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Assessment and Competence
Published in Ramesh Mehay, The Essential Handbook for GP Training and Education, 2021
Nigel De Kare-Silver, Ramesh Mehay
To help assess whether a training doctor is competent to perform as a GP, the RCGP has defined 12 areas which they must be competent in if they are to satisfactorily complete training. Competence is important at many levels – for patients, for you, for other doctors and so on. Therefore, competence is something you must be able to demonstrate to others (and thus assessors too). Assessors themselves should similarly be assessed on their ability to demonstrate their competence to carry out the task of assessing others. Gone are the days where one was deemed a competent assessor just through the very nature of being a hospital consultant or a doctor with an immense number of experiential years under his or her belt. Sure, experience gives you the foundation to become an assessor, but it is no substitute for being trained up for the role.
Professional identity and competence to practise in medicine
Published in Roger Ellis, Elaine Hogard, Professional Identity in the Caring Professions, 2020
Various organisations and individuals have attempted to help clients/patients assess the clinical competence of their doctors. In the case of individuals, they have frequently become dissatisfied with the professional advice that they have been given. In the case of organisations such as the Consumers’ Association, the Health Education Council and the Patients’ Association, encouraging patient assessment may be a very effective and efficient way of maintaining regular checks on clinical competence.
Treatment and management strategies
Published in Stephanie Martin, Working with Voice Disorders, 2020
The clinician needs to ensure that clinical competence is achieved by the patient away from the safety of the clinical environment. The increasing sophistication of mobile technology will allow the clinician a ‘virtual’ view of a patient in their place of work or home environment, in order to assess and monitor their physical environment and voice use. This would obviously be subject to proper rigour in terms of data protection issues, but it is worth a discussion with the patient. This ‘virtual tour’ could then prompt a discussion regarding changes that could be introduced in an effort, for example, to promote better posture or arrange their work station more ergonomically, if appropriate. Similarly performers can either record themselves or ask someone to record their own performances in order to allow the clinician to assess volume and projection and get a much more accurate representation of the vocal demands that the patient experiences and to note much more clearly any episodes of vocal misuse.
The relationship between perceived competence and self-esteem among novice nurses – a cross-sectional study
Published in Annals of Medicine, 2022
Lena Serafin, Zuzanna Strząska-Kliś, Gilbert Kolbe, Paulina Brzozowska, Iwona Szwed, Aleksandra Ostrowska, Bożena Czarkowska-Pączek
In our study, nurses' competencies in most areas increased as per the completed level of postgraduate education; a majority of the respondents undertook additional postgraduate education. It is important to note that in the early years of practice, nurses’ competencies increase significantly, both through their active participation in education and through the experience of independent work. Importantly, newly graduated nurses need more support in the areas of competence development [60] and wellbeing at work [60,61], as they present a high-stress level [62]. Moreover [52], revealed that newly graduated nurses’ higher general competence indicates a stronger overall occupational commitment. Undeniably, competence is a critical attribute for safe, ethical, and high-quality care [62]. Therefore, developing nurses’ competencies and monitoring this process should be a matter not only for individuals but also for healthcare organisations in the context of the system’s functioning.
Against Externalism in Capacity Assessment—Why Apparently Harmful Treatment Refusals Should Not Be Decisive for Finding Patients Incompetent
Published in The American Journal of Bioethics, 2022
Brian D. Earp, Joanna Demaree-Cotton, Julian Savulescu
It is important to get this right. Although the informed decisions of competent patients are generally respected, if a patient is deemed incompetent, doctor-recommended treatments are sometimes imposed on them against their wishes based on an appeal to the duty of beneficence. Consequently, the stakes in determining correctly whether a patient such as Carrie is competent or incompetent3 are high. If she is mistakenly deemed competent, so that her treatment refusal is honored, she will die and will arguably do so in error. If her refusal is mistakenly deemed incompetent, however, the consequences may be similarly dire: the doctors might force a genuinely unwanted procedure on a competent and non-consenting patient. This would involve a gross violation of the patient’s autonomy-based rights, and could constitute an assault and battery.
Against Over-Protectionism: Riskier Decisions Require Clearer Evidence of Capacity But Don’t Call for Stricter Criteria
Published in The American Journal of Bioethics, 2022
Manuel Trachsel, Paul S. Appelbaum
As a preliminary matter, however, we note it is not entirely clear precisely what it means to say, as Pickering and colleagues do, that a judgment of incompetence may be required “because of the harmfulness of the decision.” There are at least two interpretations that might be offered of that statement, and at different times Pickering and colleagues appear to embrace each of them. The stronger claim is that harmful decisions per se indicate the incompetence of the person making them (e.g., “In this approach, harmful consequences of a decision would play a decisive role in the decision to assess the competence of the patient, and more importantly, in the assessment itself.” [p. 39; emphasis added]). So interpreted, Pickering and colleagues would seem to be ruling out ever allowing patients to decline potentially life-saving medical treatment, though at another point in the paper they appear, citing Wicclair (1991), to reject that approach out of hand (“this view of the relationship between harm judgements and competence judgements is untenable”). A variant of this first interpretation is the claim that harmful decisions indicate incompetence when at least some degree of incapacity is present, an argument that seems to appear elsewhere in the paper (“What makes the reduced capacity within the process reason for a judgment of incompetence is the decisions it gives rise to.” [48]).