Medical education leaders have been concerned about the decline in professionalism among medical students. While many studies have documented the professional socialization of medical students most have simply noted the process or examined the adaptation on the part of the students to the environment of the academic health center. Few have examined the socialization of professionalism, although many articles in the literature have discussed the lack of professionalism seen among medical students and they progress through their medical education. This is seen in students' distancing from patients, adopting the use of dehumanizing terminology when referring to patients and their families, and the decline in psycho-social functioning. There appear to be many factors that have facilitated this decline in professional values. Some include the increasing involvement of managed care in the teaching hospital, requirements for faculty to increase their clinical revenue thus reducing their time spent with students, and relegation of the teaching of medical students to residents. This study examines an alternate environment, the rural site, as one that may favor the adoption of the traditional or core professional values of physicians. This research qualitatively examines student's comments related to their involvement in a rural medical education program. This program, which selects 15 students each year from the entering class of medical students, seeks to nurture interest in rural practice. These medical students appear to have increased exposure to professional values due to their increased time spent in the rural environment. These teaching sites provide an alternative with which to compare the values held and reinforced in the academic health center. The values in the rural environments appear to be different than those in the academic health center, and seem to reflect professionalism in ways that are more consistent with the traditional values of physicians. These values include ones such as service to the community, altruism, honesty, respect and collegiality. The professional socialization of medical students requires the socialization of professional values. The rural medical education sites examined here through the students' comments reflect a different type of experience, one in which professional values are modeled, expected and upheld.

Thesis (Ph.D.)--Indiana University, Dept. of Instructional Systems Technology, 2007. / Source: Dissertation Abstracts International, Volume: 68-09, Section: A, page: 3811. Adviser: Thomas M. Duffy. Title from dissertation home page (viewed May 8, 2008).

Collaborative patient-centered practice (CPCP) is an area of interest for continuing education in healthcare because it has the potential to increase the efficiency and effectiveness of health services. Because ELearning is becoming increasingly popular, the primary purpose of this qualitative intrinsic case study was to examine the design, development, delivery, and evaluation of a non-credited, six-week, continuing education online workshop about interprofessional education for collaborative patient-centered practice (IECPCP). This workshop was offered at no cost to the participants. The secondary focus of this study examined the self-reported outcomes that participants perceived they had achieved through the workshop in terms of the knowledge, skills, attitudes, and practices necessary to stimulate CPCP in the workplace. Three groups of participants (a total of 31 participants), were included in this intrinsic case study. The first group of six participants took part in a survey-based needs analysis to inform the design of the workshop. The second group of three participants formed the production team. During interviews, the production team members offered retrospective feedback on the design and development of the workshop based on the learners' comments. The third group of 22 participants included the learners who registered in the workshop and completed one or more data collection methods designed to capture their eLearning experience. The data collection methods included a pre-workshop survey, a temperature check, a post-workshop survey and email, and a post-workshop interview. A descriptive analysis was completed for the survey data and course records. The interview data was subjected to an interpretive analysis using the constant comparison method. All data sets were triangulated and interpreted through the lens of socioconstructivism with specific emphasis on Vygotsky's sociocultural theory. The results showed that in a continuing education context where learners are not asked to pay a registration fee, the rate of participation in an online workshop is closely linked to personal and professional motivational factors that can outweigh all design aspects of the learning resource. This study also showed that the more time the learners spent interacting with the learning resource, other learners, and the facilitator, the more they reported examples of the following: moving from knowledge construction about CPCP toward the development of CPCP skills; the adoption of attitudes conducive to CPCP; and the application of practices that stimulated CPCP in the workplace. This intrinsic case study suggests that all aspects of motivation and participation should be integrated within an eLearning model to influence the way online programs are designed, developed, delivered, and evaluated for this particular target group of learners. Integrating the concepts of motivation and participation into online program design, development, delivery, and evaluation will likely create an environment that stimulates active engagement in the online learning process.

Thesis (MPhil (Centre for Health Science Education))--University of Stellenbosch, 2009. / Introduction: Exposure to the clinical learning environment forms an essential part of nursing education. Individual student perceptions of this multi-dimensional context can greatly influence their clinical learning experiences. Insight into these perceptions may assist nurse educators in facilitating optimal learning outcomes. Aim: The aim of this study was to promote an awareness of the possible impact of various aspects of the clinical learning environment and nursing students’ perceptions thereof, on their learning experiences; and to generate guidelines for facilitating optimal learning outcomes. Methods: A qualitative, interpretive study, investigating nine individual second-year nursing students, was undertaken in a private hospital in South Africa. Interview transcripts were thematically analyzed. Results: Four themes and eleven sub-themes emerged, highlighting the impact of student nurses’ perceptions of the various aspects of the clinical learning environment on their learning experiences. Discussion: The impact of students’ perceptions of the clinical learning environment on their learning experiences is discussed. Recommendations are provided for measures to increase the focus on student-centered learning in the selected clinical context. Conclusion: The challenge remains to best prepare students for the complexities and dynamics of the workplace learning environment, while at the same time modifying this environment to effectively meet students’ learning needs.

This descriptive study used the Diagnostic Content Validity (DCV) and the Clinical Diagnostic Validation (CDV) models proposed by Fehring (1986) to clinically identify and validate the defining characteristics for Alteration in Tissue Perfusion: Peripheral. The Peripheral Vascular Assessment Tool (PVAT) was designed as the data collection tool; the DCV of the PVAT was 0.75. Twenty subjects, 18 years old and older, were selected from a population who were admitted as in-patients in one rural southwestern hospital. Data were collected through patient interviews, independent nurse assessment, and review of medical records. The CDV score for the validated tool was 0.62. No major defining characteristics and six minor defining characteristics were clinically validated. Differences in defining characteristics were found in the subjects with arterial occlusive disease and those with venous occlusive disease. Findings are applicable to nursing practice and research.

The purpose of this study was to determine what benefits have accrued as a result of five years of participation in mandatory continuing education by Florida respiratory care practitioners. The study also assessed the differences in characteristics between respiratory care practitioners who perceived benefits from participation in mandatory continuing education and those who did not; and it determined the perceptions of respiratory care practitioners regarding the effectiveness and accessibility of continuing education offerings since the implementation of mandatory continuing education. / A self-administered questionnaire was mailed to a stratified random sample of 300 respiratory care practitioners throughout the state of Florida. After initial and follow-up mailings, 81% were returned (N = 243). Results of the study indicated that the typical respondent may be described as a married female, 30 to 39 years old, held the CRTT credential, was employed full-time in a hospital as a staff respiratory care practitioner, had been employed for five to ten years, and completed an associate's degree in respiratory therapy. / Professional benefits were cited by the majority of the respondents over personal and educational benefits. Utilizing pre-determined criteria, the respondents were divided into two groups, "Benefitors" (38.7%) and "Non-benefitors" (61.3%). Significant differences were determined between the groups utilizing the Chi-square test of significance on the variables of sex, job position, and participation behavior. A discriminant analysis employed between the two groups yielded non-significant canonical discriminant functions. Comments made by the respondents regarding the effectiveness of the continuing education mandate were also reported. / Source: Dissertation Abstracts International, Volume: 51-09, Section: A, page: 2960. / Major Professor: Clyde F. Maurice. / Thesis (Ph.D.)--The Florida State University, 1990.

The purposes of this study are fourfold: (1) to examine job satisfaction among academic department chairpersons/division directors in four allied health disciplines in colleges and universities, (2) to identify factors that influence job satisfaction among chairpersons/division directors of baccalaureate and associate degree allied health academic department, (3) to identify differences in characteristics of academic department chairpersons/division directors which would influence job satisfaction, and (4) to determine the feasibility of the use of Maslow's hierarchy of needs theory in determining their job satisfaction. / The population consisted of allied health academic department chairpersons/division directors from 155 Medical Record Administration programs, 65 Occupational Therapy programs, 257 Radiologic technology programs, and 273 Respiratory Therapy (Respiratory Care) programs (n = 750). / The research method employed in this study was the survey method using a self-administered questionnaire. The questionnaire consist of two instruments: the Job Descriptive Index (JDI), Smith et. al. (1969) and Porter's needs fulfillment instrument, Porter, (1961). The data were collected through self-administered questionnaires. One hundred eighty-eight questionnaires were mailed with a return rate of 67% with 64% usable. / The results of this study indicated the following: (1) with the respect to the total sample; while not statistically significant for every job characteristic, the results generally indicated that higher ratings in job characteristics tended to be positively related to higher ratings in satisfaction with the work, (2) there was no significant difference between the means (at the.05 level) of the independent variables of discipline, formal academic preparation, classification of schools, type of institution, academic position, first administrative position, race (White/Non-White), and gender with the dependent variable of job satisfaction. However, there was a statistically significant difference between the means (p =.05) of those educationally prepared and those unprepared for the academic position and the subscale promotion for the JDI, (3) the needs categories most often reported as unsatisfied were the high level needs of autonomy and self-actualization, and (4) overall, most respondents indicated they would probably remain in the position for the next five years. / Finally, information derived from this study can be utilized to improve selection, retention, and self-motivation of allied health academic department chairpersons/division directors. This will contribute to the improvement of allied health education, and thus, the quality of care delivered by graduates of baccalaureate and associate degree programs in the allied health sciences. / Source: Dissertation Abstracts International, Volume: 52-08, Section: A, page: 2763. / Major Professor: Allan Tucker. / Thesis (Ph.D.)--The Florida State University, 1991.

The purpose of this research was to discover concepts and hypotheses related to nurse participation in patient education at the bedside. Naturalistic inquiry was used to explore patient education practices in one community hospital in South Florida. For nine months the researcher worked alongside nurses in the process of conducting fieldwork. Ethnographic methods of participant observation, informant interviewing, document analysis, and journal writing amassed a body of descriptions from which a theoretical model of the dynamics of nurse participation in patient education took form. / The emergent model is a comprehensive, hypothetical framework that includes four sets of variables: (1) Situational variables, including physical (fixtures, messages, and educational resources) and social (patients, doctors, peers, and management). (2) Intrapersonal variables, composing a hypothetical profile of the nurse as defined by the presence of three extremes of contrast (task versus process orientation, role clarity versus role ambiguity, and patient dependence versus patient independence). (3) Valuational variables, operationalized as nurse perceptions of the value of content to doctors and to patients. (4) Participatory variables, defined by four alternative roles (initiator, teacher, reinforcer, and facilitator). / Early in the research it became apparent that patient education is not a singular phenomenon but a complex of roles that nurses assume in helping patients learn. The emergence of a model, built incrementally from data derived from practice, serves as a tool for the development of theoretical hypotheses and research questions too numerous to state in a single study. More than forty hypotheses which have implications for both decision-making in practice (including legal, economic, and academic concerns) and the advancement of theory are given. / Important areas for future study include the development of measurement instruments for the above-mentioned sets of variables, verification of the hypotheses set forth, and testing of the model as a decision-making and theory-building tool. / Source: Dissertation Abstracts International, Volume: 48-12, Section: B, page: 3532. / Thesis (Educat.D.)--The Florida State University, 1987.

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.

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.