189 research outputs found
The future of clinical education: a delphi study with allied health deans
No full textThis research used a three-round Delphi technique to attain agreement on the purposes of clinical education, the key opportunities and challenges impacting clinical education, and the future (2018-2023) of clinical education. The Delphi panel consisted of 61 deans whose institution was a 2013 member of the Association of School of Allied Health Professions. Over eight months, from July 2013 to February 2014 and through 3 rounds, the AH deans expressed opinions about clinical education and its future. High agreement was achieved on the purposes of clinical education resulting in a comprehensive definition and goals of clinical education. For each Delphi round, AH dean responses were collected, coded, and analyzed; items were accepted as key factors, re-rated until agreement was achieved, or the study concluded. Agreement was achieved on key factors that could be identified as opportunities (n = 107) or challenges (n = 52) for AH clinical education. The Delphi research supported the clinical education categories identified in the Key Factors Impacting Clinical Education conceptual model (O’Sullivan Maillet & Romig, 2011-2013, p.105). Based on the results, an additional clinical education category of Population Health was added to the model and explicitly added in Clinical Education Models and AH deans. The AH deans categorized the key factors they could impact individually and/or collectively. The relationship the most realistic and most preferred case scenarios had on the key factors provided a deeper analysis into the future. Further prioritization of the key factors is the suggested next step.Ph.D.Includes bibliographical referencesby Barbara D. Romi
The role of community and professional engagement in teaching allied health higher education: the academic perspective
No full textThis article has been reproduced in accordance with the publisher's copyright transfer policy.
Copyright © 2018 Association of Schools of Allied Health Professions, Wash., DC
This author accepted manuscript is made available following 12 month embargo from date of publication (September 2018) in accordance with the publisher’s archiving policyCommunity and professional engagement describes a collaborative model of interaction between institutions of higher education and the communities in which they operate. This qualitative study aimed to examine how professional and community engagement is understood and incorporated into the role of staff members within the School of Health Sciences of one university. Twenty-one academic and professional staff were interviewed. Participants identified a range of definitions for both 'community' and 'professional' engagement, as well as the benefits and limitations of such engagement. Ability to conduct engagement was limited by time capacity when competing with other role requirements. Integration of community engagement with research and teaching requires development of a framework that addresses both the common barriers and facilitators to engagement
Professional power and the state: A study of five professions in state welfare agencies in the UK
No full textThis thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The thesis defines a profession as a group of workers who have been authorised by the state
to determine aspects of their own work, training and organisation,usually,but not necessarily,as a result of their specialist expertise. It argues that knowledge about professions would be advanced by examining the social structures and processes of regulation and management of different professions, rather than by concentrating on the particular characteristics of the work or of the workers. Following this approach the thesis presents research into the different national regulatory structures, and local management structures of five "welfare service" professions in the U.K. In explaining the differences in structure the thesis shows how each occupation exploited characteristics which provided power in particular situations to establish organisation and control advantageous to its interests,and how characteristics such as specialist knowledge, status, and income were stabilised and further developed as a result. It also examines the complex involvement of the state in legitimating, advancing and limiting professional power.
The main contribution of the thesis is to develop Freidson's theory of professions through logical critique and by reference to empirical evidence about five U.K. welfare professions, and by,
- showing that national regulatory structures do not define a division of labour or provide the absolute autonomy which Freidson proposed, - showing that different types of professional autonomy are institutionalised in local
management structures, usually on central government recommendation, and by providing a typology of professional autonomy based on empirical research, - showing that characteristics of professions are related to, but not, as proposed by Freidson, determined by professional autonomy, - developing Freidson's general perspective to accommodate the empirical evidence by reconceptualising the nature of professions in terms of professional authority, rather than autonomy, and by developing a model of the authorisation of professional power.
In developing Freidson's theory the thesis also contributes, - to knowledge about professional organisation within state welfare bureaucracies,
mainly by providing detailed descriptions of differences and changes in management structures, - to the methodology of action research by developing the theoretical basis of a method for investigating the legitimation of authority in establishing management structures, - to knowledge about the details of the relationship between the state and welfare professions, mainly by providing evidence of the involvement of the state at national and local levels in decisions and structures which profoundly shape the nature of practice, relationships with clients, and futures of welfare occupations
Allied Health Clinicians' Understanding of Palliative Care as It Relates to Patients, Caregivers, and Health Clinicians: A Cross-Sectional Survey
No full text© 2019 Journal of Allied Health and Association of Schools of Allied Health Professionals. This author accepted manuscript is made available following 12 month embargo from date of publication (June 2019) in accordance with the publisher’s archiving policyPURPOSE: The scope of hospice or palliative care has expanded since its inception, which has significant ramifications for the AH workforce. This study sought to elicit allied health (AH) clinicians' understanding and views about palliative care and its relevance to their clinical practice and to identify their educational needs. Results from analysis of free text survey responses to a single openended question from a larger survey are presented. METHODS: An online survey was distributed to AH clinicians via email lists for the CareSearch Allied Health Hub, Allied Health Professions Australia, and other groups. Descriptive statistics and content analysis of free text responses were used to analyse the data. RESULTS: A total of 217 AH clinicians responded to an email survey and 187 useable responses were analysed. Four themes were identified: 1) palliative care employs a client-centred model of care, 2) acknowledgement of living whilst dying, 3) interdisciplinary palliative care interventions provide active care in a range of domains, and 4) characteristics of palliative care teams and settings. CONCLUSION: AH clinicians plan an active role in physical, social, and psycho-spiritual care of palliative care patients and caregivers. Burgeoning numbers of palliative care patients in nonspecialist palliative care settings require AH clinicians to develop skills and competencies to work with people who have advanced disease
Systems that evaluate international equivalency in health-related professions: a scoping review with a focus on Canada
No full textHealth workforce planning has become a significant global problem considering there are estimates of an 18 million healthcare provider shortfall by 2030. There are two mechanisms to address healthcare worker shortages: (1) domestic education of those professions and (2) integration of internationally educated health professionals. Integration of internationally educated health professionals into the Canadian healthcare system requires: (1) reductions in systemic and administrative barriers and (2) development, testing, and implementation of credential equivalency recognition systems. The goal of this scoping review was to identify systems that are employed to determine credential equivalency, with a focus on Canada. The scoping review was carried by employing: (1) a systematic literature search (9) and (2) a website and grey literature Google search of professional governing bodies from a selection of medical/allied healthcare professions, but also other non-medical professions, such as law, engineering and accounting. Seven databases were searched to identify relevant sources: MEDLINE, CINAHL Plus with Full Text, PsycINFO, SPORT Discus, Academic Search Complete, Business Source Complete, and SCOPUS. The search strategy combined keyword, text terms, and medical subject headings (MeSH) and was carried out with the help of a health sciences librarian. Seven articles were included in the final manuscript review from the following professions: nursing; psychology; engineering; pharmacy; and multiple health professions. Twenty-four health-related professional governing body websites were hand searched to determine systems to evaluate international equivalency. There were many systems employed to determine equivalency, but there were no systems that were automated or that employed machine-learning or artificial intelligence to guide the evaluation process.Peer reviewedcompetenceprofessionalhealth workforceimmigrationequivalenc
Multi-disciplinary education within the health care professions
No full textThe aim of this study was to investigate the perceptions held by health care
professionals, of multi -disciplinary education. In addition, possible areas for the
development of a multi-disciplinary approach were identified. The research focused
on the views of nurses, physiotherapists, radiographers, speech therapists and
occupational therapists.
The study adopted a case study methodology, incorporating a mixed-method
approach in terms of data collection. A questionnaire was used to review the
perceptions of multi-disciplinary education amongst health care professionals, and
interviews were then conducted with a sample of the respondents to explore their
views further.
From the outset, the research process assumed a multi-disciplinary
perspective. During the study it became clear that organisational and professional
factors were important influences on how health care professionals perceived multidisciplinary
education. The research appeared to indicate that the idea of "multidisciplinary
education" is a problematic concept and that multi-disciplinary education
is acceptable, where it is appropriate. Most of the professions involved recognised the
benefits of the process, but were anxious to protect the integrity of each individual
profession, in the long term. Moreover, they maintained that the medical profession
needs to be included in the process. The organisational findings were, primarily, that
multi-disciplinary education might benefit from a cross-agency approach.
Perhaps significantly, it was suggested that multi-disciplinary education
should be introduced at the pre-registration stage. It was apparent that teamwork does
not always occur in practice and that this was an area that could be a focus for multidisciplinary
education. The research concluded that there should be joint ownership of
any multi-disciplinary education programme across professions and organisations
An integrated literature review of undergraduate peer teaching in allied health professions
No full textBackground. The concept of peer-assisted teaching or peer-assisted learning (PAL) has been receiving more attention in the teaching of medical and alliedhealth students. Many advantages have been described in the literature, but much more research is needed. Challenges with the academic platform at aspecific institution of higher learning necessitate investigation into the current literature on PAL, which can inform decisions in terms of teaching and learning of allied health professions students.Objective. To critically appraise evidence of the effectiveness and implementation of PAL during the professional clinical skills training of undergraduate students in allied health professions to make informed future decisions on teaching and learning.Methods. A literature search was conducted by an experienced librarian in the Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa and the researcher in multiple electronic databases (MEDLINE, CINAHL, Africa-Wide Information, ERIC and PubMed) published from 2000 to 2014.Results. One hundred and seventy-five articles on PAL in health professions training were identified. The selected articles (n=20) were independentlycritically appraised by two researchers by means of the standardised critical appraisal skills programme (CASP) and the Author Manuscript of theNational Institutes of Health on Appraising Quantitative Research in Health Education. Nine articles were identified to be reviewed (two by the same author).Conclusion. The findings with regard to the limited number of articles reviewed suggested that PAL may address some of the needs of the new generation of students and may be beneficial to the student tutor, student tutee and clinical supervisor. More evidence is needed in terms of the questions arising from the review, especially with regard to occupational therapy, dietetics and nutrition, and optometry, to fully implement PAL
Continuing differences between health professions' attitudes: The saga of accomplishing systems-wide interprofessionalism
No full textObjective: To compare four health professions' attitudes towards interprofessional collaboration (IPC) and their evaluations of a programme aimed at enhancing IPC across a health system. Design: Questionnaire survey. Setting: Australian Capital Territory health services. Participants: Sample of medical (38), nursing (198), allied health (152) and administrative (30) staff. Intervention(s): A 4-year action research project to improve IPC. Main Outcome Measure(s): Questionnaire evaluating the project and responses to the 'Attitudes toward Health Care Teams' and 'Readiness for Interprofessional Learning' scales. Results: Significant professional differences occurred in 90% of the evaluation items. Doctors were the least and administrative staff most likely to agree project aims had been met. Nurses made more favourable assessments than did allied health staff. Doctors made the most negative assessments and allied health staff the most neutral ratings. Improved interprofessional sharing of knowledge, teamwork and patient care were among the goals held to have been most achieved. Reduction in interprofessional rivalry and improved trust and communication were least achieved. Average assessment of individual goals being met was agree (31.9%), neutral (56.9%) and disagree (11.2%). On the two attitude scales, allied health professionals were most supportive of IPC, followed by nurses, administrators and doctors. Conclusions: Although overall attitudes towards IPC were favourable, only a third of participants reported that project goals had been achieved indicating the difficulties of implementing systems change. The response profiles of the professions differed. As in the previous research, doctors were least likely to hold favourable attitudes towards or endorse benefits from social or structural interventions in health care. © The Author 2012. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved
User involvement in a Cochrane systematic review: using structured methods to enhance the clinical relevance, usefulness and usability of a systematic review update
No full textBackground: This paper describes the structured methods used to involve patients, carers and health professionals in an update of a Cochrane systematic review relating to physiotherapy after stroke and explores the perceived impact of involvement.Methods: We sought funding and ethical approval for our user involvement. We recruited a stakeholder group comprising stroke survivors, carers, physiotherapists and educators and held three pre-planned meetings during the course of updating a Cochrane systematic review. Within these meetings, we used formal group consensus methods, based on nominal group techniques, to reach consensus decisions on key issues relating to the structure and methods of the review.Results: The stakeholder group comprised 13 people, including stroke survivors, carers and physiotherapists with a range of different experience, and either 12 or 13 participated in each meeting. At meeting 1, there was consensus that methods of categorising interventions that were used in the original Cochrane review were no longer appropriate or clinically relevant (11/13 participants disagreed or strongly disagreed with previous categories) and that international trials (which had not fitted into the original method of categorisation) ought to be included within the review (12/12 participants agreed or strongly agreed these should be included). At meeting 2, the group members reached consensus over 27 clearly defined treatment components, which were to be used to categorise interventions within the review (12/12 agreed or strongly agreed), and at meeting 3, they agreed on the key messages emerging from the completed review. All participants strongly agreed that the views of the group impacted on the review update, that the review benefited from the involvement of the stakeholder group, and that they believed other Cochrane reviews would benefit from the involvement of similar stakeholder groups.Conclusions: We involved a stakeholder group in the update of a Cochrane systematic review, using clearly described structured methods to reach consensus decisions. The involvement of stakeholders impacted substantially on the review, with the inclusion of international studies, and changes to classification of treatments, comparisons and subgroup comparisons explored within the meta-analysis. We argue that the structured approach which we adopted has implications for other systematic reviews.</p
Assessment of interhospital differences in the surgical site infection rates due to the patient and hospital related risk factors in US hospitals
No full textSurgical site infection (SSI) is a significant patient safety issue in hospitals that is related to more extended hospital stays, and increased cost burden. Since the infection prevention strategies been inconsistently implemented in hospitals, hospital size must be an influential factor to cause an impact on SSI rates.
We retrospectively analyzed 222,845 cases with SSI from National Inpatient Sample (NIS) data developed for Healthcare Cost and Utilization Project (HCUP) database, between the year 2008 and 2012 at small (<250 beds), medium (25-450 beds), and large (100-450+ beds) size hospitals. Risk factors, including demographics, socioeconomic, location, and functioning features then introduced to compare interhospital SSI prevalence and county-specific SSI rates. Finally, risk factors were regressed to assess the association between risk factors and SSI measures.
With an overall prevalence of 2.67 per 100 procedures, unadjusted prevalence rates were 2.9% in small, 2.62% in medium, and 2.65% in large hospitals (p<0.0001). Patients with transfers, high severity of the disease, comorbidities, catheterization, and academic hospitals were the vital distinguishing factors for SSI rates amongst the hospital varying in capacities. The elderly patients at the small rural and minorities (Black and Hispanic patients) at the large urban teaching hospitals were at higher SSI risks. Fluid & electrolyte imbalances and weight loss were most recorded comorbidities.
Every year hospital administration aims to reduce SSIs without losing gained revenue. Besides infrequent adherence to infection prevention (IP) strategies, it identifies hospital and patient-related conditions that influence SSI rates. According to this study, interhospital SSI rates disparity associations were multifactorial with partial elucidations allied to variances in demographics, transfers, level of severity of the disease, comorbidities, and socioeconomic factors in small and large hospitals. The findings also led to more infection reduction exertions towards hospitals from rural and teaching hospitals from urban counties. Therefore, the assessments of infection prevention deficiencies with the refined overtime data provide more information on modifiable indicators and that if explored in more detail at hospital settings, it can help infection preventionist for benchmarking.Ph.D.Includes bibliographical reference
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