Actions useful in reducing unacceptable variation in physicians' clinical activities have been identified through critical reviews of randomized controlled trials, and, from them, Richard Grol proposed six elements of effective change for mounting programs to improve clinical practice. The elements include consideration of the complex reality of clinical practice, attention ...

In preparing to undertake a clinical trial, it may be helpful to keep in mind Fredrickson's description of clinical trials (31): "Field trials are indispensable. They will continue to be an ordeal. They lack glamour, they strain our resources and patience, and they protract the moment of truth to excruciating ...

OBJECTIVE: The capacity of most clinical programs to detect early signs of relapse in schizophrenia and to implement strategies to prevent clinical progression remains unevaluated. The aim of this paper is to review the literature on the detection of relapse in schizophrenia and to draw conclusions that may be of ...

PURPOSE: To identify key functions and responsibilities of the role of clinical coordinator in a family nurse practitioner (FNP) program. DATA SOURCES: Recent articles, research, and interviews with other faculty serving as clinical coordinators in FNP programs at five other universities. CONCLUSIONS: Clinical coordinators are extremely valuable members of the ...

The needs of rural allied health professionals (AHPs) have been widely documented. In particular, problems of professional isolation, lack of professional development opportunities and limited support systems have been highlighted as problems associated with working in rural and remote areas. This research aimed to provide rural and remote AHPs with ...

There is national alarm about a decline in the number of clinician scientists. Most of the proposed solutions have focused on housestaff and junior faculty. We propose a new national program for training medical students in clinical research. This program, coined "Clinician Scientist Training Program" (CSTP), would consist of a ...

The RSC-SCI Medicinal Chemistry Symposium is a regular biennial event, always held at Churchill College, Cambridge, U.K. This year's meeting saw a diverse program of excellent medicinal chemistry presentations, mostly concentrated upon the early discovery and optimization stage, although discovery-enabling technologies were also discussed. The 24 lectures and 26 poster ...

In July 1999 I published an article in the BJPN entitled 'Introducing Clinical Supervision into the Perioperative Environment' (Smith 1999). I described what I believed to be the successful implementation of clinical supervision to the trained theatre staff. I discussed the perceived benefits of improved communication, assistance with learning, professional ...

Studies of clinical reasoning are essential if we are to extend our knowledge of occupational therapy practice, better communicate our work to clients and colleagues, and reveal to our students the nuances of therapy that cannot be gained from texts. However, accessing therapists' clinical reasoning is not an easy task ...

Clinical skills centres (CSCs) have contributed significantly to undergraduate medical education. Using alternative venues for training in communication skills, clinical examination and practical procedures they avoid jeopardising patient-care in traditional clinical settings. Using simulation they enable tutors to structure learning opportunities, provide standardized and reproducible experiences and create learner-centred environments ...

The American Dental Education Association's 1998-1999 Survey of Clinic Fees and Revenue obtained data by which to report, by school, clinic revenue information per undergraduate student. Fifty of the fifty-five U.S. dental schools responded to the survey. The median revenue per third-year student was $6,313. It was $11,680 for fourth-year ...

The standardized patient (SP) examination is used in a majority of medical schools to test clinical skills. This examination usually yields both numerical ratings of clinical skill and narrative comments by patients or observers, yet most empirical studies of SP assessment focus on the numerical ratings only. This quantitative focus ...

AIMS: To seek the views of medically qualified members of the Clinical Section of the British Pharmacological Society (BPS) on their perceived needs for Continuing Medical Education (CME); on how and by whom these needs should be addressed; and on how the outcome of any educational intervention might best be ...

The North Shore Health System and the Long Island Jewish Medical Center merged in 1997 and now form the third largest not-for-profit academic health care system in the United States. The authors analyze the specific factors responsible for the relative success of the clinical merger, review their merger's initial failures ...

Through Case Western Reserve University's Family Clinic Program, students are introduced early in their education to the professional responsibilities, attributes, and interpersonal skills needed by a physician. While this is the longest running instructional program in the school's curriculum, until 1998 it had not been assessed for points of improvement. ...

Despite the advantages of computerized psychological assessment and the proliferation of assessment software, many psychologists still do not use computerized assessment, and its utilization has not increased during the past decade. Two-hundred-fifty-one APA-accredited training programs in clinical and counseling psychology were surveyed concerning their use of computerized psychological assessment. Directors ...

OBJECTIVES: To describe the use, perceived effectiveness, and predicted future use of organisational strategies for influencing clinicians' behaviour in the approach of NHS trusts to clinical governance, and to ascertain the perceived benefits of clinical governance and the barriers to change. DESIGN AND SETTING: Whole population postal survey conducted between ...

Understanding scientific research evidence and applying it to clinical practice is a focus in today's health care arena. Fostering evidence-based care (EBC) in clinical teaching is an effective way to help students learn to think critically, search for, evaluate, and incorporate the best research evidence into their clinical practice. For ...

This paper proposes the clinical setting as an ideal learning environment for the development of skills conductive to collaborative practice. The argument is supported by findings from a small evaluation study. One cohort of physiotherapy students (n = 43) were surveyed immediately prior to their graduation in 1997, regarding their ...

INTRODUCTION: This paper describes a method of assessment of invasive clinical procedures which are currently being devised, and which are perceived to be a method that may be used to complement OSCEs in overall clinical skills assessment. OBJECTIVE: The objective of the Structured Clinical Operative Tests (SCOT) is to introduce ...

OBJECTIVES: To investigate the values and practices of assessment of the clinical practice of dental students by a sample of teachers in restorative dentistry. DESIGN: A questionnaire, based on the above objectives, was designed, piloted and redesigned. Its content was based on evidence-based good practice in assessment. Structured items in ...

OBJECTIVE: To compare the perceptions of students and clinical instructors regarding helpful clinical instructor characteristics. DESIGN AND SETTING: We developed a questionnaire containing helpful clinical instructor characteristics for facilitating student learning from a review of the medical and allied health clinical education literature. Respondents rated clinical instructor characteristics from 1 ...

This article reports a project aiming to assess the effectiveness of clinical nurses employed in support roles for students in clinical practice in one UK higher education institution and its linked NHS Trusts. Focus groups and telephone interviews were used to collect data from the clinical support nurses themselves, senior ...

Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need ...

BACKGROUND AND PURPOSE: Investigation of the clinical reasoning skills of experienced clinicians provides insight into decision-making in the practice of physiotherapy. The purpose of the present study was to analyse the clinical reasoning skills of an experienced physiotherapist during her assessment and treatment of clients with low back pain. METHOD: ...

BACKGROUND: Demographic predictions are challenging schools of medicine to emphasize geriatrics. This article describes a geriatric evaluation (GET) clinic and explores the opportunity for residents to attain core geriatric competencies. DESCRIPTION: The GET clinic is located in a small Midwestern city associated with a community-based medical school. It is staffed ...

Clinical faculty have a legal, ethical, and professional obligation to evaluate students' clinical performance to ensure safe practitioners. However, many clinical faculty members fear litigation and hesitate to give an unsatisfactory grade to students who do not meet established standards. If the decision to assign a failing clinical grade was ...

How do social justice issues affect the clinical evaluation of students? An emotionally charged issue, clinical evaluation can become a mine field when it becomes entangled with issues of social justice. The authors discuss the issues of justice and fairness in relation to situations that arise when a student repeatedly ...

Earlier and more recent clinical observations show that mistakes made in the early clinical stages of treatment have a negative effect on the time of effectiveness of the prosthetic treatment and its medicobiological value. Finding the most common mistakes and deviations from the clinical and laboratory protocol is of primary ...

There are different ways of approaching the nationally reported shortages of clinical placements for speech and language therapy students in the UK. Viewing the problem as a simple issue of high demand and shortfall may result in seeking short-term solutions. However, in order to achieve effective longer term change, there ...

The author describes his perspective on providing pastoral care to hospital patients, his search for new ways to understand that ministry, his first contact with The Discipline, and his adaptation of it to the clinical and educational programs at his center. He discusses the need to help clinical pastoral education ...

Problem oriented medical curricula claim to be based on the fact that the clinical sciences facilitate and encourage the understanding of basic sciences. The question was asked whether the correlation of gross anatomy in the Abdomen Block in the new Pretoria medical curriculum, with clinically relevant content (i.e. relevant physical ...

PURPOSE: (1) to integrate sociobehavioral science concepts into the early curriculum through a continuity ambulatory clinical experience in primary care, and (2) to expose students to a learning environment in which self-awareness and emotional development are nurtured in the context of dealing with the stresses of an early clinical experience. ...

The purpose of the present study was to investigate specific clinical behaviors exhibited by music therapy students in their 1st through 4th semesters of practicum. A secondary purpose of the study was to determine if a relationship exists between therapy students' behaviors and their assessed clinical success. Participants were instructed ...

BACKGROUND: WHO and UNICEF have recently developed the "Integrated Management of Childhood Illness" (IMCI) as an efficient strategy to assist developing countries reduce childhood mortality. Early experience with IMCI implementation suggests that clinical training is essential but not sufficient for the success of the strategy. Attention needs to be given ...

In this exploratory descriptive study, an investigator-developed survey tool was used to describe military clinical faculty's perception of the characteristics that nurse anesthesia students need for success in the clinical portion of graduate education. Study participants consisted of 29 clinical faculty from the Army, Air Force, and Navy (100% response). ...

BACKGROUND: Clinics interested in pursuing community-oriented primary care (COPC) have struggled with the implementation of its theory. Although we are still early in the COPC transformation process, the HealthPartners Family Practice Residency Program has had several successful COPC projects during our 10 years of experience. This article describes these projects ...

As clinical supervision becomes more widely implemented in the United Kingdom with concerns and resistances being eroded as practitioners discover its benefits, it is important that potential limitations and perhaps failures are avoided. This paper utilizes Johns' (1996) intent-emphasis axis to explore how a technical interest, misunderstanding of expert practice, ...

Educators have long considered assigning a grade in the assessment of student clinical practice performance as too variable, too subjective, or educationally inappropriate. Consequently, most undergraduate nurse education programs have maintained non-graded pass/fail criteria assessment for evaluating and reporting student clinical performance. This paper argues that, while the varied clinical ...

Clinical practicum experience arguably forms a critical role in the undergraduate preparation for registration to practice as a professional nurse. Whilst there appears to be a consensus about the importance of practical experience in nursing education, there has been limited research exploring the nature of clinical learning within undergraduate programs ...

CONTEXT: In-training assessment (ITA) has established its place alongside formative and summative assessment at both the undergraduate and postgraduate level. In this paper the authors aimed to identify those characteristics of ITA that could enhance clinical teaching. METHODS: A literature review and discussions by an expert working group at the ...

Clinical practicum experience arguably forms a critical role in the undergraduate preparation for registration to practice as a professional nurse. Whilst there appears to be a consensus about the importance of practical experience in nursing education, there has been limited research exploring the nature of clinical learning within undergraduate programs ...

Does the Clinical Rating Scale retain its validity when it is used, not by researchers, but by psychotherapists in their clinical practice? Students in a marital and family therapy training center routinely used the Clinical Rating Scale as part of the intake process. Although they had modest training in its ...

This article is a documentary of the history of the American College of Clinical Pharmacology (ACCP) and the Journal of Clinical Pharmacology. The history of the college and of the journal is presented as summarized by a few of the many leaders who played key roles in the growth of ...

Dynamic healthcare market forces impel educators to search for innovative methods of academic assessment to measure learning outcomes. The clinical achievement portfolio is a creative and systematic tool for documenting continuous improvement of student clinical learning. The authors describe the use of the portfolio as a pilot project aimed at ...

This paper describes a pilot study addressing issues surrounding the balance and status given to both theory and practice in the foundation part of a pre-registration programme. Contemporary thinking seems to suggest that there is a need to reverse recent trends which have placed an emphasis on theory. To facilitate ...

The dental education knowledge base suggests a lack of understanding and research about how to teach critical thinking skills in the clinical learning environment. The acquisition of critical thinking skills is essential to the development of future practitioners, yet difficult to measure quantitatively. This study used qualitative research methods to ...

In 2000, the American Board of Internal Medicine (ABIM) introduced a second-generation recertification process that builds on the current knowledge-centered program by adding assessments of clinical and communication skills, clinical performance, and medical outcomes. The three-part process, called a program of continuous professional development, includes innovative self-evaluation exercises, documentation of ...

Guidelines, protocols, and standards have gained attention as clinical tools designed to enhance clinical decision-making and practice. Yet, evidence has emerged that clinicians are having difficulty integrating new knowledge presented by these tools into practice. This article explores the benefits and barriers to using guidelines and protocols, probes the issues ...

Clinical experience provides clinicians with an intuitive sense of which findings on history, physical examination, and investigation are critical in making an accurate diagnosis, or an accurate assessment of a patient's fate. A clinical decision rule (CDR) is a clinical tool that quantifies the individual contributions that various components of ...