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Hudson, Michael B. "Mentoring effectiveness on clinical supervisors as perceived by athletic training students in the intercollegiate athletics clinical education experience /." free to MU campus, to others for purchase, 2002. http://wwwlib.umi.com/cr/mo/fullcit?p3052181.
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Somers, George Theodore 1951. "An approach to the understanding and measurement of medical students' attitudes toward a rural career." Monash University, School of Rural Health, 2004. http://arrow.monash.edu.au/hdl/1959.1/5190.
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Nasypany, Alan. "Survey of athletic training clinical education perceptions from the field /." Morgantown, W. Va. : [West Virginia University Libraries], 2005. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=4261.
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Thesis (Ed. D.)--West Virginia University, 2005.Title from document title page. Document formatted into pages; contains vii, 115 p. Includes abstract. Includes bibliographical references (p. 76-82).
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Gana-inatimi, Joy. "Self-management education in pulmonary rehabilitation for patients with COPD." Thesis, University of Central Lancashire, 2017. http://clok.uclan.ac.uk/25388/.
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Pulmonary rehabilitation (PR) is an effective strategy to manage chronic obstructive pulmonary disease (COPD). Self-management is an evolving and under-researched area within PR. The aim of this thesis was to explore the impact of self-management on health outcomes in patients with COPD.
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Padmore, Jamie Sue. "A conceptual framework of the clinical learning environment in medical education." Thesis, University of Maryland University College, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10041765.
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The hospital setting provides an environment for patients to receive medical care, for medical professionals to provide treatment, and for medical students and residents to learn the practice of medicine through supervised patient encounters. Education provided at the point of care allows students and residents to apply knowledge and develop clinical skills needed for medical practice. The hospital environment is also a confluence of learning and work, where applied learning takes place in an integrated and simultaneous manner with work duties. This setting, referred to as the clinical learning environment (CLE), is a focus for educators, scholars, administrators, regulators and accrediting agencies to understand, measure and improve it. While several instruments have been developed to measure the CLE, they suffer from great variation in subscales and content. The purpose of this study is to deconstruct the CLE, apply theories from related fields, and frame those theories in the context of the hospital setting to develop a conceptual framework for the CLE. A systematic review of the literature and thematic synthesis of existing research about the CLE provided evidence to inform and test a learning environment framework in the clinical setting. Data from qualitative CLE assessments, the ACGME Clinical Learning Environment Review (CLER) Pathways to Excellence, and existing CLE measurement instruments informed these results. Findings showed that a CLE framework consists of three mediating factors: learning, people, and change. As the clinical setting is a unique environment for learning, the people dimension (as a community of practice) was found to be the most influential on learning outcomes for students. The dimension of change was found to be most influential from the perspective of improving organizational or work outcomes, including patient care, clinical quality and patient safety. Findings from this study provide researchers and scholars with a framework to for developing measures of clinical learning environment effectiveness, and informing practitioners of CLE components and relationships that impact both learning and organizational outcomes.
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Bray, Farahnaz. "Student views on early clinical learning experiences." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86497.
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Thesis (MPhil)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Aim - The aim of this study was to explore second year medical students’ perceptions of their early clinical experiences with a view to improving curriculum development so as to enhance early clinical training programmes at Stellenbosch University (SU). Methodology - A qualitative, interpretive study, based on semi-structured focus group discussions with second year medical students was conducted in order to capture the relevant data that would provide information about their attitudes, feelings, beliefs and views on their early clinical learning experiences during their first year of studying medicine at SU. Thirty seven students participated in four focus group discussions after a process of selection of candidates using purposive sampling methods and stratification criteria to obtain the research sample. The interviews were moderated by an external facilitator, and were audiotaped and transcribed verbatim. The data transcripts were analysed and manually coded, and four broad categories with subthemes which illustrated the findings of the study, were identified and decided upon by the researcher and verified by the supervisor. Results - Early clinical exposure was generally positively perceived by students. It fostered a sense of vocation and feeling like real doctors, leaving students motivated and enhancing their learning interest. Early clinical skills training led to students’ professional development, acquiring the technical skills of a doctor, familiarisation with basic clinical terminology, and normal clinical findings which prepared them for later clinical studies. The new setting of practical learning in a simulated environment required students to adapt to small group learning and student clinical demonstrations which developed new learning styles and study skills. Some of the challenges that students encountered in the transition to clinical learning were, understanding the new subject of clinical medicine, having limited background knowledge to acquire basic clinical skills, and student clinical demonstrations. Although the strategy of peer physical examination was perceived to be effective, some ethical dilemmas emerged for students in terms of autonomy, and no opportunities available to practice on female models. Acting as a simulated patient proved to have both positive and negative outcomes on students’ skills acquisition. Factors that had a negative outcome on clinical skills learning were limited practice opportunities due to high student to teacher ratios per clinical session, and the variability of teaching content and practical techniques taught by various clinical tutors with different teaching strategies. The most stressful experience for students was the OSCE since it was a new method of assessment. Stress was attributed to uncertainty about the correct clinical content and techniques resulting from the teaching variability, while performance anxiety during the exam was related to inappropriate examiner behaviour. The OSCE was a positive learning experience because its format simulated the hospital setting which fostered students’ critical thinking abilities and time management. Conclusion - Early clinical exposure and practice have a great impact on junior medical students’ academic growth, and have positive learning outcomes. However, further development by the faculty in the areas of didactic skills, addressing the ethical issues related to student clinical demonstrations, and supporting students to enable a smooth transition to clinical learning will enhance and optimise their early clinical training.
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Wiseman, Jeffrey. "The patient problem list and clinical reasoning : linking education to practice." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=83167.
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This study examined how medical tutors used a tool from clinical practice known as the patient problem list to support students' clinical reasoning in a natural internal medicine ward setting. A grounded 2 case comparative study was conducted with 2 real patient case discussions by a tutor and 3 pre-clerkship students and a resident and 1 clerkship level student respectively. Codes that emerged by verbal analysis of the data were related to each other in a discourse map. In both cases evidence of cognitive apprenticeship teaching strategies and the patient problem list shaped and were shaped by a spiral model of increasingly elaborate shared knowledge. The patient problem list links tutor support to student education for practice with complex medical patients.
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Macdonald, Morag M. "Craft knowledge in medicine : an interpretation of teaching and learning in apprenticeship." Thesis, Open University, 1998. http://oro.open.ac.uk/56460/.
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The diagnosis and management of patients requires professional know-how or medical craft knowledge. To explain how this knowledge is acquired, this research asked 'How do medical experts pass on their craft?' Other questions arose through successive data collections and progressive focusing on what medical experts did well in their work and teaching. The programme comprised: pilot interviews with three expert physicians; a case study in a hospital medical unit; and paired consultant/SHO interviews. Participant observation, interviews, and expert-novice comparisons explored clinical work, teaching, and learning in apprenticeship. Data analysis of participants' responses and ward round discussions allowed identified categories to cluster within three inter-related constructs instrumental to the acquisition of medical knowledge: gaining experience in the experiential process of clinical practice (1); and the products of experience which manifest as experts' clinical expertise (2) and teaching/learning expertise (3). These constructs can be located within a model of apprenticeship based on Spady's (1973) analysis of authority in effective teaching containing two frames of reference: the social, 'traditional-legal'; and the individual, 'expert-charismatic'. The medical apprenticeship is associated with similar perspectives: the 'traditional-experiential' represents the professional process of learning through patient care with its infrastructure of clinical methods in presentation, discourse, and commentary; and the 'expert-charismatic' represents clinical and teaching expertise coupled with vocational enthusiasm. Experienced experts synthesised two repertoires of knowledge and skills derived from the craft knowledge of medicine and pedagogy, respectively. Both crafts are required for effective clinical education. While apprenticeship accommodates a range of teaching/learning experiences, in postgraduate education experts pass on knowledge through the deliberate engagement of junior doctors in diagnosis and management. The skills involved in this process were largely unrecognised by most senior and junior doctors and were not perceived as 'clinical teaching' although learning was structured through service-based work.
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Clark, Johanna M. "Empowerment of the Clinical Education Coordinator in the CAATE-Accredited Entry-Level Athletic Training Education Programs." Ohio University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1208535080.
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Onder, Sylvia Wing. "Women and the dynamic interaction of traditional and clinical medicine on the Black Sea coast of Turkey /." The Ohio State University, 1998. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487951907958023.
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Zellmer, Mark R. "Clinical Recognition of Obstructive Sleep Apnea in a Population-Based Sample." ScholarWorks, 2010. https://scholarworks.waldenu.edu/dissertations/837.
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Obstructive sleep apnea (OSA), a disorder in which the airway intermittently collapses and obstructs during sleep, is associated with increased cardiovascular and cerebrovascular morbidity and mortality, increased risk of motor vehicle accidents, metabolic syndrome, hypertension, and depression. Treatment of OSA attenuates or reverses many of these associated risks. However, most cases of OSA are unrecognized and untreated. The two most recent studies using 1990s data found that only 6.5 - 15.4% of OSA cases, depending on severity, are clinically recognized in mixed gender populations. Based on a conceptual framework of improved physician awareness of OSA, and reduced diagnostic access bias with the increased availability of sleep laboratory services, increased OSA recognition since the 1990s was predicted. Study participants with clinically recognized OSA were identified using the resources of the Rochester Epidemiology Project, while the Berlin Questionnaire OSA high risk classification was used as a surrogate for prevalent OSA in this population. Analysis in a mixed gender population determined that OSA clinical recognition among those with prevalent OSA was 22.7 % (95% CI 19.6 - 25.8%) for mild or greater OSA severity leaving more than 75% of prevalent OSA clinically unrecognized and untreated in this population. Obesity and male gender were associated with increased likelihood of clinical recognition in bivariate and multivariate analyses, though even among obese men only 36.5% of OSA was clinically recognized. In order to support positive social change and address these inequities of OSA clinical recognition, strategies that enhance OSA recognition overall, and more specifically target recognition of OSA among women and the nonobese, should be developed and implemented. Further research regarding such strategies should consider whether they reduce OSA associated morbidity and mortality.
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Shinew, Kayla A. "Entry-Level Athletic Trainers' Perceived Adequacy of Clinical Education in Preparationfor Confident Professional Practice." Ohio University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1304895131.
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Gates, Madison Lamar. "THE NATURE AND MEANING OF CULTURE IN PRIMARY CARE MEDICINE: IMPLICATIONS FOR EDUCATION, CLINICAL PRACTICE, AND STEREOTYPES." Lexington, Ky. : [University of Kentucky Libraries], 2009. http://hdl.handle.net/10225/1174.
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Thesis (Ph. D.)--University of Kentucky, 2009.Title from document title page (viewed on June 2, 2010). Document formatted into pages; contains: ix, 193 p. : ill. (some col.). Includes abstract and vita. Includes bibliographical references (p. 172-189).
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Amjed, Natasha. "Clinical importance of cervical cancer prevention and education in Zambia and Sub-Saharan Africa." Thesis, Boston University, 2013. https://hdl.handle.net/2144/21121.
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Thesis (M.A.)INTRODUCTION: Cervical cancer exists as the second most common cancer among women world wide, and in numerous countries is the leading type of female cancer. Specifically, Zambia has one of the highest mortality rates and cervical cancer incidence rates. The goal of this study is to analyze the published literature on preventative techniques for cervical cancer in resource-deprived areas of sub-Saharan Africa by focusing on the correlation between the Human Papilloma Virus (HPV), Acquired Immunodeficiency Syndrome (AIDS), and cervical cancer; the accuracy and feasibility of “screen and treat” clinics; and socio-economic and geographical barriers. RESULTS: Correlations exists between the prevalence of HIV, HPV, and cervical cancer in sub-Saharan Africa, and a clear association exists between HPV and cervical cancer. The deliverance of HPV vaccines as well as educational programs has helped to improve this medical problem. Main screening methods for cervical cancer include the Pap smear, naked eye visual inspection of the cervix after the application of either diluted acetic acid (VIA), Lugol’s iodine (VILI), or with a magnifying device (VIAM), colposcopy, and tests for HPV markers. Studies indicate that the VILI screening test has the highest level of sensitivity with the LEEP method also of importance. The procedure is relatively low cost and is easy to implement when excising lesions. Major risk factors and determinants of cervical cancer can help to explain the underlying barriers of access to care. Women’s misconceptions regarding cervical cancer, gender inequality in African nations, socio-economic status, and foreign aid all play major roles the cervical cancer screening process. A lack of proper education, especially among women in sub-Sahara Africa, has led to misconceptions about the causes of cervical cancer. Studies have found that some women associated cervical cancer with prostitution, a Satanic curse, and other bad behavior. Gender inequality also plays a significant role since the Zambia government had reported that a husband would have absolute rights over children and reproductive rights over his wife once he had made payments for a bride. Geographical barriers also exist as the terrain in Zambia is swamp-like and heavy flooding throughout the year is common. After flooding occurs, communities become physically separated. Furthermore, there are correlations between high incidence rates of cervical cancer and high poverty as it has been shown that the largest number of people living on less than $1.25 dollars per day is that of sub-Saharan Africa. DISCUSSION: Studies have indicated that virtually all of cases of cervical cancer are caused by HPV, implying that HPV testing and detection would largely prevent the progression of lesions. Ultimately, this would reduce the high incidence rate of cervical cancer in Zambia and in other Sub-Saharan African countries. In areas where cytology programs are either non-existent or not efficient, HPV testing approaches should be evaluated and implemented, and they should be based off of the HIV/AIDS infrastructure that has already been established. In regards to the screening approaches, VIAM and VIA are the only two tests that are also practical, affordable, and available. Affordability is the major concern when implementing screening programs in sub-Saharan Africa; for this reason, either VIAM and VIA would arguably be the best options as long as they were effective. VIA would be considered the most appropriate method in terms of screening procedures as the method has the advantage of giving immediate results that can be applied to large populations. Lastly, the lack of proper education, including sex education, has in part led to drastic misconceptions about the causes of cervical cancer. Women hold negative beliefs about cervical cancer since they associate it with being unclean and view it as a reflection of bad behavior. Geographical barriers also play a role; the physical inaccessibility of the clinic discourages women to come to the clinic for screenings. Home visits by physicians and/or the utilization of community health workers may help to eliminate this particular barrier of access. This strategy would be especially beneficial to residents of rural areas since they are more likely to live farther away from institutionalized clinics and screen and treat facilities and are also more likely to be in a state of extreme poverty.
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Laiou, Elpiniki. "The effects of practical training methods of different forms and intensities on the acquisition of clinical skills." Thesis, University of Birmingham, 2010. http://etheses.bham.ac.uk//id/eprint/1078/.
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Simulation holds enormous potential for medical education, where patient safety concerns have made practice on patients less acceptable. However, there is no unequivocal evidence of simulation training translating to improved performance in vivo. Therefore, the aim of this thesis is to add to the literature on simulation training by a) synthesising the current evidence on the effectiveness of simulation training in healthcare, b) investigating the effectiveness of different ‘doses’ of mannequin training in learning laryngeal mask airway placement and c) assessing the effectiveness of a simulation course on managing life threatening illness. This thesis has added to the literature in the field of medical education a review of reviews of the evidence regarding the effectiveness of simulation training in medicine and surgery, and two RCTs evaluating different simulation training courses. The review of reviews highlighted that simulation training can be effective, but there was little consistent evidence across tasks or types of simulator. The two RCTs reported nil results, reinforcing that simulation alone is insufficient to ensure effectiveness. These results highlight the importance of recognising when simulation training is appropriate, how simulation interacts with other elements of a training programme and how the simulation can be made maximally effective.
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Cruickshank, Mary Therese. "Developing a quality culture within a school of nursing in higher education /." View thesis View thesis, 2000. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030424.121009/index.html.
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Opusunju, Ellis Ehizele. "Quality Improvement Through Evidence-Based Education: Advancing Obesity Awareness and Clinical Management Strategies for People Living with Mental Disorders." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3407.
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People living with mental disorders (PLWMDs) are at an increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the general-population obesity rate is 36% compared to more than 50% for PLWMDs. Mental health professionals (MHPs), focused on addressing psychiatric conditions, seldom recognize and clinically manage obesity. Furthermore, this population is socioeconomically disadvantaged with poor dietary habits while consuming psychiatric medications that stimulate hunger, further exacerbating the risk for obesity. The Promoting Action on Research Implementation in Healthcare Services (PARISHS) framework guided this quality improvement project to improve obesity awareness and management for PLWMD at a large state psychiatric hospital. An evidence-based education intervention was implemented to positively impact obesity awareness and clinical management or MHPs. The evaluation used a validated instrument with a pre- and posttest design. Paired t test was used to analyze multiple constructs from the MHP participants (N = 50). Overall, the pretest indicated 76% of MHPs were not involved in helping obese PLWMDs manage their weight; however, the posttest data (at 90-days) revealed that 90% were involved in this activity. This represents a positive shift in obesity perceptions and management knowledge. Future research needs to evaluate the impact of the perceptions on process measures and clinical outcomes. This project led to positive social change as MHPs are more likely to address obesity in PLWMD due to their increased awareness and knowledge. This project has broader implications as the program can be duplicated in other psychiatric hospitals.
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Boon, Johannes Marinus. "Procedures performed by family physicians in hospital practice in a developing country (South Africa) an evaluation of clinical anatomy competence /." Pretoria : [s.n.], 2009. http://upetd.up.ac.za/thesis/available/etd-07292009-093644/.
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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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Bonanno, Laura S. "Nurse Anesthesia Program Administrator's Decision-Making in Determining Interventions for a Student Exhibiting Unsatisfactory Clinical Performance." ScholarWorks@UNO, 2019. https://scholarworks.uno.edu/td/2587.
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The purpose of this grounded theory study is to define the process that nurse anesthesia program administrators use to determine if a student nurse anesthetist’s unsatisfactory clinical performance warrants intervention by the program. There is little room for error in anesthesia practice as mishaps typically result in significant injury and death. Students who exhibit unsatisfactory clinical performance may pose an immediate risk to patient safety as well as a future risk if allowed to progress in the program. The lack of guidance in the form of clearly articulated expectations and processes contribute to the emotional strain nurse anesthesia faculty and administrators experience when observing unsatisfactory clinical performance. From the data collected in the interviews with ten nurse anesthesia program administrators, a five-phase decision-making model entitled the Nurse Anesthesia Program Administrator Decision Making Model was developed. The five phases of the model include: receiving the feedback, validating the concern, assessing accountability and planning for remediation, removing the student from clinical training and moving to dismissal, and notifying the student of the decision. The guiding principle of this model is the importance of following institutional and program policies throughout the process. This study is intended to provide guidance to nurse anesthesia program administrators who are faced with a student demonstrating unsatisfactory clinical performance regarding what behaviors may require an intervention by the program.
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Monaghan, Jenni. "Experiences and perspectives of self-management for low back pain in clinical practice : implications for support and education." Thesis, Northumbria University, 2015. http://nrl.northumbria.ac.uk/28953/.
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Pain is multidimensional and self-management is advocated to manage the biopsychosocial impact of this on individuals’ lives. Thus, these individuals’ perspectives regarding self-management have been explored. This study aimed to firstly explore how self-management was understood in the context of low back pain through the experiences of people living with low back pain and physiotherapists’. This then led to informing the development of an education programme for physiotherapists to support self-management. The study used a mixed method approach, which involved three phases being carried out over a period of time with each informing the subsequent phase. Phase 1, a qualitative synthesis examined primary qualitative research focusing on people living with low back pain and physiotherapist experiences of self-management of low back pain. The synthesis informed phase 2, two qualitative studies addressing areas of paucity found within the literature. The final phase, a feasibility study involved the development of an education programme for physiotherapists who completed pre and post outcome measures. Focus groups were also used in evaluating the intervention. The qualitative synthesis revealed a limited amount of literature regarding physiotherapists’ views and experiences of self-management of low back pain. A large proportion of studies that related to physiotherapy focusing on people living with low back pain experiences of self-management concentrated on strategies, in particular exercise with limited relation of this to daily life. The primary qualitative studies highlighted some difficulties physiotherapists faced when supporting the management of the biopsychosocial impact of LBP. Further, at times self-management could be used as a last resort. In relation to this, half of the people interviewed living with low back pain found this to be restricting their daily activities and were fearful and concerned regarding worsening pain in the future. These findings suggested people were not managing the biopsychosocial impact of low back pain and physiotherapists at times viewed influences on the pain experience as separate rather than integrated. Pain neurophysiology education linked to clinical practice was used to demonstrate the integrated nature of the pain experience, be relevant to physiotherapists and ultimately facilitate biopsychosocial self-management through enhancing understanding of the multidimensional nature of pain. Collectively, this thesis has developed understanding of self-management from the physiotherapist perspective, illuminating the support required for physiotherapists and revealed physiotherapists value pain neurophysiology education linked to practice however further support is required to implement this in clinical practice.
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Schladen, Manon Maitland. "Formative Research on an Instructional Design Theory for Virtual Patients in Clinical Education: A Pressure Ulcer Prevention Clinical Reasoning Case." NSUWorks, 2015. http://nsuworks.nova.edu/gscis_etd/35.
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Despite advances in health care over the past decades, medical errors and omissions remain significant threats to patient safety and health. A large number of these mistakes are made by trainees, persons who are just beginning to build the case-based experiences that will transform them from novices to expert practitioners. Clinicians use both intuitive and deductive problem-solving skills in caring for patients and they acquire expertise in applying these skills through interaction with many and varied cases.
The contemporary heath care environment, with decreased lengths of stay for patients and reduced duty hours for trainees, makes getting optimal patient exposure difficult. Virtual patients (VPs), online, interactive patient cases, may help close the case exposure gap. Evidence has shown that VPs improve clinical reasoning skills, but no formal instructional design theory of VPs has been advanced. The goal was to conduct formative research to develop an instructional design theory of VPs to help novice clinicians cultivate clinical reasoning and diagnostic skills. The instructional design theory, goal-based scenarios (GBS), grounded in the learning theory, Case-based Reasoning, provided methods that promised to be appropriate to the goal.
An existing, two-module, multimedia VP, Matt Lane, A Pressure Ulcer Prevention Virtual Patient, was tested with 10 medical trainees to determine which methods of GBS it incorporated and which of its methods were not part of GBS. Leaners' experience of what worked and didn't work to promote learning in the VP was analyzed. The VP was found to incorporate all GBS methods and one significant method, the Life Model, that was not part of GBS. The Life Model Method involved replicating, with a high degree of fidelity, the experiences of a real patient in creating the VP scenario.
Recommendations for customization of GBS for VPs included more explicit advertisement of learning goals and leverage of Internet search engines to provide just-in-time resources to support problem-solving. Incorporation of the Life Model was also recommended along with the Simplifying Conditions Method from Elaboration Theory to manage the complexity inherent in the Life Model. The resultant, enhanced GBS theory may be particularly relevant in teaching patient-centered care.
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Naylor, Amy Rose. "Exploring the utility and phenomenological experience of group and individual clinical supervision." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6981/.
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Volume One. Volume one comprises of three chapters. The first chapter is a systematic review of research into the utility of group format clinical supervision in the clinical practice of therapists. The second chapter is an empirical paper which explores the phenomenological experience of clinical supervision from the perspective of clinical psychologists. The final chapter is a public dissemination document which provides an accessible summary of the above documents. Volume Two: Volume two consists of five clinical reports. The first report presents the case of a woman with a moderate learning disability and low mood, formulated using behavioural and psychodynamic theory. The second report is a service evaluation exploring the utility of a set of easy read, adapted maternity notes for expectant mothers with learning disabilities. The third report presents an analogue assessment completed to aid a staff team in the support of a service user with agitation in the context of dementia. The fourth report presents a behavioural approach in the support of a female who experiences compulsive hair pulling. The final report is the abstract of an oral presentation describing how acceptance and commitment therapy was used to support a male with cystic fibrosis and low mood.
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Ajjawi, Rola. "Learning to communicate clinical reasoning in physiotherapy practice." University of Sydney, 2006. http://hdl.handle.net/2123/1556.
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Doctor of Philosophy (PhD)Effective clinical reasoning and its communication are essential to health professional practice, especially in the current health care climate. Increasing litigation leading to legal requirements for comprehensive, relevant and appropriate information exchange between health professionals and patients (including their caregivers) and the drive for active consumer involvement are two key factors that underline the importance of clear communication and collaborative decision making. Health professionals are accountable for their decisions and service provision to various stakeholders, including patients, health sector managers, policy-makers and colleagues. An important aspect of this accountability is the ability to clearly articulate and justify management decisions. Considerable research across the health disciplines has investigated the nature of clinical reasoning and its relationship with knowledge and expertise. However, physiotherapy research literature to date has not specifically addressed the interaction between communication and clinical reasoning in practice, neither has it explored modes and patterns of learning that facilitate the acquisition of this complex skill. The purpose of this research was to contribute to the profession’s knowledge base a greater understanding of how experienced physiotherapists having learned to reason, then learn to communicate their clinical reasoning with patients and with novice physiotherapists. Informed by the interpretive paradigm, a hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants’ learning journeys were diverse, although certain factors and episodes of learning were common or similar. Participation with colleagues, peers and students, where the participants felt supported and guided in their learning, was a powerful way to learn to reason and to communicate reasoning. Experiential learning strategies, such as guidance, observation, discussion and feedback were found to be effective in enhancing learning of clinical reasoning and its communication. The cultural and environmental context created and supported by the practice community (which includes health professionals, patients and caregivers) was found to influence the participants’ learning of clinical reasoning and its communication. Participants reported various incidents that raised their awareness of their reasoning and communication abilities, such as teaching students on clinical placements, and informal discussions with peers about patients; these were linked with periods of steep learning of both abilities. Findings from this research present learning to reason and to communicate reasoning as journeys of professional socialisation that evolve through higher education and in the workplace. A key finding that supports this view is that clinical reasoning and its communication are embedded in the context of professional practice and therefore are best learned in this context of becoming, and developing as, a member of the profession. Communication of clinical reasoning was found to be both an inherent part of reasoning and an essential and complementary skill necessary for sound reasoning, that was embedded in the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined and should be learned concurrently. The learning and teaching of clinical reasoning and its communication should be synergistic and integrated; contextual, meaningful and reflexive.
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Payor, Tara. "Perspective from Two Professions: Two professionals Making Meaning of the Clinical Educator Role." Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/6349.
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The purpose of this phenomenological study was to describe how professional educators make sense of their role in helping novice practitioners make meaning from authentic clinical practice. Simultaneously studying a clinical educator from teacher and graduate medical education, and subsequently setting their stories side by side, speaks to the interest both professions have in learning from the other. Both clinical educators were Board certified in their respective area of practice. In-depth phenomenological interviewing was used as the study’s methodology, and the professional formation construct served as the study’s conceptual framework. Data corroborate findings in the literature that there is a lack of consensus about what the clinical educator role entails. Participants showed alignment with the professional formation conceptual framework and demonstrated that the clinical educator role is multifaceted, complex, and made up of more than discrete functions. Their capacity to support professional formation comes from their ownership of a special mix of cognitive and behavioral processes, professional knowledge, and personal attributes. Given both professions’ interest in and ongoing efforts to improve clinical education, the study can help both continue their work toward understanding the clinical educator role and ensuring that people selected for the role are chosen through thoughtful methods and provided with clinical-educator-specific professional development throughout the professional lifespan.
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Ogston, Jill. "Educational staff's responses to challenging behaviour of children with learning disabilities : the impact of diagnosis and clinical research portfolio." Thesis, University of Glasgow, 2008. http://theses.gla.ac.uk/404/.
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Background Current behavioural models of challenging behaviour suggest that the way in which difficult behaviour is managed by staff can serve to either reduce or maintain the behaviour in the long term (Hastings & Remington, 1994; Hastings & Brown, 2000; Hastings et al, 2003). Therefore, it is important to consider factors that may influence special education staff’s behavioural responses to pupils’ challenging behaviour and the associated causal attributions and emotional reactions. One area that has received little attention is the potential impact of a pupil’s diagnosis in addition to their learning disability on staff members’ responses. Materials and Methods This present study involved 102 special education staff who were asked to provide cognitive, emotional and behavioural responses to written vignettes of one of three conditions: (1) a pupil with a learning disability without an additional diagnosis displaying aggressive behaviour, (2) a pupil with a learning disability and an Autism Spectrum Disorder displaying aggressive behaviour, and (3) a pupil with a learning disability and Epilepsy displaying aggressive behaviour. Staff background characteristics were also measured. Results Planned analysis showed that participants did not significantly differ in their responses to challenging behaviour of a pupil with and without additional diagnoses. Secondary analysis indicated that only a minority of participants considered the additional diagnosis to be the main cause of the pupil’s challenging behaviour. In addition, a number of significant associations between staff background characteristics and self-efficacy were found. Conclusions The results are discussed in relation to recent literature. Methodological issues and implications for clinical practice are also considered.
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Stidworthy, Jennifer Jane. "The implementation of a portfolio assessment system for a rural clinical school in South Africa : what can be learned from the implementation of portfolios as an assessment system in a rural clinical school." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80389.
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Thesis (MPhil)--Stellenbosch University, 2013.ENGLISH ABSTRACT: A portfolio assessment system was designed to meet the needs of a Rural Clinical School education platform, hosting final year MB ChB students for the duration of their final year. A study entitled “What can be learned from the implementation of a portfolio assessment system, to be used in the assessment of clinical reasoning of final MB ChB students placed in a Rural Clinical School in South Africa? “ was conducted. The experience of educators and students during this process was explored. The findings are in keeping with the literature. Van Tartwijk & Driessen 2009, Eley et Al 2002, Lake & Ryan 2004, Burch & Seggie 2008 claim that portfolios drive deep student learning and develop clinical reasoning. Burch & Seggie (2008) offer an assessment tool which has proved feasible within the South African setting on which this portfolio assessment system was modelled. The assessment tool design faced a number of challenges within the RCS setting which were addressed during a review process. The portfolio assessment system is viewed as a work in progress requiring further development. Despite the constraints and challenges, both staff and students unanimously supported the development of patient case studies within the design as a valuable learning tool.
AFRIKAANSE OPSOMMING: ‘n Portefeulje assesserings sisteem is ontwerp om die behoeftes van ‘n UKWANDA Landelike Kliniese Skool opvoedings program wat die gasheer van die MB ChB student tydens hul finale jaar is, na te kom. ‘n Studie genaamd “ Wat kan geleer word uit die implementering van ‘n portefeulje assesserings sisteem, wat gebruik gaan word om die kliniese redenering te bepaal van finale jaar MB ChB student wat geplaas is in ‘n Landelike Klinieke Skool in Suid Afrika? ” is uitgeoefen. Die ervaring van die dosent, so wel as die studente, is ondersoek. Die bevinding is in lyn met die literatuur. Van Tartwijk & Driessen 2009, Eley et Al 2002, Lake & Ryan 2004, Burch & Seggie 2008 beweer dat portfeuljes dryf student tot diep studie en ontwikkel kliniese redenasie. Burch & Seggie (2008) bied ‘n assesserings (hulp)middel aan wat toepaslik en uitvoerbaar is in die SA konteks , waarop die portfeulje assessering sisteem gebaseer is. Die ontwerp van die assesserings (hulp)middel het vele uitdagings binne die RCS opset in die oog gestaar. Dit is aangespreek tydens ‘n proses van hersiening. (Lather, 2006).Die portefeulje assesserings sisteem word gesien as ‘n werk onder hande en vereis verdere ontwikkeling. Ten spyte van die beperkinge en uitdagings het beide die staf en die student onomwonde die ontwikkeling van pasiente gevalle studies, binne die ontwerp, as ‘n waardevolle leermiddel gesien.
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Jarden, Rebecca Jane. "Gastric residual volumes in the adult intensive care patient : a systematic review : a thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Master of Nursing (Clinical) /." ResearchArchive@Victoria e-Thesis, 2009. http://hdl.handle.net/10063/1188.
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Stretton, David. "The effect of governmental reimbursement policies on curriculum and programs in medical education through their impact on clinical organizations associated with colleges of medicine /." View abstract, 2005. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3191720.
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Olsen, Gaynel S. "A Study of the Relationships among Characteristics of Experiences Medical Students Encounter of Patients Diagnosed with Diabetes Mellitus and the Objective Standardized Clinical Exam Scores during the Family Medicine Clerkship." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd_retro/136.
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This study was conducted using a quantitative, non-experimental, correlation design to explore the relationships between student-patient encounters with Diabetes Mellitus and the scores on the Diabetes Mellitus OSCE during Family Medicine clerkship. The focus of the research was to explore relationships between various methods of competency measures of third-year medical students during their Family Medicine clerkship as they encountered patients diagnosed with Diabetes Mellitus (DM). A paradigm shift in medical education is taking place and driven by the Liaison Committee for Medical Education (LCME). These changes are fueled by the public outcry demanding verification of competency of our physicians. The study's focus is on the competency outcome measures from a new educational design, moving away from patient-centered education to competency-based, student-centered education and away from a norm-referenced assessment to a criterion-referenced assessment. Relevant literature on the need for competency-based medical education and various methods for implementation informed this study, including Miller (1990); Barman (2005); Barrows (1993), De Champlain, Margolis, Macmillan, and Klass (2001); Harden and Gleeson (1979); and Howley and Wilson (2004). More direct observation of student performance must be instituted with documentation of student clinical skills. Findings revealed no differences are seen in medical student competency acquisition during encounters of patients diagnosed with DM, in terms of cognitive, psychomotor, neck exam or affective measures, during the VCU SOM Family Medicine Clerkship. Significant differences are noted in the psychomotor subscale scores of the DM OSCE as the result of suburban clerkship site placement, as opposed to rural or urban sites. Finally, students at non-residencies see more patients with DM than at residency clerkship sites. Implications for further research were discussed focusing on 1) why differences were found only found in suburban clerkship sites; 2) the possibility that cultural competency understanding may play a role in these differences; 3) how do students learn about DM prior to the FM clerkship; 4) the possibility that the OSCE does not reflect community FM practice models.
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Stubenberg, Patricia Anne. "Descriptions of Clinical Teaching Excellence in the First Two Years of Medical School: The Views of Academic and Community-Based Preceptors." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4780.
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The changing dynamics in patient care, along with the increasing role of early clinical experiences and community-based teaching models, can be a catalyst in furthering important research and training for clinical teaching excellence. Curricular challenges as well as limited scholarly work generate educational possibilities for study. Embracing a strong educational doctrine of teaching excellence in undergraduate medical education will help shape the future of health care and ultimately enhance patient care.
This grounded theory study (a) described and explained descriptions of teaching excellence among first and second year academic and community-based preceptors in the Longitudinal Clinical Experience (LCE) program at the University of South Florida (USF), Morsani College of Medicine and (b) generated theory related to the explanation of the phenomenon of clinical teaching excellence. The single site study drew upon preceptors in the Longitudinal Clinical Experience (LCE) course who were nominated for a teaching excellence award by second, third, and fourth year medical students through a voluntary, online survey. Based on these surveys, 17 academic and 17 community-based preceptors who represented someone who had gone above the student's expectations in providing an exceptional learning experience were nominated. From the list of 34, 13 eligible preceptors were invited to participate in the study and a sample of eight (four academic and four community-based preceptors) were interviewed.
The semi-structured, one-hour face-to-face interviews were conducted between April and December 2012 using an interview process. All interviews were located in the preceptor's academic, hospital, or practice setting except one, which took place in the preceptor's private residence. Interview questions were distributed to participants in preparation of the meeting. After obtaining written informed consent by the participants, interviews were tape recorded and lasted an average of 60 minutes.
Data analysis was completed using a complimentary, manual and electronic coding method to categorize and develop initial concepts and themes. Data were continuously tested with field notes, observations of the interviews and settings, and thoughts from the researcher's journal, supporting the fluid and constant comparative analysis of grounded theory. The following four thematic categories, supported by preceptors' reflective and reframing practices, emerged from the presentation of data for theory development: (a) preceptors have an awareness of, and adapt to, each student's readiness to learn; (b) preceptors demonstrate an intrinsic commitment to teaching; (c) preceptors create supportive learning environments; and (d) preceptors utilize sound pedagogical practices. As a result of an in-depth, reciprocal analysis from the selected categories and descriptions of clinical teaching excellence, a higher-order construct (theory) was generated, and suggested transforming and implementing adult learning principles and strategies into early clinical education experiences can have a positive influence on medical education and strengthen student learning.
Recommendations for practice and future research include (a) utilizing findings in curriculum planning, (b) expanding the study to increase awareness of the value of reflection and reframing in clinical teaching, (c) investigating the impact of clinical teaching excellence on patient care practices, and (d) expanding the study to compare primary care and specialty disciplines. Professional development programs should include designing activities based on preceptors' instructional needs, sound pedagogical practices, and in compliance with continuing medical education requirements.
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Cox, Lisa N. "Learning Style Differences of Undergraduate Allied Health Students in the clinical and Classroom Setting." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1244737268.
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Hargreaves, Julian P. "Learning as participation in early clinical experience : its meaning for student physiotherapists." Thesis, University of Sussex, 2014. http://sro.sussex.ac.uk/id/eprint/49396/.
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This research explores the meaning of learning as a process of social participation in clinical practice. The study focused on six first‐year student physiotherapists during a period of early clinical experience on a work integrated learning programme. The programme was unique at the time of the study in that it placed students in clinical settings from the first week of their undergraduate experience. The research applied a case study design and qualitative data were gathered from each student via on‐line learning journals, reflection lines and pre/post experience interviews. Data were analysed, between and within cases, to develop a sense of progressive narrative through the experiences made significant by each participant over the course of the clinical experience. An abductive logic was applied to develop a more theoretical explanation of learning as participation in clinical practice for each participant. The study concludes that these individuals adopted an agentic approach and recognised the benefit to their learning of proactively seeking opportunities to get involved in practice. Interaction with a range of co‐participants was valued, for a variety of reasons. Students were more willing to discuss their own deficits and ask questions of junior clinicians. Interactions with senior clinicians were more likely to challenge and extend the students' practice. Interactions with non‐physiotherapy colleagues in the multidisciplinary team were valued for the different perspectives they offered. Students valued participation in situations where they could assume greater responsibility, as long as their efforts were recognised by the clinical educator. Participants did not always see value in “routine” practice where there was little opportunity to be involved in decision making or discussion, describing their involvement as being “an extra pair of hands”. Participants described their performance of secondary Discourses of practice in the construction of their respective identities, which I describe as productive worker, trustworthy student, engaged student and junior professional. These Discourses supported participants' bids for recognition and progressive involvement in communities of clinical practice. However, where the participant identity was associated too strongly with a particular Discourse the educator could restrict access to learning opportunities. Participants dis‐identified themselves from Discourses that conflicted with individual habitus and conveyed lack of care or unethical behaviour. Where power relations challenged the possibility of overt rejection, participants were strategic and excluded these Discourses from their future, rather than current repertoires. At the start of their early clinical experience, participants expressed a desire to “learn by doing” and “learn on the job”. These cases demonstrate that even at an early stage of experience, participants were contributing to the productivity of the workplace and they felt valued when their contributions were recognised. These cases demonstrate that mutual relations support participation but require ongoing negotiation. Considering mutuality as a mechanism for participation in early clinical experience can support analysis of the ways in which social relations support both learning and work objectives. Mutuality as a mechanism for participation requires the learner and educator to recognise these dual objectives. Changing conditions of practice can threaten mutuality. Where a threat occurs, it is countered by adaptive practices that continue to support mutuality in terms of engagement, repertoire and enterprise with the community of clinical practice.
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Doby, Cynthia Funnye. "Awareness of Clinical Laboratory Sciences and Shortage of Clinical Laboratory Scientists in the 21st Century." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3095.
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Retiring baby boomers and the lack of interest and awareness among college students to enroll in an accredited Clinical Laboratory Science (CLS) program have created a shortage of CLS professionals in the 21st century. The U.S. Bureau of Labor Statistics predicts 18,000 CLS vacancies by 2018. However, only about 5,000 students graduate from accredited CLS programs each year. The purpose of this study was to explore students' perceptions of allied health professions and factors that influenced students and CLS professionals to select CLS as a profession. Bandura's social cognitive career theory served as the theoretical framework for this phenomenological study. Convenient purposeful sampling was used to select the 7 CLS professionals, 5 high school students, and 5 college students in the Chicago area. Participants took part in either a 30- to 60-minute group session or a 45- to 90-minute semi structured interview. Qualitative analysis included open axial coding to identify emerging patterns and themes from the transcripts. Findings revealed that the perceptions of both high school and college students' knew little about the CLS profession, and factors influencing CLS as a career choice included interests in science, health care, and family. CLS professionals indicated their interests in science and a high demand for CLS services in the workforce led them to pursue careers in the field. Implications for social change include improving professional-development programs for student awareness of allied health professions and mitigating the shortage of clinical laboratory scientists.
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Leclair, Susan J. "The Correlation Between the Levels of Education of Clinical Laboratory Personnel and the Accuracy of Peripheral Blood Smear Results." ScholarWorks, 2001. https://scholarworks.waldenu.edu/dissertations/1393.
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This study correlated the performance accuracy of peripheral blood differentials evaluated by clinical laboratory scientists and clinical laboratory technicians. Fifty-one senior-year students from four clinical laboratory science baccalaureate programs and 37 second-year students from five clinical laboratory technician programs were given 10 peripheral blood differentials to perform. Results were compared to the values assigned by the Rajamaki method of proficiency testing. There was a significant discrepancy in the levels of accuracy between the two cohorts, suggesting that the results of peripheral blood differentials performed by clinical laboratory technicians is suspect. Facilities wishing to maintain or improve the quality of laboratory services should consider allowing only baccalaureate level clinical laboratory scientists to perform peripheral blood differentials.
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McLain, Nina E. "Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make A Difference?" Availabe to VCU users online at:, 2007. http://hdl.handle.net/10156/1778.
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Jelso, Janay. "Development and Formative Implementation of a Nutrition Assessment and Peer Education Program Based on Dietary Analysis at a California State University." DigitalCommons@CalPoly, 2009. https://digitalcommons.calpoly.edu/theses/165.
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A healthy diet has been established as a key component contributing to an individual’s quality of life. Statistics show that the diet of Americans needs improvement (Guenther et al., 2007) indicating possible lack knowledge of what healthy eating behaviors are. There is an abundance of nutrition misinformation available to the consumer (American Dietetic Association, 2002a). Dietary interventions that provide credible education based on readiness to change behaviors and goal setting have been successful in increasing awareness of what healthy eating behaviors are and changing existing behaviors over time (Ammerman et al., 2002; Evans & Sawyer-Morse, 2002; Gambera et al., 1995; Hebert et al., 1999; Oenema & Brug, 2003; Proper, et al., 2003).
In an effort to provide a college community with credible nutrition education based on dietary analysis and stage of change, a nutrition assessment and consultation program was developed and implemented at a college campus during the fall 2003 quarter. It was integrated into the existing fitness testing and prescription program, polyFIT. Seven students, referred to as fitness consultants, majoring in Nutrition or Kinesiology were recruited and trained to distribute appropriate education based on individual clients’ dietary analysis, a stage of change assessment and personal goals. Intervention materials were constructed using a variety of resources focusing on areas of nutrition. Thirty clients participated during the fall 2003 quarter; all were freshman and sophomores enrolled in a Healthy Living course. Separate survey questionnaires were designed for the consultants and the clients to gather their perceptions of the program components. PolyFIT continued to offer the program, modifying it over time, for at least 4 years after the initial implementation.
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Hanson, Caroline E. "Athletic Training Education Reform." Otterbein University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=otbn161099572507585.
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Cunningham, Shala. "Influence of a post-graduate physical therapy residency program on clinical reasoning, professional development, and career advancement in Nairobi, Kenya." Diss., NSUWorks, 2018. https://nsuworks.nova.edu/hpd_pt_stuetd/64.
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Problem Statement
Residency programs that emphasize clinical reasoning and manual therapy can provide a means to optimize the outcomes of physical therapy without the need for or access to expensive equipment. The residency format of continuing education could allow physical therapists in developing countries access to specialty training and ongoing mentorship. However, there are limited studies that investigate the influence of residency training on the progression of clinical reasoning, professional development, and career advancement.
Purpose
The purpose of this study was threefold. The first objective was to describe the outcome of a post-graduate orthopaedic manual therapy residency program on development of knowledge and clinical reasoning skills by physical therapists in Nairobi, Kenya. The second objective was to explore the influence of the residency program on the participants’ professional development and career advancement. The last objective was to explore the residency experience from participants’ perspectives.
Methodology
This mixed methods study utilized a sample of convenience that included residents in the third (n=14) and fourth (n=13) cohorts of the orthopaedic manual therapy residency program in Kenya. Data collection included an assessment of clinical reasoning through a live patient examination, a survey on professional and career development, and qualitative interviews.
Results
There was a significant improvement in clinical reasoning development as measured by an assessment of a live patient examination (p
Discussion
The residency program in Nairobi, Kenya may serve as a framework for the formation of post-graduate education programs in other developing countries. The development of residency programs that can influence the ability of physical therapists to provide treatment efficiently and effectively may ultimately assist in serving community physical therapy needs.
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Keith, Diana K. "Body Image Education as a Preventive Measure for Eating Disorders and Obesity in Ninth-Grade Students." DigitalCommons@USU, 2010. https://digitalcommons.usu.edu/etd/758.
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Obesity and eating disorders are major public health problems in the U.S. Prevention of these problems in childhood and adolescence is crucial to avoid medical complications and costs associated with these conditions. A growing body of research supports designing and implementing interventions to prevent obesity and eating disorders simultaneously by targeting common risk factors such as poor body image. This study explored the use of a body image education unit as a preventive measure for obesity and eating disorders. Ninth-grade students attending health class in a public school in Northern Utah (n = 117) were assigned to either an intervention or control group. At the end of a 3-week nutrition unit, the intervention group received a 3-day intervention designed to promote body image. Participants were surveyed at baseline, immediately following the nutrition unit and intervention, and at a 2-month follow-up. At post-test and follow-up, participants in the intervention group and the control group both self-reported improved body image and dietary practices. Modest improvements were seen in both the intervention and control groups. The intervention group did not have any advantage over the control group. It is recommended that future interventions be of greater intensity and longer duration in order to assess use of body image education to improve body image and dietary constructs. Interventions will have the greatest effect sizes if they target high risk individuals. Universal interventions targeting entire schools and communities are also recommended to help change environmental risk factors and reduce risk in those who may be at high risk but would not be included in a high risk grouping for a targeted intervention.
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Condron, Kelly Brookshire. "The impact of a novel mobile-friendly nutrition education intervention on dietary patterns among CalFresh applicants." DigitalCommons@CalPoly, 2019. https://digitalcommons.calpoly.edu/theses/2101.
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Background: College students experience food insecurity at a rate 3.5 times higher than the U.S. general population, affecting 43% of students. Furthermore, college students consume high amounts of ultra-processed products. NOVA, a food classification system, takes into account food processing and is thought to better fit the modern food environment.
Purpose: The purpose of this research project was to examine the impact of CalFresh enrollment on food security status. This study also evaluated the impact of two different nutrition education interventions (MyPlate and MyPlate+NOVA) on participants’ dietary habits and nutrition knowledge.
Methods: Food security, dietary habits, and nutrition knowledge were assessed at baseline, three-month, and at six months follow-up. Food security status was measured using the USDA 6-item Short Form Food Security Assessment Module. A 12-week mobile nutrition education intervention providing MyPlate or MyPlate+NOVA nutrition messages was implemented, and dietary habits were assessed using an adapted NHANES 2009-2010 dietary screener questionnaire, while nutrition knowledge questions were created from the nutrition education messages.
Results: Food insecurity decreased by approximately 63% among CalFresh participants. There were no differences in dietary habits or nutrition knowledge among any of the intervention groups or the control group.
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Mpuntsha, Loyiso F. "Continuing professional development in medicine : the inherent values of the system for quality assurance in health care." Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52173.
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Thesis (MPhil)--Stellenbosch University, 2001.ENGLISH ABSTRACT: The practice of medicine has always been a big area of interest as a profession. The focus ranges depending on issues at hand - it may be on the educational, training, humanistic, economic, professional ethics and legal aspects. One area of medicine that is under the spotlight around the world is that of the maintenance of clinical competency, followed very closely and almost linked to professional ethics. This study follows the introduction of a system of Continuing Professional Development (hereinafter also referred to as CPD), in South Africa and an overview of how it has been introduced in a few other countries. The main areas of focus being the extrication of inherent values of CPD, relating this aspect to quality improvement in medical health care. The medical profession as well as most of the interested parties, has different perspectives regarding the fact that the system is regulated through legislation. There is also the doubt whether the CPD system will be effective in achieving the goals that it has been set to achieve. Although a system of Continuing Medical Education has been a tradition in all countries, which implies that the CPD system is not totally new as far as the educational principles are concerned, the values accruable need to be exploited. It is the possible success of this kind of evaluations that may foster more understanding of the inherent values in this CPD system.
AFRIKAANSE OPSOMMING: Beroepsgewys het die praktyk van geneeskunde nog altyd groot belangstelling gelok. Die fokus verskuif na gelang van die onderwerpe ter sprake. Dit wissel van opvoedkunde, opleiding, humanisme, ekonomie, en professionele etiek tot regsaspekte. Dwarsoor die wêreld word daar gefokus op die handhawing van kliniese vaardighede, gevolg deur professionele etiek wat ook daarin verweef is. Hierdie studie bespreek die instelling van 'n stelsel van Voortgesette Professionele Ontwikkeling (hierna verwys na as VPO) in Suid-Afrika asook oorsig oor die wyse waarop dit in 'n paar ander lande ingestel is. Die klem lê op die inherente waardes met betrekking tot die verbetering gehalte in mediese gesondheidsorg. Die mediese beroep, asook meeste van die belangegroepe het verskillende opvattings oor die feit dat die stelsel deur wetgewing gereguleer word. Daar is ook twyfel of die VPO-stelsel in sy vooropgestelde doelwitte sal slaag. Wat die opvoedkundige beginsels betref, is die VPO-stelsel nie totaal en al nuut nie. Alhoewel VPO in ander lande tradisie is, is dit nodig om die totstandkoming van waardes te ontgin. Die moontlike sukses van hierdie tipe van evaluasies mag dalk beter begrip ten opsigte van die inherente waardes in die VPO-stelsel bevorder.
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Malachi, Judia Yael. "Physician Assistants' Preventive Medicine Practices and Related Habits, Attitudes, and Beliefs." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/890.
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Physician assistants play a pivotal role in expanding access to care, yet research on their preventive medicine practices is limited. Guided by Lewis's conceptual model for predicting counseling practices, this cross-sectional study examined the relationship between physician assistants' preventive medicine practices, personal health habits, prevention and counseling attitudes, and perceived barriers to the delivery of clinical preventive services. A 104-item self-administered survey was used to collect data from 314 physician assistants attending the American Academy of Physician Assistants' 42nd Annual Conference. Data were analyzed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. Results indicated that physician assistants engaged in preventive medicine activities about half the time, believed it was very important to counsel patients on prevention topics, felt they were somewhat effective in changing patient behaviors, and reported that barriers were somewhat important in hindering preventive care delivery. Significant and predictive relationships between physician assistants' health habits, attitudes, perceived barriers, and practices were found. These findings may guide researchers, providers, policymakers, and the public in making informed and comprehensive health care decisions. This study contributes to social change by serving as a baseline for the creation of effective strategies for physician assistant practice and self-assessment. Additionally, data from this study can be used to advocate changes in the education, training, and certification of physician assistants, as well as foster medicine and public health collaborations.
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Singh, Jitendra, and Tracy Eisenschenk. "A Thematic Analysis of the Attitudes and Perceptions of Faculty Towards Inclusion of Interprofessional Education in Healthcare Curriculum." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/ijhse/vol8/iss1/1.
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This qualitative study aimed to explore attitudes and perceptions of faculty towards inclusion of interprofessional education (IPE) in healthcare curriculum. Efforts were made to explore faculty members’ definition of IPE, significance of including IPE in content and curriculum and resources available to implement such initiatives in healthcare education programs. Further, challenges faced while including IPE in curriculum were also explored. Face to face semi structured interviews were conducted, and a six-step thematic analysis framework was utilized to analyze the collected data. Further, four dimension criteria was utilized to establish the rigor of the study. Eleven participants across undergraduate and graduate health profession programs participated in in-depth semi structured interviews. Findings suggest that faculty defined IPE through the framework of teamwork, the integration of clinical and non-clinical health-based disciplines, and as a means to foster experiential learning. Faculty identified organizational support, culture, the healthcare industry, administration, and accreditation as both resources and barriers to the successful implementation of IPE. Because there is paucity of research on IPE in clinical and non-clinical health disciplines, this research can provide practical tips to both academic administrators and faculty members.
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Amal, Asiri. "Saudi Arabian Students in Postgraduate Dental Programs: Investigating Factors Associated with Burnout." Scholarly Commons, 2019. https://scholarlycommons.pacific.edu/uop_etds/3641.
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Burnout related to emotional and physical study or work demands affects an individual’s performance and well being. This study focused on Saudi Arabian dental residents studying in the United States and the United Kingdom who are faced with many challenges in pursuit of a higher education degree. A survey including demographic and MBI questions was distributed to assess this population’s level of burnout. The Maslach Burnout inventory (MBI) was has been widely used in the literature to assess three components of burnout: emotional exhaustion (EE), depersonalization (DEP), and (diminished) personal accomplishment (PA). Potential predictors of burnout level, tested for statistical significance, included: (1) country (US vs UK), (2) hours of work, (3) sponsorship status, (4) marital status (5) gender and (6) prior work experience. Using multiple regression analyses, those found to predict EE included hours of work, sponsorship status, and gender. Only gender was found to predict PA. None of the variables were predictive of DEP. Moreover, after controlling for the demographic variables, the country where studying did not help account for level of burnout. Limitations of the study, implications for practice and suggestions for further research are offered in the discussion.
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Lower, Tonia L. "Improving healthcare provider knowledge in acute and primary transgender health needs:The implementation of a clinical education program with urgent care and emergency room staff and providers." Otterbein University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1481300755682172.
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Kauffman, Jill Lauren. "Poetry "Found" in Illness Narrative: A Feminist Approach to Patients' Ways of Knowing and the Concept of Relational Autonomy." Thesis, Connect to resource online, 2009. http://hdl.handle.net/1805/1963.
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Thesis (M.A.)--Indiana University, 2009.Department of Philosophy, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Peg Brand, James Capshew, Richard Gunderman, Jane E. Schultz. Includes vitae. Includes bibliographical references (leaves 117-122).
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Mai, Yvonne M. "Use of various health care providers and the associated clinical and humanistic outcomes in an ambulatory Medicare population." Scholarly Commons, 2016. https://scholarlycommons.pacific.edu/uop_etds/265.
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Background: The use of complementary and alternative medicine (CAM) and other non-physician health care providers (dentists, optometrists, etc.) has steadily increased in the United States; however, the associated outcomes reported in the Medicare beneficiary population are limited. Objective: To evaluate the utilization of different healthcare providers by Medicare beneficiaries and assess resultant beneficiary outcomes. Methods: Fourteen outreach events targeting Medicare beneficiaries were conducted throughout Northern/Central California during the 2014 open enrollment period. Trained student pharmacists (working under licensed pharmacist supervision) provided beneficiaries with comprehensive medication therapy management (MTM) services. During each intervention, demographic, quality-of-life, health behavior and health provider/service utilization data were collected. Results: Of 620 respondents, 525 (84%) and 84 (14%) reported using at least one non-physician healthcare professional or CAM provider, respectively. Beneficiaries who reported using non-physician healthcare providers were significantly (p < 0.05) more likely to indicate being ‘very confident’ in managing their chronic health conditions. The number of providers seen with prescriptive authority was positively correlated with the number of prescription medications taken (r s =0.342, p < 0.001). The total number of providers seen was positively correlated with the number of drug-related issues identified (r s = 0.179, p < 0.001). Conclusion: Many beneficiaries have multiple chronic conditions and increasingly utilize a variety of healthcare professionals. As such, bridging the communication chasm between these professionals can improve humanistic outcomes and minimize medication related issues of Medicare beneficiaries. Coordinated care, a key strategy for improving healthcare delivery under the Affordable Care Act, is a step in the right direction.
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Conroy, Megan Elizabeth MD. "A qualitative study on entrustment decision making in the intensive care unit: about more than the learner." The Ohio State University, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=osu1618222237764719.
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Haynes, Angela. "Assessing Nurse Practitioners' Knowledge and Clinical Practice with Regard to the Oral-Systemic Link." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etd/3848.
Full textAbstract:
Nurse Practitioners (NPs) comprise a significant portion of the U.S. primary care workforce and play an essential role in patients' health awareness, prevention strategies, disease management, and in providing appropriate provider referrals. Nurse Practitioners receive education on the oral-systemic connection, yet there have been limited studies on the clinical practice of NPs assessing the oral cavity to evaluate the condition of the teeth and the oral tissues. The purpose of this study was to explore the nurse practitioners’ knowledge and practice habits of assessing the oral cavity for diseases or abnormalities in the mouth that can, in turn, affect overall health. A total of 66 NPs were included in the study, primarily female (91%) with master’s degrees (77%). While knowledge and education were not significantly associated, this research found significant associations between confidence and assessments, less than one-third (30.3%) were confident in their knowledge and ability to evaluate oral abnormalities.