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CLINICAL PRACTICE GUIDELINES FOR EMERGING ULTRASOUND APPLICATIONS: DRAFTING FOR VALIDITY AND USABILITY
Title
CLINICAL PRACTICE GUIDELINES FOR EMERGING ULTRASOUND APPLICATIONS: DRAFTING FOR VALIDITY AND USABILITY.
Creator
Borok, Katherine, Jones, Dan, University of Central Florida
Abstract / Description
Clinical practice guidelines (CPGs) are viewed by many people with interests in health care as valuable tools for reducing practice variations that undermine patient outcomes and increase medical costs. However, guidelines themselves vary in quality. Assessment tools generally base quality measures on strength of guidelinesÂÂ' evidence base, but particularly for newly emerging applications of ultrasound, standards for measuring guideline quality are controversial. The...
Show moreClinical practice guidelines (CPGs) are viewed by many people with interests in health care as valuable tools for reducing practice variations that undermine patient outcomes and increase medical costs. However, guidelines themselves vary in quality. Assessment tools generally base quality measures on strength of guidelinesÂÂ' evidence base, but particularly for newly emerging applications of ultrasound, standards for measuring guideline quality are controversial. The validity of a guideline is considered likely when strong research-based evidence supports its recommendations, but for newer medical procedures such as emerging ultrasound applications, available evidence is sparse. Existing assessment tools must be modified if they are effectively to measure the validity of these guidelines built on immature evidence. Focusing on ways document drafting affects CPG validity, this study rated six guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) tool which was customized according to categories of guideline purposes and their differing features of validity. Fine-tuning AGREE in this way may create a more consistent, informative method of evaluating guidelines for emerging applications, and standards established in such an instrument may be useful as a template during the guideline development process. Results from my analyses illuminate several common omissions that weakened documents. Most guidelines did not describe an updating procedure or identify areas for future research, but results also highlighted some highly effective techniques for building validity. Notable examples include providing full credentials for expert drafters, and embedding statement references directly in the text. From the results of the analysis, I conclude that, although the adapted assessment tool I used needs additional adjustment, it may refine analysis of guidelines for emerging ultrasound guidelines and conversely serve as a useful tool during their development process.
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Date Issued
2010
Identifier
CFE0003556, ucf:48925
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003556
THE PARTICIPATION OF OCCUPATIONAL THERAPY FACULTY IN CLINICAL PRACTICE
Title
THE PARTICIPATION OF OCCUPATIONAL THERAPY FACULTY IN CLINICAL PRACTICE.
Creator
Decker, Bonnie, Bozeman, William, University of Central Florida
Abstract / Description
The purpose of this research study was to examine the current use of clinical practice by full-time occupational therapy faculty members. Clinical practice, including faculty clinical practice and moonlighting were addressed. The seven research questions addressed were: (a) the perceived benefits of clinical practice as identified by occupational therapy faculty members; (b) the perceived barriers to clinical practice as identified by occupational therapy faculty; (c) if perceived benefits...
Show moreThe purpose of this research study was to examine the current use of clinical practice by full-time occupational therapy faculty members. Clinical practice, including faculty clinical practice and moonlighting were addressed. The seven research questions addressed were: (a) the perceived benefits of clinical practice as identified by occupational therapy faculty members; (b) the perceived barriers to clinical practice as identified by occupational therapy faculty; (c) if perceived benefits and barriers of clinical practice as identified by occupational therapy faculty differ as a function of their academic institution's Carnegie Classification (The Carnegie Foundation, 2000); (d) if perceived benefits and barriers of clinical practice differ among respondents according to tenure at the institution, tenure status, doctoral degree, rank, administrative duties, and gender; (e) the incidence of clinical practice in occupational therapy faculty members; (f) the relationship between participation in clinical practice and the Carnegie classification of the occupational therapy member's academic institution; (g) the characteristics (tenure status, doctoral degree, rank, administrative duties, and gender) of faculty members that participate in clinical practice either within or outside the faculty role; and (h) the characteristics of clinical practice as described by faculty members and how these differed if the clinical practice is conducted as part of the faculty role or outside the faculty role. Data were collected using an on-line survey that contained 43 questions designed to elicit information that addressed the research questions. The surveys were electronically mailed to the population of full-time occupational therapy faculty members obtained from a search of each academic program's website. A total of 224 responses were obtained. Descriptive statistics, ANOVAs, and Chi Square Test of Associations were used to analyze the data for the independent variables. The results showed that 60 respondents indicated that they participated in some type of faculty clinical practice as part of their faculty role. Most of this work was in a facility that was associated with the academic institution. Most of these respondents were not tenured, did not have a doctoral degree, and did not participate in administrative tasks. Most of these respondents worked in Doctoral-Extensive universities and held the Assistant Professor rank. Most worked two to four hours per week and did not receive release time or financial benefits. There were 99 respondents that indicated that they participated in moonlighting in a wide variety of settings. Most worked in their area of clinical expertise. Most of these respondents were not tenured and did not participate in administrative tasks. Only 37% had a doctoral degree. Over half had the rank of Assistant Professor. Almost 42% worked in Masters I academic institutions. Most worked less than 2 hours per week outside the faculty role and they received full financial benefits. The top three benefits for participating in clinical practice were to maintain clinical skills, enhance teaching, and improve credibility with students. The top three barriers for participating in clinical practice were teaching responsibilities, not a component in tenure decisions, and the additional responsibilities of practice. There were no statistically significant differences between the benefits or barriers to clinical practice and the Carnegie Classification of the respondent's academic institution. One ANOVA was significant between the barriers to clinical practice and if the respondent had a doctoral degree. There were no statistically significant differences between the benefits or barriers and tenure at the institution, the respondent's tenure status, the respondent's degree status, faculty rank, administrative duties, and gender except the respondents that had a doctoral degree had significantly higher barrier scores than those that did not have a doctoral degree. In general, less than five percent of the variance was explained by any of the independent variables. None of the Chi Square analyses revealed any significant differences between the academic institution's Carnegie Classification and if clinical practice was required, if a faculty participated in faculty clinical practice, or if a faculty member participated in moonlighting. In conclusion, although many faculty members recognize the benefits to participation in clinical practice, the barriers to clinical practice may be too great to outweigh the benefits for some faculty members. Most reported that clinical practice carried little weight in promotion or tenure decisions. In order for the scholarship of practice to flourish, active support from all academic institution administration is critical.
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Date Issued
2005
Identifier
CFE0000563, ucf:46438
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0000563
INSTRUCTIONAL PRACTICES IN ATHLETIC TRAINING EDUCATION PROGRAMS: "WHAT METHODS ARE OF MOST WORTH?"
Title
INSTRUCTIONAL PRACTICES IN ATHLETIC TRAINING EDUCATION PROGRAMS: "WHAT METHODS ARE OF MOST WORTH?".
Creator
Cummings, Nancy, Boote, David, University of Central Florida
Abstract / Description
This study sought to understand effective and ineffective instructional practices in clinical settings and to identify problem-solving strategies used by students and instructors. Three research questions were addressed: where in the undergraduate athletic training education program do students learn, or fail to learn, particular skills; "what instructional methods are of most worth" in teaching these skills, as perceived by the students; and what are the problem-solving strategies used by...
Show moreThis study sought to understand effective and ineffective instructional practices in clinical settings and to identify problem-solving strategies used by students and instructors. Three research questions were addressed: where in the undergraduate athletic training education program do students learn, or fail to learn, particular skills; "what instructional methods are of most worth" in teaching these skills, as perceived by the students; and what are the problem-solving strategies used by novice, experienced non-expert, and expert athletic trainers when confronted with novel situations. The subjects were nine students ("novices") and ten Approved Clinical Instructors (ACI's) from three programs in the Southeast United States. Five ACI's were categorized as "experienced non-experts" and five as "experts". All subjects were videotaped while performing various tasks. Each subject was required to think-aloud while they performed typical tasks expected of an entry-level certified athletic trainer, as designated by the NATA Education Council. Subjects then performed a stimulated-recall session, with analysis adapted from Ericsson and Simon (1993). The main findings of this study supported the well-respected teaching notion of "first teach them, then show them, then have them do it". Most concepts were first taught via lecture in the classroom; however, participants believed the "method of most worth" to be hands-on strategies displayed in clinical settings and labs. This study confirmed and disconfirmed aspects of prior research on problem solving. Experts: offered the most verbal comments, used their self-talk to stay on task, displayed intimate rapport with the models, and used various problem-solving strategies based upon the task at hand. Experienced non-experts: tended to drift in their verbal comments, felt the need to justify their answers, spoke mostly with verbal commands, and used several problem solving strategies. Novices: provided the fewest verbal comments, apologized throughout their sessions, often found the problem statement to be the problem itself, and used basic problem solving strategies. Demographics revealed that close relationships, balanced with manageable ACI's and clinical sites, created the most successful programs. Based on the findings of this study, future research must focus on how to best design the curriculum to take advantage of these "methods of most worth".
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Date Issued
2004
Identifier
CFE0000269, ucf:46217
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0000269
Use of Video-Enhanced Debriefing in Clinical Nursing Skill Acquisition: Indwelling Urinary Catheterization as an Exemplar
Title
Use of Video-Enhanced Debriefing in Clinical Nursing Skill Acquisition: Indwelling Urinary Catheterization as an Exemplar.
Creator
Hoyt, Erica, Gill, Michele, Clark, M. H., Chase, Susan, Gonzalez, Laura, University of Central Florida
Abstract / Description
Nursing students struggle to acquire and maintain clinical psychomotor skills. Hiring agencies bear the cost of retraining graduate nurses inept with skills learned early in their nursing curriculum. Improperly performed clinical skills pose a risk to patient safety, resulting in pain and suffering for the patient. This empirical study aimed to determine if video-enhanced debriefing (VED) improved initial skill validation scores, skill feedback, satisfaction with learning, and reduced skill...
Show moreNursing students struggle to acquire and maintain clinical psychomotor skills. Hiring agencies bear the cost of retraining graduate nurses inept with skills learned early in their nursing curriculum. Improperly performed clinical skills pose a risk to patient safety, resulting in pain and suffering for the patient. This empirical study aimed to determine if video-enhanced debriefing (VED) improved initial skill validation scores, skill feedback, satisfaction with learning, and reduced skill decay among first-semester, pre-licensure BSN students performing female indwelling urinary catheterization (IUC) in a simulated clinical setting compared to no debriefing. Participants received standard instruction, then video-recorded their IUC skill. Participants randomized into the VED group individually participated in an advocacy/inquiry debriefing with the principal investigator while viewing their performance video. Both groups completed a summative IUC skill validation per standard course instruction and submitted their skill performance ratings. All participants completed a survey including their perceived IUC knowledge, amount of skill practice, learning satisfaction with VED, and an evaluation of their skill performance feedback. All participants re-recorded their IUC skill and received performances ratings with the same instruments again ten weeks after the initial skill validation. The analysis revealed that VED did not improve nursing skills, knowledge, practice, or perceptions of the learning experience compared to the video-only group. Nursing students in the VED condition did rate their skill performance feedback higher than those in the video-only group. Students improved performance in both conditions, showing that learning via video is an effective teaching strategy to enhance student's satisfaction with learning, to engage in repetitive practice with feedback, and to improve learning.
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Date Issued
2019
Identifier
CFE0007656, ucf:52504
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007656
An Analysis of the Variables in Implementation of the Marzano Causal Teacher Evaluation System in the State of Florida
Title
An Analysis of the Variables in Implementation of the Marzano Causal Teacher Evaluation System in the State of Florida.
Creator
Phillips, Matthew, Murray, Barbara, Murray, Kenneth, Baldwin, Lee, Hutchinson, Cynthia, University of Central Florida
Abstract / Description
This was a non-experimental, mixed methods study to research the different ways in which the Marzano casual teacher evaluation system was implemented in 25 school districts in the state of Florida during the 2012-2013 school year. Based on seven implementation variables, the teacher evaluation systems were compared to the implementation model and research-based best practice. The researcher then sought to determine what relationships may or may not exist in teacher performance ratings between...
Show moreThis was a non-experimental, mixed methods study to research the different ways in which the Marzano casual teacher evaluation system was implemented in 25 school districts in the state of Florida during the 2012-2013 school year. Based on seven implementation variables, the teacher evaluation systems were compared to the implementation model and research-based best practice. The researcher then sought to determine what relationships may or may not exist in teacher performance ratings between districts that followed the research-based implementation model and districts that did not. Two stated purposes of the Marzano causal teacher evaluation system were to improve the accuracy of teacher performance ratings and to improve the accuracy of feedback provided to teachers. Variation in implementation may possibly occur among school districts. To date no research has been conducted to analyze how variations in implementation may relate to teacher performance ratings. The purpose of this study was to provide data to support best-practice in the implementation of the Marzano causal teacher evaluation system and to guide instructional leaders on the implementation of this evaluation system. The researcher also sought to ensure the Marzano causal teacher evaluation system provides both accurate teacher feedback and accurate teacher evaluations. Data was collected from the Florida Department of Education published reports and information. School district implementation plans were gathered from state submitted documentation. Implementation plans were analyzed and read. Data was collected on a data collection sheet and then analyzed in SPSS using a crosstab Chi square test to determine if a statistically significant relationships existed between districts that followed the research-based implementation model and districts that did not. It was determined that implementation of the Marzano causal evaluation system varies widely. In six out of the seven implementation variables, it was determined that there were statistically significant relationships in teacher evaluation scores between districts that followed the research-based implementation variables and districts that did not. Further research should include validity and reliability studies on the Marzano causal evaluation system. Research should continue to analyze different ways in which the Marzano causal evaluation system is implemented, and what relationship there is between implementation and teacher performance ratings. Research should be conducted to analyze the effectiveness of feedback provided to teachers through the Marzano causal teacher evaluation system. This research indicates that the Marzano causal teacher evaluation system should be used following research based best-practice and how it is intended to be used. The research in this study shows that when implementation variables are altered in the Marzano causal teacher evaluation system, teacher performance ratings may become inaccurate. Based on misunderstandings of the Marzano causal evaluation system, it is recommended school leaders receive additional training on the understanding and implementation of the Marzano casual teacher evaluation system.
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Date Issued
2014
Identifier
CFE0005399, ucf:50460
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0005399