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Practitioners
Kinds of Practitioners Terms modified by Practitioners Selected AbstractsAMERICAN ACADEMY OF NURSE PRACTITIONERS 19th NATIONAL CONFERENCE FOR NURSE PRACTITIONERSJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 8 2003Louisiana June 1, Morial Convention Center New Orleans [source] FELLOWS OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERSJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2000Article first published online: 24 MAY 200 First page of article [source] RURAL NURSE PRACTITIONERS IN SOUTH AUSTRALIA: RECOGNITION FOR REGISTERED NURSES ALREADY FULFILLING THE ROLEAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2004Judy Bagg ABSTRACT:The introduction of the nurse practitioner role is hailed as a new initiative in the South Australian public health system. In reality, some registered nurses working in rural public health care facilities have been practicing in the role for many years. The role of the rural registered nurse, the pathway towards achieving rural nurse practitioner status and the anticipated advantages of implementing the rural nurse practitioner role will be presented. [source] Using NIC to Describe the Role of the Nurse PractitionerINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Cindy S. Haugsdal PURPOSE To have nurse practitioners (NPs) identify the 20 most prevalent NIC interventions describing their nursing practice; to determine if the NIC is applicable to the NP role. METHODS The study used a descriptive survey design. NPs with prescriptive privileges in the state of Minnesota received a cover letter and survey that included a description of NIC and a list of the 486 intervention labels and their definitions from the NIC (3rd ed.). Each participant was asked to identify all interventions performed at least once per month in their practice and to provide basic demographic data, including identification of NP specialty. FINDINGS A total of 1,190 surveys were mailed with a return rate of 37%. NPs' average age was 45 years; the average number of years of NP practice was 9. Employment in a clinic represented the work setting of 72% of respondents followed by hospital practice (11%) and long-term care (10%). Specialty (certified) areas were family practice (27%), pediatrics (21%), adult (19%), women's health (16%), geriatrics (11%), psychiatric (5%), and oncology (1%). The educational level was primarily master's degree (73%). NPs identified an average of 120 interventions they performed at least once per month. These interventions reflected areas of patient education and support, as well as documentation and physician collaboration. The 20 most frequently selected interventions were reported by 71%, 90% of respondents. Four core interventions ,"documentation,""telephone consultation,""teaching: prescribed medication," and "emotional support", were used at least once per month by all specialties. DISCUSSION The level of consistency (70%) among responses validates the strong foundation that professional nursing, as described by NIC, provides NPs in their role. Four core interventions and the remaining 16 most frequently selected interventions that are more specific to each specialty practice indicates that NIC is comprehensive enough to meet the needs of a variety of NP practices. CONCLUSIONS NIC encompasses key areas of interventions (health screening, treatment and management, health promotion and education, psychosocial support, indirect activities) central to the role of NPs, but qualitative comments described the need for more language within NIC to characterize the NP role related to the prescribing of medications and treatments. Some respondents found the definitions to be unclear as to whether they were performing or ordering/prescribing the intervention. This lack of clarity could be addressed by further development of the NIC definitions and activities so the advanced role of the NP is more fully described. Development of documentation systems using the core interventions identified by the various NP specialties is needed. Using standardized nursing language for documentation will enable NPs to build clinical databases that reflect and describe the role. Future research needs to be focused by NP specialty and to go beyond the NIC definition and include analysis at the activity level. [source] The Acute Care Nurse Practitioner: challenging existing boundaries of emergency nurses in the United KingdomJOURNAL OF CLINICAL NURSING, Issue 3 2006Tracey Norris BSc Hons Aim., This study explored the opinions of nurses and doctors working in emergency departments towards the development of the Acute Care Nurse Practitioner service in the United Kingdom. Background., Studies carried out in the United States and Canada suggest that the Acute Care Nurse Practitioner can have a positive impact on the critically ill or injured patients' experiences in the emergency department. This role is well developed in the United States and Canada, but is still in its infancy in the United Kingdom. Design and methods., A descriptive, exploratory design incorporating questionnaires (n = 98) and semi-structured interviews (n = 6) was employed. The sample included nurses and doctors from seven emergency departments and minor injury units. Results., Respondents felt it was important for the Acute Care Nurse Practitioner to have obtained a specialist nurse practitioner qualification and that the Acute Care Nurse Practitioner should retain a clinical remit. While participants seemed comfortable with nurses undertaking traditional advanced skills such as suturing, reluctance was displayed with other advanced skills such as needle thoracocentesis. Three main themes were identified from the interviews: inter-professional conflict, autonomy and the need for the Acute Care Nurse Practitioner. Discussions., Doctors were reluctant to allow nurses to practise certain additional advanced skills and difficulties appear to be centred on the autonomy and other associated inter-professional conflicts with the role of the Acute Care Nurse Practitioner. Conclusion., Nurses and doctors identified a need for the Acute Care Nurse Practitioner, but the blurring of boundaries between doctors and nurses can result in inter-professional conflict unless this is addressed prior to the introduction of such advanced practitioners. Relevance to clinical practice., As the role of the emergency nurse diversifies and expands, this study re-affirms the importance of inter-professional collaboration when seeking approval for role expansions in nursing. [source] Clinical evaluation tools for dual track adult and gerontology nurse practitioner studentsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2009Adult Health Nurse Practitioner Program, Director, FAANP Advanced Senior Lecturer, Valerie T. Cotter MSN Abstract Purpose: To describe the development of a dual track offering for the Adult Health and Gerontology Nurse Practitioner (AGNP) Programs at the University of Pennsylvania School of Nursing and share clinical evaluation tools used with nurse practitioner students in this curriculum. Data sources: Selected research and clinical articles. Conclusions: A variety of evaluation approaches are utilized in the AGNP student clinical performance evaluation. These incorporate the extended clinical practicum sequence for the dual track curriculum in addition to each individual program's objectives. Formative and summative evaluations include reflective logs, clinical documentation of patient encounters, preceptor evaluation, and faculty site visits. Self-evaluative skills of the student and quality faculty feedback are two additional integral components that facilitate learning outcomes in the cognitive, psychomotor, and affective learning domains. Implications for practice: The summary of evaluation tools presented here is an example of how the AGNP Programs at the University of Pennsylvania School of Nursing effectively measure student progress in a curriculum model for dual track enrollment. [source] Motivating Health: Strategies for the Nurse PractitionerJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2003Lynne S. Duran ARNP Purpose To provide the nurse practitioner (NP) with a practical prescription for acquiring expertise in health behavior change using integrated principles from the transtheoretical model of change and motivational interviewing. Data Sources Extensive literature review of current theory and research on health behavior change. Conclusion Expertise in motivating health behavior change is essential to effective health promotion and to the NP role. Implications for Practice Lifestyle choices are principal contributors to the leading causes of death and most chronic diseases in the United States. Traditional health behavior interventions are often ineffective in motivating and sustaining lifestyle change. [source] Nurse Practitioner, Nurse Midwife and Physician Assistant Attitudes and Care Practices Related to Persons with HIV/AIDSJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2000Jane E. Martin RN ABSTRACT Although multiple studies of nurses' attitudes toward people living with HIV/AIDS (PLWAs) can be found in the literature, little is known about the attitudes, beliefs and practices of nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs). A survey including a 21-item AIDS Attitude Scale measuring the constructs of Avoidance and Empathy was sent to 1,291 NPs, CNMs and PAs in Louisiana, Arkansas and Mississippi to describe their attitudes and care practices related to PLWAs. Respondents who were more comfortable treating PLWAs had significantly lower avoidance scores and significantly higher empathy scores than respondents with lower comfort levels in providing care. Greater than 80% of respondents indicated that they would provide health care to HIV-infected individuals. Respondents who referred HIV/AIDS patients for all care did so primarily due to lack of experience with HIV and the availability of more experienced providers. Avoidance and empathy scores were not found to be significantly associated with referral for care. This study suggests that this group of providers has relatively low avoidance and high empathy toward PLWAs and is willing to care for HIV-infected individuals. This study was supported by Grant No. 5U69PE00112-06 from the Department of Health & Human Services, Health Resources and Services Administration, HIV/AIDS Bureau, National AIDS Education and Training Center. [source] Professional knowledge and the epistemology of reflective practiceNURSING PHILOSOPHY, Issue 1 2010Elizabeth Anne Kinsella PhD Abstract Reflective practice is one of the most popular theories of professional knowledge in the last 20 years and has been widely adopted by nursing, health, and social care professions. The term was coined by Donald Schön in his influential books The Reflective Practitioner, and Educating the Reflective Practitioner, and has garnered the unprecedented attention of theorists and practitioners of professional education and practice. Reflective practice has been integrated into professional preparatory programmes, continuing education programmes, and by the regulatory bodies of a wide range of health and social care professions. Yet, despite its popularity and widespread adoption, a problem frequently raised in the literature concerns the lack of conceptual clarity surrounding the term reflective practice. This paper seeks to respond to this problem by offering an analysis of the epistemology of reflective practice as revealed through a critical examination of philosophical influences within the theory. The aim is to discern philosophical underpinnings of reflective practice in order to advance increasingly coherent interpretations, and to consider the implications for conceptions of professional knowledge in professional life. The paper briefly examines major philosophical underpinnings in reflective practice to explicate central themes that inform the epistemological assumptions of the theory. The study draws on the work of Donald Schön, and on texts from four philosophers: John Dewey, Nelson Goodman, Michael Polanyi, and Gilbert Ryle. Five central epistemological themes in reflective practice are illuminated: (1) a broad critique of technical rationality; (2) professional practice knowledge as artistry; (3) constructivist assumptions in the theory; (4) the significance of tacit knowledge for professional practice knowledge; and (5) overcoming mind body dualism to recognize the knowledge revealed in intelligent action. The paper reveals that the theory of reflective practice is concerned with deep epistemological questions of significance to conceptions of knowledge in health and social care professions. [source] Use of intravenous sedation in the management of patients with high blood pressureORAL SURGERY, Issue 3 2009S. Woolcombe Abstract Aim:, We aim to determine the prevalence of undiagnosed/poorly controlled hypertension and study the population demographics. We also aim to study the effects of intravenous midazolam on peri-operative blood pressure and pulse. Finally, we aim to assess the value of screening for hypertension and determine the degree of white coat hypertension. Material and methods:, A cohort of 83 patients with a pre-assessment blood pressure recording ,160/100 mmHg was studied. Oral surgery treatment was performed under intravenous sedation with midazolam or local anaesthesia alone where sedation was contraindicated. Blood pressure and pulse were monitored throughout surgery. Following treatment, patients were advised to attend their General Practitioner (GP) for assessment of their blood pressure and information regarding the outcome of this visit was requested. Results:, Seventy-three percent of the cohort had no previous diagnosis of hypertension. The use of intravenous midazolam significantly reduced peri-operative blood pressure compared with local anaesthesia alone [reduction in systolic blood pressure (BP) of 40 mmHg and diastolic BP of 21 mmHg]. Fifty percent of those who attended their GP received active treatment for hypertension at the first visit. A further 25% were kept under review. Blood pressure measurements at hospital pre-assessment were substantially higher than those recorded by GPs. Conclusion:, A clear indication exists for the use of intravenous sedation with midazolam for oral surgery procedures in patients with high blood pressure. There is a significant prevalence of undiagnosed and poorly controlled hypertension. Blood pressure screening in the dental setting is a valuable tool for identifying hypertensive patients. White coat hypertension is significantly greater in the oral surgery department than at the GP surgery. [source] Identity wars, the counselling and psychotherapy profession and practitioner-based researchPSYCHOTHERAPY AND POLITICS INTERNATIONAL, Issue 1 2010John Lees Abstract The counselling and psychotherapy profession has reached a watershed in its history. After a century of introspection and disputes between different theoretical orientations the profession is now facing outwards to the world. This is leading to a great deal of turmoil and upheaval. Instead of the theoretical disputes which typified the twentieth century the current disputes concern the relationship between the profession and society at large. Identity Wars have replaced the Paradigm Wars. These cover a range of practice-orientated and research-orientated issues. This article looks at the recently-published book, Practitioner-based Research: Power, Discourse and Transformation (Lees and Freshwater, 2008), from the point of view of these broader contextual developments. It discusses, amongst other things, the contribution of the book to these developments. Copyright © 2010 John Wiley & Sons, Ltd. [source] ,Psy' research beyond late modernity: towards praxis-congruent researchPSYCHOTHERAPY AND POLITICS INTERNATIONAL, Issue 1 2010Richard House Abstract Lees and Freshwater's Practitioner-based Research is a significant intervention into the struggle for the ,research soul' of the psychological therapies. Positivistic notions beloved of the managerialist ,audit culture', centred on the totem of ,evidence-based practice', are increasingly colonizing psy research, creating a new ,regime of truth' that privileges ,standards', ,competencies' and ,quality assurance', and presages a shift in the locus of power away from practitioners' professional autonomy and towards managerialist bureaucracy. In arguing that no one (,scientific') paradigm should necessarily be assumed to be more ,valid' than a multiplicity of possible others, they advocate the practitioner's voice having at least equal validity to that of academics and bureaucrats, aiming to establish an ,epistemology of practice' that redresses a balance that has become too skewed towards uncritical, and in many ways anti-human, ,technical rationality'. This review article explores the rationale for this shift, and finds it compelling and convincing. It is also argued here that great benefit can be gained for the future flourishing of psy research from building bridges to other radical-critical research traditions and innovations in late-modern culture. Copyright © 2010 John Wiley & Sons, Ltd. [source] The problem that is researchPSYCHOTHERAPY AND POLITICS INTERNATIONAL, Issue 1 2010Stephen Paul Abstract In this paper the author considers the newly published book Practitioner-based Research: Power, Discourse and Transformation in the context of the current research agenda in the psychological therapies. He questions the dominant research paradigm with its emphasis on quantitative and/or reductionist methodologies. He postulates that a different approach is needed to understand human suffering and mental health. He contextualizes psychological therapy in a social context and proposes that it is a political act where its focus is on empowerment and liberation. Copyright © 2010 John Wiley & Sons, Ltd. [source] Finding the Heart and Soul of Bureaucrats: A Practitioner Talks BackPUBLIC ADMINISTRATION REVIEW, Issue 3 2009Claire Mostel First page of article [source] The Response to Hurricane Katrina: A Practitioner,Academic ExchangePUBLIC ADMINISTRATION REVIEW, Issue 6 2006Article first published online: 15 NOV 200 No abstract is available for this article. [source] Practitioner in the Classroom: Bringing Local Government Experience into the Public Administration CurriculumPUBLIC ADMINISTRATION REVIEW, Issue 3 2003Donna M. Milam First page of article [source] The Evolution of the Community Health Nurse Practitioner in KoreaPUBLIC HEALTH NURSING, Issue 3 2004Ho Soon Michelle Cho Ph.D. Abstract Community health nursing in Korea has undergone dramatic changes since 1980. These changes arose through the efforts of Mo Im Kim, an internationally known leader in Korean nursing, and colleagues who successfully worked to establish a national community health nurse practitioner program. This article will review these changes with the aim of describing the evolutionary process that culminated in a community health care system that is meeting the needs of Korean citizens who live in rural and isolated areas. The authors believe that the evolution of the community health nurse practitioner in Korea provides a paradigm that can serve as a model for other countries. Health care in Korea is organized differently than that in the United States. However, the plan, process, and political activism can be used for community and public health nursing change in the United States. The information contained in this article is based upon interviews with Mo Im Kim and 20 of her colleagues and associates. Interviewees were selected using a "snowball" sampling technique. Additional data were derived from various professional and personal documents of these individuals. The first author conducted the interviews in both Korea and in the United States. [source] Extended scope practitioners and clinical specialists: A place in rural health?AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2008Sally A. Ruston Abstract This review identifies two models of allied health advanced practitioner practice that are currently in place in the National Health Service in the United Kingdom (UK). A review of the background to advanced practitioner status is given for UK allied health professionals and comments made on the outcomes of the UK roles. Description of the work of Clinical Specialist and Extended Scope Practitioner is given. Alignment with senior physiotherapy staff roles in Australia is commented upon. Some barriers or impediments to implementation of such a system in Australia are discussed with respect to registration, funding and support. The feasibility of such advanced practice roles for physiotherapy is discussed while benefits and cautions are identified. The potential for such a model of health service to be used in Australia, particularly in rural and remote areas, is identified for debate. [source] Prostate-specific antigen testing: uncovering primary care influencesBJU INTERNATIONAL, Issue 5 2006Gerard J. Gormley OBJECTIVES To examine influences on the behaviour of General Practitioner (GP) in relation to prostate-specific antigen (PSA) testing. SUBJECTS AND METHODS In Northern Ireland in 2003,2004, all GPs (1067) were invited to complete a self-administered postal questionnaire survey that was then matched with a regional PSA-testing database. The main outcome measures were individual GP responses for demographic, practice and training characteristics, PSA testing behaviour and perceived influences, matched against GP-initiated first PSA tests performed in 2003 and 2004 (22 207 tests). RESULTS In all, 704 GPs (66%) responded and 49% of these reported awareness of the national guidelines, which was highest among those attending postgraduate meetings. PSA tests were more likely to be ordered by full-time male GPs who had attended a local postgraduate urology meeting; ran a ,well-man' clinic; tested men with unrelated complaints; and were not in a training practice. Testing levels were highest among GPs who had been practising for 21,30 years and those in rural practices. Awareness of national guidelines or having had a postgraduate post in urology did not affect testing behaviour. After adjusting for gender, working hours, duration in practice and urban/rural setting, independent influences increasing testing behaviour were: testing men with a positive family history or unrelated complaints; testing any man who requests it; and previous experience of prostate cancer being detected in an asymptomatic patient by PSA testing. Working in an accredited training practice was associated with lower testing levels. CONCLUSION There are complex influences on the PSA testing behaviour of GPs; addressing these influences could contribute to the rationalization of testing. A low awareness of national guidelines indicates a need for new strategies to disseminate and implement guidelines. The influence of local educational meetings on PSA testing is an unharnessed force. [source] Attention Deficit Hyperactivity Disorder: New Ways of Working in Primary CareCHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2007Gill Salmon Children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and prescribed pharmacotherapy require ongoing regular follow-up for many years. Recent literature outlining the role of primary care in the ongoing medication monitoring of children and young people with ADHD is reviewed. We propose that a General Practitioner with a Specialist Interest (GPwSI) model could be developed in relation to ADHD to ensure that shared care arrangements between CAMHS and primary care for children with ADHD are in place. Clinical materials to support GPs in this new role are described. [source] Globus sensation as early presentation of hypopharyngeal cancerCLINICAL OTOLARYNGOLOGY, Issue 6 2007A. Tsikoudas Objectives:, To identify if patients with early hypopharyngeal carcinoma can present with only the single complaint of globus sensation. Design:, Retrospective case review. Setting:, Teaching Hospital in Scotland. Participants:, Cohort of 23 patients with hypopharyngeal carcinoma. Retrospective review of their case notes with regards to their hospital pathway from initial referral from the General Practitioner to diagnosis. Outcome measures:, Symptoms & signs on presentation, subsequent investigations and time interval between initial presentation and diagnosis. Results:, We identified two patients (9%) who presented early with globus or other soft symptoms as the only complaint and with normal clinical findings. There was a 78%,pick up' rate of abnormalities in the barium swallow examination. Conclusion:, We believe this can have important clinical implications in the screening & investigation of globus patients who represent a significant outpatient workload. We review the relevant literature. [source] A Risk Adjusted Method for Comparing Adverse Outcomes among Practitioners in Pediatric and Congenital Cardiac CatheterizationCONGENITAL HEART DISEASE, Issue 4 2008Lisa Bergersen MD ABSTRACT Objective., We sought to develop a method to adjust for case mix diversity and allow comparison of adverse outcome rates among practitioners in pediatric and congenital cardiac catheterization. Patients and Methods., A single institutional database that captured demographic and procedural data was used to identify patient and procedural characteristics associated with adverse events (AE) and any high severity event classified as preventable or possibly preventable (P/PP). Diagnostic and procedural risk groups were created and indicators of hemodynamic vulnerability were defined. Expected event rates by the practitioners adjusting for case mix were calculated. Standardized adverse event ratios (SAER), defined as the observed rate divided by the expected rate for each practitioner were calculated with 95% confidence intervals. Results., The database included 1727 hemodynamic (30%) and interventional (70%) cases performed by seven practitioners in 18 months. During 147 cases, at least one P/PP AE occurred; among the seven practitioners observed, event rates ranged from 3.2 to 14.2%. In multivariable analysis, risk factors for all P/PP events included highest procedure risk group (odds ratio [OR] 2.1 for group 2, and 2.8 for group 3, relative to group 1, P = .001 and P < .001, respectively) and weight less than 4 kg (OR 2.8, P < .001). High severity P/PP events occurred in 67 cases with rates ranging from 2.0 to 6.6% by the practitioners. For these events, risk factors included: highest procedure risk group (OR 4.5 for group 2, and 4.9 for group 3, both P < .001) and an indicator of hemodynamic vulnerability (OR 1.8, P = .026). For the seven practitioners, the SAER ranged from 0.41 to 1.32 for any P/PP AE and from 0.69 to 1.44 for P/PP high severity events. In this cohort, we did not identify any statistically significant performance differences. Conclusion., Despite wide variations in case mix complexity in pediatric and congenital cardiac catheterization, this study demonstrates a method for risk adjustment which allows equitable comparisons among practitioners at a single institution. [source] Academic Research Training for a Nonacademic Workplace: a Case Study of Graduate Student Alumni Who Work in ConservationCONSERVATION BIOLOGY, Issue 6 2009MATTHEW J. MUIR educación en conservación; formación de graduados; habilidades para el trabajo; programas universitarios Abstract:,Graduate education in conservation biology has been assailed as ineffective and inadequate to train the professionals needed to solve conservation problems. To identify how graduate education might better fit the needs of the conservation workplace, we surveyed practitioners and academics about the importance of particular skills on the job and the perceived importance of teaching those same skills in graduate school. All survey participants (n = 189) were alumni from the University of California Davis Graduate Group in Ecology and received thesis-based degrees from 1973 to 2008. Academic and practitioner respondents clearly differed in workplace skills, although there was considerably more agreement in training recommendations. On the basis of participant responses, skill sets particularly at risk of underemphasis in graduate programs are decision making and implementation of policy, whereas research skills may be overemphasized. Practitioners in different job positions, however, require a variety of skill sets, and we suggest that ever-increasing calls to broaden training to fit this multitude of jobs will lead to a trade-off in the teaching of other skills. Some skills, such as program management, may be best developed in on-the-job training or collaborative projects. We argue that the problem of graduate education in conservation will not be solved by restructuring academia alone. Conservation employers need to communicate their specific needs to educators, universities need to be more flexible with their opportunities, and students need to be better consumers of the skills offered by universities and other institutions. Resumen:,La educación en biología de la conservación a nivel licenciatura ha sido calificada como ineficaz e inadecuada para formar a los profesionales que se requieren para resolver problemas de conservación. Para identificar cómo la educación a nivel licenciatura puede satisfacer las necesidades del ámbito laboral en conservación, sondeamos a profesionales y académicos sobre la importancia de habilidades particulares del trabajo y la percepción de la importancia de esas mismas habilidades en la universidad. Todos los participantes en el sondeo (n = 189) fueron alumnos del Grupo de Graduados en Ecología de la Universidad de California en Davis y obtuvieron el grado basado en tesis entre 1973 y 2008. Los académicos y profesionales encuestados difirieron claramente en sus habilidades, aunque hubo considerablemente mayor acuerdo en las recomendaciones de capacitación. Con base en las respuestas de los participantes, los conjuntos de habilidades en riesgo de no ser consideradas en los programas educativos son la toma de decisiones y la implementación de políticas, mientras que las habilidades de investigación tienden a ser sobre enfatizadas. Sin embargo, los profesionales en diferentes puestos de trabajo requieren una variedad de conjuntos de habilidades, y sugerimos que los constantes llamados a ampliar la capacitación para responder a esta multitud de labores conducirán a un desbalance en la enseñanza de otras habilidades. Algunas habilidades, como el manejo de programas, pueden desarrollarse en proyectos colaborativos o de capacitación en el trabajo. Argumentamos que el problema de la educación en biología de la conservación a nivel licenciatura no se resolverá solo con la reestructuración de la academia. Los empleadores deben comunicar sus requerimientos específicos a los educadores, las universidades deben ser más flexibles con sus oportunidades y los estudiantes necesitan ser mejores consumidores de las habilidades ofrecidas por las universidades y otras instituciones. [source] Outcome research in diabetes: from theory to practice.DRUG DEVELOPMENT RESEARCH, Issue 3 2006Results of the QuED study Abstract Despite the fact that several pharmacological and educational interventions have been proven to improve diabetes outcomes in the context of randomized clinical trials, the transferability of these results to clinical practice can encounter obstacles represented by physicians' knowledge and beliefs, structural and organizational constraints, and patients' clinical and socio-economical characteristics. Outcomes research represents a fundamental tool to investigate the extent to which trials results can be reproduced under routine clinical conditions, to evaluate clinical behavior in areas of uncertainty, and to ascertain which features of diabetes care are more important to improve clinical outcomes and quality of life. This report will discuss some of the results of the QuED (Quality of Care and Outcomes in Type 2 Diabetes) study, to exemplify the yield of an outcomes research approach to a complex, chronic disease. The QuED Study is a nation-wide initiative aimed at assessing the relationship between the quality of care delivered to subjects with type 2 diabetes and outcomes. The study involved 101 outpatient diabetes clinics and 103 General Practitioners (GPs) in Italy. Overall, 3,437 patients have been enrolled and followed up for 5 years at 6-month intervals. Quality of life was evaluated through questionnaires filled in by the patients at 6-month intervals for 3 years. A physicians' survey was also conducted to investigate physician's beliefs regarding metabolic control, blood pressure, and lipid control. Given the multiplicity of the sources of information, the study allowed for matching physicians' beliefs and practices with intermediate and long-term clinical and humanistic outcomes. Drug Dev. Res. 67:280,286, 2006. © 2006 Wiley-Liss, Inc. [source] Responding to formal complaints about the emergency department: Lessons from the service marketing literatureEMERGENCY MEDICINE AUSTRALASIA, Issue 4 2004Gavan Doig Abstract The ability to respond to formal complaints is a necessary part of emergency medicine practice. In spite of the significance of formal complaints there is little guidance within the medical literature to understand why patients complain or how to provide satisfaction to individuals who complain. Practitioners are usually left to their own devices in the style and substance of complaint responses even when working within a defined complaint management system. This article draws on relatively abundant literature in the service marketing field to provide an understanding of dissatisfaction, complaining and complaint handling. Having developed an appropriate theoretical framework the article provides guidance for applying these concepts in dealing with formal complaints. [source] Manual of Smoking Cessation: A Guide for Counsellors and PractitionersADDICTION, Issue 7 2007GARY J. TEDESCHI No abstract is available for this article. [source] When smokers are resistant to change: experimental analysis of the effect of patient resistance on practitioner behaviourADDICTION, Issue 8 2005Nick Francis ABSTRACT Aims In the field of motivational interviewing, practitioner confrontational behaviour has been associated with lower levels of patient behaviour change. We set out to explore whether resistance to change among smokers affects practitioner confrontational and other behaviours. Design Experimental manipulation of levels of patient resistance in a role play. Setting The study was conducted at the start of a 2-day health behaviour change workshop. Participants Thirty-two practitioners who had registered for the workshop. Intervention The practitioners were assigned randomly to interview a standardized patient (actor) who portrayed a smoker who had been briefed to display either high or low levels of resistance to change. Measurements Interviews were audiotaped and transcribed. Practitioners and standardized patients completed interview ratings at the end of each interview. After listening to each taped interview practitioners were assigned a global score for confrontation, empathy and expert instructional style. Interviews were then submitted to a qualitative analysis. Findings Higher levels of practitioner confrontational behaviour were observed in the high resistance group. This was evident both from the global scores (median 2 versus 0, P = 0.001) and the qualitative analysis. Global scores for empathy and expert instruction were not significantly different. Qualitative analysis also suggests a pervasive negative impact on other practitioner behaviours. Conclusions Higher patient resistance probably leads to an increase in confrontational and other negative behaviours in health professionals attempting to promote behaviour change. This challenges important assumptions about the influence of practitioner behaviour on patient behaviour and subsequent health-related outcomes. [source] How can we increase the involvement of primary health care in the treatment of tobacco dependence?ADDICTION, Issue 3 2004A meta-analysis ABSTRACT Aims A systematic review of studies testing the effectiveness of educational and practice base strategies to increase the involvement of primary health-care practitioners in the treatment of tobacco dependence. Data sources MEDLINE, EMBASE, CINAHL and the Cochrane Library (1966,2001). Selection criteria included studies that used randomized or controlled clinical designs, controlled before and after trials and interrupted time-series designs and that presented objective and interpretable measures of practitioners' behaviour and biochemically verified patient quit rates. Review methods A meta-analysis, using a random effects model, of 24 programmes identified in 19 trials. Effect sizes were adjusted by inverse variance weights to control for studies' sample sizes. Findings Analyses to explain the heterogeneity of effect sizes found that interventions were equally effective in changing practitioners' screening and advice-giving rates and their patients' quit rates. Absolute increases for the intervention above the comparison groups were 15% (95% CI = 7,22) for screening rates, 13% (95% CI = 9,18) for advice-giving rates and 4.7% (95% CI = 2.5,6.9) for biochemically verified patient quit rates. Practitioners in training programmes were effective in changing their patients' quit rates but not their own screening rates; educational interventions were more effective than practice-based interventions. For established practitioners, programmes were effective in changing their screening and advice-giving rates, but not their patients' quit rates; a combination of practice-based and educational interventions were more effective. Conclusions Primary health-care practitioners can be engaged in the treatment of tobacco dependence to increase equally their screening and advice-giving rates and their patients' quit rates with outcomes of considerable public health and clinical significance. The provision of educational interventions for practitioners in training in combination with systematic outreach practice-based support for established practitioners is likely to be an effective strategy to increase smoking quit rates throughout primary health care. [source] Cancer of the Gastrointestinal Tract: A Handbook for Nurse PractitionersEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2005CHRIS EBERHARDIE No abstract is available for this article. [source] The use of the OSCE in postgraduate educationEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2008R. C. Arnold Abstract Background:, The Objective Structured Clinical Examination (OSCE) is a method of assessing the clinical skills of undergraduates in medicine, dentistry and other health sciences and is employed increasingly in postgraduate education. Aim:, To describe the application of the OSCE to the development of Lifelong Learning and Continuing Professional Development (CPD) for General Dental Practitioners (GDPs). Methods:, A postgraduate course was designed as an OSCE for GDPs. The OSCE comprised 12 stations covering different aspects of general dentistry. After an introductory seminar outlining the aim of the course, the participants spent 7 min at each station. Each question or task required 10 answers and was designed to highlight areas of weakness or interest and to stimulate further study of the presenting topic. Solutions and answers were provided at each station for self-assessment along with a list of locally presented courses related to that subject. Participants were invited to leave contact details and to make suggestions for future postgraduate courses. The final session consisted of a group discussion and participants were invited to complete an evaluation form to express opinions on the course. Results:, The evaluation demonstrated that most candidates found participation in the OSCE stimulated their interest in CPD. The OSCE also highlighted areas of weakness in knowledge of certain clinical procedures. Group discussion confirmed that practitioners found the hands-on component valuable and that they were likely to participate in further OSCEs to enhance their CPD. Suggestions received during the discussion were used to modify the course. Conclusions:, The OSCE course fulfilled its aim of assisting practitioners to organise their CPD. The reflective nature of the course was helpful in evaluating clinical knowledge and the unique multidisciplinary style fulfilled its objective in promoting thoughts regarding future study. 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