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Practitioner Knowledge (practitioner + knowledge)
Selected AbstractsEmergency Medicine Practitioner Knowledge and Use of Decision Rules for the Evaluation of Patients with Suspected Pulmonary Embolism: Variations by Practice Setting and Training LevelACADEMIC EMERGENCY MEDICINE, Issue 1 2007Michael S. Runyon MD Abstract Background Several clinical decision rules (CDRs) have been validated for pretest probability assessment of pulmonary embolism (PE), but the authors are unaware of any data quantifying and characterizing their use in emergency departments. Objectives To characterize clinicians' knowledge of and attitudes toward two commonly used CDRs for PE. Methods By using a modified Delphi approach, the authors developed a two-page paper survey including 15 multiple-choice questions. The questions were designed to determine the respondents' familiarity, frequency of use, and comprehension of the Canadian and Charlotte rules. The survey also queried the frequency of use of unstructured (gestalt) pretest probability assessment and reasons why physicians choose not to use decision rules. The surveys were sent to physicians, physician assistants, and medical students at 32 academic and community hospitals in the United States and the United Kingdom. Results Respondents included 555 clinicians; 443 (80%) work in academic practice, and 112 (20%) are community based. Significantly more academic practitioners (73%) than community practitioners (49%) indicated familiarity with at least one of the two decision rules. Among all respondents familiar with a rule, 50% reported using it in more than half of applicable cases. A significant number of these respondents could not correctly identify a key component of the rule (23% for the Charlotte rule and 43% for the Canadian rule). Fifty-seven percent of all respondents indicated use of gestalt rather than a decision rule in more than half of cases. Conclusions Academic clinicians were more likely to report familiarity with either of these two specific decision rules. Only one half of all clinicians reporting familiarity with the rules use them in more than 50% of applicable cases. Spontaneous recall of the specific elements of the rules was low to moderate. Future work should consider clinical gestalt in the evaluation of patients with possible PE. [source] Psychometric evaluation of the Spanish version of CONNECT: a measure of continuity of care in mental health servicesINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2007L.M. Chavez Abstract This article provides the results of the psychometric testing of the Spanish version of CONNECT(-S), a measure of continuity of care in mental health services. CONNECT-S is a multidimensional measure designed for use with seriously mentally ill respondents. Consisting of 12 scales and one single-item indicator, it addresses qualities of interaction in current relationships between mental health service providers and consumers in five conceptual domains: (1) practitioner knowledge of their clients, (2) creating flexibility, (3) practitioner availability, (4) practitioner co-ordination, and (5) smoothing transitions. One-hundred-and-fifty participants took part in the study. Participants were recruited from mental health outpatient clinics in both the Puerto Rican (n = 109) and the San Antonio (n = 41) samples. Internal consistency for scales in a combined site estimate ranged from 0.68 to 0.96. Test-retest reliability ranged from fair to substantial in all but one scale. Concurrent validity hypotheses based on a priori predictions were mostly supported. The Spanish translation and adaptation of CONNECT-S provided sound psychometric results across both sites. CONNECT-S addresses the gap in measurement of continuity of care for the two largest US Latino subgroups, Mexican Americans and Puerto Ricans; and provides an encouraging starting point for a measure that is both relevant and culturally sensitive. Copyright © 2007 John Wiley & Sons, Ltd. [source] Nursing Home Practitioner Survey of Diagnostic Criteria for Urinary Tract InfectionsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2005Manisha Juthani-Mehta MD Objectives: To identify clinical and laboratory criteria used by nursing home practitioners for diagnosis and treatment of urinary tract infections (UTIs) in nursing home residents. To determine practitioner knowledge of the most commonly used consensus criteria (i.e., McGeer criteria) for UTIs. Design: Self-administered survey. Setting: Three New Haven,area nursing homes. Participants: Physicians (n=25), physician assistants (PAs, n=3), directors/assistant directors of nursing (n=8), charge nurses (n=37), and infection control practitioners (n=3). Measurements: Open- and closed-ended questions. Results: Nineteen physicians, three PAs, and 41 nurses completed 63 of 76 (83%) surveys. The five most commonly reported triggers for suspecting UTI in noncatheterized residents were change in mental status (57/63, 90%), fever (48/63, 76%), change in voiding pattern (44/63, 70%), dysuria (41/63, 65%), and change in character of urine (37/63, 59%). Asked to identify their first diagnostic step in the evaluation of UTIs, 48% (30/63) said urinary dipstick analysis, and 40% (25/63) said urinalysis and urine culture. Fourteen of 22 (64%) physicians and PAs versus 40 of 40 (100%) nurses were aware of the McGeer criteria for noncatheterized patients (P<.001); 12 of 22 (55%) physicians and PAs versus 38 of 39 (97%) nurses used them in clinical practice (P<.001). Conclusion: Although surveillance and treatment consensus criteria have been developed, there are no universally accepted diagnostic criteria. This survey demonstrated a distinction between surveillance criteria and criteria practitioners used in clinical practice. Prospective data are needed to develop evidence-based clinical and laboratory criteria of UTIs in nursing home residents that can be used to identify prospectively tested treatment and prevention strategies. [source] The frontline and the ivory tower: A case study of service and professional-driven curriculumAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2009Sue Lenthall Abstract Objective:,To describe the development of a postgraduate, multidisciplinary program designed to meet the needs of remote health professionals, present formative evaluation findings and to offer an analysis of the difficulties and lessons learnt. Design:,Case study. Setting:,University Department of Rural Health in a remote region. Participants:, University staff, students and stakeholders involved in the development of the remote health practice program. Results:,Formative evaluation suggests that a curriculum driven by service and professional groups, such as the Flinders University Remote Health Practice program, is able to better prepare remote health practitioners and improve their effectiveness. Difficulties in development included a lack of recognition by some university academics of the value of practitioner knowledge and a reluctance to accept a clinical component in a masters program. Lessons learnt included the importance of: (i) respect for practitioner knowledge; (ii) explicit and appropriate values; (iii) high-quality academics with strong service links; (iv) appropriate length of lead time; (v) institutional links between university and both relevant professional organisations and health services; (vi) a receptive university; (vii) location; and (viii) ongoing engagement with services and professional responsive development. Conclusion:,The success of the program was due in large part to the relationship with professional bodies and close links with remote health services. We have described a number of lessons learnt from this experience that can be useful to other educational groups developing or revising their educational programs. [source] Communication and the reflective practitioner: a shared perspective from sociolinguistics and organisational communicationINTERNATIONAL JOURNAL OF APPLIED LINGUISTICS, Issue 2 2004Deborah Jones This paper provides an overview of an interdisciplinary project which draws together sociolinguistic analyses of workplace discourse and recent work in the field of organisational studies. The starting point for this collaboration was a set of questions which arose from attempts to apply the findings of a large-scale sociolinguistic study into workplace language: (i) How can sociolinguistic tools and models generate useful feedback for practitioners and contribute to organisational learning? (ii) How can the understanding researchers have developed of workplace discourse help individuals and teams critically reflect on their own communication practices? (iii) What can the action research process add to our theoretical knowledge about workplace discourse? The authors explore these questions in the context of a number of current issues in the field of organisational studies, including an increasing interest in language and communication; emerging critical perspectives on the notion of competence in workplaces; and debates over the relationships between expert and practitioner knowledges. The concept of ,reflective practice' is presented as a framework to address these issues in the evaluation and development of workplace communication. [source] Benefiting from Commissioned Research: The Role of Researcher , Client CooperationCREATIVITY AND INNOVATION MANAGEMENT, Issue 2 2002Geir Grundvåg Ottesen This paper discusses why commissioned research is often neglected and misunderstood, as well as how its use can be enhanced. We argue that the lack of use of such research can be attributed to differences in researchers' and practitioners' knowledge and expectations regarding research problems, solutions, interpretations, and applications. Two hypotheses are proposed, which link the use of research to cooperation between researchers and users during the production of the research, and to assistance in interpreting and applying the research results. The hypotheses were tested on a sample of 65 buyers of 86 research projects in the seafood industry. The reported findings reveal that collaboration fosters research utilisation, but also that close cooperation between the providers and the users of research may substitute assistance in enhancing research utilisation. [source] Medical practitioners' knowledge of LatinMEDICAL EDUCATION, Issue 12 2002Nigel E Drury No abstract is available for this article. [source] The missing link: self-assessment and continuing professional developmentAUSTRALIAN DENTAL JOURNAL, Issue 1 2010C Redwood Abstract The purpose of this paper is to review current understanding of the role of self-assessment in continuing education, particularly in the health professions, and to examine how this knowledge can assist in more effective continuing education. The ongoing debate over compulsory continuing professional development (CPD) has seen a variety of approaches proposed. CPD programmes are expected to foster self-assessing and self-directed practitioners, but the common structure is reported to be largely ineffectual in modifying behaviour. If dentistry is to maintain the rights and privileges of a self-regulating profession, then it must ensure that the development and judgement of ongoing competence is meaningful. Improving practitioners' knowledge of the how and why of effective self-assessment should improve participation in, and outcomes of, CPD. An oft-repeated observation is that the least competent are the most confident. If this is the case, then the idea that dentists should be able, or entitled, to choose the path of their continuing professional development must be open to question. We propose that development of the ability of practitioners to self-assess their ongoing requirements for CPD is essential if all stakeholders are to get the maximum return for effort. [source] | ||||||||||