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The coordinated efforts of health educators must be direc- ted to these primary concerns, ^long w^th the lesser pfoblems of coordinating ctedentialing, career mobility (utilizing persons , already employed and those who are employable), and developing improved equivalency and proficiency testing, 32. that more formal in-depth courses on- supervision and adminis Ltratlon are 13 - ERIC 22 n^e^ed in -pr.ogrcims for physical th^apistsi on both th*e under- gl^aduate and graduate -levels . t one* physical therapist inter^ viewed had recei/ed anst ruction in formal physical therapy educa- tion which he or she considered ad'equate for efffecti^ve execution ^Hendee, Wlll/^TT. creating the social -physician as team leader,- attd some /chmtge Si^Aanistrative,. which are incongruous with the antictpatet J changes in medical prac- tice. The measure of Cthe caliber of inte/ns at th^ beginning of their internships was based on National Board scares on Part 'II (by those who took ^it as they graduated ERLC 16 25 m medical school) » and the measure at the end of the Internship as base^ on Part III scpres of the same individuals, "^he effects of six liospital charactetistics were considered: (1) medical school affiliation, (2) straight vs. "Education and the Hospital: Dual Responsibility for Alii ec^Manpower^^aining." Hospital s, 47 ^CMarch 1, 1973), 05-88. "Nursing Stiiden/t Utilization of Clinical Experi- ence Settings in North Carolina." Sponsored by the General ' Administration, The University of North Carolina. Between Type of Pediatric Clerkship and Perfo T»ancj^ on^edia- - trie Eifaminatioris." Journal of Medical Education , 48- (Aprtiy. "A.'Colla^Jtrrative Pro^^am in Allied Health Training." / Jouraal of ^Medi Q^al Education ^ \b (August , /l971) , 658-65, The author describes a modeil program in. V Journal of Alliet^ Health,' 2 ('$p ring, 1973), 68-75. Holley- describes two facets of public he^th: public iealth' • ' as a 'philosophy -and public health as a specialized field «f health ' practice. fiscal and philosophical ^ v)x±ch appear- to \bjt necjess^^p^ medlcral . the role- of the coiwnity physicians, the Vole of the medical school facu Uy, and the r^mr^for students and communities^ 3$/'/: ' - . rotating internship programs » (3^ hospict^ size, (4) administrative control, (5) internship stl- (6) percentage of Intemshlpd filled. In part, and with certain— limitations, the evidence indicates that hosplt^ls-havlng a^. lis, 47^1 In this article, the authcn M^ Id^nt^-f^y problems in the education \and training of allied health pj^fsonnel. National League for Nursing/ Council of 'Baccalaureate and Higher Degree Programs. Prepared by the Health Services Research Center, The University of North Carolina at Chapel Hill In cooperation with The University of North Carolina Area Health tldxxiatlon Centers Program, February, 1975. , This repaint presents data obtained from- an analysis of question- naires completed by the de^s of every school of nursing in North Qarolina and an analysis of responses to questionnaire^ mailed to the administrators (or directors of nursing) of every hospital, health diipartment, and nursing home in the state. ^ 1973)' medical students (at t,he University of Illinois) who were\as^lgned to three different hospital settiaigs for theltr pediatric cler^r - jrhips.

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in nursing pract;ice by ptovj^ding sufficient ^taff , by discharging appropriate nur5ih| functiofis^* an4 ^y evaluating nufslng plan ^ -^Ifbt care; (4) th4t locai heait1[i-(;ar^' facilities adopt continuing edueation programs and flexible emp Xoynent policies; (5)^ that insri^j^ions tor nursing education provide' iic^o^ed practical* nurses tered iic CTtture; and (6) that all state' licensure laws for nurs- ling be revi Sldvto require jreriodic review of the individual's qualifications /5a ^^ccndit ion for licensure renewal. It iras felt that tht S guld« would also help agency .officials to understand Jt he tylpe" and -quality of clinical facili- ties that cai Ei best serve student needs. medj^cal students is that^., Xl My need not Insist on a particular type of hospital training for clerkships. ' "The Training of Undergi Wat es \n the Publi£ Health Approach J' Public Health , 79 (May, 136^), 198-207. Villard writes authorita-^ tiyely on the subject of the challenge to medical schools Co' de- '^elcp coivmnity health programs, as he was one of the founders of the Departme\it of Community Medicine at the University of Kentucky Me4Jcal t:ollege. The theae of the Institute as it expressed by the editors was that: "the conpl Ax, interrelated objectives of medical schools aiid-teaxihing hospitals «U8t be understood; careful plans must be made for pro- ceeding towards specified goals; and provision' mia X be* made for evaluating progress." Articles presented in the Institute which are of particular inter- -est included: A.' J. Geneva, Switzerland: World Health O^anization, 1^67, 36 pp.

The guide'includes a section describing tlyj actual criteria recommended for. This British author, writing a decade ago, discusses the difficulty^ in teaching, medical^ students to think ^'preventively*' and "socially" and 'prescribes the subject that -must necess^arily be Included In the tfalnlng of undergraduates in the public health afrproach* He lisps 'courses which should %e taught in both the pre-clini&al and clihical years I the various methods of teachixvg wfoidi can b« em^ plowed, and cdnlemfl In its own ^location. Carroll's '^dfical Education Costs in' Hospi- tals"; E. Nourse's ^oals, Principles, and Mechanics of Cooper- ,ation: Topography, ^Problems, aad Eisentrlal Eleme^xts of . The tasks set before the WHO (World Health Organization) Expert Remittee.

radiological technology which has been estab'lishjgd in Denver Colorado , hy the Commuaity, College of pen vex, the J^olversity of* Cblor^di-Si Ji Dbl 6% Medicine, and our tee'n " Denver hpspital^s with facilities for diagnostic radi- 'ology, radiatlart therapy, or nuclear medicine. / This arti He deals with the- broad subject of health care delivery, e Jtplorlng the major aspects af its -Implications for allied health educators, the* author organized three "i^ubject areas Which demand attention: designing the system for delivery o f he alth care; de- termining th^ roles of the health personnel to provide power; and formulating the progxams' which will work effectively to train health teams to deliver— tap rov e d c are. Holley, Lydia '*A Component of Physical Therapy Education." Physical Therapy . The one major area which the author believes incorporates both of these concepts', and is the final consideration in surveying ERIC 14 the; pub life health ^conteot In' physical therapy curriculums, involves the broad consideration of medical Card today and the trends' ' in medical pare fpr. major teaching affilia- tion with a medlca L-s^hit Kil'obtaln interns of significantly higher caliber ^aad that interns in affiliated hospitals score significantly higher on Part III ttian Interns in non-affiliated hospitals. They concentrate On the unwill- in^ess of ed^catioaa V^jo^i^utions commit aily more -of tifieir , \ ^ uadergraduatfr-prog^^wr to ocoupational orientation than is absoliite- ly necessary, t^vife^ hospitals Weem equally unwilling to recognise y the need torjo^orte sophisticatea background on the part of many of \ their emple^es. "Arrangements Between an Institution of Higher Education and Agemiies Which Provide Learning Laborartories for Nursing Education." New Xork^^ National plague for Nursing, 1973, . "The purpose -of this study is to help identify the utilization ^d projected utilization of clinical facilities by nursing students as settings in which theqe student's obtain their clinical experience." 74. The purpose of the 'study was to measure the effect of the setting on the ^students. ' * **M^rcal School- Reaching Hcu^pil^al Relations." Report of the Second Administrstive Institute of the Association, of. Journal of Medical Education , 40 (November, 1965), * • Part 2,- 254 pp.

The program,, vrhicli involves coortiiriatedi classroom and clinical training for students who are working for ^n associate degree in *radiotechnology , "was designed ^o help ease' the ) hospitals * increasing 'iii'abllities to provide' adequat^ training for r^diru lugl cal technologists as well as fulfill the rtation,*s current ineed' for more we44^'trained tech- nologists. program to selected comfnunities and other ateas of specialization together with the proposed developm'fent of^ a '^career ladder approach" in which students may discontinue education anywhere along the "career ladder" and resume it without penalty. After identifying problems in this area, the author J? W for Clinical di^se rt at ion , » Through a review of th^^ft^erature ^n analysis of a questionnaire which surveyed educational adninistrators, and opmfons developed at a workshop sponsored by super\'isors and clinical faculty at the University of North Carolina Division of Physical Therapy, Dr. London: World Conf edec At ion for Phv- This paper is a report bf a follpy-iip ^tudy op the experiences of clinical and university educatori in physical therapy from 1970 to 1973 in developing written agreements with clinical centers. V , ' * The authors, who urge public health content in curriculum for p|iy«- sical therapy students 4^scribe the program designed for student • physical therapists at The University of North Carolina at Chapel , Hill. The University of the State of New York, The, State Educatiotv De- partment. ' The settings included imiversity/ OQuxtty and private hospitals, where the clerkships differed significantly in the numbj^r^ and type of patients seen, the proportion of tiwe \ ' spent in various departneats and tlie number, of lectures and ^ \ rounds scheduled*. * ' ' Wecbsler describes the social changes underlying the spiraling 4^i Band for nationwide quality dental care and adequate dental nan- 9^oyer. "The Development of Medical School as a Con- munity Resource."' American Journal of Pxtblic Health , 54 (July, 196A), 1041-48. * , In t^is 1964 AXMQ.^Institute , teaching hospital administrators and medical school deans o^t together "on an equal basis" in order to discuss relationships between isedical schools and teaching hospi- 33 42 Ul».

standard* for a' program (a compilation of ldo%m standards and guidelines foe physical therapy assistant programs) ; a re-, source and reference guide which includer books , journals/ period- icals, films, and associations' and miscellaneous publications,- w Klch^e provided to aid the instructor as well as the student. It is his belief tliat univ^rslt^ leadership must take y Bmmand -of the changes %rtiich will ^a D4 must be made. "Educatipn of Future Health Personnel/' Australian Dental Journal . Ellis* observations, made in an address in Adelaide in Octpber, 1971, focus on the changing scene in health care needs in Canada.

Dunlop elabq/^tes on some of the changes he sees jc Smfttg; Itiich include: — new directions In Research, recognizing ty Interfaces between health, educatioti ,*^housing, transportati^, and pollution; — consideration of la national^ insurance sv Btem; —possible means o A financing new medlca Jr facilities; — development" of more paramedical perscumel In jiinipr and comonm- ,*ty colleges* with emphasis on cooper^tioi) from medical schools;* '^d -^development of more out-of-hospital facilities. His remarks apply to the issues facing liealth educators everywhere, however, stressing the need for universities to bring the training ' of allied health Sasspfnmr * Washington, b. "Impact of Clinical Training on Attitudes of Medical Student^: Self-Perpetuating Barrier to Change in the System?

Hatch, Thomas D/ "The Changjjis Stene In Allied Health Professions Educatloa«^\ Journal of Afierican Dietetic Association, 63 (July, 197 ' \ ZT" , In a point^bv-polnt survey of the changes and problems In allied haalth educa£l^on, the author makes a strong case for removing the educational barriers t TOl^divid^ the Ji^lth education field and for working cooperatively toward bett Wr and more ^fective academic and clinical training programs. Included is an annotated bibliography "Containing more than two hundred documents related to allied health and nursing education. responsibility) whether they, co Vtfiidet^d their * physical therapy education adequate preparation ior effective per-- formance in their jobs. Two propositions were tested: it) that systematic varia- tiorjs in doctors' -attitudes toward changes in the economic and administtative (^^anization of medical practice can be demonstrated related to dijaensions of their professional behavior (i.e., their current and future attivities, their specialties)^; (2) that the start of Ahe medical student's clinical training is^ a turning point in th^^ducational process, beyond which the student doctor's atti- ^ tu^« toward' changes In the organizatioj^i of medical practice are ^^entital with those of the staff group whose professional invoive- ^ ment is the s^e as that aspired to by the student. "The Effect of Characteristics of Hospitals in Relation to the Caliber of Interns Obtained aiid the Competence of Interns After One Year of Training." Journal of Medical Education, 38 (November, 1963), 909-19. Contributing to the transf ofmation is the increasingly widespread belief^ that the maximum of new knowledge must be brought to bear for each patient, in 'his own community and, if possible; independent pf his, sojectives were identified as a means of attaining | this goal includdng: the determination of the present rdle of phy sica*l therapy^ in pediatric programs^ the determination -of ^the \ p-resent needs 'o-f physical therapists working in pediatrics,^ the determination of the future- role and needs of physical therapist in pediatrics, and finally, the intention'^of making this project availab Ue to others^ "This report reflects the views relative t roles and needs, of a representative cros^ Section of physical ^ therapists working in. The^V^AMI program re- '4^» f ^ g ^ye tl^i ^a^^ma^medic Al .students an-toption^^of ^ spending 12 months with a primary care physician in. There were np significaiit- differences between the two groups of students revealed by results of their examlnatioiasy Students felt that the program accelerated their personal groifth, resulted in increased appreciation o5 the ^cononlcs 6f health and dfsease, and gave them better insight into * the operation oi both a hospital and a medical office.

He cites' expaflbion of the allied health fields, emergence of new occupational Categories (e.g., physical therapist assistants), costly Expansion in internship programs and clinical education, and uneven distribution of man- power. Based on interviews with 100 physical therapists and supportive staff members,- it was apparent. "Som ;the importance of -t Bam practice In primary care^j, the; n^ce Sslty^f.. Results allowed that both jropasitions can be supported (but the second one oijffy partially), ^e implications for change are ominous, for clinical education would sleem to be producing proft^ssionals whose ^expect.a- tions wil L match existing attitudes in the* medical profession, ? ' ' Twenty-four hundred *(2,'40{)) National Board candidates in 321 hospi- tals were surveyed for this study. pediatric settings ^throughout the United ^ States. University of North Carolina at Chapel Hill, Healtb^ig^kices Re- search Center. The students' preceptors evaluated the program favorably. * ^ Voorabchl, Bahman; Olson, ^arl J.; and ^agfrr-fiorddn G, "Elation- ^ship.

such pro- grams, as well as a checkllbt for survey and evaluation of a facility for the use of. He aasigha the tesponaibillty for designins public health programs to the heads of the departments of . were to identify all resources in the coawnity (qther than the hospital) "that repr^ent th9se settings in which the fixture physician will' ^ctyally wojrk and study ways of en- couraging medical ^hools t6 these' potentially valuable facil- ities f or- xiralnln/ purposes." Te Cornmlttee, at^knowledged the limiting f actorf^. aj5S identified are centers for aabulatory care, doalclliary situations, teaching health centers, and the broad array of c health and social serylce organizations. This is the second part of the report of Worthingham* s study of physical therapy education and the first part of the report on clinical environment.

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