Reimbursement as a legitimizing strategy for health education

The health education profession has made significant advances throughout the past few decades. However, health education is still described as an emerging profession. This article suggests strategies to move health education from its status as an emerging profession into that of an acknowledged profession. The authors assert that actively seeking direct third-party reimbursement will advance health education's emergence as a profession as well as increase its legitimacy in the eyes of other professions. The benefits of direct third-party reimbursement, experiences of the nursing profession's pursuit of direct third-party reimbursement, and the current status of health education are discussed. The article concludes by offering strategies for pursuing direct third-party reimbursement.     

Existentialism in Occupational Therapy: Implications for Practice,Research, and Education

Abstract

As the profession of occupational therapy enters a second century, its growth in an increasingly complex and globalized world requires an adaptive and diverse philosophical foundation. The existentialist school of thought offers a complementary focus, which enhances existing philosophical foundations of the profession and supports two major tenets: (1) humans as self-making beings always in the process of becoming and (2) emotions and feelings as foundations for being-in-the-world. This article explores these two themes both in the context of existentialism and occupational therapy, and then provides an examination of existentialist utility in occupational therapy practice, research, and education.     

Educating clinicians about cultural competence and disparities in health and health care

An extensive body of literature has documented significant racial and ethnic disparities in health and health care. Cultural competency interventions, including the training of physicians and other health care professionals, have been proposed as a key strategy for helping to reduce these disparities. The continuing medical education (CME) profession can play an important role in addressing this need by improving the quality and assessing the outcomes of multicultural education programs. This article provides an overview of health care policy, legislative, accreditation, and professional initiatives relating to these subjects. The status of CME offerings on cultural competence/disparities is reviewed, with examples provided of available curricular resources and online courses. Critiques of cultural competence training and selected studies of its effectiveness are discussed. The need for the CME profession to become more culturally competent in its development, implementation, and evaluation of education programs is examined. Future challenges and opportunities are described, and a call for leadership and action is issued.     

Health education: a boon to humanity or a fantasy and fraud?

The health education profession in the United States has been influenced by three major forces in recent years: sociomedical phenomena resulting in a public demand for health education, disease specificity of the practice of health education, and the process of professional credentialing. While these three forces are looked upon by many as beneficial to the profession, they also pose significant threats to the viability of the profession. Health educators must deal with these threats if the health education profession is to significantly benefit humanity. Otherwise, the profession may be ultimately perceived as a fantasy and fraud.     

Exploring spirituality and consciousness with an expanded science: beyond the ego with empiricism, phenomenology, and contemplation

Spirituality has been recognized as pivotal in health education and health promotion. Although spirituality is often discussed as a dimension of health, there is little evidence of integrating it into educational settings and health promotion programs. The difficulty in addressing the concept of spirituality is related to both its association with denominational religion and our cultural emphasis on the material realm. However, some scholars are now associating spirituality with the development of human consciousness beyond the ego level. It has been suggested that the scientific investigation of this development beyond the ego may be possible with empirical and phenomenological, as well as with traditional contemplative methods. Thus, investigation in the realms of consciousness beyond the ego can be addressed within theories of knowledge that are grounded in experience. An examination of the spirituality/consciousness relationship may be crucial for any profession that purports to address the health issues of the whole person. It may then be possible to more easily integrate spirituality into educational settings and health enhancement programs. If spirituality is part of human experience, then willingness to make forays into this dimension is fundamental to health.     

Occupational health nursing in Canada: its social foundation and future.

Our purpose in examining the social foundation of occupational health nursing is to better determine the future direction of the profession and its impact on a diverse workforce. Part of what makes up the profession of occupational health nursing is found in its definition: a process that is determined by the interaction between the occupational health nurse, worker, work and workplace; its goal is to assist the worker to achieve his or her optimal level of functioning, primarily through health education, health promotion, prevention of disease and injury and crisis intervention. Much of occupational health nursing is also based on its history and the traditions that have been established. A true understanding, then, of what occupational health nursing's future can be comes from a solid understanding of the history of the profession. As social trends in the past affected the profession, so will they in the future.     

The conversion foundations: a pot of gold or Pandora's Box for communities

The new charitable foundations being created when tax-exempt hospitals and HMOs go for-profit are enriching their communities with grants for health, education, housing and other worthy causes, but critics charge some deals shortchange the public. HSL Founding Publisher Barry S. Badfer looks at what the conversion foundations are doing and how to increase their accountability to serve the public good.     

The case for educating health care students in professionalism as the core content of interprofessional education

BACKGROUND: Professional teams are becoming more central to health care as evidence emerges that effective teamwork enhances the quality of patient care. Currently, health care professionals are poorly prepared by their education for their roles on the team. In parallel, there are increasing demands from consumers for health care professionals to serve the interests of society and patients through engaging in effective professional partnerships. Professionalism for health care providers is now being defined as a commitment to standards of excellence in the practice of the profession that are designed primarily to serve the interests of the patient and to be responsive to the health needs of society. Yet, there are multiple barriers impeding the development of professionalism beyond a uni-professional frame of reference. METHOD: Incorporating teamwork and professionalism into health care professional curricula at pre-registration level is proving to be challenging. These 2 areas of learning are brought together in this paper through a discussion of the role of interprofessional education in preparing all health care professional students for the workforce. CONCLUSION: Interprofessionalism is presented as a pre-registration curriculum framework that includes values shared by all health care professionals, which should be learned in order to more adequately prepare students for working in health care teams. It will be argued that interprofessional education provides appropriate methods by which to learn interprofessionalism, and that this will ultimately contribute to overcoming uni-professional exclusivity.     

The future of the health education profession: implications for preparation and practice.

The health education profession has come to a critical point in its development. If health education is to fulfill its promise as a worthwhile strategy to improve health, the specific competencies of health education specialists and, concomitantly, the educational preparation that they need must be clearly defined. In the past, no clear definition was possible because of the diversity of preparatory programs, the absence of commonly accepted accreditation standards, educators, inconsistent employment requirements, inadequate manpower data, and poor mechanisms for quality assurance. Health educators are examining the various forms of credentialing--accreditation, licensure, and certification--with a view to their use as a means of strengthening the profession''s preparation and practice standards. A Role Delineation Project undertaken by the National Center for Health Education, San Francisco, under a contract with the Bureau of Health Professions of the Health Resources Administration, has been completed. Activities that will be carried out subsequent to role delineation are expected to enable the health profession to resolve systematically fundamental issues in respect to manpower standards.     

The “know your body” program: A developmental approach to health education and disease prevention

The goal of health education is to motivate society to adopt health behaviors that will reduce premature morbidity and mortality from known preventable causes, including major chronic disease (heart disease, cancer, and stroke) and accidents. This motivation can be effective only within the framework of an action-oriented school health education program with a high degree of personal involvement. This paper describes the foundations of a new school health education system combining health screening, a “Health Passport,” a behavior-oriented health curriculum, and special interventions for high-risk students. We suggest that effective health education programs such as Know Your Body (KYB) become as important in our schools as reading, writing, and arithmetic, and that these be taught each year on a developmentally progressive scale, much in the same fashion as the three Rs.     

Resource control: the seven per cent who spend the most

The medical profession has long been notorious for its reluctance either to adopt an administrative role itself, or to participate fully with other NHS professions in health service management. Here, Dr Graham Page of the Health Services Management Centre, Birmingham University, argues that this can lead to a substantial waste of resources. An answer, he suggests, is that participation in management should be an integral part of medical education.     

Shortage of midwives -- the effect on family planning

The Safe Motherhood Initiative calls for improved maternity care for all women, essential obstetric services at the nearest place possible, and access to and acceptance of family planning services adapted to the needs of individual couples. Central to this effort is the midwife, who can serve as a link between community health workers and physicians. However, an International Planned Parenthood (IPPF) review of 29 countries that utilize midwives in their health systems found that half had a shortage and that a collective total of 61,000 additional midwives is needed to create a midwife:live birth ratio of 1:200. The regions with the worst ratios are generally those with lowest prenatal coverage and contraceptive prevalence rates and the highest incidence of maternal mortality. This situation could be remedied, in part, by greater utilization of auxiliary nurse midwives or specially trained traditional birth attendants. In countries where trained community health workers are permitted to distribute condoms, barrier methods, and the pill, an intermediate-level health worker should be authorized to provide injectables and IUDs. In many countries, even midwives are not permitted to provide family planning services, and their education does not include family planning content. Experiments in Indonesia, Turkey, Thailand, and the Philippines have demonstrated that midwives can be trained to insert Norplant and IUDs, and even perform sterilizations, as effectively as physicians. In Chile, a core of 300 physicians and midwives were selected for training in family planning methods and education and went on to train others. It is important that midwives themselves take the lead in restructuring and upgrading their profession and form strong partnerships with women's organizations at the grass-roots and policy-making levels.     

Social work in health settings in the U.S.A.

The review of the literature on social work focuses on the development of the profession in the United States, its involvement in health areas, and some of the recent directions with which writers in the profession are concerned. The diversity of the literature, as well as the culturally defined practice nature of the profession, make cross-national comparison of patterns of development of less value. The relationship between social work in health and mental health settings is mentioned, but the literature in psychiatric social work is large enough to be the subject of a separate survey. The profession is now represented in most primary-care-giving agencies in the United States, and in public health settings as well. Practitioners meet standards of training and education in common with nationally defined norms. Future concerns of social work in health include the effects of advancing medical technology on the patient care system, the increasing life expectancy with emphasis on old age, and controlling the increase in population.     

Health education for social workers: a primer

Health education, as a discipline and specialization, is often overshadowed by other branches of public health (e.g., bio-statistics, epidemiology, and policy management). Although social workers have been performing health education for decades, social work students may not know the history of health education as a practice profession and its uses in a social work context. The purpose of this article is to introduce the field of health education to social work students who are currently, or anticipate, practicing health education in their careers. We conclude with implications for social work education and a discussion about the impact of collaborative social work and health education efforts in the reduction of health disparities.     

Examining e-health

As part of its continuing mission to serve trustees and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a small group of representatives from foundations, healthcare organizations, and the technology field to share their experiences and expertise on electronic health (e-health). This roundtable, held April 28, 2002, in Chicago, Illinois, highlighted emerging opportunities and challenges for foundations that wish to fund e-health initiatives. This report summarizes some of the key points from the day's discussion, providing both an introduction for grantmakers new to this area and offering the perspectives of some funders already experienced in funding e-health activities.     

Health Education for Social Workers: A Primer

Health education, as a discipline and specialization, is often overshadowed by other branches of public health (e.g., bio-statistics, epidemiology, and policy management). Although social workers have been performing health education for decades, social work students may not know the history of health education as a practice profession and its uses in a social work context. The purpose of this article is to introduce the field of health education to social work students who are currently, or anticipate, practicing health education in their careers. We conclude with implications for social work education and a discussion about the impact of collaborative social work and health education efforts in the reduction of health disparities.     

Role modeling: an opportunity for the health education specialist.

It is the responsibility of the profession to determine what is right, reasonable, and ethical health education practice. Opportunities within the profession abound to deliberate about the responsibility of health education specialists to role model positive health behaviors. Davis summarized the espoused perspectives nicely: We owe it to our profession and to our students to personally travel as far on the wellness continuum as behavioral choices will permit.... Health educators do have a special responsibility to be positive health role models by fulfilling their health potential and modeling the healthiest behaviors of which they are capable. All health educators need to accept for themselves the responsibilities that we assign to others.     

Continuing education—a study of dietitians participation in and attitudes to continuing education

It is now generally acknowledged that education and training is a continuing and lifelong process. It is also increasingly clear that education may take many forms, not all of them traditional. No longer can a person's education be associated exclusively with the period of induction and learning which occurs in the first 20 or so years of life. Nowhere is this more evident than in the professions.
The pace of scientific, technological, social and political change is now so rapid and intense that an initial period of professional training can only provide the foundations of knowledge, skills and attitudes on which further education and training must be built, if they are to remain current and valid.
This study seeks to inform the current debate within the profession, on the development of an education and training strategy for State Registered Dietitians. It reviews current participation in and attitudes towards continuing education among a random sample of British Detetic Association members.
The authors conclude from the results that dietitians are aware of the need for continuing education but need to be more actively involved in initiating and directing their own professional development. Some suggestions as to how this may be achieved are included at the end of this article.     

The future of health planning

What is the future of health planning? Will the profession survive? What will health planners be doing thirty years from now? The answers to these questions depend in part on prognostication and in part on the collective will of the profession to shape its own destiny. You ought to be doing something about the future in addition to waiting around for it. If by nature you are impatient for the good life, don't wait for it--invent it. The science of design is the sovereign science of the 21st century. A design for health requires us to answer three questions: (1) What should be done? (values) (2) How can it be done? (knowledge) (3) Who can do it? (power) To the degree health planners help society in its search for answers to these three questions, it will secure its own future as a profession. To the degree it fails in this quest, it will continue in its current mechanistic preoccupations and will eventually pass into irrevelance and obscurity. The impact of twenty-four societal trends are projected, as are the effects of the trends on the health planning profession and the images of its practitioners.     

International health in medical education: students' experiences and views

PURPOSE: The purpose of this paper is to describe the experiences and views of the first group of medical students to complete the intercalated International Health BSc in Leeds. DESIGN/METHODOLOGY/APPROACH: The paper draws on experiences of international health and draws parallels with those of other international health students. The paper also discusses how studying international health may benefit future doctors and considers how medical education can take a more international approach. FINDINGS: The paper finds that international health education can help future doctors acquire knowledge and skills in refugees' health, patients' cultural differences, the multifactoral influences on health, policymaking, the interests of various stakeholders, problem-solving skills and evidence-based medicine. PRACTICAL IMPLICATIONS: The paper shows that international health teaching is both relevant and valuable in medical education. The medical profession should give more recognition to its worth. ORIGINALITY/VALUE: This is the first paper to reflect on medical students' experiences of studying for an intercalated BSc at Leeds. It makes some important points about international health education for doctors and medical students world-wide.