What should we assess in practice?

Aim: This article reports on a PhD study and follow up work undertaken to review and develop a tool for assessment of practice. Background: The assessment of practice in nursing and midwifery education and, other health professions has been the source of concern, criticism and research for a number of years with the conclusion that it might not be possible to develop an assessment tool that could encompass all aspects of professional practice. Methods: A qualitative evaluation study was undertaken using the naturalistic method of inquiry. A combination of tools was used in order to collect the data and enable progressive focusing and cross checking of the findings. These included documentary analysis, a questionnaire and focus group and individual interviews. The data was collected from documents analysis, focus group interviews, individual interviews and questionnaires. Results: The results showed that the assessment tool in use at the time did not encompass all criteria assessors used and six areas were identified as those to include in any future tool. Conclusion: The six areas identified by subjects as those to include in any assessment tool were further developed with specific statements so that they could be used within a tool. Implications for nursing management and education: Within the changing nature of health care there is a need to review whether the tool used for assessing pre-registration education of nursing and midwifery students practice is ‘fit for purpose’

Doctors' personal health care choices: A cross-sectional survey in a mixed public/private setting

<p>Abstract</p> <p>Background</p> <p>Among Western countries, it has been found that physicians tend to manage their own illnesses and tend not have their own independent family physicians. This is recognized as a significant issue for both physicians and, by extension, the patients under their care, resulting in initiatives seeking to address this. Physicians' personal health care practices in Asia have yet to be documented.</p> <p>Methods</p> <p>An anonymous cross-sectional postal questionnaire survey was conducted in Hong Kong, China. All 9570 medical practitioners in Hong Kong registered with the Hong Kong Medical Council in 2003 were surveyed. Chi-square tests and logistic regression models were applied.</p> <p>Results</p> <p>There were 4198 respondents to the survey; a response rate of 44%. Two-thirds of respondents took care of themselves when they were last ill, with 62% of these self-medicating with prescription medication. Physicians who were graduates of Hong Kong medical schools, those working in general practice and non-members of the Hong Kong College of Family Physicians were more likely to do so. Physician specialty was found to be the most influential reason in the choice of caregiver by those who had ever consulted another medical practitioner. Only 14% chose consultation with a FM/GP with younger physians and non-Hong Kong medical graduates having a higher likelihood of doing so. Seventy percent of all respondents believed that having their own personal physician was unnecessary.</p> <p>Conclusion</p> <p>Similar to the practice of colleagues in other countries, a large proportion of Hong Kong physicians self-manage their illnesses, take self-obtained prescription drugs and believe they do not need a personal physician. Future strategies to benefit the medical care of Hong Kong physicians will have to take these practices and beliefs into consideration.</p

AFROC analysis of reporting radiographer’s performance in CT head interpretation

Aim: A preliminary small scale study to assess the diagnostic performance of a limited group of reporting radiographers and consultant radiologists in clinical practice undertaking computer tomography (CT) head interpretation . Method: A multiple reader multiple case (MRMC) alternative free response receiver operating characteristic (AFROC) methodology was applied. Utilising an image bank of 30 CT head examinations, with a 1:1 ratio of normal to abnormal cases. A reference standard was established by double reporting the original reports using two additional independent consultant radiologists with arbitration of discordance by the researcher. Twelve observers from six southern National Health Service (NHS) trusts were invited to participate. The results were compared for accuracy, agreement, sensitivity, specificity. Data analysis used AFROC and area under the curve (AUC) with standard error. Results: The reporting radiographers results demonstrated a mean sensitivity rate of 88.7% (95% CI 82.3 to 95.1%), specificity 95.6% (96% CI 90.1 to 100%) and accuracy of 92.2% (95% CI 89.3 to 95%). The consultant radiologists mean sensitivity rate was 83.35% (95% CI 80 to 86.7%), specificity 90% (95% CI 86.7 to 93.3%) and accuracy of 86.65% (95% CI 83.3 to 90%). Observer performance between the two groups was compared with AFROC, AUC, and standard error analysis (p=0.94, SE 0.202). Conclusion: The findings of this research indicate that within a limited study, a small group of reporting radiographers demonstrated high levels of diagnostic accuracy in the interpretation of CT head examinations that was equivalent to a small selection of consultant radiologists

A licence to practise and revalidation

Includes bibliographical references. Title from coverAvailable from British Library Document Supply Centre- DSC:m03/22593 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Guidance for doctors on transplantation of organs from live donors

SIGLEAvailable from British Library Document Supply Centre-DSC:5815.3675(108) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Acting fairly to protect patients Reform of the GMC's fitness to practise procedures

SIGLEAvailable from British Library Document Supply Centre-DSC:m01/16035 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Making and using visual and audio recordings of patients

SIGLEAvailable from British Library Document Supply Centre-DSC:GPE/4865 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Professional conduct and discipline Fitness to practise

SIGLEAvailable from British Library Document Supply Centre- DSC:GPD/0378 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Revalidating doctors Ensuring standards, securing the future

SIGLEAvailable from British Library Document Supply Centre-DSC:m00/28586 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Commentary on the second survey of medical education practices in United Kingdom medical schools

SIGLEAvailable from British Library Document Supply Centre-DSC:GPC/08968 / BLDSC - British Library Document Supply CentreGBUnited Kingdo