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Accuracy and reliability of 'specialized' physical therapists in auscultating tape-recorded lung sounds.

https://arctichealth.org/en/permalink/ahliterature219667
Source
Physiother Can. 1993;45(1):21-4
Publication Type
Article
Date
1993
Author
D. Brooks
L. Wilson
C. Kelsey
Author Affiliation
Department of Rehabilitation Medicine, University of Toronto.
Source
Physiother Can. 1993;45(1):21-4
Date
1993
Language
English
Publication Type
Article
Keywords
Auscultation - standards - statistics & numerical data
Clinical Competence - standards - statistics & numerical data
Diagnostic Errors
Evaluation Studies as Topic
Humans
Ontario
Physical Therapy Modalities - classification - standards - statistics & numerical data
Reproducibility of Results
Research Design
Respiratory Function Tests - standards - statistics & numerical data
Tape Recording
Abstract
This study investigated the accuracy and inter-rater reliability of 'specialized' physical therapists in the auscultation of tape-recorded lung sounds. In addition, a correlation was investigated between accuracy of interpretation and the number of years of specialization in the field of cardiorespiratory physical therapy. This research follows an earlier study which investigated the accuracy and inter-rater reliability of auscultating tape-recorded lung sounds in a 'non-specialized' cohort of physical therapists. The subjects were 26 'specialized' cardiorespiratory physical therapists working in acute urban teaching hospitals. These individuals were required to have been practising currently and exclusively for at least one year in the area of cardiorespiratory physical therapy. Participants listened with a stethoscope to five different sounds and identified them from a standardized list of terms. One of three tapes with the same lung sounds in different order was randomly selected for each physical therapist. The percentage of correct answers for all subjects was calculated. An accurate response in the detection of lung sounds was arbitrarily defined as a percentage of correct answers of 70% or greater. The difference between the pooled correct response rate of 50% and the arbitrarily set value of 70% was statistically significant (z = 2.23, p
PubMed ID
10124337 View in PubMed
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An exploratory study of factors influencing resuscitation skills retention and performance among health providers.

https://arctichealth.org/en/permalink/ahliterature123106
Source
J Contin Educ Health Prof. 2012;32(2):126-33
Publication Type
Article
Date
2012
Author
Vernon Curran
Lisa Fleet
Melanie Greene
Author Affiliation
Faculty of Medicine, Memorial University of Newfoundland, Canada. vcurran@mun.ca
Source
J Contin Educ Health Prof. 2012;32(2):126-33
Date
2012
Language
English
Publication Type
Article
Keywords
Certification
Clinical Competence - standards - statistics & numerical data
Education, Medical, Continuing - standards
Educational Measurement
Female
Focus Groups
Health Personnel - psychology
Humans
Life Support Care - psychology
Male
Newfoundland and Labrador
Qualitative Research
Questionnaires
Regional Health Planning
Resuscitation - education
Retention (Psychology)
Rural Health Services - manpower
Urban Health Services - manpower
Abstract
Resuscitation and life support skills training comprises a significant proportion of continuing education programming for health professionals. The purpose of this study was to explore the perceptions and attitudes of certified resuscitation providers toward the retention of resuscitation skills, regular skills updating, and methods for enhancing retention.
A mixed-methods, explanatory study design was undertaken utilizing focus groups and an online survey-questionnaire of rural and urban health care providers.
Rural providers reported less experience with real codes and lower abilities across a variety of resuscitation areas. Mock codes, practice with an instructor and a team, self-practice with a mannequin, and e-learning were popular methods for skills updating. Aspects of team performance that were felt to influence resuscitation performance included: discrepancies in skill levels, lack of communication, and team leaders not up to date on their skills. Confidence in resuscitation abilities was greatest after one had recently practiced or participated in an update or an effective debriefing session. Lowest confidence was reported when team members did not work well together, there was no clear leader of the resuscitation code, or if team members did not communicate.
The study findings highlight the importance of access to update methods for improving providers' confidence and abilities, and the need for emphasis on teamwork training in resuscitation. An eclectic approach combining methods may be the best strategy for addressing the needs of health professionals across various clinical departments and geographic locales.
PubMed ID
22733640 View in PubMed
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The asthma programme of Finland: an evaluation survey in primary health care.

https://arctichealth.org/en/permalink/ahliterature185016
Source
Int J Tuberc Lung Dis. 2003 Jun;7(6):592-8
Publication Type
Article
Date
Jun-2003
Author
M. Erhola
R. Mäkinen
K. Koskela
V. Bergman
T. Klaukka
M. Mäkelä
L. Tirkkonen
M. Kaila
Author Affiliation
Finnish Lung Health Association, Helsinki, Finland.
Source
Int J Tuberc Lung Dis. 2003 Jun;7(6):592-8
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Asthma - diagnosis - therapy
Clinical Competence - standards - statistics & numerical data
Finland
Health Care Surveys - standards - statistics & numerical data
Humans
Outcome Assessment (Health Care) - standards - statistics & numerical data
Physician's Practice Patterns - standards - statistics & numerical data
Physicians, Family - standards - statistics & numerical data
Practice Guidelines as Topic - standards
Primary Health Care - standards - statistics & numerical data
Program Evaluation - standards - statistics & numerical data
Quality of Health Care - standards - statistics & numerical data
Time Factors
Abstract
To evaluate the basic structures and processes of asthma care 6 years after the launch of the Finnish Asthma Programme. The evaluation will serve as the baseline for the implementation of the evidence-based guidelines for asthma published in 2000.
A descriptive type-2 evaluation (managerial monitoring of a policy implementation), based on operationalised statements of the Asthma Programme.
A co-ordinating doctor for asthma, usually a general practitioner (GP), was interviewed in 248 (91%) health centres; 83% of the health centres have at least one GP nominated as the local asthma co-ordinator and 94% have a nurse. Asthma education for the professionals had been organised in 71% of the health centres in the previous 2 years. First-line treatment consists of an inhaled corticosteroid. Guided self-management is used in 98% of the health centres, but its components were not clear to the doctors.
The basic structure of equipment and organisation for the diagnosis and treatment of asthma has been set up in the primary health care services.
PubMed ID
12797704 View in PubMed
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Audit report from Greenland on nurses' tasks and perceived competency.

https://arctichealth.org/en/permalink/ahliterature118249
Source
Rural Remote Health. 2012;12:1909
Publication Type
Article
Date
2012
Author
J. Nexøe
E. Skifte
B. Niclasen
A. Munck
Author Affiliation
Research Unit for General Practice, University of Southern Denmark, Odense, Denmark. jnexoe@health.sdu.dk
Source
Rural Remote Health. 2012;12:1909
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
After-Hours Care
Clinical Audit
Clinical Competence - standards - statistics & numerical data
Data Interpretation, Statistical
Female
Greenland
Humans
Male
Middle Aged
Nurse Administrators - education - psychology - statistics & numerical data
Nurse's Practice Patterns - statistics & numerical data
Outcome and Process Assessment (Health Care) - methods - standards
Physician-Nurse Relations
Qualitative Research
Referral and Consultation - utilization
Task Performance and Analysis
Abstract
Despite all efforts, recruitment of healthcare personnel has become increasingly difficult in Greenland as in other remote areas. The aim of this observational study was to describe the extent of health care delivered by nurses in Greenland's healthcare system. Reasons for encounter, diagnostic procedures, treatments and need for a physician's assistance, as well as the nurses' self-perceived competency, were also analysed.
A total of 42 nurses registered all patient encounters for 10 days in late autumn 2006 in 14 out of 16 healthcare districts in Greenland.
Nurses treated 1117 encounters (60%) singlehandedly. The nurses felt competent in what they were doing in 1415 encounters (76%). In 525 encounters (31%), a physician's advice was sought. Either the physician was asked to come or the physician's advice was obtained by telephone. In four cases the nurses did not feel completely competent, but did not seek advice from the physician on call. Feeling competent did not depend on length of experience in Greenland.
In Greenland, nurses independently receive, diagnose and treat a substantial number of primary healthcare patients. The nurses take care of the patients and perform a number of clinical and laboratory procedures with great confidence. There has been speculation that part of the difficulty in recruiting doctors and healthcare personnel in remote areas may be due to uneasiness about professional responsibilities and, to some extent, lack of confidence. At least among the registering nurses in this study, this did not seem to be a problem.
PubMed ID
23228181 View in PubMed
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Certification examinations for massage therapists: a psychometric analysis.

https://arctichealth.org/en/permalink/ahliterature191015
Source
J Manipulative Physiol Ther. 2002 Feb;25(2):111-5
Publication Type
Article
Date
Feb-2002
Author
Claudio Violato
Lanree Salami
Sylvia Muiznieks
Author Affiliation
Department of Applied Psychology, University of Calgary, Alberta, Canada. violato@ucalgary.ca
Source
J Manipulative Physiol Ther. 2002 Feb;25(2):111-5
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Canada
Certification - methods - statistics & numerical data
Clinical Competence - standards - statistics & numerical data
Factor Analysis, Statistical
Humans
Massage - standards
Psychometrics
Reproducibility of Results
Societies, Medical - standards
Abstract
To describe the components of the Alberta Registered Massage Therapists Society (ARMTS) examination and their psychometric properties.
All 3 components of the ARMTS examination (knowledge, clinical judgement, and clinical skills) were administered to 112 candidates. The examination consisted of 2 written components (140 multiple-choice questions on basic science knowledge and 60 multiple-choice questions on clinical judgment) and a clinical competency assessment of the following practical skills with standardized patients: (1) taking a case history, (2) assessing physical condition, and (3) treating the condition. All components of the examination were criterion-referenced with the methods of minimum performance level (MPL).
The internal consistency reliability coefficients (Cronbach alpha) ranged from 0.60 to 0.88 for all test components. The descriptive statistics, performance levels, and reliability estimates indicate that the examination is functioning well. Concurrent, criterion-related validity evidence was provided by correlations between the examination components that ranged from r = 0.24 (P
PubMed ID
11896380 View in PubMed
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A comparison of competencies between problem-based learning and non-problem-based graduate nurses.

https://arctichealth.org/en/permalink/ahliterature141037
Source
Nurse Educ Today. 2011 Feb;31(2):129-34
Publication Type
Article
Date
Feb-2011
Author
Harrison Applin
Beverly Williams
Rene Day
Karen Buro
Author Affiliation
Critical Care Nursing, Royal Alexandra Hospital, Edmonton, Canada. happlin@telus.net
Source
Nurse Educ Today. 2011 Feb;31(2):129-34
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adult
Canada
Clinical Competence - standards - statistics & numerical data
Data Collection
Education, Medical, Graduate - methods - standards - statistics & numerical data
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Nursing Evaluation Research
Perception
Problem-Based Learning - methods - standards - statistics & numerical data
Questionnaires
Statistics as Topic
Teaching
Young Adult
Abstract
Competence is essential to ensuring safe, ethical and legal nursing practice. Various teaching strategies are used in nursing education in an effort to enhance graduate competence by bridging the gap between theory learned in the classroom and professional practice as a nurse. The objective of this comparative descriptive research was to determine if there was a difference in self reported competence between graduates from PBL and non PBL (NPBL) nursing programs. A convenience sample of 121 graduate nurses in one Canadian province, who had been practicing for at least 6 months took part in the study. The researcher designed questionnaire included both forced choice and open ended questions. There was no statistical significance difference between the PBL and NPBL graduates on self reported entry-to-practice competence. However, several significant themes did emerge from the answers to open ended questions which asked graduates how their nursing programs prepared them to meet the entry-to-practice competencies and what program improvements they might suggest. Unlike the NPBL graduates, the PBL graduates identified the structure and process of their programs as instrumental in their preparation to meet the entry-to-practice competencies. PBL graduates associated their abilities to think critically and engage in self-directed evidence-based practice as key to enabling them to meet the competencies. A common theme for program improvement for both PBL and NPBL graduates was a request for more clinical time.
PubMed ID
20817332 View in PubMed
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Comparison of self, nurse, and physician assessment of residents rotating through an intensive care unit.

https://arctichealth.org/en/permalink/ahliterature203880
Source
Crit Care Med. 1998 Nov;26(11):1811-6
Publication Type
Article
Date
Nov-1998
Author
D. Johnson
B. Cujec
Author Affiliation
Department of Critical Care, Royal University Hospital, Saskatoon, SK, Canada.
Source
Crit Care Med. 1998 Nov;26(11):1811-6
Date
Nov-1998
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Attitude of Health Personnel
Clinical Competence - standards - statistics & numerical data
Critical Care - manpower - statistics & numerical data
Employee Performance Appraisal - statistics & numerical data
Female
Hospitals, University - manpower - standards
Humans
Intensive Care Units - manpower - statistics & numerical data
Internship and Residency - standards - statistics & numerical data
Male
Medical Staff, Hospital
Nursing Staff, Hospital
Regression Analysis
Saskatchewan
Self-Assessment
Statistics, nonparametric
Abstract
Compare resident evaluations by self, nurses, and attending physicians.
Prospective cohort.
University intensive care unit.
Sixty residents.
End-rotational evaluation using a standardized, multiple-choice examination and one of two subjective instruments, Global Rating Scale and Behaviorally Anchored Rating Scale.
Means for overall competence, using both the Behaviorally Anchored Rating Scale and the Global Rating Scale clustered between 3 to 4 on a 5-point scale. Physicians' evaluations correlated with the multiple-choice test scores (Spearman's rho 0.3082, p = .005, n = 82), whereas neither self-evaluation (Spearman's rho 0.1124, p = .65, n = 42) nor nurses' evaluations (Spearman's rho 0.2060, p = .069, n = 79) had a significant correlation with test scores. Spearman's correlations were not significant for either overall competence or specific medical knowledge by any category of evaluator using the Global Rating Scale. Spearman's rho correlations and kappa statistic between the three types of evaluators (physicians, nurses, and self) for each criterion of the Behaviorally Anchored Rating Scale demonstrated significant correlations between the ratings of physicians and nurses, except for the assessment of humanistic qualities. Pooled clinical skills-history taking (b = 0.277, p
Notes
Comment In: Crit Care Med. 1998 Nov;26(11):1772-39824057
PubMed ID
9824072 View in PubMed
Less detail
Source
J Hand Ther. 2003 Jan-Mar;16(1):49-58
Publication Type
Article
Author
Mary C Kasch
Sandra Greenberg
Patricia M Muenzen
Author Affiliation
Hand Therapy Certification Commission, Rancho Cordova, California 95670-6121, USA. mkasch@htcc.org
Source
J Hand Ther. 2003 Jan-Mar;16(1):49-58
Language
English
Publication Type
Article
Keywords
Adult
Canada
Clinical Competence - standards - statistics & numerical data
Credentialing - standards - statistics & numerical data
Guideline Adherence - standards - statistics & numerical data
Hand Injuries - physiopathology - rehabilitation
Health Care Surveys - standards - statistics & numerical data
Humans
Musculoskeletal Diseases - physiopathology - rehabilitation
Physical Therapy Specialty - education - standards - statistics & numerical data
Reproducibility of Results
Time Factors
United States
Abstract
The Hand Therapy Certification Commission, Inc., in consultation with the Professional Examination Service, completed a practice analysis of hand therapy in 2001. One goal was to obtain information about the competencies shown by therapists at specific points of experience. Six competency areas were identified and included in the final survey: scientific knowledge, clinical judgment/clinical reasoning, technical skills, interpersonal and communication skills, professionalism, and resource management. Certified Hand Therapists (CHTs) in the United States and Canada participated in the survey. All six competencies were rated moderately or highly critical to professional effectiveness. Thirty hypothesized behavioral progressions (from novice to expert) were included; 27 were validated by the results, indicating that CHTs show competence that is unique and increases over time. Potential uses of these results by CHTs and hand therapy organizations are proposed, especially in regard to candidate eligibility, self-assessment by CHTs, and planning for continuing education.
PubMed ID
12611446 View in PubMed
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Continuing education training focused on the development of behavioral telehealth competencies in behavioral healthcare providers.

https://arctichealth.org/en/permalink/ahliterature118107
Source
Rural Remote Health. 2012;12:2108
Publication Type
Article
Date
2012
Author
V. Gifford
B. Niles
I. Rivkin
C. Koverola
J. Polaha
Author Affiliation
Psychology Department, University of Alaska Fairbanks, Fairbanks, Alaska, USA. vmgifford@alaska.edu
Source
Rural Remote Health. 2012;12:2108
Date
2012
Language
English
Publication Type
Article
Keywords
Alaska
Clinical Competence - standards - statistics & numerical data
Cultural Competency - ethics
Education, Continuing - methods
Educational Measurement
Female
Follow-Up Studies
Health Personnel - psychology - statistics & numerical data
Health Services Accessibility
Humans
Male
Mental Health - education - manpower
Professional Role
Professional-Patient Relations - ethics
Program Development
Questionnaires
Resilience, Psychological
Rural Health Services - ethics - manpower - standards
Self Report
Specialization
Staff Development
Telemedicine - ethics
Abstract
Telehealth allows behavioral health care and specialty services to be extended to rural residents. Telehealth is an important resource for the Alaskan healthcare system, which is tasked with providing services to culturally diverse populations living in remote areas. Training competent providers to deliver telehealth services is vital for the implementation of successful telehealth programs. Yet, the literature is lacking in the area of provider behavioral telehealth competency training.
This study assessed the impact of a Behavioral Telehealth Ethical Competencies Training program on 16 behavioral health providers' development of behavioral telehealth competency. A total of 14 competencies were developed, which required participants to understand the roles and responsibilities of a behavioral telehealth coordinator working at the distal site as well as the roles and responsibilities of the therapist. Video vignettes evaluating the 14 competencies, self-reported competence surveys and follow-up surveys of progress on telehealth goals were utilized to assess effects of the training.
Results indicated participants' behavioral telehealth competencies increased following training. Participants reported positive perceptions regarding their competency, and achieved progress on the majority of behavioral telehealth goals set during the training.
This study provides a baseline for developing a best practice model for behavioral telehealth service delivery by identifying specific provider competencies for administering effective behavioral telehealth services. A unique continuing education training model, led by content experts including university professors and Alaska Native Elders, incorporating behavioral telehealth, rural ethics, cultural competency and vicarious trauma training is described. Lastly, this study details the use of an innovative video vignette assessment instrument for evaluating the effectiveness of continuing education training.
PubMed ID
23240871 View in PubMed
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Correcting biases in psychiatric diagnostic practice in Northwest Russia: comparing the impact of a general educational program and a specific diagnostic training program.

https://arctichealth.org/en/permalink/ahliterature157862
Source
BMC Med Educ. 2008;8:15
Publication Type
Article
Date
2008
Author
Grigory Rezvyy
Alexander Parniakov
Elena Fedulova
Reidun Olstad
Author Affiliation
Nordland Hospital, Psychiatric Department, N-8092, Bodø, Norway. grigory.rezvy@nlsh.no
Source
BMC Med Educ. 2008;8:15
Date
2008
Language
English
Publication Type
Article
Keywords
Clinical Competence - standards - statistics & numerical data
Diagnostic Errors
Education, Medical, Continuing - methods
Educational Measurement
Humans
Mental Disorders - diagnosis
Models, Educational
Program Development
Program Evaluation
Psychiatry - education
Russia
Abstract
A general education in psychiatry does not necessary lead to good diagnostic skills. Specific training programs in diagnostic coding are established to facilitate implementation of ICD-10 coding practices. However, studies comparing the impact of these two different educational approaches on diagnostic skills are lacking. The aim of the current study was to find out if a specific training program in diagnostic coding improves the diagnostic skills better than a general education program, and if a national bias in diagnostic patterns can be minimised by a specific training in diagnostic coding.
A pre post design study with two groups was carried in the county of Archangelsk, Russia. The control group (39 psychiatrists) took the required course (general educational program), while the intervention group (45 psychiatrists) were given a specific training in diagnostic coding. Their diagnostic skills before and after education were assessed using 12 written case-vignettes selected from the entire spectrum of psychiatric disorders.
There was a significant improvement in diagnostic skills in both the intervention group and the control group. However, the intervention group improved significantly more than did the control group. The national bias was partly corrected in the intervention group but not to the same degree in the control group. When analyzing both groups together, among the background factors only the current working place impacted the outcome of the intervention.
Establishing an internationally accepted diagnosis seems to be a special skill that requires specific training and needs to be an explicit part of the professional educational activities of psychiatrists. It does not appear that that skill is honed without specific training. The issue of national diagnostic biases should be taken into account in comparative cross-cultural studies of almost any character. The mechanisms of such biases are complex and need further consideration in future research. Future research should also address the question as to whether the observed improvement in diagnostic skills after specific training actually leads to changes in routine diagnostic practice.
Notes
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PubMed ID
18394150 View in PubMed
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39 records – page 1 of 4.