Definitions of Physician Certification Used in the North American Literature: A Scoping Review.

INTRODUCTION: The authors sought to identify how physician specialty certification is defined in the North American literature. METHODS: A rigorous, established six-stage scoping review framework was used to identify the North American certification literature published between January 2006 and May 2016 relating to physician specialty certification. Data were abstracted using a charting form developed by the study team. Quantitative summary data and qualitative thematic analysis of the purpose of certification were derived from the extracted data. RESULTS: A two stage screening process identified 88 articles that met predefined criteria. Only 14 of the 88 articles (16%) contained a referenced purpose of certification. Eighteen definitions were identified from these articles. Definitional concepts included lifelong learning and continuous professional development, assessment of competence and performance, performance improvement, public accountability, and professional standing. DISCUSSION: Most articles identified in this scoping review did not define certification or describe its purpose or intent. Future studies should provide a definition of certification to further scholarly examination of its intent and effects and inform its further evolution.

The doctorate of nursing practice and entry into midwifery practice: Issues for consideration and debate.

The American College of Nurse-Midwives represents two cadres of midwifery professionals: certified nurse-midwives who are educated in both midwifery and nursing, and certified midwives who are educated in the discipline of midwifery. Certified nurse-midwives are designated by nursing professional organizations as advanced practice nurses. The United States nursing profession is advancing toward adoption of the Doctor of Nursing Practice degree, as the entry into practice credential for advanced practice nursing. There is no evidence to date to demonstrate differences in clinical practice outcomes between certified nurse-midwives and certified midwives. A secondary analysis of data from a series of compensation and benefits surveys did not demonstrate differences in salaries between respondents who held a practice-focused doctoral degree compared to a master's degree. The requirement of the practice-focused nursing doctoral degree for entry into midwifery practice for certified nurse-midwives would require additional evidence to support both a professional and a business case for such a change in policy. It would also require consideration of the professional and business impact that such a policy would have on certified midwives who do not hold the nursing credential. Equivalent entry into practice pathways would need to be developed.

The Milan System for Reporting Salivary Gland Cytopathology: Analysis and suggestions of initial survey.

BACKGROUND: An international panel of experts in the field of salivary gland cytology (SGC), supported by the American Society of Cytopathology (ASC) and the International Academy of Cytology, conducted a survey to seek evidence and practice patterns regarding SGC. Results were used to provide focus for the proposed Milan System for Reporting Salivary Gland Cytopathology. METHODS: The study group, formed during the 2015 European Congress of Cytology held in Milan, Italy, generated a survey that included 49 specific questions related to the taxonomies, practices, and diagnostic entities of salivary cytology. Qualtrics software was used as the study platform. Software and server support were provided by the division of information technology at the University of Wisconsin. The survey was available online from November 2015 until February 2016. Participants were invited through the Web sites of the ASC, the International Academy of Cytology, and the Papanicolaou Society of Cytopathology as well as by the ASC e-mail "ListServe"; responses were evaluated by the Milan System editors. RESULTS: Responses from a total of 515 participants were collected and reviewed. A total of 347 participants provided demographic data information. Responses revealed variations in diagnostic practice and subsequent management. Participants believed that the acceptable rate for nondiagnostic samples should not be higher than 10%. There were varied opinions regarding the approach to neoplastic lesions of uncertain malignant potential, those that may or may have not local invasion and distant spread. CONCLUSIONS: Results of the survey demonstrated strong support for the development of a unified system for reporting SGC. Cancer Cytopathol 2017;125:757-66. © 2017 American Cancer Society.

The demographics and diving behaviour of DAN Asia-Pacific members with and without pre-existing medical conditions.

INTRODUCTION: This report examines Diver Alert Network Asia-Pacific (DAN AP) members with and without cardiac or respiratory conditions, diabetes or hypertension and compares their demographics, health and diving activities. METHODOLOGY: Two online cross-sectional surveys of DAN AP members were conducted. The first sought information from 833 divers who applied for membership between July 2009 and August 2013 and who had declared the targeted medical conditions. The second, conducted between December 2014 and April 2015, was sent to 9,927 current members with known email addresses. The groups were compared for age, gender, body mass index, fitness, smoking and diving qualifications, history, currency and practices. RESULTS: Of 343 (41%) respondents to the first survey, 267 (32%) provided sufficient information for inclusion. Of 1,786 (18%) respondents to the second survey, 1,437 (15%) had no targeted medical condition and were included in the analysis. Those with medical conditions were on average 4.7 years older (P 〈 0.001); more overweight or obese (68% versus 57%, P = 0.001); took more medications (57% vs. 29%, P 〈 0.001), smoked less (4% vs. 7%, P = 0.02) and did less repetitive diving (median 75 vs 90, P 〈 0.001). Other diving demographics were similar. CONCLUSIONS: A substantial number of people are diving with medical conditions and there is a need to better understand the associated risks. Divers need to be well-educated about the potential impact such conditions may have on diving safety and should monitor their health status, especially as they age.

Objective structured clinical examination (OSCE) in pharmacy education - a trend / Examen clínico estructurado y objetivo (OSCE) en la educación de farmacia - una tendencia

Pharmacy education has undergone a radical change as it evolves towards becoming a more patient oriented profession. With a greater emphasis on problem based teaching and competency, the Objective Structured Clinical Examination (OSCE), supported by its reliability and validity became the gold standard for the evaluation of clinical skills of undergraduate students of medicine and pharmacy worldwide. Core competency evaluation has become a mandatory and critical norm for accountability of educational objectives as the traditional testing tools cannot evaluate clinical competence. Interpersonal and communication skills, professional judgment, skills of resolution etc., may be best assessed through a well structured OSCE in comparison to oral examinations, multiple choice tests and other methods of assessment. Though OSCEs as an objective method of evaluation offer several advantages to both students and teachers, it also has disadvantages and pitfalls in implementation. This article reviews the OSCE as a trend in pharmacy education (AU)

La educación en farmacia ha sufrido un cambio radical a medida que evoluciona hacia convertirse en una profesión más orientada hacia el paciente. Con un mayor énfasis en la enseñanza basada en problemas y competencias, el examen clínico estructurado y objetivo (OSCE), soportado por su fiabilidad y validez, se ha convertido en el patrón-oro para la evaluación de las habilidades clínicas de los estudiantes de grado de medicina y farmacia en todo el mundo. La evaluación de las competencias centrales se ha convertido en una norma obligatoria y crucial para la responsabilidad de los objetivos educativos, ya que los exámenes tradicionales no pueden evaluar la competencia clínica. Las habilidades interpersonales y de comunicación, el juicio profesional, las habilidades de resolución, etc. Pueden evaluarse mejor mediante un OSCE bien estructurado en comparación con los exámenes orales, los exámenes de elección múltiple y otros métodos de evaluación. Aunque los OSCE son un método objetivo de evaluación que ofrece varias ventajas tanto a estudiantes como a profesores, también tiene inconvenientes y problemas de implantación. Este articulo revisa los OSCE como una tendencia en la educación de farmacia (AU)

[Authorized Qualifications of Staff Conducting Examinations in the Field of Clinical Microbiology].

Because of the increase in healthcare-associated infections, appearance of highly resistant bacteria, and that of emerging/re-emerging infectious diseases, it is necessary for the skills of clinical microbiological technologists and the associated technology to be improved. Technologist in Microbiology (4,717 certified) and Specialist in Microbiology (58 certified) are authorized qualifications in the field of examination for clinical microbiology, with a history of 60 years, and Clinical Microbiological Technologist (670 certified) and Infection Control Microbiological Technologist (ICMT) (528 certified) are necessary qualifications to become a member of an infection control team. As problems to be resolved, clarifying the relationships among the authorized qualifications, reconsidering the fairness of evaluating written examinations, and further consideration of the administration method for an increasing number of examinees need to be tackled.

Public health workforce taxonomy.

Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.

Decompression illness in divers treated in Auckland, New Zealand, 1996-2012.

INTRODUCTION: The treatment of divers for decompression illness (DCI) in Auckland, New Zealand, has not been described since 1996, and subsequent trends in patient numbers and demographics are unmeasured. METHODS: This was a retrospective audit of DCI cases requiring recompression in Auckland between 01 January 1996 and 31 December 2012. Data describing patient demographics, dive characteristics, presentation of DCI and outcomes were extracted from case notes and facility databases. Trends in annual case numbers were evaluated using Spearman's correlation coefficients (ρ) and compared with trends in entry-level diver certifications. Trends in patient demographics and delay between diving and recompression were evaluated using regression analyses. RESULTS: There were 520 DCI cases. Annual caseload decreased over the study period (ρ = 0.813, P < 0.0001) as did entry level diving certifications in New Zealand (ρ = 0.962, P < 0.0001). Mean diver age was 33.6 (95% confidence limits (CI) 32.7 to 34.5) years and age increased (P < 0.0001) over the study period. Median (range) delay to recompression was 2.06 (95% CI 0.02 to 23.6) days, and delay declined over the study period (P = 0.005). CONCLUSIONS: Numbers of DCI cases recompressed in Auckland have declined significantly over the last 17 years. The most plausible explanation is declining diving activity but improvements in diving safety cannot be excluded. The delay between diving and recompression has reduced.

Certificado médico de defunción como instrumento de certificación de muerte fetal, análisis en hospitales de La Paz y El Alto durante la gestión 2004 / Medical death certificate as instrument of certificatión of death fetal, analysis in hospitals of La PAz and The High during the management 2004

El estudio y certificación de las muertes ocurridas durante la etapa perinatal, y por ende de las muertes fetales, es diferente al de otras etapas de la vida, ya que los componenetes materno y placentario juegan un papel importante en las causas de muerte. Entonces es lógico pensar que al momento de realizar un estudio o certificar una muerte fetal, se tiene que indagar en los componentes señalados. El objeto del presente estudio fue establecer que el Certificado Médico Unico de Defunción (CEMEUD), no recolecta datos necesarios para un estudio y registro adecuado de la muerte fetal intrauterina. se realizó un estudio descriptivo retrospectivo, donde se realizó al CEMEUD como instrumento captador de información y certificador de la muerte fetal intrauterina...