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Selected AbstractsPediatric hospital medicine core competencies: Development and methodologyJOURNAL OF HOSPITAL MEDICINE, Issue S2 2010Erin R. Stucky MD Abstract Background: Pediatric hospital medicine is the most rapidly growing site-based pediatric specialty. There are over 2500 unique members in the three core societies in which pediatric hospitalists are members: the American Academy of Pediatrics (AAP), the Academic Pediatric Association (APA) and the Society of Hospital Medicine (SHM). Pediatric hospitalists are fulfilling both clinical and system improvement roles within varied hospital systems. Defined expectations and competencies for pediatric hospitalists are needed. Methods: In 2005, SHM's Pediatric Core Curriculum Task Force initiated the project and formed the editorial board. Over the subsequent four years, multiple pediatric hospitalists belonging to the AAP, APA, or SHM contributed to the content of and guided the development of the project. Editors and collaborators created a framework for identifying appropriate competency content areas. Content experts from both within and outside of pediatric hospital medicine participated as contributors. A number of selected national organizations and societies provided valuable feedback on chapters. The final product was validated by formal review from the AAP, APA, and SHM. Results: The Pediatric Hospital Medicine Core Competencies were created. They include 54 chapters divided into four sections: Common Clinical Diagnoses and Conditions, Core Skills, Specialized Clinical Services, and Healthcare Systems: Supporting and Advancing Child Health. Each chapter can be used independently of the others. Chapters follow the knowledge, skills, and attitudes educational curriculum format, and have an additional section on systems organization and improvement to reflect the pediatric hospitalist's responsibility to advance systems of care. Conclusion: These competencies provide a foundation for the creation of pediatric hospital medicine curricula and serve to standardize and improve inpatient training practices. Journal of Hospital Medicine 2010;5(4)(Suppl 2):82,86. © 2010 Society of Hospital Medicine. [source] Introduction to the Assessing Care of Vulnerable Elders-3 Quality Indicator Measurement SetJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2007Neil S. Wenger MD OBJECTIVES: To update and increase the comprehensiveness of the Assessing Care of Vulnerable Elders (ACOVE) set of process-of-care quality indicators (QIs) for the medical care provided to vulnerable elders and to keep up with the constantly changing medical literature, the QIs were revised and expanded. DESIGN: The ACOVE Clinical Committee expanded the number of measured conditions to 26 in the revised (ACOVE-3) set. For each condition, a content expert created potential QIs and, based on systematic reviews, developed a peer-reviewed monograph detailing each QI and its supporting evidence. Using these literature reviews, multidisciplinary panels of clinical experts participated in two rounds of anonymous ratings and a face-to-face group discussion to evaluate whether the QIs were valid measures of quality of care using a process that is an explicit combination of scientific evidence and professional consensus. The Clinical Committee evaluated the coherence of the complete set of QIs that the expert panels rated as valid. RESULTS: ACOVE-3 contains 392 QIs covering 14 different types of care processes (e.g., taking a medical history, performing a physical examination) and all four domains of care: screening and prevention (31% of QIs), diagnosis (20%), treatment (35%), and follow-up and continuity (14%). All QIs also apply to community-dwelling patients aged 75 and older. CONCLUSION: ACOVE-3 contains a set of QIs to comprehensively measure the care provided to vulnerable older persons at the level of the health system, health plan, or medical group. These QIs can be applied to identify areas of care in need of improvement and can form the basis of interventions to improve care. [source] Quality Indicators for Geriatric Emergency CareACADEMIC EMERGENCY MEDICINE, Issue 5 2009Kevin M. Terrell DO Abstract Objectives:, Emergency departments (EDs), similar to other health care environments, are concerned with improving the quality of patient care. Older patients comprise a large, growing, and particularly vulnerable subset of ED users. The project objective was to develop ED-specific quality indicators for older patients to help practitioners identify quality gaps and focus quality improvement efforts. Methods:, The Society for Academic Emergency Medicine (SAEM) Geriatric Task Force, including members representing the American College of Emergency Physicians (ACEP), selected three conditions where there are quality gaps in the care of older patients: cognitive assessment, pain management, and transitional care in both directions between nursing homes and EDs. For each condition, a content expert created potential quality indicators based on a systematic review of the literature, supplemented with expert opinion when necessary. The original candidate quality indicators were modified in response to evaluation by four groups: the Task Force, the SAEM Geriatric Interest Group, and audiences at the 2007 SAEM Annual Meeting and the 2008 American Geriatrics Society Annual Meeting. Results:, The authors offer 6 quality indicators for cognitive assessment, 6 for pain management, and 11 for transitions between nursing homes and EDs. Conclusions:, These quality indicators will help researchers and clinicians target quality improvement efforts. The next steps will be to test the feasibility of capturing the quality indicators in existing medical records and to measure the extent to which each quality indicator is successfully met in current emergency practice. [source] A Guide to Understanding and Developing Performance-Level DescriptorsEDUCATIONAL MEASUREMENT: ISSUES AND PRACTICE, Issue 4 2008Marianne Perie There has been much discussion recently about why the percentage of students scoring Proficient or above varies as much as it does on state assessments across the country. However, most of these discussions center on the leniency or rigor of the cut score. Yet, the cut score is developed in a standard-setting process that depends heavily on the definition for each level of performance. Good performance-level descriptors (PLDs) can be the foundation of an assessment program, driving everything from item development to cut scores to reporting. PLDs should be written using a multistep process. First, policymakers determine the number and names of the levels. Next, they develop policy definitions specifying the level of rigor intended by each level, regardless of the grade or subject to which it is applied. Finally, content experts and education leaders should supplement these policy definitions with specific statements related to the content standards for each assessment. This article describes a process for developing PLDs, contrasts that with current state practice, and discusses the implication for interpreting the word "proficient," which is the keystone of No Child Left Behind. [source] Rethinking the OSCE as a Tool for National Competency EvaluationEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2004M. A. Boyd The relatively recent curriculum change to Problem-Based Learning/Case-Based Education has stimulated the development of new evaluation tools for student assessment. The Objective Structured Clinical Examination (OSCE) has become a popular method for such assessment. The National Dental Examining Board of Canada (NDEB) began using an OSCE format as part of the national certification testing process for licensure of beginning dentists in Canada in 1996. The OSCE has been well received by provincial licensing authorities, dental schools and students. ,Hands on' clinical competency is trusted to the dental programs and verified through NDEB participation in the Accreditation process. The desire to refine the OCSE has resulted in the development of a new format. Previously OSCE stations consisted of case-based materials and related multiple-choice questions. The new format has case-based material with an extended match presentation. Candidates ,select one or more correct answers' from a group of up to15 options. The blueprint is referenced to the national competencies for beginning practitioners in Canada. This new format will be available to students on the NDEB website for information and study purposes. Question stems and options will remain constant. Case histories and case materials will change each year. This new OSCE will be easier to administer and be less expensive in terms of test development. Reliability and validity is enhanced by involving content experts from all faculties in test development, by having the OSCE verified by general practitioners and by making the format available to candidates. The new OSCE will be pilot tested in September 2004. Examples will be provided for information and discussion. [source] Academic Freedom and Academic Duty to Teach Social Justice: A Perspective and Pedagogy for Public Health Nursing FacultyPUBLIC HEALTH NURSING, Issue 2 2007Nancy L. Fahrenwald ABSTRACT Public health nursing practice is rooted in the core value of social justice. Nursing faculty whose expertise is in public health are often the content experts responsible for teaching this essential, yet potentially controversial, value. Contemporary threats to academic freedom remind us that the disciplinary autonomy and academic duty to teach social justice may be construed as politically ideological. These threats are of particular concern when faculty members guide students through a scientific exploration of sociopolitical factors that lead to health-related social injustices and encourage students to improve and transform injustices in their professional careers. This article (a) reviews recent challenges to academic freedom that influence social justice education, (b) explores academic freedom and duty to teach social justice within the discipline of nursing, and (c) proposes a praxis-based approach to social justice education, which is grounded in transformative pedagogy. [source] |