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Teaching and modeling professionalism in health professions
Published in Joseph A. Balogun, Health Care Education in Nigeria, 2020
It is critical to recognize that many factors may impair the remediation process. Such factors include the use of inappropriate tools, concern about the future impact it may have on the student’s career, the shortage of time necessary to intervene, the potential for strained relationships, fear of student retribution or litigation, and lack of skills to address the issues. Communicating these fears through proper channels with clear delineation of responsibilities can help alleviate some of these concerns.
Physical and Cognitive Rehabilitation for Children with Brain and Spinal Tumors
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Alexandra M. Gaynor, Helen Hartley, Stephen A. Sands
Following the success of this pilot study, Butler and colleagues tested the efficacy of the remediation program when the duration was shortened to 20 total 2-hour weekly sessions. The authors demonstrated that, in a cohort of 161 brain tumor, leukemia, and lymphoma patients, the cognitive remediation program resulted in improvements in arithmetic and language-based academic functioning and parent-reported attention. However, both the intervention and control groups also demonstrated significant improvements in focused attention, working memory, long-term memory recall, and vigilance, perhaps due to the performance benefits of practice effects irrespective of intervention.127 A subset of the sample who completed the cognitive remediation program also participated in a pilot functional magnetic resonance imaging (fMRI) study to investigate pre- and post-intervention changes in brain function. Results showed that regions within the prefrontal cortex that were engaged during a CPT task differed between survivors and healthy controls pre-intervention, but activity was more similar postintervention (Figure 8.3).128
A framework for medical rehabilitation: Restoring function and improving quality of life
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Rehabilitation is an inter-professional discipline, which deals with various disease entities with functional limitations (3). The first step involves diagnosing health conditions and assessing their impact on body structures, functioning and participation. Treatment can be focused on remediation, which refers to reducing impairments and stabilizing, improving or restoring function. However, in many cases it is focused on compensation for the absence or loss of body functions and structures, such as by providing assistive technology or teaching the individual to change their environment. Regardless of which of these two treatment approaches is most predominant, an individual will need training in remediation and/or compensation techniques to improve their function and wellbeing (Figure 1.2).
Community-Based Remediation of Juvenile Competence to Stand Trial: A National Survey
Published in International Journal of Forensic Mental Health, 2022
Ivan Kruh, Neil Gowensmith, Amanda Alkema, Kristin Swenson, Derrick Platt
Arizona legislation enacted in 1980 provides for a competency evaluation and remediation process for juveniles. Prior to 2009, Maricopa County remediation providers were funded through the county budget and contracted through the State’s Administrative Office of the Court. This model proved to be expensive and ineffective. In 2009, the Superior Court in Maricopa County Juvenile Department directly hired six remediation providers and a program supervisor into the JCRS. The yearly operating cost of the program dropped from $864,969.00 to $425,982.00. The remediation provider positions were subsequently incorporated into the Court Administration to improve accountability, oversight, and fiscal responsibility. Remediation providers are hired with backgrounds in education or teaching, as well as juvenile justice and case work experience. Internal training is provided, which includes shadowing senior staff.
Historical Trajectory and Implications of Duty-Hours in Graduate Medical Education
Published in Journal of Legal Medicine, 2019
Bobbie Ann A White, Heath D White, Alejandro C Arroliga
The Accreditation Council for Graduate Medical Education (ACGME) was established in 1981 with the purpose of creating standards for graduate medical education (GME) programs. As residency education shifted to include employment, the ACGME’s responsibility became more complex. Although residents and fellows are students, they are also providing patient care and a service to the hospital, creating a fine line between employee and student. For example, is the GME department responsible for reprimand or remediation of training physicians, or should they be treated as employees and sent through the human resources process? Because the issue of employment in GME is convoluted, governmental agencies do not have oversight. This lack of oversight combined with increasing emphasis on patient safety and reduction in medical errors has required the ACGME to fulfill unanticipated responsibilities of addressing employment regulations. Ultimately, these additional responsibilities were addressed through duty-hour policies.
Diversity in Professionalism Framings Across U.S. Medical Boards
Published in Journal of Legal Medicine, 2019
Some studies have examined causes of state medical board action against physicians. A 2004 case–control study examining medical students and future disciplinary action by the medical board of California found that professionalism violations, as defined by the study, constituted the majority of offenses.6 These violations included use of drugs or alcohol, unprofessional conduct, sexual misconduct, and crimes. As of 2017, California’s medical board had an excellence framing of professionalism, and though any of the cited violations could impair the physician’s performance, the general categories seem to fall into more behavior or integrity framings, or outright criminal behavior, than an excellence framing. California’s framing may have changed over the years, and the study’s authors may have a different conception of professionalism, but in including criminal activity with unprofessional conduct under the umbrella of professionalism, the meaning of professionalism is obscured. Under this framework, a California physician guilty of a professionalism violation could have a substance use disorder, break confidentiality, or steal from his or her patients. These offenses all necessitate different approaches in remediation, and grouping them as issues of professionalism does not allow for effective physician rehabilitation.