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This article discusses the evolving role of advanced clinical practitioners in outpatient clinics and investigates required competency and governance and how this translates into patient care. Until recently, there has been little clear guidance in terms of how to cultivate and develop staff to the level of practice required for autonomous management of the patient pathway. This has been variable, dependent on the employing organisation and the enthusiasm for advanced practice at a senior level. The current frameworks and competency documents available are identified and how the competent practitioner can provide safe, effective care. The authors use their own practice within gynaecology as an example.
Chronic pelvic pain is one of the most difficult conditions encountered by health professionals working with women both in primary and secondary care. The cause is variable, and for some women a diagnosis is never determined. While it is acknowledged that it is a symptom and not a condition, many women and professionals continue to seek a cause and cure. It is contended that this client group is best supported by a multidisciplinary approach to symptom control that incorporates the skills of the gynaecologist, physiotherapist, nurse, psychologist and pain management specialist. This is often difficult to achieve within a resource-limited environment. An alternative approach is suggested using current resources, which provides patient education and support, thus empowering women to influence their health behaviours and situations.
Describes the development in Australia of TeleQACE, a Web‐based learning environment, which allows clinicians to participate in interactive learning at times that suit them. The design addressed the balance between richness of content and bandwidth to reach geographically dispersed regions. The guiding philosophy was shared knowledge and interaction based around actual experience and cases developed by practicing academic general practitioners in consultation with specialists. A constructivist approach, focused on discussion to build a “basic case” into an “advanced case” over a learning cycle of 13‐16 weeks, was adopted. Knowledge gaps and suggestions from participants guided the development of a “basic” case into its “advanced” equivalent which was re‐presented to the participants, accompanied by relevant reference material, for reflection and interaction. The final outcome was a “model case”, archived for ongoing reference by the group. Participation rates appear to be consistent with other Internet‐based continuing medical education programs.
Many research studies show that predictions made at interviews often fail because of bias, failure to obtain the information required, or the inability to interpret information. To minimise these problems, a systematic approach to interviewing must be adopted.
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