Learning in practice (nursing)
This is a time of great transformation in health services. Hence there is the need for a clear view on the best way to deliver services within dermatology department. Educational programs in dermatology are quite vital to the improvement of competencies by the employees; however, these programs must be relevant to a multi-professional dermatologist at the most appropriate level of their specialty rather than their profession. This competence strategy will describe the remit of the educational programs and will offer a variety of skills that may be regarded as important in their role hence allowing the development of job specialization. However, the current state of education and clinical preparation for dermatologists is at a critical position. This is because of the fact that most of the dermatologists acquire their specialized skills and know-how through the on-job training with other dermatologists, educational training and with restricted clinical residency experiences. This has therefore made it so hard for the definition of the core body of knowledge and the standard for education preparation required in offering a base for competent dermatology nurse practitioners. There is the need for the realization of the importance of the establishment of minimum knowledge and standard of dermatologist’s competencies.
According to Dermatology Workforce Group, (2007), the decisions in regards to patient care by dermatologists are often made by a team rather than an individual. Therefore, dermatologists must, therefore, rely on the role of the leaders so as to empower the team to attain the organization’s goal. As a result of this, a well maintained open communication, as well as better coordination within the organization, will be realized. Dermatologist leaders should, therefore, encourage and support the subordinate dermatologists placing on a clear vision and building on trust and their capacity to influence subordinates to realize their vision, greatly influences the employees' satisfaction. Good health care requires a good team conduct, hence, it is recommended that dermatologists should establish good relationships with the care teams and should work on improving these relationships. In so doing, employees’ satisfaction will be developed.
Transformational leadership in dermatology is one of the most effective leadership following its emphasis on the improvement of supportive relationship building. These relationships are attributed to enabling employees to find meaning in their work, allowing them to communicate their proposals and collaborative participation in teamwork towards effecting positive change. Dermatologist practitioners cite recognition and empowerment as major reasons behind satisfaction and acceptance of the profession hence resulting in nurses’ engagement in learning (Walker, Cooke, Henderson, & Creedy, 2011).
In today’s nurse leader, an appreciation for workplace culture is quite important. Nurse practitioner’s attitude towards culture enhances them to better understand staff conducts and relationships. Continuous learning culture in dermatology organizations is quite important. This learning environment allows nurse practitioners to propose new schemes. Nurses are therefore challenged to become inquisitive and more research-oriented (Tsai, 2011). This, therefore, fosters a culture of continuous competence improvement. In most cases, dermatology nurse practitioners may collide with each other but it is important for them to realize the power that is vested in apology and transparency. Organizations that embrace this culture often improve their relationships and thus are able to help one another in the different cases regarding the patients and also the treatment options hence becoming productive. The dermatology organization ought to develop a just and fair culture is quite important in having a productive workforce. In a fair and just organization, interpersonal learning is balanced with an individual’s discipline and responsibility. Anytime that the organization is at a position of discussing mistakes with transparency with a motive of learning from them and when the organization uses resources needed to get to understand the root cause of the mistake, then the organization seizes to being a blame game but rather it becomes an environment that fosters respect and open learning of new ways of doing things in a better way.
Presence of a healthy organizational culture allows practitioners to experience precious learning in the organization. Learning in the workplace is quite essential as it allows the provision of an evidence-based and progressive improvement in safe patient care which is core in attaining good patient results. Therefore, there is the need for dermatologists to learn within an organization that promotes the implementation of evidence-based, expert practice and allows for the best patient results. In addition, organizations’ learning informs the extent and progression of nursing practice and is also linked to the regulatory needs that are connected to dermatology practice. Organization culture has important economic as well as organizational imperatives. A healthy organization fosters good human relationships and hence promoting job satisfaction. As a result of the increased job satisfaction, there are high chances of employees’ retention and ultimately low dermatologists’ turnover rates. Therefore, by addressing the issue of nurses’ retention, organizations are in a better position to economically save so many finances due to the already cut cost of employing new employees (Tsai, 2011).
Following the high need for education in dermatology, it is important for the organization to offer educational and career empowerment through offering the nurses financial support and also allocating them with enough time for educational development and research. The organization should also empower them to carry out special projects and publications. This will expound on their knowledge of dermatology health knowledge hence will reduce their need to quit and thus less turnover and competence. The organization should incorporate a culture of mentorship through arranging for educational seminars and conferences for the dermatologists as this will allow them to all benefit from the organization’s effort in creating awareness about a given subject related to skin disorders (Davis, White, & Stephenson, 2016).
The most common diseases experienced by health professionals are the skin disorders. There is a high prevalence of a wide range of people suffering from eczema while others suffer from psoriasis and a small number suffer from rare genetic skin disorders. These skin disorders, however, have proved to affect people of all ages and the increasing need for children, teenagers and in old patients needs to be realized and a solution needs to be established. Some of the common skin disorders are frequently increasing in numbers and this has resulted in an epidemic of skin cancer. As a result of this, there has been a rapid increase in demand for dermatological services as an outcome of this change and due to the changing attitude of people towards skin disorders. There has also been an increase in the number of referral cases to dermatologists by general practitioners more than all the other medical specialties. However, the majority of these patients are faced with mild skin problems that are often self-managed and they become effective once an earlier diagnosis is offered to them. The referral systems are quite positive hindrances to optimal care for patients suffering from long-term skin disorders. This is because of the long waiting period that the patients go through. The patient’s skin problem may end up deteriorating during the intervening period, in spite of the fact that the dermatologist is already aware of the patient’s diagnosis and the treatment needs required by the patient. However, in relation to these facts, it is so disappointing that the education curriculum in dermatology for all professions and to all levels is very restricted, with the exception of the education skills offered for hospital physicians training in this area (Dermatology Workforce Group, 2007). The standard medical undergraduate curriculum for dermatologists involves only six days of training while the general practitioners are usually exposed to skin problems during their daily practice. It is so unfortunate that in six GP’s only one of them has the formal training in dermatology. There is no prearranged post-qualifying education program for nurses in dermatology. On the other hand, dermatology content among the pre-registered nursing programs differs largely and is at present not standardized. Therefore, there are limited educational opportunities in dermatological pharmacy with no structure formulated. Though there are accredited open learning courses for pharmacists interested, there are no standards set as to whether it is mandatory for dermatologists’ pharmacists to take this course and there are no incentives allocated for the same. In regards to these arguments, there is a pressing need to consider how dermatological services should be configured so as to ensure that the already existing expertise is at maximum use and to delineate the educational aspects that are of importance in generating competent dermatologist practitioners at all levels (Dermatology Workforce Group, 2007).
According to Bobonich, & Cooper, 2012), for a nurse to specialize in dermatology, they are required to first complete their master program focusing on a specialty in one of the well-defined populations. In the past, acquiring an additional dermatology was just a subspecialty know-how and having the clinical skills was just subjective, inconstant and unclearly defined. However, in the modern health care systems, there is the need for advanced dermatology science which is essential in the development of competencies. The current dermatology education programs should, therefore, consider integrating the basic science and advanced science in dermatology. These educational elements in the core curricular of dermatology will enable learners to improve on their clinical competencies. It is therefore paramount that the dermatology institutions should define and create a standard for the dermatology studies. In doing so, the practitioners will be able to understand the expected minimum level of expert performance in their area of work hence they will be able to increase their productivity.
According to Lyons & Ousley, (2015), insufficient dermatological education is not limited to nurse practitioners. A considerable amount of United States medical school graduates pursue primary medical care courses while another large number devotes their studies to dermatology diseases. According to a survey carried out, it is quite evident that dermatology is among the most inadequately taught course in medical schools as compared to other educational curriculums. Medical schools thus fail to adequately prepare dermatology students in regards to diagnosis and treatment of the common skin disorders. Most of the medical schools offered dermatology students less than 18 hours of dermatology training. This is the major reason as to why the primary caregivers and nurse practitioners have a difficult time diagnosing the skin problems. Nurse practitioners as well as dermatologists within the primary care department, they ought to have accurate, useful and proficient tools so as to direct them in diagnosing a skin problem (Bobonich, & Cooper, 2012). Dermatology education, therefore, requires clinical experience and exposure, an interaction between instructor and feedback from them, quality and focused know-how attainment. However, there are limited commitments in regards to dermatology education with reverence to clinical requirements of advanced practice programs.
The need for dermatological education has been determined by the high rates of skin disorders mostly among the elderly. In reality, frequently, the primary care physicians are the ones who are initially held responsible for treating skin patients. They are thus expected and challenged to train themselves while on the job so as to have an effective response to some of the common dermatologic problems amongst these patients. Their inexperience is attributed to the lack of training on dermatology as only a few numbers of practitioners have received formal training at a dermatology medical school. Although this educational need has been acknowledged by practitioners and medical schools, it is so unfortunate that the need has been unmet (Bobonich, & Cooper, 2012). It is thus quite clear that this knowledge deficit is translating to insufficient diagnosis and unsuitable treatments that are out of place in treating skin disorders. This, therefore, promotes a need for more efficient training strategies in dermatology health area. There is limited research in dermatology area and this has created a gap in pediatric dermatological treatments. The lack of research has therefore caused an increase in the number of dermatological problems amongst patients of this age group. Due to lack of knowledge on how to diagnose and treat these skin disorders in children has resulted in increased referrals to the few dermatologists in the field. As these dermatologists enquire and read about the alternative treatment options they end up taking a lot of time to treat these patients hence aggravating the numbers of sick children. Most practitioners or even dermatological nurses have insufficient or no specific education skills in pediatrics (Bobonich, & Cooper, 2012).
According to In Brooker, & In Waugh, (2013), leadership is all about setting pace and opening up f new opportunities in order to assist people in achieving their goals and in delivering quality standards. Registered practitioners, therefore, has a leadership potential which goes beyond knowing everything but rather it is all about being able to reflect the knowledge in practice, connecting energy from the clinical team and to progressively make improvements in the day to day activities. Therefore, for dermatologists to lead in delivering their quality services to their patients a national standard on their program of study ought to be delivered to all universities and it should be inclusive of work-related learning. The core role of health practice and service improvement, research and evaluation include an establishment of a research culture that would be embedded in providing evidence in practice. Dermatologists among other nurse practitioners are required to make a considerable contribution to the strategic governance of clinical administration. Clinical dermatologists should work towards ensuring effective mechanisms in health care are put in place and to ensure that the patients’ safety is adhered to. This will foster a culture of patient-centered practice, teamwork development and meeting of health services delivery. Education, training and staff development are some of the elements that aim at developing a culture for learning in practice and to maintain the connection with the specialists hence resulting in improved competencies. It is through this expert practice, education, research, and development that the dermatologic health department will improve its service delivery, diagnosis, treatment and therapies across all age groups including the pediatrics (In Brooker, & In Waugh, 2013).
To sum it up, dermatology leaders should establish a standardized educational curriculum and preparation of dermatology nurse practitioners. This curriculum development, therefore, ought to be planned carefully, with well-thought implementation process and evaluation. It is thus recommended that a thorough health education in this line of profession ought to be considered with a high emphasis on the interdisciplinary education. The standardized program of study should be founded on the basis of consensus of judgment as this will direct the formal as well as the informal dermatology education and practice. All this will help in promoting dialogue and ensuring that there is quality dermatological health care.
References
Tsai, Y. (2011). The relationship between organizational culture, leadership behavior, and job satisfaction. BMC health services research, 11(1), 98.
Davis, K., White, S., & Stephenson, M. (2016). The influence of workplace culture on nurses’ learning experiences: A systematic review of qualitative evidence. JBI database of systematic reviews and implementation reports, 14(6), 274-346.
Walker, R., Cooke, M., Henderson, A., & Creedy, D. K. (2011). Characteristics of leadership that influence clinical learning: A narrative review. Nurse Education Today, 31(8), 743-756.
Lyons, F., & Ousley, L. E. (2015). Dermatology for the advanced practice nurse.
In Brooker, C., & In Waugh, A. (2013). Foundations of nursing practice: Fundamentals of holistic care.
Bobonich, M., & Cooper, K. D. (2012). A core curriculum for dermatology nurse practitioners: Using Delphi technique. Journal of the Dermatology Nurses' Association, 4(2), 108.
Dermatology Workforce Group. (2007). Models of Integrated Service Delivery in Dermatology.
