Education Of Other Health Professionals Research Articles

A pilot brief therapy intervention for Functional Neurological Disorder (FND) and Non-Epileptic Attack Disorder (NEAD): A service evaluation

This service evaluation examined the feasibility and service user reported experience of a brief psychological intervention for adults with Non-Epileptic Attack Disorder (NEAD). 15 participants attended an individual six-session Acceptance and Commitment therapy (ACT)-informed intervention comprising of psychoeducation and grounding techniques. Participant experience of the intervention was assessed using outcome measures and an online focus group which indicated their satisfaction. Participants fed back that longer therapy intervention; education of other health professionals (having reported previous negative experiences); and group/family support sessions would enhance future care.

Undiagnosed diseases: Needs and opportunities in 20 countries participating in the Undiagnosed Diseases Network International.

Rare diseases (RD) are a health priority worldwide, overall affecting hundreds of millions of people globally. Early and accurate diagnosis is essential to support clinical care but remains challenging in many countries, especially the low- and medium-income ones. Hence, undiagnosed RD (URD) account for a significant portion of the overall RD burden. In October 2020, the Developing Nations Working Group of the Undiagnosed Diseases Network International (DNWG-UDNI) launched a survey among its members, belonging to 20 countries across all continents, to map unmet needs and opportunities for patients with URD. The survey was based on questions with open answers and included eight different domains. Conflicting interpretations were resolved in contact with the partners involved. All members responded to the survey. The results indicated that the scientific and medical centers make substantial efforts to respond to the unmet needs of patients. In most countries, there is a high awareness of RD issues. Scarcity of resources was highlighted as a major problem, leading to reduced availability of diagnostic expertise and research. Serious equity in accessibility to services were highlighted both within and between participating countries. Regulatory problems, including securing informed consent, difficulties in sending DNA to foreign laboratories, protection of intellectual property, and conflicts of interest on the part of service providers, remain issues of concern. Finally, most respondents stressed the need to strengthen international cooperation in terms of data sharing, clinical research, and diagnostic expertise for URD patients in low and medium income countries. The survey highlighted that many countries experienced a discrepancy between the growing expertise and scientific value, the level of awareness and commitment on the part of relevant parties, and funding bodies. Country-tailored public health actions, including general syllabus of medical schools and of the education of other health professionals, are needed to reduce such gaps.

Applying Clinical Reasoning Theories to Kinesiology: Advancing the Education of Future Healthcare Professionals

ABSTRACT In Canada, kinesiology academic units are undergoing change. The growth of kinesiology as a health profession is reflected in increased clinical course offerings to train student clinicians. These courses require clinical educators, however, not all programs have clinical staff and faculty with the required knowledge or experience. In particular, prospective clinical educators may lack fundamental knowledge of clinical reasoning theory. Clinical reasoning is defined as problem solving and judgment in relation to patient or client assessment, diagnosis, treatment and management, and is considered to be essential for the development of autonomous health professionals. Clinical reasoning theory is applied in an educational context to streamline and enhance student clinician development. Unlike in the education of other health professionals, there has been no literature detailing the application of clinical reasoning theory to the kinesiology educational context. Thus, the objectives of this paper are to: (1) introduce the theories in clinical reasoning relevant to kinesiology, (2) link these theories to practical educational strategies and, (3) connect these strategies directly to the teaching of clinical kinesiology subjects.

Rapid acute care genomics: Challenges and opportunities for genetic counselors.

Genomic medicine in pediatric acute care is showing great promise, with rapid results from exome and genome sequencing returned within days providing critically important information for treatment and management of seriously ill children. Many have suggested that rapid acute care genomics presents novel genetic counseling issues. This is due to the need for rapid response to referrals, the immense emotional distress that parents are likely to experience when their child is in acute care, and the unfamiliar environment of the acute care setting. To explore the practice of genetic counselors in this setting, we conducted qualitative interviews with 16 genetic counselors (GCs), representing a large proportion of GCs at the frontline of providing genetic counseling in acute care settings in Australia. Interviews revealed themes describing genetic counseling in acute care, including practical challenges of counseling within a rapid turnaround time, similarities with other contexts such as prenatal counseling, and the need for education of other health professionals. Interestingly, GCs did not raise concerns in the interviews for parents' ability to provide informed consent for rapid genomic sequencing. GCs also encountered practical and organizational challenges with counseling in this setting where 24-hr care is provided, at odds with traditional '9 to 5' Genetics service delivery. Working closely in a multidisciplinary team was common and participants believed that GCs are well positioned to take a leading role in the education of other health professionals as rapid acute care genomics becomes routine clinical practice. Despite views that genetic counseling practice in rapid acute care genomics is unique, these exploratory data suggest that GCs are flexible, adaptable, and sufficiently skilled to deliver patient-centered counseling in this setting. Our work indicates GCs are ready and willing to contribute at an early stage of adoption of genomic investigations in acute care.

The development of clinical thinking in trainee physicians: the educator perspective

BackgroundAn important element of effective clinical practice is the way physicians think when they encounter a clinical situation, with a significant number of trainee physicians challenged by translating their learning into professional practice in the clinical setting. This research explores the perceptions of educators about how trainee physicians develop their clinical thinking in clinical settings. It considers what educators and their colleagues did to help, as well as the nature of the context in which they worked.MethodA qualitative approach was used in this study with in depth interviews carried out with educators as key informants. Rich data derived from 15 interview transcripts were analysed thematically in a rigorous and iterative process.ResultsThree broad and overlapping themes were identified: working in an educationally minded culture; proximity of the educator to the trainee physician; and trajectory of the trainee physician. The departments in which these educators worked emphasised the importance for the education of trainee physicians. All members of the team were responsible for education of the team, and all members, particularly senior nurses, were able to give feedback upon the trainee physicians’ progress. Educators described working side by side with their trainee physician and frequently being in close proximity to them which means that the educator was both easily accessible and spent more time with their trainee physicians. They described a trajectory of the trainee physicians through the placement with close monitoring and informal assessment throughout.ConclusionRecommendations are made as to how trainee physicians can be supported to develop their clinical thinking. Educators and managers can analyse their own and their department’s practice and select the recommendations relevant to their local circumstances in order to make change. This study adds the educator perspective to a body of literature about the importance of context and supportive learning environments. As such the discussion is applicable to the education of other health professionals.

Teaching of leprosy: current challenges.

In the context of declining leprosy endemicity worldwide, keeping the interest in knowledge and expertise in leprosy alive has been a matter of concern. Approaching the problem only in primary care, without the proper integration with other levels of care in the health system fails to account for the complexity of the disease. Training professionals to work at different levels of health care is a current challenge. The objective of this review was to look for experiences related to the teaching of leprosy both in undergraduate courses in the field of health sciences and in training programs for professionals who work in patient care. We highlight the role of the dermatologist in the management of control programs, diagnosis and treatment of the disease, as well as in the continuous education of other health professionals.

The global public health issue of pharmaceutical waste: what role for pharmacists?

Purpose – Pharmaceuticals have played an important role in improving the quality of life of the human population in modern times. However, it must also be acknowledged that both the production and use of pharmaceuticals have a significant, negative impact on the environment and consequently, a negative impact on the health of humans and wildlife. This negative impact is due to the embedded carbon in pharmaceuticals' manufacture and distribution and the waste generated in their manufacture, consumption and disposal. Pharmaceutical waste is comprised of contaminated waste (unwanted pharmaceuticals and their original containers) and non-contaminated waste (non-hazardous packaging waste). The paper aims to discuss these issues. Design/methodology/approach – The article is a literature review. Findings – The article identified a gap in the literature around pharmacist attitudes and behaviour toward the environmentally responsible handling of pharmaceutical waste. Originality/value – Pharmacists, with their professional commitment to the quality use of medicines and their active participation in the medicines management pathway, already play an important role in the more sustainable use of pharmaceuticals. Even so, they have the potential to play an even greater role with the environmentally responsible disposal of pharmaceutical waste (including packaging waste) and the education of other health professionals and the general public on this topic.

Genetics in Health Practice and Education Special Issue

Genetic counselors have long been involved in the education of other health professionals, both formally and informally. As pointed out by Seibert in this issue, the NSGC professional status survey offers evidence that a substantial proportion of NSGC members develops and delivers education to others, including to other health professionals. In compiling a special issue on genetics in health practice and education, we sought to recognize the increasing importance of this work. Our intention was to publish papers that would support practitioners to base these efforts on sound educational principles and to illustrate the range of strategies and programs adopted internationally to incorporate genetics into ongoing education of health care providers. The issue begins with a description by McInerney of the scientific, clinical and education context in which this work is occurring. This paper highlights changes as well as areas in which change is desired, but not yet realized. The ultimate goal of health professional education is to facilitate a system change, i.e. the widespread incorporation of new knowledge, skills, values, behaviors into a health professional’s own clinical practice in order to reach optimal patient outcomes. A necessary component of any system change is collaboration among the different disciplines involved in it: consequently interdisciplinary collaboration is key to any strategy to educate and train health care professionals (Institute of Medicine 2001). This notion of collaboration means both the desire to share knowledge from a health care profession, as well as the curiosity to comprehend a health care topic from the perspective of other health care professions. Becoming skilled in sharing and understanding the perspective of multiple health care disciplines requires thoughtful and deliberate preparation. In this issue, Farndon and his colleagues emphasize the need for the collaborative involvement of statutory and professional organisations, as well as individual educators, to develop and deliver a national education strategy whilst recognising that engaging these stakeholders can be challenging. Collaboration among practitioners is found in a mentorship program for nurses in cancer risk counseling described by Masny et al., with genetic counselors mentoring participants in incorporating the risk assessment program into practice. Clarke (2006) suggests that health care professionals think of the knowledge and skills of each profession as components of its “toolkit.” In this analogy, health care professionals such as a primary care physician, nurse, or physical therapist may use a tool from another’s toolkit, perhaps a component of the knowledge, skills, values or behaviors that are central to the profession of genetic counseling. This would allow the health care provider to work more effectively. These tools can be formally captured in competencies and learning outcomes across the continuum of undergraduate education to continuing education in the workplace, as seen in two initiatives, one to enhance genetic education for health professionals across a national health system broadly (Farndon et al., this issue) and another specifically for nursing (Kirk et al., this issue). Equally important is the ability of health care providers to also know when their skill in using a tool is not sufficient to completely do the job and a genetic counseling professional is needed. The challenge of educating other health professionals to refer to a genetic counselor is familiar, J Genet Counsel (2008) 17:143–144 DOI 10.1007/s10897-008-9149-0

Breast cancer in Serbia: preparations for a screening program

Background: Breast cancer is the leading malignancy in females in Serbia with incidence and mortality rates constantly increasing in the last several decades. Materials and methods: Current situation and activities for the improvement of breast cancer control in Serbia are presented. Results. Breast cancer is a leading cancer in females with a 25% share in cancer incidence, age adjusted rate of 60 per 100,000 and median age of 56 years. In the last three decades, there was an almost 4-fold increase in the crude mortality rate and the 2, 4-fold increase in the age adjusted rate. Only 40% of women are diagnosed with a localized disease. Clinically, less then quarter of patients are diagnosed with a small tumor (<2cm). There is only 1% of non-invasive tumors. Sparing surgical procedures are performed in only one third of breast cancer patients. Main reasons for late diagnosis of breast cancer are: lack of diagnostic capacities, inadequate professional education, low breast cancer awareness and the absence of a screening program. In order to improve the situation, the Breast cancer working group was established by the Ministry of Health, with a task to develop a national program for breast cancer prevention and control. Guidelines for breast cancer screening were developed. Several mammographs were purchased but more than twice new machines are still needed. Education of other health professionals will be carried out through a continuous medical education developed as a part of accreditation and licensing system by the Ministry of Health. Conclusion: National program for breast cancer prevention and control is regarded as a healthcare priority in Serbia.

A Close and Practical Association with the Medical Profession: Scottish Medical Social Workers and Social Medicine, 1940–1975

This study is concerned with the development of the profession of almoner (renamed medical social worker in the 1960s) in Scotland in the period from the outbreak of the Second World War until the mid-1970s. In addition to primary and secondary documentary sources, it is based on extended interviews with practitioners of different generations, the collected personal records of individuals, and a witness seminar which involved medical social workers, members of parallel professions, and those who carried political responsibility for social work both at the Scottish Office and within the local authorities during the critical years.1 The story of the development of a small, well organized, purposeful, predominantly female, profession would be worth telling for its own sake, but there are wider implications. In the first place this is an example of a profession or, to be more specific, what we shall call an insecure profession, developing initially within one professional jurisdiction, the medical, and then switching to another, social work. As such, it offers an insight into the dynamics of professional politics. Secondly, there are social change issues and their impact on health services; all professions mirror the times in which they operate but the almoners’ experience was particularly interesting because they engaged with issues of poverty, poor housing, abortion, adoption, and domestic violence in a period when popular and professional attitudes were subject to challenge and change. Thirdly, the story carries implications for the NHS as a whole. Currently the social contexts of health and medicine are much debated and often outlined as if they rested on novel insights. In reality, there have always been individuals and organizations arguing passionately for the social dimension. By 1948 politicians and prominent physicians had identified the almoners as a way of advancing social medicine. Over the next twenty years the profession did much to justify such expectations. Almoners, or medical social workers, were never as numerous on the wards and surgeries of the NHS as they would have liked but they became a part of many medical teams and were involved in the “social” education of other health professionals, including doctors. In the late 1960s changes began which would take the profession out of the NHS and into the new social work departments of the local authorities. At the same time, the profession lost its separate identity and became part of the new generic social work profession. The developments, which in Scotland were completed with the reorganization of local government in 1975, represented, in the view of many practitioners, the moment when their profession lost its effectiveness. In discussing why this happened, it is possible to shed light on some of the difficulties of embedding social considerations in the practice of health care. The significance of this debate becomes clear when we note the striking parallel between what have recently been identified as key service weaknesses and what the almoners were trying to promote: an informed social input into clinical decisions on wards and in surgeries, and continuity of care linking primary and secondary, health and welfare, and state and voluntary services. Not for the first time, the intricacies of professional politics appear to have thwarted desirable ends. That the activities of almoners promised not only better but also more cost effective care only adds a degree of mystery.

The Nurseʼs Role as Clinical Coordinator for the Center for Cranial Base Surgery

The newly created position of clinical coordinator for the Center for Cranial Base Surgery at Presbyterian-University Hospital is detailed in this article. The position evolved in response to needs of this specialized center, because the complexities of cranial base tumors (CBTs) require optimal patient care be a collaborative effort. The clinical coordinator works with the neurosurgeon in all phases of treatment. From the preoperative visit, through admission and surgery, and then in postoperative care and follow-up, patient care is centered not only on the physical aspects inherent in surgery and recovery, but also on psychological support and attention which must be maintained throughout the patient's treatment course. In addition, the clinical coordinator has important input concerning research activities, particularly in clinical implementation of new therapies, as well as patient data management. Inservice education of other health professionals in their dealings with CBT patients further enhances quality of and continuity in patient care. Patient-care responsibilities as well as related research and training activities are discussed.

Leadership in clinical dietetics: Meeting the challenge to roles in nutritional support

The success of efforts to improve nutrition training of other health professionals poses a threat to the position of clinical dietitians as authorities in nutrition. In situations in which no dietitians are present or dietitians' skills are not recognized, pharmacists and nurses are especially likely to take over nutritional support roles traditionally assigned to the clinical dietitian. At the University of California, San Francisco, where dietitians are included in nutrition education and patient care programs and where understanding of the role of the dietitian is a stated educational goal, a preliminary survey suggests that conflicts occur in roles that are shared by members of nutritional support teams. Factors contributing to role conflicts include not only inadequate education of other health professionals but also problems of job expectations, education, training, and self-image among dietitians. Improved training in clinical nutrition, acquisition of better team and patient care skills, documentation of the effectiveness of dietetic services, and efforts to improve status and visibility would help alleviate role conflicts and ensure clinical dietitians a more rewarding place in the health care system.