Thesis (Ph.D.)--University of California, San Francisco, 2008. / Source: Dissertation Abstracts International, Volume: 69-09, Section: B, page: 5320. Adviser: Patricia Benner.

Thesis (Ed.D.)--University of Illinois at Urbana-Champaign, 2006. / Source: Dissertation Abstracts International, Volume: 67-11, Section: A, page: 4113. Adviser: Jane W. Loeb. Includes bibliographical references (leaves 151-155) Available on microfilm from Pro Quest Information and Learning.

This scoping review examines the available evidence supporting accommodation use in the assessment of health professionals with disabilities in licensing contexts. While test accommodations are a protected right under antidiscrimination legislation, the peer-reviewed evidence informing their use is contested and widely dispersed. Furthermore, the ramifications of accommodation misuse are significant, including human rights violations and increased risks to patients. As such, this study addressed two research questions: 1) What is the current state of literature on accommodation use in the assessment of health professionals? and 2) What programs of research would address stakeholders’ concerns about the use of accommodations in the assessment of those professionals? Systematic searches of five prominent databases identified 15 articles for analysis. Several major themes emerged from that analysis: interpreting legislation, administration and process, relationships between education and licensure, and psychometrics and test development. Stakeholder consultation revealed that stakeholders face challenges managing accommodation requests and defining reasonable accommodations. While there is a paucity of literature on the topic overall, especially of an empirical nature, this study mapped the available evidence and laid the foundation for future studies by delineating the gaps in the scholarly literature as defined by stakeholders’ needs.

<p> <b>Introduction:</b> Obtaining higher education increases the amount of stressors physically, mentally, and emotionally. College is more than parties, pledging, and freedom from authoritative figures. For many young adults, it is the time to learn independence, responsibility, and roads to success. Today&rsquo;s students are making life-altering decisions under the influences and pressures of society. Coping with stress is just one of the challenges students will endure while in college. Stressors are often considered normal, and students may not immediately recognize certain stressors as being problematic. They may also fail to identity and differentiate between eustress and distress. </p><p> <b>Purpose:</b> This exploratory study defines the role of stress in coping mechanisms (healthy and unhealthy decision making) as it relates to African American college students&rsquo; success (ability to strive academically) at Historically Black College and University (HBCU) and Predominantly White Institutions (PWI). <b>Methodology:</b> A mixed method research design was applied to determine the effects of culture on stressors and coping mechanisms of African American college and graduate students at Florida Agricultural and Mechanical University (FAMU) and Florida State University (FSU). The <i> Transactional Model of Stress and Coping</i> framework was utilized to evaluate the processes of coping with stressful events. To ensure rigor and validity, the study was segmented into two phases, qualitative (Phase I) and quantitative (Phase II). Phase I consisted of the primary researcher transcribed 17 interviews. A second researcher reviewed and coded for themes. Phase II consisted of 300 student respondents to the College Student&rsquo;s Stressful Event Checklist (CSSEC) and the Brief COPE (COPE) surveys. Descriptive statistical analyses were conducted for each variable using quantitative software, SPSS Statistics. A comprehensive analysis was conducted to identify new or merging themes bases on the research questions. </p><p> <b>Results:</b> African American college and graduate students perceived both their susceptibility and severity to stress to result in negative outcomes (problems or health issues). The problems were categorized as maladaptive (overeating, smoking marijuana and drinking alcohol) and non-maladaptive (prayer, meditation, and exercising) behaviors. The health issues experienced, are listed as the following but not limited to: Unwanted pressure, feeling overwhelmed, tired, embarrassed, and symptoms of Irritable Bowel Syndrome (IBS). As an individuals&rsquo; perception of susceptibility and severity increased in regards to demographics so did their level of stress (CSSEC scoring). Although there was almost an even split about culture being an influence, it played a factor in normalizing stress. A positive relationship was discovered between a student&rsquo;s academic matriculation (classification) and their amount of coping (COPE score). </p><p> <b>Discussion/Conclusion:</b> The findings from phase I were consistent with Lazarus and Folkman&rsquo;s Transactional Model of Stress and Coping and the importance of evaluating harm, threat, and challenges among African American college students. Students perceived both their susceptibility and severity as high due to the pressures of life and past experiences. Students perceived expressions to stress as maladaptive and non-maladaptive behaviors. Students also responded to adaptation with actual style of coping mechanisms. The findings from phase II shows a positive relationship between an individual&rsquo;s classification and the amount of coping mechanisms developed. All four hypotheses were accepted. As students matriculate throughout school (classification) they will adopt coping mechanisms. Stressors may also become more common and easier to normalize; however, adaptation will allow for coping mechanisms to augment from other stressful events. Students utilized the revision of goals and spiritualty as a meaning-based coping mechanisms. The cultural lens influences the coping styles of students within their particular way of life, traditions, and beliefs. As a preventative measure, it is essential to seek counseling services that will assist in obtaining effective ways of coping and possibly healing past issues. Further, exploration of stigma and discrimination among those who self-identify as being a racial/ethnicity or gender/sexual identity minorities in both Historically Black College and Universities and Predominantly White Institutions.</p><p>

No description available.

Within the profession of nursing, reflective journal writing is enthusiastically endorsed as an essential pedagogical strategy for producing reflective practitioners. Despite a lack of empirical evidence to substantiate the claims associated with reflective journaling, the prevailing belief in contemporary nursing education reflects an assumption that this practice is essential in the production of critically engaged nurses. This has resulted in a totalizing discourse that presents the adoption of reflective journaling within nursing curricula as unproblematic. This study combines the methodological principles of grounded theory, along with a poststructuralist approach, to explore the experience of reflective journaling from the perspective of university nursing students. Application of a Foucauldian analysis demonstrates how assumptions related to the utility of reflective journal writing are embedded within a variety of powerful discourses that shape how we think and speak about this practice. Of particular relevance is Foucault's exploration of the impact of surveillance, observation and disciplinary power. Reflective journaling is identified as a ritual of confession that produces self-regulating and compliant students. This study reveals that journal writing is largely viewed as a prescribed activity and assumptions are made by nurse educators regarding the ability of journals to facilitate critical reflection. The discourses that emerged from this analysis reflect different aspects of the socialization process that ultimately results in the construction of an "authentic" nurse. In closing, students and nurse educators are encouraged to develop alternative discourses that challenge the uncritical acceptance of reflective journal writing within contemporary nursing education.

Performance assessments of professionals are commonly scored with rating scales but checklists are used with the Objective Structured Clinical Examination (OSCE). Theory suggests checklists are too detailed (Norman, 2005a) and studies show that generic rating scales (e.g., Hodges, Regehr, McNaughton, Tiberius, & Hanson, 1999) are more discriminating and reliable. However, generic scales may represent clinical expertise too narrowly, resulting in less valid scores. Study One asked how case-specific rating scale scores and decisions compared to checklist scores and decisions at representing professional competency. Study Two asked the same question about a skill-specific rating scale. Data were from a medical licensure OSCE. Participants were 1,587 test takers and 190 physician raters. Two patient cases (Depression and Delirium) were used. In each case, two physicians scored. One scored a checklist and the other a rating scale; both scored a patient interaction rating scale (PIRS). Results from both studies showed internal consistency was higher for rating scales (e.g., for Study One alpha=.87 and alpha=.79 for rating scales; alpha=.55 and alpha=.64 for checklists). Item-total score correlations (ITC) for each rating scale as an item within the OSCE were also higher than the ITC for the checklists in both studies. Logistic regression analyses predicting pass/fail decisions from a 3-variable expertise model explained more variance for the rating scales decisions than it did for the checklists in both studies (e.g., RL2=16.4% and RL2=16.4% for rating scales; RL2=12.7% and RL2=5.7% for checklists in Study One). The highest Pearson correlations (corrected for attenuation) were between the rating scale scores and the respective PIRS scores. In conclusion, these rating scale scores are more discriminating and reliable than checklist scores but correlations with PIRS scores indicate they may not measure the intended dimension of the clinical expertise construct. Evidence for a validity argument was strongest for the case-specific rating scale for Depression, raising the question of whether rating scale methodology is appropriate for all OSCE cases.

This study seeks to understand the effects of HIV/AIDS on the education sector in Malawi, Africa and to assess its capacity to be an effective safeguard against the spread of HIV/AIDS. The study fills in gaps in the literature by analyzing the perspectives of educators at six levels of the hierarchy—from schools to the Ministry of Education—and assessing their professional, as opposed to personal, HIV/AIDS-related knowledge, attitudes, and practices (KAP). This study benefits international education and health specialists in the preparation and implementation of HIV/AIDS strategies. The study utilizes a sequential, mixed-methods design in which qualitative data were obtained from 31 participants through interviews and focus group discussions and quantitative data were obtained from 207 respondents through a survey. The data were collected from representatives of the six levels of the hierarchy: teachers, head teachers, zonal advisors, district managers, division officers, and Ministry personnel. Teachers and head teachers represented 32 primary and secondary schools divided between one rural and one urban district in the southern region of Malawi. Descriptive statistics and cross tabulations were used to analyze the data. The study shows that Malawi's education system is weak, with HIV/AIDS greatly affecting supply, quality, and psycho-social well being. To a lesser degree, demand and management are affected. The effects are strongly felt at all levels of the hierarchy. It was found that the sector is weakened through sickness and death, difficulty of replacing deceased teachers, the enormous financial burden of paying for educators' funerals and lengthy sick leave, and depression. Education personnel—especially those at the school level—are knowledgeable, have positive attitudes about their capabilities, and demonstrate a strong desire to provide teaching and counseling services to their students. Although HIV/AIDS has severely weakened the education sector, the self-reported high levels of confidence amongst Malawi's educators could enable them to take positive steps to change their own behavior and to influence behavior change in others, thus allowing them to play the role of "doctor" to help cure the rest of society of the ills of HIV/AIDS.

There are many factors that affect the hours worked by various professions. The literature discusses some of these factors in professions such as management and various fields of medicine. However, no information has been gathered on factors that affect the practice of dentists. A survey was disseminated to all Iowa dentists inquiring about various factors that may affect the number of hours they spend at work. The survey inquired about demographics, educational indebtedness, caregiving responsibilities of both children and dependent adults, contribution to household income, relationship status, domestic responsibilities, busyness and type of practice. The data was collected and analyzed. It was hypothesized that there was no difference in the number of hours worked between male and female Iowa dentists and there was no difference in the number of hours worked between female Iowa dentists with minor children (18 years old or younger) and female dentists without minor children. When hypotheses were statistically analyzed, the data showed there was no difference between male and female dentists' working hours in the bivariate analysis. In the multiple logistic regression model, while controlling for various factors such as age and busyness, gender was statistically significant in the number of hours worked. When evaluating the hours worked between female dentists with and without minors, there was a statistically significant difference in the number of hours worked between women with minor children and women without minors. However, in the multiple logistic regression model, presence of minors was not statistically significant. This lack of statistical significance is likely attributed to the small sample size of women dentists. As such, there was not enough power to have more than 2 variables and minor children was not included. The data suggests that young male dentists, who are responsible for 61% or more of their household income and are solo practitioners are the most likely to work full-time (32+ hours/week).

Background The University of Cape Town Faculty of Health Sciences (UCT FHS) adopted the Primary Health Care (PHC) approach as its lead theme for teaching, research, and clinical service in1994 Aim To develop indicators to monitor and evaluate the implementation of the PHC approach in Health Sciences Education . Method A Delphi study, conducted over two rounds, presented indicators of Social Accountability from the Training for Health Equity Network (THEnet), as well as indicators derived from the principles of the PHC approach in the UCT FHS, to a national multidisciplinary panel. An electronic questionnaire was used to score each indicator according to relevance, feasibility/measurability, and its application to undergraduate and postgraduate curricula. Qualitative feedback on the proposed indicators was also elicited. Results Round 1: Of the 59 Social Accountability indicators presented to the panel, the 20 highest ranked indicators were selected for Round 2. Qualitative feedback challenged the link between social accountability and PHC, resulting in an additional 19 PHC-specific indicators being presented in Round 2. Round 2: The indicators which scored >85% and made the final list were: PHC: Continuity of care (94%); Holistic understanding of health care (88%); Respecting human rights (88%); Providing accessible care to all (88%); and Promoting health through health education (88%). THEnet: Safety of learners (88%); Education reflects communities' needs (86%); Teaching embodies social accountability (86%); Teaching is appropriate to learners' needs (86%) Conclusion These PHC and THEnet indicators can be used to assess the implementation of PHC in Health Sciences Education. The specific indicators identified reflect priorities relevant to the local context. One limitation is that some key priority indicators did not make the final list.