Trainee health care professionals'' knowledge of the health risks associated with obesity

BACKGROUND: Trainee nurses, doctors and dietitians will direct the future of obesity treatment and prevention. To do so effectively, they must have sufficient knowledge regarding the health risks associated with obesity and feel that part of their professional role is to counsel obese patients regarding these risks. METHODS: An online survey collected data on professional roles, training needs and the Obesity Risk Knowledge-10 (ORK-10) scale from 38 dietetic, 88 nursing (Diploma), 74 nursing (Masters) and 389 medical students. RESULTS: Final-year dietetic students demonstrated higher ORK-10 scale scores than final-year nursing (Dip), nursing (MSc) and medical students (P < 0.001). The majority of students agreed that part of their profession's role was to counsel obese patients about the health risks associated with obesity. Dietetic students were more satisfied with the teaching they had received than each of the other student groups (P < 0.05). CONCLUSION: Future health care professionals recognize their responsibility to communicate health risk information to obese patients. Dietetic students have a sound knowledge base to support them in this. Educators of trainee nurses and doctors may like to respond to their students' lower levels of knowledge and desire for more training.     

The AHEC contribution to social work education

The Area Health Education Center (AHEC) Program is a Federal initiative funded by the Public Health Service. The goal of the program is to improve the distribution and quality of training for health professionals. Funds are awarded to schools of medicine or osteopathy which in turn subcontract with at least two other health professional schools. Each project recipient must establish an AHEC center to plan and coordinate community-based educational experiences for health professions students in designated health shortage areas. The AHEC program fosters interdisciplinary training among health professionals. As part of the basic program thrust, some AHECs have included the social work profession in their program design. The Massachusetts AHEC, through Boston University's School of Social Work, established a health care concentration and interdisciplinary rotation that included students from social work, psychology, nursing, and medicine. Other examples of AHEC-sponsored training are presented from Baltimore, the eastern shore of Virginia, and several centers in Massachusetts. Through the AHEC training mechanism, social work students as well as practitioners in the field have the opportunity to encounter the most current and urgent issues in health care practice.     

Discourse of primary care professionals of the community of Madrid about work with groups: on techniques and technicians

BACKGROUND: Group-focused education for health is becoming a progressively more important activity in primary care. With the metaobjective of contributing to the further development thereof, this research set outs as specific objectives: knowing what is meant by "group-focused work" and ascertaining who is doing this work and how the group practices are carried out. METHODS: From a qualitative-structural standpoint, four discussion groups and four open interviews were held. The discussion groups held were: two with physicians, specialists in pediatrics, in family medicine and in community medicine, one with nursing professionals and another with professional social workers. The open interviews: two with general practitioners and two with social workers in the Primary Care Areas in the Autonomous Community of Madrid. RESULTS: The groups are understood, by most of the professionals, as groupings of homogeneous individuals as regards age and the disease involved to which information is conveyed by means of informal "talks" which are given mainly by nurses. A minority called for another way of construing and doing work with groups based more on a sharing of experiences and on fostering the group dynamics, an approach spearheaded particularly by women social workers. The physicians play a minority, sporadic role which is always in conjunction with the other professions. CONCLUSIONS: Groups-focused work in education for health in primary care involves mostly "talks" given by nurses and social workers, it therefore being found necessary to promote team activities in this group-focused work, by boosting the motivation and the training of the professional and bettering the evaluation of group experiences.     

Community health centers: unrecognized partners in health professions education.

Increasing demand for health professionals with training in ambulatory and primary care practice is placing stress on existing training site capacity. Community health centers can serve as model training sites, offering comprehensive multidisciplinary health care services and teaching clinician role models. In this study, 32 Illinois community and migrant health centers and federally qualified health centers were surveyed to asses their involvement with training in the past three years. Thirty centers had offered training to students from many disciplines, with nursing (27 centers) and medicine (24) the most frequent. Most centers had established formal relationships with training institutions but generally had limited involvement with course planning. Continued participation will likely require adequate funding, with some centers also seeking stronger institutional relationships and better integration of community health issues. Educators and policy makers may need to take a more active role in supporting centers, acquiring funds, and other enabling factors.     

Sixteen years of nursing education with diploma at the Semmelweis University

Nowadays it is already known that medical sciences on their own cannot achieve spectacular improvement in the state of health of the population even with high-tech appliances. Health care professionals, who can aid individuals, families, and communities in optimizing their physical, mental and social functions, are also needed in the fields of basic provision and clinical-hospital provision and, to achieve this, they possess wider medical, nursing and social scientific expertise. The training of registered nurses was first launched in Hungary at the Postgraduate Medical Institute's Faculty of Health Care (nowadays Semmelweis University Faculty of Health Care) in 1989 as a correspondence, then in 1990 as a full-time program. This was the first step towards the realization of a better, high-standard, individualized nursing system. The aim is training health care professionals who are able to individually assess the needs of people under their care, define the problems, plan, execute and evaluate the nursing-caring process, and take part in nursing research. Besides the positive results of the follow-up examinations of graduate students, the fact cannot be neglected that since the introduction of the training, in the last 15 years it has not become clear to everyone, why the training of registered nurses is necessary, and what these "new-type" professionals can be used for. It is clear to everyone that for real teamwork the mutual appreciation of each other's work, maximum accord, the acceptance and honor of each other are indispensable. Still, all these cannot be expected from school qualification only, these can only be achieved with the continuous proof of aptitude and expertise. For the realistic judgement of registered nurses it is also needed that their nearest colleague, the physician should know in depths and accept the syllabus of the training. That is why the author of the article feels that the history of the first sixteen years of the accredited training is important to be shown, and her message is grouped around four most important elements: curriculum, teachers participating in the training, practice bases and students.     

Multiprofessional learning: the attitudes of medical, nursing and pharmacy students to shared learning

OBJECTIVES: The belief that the effectiveness of patient care will improve through collaboration and teamwork within and between health care teams is providing a focus internationally for 'shared learning' in health professional education. While it may be hard to overcome structural and organizational obstacles to implementing interprofessional learning, negative student attitudes may be most difficult to change. This study has sought to quantify the attitudes of first-year medical, nursing and pharmacy students' towards interprofessional learning, at course commencement. DESIGN: The Readiness for Interprofessional Learning Scale (RIPLS) (University of Liverpool, Department of Health Care Education), was administered to first-year medical, nursing and pharmacy students at the University of Auckland. Differences between the three groups were analysed. SETTING: The Faculty of Medical and Health Sciences, University of Auckland. RESULTS: The majority of students reported positive attitudes towards shared learning. The benefits of shared learning, including the acquisition of teamworking skills, were seen to be beneficial to patient care and likely to enhance professional working relationships. However professional groups differed: nursing and pharmacy students indicated more strongly that an outcome of learning together would be more effective teamworking. Medical students were the least sure of their professional role, and considered that they required the acquisition of more knowledge and skills than nursing or pharmacy students. CONCLUSION: Developing effective teamworking skills is an appropriate focus for first-year health professional students. The timing of learning about the roles of different professionals is yet to be resolved.     

The motivational value foundations in the choice of career among professional nursing students and students studying at teacher's college

For the profession of teachers and nurses we need well-trained, highly qualified employees with a sense of vocation. AIM: A comparative analysis of motivation in the choice of career among professional nursing students and teacher-students. METHODS: This analysis was done in Hungary among professional nursing students and students participating in teacher training. In this sample 783 students were analysed. RESULTS: In the choice of career of nurses and teachers the primary motivation is of altruistic nature and also the human characteristics of the chosen career. According to genders in the case of female interviewed people we got a higher value than in the case of males in connection with "Helping people". It is more typical in the case of professional nursing students to choose the career as early as in their childhood. Choosing the career at a later age is typical for those who are teacher-students. CONCLUSION: As a consequence of our rapid economic changes or because of the dissatisfaction caused by career, we have to face the fact that the qualification obtained at a young age will not last till the end of life, the majority of people are forced to change their jobs several times during their lives. In harmonizing the demands of the labour market and education, those people who take part in education and professional training have a favoured role.     

Interprofessional training in the context of clinical practice: goals and students' perceptions on clinical education wards

AIMS: This paper describes the context of interprofessional training on clinical education wards (CEWs) and reports students' perceptions of this type of interprofessional and professional training. CONTEXT: A 2-week interprofessional clinical course was designed for medical students in their surgical eighth term, and nursing, occupational therapy and physiotherapy students, all in their sixth term. Clinical tutors were responsible for the patients and also supervised the students. The goals for the students included: to provide the patients with good medical care, nursing and rehabilitation; to develop their own professional roles; to enhance their level of understanding of the other professions; to stress the importance of good communication for teamwork and for patient care; to enhance understanding of the role of the patient, and to become more aware of ethical aspects of health care. MATERIAL AND METHODS: A questionnaire developed by teachers from the 4 educational departments was used. A total of 962 students responded (78%). RESULTS: The CEWs provided the students with good clinical practice in terms of training in their own professions as well in learning more about the other professions. The importance of good communication for teamwork and for patient care was recognised. The quality of supervision and students' perception of their own professional roles were important factors regarding satisfaction with the CEW course. CONCLUSIONS: The CEW course seemed to provide the students with an opportunity to develop their own professional roles and their functions as team members.     

A brief training program on resident assessment instrument improves motivation of nursing home staff

The Resident Assessment Instrument (RAI) has been designed to improve the quality of assessment and care in nursing home patients through a better understanding of resident needs. We organized three short courses (two weeks) on RAI, involving sixty-six nursing home health professionals. The course provided students both a theoretical and practical knowledge of RAI. At the end of the program, participants were asked to answer to an anonymous questionnaire about the course itself and their future professional motivation. The participants showed increased motivation and attitudes toward the elderly care. The good results obtained indicates that RAI not only may improve quality of nursing home care, but it is also an useful tool in the training of geriatric professionals enhancing their motivation and job satisfaction.     

A community-based approach to the medical humanities

BACKGROUND: This paper discusses the rationale behind, and an approach to, the development of a graduate level interdisciplinary curriculum in literature and health care that incorporates community-based learning. Such an innovative approach emerges from the recognition that professional training in both health care and humanities programmes often does not model the kinds of collaborative relationships and professional values desired by contemporary health care students, providers and patients. METHOD: Recent trends in literary study and the medical humanities are described, along with the function (and benefits to students) of interdisciplinary classrooms and the role of community-based learning in higher education. The authors discuss their experiences teaching, and offer students' responses to medical humanities courses from which the concept for such a curriculum evolved. The paper offers advice on developing, evaluating and disseminating such a model curriculum for medical, nursing and graduate literature students. PROPOSAL: By linking health care with graduate English literature students, such a course would promote dialogue and understanding among health professionals, enhance student awareness of the effects of illness on patients, their caregivers and families, and encourage student activism and community service. A common set of literary works would provide a shared vocabulary and opportunities for ethical, critical and personal response. Working together in a community-based project, students from different programmes would learn to appreciate alternative professional and lay perspectives on common experiences.     

Twenty years of care for persons living with HIV/AIDS in Brazil: the health professionals' perspective

The aim of this study was to describe the meaning ascribed by health professionals to the care they provide for persons with HIV/AIDS. Data were collected through recorded interviews with 10 health professionals providing care to AIDS patients in different institutions in S?o Paulo State, Brazil. Three themes emerged from the analysis: (a) the overall scenario of healthcare provision for AIDS patients; (b) the relationship between healthcare professionals and patients; and (c) ethical aspects related to care. Despite significant advances, the study identified discriminatory behavior in the treatment. Such behaviors were related to feelings of insecurity and fear of infection on the part of healthcare professionals, which could be explained by the lack of appropriate training in general services and hospitals. Specific training for treating the patients mainly targeted health professionals in centers specializing in HIV/AIDS, resulting in difficulties for integrating the care of these patients with other services under the Unified National Health System. The data related to characteristics of professional training in the health field as a whole, leading one to reflect on the skills expected of health professionals in caring for (and relating to) persons with HIV/AIDS, as well as the impact on AIDS prevention.     

Working by the rules: early childhood professionals' perceptions of regulatory requirements

The regulatory environment in which long daycare centres are required to operate plays a key role in determining what early childhood professionals do and how they go about doing it. This paper reports findings from a state-wide survey undertaken in New South Wales, Australia, which shows how early childhood professionals position themselves on four key aspects of the regulatory environment: the premises underlying regulatory requirements; its perceived support of them as professionals to provide quality care; how state regulations and the national accreditation system impact upon their daily practice; and the way these audit systems affect their professional esteem. Implications for job satisfaction are discussed. The paper concludes by asserting that regulatory requirements need to be evaluated in terms of their contribution to structural, process, contextual and work environment dimensions of quality.     

Students’ experiences of learning manual clinical skills through simulation

Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. The present study aimed to investigate the students’ experiences and thoughts about their learning through simulation skills training. The study was designed for an educational setting at a clinical skills centre. Ten third-year undergraduate nursing students performed urethral catheterisation, using the virtual reality simulator UrecathVision^?, which has haptic properties. The students practised in pairs. Each session was videotaped and the video was used to stimulate recall in subsequent interviews. The interviews were analysed using qualitative content analysis. The analysis from interviews resulted in three themes: what the students learn, how the students learn, and the simulator’s contribution to the students’ learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability. The findings show that the students related the task to previous experiences, used sensory information, tested themselves and practised techniques in a hands-on fashion, and reflected in and on action. The simulator was seen as a facilitator to learning the manual skills. The study design, with students working in pairs combined with video recording, was found to enhance opportunities for reflection.     

Work process of professional nurses: perceptions of undergraduate nursing falculty

The purpose of this study was to explore perceptions of undergraduate nursing faculty about the work processes of professional nurses, particularly, nursing care and competency - from ways of learning, knowing, and doing, which were developed during their undergraduate nursing education. Focus groups among fifteen undergraduate faculty members were conducted to collect data for this qualitative study. Content analysis was used to analyze the data. Six categories have emerged: Technical skills are fundamental to provide nursing care; Complexities of technical skills and nursing care; Differences in the process of providing nursing care; Competency from ways of learning, knowing, and doing are essential for providing nursing care; Learning to be a nurse is understood by different perspectives; The need of undergraduate faculty to discuss about nursing technical care.     

Importance of history and physical examination for the care of nurses

The history and physical examination are part of data collection of the Nursing Process. Its implementation is aimed at individualized care, holistic, humane and scientific foundation. The literature review was carried out in indexed databases as LILACS and SciELO, books and journals available in local libraries as published between the years 2000 to 2009. The aim is to describe the importance of clinical history and physical examination in the care provided by nurses. The results of this research will enable nursing students and health professionals can better understand the importance of history taking and physical examination to their professional practice, implement properly all stages of NAS and arouse interest in research on this topic.     

Danger signs. Coalition points to causes and consequences of inadequate care of the dying

Dying patients and their families repeatedly express their need for supports based on compassion and caring, yet healthcare efforts focus on often ineffective technological interventions and procedures. Professional healthcare schools provide little or no formal training in pain and palliative symptom management or in the multidimensional approach to care of the dying. And the pace of change in healthcare leaves little time for communication between the patient, family, and caring team. Physician denial of death and dying has a significant impact on clinical decision making and misleads healthcare administrators about priorities. Even when clinicians want to practice holistic supportive care, they are often unable to because of competing productivity demands and lack of reimbursement. Inappropriate therapies may be initiated to justify continued care in acute and skilled nursing environments. Because healthcare professionals may not inform families about what can be done in the way of supportive care, they may choose to ?do everything,? which often means using inappropriate treatments. Supportive Care of the Dying: A Coalition for Compassionate Care is a unique collaborative effort to help change the culture of dying in healthcare and to help Catholic and other organizations offer appropriate care based on respect for the sanctity of life, regard for human dignity, and a commitment to stewardship. The coalition intends to develop a comprehensive supportive care model built on Catholic values and tradition.     

Nursing teachers in clinical training areas: a phenomenological focus

During theoretical and practical activities in clinical training areas, nursing teachers provide the bases needed for the development of future professionals. The goal is to understand the experience of nursing teachers with nursing students in clinical training areas. Therefore, a phenomenological qualitative method was chosen, and Martin Heidegger's philosophical framework was used to support data analysis. Five faculty from a Chilean university participated in the study. The analysis permitted discovering the following themes: being a faculty at the hospital, contact with nurse practitioners and being a faculty in care teaching. The study demonstrated that teaching/care integration is a constructive element that facilitates the teaching and learning process, aiming to prepare nursing professionals who incorporate the bases of authentic care into their activities.     

Quality control in ambulatory health care. Results of an area-wide study by the public medical service of the Baden-Württemberg health insurance

Discussions surrounding the quality of nursing care, fueled by recurring press reports, prompted the State Nursing Insurance Associations in Baden-Wuerttemberg to request the Health Insurance Medical Service to perform a quality control of outpatient nursing care services in the state. Based on a coordinated concept and for the first time in the Federal Republic of Germany, all authorized ambulatory institutions area-wide were subjected to a uniform assessment (total survey) during an official inquiry time period. The end results of these controls failed to verify the judgement often propagated by the press based on individual cases that high-quality nursing care can no longer be afforded under the present circumstances. On the average, 55% of the personnel provided to patients by outpatient nursing services were health care professionals. What is more, this professional staff rendered 75% of all nursing care services. The evaluation of the accompanied medical visits indicated that the vast majority attempted to take active nursing care into account. With regard to quality assurance, a great optimisation potential was indicated primarily in the area of nursing documentation. Only in about 35% of the nursing documents inspected was the nursing procedure always clearly evident. A future problem could arise from the fact that of all nursing professionals with leadership responsibilities, at the time of the survey only about 37% had completed the requisite professional training qualification programme of 460 training hours. If the time before the interim deadline (March 31, 2002) is not utilised, the institutions in question could face consequences that could threaten their very existence. It is evident that a large number of outpatient nursing care services in the state of Baden-Wuerttemberg do not have their economic foundation in the domain of the Nursing Care Insurance Law, which affects both patient structure and care intensity. As a consequence, there is no quality control or inspection whatsoever for the majority of nursing care services rendered by ambulatory nursing care services at present because they are not under the jurisdiction of the German Federal Social Legislation SGB XI.