘reference’ status however, they can inadvertently become barriers to new technologies that do not work the same way as existing vaccines. This is particularly true when these tests are based upon circularly-defined ‘reference’ or, even worse, proprietary reagents. The situation with inactivated influenza vaccines is a good example of this phenomenon. The most frequently used tests to define vaccine-induced immunity are all serologic assays: hemagglutination inhibition (HI), single radial hemolysis (SRH) and microneutralization (MN). The first two, and particularly the HI assay, have achieved reference status and criteria have been established in many jurisdictions for their use in licensing new vaccines and to compare the performance of different vaccines. However, all of these assays are based on biological reagents that are notoriously difficult to standardize and can vary substantially by geography, by chance (i.e. developing reagents in eggs that may not antigenitically match wild-type viruses) and by intention (ie: choosing reagents that yield the most favorable results). This review describes attempts to standardize these assays to improve their performance as surrogates, the dangers of over-reliance on ‘reference’ serologic assays, the ways that manufacturers can exploit the existing regulatory framework to make their products ‘look good’ and the implications of this long-established system for the introduction of novel influenza vaccines. PMID:29252098
Disciplinary action against physicians: who is likely to get disciplined?

PubMed

Khaliq, Amir A; Dimassi, Hani; Huang, Chiung-Yu; Narine, Lutchmie; Smego, Raymond A

2005-07-01

We sought to determine the characteristics of disciplined physicians at-large and the risk of disciplinary action over time and to report the type and frequency of complaints and the nature of disciplinary actions against allopathic physicians in Oklahoma. Descriptive statistics, Kaplan-Meier analysis, and Cox proportional hazards modeling of publicly available data on physicians licensed by the Oklahoma Board of Medical Licensure and Supervision. Among 14,314 currently or previously licensed physicians, 396 (2.8%) had been disciplined. Using univariate proportional hazards analysis, men (P <0.04), non-whites (P < 0.001), non-board-certified physicians (P < 0.001), and those in family medicine (P < 0.001), psychiatry (P < 0.001), general practice (P < 0.001), obstetrics-gynecology (P < 0.03) and emergency medicine (P < 0.001) were found to be at greater risk of being disciplined than other medical specialty groups. Foreign medical graduates had a higher risk of disciplinary action compared to US medical graduates (P < 0.001), although this finding was not confirmed by multivariate analysis. Kaplan-Meier analysis revealed that the proportion of physicians disciplined increased with each successive 10-year interval since first licensure. Complaints against physicians originated most often from the general public (66%), other physicians (5%), and staff (4%), and the complaints most frequently involved issues related to quality of care (25%), medication/prescription violations (19%), incompetence (18%), and negligence (17%). To improve physician behavior and reduce the need for disciplinary action, medical schools and residency training programs must continue to emphasize both patient care and medical professionalism as critical core competencies.
The Last State to Grant Nurse Practitioners DEA Licensure: An Education Improvement Initiative on the Florida Prescription Drug Monitoring Program.

PubMed

Kellams, Joni R; Maye, John P

Nurse practitioners (NPs) now have prescriptive authority for controlled substances in all 50 states in the United States. Florida, the last state to grant NPs DEA licensure, has been wrought with prescription diversion practices for a number of years as pill mills, doctor shopping, and overprescribing proliferated. Prescription Drug Monitoring Programs (PDMPs) help curb drug diversion activity and play a key role in reducing the abuse of controlled substances. The primary objective of this education improvement initiative was to increase knowledge of actively licensed NPs in the state of Florida regarding the state's PDMP. The main themes included the drug abuse problem, description and progression of the PDMP, and how to use the Florida PDMP. Upon approval from the institutional review board, this education improvement initiative gauged NP knowledge of the PDMP and main themes before and after an educational PowerPoint intervention. A pretest/posttest questionnaire was administered for assessment of all knowledge questions. One hundred forty-five NPs with active advanced registered NP licenses in Florida completed both the pretest and posttest questionnaires. Descriptive statistics and paired t tests were used for statistical significance testing. Knowledge of the PDMP and the main themes of the education improvement initiative significantly increased (p < .001) from pretest to posttest results. This education improvement initiative had positive effects for NPs on the knowledge of the Florida PDMP and the main themes. This indicated that Florida NPs are able to acquire greater comprehension of the PDMP by an education intervention.
Promoting parental management of teen driving

PubMed Central

Simons-Morton, B; Hartos, J; Leaf, W; Beck, K

2002-01-01

Methods: Parent-teen dyads (n = 452) were recruited when teens received learner's permits and interviewed over the telephone at baseline, licensure, and three months post-licensure. After baseline, families were randomized to either the intervention group that received persuasive communications or to the comparison group that received general information about driving safety. Results: Both parents and teens in the intervention group reported significantly greater limits on teen driving at licensure and three months post-licensure. In multivariate analyses, intervention and baseline driving expectations had significant effects on driving limits at licensure. Intervention and driving limits established at licensure were associated with three month driving limits. Conclusion: The findings indicate that exposure to the Checkpoints Program increased parental limits on teen driving. PMID:12221027
Novice Drivers' Exposure to Known Risk Factors During the First 18 Months of Licensure: The Effect of Vehicle Ownership

PubMed Central

Klauer, Sheila G.; Simons-Morton, Bruce; Lee, Suzanne E.; Ouimet, Marie Claude; Howard, E. Henry; Dingus, Thomas A.

2014-01-01

Objective Though there is ample research indicating that nighttime, teen passengers, and speeding increase the risk of crash involvement, there is little research about teen drivers' exposure to these known risk factors. Three research questions were assessed in this article: (1) Does exposure to known risk factors change over time? (2) Do teenage drivers experience higher rates of exposure to known risk factors than adult drivers? (3) Do teenage drivers who own a vehicle experience higher rates of exposure to risk factors than those who share a family vehicle? Methods Forty-one newly licensed teenage drivers and at least one parent (adult) were recruited at licensure. Driving data were recorded for 18 months. Results Average vehicle miles traveled (VMT) or average nighttime VMT for teens did not increase over time. Teenagers consistently drove 24 percent of VMT at night, compared with 18 percent for adults. Teenagers drove 62 percent of VMT with no passengers, 29 percent of VMT with one passenger, and less than 10 percent of VMT with multiple passengers. Driving with no passengers increased with driving experience for these teens. Teenage drivers who owned their vehicles, relative to those who shared a vehicle, sped 4 times more frequently overall and more frequently at night and with multiple teen passengers. Conclusion These findings are among the first objective data documenting the nature of teenage driving exposure to known risk factors. The findings provide evidence that vehicle access is related to risk and suggest the potential safety benefit of parental management of novice teenage driving exposure. PMID:21469023
Novice drivers' exposure to known risk factors during the first 18 months of licensure: the effect of vehicle ownership.

PubMed

Klauer, Sheila G; Simons-Morton, Bruce; Lee, Suzanne E; Ouimet, Marie Claude; Howard, E Henry; Dingus, Thomas A

2011-04-01

Though there is ample research indicating that nighttime, teen passengers, and speeding increase the risk of crash involvement, there is little research about teen drivers' exposure to these known risk factors. Three research questions were assessed in this article: (1) Does exposure to known risk factors change over time? (2) Do teenage drivers experience higher rates of exposure to known risk factors than adult drivers? (3) Do teenage drivers who own a vehicle experience higher rates of exposure to risk factors than those who share a family vehicle? Forty-one newly licensed teenage drivers and at least one parent (adult) were recruited at licensure. Driving data were recorded for 18 months. Average vehicle miles traveled (VMT) or average nighttime VMT for teens did not increase over time. Teenagers consistently drove 24 percent of VMT at night, compared with 18 percent for adults. Teenagers drove 62 percent of VMT with no passengers, 29 percent of VMT with one passenger, and less than 10 percent of VMT with multiple passengers. Driving with no passengers increased with driving experience for these teens. Teenage drivers who owned their vehicles, relative to those who shared a vehicle, sped 4 times more frequently overall and more frequently at night and with multiple teen passengers. These findings are among the first objective data documenting the nature of teenage driving exposure to known risk factors. The findings provide evidence that vehicle access is related to risk and suggest the potential safety benefit of parental management of novice teenage driving exposure.
Current practices in library/informatics instruction in academic libraries serving medical schools in the Western United States: a three-phase action research study.

PubMed

Eldredge, Jonathan D; Heskett, Karen M; Henner, Terry; Tan, Josephine P

2013-09-04

To conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools. Action research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews. Publicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are respected for their knowledge and
Current practices in library/informatics instruction in academic libraries serving medical schools in the western United States: a three-phase action research study

PubMed Central

2013-01-01

Background To conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools. Methods Action research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews. Results Publicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are
[Cross-sectional field pain medicine Q14 - the Mainz model : Development of the pain medicine curriculum in the standard study course at the University Medical School of the Johannes Gutenberg University Mainz].

PubMed

Kurz, S; Buggenhagen, H; Schwab, R; Laufenberg-Feldmann, R

2017-10-01

Following the amendment of the Medical Licensure Act (ÄAppO) in 2012, pain medicine was introduced as a mandatory subject for students during undergraduate medical training. Medical schools were required to define and to implement adequate curricular and formal teaching structures based on interdisciplinary and multiprofessional requirements according to the curriculum for pain medicine of the German Pain Society. These aspects were considered in the new interdisciplinary curriculum for pain medicine, the so-called Mainz model. A new curriculum based on the Kern cycle was developed and implemented at the Medical Center of the Johannes Gutenberg University in Mainz. Different teaching methods (lectures, interprofessional tutorials and bedside coaching in small groups) were used to impart professional expertise in pain medicine to medical students in an interdisciplinary clinical context. The new curriculum was put into practice and evaluated starting from the winter semester 2014/2015. Before and after the first implementation, medical students were asked about the relevance of pain medicine and their perception of personal competence. The interdisciplinary course in pain medicine was successfully introduced into the degree program based on the curriculum of the German Pain Society and the Kern cycle. With educational support, interdepartmental and multiprofessional collaboration the process of implementation of new interdisciplinary courses can be facilitated. In the future, the question how to increase the amount of practical lessons without increasing the load on teaching resources has to be resolved. Blended learning modules, such as a combination of E‑learning and practical lessons are currently being studied in smaller cohorts.
Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data

PubMed Central

Gauer, Jacqueline L.; Wolff, Josephine M.; Jackson, J. Brooks

2016-01-01

Introduction The purpose of this study was to determine the associations and predictive values of Medical College Admission Test (MCAT) component and composite scores prior to 2015 with U.S. Medical Licensure Exam (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, with a focus on whether students scoring low on the MCAT were particularly likely to continue to score low on the USMLE exams. Method Multiple linear regression, correlation, and chi-square analyses were performed to determine the relationship between MCAT component and composite scores and USMLE Step 1 and Step 2 CK scores from five graduating classes (2011–2015) at the University of Minnesota Medical School (N=1,065). Results The multiple linear regression analyses were both significant (p<0.001). The three MCAT component scores together explained 17.7% of the variance in Step 1 scores (p<0.001) and 12.0% of the variance in Step 2 CK scores (p<0.001). In the chi-square analyses, significant, albeit weak associations were observed between almost all MCAT component scores and USMLE scores (Cramer's V ranged from 0.05 to 0.24). Discussion Each of the MCAT component scores was significantly associated with USMLE Step 1 and Step 2 CK scores, although the effect size was small. Being in the top or bottom scoring range of the MCAT exam was predictive of being in the top or bottom scoring range of the USMLE exams, although the strengths of the associations were weak to moderate. These results indicate that MCAT scores are predictive of student performance on the USMLE exams, but, given the small effect sizes, should be considered as part of the holistic view of the student. PMID:27702431
Preventive medicines: vaccination, prophylaxis of infectious diseases, disinfectants.

PubMed

Heininger, Ulrich

2011-01-01

Immunizations belong to the most successful interventions in medicine. Like other drugs, vaccines undergo long periods of pre-clinical development, followed by careful clinical testing through study Phases I, II, and III before they receive licensure. A successful candidate vaccine will move on to be an investigational vaccine to undergo three phases of pre-licensure clinical trials in a stepwise fashion before it can be considered for approval, followed by an optional fourth phase of post-marketing assessment. The overall risk-benefit assessment of a candidate vaccine is very critical in making the licensure decision for regulatory authorities, supported by their scientific committees. It includes analyses of immunogenicity, efficacy, reactogenicity or tolerability, and safety of the vaccine. Public trust in vaccines is a key to the success of immunization programs worldwide. Maintaining this trust requires knowledge of the benefits and scientific understanding of real or perceived risks of immunizations. Under certain circumstances, pre- or post-exposure passive immunization can be achieved by administration of immunoglobulines. In terms of prevention of infectious diseases, disinfection can be applied to reduce the risk of transmission of pathogens from patient to patient, health-care workers to patients, patients to health-care workers, and objects or medical devices to patients.
Cross-Sectional Analysis of the 1039 U.S. Physicians Reported to the National Practitioner Data Bank for Sexual Misconduct, 2003–2013

PubMed Central

AbuDagga, Azza

2016-01-01

Background Little information exists on U.S. physicians who have been disciplined with licensure or restriction-of-clinical-privileges actions or have had malpractice payments because of sexual misconduct. Our objectives were to: (1) determine the number of these physicians and compare their age groups’ distribution with that of the general U.S. physician population; (2) compare the type of disciplinary actions taken against these physicians with actions taken against physicians disciplined for other offenses; (3) compare the characteristics and type of injury among victims of these physicians with those of victims in reports for physicians with other offenses in malpractice-payment reports; and (4) determine the percentages of physicians with clinical-privileges or malpractice-payment reports due to sexual misconduct who were not disciplined by medical boards. Methods and Results We conducted a cross-sectional analysis of physician reports submitted to the National Practitioner Data Bank (NPDB) from January 1, 2003, through September 30, 2013. A total of 1039 physicians had ≥ 1 sexual-misconduct–related reports. The majority (75.6%) had only licensure reports, and 90.1% were 40 or older. For victims in malpractice-payment reports, 87.4% were female, and “emotional injury only” was the predominant type of injury. We found a higher percentage of serious licensure actions and clinical-privileges revocations in sexual-misconduct–related reports than in reports for other offenses (89.0% vs 68.1%, P = < .001, and 29.3% vs 18.8%, P = .002, respectively). Seventy percent of the physicians with a clinical-privileges or malpractice-payment report due to sexual misconduct were not disciplined by medical boards for this problem. Conclusions A small number of physicians were reported to the NPDB because of sexual misconduct. It is concerning that a majority of the physicians with a clinical-privileges action or malpractice-payment report due to sexual misconduct
Post licensure surveillance of influenza vaccines in the Vaccine Safety Datalink in the 2013-2014 and 2014-2015 seasons.

PubMed

Li, Rongxia; Stewart, Brock; McNeil, Michael M; Duffy, Jonathan; Nelson, Jennifer; Kawai, Alison Tse; Baxter, Roger; Belongia, Edward A; Weintraub, Eric

2016-08-01

The changes in each year in influenza vaccine antigenic components as well as vaccine administration patterns may pose new risks of adverse events following immunization (AEs). To evaluate the safety of influenza vaccines annually administered to people ≥ 6 months, we conducted weekly post licensure surveillance for seven pre-specified adverse events following receipt of influenza vaccines during the 2013-2014 and 2014-2015 seasons in the Vaccine Safety Datalink (VSD). We used both a historically-controlled cohort design with the Poisson-based maximized sequential probability ratio test (maxSPRT) and a self-controlled risk interval (SCRI) design with the binomial-based maxSPRT. For each adverse event outcome, we defined the risk interval on the basis of biologic plausibility and prior literature. For the historical cohort design, numbers of expected adverse events were calculated from the prior seven seasons, adjusted for age and site. For the SCRI design, a comparison window was defined either before vaccination or after vaccination, depending on each specific outcome. An elevated risk of febrile seizures 0-1 days following trivalent inactivated influenza vaccine (IIV3) was identified in children aged 6-23 months during the 2014-2015 season using the SCRI design. We found the relative risk (RR) of febrile seizures following concomitant administration of IIV3 and PCV13 was 5.3 with a 95% CI 1.87-14.75. Without concomitant PCV 13 administration, the estimated risk decreased and was no longer statistically significant (RR: 1.4; CI: 0.54 - 3.61). No increased risks, other than for febrile seizures, were identified in influenza vaccine safety surveillance during 2013-2014 and 2014-2015 seasons in the VSD. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Parental licensure.

PubMed

Lykken, D T

2001-11-01

Most of the 1,400,000 men currently locked up in American prisons would have become tax-paying neighbors had they been switched in the hospital nursery and sent home with a mature, self-supporting, married couple. The parent with whom they did go home would in most instances not have been fit to adopt someone else's baby. It is argued that perhaps the only effective way to reduce crime and the other pathologies of the growing American underclass--apart from building still more prisons--would be to require from persons wishing to birth and rear a child of their own those same minimal criteria usually expected in adoptive parents. For evolutionary reasons, human beings are reluctant to interfere with the procreational rights of any person, no matter how immature, incompetent, or unsocialized he or she might be. In consequence, human beings tend not to think about the right of the child to a reasonable opportunity for life, liberty, and the pursuit of happiness.

Implementation of palliative care as a mandatory cross-disciplinary subject (QB13) at the Medical Faculty of the Heinrich-Heine-University Düsseldorf, Germany

PubMed Central

Schulz, Christian; Wenzel-Meyburg, Ursula; Karger, André; Scherg, Alexandra; in der Schmitten, Jürgen; Trapp, Thorsten; Paling, Andreas; Bakus, Simone; Schatte, Gesa; Rudolf, Eva; Decking, Ulrich; Ritz-Timme, Stephanie; Grünewald, Matthias; Schmitz, Andrea

2015-01-01

Background: By means of the revision of the Medical Licensure Act for Physicians (ÄAppO) in 2009, undergraduate palliative care education (UPCE) was incorporated as a mandatory cross sectional examination subject (QB13) in medical education in Germany. Its implementation still constitutes a major challenge for German medical faculties. There is a discrepancy between limited university resources and limited patient availabilities and high numbers of medical students. Apart from teaching theoretical knowledge and skills, palliative care education is faced with the particular challenge of imparting a professional and adequate attitude towards incurably ill and dying patients and their relatives. Project description: Against this background, an evidence-based longitudinal UPCE curriculum was systematically developed following Kern’s Cycle [1] and partly implemented and evaluated by the students participating in the pilot project. Innovative teaching methods (virtual standardised/simulated patient contacts, e-learning courses, interdisciplinary and interprofessional collaborative teaching, and group sessions for reflective self-development) aim at teaching palliative care-related core competencies within the clinical context and on an interdisciplinary and interprofessional basis. Results: After almost five years of development and evaluation, the UPCE curriculum comprises 60 teaching units and is being fully implemented and taught for the first time in the winter semester 2014/15. The previous pilot phases were successfully concluded. To date, the pilot phases (n=26), the subproject “E-learning in palliative care” (n=518) and the blended-learning elective course “Communication with dying patients” (n=12) have been successfully evaluated. Conclusion: All conducted development steps and all developed programmes are available for other palliative care educators (Open Access). The integrated teaching formats and methods (video, e-learning module
45 CFR 60.8 - Reporting licensure actions taken by Boards of Medical Examiners.

Code of Federal Regulations, 2010 CFR

2010-10-01

... based on reasons relating to a physician's or dentist's professional competence or professional conduct: (1) Which revokes or suspends (or otherwise restricts) a physician's or dentist's license, (2) Which censures, reprimands, or places on probation a physician or dentist, or (3) Under which a physician's or...
45 CFR 60.8 - Reporting licensure actions taken by Boards of Medical Examiners.

Code of Federal Regulations, 2011 CFR

2011-10-01

... based on reasons relating to a physician's or dentist's professional competence or professional conduct: (1) Which revokes or suspends (or otherwise restricts) a physician's or dentist's license, (2) Which censures, reprimands, or places on probation a physician or dentist, or (3) Under which a physician's or...
45 CFR 60.8 - Reporting licensure actions taken by Boards of Medical Examiners.

Code of Federal Regulations, 2012 CFR

2012-10-01

... based on reasons relating to a physician's or dentist's professional competence or professional conduct: (1) Which revokes or suspends (or otherwise restricts) a physician's or dentist's license, (2) Which censures, reprimands, or places on probation a physician or dentist, or (3) Under which a physician's or...
45 CFR 60.8 - Reporting licensure actions taken by Boards of Medical Examiners.

Code of Federal Regulations, 2014 CFR

2014-10-01

... must report to the NPDB any action based on reasons relating to a physician's or dentist's professional... dentist's license, (2) Which censures, reprimands, or places on probation a physician or dentist, or (3) Under which a physician's or dentist's license is surrendered. (b) Information that must be reported...
45 CFR 60.8 - Reporting licensure actions taken by Boards of Medical Examiners.

Code of Federal Regulations, 2013 CFR

2013-10-01

... must report to the NPDB any action based on reasons relating to a physician's or dentist's professional... dentist's license, (2) Which censures, reprimands, or places on probation a physician or dentist, or (3) Under which a physician's or dentist's license is surrendered. (b) Information that must be reported...
Funding sources for continuing medical education: An observational study

PubMed Central

Venkataraman, Ramesh; Ranganathan, Lakshmi; Ponnish, Arun S.; Abraham, Babu K.; Ramakrishnan, Nagarajan

2014-01-01

Aims: Medical accreditation bodies and licensing authorities are increasingly mandating continuing medical education (CME) credits for maintenance of licensure of healthcare providers. However, the costs involved in participating in these CME activities are often substantial and may be a major deterrent in obtaining these mandatory credits. It is assumed that healthcare providers often obtain sponsorship from their institutions or third party payers (i.e. pharmaceutical-industry) to attend these educational activities. Data currently does not exist exploring the funding sources for CME activities in India. In this study, we examine the relative proportion of CME activities sponsored by self, institution and the pharmaceutical-industry. We also wanted to explore the characteristics of courses that have a high proportion of self-sponsorship. Materials and Methods: This is a retrospective audit of the data during the year 2009 conducted at an autonomous clinical training academy. The details of the sponsor of each CME activity were collected from an existing database. Participants were subsequently categorized as sponsored by self, sponsored by institution or sponsored by pharmaceutical-industry. Results: In the year 2009, a total of 2235 participants attended 40 different CME activities at the training academy. Of the total participants, 881 (39.4%) were sponsored by self, 898 (40.2%) were sponsored by institution and 456 (20.3%) by pharmaceutical-industry. About 47.8% participants attended courses that carried an international accreditation. For the courses that offer international accreditation, 63.3% were sponsored by self, 34.9% were sponsored by institution and 1.6% were sponsored by pharmaceutical-industry. There were 126 participants (5.6%) who returned to the academy for another CME activity during the study period. Self-sponsored (SS) candidates were more likely to sponsor themselves again for subsequent CME activity compared with the other two groups (P < 0
Young driver licensing: examination of population-level rates using New Jersey's state licensing database.

PubMed

Curry, Allison E; Pfeiffer, Melissa R; Durbin, Dennis R; Elliott, Michael R; Kim, Konny H

2015-03-01

Recent surveys have provided insight on the primary reasons why US teens delay licensure but are limited in their ability to estimate licensing rates and trends. State administrative licensing data are the ideal source to provide this information but have not yet been analyzed for this purpose. Our objective was to analyze New Jersey's (NJ) licensing database to: (1) describe population-based rates of licensure among 17- to 20-year-olds, overall and by gender and zip code level indicators of household income, population density, and race/ethnicity; and (2) examine recent trends in licensure. We obtained records on all licensed NJ drivers through June 2012 from the NJ Motor Vehicle Commission's licensing database and determined each young driver's age at the time of intermediate and full licensure. Data from the US Census and American Community Survey were used to estimate a fixed cohort of NJ residents who turned 17 years old in 2006-2007 (n=255,833). Licensing data were used to estimate the number of these drivers who obtained an intermediate license by each month of age (numerators) and, among those who obtained an intermediate license, time to graduation to full licensure. Overall, 40% of NJ residents-and half of those who ultimately obtained a license by age 21-were licensed within a month of NJ's minimum licensing age of 17, 64% by their 18th birthday, and 81% by their 21st birthday. Starkly different patterns of licensure were observed by socioeconomic indicators; for example, 65% of 17-year-olds residing in the highest-income zip codes were licensed in the first month of eligibility compared with 13% of residents living in the lowest-income zip codes. The younger an individual obtained their intermediate license, the earlier they graduated to a full license. Finally, the rate and timing of licensure in NJ has been relatively stable from 2006 to 2012, with at most a 1-3% point decline in rates. These findings support the growing body of literature suggesting
Driving with Bioptic Telescopes: Organizing a Research Agenda

PubMed Central

Owsley, Cynthia

2012-01-01

Being a licensed driver in the U. S. and many other countries facilitates health and well-being. Based on the vision standards in most states, individuals with worse than 20/40 visual acuity who desire licensure are denied through the usual licensure application process. However, over 40 states have bioptic telescope licensing programs where applicants can gain licensure contingent on meeting specific requirements. In spite of the existence of the bioptic telescope and these licensing programs since the 1970s, there has been little rigorous scientific study of this topic. Here I offer an organizing perspective for a research agenda on driving with bioptic telescopes, with the long term practical goal being to provide an evidence basis for licensure policies and training programs. PMID:22863791
Teacher Identity and Self-efficacy Development in an Alternative Licensure Program for Middle and High School Math and Science Teachers

NASA Astrophysics Data System (ADS)

West, Robert J.

This mixed-method case study focused on the phenomenon of the transition from student to teacher. The educational system in the United States is constantly shifting to provide the correct number of teachers for our nations' schools. There is no simple formula for this process and occasionally an area of need arises that is not being met. Recently, the demand for science and math teachers in the K-12 system has outpaced the supply of new teachers (Business-Higher Education Forum, 2011). To complicate the problem further, teachers are leaving the field in record numbers both through retirement and attrition (National Commission on Teaching and America's Future, 2007). Particularly hard hit are poor rural schools with low-performing students, such as the schools of Appalachia (Barley, 2009; Goodpaster, Adedokun, & Weaver, 2012). Out of this need, alternative licensure programs for teachers have developed. The alternative teacher-training program studied in this research is the Woodrow Wilson Teaching Fellowship (WWTF) website, "The Woodrow Wilson Ohio Teaching Fellowship seeks to attract talented, committed individuals with backgrounds in the STEM fields---science, technology, engineering, and mathematics---into teaching in high-need Ohio secondary schools" (para. 2) . The researcher was interested in the formation of teacher identity and self-efficacy as these constructs have been shown to manifest in highly effective teachers that are likely to remain in the field of teaching (Beaucamp & Thomas 2009; Klassen, Tze, Betts, & Gordon, 2010). The research method included in-depth interviews, mixed with pretest/posttest administrations of the Teacher Sense of Efficacy Scale (TSES) (Tschannen-Moran & Woolfolk Hoy 2001) given during the teacher-training period and again following the first year of professional teaching. Results from both the TSES and the interviews indicate that the participants had a successful transition into teaching. They both felt and demonstrated that
Vaccine provision: Delivering sustained & widespread use.

PubMed

Preiss, Scott; Garçon, Nathalie; Cunningham, Anthony L; Strugnell, Richard; Friedland, Leonard R

2016-12-20

The administration of a vaccine to a recipient is the final step in a development and production process that may have begun several decades earlier. Here we describe the scale and complexity of the processes that brings a candidate vaccine through clinical development to the recipient. These challenges include ensuring vaccine quality (between 100 and 500 different Quality Control tests are performed during production to continually assess safety, potency and purity); making decisions about optimal vaccine presentation (pre-filled syringes versus multi-dose vials) that affect capacity and supply; and the importance of maintaining the vaccine cold chain (most vaccines have stringent storage temperature requirements necessary to maintain activity and potency). The ultimate aim is to make sure that an immunogenic product matching the required specifications reaches the recipient. The process from concept to licensure takes 10-30years. Vaccine licensure is based on a file submitted to regulatory agencies which contains the comprehensive compilation of chemistry, manufacturing information, assay procedures, preclinical and clinical trial results, and proposals for post-licensure effectiveness and safety data collection. Expedited development and licensure pathways may be sought in emergency settings: e.g., the 2009 H1N1 influenza pandemic, the 2014 West African Ebola outbreak and meningococcal serogroup B meningitis outbreaks in the United States and New Zealand. Vaccines vary in the complexity of their manufacturing process. Influenza vaccines are particularly challenging to produce and delays in manufacturing may occur, leading to vaccine shortages during the influenza season. Shortages can be difficult to resolve due to long manufacturing lead times and stringent, but variable, local regulations. New technologies are driving the development of new vaccines with simplified manufacturing requirements and with quality specifications that can be confirmed with fewer
Disciplinary careers of drug-impaired physicians.

PubMed

Holtman, Matthew C

2007-02-01

Alcohol and drug abuse are among the leading reasons for disciplinary action against physicians by state licensing authorities in the United States. I use event history models to describe the longitudinal patterns in disciplinary actions taken against physicians' licenses by state medical boards in the United States, 1990-2000. Adverse licensure action episodes that included discipline for drug or alcohol abuse were more likely to be followed by license restoration than episodes that did not. However, those restorations were also more likely to be followed by subsequent disciplinary action than episodes that did not include discipline for drug abuse. Furthermore, disciplinary licensure actions for drug abuse were the category most likely to be followed by a subsequent action for the same reason over the longer term (4-11 years). The increased risk of repeat disciplinary action associated with drug abuse may result in part from intensive surveillance of physicians who complete impaired physician programs, through mechanisms that include urine screening. However, it is also likely that the chronic nature of addiction leads to continued risk of relapse even among physicians receiving appropriate treatment.
Vaccine Development for Zika Virus-Timelines and Strategies.

PubMed

Durbin, Anna P

2016-09-01

Zika virus is a mosquito-borne Flavivirus that spread rapidly through South and Central America in 2015 to 2016. Microcephaly has been causally associated with Zika virus infection during pregnancy and the World Health Organization declared Zika virus as a Public Health Emergency of International Concern. To address this crisis, many groups have expressed their commitment to developing a Zika virus vaccine. Different strategies for Zika virus vaccine development are being considered including recombinant live attenuated vaccines, purified inactivated vaccines (PIVs), DNA vaccines, and viral vectored vaccines. Important to Zika virus vaccine development will be the target group chosen for vaccination and which end point(s) is chosen for efficacy determination. The first clinical trials of Zika virus vaccine candidates will begin in Q3/4 2016 but the pathway to licensure for a Zika virus vaccine is expected to take several years. Efforts are ongoing to accelerate Zika virus vaccine development and evaluation with the ultimate goal of reducing time to licensure. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Parenting and the Young Driver Problem

PubMed Central

Simons-Morton, Bruce G.; Ouimet, Marie Claude; Catalano, Richard F.

2008-01-01

Crash rates increase sharply at the age teenagers begin to drive and remain elevated relative to adult levels well into the twenties. Parents have important roles to play in managing the risk for teenage drivers before and after licensure. Parents can be involved in their teenagers’ driving, allowing them to test for permit and licensure, supervising practice driving, providing access to a vehicle, and setting and enforcing limits on driving privileges after licensure. However, the management practices of many parents may not be sufficient to provide safety effects. The literature indicates that the two most important decisions parents can make to reduce teenagers driving risk is to delay licensure and impose limits on high-risk driving conditions (such as driving at night and with teenage passengers) during the first year of licensure. Two intervention programs have been shown to increase parent limit setting as a means of reducing risky driving behaviors and improving driving performance among novice teenage drivers. This article describes the contexts of and opportunities for parent involvement in teenage driving and the efficacy of interventions to increase and improve parental management of young drivers. PMID:18702985
Effect of the teen driving plan on the driving performance of teenagers before licensure: a randomized clinical trial.

PubMed

Mirman, Jessica H; Curry, Allison E; Winston, Flaura K; Wang, Wenli; Elliott, Michael R; Schultheis, Maria T; Fisher Thiel, Megan C; Durbin, Dennis R

2014-08-01

Many studies have failed to show an effect of parent-supervised practice driving on the driving performance of teenagers; nevertheless, most Graduated Driver Licensing programs have provisions that require supervised practice. To determine whether a web-based intervention, the Teen Driving Plan (TDP), can improve the driving performance of teenagers before licensure as measured by the Teen On-road Driving Assessment (tODA). Randomized, single-blind, clinical trial among 217 dyads (1 parent: 1 teenaged learner's-permit holder) to test TDP effectiveness on increasing the quantity and diversity of supervised practice and improving the teenagers' prelicensed driving performance. The study was conducted from December 2011 through January 2013 in Southeastern Pennsylvania. Dyads were randomized (3:2) to receive the TDP or the Pennsylvania driver's manual (control group). The TDP is a psychoeducational intervention designed to increase the quantity and diversity of parent-supervised practice. Materials are grouped by the following driving environments: empty parking lots, suburban residential streets, intermediate (1- or 2-lane) roads, highways, rural roads with curves and elevation changes, and commercial districts. The main outcomes were self-reported practice driving across 6 environments and 2 conditions and driving performance as measured by the teenagers' completion of the standardized and validated tODA 24 weeks after enrollment. Certified professional driving evaluators blinded to randomization status terminated the tODA if they determined that the teenager could not safely complete it. We examined mean differences in the quantity of supervised practice, differences in the overall proportion of teenagers in each group that had assessments terminated for unsafe driving, and the point of termination during the assessment. The TDP dyads reported more practice in 5 of the 6 environments and at night and in bad weather compared with the control dyads. Overall, 5 of 86
Post-licensure surveillance of trivalent live attenuated influenza vaccine in adults, United States, Vaccine Adverse Event Reporting System (VAERS), July 2005-June 2013.

PubMed

Haber, Penina; Moro, Pedro L; McNeil, Michael M; Lewis, Paige; Woo, Emily Jane; Hughes, Hayley; Shimabukuro, Tom T

2014-11-12

Trivalent live attenuated influenza vaccine (LAIV3) was licensed and recommended for use in 2003 in children and adults 2-49 years of age. Post-licensure safety data have been limited, particularly in adults. We searched Vaccine Adverse Event Reporting System (VAERS) for US reports after LAIV3 from July 1, 2005-June 30, 2013 (eight influenza seasons) in adults aged ≥ 18 years old. We conducted descriptive analyses and clinically reviewed serious reports (i.e., death, life-threatening illness, hospitalization, prolonged hospitalization, or permanent disability) and reports of selected conditions of interest. We used empirical Bayesian data mining to identify adverse events (AEs) that were reported more frequently than expected. We calculated crude AE reporting rates to VAERS by influenza season. During the study period, VAERS received 1207 LAIV3 reports in adults aged 18-49 years old; 107 (8.9%) were serious, including four death reports. The most commonly reported events were expired drug administered (n=207, 17%), headache (n=192, 16%), and fever (n=133, 11%). The most common diagnostic categories for non-fatal serious reports were neurological (n=40, 39%), cardiovascular (n=14, 14%), and other non-infectious conditions (n=20, 19%). We noted a higher proportion of Guillain-Barré syndrome (GBS) and cardiovascular reports in the Department of Defense (DoD) population compared to the civilian population. Data mining detected disproportional reporting of ataxia (n=15); clinical review revealed that ataxia was a component of diverse clinical entities including GBS. Review of VAERS reports are reassuring, the only unexpected safety concern for LAIV3 identified was a higher than expected number of GBS reports in the DoD population, which is being investigated. Reports of administration of expired LAIV3 represent administration errors and indicate the need for education, training and screening regarding the approved indications. Published by Elsevier Ltd.
42 CFR 493.575 - Removal of deeming authority or CLIA exemption and final determination review.

Code of Federal Regulations, 2014 CFR

2014-10-01

... an accreditation organization's program if the comparability or validation review produces findings...) An exemption review of a State's licensure program if the comparability or validation review produces... review of an accreditation organization or State licensure program, at CMS's discretion, if validation...
42 CFR 493.575 - Removal of deeming authority or CLIA exemption and final determination review.

Code of Federal Regulations, 2012 CFR

2012-10-01

... an accreditation organization's program if the comparability or validation review produces findings...) An exemption review of a State's licensure program if the comparability or validation review produces... review of an accreditation organization or State licensure program, at CMS's discretion, if validation...
42 CFR 493.575 - Removal of deeming authority or CLIA exemption and final determination review.

Code of Federal Regulations, 2013 CFR

2013-10-01

... an accreditation organization's program if the comparability or validation review produces findings...) An exemption review of a State's licensure program if the comparability or validation review produces... review of an accreditation organization or State licensure program, at CMS's discretion, if validation...
Primary care physicians in underserved areas. Family physicians dominate.

PubMed Central

Burnett, W H; Mark, D H; Midtling, J E; Zellner, B B

1995-01-01

Using the definitions of "medically underserved areas" developed by the California Health Manpower Policy Commission and data on physician location derived from a survey of California physicians applying for licensure or relicensure between 1984 and 1986, we examined the extent to which different kinds of primary care physicians located in underserved areas. Among physicians completing postgraduate medical education after 1974, board-certified family physicians were 3 times more likely to locate in medically underserved rural communities than were other primary care physicians. Non-board-certified family and general physicians were 1.6 times more likely than other non-board-certified primary care physicians to locate in rural underserved areas. Family and general practice physicians also showed a slightly greater likelihood than other primary care physicians of being located in urban underserved areas. PMID:8553635

Comparison of older and younger novice driver crash rates: Informing the need for extended Graduated Driver Licensing restrictions.

PubMed

Curry, Allison E; Metzger, Kristina B; Williams, Allan F; Tefft, Brian C

2017-11-01

Few previous studies have directly compared crash rates of older and younger novice drivers. To inform discussion about whether Graduated Driver Licensing (GDL) policies that are applied in the US for younger novice drivers should be applied to older novice drivers, we conducted a longitudinal study to examine overall, nighttime, and multiple passenger crash rates over the initial four years of licensure differ for novice drivers licensed at different ages. Using data from the New Jersey Traffic Safety Outcomes (NJ-TSO) data warehouse, we selected all NJ drivers who obtained their initial intermediate driver's license from 2006 through 2014 and had at least one month of follow-up from the date of licensure to study end or death (n=1,034,835). Novice drivers were grouped based on age at licensure: age 17; 18-20; 21-24; and 25 or older. We estimated monthly rates for overall crashes (per 10,000 licensed drivers) as well as: late night crashes (11:01 p.m.-4:59 a.m.); early night crashes (9:00 p.m.-11:00 p.m.); and multiple passenger crashes (two or more passengers). Average monthly rates were calculated for specific relevant time periods and Poisson regression models were used to compare rates: (1) between novice driver groups with the same time since licensure; (2) over the first 48 months of licensure within each novice driver group; and (3) between same-aged 21-year-old drivers with varying lengths of licensure. Although initial (three months post-licensure) overall crash rates of novice NJ drivers age 21 and older were higher than rates of same-aged experienced drivers, they were substantially lower than initial rates for 17- to 20-year-old novice drivers, who are licensed under GDL policies. Moreover, older novice drivers experience much less steep crash reductions over the first year of licensure than younger novice drivers. Nighttime crash rates among the 21- to 24-year old and aged 25 and older novice driver groups were stable over the first year of licensure
77 FR 8883 - Draft Guidance for Industry on Scientific Considerations in Demonstrating Biosimilarity to a...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

... reference product for the purpose of submitting a marketing application through an abbreviated licensure... submitting a marketing application through the abbreviated licensure pathway under section 351(k) of the... FDA will use to review applications for biosimilar products; and General scientific principles in...
Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

PubMed

Lewis, Catherine E; Hiatt, Jonathan R; Wilkerson, Luann; Tillou, Areti; Parker, Neil H; Hines, O Joe

2011-03-01

Although the primary purpose of the US Medical Licensing Examination (USMLE) is assessment for licensure, USMLE scores often are used for other purposes, more prominently resident selection. The Committee to Evaluate the USMLE Program currently is considering a number of substantial changes, including conversion to pass/fail scoring. A survey was administered to third-year (MS3) and fourth-year (MS4) medical students and residents at a single institution to evaluate opinions regarding pass/fail scoring on the USMLE. Response rate was 59% (n = 732 of 1249). Reported score distribution for Step 1 was 30% for <220, 38% for 220-240, and 32% for >240, with no difference between MS3s, MS4s, and residents (P = .89). Score distribution for Step 2 Clinical Knowledge (CK) was similar. Only 26% of respondents agreed that Step 1 should be pass/fail; 38% agreed with pass/fail scoring for Step 2 CK. Numerical scoring on Step 1 was preferred by respondents who: (1) agreed that the examination gave an accurate estimate of knowledge (odds ratio [OR], 4.23; confidence interval [CI], 2.41-7.43; P < .001); (2) scored >240 (OR, 4.0; CI, 1.92-8.33; P < .001); and (3) felt that acquisition of knowledge might decrease if the examination were pass/fail (OR, 10.15; CI, 3.32-31.02; P < .001). For Step 2 CK, numerical scoring was preferred by respondents who: (1) believed they gained a large amount of knowledge preparing for the examination (OR, 2.63; CI, 1.52-4.76; P < .001); (2) scored >240 (OR, 4.76; CI, 2.86-8.33; P < .001); (3) felt that the amount of knowledge acquired might decrease if it were pass/fail (OR, 28.16; CI, 7.31-108.43; P < .001); and (4) believed their Step 2 CK score was important when applying for residency (OR, 2.37; CI, 1.47-3.84; P < .001). Students and residents prefer the ongoing use of numerical scoring because they believe that scores are important in residency selection, that residency applicants are advantaged by examination scores, and that scores
Georgia's Teacher Performance Assessment

ERIC Educational Resources Information Center

Fenton, Anne Marie; Wetherington, Pamela

2016-01-01

Like most states, Georgia until recently depended on an assessment of content knowledge to award teaching licenses, along with a licensure recommendation from candidates' educator preparation programs. While the content assessment reflected candidates' grasp of subject matter, licensure decisions did not hinge on direct, statewide assessment of…
Service Learning: Providing the Building Blocks for a Socially Responsible Nursing Role

ERIC Educational Resources Information Center

Johnson, Judith M.

2013-01-01

An explanatory correlational study was conducted to explore whether and to what extent a relationship between hours of participation in service learning and commitment to social responsibility exists for students enrolled in pre-licensure baccalaureate-nursing programs currently participating in the Nursing Licensure Compact. The convenience…
Making vaccines "on demand": a potential solution for emerging pathogens and biodefense?

PubMed

De Groot, Anne S; Einck, Leo; Moise, Leonard; Chambers, Michael; Ballantyne, John; Malone, Robert W; Ardito, Matthew; Martin, William

2013-09-01

The integrated US Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) has made great strides in strategic preparedness and response capabilities. There have been numerous advances in planning, biothreat countermeasure development, licensure, manufacturing, stockpiling and deployment. Increased biodefense surveillance capability has dramatically improved, while new tools and increased awareness have fostered rapid identification of new potential public health pathogens. Unfortunately, structural delays in vaccine design, development, manufacture, clinical testing and licensure processes remain significant obstacles to an effective national biodefense rapid response capability. This is particularly true for the very real threat of "novel pathogens" such as the avian-origin influenzas H7N9 and H5N1, and new coronaviruses such as hCoV-EMC. Conventional approaches to vaccine development, production, clinical testing and licensure are incompatible with the prompt deployment needed for an effective public health response. An alternative approach, proposed here, is to apply computational vaccine design tools and rapid production technologies that now make it possible to engineer vaccines for novel emerging pathogen and WMD biowarfare agent countermeasures in record time. These new tools have the potential to significantly reduce the time needed to design string-of-epitope vaccines for previously unknown pathogens. The design process-from genome to gene sequence, ready to insert in a DNA plasmid-can now be accomplished in less than 24 h. While these vaccines are by no means "standard," the need for innovation in the vaccine design and production process is great. Should such vaccines be developed, their 60-d start-to-finish timeline would represent a 2-fold faster response than the current standard.
Making vaccines “on demand”

PubMed Central

De Groot, Anne S; Einck, Leo; Moise, Leonard; Chambers, Michael; Ballantyne, John; Malone, Robert W; Ardito, Matthew; Martin, William

2013-01-01

The integrated US Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) has made great strides in strategic preparedness and response capabilities. There have been numerous advances in planning, biothreat countermeasure development, licensure, manufacturing, stockpiling and deployment. Increased biodefense surveillance capability has dramatically improved, while new tools and increased awareness have fostered rapid identification of new potential public health pathogens. Unfortunately, structural delays in vaccine design, development, manufacture, clinical testing and licensure processes remain significant obstacles to an effective national biodefense rapid response capability. This is particularly true for the very real threat of “novel pathogens” such as the avian-origin influenzas H7N9 and H5N1, and new coronaviruses such as hCoV-EMC. Conventional approaches to vaccine development, production, clinical testing and licensure are incompatible with the prompt deployment needed for an effective public health response. An alternative approach, proposed here, is to apply computational vaccine design tools and rapid production technologies that now make it possible to engineer vaccines for novel emerging pathogen and WMD biowarfare agent countermeasures in record time. These new tools have the potential to significantly reduce the time needed to design string-of-epitope vaccines for previously unknown pathogens. The design process—from genome to gene sequence, ready to insert in a DNA plasmid—can now be accomplished in less than 24 h. While these vaccines are by no means “standard,” the need for innovation in the vaccine design and production process is great. Should such vaccines be developed, their 60-d start-to-finish timeline would represent a 2-fold faster response than the current standard. PMID:23877094
Teenage driver licensing in relation to state laws.

PubMed

Williams, A F; Lund, A K; Preusser, D F

1985-04-01

Previous studies have shown that delaying licensure reduces motor vehicle injuries. This study examined the relationship between licensing laws and the timing of obtaining drivers licenses. The states studied have various laws, including minimum licensing ages of 15, 16 and 17; minimum learners permit ages of 15 and 16; and teenage night driving curfews. A questionnaire survey of 52,304 students was conducted in 75 high schools during the spring of 1983. The schools were selected from Orange County, California; rural Colorado; and most or all of Louisiana, Michigan, Mississippi, New Jersey and New York. The results indicated that the minimum age of licensure has obvious strong effects in delaying licensure. Setting the learners permit age later also apparently delays licensure. The night driving curfew in New York State (9 p.m.-5 a.m.) is seen by students as a factor in their decisions to delay obtaining licenses; Louisiana's 11 p.m.-5 a.m. curfew has a much smaller effect, if any.
Online Clinical Post-Conference, Face-to-Face Clinical Postconference: Effects on Critical Thinking in Associate Degree Nursing Students

ERIC Educational Resources Information Center

Ebersole-Berkstresser, Kristie Anne

2013-01-01

Nurse educators, at every level of pre-licensure nursing education, are charged with developing critical thinking skills within their students. Post-clinical conference is one teaching strategy that nurse educators can employ to help promote the development of critical thinking skills in pre-licensure nursing students. However, traditional…
Out over Their Skis: A Study of Principal Preparation Program Policy in Florida

ERIC Educational Resources Information Center

Storey, Valerie A.; Johnson, Jerry

2017-01-01

Perceived shortage of principals, increased accountability demands, the changing role of principals, and the growing influence of the state over school administration have created a set of challenges for principal certification and licensure that have propelled a renewed need for analysis of certification and licensure processes. Recent calls to…
Restrictive Measures for Young, Beginning Drivers.

ERIC Educational Resources Information Center

Williams, Allan F.

Worldwide there is great variation in how licensing young people to drive is handled. The minimum age for regular licensure varies, generally from 15 to 18 years. Prerequisites and conditions for licensure vary. Some licensing policies are more effective than others in controlling injuries associated with youthful driving; crashes involving young…
Content Mastery Exams: An Option to Replace Faculty-Generated Final Exams

ERIC Educational Resources Information Center

Martin, Deanna K.

2017-01-01

Determining the most effective means of assessing content mastery as well as preparedness for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) is a task of all pre-licensure nursing faculty. The records of 331 diploma nursing students were reviewed for this retrospective, descriptive, correlational study that examines…
Predictors of Success on the Prosthetics Certification Examination

ERIC Educational Resources Information Center

Miro, Rebecca Maria

2014-01-01

Students who graduate from a practitioner program in prosthetics & orthotics must achieve certification in order to obtain licensure and practice independently in 16 states. In states where licensure is not mandatory, graduates may choose to pursue certification in order assure patients that they are practicing at the highest level as well as…
Using the impact of pneumococcal vaccines on nasopharyngeal carriage to aid licensing and vaccine implementation; a PneumoCarr meeting report March 27-28, 2012, Geneva.

PubMed

Goldblatt, David; Ramakrishnan, Meena; O'Brien, Katherine

2013-12-17

An international consultation was convened in March 2012 to provide feedback on the Case for Carriage, a summary statement by the Pneumococcal Carriage Consortium (PneumoCarr) proposing nasopharyngeal (NP) colonization as a supplementary or alternative endpoint in vaccine licensure. PneumoCarr members provided information to vaccine manufacturers, regulators and the WHO on the evidence for NP carriage as a precursor to pneumococcal disease, standardization of laboratory methods for the detection of multiple serotype carriage, definition and estimation of pneumococcal vaccine efficacy against carriage (VE-col), and the direct and indirect impact of vaccination on carriage. Manufacturers and regulators had the opportunity to respond to the information compiled by PneumoCarr and share their perspectives. VE-col as a licensure endpoint may be more useful for the next generation pneumococcal vaccine products, particularly those for which the immunological correlate of protection is not established, whereas it may be less needed for pneumococcal conjugate vaccines which have an established licensure pathway. The consultation supported the importance of NP carriage data as a critical element linking vaccine impact on the individual direct risk of disease to the population-level impact: indirect effects such as herd protection and serotype replacement. The indirect effects of vaccination, however, are not currently established as part of the licensure process and to include them would be a paradigm shift for regulatory agencies who currently consider this information in the post-licensure setting. More discussion and consensus-building is needed around the rationale and optimal mechanism to include carriage data in the licensure pathway for new pneumococcal vaccines. The WHO and national advisory groups on immunization policy may have an important role in considering the evidence for the indirect benefit of vaccination as informed by its impact on NP carriage. Copyright �
Culminating Experience Action Research Projects, Volume 1, Spring 2002

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Moyer, Peggy S, Ed.; Bothman, Susan M., Ed.

2005-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is now required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Culminating Experience Action Research Projects, Volume 10, Spring 2007

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Deaver, Sharon R., Ed.

2008-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Culminating Experience Action Research Projects, Volume 8, Part 1, Spring 2006

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Fritch, Sarah C., Ed.

2007-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Survey of Foreign Nurse Graduates.

ERIC Educational Resources Information Center

Harris, Ruby; And Others

A survey of fifty-one State Boards of Nursing (SBNs) was conducted to secure 1970 through 1972 information regarding the (1) number and characteristics of foreign nurse graduates (FNGs) who apply for licensure and those who fail to achieve licensure in the United States; (2) the availability and effectiveness of remedial courses and their…
Culminating Experience Action Research Projects, Volume 11, Fall 2007

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Deaver, Sharon R., Ed.

2008-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Culminating Experience Action Research Projects, Volume 15, Part 1, Fall 2009

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Cutcher, Cortney L., Ed.

2011-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…

Culminating Experience Action Research Projects, Volume 17, Fall 2010

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Cutcher, Cortney L., Ed.

2011-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 5900 Culminating…
Culminating Experience Action Research Projects, Volume 5, Spring 2004

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Bothman, Susan M., Ed

2005-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Standards for School Leaders Get New Thumbs Up

ERIC Educational Resources Information Center

Olson, Lynn

2008-01-01

A coalition of education groups came together in the mid-1990s to draft model standards for school leaders that would refocus the profession on student learning. Since then, the resulting Interstate School Leaders Licensure Consortium standards have been used or adapted by more than 40 states to guide their own preparation, licensure, and…
Culminating Experience Action Research Projects, Volume 16, Part 1, Spring 2010

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Cutcher, Cortney L., Ed.

2011-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Early Educators as Agents of Social Change for Inclusive Practices: An Action Research Study

ERIC Educational Resources Information Center

Rausch, Alissa

2016-01-01

The purpose of this study was to evaluate a new course developed for students in the early childhood education (ECE) graduate and/or licensure in early childhood special education (ECSE)--a Colorado teacher licensure program--in the School of Education and Human Development at CU Denver. The study explored graduate students' learning in a course…
Culminating Experience Action Research Projects, Volume 13, Fall 2008

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Cutcher, Cortney L., Ed.

2010-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Culminating Experience Action Research Projects, Volume 7, Fall 2005

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Fritch, Sarah C., Ed.

2007-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Culminating Experience Action Research Projects, Volume 14, Spring 2009

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.; Cutcher, Cortney L., Ed.

2010-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. Licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience. This course, Education 590 Culminating…
Driving experience, crashes and traffic citations of teenage beginning drivers.

PubMed

McCartt, Anne T; Shabanova, Veronika I; Leaf, William A

2003-05-01

Teenagers were surveyed by telephone every 6 months from their freshman to senior high school years (N=911). Self-reported crash involvements and citations were examined for each teenager's first year of licensure and first 3500 miles driven. Based on survival analysis, the risk of a first crash during the first month of licensure (0.053) was substantially higher than during any of the next 11 months (mean risk per month: 0.025). The likelihood of a first citation during the first month of licensure (0.023) also was higher than during any of the subsequent 11 months (mean risk per month: 0.012). Similarly, when viewed as a function of cumulative miles driven, the risk of a first crash or citation was highest during the first 500 miles driven after licensure. Fewer parental restrictions (e.g. no nighttime curfew) and a lower grade point average (GPA) were associated with a higher crash risk. Male gender, a lower GPA and living in a rural area were associated with a higher citation rate.
Stakeholders' perceptions on competency and assessment program of entry-level pharmacists in developing countries.

PubMed

Asante, Isaac; Andoh, Irene; Muijtjens, Arno M M; Donkers, Jeroen

2017-05-01

To assess the stakeholders' perceptions on the competency of entry-level pharmacists and the use of written licensure examination as the primary assessment for licensure decisions on entry-level pharmacists who have completed the Pharmacy Internship Program 1 (PIP) in developing countries. A cross-sectional survey was conducted among stakeholders in which they completed a web-based 21-item pre-tested questionnaire to determine their views regarding the competency outcomes and assessment program for entry-level pharmacist. The stakeholders rated the entry-level pharmacists to possess all competencies except research skills. Stakeholders suggested improvement of the program by defining the competency framework and training preceptors. However, stakeholders disagree on using written examination as the primary assessment for licensure decision and suggested the incorporation of other performance-based assessments like preceptor's assessment reports. Stakeholders are uncertain on entry-level pharmacists in developing countries possessing adequate research competencies and think their assessment program for licensure need more than written examination to assess all required competencies. Copyright © 2017 Elsevier Inc. All rights reserved.
The NAPLEX: Evolution, Purpose, Scope, and Educational Implications

PubMed Central

Boyle, Maria; Catizone, Carmen A.

2008-01-01

Since 2004, passing the North American Pharmacist Licensure Examination (NAPLEX) has been a requirement for earning initial pharmacy licensure in all 50 United States. The creation and evolution from 1952-2005 of the particular pharmacy competency testing areas and quantities of questions are described for the former paper-and-pencil National Association of Boards of Pharmacy Licensure Examination (NABPLEX) and the current candidate-specific computer adaptive NAPLEX pharmacy licensure examinations. A 40% increase in the weighting of NAPLEX Blueprint Area 2 in May 2005, compared to that in the preceding 1997-2005 Blueprint, has implications for candidates' NAPLEX performance and associated curricular content and instruction. New pharmacy graduates' scores on the NAPLEX are neither intended nor validated to serve as a criterion for assessing or judging the quality or effectiveness of pharmacy curricula and instruction. The newest cycle of NAPLEX Blueprint revision, a continual process to ensure representation of nationwide contemporary practice, began in early 2008. It may take up to 2 years, including surveying several thousand national pharmacists, to complete. PMID:18483600
The NAPLEX: evolution, purpose, scope, and educational implications.

PubMed

Newton, David W; Boyle, Maria; Catizone, Carmen A

2008-04-15

Since 2004, passing the North American Pharmacist Licensure Examination (NAPLEX) has been a requirement for earning initial pharmacy licensure in all 50 United States. The creation and evolution from 1952-2005 of the particular pharmacy competency testing areas and quantities of questions are described for the former paper-and-pencil National Association of Boards of Pharmacy Licensure Examination (NABPLEX) and the current candidate-specific computer adaptive NAPLEX pharmacy licensure examinations. A 40% increase in the weighting of NAPLEX Blueprint Area 2 in May 2005, compared to that in the preceding 1997-2005 Blueprint, has implications for candidates' NAPLEX performance and associated curricular content and instruction. New pharmacy graduates' scores on the NAPLEX are neither intended nor validated to serve as a criterion for assessing or judging the quality or effectiveness of pharmacy curricula and instruction. The newest cycle of NAPLEX Blueprint revision, a continual process to ensure representation of nationwide contemporary practice, began in early 2008. It may take up to 2 years, including surveying several thousand national pharmacists, to complete.
Culminating Experience Action Research Projects, Volume 18, Part 1, Spring 2016

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.

2017-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience or with school employment. This course, Education…
Culminating Experience Action Research Projects, Volume 18, Part 2, Spring 2016

ERIC Educational Resources Information Center

McAllister, Deborah A., Ed.

2018-01-01

As a part of the teacher licensure program at the graduate level at The University of Tennessee at Chattanooga (UTC), the M.Ed. licensure candidate is required to complete an action research project during a 3-semester-hour course that coincides with the 9-semester-hour student teaching experience or with school employment. This course, Education…
Adverse events following quadrivalent meningococcal CRM-conjugate vaccine (Menveo®) reported to the Vaccine Adverse Event Reporting system (VAERS), 2010-2015.

PubMed

Myers, Tanya R; McNeil, Michael M; Ng, Carmen S; Li, Rongxia; Lewis, Paige W; Cano, Maria V

2017-03-27

Limited data are available describing the post-licensure safety of meningococcal vaccines, including Menveo®. We reviewed reports of adverse events (AEs) to the Vaccine Adverse Event Reporting System (VAERS) to assess safety in all age groups. VAERS is a national spontaneous vaccine safety surveillance system co-administered by the Centers for Disease Control and Prevention and the US Food and Drug Administration. We searched the VAERS database for US reports of adverse events in persons who received Menveo from 1 January 2010 through 31 December 2015. We clinically reviewed reports and available medical records for serious AEs, selected pre-specified outcomes, and vaccination during pregnancy. We used empirical Bayesian data mining to identify AEs that were disproportionately reported after receipt of Menveo. During the study period, VAERS received 2614 US reports after receipt of Menveo. Of these, 67 were classified as serious, including 1 report of death. Adolescents (aged 11-18years) accounted for 74% of reports. Most of the reported AEs were non-serious and described AEs consistent with data from pre-licensure studies. Anaphylaxis and syncope were the two most common events in the serious reports. We did not identify any new safety concerns after review of AEs that exceeded the data mining threshold, although we did observe disproportionate reporting for terms that were not associated with an adverse event (e.g., "incorrect drug dosage form administered", "wrong technique in drug usage process"). Although reports were limited, we did not find any evidence for concern regarding the use of Menveo during pregnancy. In our review of VAERS reports, findings of AEs were consistent with the data from pre-licensure studies. Vaccine providers should continue to emphasize and adhere to proper administration of the vaccine. Copyright © 2017 Elsevier Ltd. All rights reserved.
Evidence based vaccinology.

PubMed

Nalin, David R

2002-02-22

Evidence based vaccinology (EBV) is the identification and use of the best evidence in making and implementing decisions during all of the stages of the life of a vaccine, including pre-licensure vaccine development and post-licensure manufacture and research, and utilization of the vaccine for disease control. Vaccines, unlike most pharmaceuticals, are in a continuous process of development both before and after licensure. Changes in biologics manufacturing technology and changes that vaccines induce in population and disease biology lead to periodic review of regimens (and sometimes dosage) based on changing immunologic data or public perceptions relevant to vaccine safety and effectiveness. EBV includes the use of evidence based medicine (EBM) both in clinical trials and in national disease containment programs. The rationale for EBV is that the highest evidentiary standards are required to maintain a rigorous scientific basis of vaccine quality control in manufacture and to ensure valid determination of vaccine efficacy, field effectiveness and safety profiles (including post-licensure safety monitoring), cost-benefit analyses, and risk:benefit ratios. EBV is increasingly based on statistically validated, clearly defined laboratory, manufacturing, clinical and epidemiological research methods and procedures, codified as good laboratory practices (GLP), good manufacturing practices (GMP), good clinical research practices (GCRP) and in clinical and public health practice (good vaccination practices, GVP). Implementation demands many data-driven decisions made by a spectrum of specialists pre- and post-licensure, and is essential to maintaining public confidence in vaccines.
Prospects and perspectives for development of a vaccine against herpes simplex virus infections.

PubMed

McAllister, Shane C; Schleiss, Mark R

2014-11-01

Herpes simplex viruses 1 and 2 are human pathogens that lead to significant morbidity and mortality in certain clinical settings. The development of effective antiviral medications, however, has had little discernible impact on the epidemiology of these pathogens, largely because the majority of infections are clinically silent. Decades of work have gone into various candidate HSV vaccines, but to date none has demonstrated sufficient efficacy to warrant licensure. This review examines developments in HSV immunology and vaccine development published since 2010, and assesses the prospects for improved immunization strategies that may result in an effective, licensed vaccine in the near future.
Prospects and Perspectives for Development of a Vaccine Against Herpes Simplex Virus Infections

PubMed Central

McAllister, Shane C.; Schleiss, Mark R.

2014-01-01

Herpes simplex viruses 1 and -2 are human pathogens that lead to significant morbidity and mortality in certain clinical settings. The development of effective antiviral medications, however, has had little discernible impact on the epidemiology of these pathogens, largely because the majority of infections are clinically silent. Decades of work have gone into various candidate HSV vaccines, but to date none has demonstrated sufficient efficacy to warrant licensure. This review examines developments in HSV immunology and vaccine development published since 2010, and assesses the prospects for improved immunization strategies that may result in an effective, licensed vaccine in the near future. PMID:25077372
Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

PubMed Central

Lewis, Catherine E; Hiatt, Jonathan R; Wilkerson, LuAnn; Tillou, Areti; Parker, Neil H; Hines, O. Joe

2011-01-01

Background Although the primary purpose of the US Medical Licensing Examination (USMLE) is assessment for licensure, USMLE scores often are used for other purposes, more prominently resident selection. The Committee to Evaluate the USMLE Program currently is considering a number of substantial changes, including conversion to pass/fail scoring. Methods A survey was administered to third-year (MS3) and fourth-year (MS4) medical students and residents at a single institution to evaluate opinions regarding pass/fail scoring on the USMLE. Results Response rate was 59% (n = 732 of 1249). Reported score distribution for Step 1 was 30% for <220, 38% for 220–240, and 32% for >240, with no difference between MS3s, MS4s, and residents (P = .89). Score distribution for Step 2 Clinical Knowledge (CK) was similar. Only 26% of respondents agreed that Step 1 should be pass/fail; 38% agreed with pass/fail scoring for Step 2 CK. Numerical scoring on Step 1 was preferred by respondents who: (1) agreed that the examination gave an accurate estimate of knowledge (odds ratio [OR], 4.23; confidence interval [CI], 2.41–7.43; P < .001); (2) scored >240 (OR, 4.0; CI, 1.92–8.33; P < .001); and (3) felt that acquisition of knowledge might decrease if the examination were pass/fail (OR, 10.15; CI, 3.32–31.02; P < .001). For Step 2 CK, numerical scoring was preferred by respondents who: (1) believed they gained a large amount of knowledge preparing for the examination (OR, 2.63; CI, 1.52–4.76; P < .001); (2) scored >240 (OR, 4.76; CI, 2.86–8.33; P < .001); (3) felt that the amount of knowledge acquired might decrease if it were pass/fail (OR, 28.16; CI, 7.31–108.43; P < .001); and (4) believed their Step 2 CK score was important when applying for residency (OR, 2.37; CI, 1.47–3.84; P < .001). Conclusions Students and residents prefer the ongoing use of numerical scoring because they believe that scores are important in residency selection, that residency applicants
Bias with respect to socioeconomic status: A closer look at zip code matching in a pneumococcal vaccine effectiveness study.

PubMed

Link-Gelles, Ruth; Westreich, Daniel; Aiello, Allison E; Shang, Nong; Weber, David J; Holtzman, Corinne; Scherzinger, Karen; Reingold, Arthur; Schaffner, William; Harrison, Lee H; Rosen, Jennifer B; Petit, Susan; Farley, Monica; Thomas, Ann; Eason, Jeffrey; Wigen, Christine; Barnes, Meghan; Thomas, Ola; Zansky, Shelley; Beall, Bernard; Whitney, Cynthia G; Moore, Matthew R

2016-12-01

In 2010, 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the US for prevention of invasive pneumococcal disease in children. Individual-level socioeconomic status (SES) is a potential confounder of the estimated effectiveness of PCV13 and is often controlled for in observational studies using zip code as a proxy. We assessed the utility of zip code matching for control of SES in a post-licensure evaluation of the effectiveness of PCV13 (calculated as [1-matched odds ratio]*100). We used a directed acyclic graph to identify subsets of confounders and collected SES variables from birth certificates, geo-coding, a parent interview, and follow-up with medical providers. Cases tended to be more affluent than eligible controls (for example, 48.3% of cases had private insurance vs. 44.6% of eligible controls), but less affluent than enrolled controls (52.9% of whom had private insurance). Control of confounding subsets, however, did not result in a meaningful change in estimated vaccine effectiveness (original estimate: 85.1%, 95% CI 74.8-91.9%; adjusted estimate: 82.5%, 95% CI 65.6-91.1%). In the context of a post-licensure vaccine effectiveness study, zip code appears to be an adequate, though not perfect, proxy for individual SES.

Do recommended driving limits affect teen-reported traffic violations and crashes during the first 12 months of independent driving?

PubMed

Simons-Morton, Bruce; Hartos, Jessica L; Leaf, William A; Preusser, David F

2006-09-01

Motor vehicle crashes are highly elevated among newly licensed teenage drivers. Limits on high-risk driving conditions by driver licensing policies and parents can protect novice teens from negative driving outcomes, while they experience and driving proficiency. The purpose of this research was to evaluate the effects of strict parent-imposed driving limits on driving outcomes during the first year of licensure. A sample of 3,743 Connecticut teens was recruited and randomized to the Checkpoints Program or comparison condition. Assessments conducted at baseline, licensure, 3-, 6-, and 12-months postlicensure included parent-imposed driving limits, traffic violations, and crashes. Bivariate and multivariate analyses were conducted to assess the effects of strict parent limits on traffic violations and crashes during the first year of licensure. Thirty percent of teens reported at least one traffic violation and 40% reported at least one crash. More strict parent-imposed limits at licensure, 3-, 6-, and 12-months postlicensure, were associated with fewer violations and crashes in multivariate analyses. Notably, adherence to recommended night curfew was consistently associated with fewer violations and crashes. The findings indicate that strict parent-imposed limits may protect novice teen drivers from negative driving outcomes.
Use of NCLEX preparation strategies in a hospital orientation program for graduate nurses.

PubMed

Wray, Karen; Whitehead, Tanya; Setter, Robyn; Treas, Leslie

2006-01-01

This article describes outcomes from the first year of a hospital orientation program for graduate nurses that was expanded to systematize and enrich preparation of graduate nurses for success on the NCLEX-RN licensure examination. The study protocol provided the Assessment Technologies Institute predictor examination to assess risk for licensure examination failure, review materials, and a meeting with an education specialist to identify and prioritize study needs. Those at highest risk for failure were also provided an in-depth written study plan and ongoing follow-up and support until the licensure examination was taken. The study sample consisted of 90 graduate nurses who were hired from May through August of 2005 at the University of Kansas Hospital. The pass rate for participants was 86.7% on the first attempt in year 1 of the program. At-risk graduates who reported that the predictor results impacted their study habits and followed the study recommendations were more likely to pass the licensure examination. Graduate nurses reported a high level of satisfaction with the support provided. Specific challenges faced by hospital nurse administrators in recruitment and retention and return on investment over a 3-year improvement plan are described.
Models of initial training and pathways to registration: a selective review of policy in professional regulation.

PubMed

Fealy, Gerard M; Carney, Marie; Drennan, Jonathan; Treacy, Margaret; Burke, Jacqueline; O'Connell, Dympna; Howley, Breeda; Clancy, Alison; McHugh, Aine; Patton, Declan; Sheerin, Fintan

2009-09-01

To provide a synthesis of literature on international policy concerning professional regulation in nursing and midwifery, with reference to routes of entry into training and pathways to licensure. Internationally, there is evidence of multiple points of entry into initial training, multiple divisions of the professional register and multiple pathways to licensure. Policy documents and commentary articles concerned with models of initial training and pathways to licensure were reviewed. Item selection, quality appraisal and data extraction were undertaken and documentary analysis was performed on all retrieved texts. Case studies of five Western countries indicate no single uniform system of routes of entry into initial training and no overall consensus regarding the optimal model of initial training. Multiple regulatory systems, with multiple routes of entry into initial training and multiple pathways to licensure pose challenges, in terms of achieving commonly-agreed understandings of practice competence. The variety of models of initial training present nursing managers with challenges in the recruitment and deployment of personnel trained in many different jurisdictions. Nursing managers need to consider the potential for considerable variation in competency repertoires among nurses trained in generic and specialist initial training models.
How to distinguish medicalization from over-medicalization?

PubMed

Kaczmarek, Emilia

2018-06-27

Is medicalization always harmful? When does medicine overstep its proper boundaries? The aim of this article is to outline the pragmatic criteria for distinguishing between medicalization and over-medicalization. The consequences of considering a phenomenon to be a medical problem may take radically different forms depending on whether the problem in question is correctly or incorrectly perceived as a medical issue. Neither indiscriminate acceptance of medicalization of subsequent areas of human existence, nor criticizing new medicalization cases just because they are medicalization can be justified. The article: (i) identifies various consequences of both well-founded medicalization and over-medicalization; (ii) demonstrates that the issue of defining appropriate limits of medicine cannot be solved by creating an optimum model of health; (iii) proposes four guiding questions to help distinguish medicalization from over-medicalization. The article should foster a normative analysis of the phenomenon of medicalization and contribute to the bioethical reflection on the boundaries of medicine.
Rater Training to Support High-Stakes Simulation-Based Assessments

PubMed Central

Feldman, Moshe; Lazzara, Elizabeth H.; Vanderbilt, Allison A.; DiazGranados, Deborah

2013-01-01

Competency-based assessment and an emphasis on obtaining higher-level outcomes that reflect physicians’ ability to demonstrate their skills has created a need for more advanced assessment practices. Simulation-based assessments provide medical education planners with tools to better evaluate the 6 Accreditation Council for Graduate Medical Education (ACGME) and American Board of Medical Specialties (ABMS) core competencies by affording physicians opportunities to demonstrate their skills within a standardized and replicable testing environment, thus filling a gap in the current state of assessment for regulating the practice of medicine. Observational performance assessments derived from simulated clinical tasks and scenarios enable stronger inferences about the skill level a physician may possess, but also introduce the potential of rater errors into the assessment process. This article reviews the use of simulation-based assessments for certification, credentialing, initial licensure, and relicensing decisions and describes rater training strategies that may be used to reduce rater errors, increase rating accuracy, and enhance the validity of simulation-based observational performance assessments. PMID:23280532
Evidence-Based Redesign of the COMLEX-USA Series.

PubMed

Gimpel, John R; Horber, Dorothy; Sandella, Jeanne M; Knebl, Janice A; Thornburg, John E

2017-04-01

To ensure that the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) reflects the evolving practice of osteopathic medicine, the National Board of Osteopathic Medical Examiners has developed new content and format specifications for an enhanced, competency-based examination program to be implemented with COMLEX-USA Level 3 in 2018. This article summarizes the evidence-based design processes that served as the foundation for blueprint development and the evidence supporting its validity. An overview is provided of the blueprint's 2 dimensions: Competency Domains and Clinical Presentations. The authors focus on the evidence that supports interpretation of test scores for the primary and intended purpose of COMLEX-USA, which is osteopathic physician licensure. Important secondary uses and the educational and catalytic effect of assessments are also described. This article concludes with the National Board of Osteopathic Medical Examiners' plans to ensure that the COMLEX-USA series remains current and meets the needs of its stakeholders-the patients who seek care from osteopathic physicians.
Medical humanities in the undergraduate medical curriculum.

PubMed

Supe, Avinash

2012-01-01

The medical humanities have been introduced in medical curricula over the past 30 years in the western world. Having medical humanities in a medical school curriculum can nurture positive attitudes in the regular work of a clinician and contribute equally to personality development. Though substantial evidence in favour of a medical humanities curriculum may be lacking, the feedback is positive. It is recommended that medical humanities be introduced into the curriculum of every medical school with the purpose of improving the quality of healthcare, and the attitudes of medical graduates.
The law and the expanding nursing role.

PubMed Central

Bullough, B

1976-01-01

Nursing has moved through two major phases in licensure. From 1900 to 1938 basic registration acts were passed and amended. In 1938 the goal became mandatory licensure for all those who nursed for hire. This move was linked with the stratification of the nursing role to include both practical and registered nurses. The third and current phase in licensure began in 1971 with the Idaho revision of the nurse practice act; 30 states have now revised their nurse practice acts to facilitate role expansion for registered nurses. Several approaches are being used in these laws including mandating new board regulations, expanding the definitions of nursing; increasing the power of physicians to delegate, and mandating the use of standardized protocols to guide the practice of nurses who are accepting new responsibilities. PMID:769567
The law and the expanding nursing role.

PubMed

Bullough, B

1976-03-01

Nursing has moved through two major phases in licensure. From 1900 to 1938 basic registration acts were passed and amended. In 1938 the goal became mandatory licensure for all those who nursed for hire. This move was linked with the stratification of the nursing role to include both practical and registered nurses. The third and current phase in licensure began in 1971 with the Idaho revision of the nurse practice act; 30 states have now revised their nurse practice acts to facilitate role expansion for registered nurses. Several approaches are being used in these laws including mandating new board regulations, expanding the definitions of nursing; increasing the power of physicians to delegate, and mandating the use of standardized protocols to guide the practice of nurses who are accepting new responsibilities.
[The use of medical journals by medical students. Which medical journals are read?].

PubMed

Algra, Annemijn M; Dekker, Friedo W

2015-01-01

To investigate the role of scientific medical journals in Dutch medical curricula. Descriptive questionnaire study. In 2013, medical students (from year 3 onwards) at the Leiden University Medical Centre (LUMC), were invited to respond to an online questionnaire. They were presented with 28 multiple-choice questions and 11 statements about the use of scientific medical journals in the medical curriculum. We calculated the frequencies of the answers per question and analysed differences between medical students using two-by-two tables. The questionnaire was completed by 680 (53.0%) of 1277 invited medical students enrolled at the LUMC. Most of the respondents were those doing clinical rotations (56.6%) and 60.1% had research experience. More than half of the students read at least one scientific journal a few times per month; this percentage was 38.8% among third-year students, 49.3% among fourth-year students, 60.0% among those on clinical rotation, and was higher among students with research experience (63.3%) than among those without research experience (44.1%). Nearly 90% of students agreed with the statement that the development of academic and scientific education should take place in the bachelor's phase of medical school. Medical students start to read scientific medical journals at an early phase in the medical curriculum and this increases further when students start to undertake research projects or go on clinical rotation. Medical curricula should be constructed in such a way that medical students learn to select and interpret research findings adequately for themselves before they turn to articles from scientific medical journals.
Why Crisis Pregnancy Centers Are Legal but Unethical.

PubMed

Bryant, Amy G; Swartz, Jonas J

2018-03-01

Crisis pregnancy centers are organizations that seek to intercept women with unintended pregnancies who might be considering abortion. Their mission is to prevent abortions by persuading women that adoption or parenting is a better option. They strive to give the impression that they are clinical centers, offering legitimate medical services and advice, yet they are exempt from regulatory, licensure, and credentialing oversight that apply to health care facilities. Because the religious ideology of these centers' owners and employees takes priority over the health and well-being of the women seeking care at these centers, women do not receive comprehensive, accurate, evidence-based clinical information about all available options. Although crisis pregnancy centers enjoy First Amendment rights protections, their propagation of misinformation should be regarded as an ethical violation that undermines women's health. © 2018 American Medical Association. All Rights Reserved.
An Objective Approach for Burkholderia pseudomallei Strain Selection as Challenge Material for Medical Countermeasures Efficacy Testing

PubMed Central

Van Zandt, Kristopher E.; Tuanyok, Apichai; Keim, Paul S.; Warren, Richard L.; Gelhaus, H. Carl

2012-01-01

Burkholderia pseudomallei is the causative agent of melioidosis, a rare disease of biodefense concern with high mortality and extreme difficulty in treatment. No human vaccines are available that protect against B. pseudomallei infection, and with the current limitations of antibiotic treatment, the development of new preventative and therapeutic interventions is crucial. Although clinical trials could be used to test the efficacy of new medical countermeasures (MCMs), the high mortality rates associated with melioidosis raises significant ethical issues concerning treating individuals with new compounds with unknown efficacies. The US Food and Drug Administration (FDA) has formulated a set of guidelines for the licensure of new MCMs to treat diseases in which it would be unethical to test the efficacy of these drugs in humans. The FDA “Animal Rule” 21 CFR 314 calls for consistent, well-characterized B. pseudomallei strains to be used as challenge material in animal models. In order to facilitate the efficacy testing of new MCMs for melioidosis using animal models, we intend to develop a well-characterized panel of strains for use. This panel will comprise of strains that were isolated from human cases, have a low passage history, are virulent in animal models, and are well-characterized phenotypically and genotypically. We have reviewed published and unpublished data on various B. pseudomallei strains to establish an objective method for selecting the strains to be included in the panel of B. pseudomallei strains with attention to five categories: animal infection models, genetic characterization, clinical and passage history, and availability of the strain to the research community. We identified 109 strains with data in at least one of the five categories, scored each strain based on the gathered data and identified six strains as candidate for a B. pseudomallei strain panel. PMID:23057010
An objective approach for Burkholderia pseudomallei strain selection as challenge material for medical countermeasures efficacy testing.

PubMed

Van Zandt, Kristopher E; Tuanyok, Apichai; Keim, Paul S; Warren, Richard L; Gelhaus, H Carl

2012-01-01

Burkholderia pseudomallei is the causative agent of melioidosis, a rare disease of biodefense concern with high mortality and extreme difficulty in treatment. No human vaccines are available that protect against B. pseudomallei infection, and with the current limitations of antibiotic treatment, the development of new preventative and therapeutic interventions is crucial. Although clinical trials could be used to test the efficacy of new medical countermeasures (MCMs), the high mortality rates associated with melioidosis raises significant ethical issues concerning treating individuals with new compounds with unknown efficacies. The US Food and Drug Administration (FDA) has formulated a set of guidelines for the licensure of new MCMs to treat diseases in which it would be unethical to test the efficacy of these drugs in humans. The FDA "Animal Rule" 21 CFR 314 calls for consistent, well-characterized B. pseudomallei strains to be used as challenge material in animal models. In order to facilitate the efficacy testing of new MCMs for melioidosis using animal models, we intend to develop a well-characterized panel of strains for use. This panel will comprise of strains that were isolated from human cases, have a low passage history, are virulent in animal models, and are well-characterized phenotypically and genotypically. We have reviewed published and unpublished data on various B. pseudomallei strains to establish an objective method for selecting the strains to be included in the panel of B. pseudomallei strains with attention to five categories: animal infection models, genetic characterization, clinical and passage history, and availability of the strain to the research community. We identified 109 strains with data in at least one of the five categories, scored each strain based on the gathered data and identified six strains as candidate for a B. pseudomallei strain panel.
Things Are Not as Bad as They Seem: Physicians' Ability to Predict Their Clinical Practice When a New Vaccine Becomes Available

PubMed Central

Hurley, Laura; Crane, Lori A.; Dong, Fran; Stokley, Shannon; Daley, Matthew F.; Barrow, Jennifer; Babbel, Christine; Dickinson, L. Miriam; Kempe, Allison

2013-01-01

Survey results regarding primary care physicians' likelihood of recommending a new vaccine were compared before and after the vaccine was licensed by the Food and Drug Administration for three new vaccines: herpes zoster (HZ), human papillomavirus (HPV) and rotavirus (RV), using physician networks representative of United States physicians. The main purpose of this study was to determine (a) how accurately physicians predict their eventual vaccine recommendations and the barriers they will experience in delivering the new vaccine and (b) whether physicians shift towards more or less strongly recommending a new vaccine from pre- to post-licensure. Responses from 284, 152 and 184 physicians were analyzed for the three vaccines, respectively. For all vaccines, there was a significant association between physicians' pre- and post-licensure recommendations (p<0.05). When responses changed from pre- to post-licensure, physicians tended to recommend a given vaccine more strongly than they had anticipated pre-licensure. Before vaccine availability, physicians tended to predict greater barriers to vaccine delivery than they eventually experienced. Surveys are useful for predicting physician practices, but may provide a slightly pessimistic view of physician adoption of new vaccines. Such data can be helpful in devising strategies to encourage vaccine delivery by physicians. PMID:23968639
Medication safety initiative in reducing medication errors.

PubMed

Nguyen, Elisa E; Connolly, Phyllis M; Wong, Vivian

2010-01-01

The purpose of the study was to evaluate whether a Medication Pass Time Out initiative was effective and sustainable in reducing medication administration errors. A retrospective descriptive method was used for this research, where a structured Medication Pass Time Out program was implemented following staff and physician education. As a result, the rate of interruptions during the medication administration process decreased from 81% to 0. From the observations at baseline, 6 months, and 1 year after implementation, the percent of doses of medication administered without interruption improved from 81% to 99%. Medication doses administered without errors at baseline, 6 months, and 1 year improved from 98% to 100%.
[Euthanasia: medications and medical procedures].

PubMed

Lossignol, D

2008-09-01

The Belgian law relative to euthanasia has been published in 2002. A physician is allowed to help a patient with intractable suffering (physical or psychological). Legal conditions are clear. However, nothing is said about medical procedures or medications to be used. The present paper will present specific clinical situations at the end of life, practical procedures and medications. A special focus is made on psychological impact of euthanasia.
Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism.

PubMed

Doukas, David J; McCullough, Laurence B; Wear, Stephen

2012-03-01

Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.
First vaccine approval under the FDA Animal Rule

PubMed Central

Beasley, David W C; Brasel, Trevor L; Comer, Jason E

2016-01-01

The US Food and Drug Administration’s Animal Rule was established to facilitate licensure of new products for life-threatening conditions when traditional efficacy trials in humans are unethical or impractical. In November, 2015 BioThrax became the first vaccine to receive approval for a new indication via this pathway. The basis for this approval and use of Animal Rule or other non-traditional approval pathways for licensure of vaccines for serious conditions are discussed. PMID:29263855
Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit.

PubMed

Song, Peipei; Tang, Wei

2017-05-23

In the era of the biological-psychological-social medicine model, an ideal of modern medicine is to enhance the humanities in medical education, to foster medical talents with humanistic spirit, and to promote the integration of scientific spirit and humanistic spirit in medicine. Throughout the United States (US), United Kingdom (UK), other Western countries, and some Asian countries like Japan, many medical universities have already integrated the learning of medical humanities in their curricula and recognized their value. While in China, although medical education reform over the past decade has emphasized the topic of medical humanities to increase the professionalism of future physicians, the integration of medical humanity courses in medical universities has lagged behind the pace in Western countries. In addition, current courses in medical humanities were arbitrarily established due to a lack of organizational independence. For various reasons like a shortage of instructors, medical universities have failed to pay sufficient attention to medical humanities education given the urgent needs of society. The medical problems in contemporary Chinese society are not solely the purview of biomedical technology; what matters more is enhancing the humanities in medical education and fostering medical talents with humanistic spirit. Emphasizing the humanities in medical education and promoting the integration of medical scientific spirit and medical humanistic spirit have become one of the most pressing issues China must address. Greater attention should be paid to reasonable integration of humanities into the medical curriculum, creation of medical courses related to humanities and optimization of the curriculum, and actively allocating abundant teaching resources and exploring better methods of instruction.
Teaching Medical Ethics to Medical Students.

ERIC Educational Resources Information Center

Loewy, Erich H.

1986-01-01

The evolution and goals of teaching medical ethics, the nature of medical ethics, and integrating such teaching into the curriculum are examined. Because moral considerations are as much a part of medical decisions as technical considerations, teaching is best done in the context of real cases. (Author/MLW)

Vision, Training Hours, and Road Testing Results in Bioptic Drivers

PubMed Central

Dougherty, Bradley E.; Flom, Roanne E.; Bullimore, Mark A.; Raasch, Thomas W.

2015-01-01

Purpose Bioptic telescopic spectacles (BTS) can be used by people with central visual acuity that does not meet the state standards to obtain an unrestricted driver’s license. The purpose of this study was to examine the relationships among visual and demographic factors, training hours, and the results of road testing for bioptic drivers. Methods A retrospective study of patients who received an initial daylight bioptic examination at the Ohio State University and subsequently received a bioptic license was conducted. Data were collected on vision including visual acuity, contrast sensitivity, and visual field. Hours of driver training and results of Highway Patrol road testing were extracted from records. Relationships among vision, training hours, and road testing were analyzed. Results Ninety-seven patients who completed a vision examination between 2004 and 2008 and received daylight licensure with BTS were included. Results of the first Highway Patrol road test were available for 74 patients. The median interquartile range (IQR) hours of training prior to road testing was 21±17 hours, (range of 9 to 75 hours). Candidates without previous licensure were younger (p< 0.001) and had more documented training (p< 0.001). Lack of previous licensure and more training were significantly associated with having failed a portion of the Highway Patrol test and points deducted on the road test. Conclusions New bioptic drivers without previous non-bioptic driving experience required more training and performed more poorly on road testing for licensure than those who had previous non-bioptic licensure. No visual factor was predictive of road testing results after adjustment for previous experience. The hours of training received remained predictive of road testing outcome even with adjustment for previous experience. These results suggest that previous experience and trainer assessments should be investigated as potential predictors of road safety in bioptic drivers in
Do we need medical leadership or medical engagement?

PubMed

Spurgeon, Peter; Long, Paul; Clark, John; Daly, Frank

2015-07-06

The purpose of this paper is to address issues of medical leadership within health systems and to clarify the associated conceptual issues, for example, leadership versus management and medical versus clinical leadership. However, its principle contribution is to raise the issue of the purpose or outcome of medical leadership, and, in this respect, it argues that it is to promote medical engagement. The approach is to provide evidence, both from the literature and empirically, to suggest that enhanced medical engagement leads to improved organisational performance and, in doing so, to review the associated concepts. Building on current evidence from the UK and Australia, the authors strengthen previous findings that effective medical leadership underpins the effective organisational performance. There is a current imbalance between the size of the databases on medical engagement between the UK (very large) and Australia (small but developing). The authors aim to equip medical leaders with the appropriate skill set to promote and enhance greater medical engagement. The focus of leaders in organisations should be in creating a culture that fosters and supports medical engagement. This paper provides empowerment of medical professionals to have greater influence in the running of the organisation in which they deliver care. The paper contains, for the first time, linked performance data from the Care Quality Commission in the UK and from Australia with the new set of medical engagement findings.
The medical students' societies and medical students' publications.

PubMed

Lim, K H

2005-07-01

The rich corporate life of the medical student and the medical students' societies at our medical school (at the present National University of Singapore) is generally unappreciated by its graduates and regrettably, even more unknown to the medical student of today. The present generation of medical students of NUS do not know of their rich history. We have published documentation of student activities from the founding of the medical school in 1905 till the establishment of the then University of Malaya in 1950, reviewed herein. Materials presented after 1950 were gathered from personal communications from key players in the students' societies and from editors of the medical students' publications.
Beyond "medical tourism": Canadian companies marketing medical travel.

PubMed

Turner, Leigh

2012-06-15

Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, "Liberation therapy" for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other businesses market regional, cross
Medical surfing.

PubMed

Khan, L A; Khan, S A

2001-11-01

The Internet has revolutionized information technology. Vast amounts of latest information are available on the Internet to medical professionals. Medical surfing is fast becoming part of a doctor's profession. But the way to approach the Internet and retrieve useful information from myriads of medical websites seems a daunting task to many. This review aims to help the newcomer, the medical students and doctors in obtaining fruitful medical information while surfing. It will prevent them from the feeling of getting drowned in the ocean of medical information. As medical information is not restricted to books and journals, providing Internet addresses of different medical bodies with few salient features, will go a long way in helping attain the required information without wasting time. The Internet will soon become a universal library. Medical surfing should be included in the curriculum of all medical schools and universities.
Practice locations of longitudinal integrated clerkship graduates: a matched-cohort study.

PubMed

Myhre, Douglas L; Bajaj, Sameer; Woloschuk, Wayne

2016-01-01

Longitudinal integrated clerkships (LICs) have been introduced as an innovative model to impart medical education. In Canada, most LIC experiences are situated in rural communities. Studies have reported equivalence in graduates from rural LICs and traditional rotation-based clerkships (RBCs) in their performance in residency, as well as in national medical licensure examinations. We sought to determine the impact of rural LICs in terms of practice location of graduates. A matched cohort was developed on the basis of student background and sex to compare practice location of rural LIC and RBC graduates. We used the χ(2) test to assess the association between type of clerkship stream and practice location. We found an association between participation in a rural LIC and rural practice location. Rural LIC programs play an important role in introducing students to rural medicine and may be an effective tool in responding to the shortage of rural practitioners.
Medical History: Compiling Your Medical Family Tree

MedlinePlus

... family medical history, sometimes called a medical family tree, is a record of illnesses and medical conditions ... to consult family documents, such as existing family trees, baby books, old letters, obituaries or records from ...
[The mandatory medical insurance through eyes of medical personnel].

PubMed

Semenov, V Yu; Lakunin, K Yu; Livshits, S A

2014-01-01

The article considers the results of sociological survey carries out among medical personnel of the Moscowskaya oblast in August-September 2013. The purpose of the study was to examine opinions of medical personnel about system of mandatory insurance in conditions of implementation of the new law regulating system of mandatory medical insurance during last three years. The sampling included 932 respondents that corresponds approximately 1% of all medical personnel in the oblast. It is established that even 20 years later after the moment of organization of the system of mandatory medical insurance not all medical personnel is oriented in it. More than 70% of respondents consider this system too convoluted and over bureaucratized and only 22.2% of respondents assume that medical insurance organizations defense interests of patient and 25.8% feel no impact of mandatory medical insurance funds on functioning of medical organizations. Most of respondents consider functions of mandatory medical insurance organizations and mandatory medical insurance funds as controlling only. Only 31% of respondents support the actual system of mandatory medical insurance.
Evaluation of an antiretroviral medication attitude scale and relationships between medication attitudes and medication nonadherence.

PubMed

Viswanathan, Hema; Anderson, Rodney; Thomas, Joseph

2005-05-01

The objectives of this study were to refine a scale designed to assess attitudes toward antiretroviral medication, to examine variation in medication attitudes across clinical and demographic characteristics, and to assess relationships between medication attitudes and medication nonadherence. A cross-sectional design was used to survey individuals at least 18 years of age, currently on antiretroviral therapy, and served by a regional HIV/AIDS center. The survey was administered by pharmacy students using convenience sampling between February 2002 and August 2002. Nonadherence was measured using a nine-item scale with a higher score indicative of higher nonadherence. An antiretroviral medication attitude scale was developed based on revision of a zidovudine attitude inventory. The sample of 99 patients was predominantly male (79.8%), had an annual income of less than $10,000 (74%), and was comprised of 50% whites and 40.8% blacks. Participants were between 18 and 70 years old. Item reduction using item-total correlations and factor analytic techniques resulted in a 15-item medication attitude scale with good internal consistency (Cronbach alpha coefficient = 0.84). A multiple regression model showed a significant negative relationship between attitude toward medication and medication nonadherence after controlling for covariates including age, education, gender, ethnicity, work status, social support, CD4 cell count and number of antiretroviral medications, suggesting that more positive the attitude toward medication, lower the medication nonadherence. Findings underscore the importance of attitude toward medication as a modifiable factor that can be targeted to improve medication adherence.
Beyond "medical tourism": Canadian companies marketing medical travel

PubMed Central

2012-01-01

Background Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, “Liberation therapy” for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Methods Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Results Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other
An untapped resource in the nursing workforce: Licensed practical nurses who transition to become registered nurses.

PubMed

Jones, Cheryl B; Toles, Mark; Knafl, George J; Beeber, Anna S

A more diverse registered nurse (RN) workforce is needed to provide health care in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking. To characterize the occurrence of LPN-to-RN professional transitions; compare key characteristics of LPNs who do and do not make such a transition; and compare key characteristics of LPNs who do transition in the years prior to and following their transition. A retrospective design was conducted using licensure data on LPNs from 2001 to 2013. Cohorts were constructed based on year of graduation. Of 39,398 LPNs in NC between 2001 and 2013, there were 3,161 LPNs (8.0%) who had a LPN-to-RN career transition between 2001 and 2013. LPNs were more likely to transition to RN if they were male; from Asian, American Indian, or other racial groups; held an associate or baccalaureate degree in their last year as an LPN (or their last year in the study if they did not transition); worked in a hospital inpatient setting; worked in the medical-surgical nursing specialty; and were from a rural area. Our findings indicate that the odds of an LPN-to-RN transition were greater if LPNs were: male; from all other racial groups except white; of a younger age at their first LPN licensure; working in a hospital setting; working in the specialty of medical-surgical nursing; employed part-time; or working in a rural setting during the last year as an LPN. This study fills an important gap in our knowledge of LPN-to-RN transitions. Policy efforts are needed to incentivize: LPNs to make a LPN-to-RN transition; educational entities to create and communicate curricular pathways; and employers to support LPNs in making the transition. Copyright © 2017 Elsevier Inc. All rights reserved.
Introducing medical students to medical informatics.

PubMed

Sancho, J J; González, J C; Patak, A; Sanz, F; Sitges-Serra, A

1993-11-01

Medical informatics (MI) has been introduced to medical students in several countries. Before outlining a course plan it was necessary to conduct a survey on students' computer literacy. A questionnaire was designed for students, focusing on knowledge and previous computer experience. The questions reproduced a similar questionnaire submitted to medical students from North Carolina University in Chapel Hill (NCU). From the results it is clear that although almost 80% of students used computers, less than 30% used general purpose applications, and utilization of computer-aided search of databases or use in the laboratory was exceptional. Men reported more computer experience than women in each area investigated by our questionnaire but this did not appear to be related to academic performance, age or course. Our main objectives when planning an MI course were to give students a general overview of the medical applications of computers and instruct them in the use of computers in future medical practice. As our medical school uses both Apple Macintosh and IBM compatibles, we decided to provide students with basic knowledge of both. The programme was structured with a mix of theoretico-practical lectures and personalized practical sessions in the computer laboratory. As well as providing a basic overview of medical informatics, the course and computer laboratory were intended to encourage other areas of medicine to incorporate the computer into their teaching programmes.
The Royal Naval Medical Services: delivering medical operational capability. the 'black art' of Medical Operational Planning.

PubMed

Faye, M

2013-01-01

This article looks to dispel the mysteries of the 'black art' of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.
Medical Waste Management Implications for Small Medical Facilities.

ERIC Educational Resources Information Center

Byrns, George; Burke, Thomas

1992-01-01

Discusses the implications of the Medical Waste Management Act of 1988 for small medical facilities, public health, and the environment. Reviews health and environmental risks associated with medical waste, current regulatory approaches, and classifications. Concludes that the health risk of medical wastes has been overestimated; makes…
Ohio's Middle Childhood Licensure Study

ERIC Educational Resources Information Center

White, Paula M.; Ross, Diane; Miller, Jennifer; Dever, Robin; Jones, Karen A.

2013-01-01

The purpose of this qualitative study was to describe middle level prepared teachers' perceptions of their practices after completing an Ohio Middle Childhood: Grades 4-9 teacher education program. Using the National Middle School Association/National Council of Accreditation of Teacher Education Initial Level Teacher Preparation Standards (2001)…
Parental Licensure and Its Sanction.

ERIC Educational Resources Information Center

Gordon, Robert A.

1996-01-01

Suggests the use of scenario analysis in assessing some of the options offered as interventions to adolescent crime prevention, including child protection policies and guardianship, and parent licensing. Also explores the problem of racism and other social concerns in implementing some interventions. Finally, the influence of IQ on sociopathy is…
Attitudes Toward Medical Cannabis Legalization Among Serbian Medical Students.

PubMed

Vujcic, Isidora; Pavlovic, Aleksandar; Dubljanin, Eleonora; Maksimovic, Jadranka; Nikolic, Aleksandra; Sipetic-Grujicic, Sandra

2017-07-29

Currently, medical cannabis polices are experiencing rapid changes, and an increasing number of nations around the world legalize medical cannabis for certain groups of patients, including those in Serbia. To determine medical students' attitudes toward medical cannabis legalization and to examine the factors influencing their attitudes. Fourth-year medical students at the Faculty of Medicine, University of Belgrade, had participated in a cross-sectional study. Data were collected by an anonymous questionnaire. Overall, 63.4% students supported medical cannabis legalization, and only 20.8% supported its legalization for recreational use. Students who previously used marijuana (p <.001) and alcohol (p =.004) were significantly more in favor of medical cannabis legalization compared with students who never used them. Support for marijuana recreational use was also related to prior marijuana (p <.001) and alcohol consumption (p =.006). Only cancer (90.4%) and chronic pain (74.2%) were correctly reported approved medical indications by more than half the students. Students who supported medical cannabis legalization showed better knowledge about indications, in contrast to opponents for legalization who showed better knowledge about side effects. Beliefs that using medical cannabis is safe and has health benefits were correlated with support for legalization, and previous marijuana and alcohol use, while beliefs that medical cannabis poses health risks correlated most strongly with previous marijuana use. Conclusions/Importance: The medical students' attitudes toward medical cannabis legalization were significantly correlated with previous use of marijuana and alcohol, knowledge about medical indications and side effects, and their beliefs regarding medical cannabis health benefits and risks.
The Academic Support Program at the University of Michigan School of Medicine.

PubMed

Segal, S S; Giordani, B; Gillum, L H; Johnson, N

1999-04-01

The University of Michigan has a support program aimed at early identification, remedial plans, and appropriate academic accommodations for at-risk students in under-graduate colleges and graduate and professional schools. Since 1994, the medical school has formally taken part in this program. Medical students at risk for academic failure (e.g., repeated failure in academic course work, licensure examinations, clinical examinations) are automatically referred to their academic counselors in the Student Programs Office of the medical school. Once a referral is made, the student is evaluated at the Office of Services for Students with Disabilities to identify problem areas. The office makes appropriate recommendations for interventions or accommodation. Tutoring, academic assistance, and other services are available through the medical school, specific divisions of the medical center, and the community. The Student Programs Office acts as a liaison between community and university assistance programs and between the student and the medical school. During the first four years of the program, 28 medical students were identified through it; of these, 24 (86%) were underrepresented minorities. Most (21) were referred during the first and third years of the curriculum. After a range of services for a variety of problems, 26 (93%) of the 28 students either graduated or continued to progress in their studies; the other two left the medical school for academic reasons.
Safety assessment of adjuvanted vaccines: Methodological considerations

PubMed Central

Da Silva, Fernanda Tavares; Di Pasquale, Alberta; Yarzabal, Juan P; Garçon, Nathalie

2015-01-01

Adjuvants mainly interact with the innate immune response and are used to enhance the quantity and quality of the downstream adaptive immune response to vaccine antigens. Establishing the safety of a new adjuvant-antigen combination is achieved through rigorous evaluation that begins in the laboratory, and that continues throughout the vaccine life-cycle. The strategy for the evaluation of safety pre-licensure is guided by the disease profile, vaccine indication, and target population, and it is also influenced by available regulatory guidelines. In order to allow meaningful interpretation of clinical data, clinical program methodology should be optimized and standardized, making best use of all available data sources. Post-licensure safety activities are directed by field experience accumulated pre- and post-licensure clinical trial data and spontaneous adverse event reports. Continued evolution of safety evaluation processes that keep pace with advances in vaccine technology and updated communication of the benefit-risk profile is necessary to maintain public confidence in vaccines. PMID:26029975
Naturopathy and the Primary Care Practice

PubMed Central

Fleming, Sara A.; Gutknecht, Nancy C.

2010-01-01

Synopsis Naturopathy is a distinct type of primary care medicine that blends age-old healing traditions with scientific advances and current research. It is guided by a unique set of principles that recognize the body's innate healing capacity, emphasize disease prevention, and encourage individual responsibility to obtain optimal health. Naturopathic treatment modalities include diet and clinical nutrition, behavioral change, hydrotherapy, homeopathy, botanical medicine, physical medicine, pharmaceuticals, and minor surgery. Naturopathic physicians (NDs) are trained as primary care physicians in four-year, accredited doctoral-level naturopathic medical schools. Currently, there are 15 U.S. states, 2 U.S. territories, and a number of provinces in Canada, Australia, and New Zealand that recognize licensure for NDs. PMID:20189002

Medical service plans in academic medical centers.

PubMed

Siegel, B

1978-10-01

Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.
Influence of medical training on self-medication by students.

PubMed

James, H; Handu, S S; Khaja, K A J Al; Sequeira, R P

2008-01-01

To examine the influence of medical training on the knowledge, attitude and practice of self-medication by medical students. This was a cross-sectional, descriptive study. A self-developed, pre-validated questionnaire containing open-ended and close-ended items was used for data collection. Medical students in the 2nd and 4th year of the medical course at the Arabian Gulf University Bahrain filled in the questionnaire anonymously. Data were analyzed using SPSS and results expressed as counts and percentages. 2-tailed Chi2-test was applied and p < 0.05 was considered significant. The respondents (n = 141) had a mean age of 19.94 A+/- 1.21 years. Overall, they had a fair knowledge about appropriate self-medication but knowledge of the benefits and risks of self-medication was adequate. Self-medication was perceived to be time-saving, providing quick relief in common illnesses, a learning experience, economical, and convenient. Among the perceived disadvantages were adverse drug reactions, inappropriate drug use, and the risk of making a wrong diagnosis. Majority of the respondents had a positive attitude favoring self-medication and read the package insert. The practice of self-medication was common and often inappropriate. The commonest indications for self-medication were cough, cold and sore throat (63.2% in Year 2) and headache (78.3% in Year 4). Mild illness, previous experience, and lack of time were the most frequent reasons for resorting to self-medication. Analgesics were the commonest drugs used, and drugs were mostly obtained from private pharmacies. Students of Year 4 had better knowledge about appropriate self-medication (58.7% versus 35.8%, p = 0.02), had greater awareness of the risks of self-medication and would discourage others from practicing self-medication (58.7% versus 40.4%, p = 0.04). They had a more confident attitude (54.3% versus 35.1%, p = 0.03) and a smaller number of them would seek a prescription (34.8% versus 54.3%, p = 0.03). They
Medication Guide

MedlinePlus

... before starting any new medication. First-Line Medications: Nicotine Replacement Therapy (NRT) These medications are called "first- ... they might try a "second-line" medication instead. Nicotine replacement therapy (NRT) helps smokers quit by reducing ...
[Involvement of medical representatives in team medical care].

PubMed

Hirotsu, Misaki; Sohma, Michiro; Takagi, Hidehiko

2009-04-01

In recent years, chemotherapies have been further advanced because of successive launch of new drugs, introduction of molecular targeting, etc., and the concept of so-called Team Medical Care ,the idea of sharing interdisciplinary expertise for collaborative treatment, has steadily penetrated in the Japanese medical society. Dr. Naoto Ueno is a medical oncologist at US MD Anderson Cancer Center, the birthplace of the Team Medical Care. He has advocated the concept of ABC of Team Oncology by positioning pharmaceutical companies as Team C. Under such team practice, we believe that medical representatives of a pharmaceutical company should also play a role as a member of the Team Medical Care by providing appropriate drug use information to healthcare professionals, supporting post-marketing surveillance of treated patients, facilitating drug information sharing among healthcare professionals at medical institutions, etc.
Medical marijuana

MedlinePlus

... this page: //medlineplus.gov/ency/patientinstructions/000899.htm Medical marijuana To use the sharing features on this page, ... have legalized marijuana for medical use. How Does Medical Marijuana Work? Medical marijuana may be: Smoked Vaporized Eaten ...
Entrustable professional activities in post-licensure training in primary care pediatrics: Necessity, development and implementation of a competency-based post-graduate curriculum.

PubMed

Fehr, Folkert; Weiß-Becker, Christoph; Becker, Hera; Opladen, Thomas

2017-01-01

There is an absence of broad-based and binding curricular requirements for structured competency-based post-graduate medical training in Germany, and thus no basis for comparing the competencies of physicians undergoing training in a medical specialty ( Ärzte im Weiterbildung ). In response, the German Society of Primary Care Pediatrics' working group on post-graduate education (DGAAP) has identified realistic entrustable professional activities (EPAs) in primary care, defined their number, scope and content, selected competency domains, specified required knowledge and skills, and described appropriate assessment methods. These guidelines are referred to as PaedCompenda and can be accessed electronically by educators in pediatric medicine; the use and effectiveness of these guidelines are monitored by the German Association for Medical Education's committee on post-graduate education (GMA). Teaching and training in pediatric medicine should take EPAs into consideration. To accomplish this, phases dedicated to primary care should be integrated into formal medical specialty training. Primary care pediatrics must enhance the sites where such training takes place into learning environments that prepare physicians trainees and turn the practicing specialists into mentoring educators.
[Insurance medical consultation in private health insurance - which insurance medical questions are put to the medical consultant?].

PubMed

Hakimi, R; Herre, K; Seyffer, R

2015-03-01

This study deals with the task areas of the medical consultant in private health insurance. Although insurance medical consultation for the insurance business originated in the 19th century, the tasks and competencies of the medical consultants are still mostly unknown. This study is a complete inventory count of all insurance medical consultation requests for the year 2013. All of the 5493 insurance medical consultation requests have been evaluated. Most of the consultation requests concern the medical necessity for medical drugs, followed by the medical consultation of alternative medicine and the classification of cure and rehabilitation measures of hospital medical treatments. The need for insurance medical consultation on lifestyle drugs, cosmetic operations and artificial insemination has increased significantly in the past 10 years. Since 2009, moreover, the need for medical consultation on the subject of "Ruhensleistungen" with regard to non-payers and "Notlagentarif" has strongly increased.
Rethinking the medical in the medical humanities.

PubMed

O'Neill, Desmond; Jenkins, Elinor; Mawhinney, Rebecca; Cosgrave, Ellen; O'Mahony, Sarah; Guest, Clare; Moss, Hilary

2016-06-01

To clinicians there are a number of striking features of the ever-evolving field of the medical humanities. The first is a perception of a predominantly unidirectional relationship between medicine and the humanities, generally in terms of what the arts and humanities have to offer medicine. The second is the portrayal of medical practice in terms of problems and negativities for which the medical humanities are seen to pose the solution rather than viewing medicine as an active and positive contributor to an interdisciplinary project. Paradigms that fail to recognise the contributions of medicine and its practitioners (including students) to the medical humanities, this paper argues, will continue to struggle with definition and acceptance. This paper explores the possibilities for advancing the medical humanities through recognition of the contribution of medicine to the humanities and the importance of engaging with the arts, culture and leisure pursuits of doctors and medical students. Our research shows the richness of cultural engagement of medical students, their broad range of cultural interests and their ability to contribute to research and scholarship in the medical humanities. Mutual recognition of strengths, weaknesses and differences of scholarly approach is critical to successful development of the enterprise. Recognising and building on the interests, sympathies and contributions of medicine and its practitioners to the medical humanities is a fundamental component of this task. Future directions might include introductory courses for humanities scholars in aspects of healthcare and medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Kennedy Space Center Medical Operations and Medical Kit

NASA Technical Reports Server (NTRS)

Scarpa, Philip

2011-01-01

This slide presentation reviews the emergency medical operations at Kennedy Space center, the KSC launch and landing contingency modes, the triage site, the medical kit, and the medications available.
Current trends in medical ethics education in Japanese medical schools.

PubMed

Kurosu, Mitsuyasu

2012-09-01

The Japanese medical education program has radically improved during the last 10 years. In 1999, the Task Force Committee on Innovation of Medical Education for the 21st Century proposed a tutorial education system, a core curriculum, and a medical student evaluation system for clinical clerkship. In 2001, the Model Core Curriculum of medical education was instituted, in which medical ethics became part of the core material. Since 2005, a nationwide medical student evaluation system has been applied for entrance to clinical clerkship. Within the Japan Society for Medical Education, the Working Group of Medical Ethics proposed a medical ethics education curriculum in 2001. In line with this, the Japanese Association for Philosophical and Ethical Research in Medicine has begun to address the standardization of the curriculum of medical ethics. A medical philosophy curriculum should also be included in considering illness, health, life, death, the body, and human welfare.
Medical students' experiences with medical errors: an analysis of medical student essays.

PubMed

Martinez, William; Lo, Bernard

2008-07-01

This study aimed to examine medical students' experiences with medical errors. In 2001 and 2002, 172 fourth-year medical students wrote an anonymous description of a significant medical error they had witnessed or committed during their clinical clerkships. The assignment represented part of a required medical ethics course. We analysed 147 of these essays using thematic content analysis. Many medical students made or observed significant errors. In either situation, some students experienced distress that seemingly went unaddressed. Furthermore, this distress was sometimes severe and persisted after the initial event. Some students also experienced considerable uncertainty as to whether an error had occurred and how to prevent future errors. Many errors may not have been disclosed to patients, and some students who desired to discuss or disclose errors were apparently discouraged from doing so by senior doctors. Some students criticised senior doctors who attempted to hide errors or avoid responsibility. By contrast, students who witnessed senior doctors take responsibility for errors and candidly disclose errors to patients appeared to recognise the importance of honesty and integrity and said they aspired to these standards. There are many missed opportunities to teach students how to respond to and learn from errors. Some faculty members and housestaff may at times respond to errors in ways that appear to contradict professional standards. Medical educators should increase exposure to exemplary responses to errors and help students to learn from and cope with errors.
Political and medical views on medical marijuana and its future.

PubMed

Rubens, Muni

2014-01-01

The policies, laws, politics, public opinions, and scientific inferences of medical marijuana are rapidly changing as the debate on medical use of marijuana has always been political, rather than scientific. Federal law has barred the use of medical marijuana though 18 state governments and Washington, DC, support the medical use of marijuana. Unfortunately, not many studies exist on medical marijuana to back these laws and policies. The judiciary, on the other hand, has elicited a diverse response to medical marijuana through its rulings over several decades. Some rulings favored the federal government's opinion, and others supported the larger public view and many state governments with legalized medical marijuana. Public opinion on legalizing medical marijuana has always favored the use of medical marijuana. The movement of scientific knowledge of medical marijuana follows an erratic, discontinuous pathway. The future place of medical marijuana in U.S. society remains unknown. The three forces-scientific knowledge, social-political acceptance, and laws-play a role in the direction that medical marijuana takes in society. Overcoming political-social forces requires a concerted effort from the scientific community and political leaders. The results of scientific research must guide the decisions for laws and medical use of marijuana. This article aims to trace the political dilemma and contradictory views shared by federal and state governments and predict the future of medical marijuana by tracing the past history of medical marijuana with its bumpy pathway in the social-political arena.
Education in Pediatrics Across the Continuum (EPAC): First Steps Toward Realizing the Dream of Competency-Based Education.

PubMed

Andrews, John S; Bale, James F; Soep, Jennifer B; Long, Michele; Carraccio, Carol; Englander, Robert; Powell, Deborah

2018-03-01

The Education in Pediatrics Across the Continuum (EPAC) Study Group is developing the first competency-based, time-variable progression from undergraduate medical education (UME) to graduate medical education (GME) in the history of medical education in the United States. EPAC, an innovation project sponsored by the Association of American Medical Colleges and supported by the Josiah Macy Jr. Foundation, was developed through a collaboration between five medical schools and multiple professional organizations with an interest in undergraduate and graduate medical education. The planning and implementation process demanded cooperatively addressing practical barriers such as education requirements for licensure and developing approaches to learner assessment that provided meaningful information about competency. Each participating school now has at least three cohorts of learners participating, and the program is transitioning its first cohort of students from UME to GME based on achievement of predetermined competencies that allow this transition. Members of the first cohort of learners in this program have begun their pediatric residency training at different times beginning in late 2016, confirming the feasibility of competency-based advancement from UME to GME in pediatrics. Although there is still much to learn about the outcomes of EPAC learners' professional development in residency training and beyond, EPAC has defined an operational approach to a different path through medical school and into residency training, based on the attainment of competence.
Medical tourism.

PubMed

Leggat, Peter

2015-01-01

Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.
Undergraduate medical education in emergency medical care: A nationwide survey at German medical schools

PubMed Central

Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix

2009-01-01

Background Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Methods Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Results Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Conclusion Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education
Undergraduate medical education in emergency medical care: a nationwide survey at German medical schools.

PubMed

Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix

2009-05-12

Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.
Medical students' agenda-setting abilities during medical interviews.

PubMed

Roh, HyeRin; Park, Kyung Hye; Jeon, Young-Jee; Park, Seung Guk; Lee, Jungsun

2015-06-01

Identifying patients' agendas is important; however, the extent of Korean medical students' agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students' agenda solicitation. A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients' reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient's initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined. The medical students did not explore the patients' concerns and did not negotiate an agenda. Interruption of the patient's opening statement occurred in 4.62±2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions. Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students' ability to set an agenda.
Licensing Behavior Analysts: Risks and Alternatives

PubMed Central

Green, Gina; Johnston, James M

2009-01-01

Under certain conditions, obtaining state laws to license practitioners of behavior analysis might be feasible and could produce benefits for practitioners and consumers. Those conditions are not yet in place in most states, however, and pursuing licensure prematurely carries substantial risks for the entire field. We describe the most serious risks and the conditions that make it more or less likely that licensure initiatives will succeed. Finally, we recommend strategies for securing recognition of practitioners of behavior analysis in laws, regulations, and policies that can minimize risks. PMID:22477698
A Step Towards Improving Food Safety in India: Determining Baseline Knowledge and Behaviors Among Restaurant Food Handlers in Chennai.

PubMed

Manes, Mindi R; Kuganantham, Paraswami; Jagadeesan, Murugesan; Laxmidevi, M; Dworkin, Mark S

2016-01-01

With the establishment of the Food Safety and Standards Authority of India (FSSAI) and new food safety regulations, a precedent has been set to prevent foodborne illness in India. The objective of the authors' study was to identify knowledge gaps among food handlers in Chennai, Tamil Nadu, to establish priorities for future intervention. A 44-question survey was administered to 156 food handlers at 36 restaurants in Chennai between April and June of 2011. The overall mean knowledge score was 49% and knowledge gaps related to hand hygiene, proper food cooking and holding temperatures, and cross contamination were identified. Food handlers with a Medical Fitness Certificate scored significantly higher than those without a certificate, after controlling for food safety training and level of education (p < .05). As the FSSAI standards now require a medical certificate for restaurant licensure and registration, consideration should be given to include an educational component to this certification with an explanation of expected food safety behavior.
Advancing Health Equity Through Student Empowerment and Professional Success: A Statewide Approach.

PubMed

Noone, Joanne; Wros, Peggy; Cortez, David; Najjar, Rana; Magdaleno, Leela

2016-06-01

A lack of diversity in the nursing workforce nationally has been identified by Oregon state leaders as a factor contributing to health inequity. The goal of Advancing Health Equity Through Student Empowerment and Professional Success (HealthE STEPS) is to graduate nursing students from disadvantaged backgrounds to improve health equity within their communities. A comprehensive plan of evidence-based strategies was developed based on social determinants of health and addresses academic socialization, learning support, financial resources, networking, curriculum development, and campus culture. Ninety undergraduate nursing students participated in the program during a 2-year period. Retention of participants was 97% with graduation rates of 94%. First-time licensure pass rates were 82% and 96% of participating graduates employed in a medically underserved community. This comprehensive innovative program of evidence-based strategies addresses health equity by developing a diverse nursing workforce to practice in medically underserved communities. [J Nurs Educ. 2016;55(6):316-322.]. Copyright 2016, SLACK Incorporated.

Using a medical volunteer program to motivate medical freshmen.

PubMed

Na, Beag Ju; Hur, Yera; Yun, Jungmin; Kang, Jaegu; Han, Seungyeon; Whang, Wonmin; Lee, Keumho; Lee, Jungmin

2013-09-01

A task force identified 4 core properties of motivation-related improvement and developed a medical volunteer program for 63 medical freshmen in 2012. Three overarching topics were examined: What were the contents of the program? Did students' motivation improve? Were the students satisfied with the course? Pretest and posttest motivation levels and program evaluation forms were analyzed. We organized a series of committee meetings and identified 4 core factors of motivation. The program was conducted for 63 medical freshmen in March 2012. The program evaluation form was analyzed using SPSS 17.0. The core factors of motivation were interest in medical studies, volunteer-mindedness, medical humanities, and self-management. The program was composed of lectures, medical volunteer hours, and program evaluation and feedback sessions. Students' motivation differed significantly with regard to interest in medical studies (t=-2.40, p=0.020) and volunteer-mindedness (t=-3.45, p=0.001). Ninety percent of students were satisfied with the program, 67.8% of students were satisfied with the medical volunteer activity, and the feedback session of the program was meaningful (66.1%). The medical volunteer program, held in the first month of the medical education year, was meaningful, but the reasons for dissatisfaction with the program should be examined. We should also develop a system that has lasting beneficial effects on academic achievement and career selection.
Designated Medical Directors for Emergency Medical Services: Recruitment and Roles

ERIC Educational Resources Information Center

Slifkin, Rebecca T.; Freeman, Victoria A.; Patterson, P. Daniel

2009-01-01

Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban…
Animal models for ebolavirus countermeasures discovery: what defines a useful model?

PubMed

Shurtleff, Amy C; Bavari, Sina

2015-07-01

Ebolaviruses are highly pathogenic filoviruses, which cause disease in humans and nonhuman primates (NHP) in Africa. The Zaire ebolavirus outbreak in 2014, which continues to greatly affect Western Africa and other countries to which the hemorrhagic fever was exported due to travel of unsymptomatic yet infected individuals, was complicated by the lack of available licensed vaccines or therapeutics to combat infection. After almost a year of research at an increased pace to find and test vaccines and therapeutics, there is now a deeper understanding of the available disease models for ebolavirus infection. Demonstration of vaccine or therapeutic efficacy in NHP models of ebolavirus infection is crucial to the development and eventual licensure of ebolavirus medical countermeasures, so that safe and effective countermeasures can be accelerated into human clinical trials. The authors describe ebolavirus hemorrhagic fever (EHF) disease in various animal species: mice, guinea pigs, hamsters, pigs and NHP, to include baboons, marmosets, rhesus and cynomolgus macaques, as well as African green monkeys. Because the NHP models are supremely useful for therapeutics and vaccine testing, emphasis is placed on comparison of these models, and their use as gold-standard models of EHF. Animal models of EHF varying from rodents to NHP species are currently under evaluation for their reproducibility and utility for modeling infection in humans. Complete development and licensure of therapeutic agents and vaccines will require demonstration that mechanisms conferring protection in NHP models of infection are predictive of protective responses in humans, for a given countermeasure.
Medication safety.

PubMed

Keohane, Carol A; Bates, David W

2008-03-01

Patient safety is a state of mind, not a technology. The technologies used in the medical setting represent tools that must be properly designed, used well, and assessed on an on-going basis. Moreover, in all settings, building a culture of safety is pivotal for improving safety, and many nontechnologic approaches, such as medication reconciliation and teaching patients about their medications, are also essential. This article addresses the topic of medication safety and examines specific strategies being used to decrease the incidence of medication errors across various clinical settings.
Relationships between beliefs about medications and nonadherence to prescribed chronic medications.

PubMed

Phatak, Hemant M; Thomas, Joseph

2006-10-01

Medication beliefs of patients with a specific medical condition have been associated with nonadherence to drugs used to treat that condition. However, associations between medication beliefs and nonadherence of individuals on chronic, multiple medications have not been studied. To investigate associations between patients' medication beliefs and nonadherence to chronic drug therapy. A cross-sectional, self-administered survey of patients waiting to see pharmacists at an outpatient pharmacy in a primary care clinic was conducted. Participants' medication beliefs were assessed using the Beliefs about Medicines Questionnaire, and nonadherence was assessed using the Morisky Medication Adherence Scale. Pearson correlation analysis was used to assess bivariate associations between medication beliefs and nonadherence. Regression was used to assess relative strength of associations between various medication beliefs and nonadherence and also to assess the significance of the interactions between those beliefs and nonadherence. There were positive bivariate associations between specific concerns about medications (p < 0.001), perceived general harmful effects of medications (p < 0.001), and perceived overprescribing of medications by physicians (p < 0.001) and medication nonadherence. When relative strength of associations between each medication belief and nonadherence was assessed, while controlling for other medication beliefs, specific-necessity (p = 0.02) and specific-concerns (p = 0.01) exhibited significant negative and positive associations with nonadherence, respectively. All two-way interactions between variables in the model were insignificant. A model consisting of age, total number of drugs used, and medication beliefs, that is, specific-necessity, specific-concerns, general-overuse, and general-harm, accounted for 26.5% of variance. Medication beliefs alone explained 22.4% of variation in nonadherence to chronic drug therapy. Patients' medication beliefs
Capturing readiness to learn and collaboration as explored with an interprofessional simulation scenario: A mixed-methods research study.

PubMed

Rossler, Kelly L; Kimble, Laura P

2016-01-01

Didactic lecture does not lend itself to teaching interprofessional collaboration. High-fidelity human patient simulation with a focus on clinical situations/scenarios is highly conducive to interprofessional education. Consequently, a need for research supporting the incorporation of interprofessional education with high-fidelity patient simulation based technology exists. The purpose of this study was to explore readiness for interprofessional learning and collaboration among pre-licensure health professions students participating in an interprofessional education human patient simulation experience. Using a mixed methods convergent parallel design, a sample of 53 pre-licensure health professions students enrolled in nursing, respiratory therapy, health administration, and physical therapy programs within a college of health professions participated in high-fidelity human patient simulation experiences. Perceptions of interprofessional learning and collaboration were measured with the revised Readiness for Interprofessional Learning Scale (RIPLS) and the Health Professional Collaboration Scale (HPCS). Focus groups were conducted during the simulation post-briefing to obtain qualitative data. Statistical analysis included non-parametric, inferential statistics. Qualitative data were analyzed using a phenomenological approach. Pre- and post-RIPLS demonstrated pre-licensure health professions students reported significantly more positive attitudes about readiness for interprofessional learning post-simulation in the areas of team work and collaboration, negative professional identity, and positive professional identity. Post-simulation HPCS revealed pre-licensure nursing and health administration groups reported greater health collaboration during simulation than physical therapy students. Qualitative analysis yielded three themes: "exposure to experiential learning," "acquisition of interactional relationships," and "presence of chronology in role preparation
[Medical Humanities--the Historical Significance and Mission in Medical Education].

PubMed

Fujino, Akihiro

2015-12-01

In this paper we consider the significance and mission of medical humanities in medical education from the following six viewpoints: (1) misunderstanding of the medical humanities; (2) its historical development; (3) the criteria for the ideal physician; (4) the contents of current Medical Humanities education; (5) the basic philosophy; and (6) its relation to medical professionalism. Medical humanities consists of the three academic components of bioethics, clinical ethics and medical anthropology, and it is a philosophy and an art which penetrate to the fundamental essence of medicine. The purpose of medical humanities is to develop one's own humanity and spirituality through medical practice and contemplation by empathizing with patients' illness narratives through spiritual self-awakening and by understanding the mutual healing powers of human relations by way of the realization of primordial life. The basic philosophy is "the coincidence of contraries". The ultimate mission of medical humanities is to cultivate physicians to educate themselves and have a life-long philosophy of devotion to understanding, through experience, the coincidence of contraries.
Correlation Research of Medical Security Management System Network Platform in Medical Practice

NASA Astrophysics Data System (ADS)

Jie, Wang; Fan, Zhang; Jian, Hao; Li-nong, Yu; Jun, Fei; Ping, Hao; Ya-wei, Shen; Yue-jin, Chang

Objective-The related research of medical security management system network in medical practice. Methods-Establishing network platform of medical safety management system, medical security network host station, medical security management system(C/S), medical security management system of departments and sections, comprehensive query, medical security disposal and examination system. Results-In medical safety management, medical security management system can reflect the hospital medical security problem, and can achieve real-time detection and improve the medical security incident detection rate. Conclusion-The application of the research in the hospital management implementation, can find hospital medical security hidden danger and the problems of medical disputes, and can help in resolving medical disputes in time and achieve good work efficiency, which is worth applying in the hospital practice.
Meeting medical terminology needs--the Ontology-Enhanced Medical Concept Mapper.

PubMed

Leroy, G; Chen, H

2001-12-01

This paper describes the development and testing of the Medical Concept Mapper, a tool designed to facilitate access to online medical information sources by providing users with appropriate medical search terms for their personal queries. Our system is valuable for patients whose knowledge of medical vocabularies is inadequate to find the desired information, and for medical experts who search for information outside their field of expertise. The Medical Concept Mapper maps synonyms and semantically related concepts to a user's query. The system is unique because it integrates our natural language processing tool, i.e., the Arizona (AZ) Noun Phraser, with human-created ontologies, the Unified Medical Language System (UMLS) and WordNet, and our computer generated Concept Space, into one system. Our unique contribution results from combining the UMLS Semantic Net with Concept Space in our deep semantic parsing (DSP) algorithm. This algorithm establishes a medical query context based on the UMLS Semantic Net, which allows Concept Space terms to be filtered so as to isolate related terms relevant to the query. We performed two user studies in which Medical Concept Mapper terms were compared against human experts' terms. We conclude that the AZ Noun Phraser is well suited to extract medical phrases from user queries, that WordNet is not well suited to provide strictly medical synonyms, that the UMLS Metathesaurus is well suited to provide medical synonyms, and that Concept Space is well suited to provide related medical terms, especially when these terms are limited by our DSP algorithm.
Awareness of academic use of smartphones and medical apps among medical students in a private medical college?

PubMed

Shah, Jehanzaib; Haq, Usman; Bashir, Ali; Shah, Syed Aslam

2016-02-01

To assess the awareness of medical apps and academic use of smartphones among medical students. The questionnaire-based descriptive cross-sectional study was conducted in January 2015 and comprised medical students of the Rawal Institute of Health Sciences, Islamabad, Pakistan. The self-designed questionnaire was reviewed by a panel of expert for content reliability and validity. Questionnaires were distributed in the classrooms and were filled by the students anonymously. SPSS 16 was used for statistical analysis. Among the 569 medical students in the study, 545 (95.8%) had smartphones and 24(4.2%) were using simple cell phones. Overall, 226(41.46%) of the smart phone users were using some medical apps. Besides, 137(24.08%) were aware of the medical apps but were not using them. Also, 391(71.7%) students were not using any type of medical text eBooks through their phone, and only 154(28.3%) had relevant text eBooks in their phones. Medical college students were using smartphones mostly as a means of telecommunication rather than a gadget for improving medical knowledge.
Medical Readers' Theater: Relevance to Geriatrics Medical Education

ERIC Educational Resources Information Center

Shapiro, Johanna; Cho, Beverly

2011-01-01

Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required…
Medical Terminology of the Circulatory System. Medical Records. Instructional Unit for the Medical Transcriber.

ERIC Educational Resources Information Center

Gosman, Minna L.

Developed as a result of an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis…
Medical Terminology of the Respiratory System. Medical Records. Instructional Unit for the Medical Transcriptionist.

ERIC Educational Resources Information Center

Gosman, Minna L.

Following an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis for…
Medical Terminology of the Musculoskeletal System. Medical Records. Instructional Unit for the Medical Transcriber.

ERIC Educational Resources Information Center

Gosman, Minna L.

Following an analysis of the task of transcribing as practiced in a health facility, this study guide was developed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis for a…
[The standardization of medical care and the training of medical personnel].

PubMed

Korbut, V B; Tyts, V V; Boĭshenko, V A

1997-09-01

The medical specialist training at all levels (medical orderly, doctor's assistant, general practitioner, doctors) should be based on the medical care standards. Preliminary studies in the field of military medicine standards have demonstrated that the medical service of the Armed Forces of Russia needs medical resources' standards, structure and organization standards, technology standards. Military medical service resources' standards should reflect the requisitions for: all medical specialists' qualification, equipment and material for medical set-ups, field medical systems, drugs, etc. Standards for structures and organization should include requisitions for: command and control systems in military formations' and task forces' medical services and their information support; health-care and evacuation functions, sanitary control and anti-epidemic measures and personnel health protection. Technology standards development could improve and regulate the health care procedures in the process of evacuation. Standards' development will help to solve the problem of the data-base for the military medicine education system and medical research.
Implementation of the Medical Education Partnership Initiative: medical students' perspective.

PubMed

Bagala, John Paul; Macheka, Nyasha D; Abebaw, Hiwot; Wen, Leana S

2014-08-01

The Medical Education Partnership Initiative (MEPI) is contributing to the transformation of medical training in Africa. In this paper, medical students present their perspective on how MEPI initiatives have influenced five key areas related to African medical trainees: educational infrastructure, information technology, community-based training, scientific research, and professional outlook and goals. They propose three new areas of focus that could further assist MEPI in bettering medical training in Africa.
Infectious Diseases Society of America Position Statement on Telehealth and Telemedicine as Applied to the Practice of Infectious Diseases.

PubMed

Siddiqui, Javeed; Herchline, Thomas; Kahlon, Summerpal; Moyer, Kay J; Scott, John D; Wood, Brian R; Young, Jeremy

2017-02-01

The use of telehealth and telemedicine offers powerful tools for delivering clinical care, conducting medical research, and enhancing access to infectious diseases physicians. The Infectious Diseases Society of America (IDSA) has prepared a position statement to educate members on the use of telehealth and telemedicine technologies. The development of telehealth and telemedicine programs requires the consideration of several issues such as HIPAA, state and local licensure requirements, credentialing and privileging, scope of care, quality, and responsibility and liability. IDSA supports appropriate use of telehealth and telemedicine to provide timely, cost-effective specialty care to resource-limited populations. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
MEDIC: medical embedded device for individualized care.

PubMed

Wu, Winston H; Bui, Alex A T; Batalin, Maxim A; Au, Lawrence K; Binney, Jonathan D; Kaiser, William J

2008-02-01

Presented work highlights the development and initial validation of a medical embedded device for individualized care (MEDIC), which is based on a novel software architecture, enabling sensor management and disease prediction capabilities, and commercially available microelectronic components, sensors and conventional personal digital assistant (PDA) (or a cell phone). In this paper, we present a general architecture for a wearable sensor system that can be customized to an individual patient's needs. This architecture is based on embedded artificial intelligence that permits autonomous operation, sensor management and inference, and may be applied to a general purpose wearable medical diagnostics. A prototype of the system has been developed based on a standard PDA and wireless sensor nodes equipped with commercially available Bluetooth radio components, permitting real-time streaming of high-bandwidth data from various physiological and contextual sensors. We also present the results of abnormal gait diagnosis using the complete system from our evaluation, and illustrate how the wearable system and its operation can be remotely configured and managed by either enterprise systems or medical personnel at centralized locations. By using commercially available hardware components and software architecture presented in this paper, the MEDIC system can be rapidly configured, providing medical researchers with broadband sensor data from remote patients and platform access to best adapt operation for diagnostic operation objectives.
Telehealth among US hospitals: several factors, including state reimbursement and licensure policies, influence adoption.

PubMed

Adler-Milstein, Julia; Kvedar, Joseph; Bates, David W

2014-02-01

Telehealth is widely believed to hold great potential to improve access to, and increase the value of, health care. Gaining a better understanding of why some hospitals adopt telehealth technologies while others do not is critically important. We examined factors associated with telehealth adoption among US hospitals. Data from the Information Technology Supplement to the American Hospital Association's 2012 annual survey of acute care hospitals show that 42 percent of US hospitals have telehealth capabilities. Hospitals more likely to have telehealth capabilities are teaching hospitals, those equipped with additional advanced medical technology, those that are members of a larger system, and those that are nonprofit institutions. Rates of hospital telehealth adoption by state vary substantially and are associated with differences in state policy. Policies that promote private payer reimbursement for telehealth are associated with greater likelihood of telehealth adoption, while policies that require out-of-state providers to have a special license to provide telehealth services reduce the likelihood of adoption. Our findings suggest steps that policy makers can take to achieve greater adoption of telehealth by hospitals.
Non-medical influences on medical decision-making.

PubMed

McKinlay, J B; Potter, D A; Feldman, H A

1996-03-01

The influence of non-medical factors on physicians' decision-making has been documented in many observational studies, but rarely in an experimental setting capable of demonstrating cause and effect. We conducted a controlled factorial experiment to assess the influence of non-medical factors on the diagnostic and treatment decisions made by practitioners of internal medicine in two common medical situations. One hundred and ninety-two white male internists individually viewed professionally produced video scenarios in which the actor-patient, presenting with either chest pain or dyspnea, possessed various balanced combinations of sex, race, age, socioeconomic status, and health insurance coverage. Physician subjects were randomly drawn from lists of internists in private practice, hospital-based practice, and HMO's, at two levels of experience. The most frequent diagnoses for both chest pain and dyspnea were psychogenic origin and cardiac problems. Smoking cessation was the most frequent treatment recommendation for both conditions. Younger patients (all other factors being the same) were significantly more likely to receive the psychogenic diagnosis. Older patients were more likely to receive the cardiac diagnosis for chest pain, particularly if they were insured. HMO-based physicians were more likely to recommend a follow-up visit for chest pain. Several interactions of patient and physician factors were significant in addition to the main effects. The variability in decision-making evidenced by physicians in this experiment was not entirely accounted for by strictly rational Bayesian inference (the common prescriptive model for medical decision-making), in-as-much as non-medical factors significantly affected the decisions that they made. There is a need to supplement idealized medical schemata with considerations of social behavior in any comprehensive theory of medical decision-making.

Medical Abortion

MedlinePlus

... Headache You may be given medications to manage pain during and after the medical abortion. You may also be given antibiotics, although infection after medical abortion is rare. Your health care provider will explain how much pain and bleeding to expect, depending on the number ...
A Smartphone-based Medication Self-management System with Realtime Medication Monitoring

PubMed Central

Hayakawa, M.; Uchimura, Y.; Omae, K.; Waki, K.; Fujita, H.; Ohe, K.

2013-01-01

Background Most patients cannot remember their entire medication regimen and occasionally forget to take their medication. Objectives The objective of the study was to design, develop, and demonstrate the feasibility of a new type of medication self-management system using smartphones with real-time medication monitoring. Methods We designed and developed a smartphone-based medication self-management system (SMSS) based on interviews of 116 patients. The system offered patients two main functions by means of smartphones: (1) storage and provision of an accurate, portable medication history and medication-taking records of patients; and (2) provision of a reminder to take medication only when the patient has forgotten to take his/her medication. These functions were realized by two data input methods: (a) reading of prescription data represented in two-dimensional barcodes using the smartphone camera and getting the photographic images of the pills; and (b) real-time medication monitoring by novel user-friendly wireless pillboxes. Results Interviews suggested that a pocket-sized pillbox was demanded to support patient’s medication-taking outside the home and pillboxes for home use should be adaptable to the different means of pillbox storage. In accordance with the result, we designed and developed SMSS. Ten patients participated in the feasibility study. In 17 out of 47 cases (36.2%), patients took their medication upon being presented with reminders by the system. Correct medication-taking occurrence was improved using this system. Conclusions The SMSS is acceptable to patients and has the advantage of supporting ubiquitous medication self-management using a smartphone. We believe that the proposed system is feasible and provides an innovative solution to encourage medication self-management. PMID:23650486
Structured inspection of medications carried and stored by emergency medical services agencies identifies practices that may lead to medication errors.

PubMed

Kupas, Douglas F; Shayhorn, Meghan A; Green, Paul; Payton, Thomas F

2012-01-01

Medications are essential to emergency medical services (EMS) agencies when providing lifesaving care, but the EMS environment has challenges related to safe medication storage when compared with a hospital setting. We developed a structured process, based on common pharmacy practices, to review medications carried by EMS agencies to identify situations that may lead to medication error and to determine some best practices that may reduce potential errors and the risk of patient harm. To provide a descriptive account of EMS practices related to carrying and storing medications that have the potential for causing a medication administration error or patient harm. Using a structured process for inspection, an emergency medicine pharmacist and emergency physician(s) reviewed the medication carrying and storage practices of all nine advanced life support ambulance agencies within a five-county EMS region. Each medication carried and stored by the EMS agency was inspected for predetermined and spontaneously observed issues that could lead to medication error. These issues were documented and photographed. Two EMS medical directors reviewed each potential error for the risk of producing patient harm and assigned each to a category of high, moderate, or low risk. Because issues of temperature on EMS medications have been addressed elsewhere, this study concentrated on potential for EMS medication administration errors exclusive of storage temperatures. When reviewing medications carried by the nine EMS agencies, 38 medication safety issues were identified (range 1 to 8 per EMS agency). Of these, 16 were considered to be high risk, 14 moderate risk, and eight low risk for patient harm. Examples of potential issues included carrying expired medications, container-labeling issues, different medications stored in look-alike vials or prefilled syringes in the same compartment, and carrying crystalloid solutions next to solutions premixed with a medication. When reviewing
Predictive Analytics In Healthcare: Medications as a Predictor of Medical Complexity.

PubMed

Higdon, Roger; Stewart, Elizabeth; Roach, Jared C; Dombrowski, Caroline; Stanberry, Larissa; Clifton, Holly; Kolker, Natali; van Belle, Gerald; Del Beccaro, Mark A; Kolker, Eugene

2013-12-01

Children with special healthcare needs (CSHCN) require health and related services that exceed those required by most hospitalized children. A small but growing and important subset of the CSHCN group includes medically complex children (MCCs). MCCs typically have comorbidities and disproportionately consume healthcare resources. To enable strategic planning for the needs of MCCs, simple screens to identify potential MCCs rapidly in a hospital setting are needed. We assessed whether the number of medications used and the class of those medications correlated with MCC status. Retrospective analysis of medication data from the inpatients at Seattle Children's Hospital found that the numbers of inpatient and outpatient medications significantly correlated with MCC status. Numerous variables based on counts of medications, use of individual medications, and use of combinations of medications were considered, resulting in a simple model based on three different counts of medications: outpatient and inpatient drug classes and individual inpatient drug names. The combined model was used to rank the patient population for medical complexity. As a result, simple, objective admission screens for predicting the complexity of patients based on the number and type of medications were implemented.
Vision and Driving

PubMed Central

Owsley, Cynthia; McGwin, Gerald

2010-01-01

Driving is the primary means of personal travel in many countries and is relies heavily on vision for its successful execution. Research over the past few decades has addressed the role of vision in driver safety (motor vehicle collision involvement) and in driver performance (both on-road and using interactive simulators in the laboratory). Here we critically review what is currently known about the role of various aspects of visual function in driving. We also discuss translational research issues on vision screening for licensure and re-licensure and rehabilitation of visually impaired persons who want to drive. PMID:20580907
Telemedicine: the invisible legal barriers to the health care of the future.

PubMed

Daly, H L

2000-01-01

Telemedicine has the potential to transform the world of health care just as the Internet transformed the world of commerce. Ms. Daly examines two legal obstacles to expanding the use of telemedicine: licensure and liability. She defines telemedicine and discusses its common applications and significant benefits. Licensure laws and liability rules result in formidable barriers to the expanded use of telemedicine, while also failing to provide sufficient protection for consumers. Ms. Daly argues that for the benefits of telemedicine to reach those most in need, mutual recognition of licensing laws coupled with a universal standard of care is necessary.
[Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

PubMed

Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

2015-06-01

The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations.
Medical professionalism from a socio-cultural perspective: evaluating medical residents communicative attitudes during the medical encounter in malaysia.

PubMed

Ganasegeran, K; Al-Dubai, S A R

2014-01-01

The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Cross-sectional survey, in a Malaysian public health hospital. A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Package of Social Sciences (SPSS®) (version 16.0, IBM, Armonk, NY) was used. Cronbach's alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%). Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.
Impact of an electronic medication administration record on medication administration efficiency and errors.

PubMed

McComas, Jeffery; Riingen, Michelle; Chae Kim, Son

2014-12-01

The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors.
Disciplinary action by medical boards and prior behavior in medical school.

PubMed

Papadakis, Maxine A; Teherani, Arianne; Banach, Mary A; Knettler, Timothy R; Rattner, Susan L; Stern, David T; Veloski, J Jon; Hodgson, Carol S

2005-12-22

Evidence supporting professionalism as a critical measure of competence in medical education is limited. In this case-control study, we investigated the association of disciplinary action against practicing physicians with prior unprofessional behavior in medical school. We also examined the specific types of behavior that are most predictive of disciplinary action against practicing physicians with unprofessional behavior in medical school. The study included 235 graduates of three medical schools who were disciplined by one of 40 state medical boards between 1990 and 2003 (case physicians). The 469 control physicians were matched with the case physicians according to medical school and graduation year. Predictor variables from medical school included the presence or absence of narratives describing unprofessional behavior, grades, standardized-test scores, and demographic characteristics. Narratives were assigned an overall rating for unprofessional behavior. Those that met the threshold for unprofessional behavior were further classified among eight types of behavior and assigned a severity rating (moderate to severe). Disciplinary action by a medical board was strongly associated with prior unprofessional behavior in medical school (odds ratio, 3.0; 95 percent confidence interval, 1.9 to 4.8), for a population attributable risk of disciplinary action of 26 percent. The types of unprofessional behavior most strongly linked with disciplinary action were severe irresponsibility (odds ratio, 8.5; 95 percent confidence interval, 1.8 to 40.1) and severely diminished capacity for self-improvement (odds ratio, 3.1; 95 percent confidence interval, 1.2 to 8.2). Disciplinary action by a medical board was also associated with low scores on the Medical College Admission Test and poor grades in the first two years of medical school (1 percent and 7 percent population attributable risk, respectively), but the association with these variables was less strong than that with
[The early medical textbooks in Korea: medical textbooks published at Je Joong Won-Severance Hospital Medical School].

PubMed

Park, H W

1998-01-01

Kwang Hye Won(Je Joong Won), the first western hospital in Korea, was founded in 1885. The first western Medical School in Korea was open in 1886 under the hospital management. Dr. O. R. Avison, who came to Korea in 1893, resumed the medical education there, which was interrupted for some time before his arrival in Korea. He inaugurated translating and publishing medical textbooks with the help of Kim Pil Soon who later became one of the first seven graduates in Severance Hospital Medical School. The first western medical textbook translated into Korean was Henry Gray's Anatomy. However, these twice-translated manuscripts were never to be published on account of being lost and burnt down. The existing early anatomy textbooks, the editions of 1906 and 1909, are not the translation of Gray's Anatomy, but that of Japanese anatomy textbook of Gonda. The remaining oldest medical textbook in Korean is Inorganic Materia Medica published in 1905. This book is unique among its kind that O. R. Avison is the only translator of the book and it contains the prefaces of O. R. Avison and Kim Pil Soon. The publication of medical textbook was animated by the participation of other medical students, such as Hong Suk Hoo and Hong Jong Eun. The list of medical textbooks published includes almost all the field of medicine. The medical textbooks in actual existence are as follows: Inorganic Materia Medica (1905), Inorganic Chemistry (1906), Anatomy I (1906), Physiology (1906), Diagnostics I (1906), Diagnostics II (1907), Obstetrics (1908), Organic Chemistry (1909), Anatomy (1909), and Surgery (1910).
Medical practice in organized settings. Redefining medical autonomy.

PubMed

Astrachan, J H; Astrachan, B M

1989-07-01

Physicians are perplexed by the ongoing erosion of their individual professional autonomy. While the economic forces underlying such change have received much attention, the evolution of new organizational forms that modify and often diminish medical autonomy is less well understood. The practice of medicine is becoming more organized and more hierarchical. We emphasize the importance of organized medical groups, including the medical staff organization, as structures for appropriate peer monitoring, and for counterbalancing the burgeoning influence of governance and administrative constraints on practice. There is an ongoing tension within organizations between management, governance, and physicians. Over time one or another of these groups achieves some measure of dominance, but good management requires a balance of power. The role of the medical staff, which is poorly represented in some health care institutions and under threat in others, is considered. In general, we find that medical work is becoming more hierarchical, and that physician "leaders" do not substitute for collegial processes.
Integrating medical informatics into the medical undergraduate curriculum.

PubMed

Khonsari, L S; Fabri, P J

1997-01-01

The advent of healthcare reform and the rapid application of new technologies have resulted in a paradigm shift in medical practice. Integrating medical Informatics into the full spectrum of medical education is a viral step toward implementing this new instructional model, a step required for the understanding and practice of modern medicine. We have developed an informatics curriculum, a new educational paradigm, and an intranet-based teaching module which are designed to enhance adult-learning principles, life-long self education, and evidence-based critical thinking. Thirty two, fourth year medical students have participated in a one month, full time, independent study focused on but not limited to four topics: mastering the windows-based environment, understanding hospital based information management systems, developing competence in using the internet/intranet and world wide web/HTML, and experiencing distance communication and TeleVideo networks. Each student has completed a clinically relevant independent study project utilizing technology mastered during the course. This initial curriculum offering was developed in conjunction with faculty from the College of Medicine, College of Engineering, College of Education, College of Business, College of Public Health. Florida Center of Instructional Technology, James A. Haley Veterans Hospital, Moffitt Cancer Center, Tampa General Hospital, GTE, Westshore Walk-in Clinic (paperless office), and the Florida Engineering Education Delivery System. Our second step toward the distributive integration process was the introduction of Medical Informatics to first, second and third year medical students. To date, these efforts have focused on undergraduate medical education. Our next step is to offer workshops in Informatics to college of medicine faculty, to residents in post graduate training programs (GME), and ultimately as a method of distance learning in continuing medical education (CME).
Rethinking medical humanities.

PubMed

Chiapperino, Luca; Boniolo, Giovanni

2014-12-01

This paper questions different conceptions of Medical Humanities in order to provide a clearer understanding of what they are and why they matter. Building upon former attempts, we defend a conception of Medical Humanities as a humanistic problem-based approach to medicine aiming at influencing its nature and practice. In particular, we discuss three main conceptual issues regarding the overall nature of this discipline: (i) a problem-driven approach to Medical Humanities; (ii) the need for an integration of Medical Humanities into medicine; (iii) the methodological requirements that could render Medical Humanities an effective framework for medical decision-making.
Medical spa marketing.

PubMed

Sadick, Neil S; Dinkes, Adam; Oskin, Larry

2008-07-01

Medical spas are different. We are not just selling medical and dermatology services; we are offering clients viable new solutions to their skin care, body care, and hair care challenges. Traditional medical marketing becomes blurred today, as the expansion and acceptance of medical spas helps you to effectively compete with traditional skin care clinics, salons, and spas, while offering more therapeutic treatments from professionally licensed doctors, nurses, aestheticians, massage therapists, spa professionals, and medical practitioners. We recommend that you make the choice to successfully and competitively become a market-driven medical spa with an annual strategic plan, rather than an operationally driven business.
Medical student and medical school teaching faculty perceptions of conflict of interest.

PubMed

Andresen, Nicholas S; Olson, Tyler S; Krasowski, Matthew D

2017-07-11

Attitudes towards conflict of interest (COI) and COI policy are shaped during medical school and influence both the education of medical students and their future medical practice. Understanding the current attitudes of medical students and medical school teaching faculty may provide insight into what is taught about COI and COI policy within the 'hidden' medical curriculum. Differences between medical student and medical school teaching faculty perceptions of COI and COI policy have not been compared in detail. The authors surveyed first year medical students and medical school teaching faculty at one academic medical center. The response rate was 98.7% (150/152) for students and 34.2% (69/202) for faculty. Students were less likely than faculty to agree that lecturers should disclose COI to any learners (4.06 vs. 4.31, p = 0.01), but more likely to agree that COI disclosure decreases the presentation of biased material (3.80 vs. 3.21, p < 0.001). Student and faculty responses for all other questions were not different. Many of these responses suggest student and faculty support for stronger COI policy at academic medical centers. Students and faculty perceptions regarding COI and COI policy are largely similar, but differ in terms of the perceived effectiveness of COI disclosure. This study also suggests that medical students and medical school teaching faculty support for stronger COI policy at academic medical centers.
The Medical Ethics Curriculum in Medical Schools: Present and Future.

PubMed

Giubilini, Alberto; Milnes, Sharyn; Savulescu, Julian

2016-01-01

In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students' levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects of the "hidden curriculum," teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors' right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.
Knowledge of medical abortion among Brazilian medical students.

PubMed

Fernandes, Karayna Gil; Camargo, Rodrigo Pauperio Soares; Duarte, Graciana Alves; Faúndes, Anibal; Sousa, Maria Helena; Maia Filho, Nelson Lourenço; Pacagnella, Rodolfo Carvalho

2012-09-01

To assess the knowledge of Brazilian medical students regarding medical abortion (MA) and the use of misoprostol for MA, and to investigate factors influencing their knowledge. All students from 3 medical schools in São Paulo State were invited to complete a pretested structured questionnaire with precoded response categories. A set of 12 statements on the use and effects of misoprostol for MA assessed their level of knowledge. Of about 1260 students invited to participate in the study, 874 completed the questionnaire, yielding a response rate of 69%. The χ(2) test was used for the bivariate analysis, which was followed by multiple regression analysis. Although all students in their final year of medical school had heard of misoprostol for termination of pregnancy, and 88% reported having heard how to use it, only 8% showed satisfactory knowledge of its use and effects. Academic level was the only factor associated with the indicators of knowledge investigated. The very poor knowledge of misoprostol use for MA demonstrated by the medical students surveyed at 3 medical schools makes the review and updating of the curriculum urgently necessary. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Attrition during graduate medical education: medical school perspective.

PubMed

Andriole, Dorothy A; Jeffe, Donna B; Hageman, Heather L; Klingensmith, Mary E; McAlister, Rebecca P; Whelan, Alison J

2008-12-01

To identify predictors of attrition during graduate medical education (GME) in a single medical school cohort of contemporary US medical school graduates. Retrospective cohort study. Single medical institution. Recent US allopathic medical school graduates. Attrition from initial GME program. Forty-seven of 795 graduates (6%) did not complete the GME in their initial specialty of choice. At bivariate analysis, attrition was associated with election to the Alpha Omega Alpha Honor Medical Society, being an MD-PhD degree holder, and specialty choice (all P < .05). Attrition was not associated with graduation year (P = .91), sex (P = .67), or age (P = .12). In a multivariate logistic regression model, MD-PhD degree holder (odds ratio, 3.43; 95% confidence interval, 1.27-9.26; P = .02), election to Alpha Omega Alpha (2.19; 1.04-4.66; P = .04), choice of general surgery for GME (5.32; 1.98-14.27; P < .001), and choice of 5-year surgical specialty including those surgical specialties with a GME training requirement of 5 years or longer (2.74; 1.16-6.44; P = .02) each independently predicted greater likelihood of attrition. Academically highly qualified graduates and graduates who chose training in general surgery or in a 5-year surgical specialty were at increased risk of attrition during GME.
Progress integrating medical humanities into medical education: a global overview.

PubMed

Pfeiffer, Stefani; Chen, Yuchia; Tsai, Duujian

2016-09-01

The article reviews the most recent developments in integrating humanities into medical education. Global implications and future trends are illustrated. The main concern of medical humanities education is teaching professionalism; one important aspect that has emerged is the goal of nurturing emotion through reflexivity. Relating effectively to all stakeholders and being sensitive to inequitable power dynamics are essential for professional social accountability in modern medical contexts. Mediating doctors' understanding of the clinical encounter through creative arts and narrative is part of most recent pedagogic innovations aimed at motivating learners to become empowered, engaged and caring clinicians. Scenario-based and discursive-oriented evaluations of such activities should be aligned with the medical humanities' problem-based learning curriculum. Medical humanities education fosters professional reflexivity that is important for achieving patient-centered care. Countering insufficient empathy with reflective professionalism is an urgent challenge in medical education; to answer this need, creative arts and narrative understanding have emerged as crucial tools of medical humanities education. To ensure competent professional identity formation in the era of translational medicine, medical humanities programs have adopted scenario-based assessments through inclusion of different voices and emphasizing personal reflection and social critique.

Step Up-Not On-The Step 2 Clinical Skills Exam: Directors of Clinical Skills Courses (DOCS) Oppose Ending Step 2 CS.

PubMed

Ecker, David J; Milan, Felise B; Cassese, Todd; Farnan, Jeanne M; Madigosky, Wendy S; Massie, F Stanford; Mendez, Paul; Obadia, Sharon; Ovitsh, Robin K; Silvestri, Ronald; Uchida, Toshiko; Daniel, Michelle

2018-05-01

Recently, a student-initiated movement to end the United States Medical Licensing Examination Step 2 Clinical Skills and the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation has gained momentum. These are the only national licensing examinations designed to assess clinical skills competence in the stepwise process through which physicians gain licensure and certification. Therefore, the movement to end these examinations and the ensuing debate merit careful consideration. The authors, elected representatives of the Directors of Clinical Skills Courses, an organization comprising clinical skills educators in the United States and beyond, believe abolishing the national clinical skills examinations would have a major negative impact on the clinical skills training of medical students, and that forfeiting a national clinical skills competency standard has the potential to diminish the quality of care provided to patients. In this Perspective, the authors offer important additional background information, outline key concerns regarding the consequences of ending these national clinical skills examinations, and provide recommendations for moving forward: reducing the costs for students, exploring alternatives, increasing the value and transparency of the current examinations, recognizing and enhancing the strengths of the current examinations, and engaging in a national dialogue about the issue.
How Do Providers Assess Antihypertensive Medication Adherence in Medical Encounters?

PubMed Central

Bokhour, Barbara G; Berlowitz, Dan R; Long, Judith A; Kressin, Nancy R

2006-01-01

BACKGROUND Poor adherence to antihypertensives has been shown to be a significant factor in poor blood pressure (BP) control. Providers' communication with patients about their medication-taking behavior may be central to improving adherence. OBJECTIVE The goal of this study was to characterize the ways in which providers ask patients about medication taking. DESIGN Clinical encounters between primary care providers and hypertensive patients were audiotaped at 3 Department of Veterans' Affairs medical centers. PARTICIPANTS Primary care providers (n =9) and African-American and Caucasian patients (n =38) who were diagnosed with hypertension (HTN). APPROACH Transcribed audiotapes of clinical encounters were coded by 2 investigators using qualitative analysis based on sociolinguistic techniques to identify ways of asking about medication taking. Electronic medical records were reviewed after the visit to determine the BP measurement for the day of the taped encounter. RESULTS Four different aspects of asking about medication were identified: structure, temporality, style and content. Open-ended questions generated the most discussion, while closed-ended declarative statements led to the least discussion. Collaborative style and use of lay language were also seen to facilitate discussions. In 39% of encounters, providers did not ask about medication taking. Among patients with uncontrolled HTN, providers did not ask about medications 33% of the time. CONCLUSION Providers often do not ask about medication-taking behavior, and may not use the most effective communication strategies when they do. Focusing on the ways in which providers ask about patients' adherence to medications may improve BP control. PMID:16808739
Medical revolution in Argentina.

PubMed

Ballarin, V L; Isoardi, R A

2010-01-01

The paper discusses the major Argentineans contributors, medical physicists and scientists, in medical imaging and the development of medical imaging in Argentina. The following are presented: history of medical imaging in Argentina: the pioneers; medical imaging and medical revolution; nuclear medicine imaging; ultrasound imaging; and mathematics, physics, and electronics in medical image research: a multidisciplinary endeavor.
Medical confidence.

PubMed Central

Havard, J

1985-01-01

If medical confidentiality is not observed patients may well be reluctant to disclose information to their doctors or even to seek medical advice. Therefore, argues the author, it is of the utmost importance that doctors strive to protect medical confidentiality, particularly now when it is under threat not only in this country but also overseas. The profession must cease to regard ethical issues to do with confidentiality, and indeed to do with all areas of medical practice, as abstract phenomena requiring no justification. If it does not then it will come under increasing and justified criticism from the community it serves. PMID:3981576
Demonopolizing medical knowledge.

PubMed

Arora, Sanjeev; Thornton, Karla; Komaromy, Miriam; Kalishman, Summers; Katzman, Joanna; Duhigg, Daniel

2014-01-01

In the past 100 years, there has been an explosion of medical knowledge-and in the next 50 years, more medical knowledge will be available than ever before. Regrettably, current medical practice has been unable to keep pace with this explosion of medical knowledge. Specialized medical knowledge has been confined largely to academic medical centers (i.e., teaching hospitals) and to specialists in major cities; it has been disconnected from primary care clinicians on the front lines of patient care. To bridge this disconnect, medical knowledge must be demonopolized, and a platform for collaborative practice amongst all clinicians needs to be created. A new model of health care and education delivery called Project ECHO (Extension for Community Healthcare Outcomes), developed by the first author, does just this. Using videoconferencing technology and case-based learning, ECHO's medical specialists provide training and mentoring to primary care clinicians working in rural and urban underserved areas so that the latter can deliver the best evidence-based care to patients with complex health conditions in their own communities. The ECHO model increases access to care in rural and underserved areas, and it demonopolizes specialized medical knowledge and expertise.
Library collaboration with medical humanities in an american medical college in qatar.

PubMed

Birch, Sally; Magid, Amani; Weber, Alan

2013-11-01

The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of 'doctors' stories' related to the practice of medicine (including medically-oriented movies and TV programs), and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a 'best practices' approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.
Library Collaboration with Medical Humanities in an American Medical College in Qatar

PubMed Central

Birch, Sally; Magid, Amani; Weber, Alan

2013-01-01

The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of ‘doctors’ stories’ related to the practice of medicine (including medically-oriented movies and TV programs), and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a ‘best practices’ approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders. PMID:24223240
Post-licensure surveillance of 13-valent pneumococcal conjugate vaccine (PCV13) in adults aged ⩾19years old in the United States, Vaccine Adverse Event Reporting System (VAERS), June 1, 2012-December 31, 2015.

PubMed

Haber, Penina; Arana, Jorge; Pilishvili, Tamara; Lewis, Paige; Moro, Pedro L; Cano, Maria

2016-12-07

The 13-valent pneumococcal conjugate vaccine (PCV13) was first recommended for use in adults aged ⩾19years with immunocompromising conditions in June 2012. On August 2014, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of PCV13 among adults aged ⩾65years. We assessed adverse events (AEs) reports following PCV13 in adults aged ⩾19years reported to the Vaccine Adverse Event Reporting System (VAERS) from June 2012 to December 2015. VAERS is a national spontaneous reporting system for monitoring AEs following vaccination. Our assessment included automated data analysis, clinical review of all serious reports and reports of special interest. We conducted empirical Bayesian data mining to assess for disproportionate reporting. VAERS received 2976 US PCV13 adult reports; 2103 (71%) of these reports were from PCV13 administered alone. Fourteen percent were in persons aged 19-64years and 86% were in persons aged ⩾65years. Injection site erythema (28%), injection site pain (24%) and fever (22%) were the most frequent AEs among persons aged 19-64years; injection site erythema (30%), erythema (20%) and injection site swelling (18%) were the most frequent among persons aged ⩾65years who were given the vaccine alone. The most frequently reported AEs among non-death serious reports were injection site reactions and general malaise among persons 19-64years old; injection site reactions, general malaise and Guillain-Barré syndrome among those ⩾65years (Table 2). Data mining did not detect disproportional reporting for any unexpected AE. The results of this study were consistent with safety data from pre-licensure studies of PCV13. We did not detect any new or unexpected AEs. Published by Elsevier Ltd.
'The medical' and 'health' in a critical medical humanities.

PubMed

Atkinson, Sarah; Evans, Bethan; Woods, Angela; Kearns, Robin

2015-03-01

As befits an emerging field of enquiry, there is on-going discussion about the scope, role and future of the medical humanities. One relatively recent contribution to this debate proposes a differentiation of the field into two distinct terrains, 'medical humanities' and 'health humanities,' and calls for a supersession of the former by the latter. In this paper, we revisit the conceptual underpinnings for a distinction between 'the medical' and 'health' by looking at the history of an analogous debate between 'medical geography' and 'the geographies of health' that has, over the last few years, witnessed a re-blurring of the distinction. Highlighting the value of this debate within the social sciences for the future development of the medical humanities, we call for scholars to take seriously the challenges of critical and cultural theory, community-based arts and health, and the counter-cultural creative practices and strategies of activist movements in order to meet the new research challenges and fulfill the radical potential of a critical medical humanities.
Differences of smoking knowledge, attitudes, and behaviors between medical and non-medical students.

PubMed

Han, Min-Yan; Chen, Wei-Qing; Wen, Xiao-Zhong; Liang, Cai-Hua; Ling, Wen-Hua

2012-03-01

Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education.
Medical Students' Impressions and Satisfactions from Medical Professional Skill Education Lessons

ERIC Educational Resources Information Center

Ongel, Kurtulus; Mergen, Haluk; Kayacan, Hacer; Yildizhan, Alpaslan

2008-01-01

(Background) To help us understand the medical students' reflections about professional skill educations we conducted a study on medical students' conceptions of selected medical phenomena, cardiopulmonary resuscitation, CPR. (Methods) The study was conducted in January 2008, using a sample consisting of medical students from one of the…
The Medical Passport

ERIC Educational Resources Information Center

Ineson, Sue; Seeling, Stephen S.

2005-01-01

A Working Group on Medical Passports was established in 2002 by the International Association of Medical Regulatory Authorities. The goal of this group was to develop a fast-track registration process for highly qualified medical practitioners wishing to move from one jurisdiction to another. A "medical passport" would be available only to…
Postgraduation retention of medical students from Otago and Auckland medical programmes.

PubMed

Shelker, William; Poole, Phillippa; Bagg, Warwick; Wood, Ian; Glue, Paul

2014-01-24

Auckland and Otago medical programmes have different methods for selecting students. This study compared postgraduate retention in New Zealand (NZ) of medical graduates from the two medical programmes, to assess whether different selection methods influenced retention. Other variables assessed included entrance category and age at graduation. Anonymised databases were created of all graduates from the Otago Faculty of Medicine (1999-2011) and the Auckland medical programme (2000-2012). Demographic and entry category data were recorded. Retention was defined as presence on the NZ Medical Register in December 2012. Risk differences (RD) were calculated to compare retention between the two medical programmes using the Mantel-Haenszel method. The influence of medical programme entrance category on retention was also tested. The influence of covariates on retaining graduates on the register was evaluated using a multiple logistic regression model. The postgraduate retention of graduates of the two medical programmes over 13 years was identical (Auckland 74.9%, Otago 73.6%, P=0.48). Retention of graduate and non-graduate entry students from both medical programmes was similar by 6 years after graduation. Age during medical school did not affect retention. University of attendance had no effect on postgraduation retention of students on the NZ Medical Register, suggesting that retention is not influenced by the different student selection methods at each programme. The data presented shows that New Zealand graduates regardless of programme completed show a similar profile in terms of retention.
[Structured medication management in primary care - a tool to promote medication safety].

PubMed

Mahler, Cornelia; Freund, Tobias; Baldauf, Annika; Jank, Susanne; Ludt, Sabine; Peters-Klimm, Frank; Haefeli, Walter Emil; Szecsenyi, Joachim

2014-01-01

Patients with chronic disease usually need to take multiple medications. Drug-related interactions, adverse events, suboptimal adherence, and self-medication are components that can affect medication safety and lead to serious consequences for the patient. At present, regular medication reviews to check what medicines have been prescribed and what medicines are actually taken by the patient or the structured evaluation of drug-related problems rarely take place in Germany. The process of "medication reconciliation" or "medication review" as developed in the USA and the UK aim at increasing medication safety and therefore represent an instrument of quality assurance. Within the HeiCare(®) project a structured medication management was developed for general practice, with medical assistants playing a major role in the implementation of the process. Both the structured medication management and the tools developed for the medication check and medication counselling will be outlined in this article; also, findings on feasibility and acceptance in various projects and experiences from a total of 200 general practices (56 HeiCare(®), 29 HiCMan,115 PraCMan) will be described. The results were obtained from questionnaires and focus group discussions. The implementation of a structured medication management intervention into daily routine was seen as a challenge. Due to the high relevance of medication reconciliation for daily clinical practice, however, the checklists - once implemented successfully - have been applied even after the end of the project. They have led to the regular review and reconciliation of the physicians' documentation of the medicines prescribed (medication chart) with the medicines actually taken by the patient. Copyright © 2013. Published by Elsevier GmbH.
Medical misconduct in Hong Kong: implications for medical education around the world.

PubMed

Chan, Zenobia C Y

2012-10-01

Medical educators emphasise responses to medical misconduct, but little is known about medical misconduct and its implications for medical education. This article investigates the nature of medical malpractice in Hong Kong and offers guidance for the inclusion of a curriculum to prevent the occurrence of medical misconduct in medical education around the world. A comprehensive review of judgements made by the Medical Council of Hong Kong during the period from July 2008 to December 2010 was conducted. Each of the 40 cases of inquiry related to medical misconduct were summarised and analysed according to 14 factors. Of the 40 cases, nearly half involved only one or two charges. The Council found the defendants guilty of professional misconduct on 148 of 169 charges, and ordered the following four types of penalty: removal order, suspension, warning letter, and reprimand. Cases are grouped into three categories involving: improper documentation, inappropriate management or prescription of drugs, and failure to interact appropriately with patients. The relevant ethical codes or legislation for each category are illustrated. Various types of medical misconduct unquestionably caused suffering to the patients involved, their families and society. Hence, it is crucial for medical educators to teach students about the importance of medical ethics and the prevention of misconduct. © Blackwell Publishing Ltd 2012.
Medication deserts: survey of neighborhood disparities in availability of prescription medications.

PubMed

Amstislavski, Philippe; Matthews, Ariel; Sheffield, Sarah; Maroko, Andrew R; Weedon, Jeremy

2012-11-09

Only a small amount of research has focused on the relationship between socio-economic status (SES) and geographic access to prescription medications at community pharmacies in North America and Europe. To examine the relationship between a community's socio-economic context and its residents' geographic access to common medications in pharmacies, we hypothesized that differences are present in access to pharmacies across communities with different socio-economic environments, and in availability of commonly prescribed medications within pharmacies located in communities with different socio-economic status. We visited 408 pharmacies located in 168 socio-economically diverse communities to assess the availability of commonly prescribed medications. We collected the following information at each pharmacy visited: hours of operation, pharmacy type, in-store medication availability, and the cash price of the 13 most commonly prescribed medications. We calculated descriptive statistics for the sample and fitted a series of hierarchical linear models to test our hypothesis that the in-stock availability of medications differs by the socio-economic conditions of the community. This was accomplished by modeling medication availability in pharmacies on the socio-economic factors operating at the community level in a socio-economically devise urban area. Pharmacies in poor communities had significantly higher odds of medications being out of stock, OR=1.24, 95% CI [1.02, 1.52]. There was also a significant difference in density of smaller, independent pharmacies with very limited stock and hours of operation, and larger, chain pharmacies in poor communities as compared to the middle and low-poverty communities. The findings suggest that geographic access to a neighborhood pharmacy, the type of pharmacy, and availability of commonly prescribed medications varies significantly across communities. In extreme cases, entire communities could be deemed "medication deserts
Medication communication through documentation in medical wards: knowledge and power relations.

PubMed

Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

2014-09-01

Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals. © 2013 John Wiley & Sons Ltd.
Mixing with Medics

PubMed Central

Smith, Matthew

2011-01-01

Historians are increasingly required to produce research that makes an impact. This is particularly the case for medical historians, partly because of our funders' expectations, but also because there is a sense that medical history can inform today's thorny debates about health. Unfortunately, many historians struggle to make an impact. I suggest that participating in medical conferences (broadly defined), not only provides opportunities to make an impact on the medical community, but also offers chances to observe and participate in medical history as it happens.
Smoking cessation medications

MedlinePlus

Smoking cessation - medications; Smokeless tobacco - medications; Medications for stopping tobacco ... Smoking cessation medicines can: Help with the craving for tobacco. Help you with withdrawal symptoms. Keep you ...
Cannabinoids: Medical implications.

PubMed

Schrot, Richard J; Hubbard, John R

2016-01-01

Herbal cannabis has been used for thousands of years for medical purposes. With elucidation of the chemical structures of tetrahydrocannabinol (THC) and cannabidiol (CBD) and with discovery of the human endocannabinoid system, the medical usefulness of cannabinoids has been more intensively explored. While more randomized clinical trials are needed for some medical conditions, other medical disorders, like chronic cancer and neuropathic pain and certain symptoms of multiple sclerosis, have substantial evidence supporting cannabinoid efficacy. While herbal cannabis has not met rigorous FDA standards for medical approval, specific well-characterized cannabinoids have met those standards. Where medical cannabis is legal, patients typically see a physician who "certifies" that a benefit may result. Physicians must consider important patient selection criteria such as failure of standard medical treatment for a debilitating medical disorder. Medical cannabis patients must be informed about potential adverse effects, such as acute impairment of memory, coordination and judgment, and possible chronic effects, such as cannabis use disorder, cognitive impairment, and chronic bronchitis. In addition, social dysfunction may result at work/school, and there is increased possibility of motor vehicle accidents. Novel ways to manipulate the endocannbinoid system are being explored to maximize benefits of cannabinoid therapy and lessen possible harmful effects.

From Servicescape to Loyalty in the Medical Tourism Industry: A Medical Clinic's Service Perspective.

PubMed

Kim, Minseong; Koo, Dong-Woo; Shin, Dong-Jin; Lee, Sae-Mi

2017-01-01

Medical tourism organizations have increasingly recognized that loyalty makes a medical clinic a marketing success. To increase understanding of the importance of medical clinics, this study examined the roles of servicescapes, emotions, and satisfaction in the development of customer loyalty toward medical clinics and destination. Data were collected among international medical tourists visiting Korea. Results identified that dimensions of medical clinics' servicescape (ie, medical clinic environment, medical treatment, staff, and doctor) influenced emotions and satisfaction among international medical tourists. Also, positive emotions and the 2 dimensions of satisfaction with a medical clinic and doctor mediate the influence of medical clinics' servicescapes on 2 types of loyalty (the medical clinic and Korea for medical care). Overall, these findings indicate that the interrelationship of servicescapes, positive emotion, and satisfaction is essential in influencing international medical tourists' loyalty to a medical clinic.
Patient safety awareness among Undergraduate Medical Students in Pakistani Medical School.

PubMed

Kamran, Rizwana; Bari, Attia; Khan, Rehan Ahmed; Al-Eraky, Mohamed

2018-01-01

To measure the level of awareness of patient safety among undergraduate medical students in Pakistani Medical School and to find the difference with respect to gender and prior experience with medical error. This cross-sectional study was conducted at the University of Lahore (UOL), Pakistan from January to March 2017, and comprised final year medical students. Data was collected using a questionnaire 'APSQ- III' on 7 point Likert scale. Eight questions were reverse coded. Survey was anonymous. SPSS package 20 was used for statistical analysis. Questionnaire was filled by 122 students, with 81% response rate. The best score 6.17 was given for the 'team functioning', followed by 6.04 for 'long working hours as a cause of medical error'. The domains regarding involvement of patient, confidence to report medical errors and role of training and learning on patient safety scored high in the agreed range of >5. Reverse coded questions about 'professional incompetence as an error cause' and 'disclosure of errors' showed negative perception. No significant differences of perceptions were found with respect to gender and prior experience with medical error (p= >0.05). Undergraduate medical students at UOL had a positive attitude towards patient safety. However, there were misconceptions about causes of medical errors and error disclosure among students and patient safety education needs to be incorporated in medical curriculum of Pakistan.
Medicalization, markets and consumers.

PubMed

Conrad, Peter; Leiter, Valerie

2004-01-01

This paper examines the impact of changes in the medical marketplace on medicalization in U.S. society. Using four cases (Viagra, Paxil, human growth hormone and in vitro fertilization), we focus on two aspects of the changing medical marketplace: the role of direct-to-consumer advertising of prescription drugs and the emergence of private medical markets. We demonstrate how consumers and pharmaceutical corporations contribute to medicalization, with physicians, insurance coverage, and changes in regulatory practices playing facilitating roles. In some cases, insurers attempt to counteract medicalization by restricting access. We distinguish mediated and private medical markets, each characterized by differing relationships with corporations, insurers, consumers, and physicians. In the changing medical environment, with medical markets as intervening factors, corporations and insurers are becoming more significant determinants in the medicalization process.
Inflight medical emergencies.

PubMed

Lyznicki, J M; Williams, M A; Deitchman, S D; Howe, J P

2000-08-01

This report responds to resolutions asking the American Medical Association (AMA) to develop recommendations for the use of medical equipment and technology onboard commercial airlines. Information for the report was derived from a search of the MEDLINE database and references listed in pertinent articles, as well as through communications with experts in aerospace and emergency medicine. Based on this information, the AMA Council on Scientific Affairs determined that, while inflight morbidity and mortality are uncommon, serious events do occur, which require immediate emergency care. Management of serious problems requires an integrated emergency response system that ensures rapid notification of medical personnel on the ground, assistance from appropriately trained flight crews and passenger volunteers (if available), and adequate medical supplies and equipment to stabilize the victim. Physicians have an important role in the preflight evaluation and counseling of potential passengers who are at risk of inflight medical complications, and in providing inflight medical assistance. Some U.S. and foreign air carriers are upgrading inflight emergency medical kits and placing automated external defibrillators aboard aircraft. Few data are available regarding the effectiveness of such improvements in improving health or survival outcomes. Recent federal legislation requires assessment of the extent of inflight medical emergencies, including the adequacy of emergency medical supplies and equipment carried onboard commercial airliners. This legislation also should alleviate liability concerns by providing immunity for physicians and others who render inflight medical assistance.
Professional licensure: investigation and disciplinary action.

PubMed

Brous, Edie

2012-11-01

This is the second article in a three-part series on nursing boards' disciplinary actions and what nurses need to know to maintain their license in good standing. This article discusses common reasons boards of nursing conduct investigations and take disciplinary action. The third and final article will discuss strategies for protecting your license.
Taking stock of medication wastage: Unused medications in US households.

PubMed

Law, Anandi V; Sakharkar, Prashant; Zargarzadeh, Amir; Tai, Bik Wai Bilvick; Hess, Karl; Hata, Micah; Mireles, Rudolph; Ha, Carolyn; Park, Tony J

2015-01-01

Despite the potential deleterious impact on patient safety, environmental safety and health care expenditures, the extent of unused prescription medications in US households and reasons for nonuse remain unknown. To estimate the extent, type and cost of unused medications and the reasons for their nonuse among US households. A cross-sectional, observational two-phased study was conducted using a convenience sample in Southern California. A web-based survey (Phase I, n = 238) at one health sciences institution and paper-based survey (Phase II, n = 68) at planned drug take-back events at three community pharmacies were conducted. The extent, type, and cost of unused medications and the reasons for their nonuse were collected. Approximately 2 of 3 prescription medications were reported unused; disease/condition improved (42.4%), forgetfulness (5.8%) and side effects (6.5%) were reasons cited for their nonuse. "Throwing medications in the trash" was found being the common method of disposal (63%). In phase I, pain medications (23.3%) and antibiotics (18%) were most commonly reported as unused, whereas in Phase II, 17% of medications for chronic conditions (hypertension, diabetes, cholesterol, heart disease) and 8.3% for mental health problems were commonly reported as unused. Phase II participants indicated pharmacy as a preferred location for drug disposal. The total estimated cost for unused medications was approximately $59,264.20 (average retail Rx price) to $152,014.89 (AWP) from both phases, borne largely by private health insurance. When extrapolated to a national level, it was approximately $2.4B for elderly taking five prescription medications to $5.4B for the 52% of US adults who take one prescription medication daily. Two out of three dispensed medications were unused, with national projected costs ranging from $2.4B to $5.4B. This wastage raises concerns about adherence, cost and safety; additionally, it points to the need for public awareness and
Fertility awareness among medical and non-medical students: a case-control study.

PubMed

Nouri, Kazem; Huber, Dagmar; Walch, Katharina; Promberger, Regina; Buerkle, Bernd; Ott, Johannes; Tempfer, Clemens B

2014-09-26

To compare the understanding and perceptions of fertility issues among medical and non-medical University students. In a prospective case-control study, using a 43 item questionnaire with 5 sections and 43 questions regarding personal data (8 questions), lifestyle factors (9 questions), plans on having children (5 questions), age and fertility (5 questions), and lifestyle and fertility (16 questions), knowledge of fertility and influencing factors, desired age at commencement and completion of childbearing, among male and female medical and non-medical students in their first academic year at Vienna University, Vienna, Austria were evaluated. 340 students were included. 262/340 (77%) participants planned to have children in the future. Medical students (n = 170) planned to have fewer and later children and had a higher awareness of the impact of age on fertility than non-medical students (n = 170; estimated knowledge probability 0.55 [medical students] vs. 0.47 [non-medical students]; F (1, 336) = 5.18 and p = .024 (η p = .015). Gender did not independently affect estimated knowledge probability (F (1, 336) = 1.50 and p = .221). More female and male medical students had a positive attitude towards Assisted Reproductive Technology in case of infertility than non-medical students (47 and 55% vs. 23 and 29%, respectively; p = <.001). Medical students had a healthier lifestyle than non-medical students. A healthy lifestyle and female gender were associated with higher fertility awareness. Medical students have a higher awareness of fertility issues than non-medical students. Choice of academic study, gender, and personal life style are important factors affecting fertility awareness. These data may be helpful to address knowledge gaps among young non-medical Academics.
The Hospital Medical Advisory Committee—The Cabinet of the Medical Staff

PubMed Central

Williams, K. J.; Osbaldeston, J. B.

1965-01-01

Before a hospital medical staff can realistically accept responsibility for the professional practices of its members, a principle initially fostered by the American College of Surgeons and adopted by both the Canadian and American accreditation programs, it must have an effectively functioning medical staff organization. The medical advisory committee is the most important committee of the medical staff organization. A representative composition, adherence to sound administrative principles, and recognition of its prime functions of co-ordination, supervision and jurisdiction will permit this committee—and the total medical staff organization—to discharge adequately the very important responsibilities delegated to them by the governing board of the hospital. Properly structured medical staff bylaws with clearly defined terms of reference assist the smooth functioning of the “cabinet” of the medical staff and safeguard the prerogatives of the individual members of the staff. PMID:14285296
Medical Physics Panel Discussion

NASA Astrophysics Data System (ADS)

Guèye, Paul; Avery, Steven; Baird, Richard; Soares, Christopher; Amols, Howard; Tripuraneni, Prabhakar; Majewski, Stan; Weisenberger, Drew

2006-03-01

The panel discussion will explore opportunities and vistas in medical physics research and practice, medical imaging, teaching medical physics to undergraduates, and medical physics curricula as a recruiting tool for physics departments. Panel members consist of representatives from NSBP (Paul Guèye and Steven Avery), NIH/NIBIB (Richard Baird), NIST (Christopher Soares), AAPM (Howard Amols), ASTRO (Prabhakar Tripuraneni), and Jefferson Lab (Stan Majewski and Drew Weisenberger). Medical Physicists are part of Departments of Radiation Oncology at hospitals and medical centers. The field of medical physics includes radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. It also ranges from basic researcher (at college institutions, industries, and laboratories) to applications in clinical environments.
National Survey of Medical Spanish Curriculum in U.S. Medical Schools.

PubMed

Morales, Raymond; Rodriguez, Lauren; Singh, Angad; Stratta, Erin; Mendoza, Lydia; Valerio, Melissa A; Vela, Monica

2015-10-01

Patients with limited English proficiency (LEP) may be at risk for medical errors and worse health outcomes. Language concordance between patient and provider has been shown to improve health outcomes for Spanish-speaking patients. Nearly 40 % of Hispanics, a growing population in the United States, are categorized as having limited English proficiency. Many medical schools have incorporated a medical Spanish curriculum to prepare students for clinical encounters with LEP patients. To describe the current state of medical Spanish curricula at United States medical schools. The Latino Medical Student Association distributed an e-mail survey comprising 39 items to deans from each U.S. medical school from July 2012 through July 2014. This study was IRB-exempt. Eighty-three percent (110/132) of the U.S. medical schools completed the survey. Sixty-six percent (73/110) of these schools reported offering a medical Spanish curriculum. In addition, of schools with no curriculum, 32 % (12/37) planned to incorporate the curriculum within the next two years. Most existing curricula were elective, not eligible for course credit, and taught by faculty or students. Teaching modalities included didactic instruction, role play, and immersion activities. Schools with the curriculum reported that the diverse patient populations in their respective service areas and/or student interest drove course development. Barriers to implementing the curriculum included lack of time in students' schedules, overly heterogeneous student language skill levels, and a lack of financial resources. Few schools reported the use of validated instruments to measure language proficiency after completion of the curriculum. Growing LEP patient populations and medical student interest have driven the implementation of medical Spanish curricula at U.S. medical schools, and more schools have plans to incorporate this curriculum in the near future. Studies are needed to reveal best practices for developing and
Lead User Design: Medication Management in Electronic Medical Records.

PubMed

Price, Morgan; Weber, Jens H; Davies, Iryna; Bellwood, Paule

2015-01-01

Improvements in medication management may lead to a reduction of preventable errors. Usability and user experience issues are common and related to achieving benefits of Electronic Medical Records (EMRs). This paper reports on a novel study that combines the lead user method with a safety engineering review to discover an innovative design for the medication management module in EMRs in primary care. Eight lead users were recruited that represented prescribers and clinical pharmacists with expertise in EMR design, evidence-based medicine, medication safety and medication research. Eight separate medication management module designs were prototyped and validated, one with each lead user. A parallel safety review of medicaiton management was completed. The findings were synthesized into a single common set of goals, activities and one interactive, visual prototype. The lead user method with safety review proved to be an effective way to elicit diverse user goals and synthesize them into a common design. The resulting design ideas focus on meeting the goals of quality, efficiency, safety, reducing the cognitive load on the user, and improving communication wih the patient and the care team. Design ideas are being adapted to an existing EMR product, providing areas for further work.
Emerging adults without a driver's license engage in more transportation-related physical activity to school/work in certain environmental contexts.

PubMed

Kar, Indra Neal; Li, Kaigang; Haynie, Denise L; Simons-Morton, Bruce G

2017-03-01

The aim was to examine the moderation effect of driving licensure status on the association between different environmental contexts and transportation-related physical activity to and from school and/or work (TPA-SW) among emerging adults. The data were from Wave 4 (n=2026, year 2013) of the NEXT Generation Health Study, an annual assessment of a nationally representative cohort across the nine U.S. Census Divisions. The outcome variable, TPA-SW, was derived from walking or cycling as modes of travel to and from school and/or work. Environmental context variables included residence, college attendance, and work status. Driving licensure status indicated whether or not participants had an independent driver's license. Poisson regression models, adjusted for potential confounders, were used to test interactions between environmental context and driving licensure. There were significant interactions between environmental context and licensure. Interaction contrasts indicated that participants who did not have a driver's license engaged in more TPA-SW than their licensed counterparts if they were living at home (β=1.10, p<0.001), not attending school (β=0.73, p<0.001), attending a technical school/community college (β=1.13, p<0.001), working 1-30 hours/week (β=0.69, p<0.001), or working 30+hours/week (β=1.12, p<0.001). Among non-workers, those without a license engaged in less TPA-SW than participants with a license (β=-0.22, p=0.05). Among emerging adults in certain environmental contexts, delayed driver licensing may result in more physical activity with the possible tradeoff of less transportation mobility. Published by Elsevier Inc.
Emerging Adults without a Driver’s License Engage in More Transportation-Related Physical Activity to School/Work in Certain Environmental Contexts

PubMed Central

Kar, Indra Neal; Li, Kaigang; Haynie, Denise L.; Simons-Morton, Bruce G.

2017-01-01

The aim was to examine the moderation effect of driving licensure status on the association between different environmental contexts and transportation-related physical activity to and from school and/or work (TPA-SW) among emerging adults. The data were from Wave 4 (n = 2,026, year 2013) of the NEXT Generation Health Study, an annual assessment of a nationally representative cohort across the nine U.S. Census Divisions. The outcome variable, TPA-SW, was derived from walking or cycling as modes of travel to and from school and/or work. Environmental context variables included residence, college attendance, and work status. Driving licensure status indicated whether or not participants had an independent driver’s license. Poisson regression models, adjusted for potential confounders, were used to test interactions between environmental context and driving licensure. There were significant interactions between environmental context and licensure. Interaction contrasts indicated that participants who did not have a driver’s license engaged in more TPA-SW than their licensed counterparts if they were living at home (β = 1.10, p < 0.001), not attending school (β = 0.73, p < 0.001), attending a technical school/community college (β = 1.13, p < 0.001), working 1–30 hours/week (β = 0.69, p < 0.001), or working 30+ hours/week (β = 1.12, p < 0.001). Among nonworkers, those without a license engaged in less TPA-SW than participants with a license (β = − 0.22, p = 0.05). Among emerging adults in certain environmental contexts, delayed driver licensing may result in more physical activity with the possible tradeoff of less transportation mobility. PMID:28011136
Chemistry, manufacturing and control (CMC) and clinical trial technical support for influenza vaccine manufacturers.

PubMed

Wahid, Rahnuma; Holt, Renee; Hjorth, Richard; Berlanda Scorza, Francesco

2016-10-26

With the support of the Biomedical Advanced Research and Development Authority (BARDA) of the US Department of Health and Human Services, PATH has contributed to the World Health Organization's (WHO's) Global Action Plan for Influenza Vaccines (GAP) by providing technical and clinical assistance to several developing country vaccine manufacturers (DCVMs). GAP builds regionally based independent and sustainable influenza vaccine production capacity to mitigate the overall global shortage of influenza vaccines. The program also ensures adequate influenza vaccine manufacturing capacity in the event of an influenza pandemic. Since 2009, PATH has worked closely with two DCVMs in Vietnam: the Institute of Vaccines and Medical Biologicals (IVAC) and VABIOTECH. Beginning in 2013, PATH also began working with Torlak Institute in Serbia; Instituto Butantan in Brazil; Serum Institute of India Private Ltd. in India; and Changchun BCHT Biotechnology Co. (BCHT) in China. The DCVMs supported under the GAP program all had existing influenza vaccine manufacturing capability and required technical support from PATH to improve vaccine yield, process efficiency, and product formulation. PATH has provided customized technical support for the manufacturing process to each DCVM based on their respective requirements. Additionally, PATH, working with BARDA and WHO, supported several DCVMs in the clinical development of influenza vaccine candidates progressing toward national licensure or WHO prequalification. As a result of the activities outlined in this review, several companies were able to make excellent progress in developing state-of-the-art manufacturing processes and completing early phase clinical trials. Licensure trials are currently ongoing or planned for several DCVMs. Copyright © 2016 Elsevier Ltd. All rights reserved.
Progress and challenges in viral vector manufacturing

PubMed Central

van der Loo, Johannes C.M.; Wright, J. Fraser

2016-01-01

Promising results in several clinical studies have emphasized the potential of gene therapy to address important medical needs and initiated a surge of investments in drug development and commercialization. This enthusiasm is driven by positive data in clinical trials including gene replacement for Hemophilia B, X-linked Severe Combined Immunodeficiency, Leber's Congenital Amaurosis Type 2 and in cancer immunotherapy trials for hematological malignancies using chimeric antigen receptor T cells. These results build on the recent licensure of the European gene therapy product Glybera for the treatment of lipoprotein lipase deficiency. The progress from clinical development towards product licensure of several programs presents challenges to gene therapy product manufacturing. These include challenges in viral vector-manufacturing capacity, where an estimated 1–2 orders of magnitude increase will likely be needed to support eventual commercial supply requirements for many of the promising disease indications. In addition, the expanding potential commercial product pipeline and the continuously advancing development of recombinant viral vectors for gene therapy require that products are well characterized and consistently manufactured to rigorous tolerances of purity, potency and safety. Finally, there is an increase in regulatory scrutiny that affects manufacturers of investigational drugs for early-phase clinical trials engaged in industry partnerships. Along with the recent increase in biopharmaceutical funding in gene therapy, industry partners are requiring their academic counterparts to meet higher levels of GMP compliance at earlier stages of clinical development. This chapter provides a brief overview of current progress in the field and discusses challenges in vector manufacturing. PMID:26519140
Humanities for medical students? A qualitative study of a medical humanities curriculum in a medical school program

PubMed Central

Wachtler, Caroline; Lundin, Susanne; Troein, Margareta

2006-01-01

Background Today, there is a trend towards establishing the medical humanities as a component of medical education. However, medical humanities programs that exist within the context of a medical school can be problematic. The aim of this study was to explore problems that can arise with the establishment of a medical humanities curriculum in a medical school program. Methods Our theoretical approach in this study is informed by derridean deconstruction and by post-structuralist analysis. We examined the ideology of the Humanities and Medicine program at Lund University, Sweden, the practical implementation of the program, and how ideology and practice corresponded. Examination of the ideology driving the humanities and medicine program was based on a critical reading of all available written material concerning the Humanities and Medicine project. The practice of the program was examined by means of a participatory observation study of one course, and by in-depth interviews with five students who participated in the course. Data was analysed using a hermeneutic editing approach. Results The ideological language used to describe the program calls it an interdisciplinary learning environment but at the same time shows that the conditions of the program are established by the medical faculty's agenda. In practice, the "humanities" are constructed, defined and used within a medical frame of reference. Medical students have interesting discussions, acquire concepts and enjoy the program. But they come away lacking theoretical structure to understand what they have learned. There is no place for humanities students in the program. Conclusion A challenge facing cross-disciplinary programs is creating an environment where the disciplines have equal standing and contribution. PMID:16519815
Twelve Tips for teaching medical professionalism at all levels of medical education.

PubMed

Al-Eraky, Mohamed Mostafa

2015-01-01

Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.
Medical civil-military operations: the deployed medical brigade's role in counterinsurgency operations.

PubMed

Bryan, Jeffrey; Miyamoto, Danelle; Holman, Vincent

2008-01-01

Medical civil-military operations are a critical combat multiplier directly supporting the counterinsurgency fight. Army Medical Department Soldiers support medical civil affairs activities at all levels from platoon to the United States Mission-Iraq (Department of State) initiatives enhancing the legitimacy of medical services in the Iraq Ministry of Health, Ministry of Defense, Ministry of the Interior, and Ministry of Justice. The civil-military operations mission of the deployed Task Force 62 Medical Brigade has also evolved into a broad mission encompassing over 120 contractors including Iraqi-American, Bilingual Bicultural Advisors-Subject Matter Experts serving as case management liaison officers and medical trainers, as well as Iraqi Advisor Task Force members providing medical atmospherics, assessments, training, and the overall management of Iraqi linguists supporting all level III medical facilities.
Medication reconciliation accuracy and patient understanding of intended medication changes on hospital discharge.

PubMed

Ziaeian, Boback; Araujo, Katy L B; Van Ness, Peter H; Horwitz, Leora I

2012-11-01

Adverse drug events after hospital discharge are common and often serious. These events may result from provider errors or patient misunderstanding. To determine the prevalence of medication reconciliation errors and patient misunderstanding of discharge medications. Prospective cohort study Patients over 64 years of age admitted with heart failure, acute coronary syndrome or pneumonia and discharged to home. We assessed medication reconciliation accuracy by comparing admission to discharge medication lists and reviewing charts to resolve discrepancies. Medication reconciliation changes that did not appear intentional were classified as suspected provider errors. We assessed patient understanding of intended medication changes through post-discharge interviews. Understanding was scored as full, partial or absent. We tested the association of relevance of the medication to the primary diagnosis with medication accuracy and with patient understanding, accounting for patient demographics, medical team and primary diagnosis. A total of 377 patients were enrolled in the study. A total of 565/2534 (22.3 %) of admission medications were redosed or stopped at discharge. Of these, 137 (24.2 %) were classified as suspected provider errors. Excluding suspected errors, patients had no understanding of 142/205 (69.3 %) of redosed medications, 182/223 (81.6 %) of stopped medications, and 493 (62.0 %) of new medications. Altogether, 307 patients (81.4 %) either experienced a provider error, or had no understanding of at least one intended medication change. Providers were significantly more likely to make an error on a medication unrelated to the primary diagnosis than on a medication related to the primary diagnosis (odds ratio (OR) 4.56, 95 % confidence interval (CI) 2.65, 7.85, p<0.001). Patients were also significantly more likely to misunderstand medication changes unrelated to the primary diagnosis (OR 2.45, 95 % CI 1.68, 3.55), p<0.001). Medication reconciliation and
[Unravelling medical leadership].

PubMed

Voogt, Judith J; van Rensen, Elizabeth L J; Noordegraaf, Mirko; Schneider, Margriet M E

2015-01-01

Medical leadership is a popular topic in the Netherlands, and several interest groups now incorporate medical leadership into postgraduate medical education. However, there is no consensus on what this concept entails. By conducting a discourse analysis, a qualitative method which uses language and text to reveal existing viewpoints, this article reveals three perspectives on medical leadership: administrative leadership, leadership within organisations and leadership within each doctor's daily practice. Text analysis shows that the first two perspectives refer to medical leadership mainly in a defensive manner: by demonstrating medical leadership doctors could 'take the lead' once again; patient care only seems to play a small part in the process. These perspectives are not free of consequences, they will determine how the medical profession is constructed. For this reason, it is argued that there should be more emphasis on the third perspective, in which the quality of care for patients is of primary importance.

Should PGY-1 Be Mandatory in Dental Education? Two Viewpoints: Viewpoint 1: PGY-1 Provides Benefits That Support Making It Mandatory and Viewpoint 2: PGY-1 Should Be Available for Dental Graduates But Not Mandatory.

PubMed

Dhar, Vineet; Glascoe, Alison; Esfandiari, Shahrokh; Williams, Kelly B; McQuistan, Michelle R; Stevens, Mark R

2016-11-01

This Point/Counterpoint considers whether a general dentistry postgraduate year one (PGY-1) residency should be required for all new graduates who do not pursue specialty training. Currently, New York and Delaware require PGY-1 for dental licensure, while other states offer it as an alternative to a clinical examination for obtaining licensure. Viewpoint 1 supports the position that PGY-1 should be mandatory by presenting evidence that PGY-1 residencies fulfill new graduates' need for additional clinical training, enhance their professionalism and practice management skills, and improve access to care. The authors also discuss two barriers-the limited number of postdoctoral positions and the high cost-and suggest ways to overcome them. In contrast, Viewpoint 2 opposes mandatory PGY-1 training. While these authors consider the same core concepts as Viewpoint 1 (education and access to care), they present alternative methods for addressing perceived educational shortcomings in predoctoral curricula. They also examine the competing needs of underserved populations and residents and the resulting impact on access to care, and they discuss the potential conflict of interest associated with asking PGY-1 program directors to assess their residents' competence for licensure.
Use of a pretest strategy for physical therapist assistant programs to predict success rate on the national physical therapy exam.

PubMed

Sloas, Stacey B; Keith, Becky; Whitehead, Malcolm T

2013-01-01

This study investigated a pretest strategy that identified physical therapist assistant (PTA) students who were at risk of failure on the National Physical Therapy Examination (NPTE). Program assessment data from five cohorts of PTA students (2005-2009) were used to develop a stepwise multiple regression formula that predicted first-time NPTE licensure scores. Data used included the Nelson-Denny Reading Test, grades from eight core courses, grade point average upon admission to the program, and scores from three mock NPTE exams given during the program. Pearson correlation coefficients were calculated between each of the 15 variables and NPTE scores. Stepwise multiple regression analysis was performed using data collected at the ends of the first, second, and third (final) semesters of the program. Data from the class of 2010 were then used to validate the formula. The end-of-program formula accounted for the greatest variance (57%) in predicted scores. Those students scoring below a predicted scaled score of 620 were identified to be at risk of failure of the licensure exam. These students were counseled, and a remedial plan was developed based on regression predictions prior to them sitting for the licensure exam.
NCLEX-RN performance: predicting success on the computerized examination.

PubMed

Beeman, P B; Waterhouse, J K

2001-01-01

Since the adoption of the Computerized Adaptive Testing (CAT) format of the National Certification Licensure Examination for Registered Nurses (NCLEX-RN), no studies have been reported in the literature on predictors of successful performance by baccalaureate nursing graduates on the licensure examination. In this study, a discriminant analysis was used to identify which of 21 variables can be significant predictors of success on the CAT NCLEX-RN. The convenience sample consisted of 289 individuals who graduated from a baccalaureate nursing program between 1995 and 1998. Seven significant predictor variables were identified. The total number of C+ or lower grades earned in nursing theory courses was the best predictor, followed by grades in several individual nursing courses. More than 93 per cent of graduates were correctly classified. Ninety-four per cent of NCLEX "passes" were correctly classified, as were 92 per cent of NCLEX failures. This degree of accuracy in classifying CAT NCLEX-RN failures represents a marked improvement over results reported in previous studies of licensure examinations, and suggests the discriminant function will be helpful in identifying future students in danger of failure. J Prof Nurs 17:158-165, 2001. Copyright 2001 by W.B. Saunders Company
Developing a competency-based medical education curriculum for the core basic medical sciences in an African Medical School

PubMed Central

Olopade, Funmilayo Eniola; Adaramoye, Oluwatosin Adekunle; Raji, Yinusa; Fasola, Abiodun Olubayo; Olapade-Olaopa, Emiola Oluwabunmi

2016-01-01

The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the “old” curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula successfully. The modifications to the teaching and assessment of the core basic medical science subjects have resulted in improved learning and performance at the final examinations. PMID:27486351
Developing a competency-based medical education curriculum for the core basic medical sciences in an African Medical School.

PubMed

Olopade, Funmilayo Eniola; Adaramoye, Oluwatosin Adekunle; Raji, Yinusa; Fasola, Abiodun Olubayo; Olapade-Olaopa, Emiola Oluwabunmi

2016-01-01

The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the "old" curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula successfully. The modifications to the teaching and assessment of the core basic medical science subjects have resulted in improved learning and performance at the final examinations.
Medication deserts: survey of neighborhood disparities in availability of prescription medications

PubMed Central

2012-01-01

Background Only a small amount of research has focused on the relationship between socio-economic status (SES) and geographic access to prescription medications at community pharmacies in North America and Europe. To examine the relationship between a community’s socio-economic context and its residents’ geographic access to common medications in pharmacies, we hypothesized that differences are present in access to pharmacies across communities with different socio-economic environments, and in availability of commonly prescribed medications within pharmacies located in communities with different socio-economic status. Methods We visited 408 pharmacies located in 168 socio-economically diverse communities to assess the availability of commonly prescribed medications. We collected the following information at each pharmacy visited: hours of operation, pharmacy type, in-store medication availability, and the cash price of the 13 most commonly prescribed medications. We calculated descriptive statistics for the sample and fitted a series of hierarchical linear models to test our hypothesis that the in-stock availability of medications differs by the socio-economic conditions of the community. This was accomplished by modeling medication availability in pharmacies on the socio-economic factors operating at the community level in a socio-economically devise urban area. Results Pharmacies in poor communities had significantly higher odds of medications being out of stock, OR=1.24, 95% CI [1.02, 1.52]. There was also a significant difference in density of smaller, independent pharmacies with very limited stock and hours of operation, and larger, chain pharmacies in poor communities as compared to the middle and low-poverty communities. Conclusions The findings suggest that geographic access to a neighborhood pharmacy, the type of pharmacy, and availability of commonly prescribed medications varies significantly across communities. In extreme cases, entire communities
Patient safety awareness among Undergraduate Medical Students in Pakistani Medical School

PubMed Central

Kamran, Rizwana; Bari, Attia; Khan, Rehan Ahmed; Al-Eraky, Mohamed

2018-01-01

Objective: To measure the level of awareness of patient safety among undergraduate medical students in Pakistani Medical School and to find the difference with respect to gender and prior experience with medical error. Methods: This cross-sectional study was conducted at the University of Lahore (UOL), Pakistan from January to March 2017, and comprised final year medical students. Data was collected using a questionnaire ‘APSQ- III’ on 7 point Likert scale. Eight questions were reverse coded. Survey was anonymous. SPSS package 20 was used for statistical analysis. Results: Questionnaire was filled by 122 students, with 81% response rate. The best score 6.17 was given for the ‘team functioning’, followed by 6.04 for ‘long working hours as a cause of medical error’. The domains regarding involvement of patient, confidence to report medical errors and role of training and learning on patient safety scored high in the agreed range of >5. Reverse coded questions about ‘professional incompetence as an error cause’ and ‘disclosure of errors’ showed negative perception. No significant differences of perceptions were found with respect to gender and prior experience with medical error (p= >0.05). Conclusion: Undergraduate medical students at UOL had a positive attitude towards patient safety. However, there were misconceptions about causes of medical errors and error disclosure among students and patient safety education needs to be incorporated in medical curriculum of Pakistan. PMID:29805398
MEDRIS: The Problem Oriented Electronic Medical Record in Medical Education

PubMed Central

Rifat, Sami F.; Robert, Shanthi; Trace, David; Prakash, Sanjeev; Naeymi-Rad, Frank; Barnett, David; Pannicia, Gregory; Hammergren, David; Carmony, Lowell; Evens, Martha

1990-01-01

MEDRIS (The Medical Record Interface System) is an object oriented HyperCard interface designed to help physicians enter patient information as comfortably and naturally as possible. It can function as a stand alone system producing its own reports or serve as an interface to a medical expert system (e.g., MEDAS). MEDRIS plays an important role in the clinical education of medical students at the Chicago Medical School. MEDRIS portrays an intuitive, graphically oriented system that will provide a learning environment for the problem oriented medical record (POMR) that forms the basis of the structure of the history and physical exam. The enthusiasm shown by the medical students for this project has garnered support for including MEDRIS in the curriculum of the Introduction to Clinical Medicine course this semester. MEDRIS, developed using HyperCard, can be used as a tool not only for teaching POMR and physical diagnosis, but also computer literacy.
Computer-Based Medical System

NASA Technical Reports Server (NTRS)

1998-01-01

SYMED, Inc., developed a unique electronic medical records and information management system. The S2000 Medical Interactive Care System (MICS) incorporates both a comprehensive and interactive medical care support capability and an extensive array of digital medical reference materials in either text or high resolution graphic form. The system was designed, in cooperation with NASA, to improve the effectiveness and efficiency of physician practices. The S2000 is a MS (Microsoft) Windows based software product which combines electronic forms, medical documents, records management, and features a comprehensive medical information system for medical diagnostic support and treatment. SYMED, Inc. offers access to its medical systems to all companies seeking competitive advantages.
The teaching of medical ethics to medical students.

PubMed Central

Glick, S M

1994-01-01

Teaching medical ethics to medical students in a pluralistic society is a challenging task. Teachers of ethics have obligations not just to teach the subject matter but to help create an academic environment in which well motivated students have reinforcement of their inherent good qualities. Emphasis should be placed on the ethical aspects of daily medical practice and not just on the dramatic dilemmas raised by modern technology. Interdisciplinary teaching should be encouraged and teaching should span the entire duration of medical studies. Attention should be paid particularly to ethical problems faced by the students themselves, preferably at the time when the problems are most on the students' minds. A high level of academic demands, including critical examination of students' progress is recommended. Finally, personal humility on the part of teachers can help set a good example for students to follow. PMID:7861430
Medication/Drug Allergy

MedlinePlus

... Training Home Conditions Medication/Drug Allergy Medication/Drug Allergy Make an Appointment Find a Doctor Ask a ... risk for adverse reactions to medications. Facts about Allergies The tendency to develop allergies may be inherited. ...
Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative

DTIC Science & Technology

2007-06-01

AD_________________ Award Number: W81XWH-06-2-0045 TITLE: Mass Medication Clinic (MMC) Patient ...SUBTITLE 5a. CONTRACT NUMBER Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative 5b. GRANT NUMBER W81XWH-06-2...sections will describe the events, results, and accomplishments of this study. With validation through this project the Patient Medical Assistant
Why change habits? Early modern medical innovation between medicalisation and medical culture.

PubMed

Loetz, Francisca

2010-01-01

Based on a discussion of the concept of medicalisation and medical culture in Anglo-American, French-, and German-speaking historiography the paper argues that medical innovation in Europe from the sixteenth to the mid-nineteenth century should be approached in a different way. Instead of asking from the perspective of a too narrow concept of medicalisation why medical innovations were rejected by the population, (medical) historians should analyse medical culture and ask why people should have changed their health and illness behaviour. This conceptual argument is deduced from four empirical examples: the introduction of smallpox vaccination, "medical police," the problem of medical professionalization, and the questions arising around the relations between the healthy/sick and their practitioners.
"Medical education is the ugly duckling of the medical world" and other challenges to medical educators' identity construction: a qualitative study.

PubMed

Sabel, Esther; Archer, Julian

2014-11-01

The authors first aimed to ascertain how the Academy of Medical Educators (AoME) could develop and support early career medical educators. They expanded their study to explore the challenges to defining medical education as a discipline because of a lack of collective identity among educators. In 2010, the authors and members of the AoME Early Careers Working Group conducted focus groups with early career medical educators (clinicians and scientists) and interviews with senior medical educators in the United Kingdom. All focus groups and interviews were audio recorded and transcribed verbatim. The authors used an interpretative phenomenological analysis to explore how medical educators described events or phenomena in their careers. They inductively identified overarching theoretical perspectives to understand observed phenomena drawing on social identity theories. The authors conducted nine focus groups with 34 participants in total and six interviews. Participants identified fundamental challenges to their identity as a medical educator; they understood their medical education role to be secondary to their primary role as clinician or scientist. Participants noted that they had not developed an emotional attachment to medical education. Their relationship with the field remained at an operational level, revolving around roles and responsibilities. Medical educators' social cohesion is threatened by their sense that educators are poor relations compared with scientists and clinicians. While medical educators' identities may be in crisis, they also are changing, a change needed for medical education, medical education research, the practice of medicine, and ultimately patient care.
Medical School Research Pipeline: Medical Student Research Experience in Psychiatry

ERIC Educational Resources Information Center

Balon, Richard; Heninger, George; Belitsky, Richard

2006-01-01

Objective: The authors discuss the importance of introducing research training in psychiatry and neurosciences to medical students. Methods: A review of existing models of research training in psychiatry with focus on those providing research training to medical students is presented. Results: Two research-training models for medical students that…
[Medical negligence].

PubMed

Zipper, St G

2016-06-01

Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.
Medical Training Experience and Expectations Regarding Future Medical Practice of Medical Students at the University of Cape Verde.

PubMed

Delgado, Antonio Pedro; Soares Martins, Antonieta; Ferrinho, Paulo

2017-10-31

Cape Verde is a small insular developing state. Its first experience of undergraduate medical education began in October 2015. The purpose of this paper is to describe and analyze the professional expectations and profile of the first class of medical students at the University of Cape Verde. A piloted, standardized questionnaire, with closed and open-ended questions, was distributed to registered medical students attending classes on the day of the survey. All data were analyzed using SPSS. Students decided to study medicine in their mid-teens with relatives and friends having had significant influence over their decisions. Other major reasons for choosing medical training include "to take care of other people", "fascination for the subject matters of medicine" and "I have always wanted to". The degree of feminization of the student population is extremely high (20/25; 80.0%). Medical students are in general satisfied with the training program, and have expectations that the training received will allow them to be good professionals. Nevertheless, they consider the course too theoretical. Medical students know that this represents an opportunity for them to contribute to public welfare. Nonetheless, their expectations are to combine public sector practice with private work. Medical students come mostly from Santiago Island where the Capital of the Country is located. They still do not know about their future area of specialization. But all of those who want to specialize want to do so abroad. They mostly expect to follow hospital careers rather than health administration or family and community medicine. This study contributes to the growing body of knowledge about medical students' difficulties and expectations regarding medical schools or curriculums in lusophone countries. The decision to invest in the training of local physicians is justified by the need to be less dependent on foreigners. Local postgraduate medical training programs are already
Development of national competency-based learning objectives "Medical Informatics" for undergraduate medical education.

PubMed

Röhrig, R; Stausberg, J; Dugas, M

2013-01-01

The aim of this project is to develop a catalogue of competency-based learning objectives "Medical Informatics" for undergraduate medical education (abbreviated NKLM-MI in German). The development followed a multi-level annotation and consensus process. For each learning objective a reason why a physician needs this competence was required. In addition, each objective was categorized according to the competence context (A = covered by medical informatics, B = core subject of medical informatics, C = optional subject of medical informatics), the competence level (1 = referenced knowledge, 2 = applied knowledge, 3 = routine knowledge) and a CanMEDS competence role (medical expert, communicator, collaborator, manager, health advocate, professional, scholar). Overall 42 objectives in seven areas (medical documentation and information processing, medical classifications and terminologies, information systems in healthcare, health telematics and telemedicine, data protection and security, access to medical knowledge and medical signal-/image processing) were identified, defined and consented. With the NKLM-MI the competences in the field of medical informatics vital to a first year resident physician are identified, defined and operationalized. These competencies are consistent with the recommendations of the International Medical Informatics Association (IMIA). The NKLM-MI will be submitted to the National Competence-Based Learning Objectives for Undergraduate Medical Education. The next step is implementation of these objectives by the faculties.
Pediatric Nurses' Perceptions of Medication Safety and Medication Error: A Mixed Methods Study.

PubMed

Alomari, Albara; Wilson, Val; Solman, Annette; Bajorek, Beata; Tinsley, Patricia

2018-06-01

This study aims to outline the current workplace culture of medication practice in a pediatric medical ward. The objective is to explore the perceptions of nurses in a pediatric clinical setting as to why medication administration errors occur. As nurses have a central role in the medication process, it is essential to explore nurses' perceptions of the factors influencing the medication process. Without this understanding, it is difficult to develop effective prevention strategies aimed at reducing medication administration errors. Previous studies were limited to exploring a single and specific aspect of medication safety. The methods used in these studies were limited to survey designs which may lead to incomplete or inadequate information being provided. This study is phase 1 on an action research project. Data collection included a direct observation of nurses during medication preparation and administration, audit based on the medication policy, and guidelines and focus groups with nursing staff. A thematic analysis was undertaken by each author independently to analyze the observation notes and focus group transcripts. Simple descriptive statistics were used to analyze the audit data. The study was conducted in a specialized pediatric medical ward. Four key themes were identified from the combined quantitative and qualitative data: (1) understanding medication errors, (2) the busy-ness of nurses, (3) the physical environment, and (4) compliance with medication policy and practice guidelines. Workload, frequent interruptions to process, poor physical environment design, lack of preparation space, and impractical medication policies are identified as barriers to safe medication practice. Overcoming these barriers requires organizations to review medication process policies and engage nurses more in medication safety research and in designing clinical guidelines for their own practice.
Medical Marijuana Users are More Likely to Use Prescription Drugs Medically and Nonmedically.

PubMed

Caputi, Theodore L; Humphreys, Keith

2018-04-17

Previous studies have found a negative population-level correlation between medical marijuana availability in US states, and trends in medical and nonmedical prescription drug use. These studies have been interpreted as evidence that use of medical marijuana reduces medical and nonmedical prescription drug use. This study evaluates whether medical marijuana use is a risk or protective factor for medical and nonmedical prescription drug use. Simulations based upon logistic regression analyses of data from the 2015 National Survey on Drug Use and Health were used to compute associations between medical marijuana use, and medical and nonmedical prescription drug use. Adjusted risk ratios (RRs) were computed with controls added for age, sex, race, health status, family income, and living in a state with legalized medical marijuana. Medical marijuana users were significantly more likely (RR 1.62, 95% confidence interval [CI] 1.50-1.74) to report medical use of prescription drugs in the past 12 months. Individuals who used medical marijuana were also significantly more likely to report nonmedical use in the past 12 months of any prescription drug (RR 2.12, 95% CI 1.67-2.62), with elevated risks for pain relievers (RR 1.95, 95% CI 1.41-2.62), stimulants (RR 1.86, 95% CI 1.09-3.02), and tranquilizers (RR 2.18, 95% CI 1.45-3.16). Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.

Associations among medication regimen complexity, medical specialty, and medication possession ratio in newly diagnosed hypertensive patients

PubMed Central

Ho, Chen-Pei; Yeh, Jih-I; Wen, Shu-Hui; Lee, Tony Jer-Fu

2017-01-01

Abstract The aim of this study was to explore the associations among the medication regimen complexity index (MRCI), medical specialty, and medication possession ratio (MPR) in newly diagnosed hypertensive patients. Data from 19,859 newly diagnosed hypertensive patients were collected from 2,000,000 random samples of the National Health Insurance Research Database in Taiwan. All study participants were followed for 1 year after the first diagnosis of hypertension. MPR was defined as total days of antihypertensive drugs supplied/365 days. MRCI was calculated on the basis of the type of dosage forms, dosing frequency, and additional directions for use of antihypertensive drugs. Patients were further restricted to those who visited the same medical specialty to examine specialty-specific variations in the MRCI and MPR. The mean MPR was 54.83%, and the sample sizes for the low-, medium-, and high-MPR groups were 9806 (49.38%), 4619 (23.26%), and 5434 (27.36%), respectively. More than 50% of the patients visited the same medical specialty during the 1-year follow-up. The mean MRCI was 3.64; the cardiology specialty had the highest MRCI, and the family medicine specialty had the lowest. Multiple linear regression analyses showed that MRCI was negatively associated with MPR (β = −7.75, P ≤ .01) whether or not the patients visited the same medical specialty. For the patients who visited the same medical specialty, those treated by endocrinology and metabolism specialists had a significantly higher MPR (β = 9.87, P ≤ .01) than that of those treated by family medicine specialists. MRCI and medical specialty were both significantly associated with the MPR of newly diagnosed hypertensive patients. PMID:29137042
The depiction of medical education in medical school catalogs.

PubMed

Kohn, M; Wear, D

1994-01-01

Medical educators bear responsibility for the informational materials that their institutions use to communicate with potential applicants. These documents, because they are often the first official correspondence that prospective students receive, may be influential in shaping students' expectations. In March 1990 all North American medical schools that awarded MD or DO degrees were requested to send their catalogs and courses of study to the authors. In response came 175 documents, with nearly all the schools represented at least once. The photographs and other visual images in these documents were then analyzed from the perspective of a hypothetical applicant who perused what his or her initial request for information had produced. Nearly 3,400 images were analyzed and categorized according to content and stylistic approach. Two basic stylistic approaches were found: stylized and documentary. Few documents used exclusively one or the other approach, as the approaches represent poles along a continuum. The stylized approach portrays medical education as a product to be sold, whereas the documentary approach candidly tells the story of medical education. The authors conclude that the documentary approach is a more morally responsible way for schools to communicate with individuals who are in the beginning stages of building their mental images of medical education and medical care.
Practice, training, and research in neuropsychology in mainland China: challenges and opportunities.

PubMed

Chan, Raymond C K; Wang, Ya; Wang, Yi; Cheung, Eric F C

2016-11-01

This is an invited paper for a special issue. The objective was to review history, educational and training pathways, licensure and board certification, practice and compensation, and unique aspects of, or challenges faced by, neuropsychology in mainland China. Historical, scientific, and clinical literatures were reviewed and integrated. The history of neuropsychology in mainland China is traced back to the late 1930s. Educational pathways have not yet been fully formalized. Clinical practice generally occurs within rehabilitation settings, and medical license is required. The main challenge lies in the establishment of training guidelines and the expansion of neuropsychology to meet the tremendous needs of a large nation. Although the development and status of psychology has gradually gained momentum in mainland China, the development of neuropsychology has not shown significant advancement since the late 1930s.
AOA Approval of ACGME Internship and Residency Training.

PubMed

Duffy, Thomas; Martinez, Bulmaro

2011-04-01

Since the 1970s, the American Osteopathic Association (AOA) has provided a means for osteopathic physicians to apply for approval of their postdoctoral training in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Osteopathic physicians who trained in ACGME programs need this approval to meet AOA licensure and board certification requirements. The AOA approves ACGME residency training with several different approval processes. Approval of the first year of postdoctoral training occurs through Resolution 42, specialty approval (for specialties in which the first year of training is part of the residency), or federal or military training approval. For residency training, the AOA verifies successful completion of an ACGME training program before approving the training. The AOA is using customer surveys and online applications to improve the review process for applicants.
A Mis-recognized Medical Vocabulary Correction System for Speech-based Electronic Medical Record

PubMed Central

Seo, Hwa Jeong; Kim, Ju Han; Sakabe, Nagamasa

2002-01-01

Speech recognition as an input tool for electronic medical record (EMR) enables efficient data entry at the point of care. However, the recognition accuracy for medical vocabulary is much poorer than that for doctor-patient dialogue. We developed a mis-recognized medical vocabulary correction system based on syllable-by-syllable comparison of speech text against medical vocabulary database. Using specialty medical vocabulary, the algorithm detects and corrects mis-recognized medical vocabularies in narrative text. Our preliminary evaluation showed 94% of accuracy in mis-recognized medical vocabulary correction.
Continuing medical education.

PubMed

Todd, D

1987-04-01

With the rapid advances in medical science and increasing complexities of patient care, the need for continuing medical education (CME) is widely accepted by the profession. CME follows general and higher professional training, and should be a life long process. Teaching hospitals and postgraduate professional institutions play vital roles in organising, promoting, and monitoring this activity. CME directorates should be established. University authorities must recognise the important role of medical teachers in postgraduate and continuing medical education, and the staff establishment and terms of service should be held regularly. Medical libraries should have easy borrowing facilities. Self-assessment and audio-visual material are particularly helpful to the busy practitioner and inexpensive local or regional journals of quality can provide pertinent and up-to-date information. All charges for attending scientific meetings and educational material should be tax deductible or subsidized. The effectiveness of CME is difficult to assess and participation is almost impossible to enforce. Much depends on the standard of medical practice wanted by society. Recertification of general practitioners or specialists poses many problems. On the other hand, completion of self-assessment programmes, active participation at medical meetings, contributions to scientific literature, and membership of medical societies with built-in peer review could be monitored and regularly used to evaluate professional status.
Validation of current procedural terminology codes for rotavirus vaccination among infants in two commercially insured US populations.

PubMed

Hoffman, Veena; Everage, Nicholas J; Quinlan, Scott C; Skerry, Kathleen; Esposito, Daina; Praet, Nicolas; Rosillon, Dominique; Holick, Crystal N; Dore, David D

2016-12-01

We validated procedure codes used in health insurance claims for reimbursement of rotavirus vaccination by comparing claims for monovalent live-attenuated human rotavirus vaccine (RV1) and live, oral pentavalent rotavirus vaccine (RV5) to medical records. Using administrative data from two commercially insured United States populations, we randomly sampled vaccination claims for RV1 and RV5 from a cohort of infants aged less than 1 year from an ongoing post-licensure safety study of rotavirus vaccines. The codes for RV1 and RV5 found in claims were confirmed through medical record review. The positive predictive value (PPV) of the Current Procedural Terminology codes for RV1 and RV5 was calculated as the number of medical record-confirmed vaccinations divided by the number of medical records obtained. Medical record review confirmed 92 of 104 RV1 vaccination claims (PPV: 88.5%; 95% CI: 80.7-93.9%) and 98 of 113 RV5 vaccination claims (PPV: 86.7%; 95% CI: 79.1-92.4%). Among the 217 medical records abstracted, only three (1.4%) of vaccinations were misclassified in claims-all were RV5 misclassified as RV1. The medical records corresponding to 9 RV1 and 15 RV5 claims contained insufficient information to classify the type of rotavirus vaccine. Misclassification of rotavirus vaccines is infrequent within claims. The PPVs reported here are conservative estimates as those with insufficient information in the medical records were assumed to be incorrectly coded in the claims. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Patient and medication factors associated with preventable medication waste and possibilities for redispensing.

PubMed

Bekker, C L; van den Bemt, B J F; Egberts, A C G; Bouvy, M L; Gardarsdottir, H

2018-05-02

Background Knowledge on factors related to preventable medication waste and waste-reducing interventions, including redispensing unused medications, is needed to maximise effectiveness. Objective To assess patient and medication factors associated with preventable medication waste and possibilities for redispensing unused medications. Setting Dutch community pharmacies. Methods In this cross-sectional study, pharmacy-staff registered patient and medication characteristics of prescription medications returned to 41 Dutch community pharmacies during 1 week in 2014. Medications were classified as preventable waste if the remaining amount could have been prevented and as theoretically eligible for redispensing if the package was unopened, undamaged and ≥ 6 months until the expiry date. Associations were analysed using multivariate logistic regression. Main outcome measures Proportion of medications classified as preventable waste and as eligible for redispensing, including factors associated with these medications. Results Overall, 279 persons returned 759 (low-cost) medications, and 39.3% was classified as preventable waste. These medications were more frequently used by men than women (OR; 1.7[1.2-2.3]) and by older (> 65 years) than younger patients (OR; 1.4[1.0-2.0]). Medications dispensed for longer periods were more often unnecessary wasted (1-3 months OR; 1.8[1.1-3.0], > 3 months 3.2[1.5-6.9]). Of all returned medications, 19.1% was eligible for redispensing. These medications were more frequently used by men than women (OR; 1.9[1.3-2.9]). Medications chronically used were more frequently eligible for redispensing than acute use (OR; 2.1[1.0-4.3]), and used for longer periods (1-3 months OR; 4.6[2.3-8.9], > 3 months 7.8[3.3-18.5]). Conclusions Over one-third of waste due to medications returned to community pharmacies can be prevented. One-fifth of returned medications can be redispensed, but this seems less interesting from an economic
Knowledge, Attitude and Practice of Self-Medication Among Basic Science Undergraduate Medical Students in a Medical School in Western Nepal.

PubMed

Gyawali, Sudesh; Shankar, P Ravi; Poudel, Phanindra Prasad; Saha, Archana

2015-12-01

Studies have shown self-medication to be common among medical students. These studies are however, few in Nepal. The present study assessed knowledge, attitude, and practice of self-medication among second and fourth semesters' undergraduate medical students and studied differences in knowledge and attitude (if any) among different subgroups of the respondents. A cross-sectional survey was conducted using a questionnaire among basic science medical students of Manipal College of Medical Sciences, Nepal. Semester of study, gender, age, nationality, and the profession of their parents were noted. Students' knowledge and attitude about self-medication was studied by noting their degree of agreement with a set of 40 statements using a Likert-type scale. The average scores and frequency of occurrence of particular behaviors among different categories of respondents were compared using appropriate statistical tests. Two hundred and seventy-six of the 295 (93.6%) students participated. The mean (SD) knowledge, attitude, and total scores were 74.54 (6.92), 67.18 (5.68), and 141.73 (10.76) with maximum possible scores 100, 100 and 200, respectively. There was no significant difference in scores according to respondents' gender, age, and the profession of their parents. However, the mean knowledge, attitude and total scores were significantly different among students of different nationalities. Mean scores of fourth semester students were significantly higher compared to second semester students. There were differences in knowledge and total scores among students of different nationalities. Eighty two percent of respondents had self-medicated during the one year period preceding the study; 149 respondents (54%) shared that previous experience with the medicine was one of the information sources for self-medication. Prevalence of self-medication among respondents according to semester of study, gender, age, and profession of the parents was not significantly different. The
Issues of medical necessity: a medical director's guide to good faith adjudication.

PubMed

Quinn, C

1997-06-01

The term medical necessity is difficult to define, a problem for insurers who need to clearly describe what is and is not covered in their contracts with subscribers. An unclear, vague definition of medical necessity leaves insurers vulnerable to litigation by subscribers denied care deemed medically unnecessary. To avoid lawsuits, insurers must make every effort to educate their subscribers about their medical coverage, going beyond merely providing a lengthy subscriber handbook. In decisions on medical necessity, medical directors at insurance companies play a key role. They can bolster the insurer's position in denial-of-care cases in numerous ways, including keeping meticulous records, eliminating unreasonable financial incentives, maintaining a claims denial database, and consulting with other insurers to achieve a consensus on medical necessity.
Does medical education erode medical trainees' ethical attitude and behavior?

PubMed Central

Yavari, Neda

2016-01-01

In the last few years, medical education policy makers have expressed concern about changes in the ethical attitude and behavior of medical trainees during the course of their education. They claim that newly graduated physicians (MDs) are entering residency years with inappropriate habits and attitudes earned during their education. This allegation has been supported by numerous research on the changes in the attitude and morality of medical trainees. The aim of this paper was to investigate ethical erosion among medical trainees as a serious universal problem, and to urge the authorities to take urgent preventive and corrective action. A comparison with the course of moral development in ordinary people from Kohlberg’s and Gilligan's points of view reveals that the growth of ethical attitudes and behaviors in medical students is stunted or even degraded in many medical schools. In the end, the article examines the feasibility of teaching ethics in medical schools and the best approach for this purpose. It concludes that there is considerable controversy among ethicists on whether teaching ethical virtues is plausible at all. Virtue-based ethics, principle-based ethics and ethics of care are approaches that have been considered as most applicable in this regard. PMID:28050246
Chat reference service in medical libraries: part 2--Trends in medical school libraries.

PubMed

Dee, Cheryl R

2003-01-01

An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.
Formal verification of software-based medical devices considering medical guidelines.

PubMed

Daw, Zamira; Cleaveland, Rance; Vetter, Marcus

2014-01-01

Software-based devices have increasingly become an important part of several clinical scenarios. Due to their critical impact on human life, medical devices have very strict safety requirements. It is therefore necessary to apply verification methods to ensure that the safety requirements are met. Verification of software-based devices is commonly limited to the verification of their internal elements without considering the interaction that these elements have with other devices as well as the application environment in which they are used. Medical guidelines define clinical procedures, which contain the necessary information to completely verify medical devices. The objective of this work was to incorporate medical guidelines into the verification process in order to increase the reliability of the software-based medical devices. Medical devices are developed using the model-driven method deterministic models for signal processing of embedded systems (DMOSES). This method uses unified modeling language (UML) models as a basis for the development of medical devices. The UML activity diagram is used to describe medical guidelines as workflows. The functionality of the medical devices is abstracted as a set of actions that is modeled within these workflows. In this paper, the UML models are verified using the UPPAAL model-checker. For this purpose, a formalization approach for the UML models using timed automaton (TA) is presented. A set of requirements is verified by the proposed approach for the navigation-guided biopsy. This shows the capability for identifying errors or optimization points both in the workflow and in the system design of the navigation device. In addition to the above, an open source eclipse plug-in was developed for the automated transformation of UML models into TA models that are automatically verified using UPPAAL. The proposed method enables developers to model medical devices and their clinical environment using clinical workflows as one
A Smartwatch-Driven Medication Management System Compliant to the German Medication Plan.

PubMed

Keil, Andreas; Gegier, Konstantin; Pobiruchin, Monika; Wiesner, Martin

2016-01-01

Medication adherence is an important factor for the outcome of medical therapies. To support high adherence levels, smartwatches can be used to assist the patient. However, a successful integration of such devices into clinicians' or general practitioners' information systems requires the use of standards. In this paper, a medication management system supplied with smartwatch generated feedback events is presented. It allows physicians to manage their patients' medications and track their adherence in real time. Moreover, it fosters interoperability via a ISO/IEC 16022 data matrix which encodes related medication data in compliance with the German Medication Plan specification.
STS-3 medical report

NASA Technical Reports Server (NTRS)

Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

1982-01-01

The medical operations report for STS-3, which includes a review of the health of the crew before, during, and immediately after the third Shuttle orbital flight is presented. Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical 'kit' carried in flight, tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results, hematology and immunology analyses, medical microbiology, food and nutrition, potable water, shuttle toxicology, radiological health, and cabin acoustic noise. Environmental effects of shuttle launch and landing medical information management, and management, planning, and implementation of the medical program are also dicussed.
Medical Student Attitudes about Mental Illness: Does Medical-School Education Reduce Stigma?

ERIC Educational Resources Information Center

Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep

2012-01-01

Background: Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mental illness, as compared with…
[The medical technologist as a key professional in medical care in the 21st century].

PubMed

Iwatani, Yoshinori

2008-10-01

The dynamic healthcare environment of Japan, including the rapidly aging population and the requirement of highly sophisticated and diverse medical care, induces strict financial conditions and increases the number of those seeking medical care. Therefore, medical professionals are now required to provide safe and effective medical care with limited medical resources. Recently, Japanese medical institutions have introduced the total quality management system, which was developed for better business management, to promote safe and effective management. However, there are two major drawbacks with the introduction of this system in the sector of medical care in Japan. First, the standardization of medical skills of medical professionals is greatly affected due to the presence of different education systems for the same medical profession except for medical doctors and pharmacologists. The education system for major medical professionals, such as nurses and medical and radiological technologists, must be standardized based on the university norms. Second, the knowledge-creating process among the medical professionals has been associated with many problems. The specialized fields are quite different among medical professionals. Therefore, common specialized fields must be established among major medical professions based on the specialization of medical doctors to promote their communication and better understanding. Considering the roles of medical professionals in medical care, medical doctors and nurses are the most responsible for monitoring, assessing, and guaranteeing the safety of medical care, and medical and radiological technologists are the most responsible for effective medical care. The current medical technologists are not only required to carry out clinical laboratory tests, but also be proactive and positive as well as have marked problem-solving abilities. They are expected to improve the diagnostic test systems in medical institutes for medical doctors
Systematic Review of Medical Informatics-Supported Medication Decision Making.

PubMed

Melton, Brittany L

2017-01-01

This systematic review sought to assess the applications and implications of current medical informatics-based decision support systems related to medication prescribing and use. Studies published between January 2006 and July 2016 which were indexed in PubMed and written in English were reviewed, and 39 studies were ultimately included. Most of the studies looked at computerized provider order entry or clinical decision support systems. Most studies examined decision support systems as a means of reducing errors or risk, particularly associated with medication prescribing, whereas a few studies evaluated the impact medical informatics-based decision support systems have on workflow or operations efficiency. Most studies identified benefits associated with decision support systems, but some indicate there is room for improvement.
75 FR 49507 - Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

...] Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations AGENCY: Federal Emergency... Management Agency (FEMA) is accepting comments on RP9525.4, Emergency Medical Care and Medical Evacuations... emergency medical care and medical evacuation expenses that are eligible for reimbursement under the...
From Servicescape to Loyalty in the Medical Tourism Industry: A Medical Clinic’s Service Perspective

PubMed Central

Koo, Dong-Woo; Shin, Dong-Jin; Lee, Sae-Mi

2017-01-01

Medical tourism organizations have increasingly recognized that loyalty makes a medical clinic a marketing success. To increase understanding of the importance of medical clinics, this study examined the roles of servicescapes, emotions, and satisfaction in the development of customer loyalty toward medical clinics and destination. Data were collected among international medical tourists visiting Korea. Results identified that dimensions of medical clinics’ servicescape (ie, medical clinic environment, medical treatment, staff, and doctor) influenced emotions and satisfaction among international medical tourists. Also, positive emotions and the 2 dimensions of satisfaction with a medical clinic and doctor mediate the influence of medical clinics’ servicescapes on 2 types of loyalty (the medical clinic and Korea for medical care). Overall, these findings indicate that the interrelationship of servicescapes, positive emotion, and satisfaction is essential in influencing international medical tourists’ loyalty to a medical clinic. PMID:29233057

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