Assessment of competence in clinical practice: a phenomenological approach*

1993 ◽  
Vol 18 (1) ◽  
pp. 114-119 ◽  
Author(s):  
Elizabeth Anne Girot
Keyword(s):  
Clinical Practice ◽  
Phenomenological Approach ◽  
Assessment Of Competence

scholarly journals ‘Thrown in at the Deep End’: The Experience of Graduates of Transnational Western Medical Education Transitioning into Middle Eastern Clinical Practice

2019 ◽  
Vol 8 (6) ◽  
pp. 36
Author(s):  
Fiza Rashid-Doubell ◽  
Timothy P Doubell
Keyword(s):  
Medical Education ◽  
Clinical Practice ◽  
Cultural Context ◽  
Middle Eastern ◽  
Phenomenological Approach ◽  
Full Time ◽  
Host Countries ◽  
Medical Teams ◽  
The One ◽  
And Coping

Background: Newly qualified doctors educated in their home country usually go on to work in their first hospital job in same country. These graduates are familiar with the socio-cultural context of clinical setting they work in. But, with many Western universities providing cross-border education to host countries in the Middle East and South East Asia in subjects such as medicine. The experiences of those graduating from transnational medical education and working in local hospitals are absent.The aim of the study was to explore the early transitional experiences of newly qualified doctors moving from a European branch campus to practice at hospitals affiliated to the medical school situated in a Middle-Eastern country.Methods: A qualitative study using an interpretive phenomenological approach through interviews to explore experiences of graduates of transnational medical education working in Middle Eastern hospitals. Results: The main findings can be summarised under the three themes generated: the essentials of practice, routine of practice and realities of practice. The results evidenced the transition as a challenging period for new doctors finding dissonance between the skills taught while in transnational education and the workplace. There were three particular areas of discord for the graduates in clinical practice: working in medical teams with a different arrangement to the one prepared for; adapting to a more patient-centred language and coping with differences in ethical norms, values and practices in the hospital.Conclusions: The graduates found transitioning from university to full-time clinical practice difficult and were disappointed by their experience not matching their expectations of work. These findings are valuable for transnational medical educators seeking to improve the experience of graduates who are moving from the clear ideals, norms and values of transnational medical education into the complexity of full-time clinical practice.  

scholarly journals Therapists’ Perspective on Virtual Reality Training in Patients after Stroke: A Qualitative Study Reporting Focus Group Results from Three Hospitals

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Ludwig Schmid ◽  
Andrea Glässel ◽  
Corina Schuster-Amft
Keyword(s):  
Virtual Reality ◽  
Clinical Practice ◽  
Focus Group ◽  
Interprofessional Collaboration ◽  
Qualitative Content Analysis ◽  
Implementation Strategies ◽  
Occupational Therapists ◽  
Phenomenological Approach ◽  
Training System ◽  
Vr Training

Background. During the past decade, virtual reality (VR) has become a new component in the treatment of patients after stroke. Therefore aims of the study were (a) to get an insight into experiences and expectations of physiotherapists and occupational therapists in using a VR training system and (b) to investigate relevant facilitators, barriers, and risks for implementing VR training in clinical practice.Methods. Three focus groups were conducted with occupational therapists and physiotherapists, specialised in rehabilitation of patients after stroke. All data were audio-recorded and transcribed verbatim. The study was analysed based on a phenomenological approach using qualitative content analysis.Results. After code refinements, a total number of 1289 codes emerged out of 1626 statements. Intercoder reliability increased from 53% to 91% until the last focus group. The final coding scheme included categories on a four-level hierarchy: first-level categories are (a) therapists and VR, (b) VR device, (c) patients and VR, and (d) future prospects and potential of VR developments.Conclusions. Results indicate that interprofessional collaboration is needed to develop future VR technology and to devise VR implementation strategies in clinical practice. In principal, VR technology devices were seen as supportive for a general health service model.

The Paradoxes of Quality of Life and its Phenomenological Approach

1994 ◽  
Vol 10 (1) ◽  
pp. 37-41 ◽  
Author(s):  
François Loew ◽  
Charles-Henri Rapin
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Hospital Setting ◽  
Phenomenological Approach ◽  
Point Of View ◽  
Pressure Group ◽  
Multidimensional Complex ◽  
High Degree ◽  
Professional Judgement

Although evaluation scales for quality of life (QOL) represent considerable progress in medicine, clinical experience shows striking discrepancies between QOL as evaluated by caregivers and QOL from the patient's point of view. Such paradoxes of QOL are analyzed and discussed. Autonomy is universally advocated but may be denied, especially in the hospital setting, where caregivers, family members, and doctors act as a pressure group. Circumstances that deepen the contradictions in QOL assessment include (a) a high degree of patient dependence, (b) a professional judgement that a patient is incompetent (c) professional values being placed over a patient's values, (d) a multidisciplinary team acting as a pressure group, (e) a lack of effective communication with the patient, and (f) a determination to minimize the symptoms at evaluation. QOL is multidimensional, complex, difficult to measure in clinical practice, and sometimes paradoxical.

scholarly journals On the phenomenology of delusion: the revelation of its aprioristic structures and the consequences for clinical practice

2016 ◽  
Vol 5 (1) ◽  
pp. 1-21
Author(s):  
Melissa Garcia Tamelini ◽  
Guilherme Peres Messas
Keyword(s):  
Clinical Practice ◽  
Phenomenological Approach ◽  
Clinical Consequence ◽  
Therapeutic Implications ◽  
Psychotherapeutic Approach ◽  
General Meaning ◽  
Evolutionary Consequences ◽  
Ontological Framework ◽  
Phenomenological Psychopathology

Phenomenological Psychopathology understands delusion as the result of changes in the aprioristic structure of consciousness. In this article, we will review the main contributions that classical and contemporary phenomenological authors have made to the theme. Departing from these psychopathological syntheses, we will discuss the structural genesis of this phenomenon, the possible evolutionary consequences of the delusional state, and its general meaning within the ontological framework of consciousness. At the same time that the analytical depth of the contributions restated here comprises the best of what has been done within the phenomenological approach, the reality is that extensive areas remain uncharted, especially when regarding the clinical consequence of these insights for clinical practice. Thus, as notes of a preliminary nature, we will make observations about the therapeutic implications of previous phenomenological findings. Among them, we shall emphasize the importance of the aprioristic sphere of consciousness in the design of a pharmacological and psychotherapeutic approach to schizophrenia worthy of the psychopathological tradition to which this contribution is affiliated.

Ludwig Binswanger

2018 ◽  
pp. 110-117
Author(s):  
Klaus Hoffmann ◽  
Roman Knorr
Keyword(s):  
Clinical Practice ◽  
Martin Heidegger ◽  
Sigmund Freud ◽  
Edmund Husserl ◽  
Phenomenological Approach ◽  
Sociological Research ◽  
Psychiatric History ◽  
Psychotherapeutic Practice ◽  
Dialogical Philosophy ◽  
Multiprofessional Approach

The article presents Ludwig Binswanger’s approaches to psychoanalysis, psychiatry, and philosophy. His clinical practice in his sanatorium in Kreuzlingen, Switzerland close to the border to Germany was essentially determined by psychoanalysis and an individualized multiprofessional approach. Sigmund Freud supported this view—the published letters between him and Binswanger are important contributions of psychoanalytic and psychiatric history. In addition, Binswanger regarded philosophy as an essential foundation of psychiatry and psychoanalysis. He knew many psychiatrists, psychoanalysts, philosophers, and poets personally and exchanged many letters with them. First, he followed the phenomenological approach of Edmund Husserl and Martin Heidegger, later he was more identified with Martin Buber’s dialogical philosophy which he developed further. The article goes deeper into Binswanger’s central concepts and shows how important they became in the contemporary discussion where neurobiological, psychoanalytic, and sociological research shows new ways for psychiatric and psychotherapeutic practice.

Parents’ Lived Experiences During Their Children’s Radiotherapy

2016 ◽  
Vol 34 (2) ◽  
pp. 140-147 ◽  
Author(s):  
Jenny Gårdling ◽  
Erna Törnqvist ◽  
Marie Edwinson Månsson ◽  
Inger Hallström
Keyword(s):  
Clinical Practice ◽  
Cancer Treatment ◽  
Lived Experiences ◽  
Symptomatic Relief ◽  
Gain Control ◽  
Phenomenological Approach ◽  
Daily Basis ◽  
Children With Cancer ◽  
Hermeneutic Phenomenological ◽  
Need Support

Background: The aim of radiotherapy is to provide a cure and/or symptomatic relief for children with cancer. Treatment is delivered on a daily basis, 5 days per week, over the course of 5 to 35 days. Many parents find that leaving their children alone during treatment and exposing them to radiation is a challenging experience. To gain an understanding of parents’ lived experiences, 10 parents were asked to keep a diary while their children underwent radiotherapy. Methods: A descriptive inductive design with a hermeneutic-phenomenological approach was chosen to analyze the diaries. The parents were asked to write down their lived experiences while their children underwent radiotherapy. Daily notes, both short and long, were desirable. Findings: The parents described radiotherapy as a balancing act involving a constant attempt to maintain a balance between coercing and protecting their children in order to improve their children’s chances of survival. Meanwhile, the parents themselves were struggling with their own despair and feelings of powerlessness. While protecting their children, they experienced a sense of hope and felt that they had gained control. Conclusion: Parents’ daily written reflections are important for clinical practice and provide vital knowledge. Parents need support when focusing on coercing and protecting their children and help with information and routines that enable them gain control.

The Assessment of Competence to Make a Treatment Decision: An Empirical Approach

1996 ◽  
Vol 41 (2) ◽  
pp. 85-92 ◽  
Author(s):  
Graham Bean ◽  
Shizuhiko Nishisato ◽  
Neil A Rector ◽  
Graham Glancy
Keyword(s):  
Clinical Practice ◽  
Health Professionals ◽  
Treatment Decision ◽  
Routine Clinical Practice ◽  
Individual Item ◽  
Interview Schedule ◽  
Assessment Of Competence ◽  
Item Scores ◽  
Definition Of ◽  
Attending Physician

Objective: To compare physicians' judgements of competency in routine clinical practice with the findings obtained from a structured clinical interview. Methods: Ninety-six patients referred for electroconvulsive therapy were administered the Competency Interview Schedule (CIS) prior to their first treatment. Cluster analysis was employed to categorize patients to 1 of 5 cluster centres represented by case studies previously judged competent or incompetent by lawyers and health professionals. Results: A match-mismatch table revealed 88% (N = 66) of the 75 patients found competent by the attending physician and 90.5% (N = 19) of the 21 patients found incompetent by the attending physician were classified in agreement with the CIS. The 9 misclassified patients found competent by the attending physician but classified incompetent by the CIS had consented to treatment. The 2 misclassified patients found incompetent by the attending physician but classified competent by the CIS had refused treatment. Examination of individual item scores from the CIS indicated that, in some cases, a different standard of competency was applied in routine clinical practice depending upon the patient's treatment decision. Conclusions: The CIS is presented as a useful guide for clinicians with an interest in competency evaluations but caution is advised in using the instrument to make formal evaluations of competency owing to the imprecise definition of competency in various jurisdictions.

scholarly journals Exploring Athletic Training Educators' Development as Teachers

2017 ◽  
Vol 12 (2) ◽  
pp. 134-145 ◽  
Author(s):  
Ellen K. Payne ◽  
Stacy E. Walker ◽  
Stephanie M. Mazerolle
Keyword(s):  
Clinical Practice ◽  
Student Learning ◽  
Athletic Training ◽  
Teaching Practices ◽  
Training Programs ◽  
Athletic Trainers ◽  
Phenomenological Approach ◽  
Role Induction ◽  
Athletic Training Educators ◽  
Data Source

Context: Little research is available on how athletic training educators develop their instructional styles over the course of their careers and what influences their teaching practices. Understanding the development of athletic training educators' teaching practices may help promote effective teaching in athletic training programs and help guide professional development. Objective: To gain a better understanding of how athletic trainers develop as educators and how their experiences as an educator influence their teaching. Design: Qualitative study. Setting: Higher education institutions. Patients or Other Participants: We interviewed 11 doctorally trained athletic trainers teaching in undergraduate professional athletic training programs. Main Outcome Measure(s): Data were collected through in-depth interviews, and additional artifacts (curricula vitae, syllabi, videotaped teaching lessons) were used to triangulate data collected during the interviews. We used a phenomenological approach to analyze the data and maintained trustworthiness through member checking, data-source triangulation, multiple-analyst triangulation, and peer review. Results: Two main themes emerged from the data: (1) role induction through role continuance and (2) teaching for student learning. Participants discussed how their teaching evolved over the course of their careers, how they valued their clinical practice, how they promoted student learning, and how they aimed to challenge students to transfer knowledge learned into clinical practice. Conclusions: From the data, we are able to understand that athletic training educators develop their teaching practices through engaging in their role as a teacher. This was an informal, continual process of learning how to be an educator.

scholarly journals Nurses' experiences working with nursing students in a hospital: a phenomenological enquiry

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Yolanda Raquel Lapeña-Moñux ◽  
Luis Cibanal-Juan ◽  
Mª Isabel Orts-Cortés ◽  
Mª Loreto Maciá-Soler ◽  
Domingo Palacios-Ceña
Keyword(s):  
Clinical Practice ◽  
Nursing Students ◽  
Registered Nurses ◽  
Common Ground ◽  
Phenomenological Approach ◽  
Study Data ◽  
Clinical Settings ◽  
Structured Interviews ◽  
Qualitative Phenomenological ◽  
The University

Abstract Objective: this paper explores the experiences of registered nurses working with Spanish nursing students within the hospital. Methods: a qualitative phenomenological approach was followed. Purposeful sampling was employed. Twenty-one registered nurses, from a public hospital located in Spain, were included in the study. Data were collected by means of unstructured and semi-structured interviews and were analysed using Giorgi's proposal. The Consolidated Criteria for Reporting Qualitative Research were followed. Results: three main themes described the experience of registered nurses: "The nurse's relationship with nursing students"; most nurses emphasized the importance of the first contact with students and they considered students' attitude to be key. "Defining the role of the student in clinical practice"; it is necessary to unify the nurse's role and interventions to avoid misleading students and establish priorities in clinical practice. "Building bridges between clinical settings and the University"; the need to establish a common ground and connection between the university and hospital clinical settings was emphasized. Nurses felt that the training program should also be designed by the clinical settings themselves. Conclusions: understanding the meaning of nursing students with registered nurses might gain a deeper insight into their expectations.

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