The association of standardized patient educators (ASPE) gynecological teaching associate (GTA) and male urogenital teaching associate (MUTA) standards of best practice

AbstractGynecological Teaching Associates (GTAs) and Male Urogenital Teaching Associates (MUTAs) instruct healthcare professional learners to perform accurate and respectful breast, speculum, bimanual vaginal, rectal, urogenital, and prostate examinations. During such sessions, the GTA/MUTA uses their own body to instruct while providing real-time feedback. While GTAs/MUTAs fall under the broader umbrella of Standardized Patient methodology, the specificity of their role indicates need for establishment of Standards of Best Practice (SOBP) for GTA/MUTA programs. On behalf of the Association of Standardized Patient Educators (ASPE), the Delphi process was utilized to reach international consensus identifying the Practices that comprise the ASPE GTA/MUTA SOBP. The original ASPE SOBP was used as the foundation for the iterative series of three surveys. Results were presented at the ASPE 2019 conference for additional feedback. Fifteen participants from four countries completed the Delphi process. Four of the original ASPE SOBP Domains were validated for GTA/MUTA programs: Safe Work Environment, Instructional Session Development, Training GTAs/MUTAs, and Program Management. Principles and Practices were shaped, and in some instances created, to best fit the distinct needs of GTA/MUTA programs. The ASPE GTA/MUTA SOBP apply to programs that engage GTAs/MUTAs in formative instructional sessions with learners. Programs that incorporate GTAs/MUTAs in simulation roles or in summative assessment are encouraged to reference the ASPE SOBP in conjunction with this document. The SOBP are aspirational and should be used to shape Practices within the program’s local context. The ASPE GTA/MUTA SOBP will continue to evolve as our knowledge-base and practice develop.

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Implementation and utilization of gynecological teaching associate and male urogenital teaching associate programs: a scoping review

Advances in Simulation ◽

10.1186/s41077-021-00172-2 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Holly Hopkins ◽

Chelsea Weaks ◽

Elise Napier

Keyword(s):

Health Professional ◽

Learning Outcomes ◽

Scoping Review ◽

Best Practice ◽

Psychological Safety ◽

Specific Information ◽

Patient Centered ◽

Wide Variability ◽

Teaching Associates ◽

Professional Learners

Abstract Background Gynecological Teaching Associates (GTAs) and Male Urogenital Teaching Associates (MUTAs) are individuals trained to instruct health professional learners with their own body to conduct accurate, patient-centered breast, pelvic, urogenital, rectal, and/or prostate examinations. Evidence indicates that this results in improvements in technical competence and communication skills, but there is wide variability to how such programs are implemented and engaged within the curriculum. In this scoping review, we mapped evidence regarding (1) how GTA/MUTA programs are utilized with health professional learners, (2) how GTA/MUTA programs are implemented using the Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP) as a framework, and (3) what broad outcomes are addressed in publications. Methods PubMed, ERIC, PsychINFO, CINAHL, and Sociological Abstracts were searched for all publications addressing instruction of physical examinations with a GTA/MUTA and/or administration of GTA/MUTA programs. Studies were charted in tandem until consensus was identified and then charted individually, using an iterative process. The scoping review protocol was registered prospectively. Results One hundred and one articles were identified, and nearly all highlighted positive results regarding GTA/MUTA programs. Most studies addressed medical students within the USA and Europe. During instructional sessions, three (SD=1.4) learners worked with each GTA/MUTA and an average of 32 min (SD=17) was allocated per learner. GTAs/MUTA instructed both independently (n=33) and in pairs (n=51). Thirty-eight articles provided detailed information consistent with one or more of the Domains of the ASPE SOBP, with six providing specific information regarding safe work environments. Conclusions While studies demonstrate consistently positive outcomes for learners, there is wide variability in implementation patterns. This variability may impact learning outcomes and impact both physical and psychological safety for GTAs/MUTAs and learners. Terminology used to refer to GTAs/MUTAs is inconsistent and may obscure relevant publications. Additional research is indicated to explore the pedagogical variables that result in positive learning outcomes and examine methods to ensure physical and psychological safety of GTAs/MUTAs and learners. Trial registration https://osf.io/x9w2u/.

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Applying the Best-Fit Framework to Assess and Strengthen National Extension and Advisory Services

Journal of International Agricultural and Extension Education ◽

10.5191/jiaee.2017.24307 ◽

2017 ◽

pp. 80-90 ◽

Cited By ~ 1

Author(s):

Kristin Davis ◽

David J. Spielman

Keyword(s):

Value Chain ◽

Local Context ◽

Small Scale ◽

Extension Agents ◽

Performance Incentives ◽

Advisory Services ◽

Innovative Solutions ◽

Cross Country ◽

Small Scale Farmers ◽

Best Fit

Agricultural extension and advisory services are critical to supporting technological and institutional changes that can improve the livelihoods of small-scale farmers in developing countries. However, many extension services are under-resourced, out of date, and need of structural and content changes. However, efforts to systematically strengthen local extension systems often fall into the trap of promoting blueprints that are insufficiently adapted to local context. To that end, researchers developed the best-fit framework in the 2000s to provide impetus for pursuit of more locally-tailored extension solutions. Today, almost a decade later, researchers test the framework under real-world conditions in a cross-country application. This paper examines the application of this framework across six dimensions and seven countries to formulate a set of best-fit recommendations that are also broadly appreciable. The findings show that it is possible to apply the framework to the analysis of EAS across countries while also maintaining a very localized perspective on recommendations. Across the seven countries, certain obvious commonalities exist: The growth in pluralism in extension providers, the persistence of weak incentives for extension agents, and the lack of enabling policies. At the same time, innovative solutions to many of the challenges held in common—ICT-enabled extension, performance incentives, and value-chain oriented extension—are heterogeneous. The framework allows users to pursue change processes in EAS in response to their own local realities.

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Improving Outcomes Through Principles of Best Practice Management: Australia's National Lung Cancer Framework

Journal of Global Oncology ◽

10.1200/jgo.18.97500 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 243s-243s

Author(s):

B. Daveson ◽

V. Milch ◽

J. Chynoweth ◽

L. Kable ◽

M. Austen ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Care ◽

Best Practice ◽

Cancer Control ◽

Communication Strategy ◽

Practice Management ◽

System Level ◽

Local Context ◽

Evidence Based ◽

National Implementation

Background and context: Lung cancer is estimated to be the fifth most commonly diagnosed cancer and leading cause of cancer death in Australia, representing 9.2% of all new cancer cases (n = 138,321) diagnosed and 18.9% of all cancer deaths (n = 48,586). The 5-year survival rate for those with lung cancer is 16%, compared with 68% for all cancers combined (between 2009 and 2013). Lung cancer is also the leading cause of cancer burden in Australia and patients affected by lung cancer may experience high levels of unmet need with associated psychological distress and decreased quality of life. Cancer Australia, Australia's national cancer control agency, developed the national Lung Cancer Framework: Principles for Best Practice Lung Cancer Care (Framework) to provide evidence-based, best practice information, strategies, tools and resources to support local adoption of the 5 principles for best practice management of lung cancer (principles): patient-centered care; multidisciplinary care; timely access to evidence-based care; coordination, communication and continuity of care; and data-driven improvements. Aim: The framework aims to improve the outcomes and experiences of people affected by lung cancer in Australia by supporting national uptake of the principles. Strategy/Tactics: Cancer Australia: • established a Lung Cancer Advisory Group to advise on strategies for national implementation of the framework and its principles • conducted a national lung cancer demonstration project, with advice from an Expert Steering Group, to demonstrate the delivery of lung cancer care according to the principles across a range of service delivery settings, and identify key factors contributing to ongoing delivery of best practice cancer care • completed systematic reviews for each principle to determine the effectiveness of the principles in improving lung cancer care processes and outcomes. Program/Policy process: To support national adoption of the framework and its principles, Cancer Australia: • developed a promotion and communication strategy for widespread national dissemination • convened a National Summit to bring together policy makers, clinical stakeholders and consumers to support local application of the principles, and drive optimal care for people affected by lung cancer • identified and communicated consumer, service, and system-level approaches to aid sustainable use of the principles. Outcomes: The evidence-based approach to the development of the framework and its principles identified ways to improve the healthcare system to achieve better outcomes for those affected by lung cancer in Australia. A coordinated approach to the delivery of the National Summit supported those involved in lung cancer care to share and adopt innovative and multilevel strategies for best practice care. What was learned: Embedding strategies to support implementation of the principles, responsive to local context, was key to enabling sustainable improvements in national lung cancer control.

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Diagnosis: History, Physical Examination, Imaging, and Arthroscopy: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Foot & Ankle International ◽

10.1177/1071100718779393 ◽

2018 ◽

Vol 39 (1_suppl) ◽

pp. 3S-8S ◽

Cited By ~ 5

Author(s):

Christiaan J. A. van Bergen ◽

Onno L. Baur ◽

Christopher D. Murawski ◽

Pietro Spennacchio ◽

Dominic S. Carreira ◽

...

Keyword(s):

Physical Examination ◽

Cartilage Repair ◽

Best Practice ◽

Consensus Meeting ◽

International Consensus ◽

Best Practice Guidelines ◽

Consensus Statements ◽

Cartilage Injuries ◽

Working Groups ◽

Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Diagnosis: History, Physical Examination, Imaging, and Arthroscopy” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus: 51 - 74%; strong consensus: 75 - 99%; unanimous: 100%. Results: A total of 12 statements on the diagnosis of cartilage injuries of the ankle reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Two achieved unanimous support and 10 reached strong consensus (greater than 75% agreement). All statements reached at least 86% agreement. Conclusions: This international consensus derived from leaders in the field will assist clinicians in the diagnosis of cartilage injuries of the ankle.

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Reinventing Board Effectiveness: From Best Practice to Best Fit

How to Make Boards Work ◽

10.1057/9781137275707_6 ◽

2013 ◽

pp. 137-152

Author(s):

Lutgart Van den Berghe ◽

Abigail Levrau

Keyword(s):

Best Practice ◽

Board Effectiveness ◽

Best Fit

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Measuring standards of care for early breast cancer in an insured population.

Journal of Clinical Oncology ◽

10.1200/jco.1997.15.4.1401 ◽

1997 ◽

Vol 15 (4) ◽

pp. 1401-1408 ◽

Cited By ~ 48

Author(s):

B E Hillner ◽

M K McDonald ◽

L Penberthy ◽

C E Desch ◽

T J Smith ◽

...

Keyword(s):

Breast Cancer ◽

Ct Scan ◽

Bone Scan ◽

Best Practice ◽

Clinical Stage ◽

Primary Treatment ◽

Standards Of Care ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

International Consensus

PURPOSE To demonstrate the use of a combined data base to evaluate the care for local/regional invasive breast cancer in a large insured population of women aged less than 64 years. PATIENTS AND METHODS We linked the procedural and hospital claims from Blue Cross Blue Shield (BCBS) of Virginia with clinical stage data from the Virginia Cancer Registry (VCR) from 1989 to 1991. A total of 918 women were assessed with a median age of 50 years; 68% had tumors less than 2 cm, 30% had positive axillary nodes, and 68% were assessed as having local summary stage. A quality-of-care "report card" was used based on standards of care from international Consensus Conferences. RESULTS Eight percent had a mastectomy as the initial biopsy procedure. Sixty-nine percent of women ultimately underwent mastectomy. Of those women who underwent lumpectomy, 86% had subsequent radiation. Within 3 months of diagnosis, 43% had a bone scan and 20% a computed tomography (CT) scan. Of women with positive axillary lymph nodes, 83% aged less than 51 years and 52% aged 51 to 64 years received chemotherapy. Fifty-six percent of all women had claims from a medical oncologist. Of women having a total mastectomy, 27% had claims from a plastic surgeon. Sixty-six percent to 76% of women had a mammogram, 24% a bone scan, and 14% a CT scan in the 0-18 and 18-36 month intervals following primary treatment. CONCLUSION This study confirms the feasibility of linking sources of data that provide complementary information needed to develop measurements regarding standards of quality and efficiency of oncologic care. This report should serve as an initial benchmark while we await reports from other populations to define the best practice.

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Strategic HRM & ER: Best-Practice Versus Best Fit

Springer Texts in Business and Economics - Strategic Human Resource Management and Employment Relations ◽

10.1007/978-981-13-0399-9_3 ◽

2018 ◽

pp. 23-34 ◽

Cited By ~ 1

Author(s):

Ashish Malik

Keyword(s):

Best Practice ◽

Strategic Hrm ◽

Best Fit

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Islam Hadhari’s Principles and Reward Management Practices: A Conceptual Study in Malaysian Private Organizations

International Journal of Human Resource Studies ◽

10.5296/ijhrs.v1i2.1043 ◽

2011 ◽

Vol 1 (2) ◽

pp. 36

Author(s):

Wan Shakizah Noor Wan Mohd Noor ◽

Zulkiflee Daud ◽

Mohd Faizal Mohd Isa

Keyword(s):

Best Practice ◽

Management Practices ◽

Theory And Practice ◽

Local Context ◽

Extensive Literature ◽

Muslim Country ◽

Private Organizations ◽

Practice Models ◽

Reward Programs ◽

Conceptual Study

ABSTRACT Many best practice models exist that describe successful approaches to reward management which influence by the cultural, legal, organizational and administrative challenges in Islamic world. Thus, the decision in setting and designing reward programs in raising productivity through human effort has always been controversial. Studies that were undertaken in numerous countries have shown varying degrees of success of such practices. Even though there is a substantial amount of foreign literature on this subject, there is a paucity of information concerning the extent of such application in Malaysia. As Malaysia is a predominantly Muslim country, Islam, through national culture influences organizations. This paper is an attempt to provide further insights into the theory and practice of reward management in the local context as Malaysia is implementing Islam Hadhari’s principles in the country. The study adopts a qualitative approach. A tentative research model is developed first, based on an extensive literature review. The qualitative field study then is carried out to explore the perceptions of reward management in the Malaysian private organizations from the Islamic perspective. Twelve Malaysian private organizations of various sizes are studied via interviews with key personnel. The paper will also contribute theoretically and practically by providing direction and suggestions in designing and implementing the reward programs for the private organizations in the Malaysian environment. KEYWORDS: Reward management, Islam Hadhari, Culture

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A Universal Early Parenting Education Intervention in Community-Based Primary Care Settings: Development and Installation Challenges

Education Sciences ◽

10.3390/educsci8040178 ◽

2018 ◽

Vol 8 (4) ◽

pp. 178 ◽

Cited By ~ 3

Author(s):

Grainne Hickey ◽

Sinead McGilloway ◽

Yvonne Leckey ◽

Ann Stokes

Keyword(s):

Primary Care ◽

Best Practice ◽

Service Providers ◽

Practice Change ◽

Parenting Education ◽

Local Context ◽

Programme Implementation ◽

Community Based ◽

Early Parenting ◽

The Impact

Prevention and early intervention programmes, which aim to educate and support parents and young children in the earliest stages of the family lifecycle, have become an increasingly popular policy strategy for tackling intergenerational disadvantage and developmental inequality. Evidence-based, joined-up services are recommended as best practice for achieving optimal outcomes for parents and their children; however, there are persistent challenges to the development, adoption and installation of these kinds of initiatives in community-based primary health care settings. In this paper, we present a description of the design and installation of a multi-stakeholder early parenting education and intervention service model called the Parent and Infant (PIN) programme. This new programme is delivered collaboratively on a universal, area-wide basis through routine primary care services and combines standardised parent-training with other group-based supports designed to educate parents, strengthen parenting skills and wellbeing and enhance developmental outcomes in children aged 0–2 years. The programme design was informed by local needs analysis and piloting to establish an in-depth understanding of the local context. The findings demonstrate that a hospitable environment is central to establishing interagency parenting education and supports. Partnership, relationship-building and strategic leadership are vital to building commitment and buy-in for this kind of innovation and programme implementation. A graduated approach to implementation which provides training/education and coaching as well as organisational and administrative supports for practice change, are also important in creating an environment conducive to collaboration. Further research into the impact, implementation and cost-effectiveness of the PIN programme will help to build an understanding of what works for parents and infants, as well as identifying lessons for the development and implementation of other similar complex prevention and intervention programmes elsewhere. This kind of research coupled with the establishment of effective partnerships involving service providers, parents, researchers and policy makers, is necessary to meeting the challenge of improving family education and enhancing the capacity of family services to help promote positive outcomes for children.

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