Service Learning in an Occupation-Based Curriculum: Student Commentary

Recent trends toward occupation-based practice and the move toward masters-level occupational therapy (OT) education has forced OT educators to reevaluate their programs to meet the needs of the contemporary health care environment. Service learning is one way to bridge the gap between theory and practice. The Master of Occupational Therapy (MOT) Program at Cleveland State University (CSU), in keeping with its focus on occupation, incorporates three service-learning components into its curriculum. This paper, written by a second-year MOT student at CSU, discusses two of these experiences in depth. The first, which took place at a homeless shelter, included both a didactic and “clinical” component, with an emphasis on community-based mental health OT services. The second, which included a training component and a structured program, involved co-leading after-school social-emotional learning groups for low-income urban youth. Both experiences served to expand the clinical skills and reasoning of the MOT students while introducing both the students and agencies to the role of OT in non-traditional community settings. Based on these experiences, the author highly recommends that all masters-level OT programs should, if they have not done so already, institute service learning as a core component of their curricula, in order to prepare their students for contemporary OT practice.     

中国城市社区卫生服务可持续发展的理论与实践

鉴于中国广阔的地域和其社区卫生服务发展不均衡及运作模式的多样性，本文对我国目前社区卫生服务的模式、运作机制进行了综合性描述，并对社区卫生服务可持续发展的理论与实践问题在社区卫生服务的社会功能、经济补偿机制、全科医生培养和提高管理水平方面进行了深入的探讨     

南昌市社区卫生服务人员全科素质现状

目的了解南昌市社区卫生服务机构人员队伍的全科素质现状,为卫生行政部门制定提高社区卫生服务人员素质提供依据。方法采用普查法,对南昌市所有的社区卫生服务机构的人员及全科培训情况进行了调查与分析。结果截止2010年底,南昌市206家社区卫生服务机构中,接受全科医师规范化培训人数占临床医师的16．73％,接受全科医师岗位培训人数占31．20％。通过国家全科医学专业中级技术资格考试者占13．21％,接受社区护士岗位培训人数占护士人员总数的36．47％。结论南昌市社区卫生服务人员数量、医护比仍需完善,全科素质有待提高,全科培训需要加强。     

基于“标准工作当量”的社区健康服务机构内部绩效管理机制的研究与实践

社区健康服务机构内部绩效管理体制和机制建设已成为现代医院管理者的关注重点。介绍了如何运用“标准工作当量”,建立“服务数量+服务质量”进行社区健康服务机构内部绩效管理的经验与方法,为广大社区健康服务的管理及学者提供借鉴。     

建立社区护理基地 做好社区护理工作

阐述建立社区护理基地 ,做好社区护理调查评估、制定护理计划、组织实施及效果评价等工作。开展集预防、保健、医疗和康复于一体的社区护理 ,连续全程地为当地社区居民提供快捷、廉价、优质的社区护理服务 ,提高社区居民健康生活水平。     

Translating Evidence-Based Practices Into Policy: A Case Study in Texas

Screening and brief intervention (SBI) in health care settings is an evidence-based practice for substance misuse. The Uniform Accident and Sickness Policy Provision Law (UPPL) discourages providers from carrying out SBI by allowing insurers in 26 states to refuse coverage for injuries resulting from intoxication. This project used a qualitative case study methodology to understand how policy-advocacy communication may have impacted the success of UPPL repeal efforts in Texas. Results showed bill progress could have been impeded due to less-effective communication from advocates. These findings suggest the quality of communication may influence the success of evidence-based policy-advocacy for UPPL repeal.     

Achieving Evidence-Based Practice: A Process of Continuing Education Through Practitioner-Academic Partnership

SUMMARY

Occupational therapy is required to deliver and generate evidence-based practice. As currently articulated, evidence-based practice requires particular skills and takes time and is rarely realized. This paper illustrates a collaborative approach to building an evidence based training program within a practice context. The aim of the training program was to enable therapists in a large mental health setting to engage in evidence-based practice. Specifically, the partnership between the United Kingdom Centre for Outcomes Research and Education (UK CORE) and Gloucestershire Partnership NHS Trust (GPT) will be described. This article describes the GPT/UKCORE partnership, the process of building an evidence-based practice training program, the final structure of the evidence-based practice training program, and the evaluation of the evidence-based practice training program.     

中国全科医学教育体制理论和实践研究

为保障社区卫生服务健康持续发展进一步完善全科医学教育事业仍是一重要课题。鉴此，本文对我国全科医学教育理论进行了深刻的剖析，对全科医学教育模式进行了实践性的综合，并就全科医学持续发展问题提出了可借鉴的意见。     

极致化医疗服务的理论研究与实践探索

初步探讨了极致化医疗服务满足现实需求、引领行业发展的理论和实践价值,提出了其＂坚持以人为本、突出全面质量、追求无限标准＂3个方面的理论内涵,并从文化熏陶、教育引导、制度规范和监督约束4个方面探讨了其实现路径。     

社区家庭医生团队服务模式实践探索

家庭医生制度是我国社区卫生服务向纵深发展的重要举措.在武汉市某社区卫生服务中心开展家庭医生团队服务模式实践,总结家庭医生团队服务的经验,找出实施中存在的困难和问题,并提出相应措施和政策建议.     

Translating a Research Intervention into Community Practice: The Nurse Family Partnership

Public policy initiatives have begun to recommend that interventions have strong evidence of effectiveness before there is expenditure of restrained public funds. The Nurse Family Partnership (NFP), a home visiting program for low-income parents expecting their first child, has been identified as a preventive intervention program that meets high evidentiary standards based on results from three randomized trials. Strategies used to promote successful translation of the research intervention into clinical practice, findings from the evaluation of the replication of the NFP in 22 states, and challenges experienced in moving a research program to practice are discussed.Editors’ Strategic Implications: Policymakers, community public health officials, and researchers planning to disseminate their prevention programs will find many lessons in this example of bringing a model program (i.e., a prevention strategy that works) up to scale. Although results at replication sites are somewhat weaker than at model sites, the consistent positive outcomes are a testimony to the strength of the NFP model and the fidelity of its implementation across sites.     

Rehabilitation of Infant Oral Feeding Difficulties: A Survey of Occupational Therapists Practice Approaches

This study identifies the scope of occupational therapy practice for the rehabilitation of oral feeding difficulties in infants who are in the neonatal intensive care unit (NICU). A written survey was administered to 127 occupational therapists who work with infants in the NICU. All 68 (54%) respondents used a client-centered approach, taking into consideration the infant (intrinsic), caregiver, and environmental (extrinsic) factors. Family and health team education was the most commonly provided service with the majority of occupational therapists providing services only until feeding problems were resolved. Continuing education (n = 20, 30%) and own clinical experience (n = 22, 33%) were the two most common justifications to support their choice of practice. These results suggest a client-centered approach in the rehabilitation of oral feeding difficulties is commonly used, but services are not extended beyond hospitalization. Few occupational therapists used peer-reviewed journals as sources of evidence for their practice strategies.     

Service Learning: Meaningful,Community-Centered Professional Skill Development for Occupational Therapy Students

The profession of Occupational Therapy advocates for new and emerging areas of practice that more fully embrace our moral responsibility to address significant social injustices that exist in our communities (Kronenberg, Algado, & Pollard, 2005). The service-learning pedagogy is impacted by the philosophical and theoretical influences of John Dewey, the mission and purpose of American higher education including Boyer's (1994) call for an engaged citizenry, and the social vision of occupational therapy. The pedagogy of service learning provides a natural context for students to experience community practice while contributing to reducing existing social injustices. This paper provides an overview of service learning (SL) as a philosophical and pedagogical approach in occupational therapy education, key processes in developing successful service learning experiences and community partnerships to support service learning. Characteristics of effective service learning, assessment of community and institutional outcomes of service learning and the scholarship of service learning are also discussed. Most importantly, strategies for developing service learning scholarship, an important but frequently neglected requisite to validate any educational practice, are delineated. The authors conclude that service learning provides educators with an opportunity to provide students with experiences in natural, community contexts while developing life-long commitment to civic engagement and social responsibility.     

Employer-sponsored occupational therapy professional development in a multicampus facility: A quality project

Aim:  To critically assess and develop recommendations for professional development (PD) for occupational therapists in a multisite specialist cerebral palsy occupational therapy service.
Method:  Quality improvement project based on principles of participatory action research: audit of PD resources/activity; stakeholder consultations and literature review.
Results:  The PD program goal, resources, strategies, activities and evaluations conducted at the centre were identified and described. Areas for improvement were identified by critically considering the PD program in the context of reviewed literature. There was an assumption that personal change through PD would help attain the organisational goal of clinically competent practitioners who use evidence-based practice in a family-centred context.
Recommendations:  Future PD plans and evaluations need to explicitly address this assumption. The use of structured reflection and the 'clinical reasoning' conceptual framework was recommended as one way to help personal change from PD to have workplace impact. This project provides a precedent and guide to occupational therapy PD planners regarding a whole-of-organisation approach to developing and maintaining competence through PD.     

Service Learning in a Pediatric Weight Management Program to Address Childhood Obesity

ABSTRACT

This paper describes an inter-professional service learning collaboration and reflects benefits and considerations when incorporating a family-oriented approach in the community-based pediatric weight management program. Because obesity has tremendous consequences on a nation's health and economy, a pediatrician in a community health network has utilized an inter-professional team to implement a pediatric weight management program targeting children between the ages of 8 and 15 years. The team incorporates a culturally sensitive curriculum using a family-oriented approach for obesity prevention and intervention. Physicians, registered dietitians, occupational therapists, nurse practitioners, and mental health professionals assist participants in adopting a healthier lifestyle by addressing physical and psychosocial issues related to obesity, developing a nutrition plan, making healthier food choices, and finding fun ways to be more physically active. Graduate occupational therapy students work closely with the team members to assist delivery of interactive activities and behavior intervention.