scholarly journals "Finis Origine Pendet” – Enhancing Later Learning and Professional Socialization Through an Introductory DPT Course

2005 ◽  
Author(s):  
Kyle Meyer ◽  
Patricia Hageman ◽  
Robert Fuchs ◽  
Amy Tyler ◽  
Gregory Karst
Keyword(s):  
Physical Therapy ◽  
Qualitative Data ◽  
Clinical Decision Making ◽  
Professional Socialization ◽  
Clinical Decision ◽  
First Year ◽  
Socialization Process ◽  
Patient Centered ◽  
First Year Students ◽  
Early Introduction

Background and Purpose: In developing a new Doctor of Physical Therapy (DPT) curriculum, the faculty at a mid-west academic health sciences center decided to introduce course content historically placed near the end of the program’s Master of Physical Therapy curriculum at the beginning of the DPT curriculum. The new DPT curriculum was constructed to promote the value of three central themes; 1) evidence-based practice and 2) patient-centered care, both of which contribute to 3) sound clinical decision making. Faculty theorized that by explicitly expressing these themes in a first semester, introductory course, students would acquire a much needed framework for categorizing and integrating future knowledge, and would begin the professional socialization process earlier in the curriculum. The purpose of this report is to describe the new course and provide quantitative and qualitative data regarding the course outcomes.Methods: Quantitative data were gathered via a survey administered to 75 students, 37 who had completed all three years of the program and 38 who had completed the second year of the program. In addition, qualitative data were gathered from first year student essays summarizing the course and describing its influence on their perceptions of the field. Results: More than 80% of second and third year students agreed or strongly agreed that the course had met all of the primary objectives outlined by the faculty. Essays from first year students also supported many of the purposes envisioned in the development of the course. Conclusion: These outcomes suggest students can value and comprehend more advanced content early in allied health curricula and that the early introduction of such content may aid in organizing subsequent learning and professional socialization.

Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice

2016 ◽  
Vol 25 (4) ◽  
pp. 453-469 ◽  
Author(s):  
Jennifer Horner ◽  
Maria Modayil ◽  
Laura Roche Chapman ◽  
An Dinh
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Legal Advice ◽  
Medical Context

PurposeWhen patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice.MethodThe authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient–practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy.ConclusionsSpeech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.

scholarly journals Shared clinical decision-making experiences in nursing: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Fen-Fang Chung ◽  
Pao-Yu Wang ◽  
Shu-Chuan Lin ◽  
Yu-Hsia Lee ◽  
Hon-Yen Wu ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Education ◽  
Nursing Staff ◽  
Information Exchange ◽  
Clinical Decision Making ◽  
Medical Center ◽  
Clinical Decision ◽  
Sociocultural Factors ◽  
Patient Centered ◽  
Clinical Nursing

Abstract Background Shared decision making (SDM) is a patient-centered nursing concept that emphasizes the autonomy of patients. SDM is a co-operative process that involves information exchange and communication between medical staff and patients for making treatment decisions. In this study, we explored the experiences of clinical nursing staff participating in SDM. Methods This study adopted a qualitative research design. Semistructured interviews were conducted with 21 nurses at a medical center in northern Taiwan. All interview recordings were transcribed verbatim. Content analysis was performed to analyze the data. Results The findings yielded the following three themes covering seven categories: knowledge regarding SDM, trigger discussion and coordination, and respect of sociocultural factors. Conclusions The results of this study describe the experiences of clinical nursing staff participating in SDM and can be used as a reference for nursing education and nursing administrative supervisors wishing to plan and enhance professional nursing SDM in nursing education.

The influence of narrated group discussions on the interpretational ability of medical students: a prospective observational study

2021 ◽  
Vol 6 (8) ◽  
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
First Year ◽  
Group Discussions ◽  
Prior Literature ◽  
Long Course ◽  
Long Term Impact ◽  
First Year Medical Students

Background: Clinical decision making is predominantly knowledge-based perception, interpretation under terms of uncertainty. It is unclear whether interpretational ability can be improved. We evaluated the effect of a narrated group-discussions course (NGDC) on the interpretational ability of first-year medical students. Objective: To evaluate the effect of our course on first year medical students in respect to: a) their interpretational abilities b) their attitude towards studying literature and the core subjects. Method: Using a pre-post questionnaire, of a semester-long course, among two consecutive classes, the authors evaluated the participant’s interpretational ability and depth of understanding when analyzing four complex passages. Results: Out of 235 students, 146 (62%) responded to both questionnaires. There was a significant increase in the participant’s interpretational ability (P=0.003). ninety one participants (38%) improved their level of understanding in at least one out of the four passages, and 37 participants (25%) improved in two passages. A multivariate analysis revealed that the improvement in the interpretational ability was associated with younger age (P=0.034, CI 95%=0.64-0.98, OR=0.79), positive pre-course attitude and motivation (P<0.001, CI 95%=1.43-3.05, OR=2.09), and lack of a prior literature background (P=0.064, CI 95%=0.17-1.05, OR=0.43). Conclusion: Our data suggests that NGDC may improve and refine interpretational ability. Further studies are required to establish the short- and long-term impact of this change and whether it can be translated into better clinical decision making.

scholarly journals Creating Significant Learning Experiences for Clinical Reasoning by Physical Therapist Students

2019 ◽  
Author(s):  
Lois Stickley
Keyword(s):  
Decision Making ◽  
Clinical Reasoning ◽  
Curriculum Design ◽  
Clinical Decision Making ◽  
Physical Therapist ◽  
Learning Experiences ◽  
First Year ◽  
Clinical Decisions ◽  
First Year Students ◽  
Significant Difference

Background: Clinical reasoning skills are embedded in all aspects of practice. There is a lack of consensus and standards for curriculum design and teaching methods of clinical reasoning in entry-level education of health professionals. Purpose: The purpose was to describe a process of designing one comprehensive, planned sequence of four courses to create significant learning experiences for clinical reasoning for Doctor of Physical Therapy students. Method: Fink’s design process was used to develop four clinical decision-making courses to ensure a close alignment of learning goals, feedback and assessment, and learning activities to engage students in practicing components of clinical reasoning. Student outcomes were measured by self-efficacy ratings for clinical reasoning in a practical exam for first-year students and by ratings of performance by clinical instructors for third-year students. Results: 41 first-year students ranked their confidence in making clinical decisions both before and after a midterm practical. A paired t-test found a significant difference (.05t40 = -6.66, ρ=0.00) in the mean ratings of students from the pre-practical assessment to the post-practical assessment about confidence in making clinical decisions. Third-year students received ratings that met or exceeded expectations on five audited skills from the Physical Therapist manual for the Assessment of Clinical Skills (PT MACS), both at midterm and at the final assessment. No significant differences between midterm and final ratings on any of the selected skills were found using a Chi-Square Test of Independence (α=.05). Conclusion: The four-course sequence was designed using four themes: patient-centered care, models of practice, and evidence-based practice, and ethics/legal issues. This paper offers specific details about how one method of teaching clinical reasoning meets the current trends in education and health care for accountability and meaningful outcomes. Students gained practical knowledge and skills in the components of clinical reasoning and decision-making by participating in active and engaging significant learning experiences.

scholarly journals The University Medical Centre: A student’s perspective

2021 ◽  
Author(s):  
Gabrielle Hubert ◽  
Cameron Pow ◽  
Sandra Tullio-Pow
Keyword(s):  
Primary Care ◽  
Healthcare Professionals ◽  
Care Physician ◽  
Medical Centre ◽  
First Year ◽  
Patient Centered ◽  
First Year Students ◽  
Centered Care ◽  
The University ◽  
University Setting

Over 515,000 students attended Ontario Universities in 2015/16, including 60,000 international students from abroad (https://ontario universityes.ca/resources/data/numbers). First-year students who are away from home find themselves needing a new primary care physician. While a few researchers have examined student health care within the university setting in regard to mental health (Evans, 1999), sexual health (Habel et al., 2018)., and health promotion (Griebler et al., 2017), there has been little research focused on the first-year student experience in finding primary care. Our study examined communication pathways, wayfinding and misconceptions students have related to the university medical centre. Patient centered care involves a partnership between a healthcare provider and their patient. In this partnership healthcare professionals must consider the patient experience and be more informative, mindful, empathic and collaborative to provide the best possible care (Epstein & Street, 2011).

Impact of electrodiagnostic (EMG/NCS) tests on clinical decision-making and patient perceived benefit in the outpatient physical therapy practice

2020 ◽  
Vol 24 (1) ◽  
pp. 170-174
Author(s):  
Mohini Rawat ◽  
Dimitrios Kostopoulos ◽  
Konstantine Rizopoulos ◽  
William Dodson ◽  
Kathy Blair ◽  
...  
Keyword(s):  
Decision Making ◽  
Physical Therapy ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Perceived Benefit

The Business Values of Patient Knowledge Management (PKM) in the Healthcare Industry

2013 ◽  
Vol 8 (2) ◽  
pp. 70-79 ◽  
Author(s):  
Mohammad Soltani Delgosha ◽  
Ali Amoei Ojaki ◽  
Hamidreza Farhadi
Keyword(s):  
Decision Making ◽  
Knowledge Management ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Specific Information ◽  
Patient Knowledge ◽  
Patient Centered ◽  
Patient Decision Making ◽  
Business Values ◽  
Centered Care

Today, healthcare has become a progressive industry with novel techniques, approaches and findings in this field quickly being evaluated and improved. One of these approaches is patient-centered care (PCC), which is defined essentially as an approach that respects and responds to individual patient’s preferences, needs and values. As such, PCC concept focuses not only on the disease, but also on leveraging specific information of a patient. PCC approach is therefore going to enlarge the role of patients and families in the process of clinical decision making. Still, the authors are observing the lack of innovation in this particular domain. In this paper, the authors develop the concept of patient knowledge management (PKM) based on customer knowledge management and PCC approaches. PKM creates many values such as decreasing opportunity costs and treatment costs, aiding patient decision making to be efficient and effective, as well as creating new knowledge and developing new treatment methods.

Clinical Decision-Making for a Person Centered Medicine: the necessity of casuistic reasoning

2014 ◽  
Vol 2 (1) ◽  
pp. 71
Author(s):  
Mark Tonelli
Keyword(s):  
Decision Making ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Patient Choice ◽  
Clinical Expertise ◽  
Patient Centered ◽  
Patient Centered Medicine ◽  
The Individual ◽  
Based Medicine

In their call to develop a consistent, coherent and comprehensive notion of person-centered medicine, Miles and Mezzich have elucidated several specific challenges that need to be urgently addressed. One of these foundational tasks is the development of a more complete understanding of person-centered clinical decision-making. Miles and Mezzich note that while the emphasis on clinical research in evidence-based medicine has served to de-emphasize the importance of the individual patient, the alternative of patient-centered medicine has the potential to de-emphasize the judgment of the clinician by making unfettered patient choice paramount. A practice of medicine that reduces professional healers to an informational role only, one where they lay out potential interventions devoid of context and allow patients to choose from amongst them, undervalues clinical expertise and will clearly not lead to better outcomes. Person-centered medicine (PCM), then, must be able to develop and defend a model of clinical judgment and practice that strikes the correct balance between the science of medicine and the personal experience of the individual in search of care.

Research Becomes You: Cultivating EdD Students’ Identities as Educational Leaders and Researchers and a “Learning by Doing” Meta-Study

2016 ◽  
Vol 12 (3) ◽  
pp. 273-301 ◽  
Author(s):  
Ray R. Buss ◽  
Andrea Avery
Keyword(s):  
Qualitative Data ◽  
Possible Selves ◽  
Leadership Skills ◽  
Educational Leaders ◽  
Learning By Doing ◽  
First Year ◽  
Research Skills ◽  
First Year Students ◽  
Education Doctorate ◽  
Program Leaders

We examined how end-of-first-year students in a Carnegie Project on the Education Doctorate (CPED)-affiliated EdD program were developing professional identities as educational leaders and researchers. Quantitative and qualitative data revealed substantial development of leadership skills, but even greater growth in perceptions of research skills. Qualitative data indicated students “tried out” leadership and research skills in their workplaces. These provisional efforts were consistent with the notion of possible selves or provisional selves in which individuals try on identities. Implications for program leaders and students are also discussed. In addition, we reported on a-study-within-a-study: We examined our efforts in learning/teaching research skills as the study was conducted.

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