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Showing papers in "Journal of allied health in 2009"


Journal Article
TL;DR: Assessment of the attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education using the Interdisciplinary Education Perception Scale and Readiness for Interprofessional Learning Scale provides additional normative data on these tools that can be used when choosing tools to evaluate inter professional education attitudes.
Abstract: With the growing interest in interprofessional education and practice, methods to evaluate the effectiveness of related curricular activities are essential. The purpose of this study was twofold: ( 1 ) to assess the attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education using the Interdisciplinary Education Perception Scale and Readiness for Interprofessional Learning Scale and (2) to compare data with normative data previously reported. The two instruments were administered to 474 first-year students in medicine, nursing, occupational therapy, and physical therapy who completed the forms in the context of a workshop at the conclusion of the first year of an interprofessional health mentor program. Differences among professions were reported. Students in medicine and physical therapy rated members of their own professions significantly higher in the areas of competence/autonomy and need for cooperation as compared with those in nursing and occupational therapy. Along with reporting similarities and differences, the results provide additional normative data on these tools that can be used when choosing tools to evaluate interprofessional education attitudes. J Allied Health 2009; 38:196-200. INTERPROFESSIONAL EDUCATION "occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care."1 The National Health Service workforce plan in the United Kingdom in 2000 highlighted the need to prepare students for interprofessional practice and recommended the development of prelicensure common learning curricula.2 Interprofessional education has the potential to improve understanding among members of the health care team with the goal of enhancing patient and health outcomes.3 The Institute of Medicine, which provides advice on national health issues in the United States, has also emphasized the need for all health professionals to be educated to provide patient-centered care as members of interdisciplinary teams.4 The president of the Association of American Medical Colleges, representing allopathic medical schools in North America, designated interprofessional education and practice as key areas of its strategic plan in 2008. 5 The most recent Cochrane Review6 (an international organization that systematically reviews the effects of health care interventions) summarized the empirical research evidence on both prelicensure and postlicensure interprofessional collaborative interventions. They found that only six studies met the randomization design and instrument validity criteria, four of which showed positive improvement in outcomes. These four studies included methods to improve collaboration and patient care, including changes in the culture of an emergency department with associated patient satisfaction, collaborative team behavior and reduction in clinical error rates for emergency department teams, enhanced management of care delivered to domestic violence victims, and improvements in the competence of mental health practitioners related to the delivery of patient care. Additionally, in July 2008, a Canadian Interprofessional Health Collaborative report provided a synthesis and critical appraisal of the evidence for interprofessional education in the systematic review literature.7 Varying strategies to promote interprofessional education have been reported in the literature,8-14 along with reports on evaluation of interprofessional education interventions.15-17 With the growing importance of interprofessional education and practice, methods to evaluate the effectiveness of interprofessional curricular activities are essential. The purpose of this study was twofold: (1) to assess the attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education using the Interdisciplinary Education Perception Scale (IEPS) and Readiness for Interprofessional Learning Scale (RIPLS) and (2) to compare data with normative data previously reported by Hawk et al. …

70 citations


Journal Article
TL;DR: It is indicated that it is feasible to deliver a successful IPE session to a large cohort of first-year students and the findings presented in this report can be of value to other interprofessional groups of course developers.
Abstract: Effective interprofessional collaboration is an important factor in addressing health care needs and priorities. Educators and health care practitioners have argued that interprofessional education (IPE) is necessary to equip students with the knowledge, skills, attitudes, and behaviors to work collaboratively and ultimately deliver enhanced patient/client care. The University of Toronto has implemented an introductory IPE session for approximately 1000 health science students that focuses on teamwork. This session provides students with an opportunity to be sensitized to the client's perspective and become familiar with roles and perspectives of different professions. A mixed method pre/post research design was developed to examine changes in students' perceptions and attitudes regarding IPE following their participation in this session. This study also endeavored to explore the pedagogic effectiveness of this large-scale IPE session. Students completed pre and post surveys based on the Interprofessional Attitudes Questionnaire and the Interdisciplinary Education Perception Scale. A total of 399 surveys were matched for pre/post analysis, and 25 students participated in follow-up focus group interviews. Findings from this study reveal that a significant shift in many indicators occurred after this single intervention. Despite the large numbers of students, which meant a complex range of logistical factors to negotiate, our findings indicated that it is feasible to deliver a successful IPE session to a large cohort of first-year students. We suggest that the findings presented in this report can be of value to other interprofessional groups of course developers.

69 citations


Journal Article
TL;DR: This report demonstrates the application of a competency model to the regulated and unregulated professions of medical radiation technology, social work, pharmacy, and psychology in an effort to make the cultural shift from discipline-based silos to a common language for ascertaining the skills, knowledge, and attitudes needed to function in interprofessional teams.
Abstract: This report demonstrates the application of a competency model to the regulated and unregulated professions of medical radiation technology, social work, pharmacy, and psychology. The competency model is based on the CanMEDS framework and was originally applied to the professions of medicine, occupational therapy, physical therapy, and nursing in an earlier work. The framework identifies the core competencies common to learners in health care, which are professional (and health advocate), expert, scholar, manager, communicator, and collaborator. In this report, these core competencies are applied to four additional disciplines in an effort to make the cultural shift from discipline-based silos to a common language for ascertaining the skills, knowledge, and attitudes needed to function in interprofessional teams.

67 citations


Journal Article
TL;DR: The current findings demonstrated an appreciably higher percentage of falls (62.1%) than the national average and those 50 to 60 yrs old reported more falls than those in the other three age categories.
Abstract: The current descriptive study examined the prevalence, selected fall-related contributing factors, and ramifications of falls over 4 yrs in 663 community-dwelling adults older than 50 yrs. The current findings demonstrated an appreciably higher percentage of falls (62.1%) than the national average (33%). Unlike in past studies, those 50 to 60 yrs old reported more falls than those in the other three age categories (61-70, 71-80, and 81+ yrs). The current population reported a higher percentage of injuries from falls (80.3%) and sustained more cuts and bruises than reported in previous studies. Walking was cited as the most frequent cause of falling among both genders and all age groups. Significant findings were as follows: (1) women fell more often than men in the 71- to 80-yr-old group (X2 p value Language: en

63 citations


Journal Article
TL;DR: Members of the Journal's Editorial Board met on October 21 during the 2009 Annual Conference of the Association of Schools of Allied Health Professions in San Antonio, Texas, and were informed that the 12month period October 2008 to September 2009 was a productive one for this publication.
Abstract: According to an analysis conducted for the period September 1, 2009 to September 30, 2009 by the firm Publishing Technology pic, of more than 13,000 journal titles on IngentaConnect, the Journal of Allied Health ranks 86th with 1,141 full-text downloads, most of which were accessed through the National Library of Medicine. Ingenta is a company in the United Kingdom involved in placing each issue of the Journal online. Members of the Journal's Editorial Board met on October 21 during the 2009 Annual Conference of the Association of Schools of Allied Health Professions in San Antonio, Texas. They were informed that the 12month period October 2008 to September 2009 was a productive one for this publication. The tally is as follows: * 88 manuscripts submitted * 17 international manuscripts submitted * 20 manuscripts rejected Currently, more than 175 reviewers take part in assessing manuscripts that are submitted. This group is responsible for the high quality of the articles that eventually are published. A special note of thanks is extended to them for the time and effort that they devote to this worthy endeavor. The Awards Dinner at the Annual Conference provided an opportunity to present the J. Warren Perry Award for the best article in the past year to Nancy Sharby, DPT (Northeastern University), and Susan E. Roush, PhD (University of Rhode Island). Their manuscript is entitled "Analytical Decision-making Model for Addressing the Needs of Allied Health Students with Disabilities," which appeared in the Spring 2009 issue. The selection process consisted of taking papers that received the highest ratings by reviewers and then having them ranked by several members of the Editorial Board. Each of this year's winners was presented with a plaque. PRODUCTION OF A SPECIAL ISSUE The most recent editorial for this Journal alluded to the possibility of choosing single themes in order to produce an occasional special issue in the near future. Members who attended the Editorial Board meeting reacted positively to this prospect and identified some topics. One example would be to wait to see if proposed health reform legislation is enacted and, if it becomes law, to focus on various ramifications such as how it will affect the allied health professions and what its impact will be on accreditation. Individuals who are knowledgeable along such lines then will be requested to submit manuscripts for a special issue. Since the outcome of health reform efforts continues to be an uncertainty, two other worthy possibilities mentioned are: (1) an examination of the role of different allied health professionals in dealing with injuries sustained by combat veterans from Iraq and Afghanistan, and (2) interprofessional education and training. Because the latter topic is of major interest throughout the health professions, efforts are underway to devote a special issue to it. Kevin Lyons, PhD (Thomas Jefferson University), former chief editor of the Journal, has agreed to be the editor of this upcoming issue. PRIMACY AND HIERARCHY IN THE HEALTH PROFESSIONS An old joke involves the story of two immigrants to the United States who meet and fall in love. They eventually are married and as the wedding ceremony ended, the groom whispered in the bride's ear, "Well my dear, now we two are finally one." She responded, "Yes, and I'm the one." Another way of viewing the matter is to consider the observation by George Orwell in Chapter 10 of Animal Farm: "All animals are equal, but some are more equal than others." It is not unusual for some health professionals to view practitioners from other disciplines warily. To cite one example, by early 2006, in an effort to marshal the medical community's resources against a perceived growing threat of expanding scope-ofpractice for nonphysicians, a national partnership of medical organizations was formed. Its purpose is to fund research to refute key arguments that other professions use to advance their aims in state legislatures. …

59 citations


Journal Article
TL;DR: There is a need for greater inter professional socialization in education by creating a deliberate, planned, and integrated interprofessional socialization process that is consistent across the health professions, barriers to interprofessional practice could be mitigated.
Abstract: There is limited research on how health professionals are currently socialized to work interprofessionally. As part of a large-scale initiative funded by Health Canada, this report adds to our understanding of socialization and how it can prepare the health care student for an interprofessional health care environment. Data were collected through semistructured individual and group interviews with 83 respondents (i.e., faculty, students, health care and academic administrators, and health care providers) at seven clinical sites and five academic institutions throughout Alberta. Respondents indicated that socialization prepares health care students for interprofessional environments by "building a professional identity" and through what we are labeling "interprofessional familiarization" (i.e., where the goal is to introduce students to the roles and function of other professionals outside their own discipline). While there is interprofessional familiarization, it is neither consistently espoused as important nor systematically embedded in curriculum and clinical placements. Interprofessional competency building is lacking during this preparatory phase, leaving students ill prepared to work in interprofessional health care environments. We argue there is a need for greater interprofessional socialization in education. By creating a deliberate, planned, and integrated interprofessional socialization process that is consistent across the health professions, barriers to interprofessional practice could be mitigated.

56 citations


Journal Article
TL;DR: Clinicians' level of interest in research was significantly greater than their level of research experience, and clinicians as a whole only had "some interest" in research.
Abstract: Allied heath professionals are expected to utilize evidence-based practices in their workplaces, and there is an increasing expectation that clinicians will become involved in clinical research. With the aim of establishing the level of interest and experience in clinical research among allied health professionals in Australia, 132 allied health professional in Australia were surveyed to determine their level of interest and their level of experience in clinical research. The Research Spider survey tool was used to examine clinicians' level of research experience and level of research interest across ten core areas. These areas included writing a research proposal, using quantitative methods, publishing research, writing and presenting a research report, analysing and interpreting results, using qualitative research methods, critically reviewing literature, finding relevant literature, generating research ideas and applying for research funding. Overall, allied health professionals rated themselves as having "little research experience." While clinicians' level of interest in research was significantly greater than their level of research experience, clinicians as a whole only had "some interest" in research. Fifteen percent of the sample were very interested in research. The results of this study have implications for the implementation of education and support programs aimed at providing clinical research opportunities for allied health professionals.

46 citations


Journal Article
TL;DR: The predictors of energetic physical activity behavior were age, education, personal security score, and positive health beliefs, independent of health status, which have implications for planning and tailoring delivery of health promotion interventions.
Abstract: OBJECTIVES Physical activity is important health behavior for functional independence and quality of life in older people. This study examined factors that influence older people's engagement in physical activity. METHODS Data were analyzed from the first wave of the Melbourne Longitudinal Studies on Health Ageing program survey of 1000 persons aged 65 yrs and older living in noninstitutional settings in Melbourne, Australia. RESULTS Most people reported doing some physical activity in the previous 2 wks. Agreement that there was much older people can do to keep healthy influenced reported physical activity behaviour. Most respondents believed they did enough activity. Age, educational status, and income were also correlates of physical activity behavior. The predictors of energetic physical activity behavior (defined as engaging in both energetic and light activities in the past fortnight) were age, education, personal security score, and positive health beliefs, independent of health status. DISCUSSION These predictors have implications for planning and tailoring delivery of health promotion interventions.

42 citations


Journal Article
TL;DR: Analysis of self-reported transformational leadership behavior profiles within the six largest allied health profession groups in the National Health Service in Scotland identified significant differences in transformational leaders, indicating that some professional groups are inherently advantaged in embracing the modernization agenda.
Abstract: Objectives: The aim of this study was to explore selfreported transformational leadership behavior profiles within the six largest allied health profession groups in the National Health Service in Scotland and to determine whether factors such as seniority of grade, locus of employment, and/or leadership training have a positive influence on transformational leadership behaviors. Methods: A postal survey comprising the shorter version of the Multifactorial Leadership Questionnaire (MLQ) and contextual demographic information was completed by 753 allied health professionals from four Health Board areas across Scotland who were randomly selected through a modified cluster sampling technique. The MLQ contains 36 items that measure nine identified leadership factors; however, only the responses to the five transformational leadership factors are reported here. Results: The study identified significant differences in transformational leadership behaviors between individual allied health professions. Radiographers and podiatrists scored consistently lower than the other professional groups across the range of transformational behaviors. Seniority of grade significantly influenced the scores, with higher-graded staff reporting greater leadership behaviors (p THE INTERNATIONAL CHALLENGE to improve the delivery of health care by reforming and redesigning traditional models is increasingly contingent on effective clinical leadership at all levels. This is also recognized by the Scottish Executive Health Department through the investment made in leadership training for its medical, nursing, and allied health professional clinicians.1,2 The title allied health professional (AHP) is an umbrella term for 12 individual professions that deliver specialist health care in specific areas of expertise. The variety of skills and expertise possessed by this group is extensive and their potential contribution to transforming the delivery of health care is significant, with Wanless noting that up to 70% of doctors' tasks could be undertaken by other health care professionals, including AHPs,3 thereby not only maintaining and reducing costs but actually improving health outcomes. Strategic Context Within the United Kingdom, significant amounts of public funding have been spent investing in leadership development for those involved in clinical leadership in the National Health Service (NHS) in Scotland.4 In 2004, the NHS in Scotland published the Leadership Development Framework, demonstrating its commitment to developing leadership capacity and capability by incorporating leadership behavior as an equal partner to the more traditionally obvious strategic and service components within management.1 It is concerning, however, that the NHS Leadership Development Framework states that "there are certainly too many variables to consider evaluating return on investment, but on the other hand it is important to ensure that resources are being applied with the greatest impact." The strategic shift toward delivering health care within the communities in which people live, rather than from large acute hospitals,5 recognizes the need for well-developed leadership skills to facilitate such dramatic changes. The action plan from Building on Success-Future Directions for the Allied Health Professions in Scotland contains numerous references to AHP leaders delivering key aspects of service development. …

41 citations


Journal Article
TL;DR: The collaborative model--where two or more students complete a clinical education experience within a specific clinical area while supervised and educated by one primary clinical instructor (2:1 or 3:1)-- has been used historically within the Mayo Clinic's Department of Physical Medicine and Rehabilitation in PT and now OT.
Abstract: Clinical education experiences, a significant portion of entry-level professional education programs in physical therapy (PT) and occupational therapy (OT), commonly use a one student to one clinical instructor (1:1) model. Recently, though, the collaborative model of clinical education has received more attention in the professional literature and in clinical education experiences. The collaborative model--where two or more students complete a clinical education experience within a specific clinical area while supervised and educated by one primary clinical instructor (2:1 or 3:1)--has been used historically within the Mayo Clinic's Department of Physical Medicine and Rehabilitation in PT and now OT. Clinical instructors, referred to as clinical education coordinators, supervise and educate students as a primary job responsibility. Students also teach and learn from each other. This article describes the collaborative clinical education model used at the Mayo Clinic. Benefits and challenges of the model, feedback from students who have participated in the model, and the productivity implications of using the model are included.

41 citations


Journal Article
TL;DR: It appears that most entry-level physical therapy students are making a smooth transition to professional socialization, and 98% of the physical therapy educators view professionalism as an important component of a physical therapy curriculum.
Abstract: This study examined the opinions of physical therapy faculty relative to teaching and fostering professionalism in entry-level physical therapy education. A paper-and-pencil survey was mailed to a random sample of 318 physical therapy educators across the United States. Of the 318 surveys mailed, 166 participants (response rate, 52%) completed and returned the survey. Descriptive analysis revealed that 98% of the physical therapy educators view professionalism as an important component of a physical therapy curriculum. Eighty-nine percent of the respondents expressed concern about the professional behaviors of one or more of their entry-level students; however, based on the frequency of negative behaviors, these concerns appear to be isolated to a small percentage of the students. The most frequent negative behaviors observed among entry-level physical therapy students included tardiness and lack of personal responsibility. Respondents identified clinical reasoning, integrity, and honesty as the three most important professional skills for a physical therapist. The three most common teaching methods used to foster professionalism included generic abilities, small group discussion, and related reading assignments. Professional socialization is clearly a concern among physical therapy faculty for a few entry-level physical therapy students; however, based on the results of this investigation, it appears that most entrylevel physical therapy students are making a smooth transition to professional socialization. The information obtained from this investigation may be useful to allied health professionals and educators to help promote professionalism among entry-level students enrolled in professional programs. J Allied Health 2009; 38:74-80. ALTHOUGH PROFESSIONALISM has been a long-standing tenet of many professions, recent literature has expressed the need for further development of teaching and assessment methods related to fostering professional socialization among entry-level professional students.1-26 Professional socialization has been defined as a process by which students develop the requisite skills, knowledge, attitudes, and beliefs necessary for successful transition to professional status.27 Concern for professionalism has been expressed by many professions, including medicine,1-11 law,12 education,13 audiology,14 nursing,15-16 occupational therapy,17,18 and physical therapy.19"26 Despite the apparent interest in this topic cited in the literature, the attitudes and beliefs among entry-level physical therapy educators relative to fostering professional socialization are largely unknown. The purpose of this study was to examine issues related to teaching and fostering professionalism in entry-level physical therapy education from the perspective of physical therapy faculty. Medicine has invested considerable time and resources in an effort to improve professionalism among medical students and residents. In 1999, the American Board of Internal Medicine and the American College of Physicians sponsored a collaborative program to raise the awareness of professionalism among the medical profession.4 The founders of the program established a charter to guide future research and teaching endeavors and to promote professionalism within medical education. The charter has been translated into 10 major languages and has been adopted by almost every medical association in the United States and Europe. This project spurred several publications within the medical community and challenged other professions to examine issues related to professionalism.1-11 One outcome of this initiative has been the adoption of six values that characterize medical professionalism: altruism, accountability, excellence, duty, honor/integrity, and respect of others.4 In a similar attempt to foster professionalism, the American Physical Therapy Association (APTA) commissioned a group of 18 physical therapists to develop a set of core professional values in a consensus-based conference. …

Journal Article
TL;DR: In this article, the authors compared student satisfaction and objective learning outcomes of an undergraduate allied health online pharmacology course using streaming media lectures to traditional classroom instruction, and found that students in the online course were less satisfied with instructor rapport, course excellence, peer interaction, and self-perceived knowledge gains.
Abstract: UNLABELLED Online instruction is frequently utilized in allied health education yet only a small number of controlled comparative studies specifically in healthcare education have been published. PURPOSE The purpose of this study was to compare student satisfaction and objective learning outcomes of an undergraduate allied health online pharmacology course using streaming media lectures to traditional classroom instruction. METHODS The online (n=47) and classroom (n=177) courses for fall 2005 and spring 2006 used the same instructor, notes, text, learning objectives, and exams. Student characteristics, learning style preferences, and aptitude for distance learning were measured. A statistically reliable, valid survey measured student satisfaction with elements of the course, instructor, and self-perceived knowledge gains. Learning outcomes were evaluated using withdrawal rates and exam scores. RESULTS Mean satisfaction scores for both courses were high, generally >4.0/5.0. Mean scores from the classroom students were significantly higher than online students regarding students' ability to share ideas, instructor's ability to establish rapport, self-perceived knowledge gains, fundamental principles and application of material, and overall excellence of course. There were no significant differences in objective exam scores or withdrawal rates. CONCLUSION The online and classroom pharmacology courses had similar withdrawal rates and exam scores, indicating similar learning gains. Overall, both courses had high student satisfaction ratings in all 43 criteria measured. However, students in the online course were less satisfied with 8 criteria related to student satisfaction with instructor rapport, course excellence, peer interaction, and self-perceived knowledge gains.

Journal Article
TL;DR: The Delphi method of forecasting and exploration was used with a panel of 23 occupational therapists, currently practicing in emerging roles or settings, to gather specific information about the essential competencies and competency characteristics and to identify strategies for their future development.
Abstract: Many health professions face challenges and opportunities resulting in expanding contexts for service delivery. For the profession of occupational therapy, one element of this changing landscape is the ongoing development and delivery of services in new or underdeveloped practice settings, often identified as emerging practice. The purpose of this exploratory study was to identify the professional competencies needed for emerging practice and strategies for their development. The Delphi method of forecasting and exploration was used with a panel of 23 occupational therapists, currently practicing in emerging roles or settings, to gather specific information about the essential competencies and competency characteristics and to identify strategies for their future development. The Delphi panel identified 104 competencies essential to emerging practice and 55 strategies for the development of these competencies pertinent to occupational therapy educational programs and professional organizations. The study results are relevant to the educational preparation and professional development of health professionals for current and future practice roles and opportunities.

Journal Article
TL;DR: Job satisfaction with opportunities for advancement, job satisfaction with pay and benefits, and intent to leave the EMS profession among Nationally Registered EMTs and EMT-Paramedics is characterized.
Abstract: The primary purpose of this study was to characterize job satisfaction with opportunities for advancement, job satisfaction with pay and benefits, and intent to leave the EMS profession among Nationally Registered EMT-Basics and EMT-Paramedics. A secondary data analysis was performed on the National Registry of EMTs Longitudinal Emergency Medical Technician Attributes and Demographic Study Project (LEADS) 2005 core survey. We used chi-square and multiple logistic regression analyses to test for differences in job satisfaction with opportunities for advancement, job satisfaction with pay and benefits, and intent to leave the EMS profession across years of experience and work location. Among 11 measures of job satisfaction, NREMT-Basics and NREMT-Paramedics were least satisfied with opportunities for advancement and pay and benefits (67.8 and 55.2%, respectively). Nearly 6% of respondents reported intentions of leaving the profession within 12 months. In univariate analyses, job satisfaction with advancement opportunities varied across years of experience and work location. Job satisfaction with pay and benefits varied across years of experience and work location. The proportion reporting intentions of leaving the profession did not vary across the two independent variables of interest. In multivariable logistic regression, statistical differences observed in univariate analyses were attenuated to non-significance across all outcome models. Income, personal health, level of EMS certification, and type of EMS work were significant in several outcome models. EMS workforce research is at its infancy, thus our study adds to a limited but growing body of knowledge. In future and replicated research, one will need to consider different person and organizational variables in predicting different measures of job satisfaction among EMS personnel.

Journal Article
TL;DR: Issues in the process of assessing mental health, diet quality, physical fitness and physical activity behaviours are described as are key components of the tailored treatment programs.
Abstract: Mental illness affects one in five Australians in any given year and depression, anxiety and substance abuse are the most prevalent of the mental health problems. Mental illness is traditionally managed with medication and psychological intervention but exercise and diet have also been shown to be related to mental illness and are associated with improvements in mental health. The present article aims to describe the background and practical issues arising from the establishment of diet and exercise assessments and intervention for people receiving treatment for depression and anxiety in general practice settings. Patients were referred by their general practitioners, and attended sessions either in rooms at their practitioner's surgery or at a central clinic location. The program involved an initial assessment, four individual consultations with a dually qualified dietitian and exercise physiologist, and a final assessment. Issues in the process of assessing mental health, diet quality, physical fitness and physical activity behaviours are described as are key components of the tailored treatment programs. Strategies for improving motivation and adherence such as adjusting frequency of sessions, use of homework and means of communication are highlighted.

Journal Article
TL;DR: Inpatient stroke rehabilitation has an impact on the rehabilitation process as evidenced by the improved FIM scores at discharge, and future prospective research investigating the specific types of therapeutic interventions provided by each rehabilitation discipline is warranted.
Abstract: Purpose The purpose of this study was to describe the outcomes, frequency, duration, intensity, and the specific types of therapeutic intervention of inpatient stroke rehabilitation specific to one hospital in the upper midwestern region of the United States following implementation of the IRF PPS Design This was a non-experimental retrospective chart review of individuals who received inpatient stroke rehabilitation from January 2003 to June 2004 Methods A total of 80 medical records met inclusion and exclusion criteria Data were collected on patient and clinical characteristics, FIM scores, LOS, and discharge location as well as the intensity, frequency, and total number of occupational therapy (OT), physical therapy (PT), and speech therapy (ST) treatment sessions, the type of therapy sessions provided, and the type of therapy service providers Results LOS was 1519 days +/- 1169 There was a significant difference (t =-12163; p = 000) between FIM total admission score (7190 +/- 2147) and FIM total discharge score (9223 +/- 2443) ) There was a significant difference in FIM discharge scores (F = 26494; p = 000) based on discharge location with differences found between the discharge locations of home and skilled nursing facilities (p = 000) and skilled nursing facilities and assisted living facilities (p = 019) Mean number of therapy sessions per subject was 2173 +/- 1811 for OT, 2199 +/- 1810 for PT, and 1886 +/- 1871 for ST Mean number of sessions per day was 172 +/- 031 sessions for OT, 165 +/- 036 sessions for PT, and 152 +/- 048 for ST Mean number of minutes provided per session was 2987 +/- 177 minutes for OT, 2970 +/- 165 minutes for PT, and 2723 +/- 664 minutes for ST Mean intensity (days of therapy/length of stay) was 082 +/- 013 for OT, 085 +/- 013 for PT and 070 +/- 024 for ST Of the total OT sessions, 9741% were conducted by the OT and 7768% were intervention only Of the total PT sessions, 6566% were conducted by the PT, 1535% were by the PTA, and 9267% were for intervention only Conclusions These findings suggested inpatient stroke rehabilitation has an impact on the rehabilitation process as evidenced by the improved FIM scores at discharge Individuals who received inpatient rehabilitation for stroke at this facility stayed just over 2 weeks and improved on average by 20 points on the FIM The patients in this study were seen for skilled OT, PT, and ST for about 30 minutes per session, 15 times per day, and received therapy services for 5 to 6 days per week on average Future prospective research investigating the specific types of therapeutic interventions provided by each rehabilitation discipline is warranted in order to gain a clearer understanding of the effectiveness of inpatient stroke rehabilitation

Journal Article
TL;DR: The influence of the timing of teaching critical thinking skills in the resulting differences between the two curricula, as well as the validity of the Watson-Glaser Critical Thinking Appraisal is a valid measure of critical thinking changes in allied health students are discussed.
Abstract: This study evaluated whether critical thinking ability can be improved through participation in occupational therapy (OT) and physical therapy (PT) curricula. The researchers compared levels of the critical thinking skills of OT and PT students at the beginning and end of their programs to determine whether changes occurred and to examine facets of the curricula that may have caused the differences. The curricula include teaching strategies of problem-based learning modules, small group discussion and problem-solving, case studies, clinical observation, and evidence-based practice assignments, as well as teaching about critical thinking as a process in itself. Fifty OT and PT students completed the Watson-Glaser Critical Thinking Appraisal at the beginning and end of 20 mos of the academic phase of their master's degree programs. Researchers analyzed the data using a one-way repeated-measures ANOVA. Results showed no differences between OT and PT students on the pretest or post-test and no differences for PT students between the pretest and post-test. OT students' scores increased significantly from pretest to post-test. The influence of the timing of teaching critical thinking skills in the resulting differences between the two curricula, as well as the validity of the Watson-Glaser Critical Thinking Appraisal is a valid measure of critical thinking changes in allied health students are discussed.

Journal Article
TL;DR: This study shows that Emphases on the individual characteristics of Boomer, Generation X, and Generation Y workers need to be contextualized within broader political, social, and structural factors that take account of gender and the changing needs of workers over their life span.
Abstract: The recruitment and retention of allied health workers present challenges for organizations in Australia and internationally. Australia, in common with other developed countries, faces the prospect of a rapidly aging population and the high turnover of younger allied health workers (the majority of whom are female) from employing organizations. Emphases on the individual characteristics of Boomer, Generation X, and Generation Y workers may provide a useful starting base for recruitment and retention strategies, but our study shows that these need to be contextualized within broader political, social, and structural factors that take account of gender and the changing needs of workers over their life span. J Allied Health 2009; 38:215-219. ALLIED HEALTH PROFESSIONALS are health care practitioners who have undertaken formal and in some cases clinical training in disciplines such as physiotherapy, speech pathology, occupational therapy, and health promotion. The recruitment and retention of allied health professionals within the Australian health workforce presents many challenges for employing organizations, and the difficulties associated with this have been well documented.1,2 Problems of high turnover, professional isolation, and hard-to-fill long-term vacancies are particularly an issue in rural areas in Australia.3"5 Shortages of culturally appropriate allied health workers and health workers who are prepared to work in rural areas are also issues for the United Kingdom, United States, and Australia.6"8 The allied health workforce in Australia is young compared with the general health workforce and is predominantly female.1,9 It is also a more mobile workforce compared with other medical professionals.1 Our study explored the reasons allied health workers from the ages of 20 to 39 and 40 to 60+ yrs stayed in, or left, their positions. Our discussion focuses on the three generational groups that have been categorized in human resources and social sciences literature that fall within the age ranges of Generation X (30-39 yrs), Generation Y (20-29 yrs), and Boomer (40-60+ yrs).10"12 We discuss the employment-related characteristics that have been commonly associated with these generations and examine how othet factors such as gender, family-friendly policies, and flexible work conditions affect the recruitment and retention of younger and older allied health professionals. AIMS The broad aim of the study was to explore reasons for the lack of continuity among occupational therapists, physiotherapists, and speech pathologists working in pediatric services in the health and disability sectors in the three states of Western Australia, Tasmania, and Queensland. It was hoped that recommendations addressing recruitment and retention issues would result from the research. Methods Our study used a mixed methods approach of both quantitative and qualitative methods. In 2001, a survey was jointly developed between the Institute for Service Professions (Edith Cowan University, Bunbury, Western Australia, Australia) and Therapy Focus Inc. (Bentley, Western Australia, Australia) and designed to elicit a profile of therapists working with children and young people aged 0-18 yrs working in the health, education, and disability sectors in Western Australia, Queensland, and Tasmania. The survey comprised three sections: the respondent's sociodemographic profile, details of their employment history since 1990, and open-ended questions on recruitment, retention, and mobility. The instrument was piloted on a cross section of staff employed at Therapy Focus Inc. A total of 1 ,685 surveys were mailed to physiotherapists, speech pathologists, and occupational therapists working with children and young people (aged 0-18 yrs) in the government and nongovernment pediatric disability sectors (including those working in the health and education sectors) in Western Australia, Tasmania, and Queensland. …

Journal Article
TL;DR: The integrated model of allied health clinical-academic practice has been effective in helping the University Department of Rural Health achieve its objectives and has great potential to promote collaboration and partnership between health service and academic institutions.
Abstract: The provision of high-quality health care to rural and remote populations requires recruitment and retention initiatives that target the allied health professions as well as medicine and nursing. This report describes a model of discipline-specific rural allied health practice that has been established in the Northern New South Wales University Department of Rural Health in Tamworth, Australia. Allied health academic staff members have been appointed in nutrition and dietetics, occupational therapy, diagnostic radiography, physiotherapy, and pharmacy. The appointees are required to teach in programs managed by the University of Newcastle's Faculty of Health, develop and suppott continuing education opportunities for their professional colleagues, conduct and supervise research, and perform clinical practice in their field. The positions thus integrate both clinical and academic roles. The integration of roles has been successful in increasing rhe number and quality of student placements by close collaborarion with local clinicians. Overlapping of the clinical, research, and education roles has also encouraged clinicians' involvement in research and further education and generally promoted collaboration across the health service and tertiary education sectors in the region. The integrated model of allied health clinical-academic practice has been effective in helping the University Department of Rural Health achieve its objectives. The model has great potential to promote collaboration and partnership between health service and academic institutions. Extending the model to other allied health disciplines and other regions could help to improve recruitment and retention. J Allied Health 2009; 38:236-241 . THE HEALTH WORKFORCE SHORTAGE in rural and regional areas of Australia highlights the urgent need fot sttategic long-term workforce planning and tatgeted resource allocation. However, the provision of high-quality health care to rural and remote populations is not just about tecruiting and retaining more physicians and nurses. A strategy must be put in place that also targets the allied health professions. In Australia, the allied health professions comprise about 18% of the health care workforce, whereas medical practitioners make up about 16% and nurses about 65%.' The ratio of allied health professionals to population falls from 2.66 per 10,000 in capital cities to between 1.81 and 1.41 in regional areas,2 indicating a maldistribution that favots metropolitan ateas. In "remote" and "very remote" areas, the ratio is even lowet at 1.17 and 0.60, respectively. Medicine has a similar workforce maldisttibution, wheteas in nursing there are generally higher ratios of nurses to population in turai and remote locations compated with major cities.3 There is clearly a need to address rural allied health career pathways in addition to those of medicine and nursing. It can be argued that the standard of health care in rural and remote areas should not be expected to teach the same level as that in metropolitan areas unless the availability and access to all health services, including those delivered by allied health professionals, are addressed. It must also be said that rural allied health professionals often perform extended roles involving interprofessional team-based care as part of theit routine duties.2,4,5 The oppottunity in rural practice to work collaboratively or to extend roles beyond traditional occupational boundaries is potentially attractive to both eatly-cateer practitionets and those with yeats of experience who desire a change of career direction. Rural areas can be well suited to the development of new allied health practice models that incotporate collaboration across professional boundaries and across the health and university sectots. However, undergraduate education in the allied health professions in Australia is largely urbanized and centralized in the metropolitan-based universities. …

Journal Article
TL;DR: Results indicate IHSS are becoming more Culturally Aware as a result of CCMR participation; however, they have not achieved Cultural Proficiency.
Abstract: Introduction The University initiated an Interdisciplinary Health Sciences Students (IHSS) education program, Cultural Competency & Mutual Respect (CCMR), for medicine (MED), pharmacy (PHARM), nursing (NSG), physical (PT) and occupational therapy (OT). This study assessed CCMR pre/post learning outcomes through the Inventory for Assessing the Process of Cultural Competence-Revised((c)) (IAPCC-R). Methods Subjects included: 100 MED, 140 NSG, 36 PT, 11 OT and 53 PHARM IHSS. IAPCC-R(c) completed by IHSS: 263 Fall, 2003; 48 Spring, 2004. Controls included 100 MED and 36 PT. Pre/post test scores were calculated. Paired analyses performed, comparing overall CC scores and constructs, p Results Overall pre versus post mean scores: 2003: 69.75 and 71.62; 2004: 66.77 and 71.85. Paired t-test 2003: MED t = -3.1976 P > t = 0.0020; NSG t = 0.5196 P > t = 0.6064; PT t = 4.7181 P > t=0.0000; 2004: PHARM t =-3.7861 P > t=0.0006; All other t = -1.7392 P > t = 0.1425. Two sample t-test, significant only for post-module for Hispanic/Asian/other, 77.50, White, Non-Hispanic 70.37. Discussion Results indicate PT, MED, PHARM attained significant scores for constructs: Attitudes, Knowledge, and Skills; but not Encounters and Desires. Post-test scores indicated progressions approaching CC, however not yet Culturally Proficient. Conclusion Results indicate IHSS are becoming more Culturally Aware as a result of CCMR participation; however, they have not achieved Cultural Proficiency. The constructs of Cultural Desire and Encounters warrant curricular enhancement for progression towards Cultural Proficiency.

Journal Article
TL;DR: Rehabilitation professionals in long-term care demonstrated clinical reasoning within the context of patient-centered goals and well-developed and explicit programs for mentorship, professional development, and continuing education fostered their clinical reasoning abilities.
Abstract: The purpose of this qualitative research was to evaluate the reasoning of clinicians practicing in long-term care facilities and to explore factors influencing their professional development. Eighteen participants were recruited from eight clinical sites and included seven occupational therapists, eight physical therapists, and three speech therapists distributed across three groups relative to experience. Nonparticipant observation and videotape of therapist-patient interactions were used in semi-structured interviews with each participant. Qualitative data analysis software was used during a process of open and axial coding, followed by thematic analysis. The facilitory and inhibitory factors that affect clinical reasoning and professional development were identified. Rehabilitation professionals in long-term care demonstrated clinical reasoning within the context of patient-centered goals. Well-developed and explicit programs for mentorship, professional development, and continuing education fostered their clinical reasoning abilities. Participants perceived that these factors were vital to achieving optimal patient outcomes. J Allied Health 2009; 38:143-151. CONTEMPORARY LITERATURE indicates that effective clinical decision-making is the foundation of optimal patient management. While it is known that decision- making is shaped by prior experience,1"6 little is known about the type and scope of experiences that are most facil- itory in developing the abilities and attributes consistent with expert decision-making. Through study of the prior experiences of rehabilitation professionals, it is possible to gain insight into how their clinical decision-making thought processes develop. Knowledge of facilitory experiences identified by clinicians can be used to guide the professional development of rehabilitation professionals. This succinct definition of clinical decision-making, "reasoning that results in action,"7 captures the factors that contribute to the decision-making process. Three important premises are assumed in this definition: 1) thought that leads to action requires deliberation about an appropriate course(s) of action; 2) reasoning occurs within a specific context; and 3) there is an anticipated outcome. Across the disciplines of medicine, nursing, occupational therapy, and physical therapy, there are differences in the way that clinical decision-making has been studied. For example, the research on clinical decision-making in medicine has focused on reasoning processes and decisionmaking models used by practitioners.1,2,8 Study within the nursing field has focused on quantifying the use of clinical decision-making,9-13 the field of physical therapy has focused on behavioral attributes demonstrated by the clinicians,14-17 and the occupational therapy literature has described models of clinical reasoning during initial assessment18 as well as clinical reasoning across therapist-patient interactions throughout the episode of care.19-21 Contemporary clinical practice incorporates evidencebased practice to direct the best practice for patient management and attainment of optimal patient outcomes. Evidence-based practice integrates clinical expertise, best available evidence, and patient values.22 Clinical judgment includes declarative and tacit knowledge. Declarative knowledge is based on formal education and research, while tacit knowledge is the intuitive way in which clinicians think about and organize information that is gained through practice.23 Clinical judgment develops through observation and practice of these tasks and activities. The tacit elements are the personal and professional experiences that provide the framework used for thinking about and judging information to develop an appropriate plan of action. While these clinical reasoning processes, abilities, and behavioral attributes have been described in the literature, this has not been explored within the context of the long-term care setting. …

Journal Article
TL;DR: The use of standardized clients in a simulation learning experiences and the responses of occupational therapy students to the instructional modality are described.
Abstract: Standardized patients assist with the education of medical, physical therapy and nursing students. However, the literature does not discuss the use of these learning experiences with occupational therapy students. This article describes the use of standardized clients in a simulation learning experiences and the responses of occupational therapy students to the instructional modality. Qualitative data was analyzed and resulted in the following themes: "I felt like a therapist," "I integrated knowledge and applied my skills with the help of my partner," and "The experience could be enhanced." On a survey, students rated the live simulated learning experience higher than all other instructional methods presented. Included are recommendations for structuring activities using simulated clients and future research.

Journal Article
TL;DR: The LEP Hispanic/ Latino adults in this survey were generally aware of major health-related conditions common among Hispanics/Latinos and the presence of LEP did not significantly impact awareness of common health conditions in Hispanic/Latino communities.
Abstract: BACKGROUND Limited English proficiency (LEP) and other sociodemographic factors are believed to impact health knowledge, healthcare access and overall health status. However, the role LEP plays in the overall health awareness and receipt of healthcare services is not adequately understood. METHODS We surveyed 60 LEP Hispanic/Latino adults to determine their awareness of common health conditions in Hispanic/Latino communities and describe their experiences accessing and utilizing health services in the Charleston, SC area. RESULTS Awareness of Common Health Conditions: The majority of participants identified alcoholism as an important health condition among Hispanic/Latino adults. Other common health conditions reported included drug use, diabetes, HIV/AIDS, and cancer. Access to Health Services: All of the participants reported problems obtaining needed health services in the past. Problems reported were associated with costs, insurance and lack of Spanish-speaking service providers. Utilization of Health Services: More than 70% of the participants went to the doctor when they were sick, but 50% had never had a physical examination. CONCLUSIONS The LEP Hispanic/Latino adults in this survey were generally aware of major health-related conditions common among Hispanics/Latinos. The presence of LEP did not significantly impact awareness of common health conditions in Hispanic/Latino communities. Healthcare access and utilization were influenced by a number factors associated with the local healthcare system.

Journal Article
TL;DR: Using a sample of 854 emergency medical service (EMS) respondents, this study supported a four-dimension model of occupational commitment, comprised of affective, normative, accumulated costs, and limited alternatives, and general job satisfaction emerged as a negative correlate of intent to leave.
Abstract: Using a sample of 854 emergency medical service (EMS) respondents, this study supported a four-dimension model of occupational commitment, comprised of affective, normative, accumulated costs, and limited alternatives. When personal and job-related variables were controlled, general job satisfaction emerged as a negative correlate of intent to leave. Controlling for personal, job-related, and job satisfaction variables, affective and limited alternatives commitment were each significant negative correlates. There were small but significant interactive effects among the commitment dimensions in accounting for additional intent to leave variance, including a four-way interaction. "High" versus "low" cumulative commitment subgroups were created by selecting respondents who were equal to or above ("high") versus below ("low") the median on each of the four occupational commitment dimensions. A t-test indicated that low cumulative commitment EMS respondents were more likely to intend to leave than high cumulative commitment EMS respondents. J Allied Health 2009; 38:177-186. AS WORK ORGANIZATIONS continue to restructure and employer-employee relationships become less stable,1 many employees ate shifting their loyalty to a broader base of perceived stability, i.e., their occupation.2 However, despite often greater difficulties, such as lost income and retraining costs, employees also change occupations.3 More research is needed to study variables affecting intent to change occupation. The purpose of this study was to test the impact of occupational commitment dimensions on intent to change occupation in a sample of emergency medical service (EMS) respondents. Occupational retention has been identified as a major issue in the EMS field.4,5 A Model for Studying Changing Occupations and Empirical Research Review RHODES AND DOERING MODEL The only model of voluntary career change found in the literature was presented by Rhodes and Doeting,6 in which changing one's career "refers to movement to a new occupation that is not part of a typical career progression" (p631). Rhodes and Doering based their model on prior voluntary job turnover models, particularly Mobley, Griffeth, Hand, and Meglino.7 Rhodes and Doering theorized that personal factors (such as education level and earnings) as well as job-related factors (such as fit with work environment and growth opportunities) affected one's job satisfaction, leading to career or occupational satisfaction. Job satisfaction is generally viewed as a more transitory or dynamic work attitude than occupational satisfaction,8 which is assumed to be more stable.9 The gteater assumed stability of an occupational- vetsus job-related attitude is partly based on the idea of individuals' voluntarily changing jobs due to dissatisfaction with more dynamic issues such as supervision, coworkers, or working conditions, but often still remaining in the occupation or profession.9 The practitioner literature supports a much higher frequency of job change than occupational change.10 Reduced job satisfaction and career satisfaction lead to gteater career withdrawal cognitions (including intent to change careers) which, combined with search and availability of alternatives, then leads to actual career (occupational) change.6 EMERGING ROLE OF OCCUPATIONAL COMMITMENT Since the publication of the Rhodes and Doeting6 model 25 years ago, the terminology used and direction of research on occupational change have shifted somewhat. As noted earlier, career generally means occupation. Since the early 1990s, research has focused not on occupational satisfaction but on occupational commitment.11'13 Occupational commitment was initially broken down into three facets: affective, normative, and continuance.13 Affective commitment refers to one's emotional attachment to their occupation ("I want to stay"); normative commitment is a person's sense of obligation to remain in their occupation ("I should stay"); while continuance commitment refers to the individual's assessment of the costs associated with leaving one's occupation ("I have to stay"). …

Journal Article
TL;DR: The results of this pilot study favor the continuing practice of blended learning environments as a viable option for course delivery in health care education by implying a difference in satisfaction between cohorts.
Abstract: INTRODUCTION The undergraduate health professions student of the 21st century is very technology literate. In an attempt to provide these students with a forum to enhance learning, some educators have opted to integrate additional course materials via Internet classrooms while still maintaining the face-to-face interaction between instructor and learner. METHODS A retrospective analysis was performed with the student course evaluations and demographics of two groups of respiratory therapy students (one group participated a traditional learning environment and one group participated in a blended learning environment) in a baccalaureate degree program. The author employed SPSS quantitative data analysis software to conduct statistical analysis. RESULTS None of the studied variables showed a statistically significant difference (p =0.05). Further testing revealed an expected positive relationship between pre-existing GPA and the final examination grade as well as the final examination grade and the course grade (p = 0.05). No other positive relationships were noted. DISCUSSION The qualitative analysis implies a difference in satisfaction between cohorts; however, the quantitative analysis of the student evaluations does not provide statistically significant differences for any aspect surveyed in the anonymous standardized questionnaire. CONCLUSION The results of this pilot study favor the continuing practice of blended learning environments as a viable option for course delivery in health care education. The author recommends further study to explore this topic in depth with larger cohorts.

Journal Article
TL;DR: Six hundred occupational therapy practitioners from seven states responded to questions inquiring about the perceptions of the occupational therapy clinical doctorate degree, both at the entry-level and post-professional positions.
Abstract: Six hundred occupational therapy practitioners from seven states responded to questions inquiring about the perceptions of the occupational therapy clinical doctorate degree, both at the entry-level and post-professional positions. The majority of respondents does not approve of moving to the doctorate for entry-level practice, and are not interested in pursuing the degree personally. The most common reasons for the low interest are the respondents' belief that the degree will not further their careers, that practitioners cannot afford to stop working to pursue another degree, and that they cannot balance work, family, and education. The small number of respondents who are interested in the clinical doctorate degree want it for personal development and are interested in clinical practice specialization.

Journal Article
TL;DR: The article fills a gap in the literature by providing educators, researchers, therapists and managers with an overview of key issues to help inform ED service decision-makers, anticipate patient and departmental needs and identify areas for education, quality projects and research.
Abstract: Multi- and interdisciplinary allied health teams are an emerging service in Australian Emergency Departments (EDs). Using a literature review, this article describes the Australian ED policy and service context, factors affecting ED use, allied health roles, practices and impact. The article fills a gap in the literature by providing educators, researchers, therapists and managers with an overview of key issues to help inform ED service decision-makers, anticipate patient and departmental needs and identify areas for education, quality projects and research. Issues current in Australia will be relevant to other developed countries where the ED demand, particularly by older people with complex and chronic conditions is outstripping capacity.

Journal Article
TL;DR: Evaluated concept mapping as a learning tool for nutrition assessment among dietetic interns and its acceptability by internship preceptors perceived as effective in assisting interns to engage in critical thinking, to problem solve, and understand relationships among medical nutrition therapy concepts.
Abstract: Critical thinking and problem solving skills are currently emphasis areas in the education of allied health professionals Use of concept maps to teach these skills have been utilized primarily in nursing and medical education, but little has been published about their use in dietetics education Therefore the purpose of this study was to evaluate the potential efficacy of concept mapping as a learning tool for nutrition assessment among dietetic interns and its acceptability by internship preceptors Nineteen dietetic interns and 31 preceptors participated in a quasi-experimental pre-/post-design in which the concept mapping strategy was taught as a replacement for the traditional nutrition care plan The pre-concept map mean score was significantly lower than the post-concept mean score (2835 vs 11796; p=0001) based on the Student t-test, thus indicating improved critical thinking skills as evidenced through concept mapping Overall students' perceptions of concept mapping as a teaching-learning method were more positive than the preceptors' perceptions In conclusion, internship preceptors and dietetic interns perceived concept mapping as effective in assisting interns to engage in critical thinking, to problem solve, and understand relationships among medical nutrition therapy concepts However, preceptors had more negative attitudes toward concept mapping than the dietetic interns related to time and effort to complete and evaluate the concept map

Journal Article
TL;DR: Outcomes of the Smart Mothers Are Resisting Tobacco project support research that even brief tobacco cessation counseling, delivered by trained providers and coupled with pregnancy-specific self-help materials, can increase cessation rates in women during pregnancy.
Abstract: This article presents outcomes of the Smart Mothers Are Resisting Tobacco (S.M.A.R.T. Moms) project, a "5 A's"-based, best-practices intervention for prenatal smoking cessation targeting primarily pregnant WIC patients in Tennessee. Evidence-based training using "5 A's" materials were provided to health care providers. Providers in turn counseled patients on smoking cessation and provided individual cessation treatment plans with educational information and materials. At the conclusion of the 4-year project, 13,285 patients had received counseling and smoking cessation resources through the project. The overall success rate for participants who received counseling and agreed to use the self-help guide was 24.2% vs 20.9% for those who did not choose to use the self-help guide but did receive counseling, exceeding success rates previously found in similar settings. The outcomes of this project support research that even brief tobacco cessation counseling (5 to 15 min), delivered by trained providers and coupled with pregnancy-specific self-help materials, can increase cessation rates in women during pregnancy. Outcomes from this project also support that, when provided with adequate training and pregnancy-specific self-help materials, health care providers will more consistently counsel patients on smoking cessation during pregnancy. J Allied Health 2009; 38:170-176. PREGNANT SMOKERS represent a major public health challenge. Despite the Surgeon General's warnings about the dangers of tobacco use during pregnancy, a significant numbet of women continue to smoke during pregnancy. Tennessee has one of the highest rates of smoking and smoking-related deaths in the country and it is one of only five states that spent $0 on tobacco prevention during 2007. 1 Nationally, 1 1.4% of pregnant women in the US are identified as smokers,2 whereas the rate in Tennessee is 17.1%,3 the second highest in the nation. This rate is estimated to be even highet fot pregnant women who are socially disadvantaged, including women who ate covered by Medicaid4 and those who are unmarried, unemployed, or have less than a high school education.5 In 2005, 27,900 women received Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits. Of all pregnant WIC patients, 29.3% smoked, and in 5 out of 14 regions of Tennessee, the percentage of pregnant women who smoked ranged from 32% to 38%.6 Smoking is the single most important modifiable cause of poor pregnancy outcomes in the US.7 Studies have shown that between 25% and 60% of pregnant smokers quit smoking spontaneously when they learn they are pregnant.8-13 Smoking during pregnancy has been shown to contribute to adverse outcomes including miscarriage, placental abruption and separation, premature rupture of membranes, preterm delivery, low birth weight, increased prenatal mortality, still birth, and sudden infant death syndrome (SIDS).14-15 Economic estimates indicate that the direct medical costs of a complicated birth for a smoker are 66% higher than for a nonsmoker.16 It is estimated that in 1996 smoking-attributable neonatal expenditures accounted for $366 million in the US.17 Health care providers have compelling reasons to help pregnant women and mothers quit smoking. Many female smokers are motivated to stop smoking when they find out ttiey are pregnant. Smoking cessation provides immediate and long-term benefits for pregnant women and their young children. The US Surgeon General reported that infants of women who quit smoking by the third trimester weighed more than infants of women who continued to smoke throughout pregnancy. While quitting early in pregnancy is best, health benefits can be achieved from cessation at any time before delivery.18 Quit rates using "best practice" interventions are 14% to 16% versus 5% to 6% achieved with usual care.19 The Smart Mothers Are Resisting Tobacco (S.M.A.R.T. Moms) project is a statewide collaboration among Middle Tennessee State University, the Tennessee Department of Health, and the March of Dimes Tennessee chapter designed to educate pregnant women about the dangers of smoking and provide them with counseling from trained health care providers. …

Journal Article
TL;DR: The results of the present study indicate feeder school selectivity, GRE scores, and GPA are all independent predictors of probationary status.
Abstract: UNLABELLED Admission committee members have the important task of selecting candidates who have the best chance of academic success in their professional programs. Graduate record examination (GRE) scores and grade point average (GPA) are typically given heavy consideration in the admissions process. The purpose of the present study is to assess the impact of feeder school selectivity on the ability of GRE scores and GPA to predict probationary status in entry level physical therapy students. METHODS Three hundred five (249 female, 56 male) students, who graduated from an entry-level Doctor of Physical Therapy Program between 2001 and 2006, were included in this analysis. Feeder school selectivity was defined as either less selective/selective or more selective/most selective (US News and World Report 2005). Unpaired t-tests assessed differences in GRE scores and GPA between the less selective/selective and more selective/most selective groups. Receiver operating characteristic curve (ROC) analysis assessed the ability of GRE score and GPA to predict probationary status. Probation for at least one semester (Cumulative GPA 0.05). One hundred fourteen of the subjects attended feeder schools that were considered less selective/selective. Eighty-four students (28%( were on probation for at least one semester. Verbal GRE (ROC curve area: 0.62, p=0.001), Quantitative GRE (ROC curve area: 0.71, p<0.001), total GRE (ROC curve area: 0.69, p<0.001), total GPA (ROC curve area: 0.59, p=0.01) and undergraduate program rigor (ROC curve area: .64, p<.001) classification schemes were all significant predictors of probation. The optimal threshold values for Verbal GRE, Quantitative GRE, total GRE, and total GPA were 455 (sensitivity 61%, specificity 52%), 575 (sensitivity 69%, specificity 65%), 1025 (sensitivity 67%, specificity 61%) and 3.25 (sensitivity 64%, specificity 56%) respectively. The optimal threshold value for undergraduate rigor was 4 (sensitivity 70%, specificity 56%). DISCUSSION The results of the present study indicate feeder school selectivity, GRE scores, and GPA are all independent predictors of probationary status. Assessing feeder school selectivity in addition to GREs and GPAs during the admissions process may therefore be warranted.