The State and Future of the Primary Care Behavioral Health Model of Service Delivery Workforce.

The growth of the Primary Care Behavioral Health model (PCBH) nationally has highlighted and created a workforce development challenge given that most mental health professionals are not trained for primary care specialization. This work provides a review of the current efforts to retrain mental health professionals to fulfill roles as Behavioral Health Consultants (BHCs) including certificate programs, technical assistance programs, literature and on-the-job training, as well as detail the future needs of the workforce if the model is to sustainably proliferate. Eight recommendations are offered including: (1) the development of an interprofessional certification body for PCBH training criteria, (2) integration of PCBH model specific curricula in graduate studies, (3) integration of program development skill building in curricula, (4) efforts to develop faculty for PCBH model awareness, (5) intentional efforts to draw students to graduate programs for PCBH model training, (6) a national employment clearinghouse, (7) efforts to coalesce current knowledge around the provision of technical assistance to sites, and (8) workforce specific research efforts.

Baccalaureate nursing education: has it delivered? A retrospective critique.

Despite political support for the baccalaureate degree as entry to practice, historical concerns over nursing education - the value of education versus service, professional versus vocational identity and theoretical versus practical knowledge - persist. The authors challenge the notion of a "two-tiered" nursing system and call for a nationwide curriculum review to help the profession adapt to the changing needs of the Canadian healthcare system.

Virtual day of the midwife: a global 'pyjama party'.

The Virtual International Day of the Midwife (VIDM) (www.vidm.org) is an annual online conference designed to break down traditional barriers to continuing professional development (CPD); provide online opportunities for international midwifery networking; and model open access communication and collaboration practices. Whilst the VIDM is designed to reach midwives all around the world, issues of access to the Internet, language and cultural differences prevent some midwives from attending, especially those who live in resource-poor countries. Nevertheless, the VIDM has successfully demonstrated how CPD can be delivered to midwives in a flexible and cost-effective way, as well as bring them together in a truly global open and collaborative environment.

[Evidence-based medicine teaching activities in the German-speaking area: a survey]. / Evidenzbasierte Medizin in Aus-, Weiter- und Fortbildung im deutschsprachigen Raum: Ein Survey.

INTRODUCTION: In the last 15 years Evidence-based Medicine (EbM) has gained much publicity in the German-speaking countries, but it is currently difficult to conclude how much the contents of EbM with its five steps according to Sackett have spread. Data from the year 2006 show that less than half of all medical faculties in Germany have introduced EbM into undergraduate teaching and that there is a shortage in EbM teaching activities for graduates in the German-speaking countries as well. The goal of this survey is to display the undergraduate and graduate Evidence-based Practice teaching activities in the German-speaking countries. METHODS: In a two-step survey, we first sent out a total of 551 letters to medical faculties, colleges, boards of physicians, the German Hospital Association, the associations of statutory health insurance physicians in Germany, the Medical Service of the German health insurances and asked the 30 participants of the 2011 EbM Academy as key informants in writing to give details about potential providers of EbM teaching activities. Via email we also consulted the members of the German-speaking colleges of general practitioners and family medicine and the German Network for EBM, course participants and contact persons of familiar teaching activities. In a second step a pre-tested detailed questionnaire with 36 items in the five categories framework and structure, participant characterisation, contents and didactics, evaluation and publication, and planning and publicity was sent to potential providers. RESULTS: Altogether 185 teaching activities were identified, 80 % of which were located in Germany, 13 % in Austria and 7 % in Switzerland. In 82.6 % of the cases it was either a seminar, a course or a workshop with a median of 20 participants and an average duration of 17.9hours. The teaching activities mainly addressed students (63.2 %), physicians (37.8 %), caregivers and members of other health care professions with little or no prior knowledge of EbM. The first three steps of EbM (formulating clinical questions, search for and appraisal of the literature) were taught in more than 75 % of the teaching activities, whereas steps four and five (integration of results, evaluation) were only taught in 53.9 % and 33.3 % of the cases, respectively. DISCUSSION AND CONCLUSION: Compared to 2006, a remarkable increase in EbM teaching activities was observed in the German-speaking areas. These activities address different target audiences; the main content focus is on the first steps of EbM.

The future of monitoring in clinical research - a holistic approach: linking risk-based monitoring with quality management principles.

Since several years risk-based monitoring is the new "magic bullet" for improvement in clinical research. Lots of authors in clinical research ranging from industry and academia to authorities are keen on demonstrating better monitoring-efficiency by reducing monitoring visits, monitoring time on site, monitoring costs and so on, always arguing with the use of risk-based monitoring principles. Mostly forgotten is the fact, that the use of risk-based monitoring is only adequate if all mandatory prerequisites at site and for the monitor and the sponsor are fulfilled.Based on the relevant chapter in ICH GCP (International Conference on Harmonisation of technical requirements for registration of pharmaceuticals for human use - Good Clinical Practice) this publication takes a holistic approach by identifying and describing the requirements for future monitoring and the use of risk-based monitoring. As the authors are operational managers as well as QA (Quality Assurance) experts, both aspects are represented to come up with efficient and qualitative ways of future monitoring according to ICH GCP.

The end of an era? Midwifery conferences.

It has long been accepted that conferences are a useful mode of continuous professional development (CPD) (Russell 2010). Midwives welcome the chance to learn about recent practice developments, and the opportunity to network with each other in a face to face environment. However, barriers such as geographical isolation, time and financial constraints restrict midwives' ability to attend conferences (McIntosh 2007; Patterson and Davis 2007). At the same time, the effectiveness of conferences for CPD has been questioned (Guskey 2000). In these days of financial retrenchment, CPD has to be innovative and creative, offering ongoing support and learning in communities of practice that meet individual learning needs. The Virtual International Day of the Midwife (VIDM) is one such innovation. It is an annual 24 hour international synchronous online conference that celebrates the International Day of the Midwife on 5th May, and is freely open to all. Using the VIDM as a case study, this article discusses how online conferences may support and provide CPD for midwives.

Practice-building seminars in chiropractic: a Petit Bourgeois response to biomedical domination.

As biomedicine evolved into the preserve of upper-class and upper-middle-class physicians, working-class and lower-middle-class individuals turned to chiropractic as a vehicle of upward social mobility. Practice-building seminars constitute a largely overlooked strategy by which many chiropractors have sought to address their marginal status within the U.S. medical system. Using archival and research data, this article discusses the role of these seminars in assisting chiropractors to convince their patients of the efficacy of their treatment modalities, increase their incomes, and bolster their confidence as heterodox medical practitioners.