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Other Clinicians (other + clinician)
Selected AbstractsAustralasian emergency physicians: A learning and educational needs analysis.EMERGENCY MEDICINE AUSTRALASIA, Issue 2 2008Part Three: Participation by FACEM in available CPD: What do they do, do they like it? Abstract Objective: To determine the participation of Emergency Physicians (EP) in currently available continuing professional development opportunities (CPD), their perception of the usefulness of available CPD and their preferred format or method of CPD desired in the future. Method: A mailed survey of Fellows of the Australasian College for Emergency Medicine with 17 Likert type options on educational methods and qualitative analysis grouping volunteered free text responses. Results: The most frequent learning methods reported by EP are on the job contact with other clinicians, formal ED based teaching and reading journals, which were also perceived as useful or very useful learning methods by more than 90% of EP. Less than 15% often or always participate on hospital grand rounds, high fidelity simulation, computer programmes or commercially sponsored events. Increased exposure was desired to high-fidelity simulation center skills training by 58% of respondents with nearly 49% of fellows also wanting more participation in international conferences with around 44% of fellows also wanting more participation in international conferences with around 44% desiring more formal teaching in the ED, more formal feedback on performance, and more meetings with other hospital departments. Over 50% of EP want less or no exposure to commercially sponsored dinners or events. Conclusion: Whilst emergency physicians currently participate in a wide variety of learning methods, the results of this survey suggest EP most appreciate ED based teaching, would like more contact with other departments, along with increased opportunities for simulation based learning and attendance at international conferences. [source] Monogenic diabetes: information seeking and genetic testing access via e-mailEUROPEAN DIABETES NURSING, Issue 2 2010M Shepherd RGN, PhD Honorary Clinical Senior Lecturer Abstract Background: Confirmation of monogenic diabetes by molecular genetic testing has allowed many patients, often previously assumed to have type 1 diabetes, to transfer from insulin injections to sulphonylurea tablets, with improvements in glycaemic control and quality of life: www.diabetesgenes.org provides information about monogenic diabetes and genetic testing. Aim: To investigate key issues raised by individuals who e-mailed the monogenic diabetes team about genetic testing and monogenic diabetes management. Methods: Sixty e-mail enquiries, received over a six-month period from patients and professionals worldwide, were analysed using a qualitative thematic content approach. Results: Five themes emerged: 1. Accessing genetic technology: patients and professionals both enquired about access to testing; 2. Presentation of evidence: medical facts presented by patients and professionals included characteristics specifically relevant to diagnosing monogenic diabetes; 3. Experiences of healthcare: patients often researched their condition online and some felt dissatisfied with routine consultations; 4. Seeking specialist advice regarding treatment: specific information was sought relating to management of neonatal diabetes or monogenic diabetes and pregnancy; 5. Searching for a cure through genetic technology: patients questioned whether genetic advances would lead to a cure for diabetes. Conclusion: This project offers the first insights into use of e-mail as a means of gaining access to a specialist monogenic team and information about genetic testing. Although providing advice via e-mail can prove complicated, particularly when received from patients under the care of other clinicians, it is an efficient means of communicating specialist knowledge. Study findings will aid development of a ,frequently asked questions' section of www.diabetesgenes.org. Copyright © 2010 FEND [source] The role and scope of the clinical nurse consultant in Wentworth area health service, New South Wales, AustraliaJOURNAL OF NURSING MANAGEMENT, Issue 1 2007GradDipClinNsg, JENNY O'BAUGH RN, OncNsgCert Aims, This paper reports phase one of a two-part study in a New South Wales area health service, which aimed to evaluate the grading system for clinical nurse consultants. Background, Since its inception in 1986, the role and scope of practice of clinical nurse consultants in New South Wales has been viewed with differing expectations leading to role conflict from the nurse consultants themselves and others in health care including managers and other clinicians. Method, A quantitative approach was used for this study. A survey comprising of open and closed questions was mailed to all clinical nurse consultants (n = 42) employed in the area. Results, The data presented suggest that ambiguity continues about the role, the scope and the differences within the grading system of clinical nurse consultants. Conclusions, Clinical nurse consultants need leadership training and support from their managers to fulfil their role. More work is required to clarify the role of clinical nurse consultants. [source] Development of a Self-Report Instrument to Measure Patient Safety Attitudes, Skills, and KnowledgeJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2008Rebecca Schnall Purpose: To describe the development and psychometric testing of the Patient Safety Attitudes, Skills and Knowledge Scale (PS-ASK). Methods: Content validity of a 35-item instrument was established by a panel of experts. The instrument was pilot tested on 285 nursing students. Principal components analysis (PCA) with varimax rotation was conducted, and Cronbach's alphas were examined. Paired samples t-tests were used to show responsiveness of the scales pre- and post-patient safety curriculum. Results: The final instrument consists of 26 items and three separate scales: attitudes, skills, and knowledge. The attitudes and skills scales each had a three-factor solution. The knowledge items had a one-factor solution. Both skills and knowledge were significantly increased at Time 2 (p<0.001). Conclusions: The skills and knowledge subscales had satisfactory internal consistency reliability, evidence for construct validity, and responsiveness for use as independent scales in future studies. The attitudes subscale needs further refinement before implementation. Comparison with other measures of patient safety skills (e.g., observation) and knowledge are warranted. Clinical Relevance: A tool to measure clinicians' attitudes, skills, and knowledge about patient safety might be useful to evaluate nurses and other clinicians during educational preparation and in practice. [source] Critical care nurse practitioners and clinical nurse specialists interface patterns with computer-based decision support systemsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 11 2007APRN (Assistant Professor of Health, Community Systems, Coordinator of the Nursing Education Graduate Program), PhD(c), Scott Weber EdD Abstract Purpose: The purposes of this review are to examine the types of clinical decision support systems in use and to identify patterns of how critical care advanced practice nurses (APNs) have integrated these systems into their nursing care patient management practices. The decision-making process itself is analyzed with a focus on how automated systems attempt to capture and reflect human decisional processes in critical care nursing, including how systems actually organize and process information to create outcome estimations based on patient clinical indicators and prognosis logarithms. Characteristics of APN clinicians and implications of these characteristics on decision system use, based on the body of decision system user research, are introduced. Data sources: A review of the Medline, Ovid, CINAHL, and PubMed literature databases was conducted using "clinical decision support systems,""computerized clinical decision making," and "APNs"; an examination of components of several major clinical decision systems was also undertaken. Conclusions: Use patterns among APNs and other clinicians appear to vary; there is a need for original research to examine how APNs actually use these systems in their practices in critical care settings. Because APNs are increasingly responsible for admission to, and transfer from, critical care settings, more understanding is needed on how they interact with this technology and how they see automated decision systems impacting their practices. Implications for practice: APNs who practice in critical care settings vary significantly in how they use the clinical decision systems that are in operation in their practice settings. These APNs must have an understanding of their use patterns with these systems and should critically assess whether their patient care decision making is affected by the technology. [source] The diagnosis and management of haemorrhoidal disease from a global perspectiveALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2010L. ABRAMOWITZ Summary Background, A treatment approach for patients with haemorrhoidal disease and other anal disease, which includes the use of topical corticosteroids and other topical combination products, is widely accepted, but little has been published to compare such treatments. This publication is a valuable collection of reading material for gastroenterologists, proctologists, general practitioners, dermatologists and other clinicians who are responsible for diagnosing and managing patients with haemorrhoidal disease. Aims, To review and collect existing treatment approaches for haemorrhoidal disease, by reviewing global experience from clinicians that will contribute towards improving best practice in the management of patients. Methods, The articles include overviews of haemorrhoidal disease, differential diagnosis, topical treatment and surgical practices and patient outcomes. Case studies further reinforce treatments from individual specialists. Results, The articles between them address the classification of haemorrhoids, dermatological differential diagnoses of anal and perianal disease, and the therapeutic management of different haemorrhoidal diseases including invasive surgical and non-invasive topical combination treatments. The case studies indicate the positive impact of appropriate treatment in everyday clinical practice. Conclusion, This publication will reinforce best practice in the causative and symptomatic treatment of haemorrhoidal disease. Aliment Pharmacol Ther,31 (Suppl. 1), 1,58 [source] Development of a decision support system for diagnosis and grading of brain tumours using in vivo magnetic resonance single voxel spectraNMR IN BIOMEDICINE, Issue 4 2006Anne R. Tate Abstract A computer-based decision support system to assist radiologists in diagnosing and grading brain tumours has been developed by the multi-centre INTERPRET project. Spectra from a database of 1H single-voxel spectra of different types of brain tumours, acquired in vivo from 334 patients at four different centres, are clustered according to their pathology, using automated pattern recognition techniques and the results are presented as a two-dimensional scatterplot using an intuitive graphical user interface (GUI). Formal quality control procedures were performed to standardize the performance of the instruments and check each spectrum, and teams of expert neuroradiologists, neurosurgeons, neurologists and neuropathologists clinically validated each case. The prototype decision support system (DSS) successfully classified 89% of the cases in an independent test set of 91 cases of the most frequent tumour types (meningiomas, low-grade gliomas and high-grade malignant tumours,glioblastomas and metastases). It also helps to resolve diagnostic difficulty in borderline cases. When the prototype was tested by radiologists and other clinicians it was favourably received. Results of the preliminary clinical analysis of the added value of using the DSS for brain tumour diagnosis with MRS showed a small but significant improvement over MRI used alone. In the comparison of individual pathologies, PNETs were significantly better diagnosed with the DSS than with MRI alone. Copyright © 2006 John Wiley & Sons, Ltd. [source] Practitioner-researchers in occupational therapyAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2000Anne Cusick Few occupational therapy clinicians are research productive even though their involvement in research is encouraged. The role of ,research-practitioner' is put forward as a means by which practitioners can be research productive. There is, however, an absence of studies exploring experience of the minority of practitioners who do produce research. This study used a qualitative approach to do this in occupational therapy. Purposive sampling was conducted of all research productive clinicians in acute-care hospitals in one Australian city. Of the 20 possible researchers, 15 participated in in-depth interviews which explored their experience of research. Results were analysed using the constant comparative method and six conceptual categories were developed to describe their experience. The key findings were that clinicians who did research perceived themselves to be different from other clinicians in terms of attributes; and they described special ways of getting research done, and ways of reflecting on outcomes of their research involvement. The study provides an empirical foundation to further consider the practitioner-researcher role in practice professions such as occupational therapy. [source] Factors affecting clinical referral of young children with a subdural haemorrhage to child protection agenciesCHILD ABUSE REVIEW, Issue 6 2003Tom Sanders Abstract The research on which this paper is based aimed to identify the social and legal consequences when young children sustain a suspected non-accidental subdural haemorrhage; and to examine the clinical and social factors that impact on clinical referral decisions. Data were collected from medical, social services, police and court ,les for information on the management of children with these injuries by various agencies in the South West of England and South Wales. Data were collected on the case management of young children from time of presentation to hospital through to referral to police and social services. The paper shows that children who are most at risk of shaking injuries are likely to be very young babies between 3 and 5 months of age. They are most likely to come from deprived households where parental stability is weak and where social support for the carers is limited. Referral of children by paediatricians to child protection agencies is not always carried out in cases where coexisting signs indicate a strong reason for referral. It is recommended that paediatricians and other clinicians involved in the care of young children should embark on a multidisciplinary process of assessment and training in the identi,cation of non-accidental head injury in very young children and babies, to reduce their risk of future harm. Copyright © 2003 John Wiley & Sons, Ltd. [source] Fred Hollows lecture: Digital screening for eye diseaseCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2000Ij Constable ABSTRACT The purpose of this study was to explore progress, in the adaptation to community screening for blinding eye disease, of digital imaging devices and technology for storage and transmission. Available imaging systems were compared to gold standard clinical photography in terms of sensitivity and specificity for diagnosis of common blinding eye conditions. Since the use of expensive non-portable imaging devices is likely to be limited for widespread community screening purposes, a portable fundus camera (Nidek, Chiyoda-ku, Japan) and a prototype monocular digital indirect ophthalmoscope constructed at the Lions Eye Institute (LEI) were selected for comparative trials for the screening of optic disc cupping, glaucoma and clinical signs of diabetic retinopathy. Fifty-one eyes of 27 consecutive patients being assessed at the LEI clinic for glaucoma were dilated and photographed with a Zeiss retinal camera, and digital images were taken with the portable Nidek NM100 fundus camera (Carl Zeiss, Oberkochen, Germany) or with a prototype digital monocular indirect ophthalmoscope. Vertical cup : disc ratios (VCDR) were measured on the disc photographs by one ophthalmologist while three other clinicians were presented with compressed digital images in random order to estimate VCDR. Field trials were also carried out to demonstrate the practicality of compression, local storage and then transmission by mobile telephone ISDN lines and satellite, of optic discs and fundus images of patients with diabetes in either rural Western Australia or Surabaya, Indonesia. Kappa values of correlations of measurement of agreement between measured and estimated VCDR were 0.87, 0.45 and 0.84, respectively, for the three observers, corresponding to a specificity of 79,97% and a sensitivity of 70,95%. The portable Nidek fundus camera was also assessed for specificity and sensitivity in the diagnosis of diabetic retinopathy in comparison to standard Zeiss fundus camera photographs. Of 49 eyes in 25 consecutive patients attending the LEI clinic for assessment of diabetic retinopathy, three ophthalmologists assessed photographs and images in random order. When used for screening diabetic retinopathy, the digital images of the Nidek camera were graded as adequate quality in only 56% of eyes compared to 93% of the photographs. The kappa value of agreement in analysis of diabetic retinopathy was only 0.30. The prototype digital monocular indirect ophthalmoscope compared favourably with the Nidek camera. At 1:5 compression, images of size 36 kB transmitted from Surabaya to Perth took 29 s on the mobile telephone, while uncompressed images took 170 s. Images compressed 1:5 were transmitted in 60 s using the satellite telephone, while the uncompressed images took 240 s. Satellite transmission was more expensive but the lines were more stable than telephone connections from Indonesia. Digital imaging is becoming a powerful tool for ophthalmology in clinical records, teaching and research, and interoffice diagnostic opinions. It also has enormous potential for community screening for blinding eye diseases, such as glaucoma and diabetic retinopathy. Inexpensive portable imaging devices that are easy to use, and on which local health workers might be trained, must be developed and validated in terms of sensitivity and specificity of performance. The technology of image capture, image compression, transmission, data base storage and analysis is rapidly evolving and becoming less expensive. [source] Supporting the problem-based learning process in the clinical years: evaluation of an online Clinical Reasoning GuideMEDICAL EDUCATION, Issue 6 2004Greg Ryan Purpose, Implementing problem-based learning (PBL) in the clinical years of a medical degree presents particular challenges. This study investigated the effectiveness of using an online Clinical Reasoning Guide to assist integration of PBL in the clinical setting and promote further development of students' clinical reasoning abilities. Method, A total of 52 students in 6 PBL groups, together with their 6 clinical tutors, participated in the study. Data were analysed from videotaped observations of tutorial activity and follow-up, semistructured interviews. Results, From both the student facilitators' and the clinical tutors' perspectives, the Guide proved an effective tool for augmenting the PBL process in clinical settings and promoting the development of clinical reasoning. By combining computer-aided learning with collaborative PBL tutorials it promoted individual as well as collaborative reasoning. There is also evidence to suggest that the Guide prompted students to look more critically at their own, their colleagues' and other clinicians' reasoning processes. [source] | ||||||||||