Code of ethics: principles for ethical leadership.

The code of ethics for a professional association incorporates values, principles, and professional standards. A review and comparative analysis of a 1934 pledge and codes of ethics from 1957, 1977, 1988, 1998, 2004, and 2011 for a health information management association was conducted. Highlights of some changes in the healthcare delivery system are identified as a general context for the codes of ethics. The codes of ethics are examined in terms of professional values and changes in the language used to express the principles of the various codes.

Factors that influence the clinical decision making of novice and experienced physical therapists.

BACKGROUND: The depth and breadth of prior experience informs clinical decision making in novice and experienced physical therapist clinicians. OBJECTIVES: The aims of this research were to identify differences in clinical decision-making abilities and processes between novice and experienced physical therapist clinicians and to develop a model of the factors that influence clinical decision making. DESIGN: Qualitative research methods and grounded theory were used to gain insight into the factors and experiences that inform clinical decision making. METHODS: Three participant pairs (each pair consisted of 1 novice physical therapist and 1 experienced physical therapist) were purposively selected from 3 inpatient rehabilitation settings. Case summaries from each participant provided the basis for within- and across-case analyses. The credibility of the results was established through checking of the case summaries by the participants, presentation of low-inference data, and triangulation across multiple data sources and within and across participant groups. RESULTS: The factors that influenced clinical decision making were categorized as informative or directive. Novice participants relied more on informative factors, whereas experienced participants were more likely to rely on directive factors. An intermediate effect beyond novice practice was observed. CONCLUSIONS: The results of this study may be used by educators and employers to develop and structure learning experiences and mentoring opportunities for students and novice learners with the aim of facilitating the development of skills and abilities consistent with expert clinical decision making.

Novice and experienced physical therapist clinicians: a comparison of how reflection is used to inform the clinical decision-making process.

BACKGROUND: Prior experience informs clinical decision making and shapes how reflection is used by novice and experienced physical therapist clinicians. OBJECTIVES: The aims of this research were: (1) to determine the types and extent of reflection that informs the clinical decision-making process and (2) to compare the use of reflection to direct and assess clinical decisions made by novice and experienced physical therapists. DESIGN: Qualitative research methods using grounded theory were used to gain insight into how physical therapists use reflection to inform clinical decision making. METHODS: Three participant pairs (each pair consisting of one novice and one experienced physical therapist) were purposively selected from 3 inpatient rehabilitation settings. Case summaries of each participant provided the basis for within- and across-case analysis. Credibility of these results was established through member check of the case summaries, presentation of low-inference data, and triangulation across multiple data sources and within and across the participant groups. RESULTS: Although all participants engaged in reflection-on-action, the experienced participants did so with greater frequency. The experienced participants were distinguished by their use of reflection-in-action and self-assessment during therapist-patient interactions. An intermediate effect beyond novice practice was observed. CONCLUSIONS: The results of this study may be used by educators and employers to develop and structure learning experiences and mentoring opportunities to facilitate clinical decision-making abilities and the development of the skills necessary for reflection in students and novice practitioners.

HIPAA: a few years later.

This article addresses the impact of the Health Insurance Portability and Accountability Act (HIPAA) several years after implementation. The rationale for HIPAA and a clarification of key terms, including covered entities, personal health information, and designated record sets, is reviewed. The impact of HIPAA at work, including increased cost and the complexities of educating employees and patients is assessed. Implications for homeland security, disaster planning, unique patient identifiers, the compilation of personal health records, and research are discussed.

Attitudes toward genetic testing: gender, role, and discipline.

As a result of the Human Genome Project, genetic testing could result in the availability of detailed genetic information (presence of disease, genetic risk or predisposition to disease, and characteristics or traits) that can ultimately be used for healthcare-related decisions. This study explored whether gender, role, and professional discipline would influence attitudes toward genetic testing when making reproductive decisions, as interpreted by 2 roles--as a parent making decisions or as a professional giving advice. An original research instrument was administered to masters and doctoral genetics students, pediatric residents, and masters-level ministry students. Statistical analyses revealed that discipline strongly influenced decision making while gender rarely did. In addition, differences in attitudes were also found based on parental and professional roles.