U.S. and Canadian dental school involvement in extramural programming.
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This project was undertaken from July 1999 to August 2000 to identify the status of extramural programming (that is, a program that has undergraduate dental students providing any aspect of dental care to individuals in settings outside the main clinical facility of the school) in North American dental schools. A survey instrument was mailed to all United States and Canadian dental schools concerning student involvement in extramural programming. The response rate was 79.7 percent. Of the schools responding, 3.9 percent did not offer extramural programming. The type of extramural sites, the percentage of schools offering each type of site, and the mean number of weeks students are at each site were as follows: hospital clinics--71 percent, 2.5 weeks; public health clinics--65 percent, 6 weeks; schools and day care centers--49, 1.7 weeks; private dental offices--37 percent, 2 weeks; and "other"--29 percent, 2.5 weeks. The average number of weeks spent at extramural site(s) per class was: freshman 1.9 weeks (SD=4.3); sophomores 2.3 weeks (SD=4.2); juniors 2.6 weeks (SD=1.9); and seniors 5.3 weeks (SD=6.7). Of total student time in extramural programming, 43.3 percent was spent delivering basic clinical services, 24.4 percent comprehensive clinical services, 11.8 percent health education, 11.8 percent preventive dentistry, and 8.7 percent community activities. From the data collected it is apparent that the majority of North American dental schools are providing a variety of extramural experiences for their dental students. It was found that student involvement in extramural programming increases gradually from the freshman to the senior year. (+info)
Can an Internet-based system assist with administration and distance learning for third- and fourth-year rural clinical rotations?
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This article describes the experience of the West Virginia School of Osteopathic Medicine during the past 5 years in using Internet technology to communicate with osteopathic medical students on remote, community-based clinical rotations. Federal funding initially supported creation of a new Internet-based system to connect students on their rural family medicine rotations. Accomplishments during and after federal funding include development of systems for remote submission and student access to feedback about clinical sites; on-line access to rotation objectives, policies, housing information, maps, and affiliated internship opportunities; access to medical journals and texts; secured access to rotation grades and rotation schedules; on-line reading lists for family medicine and pediatrics rotations; and Internet-based test administration. Remaining challenges include identification or development of interactive learning materials; development of test banks; flawless administration of Web-based examinations; and finding the right balance between patient care-based learning and didactics. (+info)
Early socialization of new critical care nurses.
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BACKGROUND: Critical care nurses provide care to acutely ill patients, yet little is known about the early socialization processes of new nurses to critical care units from the nurses' perspectives. OBJECTIVES: To explore the early socialization processes of critical care nurses. METHODS: A grounded theory design was used to generate a local theory of how critical care nurses experience socialization. Interviews and journals of participants (N = 10) during the first 4 to 5 months of the socialization experiences were collected. Preceptors were interviewed to triangulate data. Orientation materials and field notes were examined. RESULTS: A process of 5 phases was uncovered: the prodrome, welcome to the unit, disengagement/testing, on my own, and reconciliation. Participants experienced difficulty while being evaluated by preceptors early in the orientation process because of changing expectations. Participants also expressed disappointment in their level of comfort at the end of the orientation. The theory termed "navigating the challenge" explains the nature of the changing expectations that new critical care nurses face during their socialization process. CONCLUSIONS: This exploratory study defines the phases that new critical care nurses experience during the early socialization process. Phase-specific recommendations are made on the basis of the results of the study. (+info)
Investigating the potential for students to provide dental services in community settings.
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Some dental educational institutions in North America have incorporated community-oriented programs into their curriculum. The purpose of this study was to investigate the potential for the clinical placement of Ontario's dental and dental hygiene students in community-based settings. Key informant interviews were used to collect data. The study group consisted of 15 key informants from 9 potential placement sites and 4 educational institutions in Toronto and London, Ontario. The textual data were analyzed qualitatively to identify important issues regarding a clinical placement program. Results showed that there is strong support for the placement of students in community-based clinics; however, the degree to which health centres can accommodate students varies. The majority would not set any limit on the types of dental services that students could provide as long as the services were within the students' competencies. Funding was identified as a barrier to the implementation of such a program, with most of the organizations not able to contribute financially. None would be able to provide sufficient supervision without additional funding. These results indicate that a clinical placement program would be a welcome addition to the training of dental and dental hygiene students, but that external funding for supervision and operational expenses must be available before a program can be instituted. (+info)
Research electives in rural health care.
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PROBLEM BEING ADDRESSED: As academic medical institutions being to address the education and service needs of rural Canadians, research will make its way to the foreground. Rural physicians are well positioned to lead in this venture, but often have little time or energy to take on extra duties. Rural populations differ in essential ways from urban populations. Certainly, the limitations of geography, funding, and population density alter medical surveillance, treatment, and research in ways that are largely undocumented. OBJECTIVE OF PROGRAM: To undertake research projects of interest to our group of rural clinicians and to expose medical students to both research and rural practice. MAIN COMPONENTS OF PROGRAM: Seven rural family physicians welcomed medical students into their group practice for summer research electives. Topics were chosen in advance by the medical group, and one member was designated as supervisor for each student. A local nurse educator also provided support to students and to clinicians after the students' departure. Several projects were undertaken simultaneously each summer; the result was several published peer-reviewed articles and good teaching and learning experiences. CONCLUSION: Rural research electives provide a valuable experience for students and preceptors. Such initiatives deserve broad promotion and support. (+info)
Dental education in Europe: the challenges of variety.
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Dental education varies considerably across Europe, with differing traditions of stomatology (dentistry as a specialty of medicine) and odontology (single autonomous discipline). Dental curricula within the European Union (EU) are governed by European law expressed in directives that are binding on all EU member states. The Dental Directives (78/686/EC) base the curriculum on the odontological model, but compliance by individual schools is often poor. The differences within the EU will likely intensify with the accession of Eastern/Central European countries where the stomatological tradition is strong. Moreover, current proposals within the EU will reduce even the limited existing effectiveness of the Dental Directives. The DentEd Thematic Network Project, which aims to promote convergence of European curricula through voluntary self-assessment and outside peer review, has involved about 25 percent of European schools. Its effectiveness in inducing changes in individual schools is unknown. It is not an accreditation system, and there is no intention to establish a European-wide common curriculum. Dentists' vocational training, here defined as "the organised education of the newly qualified dentist in supervised practice," is present in various models in many European countries, but is compulsory in only a few. Continuing dental education (CDE) is encouraged in most countries, but CDE-dependent licensure is required in only two. (+info)
Optimizing management and financial performance of the teaching ambulatory care clinic.
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OBJECTIVE: To examine how to optimize teaching ambulatory care clinics performance with regard to access to care, access to teaching, and financial viability. DESIGN: Optimization analysis using computer simulation. METHODS: A discrete-event simulation model of the teaching ambulatory clinic setting was developed. This method captures flow time, waiting time, competition for resources, and the interdependency of events, providing insight into system dynamics. Sensitivity analyses were performed on staffing levels, room availability, patient characteristics such as "new" versus "established" status, and clinical complexity and pertinent probabilities. MAIN RESULTS: In the base-case, 4 trainees:preceptor, patient flow time (registration to check out) was 148 minutes (SD 5), wait time was 20.6 minutes (SD 4.4), the wait for precepting was 6.2 minutes (SD 1.2), and average daily net clinic income was $1,413. Utilization rates were preceptors (59%), trainees (61%), medical assistants (64%), and room (68%). Flow time and the wait times remained relatively constant for strategies with trainee:preceptor ratios <4:1 but increased with number of trainees steadily thereafter. Maximum revenue occurred with 3 preceptors and 5 trainees per preceptor. The model was relatively insensitive to the proportion of patients presenting who were new, and relatively sensitive to average evaluation and management (E/M) level. Flow and wait times rose on average by 0.05 minutes and 0.01 minutes per percent new patient, respectively. For each increase in average E/M level, flow time increased 8.4 minutes, wait time 1.2 minutes, wait for precepting 0.8 minutes, and net income increased by $490. CONCLUSION: Teaching ambulatory care clinics appear to operate optimally, minimizing flow time and waiting time while maximizing revenue, with trainee-to-preceptor ratios between 3 and 7 to 1. (+info)
A comparison of private and public dental students' perceptions of extramural programming.
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This project was undertaken to compare the opinions of private and public dental school students' perceptions concerning extramural programming, which is defined as any aspect of the curriculum in which undergraduate dental students provide dental care outside the main dental facility. A survey instrument was used to collect data from undergraduate students at a private (N = 267; 88.4 percent response rate) and at a public (N = 213; 67.2 percent response rate) dental school. When asked to rate the value of various extramural sites in making them a better dentist, both groups rated private dental offices the most valuable and prisons the least valuable. When questioned about the amount of time students should spend each year in extramural programming, private students, overall, desired 34 percent more time than did public students. When asked what percentage of the total time spent in extramural programming students should spend providing various categories of dental care, public school students thought 26 percent more time should be spent rendering preventive services/health education than did the private students. The private students indicated a stronger desire (13 percent more) for rendering clinical services than did public students. Both private and public students were most likely to enter group private practice after graduation. The increasing interest in community-based programs makes the information gained from this study useful for future curriculum planning. (+info)