4,307 research outputs found

    Models for schools of public health: A scoping review and synthesis of existing evidence

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    The final report on 'Models for schools of public health: A scoping review and synthesis of existing evidence' produced by Steven, Lombardo and Goodall and commissioned by Public Health Gateshead is now available. To date, existing evidence regarding models (organisational, structural, managerial, administrational) for Schools of Public Health (SsPH) has not been systematically collected or synthesised. This study aims to begin to fill that gap by using a combination of rapid review and scoping review techniques to retrieve and assess existing literature to identify potential and existing models, themes and issues and where possible highlight strengths and weaknesses

    Patient safety in health care professional educational curricula: examining the learning experience

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    This study has investigated the formal and informal ways pre-registration students from four healthcare professions learn about patient safety in order to become safe practitioners. The study aims to understand some of the issues which impact upon teaching, learning and practising patient safety in academic, organisational and practice „knowledge? contexts. In Stage 1 we used a convenience sample of 13 educational providers across England and Scotland linked with five universities running traditional and innovative courses for doctors, nurses, pharmacists and physiotherapists. We gathered examples of existing curriculum documents for detailed analysis, and interviewed course directors and similar informants. In Stage 2 we undertook 8 case studies to develop an in-depth investigation of learning and practice by students and newly qualified practitioners in universities and practice settings in relation to patient safety. Data were gathered to explore the planning and implementation of patient safety curricula; the safety culture of the places where learning and working take place; the student teacher interface; and the influence of role models and organisational culture on practice. Data from observation, focus groups and interviews were transcribed and coded independently by more than one of the research team. Analysis was iterative and ongoing throughout the study. NHS policy is being taken seriously by course leaders, and Patient Safety material is being incorporated into both formal and informal curricula. Patient safety in the curriculum is largely implicit rather than explicit. All students very much value the practice context for learning about patient safety. However, resource issues, peer pressure and client factors can influence safe practice. Variations exist in students? experience, in approach between university tutors, different placement locations – the experience each offers – and the quality of the supervision available. Relationships with the mentor or clinical educator are vital to student learning. The role model offered and the relationship established affects how confident students feel to challenge unsafe practice in others. Clinicians are conscious of the tension between their responsibilities as clinicians (keeping patients safe), and as educators (allowing students to learn under supervision). There are some apparent gaps in curricular content where relevant evidence already exists – these include the epidemiology of adverse events and error, root cause analysis and quality assessment. Reference to the organisational context is often absent from course content and exposure limited. For example, incident reporting is not being incorporated to any great extent in undergraduate curricula. Newly qualified staff were aware of the need to be seen to practice in an evidence based way, and, for some at least, the need to modify „the standard? way of doing things to do „what?s best for the patient?. A number of recommendations have been made, some generic and others specific to individual professions. Regulators? expectations of courses in relation to patient 9 safety education should be explicit and regularly reviewed. Educators in all disciplines need to be effective role models who are clear about how to help students to learn about patient safety. All courses should be able to highlight a vertical integrated thread of teaching and learning related to patient safety in their curricula. This should be clear to staff and students. Assessment for this element should also be identifiable as assessment remains important in driving learning. All students need to be enabled to constructively challenge unsafe or non-standard practice. Encounters with patients and learning about their experiences and concerns are helpful in consolidating learning. Further innovative approaches should be developed to make patient safety issues 'real' for students

    Lost in Knowledge Translation: Moving Towards a Clearer Picture? Mapping the conceptualisation of knowledge translation, transfer and exchange across public health in the North East

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    Over recent decades the concept of evidence-based practice in health care has become part of the language of practitioners, policymakers and researchers. However, a gap between the production of research evidence and use of this evidence in practice has been identified, leading to repeated calls for solutions which will render the process more effective and efficient. It is increasingly acknowledged that getting evidence into, or out of, policy and practice arenas is not a straightforward or a linear process and to view it as such may be both misleading and overly simplistic. The term knowledge translation (KT) is used to describe the work required to close or bridge this gap and is becoming common vocabulary. However, as a concept KT (and related terms) are not yet clearly defined, nor are there agreed meanings in many areas including public health. While there is a growing body of literature exploring these concepts, using this evidence to inform public health practice, strategy, research and education is often difficult given the diverse range of sources, the worldviews upon which they are based and the need for local ‘contextual fit’. This study was commissioned by Fuse to explore how various stakeholder groups (e.g. practitioners, commissioners, academics, researchers, local authority/government) make sense of and experience the concepts and processes of knowledge translation, transfer and exchange. The study aims were to: Undertake a rapid review of recent literature syntheses pertaining to knowledge translation, exchange and transfer in public health, Explore and articulate (map) stakeholder conceptualisations and interpretations of knowledge translation, exchange and transfer in public health

    Simulation of site-specific irrigation control strategies with sparse input data

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    Crop and irrigation water use efficiencies may be improved by managing irrigation application timing and volumes using physical and agronomic principles. However, the crop water requirement may be spatially variable due to different soil properties and genetic variations in the crop across the field. Adaptive control strategies can be used to locally control water applications in response to in-field temporal and spatial variability with the aim of maximising both crop development and water use efficiency. A simulation framework ‘VARIwise’ has been created to aid the development, evaluation and management of spatially and temporally varied adaptive irrigation control strategies (McCarthy et al., 2010). VARIwise enables alternative control strategies to be simulated with different crop and environmental conditions and at a range of spatial resolutions. An iterative learning controller and model predictive controller have been implemented in VARIwise to improve the irrigation of cotton. The iterative learning control strategy involves using the soil moisture response to the previous irrigation volume to adjust the applied irrigation volume applied at the next irrigation event. For field implementation this controller has low data requirements as only soil moisture data is required after each irrigation event. In contrast, a model predictive controller has high data requirements as measured soil and plant data are required at a high spatial resolution in a field implementation. Model predictive control involves using a calibrated model to determine the irrigation application and/or timing which results in the highest predicted yield or water use efficiency. The implementation of these strategies is described and a case study is presented to demonstrate the operation of the strategies with various levels of data availability. It is concluded that in situations of sparse data, the iterative learning controller performs significantly better than a model predictive controller

    End of life care: an educational pathway for community nurses.

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    This article reports on an innovative educational pathway for district and community nurses aimed at enhancing confidence and competence in dealing with end of life care (EoLC). Nurses were aligned with a mentor from a specialist palliative care team and, after completing a training needs analysis, created their own development plan. Participants undertook a range of formal and informal education, and a rise in confidence was identified, specifically in communication skills and symptom management. Such practice-based education may offer a powerful and convenient approach to EoLC education for community staff. Read More: http://rcnpublishing.com/doi/abs/10.7748/phc2014.02.24.1.18.e80

    Learning about patient safety: organisational context and culture in the education of health care professionals

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    Objectives This study investigated the formal and informal ways pre-registration students from medicine, nursing, physiotherapy and pharmacy learn about keeping patients safe. This paper gives an overview of the study and explores findings in relation to organizational context and culture. Methods The study employed a phased design using multiple qualitative methods. The overall approach drew on ‘illuminative evaluation’. Ethical approval was obtained. Phase 1 employed a convenience sample of 13 pre-registration courses across the UK. Curriculum documents were gathered, and course directors interviewed. Phase 2 used eight case studies, two for each professional group, to develop an in-depth investigation of learning across university and practice by students and newly-qualified practitioners in relation to patient safety, and to examine the organizational culture that students and newly-qualified staff are exposed to. Analysis was iterative and ongoing throughout the study, using frameworks agreed by all researchers. Results Patient safety was felt to have become a higher priority for the health care system in recent years. Incident reporting was a key feature of the patient safety agenda within the organizations examined. Staff were often unclear or too busy to report. On the whole, students were not engaged and may not be aware of incident reporting schemes. They may not have access to existing systems in their organization. Most did not access employers' induction programmes. Some training sessions occasionally included students but this did not appear to be routine. Conclusions Action is needed to develop an efficient interface between employers and education providers to develop up-to-date curricula for patient safety
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