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Tervaskanto-Mäentausta, T. (Tiina). "Interprofessional education during undergraduate medical and health care studies." Doctoral thesis, Oulun yliopisto, 2018. http://urn.fi/urn:isbn:9789526218571.
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Abstract The two universities in Oulu developed an interprofessional (IP) curriculum by implementing the theory and training periods for different undergraduate medical and health care students. The aim was to investigate how interprofessional education (IPE), use of collaborative learning methods and innovative learning environments will promote students’ IP competencies. Furthermore, the aim was to understand how the patients and families experienced the students’ receptions in the training periods. Students’ readiness and attitudes towards interprofessional learning (IPL) were investigated with the Readiness for Interprofessional Learning Scale (RIPLS) and their learning experiences after the courses and training periods with a structured questionnaire. The patients and families filled in the feedback questionnaire after the reception. The data was collected between 2007 and 2015. Almost all students indicated, according to RIPLS great importance towards teamwork and collaboration, and felt their professional identity promoted. The medical students evaluated their roles and responsibilities significantly lower than the other health care students. After the first semester, IP course students’ learning outcomes correlated linearly with their own activity and collaboration with the IP group in the e-learning platform. During the training periods in the out patients diabetes clinic, as well as in the preventive maternity and child health clinics, they performed well with IP competencies such as patient-centeredness, communication and teamwork. Students were well briefed to take responsibility as an IP team of the patients’ visit. The care plan was finalized with the facilitators. In the reflection session, learning outcomes were summarized. Students got an overview of primary and preventive services and their professional roles there. Patients and families were very satisfied with their experience with the students. IPE programs have positively changed the overall attitudes to IPL, both with students and the educators and professionals. In addition, students’ professional and IP clinical competencies have developed and the trust in working together has increased. Feedback from patients and families has been very positive. It showed the importance of IPE and the development of collaborative practice in the service system to stakeholders. IP teamwork experience benefits current and future health care professionals in organizing patient-centered care in collaboration with educational organizations and their working life partnersTiivistelmä Oulun yliopiston ja ammattikorkeakoulun yhteistyönä kehitettiin lääketieteen ja terveydenhuollon eri perustutkinto-ohjelmille moniammatillinen opetussuunnitelma. Koulutus sisälsi teoriaopintoja sekä harjoittelua hyvinvointikeskuksessa. Tavoitteena oli tutkia, miten moniammatillinen oppiminen, osallistavien opetusmenetelmien käyttö sekä innovatiiviset oppimisympäristöt edistävät opiskelijoiden moniammatillisia taitoja. Tavoitteena oli myös kuvata potilaiden ja perheiden kokemuksia moniammatillisesti toteutetuista vastaanotoista harjoittelujaksoilla. Opiskelijoiden valmiuksia ja asenteita moniammatilliseen oppimiseen tutkittiin ”Valmiudet ja asenteet moniammatilliseen oppimiseen” (RIPLS) - mittarilla. Heidän oppimiskokemuksiaan koottiin opintojen ja harjoittelun päätteeksi strukturoidulla kyselymittarilla. Potilaat ja perheet täyttivät palautekyselyn vastaanoton päätyttyä. Aineisto kerättiin vuosina 2007-2015. Tarkasteltaessa opiskelijoiden asenteita RIPLS-mittarilla mitattuna suurin osa heistä piti erittäin tärkeänä tiimityötä ja vuorovaikutusta ja koki moniammatillisen oppimisen vahvistaneen heidän ammatillista identiteettiään. Lääketieteen opiskelijoiden arvio omasta ammattiroolistaan ja vastuistaan oli merkittävästi epävarmempi kuin muilla terveysalan opiskelijoilla. Opiskelijoiden oppiminen opintojen alkuvaiheen moniammatillisella kurssilla korreloi suoraan heidän omaan aktiivisuuteensa ja kommunikointiin moniammatillisen ryhmän kanssa verkkoalustan tehtävissä. Harjoittelujaksoilla sekä diabetesvastaanotolla että äitiys- ja lastenneuvolassa opiskelijat oppivat moniammatillisia taitoja, kuten potilaskeskeisyyttä, kommunikointia ja tiimityöskentelyä. He saivat kokonaiskuvan terveyskeskustyöstä ja ennaltaehkäisevistä palveluista sekä omista ammatillisista rooleistaan niissä. Potilaat ja perheet olivat erittäin tyytyväisiä saamaansa palveluun opiskelijavastaanotoilla. Opiskelijoiden asenteet moniammatillista oppimista kohtaan olivat positiivisia yhteisten opintojen alussa ja kehittyivät entistä positiivisemmiksi harjoittelujaksojen myötä. Samanaikaisesti opiskelijoiden ammattialakohtaiset sekä moniammatilliset taidot kehittyivät ja luottamus yhdessä työskentelyyn lisääntyi. Potilaiden ja perheiden antama erittäin myönteinen palaute on osoitus päättäjille ja palvelujärjestelmille moniammatillisen koulutuksen ja työkäytäntöjen kehittämisen merkityksestä. Moniammatilliset tiimityötaidot hyödyttävät sekä nykyisiä että tulevia terveysalan ammattilaisia toteuttamaan ja kehittämään asiakaslähtöistä työtä yhteistyössä korkeakoulujen ja työelämän palveluorganisaatioiden kanssa
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Pathmathasan, Cynthia. "DISABILITY IN MEDICAL EDUCATION & TRAINING: A DISABILITY-FOCUSED MEDICAL CURRICULUM." NEOMED College of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ne2gs1622810204171811.
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Öhman, Mattias. "Essays on Cognitive Development and Medical Care." Doctoral thesis, Uppsala universitet, Nationalekonomiska institutionen, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-305627.
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This thesis consists of four self-contained papers. Essay I (with Linuz Aggeborn): Fluoridation of the drinking water is a public policy whose aim is to improve dental health. Although the evidence is clear that fluoride is good for dental health, concerns have been raised regarding potential negative effects on cognitive development. We study the effects of fluoride exposure through the drinking water in early life on cognitive and non-cognitive ability, education and labor market outcomes in a large-scale setting. We use a rich Swedish register dataset for the cohorts born 1985-1992, together with drinking water fluoride data. To estimate the effects, we exploit intra-municipality variation of fluoride, stemming from an exogenous variation in the bedrock. First, we investigate and confirm the long-established positive relationship between fluoride and dental health. Second, we find precisely estimated zero-effects on cognitive ability, non-cognitive ability and education for fluoride levels below 1.5 mg/l. Third, we find evidence that fluoride improves later labor market outcomes, which indicates that good dental health is a positive factor on the labor market. Essay II: I study the associations between cognitive and non-cognitive abilities and mortality using a population-wide dataset of almost 700,000 Swedish men born between 1950 and 1965. The abilities were measured at the Swedish military enlistment at age 18-20. In addition, I investigate if income and education are good proxies for the abilities. The results suggest that both cognitive and non-cognitive abilities are strongly associated with mortality, but that non-cognitive ability is a stronger predictor. The associations are only partly mediated through income and education. For middle and high income earners and individuals with a college education there are no associations with mortality. However, for low income earners and individuals without a college education, both abilities are strongly associated with mortality. The associations are mainly driven by the bottom of the distributions. Essay III (with Matz Dahlberg, Kevin Mani and Anders Wanhainen): We examine how health information affects individuals' well-being using a regression discontinuity design on data from a screening program for an asymptomatic disease, abdominal aortic aneurysm (AAA). The information provided to the individuals is guided by the measured aorta size and its relation to pre-determined levels. When comparing individuals that receive information that they are healthy with those that receive information that they are in the risk zone for AAA, we find no effects. However, when comparing those that receive information that they have a small AAA, and will be under increased surveillance, with those who receive information that they are in the risk zone, we find a weak positive effect on well-being. This indicates that the positive information about increased surveillance may outweigh the negative information about worse health. Essay IV: I estimate the effect of SSRI antidepressants on the risk of mortality for myocardial infarction (MI) patients using Propensity Score Matching on individual health variables such as pharmaceutical drug prescription, patient history and severity of the MI. The effect of antidepressants on mortality is a heavily debated topic. MI patients have an elevated risk of developing depression, and antidepressants are among the most common treatments for depression and anxiety. However, there are indications that some classes of antidepressants may have drug-induced cardiovascular effects and could be harmful for individuals with heart problems, but there is a lack of large-scale studies using credible identification strategies. My findings indicate no increased risk of two-year mortality for MI patients using SSRI. The results are stable for several specifications and robustness checks.
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Al-Mansouri, Fatma Hayay. "Undergraduate and continuing medical education and the primary health care physician." Thesis, University of Aberdeen, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367367.
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The United Arab Emirates does not currently possess an adequate number of well trained Family Practitioners and only a small proportion of the medical work force are employed in Primary Care. Continuing medical education is important in Family Medicine and, to date, there has been no study in this subject carried out in the United Arab Emirates. It was decided to evaluate and assess the current situation within Family Medicine and the amount of continuing medical education received by medical practitioners in Abu-Dhabi. Accordingly, 3 studies were carried out to provide this information. Initially, a perspective, descriptive study was carried out, involving all Primary Care Practitioners. There was an 80% response, yielding 86 completed questionnaires. The study revealed a perceived low prestige for Family Medicine among Family Practitioners, over half of whom (58%), felt that they did not have the confidence of the public. Only 3% of Family Practitioners were Emirati Nationals. 23% had received training in Family Medicine but only 3% had formal qualifications. It is unlikely that the Government will spend large sums of money on the training of expatriate doctors through a residency programme but there should be a practical alternative. There is a clear need to increase the numbers of Emirati National doctors. It was seen as important to determine how medical students and Interns graduating from the United Arab Emirates University, made their career choices. A second, cross-sectional, descriptive study, was set up. A questionnaire was administered to all final year students in the Faculty of Medicine and Interns in the University hospital. There was an 80% return yielding 48 questionnaire for analysis. The leading reason for selecting a speciality was personal interest 85% and half of the respondents were of the opinion that there was no organised career structure in Family Medicine in the United Arab Emirates. 52% did not wish to enter Family Medicine although 85% appreciated the importance of this speciality. There was also a general feeling that Family Medicine was poorly organised within the Emirates (90%). Continuing medical education is a systematic attempt to facilitate change in doctors' practice. Differences observed over time in patients' health and in doctors' performance and their knowledge and skills, are the types of change that have been the focus of research in continuing medical education. Medical education is successful when it results in improved outcomes for patients, but there may not be much connection between traditional didactic instruction and improvement in clinical practice. Evidence suggests that continuing medical education activities that are learner focused, take place in small groups and adhere to the principles of adult learning, are beneficial to practising physicians and their patients. It was decided to carry out a study designed to ensure the effect of a practiced based, small group, continuing medical education programme on the knowledge and clinical practice of primary health care doctors in the management of hypertension. A randomised, controlled trial was carried out in four Primary Health Care Centres in Abu-Dhabi, two of which were designated as the intervention centres and the other two, the control centres. The first part of the study was the establishment of the intervention, which was a small-group, practice-based, continuing medical education programme (6 hours) in the care of hypertensive patients, relevant to primary care practice. The second part was a study of the effectiveness of the programme, obtained by an evaluation of knowledge and practice, three months before and three months after the intervention. There was no change in the knowledge of care of hypertensive patients between the control and intervention groups but there was evidence that the continuing education programme had changed some aspects of the clinical practice and the performance of primary health care doctors, in the management of hypertension. The results suggested that this form of medical education could be effective.
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Grant, Cindy Lynn. "Ambulatory care physician barriers contributing to the low advance directive education rate." CSUSB ScholarWorks, 2000. https://scholarworks.lib.csusb.edu/etd-project/1696.
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Johannesson, Eva. "Learning manual and procedural clinical skills through simulation in health care education." Licentiate thesis, Linköpings universitet, Sjukgymnastik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75505.
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The general aim of this thesis was to contribute to a deeper understanding of students’ perceptions of learning in simulation skills training in relation to the educational design of the skills training. Two studies were conducted to investigate learning features, what clinical skills nursing students learn through simulation, and how. Undergraduate nursing students were chosen in both studies. Study I was conducted in semester three, and study II in semester six, the last semester. Twenty-two students in study I practised intravenous catheterisation in pairs in the regular curriculum with an additional option of using two CathSim® simulators. In study II, ten students practised urethral catheterisation in pairs, using the UrecathVision™ simulator. This session was offered outside the curriculum, one pair at a time. In study I, three questionnaires were answered - before the skills training, after the skills training and the third after the skills examination but before the students’ clinical practice. The questions were both closed and open and the answers were analysed with quantitative and qualitative methods. The results showed that the simulator was valuable as a complement to arm models. Some disadvantages were expressed by the students, namely that there was no arm model to hold and into which to insert the needle and that they missed a holistic perspective. The most prominent learning features were motivation, variation, realism, meaningfulness, and feedback. Other important features mentioned were a safe environment, repeated practice, active and independent learning, interactive multimedia and a simulation device that was easy to use. In study II the students were video-recorded during the skills training. Afterwards, besides open questions, the video was used for individual interviews as stimulated recall. The interview data were analysed with qualitative content analysis. Three themes were identified: what the students learn, how the students learn, and how the simulator can contribute to the students’ learning. When learning clinical skills through simulation, motivation, meaningfulness and confidence were expressed as important factors to take into account from a student perspective. The students learned manual and procedural skills and also professional behaviour by preparing, watching, practising and reflecting. From an educational perspective, variation, realism, feedback and reflection were seen as valuable features to be aware of in organising curricula with simulators. Providing a safe environment, giving repeated practice, ensuring active and independent learning, using interactive multimedia, and providing a simulation tool that is easy to use were factors to take into account. The simulator contributed by providing opportunities to prepare for skills training, to see the anatomy, to feel resistance to catheter insertion, and to become aware of performance ability. Learning features, revealed from the students’ thoughts and experiences in these studies, are probably general to some extent but may be used to understand and design clinical skills training in all health care educations. In transferring these results it is important to take the actual educational context into account.
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Weare, Katherine. "Building bridges : the relationship of medical education to health promotion." Thesis, University of Southampton, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242681.
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Kugler, Neil. "When curing stops and caring begins : a study of the need for end-of-life care education of future health care workers /." ProQuest subscription required:, 2003. http://proquest.umi.com/pqdweb?did=990270731&sid=1&Fmt=2&clientId=8813&RQT=309&VName=PQD.
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Murray, Thomas Stuart. "Factors influencing the uptake of continuing medical education in general practice." Thesis, University of Glasgow, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.318636.
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Carroll, Melissa A. "Communication Theory in Physician Training: Examining Medical School Communication Curriculum at American Medical Universities." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504873270954601.
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Patton, Lauren Ashley. "Education and Standardized Discussion Guides to EnhanceNurses' Spiritual Care Practices in the Medical Intensive Care Unit." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1519836081431734.
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Guccione, Sharon. "Chronic Care Management Services at a Clinical Medical Group." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/7655.
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The purpose of this project was to design a chronic care plan using the chronic care management (CCM) framework to improve health services at lower healthcare costs. The practice-focused question explored whether the operationalization of the CCM model would impact progress toward the management of chronic illness for the target population of Medicare beneficiaries with 2 or more chronic illnesses in an urban acute care agency located in the western United States. The middle-range theory, logic rational plan model, Lewin’s change theory, and the CCM’s coordination care and collaborative care concepts were used to guide the project. Data were collected from nursing databases and government agencies. Nurses were significant to the CCM reform by supporting the elements for proactive care. Nurse practitioners can bill using the CCM codes, and clinical nurses can performed patient sensitive care. The social changes were patients with chronic illnesses realized a better quality of life at lower health costs.
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Murtagh, Madeleine Josephine. "Intersections of feminist and medical constructions of menopause in primary medical care and mass media: risk, choice and agency." Title page, table of contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phm9851.pdf.
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Includes bibliographical references (leaves 254-288). Examines language used by general practitioners and in mass media to ask 'what are the implications of constructions of menopause for health care practice and public health for women at menopause?'. Presents the findings of qualitative analysis of semi-structured interviews with nine general practitioners working in rural South Australia and qualitative and quantitative analyses of 345 south Australian newspaper articles from 1986 to 1998.
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Stilp, Curt Carlton. "Rural Interprofessional Health Care Education: a Study of Student Perspectives." PDXScholar, 2017. https://pdxscholar.library.pdx.edu/open_access_etds/3624.
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As the cost for health care delivery increases, so does the demand for access to care. However, individuals in a rural community often do not have access to the care they need. Shortages of rural health care professionals are an ever-increasing problem. The Affordable Care Act of 2010 sought to increase health care access by focusing on team-based care delivery. Thus, the need to educate health care students in the fundamentals of team-based practice has led to an increased emphasis on Interprofessional Education (IPE). While past research focused on urban IPE, a literature gap exists for the effects of a rural team-based educational experience on practice location decisions. This study examined how rural IPE influenced health profession students' perspectives of what it means to be a member of a rural health care team and explored what factors go into making decisions of where to live and provide care. Motivational Theory provided the framework for a mixed methods approach with data from student reflective journaling and a post-experience Q sort. Analysis yielded important understandings about the impact of rural IPE. Accordingly, having a rural IPE experience provided positive motivation for returning after graduation. Further, the time spent in rural IPE generated understandings of what it means to live and provide care to a rural community. One important new discovery gained is the clinical setting is not where most IPE took place. As a result, social interactions with fellow students and community members achieved the goals of rural IPE. Despite these influential findings, noted barriers to genuine rural IPE persisted. In the end, students, educators, and rural health care professionals need to be aware of the multiple factors that guide decisions of where to live and provide care.
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Jewell, Tess. "Gendering Genitals: Medical Discourse and Provider Education on Intersex Conditions." Oberlin College Honors Theses / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=oberlin1525771394081132.
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Zaal, Ahmad. "Benchmarking the Quality of Medical Care of Childhood-Onset SLE." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1427962136.
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Esmaily, Hamideh Mohammadzadeh. "Outcome-based continuing medical education an intervention to improve rational prescribing /." Stockholm : Karolinska institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-710-8/.
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Cayo-Rojas, César F., and Ana Sofía Miranda-Dávila. "Empathy in medical education: An opportunity after the COVID-19 crisis." Universidad de Ciencias Medicas de La Hab, 2020. http://hdl.handle.net/10757/655703.
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Marti-Morales, Madeline. "Care coordination, family-centered care and functional ability in children with special health care needs in the United States." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/870.
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Children with special health care needs (CSHCN) generally have physical, mental, or emotional conditions that require a broader range and greater quantity of health and related services compared to typical children. Care coordination (CC) and family-centered care (FCC) are necessary in the quality of health care for CSHCN. A gap exists in the literature regarding the impact of CC and FCC on children's functional ability (FA). Previous researchers have focused on met and unmet health care needs, but not on health outcomes or functionality. The purpose of this study was to determine if there was an association between CC, FCC, and FA in CSHCN. The design of this study was a secondary analysis of data from the 2005--2006 National Survey of CSHCN. The study was guided by an adapted socioecological multilevel conceptual framework. Statistical methods included univariate, bivariate, and multiple logistic regression analysis. Results indicated that CC was associated with FA in CSHCN. CSHCN that did not receive CC had a 53% increased risk (OR =1.53, 95%CI 1.21--1.94, p < 0.001) for a limitation in FA compared to CSHCN that received CC, controlling for age, gender, number of conditions, household poverty level, parental educational level, and health insurance. FCC was not associated with a limitation in FA in CSHCN ( p = 0.61). Findings from this study were consistent with the socioecological multilevel framework and the literature on care coordination. This study contributed to positive social change by providing information that can be used by public health officials, health care providers and policy makers in developing policies to assure that care coordination is provided to CSHCN and their families in order to improve their health outcomes and functionality.
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Kinkade, Scott Edward. "A Content Analysis of Medical School Problem-Based Learning Cases." Thesis, University of North Texas, 2017. https://digital.library.unt.edu/ark:/67531/metadc984174/.
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Problem-based learning (PBL) was developed for use in medical education to incorporate more active, learner-centered instruction. Central to problem-based learning is the problem, which in medical education is usually case a case presentation, revealed in stages to allow learners to form and research learning objectives. The purpose of this study was to identify themes present across the PBL cases, including the patient-centeredness of the cases. Content analysis was used to examine 62 PBL cases that comprised the first and second years' core curriculum at a public medical school. The cases included a patient population similar to the local population, but care was more hospital-centric than would be expected from the actual patterns of medical utilization in the United States. Analyzing along two axes of patient-centeredness, the PBL cases demonstrated a good understanding of the patient (knowing the patient), but other qualities such as shared decision making was not as exemplified. Medical educators can use the results to understand elements that contribute to patient-centeredness and apply the analysis framework to evaluate future cases.
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Pirtle, Jody Marie. "Collaboration Among Families, Educators, and Medical Professionals to Create a Rural Medical Home for Children with Special Health Care Needs and Disabilities." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/283632.
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Families of children with special health care needs (CSHCN) and disabilities who lived in rural communities faced a variety of economic, social, and environmental challenges. Bronfenbrenner (1979, 2005) in his Bioecological Theory of Human Development offered an insightful lens for understanding the nested environments in which these families interact. This model was used as the overarching framework for this dissertation. The three manuscripts contained in this dissertation have included analyses of the involvement and participation of families of CSHCN and disabilities in the creation of a medical home located in a rural southwestern border community. These studies were critical for the medical home professionals - family involvement was at the core of the medical home philosophy. The overarching purpose of this dissertation was to set the foundation for successful family participation and feedback in the medical home. Within the first manuscript, I used the Medical Home Family Index to discover families’ (a) perceptions of interactions with medical professionals and (b) ratings of the quality of care within the medical home. Families of CSHCN (N = 92) completed the Medical Home Family Index and descriptive statistics as well as Chi-Square analyses were completed. Significant associations between families’ home languages and the amount of time the CSHCN had been receiving services at the medical home and the families’ responses were found. No associations between the children’s ages and the families’ responses were found. Recommendations for medical home professionals to complete the partner index, the Medical Home Index, were included. The purpose of the second manuscript was to examine the support needs of families of CSHCN and disabilities. Relationships between the severity of the children’s special health care needs and disabilities and the potential services they required were explored. For this study, a small sample (N = 25) of families of CSHCN completed the Family Needs section of the Center for Medical Home Improvement Family Survey, an in-depth, five-part survey designed to have families report on the services and supports that their CSHCN actually received. Families of CSHCN identified the need for therapies to be provided within the community. Findings from this study supported the creation of a pilot program in which parents were active participants in an intensive summer program designed to address the language and communication needs of their children. The purposes of the third manuscript were to (a) conduct research in two settings - a rural medical home and the families’ natural environments, (b) identify families’ perceptions of a targeted summer language intervention program, and (c) determine what changes in young children’s communication skills could be measured when parents were active members in a targeted summer language intervention program. For the third study, fourteen children with language delays and their families participated. Children were assessed using the Battelle Developmental Inventory-2nd Edition or the Preschool Language Scale-4th Edition. Intervention was conducted within a pediatric medical home and families continued the intervention at home. For both test results, the treatment had a significant effect. All families indicated a strong desire to continue the program and families who were most concerned with their children’s language were most satisfied with the program. This pilot program model was an example of ways that interventions could be extended successfully beyond traditional settings.
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KRZYWKOWSKI-MOHN, SARA M. EdD. "Diabetic Control and Patient Perception of the Scheduled In Group Medical Appointment at the Cincinnati Veterans Administration Medical Center." University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1210103113.
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White, Connie Mae. "Diabetes education guide for primary care providers in Montana." Montana State University, 2005. http://etd.lib.montana.edu/etd/2005/white/WhiteC0505.pdf.
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DeMartini, Mikaela. "Exploring Self Care Programs in Hospitals." Thesis, Mills College, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13426861.
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Self care is more than a requirement for life. Working in a high stress hospital environment lends itself to having many personal and professional stressors that go beyond medical professionals job requirements. The purpose of this study was to explore how hospitals support medical staff through self care programs. Data was collected through semi-structured interviews of five medical professionals who work in various specialties. Results of this study indicated that self care was represented in various unstructured formats. Additionally, this study demonstrates the need for more support in the medical field to allow for more opportunities for self care to take place. Furthermore, this analysis of self care explains the importance of this practice to be implemented by medical professionals as it helps to reduce the high rates of burnout and compassion fatigue.
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Birchenall, Peter. "Skill assessment and its relationship to the training and education of nurses caring for people with mental handicap." Thesis, University of Hull, 1991. http://hydra.hull.ac.uk/resources/hull:3904.
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Currently, mental handicap nursing reflects a scenario whereby major advances have occurred within a relatively short time scale. Sophistication not previously recognised has created an educational requirement for a clear relationship between knowledge, skills and assessment. Student nurses are expected to develop their skills through reflective practice, and it is the intention of this study to analyse the place of practical skills assessment in the educational and professional growth of students as they progress through their programme of training.
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Amini, Richard, Lori A. Stolz, Nicholas C. Hernandez, Kevin Gaskin, Nicola Baker, Arthur Barry Sanders, and Srikar Adhikari. "Sonography and hypotension: a change to critical problem solving in undergraduate medical education." Dove Press, 2016. http://hdl.handle.net/10150/617204.
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UA Open Access Publishing FundStudy objectives: Multiple curricula have been designed to teach medical students the basics of ultrasound; however, few focus on critical problem-solving. The objective of this study is to determine whether a theme-based ultrasound teaching session, dedicated to the use of ultrasound in the management of the hypotensive patient, can impact medical students’ ultrasound education and provide critical problem-solving exercises. Methods: This was a cross-sectional study using an innovative approach to train 3rd year medical students during a 1-day ultrasound training session. The students received a 1-hour didactic session on basic ultrasound physics and knobology and were also provided with YouTube hyperlinks, and links to smart phone educational applications, which demonstrated a variety of bedside ultrasound techniques. In small group sessions, students learned how to evaluate patients for pathology associated with hypotension. A knowledge assessment questionnaire was administered at the end of the session and again 3 months later. Student knowledge was also assessed using different clinical scenarios with multiple-choice questions. Results: One hundred and three 3rd year medical students participated in this study. Appropriate type of ultrasound was selected and accurate diagnosis was made in different hypotension clinical scenarios: pulmonary embolism, 81% (95% CI, 73%–89%); abdominal aortic aneurysm, 100%; and pneumothorax, 89% (95% CI, 82%–95%). The average confidence level in performing ultrasound-guided central line placement was 7/10, focused assessment with sonography for trauma was 8/10, inferior vena cava assessment was 8/10, evaluation for abdominal aortic aneurysm was 8/10, assessment for deep vein thrombus was 8/10, and cardiac ultrasound for contractility and overall function was 7/10. Student performance in the knowledge assessment portion of the questionnaire was an average of 74% (SD =11%) at the end of workshop and 74% (SD =12%) 3 months later (P=0.00). Conclusion: At our institution, we successfully integrated ultrasound and critical problemsolving instruction, as part of a 1-day workshop for undergraduate medical education
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Rochon, Sophie. "Age and presence of chronic conditions, education and the health system reform : impact on utilization of health care services by the Canadian elderly." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=79806.
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This study examines the importance of age, education, and the health system reforms in the mid 1990's on the utilization of five health services: specialists' visits, family doctor visits, non-physician health professional visits, hospital use, and home care services. The analysis focuses on the Canadians 45 and over, and uses data from the National Population Health Survey.Results. Age per se has only a minor effect on utilization; the relative high utilization rates observed among the aged relate to the use of services by people with chronic conditions, whose prevalence is higher among the aged. Education has little impact on use of services among the aged. The reforms had only significant effect for four services. They increased utilization of non-medical health professional consults, and increased probability of consulting a specialist. They reduced length of stay, and decreased the number of visits made to family doctors.
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Nimmo, Graham R. "Materialities of clinical handover in intensive care : challenges of enactment and education." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21540.
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The research is situated in a busy intensive care unit in a tertiary referral centre university hospital in Scotland. To date no research appears to have been done with a focus on handover in intensive care, across the professions involved, examining how handover is enacted. This study makes an original contribution to the practical and pedagogical aspects of handover in intensive care both in terms of the methodology used and also in terms of its findings. In order to study handover a mixed methods approach has been adopted and fieldwork has been done in the ethnographic mode. Data has been audio recorded and transcribed and analysed to explore the clinical handovers of patients by doctors and nurses in this intensive care unit. Texts of both handover, and the artefacts involved, are reviewed. Material from journals, books, lectures and websites, including those for health care professionals, patients and relatives, and those in industry are explicated. This study explores the role of material artefacts and texts, such as the intensive care-based electronic patient record, the whiteboards in the doctors’ office, and in the ward, in the enactment of handover. Through analysis of the data I explore some of the entanglements and ontologies of handover and the multiple things of healthcare: patients, information, equipment, activities, texts, ideas, diseases, staff, diagnoses, illnesses, floating texts, responsibility, a plan, a family. The doing of handover is framed theoretically through the empirical philosophy of Mol’s identification of multiple ontologies in clinical practice (Mol, 2002). Each chapter is prefaced by a poem, each of which has relevant socio-material elements embedded in it. The significance of the findings of the research for both patient care and clinical education and learning is surfaced.
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Phinazee, Teresa Y. "BELIEFS ABOUT HOSPICE CARE AMONG HELPING PROFESSIONALS." CSUSB ScholarWorks, 2015. https://scholarworks.lib.csusb.edu/etd/214.
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ABSTRACT
Centered on interviews with 13 hospice care professionals from two large hospice organizations in Southern California, this thesis project examines the challenges that arise in hospice work. Hospice’s delivery of end-of-life care is becoming even more significant as the population lives longer. According to the National Institute on Aging (2014), the face of aging in the United States is changing dramatically. This examination discloses some of the challenges that hospice workers face in a continuously changing health care system, while trying to provide extraordinary service to the terminally ill.
Hospice regards dying as a conventional progression, and neither hastens nor defers death. Hospice health care professions are essential in providing care. This thesis uses a qualitative method and examined beliefs about hospice care among hospice professionals using compassion fatigue also known as burnout, job satisfaction and religion and spirituality as a foundation.
The findings of this thesis found that compassion fatigue is a real phenomenon and has been experienced by nine or 69% of participants, and of the 69%, six or 67% that experienced compassion fatigue are paid employees who work a forty hour work week. The remaining three participants or 33% who have experienced compassion fatigue are volunteers who commit to volunteering more than two days a week. Frequent contact with individuals who are terminally ill increases the likelihood of compassion fatigue. The
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findings also indicate that 100% of participants experienced job satisfaction while working in patient care, despite the length of time working in the field of hospice. Job satisfaction is contributed to the belief that participants have regarding hospice care, and that belief is the work they do in hospice is a "calling" and they all consider working with the terminally ill as a privilege. Lastly, the findings indicate that religion and spirituality play a major role in how participants deal with the ongoing death of patients. Ninety two percent or 12 out of the 13 participants claim a belief in a higher power, and they use this belief to cope with the suffering and death of patients. They also use religion and spirituality as a way to decrease stress and to have a piece of mind that when a patient dies they are in a much better place and relieved of their suffering.
Taken as a whole, this study concentrated on hospice professionals and the correlation of compassion fatigue, job satisfaction and religion and spiritually which can have a pronounced impact on the overall quality of service delivery. The purpose of this study was to bring mindfulness to the hospice social professional. What has been provided in this study is empirical support for advanced research in the field of hospice care. Additional research is necessary in order to understand more about the beliefs of hospice care among helping professionals and the motivations they use in order to deliver optimal service to the terminally ill.
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Stojakovic, Jelena. "Teaching intercultural communication competence in the healthcare context." Diss., [Missoula, Mont.] : The University of Montana, 2009. http://etd.lib.umt.edu/theses/available/etd-06052009-204749.
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Alamoud, Muhammad Y. "Mobile Computing for Trauma and Surgical Care Continuous Education." Wright State University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=wright1367327340.
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Ashe, Karen M. "Factors Associated With Weight Management Counseling During Primary Care Clerkships." eScholarship@UMMS, 2019. https://escholarship.umassmed.edu/gsbs_diss/1007.
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Background: The United States Preventive Services Task Force guidelines support screening and provision of intensive multi-component behavioral counseling for adults who have obesity. One barrier to providing such counseling is lack of training in medical school. Not much is known about factors associated with medical students’ perceived weight management counseling (WMC) skills or whether preceptors model or teach WMC during primary care clerkships.
Methods: A mixed methods approach addressed factors affecting WMC training during primary care clerkships. A secondary analysis of 3rd year medical students (n=730) described students’ perceived WMC skills, attitudes and frequency of engagement in 5As educational experiences. Linear mixed models were used to determine associations between educational experiences and perceived skills. Semi-structured interviews (n=12) and a survey were administered to primary care preceptors (n=77). Interviews described individual, inter-personal and institutional factors associated with preceptors’ WMC. The survey described preceptors’ frequency of modeling WMC behaviors, perceived WMC skills, and attitudes.
Results: Students perceived themselves to be moderately skilled (M=2.6, SD=0.05, range 1-4). Direct patient experiences and specific instruction were associated with higher perceived skill. Preceptors support WMC curricula but do not perceive themselves to be experts in WMC. Preceptors perceive themselves to be moderately skilled (M=2.8, SD=0.06, range 1-4) but only sometimes model WMC (M=3.3, SD=0.05, range 1-5) to students during clerkships.
Conclusion: Preceptor modeling WMC may not be feasible or necessary during primary care clerkships. Providing specific WMC instruction and working with patients may provide more benefit as they were more strongly associated with students’ perceived skills.
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Tan, Xiao Monica, and 談笑. "Understanding government education and health spending in China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/211031.
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This research evaluates government education and health spending in China and explores the underlying determinants of its spatial pattern. A framework defining local needs at three levels is proposed to analyze whether the expenditure has been reasonably allocated. Results show that both government education and health spending closely respond to local needs at the general level. The illiteracy rate is positively correlated with government education spending while the life expectancy is negatively correlated with government health spending. On the demand and supply sides, while government education spending is more responsive to local demand measured by student number, the needs from the supply side represented by the number of medical personnel appear to be more relevant when governments distribute resources into the health sector. One particular area that needs more effort is the responsiveness to the needs arising from the lack of teaching staff. The student-teaching ratio is now largely ignored when governments make decisions of education outlays. Given that the adequacy of teaching staff is a must to ensure the quality of teaching, governments are thus suggested to put more weights to this aspect in its decision-making process.
As for the determinants of government education and health spending, this study takes a close look at three groups of key potential explaining factors identified in the existing literature – economic development, openness and decentralization. The findings pose challenges to the existing mainstream theories developed in the western context. Only per capita gross regional product is found to have significant explanatory power for budgetary expenditure on education and a significant negative relationship is revealed. On the other hand, both economic development and the degree of fiscal dependency are significant in explaining the spatial pattern of government health spending; and their relationships are both non-linear. The fixed-effects panel data regression model predicts that, ceteris paribus, a province with a per capita gross regional product of 20,265 yuan would have the most government health outlays while a province with a fiscal dependency ratio of 63.6% would have the lowest public health expenditure. Provinces with either higher or lower per capita GRP (fiscal dependency ratio) than the threshold value allocate fewer (more) resources into government health outlays. The most important recommendation derived from the findings of this dissertation is that the central government should keep an eye on those provinces that are neither fully financially dependent nor fully financially independent, because their government health spending tends to be particularly inadequate.published_or_final_version
China Development Studies
Master
Master of Arts in China Development Studies
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Pearson, David John. "Exploration of clinical learning in general medical practice : a case study." Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/6303.
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This thesis tells a story of a single year in the life of a primary care teaching practice from the multiple perspectives of clinical learners and those supporting learning. This story involves many people from junior medical students to nurses and doctors with twenty years of experience. It explores how they learn as clinicians. The research takes the form of a single descriptive case study based within a purposefully chosen GP teaching practice in West Yorkshire, England. The case study comprises interview, observational and documentary data collected over a single academic year in 2008/9. Interview data from 33 subjects were transcribed and analysed using thematic analysis within a modified grounded theory approach. The evidence from interview data was strengthened through direct and indirect observation and from documents relating to learning and teaching. I present a theory of how clinical learning occurs within the chosen practice, and on the nature of being a teaching practice. The findings are presented in the context of the existing literature of learning in this setting and within a theoretical framework of literature on social learning and communities of practice. Clinical learning appears to occur through engagement and opportunity. Engagement in learning is made up of four elements; recognition, respect, relevance and emotion. The elements are remarkably consistent across learner groups. Opportunity includes the availability, authenticity and immediacy of patient encounters; and the opportunity to learn with and from peers and professional colleagues. The research findings are consistent with existing work on social learning from other settings, but add to the literature. Engagement appears possible through recognition, relevance and respect and in the absence of meaningful participation, belonging or a clear trajectory of learning. Meaningful opportunities for clinical learning include those where patient encounters are made powerful through the authenticity that arises from the social and personal context of illness, and from the immediacy of hearing patient narratives de novo. The teaching practice studied in the case study is not dissimilar to others described in the literature of primary care learning, but this case study offers a far more detailed exploration of the elements which contribute to learning in the practice. These elements include strong whole practice support for learning, a skilled and committed clinical and educational workforce and a more indefinable additional element which is best summarised as a passion for education.
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Rahimi-Saber, Anahita, Morgan Buda, Abby Schultz, Maureen Shelton, Leigh Johnson, Abbey K. Mann, and Ivy Click. "Transgender Medicine Integrated Grand Rounds: Are Medical Students Receiving Enough Education to Competently Care for our Patients?" Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/asrf/2018/schedule/128.
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Transgender individuals are defined as those whose gender does not match the sex they were assigned at birth. Healthcare providers receive inadequate training in transgender medicine, which could lead to provider stigma and lower health outcomes and higher health disparities. The purpose of our study was to assess the effect of an educational intervention on first and second year ETSU medical students’ knowledge and attitudes regarding transgender healthcare. A transgender healthcare-centered Integrated Grand Rounds (IGR) was used as a setting to conduct a 9-item survey regarding definitions, medical management, and attitudes/comfort levels with transgender care. First and second year medical students (n=140) who participated in the intervention had the option to complete pre and post surveys on paper before and after IGR. Of the 140 participants, 138 (98.6%) completed the pretest and posttest measures. The participants’ attitudes about transgender patients and their comfort in treating transgender patients significantly improved between pre and posttest surveys (p
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Click, Ivy A. "Transgender Medicine Integrated Grand Rounds: Are Medical Students Receiving Enough Education to Competently Care for Our Patients?" Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/6379.
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Carrillo, Victor A. "Community and Patient-Centered Medical Home in the Care of Chronically Ill Patients." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3143.
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Large portions of the US population live in poor inner-city communities. Health needs assessment data have shown that these communities have disproportionately high rates of chronic illnesses. The patient-centered medical home (PCMH) model was developed to address the gaps that exist in the primary care system, and emphasizes a redesign of primary care that is patient centered, utilizes multiple levels of healthcare professionals, information technology, and care coordination. However, little evidence exists on the value of this model which may explain why it has not gained wide acceptance by primary care providers. Therefore, this study was designed to examine the efficacy of the PCMH model through emergency department and inpatient utilization reductions, and with a specific focus on the role of social connectedness. This research used existing data on 706 participants from Columbia University and a local New York inner-city hospital. An in-depth analysis of hospital utilization data, using an unpaired two-sample t-test and linear regression, found that the PCMH framework strengthens continuity of care and care coordination, and helps reduce avoidable hospitalization utilization. Additionally, these reductions were greater for study participants with strong social support networks. This research highlights the relationships between primary care, social support networks, and good health outcomes. Over time, further enhancement of the PCMH and systemic changes to the delivery of care may contribute to the development of a stronger primary care system that place patients at the center of care, focuses on the importance of social connectedness, and contributes to a lasting impact on society through the development of overall healthier communities.
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Karajicic, Slavica. "Patient-centred care (PCC) as idea, process and practice." Doctoral thesis, Universidade de Évora, 2021. http://hdl.handle.net/10174/29830.
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This thesis contributes to the stream of studies that indicate a transformation of the future education of
medical professionals to better address patients’ needs and promote a positive attitude towards patientcentredness
in medical education. The main goal is to identify the characteristics of patient-centred care
(PCC) as ideas, processes, and practices from a medical student’s perspective in Portugal and Sweden.
The comparative study aims to answer where the differences between these two students’ groups stand
within PCC education, patient-centred beliefs, and self-perceived ability to practice PCC and, specifically,
how Portuguese medical students perceive Portuguese PCC practice and potential barriers. Quantitative
(questionnaires) and qualitative data collection (curriculum analysis and interviews) are performed.
Curriculum analysis indicates that learning about the PCC phenomena in both countries is fragmented
across the various courses, considering that in Portugal a significant number (40%) of courses are elective.
While the Portuguese curricula focus on the knowledge, the Swedish encourages skills development.
Medical students show more caring than sharing attitudes in both countries, and female medical students
have a more positive attitude toward PCC. Previous work experience does not affect the attitudes of a
medical student to the PCC; nonetheless, it does affect the self-perception of medical student confidence
in the information and power-sharing segment and dealing with communicative challenges. Portuguese
students consider that the barriers to the implementation of the PCC in Portuguese practice come from
the system, doctor, and patient. The implications of the study findings are discussed concerning both
wider theoretical perspectives and practical solutions for policymakers and doctors on these aspects of
their work. The present study reveals the need for developing an In-Service PCC Guide with all the key
elements and activities that reflect the essence of the PCC concept in practice, and that could help medical
students when they start their daily practical work with patients; RESUMO:
Cuidado centrado no paciente (PCC) como ideia, processo e prática
Esta tese contribui para a corrente de estudos que apontam para uma transformação, no futuro, da
educação dos profissionais médicos para melhor atender às necessidades do paciente e promover uma
atitude positiva em relação à centralização no paciente, da educação médica. O objetivo principal é
identificar as características dos cuidados centrados no paciente (PCC), nomeadamente ideias, processos
e práticas na perspetiva dos estudantes de medicina em Portugal e na Suécia. O estudo comparativo
realizado visa conhecer as diferenças entre esses dois grupos de estudantes relativamente à
educação/formação em PCC, as crenças centradas no paciente e capacidade auto percebida de praticar
o PCC; e ainda, compreender como os estudantes de medicina portugueses percebem a prática
portuguesa do PCC e as potenciais barreiras à mesma. Foram realizadas recolhas de dados quantitativos
(questionários) e qualitativos (análise curricular e entrevistas). A análise curricular indica que a
aprendizagem sobre o fenómeno PCC nos dois países está fragmentada nos vários cursos, sendo que em
Portugal grande parte (40%) ainda integra currículos optativos. Enquanto o currículo de português se
concentra no conhecimento, o sueco incentiva o desenvolvimento de habilidades. Os estudantes de
medicina mostram atitudes mais carinhosas do que compartilhadas em ambos os países, e as estudantes
femininas têm uma atitude mais positiva em relação à PCC. A experiência anterior de trabalho não afeta
as atitudes do estudante de medicina em relação à PCC; no entanto, afeta a autopercepção da confiança
do estudante de medicina no segmento de partilha de informações e poder e de lidar com os desafios
comunicativos. Os estudantes Portugueses consideram que as barreiras à implementação da PCC na
prática portuguesa vêm do sistema, do médico e do paciente. As implicações dos resultados do estudo
são discutidas em relação a perspetivas teóricas mais amplas e soluções práticas para os formuladores de
políticas e para os médicos, sobre esses aspetos de seu trabalho quotidiano. Este estudo revela a
necessidade de desenvolver um “In-Service PCC Guide” com todos os elementos e atividades que
refletem a essência do conceito de PCC na prática e que possam ajudar os estudantes de medicina quando
iniciam o seu trabalho prático quotidiano com os pacientes.
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Young, Adam Stephen. "Advancing the Human Condition: How Clinical Research Inspired and Prepared Me for Medical School." Miami University Honors Theses / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=muhonors1210015918.
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McCarthy, Noviski Krista Lynne. "Empathy in Medicine: What is the Lived Experience of Teaching Empathy in Medical Education?" University of Toledo / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1588620779984618.
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Scott, Edward Sherman. "Digital research cycles how attitudes toward content, culture and technology affect web development /." Orlando, Fla. : University of Central Florida, 2009. http://purl.fcla.edu/fcla/etd/CFE0002637.
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Griffin, Ann E. "The transition from training to work of newly qualified general practitioners : exploring participation and community." Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/10020771/.
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Grall, Kriti H., Ashish R. Panchal, Eliud Chuffe, and Lisa R. Stoneking. "Feasibility of Spanish-language acquisition for acute medical care providers: novel curriculum for emergency medicine residencies." Dove Press, 2016. http://hdl.handle.net/10150/617203.
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UA Open Access Publishing FundIntroduction: Language and cultural barriers are detriments to quality health care. In acute medical settings, these barriers are more pronounced, which can lead to poor patient outcomes. Materials and methods: We implemented a longitudinal Spanish-language immersion curriculum for emergency medicine (EM) resident physicians. This curriculum includes language and cultural instruction, and is integrated into the weekly EM didactic conference, longitudinal over the entire 3-year residency program. Language proficiency was assessed at baseline and annually on the Interagency Language Roundtable (ILR) scale, via an oral exam conducted by the same trained examiner each time. The objective of the curriculum was improvement of resident language skills to ILR level 1+ by year 3. Significance was evaluated through repeatedmeasures analysis of variance. Results: The curriculum was launched in July 2010 and followed through June 2012 (n=16). After 1 year, 38% had improved over one ILR level, with 50% achieving ILR 1+ or above. After year 2, 100% had improved over one level, with 90% achieving the objective level of ILR 1+. Mean ILR improved significantly from baseline, year 1, and year 2 (F=55, df =1; P,0.001). Conclusion: Implementation of a longitudinal, integrated Spanish-immersion curriculum is feasible and improves language skills in EM residents. The curriculum improved EM-resident language proficiency above the goal in just 2 years. Further studies will focus on the effect of language acquisition on patient care in acute settings
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Liebenberg, Nuraan. "A critical analysis of pre-hospital clinical mentorship to enable learning in emergency medical care." Thesis, Cape Peninsula University of Technology, 2018. http://hdl.handle.net/20.500.11838/2737.
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Thesis (Master of Emergency Medical Care)--Cape Peninsula University of Technology, 2018.For emergency medical care (EMC), clinical mentorship can be thought of as the relationship between the EMC students and qualified emergency care personnel. Through this relationship, students may be guided, supported and provided with information to develop knowledge, skills, and professional attributes needed for delivering quality clinical emergency care. However, this relationship is poorly understood and the focus of this research was to explore how this relationship enabled or constrained learning. Through having experienced mentorship, first as a student in EMC, then as an operational paramedic, mentoring students, I was privy to an insider perspective of clinical mentorship, and the experiences of fellow students‘. Through this experience the practices I observed may not have promoted learning. This is when my interest in pre-hospital clinical mentorship in relation to learning began. The aim of this research was to present a qualitative analysis of the clinical mentorship relationship in pre-hospital EMC involving the qualified pre-hospital emergency care practitioner (ECP) and the EMC student. The objectives included gaining an understanding of what enabled and/or constrained learning EMC, exploring clinical mentorship and learning in the pre-hospital EMC context, and gaining understanding of the role and scope of community members in the clinical mentorship activity system. The purpose of this study was to qualitatively document, by means of a thematic analysis, the pre-hospital clinical mentorship relationship, as well as document, by means of a Cultural Historical Activity Theory (CHAT) analysis, the clinical mentorship activity system. The focus of this qualitative documentation was the enablements and constraints to learning during clinical mentorship. This research also made possible recommendations for EMC clinical mentorship and education and may also inform (PBEC) policy, as well as work integrated learning (WIL) policy. Data collection included the use of diaries and focus group interviews. Analysis involved a two-part analysis, where data was reduced and understood with thematic analysis guided by Braun and Clarke (2006) six phase thematic analysis process (explained in Chapter three, Section 3.6). Thereafter, a CHAT analysis was conducted to uncover contradictions within the clinical mentorship activity system that made working on the object of activity difficult, thereby also uncovering constraints to learning. Inductive reasoning was applied to the thematic analysis to reduce data and identify themes and subthemes which provided insight into the enablements and constraints to learning in the pre-hospital EMC clinical mentorship relationship. The CHAT analysis of the data collected and analysed brought to surface the affordances, tensions as well as the primary-level and secondary-level contradictions of the clinical mentorship activity system. The thematic analysis of the clinical mentorship relationship provided limited understanding of the enablements and constraints to learning, and thus further motivated deeper analysis with CHAT. The results of this research included primary and secondary-level contradictions for almost all elements of the clinical mentorship activity system. Contradictions amongst the Division of Labour (DoL), the rules of the activity system, and the tools/resources of the activity system existed in that it constrained the interaction and activity of the subject and the community while working on the object of the activity system possibly achieving a lesser or undesired outcome of clinical mentorship.
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Maseti, Ophola S. "A model for role-based security education, training and awareness in the South African healthcare environment." Thesis, Nelson Mandela Metropolitan University, 2008. http://hdl.handle.net/10948/724.
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It is generally accepted that a business operates more efficiently when it is able to consolidate information from a variety of sources. This principle applies as much in the healthcare environment. Although limited in the South African context, the use of electronic systems to access information is advancing rapidly. Many aspects have to be considered in regards to such a high availability of information, for example, training people how to access and protect information, motivating them to use the systems and information extensively and effectively, ensuring adequate levels of security, confronting ethical issues and maintaining the availability of information at crucial times. This is especially true in the healthcare sector, where access to critical data is often vital. This data must be accessed by different kinds of people with different levels of access. However, accessibility often leads to vulnerabilities. The healthcare sector deals with very sensitive data. People’s medical records need to be kept confidential; hence, security is very important. Information of a very sensitive nature is exposed to human intervention on various levels (e.g. nurses, administrative staff, general practitioners and specialists). In this scenario, it is important for each person to be aware of the requirements in terms of security and privacy, especially from a legal perspective. Because of the large dependence on the human factor in maintaining information security, organisations must employ mechanisms that address this at the staff level. One such mechanism is information security education, training and awareness programmes. As the learner is the recipient of information in such a programme, it is increasingly important that it targets the audience that it is intended for. This will maximize the benefits achieved from such a programme. This can be achieved through following a role-based approach in the design and development of the SETA programme. This research therefore proposes a model for a role-based SETA programme, with the area of application being in the South African healthcare environment.
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Mindel, Merle Naomi. "The construction of medical education in an unequal society : a study of the University of Cape Town Medical School, 1904-1997." Thesis, University College London (University of London), 2003. http://discovery.ucl.ac.uk/10020434/.
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Click, Ivy A. "Practice Characteristics of Graduates of East Tennessee State University Quillen College of Medicine: Factors Related to Career Choices in Primary Care." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etd/1112.
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The nation is facing a physician shortage, specifically in relation to primary care and in rural underserved areas. The most basic function of a medical school is to educate physicians to care for the national population. The purpose of this study was to examine the physician practicing characteristics of the graduates of East Tennessee State University Quillen College of Medicine including factors that influence graduates’ specialty choices and practice locations, especially those related to primary care. Secondary data for this study were collected from the college’s student database system and the American Medical Association Physician Masterfile. The study population included all living graduates with Doctor of Medicine (MD) degrees who graduated from 1998 through 2009 (n=678). Statistical procedures included Pearson Chi-square, logistic regression, independent t tests, ANOVA, and multiple linear regression. Data analyses revealed that the majority of graduates were between 24 and 29 years of age, male, white, non-Hispanic, and from metropolitan hometowns. Most had completed the generalist track and initially entered a primary care residency training program. The majority passed USMLE Step 1 and Step 2 on the first attempt. The USMLE Step 2-CK average was 212.50. The average cumulative GPA was 3.44. Graduates were nearly evenly divided between primary care and nonprimary care practice, with the majority practicing in metropolitan areas. Graduates who initially entered primary care residency training were more likely to practice primary care medicine than those who entered nonprimary care programs; however, fewer graduates were practicing primary care than had entered primary care residency training. Graduates who attended internal medicine residency training were less likely to be practicing primary care medicine than those who attended family medicine, pediatrics, or OB/GYN programs. Women and Rural Primary Care Track graduates were significantly more likely to practice primary care than were men and generalist track graduates, respectively. Nonprimary care physicians had significantly higher USMLE Step 2-CK scores than did primary care physicians (PCPs). PCPs practiced in more rural locales than non-PCPs. Family physician graduates tended to practice in more rural locales than OB/GYNs or pediatricians. Hometown location predicted practice location over and above medical school track.
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Tomasa, Lynne Tokie. "Family medicine in the academic medical enterprise: Issues of resource dependence, culture, and professionalization." Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/282705.
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The healthcare marketplace is rapidly changing how we finance medical education, how we train physicians, and the interrelationships within an academic institution. This case study examined the historical development of the Department of Family and Community Medicine and the impact of growing financial constraints on the training of medical students and residents, the clinical practice, faculty workload, and departmental organization. The theoretical frameworks of resource dependence, culture, and professionalization theory were employed to understand how different groups within the context of an academic health center co-exist to meet the core missions of teaching, research, and service. Data collection was conducted over a two-year period and utilized the triangulation of interviews, document analysis, and participant observation methods. The study's findings indicated that the Department of Family and Community Medicine continually faced the challenge of being a primary care department in an academic medical culture that placed more emphasis on specialized care and specialty departments. Over a period of time, the Department went from a profit-center to a cost-center where faculty's ability to teach and conduct research revolved around the success or failure of the clinical care enterprise. Faculty productivity was increasingly emphasized and its definition was dependent on the healthcare marketplace and the availability of resources. The competitive health care market encroached on faculty workload and manifested itself in part through the loss of a major patient care contract, the receivership of the Department, and the splitting of the Department and its resources. During the period of time analyzed, the department was in a no-win situation because the success of the department was determined by more powerful coalitions that had decision making ability and controlled the necessary resources. The department's power lay in the provision of teaching resources and its alignment with the state's goal of training primary care physicians to work in rural and underserved communities. Conflict arose as departments tried to defend and protect their declining resources and jurisdictions. The study findings emphasized the importance of understanding departmental jurisdictions and how resource allocation decisions are made in the context of the academic setting and culture.
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Contos-McCord, Meredith L. "Health care professionals' opinions and practices concerning foodborne illness and food safety education during prenatal care." Virtual Press, 2001. http://liblink.bsu.edu/uhtbin/catkey/1221310.
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The problem of this study was to determine health care professionals' opinions and practices concerning foodborne illness and food safety education during prenatal care. Data were collected from Indiana health care professionals using a mailed questionnaire. The results found that 71.7% of respondents do not provide foodborne illness and food safety education during prenatal care, however, 80.6% would like to. Most of the respondents indicated that they do not have the time (71.4%), resources (57 1%), or knowledge (25.7%) to provide this information to patients. Many of the respondents indicated that they have not received information on foodborne illness during pregnancy and are unaware of the recommendations to provide this information during prenatal care. The opinion questions found that most agree that foodborne illness can be serious in pregnancy and would like to learn more about the risks of foodborne illness to pregnant women and the fetus.Department of Physiology and Health Science
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Williamson, Graham Richard. "Developing lecturer practitioner roles in nursing using action research." Thesis, University of Plymouth, 2003. http://hdl.handle.net/10026.1/414.
Full textAbstract:
The lecturer practitioner role in nursing is widely seen as offering hope for the future of nurse education, by overcoming the 'theory-practice gap', and establishing and maintaining effective links at many different levels between education and practice. It is clear, however, that there are a number of issues of concern about the role. These can be summarised as: lack of role clarity about overcoming the theory-practice gap; varying conceptions of the role and unclear job descriptions; and role conflicts and overload, from the conflicting demands of service and education settings Despite current political support for strengthening the links between higher education institutions and practice settings, a new governmental emphasis on the support of students in practice, and a growing in-depth evaluative literature about the role, there is no research examining its systematic development, or measuring and addressing aspects of lecturer practitioners' occupational stress and burnout. Initial project planning work found that lecturer practitioners perceived themselves as 'adding value' to education provision, with personal and professional gains for postholders. However, their key concerns were: absence of role clarity; absence of effective joint review/appraisal;a bsenceo f formal support In, order to develop and address aspects of lecturer practitioners' work roles and their employment position, this action research project was established. Using a spiral methodological framework, and a multi-methods approach to data collection to triangulate the findings, new knowledge about lecturer practitioner roles was uncovered, and employment practices were developed as a result. The project established three new mechanisms, and these outcomes can be summarised as: joint appraisal policies and materials; orientation/induction policies and materials; group support network. In addition, previously validated measures of occupational stress and burnout were used to meas. ure those conceptsi n this group of lecturer practitioners, and the impact of the project. They were found to be generally no more stressed or burnt out than comparable workers, and the project was unable to demonstrate statistically significant differences in beforeand after-scores. Synthesis of quantitative and qualitative findings indicates that these LPs were 'thriving rather than just surviving'.