Curriculum trends in nurse-midwifery education. Views of program directors

The purpose of this study was to determine the extent to which nurse-midwifery education programs are addressing the practice competencies that have been recommended by the Pew Health Professions Commission and others as essential for effective practice in the 21st century. This study was part of a larger survey of eleven health professions education programs. The 56 nurse-midwifery program directors whose names and addresses were provided by the American College of Nurse-Midwives were surveyed by mailed questionnaire, with a response rate of 59% (n = 33). The study sought to identify current and ideal emphasis placed on 33 broad topics, most important curriculum topics, and barriers to curriculum change as perceived by respondents. Findings revealed that nurse-midwifery program directors would like to see greater emphasis placed on every topic except one (tertiary/quaternary care). Desired increases ranged from .04 to 1.36. The overall mean rating for all topics was 3.51 for current emphasis (5-point scale) and 4.18 for ideal emphasis, both of which were higher than any other survey group. The greatest desired increases (> 1.00) were for "primary care," "managed care," "use of electronic information systems," and "business management of practice." Respondents identified "primary care," "health promotion/disease prevention," and "accountability for cost-effectiveness and patient outcomes" as the most important topics. The top three barriers to curriculum change were identified as "already crowded curriculum," "inadequate funding," and "limited availability of clinical learning sites," the last being statistically significant compared with other survey groups. Findings indicate that nurse-midwifery program directors perceived that they are adequately addressing most of the curriculum topics, while continuing to focus on the need for curriculum change as the health care environment changes.     

Dynein inner arm heavy chain identification in cAMP-activated flagella using class-specific polyclonal antibodies

In 1993, the Medical College of Pennsylvania (MCP), mindful of the rapidly changing environments of health care delivery, created three surveys to gather information from outside the school that would help the faculty plan how the curriculum and advising system could better prepare students and residents for the demands of twenty-first-century medicine. The first survey focused on the MCP seniors graduating that year and asked about their perceptions of their medical education and their specialty and residency choices. The second survey, directed to 40 medical residency program directors in family medicine, internal medicine, pediatrics, and surgery, sought to identify the characteristics of applicants that these directors valued when selecting entrants to their programs. The third survey, of 30 employers of physicians representing four practice environments (private practice, hospitals/other health systems, academic medical centers, and health maintenance organizations), sought information on hiring and recruitment practices and the skills, competencies, and attitudes these employers valued most when hiring recently graduated physicians. The responses showed several differences and/or misperceptions among the views held by the three groups surveyed and suggest that medical educators have not adapted as rapidly as have employers to changes in the health care environment. Academic health centers must broaden their missions and make changes in their own institutional cultures, both to maintain their own viability and to train physicians who have the balance between scientific and technical competency and essential personal characteristics (such as empathy) that the next century's practice will probably demand.     

Competency-based education

The essential elements of a P/CBDE program include the delineation of role-derived dietetic competencies, which are publicly stated in behavioral terms. The criteria used to measure the accomplishment of these competencies are criterion-referenced, and the student acquires the competencies at his own rate. Much confusion exists in differentiating between the essential characteristics and implementation modes. The use of modern technology and modular packaging of learning experiences does not automatically lead to a P/CBDE program. These are merely tools. The clear identification of competencies, objectives, and performance criteria are the essence of P/CBDE. Currently, dietetic educators are formulating competencies for their own programs. A national group of "experts" will need to be convened to develop competencies for the profession as a whole.     

Character and Fitness Requirements for Professional Psychologists: Training Directors' Perspectives.

Do directors of psychology training programs consider whether program applicants and students possess essential moral character and psychological fitness characteristics? A survey revealed that directors of clinical training (DCTs) in clinical and counseling psychology training programs are very concerned about both character and fitness. DCTs reported that evidence accrued during interviews and from undergraduate references is most salient preadmission and that behavior in the program and in clinical situations is most meaningful postadmission. The authors highlight the practices and perspectives of DCTs when it comes to evaluating character and fitness and conclude with several recommendations for training programs, licensing boards, and psychology training organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologist as ethics educator: Successes, failures, and unanswered questions.

Critically analyzes the literature documenting ethics education over the last 35 yrs, discussing changes in instructional methodology, current course content, and the empirical literature relevant to the outcomes of ethics education. This analysis reveals several gaps in the ethics competencies of students. The article next describes the results of a national survey of the views of 101 internship directors on the ethical capabilities of predoctoral interns in psychology. In contrast to ethics researchers, internship directors rate the ethics knowledge of psychology interns highly. It ends with a discussion of strengths and weaknesses of current knowledge and directions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Survey of Education and License Requirements for Structural Engineers

In order to determine the industry perception of educational and licensing requirements for entry-level structural engineers, the Structural Engineers Association of Hawaii, in conjunction with the Civil Engineering Dept. at the Univ. of Hawaii, distributed a two-part survey to their 240 members. The first part of the survey provided feedback on the current and potential license requirements for structural engineers in Hawaii. Although the majority of respondents hold a master’s degree, they do not support the ASCE proposal that a master’s degree be required for professional engineering licensure. The second part of the survey requested feedback on both undergraduate and graduate educational requirements for entry-level structural engineers. Based on the results of this survey, the structural engineering faculty at the Univ. of Hawaii are considering modifications to both undergraduate and graduate curricula. The survey results are presented along with observations that will interest all engineering educators. It is hoped that these results will encourage other universities and colleges to poll their industry constituents to aid in evaluation of their engineering programs.     

Graduate training in clinical psychology: Student perspectives on selecting a program.

Although graduate programs in clinical psychology spend considerable energy and resources selecting students, there is limited information regarding the factors students consider important when they choose a training program. A review of recent literature found one study that looked at how first-year graduate students rated the importance of a number of factors in their decision-making process when selecting a clinical psychology training program (Walfish, Stenmark, Shealy, & Shealy, 1989). The current study extends this research by comparing reports from first-year graduate students enrolled in traditional “Boulder model” programs with those enrolled in professional “Vail model” programs. As part of a larger survey project, students answered questions about factors they considered important when they made decisions about applying to and selecting a graduate program to attend. Responses from students enrolled in traditional programs were compared with students attending professional programs. These differences are discussed, as well as their implications for program directors engaged in student recruitment and selection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is there consensus among predoctoral internship training directors regarding clinical supervision competencies? A descriptive analysis.

Although psychologists increasingly provide clinical supervision, the profession has only recently begun to establish standards for competently doing so. This study was aimed at conducting a broader exploration of predoctoral psychology internship training directors’ views (n = 184) on the importance of the supervision competencies initially suggested by C. A. Falender et al. (2004). Respondents generally agreed with the importance of the competencies but showed less agreement with the importance of different types of clinical supervision training. Results reflect the need for further discussion in defining what makes for competent clinical supervision before these competencies are adopted within the profession. Practical implications of these findings are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Employment-seeking experiences of resident physicians completing training during 1996

CONTEXT: Studies analyzing the physician workforce have concluded that the United States is verging on a physician oversupply, yet we lack persuasive evidence that this is resulting in physician underemployment and/or unemployment. OBJECTIVE: To determine the degree to which graduating residents have difficulty finding or are unable to find employment in their primary career choices. DESIGN: Two 1-page surveys sent separately to residents and to program directors to collect information on the employment status of residents who were completing a graduate medical education program at the end of the 1995-1996 academic year. SETTING: A total of 25 067 resident physicians scheduled in the spring of 1996 to complete a residency program accredited by the Accreditation Council on Graduate Medical Education, and 4569 program directors in 31 specialties and subspecialties. MAIN OUTCOME MEASURE: Both the graduates' employment status and the degree of difficulty they experienced securing a practice position, as reported by resident physicians and program directors. RESULTS: After 6 months of data collection, 12135 (48.4%) of 25 067 resident physicians responded to the survey. Of the respondents, 11 200 had completed their training, and 7628 (68.1%) were attempting to enter the workforce, 28.4% were seeking additional training, and 3.5% were fulfilling their military obligations. Of the 7628 resident physicians who sought employment, 67.3% obtained clinical practice positions in their specialties, 15.5% took academic positions, 5.0% found clinical positions in other specialties, 5.1% had other plans, and 7.1% did not yet have positions but were actively looking. In addition, 22.4% of resident physicians who found clinical positions reported significant difficulty finding them. The subgroup reporting greater difficulty finding clinical positions included international medical graduates (more than 40%),those completing programs in the Pacific or East North Central region, and those in several specialties. The 1996 graduating residents reported significantly higher rates of difficulty finding suitable employment than program directors reported for their graduates (22.4% vs 6.0%); however, the percentage of graduates reported by both groups as entering the workforce was the same (68.1%). Program directors reported an unemployment rate of only 1.2%, for their 1996 graduates, which was less than the rate reported by the resident physicians (7.1%). CONCLUSIONS: Resident physicians' direct reports of their employment-seeking experiences differ from what program directors report. Program directors accurately determined the number of residents pursuing further training; however, they did not have complete information about the employment difficulties experienced by their graduates. Based on graduates' reports, we conclude that employment difficulties are greatest among international medical graduates and vary by specialty and geographic region.     

Terminal master's-level training in counseling psychology: Skills, competencies, and student interests.

We surveyed directors of terminal master's-level counseling psychology programs to determine perceptions about (a) the skills and competencies in which their students received training and (b) the interest and commitment of their students to different areas of training and practice. The data were also compared with the survey data of L. J. Schneider et al (see record 1989-13407-001) in an effort to examine similarities and differences between master's-level and doctoral level training in counseling psychology. Discussion about masters-level programs' training emphases and the master's vs. doctoral training issue is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Magic-echo phase-encoding solid imaging with improved time resolution

Anesthesiology critical care medicine (ACCM) fellowship training was accredited in 1989, and a small number of graduating anesthesiology residents pursue this additional training. Considering the flexible program guidelines of the American Board of Anesthesiology (ABA), we hypothesized that ACCM fellowship training programs varied significantly among the 42 institutions accredited to offer this program. This study of ACCM fellowship programs used a six-part, 57-item questionnaire completed by 36 program directors to describe six aspects of the program: institution size, program director, attending staff, fellowship applicants, curriculum, and the role of the American Society of Critical Care Anesthesiologists (ASCCA). Ninety-four percent of ACCM fellowships are in facilities with more than 400 beds; 81% of these institutions have more than 20 intensive care unit (ICU) beds as the basis for fellowship teaching. Eighty-three percent of ACCM program directors have practiced critical care for more than 5 yr. All programs had more than one attending physician, with the majority having a multidisciplinary attending staff. During two academic years (1990-1992), 12 (33%) of 36 programs did not have a fellow, resulting in an average of less than one fellow for each program. ACCM fellow involvement in patient care was characterized as "primary" in medical and pediatric ICUs and "cooperative" in surgical ICUs. Fellowship curricula had varied requirements for research, intraoperative anesthesia, and ICU procedures performed by the fellow. In general, program directors believe that salary and on-call responsibility are not important issues for applicants. Nineteen percent of program directors train ACCM fellows longer than the 12 mo required by the ABA and believe that ACCM training should be lengthened.     

Application of the competency model to clinical health psychology.

In response to the growing emphasis on defining professional competence within applied psychology (e.g., clinical, neuropsychology, counseling, school), in 2007 American Psychological Association Division 38 (Health Psychology) sponsored a summit meeting with a specific focus on revisiting the standards of graduate curricula and training in clinical health psychology. Using the cube model of core competency domains of professional psychology as a framework, summit participants were charged with identifying the foundational and functional competencies expected of a well-trained, entry-level clinical health psychologist. As a product of these discussions, the present article is presented as an initial effort to identify the competencies and begin the discussion in clinical health psychology. As such it is likely to be of interest to a wide audience, including clinical training programs with an existing or planned emphasis in clinical health psychology, practitioners interested in acquiring the competencies required to practice as a clinical health psychologist, and students evaluating potential graduate and postgraduate training options in clinical health psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized study of a pH sensor feeding tube vs a standard feeding tube in patients requiring enteral nutrition

RATIONALE AND OBJECTIVES: A survey of chief residents of academic radiology programs is conducted annually on behalf of the American Association of Academic Chief Residents in Radiology (A3CR2). Data are obtained to improve the training of diagnostic radiology residents and to increase the understanding of radiologists and their associates about issues of interest to radiologists in training. METHODS: Questionnaires were mailed to 133 accredited programs in the United States and Canada. A wide variety of demographic and common interest questions were asked. The analysis took into account geographic location of the responders and the size of the residency program. Comparisons were made to the data from prior years. RESULTS: Completed surveys from 93 programs (70%) were returned. The percentage of women residents is increasing. Important regional and size variations exist in several areas including salary, workload, prior clinical training, resident/fellow ratios, post residency plans, and call schedules. Although many chief residents feel knowledgeable about the health care system, opinions about the future of radiology and medical care are tentative. CONCLUSIONS: This survey provides important demographic information about academic radiology residency programs. The summary information regarding plans for fellowship training, resident call schedules, and opinions about socioeconomic issues may be useful for chief residents, program directors, and departmental chairmen.     

Utilization of psychologists in positions of responsibility in public mental health programs: A national survey.

Describes a 1969 survey of mental health programs in all 50 states. To document current status and provide precedence data, the survey sought information concerning positions including these at a divisional level within state programs and as program director of community mental health centers. 1/2 the states had psychologists as divisional chiefs, while in 75% of the states, the principle of competence in the appointment of local community mental health program directors was formally recognized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Design and Build Project Success Factors: Multivariate Analysis

This study aimed to identify a set of project success factors for design and build (D&B) projects and examine the relative importance of these factors on project outcome. Six project success factors (project team commitment, contractor's competencies, risk and liability assessment, client's competencies, end-users' needs, and constraints imposed by end-users) were extracted from factor analysis of data provided by 53 participants of public-sector D&B projects through a questionnaire survey. Project team commitment, client's competencies, and contractor's competencies were found to be important to bring successful project outcome from the multiple regression findings. Contractor's competencies also contributed to project time performance. Project team members should also recognize that time and cost performance as well as quality of design and workmanship represent the key elements of overall success of D&B projects. Practitioners are advised to focus on teamwork and partnering for successful project completion. More research should be conducted to further explore the relationship between procurement method and project success factors.     

Job analysis of psychology internships in counseling center settings.

A widely accepted method of job analysis, the critical incident technique, was applied in order to determine dimensions of performance among psychology interns. All training directors of Association of Psychology Internship Centers were contacted regarding participation, and 46 (90%) completed the critical incident interview. The 270 critical incidents were analyzed with a standard procedure for determining behaviorally defined job dimensions. Seven dimensions were identified: clinical skills, commitment to own professional development, crisis and emergency situations, interpersonal relationships, knowledge, professional and ethical behavior, and programming and consultation skills. The results are presented within the context of other definitions of intern performance and of entry-level psychological practice. In addition, suggestions for improving selection and evaluation of psychology interns are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social competence intervention and evaluation in the inner city: Cincinnati's Social Skills Development Program.

Describes a large-scale early intervention program conducted in an inner city based on a social competence conceptualization. The key elements of the school-based program and an evaluation study are presented. The program focuses on children's competencies and problems in assessment, intervention, and evaluation. Ratings by teachers indicated that interventions improved competencies, but not problems, compared to controls. Further evaluations and more intensely behavioral interventions are warranted. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of Process Quality in Building Projects

A Delphi process and a questionnaire survey are conducted to investigate the differences in the perceptions of entry-level professionals and long-time practitioners with regard to process quality in building projects. The factors that affect process quality in the three phases (design, construction, and operation) of a building project's life cycle are identified and ranked by the respondents' perceived degree of importance. The findings indicate that the perceptions of entry-level professionals and long-time practitioners are in agreement for most (74%) of the factors. Given the differences in the respondents' background, expectations, and experience, differences in perceptions are to be expected in the remaining 26% of the factors. Analyzing these differences helps in revising and improving existing training courses and academic programs. It is recommended that college programs include courses that treat the administrative aspects involved in the building project in great detail and that continuing education programs cover quality training and life cycle cost analysis.