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Clinical learning experiences have always been considered a hallmark of nursing education. Introduced in 2004, the ten-week paid internship is a fourth year summer course offered to select students who have demonstrated strong academic and clinical performance. The purpose of this paper is to report the findings of a study designed to explore student and staff perceptions about extrinsic factors that promote or impede learning during a nursing internship course. A descriptive exploratory design was used to conduct this research. Findings have been grouped into two main themes: extrinsic factors that promote interns' learning and extrinsic factors that impede interns' learning. The sub-themes under extrinsic factors that promote interns' learning are: staff making themselves available, having knowledge of policy, and units setting the tone for success. The sub-themes under extrinsic factors that impede interns' learning are: difficulty accessing staff, lack of knowledge of policy, and units not setting the tone for success. It is apparent that the factors identified in this study are similar to those found in the literature. It is striking that research findings of multiple studies examining factors that affect clinical learning converge regardless of the context or clinical learning models examined. © 2010 Elsevier Ltd.

Attention to the inequitable distribution and limited access to primary health care resources is key to addressing the priority health needs of underserved populations in rural, remote and outer metropolitan areas. There is little high-quality evidence about improving access to quality primary health care services for underserved groups, particularly in relation to geographic barriers, and limited discussion about the training implications of reforms to improve access. To progress equity in access to primary health care services, health professional education institutions need to work with both the health sector and policy makers to address issues of workforce mix, recruitment and retention, and new models of primary health care delivery. This requires a fundamental shift in focus from these institutions and the health sector, to each view themselves as partners in an integrated teaching, research and service-oriented health system. This paper discusses the challenges and opportunities for primary health care professionals, educators and the health sector in providing quality teaching and clinical experiences for increasing numbers of health professionals as a result of the reform agenda. It then outlines some practical strategies based on theory and evolving experience for dealing with some of these challenges and capitalising on opportunities. © 2011 La Trobe University.

This paper explores the nature and development of competence in speech-language pathology and is informed by the development and validation of a competency-based assessment tool to assess Australian speech-language pathology students' professional performance in the workplace (COMPASS®). Background is provided on speech-language pathology competency frameworks in Australia and a systematic program of research to validate this assessment tool. Findings relevant to understanding the nature and development of speech-language pathology competency are described. The domains of competence considered important for practice were found to extend beyond specific processes of professional practice to include generic competencies of Reasoning, Communication, Lifelong Learning, and Professionalism. The achievement of competency was identified as developmental, and clinical educators were found to validly and reliably identify seven levels of competency development. Competency may transfer across the scope of practice, and marginal students' performances were characterized by a high degree of variability. These findings are discussed in relation to the profession's understanding of competency and speech-language pathology education, professional development, and further research. © 2011 The Speech Pathology Association of Australia Limited.

Background: Having as main goal the development of a culture of professional excellence, the Family Medicine residency currently intends to correspond to the principles of adult learning approach, in which motivation for practicing is essential. Objectives: (1) To analyze the variability of Family Medicine residentes professional motivation, throughout the residency training; (2) To characterize Family Medicine residents perception about the support provided on training, during the residency; (3) To analyze the variability of Family Medicine residents perception about the support provided by the supervisor, throughout the residency. Method: Observational, quantitative and longitudinal study (2005-2008) of Family Medicine residents who participated in a survey on professional motivation. At the beginning of the residency in 2005 (N = 109) in Portugal, they were submitted to three assessment moments (n = 69) by a postal survey using a questionnaire with 57 Likert scale items, representing motivational variables - professional project, professional commitment, initial motivation, intrinsic motivation, self-efficacy expectations, self-control expectati ons,assertiveness and perception of the support provided on training program. Descriptive statistics and analytic tests (ANOVA - GLM repeated measures) were used to study the variability of the cognitive dimensions (a = 0,05). Results: Although motivated to Family Medicine practice (response rate = 47.8%, at the study entry), the physicians professional motivation variability along the residency has presented slightly positive, at the end of the study, but not statistically significant. The physicians of our cohort responded by assigning a relatively high average levels in almost all items of the scale support provided on training during the residency, and its variation showed a positive trend, at the end of the study. Conclusions: This study produced results of an important phenomenon on which there is no published information in Portugal. It provides substantial evidence on the progression of professional motivation of this physicians' cohort and on their perception about strategies used by the supervisor. The structuring of residency program may include individual strategies aimed to increase the Family Medicine residents' motivation, with benefits for their performance.

Background: Workplace-based learning is a critical component of professional preparation in speech pathology. A validated assessment of this learning is seen to be 'the gold standard', but it is difficult to develop because of design and validation issues. These issues include the role and nature of judgement in assessment, challenges in measuring quality, and the relationship between assessment and learning. Valid assessment of workplace-based performance needs to capture the development of competence over time and account for both occupation specific and generic competencies.Aims: This paper reviews important conceptual issues in the design of valid and reliable workplace-based assessments of competence including assessment content, process, impact on learning, measurement issues, and validation strategies. It then goes on to share what has been learned about quality assessment and validation of a workplace-based performance assessment using competency-based ratings. The outcomes of a four-year national development and validation of an assessment tool are described.Methods & Procedures: A literature review of issues in conceptualizing, designing, and validating workplace-based assessments was conducted. Key factors to consider in the design of a new tool were identified and built into the cycle of design, trialling, and data analysis in the validation stages of the development process.Outcomes & Results: This paper provides an accessible overview of factors to consider in the design and validation of workplace-based assessment tools. It presents strategies used in the development and national validation of a tool COMPASS®, used in an every speech pathology programme in Australia, New Zealand, and Singapore. The paper also describes Rasch analysis, a model-based statistical approach which is useful for establishing validity and reliability of assessment tools.Conclusions & Implications: Through careful attention to conceptual and design issues in the development and trialling of workplace-based assessments, it has been possible to develop the world's first valid and reliable national assessment tool for the assessment of performance in speech pathology.

This article had four goals. First, the authors identified a set of general challenges and questions that a life-span theory of development should address. Second, they presented a comprehensive account of their Motivational Theory of Life-Span Development. They integrated the model of optimization in primary and secondary control and the action-phase model of developmental regulation with their original life-span theory of control to present a comprehensive theory of development. Third, they reviewed the relevant empirical literature testing key propositions of the Motivational Theory of Life-Span Development. Finally, because the conceptual reach of their theory goes far beyond the current empirical base, they pointed out areas that deserve further and more focused empirical inquiry. © 2010 American Psychological Association.

AIM: To characterize a vocational training doctor's population that chooses General Practice and Family Medicine as career, in Portugal, trying to identify a profile; to know the proportion of the trainees that choose this specialty as a first-line option, for their professional future; to analyze the relationship between that choice and the sociodemographic and professional characteristics of the General Practice and Family Medicine trainees. Type of Study: Observational and cross-sectional study, with an analytic component. Population: Doctors who entered the vocational training program for General Practice and Family Medicine in Portugal, during the year of 2005 (N = 228). Methods: Postal questionnaire survey of all doctors that began vocational training during the year of 2005. Descriptive statistics were calculated and we use the χ 2 and T test to analyze the relationship between the variables (α = 0,05). Results: The overall response was 47,81% (n = 109). The profile found is mostly feminine (76, 15%), average age = 30, 2 years (DP = 6,28), Portuguese nationality (79,82%), graduate less than five years (Mo = 2002), and with a professional work average in medicine = 3,0 years (DP = 3,87). Most of trainees has no experience, working in undiferentiated Primary Care settings (87,04%). The specialty was chosen as a firstline option by 78,90% of the trainees, regardless of their profile. Conclusion: The high proportion of trainees choosing this specialty, as a first-line option, is a relevant result in this study. Identifying the specialty internship Doctor's profile, through a representative population, gives us an important evidence for future investigations, in a moment of a primary care reform in Portugal. © 2010 CELOM.

Problem based learning (PBL) arguably represents the most significant development in education over the past five decades. It has been promoted as the curriculum of choice, and since its introduction in the 1960's, has been widely adopted by many medical and dental schools. PBL has been the subject of much published literature but ironically, very little high quality evidence exists to advocate its efficacy and subsequently justify the widespread curriculum change. The purpose of this review is to classify and interpret the available evidence and extract relevant conclusions. In addition, it is the intent to propose recommendations regarding the relative benefits of PBL compared with conventional teaching. The literature was searched using PubMed, ERIC and PsycLIT. Further articles were retrieved from the reference lists of selected papers. Articles were chosen and included according to specific selection criteria. Studies were further classified as randomised controlled trials (RCTs) or comparative studies. These studies were then analysed according to intervention type: whole curricula comparisons and single educational interventions of shorter duration. At the level of RCTs and comparative studies (whole curricula), no clear difference was observed between PBL and conventional teaching. Paradoxically, it was only comparative studies of single PBL intervention in a traditional curriculum that yielded results that were consistently in favour of PBL. Further research is needed to investigate the possibility that multiple PBL interventions in a traditional curriculum could be more effective than an exclusively PBL programme. In addition, it is important to address the potential benefits of PBL in relation to life-long learning of health care professionals. © 2010 John Wiley & Sons A/S.

Background: Child labor remains a widespread phenomenon in today's world. The purpose of the present study was to describe the working conditions and health status of child workers in Kocaeli. Methods: A cross-sectional research study has been carried out on 365 working children at the Kocaeli Occupational Training Center. Data were collected on working conditions, smoking habits, work accidents, perceived health status and psychological status using General Health Questionnaire-12. In order to evaluate the physical growth of children, their height and weight were measured. Results: Most working children usually have a low level of education, low income and extended families. The mean age for children to start working was 14.8 ± 1.5 years and their daily working periods were 11.3 ± 1.3 h on average. Girls were found to have more psychopathology compared to boys on the GHQ-12 and the results were statistically significant. The height z score was less than-2 SD at 6.9% while the weight z score was less than-2 SD at 1.9%. According to body mass index (BMI) percentiles range, 3% of children were found to be underweight. A statistically significant and negative directional correlation was detected between body mass index z scores with age and daily working periods. Statistically significant but weak correlations were detected between height for age z scores and the starting age of work and also between weight for age z scores and chronological age. Conclusions: Both the mental and the physical health of children were found to be negatively affected, by having to work at an early age, and by long working hours. For this reason, immediate and direct intervention should be taken to eradicate child labor, and protect children from unsafe and exploitative working conditions. © 2010 Japan Pediatric Society.

High levels of youth employment, workplace hazards, and characteristics unique to adolescents contribute to a relatively high incidence of injuries among teens in the restaurant industry. This article discusses the ProSafety model of injury prevention among teen restaurant workers. Through integration with an existing career and technical education program, the ProSafety project seeks to prevent occupational injuries among the teen worker population through classroom safety education and internship skills reinforcement. ProSafety is the product of an innovative collaboration with occupational health nurses, business professionals, educators, and government. Its approach is derived from Social Cognitive Theory, is consistent with key values and strategies of occupational health nurses, and provides lessons for practitioners seeking to reduce occupational injuries in food service or among other populations of adolescent workers.