A comparative study was conducted of the professional socialization process of student nurses in three nurse education centres in South Wales. Patterns and problem areas can be identified of relevance to issues in role theory and with practical implications for the more effective implementation of Project 2000. Three cohorts of students were interviewed using a semi-structured interview schedule whilst in the introductory block and at the end of the first year. The teaching and ward staff directly involved in the socialization process were also interviewed so that their views could be compared with those of the students. There were differences between the types of ward in the opportunities they offered for role modelling. It was doubtful whether the three categories of students, teaching staff and ward staff were all employing a single conception of 'the good nurse'. The student has to find her own pathway through the divergent and often conflicting values and philosophies of the teaching staff and those in authority on the wards. It is recommended that a more unified approach be adopted to reduce the conflict which learners experience. In accordance with Project 2000, the teaching staff should act as practitioners and thereby be perceived as a professional role model with clinical credibility.
Purpose: This paper describes a self-contained model of integrated clinical experiences (ICEs) that take place during the academic portion of an entry-level physical therapist education program in a campus onsite clinic. Description of Model: Students participate in ICEs for three consecutive semesters. Students provide pro bono physical therapy services to individuals with impairments, functional limitations, or changes in physical function resulting from a variety of health conditions. In addition, students participate in an exercise/wellness program for individuals who wish to improve or maintain their current levels of fitness. The first ICE consists of second-year students observing/assisting third-year students in the onsite clinic with basic patient care skills and participation in an exercise/wellness program. Students in the second and third ICEs provide ongoing one-on-one skilled therapy for individuals with neurological or musculoskeletal diagnoses. Results: Feedback obtained from onsite clinical instructors, core academic faculty, students, and patients receiving care in the onsite clinic through group debriefings, questionnaires, and interviews is used to assess students’ readiness for full-time internships and effectiveness of the ICEs. The feedback reveals that the ICEs are meeting their intended goals. Category ratings in the “red flag” areas of the Clinical Performance Instrument (CPI) are consistently above expected levels for students completing their first full-time clinical internship. In addition, patients receiving care in the onsite clinic report a high level of satisfaction with the care provided. Conclusion/Possible Recommendations: This model provides students with an opportunity to gain clinical confidence in a realistic setting while reinforcing concepts presented in academic coursework. Providing ICEs on campus decreases reliance on clinical facilities and allows for academic program oversight of the quality of the learning experiences and early identification of students who have deficits in clinical skills and/or academic knowledge. The learning experiences provided in the onsite clinic give students a transitional experience that helps them benefit more fully from full-time internships. A potential challenge to this model is finding the space and financial resources needed to make it viable.
The authors have no conflicts of interest and no source of funding to declare. ABSTRACTPurpose: Recent research suggests the use of noncontact low-frequency ultrasound (US) as an adjunct to standard wound care to facilitate the healing process. The purpose of this systematic review was to examine the effect of noncontact low-frequency US on the healing of chronic wounds.Methods: CINHAL and PubMed were used to identify studies published from 2000 to 2011 written in English with the key words ultrasound and debridement, chronic wounds, ultrasonic-assisted wound treatment, and MIST Therapy®, resulting in the retrieval of 51 potential articles. Ten studies met the inclusion criteria and were included in the review. Two reviewers independently rated study quality and extracted data concerning study methods, quality, and outcomes. Results:Nine of the studies reviewed demonstrated improved wound healing when noncontact low-frequency US was used either as the sole treatment or as an adjunct to standard wound care, whereas the findings of one study were inconclusive. Discussion/Conclusions:The literature reviewed supports the use of noncontact low-frequency US as an adjunct in the treatment of chronic wounds. The studies reviewed suggest that noncontact low-frequency US aids in the reduction of wound volume and that healing occurs at a faster rate than with standard wound care alone. Evidence is limited by the existence of only two studies with control groups. Future research should use comparison groups and focus on dosing parameters, outcomes on the basis of the wound type, and other meaningful patient outcomes such as wound pain or cost of treatment.
Oral therapy for erectile dysfunction with type-5 phosphodiesterase (PDE5) inhibitors has revolutionized treatment. This review presents a comprehensive update on PDE5 inhibitors and covers areas including erectile physiology, pharmacology, dosing and side effects. In addition, the use of these drugs in certain clinical situations including cardiovascular disease, as well as a discussion of rare adverse events, daily dosing, use of these drugs for the treatment of lower urinary tract systems, recreational use, novel uses for PDE5 inhibitors, and strategies for treatment failures are covered in detail. Because of the widespread use of PDE5 inhibitors for the treatment of erectile dysfunction, a comprehensive under-standing of these issues by health-care providers is necessary to ensure safe and effective prescribing practices and to improve patient satisfaction and quality of life.
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