Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Self-Evaluation Programs: Educational programs structured in such a manner that the participating professionals, physicians, or students develop an increased awareness of their performance, usually on the basis of self-evaluation questionnaires.Certification: Compliance with a set of standards defined by non-governmental organizations. Certification is applied for by individuals on a voluntary basis and represents a professional status when achieved, e.g., certification for a medical specialty.Specialty Boards: Organizations which certify physicians and dentists as specialists in various fields of medical and dental practice.Educational Measurement: The assessing of academic or educational achievement. It includes all aspects of testing and test construction.Models, Educational: Theoretical models which propose methods of learning or teaching as a basis or adjunct to changes in attitude or behavior. These educational interventions are usually applied in the fields of health and patient education but are not restricted to patient care.Education, Medical: Use for general articles concerning medical education.Education, Medical, Continuing: Educational programs designed to inform physicians of recent advances in their field.Videotape Recording: Recording of visual and sometimes sound signals on magnetic tape.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Curriculum: A course of study offered by an educational institution.DNA Transformation Competence: The ability of bacterial cells to take up exogenous DNA and be genetically transformed by it.Transformation, Bacterial: The heritable modification of the properties of a competent bacterium by naked DNA from another source. The uptake of naked DNA is a naturally occuring phenomenon in some bacteria. It is often used as a GENE TRANSFER TECHNIQUE.Professional Competence: The capability to perform the duties of one's profession generally, or to perform a particular professional task, with skill of an acceptable quality.Mental Competency: The ability to understand the nature and effect of the act in which the individual is engaged. (From Black's Law Dictionary, 6th ed).Cultural Competency: Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. Competence implies the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities.Oocytes: Female germ cells derived from OOGONIA and termed OOCYTES when they enter MEIOSIS. The primary oocytes begin meiosis but are arrested at the diplotene state until OVULATION at PUBERTY to give rise to haploid secondary oocytes or ova (OVUM).Transformation, Genetic: Change brought about to an organisms genetic composition by unidirectional transfer (TRANSFECTION; TRANSDUCTION, GENETIC; CONJUGATION, GENETIC, etc.) and incorporation of foreign DNA into prokaryotic or eukaryotic cells by recombination of part or all of that DNA into the cell's genome.
Oncology Nursing Certification Corporation: The Oncology Nursing Certification Corporation (ONCC) was established for the development, administration, and evaluation of a program for certification in oncology nursing. Incorporated in 1984 and governed by a board of directors, ONCC is the certifying body for oncology nursing and meets standards established by the Accreditation Board for Specialty Nursing Certification and the National Commission for Certifying Agencies.American Board of Anesthesiology: The American Board of Anesthesiology sets standards and exams for the accreditation of Board certified anesthesiologists coming to the end of their residency. It is one of the 24 medical specialty boards that constitutes the American Board of Medical Specialties.Video tape tracking: In a video tape recorder, tracking is a calibration adjustment which ensures that the spinning playback head is properly aligned with the helical scan signal written onto the tape.American Osteopathic Board of Internal MedicineSyllabus: A syllabus (pl. syllabi) is an outline and summary of topics to be covered in an education or training course.Avery–MacLeod–McCarty experimentUpsilon Phi Delta: Upsilon Phi Delta (ΥΦΔ) is the national academic honor society for students in healthcare administration in the United States. The organization was formed in 1965 to further the profession of health administration and the professional competence and dedication of its members.Business Model of Intercultural Analysis: The Business Model of Intercultural Analysis (BMIA) is a tool developed to address cross-cultural problems. The BMIA framework uses six comprehension lenses to analyze cross-cultural interaction in the business environment.Oocyte selection: Oocyte selection is a procedure that is performed prior to in vitro fertilization, in order to use oocytes with maximal chances of resulting in pregnancy. In contrast, embryo selection takes place after fertilization.
(1/5672) Reactions to medical abortion among providers of surgical abortion: an early snapshot.
(2/5672) Randomized, controlled trial to evaluate increased intensity of physiotherapy treatment of arm function after stroke.
BACKGROUND AND PURPOSE: Many patients have impaired arm function after stroke, for which they receive physiotherapy. The aim of the study was to determine whether increasing the amount of physiotherapy early after stroke improved the recovery of arm function and to compare the effects of this therapy when administered by a qualified therapist or a trained, supervised assistant. The physiotherapy followed a typical British approach, which is Bobath derived. Ten hours of additional therapy were given over a 5-week period. METHODS: The study design was a single-blind, randomized, controlled trial. Stroke patients were recruited from those admitted to the hospital in the 5 weeks after stroke. They were randomly allocated to routine physiotherapy, additional treatment by a qualified physiotherapist, or additional treatment by a physiotherapy assistant. Outcome was assessed after 5 weeks of treatment and at 3 and 6 months after stroke on measures of arm function and of independence in activities of daily living. RESULTS: There were 282 patients recruited to the study. The median initial Barthel score was 6.5, and the median age of the patients was 73 years. The median initial Rivermead Motor Assessment Arm score was 1. There were no significant differences between the groups at randomization or on any of the outcome measures. Only half of the patients allocated to the 2 additional-therapy groups completed the program. CONCLUSIONS: This increase in the amount of physiotherapy for arm impairment with a typical British approach given early after stroke did not significantly improve the recovery of arm function in the patients studied. A number of other studies of interventions aimed at rehabilitation of arm function have reported positive results. Such findings may have been due to the content of these interventions, to the greater intensity of the interventions, or to the selection of patients to whom the treatments were applied. (+info)
(3/5672) Competency, board certification, credentialing, and specialization: who benefits?
Pharmacists are concerned with the rapid changes in the healthcare system and what the requirements will be for a pharmacist in the near future. The emergence of board certification, credentialing, and other certification programs for pharmacists are causing significant concern among pharmacists. Pharmacists must assess certification programs and decide on the value of certification to their careers and to the patients they serve. Employers of pharmacists and those paying for healthcare and pharmacy services must also evaluate the value of pharmacists certification. Perhaps the most direct and significant benefit of pharmacist certification lies in the ability of the pharmacist to provide better and more comprehensive care to patients or selected groups of patients (eg, diabetic patients). Better and more comprehensive care provided by a pharmacist benefits the patient, other healthcare professionals, the healthcare system generally, and payers of healthcare and pharmacy services. Demonstrated competence of the pharmacist to provide pharmaceutical care is essential to achieving this benefit. Board certification of pharmacists in current board-recognized specialty areas of nutrition support pharmacy, pharmacotherapy, psychiatric pharmacy, nuclear pharmacy, and oncology pharmacy totaled 2075 board certified pharmacists in the United States as of January 1997. (+info)
(4/5672) Epidemiology and screening for prostate cancer.
This activity is designed for primary care physicians, internists, and general audiences. GOAL: To provide the reader with a basic understanding of the controversy surrounding population-based prostate cancer screening and of the tools needed to conduct early detection programs for prostate cancer among enrollees. OBJECTIVES: 1. Become familiar with the national debate regarding population-based prostate cancer screening. 2. Learn the essential elements of prostate specific antigen testing for patients. 3. Understand the cost-effectiveness and medico-legal/informed consent issues surrounding prostate cancer detection and screening. (+info)
(5/5672) Nurses' participation in audit: a regional study.
OBJECTIVES: To find out to what extent nurses were perceived to be participating in audit, to identify factors thought to impede their involvement, and to assess progress towards multidisciplinary audit. RESEARCH DESIGN: Qualitative. METHODS: Focus groups and interviews. PARTICIPANTS: Chairs of audit groups and audit support staff in hospital, community and primary health care and audit leads in health authorities in the North West Region. RESULTS: In total 99 audit leads/support staff in the region participated representing 89% of the primary health care audit groups, 80% of acute hospitals, 73% of community health services, and 59% of purchasers. Many audit groups remain medically dominated despite recent changes to their structure and organisation. The quality of interprofessional relations, the leadership style of the audit chair, and nurses' level of seniority, audit knowledge, and experience influenced whether groups reflected a multidisciplinary, rather than a doctor centred approach. Nurses were perceived to be enthusiastic supporters of audit, although their active participation in the process was considered substantially less than for doctors in acute and community health services. Practice nurses were increasingly being seen as the local audit enthusiasts in primary health care. Reported obstacles to nurses' participation in audit included hierarchical nurse and doctor relationships, lack of commitment from senior doctors and managers, poor organisational links between departments of quality and audit, work load pressures and lack of protected time, availability of practical support, and lack of knowledge and skills. Progress towards multidisciplinary audit was highly variable. The undisciplinary approach to audit was still common, particularly in acute services. Multidisciplinary audit was more successfully established in areas already predisposed towards teamworking or where nurses had high involvement in decision making. Audit support staff were viewed as having a key role in helping teams to adopt a collaborative approach to audit. CONCLUSION: Although nurses were undertaking audit, and some were leading developments in their settings, a range of structural and organisational, interprofessional and intraprofessional factors was still impeding progress. If the ultimate goal of audit is to improve patient care, the obstacles that make it difficult for nurses to contribute actively to the process must be acknowledged and considered. (+info)
(6/5672) The abilities of primary care physicians in dermatology: implications for quality of care.
Quality of care in medicine has become an increasingly important issue as the nature of healthcare delivery has changed. Many managed care systems rely on the primary care physician to serve as a gatekeeper, thereby limiting access to specialist care. Controversy has arisen regarding the abilities of primary care physicians in one such specialty: dermatology. We reviewed the many studies conducted in the United States evaluating primary care physicians' abilities in dermatology. Despite inherent flaws in many of the studies, one can conclude that primary care providers are inferior to dermatologists in the diagnosis and treatment of skin disease. Whether these process-based data predict outcome is not known. (+info)
(7/5672) Evaluation of "solitary" thyroid nodules in a community practice: a managed care approach.
Evaluation of thyroid nodules remains a challenge for primary care physicians. To include or exclude the presence of malignancy in a thyroid nodule, radioisotope scan, ultrasound, and fine-needle aspiration biopsy of the thyroid generally are used. The objectives of this study were to determine the utility and cost effectiveness of fine-needle aspiration biopsy of solitary thyroid nodules in a community setting; to compare the cost of fine-needle aspiration biopsy with that of radioisotope scan and ultrasound; and to determine whether the practice of obtaining radioisotope scans and ultrasound has changed in the 1990s compared with the 1980s. Patients were referred by community physicians to university-based endocrinologists for evaluation of thyroid nodules. Many of the patients had previously undergone radioisotope scans and ultrasound scans at the discretion of their primary care physicians. All patients underwent fine-needle aspiration biopsy. The biopsy results were evaluated prospectively, and the practice of community physicians' obtaining radioisotope scans and ultrasound scans was compared for the 1980s and 1990s. Eighty-three patients underwent 104 biopsies. In 20 biopsies the specimens were inadequate; the others showed 70 benign, 9 suspicious, and 4 malignant lesions. All four patients with biopsy findings read as malignant were found to have malignant growth at surgical procedures. Two benign biopsy findings were false-negative results. Malignant growth was correctly diagnosed later for one patient at a second biopsy and for the other because of growth of the nodule. The cost of 104 biopsies was $20,800. The cost of radioisotope scans was $22,400, and the cost of ultrasound scans was $10,640. The frequency of obtaining radioisotope scans (84.5% vs 77%) and ultrasound scans (65% vs 45%) was slightly higher in the 1990s compared with the 1980s. Fine-needle aspiration biopsy is a safe and cost effective initial evaluation modality for smaller community-based centers, as it is at large tertiary centers. The cost incurred ($33,040) in obtaining the radioisotope scans and ultrasound scans could have been saved if fine-needle aspiration biopsy had been used as the initial diagnostic procedure for evaluation of these nodules. Although radioisotope scan and ultrasound scan are of little diagnostic help in the evaluation of thyroid nodules, they continued to be obtained at a high frequency during the last decade. (+info)
(8/5672) Mammography: influence of departmental practice and women's characteristics on patient satisfaction: comparison of six departments in Norway.
OBJECTIVE: To investigate how departmental practice and women's characteristics are related to low patient satisfaction with mammography. DESIGN: Survey of patients by means of self administered questionnaires before and after mammography. PATIENTS: 488 women (89% of those invited), aged 23-86 years, at six departments. MAIN OUTCOME MEASURES: Low level of satisfaction measured on psychometric scales of physical pain, psychological distress, staff punctuality and technical skills, information provided, and physical surroundings. RESULTS: Satisfaction varied by department on the scales for pain, punctuality, information, and surroundings. After adjustment for women's characteristics an attributable risk of negative outcome by department was identified on the scales for pain, distress, punctuality, information, and surroundings. Adjusted odds ratio (ORs) ranged from 0.3 (95% confidence interval (95% CI) 1.2 to 6.0) on the pain scale, to 6.0 (2.9 to 12.3) on the punctuality scale. After adjustment for confounding variables, higher risk of dissatisfaction was associated with age < 50, nervousness about mammography, expected pain, lack of knowledge about mammography, and distrust in mammography (adjusted OR (95% CI) ranged from 1.6 (1.0 to 2.7) to 3.7 (2.0 to 7.3)). CONCLUSION: Departmental practices differed for breast compression, information, punctuality, and facilities and were associated with a low level of satisfaction irrespective of patient characteristics. Women's lack of knowledge about mammography and distrust in the procedure were confirmed as risk factors for dissatisfaction. All these factors might be helped by training the staff, improving facilities, and informing the women. (+info)