Ethics instruction at schools of public health in the United States. Association of Schools of Public Health Education Committee

OBJECTIVES: A survey of US schools of public health was undertaken in 1996 and 1997 to obtain a general picture of public health ethics curricula. METHODS: An explanatory letter with a list of questions for discussion was sent to the deans of the accredited US schools of public health. The deans were asked that at least 1 individual at their school who "is most knowledgeable about ethics curricula" review the list of questions and complete an ethics survey contact form. RESULTS: Ethics instruction was required for all students at only 1 (4%) of the 24 schools surveyed, while 7 schools required ethics instruction for some students. Two of the schools had no ethics courses. Ethics instruction was required for all MPH students at 9 (38%) of the schools and for all doctoral students at 4 (17%) of the schools. Most of the schools (19 of 24, or 79%) offered short courses, seminar series, or invited lectures on ethical topics, and 23 (96%) included lectures on ethics topics in other courses such as health law. CONCLUSIONS: Training programs at US schools of public health vary greatly in how much attention is given to ethics instruction. Model curricula in public health ethics should be developed to help fill this gap.     

Abortion education in nurse practitioner, physician assistant and certified nurse-midwifery programs: a national survey

OBJECTIVE: This study was undertaken to examine the inclusion and extent of abortion education in accredited nurse practitioner (NP), physician assistant (PA) and certified nurse-midwifery (CNM) programs in the United States. METHODS: In January 2000, a confidential survey requesting information about the curricular inclusion of eight reproductive health topics was mailed to program directors at all 486 accredited NP, PA and CNM programs in the United States. RESULTS: Two hundred two surveys were returned, with a response rate of 42%. Overall, 53% of programs reported didactic instruction on surgical abortion, manual vacuum aspiration or medication abortion and 21% reported including at least one of these three procedures in their routine clinical curriculum. CONCLUSION: Abortion education is deficient in NP, PA and CNM programs in the United States. As integral components of women's health care, abortion, pregnancy options counseling and family planning merit incorporation into routine didactic and clinical education.     

举办宫内节育器换代培训班的体会

<正> 宫内节育器(IUD)在当今我国的计划生育工作中占据了重要的地位,并已取得了明显的成绩。1988年我国育龄妇女应用IUD避孕的人数占应用可逆性避孕措施的80％。在国家计划生育委员会的重视下,随着放置IUD的育龄妇女数的逐年增加,IUD的系统管理也在逐渐建立和完善。自1993年已开始推广由活性带铜IUD替代隋性不锈钢IUD。由于我国广大使用IUD的育龄妇女在基层农村,根据这一特性,天津市计划生育研究所宫内节育器研究室与天津市计划生育委员会科技处自1993年开始共同主办了面对基层(市郊、县和乡计划生育技术服务站)的技术人员的IUD换代培训班8期,每期3天,共培训人员175人。     

A distance education in undergraduate dietetic education

Distance education is an exploding phenomenon that allows people to pursue higher education on their own time, at a pace that meets their needs, in locations where there are no colleges and universities, or where there is not a desired program of study. This study examined the use of distance education in undergraduate dietetic education programs and the opportunities for obtaining an undergraduate degree in dietetics solely via distance education. A survey was sent to all directors (n = 279) of undergraduate programs accredited/approved by the Commission on Accreditation for Dietetics Education to determine the current status and projected future use of distance education in their institutions' on-campus programs. The survey had a 54% response rate. Approximately 32% (n = 150) of undergraduate dietetics programs offer distance education courses in some format. Institutions that offer nondietetics distance education courses were more likely to offer dietetics distance education courses. The most common distance education format utilized in dietetics was 100% Internet courses (48%). The most common distance education dietetics course offered was a basic or introductory nutrition course (31%). From the data of courses offered, or permitted to be transferred, it would not be possible for a student to complete an undergraduate degree in dietetics solely via distance education methodologies at the time this study was conducted.     

Training needs in adolescent medicine of practising doctors: a Swiss national survey of six disciplines

OBJECTIVE: To assess and compare the training needs in adolescent medicine of doctors within 6 specialties as a basis for the development of pre/postgraduate and continuing medical education (CME) training curricula. DESIGN: Cross-sectional postal survey. SETTING: Switzerland. PARTICIPANTS: National, representative, random sample of 1857 practising doctors in 6 disciplines (general practitioners, paediatricians, gynaecologists, internists, psychiatrists, child psychiatrists) registered with the Swiss Medical Association. MAIN OUTCOME MEASURES: Perceived importance of and training interest in 35 topics related to adolescent medicine listed in a self-administered, anonymous questionnaire. RESULTS: A total of 1367 questionnaires were returned, representing a response rate of 73.9%. Clear interest in adolescent medicine was reported by 62.1% of respondents. Topics perceived to be the most important in everyday practice were functional symptoms (71.4%), acne (67.1%), obesity (64.6%), depression-anxiety (68.1%) and communication with adolescents (61.7%). Differences between disciplines were especially marked for gynaecologists, who expressed interest almost exclusively in medical topics specific to their field. In contrast, other disciplines commonly reported a keen interest in psychosocial problems. Accordingly, interest in further training was expressed mostly for functional symptoms (62.4%), eating disorders (56.3%), depression-anxiety (53.7%) and obesity (52.6%). Issues related to injury prevention, chronic disease and confidentiality were rated as low priorities. CONCLUSIONS: Regardless of discipline, Swiss primary care doctors expressed a strong interest in adolescent medicine. Continuing medical education courses should include both interdisciplinary courses and discipline-specific sessions. Further training should address epidemiological and legal/ethical issues (e.g. injury prevention, confidentiality, impact of chronic conditions).     

Education of preventive medicine residents: alcohol,tobacco, and other drug abuse

BACKGROUND: Generalist physicians' addiction training is inadequate, but general preventive medicine residency (PMR) programs have not been studied. We determined PMR programs' alcohol, tobacco, and other drug abuse (ATOD) training from 1995 to 2000 and identified barriers to this education. METHODS: Interviewer-administered telephone survey of program directors (PDs) of accredited PMR programs in the United States. RESULTS: We interviewed all 41 PMR PDs. While 78% of PMR PDs reported interest in increasing ATOD education, for 68% it was not a high educational priority. Tobacco ranked in the top third of preventive medicine topics by 58%, while alcohol and other drugs ranked in the bottom third by 48% and 52%, respectively. Twenty-two percent of programs required a clinical ATOD rotation, most commonly smoking-cessation clinics. Only 29% of PMR PDs felt that residents were well prepared in clinical aspects of ATOD, while 60% felt that residents were prepared in ATOD research and public health issues. The most commonly reported barriers to ATOD training were lack of resident interest and defined competencies (64% each); limited faculty time (59%); limited teaching time (54%); lack of available teaching materials (53%); and lack of faculty expertise (51%). CONCLUSIONS: While the majority of PMR PDs recognize the importance of incorporating teaching about addictions into training, much of the ATOD education in PMRs focuses on tobacco alone. Setting educational standards, defining competencies, investing in faculty development, and creating ATOD curricular modules are important next steps toward preparing preventive medicine physicians to effectively reduce the public health toll of addictions.     

农村卫生技术人员素质现状与培训需求研究

目的：通过调查了解农村乡镇卫生院卫生技术人员的业务素质与接受专业培训现状，并调查了解他们对未来培训的需求。调查发现，3个样本县乡镇卫生院卫生技术人员有9．9％无专业，苏南、苏中、苏北差距不大。过去5年内有70％以上的人接受过培训。对未来3年的培训需求调查则发现，高职称人员对培训需求相对稍低，高学历人员的培训需求较高。建议采取有效措施，通过培训与分流相结合提高农村卫生技术人员专业索质，开展经常性的业务培训，跟上知识更新的步伐，并针对不同层次人员的需求，开展有目的、有计划的业务培训活动。     

Original Research: Lesbian Health Education: A Survey of Obstetrics and Gynecology Residency Training Programs

The purpose of this study was to assess the status of lesbian health education in obstetrics and gynecology training programs in the United States and Canada. A survey was conducted of program directors of all accredited North American obstetrics and gynecology residency training programs. The response rate was 42% (118/283). The mean number of hours devoted to lesbian health education over the 4 years was 1.86 hr (n = 118 programs), with the most frequent method of instruction being lectures and seminars. More than half of the programs offered no instruction in lesbian health. Seventy-three percent of program directors felt that the lesbian health training was less than adequate, and 71% perceived a need to expand the lesbian health curriculum in their programs. In conclusion, lesbian health education is variable across institutions. The current status of lesbian health education is felt to be inadequate by program directors and there is a perceived need to expand the lesbian health curriculum in obstetrics and gynecology training programs.     

基于Web of Science数据库的全球健康领域研究的文献计量学分析

摘要:目的 追踪和分析全球健康研究领域的发展历程和研究热点,为全球健康后续研究工作提供参考。方法 对Web of Science核心合集数据库中的全球健康、国际卫生相关文献进行引文分析,截取被引频次百分比大于0.01%(被引频次≥40次)的引文文献共54篇纳入本研究。通过词篇矩阵对引文进行提取,应用SPSS21.0对数据进行聚类分析,并根据各类引文的内容归纳其主题,通过战略引文坐标确定各类主题在全球健康研究领域的地位。结果 高被引文献的平均被引频次为61次,最高303次,最低40次。近年来全球健康的高被引文献数量呈现快速增长,2008年最多,共有9篇。全球健康领域的研究内容可大致分为6类:全球健康的发展与课程项目开展;国际组织在全球健康中的作用;传染病与慢性病的防治;全球健康项目筹资与卫生系统研究;全球健康研究的技术与方法;健康危险因素与疾病负担研究。其中全球健康的课程与项目研究受关注度最高,共被引920次;传染病和慢性病防治、健康危险因素与疾病负担研究的新颖度最高,平均发表时间为2006年。结论 全球健康研究正进入加速发展阶段,全球健康的课程与项目研究是目前研究的热点,传染病和慢性病防治、健康危险因素与疾病负担研究将成为未来的主要发展方向。     

Higher nutrition training in Europe: towards the establishment of a database

A survey of higher training in nutrition in Europe was conductedin 1989. Replies came from 57 institutions in 22 of the 31 WHOmember countries, reporting in 69 courses. Only 33 of the reportedcourses awarded an MSc, PhD or diploma, in addition ten awardedBSc, five trained dietitians or clinical nutritionists and twocourses gave the title of bio-engineer and food technologist.Thus 69% of the courses reported trained nutritionists for adiploma, BSc or higher degree. Higher training in nutrition in Europe is dominated by femalestudents. Only in Greece were there equal numbers of femaleand male students. The proportion of male students did howeverincrease in PhD courses compared to MSc and diploma courses. There are differences in duration of similar types of courses.Duration of a diploma course can wuy from eight weeks to fouryears, MSc from one to five years and a PhD from three to fouryears. Very few students complete PhDs in nutrition. The majoritystop their training at BSc, MSc or diploma level A strengtheningof higher nutrition training in Europe as part of a health promotionstrategy is called for.     

Health education: results from the School Health Policies and Programs Study 2006

BACKGROUND: School health education can effectively help reduce the prevalence of health-risk behaviors among students and have a positive influence on students' academic performance. This article describes the characteristics of school health education policies and programs in the United States at the state, district, school, and classroom levels. METHODS: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n=459). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=920) and with a nationally representative sample of teachers of classes covering required health instruction in elementary schools and required health education courses in middle and high schools (n=912). RESULTS: Most states and districts had adopted a policy stating that schools will teach at least 1 of the 14 health topics, and nearly all schools required students to receive instruction on at least 1 of these topics. However, only 6.4% of elementary schools, 20.6% of middle schools, and 35.8% of high schools required instruction on all 14 topics. In support of schools, most states and districts offered staff development for those who teach health education, although the percentage of teachers of required health instruction receiving staff development was low. CONCLUSIONS: Health education has the potential to help students maintain and improve their health, prevent disease, and reduce health-related risk behaviors. However, despite signs of progress, this potential is not being fully realized, particularly at the school level.     

Continuing professional development system for health-care professions,Egypt

While the regulatory framework for medical education in Egypt has rapidly evolved, the progress of developing a system for continuing professional development has been slow. In 2018 the government approved legislation establishing a regulatory authority for continuing professional development and added expectations for continuing professional development as a condition of relicensure for physicians in Egypt. The new authority has deployed a provider-accreditation model that sets criteria for educational quality, learning outcomes, independence from industry, and tracking of learners. Only accredited providers can submit continuing professional development accredited activities. Despite regulatory and administrative support there have been several barriers to the implementation of the system including limited availability of funding, lack of suitable training venues and equipment for hands-on training, and resistance from the profession. As of March 2022, 112 continuing professional development providers have achieved accreditation, and deployed 154 accredited continuing professional development activities. The majority of accredited providers were medical associations (64%) and higher education institutions (18%), followed by medical foundations and nongovernmental organizations (13%) and health-care facilities (5%). One electronic learning platform has been accredited. Any entity with commercial interests cannot be accredited as a continuing professional development provider. Funding of continuing professional development activities can be derived from provider budgets, programme registration fees or appropriate sponsors. Funding from industry is limited to unrestricted educational grants. The foundations for an effective continuing professional development system have been established in Egypt with the aim of achieving international recognition.     

Continuing education courses in dentistry: assessing impact on practice

INTRODUCTION: In the context of movement towards mandatory continuing dental education, this paper describes how a delayed postal questionnaire can be used in course evaluation. Specifically, the value of the questionnaire as a tool for assessing the impact of short course attendance on general dental practice is examined. METHOD: Questionnaires were distributed to all those attending three courses, ranging in size, in the West Midlands region. As well as reflecting on the course, respondents were asked their views on the usefulness of the questionnaire, the length of time between course attendance and assessment of impact, and types of courses likely to have greatest impact. RESULTS: Respondents thought the questionnaire an appropriate tool for assessing impact on practice, that an appropriate interval of time between the course and the delayed questionnaire is about six weeks, and that courses most likely to impact on practice are those which offer updates on common clinical topics and are hands-on in nature. DISCUSSION: A delayed questionnaire could be a useful mechanism for evaluating the impact on practice of some types of courses. Response rates from those attending large lecture courses might be low. Course evaluation is also limited by resources and time. Criteria for identifying which courses should be subject to such evaluation might include high cost per participant and links with review cycles. CONCLUSION: There is scope for more structured evaluation of continuing dental education, including the assessment of impact on practice. The questionnaire described is a useful component of an evaluation framework.     

Which Counts More for Excellence in Childcare Staff — Years in Service, Education Level or ECE Coursework?

A sample of 81 caregivers in 24 urban centers was observed in interactions with preschool children three-to-five years old, in domains of positive and negative socioemotional inputs, language facilitation, concept promotion, and caregiving and cleaning up (of children and of environment).The teachers independently had provided responses to questions about their: number of years of formal schooling, years in childcare, years at the same center, own parenting status, and how many ECE/CD (early childhood education and child development) courses and workshops they had ever taken. Hierarchical stepwise regressions and ANOVAs showed the importance of ECE/CD training. When all positive teacher interactions tallied in the classroom were combined, ECE/CD training accounted for over 62 percent of the variance in teacher inputs. Thus, when interviewing candidates for childcare positions, directors need to verify a candidate's prior ECE/CD training and they need provide supports for staff to obtain ongoing ECE/CD coursework to ensure high quality childcare.     

The Wellness Child Care Assessment Tool: a measure to assess the quality of written nutrition and physical activity policies

BackgroundThere is a growing interest in studying the influence of child-care center policies on the health of preschool-aged children.ObjectiveTo develop a reliable and valid instrument to quantitatively evaluate the quality of written nutrition and physical activity policies at child-care centers.DesignReliability and validation study. A 65-item measure was created to evaluate five areas of child-care center policies: nutrition education, nutrition standards for foods and beverages, promoting healthy eating in the child-care setting, physical activity, and communication and evaluation. The total scale and each subscale were scored on comprehensiveness and strength.SettingAnalyses were conducted on 94 independent policies from Connecticut child-care centers participating in the Child and Adult Care Food Program.Statistical analyses performedIntraclass correlation coefficient was calculated to measure inter-rater reliability, and Cronbach's α was used to estimate internal consistency. To test construct validity, t tests were used to assess differences in scores between Head Start and non–Head Start centers and between National Association for the Education of Young Children–accredited and nonaccredited centers.ResultsInter-rater reliability was high for total comprehensiveness and strength scores (intraclass correlation coefficient=0.98 and 0.94, respectively) and subscale scores (intraclass correlation coefficient=0.84 to 0.99). Subscales were adequately internally reliable (Cronbach's α=.53 to .83). Comprehensiveness and strength scores were higher for Head Start centers than non–Head Start centers across most domains and higher for National Association for the Education of Young Children–accredited centers than nonaccredited centers across some but not all domains, providing evidence of construct validity.ConclusionsThis instrument provides a standardized method to analyze and compare the comprehensiveness and strength of written nutrition and physical activity policies in child-care centers.     

Predictors of interest in nutrition topics and willingness to participate in local nutrition programmes

OBJECTIVE: To investigate the predictors of interest in nutrition topics and willingness to participate in weight management courses and nutrition-related chronic disease management courses. METHODS: Data from a cross-sectional survey (n = 1007 Koreans aged >or=30) on nutrition-related conditions, nutrition behaviours, interest in nutrition topics and willingness to participate in two types of nutrition education courses, and general characteristics. Binary logistic regression was used to identify predictors of the participants' interest in the topic and willingness to participate. RESULTS: Younger, richer and more-educated participants were significantly more likely to be willing to participate in 'nutrition-related chronic disease management'. Having a higher income and being male increased the odds of being interested in this topic. Younger, more obese, high-income females and those interested to keep their weight and reduce fatty foods were more likely to be willing to participate in 'weight management'. CONCLUSION: There is a need to increase awareness about the link between nutrition and related health problems, especially regarding 'hidden' health problems to tailor the programmes especially for older, low-income and less-educated people and to focus on increasing their interest in nutrition topics.     

Peer Reviewed: Therapeutic Lifestyle Strategies Taught in U.S. Pharmacy Schools

Introduction

Several organizations representing pharmacy and other health professions stress the importance of teaching public health topics as part of training future practitioners. The objective of our study was to assess the number of U.S. pharmacy schools that incorporate lifestyle modification topics into their curricula.

Methods

We developed an electronic survey on lifestyle modification topics and sent it to each of the 89 pharmacy schools in the United States. The survey defined lifestyle modification topics as topics that address nutrition, exercise, weight loss, smoking cessation, and alcohol use.

Results

Of 89 pharmacy schools contacted, 50 (56%) responded to the survey. Of the 50, four offer at least one required course in a lifestyle modification topic, seven offer at least one elective course, and one offers a required course that incorporates more than one lifestyle modification topic. Five required and nine elective courses were identified from the responses. Nutrition was the most commonly offered required course topic, followed by smoking cessation, exercise, weight loss, and alcohol use.

Conclusion

Few pharmacy schools are addressing recommendations to promote public health education through formalized didactic courses. More courses on lifestyle modification topics should be offered to pharmacy students, who will be highly accessible to the public as pharmacists and will be able to offer education to enhance public health focused on the prevention of chronic diseases.     

Global vaccinology training: Report from an ADVAC workshop

At a workshop on 7–8 November 2018 the leaders of 26 advanced vaccinology courses met to carry out an extensive review of the existing courses worldwide, in order to identify education gaps and future needs and discuss potential collaboration. The main conclusions of the workshop concerned: opportunities for strengthening and expanding the global coverage of vaccinology training; evaluation of vaccinology courses; updating knowledge after the course; how to facilitate post-course ‘cascade’ training; developing and sharing best practices; the application of online and innovative approaches in adult education; and how to reduce costs and facilitate wider access to vaccinology training. The importance of collaboration and information exchange through networks of alumni and between courses was stressed. A web platform to provide information about existing courses for potential applicants is needed. Lack of sustainable funding is a constraint for vaccinology training and needs to be addressed.     

Sex education mandates: are they the answer?

This article examines the question of mandating family life education in schools. Findings are presented of a recent study on the implementation of New Jersey's family life education requirement, (proposed by the State Board of Education and Education Department) which, in its original form in 1979, required that 31 specific topics be addressed by the end of high school; (e.g. human reproduction, child abuse and assault, and others). Intense pressure from conservative activist groups, education associations fearing a threat to local control of curricula, and important elements of the press, caused a change in the language of the draft regulation to be much less specific. In 5 school districts selected, the norm was conformity to the very broad mandates simply by verifying that certain topics were touched on in courses already offered in the curriculum. Teachers did not seem motivated to give out more than simple correct information on human reproduction, and family life education is commonly discussed in a limited way as part of health education. Beyond more emphasis being placed on the topic of child abuse in elementary schools, little structural change took place in curricula, and there was little actual training of staff. In a 6th district (chosen on the basis of prior knowledge about its program), specific teacher training and curriculum development were evident. It is proposed that information connected with reproduction be regared as something students have a right to know, and that family life education be designed with this goal in mind, and not with the idea of making a political staement, or with the strategy of politically dangerous mandates.