Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 143-148). Available also in a digital version from Dissertation Abstracts.

Thesis (Ed.D.)--University of Illinois at Urbana-Champaign, 2009. / Source: Dissertation Abstracts International, Volume: 70-06, Section: A, page: . Adviser: Debra D. Bragg. Includes bibliographical references (leaves 158-164) Available on microfilm from Pro Quest Information and Learning.

<p> Proper implementation of pregnancy prevention programs is essential to sexual health program success and intended health outcomes for participants (Demby et. al, 2014). Large scale implementation of state-wide and local programs can vary. Multiple studies have shown that proper implementation of such programs is an essential requirement to their success (LaChausse, Clark, &amp; Chapple, 2014; Demby et. al, 2014; Fixsen et. al, 2009). Generally, there are three types of organizations that receive funds for pregnancy prevention program implementation: schools, large city community organizations, and smaller community-based organizations (Demby et. al, 2014; Fixsen et. al, 2009). Be Proud! Be Responsible! is an evidence-based comprehensive sexual health curriculum that is implemented in all three settings.</p><p> The current study is an evaluability assessment of Be Proud! Be Responsible!, one of the evidence-based programs implemented as part of the New York State Department of Health&rsquo;s Comprehensive Adolescent Pregnancy Prevention initiative. Evaluability assessments, also known as &lsquo;exploratory evaluations&rsquo;, are administered with the intention of providing enough useful information to maximize the program&rsquo;s subsequent evaluations, policies, or practices (Leviton et. al, 2010). This evaluability assessment utilized a mixed-methods approach in the form of interviews, fieldnotes from observation, document review, and secondary data analysis during Fall 2014 and Spring 2015, using Be Proud! Be Responsible! data from 2012-2013. </p><p> This study drew upon multiple sources to seek convergence and corroboration through the use of different data sources and methods (Bowen, 2009). By using this mixed-method approach to analysis it was determined that process evaluation is feasible and assessable while outcome evaluation can be carried out in the future with slight modification to the current measurement tools &ndash; the pre- and post- test, attendance records, and the fidelity checklist. It was also determined that there was a significant change in pre- and post- test responses for Be Proud! Be Responsible! participants in 2013, showing that evidence-based sexual health programs can be successful when properly implemented in specific settings.</p>

This sociological study of medical school culture employed a critical framework for analysis of ideological reproduction and social control. A literature review provided a social-historical context for the empirical findings that focused on student-faculty discourse at one college of medicine during the third-year Family and Community Medicine clerkship. Data collection consisted of audio recording and observation in both classroom and clinical settings. A depth hermeneutical analysis was used to answer three research questions. For question 1, "What is the macro medical social context within which ideologies are being reproduced and received in medical education?" a literature review on recent trends in health care delivery and medical education elucidated the social-historical conditions in which ideological and social control constructs are embedded today. The principal finding was that the U.S. health system is embroiled in a revolution, characterized by the frequently contradictory ideologies of medical advocacy and business allocation. For question 2, "What are the principal ideological and social control messages being reproduced in medical education?" a discursive analysis of faculty-student dialogue was structured around eight thematic elements. Findings revealed that medical education does not prepare students to think critically about social and environmental issues that cause 85% of illness in our society, with faculty dominance often acting as a major deterrent. The principal messages being reproduced extended from a therapeutic ideology that promotes the physician's definition/control of patient problems. Also found was a deeply conflictual relationship between managed and medical care. For question 3, "How does the meaning mobilized by these ideological messages in medical education serve to establish and sustain relations of domination and social control?" an interpretive process clarified how ideology and social control sustain relations of power that systematically confound and effectively eliminate social justice in health care. Because the right to define the patient's problem gives the physician extraordinary power, the drive to reach a differential diagnosis is extremely strong, and gaining diagnostic expertise is medical education's consuming focus. As a result, students leave medical school prepared for their professional social control role, while uncritically accepting the inequitable and illness-causing social, economic, and political ideologies of our time.

The purpose of this study was to validate the proposed Metaparadigm of Clinical Dietetics. The proposed Metaparadigm of Clinical Dietetics is the most abstract level of the profession's body of knowledge and is a statement of seven domains of concern. The seven domains are Reference Person, Human Condition, Practitioner Actions/Attitudes, Practitioner Environment, Client Actions/Attitudes, Client Environment and Nutraceuticals and are characterized by ninety-four knowledge topics. A further purpose was to determine comparative relevance of these ninety-four knowledge topics to other health professionals and nutritional scientists. A descriptive-correlational-factor-analytical design was used for this study. An expert panel of clinical dietetic practitioners and an extensive literature review were used to develop the mailed survey instrument. A random sample of five hundred clinical dietitians was selected from members of thirteen clinical Dietetic Practice Groups of The American Dietetic Association. One hundred thirty-six surveys were returned for a response rate of twenty-seven percent.

<p> By 2030, older adults will comprise more than 20% of the population and include 80 million adults age 65 and older (U.S. Census, 2010). A corresponding increase is predicted in the number of older adults in need of mental health counseling (American Association of Geriatric Psychiatry, 2010). According to the Institute of Medicine, in 2012, nearly one in five older adults had one or more mental health and/or substance abuse conditions. There is an emerging demand for counselors who specialize in gerontological counseling to meet the mental health and substance abuse needs of older adults. Despite the anticipated demand to increase the workforce with counselors who specialize in gerocounseling, research has shown that students in the human service professions are not interested or prepared to work with older adults (Institute of Medicine, 2012). This lack of interest and preparedness does not bode well for meeting the future needs of this population. If there is a genuine lack of interest in counseling older adults among counseling students, particularly the youngest to enter the profession, then it is important to explore their perspectives to understand them and design training strategies to prepare them for meeting the mental health needs of older adults. </p><p> This exploratory study used qualitative description to capture the perspectives of eight millennial counselors-in-training (CITs). Data and findings were organized to construct analysis of the themes that emerged. The framework of critical gerontology was used to examine findings. Participants identified primarily with their own aging family members to describe their age-related perspectives. Findings suggest that CITs struggled with their own privileged status as younger adults as they described their perception of how older adults were devalued by society. Evidence revealed a tension as they realized that they will likely counsel older adults regardless of their area of specialization. Students wanted age-related foundational knowledge to help their own aging family members, to work with clients being raised by grandparents, and to assist families in accommodating their aging family members but experienced systemic and structural obstacles that might prevent them from acquiring this knowledge. This research has critical implications for the field of counselor education.</p>

The present study surveyed occupational therapy clinical supervisors working in a number of university affiliated hospitals in the Montreal area, via a mail questionnaire. Therapists were first asked to rate the importance of behaviours in facilitating student learning during clinical instruction. Then they were asked to report their attendance at continuing education courses on clinical instruction. The relationship between attendance at these courses, number of years of clinical experience and rating of behaviours was investigated. Therapists with few years of clinical experience had a low rate of attendance and rated behaviours as important more frequently. Therapists who attended a course rated behaviours as important less frequently. Behaviours rated as most important belonged to the area of communication, followed by the areas of teaching and interpersonal relationships. The results of this study demonstrated that a workshop on clinical instruction would benefit therapists by improving their clinical supervisory skills.

Doctor of Philosophy (PhD) / Effective clinical reasoning and its communication are essential to health professional practice, especially in the current health care climate. Increasing litigation leading to legal requirements for comprehensive, relevant and appropriate information exchange between health professionals and patients (including their caregivers) and the drive for active consumer involvement are two key factors that underline the importance of clear communication and collaborative decision making. Health professionals are accountable for their decisions and service provision to various stakeholders, including patients, health sector managers, policy-makers and colleagues. An important aspect of this accountability is the ability to clearly articulate and justify management decisions. Considerable research across the health disciplines has investigated the nature of clinical reasoning and its relationship with knowledge and expertise. However, physiotherapy research literature to date has not specifically addressed the interaction between communication and clinical reasoning in practice, neither has it explored modes and patterns of learning that facilitate the acquisition of this complex skill. The purpose of this research was to contribute to the profession’s knowledge base a greater understanding of how experienced physiotherapists having learned to reason, then learn to communicate their clinical reasoning with patients and with novice physiotherapists. Informed by the interpretive paradigm, a hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants’ learning journeys were diverse, although certain factors and episodes of learning were common or similar. Participation with colleagues, peers and students, where the participants felt supported and guided in their learning, was a powerful way to learn to reason and to communicate reasoning. Experiential learning strategies, such as guidance, observation, discussion and feedback were found to be effective in enhancing learning of clinical reasoning and its communication. The cultural and environmental context created and supported by the practice community (which includes health professionals, patients and caregivers) was found to influence the participants’ learning of clinical reasoning and its communication. Participants reported various incidents that raised their awareness of their reasoning and communication abilities, such as teaching students on clinical placements, and informal discussions with peers about patients; these were linked with periods of steep learning of both abilities. Findings from this research present learning to reason and to communicate reasoning as journeys of professional socialisation that evolve through higher education and in the workplace. A key finding that supports this view is that clinical reasoning and its communication are embedded in the context of professional practice and therefore are best learned in this context of becoming, and developing as, a member of the profession. Communication of clinical reasoning was found to be both an inherent part of reasoning and an essential and complementary skill necessary for sound reasoning, that was embedded in the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined and should be learned concurrently. The learning and teaching of clinical reasoning and its communication should be synergistic and integrated; contextual, meaningful and reflexive.

Thesis (PH.D.) -- Syracuse University, 2007. / "Publication number AAT 3266297"

Thesis (Ed.D.)--Argosy University/Honolulu, 2007. / (UMI)AAI3256145. Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1555. Adviser: Carole E. Freehan.