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"Professional Competence"
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Professionalism in mental healthcare : experts, expertise and expectations
\"In mental health, as in other medical disciplines, the role of the professional is changing. The availability of information, enhanced roles of other healthcare professionals and changes in training have altered the doctor-patient relationship and left professionals accountable to the needs of clients, politicians, policy makers and funding agencies. This book seeks to redefine the professional role of the specialist mental health worker by bringing perspectives from leading experts from both developed and developing countries, and also from a wide range of professionals in the field of law, medical ethics, education and medical leadership. Uniquely, it also looks at the views of patients and next-generation psychiatrists. It will be of interest to those involved in providing mental healthcare as well as those responsible for health policy initiatives and training\"--Provided by publisher.
Book
Understanding the Determinants of Antimicrobial Prescribing Within Hospitals: The Role of \Prescribing Etiquette\
Background. There is limited knowledge of the key determinants of antimicrobial prescribing behavior (APB) in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in antimicrobial stewardship programs. Methods. Qualitative semistructured interviews were conducted with doctors (n = 10), pharmacists (n = 10), and nurses and midwives (n = 19) in 4 hospitals in London. Interviews were conducted until thematic saturation was reached. Thematic analysis was applied to the data to identify the key determinants of antimicrobial prescribing behaviors. Results. The APB of healthcare professionals is governed by a set of cultural rules. Antimicrobial prescribing is performed in an environment where the behavior of clinical leaders or seniors influences practice of junior doctors. Senior doctors consider themselves exempt from following policy and practice within a culture of perceived autonomous decision making that relies more on personal knowledge and experience than formal policy. Prescribers identify with the clinical groups in which they work and adjust their APB according to the prevailing practice within these groups. A culture of \"noninterference' in the antimicrobial prescribing practice of peers prevents intervention into prescribing of colleagues. These sets of cultural rules demonstrate the existence of a \"prescribing etiquette,\" which dominates the APB of healthcare professionals. Prescribing etiquette creates an environment in which professional hierarchy and clinical groups act as key determinants of APB. Conclusions. To influence the antimicrobial prescribing of individual healthcare professionals, interventions need to address prescribing etiquette and use clinical leadership within existing clinical groups to influence practice.
Journal Article
Sight over sound in the judgment of music performance
Social judgments are made on the basis of both visual and auditory information, with consequential implications for our decisions. To examine the impact of visual information on expert judgment and its predictive validity for performance outcomes, this set of seven experiments in the domain of music offers a conservative test of the relative influence of vision versus audition. People consistently report that sound is the most important source of information in evaluating performance in music. However, the findings demonstrate that people actually depend primarily on visual information when making judgments about music performance. People reliably select the actual winners of live music competitions based on silent video recordings, but neither musical novices nor professional musicians were able to identify the winners based on sound recordings or recordings with both video and sound. The results highlight our natural, automatic, and nonconscious dependence on visual cues. The dominance of visual information emerges to the degree that it is overweighted relative to auditory information, even when sound is consciously valued as the core domain content.
Journal Article
The skills and experience of GRADE methodologists can be assessed with a simple tool
To suggest approaches for guideline developers on how to assess a methodologist's expertise with Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods and tasks and to provide a set of minimum skills and experience required to perform specific tasks related to guideline development using GRADE.
We used an iterative and consensus-based process involving individuals with in-depth experience with GRADE. We considered four main tasks: (1) development of key questions; (2) assessment of the certainty of effect estimates; (3) development of recommendations; and (4) teaching GRADE.
There are three basic approaches to determine a methodologist's skill set. First, self-report of knowledge, skills, and experience with a standardized “GRADE curriculum vitae (CV)” focused on each of the GRADE-related tasks; second, demonstration of skills using worked examples; third, a formal evaluation using a written or oral test. We suggest that the GRADE CV is likely to be useful and feasible to implement. We also suggest minimum training including attendance at one or more full-day workshops and familiarity with the main GRADE publications and the GRADE handbook.
The selection of a GRADE methodologist must be a thoughtful, reasoned decision, informed by the criteria suggested in this article and tailored to the specific project. Our suggested approaches need further pilot testing and validation.
Journal Article
Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial
Objective To assess the effect of general practitioner testing for C reactive protein (disease approach) and receiving training in enhanced communication skills (illness approach) on antibiotic prescribing for lower respiratory tract infection.Design Pragmatic, 2×2 factorial, cluster randomised controlled trial.Setting 20 general practices in the Netherlands.Participants 40 general practitioners from 20 practices recruited 431 patients with lower respiratory tract infection.Main outcome measures The primary outcome was antibiotic prescribing at the index consultation. Secondary outcomes were antibiotic prescribing during 28 days’ follow-up, reconsultation, clinical recovery, and patients’ satisfaction and enablement.Interventions General practitioners’ use of C reactive protein point of care testing and training in enhanced communication skills separately and combined, and usual care.Results General practitioners in the C reactive protein test group prescribed antibiotics to 31% of patients compared with 53% in the no test group (P=0.02). General practitioners trained in enhanced communication skills prescribed antibiotics to 27% of patients compared with 54% in the no training group (P<0.01). Both interventions showed a statistically significant effect on antibiotic prescribing at any point during the 28 days’ follow-up. Clinicians in the combined intervention group prescribed antibiotics to 23% of patients (interaction term was non-significant). Patients’ recovery and satisfaction were similar in all study groups.Conclusion Both general practitioners’ use of point of care testing for C reactive protein and training in enhanced communication skills significantly reduced antibiotic prescribing for lower respiratory tract infection without compromising patients’ recovery and satisfaction with care. A combination of the illness and disease focused approaches may be necessary to achieve the greatest reduction in antibiotic prescribing for this common condition in primary care.Trial registration Current Controlled Trials ISRCTN85154857.
Journal Article
Comparison of professional competency and anxiety of nursing students trained based on two internship models: a comparative study
Background
Improving the professional competency of nursing students during the internship is critical. This study aimed to compare the professional competency and anxiety of nursing students trained based on two internship models.
Methods
This is a two-group posttest-only quasi-experimental design study. One hundred nursing students who passed internship models A (a previous internship model) and B (an intervention with more educator support and a more planned and programmed process) were randomly enrolled in this study. Internship model groups A and B were conducted for the students in semesters 7 and 8. The outcomes assessed in both groups were “The Competency Inventory for Registered Nurses” and Spielberger “State-Trait Anxiety Inventory”. T-test and MANOVA were used to analyze the data.
Results
The mean scores of competency were 134.56 (SD = 43.23) and 160.19 (SD = 35.81) for the nursing students in the internship model groups A and B, respectively. The mean scores of nursing students’ anxiety were 92.14 (SD = 15.36) and 80.44 (SD = 18.16) in the internship model groups A and B, respectively. MANOVA test showed a significant difference between the groups regarding professional competency (F = 10.34,
p
= 0.002) and anxiety (F = 11.31,
p
= 0.001).
Conclusions
The internship model group B could improve the professional competency of nursing students to a great extent and they experienced mild anxiety; it is suggested that this intervention should be done for nursing students. Conducting more studies to evaluate the effect of this model on the nursing students’ competency and anxiety after graduation and as a novice nurse is suggested.
Journal Article
Characteristics of nursing educators' professional competency standards: A scoping review
To map the characteristics of nursing educators' competency standards for practice from the existing literature, examine the evidence and identify commonalities and differences.
Many countries or regions have produced nursing educator standards, however, there is no common set of standards or competencies used globally. Mapping these nursing educator standards should identify a common set of standards that can be applied across any nursing educator practice setting.
The review was conducted using the JBI methodology for scoping reviews and followed an a priori protocol.
A comprehensive search of studies or guidelines (2001–2022) was undertaken to identify specific nursing educator competencies from any practice setting and in any language. Preceptorship and mentorship studies were excluded from the search terms. Databases searched for relevant records and guidelines were CINAHL, ERIC, Medline (Ovid), Pubmed, Scopus, Google and targeted websites. After screening and selection, relevant data were extracted and summarized using an extraction guide. Characteristics of the reports were identified and all three levels of competency statements were mapped against commonly occurring categories derived from the data.
1145 evidence records were screened after removal of duplicates with 14 records included in the review. The included evidence sources were from various nursing educator practice settings and educator roles. All evidence sources had at least two levels of competency statements and 16 competency categories were identified. Common categories in the first two competency levels were: leadership and management; research and scholarship; professional values and professional development; and facilitating learning. Statements related to learner evaluation were also common in the level 2 competencies. Level 3 competencies were included in seven evidence sources and most of the sources included almost all categories. Low-occurring statements at all levels were in the ‘Nursing skills’ and ‘Decision-making/strategic planning” categories.
Common characteristics and categories were found between different evidence sources in this review. The most common competency review categories included leadership and management, professional development and facilitating learning. Few decision-making competencies were identified from the evidence sources. These results can inform educators and managers in developing globally-based nursing educator competencies, performance management tools and job descriptions.
Journal Article