Education, Ethics, and History: The Peer Review Process in the US.

Despite the near-universal acceptance of the benefits of a sound peer review process (PRP), the topic of peer review remains a source of controversy among surgeons. The current PRP is plagued by heterogeneity across different hospital and institutional systems. These inconsistencies, combined with a perceived lack of fairness inherent to the PRP in some institutions, led to concerns among practicing surgeons. In this review of the relevant literature on the PRP, we attempted to provide some context and insight into the history of the PRP, its role, its shortcomings, its potential abuses, and some key requirements for its successful execution.

Shaping nursing profession regulation through history - a systematic review.

AIM: The aim of this systematic review was to provide a critical synthesis of the factors that historically shaped the advancements of nursing regulators worldwide. BACKGROUND: An in-depth examination of the different factors that moulded regulatory changes over time is pivotal to comprehend current issues in nursing. INTRODUCTION: In the light of global health scenarios, the researchers explored the factors that historically influenced the socio-contextual circumstances upon which governments made regulatory changes. METHODS: A systematic search was performed on the following databases: PubMed, CINAHL, Scopus, OpenGrey and ScienceDirect. The review included papers from January 2000 to October 2016 published in English. The authors used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and an inductive thematic approach for synthesis. RESULTS: Two main themes were identified: factors underpinning current challenges and historical and contextual triggers of regulation. The first theme was composed of three aspects: education, migration and internationalization, and policy and regulation; the second theme consisted of four attributes: demographics, economics, history of registration and wars, and historical changes in nursing practice. DISCUSSION: Factors that shaped nursing regulation were linked to changing demographics and economics, education, history of nursing registration, shifting patterns of migration and internationalization, nursing practice, policy and regulation and significant societal turns often prompted by wars. CONCLUSION: A deeper understanding of the developments of the nursing regulatory institutions provides the foundation for portable standards that can be applied across an array of jurisdictions to guarantee a better public safety. IMPLICATION FOR NURSING AND HEALTH POLICY: Understanding factors that socially, legislatively and politically have influenced the development of regulatory bodies over time helps to mould local, national and international policies that have a stronger impact on health worldwide. To achieve this, there must be effective cooperation among systems of nursing regulations globally.

Moving the Nursing Profession Forward.

One nurse has traveled the world to advocate higher standards in nursing.

A game of snakes and ladders: negotiating the 'ups and downs' of endorsement as a nurse practitioner in Australia.

BACKGROUND: Australian legislation supporting the nurse practitioner (NP) role was enacted in 1998. Since then, NPs have played an important advanced practice role within the interdisciplinary healthcare team. However, the literature suggests that transition to the NP role can be challenging. AIM: This paper highlights the complex transition experiences of ten recently endorsed Australian NPs. The convoluted legislative and regulatory requirements that were negotiated by the NPs are presented as narratives. METHODS: Informed by an ethnographic approach, participants were interviewed several times during their first year. Interview transcripts were thematically analysed and aggregated into three narratives representative of key findings. KEY FINDINGS: The findings exemplify the complexity of navigating through a labyrinth of bureaucracy and the extensive negotiations required to appease those who yielded power over their future practice. CONCLUSION: This study raises awareness of the transition experiences of Australian NPs and their challenges and barriers during this time.

Seminário: Trabalhadores Técnicos da Saúde: aspectos da qualificação profissional no SUS - 3ª Edição / Seminar: Technical Workers Health: aspects of professional qualification in SUS - 3ª Edition

O programa do dia 03 de junho de 2013 recebeu Carmen Tereza Gonçalves Trautwein, coordenadora da Escola Municipal de Saúde Regional Sudeste, para falar sobre o seminário "Trabalhadores Técnicos da Saúde: aspectos da qualificação profissional do SUS". O Seminário, que ocorreu nos 07 e 08 de maio de 2013 na Escola Politécnica de Saúde Joaquim Venâncio da Fiocruz, Rio de Janeiro, fez parte do projeto "Processo de Qualificação de Trabalhadores Técnicos em Saúde". No total, participaram dos estudos apresentados dez subgrupos, com 45 professores-pesquisadores da EPSJV/Fiocruz, cinco bolsistas contratados pelo Plano Diretor do Observatório e duas pesquisadoras do Instituto Nacional do Câncer (Inca). O resgate histórico foi muito debatido no Seminário, em especial, da regulamentação educacional e profissional em saúde e das profissões técnicas de nível médio. "O resgate histórico fez parte de toda a coletânea de pesquisas e se retrocedeu, há pelo menos, quatro séculos de história, então, por exemplo, nós tomamos conhecimento com o fato de que no século XVIII o médico não estava no topo da hierarquia profissional e compartilhava com outros profissionais da saúde das questões da prática terapêutica. Então, algumas pessoas -- os aprendizes -- aprendiam vendo esses profissionais estabelecendo a sua prática e solicitando sua certificação como médicos", disse Carmen. A lei 8.080 de 19 de setembro de 1990 decretada em 2011, em que se constitui a necessidade de uma ordenação dos recursos humanos pelo SUS, também foi citada no programa.

A naturologia no Brasil: avanços e desafios / The naturology in Brazil: developments and challenges

A naturologia é uma profissão recente no Brasil, a qual busca entendero ser-humano multidimensionalmente e respeitar a singularidade humana na busca de bem-estar, qualidade de vida e saúde através da relação de interagência e das Práticas Integrativas e Complementares.Este dossiê aborda um breve histórico das Práticas Integrativas e Complementares e Naturologia no Brasil, o processo de reconhecimentoda ocupação e regulamentação da profissão. O texto também explora os campos de atuação do naturólogo, órgãos de representação profissional, principais eventos científicos e publicações importantes da área. Por fim, são apresentados documentos importantes: Aprovaçãodo MEC dos cursos existentes, Carta de Intenção de abertura de curso superior de Naturologia por uma Universidade Federal, Editais de concursos públicos, Relatos de experiências de trabalhos de Naturólogosem instituições de renome nacional, Anais dos Congressos Brasileiros de Naturologia e Carta da Pedra Branca, a qual traça diretrizesfuturas para a Naturologia no Brasil.(AU)

Naturology is a new profession in Brazil, one which seeks to understand the human being in a multi-dimensional way, and respect human singularity in its search for well-being, quality of life and health through a relationship of interagency and Complementary and Integrative Practices. The present dossier addresses a brief history of Complementary and Integrative Practices and Naturology in Brazil, the process of recognizing the occupation and regulation of the profession. The paper also explores the fields in which the naturologist is active, the bodies of professional representation, the main scientific events and important publications in the fiels. Finally, important documents are presented: the approval by the Brazilian Ministry of Education (MEC) of existing courses, Statement of Purpose for opening undergraduate-level major in Naturology by a Federal University, notices for public tendering, Proceeding of Brazillian Naturology Conferences and the Charter of Pedra Branca, which sets future guidelines for Naturology in Brazil.(AU)

Spanish nurses' credentialing in the 20th century.

BACKGROUND: Nurses credentialing as healthcare professionals commenced in Western Europe and in the USA by the end of the 19th and the beginning of the 20th century, boosted by the protestant reform movement. In Spain, it started in 1915, during the kingdom of Alfonso XIII (1902-1931). This historical period was marked by great political instability and big flaws in the healthcare delivery system. AIM: To describe the regulatory pathway that gave rise to the nursing profession in Spain, through official credentialing and regulation during the first third of the 20th century. METHOD: Documental, historical and regulatory documental research describing and analysing the national legislative sources used to regulate the professional development, as well as the education, training and competencies of the nursing practice in Spain, as compared with the developments in the European and American context. CONCLUSIONS: Professional development of the nursing profession in Western Europe and in the USA is consolidated during the 20th century as resulting in educational and training enhancement and the establishment of national and international professional bodies. In Spain, the regulatory and legal recognition of the nursing profession come into being in 1915 in response to a request from a female religious congregation.

Historical and cultural influences on establishing professional legitimacy: a case example from Lionel Logue.

PURPOSE: In the film The King's Speech, the credibility of the king's speech clinician, Lionel Logue, is challenged. This article examines Logue's credentials in light of the credentialing standards and attitudes of Logue's time as well as those affecting today's practices. The aim is to show how standards of legitimacy change with the times. METHOD: Documents related to clinical qualifications and clinical practices are analyzed for the period in the early 20th century, when Logue practiced. They are then compared with how clinicians of today attain professional legitimacy. CONCLUSION: Early 20th century clinicians drew their credibility from their home disciplines such as medicine, phonetics, elocution, and education. Some of their therapies originated in the home discipline. Other therapies were commonly used, regardless of one's disciplinary background. Lionel Logue's background and methods would not have been suspect in his time. He may have been faulted by some for his lack of scientific perspective, but another likely source for the challenges to his credibility were early 20th century British social biases against Australians and against those using Australian dialects. The comparative analysis revealed that early 20th century clinicians and clinicians of today have certain clinical practices in common, but they differ considerably in how they establish their legitimacy. This indicates that judgments about a clinician's legitimacy are both historically and culturally determined.

The making and transnationalization of an ethnic niche: Vietnamese manicurists.

The article addresses how Vietnamese immigrant women developed an urban employment niche in the beauty industry, in manicuring. They are shown to have done so by creating a market for professional nail care, through the transformation of nailwork into what might be called McNails, entailing inexpensive, walk-in, impersonal service, in stand-alone salons, nationwide, and by making manicures and pedicures de riguer across class and racial strata. Vietnamese are shown to have simultaneously gained access to institutional means to surmount professional manicure credentializing barriers, and to have developed formal and informal ethnic networks that fueled their growing monopolization of jobs in the sector, to the exclusion of non-Vietnamese. The article also elucidates conditions contributing to the Vietnamese build-up and transformation of the niche, to the nation-wide formation of the niche and, most recently, to the transnationalization of the niche. It also extrapolates from the Vietnamese manicure experience propositions concerning the development, expansion, maintenance, and transnationalization of immigrant-formed labor market niches.

A Escola Anna Nery e a formação de enfermeiras, assistentes sociais e nutricionistas na Universidade do Brasil nos anos 30/40 do século XX / Anna Nery Institute and its background of nurses, social assistants and nutritionists at Universidade do Brasil in the 30s and 40s of the century XX

Este estudo, de natureza histórico-social, tem como objeto a contribuição da Escola Anna Nery (EAN) para a formação de enfermeiras, assistentes sociais e nutricionistas, nos anos 30 e 40do século XX, no âmbito da Universidade do Brasil (UB). O recorte temporal, de 1937 a 1949, corresponde ao ano em que a EAN logra ingressar na UB e ao ano em que se observa o reconhecimento social dessas três carreiras em editorial da revista Anais de Enfermagem (AE). Os objetivos do estudo foram: descrever as circunstâncias da transferência da EAN do Departamento Nacional de Saúde para a UB; analisar os discursos sobre a Enfermagem, o Serviço Social e aNutrição à época; discutir a contribuição da EAN para a formação de enfermeiras, assistentes sociais e nutricionistas no âmbito da UB. As fontes primárias incluíram artigos, editoriais e oraçõesproferidas em solenidades, publicados na AE e na revista Arquivos Brasileiros de Nutrição. As fontes secundárias incluíram artigos, teses e livros referentes ao contexto histórico-social,pertencentes ao acervo de bibliotecas tradicionais ou virtuais e do Banco de Textos do Cedoc/EEAN...

The Doctor of Nursing Practice degree: lessons from the history of the professional doctorate in other health disciplines.

Despite the American Association of Colleges of Nursing's adoption of the Doctor of Nursing Practice (DNP) degree as the appropriate level of education for advanced practice, a number of controversies have persisted, including questions of timing, academic support, grandfathering, diffusion of nursing research, and economics. This article discusses the path to the professional doctorate in optometry, osteopathy, public health, pharmacy, physical therapy, audiology, chiropractic, and naturopathy. It reveals similar struggles to professionalism and the consensus drawn from doctoral development in these fields. It concludes with lessons for a path forward for the DNP.

Translating the family medicine vision into educational programmes in Singapore.

The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. We traced how FM education started and what have been achieved. FM training began in 1971 with the formation of the College of General Practitioners Singapore. Previously, training consisted of self-directed learning, lunchtime talks and examination preparation courses run by hospital specialists. Formal FM vocational training programmes in the United Kingdom and Australia provided the model for a 3-year programme in 1988. The tripartite relationship between the local university, College of Family Physicians and Ministry of Health, together with a structured training programme, contributed to its success. To date, more than 240 Family Physicians in Singapore have been awarded the Masters in Medicine (FM) degree. The Graduate Diploma in Family Medicine programme (GDFM) was introduced in 2000 for Family Physicians who wished to practice at an enhanced level. This programme has trained 194 doctors since then. Behind the scenes, the following were important developments: counterculture with a difference, tripartite stake-holding, training the trainers and learning from others. For the FM undergraduate programme, our aim is to develop the knowledge base, core values and roles of the Family Physician. Sustaining the value of Family Medicine as a career choice is the enduring vision.

The emergence of clinical practice guidelines.

Clinical practice guidelines are now ubiquitous. This article describes the emergence of such guidelines in a way that differs from the two dominant explanations, one focusing on administrative cost-cutting and the other on the need to protect collective professional autonomy. Instead, this article argues that the spread of guidelines represents a new regulation of medical care resulting from a confluence of circumstances that mobilized many different groups. Although the regulation of quality has traditionally been based on the standardization of professional credentials, since the 1960s it has intensified and been supplemented by efforts to standardize the use of medical procedures. This shift is related to the spread of standardization within medicine and especially in research, public health, and large bureaucratic health care organizations.