Chinese medicine (CM) as a popular form of complementary and alternative medicine (CAM) has been increasingly used in the Western world over the last three decades. While the importance of original research on quality, safety and efficacy of CM therapies is well argued and supported, there has been a general negligence of the role of education in protecting public safety, promoting CM as a form of evidence-based healthcare and improving the quality of clinical CM services. This study aimed to determine the essential practitioner capabilities to ensure the safe, competent and contemporary Chinese medicine clinical practice in complex healthcare systems such that of Australia. There are two major studies in this thesis: the workforce study and the capability postal survey. For the workforce study, a specific instrument with a coding system was developed and approved by the Chinese Medicine Registration Board of Victoria (CMRBVic) prior to the commencement of the data collection based on registration forms submitted by all practitioners registered with CMRBVic during the transitional (also known as grand-parenting) period. Findings from the workforce study provide comprehensive data on the current state of the Victorian CM workforce concerning their educational background, clinical experience and their current practice of CM. Findings of the capability postal survey represent a major step in the development of a capability-based curriculum that meets the needs of the Chinese medicine workforce. The findings of this study provide the basis for developing specific continuing professional educational programs that address knowledge and skill gaps such as communication, referral, research training and for some practitioners, basic biomedical sciences. In conclusion, this study, for the first time, provided the comprehensive data on the state of the Victorian CM workforce and CM practitioners' views on desired practitioner capabilities. A number of continuing professional education needs were identified and the successful implementation of these programs will contribute to the safe and competent CM practice and thus protect the public safety.

Preceptorship is a teaching-learning approach in which learners are individually assigned to expert practitioners in the practice setting. The purpose is to provide them with daily experience on a one-to-one basis with a role model and resource person who is immediately available to them. Currently, the literature is replete with research on various aspects of preceptorship, including the preceptor role, the evaluation process, professional socialization, the promotion of clinical competence, and the fostering of critical thinking in undergraduate and graduate education, to name a few. To date, however, no studies have specifically explored the process involved in promoting the education of nurse practitioner students in preceptorship. The purpose of this grounded theory study was to explore the process used in preceptorship to prepare nurse practitioner students for their future role in professional practice. To that end, the process in which preceptors, nurse practitioner students, and faculty engage was explored. The sample comprised nurse practitioner students, preceptors and faculty from a large university in western Canada. Findings from this study revealed that as students proceeded through the preceptorship program they worked through or navigated what could be described as the liminal space or an in-between place. As a result of the findings of this study, several crucial points have been recognized that have implications for the nurse practitioner student who engages in preceptorship. First, upon acceptance into an advanced practice nursing program it is important for students who are themselves experienced professionals in their own right, to understand the preceptorship process of transition, found in this study to be the liminal space, intrinsic to which are adjustments from the role of nurse, to that of student and finally to that of the nurse practitioner. Second, to adequately prepare students for their transition, faculty need to develop curricula that address the challenges involved with this phenomenon, specifically knowledge related to threshold concepts and troublesome knowledge. Third, support for these students from faculty, preceptors and fellow students was found to directly affect the ability of these learners to successfully navigate their transitional process in preceptorship.

As a result of changing demographics and an increasing need for access to healthcare, in 2013, the Nevada Legislature passed Assembly Bill 170 (AB170) allowing nurse practitioners (NPs) full practice authority in Nevada in 2013 (VanBeuge & Walker, 2014). With the movement from collaborative agreement to independent practice, recent NP graduates need to be prepared for transitioning from the NP student role to an independent practitioner role. Historically, speaking there have been numerous studies citing that NPs provide high-quality health care and have high patient satisfaction, yet there has been almost no research regarding the readiness for clinical practice post-graduation (Hart & Macnee, 2007). The purpose of this project was to develop a better understanding of readiness to practice, perceived barriers, and to develop recommendations for post-graduation nurse practitioners in Nevada. A brief survey was provided electronically to NPs who were members of the Nevada Advanced Practice Nurses Association (NAPNA).

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / The Chiropractic profession has made significant progress with regard to the production of high quality and clinically relevant research in the last 20 years. This correlates with a spike in development within the chiropractic profession as well as its acceptance by the medical fraternity and public. The responsibility for continuing this positive trend is dependent on the chiropractic graduates and practitioners of the future. Therefore, it is important to establish the current perceptions and utilization of research by Chiropractors, so that future research can be built around the needs and requirements of today’s practitioners, thereby ensuring the profession’s continued development and future in health care. The aim of this study was to determine the perceptions that Chiropractors have of research and its relevance / utilization in practice. Method: The study was a quantitative questionnaire based, self administered survey. The sample group included all Chiropractic practitioners currently practising in South Africa (N=515). Results: There was a response rate of 35% (n=174). The results indicated that the perception of research was very positive overall, with the strongest positive response being that research adds credibility to the profession. However, most respondents disagreed with the statement that chiropractors who had done research had an advantage above those who had not. There was a positive, albeit weak correlation between perceptions and utilization of research, indicating that as perceptions increased, so did utilization of research. The area of greatest concern was that even though a high degree of research utilization was reported by chiropractors, research was least likely to be used to change conditions, policies or practices in practice. v Conclusion: The most significant factors associated with positive perceptions and utilization were found to be publishing in a journal and receiving referrals from other health care practitioners. Chiropractors who indicated an interest in doing research again were also very positively linked to utilization. It would seem that even though chiropractors perceive research positively, their implementation into practice has some hurdles that impede the full integration of research into practice. As very few demographic and personal attributes of the South African chiropractor were found to be primarily responsible for low utilization of research in practice, it can be hypothesised that the factors impeding research implementation are most likely environmental in nature.

No description available.

Purpose: To examine stakeholder participation in the primary care system change process that led to the introduction of the first Nurse Practitioner-Led Clinic in Ontario. Design: Qualitative case study guided by the principles of stakeholder and system change theory. Setting: Northern Community in Ontario, Canada. Participants: Purposeful sample of healthcare providers, healthcare managers and health policy stakeholders. Procedures: This case study was bound by place (Sudbury), time (January 2006–January 2008), activity (stakeholder participation), and process (introduction of an innovation, the first Nurse Practitioner-Led Clinic in Ontario, during a primary care system change). Semi-structured individual interviews were conducted with participants who represented the clinic, the local community, and the province. Public documents, such as newspaper articles published during the 2 year time boundary for this case and professional healthcare organization publications, were also examined. Interviews were analyzed using qualitative content analysis and public documents were reviewed for key messages to complement the interview findings. Field notes written during data collection and analysis were used to provide additional depth, contribute insights to the data, and ascribe meaning to the results. Main Findings: Sixteen interviews were conducted with key stakeholders. Twenty public documents which yielded the most specific information relevant to the case study time boundaries and activities were selected and reviewed. Six main themes are reported: felt need, two visions for change (one for a Nurse Practitioner-Led Clinic and one for Family Health Teams [FHTs]), vision processes related to ensuring the visions became or continued to be a reality in Ontario’s healthcare system (shaping, sharing, and protecting the vision), stakeholder activities, and sustaining and spreading the vision. Conclusions: In this case, stakeholder participation influenced policy decisions and was a key contributor to the primary care system change process to introduce the first Nurse Practitioner-Led Clinic in Ontario. Stakeholders are motivated by various needs to engage in activities to introduce an innovation in primary care. One of the most common needs felt by both those who supported the introduction of the first Nurse Practitioner-Led Clinic and those who were opposed to it was the need for improved patient access to primary care.

This thesis focuses on the relationship between public libraries, that is, those library services provided by local authorities under the 1964 Public Libraries and Museums Act for use by the general public, and research conducted in such services by professional library staff - 'practitioner-researchers'- within the local government context. The aims of the study are: • To examine the relationships between local authorities, public library services, and research activities. • To review and evaluate contemporary research activities in public library services carried out by practitioner-researchers. • To identify and investigate the use of particular research methods and techniques used by practitioner-researchers. • To analyse, and provide a clear understanding of, limitations in current practice. Chapter One introduces the study and states the parameters and constraints of the research. The time period covered by this thesis is from the 1964 Public Libraries and Museums Act until April 1998. Chapter Two argues that as local government moves from a traditional model of service provision to a model of activities in support of strategic policy objectives, more attention will need to be given to 'deep' research in order to address cross-cutting issues. Chapter Three reviews the public library research scene from three perspectives, historical, thematic and current, and demonstrates the emergence of a more coherent approach with co-ordination and funding at a national level. It also shows that research methods remain undeveloped in the public library service as a whole. Research activity is largely confined to simpler issues of service development and does not extend to research addressing the impact of the service. Chapter Four outlines and explains the methodology used for the fieldwork. It demonstrates the rigour incorporated in the naturalistic inquiry approach, verifies the sample, and describes the process of data analysis. Chapter Five examines current practice in public library services through a series of twenty interviews with Chief Librarians. An overview of the findings is followed by a more detailed analysis which draws from the qualitative data. The analysis is set in context, making links with the earlier literature reviews. The closing section broadens the discussion to consider the influence of research on policy. Chapter Six synthesises the themes of the thesis. A description of the new agenda, and an analysis of its implications for research and organisational structures, enables a reconsideration of the rationale for research in local government. It is argued that simply demonstrating the relevance of the service is not enough; the real contribution of research must be in terms of policy development. Approaches to research, and in particular research methods, are reviewed to assess their suitability and a way forward is identified.

Purpose: To examine stakeholder participation in the primary care system change process that led to the introduction of the first Nurse Practitioner-Led Clinic in Ontario. Design: Qualitative case study guided by the principles of stakeholder and system change theory. Setting: Northern Community in Ontario, Canada. Participants: Purposeful sample of healthcare providers, healthcare managers and health policy stakeholders. Procedures: This case study was bound by place (Sudbury), time (January 2006–January 2008), activity (stakeholder participation), and process (introduction of an innovation, the first Nurse Practitioner-Led Clinic in Ontario, during a primary care system change). Semi-structured individual interviews were conducted with participants who represented the clinic, the local community, and the province. Public documents, such as newspaper articles published during the 2 year time boundary for this case and professional healthcare organization publications, were also examined. Interviews were analyzed using qualitative content analysis and public documents were reviewed for key messages to complement the interview findings. Field notes written during data collection and analysis were used to provide additional depth, contribute insights to the data, and ascribe meaning to the results. Main Findings: Sixteen interviews were conducted with key stakeholders. Twenty public documents which yielded the most specific information relevant to the case study time boundaries and activities were selected and reviewed. Six main themes are reported: felt need, two visions for change (one for a Nurse Practitioner-Led Clinic and one for Family Health Teams [FHTs]), vision processes related to ensuring the visions became or continued to be a reality in Ontario’s healthcare system (shaping, sharing, and protecting the vision), stakeholder activities, and sustaining and spreading the vision. Conclusions: In this case, stakeholder participation influenced policy decisions and was a key contributor to the primary care system change process to introduce the first Nurse Practitioner-Led Clinic in Ontario. Stakeholders are motivated by various needs to engage in activities to introduce an innovation in primary care. One of the most common needs felt by both those who supported the introduction of the first Nurse Practitioner-Led Clinic and those who were opposed to it was the need for improved patient access to primary care.

In this thesis, the nature and extent of practitioners' dissatisfaction with the psychotherapy research literature will first be described. A case will be made that a deeper analysis needs to be conducted to fully understand this dissatisfaction. Next, this dissatisfaction will be framed in the context of a particular ontology that seems to have largely contributed to it. Most importantly, several features of this ontology will be described and connected to practitioners' dissatisfaction. Finally, an alternative framework for understanding practitioners' dissatisfaction will be tentatively proposed, and it will be suggested that this alternative could help researchers and practitioners understand their dissatisfaction with one another and lead to a more fruitful dialogue.

In 2010, the Patient Protection and Affordable Healthcare Act (PPACA) implemented changes to reduce healthcare spending that incorporated Centers for Medicare and Medicaid (CMS) incentive programs to reduce 30-day readmission rates in seniors with heart failure. This project includes a policy and procedure for private practice using a nurse practitioner navigator (NPN) led multidisciplinary team (MDT) for the patient-centered medical home (PCMH) to improve communication between hospitals and PCMH to decrease readmission rates in seniors with heart failure (HF). This practice change will provide an implementation and evaluation plan along with plans for future expansion. Meetings were held twice weekly along with the use of Skype when team members were unavailable. A literature review explored methods to improve communication between hospitals and PCHM to reduce readmission rates. Thirty-two peer-reviewed articles were identified in a search of CINAHL and ProQuest Nursing and Allied Health Source databases that served as the primary pool of evidence used for this project, supplemented by context considerations provided by the project team. Evaluating the evidence based research provided support for this project using a NPN led MDT to reduce readmission rates. Coleman's transition of care (TOC) model was used as a framework for both the policy and procedure to integrate patient, provider, and environmental contexts, support health care policy changes, and reduce health care spending. This scholarly project supports the role of DNPs as leaders in the medical field working to translate existing evidence into policy and practice and lead interdisciplinary health care teams.