This paper describes a shift in the focus of mental health services to remote Indian villages in Northwestern Ontario. Traditional indigenous counsellors are assuming control of this service, previously offered by non-Indian outsiders. The resources of the Federal Sioux Lookout Zone Hospital and psychiatrists from the University of Toronto are used in the ongoing training of the counsellors. Challenges encountered by outside non-Indian professionals providing relevant training and consultation to the area's natural helpers are described. This unique program has enjoyed enthusiastic acceptance by local people in helping positions.
What is the potential of courses designed for nursing students to meet the learning priorities of other disciplines? Who could benefit? Nursing students at Brandon University interested in the 'community as client' concept requested a course that focused on the health of rural residents and the communities in which they live. Questions about (1) measuring the health of rural populations; (2) comparing health status, health resources and health care utilization of rural and urban populations; and (3) determining the health of rural communities emerged. As a result the course, 'Health of Rural Populations and Communities', was created. The Director of the Rural Development Institute examined the syllabus for the new course and asked that Rural Development students be allowed to enroll. This paper focuses on the challenges and opportunities for nursing education to address learning needs of other disciplines by sharing health and nursing knowledge. In doing so the learning of nursing students is also advanced. The development and delivery of a rural health course is used as a case study to illustrate the potential of this approach for nursing and interdisciplinary education.
A three-year national intervention program introduced into the School Psychology Service (SPS) in Norway with the aim of increasing systemic level work among SP counselors was investigated. Latent variable growth models based on longitudinal data from 195 SP counselors gave no significant mean level change in systemic level work. This concurred with GLM analyses based on data from a sample of 20 schools. However, retrospective self-reported significant positive mean level change for systemic level work was detected among the SP counselors. Intervention program participation was associated with individual change in systemic level work. Self-efficacy beliefs about systemic level work, and school-related etiology beliefs predicted individual change to a certain degree. Comparison of two rival models gave no support for a hypothesized interaction among intervention program participation and beliefs in their effects on systemic level work. Open-ended questions indicated that individual level workload and the perceived expectations from the schools may have concern for a successful effect of the intervention program in addition to the hypothesized ones. Individual change in systemic level work was positively associated with individual change in job satisfaction.
To study undergraduate learning of and current clinical practice on counseling to reduce road injuries and deaths.
Questionnaire on high-risk clinical scenarios.
Canadian medical schools, one family medicine program, and a Toronto trauma centre.
Three groups: 338 final-year medical students from 12 Canadian universities, 183 family practice teachers from the Ontario-wide University of Toronto teaching network, and 45 trauma-team members from a Toronto regional trauma centre.
All health promotion items identified by students are relevant to the clinical scenarios presented to them were tabulated to identify general knowledge of health promotion counseling and specific knowledge of road trauma prevention. The trauma-related counseling practices of family practice teachers were tabulated from their responses to one of the student scenarios. The same process tabulated the counseling that trauma-team members would expect family physicians to do in busy practices.
Students' knowledge about health promotion counseling was generally good, except for road trauma prevention, where counseling is seldom done unless heavily prompted. Family practice teacher responses indicated that approximately 15% have not accepted road trauma counseling as part of clinical practice. Trauma-team members ranked trauma prevention items similarly to family practice teachers, but had higher expectations for performance. The neck is the most commonly injured site, but no group identified headrest adjustment as important.
Counseling to prevent road trauma is deficient both in practice and teaching.
The role of health care providers in patient counseling for tobacco use cessation has gained increased attention in recent years. The present survey examined the activities of dental school continuing education departments in providing continuing education in tobacco use cessation counseling to oral health care personnel. A questionnaire was sent to the director of continuing education at all U.S. and Canadian dental schools. The results indicate that few continuing education programs have been or currently are being offered. Respondents to the survey perceived little interest in this topic among their target audiences. The reasons for the current situation and barriers to practitioner involvement are discussed.
In sum, community participation was central from the inception of this project and throughout the four phases. Participants were involved in trainee selection, curriculum development and modification and negotiation of clinical practicum and evaluation. Their contributions significantly influenced the content and process of the workshops on a daily basis. For the in situ training the indigenous trainers used a similar process of participation and planning, and adapted the workshops specifically to the island culture. Evaluation methods were similarly adapted to the specific communities. High success rate of returns resulted from the evaluators' careful sensitivity to the culture and the adaptation of the Western research process. The team involvement in the participant's transformation and self-reliance created a productive mutual experience.
The development of a comprehensive competency-based substance abuse curriculum is reviewed and described. The curriculum, which is designed to help persons to further their understanding of alcohol and drug abuse, and/or to help strengthen counseling skills, can be adopted to meet a wide variety of delivery methods. The curriculum, which can be delivered at a university or within a treatment setting, offers a flexible and innovative way of providing substance abuse training to alcohol and drug workers and to those in health and health-related professions.
Faculty of Sport Sciences, Department of Health Sciences, University of Jyväskylä, and Continuing Education Manager, School of Health and Social Care, Jyväskylä Polytechnic, Jyväskylä, Finland. email@example.com
The purpose of this follow-up study was to describe the development of reflective learning of 16 student nurses in the context of health counselling and promotion during clinical training of a 3-year nursing education programme in two Finnish polytechnics. The first aim was to analyse the levels of reflectivity in the student nurses' reflections on their videotaped counselling situations. The second aim was to explore the qualitative features of the reflective health counselling learning process in the context of health promotion. The theoretical background of the study was based on a transformative learning theory.
The data consisted of stimulated recall interviews with 16 student nurses conducted once a year between 1998 and 2000. The data were analysed using categorization and thematic analysis.
The findings of the study showed that half of the students in the research group reached the level of critical consciousness during their nursing education. The others remained at the level of consciousness. Two students who represented thoughtful action without reflection in the first study year were able to reach reflection and even critical reflection later during their education. The meaning schemas of counselling developed and were enriched when the students moved into the higher stages of reflection. There were features of an empowerment approach to health promotion only in the meaning schemas and perspectives of critical reflectors.
These results may indicate that the empowerment approach to health promotion within the modern health promoting role of nurses requires critical reflection. Therefore, effective methods and evaluation tools of reflective learning are needed to support learning from practice via critical reflection.