A STUDY OF THE IDENTIFICATION OF CORE CONTENT OF TECHNICAL
COURSES IN THREE ALLIED HEALTH TECHNOLOGIES
Peggy Ann Bensman
A Dissertation
Submitted to the Graduate School of Bowling Green State University in partial fulfillment of the requirements for the degree of
DOCTOR OF PHILOSOPHY
March 1975
BOWLING GREEN STATE UNIVERSITY LIBRARY il
ABSTRACT
The study was undertaken to determine if there were a common core of content included in the technical courses of dental hygiene programs at the certificate or associate degree level and nursing and radiologic technology programs at the associate degree level. The study also ascertained whether there were possible additions or deletions to content that was being taught in these programs.
The information was obtained through a questionnaire survey which was sent to the directors of all of the three types of programs in the United States. Five levels were used to determine the amount of emphasis placed on each item of content. Two cores of common con tent were identified: core A which included content on which 75% or more of the respondents placed average or greater emphasis and core B which included content on which 51% or more of the respondents placed average or more emphasis .
Thirty-two items of content were analyzed as to whether they were common to two or three of the programs under investigation. The findings revealed that seventeen items of content were common to the three programs at the core A level and twenty-three at the core B level. Six were common to two programs at the core A level and eight at the core B level.
The conclusion reached in this study was that there was a common core of technical content in dental hygiene, nursing and radiologic technology programs as presently being taught in separate courses. The greatest similarity of content was found in the technician-patient relations category. The conclusion was also reached that the content which was presently included in the three types of programs would remain as essential content in the programs within the next ten years if the opinions presented by the respondents were valid.
The results of the study have implications for departments of allied health, educators, students and practitioners in the allied health field. The findings could serve as a basis for determining content to be included in core courses or other types of common learning experiences. m
ACKNOWLEDGMENTS
I take pride in expressing my appreciation to all those who have assisted me in a variety of ways throughout the writing of this dissertation. I am indebted to Dr. Morris J. Weinberger, the chairman of my committee for many reasons, but mostly for his interest in me as a person. I am also indebted to the other members of my committee:
Dr. Leslie J. Chamberlin, Dr. Fred Pigge and Dr. Donald Ragusa for their assistance which each rendered when requested. I am also indebted to my typist and the many relatives and friends who were helpful to me in innumerable ways but most particularly to my parents without whose assistance, understanding and prayers the writing of this dissertation would not have been possible. IV
TABLE OF CONTENTS
Page
LIST OF TABLES...... vii
Chapter
1 . THE PROBLEM , DEFINITIONS AND PROCEDURES...... 1
Introduction to the Problem...... 1
Statement of the Problem...... 4
Definition of Terms...... 6
Allied Health Personnel...... 6
Core...... 7
Technical Course ...... 8
Dental Hygienist...... 9
Nurse Technician ...... 10
Radiologic Technologist...... 10
Significance of the Study...... 11
Problem to be Investigated...... 11
Procedures...... 11
Organization of the Study...... 12
2. REVIEW OF THE LITERATURE...... 13
Overview of Core Curricula ...... 13
Core Curricula in Allied Health...... 17 V
Chapter Page
Summary...... 44
3. STATEMENT OF PROCEDURES ...... 47
Introduction...... 47
Distribution of Questionnaire...... 54
Analysis of Data...... 58
4. REPORT OF FINDINGS...... 60
Introduction...... 60
Respondents...... 60
Analysis of Data...... 62
Disease Process ...... 63
Introduction to Health Care...... 70
Pharmacology...... 72
Problem Solving...... 73
Safety Factors ...... 74
Application of Technical Skills...... 75
Technician - Patient Relations...... 77
Final Question...... 78
Summary of Findings...... 78
5. SUMMARY AND SUGGESTIONS FOR ADDITIONAL RESEARCH...... 87
Summary...... 8 7
Conclusions...... 89 vi
Chapter Page
Limitations ...... 93
Suggestions for Additional Research...... 95
Recommendations for Use of This Study...... 97
Schools or Departments of Allied Health...... 98
Educators...... 99
Students...... 101
Practitioners...... 102
BIBLIOGRAPHY...... 105
APPENDIXES
A. Survey on Curriculum Content ...... 115
B. List of Directors Included in Sample Group...... 122
C. Items Found to Be Unreliable...... 124
D. List of Institutions to Which the Questionnaire Was Sent...... 126
E. Responses by States...... 158
F. Graphs Depicting Emphasis by Programs ...... 160 Vil
LIST OF TABLES
Table Page
1. Arrangement of Core: General Studies ...... 38
2. Arrangement of Core: Special Studies...... 38
3. Reliability of Items Used in Questionnaire...... 57
4. Summary of Questionnaire Returns...... 61
5. Dental Hygiene Programs, Responses by Percentage...... 64
6. Nursing Programs, Responses by Percentage...... 66
7. Radiologic Technology Programs, Responses by Percentage ...... 68
8. Commonalities of Content...... 80 t
Chapter 1
THE PROBLEM, DEFINITIONS AND PROCEDURES
Introduction to the Problem
Almost unnoticed in the mounting concern and debate over the "crises" in health care is the fact that revolutionary changes have occurred since World War II in the ways in which health services are produced. Pressed by increased demand for services and assisted by scientific breakthroughs, the technology of delivering health care has been significantly altered over the past three decades in a form that parallels the growth of other productive activities: the utilization of capital equipment has expanded and the division or specialization of labor has increased. . . . With respect to health manpower. . .it was possible only a short time ago to count the different types of personnel utilized in providing health care easily on the fingers of two hands; at present upwards of twenty hands are needed to enumerate the specialized job functions performed in promoting good health and caring for the ill. 1
In the United States today there are at least seven hundred different career opportunities in the health professions and occupations .2
This large number of categories of health workers has resulted in large part from an attempt to provide an increasing proportion of the population with health care at a time when there is already a shortage of profes sional health workers.
1 Thomas N . Chirikos , Allied Health Manpower in Ohio (Columbus: Center for Human Research, The Ohio State University, 1972), p. 1. 2Horizons Unlimited (Chicago: American Medical Association, 1970), p. viii. 2 Leaders in medicine and allied professions estimate, for example, that the nation will need 22 9,000 more professional nurses ... at least 50,000 more physicians, 40,000 more speech pathologists, 38,000 more medical technologists, 30,000 more dietitions and 18,000 more medical social workers within the next five to ten years . 1
To alleviate this shortage of professional workers, an increasing number
of technicians have been added to the health field.
Indeed, no longer is the health care system manned, in large measure, by those who have earned doctoral degrees, but rather by persons with substantially less (albeit more specialized) training who perform functions "allied" to the highly skilled practitioner. Such allied workers now constitute the majority of all persons employed in the health care field; prospects are that this proportion will grow even larger over the next decade.2
Some 3.5 to 4 million persons are now engaged in the many aspects of health services and this does not include the million or so engaged in the manufacture and wholesale distribution of drugs... . Within the great overall growth, perhaps the most striking single fact is the declining ratio of doctors to all health personnel. It is now in the order of one to eleven.3
Preparation for these careers in the allied health fields takes place primarily in educational institutions and hospitals. The trend in recent years has been to move these programs from hospital to educational institution control. The preparation of a major percentage
1 Horizons Unlimited (Chicago: American Medical Association, 1970), p. ix.
2Thomas N. Chirikos, Allied Health Manpower in Ohio (Columbus: Center for Human Research, The Ohio State University, 1 972), pp. 1-2 .
3 Anne R. Somers, Health Care in Transition: Directions for the Future (Chicago: Hospital Research and Educational Trust, 1971), p. 19. 3 of these allied health workers is now taking place in educational institutions which award the associate degree or certificate upon completion of the program.
. . .although the traditional nexus between health manpower and educational policy has been focused at the level of the university—typically at the post-baccalaureate level of ins- truction--the trend toward the increased utilization of allied health personnel has shifted this focus to lower levels of the educational structure, generally somewhere between the high school diploma and the baccalaureate degree. This implies, among other things, that the vocational/technical education components of a community's school system now have an aug mented role to play in training man power for the health delivery system. 1
When these large numbers of health technologies are offered as separate and distinct programs, problems are presented for the institution offering the technologies as well as for the students enrolled in the technologies. The number of students enrolled in many of the tech nologies is quite small, thus making it expensive for an institution to offer the separate programs. The student upon entering the college, must decide immediately upon the health field that he wishes to enter.
If he changes his mind one or two semesters later and decides to trans- fer,to another health technology, the time spent in the technical courses related to the field of his first choice is usually lost. It would
1 Thomas N. Chirikos, Allied Health Manpower in Ohio (Columbus: Center for Human Research, The Ohio State University, 1972), pp. 2-3. 4 certainly be to the advantage of the institution and the student if there were a course or courses offered which contained a core of con tent relating to more than one health technology. The institution could then:
1. utilize faculty more effectively by offering all students entering these fields courses that cover material common to all of the occupations; 2. recruit students for the health field in general and defer for at least a semester a decision on which field best fits the students' interest and aptitudes; 3. relieve high school coun selors of the almost impossible chore of keeping abreast of the details of newly developing health fields by enabling them to counsel students broadly regarding the opportunities in the general field of health service technology; 4. provide an opportunity for the college faculty to observe, evaluate and counsel students before they choose a specific health field; 5. provide students with a better perspective of the several fields so that they may make their career decisions with greater certainty. 1
More specifically, the reasons a core approach is considered desirable are: to increase efficiency and economy in program planning, to assist students in career choice, to encourage career mobility, to enhance the health team concept, and to promote more effective teaching and learning.2
Statement of the Problem
This study was undertaken to investigate the possibility of a common core of technical content in three allied health technologies .
1 Robert Kinsinger, "A Core Curriculum for the Health Field, " Nursing Outlook, XV (February, 1967), p. 28.
2"Core Concept in Allied Health, A Summary of the ASAHP Report", Journal of Allied Health, II (Summer, 1973), p. 99. 5 The information was obtained through a questionnaire survey of
institutions conducting any of these programs .
The purpose of this study was to examine the content of the technical courses of three allied health technologies which lead to an associate degree to determine if there were a common core of content included in these courses. Opinions were also elicited as to whether there would be greater, less or the same need for specific areas of con tent in the future. The three technologies that were examined were dental hygiene, nursing, and radiology. These three programs were selected for the following reasons: they are all offered by institutions of higher learning at the associate degree or certificate level, they must all meet state or national requirements for licensure or certification and they all deal directly.with the consumer of their services. These pro grams were also of primary interest to the researcher since they were in operation or in the planning stages in the institution in which she was employed. Only the content of technical courses was examined since this was the area in which the least research had been done.
From a review of the literature it appeared that some studies had been directed at the liberal arts or general studies areas and the physical and biological science areas to determine if there were a common core of content in these courses. Curricular offerings in institutions which conducted more than one allied health program also supported this premise. 6
The information relating to the relationship of technical con tent in the three allied health programs was obtained by a questionnaire survey of all institutions of higher learning throughout the country that conducted any of the three technical programs at the associate degree or certificate level. In the case of nursing and radiologic technology, the basic programs offered by institutions of higher learning all led to an associate or baccalaureate degree but with dental hygiene the programs led to a certificate, associate or baccalaureate degree.
Since according to the definition of the dental hygienist, there was no differentiation made in the scope of functioning between an associate degree and certificate level hygienist, questionnaires were sent to all colleges and universities which conducted dental hygiene programs at the associate degree or certificate level.
Definition of Terms
Since the understanding of this study depends' in part upon a common understanding of definition of terms, it would be well to present the definitions which have been utilized in this study.
Allied Health Personnel
Although there is some disagreement as to which group of health occupations should be termed allied, for the purpose of this study the allied health personnel included "all of the health occupations below 7 the (autonomous) Csicl doctoral level".
Core
In 1971 the Association of Schools of Allied Health Professions
was awarded a contract by the Division of Allied Health Manpower,
Bureau of Health Manpower Education, National Institutes of Health to
study the state of the art of core concept in allied health professions.
They found that there was no single accepted meaning of the term
"core". In this study it was found that core was organizationally defined in the following ways: 1. a course which all students take;
2 . a course which all students take but from which students in
selected specialties may delete certain parts or be given additional material; 3. a unit of work incorporated within a structured course that several groups take; 4. programmed or autotutorial materials utilized by students from several areas; 5. integrated approach; 6. common material that professional and technical students take.2 In a paper presented at a Paramedical Education and Career Mobility Symposium in 1968, Turner made five assumptions which could serve as guidelines for paramedical program development. One of these assumptions was
1 Harry I. Greenfield, Allied Health Manpower: Trends and Prospects (New York: Columbia University Press, 1969), p. 23.
2 "Core Concept in Allied Health, A Summary of the ASAHP Report", Journal of Allied Health, II (Summer, 1973), p. 99. 8
that "There are certain commonalities in families of occupations which,
when carefully identified, can be taught as a part of a curriculum which will be the same for all, or nearly all, of the specific occupations within that family."! In keeping within the guidelines of this assump tion the following definition of core has been utilized in this study: core—common requirements of skills and knowledge for a group of occupations.
Technical Course
Although the term "technical course" is commonly used by educational bodies, a precise definition of the term was not readily available. Therefore the following definition will be used in this study:
A course that is designed to prepare the student for practice within his chosen field. Emphasis is placed upon development of know ledge and skills which must be utilized at the application level. The course draws upon principles and concepts from the social, behavioral, biological and mathematical sciences which are necessary to understand the knowledge and skills required for practice within the particular occupational field.
The technologists which have been included in this study have
!Robert E. Turner, "Core Curriculum and Mobility" (paper presented at the Paramedical Education and Career Mobility Symposium, Evergreen Park, Illinois, June 6, 1968). 9
been defined by their respective organizations according to their scope
of function.
Dental Hygienist
The dental hygienist by direction of the dentist and within limits of the dental practice acts. . .removes stains and deposits from teeth with manual or mechanized instruments; applies preven tive agents to oral structures; administers prescribed medications; obtains and prepares nonsurgical clinical and laboratory oral diagnostic tests for interpretation by the dentist; and assists the dentist at the chair. He provides dental health education according to individual needs and recommendations based on current findings of dental research and motivates the public to accept and follow professional recommendations. He plans and conducts and evaluates dental health programs according to community needs; provides consultative services to health classes and conferences planned by civic and voluntary groups; conducts and evaluates pre-service and in-service programs for personnel in related health fields. 1
The above definition which was adopted by the House of
Delegates of the American Dental Hygienists' Association in November
1966 does not distinguish between the certificate or associate degree and baccalaureate degree graduate. However, according to Bruce,
Burnham et al., the baccalaureate graduates "are qualified for entering positions in dental hygiene education or for some supervisory positions in dental public health agencies . "12 Therefore, it would seem that only
1 Harry W. Bruce and others, Planning a Program for Dental Hygienists (Washington: U.S. Government Printing Office, 1968), p. 37.
2 Ibid ., p. 11. 10 the first statement relating to technical skills would apply to the
associate degree or certificate level graduate.
Nurse Technician
The following definition of the nurse technician has been
adopted by the Council of Member Agencies, Department of Associate
Degree Programs, National League for Nursing:
The nurse technician is a registered nurse with an associate degree in nursing licensed for the practice of nursing and other therapeutic measures with a high degree of skill, using prin ciples from an ever-expanding body of science. The technical nurse performs nursing functions with patients who are under the supervision of a physician and/or professional nurse and assists in planning the day-to-day care of patients: evaluating the patient's physical and emotional reactions to therapy, taking measures to alleviate distress, using treatment modalities with knowledge and precision and supervising other workers in the technical aspects of care. 1
Radiologic Technologist
The duties of a radiologic or x-ray technologist:
. . .include making of x-ray exposures, aiding the radiologist in fluoroscopy, processing of films and adjusting controls and positioning patients for therapy treatments. In small institutions and doctors' offices the technologist also many be called upon to do the clerical work involved in keeping records of the patients and films. The technologist is also responsible for the mental and physical comfort of the patient while in his care.2
!.New England Board of Higher Education, How the Associate Degree Graduate Nurse Contributes to Patient Care (cn.p.:n.n.j, July, 1968).
2American Society of Radiologic Technologists, Careers in X-ray Technology (Chicago: Cn.n.d, 1961). 11 Significance of the Study
If there were a common core of content it would be possible to design a course or courses that included this content and which could be required of students entering any of the three technologies. This method would provide for larger enrollment in health technology courses, thus providing for better utilization of the faculty and a lower cost to the institution. If the courses were offered early in a student's program it would provide the opportunity for him to become familiar with more than one health technology before making his final career decision.
Problem to be Investigated
The following problem was defined for investigation: is there a common core of technical content within the three allied health tech nologies, namely dental hygiene, nursing and radiologic technology, as presently offered in educational institutions. The study also attempted to ascertain if there were possible additions or deletions to content that was presently being taught in each of the three programs.
Procedures
A questionnaire was formulated which included areas of con tent which might be included in the technical courses of the three allied health technology programs under investigation. For each item in the questionnaire, the respondent was asked to specify, on a checklist, the amount of emphasis placed upon the particular item in the curriculum 12 offered in his college. The five levels of emphasis were: major,
above average, average, little, and do not include.
Prior to sending out the questionnaire it was presented to dental hygienists, registered nurses and radiologic technologists at a regular meeting of their respective local or area professional organization. The purpose of the presentation was to elicit suggestions as to clarity of statements, mode of presentation, and content to be added or deleted.
The population used in the study was all of the directors in the United States of programs leading to an associate degree or certificate in the case of dental hygiene. Before sending the question naire to all of the directors, it was sent to a sample group of thirty
(ten from each program) to elicit suggestions for clarity and content and to determine its reliability.
Organization of the Study
The study is organized into five chapters. Chapter 2 contains a review of the literature relating to this study. The two areas of review are an overview of core curricula and core curricula in allied health programs. Chapter 3 describes the procedures used in conducting the study. A report of the findings are presented in Chapter 4. The conclusions, limitations of the study and recommendations for further research are included in Chapter 5. Chapter 2
REVIEW OF THE LITERATURE
Overview of Core Curricula
The term core first appeared in educational literature in relation to curricular offerings in secondary schools. "In 1935 the term 'core curriculum' was used to designate a new type of educational program being developed in a few American high schools. Historically, the concept of core curriculum can be traced to the 1930's . Between the two world wars changes were occurring within society which had major implications for the educational systems and practices. The core cur riculum evolved from society's reaction against the fragmented learning resulting from the separate subjects curriculum and changes in the concept of the social role of the schools.
Curriculum writers cited various general causes for the develop ment of the core curriculum. Tyler listed the causes as being increasing complexities of American life which required students to develop a wide range of competencies, increasing proportions of youth remaining in
1 Ralph W. Tyler, "The Core Curriculum," NEA journal, XLII (December, 1953 ), p. 563. 14
high school and increased research findings on the learning process.!
Faunce and Bossing attributed the development to the growing emphasis
on general education during the 1930‘s and the idea that the curriculum
consisted of all experiences of students which were under the school's
direction.2 Harvill felt that the causes leading to the development of
the core curriculum were the results of the report of the Commission of
Ten in 1893 which recommended "constant courses" for all students,
Herbart's idea of correlation which demanded more unity of educational
experiences, the wholeness concept of Gestalt psychologists, and the
increased responsibility of secondary schools for citizenship during this time .2
Specifically the core curriculum came into being as a result of the Eight Year Study. In 1930 at the Progressive Education Association meeting, questions were asked on how secondary schools could better serve students to prepare them for living in a democratic society. As a result of these concerns, thirty schools inaugurated an experiment which was designed to meet this challenge. One curriculum revision resulting
!Ralph W. Tyler, "The Core Curriculum," NEA Journal, XLII (December, 1953), p. 563.
2Roland C. Faunce and Nelson L. Bossing, Developing the Core Curriculum (2d ed.; Englewood Cliffs, New Jersey: Prentice-Hall, 1958), pp. 49-50.
^Harris Harvill, "Origins of the Core Concept," Social Education, XVIII (April, 1954), pp. 161-162. 15 from this study was the core curriculum. 1
The term core as used in secondary education has had a
variety of meanings. It usually referred to special types of course
offerings required of all students. Other terms used to describe core
curriculum were general education, unified studies, common learnings,
basic living, social living, integrated program and core classes.2
Certain characteristics of core curriculum in secondary educa
tion have been emphasized by the curriculum writers. Leonard said it
" . . .implies that part of the curriculum which takes as its major job the
development of personal and social responsibility and competency need
ed by all youth to serve the needs of a democratic society. "3 This con
cept of social responsibility and competencies needed for living in a
democratic society was inherent in the characteristics ascribed to core
curriculum.
l-Wilford M. Aikin, Adventure in American Education, Vol. I, The Story of the Eight-Year Study (New York: Harper, 1942). 2Grace S. Wright, Core Curriculum in Public High Schools, an Inguiry Into Practices, Federal Security Agency Office of Education Bulletin, No. 5 (Washington: Government Printing Office, 1950), p. 1.
3j. Paul Leonard, Developing the Secondary School Curriculum (New York: Reinhart, 1953), pp. 396-397.
4Roland C. Faunce and Nelson L. Bossing, Developing the Core Curriculum (2d ed.; Englewood Cliffs, New Jersey: Prentice - Hall, 1958), pp. 49-50; see also Ralph W. Tyler, "The Core Curriculum", NEA Journal, XLII (December, 1953), p. 563; Victor B. Lawhead, "Guidelines for Evaluating Core Programs." Educational Leadership, XVIII (December, 1960). 16
Other characteristics of core curricula as found in secondary-
schools included dealing with content from more than one subject,
using blocks of time longer than one period for classes, pupil and
teacher involvement in planning the classes, and allowing for guidance
of students by the teacher. 1
The most extensive evaluation of core curricula in secondary
education was done by Wright in the late 1940's and 1950's. Her
studies during this period revealed that core programs were confined mainly to Junior high schools and the subjects included in core courses consisted primarily of English and social studies. Teacher preparation and qualifications were found to be major problems relating to the implementation of core curricula.2
1 Ralph W. Tyler, "The Core Curriculum, " NEA Tournai, XLII (December, 1953), p. 563; see also Grace S. Wright, Core Curriculum in Public High Schools, an Inquiry Into Practices, Federal Security Agency Office of Education Bulletin, No. 5 (Washington: Government Printing Office, 1950), pp. 5 9-60; Roland C. Faunce and Nelson L. Bossing, Developing the Core Curriculum (2d ed.; Englewood Cliffs, New Jersey: Prentice-Hall, 1958), pp. 59-60; J. Paul Leonard, Developing the Secondary School Curriculum (New York: Rinehart, 1953), pp. 397- 400; Harold B. Alberty and Elsie J. Alberty, Reorganizing the High School Curriculum (3d ed.; New York: Macmillan, 1962), pp. 204-230.
2Grace S. Wright, Core Curriculum In Public High Schools an Inquiry into Practices, Federal Security.Agency Office of Education Bul letin No. 5 (Washington: Government Printing Office, 1950); see also Wright, Core Curriculum Development Problems and Practices, Federal Security Agency Office of Education, Bulletin No. 5 (Washington: Government Printing Office, 1952); Wright, Block Time Classes and the Core Program in the Junior High School, Dept. of HEW, Bulletin No. 6 (Washington: Government Printing Office, 1958). 17
Core Curricula in Allied Health
The evolvement of the terms "core course" and "core cur
riculum" as related to the allied health field was more difficult to trace than as related to secondary education. There was no "Eight-Year
Study" to pinpoint the beginning of core in allied health education.
Burnett found that the development of core courses in allied health has generally occurred since 1970. "In many cases, planning for core was concurrent with the development of an administrative educational structure to house the health occupations and professions . The development of the administrative structure for housing health occupations can, in turn, be traced to the provision of federal funds in 1966 for the establishment of school and departments of allied health programs.
As the technological advances in health care and the public's demand for health care as a right rather than a privilege continued to increase during the early 1960's, the shortage of health personnel at all levels became a critical issue in the United States. In 1966, William H.
Stewart, then Surgeon General of the United States Public Health Service, identified the need to prepare 10,000 health workers a month for the next ten years if the health needs of the citizens were to be met. This
! "Core Concept in Allied Health, A Summary of the ASAHP Report, " Journal of Allied Health, II (Summer, 1973), p. 101. 18 increase would mean that by 1975 one out of sixteen workers in the labor market would be in the health field thus making the health industry the largest employer in the United States. 1 Projections of the Bureau of
Labor Statistics Matrix
. . .assume that increased income, expansion of public and private insurance coverage, higher levels of educational attainment and some related demographic variables will cause demands for health care to grow cumulatively in roughly the same way and at approximately the same rate as it has over the past five to ten years .2
To meet this demand of additional personnel for the health field, the first piece of federal legislation designed to increase the numbers of allied health personnel was passed in 1966, this being the
Allied Health Professions Personnel Training Act. This act provided funds for the establishment of schools and departments of allied health professions. At that time the majority of training programs for allied health personnel were based in the health service institutions, primarily hospitals. As the demands and cost for improved methods of training and additional types of specialists increased, the health service institutions encountered problems in meeting these increased demands.
1 Elizabeth Kerr, "Utilization and Preparation of Personnel to Deliver Health Care." Respiratory Care, XVI (March-April, 1971), p. 42.
2Thomas N. Chirikos, Allied Health Manpower in Ohio (Columbus, Ohio: Center for Human Resource Research, The Ohio State University, 19 72), pp. 54-55. 19
Federal funds that had become available through the Allied
Health Professions Personnel Training Act and later the Comprehensive
Health Manpower Training Act of 19 71 served as incentives to the
educational institutions to assume the responsibility for the training of
the allied health personnel. Prior to 1950 only one university had
undertaken the development of the allied health school. This took place
at St. Louis University in 1929. In the 1950's two attempts were made
to bring together health programs in educational institutions. The
University of Pennsylvania in 1950 and the University of Florida in
1957 inaugurated schools with more than one health program. With the
introduction of federal funds, the number of allied health professions
schools had increased from thirteen in 1966 to eighty in 1972.
With the establishment of schools and departments of allied
health, increasing numbers of health programs were developed within
one institution. With the initiation of numerous allied health programs
educators in the allied health field became concerned about the cost of
developing allied health curricula, the narrowness of some of the
speciality fields, and the need for the development of the health team
concept. Therefore it was in the late 1960‘s and 1970's that frequent
J-U.S. Dept. of Health, Education and Welfare, Training the Nation's Health Manpower, U.S. Public Health Service Publication No. (NIH) 73-348 (Bethesda, Md.: National Institutes of Health, 1972), p. 17. 20 references to the term "core" were made in allied health literature
since the development of core courses was viewed as a solution to
some of the emerging problems.
In 1971 Duggins reported that the per credit hour cost for nur sing students at Forest Park Community College in St. Louis, Missouri was $71, while the cost was only $16 per credit hourfor biology students and $12 for humanities and social science students. He suggested that a core curriculum could lower this cost.l
Based on seven case studies Chase found that ".. .the expen ditures for allied health educational programs at an academic institution depended on two factors: (l) the expenditures for particular curricula; and (2) the combination of curricula at that institution. "2 Cost as one reason for the development of core curricula was also mentioned by
Kerr, Kinsinger, and Rosenfeld.*2
■’•Oliver Duggins, "The Development of Health Core Areas: Development of the Concept" (paper presented at the annual meeting of the Council of Associate Degree Programs, National League for Nursing, Washington, D.C., March 3-5, 1971).
2Helen C. Chase, Cost Analysis in Higher Education: A Review with Recommendations for Allied Health Education Programs (Bethesda, Md.: National Institutes of Health, 1970), p. 24. 2Elizabeth Kerr, "Utilization and Preparation of Personnel to Deliver Health Care," Respiratory Care, XVI (March-April, 1971), p. 46; see also Robert E. Kinsinger, "A Core Curriculum for the Health Field," Nursing Outlook, XV (February, 1967), p. 28; Martin H. Rosenfeld, "Organizing for Allied Health Education in Educational Institutions," Educating Personnel for the Allied Health Professions and Services, eds. Edmund J. McTernan and Robert O. Hawkins (St. Louis:Mosby, 1972), p. 20. 21
The narrowness of some of the newly developing allied health specialties and the promise of core as a means of facilitating career choice and mobility was discussed by Louk, Kerr, Hamburg, Light and others.1 Henderson attributed the narrowness of professional education to the traditional efforts to instill all possible knowledge into the student. Educators now recognize the impossibility of this task and therefore emphasize the learning process and necessity for continued learning. With this recognition a greater awareness of the need for orienting the student to general health concerns had emerged.
Henderson perceived a common core of subject matter for all health students as an answer to providing the student with an awareness of general health concerns as well as providing the student an opportunity for making a career choice.2
DevittLn her research as part of her dissertation examined curriculum objectives of nursing, physical therapy, occupational therapy, and therapeutic dietetic programs at the baccalaureate level * 9
!Sister Rose Agnes Louk, "Sharing: An Educational Experience, Journal of Allied Health, II (Summer, 1973); see also Elizabeth Kerr, "Utilization and Preparation of Personnel to Deliver Health Care, " Respiratory Care, XVI (March-April, 1971), p. 46; Joseph Hamburg, "A Core Curriculum for the Allied Health Professions" (paper presented at the Sixty-fifth Congress on Medical Education, Chicago, Illinois, Feb. 9, 1969); Israel Light, "Development and Growth of New Allied Health Fields , " Journal of AMA, CCX (Oct. 1969).
2Algo D. Henderson, "Innovations in Educating for the Profes sions," Educational Record, XLIX (Summer, 1968), pp. 291-292 . 22 to determine whether there were commonalities of objectives. She dis
covered that sixty-three of the 122 abilities identified in the objectives were common to all four fields and additional abilities were common to two or three fields. She concluded that these commonalities could lend themselves to becoming a part of a unified health professions program.
Such a program could provide the basis for career mobility.
Core curriculum as the basis for the concept of "career ladder", or the building upon current education and experience to advance to the next step within the same job family, and "career lattice", or using knowledge and skills of an entry level or intermediary level job to move into laterally related jobs were discussed by Perry and Holloway and
Holloway. 2
Egelston brought out the concerns of hospital personnel about
"dead end" jobs and the need for career ladders for hospital personnel.
He discussed the roles of the educational institutions in providing core courses which would allow for the career ladder concept and the role
^Grace A. Devitt, "Commonalities of Curricular Objectives in the Preparation of Nurses, Physical Therapists, Occupational Therapists, and Therapeutic Dietitions at the Baccalaureate Level” (Doctoral dissertation, University of Pittsburgh, 1970).
2warren Perry, "Career Mobility in Allied Health Education, " Journal of the AMA, CCX (October, 1969); see also Sally Holloway and Robert Holloway, "The Development of a Program of Career Mobility in Hospitals" (paper presented at the American Hospital Association con vention, Chicago, Illinois, August, 1971). 23 of the hospitals in providing the clinical component for these courses.!
Hinsvark in responding to Ingles' proposal for a health core education program^ felt that the time spent in a core program could help the student choose his career with intelligence. She also believed that working together in a common core program would later help the graduates in improving communications between and among professional groups. Although Hinsvark favored the core concept and recommended that it be developed she emphasized, "What is needed.. ., is content analyses of required knowledge in all recognized health professions which would, in turn, dictate content. "2 Along with delineating the core of knowledge required for practice in all health professions, she felt that the unique focus of each profession should be developed.
There were many references in the literature of core courses and core curriculum as a means of fostering the health team concept.
Christman, Duncan, Kempe, and Szasz discussed the necessity of providing opportunities for students to work together in college in order
!e. Martin Egelston, "Licensure and Career Mobility, " Hospitals, XLIV (Dec. 1, 1970), pp. 42-44.
^Thelma Ingles, "A Proposal for Health Care Education," American Journal of Nursing, LXVIII (October, 1968).
2lnez Hinsvark, "Discussion in response to 'A Proposal for Health Care Education' by Thelma Ingles, " American Journal of Nursing, LXVIII (Oct. 1968), p. 2140. 24 to foster the health team concept after graduation.! The role of core curriculum as a facilitator of this concept was also presented by Kerr,
Louk, Hamburg, Perry, Zentmyer, and Meredith.2
James did not suggest core curricula as a means of facilitating the health team concept but he did emphasize the need for the concept and suggested benefits of training several health workers under one roof in order to implement this concept.2 Duncan and Kempe disagreed with James in that they found that having students in the same physical environment was not sufficient to insure satisfactory working relation ships. Rather, they suggested joint educational experiences such as
!Luther Christman, "Education of the Health Team," Tournal of the AMA, CCXIII (July, 1970); see also Burris Duncan and C. Henry Kempe, "Joint Education of Medical Students and Allied Health Person nel ," American Tournal of Diseases of Children, CXVI (November, 1968); George Szasz, "Education for the Health Team," Canadian Tournal of Public Health, LXI (Sept.-Oct., 1970). 2Elizabeth Kerr, "Utilization and Preparation of Personnel to Deliver Health Care," Respiratory Care, XVI (March-April, 1971), p. 46; see also Sister Rose Agnes Louk, "Sharing:An Educational Experience," Tournal of Allied Health, II (Summer, 1973), p. 121; Joseph Hamburg, "A Core Curriculum for the Allied Health Professions" (paper presented at the Sixty-fifth Congress on Medical Education, Chicago, Illinois, Feb. 9, 1969); Warren Perry, "The Assistant: Mobile or Immobile" (paper presented at the Manpower Conference on Allied Health Professions Assistants, Buffalo, N.Y., April 16-17, 1970); Robert Kenneth Zentmyer, Training of Allied Health Personnel: A Practical Approach," Clinical Obstetrics and Gynecology, XV (June, 1972), p. 340; Glen Meredith, "Schools of Allied Health Professions: Concepts of Their Organization and Administration, " The American Journal of Occupational Therapy, XXV (Jan.-Feb., 1971), p. 29. ^George James, "Educational Role of the New Health Science Centers in the Health Related Professions," Annals of the New York Academy of Sciences, CLXVI (December, 1969), pp. 862-868. 25
core courses, seminars and field work as a means of fostering the
health team concept. 1
The term "core course" as used in allied health education has been used in a much narrower sense than in secondary education. One aspect of the term as used in secondary education was that it included offerings required of all students . Although there has been some disagreement among health educators on the use of the term "core" it is this aspect of the term which has been utilized in allied health.
Although the literature abounded with references to the need for core courses in allied health, examples of attempts to implement the concept, particularly as related to research on the identification of a common core of content, were limited. This was particularly evident in the technical areas. The major accomplishments in the development of core courses seem to have been in the biological science areas .
A nursing advisory committee at Long Beach College began working on identifying knowledges and skills needed to function within the various levels in nursing in 1966. The possibility of upward and lateral mobility was appealing to the group but when Drage reported on the project in 19 71 the only core courses that had been developed were
•'•Burris Duncan and C. Henry Kempe, "Joint Education of Med ical Students and Allied Health Personnel," American Journal of Diseases of Children, CXVI (November, 1968), p. 502. 26 in the area of the life sciences rather than in the technical courses.
The core courses in the life sciences were offered for students in inhalation therapy, radiologic technology, medical assisting, licensed practical nursing and associate degree nursing programs.!
A survey of fifty colleges and universities to determine the amount of sciences that was necessary for five allied health profes sions, namely medical record library science, medical technology, nursing (baccalaureate and associate degree), occupational therapy, and physical therapy was conducted by Zabsky. His findings indicated that content from anatomy and physiology, chemistry, mathematics, microbiology, physics, biology, zoology, genetics, and botany were required in one or more of the allied health programs.
Discussion and attempts to develop core courses were not limited to the United States. McCreary reported on the activity of the
Interprofessional Curriculum Committee at the University of British
Columbia in 1962 in its ”. . .attempt to identify a block of material which should be known by every member of the health sciences team
! Martha Dr age, Implementation of the Concept of Health Core Areas (panal presentation at the annual meeting of the Council of Associate Degree Programs, National League for Nursing, Washington, D.C., March 3-5, 1971).
2Harold Zabsky, "Basic Science Education for Health Related Personnel.-, " Annals of the New York Academy of Sciences, CLXVI (December, 1969 ). 27
and to which the total group could be exposed simultaneously. "1 They
found the greatest problem in the development of a block of inter
professional content was lack of a model. The core content and
experiences which were developed were included in a six week general
course on history of health sciences and home visits by medical,
nursing, and pharmacy students.2
Bonneau, Rattez and Brunet reported on the work at Laval
University in Canada in setting up common courses for medical,
nursing, pharmacy, physiotherapy and dietetic students. A Health
Sciences Study Committee with representation from each area decided
upon the courses which were to be common to all health science
students . The courses that were felt to be common were general and microscopic anatomy, cellular biology, static biochemistry, dynamics
of biochemistry, general and dynamic psychology, one course in behavioral science, health, medical microbiology, immunology, systemic physiology, general pathology, pharmacology, toxicology, and sociology.3
lj. F. McCreary, "The Health Team Approach to Medical Education." journal of the AMA, CCVI (November, 1968), p. 1555.
2Ibid.
^Louis-Philippe Bonneau and Gustave Ratted "Laval Univer sity Embraces the Health Science Concept," Journal of Canadian Dental Association, XXXVI (June, 1970); see also Jacques Brunet, "Education and the Health Sciences, ” Journal of Medical Education, XLVI (January, 1971). 28
Wollenstein surveyed instructors, practitioners, and super visors in twelve allied health occupations; namely dental assistant, dental lab technician, inhalation therapist, medical assistant, medical records technician, associate degree registered nurse, licensed practical nurse, occupational therapist, physical therapist, recreational therapist, medical secretary, and medical laboratory assistant to determine the knowledge needed from the physical and biological life sciences, psychology, and sociology in each of the occupational fields.
His findings indicated that sixty per cent or more of those surveyed in each field identified anatomy and physiology as an essential body of content. A need for microbiology was evident in all fields except medical records technology and occupational therapy. Chemistry was important in all fields except occupational therapy. All fields indicated some need for principles from physics. The importance of psychology and sociology was evident in all fields except medical laboratory assistant. !
Fullerton reported on the findings of a committee of paramedical educators which investigated curriculum materials from 126 educational programs in 110 universities, junior colleges, and high
1 Robert J. Wollenstein, Knowledges Commonly Useful in Twelve Allied Health Occupations (Washington: Dept. of HEW, Office of Education, 1968). 29 schools in an attempt to identify common courses in paramedical education and explore the possibility of integration of paramedical education through curriculum consolidation of related training programs.
The twenty health programs analyzed were two and three year registered nursing, licensed practical nursing, nurses' aide, dental assisting, medical technology, medical secretarial, radiologic technology, dental hygiene, dental technology, physical therapy, physical therapy assisting, occupational therapy, occupational therapy assisting, inhalation therapy, medical assisting, laboratory assisting, medical records librarian, medical records technology, and radioisotope technology. The study uncovered 2613 course titles which were reduced to 126 general subject classifications. Seventy-eight of these general classifications were common to more than one field. The most frequent commonalities were as follows: "generaleducation" com mon to sixteen fields; "anatomy and physiology" common to fifteen fields; "microbiology" common to fourteen fields; "anatomy", "general psychology", "professional ethics", and "electives" common to twelve fields; "medical terminology" common to eleven fields, and "mathematics" and "general chemistry” common to nine fields.!
!Bill J. Fullerton, The Identification of Common Courses in Paramedical Education (Washington: Dept. of HEW, Office of Education, Bureau of Research, 1966). 30 Further findings revealed that the highest incidence of
commonalities was found in programs requiring the highest levels of skills and knowledge. On the basis of this study Fullerton stated that
" . . .paramedical education today reflects the personal philosophies of the educators who have developed a variety of curricula. "1 The study also indicated
. . .that many of the paramedical educational programs in which students are trained for different careers require much of the same course content. This would indicate that curriculum developers can, in fact, combine courses, classes, faculty, facilities, and material for more efficient and economical programs. 2
Weil reviewed the requirements of eleven accrediting organ izations and ten college bulletins relating to the following allied health programs which were offered at an undergraduate level to determine if greater coordination were possible among the fields; dental hygiene, dietetics, inhalation therapy, medical records librarian, medical tech nology, nurse anesthesiology, occupational therapy, physical therapy, pharmaceutical technology, baccalaureate degree nursing, and radiologic technology. The numbers of clock hours and subjects required by the respective accrediting groups were used to determine
1 Bill J. Fullerton, The Identification of Common Courses in Paramedical Education (Washington: Dept. of HEW, Office of Education, Bureau of Research, 1966), p. viii.
2 Ibid ., p. vii. 31
courses which could be adopted to meet the needs of this diverse group
of allied health students. Based on the requirements it was determined
that introductory science courses, psychology, sociology, and
introductory courses in management and supervision could be taught to
the eleven categories of health students since content from these
courses were frequent program requirements.!
Another method that has been used to determine common core
of content in health technologies has been the occupational and task
analysis. Using this method, tasks needed to perform a particular job
and knowledges and skills needed to perform the task are identified.
The Decker Study was concerned with the analysis of tasks required of the medical laboratory technician. This analysis provided
behavioral descriptions in terms of events performed. The skills,
knowledge, and personal traits, necessary for a particular occupation 2 can be determined by this method.
Another study related to occupational and task analysis was the study conducted by the Coordinating Council for Education in the
’■Thomas Weil and H. M. Parrish, "Development of a Coor dinated Approach for the Training of Allied Health Personnel, " Tournal of Medical Education, XLII (July, 1967).
2John P. Decker, A Functional Analysis of Paramedical Occupations as a Foundation for Curriculum Development (Washington: Dept. of HEW, Bureau of Research, 1967). 32 Health Sciences for San Diego and Imperial Counties. In this study, an analysis of entry level tasks for medical assistants, dental assistants, radiologic technologists, physical therapy assistants, licensed practical nurses, and registered nurses was performed by educators from four community colleges. Commonalities relating to the science curricula for the various health programs were identified and learning modules were developed from this information and utilized by the participating institutions. 1
As part of the University of California at Los Angeles Allied
Health Professions Project, task analyses were done on the various allied health professions as one step in the development of instructional programs and instructional materials for these programs. The project was begun in 1968 and after four years the goals of the project were completed to varying extents. Common functions for various disciplines within each field were identified, e.g. dental auxiliary occupations and nursing occupations. The objectives of the project, however, did not include the identification of common elements within the inter disciplinary health fields.12
1 Coordinating Council for Education in the Health Sciences for the San Diego and Imperial Counties, Program for Educational Mobility for Health Manpower (The Basic Sciences), U.S. Educational Resources Information Center, ERIC Document ED 054 332, December, 1970.
2Mary Ellison and others, The UCLA Allied Health Professions Project; the Background, the Programs, the People (Washington: Dept. of HEW, Office of Education, Bureau of Research, 1971). 33
In a study on the functions of nurses and social workers,
Dammann found that many duties and functions overlapped, particularly between social workers and public health nurses. This overlapping of functions necessitated working together by the two groups which
Dammann felt could be encouraged during the nursing and social workers student experiences. In a survey of sixty-four accredited master's programs in social work and 160 accredited baccalaureate nursing programs, she found that a few schools (four social work and nine nursing) had recognized this opportunity by employing professionals from the related field on their faculty or using them in special lectures and by including aspects of the related field in their courses . However, limited joint educational experiences were provided for nursing and social work students. Thirteen of the fifty responding social work programs provided integrated courses with nursing students and fifteen had cooperative field experiences. Thirty-one of the 121 responding nursing programs indicated that experiences were provided for inter professional planning in the clinical area between nursing and social work students. 1
^Gloria L. Dammann, "Interprofessional Aspects of Nursing and Social Work Curricula," Nursing Research, XXI (March-April, 1972). 34
Rosinski suggested that the core curricula should evolve from common goals determined by health educators from the representative programs. This group should then select relevant subject matter to meet these goals. Following the determination of common goals, the unique goals of the specific disciplines should be identified.!
This committee approach as recommended by Rosinski was utilized by the Community College Health Careers Project, State
University of New York; Kellogg Community College; and University of
Kentucky in their development of core curricula. A study group of the
Community College Health Careers Project of the State University of
New York studied the findings and recommendations of specific study groups in the areas of radiologic technology, inhalation therapy, dental auxiliaries, medical records, occupational therapy, surgical technology, biomedical engineering, ophthalmic dispensing, public health tech nology, and medical emergency technology. These study groups had arrived at curriculum content for the specific fields. From this information the Core Curriculum Committee identified common content from the natural and physical and social sciences, math and language arts, and skills relating to health services. A one semester core
’■Edwin Rosinski, "Impact of Technology and Evolving Health Care Systems on the Training of Allied Health Personnel, Military Medicine, CXXXIV (Tune, 1969), p. 391. 35 program was developed which included this common content. The core semester consisted of the following courses: anatomy and physiology, psychology or sociology, a liberal arts course, math, and a basic health technology course. The basic health technology course included health service resources; team relationships; ethics in the health field; an introduction into patho-psychology, and treatment of disease; and the maintenance of an environment conducive to patient welfare.
At Kellogg Community College a one semester core was first developed in 1968 for students in the associate degree and practical nursing programs . When a radiologic technology program was intro duced in 1968 the decision to expand the core to include all health programs was made in order to offer students the opportunity to explore various health careers before making a choice and thereby decrease attrition rate, stress the team concept of health care, and allow for more effective utilization of staff and clinical facilities. A faculty committee representing all health technologies identified the content that was common to the eight technologies at their college; namely practical and associate degree nursing, radiologic technology, medical assisting, physical therapy assisting, medical laboratory technology,
1 Robert E. Kinsinger and Muriel Ratner, Technicians for the Health Field - A Community College Health Careers Study Program (Albany, New York: N.Y. State Dept. of Education, 1966). 36 dental assisting, and dental hygiene. In light of the findings a core semester consisting of English, psychology, anatomy and physiology, and integrated health services was planned. The integrated health services course focused on the team approach and included content relating to the health team concept; ethical and legal considerations; aspects of mental and physical health; medical terminology; first aid for medical and dental emergencies; and basic concepts from nutrition, pharmacology, microbiology, and physiology as related to vital signs, fluid balance, irrigation and homeostasis. Common laboratory experiences were provided during the first eight weeks of the semester and segregated experiences during the last eight weeks based upon the student's career preference. 1
The University of Kentucky School of Allied Health Professions identified two levels of core, the first level being general studies which were offered during the first two years of a four year curriculum and the second level being special studies which were offered during the last two years . The general studies core consisted of the environ mental area which included the biological, physical and social sciences; the communicative area which included humanities, language,
1 Robert D. Steely, "Core Curriculum Planning and Evaluation" (paper presented at a Workshop for Faculty in Nursing and Other Health Occupation Programs, Denver, Colorado, June 18-20, 1973). 37 and math; and the interpretive area which included behavioral science, history and philosophy. The special studies core involved the environ mental area which consisted of man and his environment including natural and social sciences and community health; communicative area which included health terminology, techniques of interview and communication, and computer science; interpretive area which included health ethics, behavioral sciences, and statistics; and the directive area which included emergency care and preventive medicine.’ Tables 1 and 2 show the Arrangement of Core as developed by the University of Kentucky.
Writing in the Tournal of Allied Health in 1973, Hamburg dis cussed the frustrations experienced in implementing the core curriculum at the University of Kentucky. Despite the frustrations and failures he felt that, "Perhaps the failures experienced to date in the implemen tation of the concept are not so much a reflection of its impracticability as they are our lack of sophistication as creative educators. "2
’Joseph Hamburg, "Core Curriculum in Allied Health Education, " Journal of the AMA, CCX (October, 1969).
2joseph Hamburg, "Push On. " Journal of Allied Health, II (Summer, 1973), p. 117. 38
Table 1 1
General, Studies
Environmental 1. Biological Sciences 2. Physical Sciences 3. Social Sciences
Communicative Interpretive 1. Humanities 1. Behavioral Science 2 . Languages 2 . History 3. Mathematics 3 . Philosophy
Table 2 2
Special Studies
Environmental 1 Man and His Environment a. Natural Science b. Social Science c. Community Health
Communicative Interpretive Directive 1. Health Terminology 1. Health Ethics 1 . Emergency Care 2 . Techniques of 2 . Behavioral Science 2 . Preventive Interview and Com 3. Statistics medicine munication 3 . Computer Science
^Joseph Hamburg, "A Core Curriculum for the Allied Health Professions" (paper presented at the Sixty-fifth Congress on Medical Education, Chicago, Illinois, Feb. 9, 1969).
2 Ibid. 39
Another example of implementation of the core concept was
described by Wilson in her doctoral dissertation. She developed and
evaluated a one quarter core introductory course for medical assisting
and registered nursing students. The content common to the two
occupational groups was identified by a ten member "panel of experts"
which was composed of Advisory Committee members representing
physicians, hospital administrators, directors of nursing, and practicing
registered nurses and medical assistants. The topics which were
identified as being common to the two groups were asepsis and environ mental safety, communications skills, dental health, effective use of
one's body to avoid fatigue, ethical and legal behaviors, observational
powers, health care economics, growth and development, normal
nutrition, observation and recording, personal care and hygiene for patients, pharmacology, radiation safety, role definition, and health care industry. The success of the course was determined by the number of students completing the course with a C or better and the students' performance in the succeeding course. Since the findings showed an improvement over the preceding three years the course was considered to be a success.-'
'Glenys Wilson, "An Evaluative Study of A Core Course for Health Occupations" (Doctoral dissertation, University of California at San Francisco, 1974), pp. 33-63. 40 In 1971 the Association of Schools of Allied Health Professions,
with Burnett as research director, began a study of the "state of the art"
of core curriculum in allied health fields. The activities involved in the
study included a review of the literature and visits to nine institutions
which conducted core programs. Criteria for selection of institutions to
be visited included current implementation of the core curriculum, all
educational levels be included in the sample, a variety of programs ser
ving different student populations be represented, and that the core had
been utilized long enough for evaluation to have occurred. Five of the
nine institutions awarded associate degrees and two awarded bac
calaureate degrees. Two additional institutions awarded associate
degrees and baccalaureate degrees. Four of the associate degree
institutions also conducted certificate level programs . Two bac
calaureate institutions also conducted graduate level programs . The
investigation of the institutions and review of the literature revealed the following:
1. Core programs in allied health education existed at the certificate,
associate degree and baccalaureate levels. Although many schools
did not have core courses, most institutions expressed interest
in this aspect of curriculum.
2 . Implementation of common materials had occurred in a variety of
subject matter areas. One and two year programs had been primar
ily concerned with the development of core courses in the
biological sciences, psychology, and some orientation to health 41
care. The baccalaureate programs considered similar areas but
also had implemented common material in clinical medicine,
research and growth and development.
3. No evidence was seen in this study that common courses reduced
administrative costs and increased efficiency of programs. Although
several of the schools that were visited felt that core curriculum
would be more economical, reports of cost analyses were not
found.
4. Task analyses had contributed to the identification of content for
shared experiences.
5. Modularization had been used for developing units of common
materials in addition to common courses .
6. Vertical career mobility based on common courses had not occurred.
The investigation found that vertical mobility was based primarily
upon proficiency and challenge examinations and transfer of
credit rather than on common courses .
7. A common semester or year which some programs provided
allowed for lateral career mobility.
8. How to foster the health team concept had been impeded by a lack
of definition of the health team and how it functions .
9. There was no demonstrated evidence that common courses fostered
the health team concept. Although faculty from several institutions
reported improved relations among students from various health 42
programs who were enrolled in common courses, this view had not
been objectively documented.
10. Learning experiences offered to all health students had been of
interest to educators but had not been implemented to any degree.
11. Interdisciplinary field experiences had been considered important
but had not been implemented. At the majority of the institutions
visited, the only examples of shared experiences were in the
classroom.
12 . Planning of the curriculum had been a faculty effort rather than a
student-teacher experience, only one institution stressed this
joint planning as a means of facilitating the teaching-learning
process.
13. Evaluation of core curricula had not been comprehensive due to lack
of objectives with measurable criteria. Of the nine institutions
studied, three had formal objectives for the core curriculum, but
there was no clear distinction between objectives and rationale
for establishment of the core curriculum.'
Despite the many references related to the need or desirability of core courses or subject matter the references on the actual implement -
'Carolyn Burnett, The Core Concept in Allied Health, A "State of the Art" Document (Springfield, Va.: National Technical Information Service, 1972), pp. 156-159. 43
ation of the core concept in allied health programs were limited. In
1 969 Light stated ". . .the logic, economy and related values of the core
course and core curriculum continue more as a pious declaration of intent than a conviction and fact of operational curricular life. " ’
Zentmyer reflected this same belief in his statement
To the outsider observing the academic world, there appears to be little hope for a true core-curriculum concept until the multidisciplinary approach to training is more widely accepted and utilized in educational institutions.*2
Possible reasons for the delay in developing core curricula were discussed by Hamburg in his address to the sixty-fifty Congress on Medical Education in 1969. Some of the reasons put forth by him were reluctance to change traditional methods of course presentation, lack of precise data on what particular health fields require in preparatory courses, restrictive and archaic licensure and accreditation requirements, and setting unrealistic goals for core curricula.2
The delay in developing core courses in two year institutions may be explained by Egelston's statement that, "Some junior college
’Israel Light, "Development and Growth of New Allied Health Fields, " Journal of AMA, CCX (Oct., 1969), p. 119.
2Robert Kenneth Zentmyer, "Training of Allied Health Person nel: A Practical Approach, " Clinical Obstetrics and Gynecology, XV (June, 1972), p. 338.
^Joseph Hamburg, "A Core Curriculum for the Allied Health Professions" (paper presented at the Sixty-fifth Congress on Medical Education, Chicago, Illinois, Feb. 9, 1969). 44 deans believe that the brevity of a two-year program and specific requirements of certification and licensure in an occupation do not facilitate the development of core courses."!
Another reason for the delay may be due to lack of qualified educators. A report on health manpower to the President and Congress stated that, "The shortages of competent faculty in training programs at all levels probably constitutes the greatest obstacle to the improvement and enlargement of educational programs for the allied health profes sions . "*2
Summary
A review of the literature indicated that core curriculum had its beginnings in secondary education. It resulted from society's reactions against fragmented learning and changing views as to the role of the schools in educating youth for living in a democracy. The major characteristics of core as related to secondary education were block time classes, courses including content from more than one subject, stressing the development of social responsibility, including
!e. Martin Egelston, "Licensure and Career Mobility," Hospitals, XLIV (December 1 , 19 70), p. 44. 2U.S. Dept. of Health Education, and Welfare, Report to the Congress, The Allied Health Professions Personnel Training Act of 1966, as Amended (Washington: Government Printing Office, 1969), p. 44. 45 content required of all students, teacher and student planning, and
providing for guidance of students by teachers.
The utilization of core curricula in allied health had its real
beginnings in the late 1960's and 1970's. As in secondary education it was viewed as a means of solving some existing problems, namely cost, narrowness of some specialties, and fragmentation of patient care.
Student-teacher planning was considered an important characteristic of core in secondary education, however, it was not a major component of core in allied health. Cost was considered an important reason for the development of core curricula in allied health but was not mentioned as a reason for its development in secondary education. Despite these differences similarities can be seen between characteristics of core and reasons for its development in secondary and allied health education.
The emphasis on educating the individual to assume his role as a member of the health team and decreasing fragmentation of patient care parallels the characteristic of core as found in secondary education for stressing the development of social responsibility. Providing for health career mobility rather than locking a student into a narrow specialty area parallels the idea of eliminating fragmented learning as existed in secondary education. The term "core" in allied health education has been used in a much narrower sense than in secondary 46
education. The major component of core as it related to secondary and
allied health education was the emphasis on course content required of
all students .
With both secondary and allied health education the literature abounded with statements on the desirability and possibilities for implementation of core, however in both areas the concept was implemented to a limited degree. In secondary education the utilization of core was confined mainly to Junior high schools and course content was usually extracted from English and social studies . In allied health education the examples of actual implementation were limited and when they did exist they were confined largely to the biological and general education areas.
One possible cause that was suggested as a reason for the lack of success in implementing core both in secondary and allied health education was teacher qualifications. Wright in her studies in secondary education found this to be a major factor and Hamburg in commenting on his experiences in allied health education suggested this as a possibility. The shortage of competent allied health faculty was also brought out in the health manpower report to the President and Congress. Chapter 3
STATEMENT OF PROCEDURES
Introduction
The desirability of developing core courses was evident from
a review of the literature. Evidence was also available on the difficulty
of determining content to be included in core courses and the difficulty
of developing such courses. Numerous ways for determining core
content were tried; such as task analysis, opinions of educators and
practitioners and committee approaches. However, relatively small numbers of core courses were available in the technical areas. If a well defined common core of technical content could be identified the development of the core courses might be facilitated.
For these reasons it was decided to investigate what, if any, common technical content was currently included in three allied health programs. The study sought to determine whether there was a common core of content included in the technical courses as presently offered in American educational institutions which conducted the three programs.
The study also attempted to ascertain if there were possible additions or deletions to content that was being taught in each of the three programs . 48 The following steps were taken to delineate a core of tech nical content that was common to nursing, radiologic technology and dental hygiene programs that were offered by institutions of higher education at the associate degree or certificate level:
1. A list of possible areas of common content was developed.
2 . This list was pretested by presenting it to licensed or certified
members of each occupational area at a regular meeting of the
respective local or area professional organization.
3. Based on suggestions of the above groups, the questionnaire was
revised.
4. The second draft was mailed to a sample group of thirty (ten from
each program) directors of existing programs.
5. The questionnaire was again revised based on the suggestions of
the participants in the sample group.
6. The third draft was mailed to the sample group and the returns were
compared for reliability.
7. The questionnaire was then mailed to the directors of all dental
hygiene, nursing and radiologic technology programs in the United
States that were offered in institutions of higher learning at the
associate degree level, and in the case of dental hygiene at the
certificate level in addition to associate degree.
8. The results of the survey were tabulated by program and the
responses to each question were compared. 49 In order to determine areas of commonality of content in the three allied health technologies, it was necessary to develop a fairly complete list of content that might be included in the curricula of two or all of the programs under investigation. Since the three programs required accreditation or approval of the programs by an accrediting or approving body, some common areas of curricular requirements had been established by the respective accrediting or approving groups for each program. Therefore all approved educational programs of each type met the minimum curriculum requirements of their accrediting or approving body.
For the dental hygiene programs, these requirements were established by the Council on Dental Education of the American Dental
Association,. Programs leading to a certificate, associate degree or baccalaureate degree were required to meet the same minimal standards.
For the nursing programs there was no requirement for national accreditation; however the programs in each state had to meet the minimum requirements as established by the respective state boards of nursing. As with dental hygiene, registered nursing programs leading to a diploma, associate degree or baccalaureate degree were required to meet the same minimal standards. A review of the requirements indicated that state boards of nursing were less rigid in their curriculum requirements than were dental hygiene and radiologic technology accrediting bodies. Through the efforts of a National Committee on 50
State Boards of Nursing the requirements from state to state, but for a
few exceptions, had relatively few major differences. Since all states
participated in the same state board test pool examination, the basic
content included in nursing curricula was fairly standardized. Since
each state set its own requirements, the Rules and Regulations of six
states were investigated. The states represented were Arizona, Idaho,
Illinois, Ohio, South Dakota and Texas. Except for Ohio the states
were selected by a random sampling, using a table of random numbers.
The sampling was deemed adequate since basic content in nursing
programs is fairly common nationally and the requirements were used
only in the development of the questionnaire.
The radiologic technology requirements were established by
the Council on Medical Education of the American Medical Association.
As with dental hygiene and nursing, the minimum requirements applied to certificate, associate degree and baccalaureate programs.
The subject areas relating to technical content that were required by the Council on Dental Education of the American Dental
Association for approved dental hygiene programs were as follows: dental materials, chairside dental assisting, clinical dental hygiene, dental health education, ethics, history and jurisprudence, pathology, medical and dental emergencies, orientation to dental practice, pharmacology, radiology, public health and office procedures. In addition, the following content relating to general and basic areas was 51
required: anatomy, chemistry, embryology, microbiology, nutrition,
physiology, English, psychology and sociology.
Although the state board curriculum requirements for nursing
programs were much less specific than the requirements for dental
hygiene and radiologic technology programs, the following areas relating to technical content were identified in the sampling that was included in the study: (numbers in parentheses indicate the numbers of states that required the content) professional relations and ethics (4), legal aspects (1), pharmacology (3), pathology (l), problem solving (l), health maintenance and promotion (4), technical skills (4), interper sonal relationships and communication with patients and members of the health team (5), observation skills (l), nursing care planning (l), and medical emergencies (l). Four states specified the requirements of theory and practice in medical, surgical, maternal-child and psychiatric nursing. In addition, the following areas relating to general and basic areas of content were required by some states: historical aspects and trends in nursing (3), growth and development
(1), biological, physical and behavioral sciences (5), nutrition and diet therapy (l).
The subject areas relating to technical content that were required by the Council on Medical Education of the American Medical
Association for approved radiologic technology programs were as follows: radiation protection, darkroom procedures, radiographic 52
exposure, positioning of patients for radiographic procedures, radiographic procedures, nursing procedures pertinent to radiography, film critique, professional ethics, medical terminology, survey of medical-surgical diseases and equipment maintenance. In addition, the following areas relating to basic and general content were required: anatomy and physiology, physics and administration skills.
Based upon the recommendations and requirements of the accrediting and approving bodies a questionnaire! was formulated which included areas of technical content that might be common to the three technologies. The respondents were asked to indicate by a checklist the level of importance that was placed on each specific item of content in their curriculum. The five levels of emphasis were: major emphasis, above average emphasis, average emphasis, little emphasis, and do not include. The following criteria were assigned to each level of response:
major emphasis-~the content in the item under question must be
included in the technical (major) courses and it is the most
important content in the course -
above average emphasis—the content in the item under question
must be included in the technical (major) courses and it is
^A copy of the final questionnaire is found in Appendix A. 53
equally important or of greater importance than other areas of
content
average emphasis—the content in the item under question must be
included in the technical (major) courses but other areas of content
are equally important or of greater importance
little emphasis--the content in the item under question need not
be included in the technical (major) courses, however if there is
available time it may be included
do not include—the content in the item under question is never
included in the technical (major) courses.
The respondents were also asked to give their opinion as to whether there would be the same need, less need, or greater need for the specific items of content in their curriculum within the next ten years .
The questionnaire that had been developed was presented in a pilot study to thirty dental hygienists, thirty-nine registered nurses and twenty-one radiologic technologists at a regular meeting of their respective area professional organization. The purpose of this presentation was to determine clarity and inclusiveness of the question naire. These respondents were asked to complete the questionnaire, identify statements or areas which were unclear, make suggestions for other areas of content that should be included and comment on the 54
adequacy of the questionnaire in general.
Using the suggestions that were elicited in the pilot study
group, some revisions were made in the original questionnaire.
Distribution of Questionnaire
The revised questionnaire was then sent to a small sample
group of thirty directors of educational programs (ten in each type of
program).' Questionnaires were sent to directors of dental hygiene in
four states, to directors of nursing in four states and to directors of
radiologic technology in seven states. The information requested from
the respondents was the same as that requested from the original groups
that participated in the pilot study except for the revisions. The purpose
of the survey was to further determine inclusiveness and clarity of the
questionnaire and to have some indication of the likelihood of returns.
Returns were received from five directors of dental hygiene programs, ten directors of nursing programs and six directors of radiologic tech nology programs. Slight revisions were again made in the directions and in the questionnaire itself to incorporate the suggestions of the sample group. This third draft of the questionnaire was then sent to the twenty- one directors who had participated in the sample mailing. It was
'A complete list of directors included in the sample group is found in Appendix B. 55
requested that the person who completed the first questionnaire also
complete the second one. Returns were received from eighteen of the
respondents in the sample group in the second mailing. Each item in
the questionnaire was checked for reliability before the mass mailing
was undertaken. Reliability was checked by comparing the responses
for each identical item between the first and second returns .
Responses to any of the three upper levels (i.e. , "major,"
"above average" or "average"), indicated that the item must be
included in the curriculum while responses at the lower two levels
(i.e., "little emphasis" and "do not include"), indicated that the
item need not be included. Since the degree of discrimination between
major, above average and average emphasis was so narrow and since
each of these responses indicated that the item needed to be included
in the curriculum it was necessary to be most concerned with cross overs from the three upper level responses to the two lower level responses and vice versa.
Therefore the following criteria were established for deter mining reliability of the items: if three or more respondents crossed over from a "must be included" to a "need not be included" response or vice versa between the first and second mailings the item was deemed unreliable. If two crossovers occurred between the first and second mailings the item needed eleven or 61% of identical responses on the first and second mailings for the item to be considered reliable. For 56 all items for which there were none or only one crossover, the items were considered to be reliable.
The decision was made to leave the item in the questionnaire if the item appeared reliable after ten of the twenty-one surveys from the second mailing to sample group participants had been returned.
Since some of these questionnaires were returned late, the last one being returned three months after the second mailing, the final reliability was not obtained until after the mass mailing had been sent.
Therefore, twelve of the items included in the questionnaire were deemed unreliable when the final reliability factor was checked. Table
3 shows the reliability of each item used in the questionnaire.
The reason for the differing responses between the first and second mailings may have been due to the fact that possible responses were not differentiated sufficiently. This was particularly true for the three upper level responses: major, above average and average. How ever, since the twelve items were determined to be unreliable they have not been included in the consideration of common areas of content.’
Since one item in the questionnaire was revised and two items were added to the questionnaire between the first and second mailings
!a list of the items which were found to be unreliable and a discussion of the findings are found in Appendix C. 5 7 Table 3
Reliability of Items Used in Questionnaire (Based on 18 Returns)
Item Same Both Responses Crossover Between *Reliability Response Within Upper and Upper Lower Lower Levels Levels Levels I. A 7 10 0 1 B 10 8 0 0 C 7 10 0 1 D 9 7 0 1 II. A new item B 5 11 0 1 C new item D 11 5 0 2 E 9 6 0 2 X III. A 8 9 0 1 B 7 7 3 1 C 10 5 1 2 X D 11 4 1 2 E 11 5 1 1 F 6 9 1 2 X IV. A 12 5 0 1 B 9 6 1 2 X V. A 9 7 1 1 B 7 9 0 2 X C 9 9 0 0 D 7 8 0 3 X E 8 5 0 5 X F 11 6 0 1 VI. A 12 5 0 1 B 12 5 0 1 C revised item D .1.1 3 1 3 X E 12 6 0 0 F 9 8 0 1 G 13 5 0 0 H 11 4 0 2 I 10 3 0 5 X J 14 2 0 1 K g 5 1 L 9 6 1 M 12 5 0 1 N 8 4 1 4 X VII. A 14 4 0 0 B 12 6 0 0 C 12 6 0 0 D 10 8 0 0 E 12 6 0 0 F 13 5 0 0 G 11 6 0 1
* X indicates items that were eliminated as unreliable. 58
to the sample group, these items were not checked for reliability, but
are included in the report.
After ten of the twenty-one sample group responded for the
second time the survey was mailed to the directors of all of the
remaining dental hygiene, nursing and radiologic technology programs
in the United States that were offered in institutions of higher learning
at the associate degree level, and in the case of dental hygiene at the
certificate as well as the associate degree level. The most recent
listing of programs that had been compiled by the respective accrediting
or professional organizations was used for the mailing.! Questionnaires
were sent to directors of 131 dental hygiene programs, 499 nursing
programs and 141 radiologic technology programs.
A method suggested by Suchman and McCandless was used
for timing of a follow-up reminder. When not more than one return per day for five successive days was received, a follow-up post card was
sent to the non-respondents.*2
Analysis of Data
When the maximum number of questionnaires were returned, the
!a list of institutions to which the questionnaire was sent is found in Appendix D.
2Mildred Parten, Surveys, Polls and Samples: Practical Procedures (New York: Harper and Bros., 1950), p. 3 99. 59 responses to each item by program were tabulated. These cumulative frequencies were converted to cumulative percentages. Graphs depicting the responses to each item by program were constructed. The content was considered common to the three programs if fifty-one per cent or more directors of each type of program indicated that the item received average or above average emphasis in the curricula in their programs. Further discrimination of the common content was done by dividing it into Core A, or content that was included in 75% or more of the programs, and Core B, or content that was included in 51% or more of the programs. The future need for the content was then tabulated and if fifty-one per cent or more in any of the three types of programs indicated that the present status would change toward either less or more emphasis this was brought out in the findings. Chapter 4
REPORT OF FINDINGS
Introduction
A review of the literature suggested that the majority of core courses in existence in allied health programs were based upon opinions of educators or practitioners as to what content should be included in specific programs and what content was common to two or more programs. The present study elicited responses of educators as to what was actually being taught in their specific programs and their perceptions on future need. Based on these responses commonalities of technical content were identified for dental hygiene, nursing, and radiologic technology programs.
Respondents
The respondents in the study were directors of programs or faculty members in dental hygiene, nursing and radiologic technology programs . A total of 771 questionnaires were mailed to all directors of dental hygiene programs offered at the certificate and associate degree level, nursing programs offered at the associate degree level 61
and radiologic technology programs offered at the associate degree
level. The numbers sent to each group were as follows: dental
hygiene 131, nursing 499, and radiologic technology 141. A total of
456 responses or 59.14% were received. Seventy-seven or 58.78%
were returned from dental hygiene programs, 291 or 58.32% from
nursing programs and eighty-one or 57.45% from radiologic technology
programs . Twenty of the returns could not be used in the study for
the following reasons: seven did not identify the type of program for which they were responding, two indicated that their respective
programs had been discontinued, five returned the questionnaire
unanswered, three included responses for more than one type of
program on one form and three had more than one person complete the questionnaire and therefore had various answers on some questions.
Table 4 provides a summary of questionnaire returns.
Table 4
Summary of Questionnaire Returns
\?o 0^/ ¿Ao 0xy
Dental hygiene 131 77 74 58.78 56.49 Nursing 499 291 283 58.32 56.71 Radiologic Technology 141 81 79 57.45 56.03 Unidentified as to 7 type of program Totals 771 456 436 59.14 56.55 62
The geographic area represented by the returns was widespread.
In the case of nursing, questionnaires were mailed to directors in fifty states and the District of Columbia and responses were received from forty-seven states. Dental hygiene directors in forty-one states and the District of Columbia received questionnaires and returns were received from twenty-nine states and the District of Columbia. Quest ionnaires were sent to directors of radiologic technology programs in thirty-one states and the District of Columbia and replies were received from twenty-six states. Of the twenty-two states and
District of Columbia for each technology which did not submit responses, nineteen had only one program of the specific type in existence. '
Analysis of Data
The questionnaire which was used in the study attempted to elicit information relating to seven general areas, namely the disease process, an introduction to health care, pharmacology, problem solving, safety factors, technical skills, and relations with patients.
'A list of states with the numbers of responses is found in Appendix E. 63
Within each general area responses were elicited on the amount of
emphasis placed on specific items of content. The numbers of responses and percentages for each level of emphasis by program are presented in Tables 5, 6 and 7.
Disease Process
Under the general area of disease process four items of content were included. These were
A. General causes of disease •
B. Changes produced in the body by disease
C. General methods of therapy
D. Methods of disease prevention
Over 75% of respondents from the dental hygiene programs indicated that all of this content received average or greater emphasis in their programs. The majority of opinions as to the future need for this content was the same as at the present time.
An even larger percentage of respondents from nursing programs placed average or greater emphasis on this content.
Regarding item D, "Methods of disease prevention, " 55% of the respondents from nursing programs felt that an even greater need for this content would be evident within the next ten years. The amount of emphasis placed on the content relating to Table 5
Dental Hygiene Programs Responses by percentage
Total of Major Above Average Little Do not Future need Major emphasis average emphasis emphasis include Less Same Greater Above emphasis average Averaae I. A 97.2 (69) 38.0(2 7) 42.3(30) 16.9(12) 2.8(2) 0 (0) 1.6(1) 76..B(4,7) ) 24.2(15) B 95.7(67) 40.0(28) 38.6(27) 17.1 (12) 4.3(3) 0 (0) 0 (0) 81.3(52) 18.8(12) C 81.2(56) 17.4(12) 3 7.7 (2 6) 26.1 (18) 15.9(11) 2.9(2) 0 (0) 74.2(46) 25.8(16) D 95.8(67) 54.3(38) 22.9(16) 18.6(13) 4.3(3) 0 (0) 0 (0) 50.8(32) 49.2(31) II. A 74.7(53) 9.9(7) 14.1(10) 50.7(36) 19.7(14) 5.6(4) 0 (0) 51.5(34) 48.5(32) B 86.1 (62) 15.3(11) 25.0(18) 45.8(33) 11.1 (8) 2.8(2) 0 (0) 61.5(40) 38.5(25) C 84.8(61) 13.9(10) 2 9.2(21) 41.7(30) 12.5(9) 2.8(2) 0 (0) 61.5(40) 38.5(25) D 88.9(64) 15.3(11) 41.7(30) 31 .9(23) 9.7(7) 1.4(1) 0 (0) 81.3(52) 18.8(12) III. A 100%(74) 21.6(16) 44.6(33) 33.8(25) 0 (0) 0 (0) 0 (0) 89.2(58) 10.8(7) B 45.8(33) 2.8(2) 11.1(8) 31 .9(23) 40.3(29) 13.9(10) 10.8(7) 83.1 (54) 6.2(4) C 95.7(69) 19.4(14) 44.4(32) 31 .9(23) 2.8(2) 1.4(1) 1.6(1) 75.0(48) 23.4(15) D 98.6(73) 21.6(16) 45.9(34) 31 .1 (23) 1 .4(1) 0 (0) 0 (0) 71.9(46) 28.1 (18) IV. A 74.2 (52) 5.7(4) 21.4(15) 47.1 (33) 18.6(13) 7.1(5) 0 (0) 50.9(29) 49.1 (28) V. A 45.9(33) 5.6(4) 9.7(7) 30.6(22) 34.7(25) 19.4(14) 0 (0) 56.7(34) 43.3(26) B 91 .9(68) 10.8(8) 29.7(22) 51 .4(38) 4.1(3) 4.1(3) 0 (0) 65.0(39) 35.0(21) C 84.9(62) 12.3(9) 35.6(26) 37.0(27) 12.3(9) 2.7(2) 0 (0) 77.0(4 7) 23.0(14) VI. A 94.2 (65) 46.4(32) 36.2(25) 11 .6(8) 0 (0) 5.8(4) 3.2(2) 91.9(57) 4.8(3) B 20.5(15) 4.1(3) 6.8(5) 9.6(7) 15.1 (11) 64.4(47) 9.6(5) 84.6(44) 5.8(3) C 8.4(6) 2.8(2) 1.4(1) 4.2(3) 25.0(18) 66.7(48) 7.7(4) 53.8(28) 38.5(20) D 100% (72) 65.3(47) 30.6(22) 4.2(3) 0 (0) 0 (0) 0 (0) 83.3(50) 16.7(10) Total of Major Above Average Little Do not Future need Maj or emphasis average emphasis emphasis include Less Same Greater Above emphasis average Averaqe VI. E 82.1 (60) 12.3(9) 20.5(15) 49.3 (36) 12.3(9) 5.5(4) 1.6(1) 88.9(56) 9.5(6) F 98.6(72) 53.4(39) 32.9(24) 12.3(9) 1.4(1) 0 (0) 0 (0) 93.5(58) 6.5 (4) G 69.9(51) 11.0(8) 15.1(11) 43.8(32) 20.5(15) 9.6(7) 0 (0) 55.7(34) 44.3(27) H 26.0(18) 1.4(1) 5.8(4) 18.8(13) 15.9(11) 58.0(40) 4.5(2) 88.6(3 9) 6.8(3) I 63 .0(46) 8.2(6) 11.0(8) 43.8(32) 30.1 (22) 6.8(5) 1.9(1) 58.5(31) 39.6(21) VII. A 92.9(66) 35.2(25) 35.2(25) 22.5(16) 1 .4(1) 5.6(4) 1.9(1) 86.5(45) 11 .5(6) B 100% (73) 45.2(33) 39.7(29) 15.1 (11) 0 (0) 0 (0) 0 (0) 86.3(44) 13.7(7) C 97.3(72) 27.0(20) 36.5(2 7) 33.8(25) 2.7(2) 0 (0) 0 (0) 67.9(36) 32.1 (17) D 100% (73) 35.6(26) 3 5.6 (2 6) 28.8(21) 0 (0) 0 (0) 0 (0) 69.8(3 7) 30.2(16) E 100% (72) 43.1(31) 41.7(30) 15.3(11) 0 (0) 0 (0) 0 (0) 83.0(44) 17.0(9) F 100% (74) 3 7.8(2 8) 51.4(38) 10.8(8) 0 (0) 0 (0) 0 (0) 79.2(42) 20.8(11) G 100% (73) 61.6(45) 31.5(23) 6.8(5) 0 (0) 0 (0) 0 (0) 76.5(3 9) 23.5(12) Numbers in parentheses indicate total number of responses. O', tri Table 6 Nursing Programs Responses by percentage Total of Major Above Average Little Do not ._____ Future need______t Maj or emphasis average emphasis emphasis include Less Same Greater Above emphasis average Average I. A 99.2(275) 32.1 (89) 32.1 (89) 35.0(97) 0.7(2) 0 (0) 2.9(7) 86.9(213) 10.2 (25) B 100% (280) 43.9(123) 36.4(102) 19.6(55) 0 (0) 0 (0) 0.4(1) 85.3(209) 14.3(35) C 100% (281 ) 34.5(97) 34.9(98) 30.6(86) 0 (0) 0 (0) 2.0(5) 84.8(207) 13.1 (32) D 98.1 (274) 40.1 (112) 33.3(93) 24.7(69) 1.8(5) 0 (0) 0 (0) 45.0(108) 55.0(132) II. A 77.5(213) 6.9(19) 17.5(48) 53.1 (146) 21 .5(59) 1.1(3) 0 (0) 36.8(89) 63.2 (153) B 96.2 (270) 13.2(37) 27.8(78) 55.2 (155) 3.9(11) 0 (0) 0 (0) 60.1(146) 39 .9(97) C 96.0(266) 14.4(40) 34.3(95) 47.3(131) 4.0(11) 0 (0) 0.4(1) 53.1 (127) 46.4(111) D 92.8(259) 20.4(57) 34.4(96) 38.0(106) 6.5(18) 0.7(2) 2.5(6) 83.5(197) 14.0(33) III. A 97.5(275) 25.5(72) 35.5(100) 36.5(103) 2.1 (6) 0.4(1) 6.4(15) 85.4(199) 8.2(19) B 95.4(268) 24.6(69) 37.0(104) 33.8(95) 4.3(12) 0.4(1) 39.9(95) 54.2(129) 5.9(14) C 96.0(268) 25.8(72) 38.7(108) 31 .5(88) 3.9(11) 0 (0) 3.8(9) 84.0(200) 12.2(29) D 96.0(268) 31.2(87) 37.6(105) 2 7.2 (76) 3.6(10) 0.4(1) 3.8(9) 78.3(188) 17.9(43) IV. A 99.1 (279) 55.5(156) 30.6(86) 13.2 (37) 0.4(1) 0.4(1) 0 (0) 51.3(120) 48.7(114) V. A 94.6(264) 25.8(72) 26.9(75) 41.9(117) 5.0(14) 0.4(1) 6.9(16) 88.4(205) 4.7(11) B 99.0(274) 30.0(83) 41.9(116) 27.1 (75) 1.1(3) 0 (0) 0 (0) 68.7(158) 31.3(72) C 100% (278) 43.2(120) 37.1 (103) 19.8(55) 0 (0) 0 (0) 0 (0) 90.5(209) 9.5(22) VI. A 93.9(262) 21.5(60) 20.8(58) 51.6(144) 6.1 (17) 0 (0) 7.0(16) 90.0(207) 3 .0(7) B 95.4(269) 20.6(58) 29.4(83) 45.4(128) 4.6(13) 0 (0) 7.4(17) 88.6(203) 3.9(9) C 62.7(175) 9.3(26) 21.1 (59) 32.3 (90) 17.9(50) 9.4(54) 4.4(10) 60.8(138) 34.8(79) CD CD Table 6' (continued) Total of Major Above Average Little Do not Future need Maj or emphasis average emphasis emphasis include Less Same Greater Above emphasis average Average VI. D 99.0(279) 41.1(116) 30.9(87) 27.0 (76) 1.1 (3) 0 (0) 0 (0) 94.3(217) 5.7(13) E 99.2 (275) 25.6(71) 33.2(92) 40.4(112) 0 (0) 0.7(2) 1.3(3) 91.2(206) 7.5(17) F 98.9(276) 43.0(120) 31.2(87) 24.7(69) 1.1(3) 0 (0) 2.6(6) 93.0(213) 4.4(10) G 98.9(275) 29.1(81) 27.0(75) 42.8(119) 0.7 (2) 0.4(1) 4.9(11) 92.0(206) 3.1(7) H 97.5(272) 19.4(54) 32.6(91) 45.5(127) 1 .8(5) 0.7(2) 4.9(11) 91.5(204) 3.6(8) I 99.3(278) 28.6(80) 24.3(68) 46.4(130) 0.7(2) 0 (0) 10.6(24) 88.1(200) 1.3(3) VII. A 99.3 (278) 50.0(140) 31.1 (87) 18.2(51) 0.7(2) 0 (0) 0.9(2) 90.7(205) 8.4(19) B 96.4(267) 30.3(84) 37.9(105) 28.2 (78) 3.2(9) 0.4(1) 1.3(3) 50.7(115) 48.0(109) C 98.9(276) 29.0(81) 34.8(97) 35.1 (98) 1 .1 (3) 0 (0) 0 (0) 48.7(112) 51 .3(118) D 98.2 (276) 28.8(81) 35.6(100) 33.8(95) 1.8(5) 0 (0) 0 (0) 61.1(138) 38.9(88) E 98.9(276) 38.4(110) 35.5(99) 24.0(67) 1.1(3) 0 (0) 0 (0) 81.5(185) 18.5(42) F 99.7(277) 43.2(120) 40.3(112) 16.2(45) 0.4(1) 0 (0) 0 (0) 74.8(169) 25.2(57) G 99.6(275) 38.4(106) 42.4(117) 18.8(52) 0.4(1) 0 (0) 0 (0) 53.1(119) 46.9(105) Numbers in parentheses indicate total number of responses. Table 7 Radiologic Technology Programs Responses by percentage Total of Major Above Average Little Do not ______Future need______Maj or emphasis average emphasis emphasis include Less Same Greater Above emphasis average Average I. A 75.3(55) 5.5(4) 21.9(16) 47.9 (35) 20.5(15) 4.1(3) 1.5(1) 78.8(52) 19.7(13) B 85.9(61) 18.3(13) 35.2(25) 32 .4(23) 14.1 (10) 0 (0) 1.4(1) 64.8(46) 33.8(24) C 56.7(42) 8.1(6) 10.8(8) 3 7.8(28) 32 .4(24) 10.8(8) 1.5(1) 84.8(56) 13.6(9) D 48.0(35) 0 (0) 11.0(8) 37.0(27) 34.2(25) 17.8(13) 2.9(2) 83.8(57) 13.2 (9) II. A 45.2(35) 2.7(2) 15.1(11) 27.4(20) 31 .5(23) 23.3(17) 3.1(2) 64.6(42) 32.3(21) B 82.6(62) 8.0(6) 21.3(16) 53.3(40) 16.0(12) 1 .3(1) 2.9(2) 78.3(54) 18.8(13) C 88.9(64) 11.1 (8) 2 9.2(21) 48.6(35) 11 .1 (8) 0 (0) 3.0(2) 62.1 (41) 34.8(23) D 98.7(73) 50.0(3 7) 33.8(25) 14.9(11) 1 .4(1) 0 (0) 0 (0) 75.0(51) 25.0(17) III. A 31 .1 (23) 1.4(1) 5.4(4) 24.3(18) 37.8(28) 31.1(23) 5.7(4) 70.0(49) 24.3 (17) B 23.9(18) 1.3(1) 1.3(1) 21.3(16) 24.0(18) 52.0(3 9) 7.7(5) 67.7(44) 24.6(16) C 50.7(38) 2.7(2) 12.0(9) 36.0(27) 21 .3(16) 2 8.0(21) 2.9(2) 72.1 (49) 25.0(17) D 61.1 (44) 11.1(8) 16.7(12) 33.3(24) 20.8(15) 18.1 (13) 2.9(2) 70.6(48) 26.5(18) IV. A 64.5(49) 10.5(8) 13.2(10) 40.8(31) 18.4(14) 17.1(13) 2.7(2) 56.2 (41) 41 .1 (30) V. A 58.6(44) 5.3(4) 28.0(21) 25.3(19) 24.0(18) 17.3(13) 3.0(2) 74.2 (49) 22.7(15) B 90.5(67) 16.2(12) 37.8(28) 3 6.5 (2 7) 9.5(7) 0 (0) 1.4(1) 73.2 (52) 25.4(18) C 90.7(68) 21.3(16) 34.7(26) 34.7(26) 9.3(7) 0 (0) 0 (0) 68.6(48) 31 .4(22) VI. A 100% (76) 93.4(71) 6.6(5) 0 (0) 0 (0) 0 (0) 0 (0) 74.3 (52) 25.7(18) B 97.4(73) 38.7(29) 36.0(2 7) 22.7(17) 2.7(2) 0 (0) 0 (0) 78.6(55) 21 .4(15) C 44.7(33) 4.1(3) 4.1(3) 36.5(27) 25.7(19) 29.7(22) 1.4(1) 65.7(46) 32.9(23) Total of Major Above Average Little Do not Future need Maj or emphasis average emphasis emphasis include Less Same Greater Above emphasis average Average VI .D 98.7(74) 40.0(30) 30.7(23) 28.0(21) 1.3(1) 0 (0) 0 (0) 73.6(53) 26.4(19) E 53.3 (40) 5.3(4) 6.7(5) 41 .3(31) 32.0 (24) 14.7(11) 3.1(2) 73.4(4 7) 23.4(15) F 89.2 (66) 17.6(13) 25.7(19) 45.9(34) 9.5(7) 1.4(1) 0 (0) 78.5(51) 21 .5(14) G 77.3 (58) 8.0(6) 24.0(18) 45.3(34) 18.7(14) 4.0(3) 1.5(1) 84.6(55) 13.8(9) H 19.0(14) 1.4(1) 1.4(1) 16.2 (12) 31 .1 (23) 50.0(3 7) 8.6(5) 84.5(49) 6.9 (4) I 65.3 (49) 5.3(4) 12.0(9) 48.0(36) 24.0(18) 10.7(8) 1.6(1) 85.5(53) 12.9(8) VII. A 98.6(73) 63.5(47) 27.0(20) 8.1 (6) 1.4(1) 0 (0) 0 (0) 6 7.2(43) 32.8(21) B 86.5(64) 35.1 (26) 23.0(17) 28.4(21) 8.1 (6) 5.4(4) 0 (0) 78.7(48) 21 .3(13) C 90.5 (67) 3 7.8(28) 2 8.4(21) 24.3(18) 9.5(7) 0 (0) 0 (0) 54.7(35) 45.3 (29) D 98.7(74) 50.7(38) 30.7(23) 17.3(13) 1.3(1) 0 (0) 0 (0) 65.1(41) 34.9(22) E 100%(75) 62.7(47) 24.0(18) 13.3(10) 0 (0) 0 (0) 0 (0) 62.5(40) 37.5(24) F 98.6(74) 61.3(46) 28.0(21) 9.3(7) 1.3(1) 0 (0) 0 (0) 68.8(44) 31 .3(20) G 98.7(72) 60.3(44) 24.7(18) 13.7(10) 0 (0) 1.4(1) 0 (0) 71.9(46) 28.1 (18) Numbers in parentheses indicate total number of responses . to 70 the disease process was less in the radiologic technology programs than in dental hygiene or nursing. Over 75% of respondents placed average or greater emphasis on items A and B, and 56.7% placed this much emphasis on item C. Only 48% gave this much emphasis to item D, "Methods of disease prevention." Opinions as to future need for this total area of content was generally the same as at the present time. As observed on the graphs’ the dental hygiene and nursing responses are more similar than are radiologic technology responses. However, 75% or more of the respondents from all three programs indicated that average or above emphasis was placed on items A and B and therefore these two items are suggested for inclusion in Core A, or the strong core, of common content; while over 51% of all respondents gave this much emphasis to item C and therefore this item is suggested for inclusion in Core B, or the weaker core. Introduction to Health Care Two items of content were considered reliable within this general category and two new items were added between the first and second mailings of the sample study. These four items were: ’Graphs depicting emphasis by programs for each item are found in Appendix F. 71 A. Health care system in the United States B. Members of the health team C. Relationships among health team members D. Medical terminology Over 75% of respondents from dental hygiene programs reported that an average or greater amount of emphasis was placed on each item of content in their curricula except for item A in which 74.7% placed average or more emphasis on the content. All items received average or greater emphasis by 75% or more of the nursing respondents. The majority of dental hygiene respondents felt that the need for this content would remain the same in the future but 63.2% of nursing respondents felt that the future need for A, "Health care system in the United States" would increase. Under the category of "Introduction to health care, " over 75% radiologic technology respondents indicated that an average or greater amount of emphasis was placed on three items, these being B, C and D. However the majority of radiologic technology educators replied that little or no emphasis was placed on item A, "Health care systems in the United States. " Again less than 50% felt the need for greater emphasis in the future. A review of the graphs reveals that the responses for all three programs were quite similar for items B and C. Although the 72 responses are similar for dental hygiene and nursing on items A and D, the radiologic technology responses are somewhat divergent. Items B, C and D received average or more emphasis in over 75% of the three types of programs and therefore are suggested for inclusion in Core A. Since item A received less than average emphasis in the majority of radiologic technology programs it is not suggested for inclusion in Core A or B. Pharmacology Under the broad area of pharmacology the following four items of content were identified and found to be reliable: A. General classification of drugs B. Computing fractional dosages C. Indications for use of specific drugs D. Contraindications for use of specific drugs Of the responses from dental hygiene programs the majority of the programs placed average or greater emphasis on all items of content except item B, "Computing fractional dosages." The future need for all content was viewed as being approximately the same as at the present time. Over 75% of responses from nursing programs indicated that average or greater emphasis was placed on each item under study. As 73 with the dental hygiene respondents there was no major change in their views for the future need for this content. The majority of replies from radiologic technology programs indicated that an average or greater emphasis was placed on each item of content except item A, "General classification of drugs" and B, "Computing fractional dosages ." However, for item C, "Indications for use of specific drugs," only 50.7% replied that they gave average or greater emphasis to this area of content. The future need for the content was felt to be about the same as at the present time . The graphs again reveal a similarity of responses for the dental hygiene and nursing programs for items A, C and D. The radiologic technology responses differed noticeably for these three items and there was a fairly wide variation for all three responses for item B. Problem Solving One item was found to be reliable and was included in this category: A. Steps of the problem solving process The majority of responses from each type of program indicated that average or greater amounts of emphasis were placed on this content within their curricula. However, less than 75% of the 74 dental hygiene and radiologic technology respondents placed this much emphasis on the content. Therefore the item would be recom mended for inclusion in Core B. The future need for "Steps of the problem solving process" was viewed as being the same as at the present time by the three types of respondents. The graph indicates a similarity of responses for the dental hygiene and radiologic technology programs but a higher level of responses from nursing programs. Safety Factors Three items of content were considered reliable and were included under the broad heading of "Safety factors." The three items were: A. Caring for the anesthetized patient B. Caring for very young or elderly patients C. Observation of patients for signs of shock The majority of nursing and radiologic technology responses indicated that average or greater amounts of emphasis were placed on each item of content by the respective programs. However less than 75% of the respondents from the radiologic technology programs placed average or greater emphasis on item A. Over 75% of the replies from dental hygiene programs revealed that average or greater 75 amounts of emphasis were placed on items B and C but only 45.9% indicated that this much emphasis was placed on item A, "Caring for the anesthesized patient." There was no noticeable change noted in future need for the specific content in any of the types of programs . Therefore items B and C would be suggested for inclusion in Core A but item A would not be suggested for either Core A or B for the three programs. The graphs show the closest similarity of responses between dental hygiene and radiologic technology. Application of Technical Skills Within this broad area the following nine specific areas of content were considered reliable and included: A. Positioning of patients for treatments and examinations B. Carrying out techniques for patients in isolation C. Insertion of needle into a vein (venipuncture) D. Using sterile technique E. Suctioning patients F. Washing hands G. Taking a blood pressure H. Irrigating a body cavity I. Taking temperature, pulse and respirations All nine items received average or greater emphasis in the majority of the nursing programs, however, less than 75% placed average or greater emphasis on item C, "Insertion of a needle into a vein." Six of the nine items received average or greater emphasis in the majority of the dental hygiene programs, but only four items received average or greater emphasis in over 75% of the programs. Those items in which the majority of programs devoted little or no time related to caring for patients in isolation, venipuncture and irrigating body cavities . The radiologic technology programs also placed average or greater emphasis on seven of the nine items, but only five of these items received average or above emphasis in over 75% of the programs responding. Those items receiving little or no emphasis related to venipuncture and irrigating a body cavity. The future need for all areas of content in each type of program was generally considered to be about the same as at the time of the survey. Items A, D and F would be recommended for inclusion in Core A and items E, G and I would be recommended for Core B. Items B, C and H would not be suggested for either core since less than 51% of the respondents from the three programs placed average or above emphasis on the items in their curricula. 77 The graphs reveal a close similarity of responses for nursing and radiologic technology for item D and a close similarity for dental hygiene and radiologic technology for items G, H and I. Technician-Patient Relations All items included in this category were deemed reliable. These were: A. Identification of patient before performing procedures B. Interviewing patient C . Legal implications of patient care D. Ethical implications of patient care E. Courtesy to patients F. Explanations of procedures to patients G. Instruction of patients Over 75% of the respondents from the three types of programs stressed all areas of content within the category of technician-patient relations. Therefore all items would be suggested for inclusion in Core A. The majority of respondents from dental hygiene and radiologic technology programs indicated that the future need for all content would be the same as at the present time. The respondents from the nursing programs indicated that the future need for legal and ethical 78 implications of patient care would be even greater in the future than at the time of the survey. The graph patterns for all three types of programs are more similar within this category than any other category. The pattern of responses are the closest for item C. Final Question A final question, "Have you had any experience with core curriculum?" and the respondents' opinions on the success of the experience were asked. A total of 407 respondents answered this question. One hundred and fifty-five answered "yes" and two hundred and fifty-two answered "no." Of those responding "yes" fifty-four felt that their experience had been successful, eighty moderately successful, and thirteen unsuccessful. No information was requested on the types of core courses with which the individuals had been involved, the amount of experience they had had with core courses or reasons for their opinions on the success of the courses. Summary of Findings The problem that was defined for testing in this study was whether there is a common core of technical content within three allied health programs, namely dental hygiene, nursing and radiologic 79 technology. Two levels of commonalities were identified: Core A, that which was included in 75% or more of the programs, and Core B, that which was included in 51% or more of the programs. In the present study thirty-two specific items of content were studied as to whether the content was common to two or three of the allied health programs under investigation. The responses from the nursing programs that participated in the study indicated that all items of content received average or above average degrees of emphasis in 51% or more of the programs and thirty-one of these items received average or above emphasis in 75% or more of the programs. Dental hygiene responses indicated that twenty-seven of the thirty-two items received average or greater emphasis in 51% or more of the programs and twenty-three of these items received average or above emphasis in 75% or more of the programs. The radiologic technology program responses indicated that twenty-five of the thirty-two items of content received average or higher emphasis in 51% or more of the programs and nineteen of these items received average or above emphasis in 75% or more of the programs. Within Core A there were seventeen items common to the three programs and six items common to two programs. Within Core B there were twenty-three items common to the three programs and eight items common to two programs. Table 8 depicts commonalities of Table 8 Commonalities of Content Core A Core B Included in 75% or more Included in 51% or more Items programs in programs in Dental Nursing Radiologic Dental Nursing Radiologic Hygiene Technology. Hygiene Technology I. Disease Process A. General causes of disease X X X X X X B. Changes produced in the body by disease X X X X X X C. General methods of therapy X X X X X D. Methods of disease prevention X X X X II. Introduction to health care A. Health care systems in the U.S. X X X B. Members of the health team X X X X X X C. Relationships among health team members X X X X X X D. Medical terminology X X X X X X III. Pharmacology A. General classification of drugs X X X X B. Computing fractional dosages X X C. Indications for use of specific drugs X X X X D. Contraindictions for use of specific drugs X X X X X IV. Problem solving A. Steps of the problem solving process X X X X Table 8 (continued) Core A Core B Included in 75% or more Included in 51% or more Items programs in programs in Dental Nursing Radiologic Dental Nursing Radiologic Hygiene Technology Hygiene Technology V. Safety factors A. Caring for the anesthetized patient X X X B. Caring for very young or elderly patients X X X X X X C. Observation of patients for signs of shock X X X X X X VI. Application of technical skills A. Positioning of patients for treatments and examinations X X X X X X B. Carrying out techniques for patients in isolation X X X X C. Insertion of needle into a vein (venipuncture) X D. Using sterile technique X X X X X X E. Suctioning patients X X X X X F. Washing hands X X X X X X G. Taking a blood pressure X X X X X H. Irrigating a body cavity X X I. Taking temperature, pulse and respirations X X X X VII. Technician-patient relations A. Identification of patient before performing procedures X X X X X X Table 8 (continued) Core A Core B Included in 75% or more Included in 51% or more Items programs in programs in Dental Nursing Radiologie Dental Nursing Radiologic Hyqiene Technology Hygiene Technology VII. B. Interviewing patient X X X X X X C. Legal implications of patient care X X X X X X D. Ethical implications of patient care X X X X X X E . Courtesy to patients X X X X X X F. Explanation of procedures to patients X X X X X X G. Instruction of patients X x x X X X 00 83 content.' The items common to the three programs within Core A were: I. Disease Process A. General causes of disease B. Changes produced in the body by disease II. Introduction to Health Care B. Members of the health team C. Relationships among health team members D. Medical terminology. V. Safety Factors B. Caring for very young or elderly patients C. Observation of patients for signs of shock VI. Application of Technical Skills A. Positioning patients for treatments and examinations D. Using sterile technique F. Washing hands VII. Technician-Patient Relations A. Identification of patient before performing procedures B. Interviewing patients ICommon content among items judged unreliable can be found in Appendix C. 84 VII. C. Legal implications of patient care D. Ethical implications of patient care E. Courtesy to patients F. Explanation of procedures to patients G. Instruction of patients In addition to the above seventeen items which were included in Core A, six were also included in Core B as being common to the three programs. These items were: I. Disease Process C. General methods of therapy III. Pharmacology D. Contraindications for use of specific drugs IV. Problem Solving A. Steps of the problem solving process VI. Application of Technical Skills E. Suctioning patients G. Taking a blood pressure I. Taking temperature, pulse and respirations The majority of programs in each technology indicated that the need for including each item of content in their respective curricula within the next ten years would be the same or greater than at the time of the survey. The majority of respondents did not feel 85 that the need for any items would be less than at the time of answering the questionnaire. Therefore all items which are presently common to two or three technologies could be included in a common core of content since the need for this content would not be likely to diminish in the near future. The majority of respondents from nursing programs felt that an even greater emphasis would need to be placed on three items of content than at the present time. These items were "methods of disease prevention," "health care system in the United States" and "legal implications of patient care." All of these items were receiving an average or above amount of emphasis in 77.5% or more of the nursing programs at the time of the survey and therefore were already included in the majority of the nursing programs. The majority of respondents from dental hygiene and radiologic technology programs indicated that the future need for each item of content would not change appreciably. The findings in this study relating to future need for content would not be a major influence on curricular additions or deletions since the opinions of educators suggested that the emphasis was not likely to decrease in any area and only three items were identified by one type of program as content which would require greater emphasis 86 in the future. However, the few suggestions for needed "additional emphasis" may refer to a belief that an area of content which is already included needs even more time or focus emphasis . Chapter 5 SUMMARY AND SUGGESTIONS FOR ADDITIONAL RESEARCH Summary An overview of the development of core courses and core curricula revealed that core had its beginnings in secondary education in the 1930's as a result of society's changing views of the role of the schools in preparing youth for living in a democracy and society's reaction against fragmented learning. Although the development of core curricula as related to allied health was more difficult to trace than in secondary education, reports in the literature began to appear in the late 1960's and 1970's with the establishment of schools and departments of allied health. The term "core" has been used in a broader sense in secondary education than in allied health education. Student-teacher planning was considered an important aspect of core in secondary education but little evidence of this was found in allied health education. A common characteristic in both areas is its emphasis on content required of all students. In both secondary and allied health education core courses 88 were viewed as a means of solving existing problems . Some common concerns which core was expected to alleviate were narrowness and fragmentation of educational programs and deficient preparation for functioning within a designated group, i.e., society or health team. These concerns received much attention in the literature by educators from secondary and allied health programs . In addition to these common problems, the utilization of core courses in allied health was viewed as a means of reducing the cost of allied health programs . Studies by Duggins, Chase and others revealed the high cost of allied health education but Burnett found that studies were limited as to how core helped reduce this cost. The need for core curricula was stressed by secondary and allied health educators but examples of its implementation were limited. Evidence in the literature of its implementation was confined mainly to English and social studies content at the Junior high school level and to biological and general education content in allied health. With both groups lack of prepared faculty was suggested as a possible reason for its limitations. The majority of the core courses that were in existence in allied health education were based upon opinions of educators as to what should be included. The present study sought to determine what actually was included in existing allied health programs. 89 Conclusions The fact that seventeen of the thirty-two items of content were included in 75% or more of the three types of programs and twenty-three items were included in 51% or more of the programs verified that there is now a common core of technical content in the three programs that were investigated. Within Core A, twenty-three of the thirty-two items were common to dental hygiene and nursing, seventeen were common to dental hygiene and radiologic technology and nineteen were common to nursing and radiologic technology. Within Core B, twenty-seven items were common to dental hygiene and nursing, twenty-three to dental hygiene and radiologic technology and twenty-five to nursing and radiologic technology. Therefore it can be concluded that for the content that was investigated there is a greater similarity between numbers of items of content included in dental hygiene and nursing programs than in nursing and radiologic technology programs or dental hygiene and radiologic technology programs . The category in which there was the greatest similarity of content was "Technician-patient Relations." All seven items were included in Core A of common content. With all items of content, except "Interviewing patients," there was less than 10% difference 90 in percentage of programs which placed average or more emphasis on the content in their curricula. Other items in which there was close similarity of content, or less than 10% difference in numbers of programs giving average or more emphasis to the content were: II. Introduction to Health Care D. Medical terminology V. Safety Factors B. Caring for very young or elderly patients VI. Application of Technical Skills A. Positioning of patients for treatments and examination D. Using sterile technique F. Washing hands In two categories there were no items included in Core A for all three programs. These categories were "Pharmacology" and "Problem Solving." It should be noted, however, that only one item of content was included under the category of "Problem Solving." It can be concluded that for the content that was investigated a strong core of common technical content exists within dental hygiene, nursing and radiologic technology for seventeen items of content and an additional weaker common core for six items. The conclusion is also warranted that the greatest degree of similarity 91 exists in the general area of "Technician-patient Relations." Therefore, this area of "Technician-patient Relations" would be an excellent area on which to focus in the development of core courses or other common learning experiences. Since all thirty-two items were included in the majority of nursing programs the conclusion is warranted that nursing programs include a greater amount of content within the areas surveyed than do dental hygiene or radiologic technology. Since all possible areas of common content between any two of the programs were undoubtedly not surveyed and since the items may have been screened by the researcher during the development of the questionnaire,' it cannot be concluded that there is a greater similarity of content between any two programs in general. For three of the items under study the majority of respondents from nursing programs replied that they felt there would be a greater need for the content in the future. With all other items of content the majority of nursing responses indicated that the future need would be 'The reader should be cautioned that since the researcher is a nurse she may have unconsciously screened the items common to nur sing while developing the questionnaire. However, since the question naire was presented to dental hygienists and radiologic technologists as well as nurses for pre-testing, items should also have been screened out for these disciplines before the final draft of the questionnaire was completed and hence would not have been surveyed . 92 the same as at the time of the survey. The majority of responses from dental hygiene and radiologic technology programs indicated that future need for all items of content would .not vary greatly from the present status. Since the three items which were identified as requiring greater emphasis in the future were already receiving average or greater emphasis at the time of the survey, the conclusion can be made that those items which were included in the majority of curricula of specific programs at the time of the survey would probably remain in the curricula for the next ten years while those which were not included would probably not be added unless there were unforeseen changes in the health care system. However, even though the three items were already included in the nursing curricula, it can be con cluded that these items would need to receive even more attention in the future in nursing programs. Of the 436 usable surveys, twenty-seven or 6.19% of the respondents marked "the same" column for future need for all thirty- two items included in the questionnaire (six or 8.1 l%--dental hygiene, thirteen or 4.59%—nursing and eight or 10 .13%—radiologic technology). Thirty-six or 8.26% of the total number of respondents left the future need column blank (seven or 9.46%--dental hygiene, twenty-six or 9.19%—nursing and three or 3.8%—radiologic tech- 93 nology). The total number of respondents who failed to mark the future need column or marked "the same" column for each item was sixty-three or 14.45%. Of the total number of usable questionnaires only one respondent indicated that the same amount of emphasis was placed on each item of content in their curricula at the time of the survey. This person indicated that major emphasis was placed on each item of content in their nursing curriculum. This same respondent was one of the thirty-six who failed to mark the "future need" column. One can conclude from these types of responses that some persons had either not given much thought to future need for content, had not yet formulated opinions on future curricular needs, were satisfied or complacent with the present status, did not have time to answer the questionnaire adequately, or did not feel that this area was of sufficient importance to answer. Limitations The major limitations of the study were that it was confined to a small number of existing types of allied health programs, a course or courses which contained the identified common content were not developed and evaluated and limited information was obtained on the types of core courses that were in existence and relative success of these courses. 94 Although the numbers of respondents who failed to answer the questions relating to future need or who indicated that the future need for all items would remain the same were tabulated, it would also be well to study the returns to determine if there were many respondents who left a large number of the items unanswered. Of the individuals who completed the questionnaire 155 reported that they had had experience with core curricula. The study did not elicit information on the types of courses with which they had been involved. Therefore it is unknown if their involvement was only with general studies and/or biological and the physical science courses or with technical courses. Those completing the questionnaire were asked to respond as to whether they felt their experiences with core curricula had been successful, moderately successful or unsuccessful; however reasons for their opinions were not requested. Therefore no information became available as to whether or not there is a prevailing factor influencing the success or lack of success of core curricula. Another limitation related to the reliability of content included in the questionnaire. Initially forty-four items were included in the questionnaire which was sent to the sample group. Twelve of the forty-four items were found to be unreliable. Possible reasons for changing opinions between the first and second mailing might be 95 instability of beliefs as to curricular emphasis, different people completing the questionnaire (this occurred in at least one known instance) and/or criteria for levels of responses may not have been differentiated sufficiently. Suggestions for Additional Research The present study investigated the status of thirty-two items of technical content within seven broad categories in all of the associate degree and/or certificate level programs in the United States in three allied health technologies . The findings of this study provide implications for further research. Additional areas of research suggested by these findings include: 1. Survey of additional allied health programs which would include content that was used in the present survey,content that was found to be unreliable in this survey and other content which might be common to additional types of programs. 2. Develop learning situations, such as courses or modules, which included the common areas of content and evaluate the effect iveness in light of its contributions to program objectives. Wilson, in her study, evaluated the success of the core course by student performance in the course and in the succeeding course. Student performance within a course or courses does 96 not reflect the contribution of the course to program objectives or the importance of the course within the curriculum. Other means of evaluation of effectiveness of courses is student opinion and job performance of graduates . In secondary education student involvement in planning and evaluation of core courses was considered essential, however, references to this aspect of core curriculum were lacking in allied health education. Student evaluation of core courses would be one means of including this aspect of core. Comparisons of job performance of graduates who had been involved with core courses and those who had been taught in separate courses would be helpful since a major objective of the allied health programs is to prepare the graduates for functioning in specific occupations . 3. Although content was common to two or three of the programs under investigation, varying degrees of emphasis were placed upon the content. A study to determine the amount of time spent on the common areas of content would be beneficial in the development of the core courses . The results of this study might also reveal that the common content could be better covered in some other manner than the traditional course. Burnett found that modularization has been used for presenting 97 common content. Additional methods might be programmed instruction and mini courses. 4. Determine if the placement and sequence of the common content within the three allied health programs is of importance. If it were of importance and if it differed in the three programs the development of a core course or courses might be impeded. Again, modules, mini courses or other means of independent study might be a solution. 5. A follow-up study of the individuals who indicated that they had had experience with core curricula would be useful in deter mining how the common content was derived, if the core courses included technical content and reasons for success or failure of the core courses. A review of how the findings of the present study relate to core courses that are already in existence would also be useful. Recommendations for Use of This Study The findings of this study support the opinions of educators that there is a common core of content in allied health programs. The results have implications for schools or departments of allied health, educators teaching in allied health programs, students in allied health 98 programs and practitioners within the allied health field. If the common areas of content that were identified for two or three of the programs were included in common learning experiences, some of the problems peculiar to the above groups could be alleviated. If placement and/or sequence precluded the inclusion of specific items in a core course; modules, mini courses, or programmed units based on the common content, could be developed which could then be utilized by the respective programs . Schools or Departments of Allied Health Some of the major reasons given for the development of core courses have been those which would be of benefit to the institution conducting more than one allied health program. Some of these reasons were improvement of efficiency and economy in program plan ning thus reducing the cost of specific programs. Studies by Duggins, Chase and others reflected the high cost of allied health education and pointed out the need for finding ways of reducing cost. In the past a major task of allied health departments or schools in the development of core courses has been to identify the content that was common to the programs under investigation. The committee approach in identifying areas of common content within their own programs was used by the University of Kentucky, State University of New York and 99 Kellogg Community College. The findings of the present study have defined areas of content which are common to the majority of three allied health programs in the United States. These findings could be used as basis for these schools or departments in delineating common areas of content. Those areas which are included in Core A could be developed into courses or modules which would require little or no variation for the students from the three programs. Those areas included in the weaker Core B might be developed into self-instructional modules or units which could be used by the programs if they were applicable. Since there might be some variations for specific programs, follow-up core or separate classes could focus on the unique aspects of the content. Educators Even though educators may be involved with only one type of allied health program they are frequently concerned about the content which should be included in the curriculum and the amount of emphasis that should be placed on specific areas of content. The results of this study have determined content that is included and that which is not included in three allied health programs. It has also determined the amount of emphasis placed on specific items of content by the respective programs. This information on what is 100 being done nationally can serve as a guideline to educators administering or teaching in one of the three types of programs. It can provide data for the determination of common program goals followed by the identification of unique goals as suggested by Rosinski. In addition, if common content were included in core courses educators within an area of specialization could focus on content unique to the specialty in separate courses as recommended by Hinsvark. In line with Hinsvark's recommendation, educators teaching in core courses could also focus on unique aspects of the common content as this uniqueness relates to each program. Since 14.5% of the respondents of the usable surveys failed to respond on the future need for content or indicated that all items would receive the same emphasis, one must be .concerned about the future of curriculum development in allied health. If these responses are valid the recommendation must be made that educators in the field of allied health investigate trends in society as they relate to or influence the delivery of health care. Pressed by society's demands for more and improved health care, changes that have occurred and that will occur in the health care system were discussed by Chirikos, Somers and others. Studies by Decker, the Coordinating Council for Education in the Health Services for San Diego and Imperial Counties and the UCLA Allied Health Professions Project on the occupational 101 and task analysis of the various categories of health personnel should influence the curriculum content of allied health programs. The present concern over narrowness of content, health team concept, career ladder concept, and high cost of allied health programs should have implications for curricular content in the future. Failure to recognize these trends and results of task analyses studies will result in an educational system that will be unable to cope with the changing needs of society. The present study sought to determine the status of cur riculum content at the present time and opinions on future needs. Another study of the same type should be done in five to ten years to determine if the findings of the present study are still accurate and/or changes that had occurred. Students Concerns over students' career choice in the allied health field were discussed by Kinsinger, Burnett, Perry, Holloway and Holloway, Egelston and others. If a core course or courses were developed as a result of this present study, students could delay their choice of a definite type of allied health career if the course were offered early in their program. Even if it were offered later in the program it would allow for minimum loss of credit if the student trans 102 ferred to another type of health program . Since a greater amount of content under investigation was included in nursing programs than in dental hygiene or radiologic technology programs, an uncertain student could first be encouraged to focus on nursing. If and when the student branched out into another field he would have already acquired a body of usable content than if he had started in another field. The need for development of the health team concept was stressed by Christman, Duncan, Kempe, Szasz, Kerr, Louk and others. Although some research findings have suggested that core courses do not necessarily foster the health team concept, core courses do provide an opportunity for the students to be exposed to other members of the health team and to become aware of their roles . Studies on graduates' performance in their occupational fields should be done and comparisons made between those who have been taught in core courses and those who have not had this experience. A survey of students' opinions on the benefits of common core learning experiences would provide helpful information as well as providing for the inclusion of one of the basic concepts of core, namely student involvement. Practitioners Ingles has stated that, 103 The development of systematic and effective health programs is going to necessitate research in methods of health care, the results of which will inevitably bring about revolutionary changes in the present practices, and concomitant changes in the education patterns for all types of health care personnel. ’ The pending federal legislation which gives promise of health care for the entire population has stimulated research on how the health care delivery system can be improved. Changes in the delivery of health care will affect the roles of the practitioners in the health field. If major changes occur in the health care system the present method of preparation of the practitioners may be inadequate. Before recommendations can be made for revisions in educational programs the present status of the programs must be ascertained. The contributions made by this study in identifying some areas of content which are presently included in existing programs can help in evaluating the preparation of current practitioners and in determining curriculum needs for content additions or deletions in the future. Input from practitioners should be elicited as to whether content identified by educators as being important is still relevant in the present health care delivery system. If opinions of educators and ’Thelma Ingles, "A Proposal for Health Care Education," American Journal of Nursing, LXVIII (October, 1968), p. 2136. 104 practitioners were similar it would provide evidence that the educational system is preparing graduates for the real world of work. If differing opinions were found it would indicate a serious dichotomy between the preparation of students and the expectations of service agencies. The findings of this study provide a body of content that was identified as important by educators and which can now be used to survey the practitioners . 105 BIBLIOGRAPHY BOOKS Aikin, Wilford M. Adventure in American Education. Vol. I, The Story of the Eight-Year Study. New York: Harper Bros ., 1942 . Alberty, Harold B. , and Elsie J. Alberty. .Reorganizing the High School Curriculum. 3ded. New York: Macmillan Co. , 1962. Chirikos , Thomas N . Allied Health Manpower in Ohio. Columbus , Ohio: Center for Human Resource Research, The Ohio State University, 1 9 72 . Faunce, Roland C., and Nelson L. Bossing. Developing the Core Curriculum . 2ded. Englewood Cliffs, New Jersey: Prentice-Hall Inc., 1958. Greenfield, Harry I. Allied Health Manpower: Trends and Prospects. New York: Columbia University Press, 1969. Horizons Unlimited. Chicago: American Medical Association, 1970. Leonard, J. Paul. Developing the Secondary School Curriculum. New York: Reinhart and Co. , 1953. 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U.S. Public Health Service Publication No. (NIH) 73-348. Bethesda, Md.: National Institutes of Health, 19 72. Wollenstein, Robert J. Knowledges Commonly Useful in Twelve Allied Health Occupations. Washington: Dept. of Health, Education and Welfare, Office of Education, 1968. Wright, Grace S. Block Time Classes and the Core Program in the Junior High School. Dept. of Health, Education and Welfare Bulletin No. 6. Washington: Government Printing Office, 1958. ______. Core Curriculum Development Problems and Practices . Federal Security Agency, Office of Education Bulletin No. 5. Washington: Government Printing Office, 1952. ______. Core Curriculum in Public High Schools an Inquiry Into Practices . Federal Security Agency, Office of Education Bulletin No. 5. Washington: Government Printing Office, 1950. PAMPHLETS AND DOCUMENTS American Dental Association, Council on Dental Education. Accredited Dental Hygiene Programs. Chicago: American Dental Association, 1973 . ______. Requirements and Guidelines for Dental Hygiene Education Programs . Chicago: American Dental Association, 1971. 109 American Society of Radiologie Technologists. Careers in X-ray Tech nology. CChicago : n.n.JJ, 1961. Burnett, Carolyn. The Core Concept in Allied Health, A "State of the Art" Document. Springfield, Virginia: National Technical Infor mation Service, 1972. Career Mobility: A Guide for Program Planning in Health Occupations. Chicago: American Hospital Association, 1971. Council on Medical Education of the American Medical Association. Approved Educational Programs for Radiologic Technologists. Chicago: American Medical Association, 1972. ______. Essentials of an Accredited Educational Program for Radiologic Technologists. Chicago: American Medical Association, 1970. National League for Nursing, Dept. of Associate Degree Programs. Associate Degree Education for Nursing . New York: National League for Nursing, 1972 . PERIODICALS Anderson, Vernon E. "Team Teaching vs. Core? A Reply," Educational Leadership, XXIII (May, 1966), 620-622. "Basic Science Education for Health Related Personnel," Annals of the New York Academy of Sciences, CLXVI (Decernber, 1969), 1050-1055. Blechman, Harry. "Curriculum--the Basic Science Program. " Tournal of Dental Education, XXXIII (December, 1969), 546-553. Bonneau, Louis-Philippe, and Gustave Rattez. "Lavel University Embraces the Health Science Concept," Tournal of Canadian Dental Association, XXXVI (June, 1970), 222-223. Brunet, Jacgues. "Education and the Health Sciences, " Journal of Medical Education, XLVI (January, 1971), 51-57. Brunet, Jacgues and C. Gagnon. "Laval University Accepts a Chal lenge," Canadian Nurse, LXV (August, 1969), 44-45. no Burnett, Carolyn. "A Closer Look at Core." Tournal of Allied Health, II (Summer, 1973), 107-112. Cantwell, J. Lawrence. "The Galveston Approach to Health Care Education, " American Vocational Tournal, XLIX (Tanuarv, 1974), 57-58. Christman, Luther. "Education of the Health Team," Journal of the AMA, CCXIII (July, 1970), 284-285. "Core Concept in Allied Health, A Summary of the ASAHP Report," Journal of Allied Health, II (Summer, 1973), 97-106. Dammann, Gloria L. "Interprofessional Aspects of Nursing and Social Work Curricula," Nursing Research, XXI (March-April, 19 72), 160— 163. deShazer, Douglas O. "Heroic Correlations Lead to Mediocre Integrations, " Tournal of Dental Education, XXXIII (June, 1969), 221-223.. Drage, Martha. "Core Courses and Career Ladder," American Tournal of Nursing, LXXI (July, 1971), 1356-1358. Duncan, Burris, and C. Henry Kempe. "Joint Education of Medical Students and Allied Health Personnel, " American Journal of Diseases of Children, CXVI (November, 1968), 499-504. Durocher, Roy T. "Auxiliary Personnel—American Dentistry at a Crossroad," Journal of American College of Dentists, XXXIV (July, 1 967), 133-141 . Egelston, E. Martin. "Licensure and Career Mobility," Hospitals, XLIV (December 1, 1970), 42-46. Hamburg, Joseph. "Core Curriculum in Allied Health Education, " Journal of the AMA, CCX (October, 1969), 111-113. ______. "Future Trends in Professional Education," The American Journal of Occupational Therapy, XXIV (October, 1970), 488-489. ______. "Push On," Tournal of Allied Health, II (Summer, 1973), 117. Harvill, Harris. "Nature of Core Curriculum," Social Education, XVIII (May, 1954), 215-218. Ill Harvill, Harris. "Origins of the Core Concept," Social Education, XVIII (April, 1954), 161-163. Hatch, Thomas . "Allied Health Manpower Direction for the 1970's and 1980's," Respiratory Care, XVI (Tanuary-Februarv. 1971), 7-10. Hendee,. William . "A Collaborative Program in Allied Health Training, " Journal of Medical Education, XLVII (August, 1971), 658-665. Henderson, Algo D. "Innovations in Educating for the Professions, " Educational Record, XLIX (Summer, 1968), 290-297. Hinsvark, Inez. "Discussion in response to 'A Proposal for Health Care Education,' by Thelma Ingles," American Journal of Nursing, LXVIII (October, 1968), 2135-2140. Holloway, Otto. "Scope, Trends and Problems of Core Curriculum Work in Alabama," Educational Administration and Supervision, XLV (May, 1959), 153-1 61. Ingles, Thelma. "A Proposal for Health Care Education, " American Journal of Nursing, LXVIII (October, 1968), 2135-2140. James, George. "Educational Role of New Health Science Centers in the Health Related Professions, " Annals of the New York Academy of Sciences, CLXVI (December, 1969), 862-868. Kerr, Elizabeth. "Utilization and Preparation of Personnel to Deliver Health Care. " Respiratory Care, XVI (March-April, 1971), 41-48. Kinsinger, Robert E. "A Core Curriculum for the Health Field," Nursing Outlook, XV (February, 1967), 28-29. Lawhead, Victor B. "Guidelines for Evaluating Core Programs, " Educational Leadership, XVIII (December, 1960), 187-189. Lenburg, Carrie, and Walter Johnson. "Career Mobility Through Nursing Education," Nursing Outlook, XXII (April, 19 74), 2 65-269. Light, Israel. "Development and Growth of New Allied Health Fields," Journal of the AMA, CCX (October, 1969), 114-120. ,_____ . "Growth and Development of New Allied Health Fields, " American Tournal of Medical Technology, XXXVI (February, 1970), 75-83. 112 Little, James W. "Teaching Related Dental and Medical Subjects as a Conjoint Course for Dental Students , " Tournal of Dental Education, XXXIII (March, 1969), 89-91 . Louk, Sister Rose Agnes. "Sharing: An Educational Experience, " Journal of Allied Health, II (Summer, 1973), 121-122. McCreary, J. F. "The Health Team Approach to Medical Education," Journal of the AMA, CCVI (November, 1968), 1554-1557. McLeod, J. W. "Education for the Health Professions to Meet Tomor row's Needs," Applied Therapeutics, VIII (April, 1966), 354-367. Meredith, Glen. "Schools of Allied Health Professions: Concepts of Their Organization and Administration, " The American Journal of Occupational Therapy, XXV (January-February, 1971), 29-31. Mickelson, John. "What Does Research Say About the Effectiveness of the Core Curriculum?" The School Review, LXV (June, 195 7), 144-160. Moore, Sister Anne Joachim. "The Ladder and the Lattice," Nursing Outlook, XX (May, 1972), 330-332. Perry, Warren. "Career Mobility in Allied Health Education, " Journal of the AMA, CCX (October, 1969), 107-110. Phillips, Richard C. "Development of the Term, Core Curriculum," Educational Forum, XXIX (May, 1965), 423-430. Rosinski, Edwin. "Impact of Technology and Evolving Health Care Systems on the Training of Allied Health Personnel, " Military Medicine, CXXXIV (June, 1969), 390-393. Sanazarro, P. J. "Emerging Patterns in Medical Education," Mayo Clinic Proceedings, XLII (December, 1967), 777-790. Szasz, George. "Education for the Health Team," Canadian Journal of Public Health. LXI (September-October, 1970), 386-390. Tyler, Ralph W. "The Core Curriculum," NEA Journal, XLII (December, 1953), 563-565. Vars, Gordon F. "Leadership in Core Program Development," Educational Leadership, XIX (May, 1962), 51 7-522 . 113 Vidmar, Gordon C. "Core Curriculum in Preventive Dentistry," Journal of Dental Education, XXXV (February, 1971), 53. Weil, Thomas, and H. M. Parrish. "Development of a Coordinated Approach for Training of Allied Health Personnel, " Journal of Medical Education, XLII (July, 1967), 651-659. Zabsky, Harold. "Basic Science Education for Health Related Personnel," Annals of the New York Academy of Sciences, CLXVI (December, 1969), 1050-1055. Zentmyer, Robert Kenneth. "Training of Allied Health Personnel: A Practical Approach," Clinical Obstetrics and Gynecology, XV (June, 1972), 333-341. UNPUBLISHED WORKS Andrews, Aaron L. "Challenge for Action. " Paper presented at the American Dental Hygienists' Association Workshop, July 6, 1967, Chicago, Illinois. Belote, Everett. "Team Approach to Health Care. " Paper presented at the Paramedical Education and Career Mobility Symposium, June 6- 7, 1968, Evergreen Park, Illinois. Devitt, Grace A. "Commonalities of Curricular Objectives in the Preparation of Nurses, Physical Therapists, Occupational Therapists, and Therapeutic Dietitians at the Baccalaureate Level." Unpublished PhD dissertation, University of Pittsburg, 1970. Drage, Martha. "Implementation of the Concept of Health Core Areas." Panel presentation at the Council of Associate Degree Programs of the National League for Nursing annual meeting, March 3-5, 19 71 , Washington, D. C. Duggins, Oliver. "The Development of Health Core Areas: Development of the Concept. " Paper presented at the Council of Associate Degree Programs of the National League for Nursing annual meeting, March 3-5, 1971, Washington, D. C. Hamburg, Joseph. "A Core Curriculum for the Allied Health Profes sions ." Paper presented at the Sixty-fifth Congress on Medical Education, February 9, 1969, Chicago, Illinois. 114 Holloway, Sally and Robert Holloway. "The Development of a Program of Career Mobility in Hospitals." Paper presented at the American Hospital Convention, August, 19 71, Chicago, Illinois. Kadish, Joseph. "The Critical Challenge." Paper presented at the Paramedical Education and Career Mobility Symposium, June 6-7, 19 68, Evergreen Park, Illinois. Katz, Stanley S. "Implementation of the Concept of Health Core Areas ." Panel presentation at the Council of Associate Degree Programs of the National League for Nursing annual meeting, March 3-5, 1971, Washington, D. C. Perry, Warren. "The Assistant: Mobile or Immobile ?. " Paper presented at the Manpower Conference on Allied Health Professions Assistants, April 16-17, 1970, Buffalo, New York. Skaggs, Kenneth. "Health Education Centers—Community Junior College View. " Paper presented at the Paramedical Education and Career Mobility Symposium, June 6-7, 1968, Evergreen Park, Illinois. Steely, Robert D. "Core Curriculum Planning and Evaluation." Paper presented at the Workshop for Faculty in Nursing and Other Health Occupation Programs, June 18-20, 1973, Denver, Colorado. Turner, Robert E. "Core Curriculum and Mobility." Paper presented at the Paramedical Education and Career Mobility Symposium, June 6-7, 1 968, Evergreen Park, Illinois. Wilson, Glenys. "An Evaluative Study of a Core Course for Health Occupations." Unpublished PhD dissertation, University of California at San Francisco, 1974. 115 APPENDIX A SURVEY ON CURRICULUM CONTENT IDENTIFYING INFORMATION AND INSTRUCTIONS IDENTIFYING INFORMATION: The information given on this page is for the use of the principal investigator and will remain confidential. Name of person answering questionnaire ______ Position of person answering questionnaire______ Name of institution represented______ Address of institution (city & state) ______ Type of program represented (check one) Dental hygiene ______N urs ing ______Radiologic technology______ How long has program been in existence in the institution______ Date questionnaire completed 116 DIRECTIONS FOR COMPLETION OF QUESTIONNAIRE: Please indicate by a check mark in the appropriate column the amount of emphasis placed on the specific areas of content in the dental hygiene, nursing or radiologic technology curriculum of your college. It might be helpful to keep the criteria before you when completing the questionnaire. Please base your response on the following criteria: Major emphasis - The content in the item under question must be included in the technical (major) courses and it is the most im portant content in the course. Above average emphasis - The content in the item under question must be included in the technical (major) courses and it is equally important or of greater importance than other areas of content. Average emphasis - The content in the item under question must be included in the technical (major) courses but other areas of content are equally important or of greater importance. Little emphasis - The content in the item under question need not be included in the technical (major) courses, however if there is available time it may be included. Do not include - The content in the item under question is never included in the technical (major) courses. Please indicate in the last 3 columns your opinion as to the future need for the content in your curriculum. Please base your response on the following criteria: Less need - You feel that within 10 years there will be less need than there is at the present time for the item under question in your curriculum. Same need - You feel that within 10 years there will be the same need as at the present time for the item under question in your curriculum. Greater need - You feel that within 10 years there will be greater need than there is at the present time for the item under question in your curriculum. SURVEY ON CURRICULUM CONTENT Major Above Average Little Do not Future need for Emphasis Average Emphasis Emphasis Include Content in Cur Emphasis riculum Less Same Greater Need , Need Need I. Disease Process’ A. General causes of disease B. Changes produced in the body by disease C. General methods of therapy D. Methods of disease prevention II. Introduction to health care A. Health Care system in the United States B . Members of the health team C. Relationships among health team mem bers D. Medical ter minology E. Community resources for health care 1 1 7 Major Above Average Little Do not Future Need for Emphasis Average Emphasis Emphasis Include Content in Cur- Emphasis riculum______Less Same Greater Need Need Need III. Pharmacology A. General classifi cation of drugs B. Computing fractional dosages C. Effects of specific drugs D. Indications for use of specific drugs E. Contraindications for use of specific drugs F. Observations of patient receiving drugs IV. Problem solving A. Steps of the problem solving process B. Methods of identify ing patients' problems V. Safety factors A. Caring for the anes thetized patient B. Caring for patients with reduced levels of consciousness 1 1 C. Caring for very young 8 or elderly patients Major Above Average Little Do not Future need for Emphasis Average Emphasis Emphasis Include Content in Cur- Emphasis riculum______Less Same Greater Need Need Need D. Observation of patient for signs of respiratory distress E. Maintenance and care of electrical equip ment F. Observation of patients for signs of shock VI. Application of technical skills A. Positioning of patients for treatments and examinations B. Carrying out techniques for patients in iso lation C. Insertion of needle into a vein (veni puncture) D. Administering oxygen E. Using sterile technique F. Suctioning patients G. Washing hands 1 1 H. Taking a blood 9 pressure Major Above Average Little Do not Future Need for Emphasis Average Emphasis Emphasis Include Content in Cur- Emphasis riculum______, Less Same Greater ;______Need Need Need I. Administering cardio pulmonary resus citation J . Irrigating a body cavity K. Administering sub- ’ cutaneous medications L. Administering oral medications M. Taking temperature, pulse and respir ations N .Administering intra muscular medications VII. Technician-patient relations A. Identification of patient before per forming procedures B. Interviewing patient C. Legal implications of patient care D. Ethical implications of patient care E . Courtesy to patients 1 2 F . Explanation of pro 0 cedures to patients , • Major Above Average Little Do not Future Need for Emphasis Average Emphasis Emphasis Include Content in Cur- Emphasis riculum______Less Same Greater ” ’ 'T ’ 'T ed G. Have you had any experience with core curriculum ? Yes_____ No_____ If you answered yes, do you feel it was Successful_____ Moderately Successful . Uns ucce s sful_____ 122 APPENDIX B List of Directors Included in Sample Group Dental Hygiene Dr. Samuel P. Adams Dr. Nancy Reynolds Scioto Technical College The Ohio State University Lucasville, Ohio Columbus, Ohio Ms. Judith Broska Ms. Janet Scharer Sinclair Community College Lakeland Community College Dayton, Ohio Mentor, Ohio Ms. Jacqueline Heine Ms. Pauline Schmidt Indiana University University of Kentucky South Bend, Indiana Lexington, Kentucky Dr. Malcolm A. Perlich Ms . Barbara Schnurr University of Cincinnati Cuyahoga Community Raymond Walters General & College Technical College Cleveland, Ohio Cincinnati, Ohio Ms . Pauline Steele Dr. James E . Pilon University of Michigan Genesee Community College Ann Arbor, Michigan Flint, Michigan Nursing Ms. Ruth Ann Busald Ms . Rogene Schoffner Miami University Lakeland Community College Hamilton, Ohio Mentor, Ohio Ms. Barbara Choplin Ms . Georgeen DeChow Community & Technical College Manatee Junior College of the University of Toledo Bradenton, Florida Toledo, Ohio Ms . Dixie Emler Ms. Dorothy Oe sc hl er Purdue University University of Cincinnati Lafayette, Indiana Raymond Walters General & Ms . Connie Murphy Technical College Clark Technical College Cincinnati, Ohio Springfield, Ohio 123 APPENDIX B (continued) Nursing Ms. Eleanor Tourtillott Ms . Alma Wittmeyer Henry Ford Community College Lima Technical College Dearborn, Michigan Lima, Ohio Ms. Nancy Voelker Cuyahoga Community College Cleveland, Ohio Radiologic Technology Mr. N. P. Arthur Mr. Henry Konecny Little Company of Mary Hospital Elkhart General Hospital Evergreen Park, Illinois Elkhart, Indiana Mr. C. Bauer Mr. Ronald Korb Delta College University of Cincinnati University Center, Michigan Raymond Walters General & Technical College Ms. Brenda Bennett Cincinnati, Ohio Williamson Appalacian Regional Hospital Mr. R. Nelson Williamson, W. Virginia Washtenaw Community College Mr. C. L. Christensen Ann Arbor, Michigan Ferris State College Big Rapids, Michigan Ms . B. Rodman University of Kentucky Sr. M. L. Golante Medical Center Trocaire College Lexington, Kentucky Buffalo, New York Ms. Nancy Huskinson Lorain County Community College Elyria, Ohio 124 APPENDIX C Items Found to Be Unreliable The following twelve items which were included within the category of the respective general headings were found to be unreliable: II. Introduction to Health Care E. Community resources for health care III. Pharmacology C . Effects of specific drugs F. Observation of patient receiving drugs IV. Problem Solving B. Methods of identifying patients' problems V. Safety Factors B. Caring for patients with reduced levels of consciousness D. Observation of patient for signs of respiratory distress E. Maintenance and care of electrical equipment VI. Application of Technical Skills D. Adminstering oxygen I. Administering cardio-pulmonary resuscitation K. Administering subcutaneous medications L. Administering oral medications N . Administering intramuscular medications Of these twelve items, two would have been included in a strong core of technical content, or one in which 75% or more of the respondents in the three programs indicated average or more emphasis in their programs. These items were V. D. "Observation of patient for signs of respiratory distress" and VI. I. "Administering cardio pulmonary resuscitation." An additional five items would have been included in a weaker core of technical content, or one in which 51% or more of the 125 APPENDIX C (continued) respondents in the three programs indicated average or greater emphasis. These items were III. C. "Effects of specific drugs," III. F. "Observation of patient receiving drugs," IV. B. "Methods of identifying patients' problems," V. E. "Maintenance and care of eletrical equipment" and VI. D. "Administering oxygen." 126 APPENDIX D List of Institutions to Which the Questionnaire Was Sent Dental Hygiene Arizona Connecticut Phoenix College Fones School of Dental Hygiene Phoenix Bridgeport Arkansas District of Columbia University of Arkansas Howard University* Little Rock Washington California Florida Cabrillo College* Florida Junior College Aptos Jacksonville Cerritos College* Miami-Dade Junior College Norwalk Miami Chabot College Palm Beach Junior College Hayward Lake Worth Diablo Valley College* Pensacola Junior College* Pleasant Hill Pensacola Foothill College St. Petersburg Junior College* Los Altos Hills St. Petersburg Los Angeles City College* Georgia Los Angeles Albany Junior College Albany Pasadena City College* Pasadena Armstrong State College* Savannah Sacramento City College Sacramento Clayton Junior College M orrow Colorado Rangely College Columbus College Rangely Columbus 127 APPENDIX D (continued) Dental Hyqiene Macon Junior College Indiana University-Purdue Macon University at Indianapolis Indianapolis Hawaii University of Hawaii* Indiana University at Fort Wayne Honolulu Fort Wayne Idaho Indiana University at South Bend Idaho State University South Bend Pocatello Kansas Illinois Johnson County Community College Illinois Central College Shawnee Mission East Peoria Wichita Dental Hygiene School* Lake Land College Wichita Mattoon Kentucky Loyola University University of Kentucky Maywood Lexington Northwestern University* University of Louisville Chicago Louisville Parkland College Western Kentucky University Champaign Bowling Green Prairie State College* Louisiana Chicago Heights Loyola University New Orleans Southern Illinois University Carbondale Maryland Allegany Community College* William Rainey Harper College* Cumberland Palatine Community College of Baltimore* Indiana Baltimore Indiana State University at Evansville Massachusetts Evansville Bristol Community College Fall River 128 APPENDIX D (continued) Dental Hygiene Forsyth School for Dental Normandale State Junior College Hygienists Bloomington Boston University of Minnesota Middlesex Community College* Minneapolis Bedford Missouri Springfield Technical Community Forest Park Community College College* St. Louis Springfield Nebraska Michigan University of Nebraska Ferris State College Lincoln Big Rapids New Hampshire Genesee Community College New Hampshire Technical Institute* Flint Concord Grand Rapids Junior College New Jersey Grand Rapids Bergen Community College Paramus Kalamazoo Valley Community College* Camden County College Kalamazoo Blackwood Kellogg Community College* Fairleigh Dickinson University Battle Creek Hackensack Lansing Community College* Middlesex County College Lansing Edison University of Detroit Union County Technical Institute Detroit Scotch Plains The University of Michigan New Mexico Ann Arbor The University of New Mexico* Albuquerque Minnesota Mankato State College New York Mankato Broome Community College Binghamton 129 APPENDIX D (continued) Dental Hygiene Erie Community College University of North Carolina Buffalo School of Dentistry* Chapel Hill Eugenio Maria de Hostos Community College Wayne Community College Bronx Goldsboro Hudson Valley Community College North Dakota Troy North Dakota State School of Science Monroe Community College Wahpeton Rochester. Ohio New York City Community College Cuyahoga Community College Brooklyn Cleveland Onondaga Community College Lakeland Community College Syracuse Mentor State University of New York at Ohio State University* Farmingdale Columbus Farmingdale Scioto Technical College North Carolina Lucasville Asheville-Buncombe Technical Institute Sinclair Community College Asheville Dayton Central Piedmont Community College University of Cincinnati Charlotte Cincinnati Coastal Carolina Community Oklahoma College Oscar Rose Junior College* Jacksonville Midwest City Fayetteville Technical Institute University of Oklahoma Fayetteville Oklahoma City Guilford Technical Institute Oregon Jamestown Lane Community College Eugene 130 APPENDIX D (continued) Dental Hygiene Mt. Hood Community College* Tennessee Gres ham Aquinas Junior College* Nashville Oregon Technical Institute Klamath Falls East Tennessee State University Johnson City Portland Community College* Portland Meharry Medical College Nashville University of Oregon Dental School Portland University of Tennessee Pennsylvania Memphis Northampton County Area Community College Texas Bethlehem Amarillo College Amarillo Temple University Philadelphia Baylor College of Dentistry Dallas University of Pennsylvania* Philadelphia Bee County College University of Pittsburgh Beeville Pittsburgh De Mar College* Rhode Island Corpus Christi University of Rhode Island Kingston Lamar University* Beaumont South Carolina Greenville Technical Education Tarrant County Junior College Center Hurst Greenville Texas Woman's University Midlands Technical Education Denton Center Columbia Tyler Junior College Tyler South Dakota The University of Texas Dental The University of South Dakota Branch Vermillion Houston 131 APPENDIX D (continued) Dental Hygiene Wharton County Junior College Yakima Valley College Wharton Yakima Vermont West Virginia University of Vermont * West Liberty State College Burlington West Liberty Virginia Wisconsin Old Dominion University Madison Area Technical College Norfolk Madison Virginia Commonwealth University Marquette University* Richmond Milwaukee Washington Milwaukee Area Technical College* Clark College Milwaukee Vancouver Wyoming Shoreline Community College Sheridan College* North Seattle Sheridan Nursing Alabama Northwest Alabama State Junior Gadsden State Junior College College Gadsden Phil Campbell George C. Wallace State Theodore Alfred Lawson State Technical Junior College Junior College Dothan Birming ham Jefferson Davis State Junior Troy State University College Montgomery Brewton Alaska Jefferson State Junior College Anchorage Community College of Birmingham University of Alaska* Anchorage John C. Calhoun State Junior College Arizona Arizona Western College Decatur Yuma 132 APPENDIX D (continued) Nursing Central Arizona C ollege Phillips County Community College Coolidge Helena Cochise College* Southern State College Douglas Magnolia Eastern Arizona College State College of Arkansas Thatcher Conway Glendale Community College* University of Arkansas at Little Rock Glendale Little Rock Maricopa Technical College* University of Arkansas at Monticello Phoenix Monticello Mesa Community College University of Arkansas Mesa Fayetteville Navajo Community College Westark Community College Via Chinle Fort Smith Northern Arizona University* California Flagstaff American Ri.ver College Sacramento Phoenix College Phoenix Antelope Valley College* Lancaster Pima College Tucson Bakersfield College Bakersfield Scottsdale Community College Scottsdale Cabrillo College Aptos Yavapai College Prescott Cerritos College Norwalk Arkansas Arkansas State University Chabot College* State University Hayward 133 APPENDIX D (continued) Nursinq Chaffey College Fullerton Junior College Alta Loma Fullerton City College of San Francisco Golden West College San Francisco Huntington Beach College of Marin Grossmont College Kentfield El Cajon College of San Mateo* Hartnell College San Mateo Salinas College of the Desert Imperial Valley College Palm Desert Imperial College of the Redwoods Loma Linda University* Eureka Riverside College of the Sequoias Long Beach City College* Visalia Long Beach Compton College* Los Angeles City College Compton Los Angeles Contra Costa College* Los Angeles Harbor College* San Pablo Wilmington Cuesta College Los Angeles Pierce College* San Louis Obispo Woodland Hills De Anza College Los Angeles Southwest College Cupertino Los Angeles East Los Angeles College Los Angeles Trade Technical College Los Angeles Los Angeles El Camino College* Los Angeles Valley College Via Torrance Van Nuys Fresno City College Merritt College Fresno Oakland 134 APPENDIX D (continued) Nursing Modesto Junior College San Jose City College* Modesto San Jose Mt. San Antonio College Santa Barbara City College Walnut Santa Barbara Napa College Santa Monica College Napa Santa Monica Ohlone College Santa Rosa Junior College Fremont Santa Rosa Pacific Union College Shasta College Angwin Redding Palomar College* Solano Community College San Marcos Suisun City Pasadena City College Southwestern College Pasadena Chula Vista Rio Hondo College Ventura College Whittier Ventura Riverside City College Colorado Riverside Arapahoe Community College Littleton Sacramento City College Sacramento Community College of Denver* Denver Saddleback College* Mission Viejo El Paso Community College Colorado Springs San Bernardino Valley College San Bernardino Mesa College.* Grand Junction San Diego City College San Diego Metropolitan State College Denver San Joaquin Delta College* Stockton Southern Colorado State College Pueblo 135 APPENDIX D (continued) Nursing Connecticut Gulf Coast Community College Junior College of Connecticut, Panama City University of Bridgeport Bridgeport Hillsborough Community College Tampa Norwalk Community College* Norwalk Indian River Community College Fort Pierce Quinnipiac College Hamden Lake City Community College Lake City Deleware Wesley College Manatee Junior College Dover Bradenton District of Columbia Miami-Dade Junior College Washington Technical Institute Miami Washington, D.C. Miami-Dade Junior College, South Florida Campus Brevard Community College Miami Cocoa Palm Beach Junior College Broward Community College Lake Worth Fort Lauderdale Pensacola Junior College Central Florida Community College Pensacola Ocala Polk Community College* Daytona Beach Community College Winter Haven Daytona Beach St. Petersburg Junior College Edison Community College St. Petersburg Fort Myers Santa Fe Junior College Florida Junior College at Gainesville Jacksonville Jacksonville Tallahassee Community College Tallahassee Florida Keys Community College* Stock Island Valencia Community College Orlando 136 APPENDIX D (continued) Nursing Georgia Macon Junior College Abraham Baldwin Agricultural College*Macon Tifton South Georgia College* Albany Junior College* Douglas Albany Hawaii Armstrong State College Maui Community College Savannah Kahului Augusta College University of Hawaii Augusta Honolulu Brunswick Junior College Idaho Brunswick Boise State College* Boise Clayton Junior College Morrow College of Southern Idaho Twin Falls Columbus College Columbus Lewis-Clark State College Lewiston Dalton Junior College Dalton North Idaho College Coeur d'Alene DeKalb College Clarkston Ricks College Rexburg Floyd Junior College* Rome Illinois Belleville Area College Georgia College Belleville Milledgeville Black Hawk College Georgia Southwestern College Moline Americus Carl Sandburg College Georgia State University Galesburg Atlanta College of DuPage Kennesaw Junior College Glen Ellyn Marietta 137 APPENDIX D (continued) Nursinq College of Lake County Olive-Harvey College Grayslake Chicago Elgin Community College Olney Central College* Elgin Olney Illinois Central College Parkland College East Peoria Champaign Illinois Valley Community College Prairie State College* Oglesby Chicago Heights Joliet Junior College Rock Valley College* Joliet Rockford Kankakee Community College Sauk Valley College Kankakee Dixon Kaskaskia College State Community College Centralia East St. Louis Kennedy-King College Thornton Community College* Chicago South Holland Lewis and Clark Community College Triton College Godfrey River Grove Lincoln Land Community College* Waubonsee Community College Springfield Sugargrove MalcolmXCommunity College William Rainey Harper College* Chicago Palatine Mayfair College Indiana Chicago Indiana Central College* Indianapolis Moraine Valley Community College Palos Hills Indiana University of Kokomo Kokomo Morton College Cicero Indiana University, Northwest Campus* Gary 138 APPENDIX D (continued) Nursing Indiana University-Purdue Iowa Lakes Community College* University at Indianapolis Emmetsburg Indianapolis Iowa Western Community College* Indiana University, Southeast Council Bluffs Campus Jeffersonville Kirkwood Community College* Cedar Rapids Purdue University, Calumet Campus Hammond Northeast Area One Vocational- Technical School Purdue University, North Central Calmar Campus Westville North Iowa Area Community College Mason City Purdue University, Regional Campus at Fort Wayne Southeast Community College Fort Wayne Keokuk Purdue University, South Campus Western Iowa Tech* West Lafayette Sioux City University of Evansville Kansas Evansville Barton County Community Junior College Vincennes University Great Bend Vincennes Butler County Community Junior Iowa College Clinton Community College El Dorado Clinton Garden City Community Junior Indian Hills Community College, College* Iowa Technical Campus Garden City Ottumwa Hesston College Iowa Central Community College* Hesston Fort Dodge Johnson County Community College Shawnee Mission 139 APPENDIX D (continued) Nursing Kansas City Community Junior University of Kentucky College Henderson Kansas City Western Kentucky University Labette Community Junior College Bowling Green Parsons Louisiana Kentucky Louisiana State University of Eastern Kentucky University Alexandria Richmond Alexandria Hopkinsville Community College Nicholls State University* Hopkinsville Thibodaux Jefferson Community College Maine Louisville University of Maine at Augusta University Heights Kentucky State College* Augusta Frankfort Westbrook College Lexington Technical Institute Portland of the University of Kentucky Lexington Maryland Allegany Community College Midway Junior College Cumberland Midway Anne Arundel Community College Moorehead State University* Arnold Moore he ad Catonsville Community College Northern Kentucky State College Catonsville Covington Community College of Baltimore Paducah Community College Baltimore Paducah Essex Community College Somerset Community College Baltimore County Somerset Frederick Community College* University of Kentucky, Elizabeth Frederick town Community College Elizabethtown 140 APPENDIX D (continued) Nursinq Hagerstown Junior College Massachusetts Bay Community Hagerstown College Watertown Harford Community College Bel Air Massasoit Community College West Bridgewater Howard Community College Columbia Mount Wachusett Community College Gardner Montgomery Community College Takoma Park Newtown Junior College Newtonville Prince George's Community College* Largo Northeastern University Boston Massachusetts Atlantic Union College Northern Essex Community College South Lancaster Haverhill Berkshire Community College North Shore Community College Pittsfield Beverly Bristol Community College Quinsigamond Community College Fall River Worcester Cape Cod Community College Springfield Technical Community West Barnstable College* Springfield Catherine Laboure Junior College Boston Michigan Delta College* Greenfield Community College University Center Greenfield Ferris State College Holyoke Community College Big Rapids Holyoke Genesee Community College Lasell Junior College Flint Auburndale Grand Rapids Junior College Grand Rapids 141 APPENDIX D (continued) Nursing Henry Ford Community College Southwestern Michigan College Dearborn Dowagiac Highland Park College Minnesota Highland Park Anoka-Ramsey State Junior College Coon Rapids Kalamazoo Valley Community College Austin State Junior College Kalamazoo Austin Kellogg Community College Hibbing State Junior College Battle Creek Hibbing Lake Michigan College Metropolitan State Junior College Benton Harbor Minneapolis Lake Superior State College North Hennepin State Junior College Saulte Sainte Marie Minneapolis Lansing Community College* Rochester State Junior College Lansing Rochester Macomb County Community St. Mary's Junior College College* Minneapolis Mt. Clemens Mississippi North Central Michigan College Hinds Junior College Petoskey Raymond Northwestern Michigan College Jones County Junior College Traverse City Ellisville Oakland Community College Meridian Junior College Union Lake Meridian St. Clair County Community Mississippi Delta Junior College College Moorhead Port Huron Mississippi Gulf Coast Junior Schoolcraft College College, Jackson County Campus Livonia Gautier 142 APPENDIX D (continued) Nursing Mississippi Gulf Coast Junior Penn Valley Community College College, Jefferson Davis Campus Kansas City Gulfport St. Mary's College of O'Fallon Mississippi Valley State College O'Fallon Itta Bena Southeast Missouri State College Northeast Mississippi Junior Cape Girardeau College Booneville Three Rivers Junior College Poplar Bluff Pearl River Junior College Poplarville Montana Miles Community College University of Southern Mississippi Miles City Natchez Northern Montana College Missouri Havre Florissant Valley Community College Nebraska St. Louis College of Saint Mary Omaha Forest Park Community College* St. Louis University of Nebraska* Omaha Lincoln University of Missouri Jefferson City Nevada University of Nevada, College of Maryville College Allied Health Professions* St. Louis Las Vegas Meramec Community College University of Nevada, Western St. Louis Nevada Community College* Reno Mineral Area College Flat River New Hampshire New Hampshire Technical Institute Missouri Southern College Concord Joplin New Jersey Missouri Western College St. Joseph Atlantic Community College* Mays Landing 143 APPENDIX D (continued) Nursinq Bergen Community College New Mexico Junior College Paramus Hobbs Brookdale Community College University of Albuquerque Lincroft Albuquerque County College of Morris New York Dover Adirondack Community College Glen Falls Cumberland County College Vineland Broome Community College Binghamton Essex County College Newark City University of New York, Borough of Manhattan Community Felician College College Lodi New York Gloucester County College* City University of New York, Sewell Bronx Community College Bronx Mercer County Community College* City University of New York, Trenton Kings borough Community College Brooklyn Middlesex County College Edison City University of New York, New York City Community College Ocean County College Brooklyn Toms River City University of New York, Passaic County Community Queens borough Community College College* Bayside Paterson City University of New York, Staten Somerset County College Island Community College Somerville Staten Island New Mexico Eastern New Mexico University Community College of the Finger of Roswell Lakes Roswell Canandaigua 144 APPENDIX D (continued) Nursing Corning Community College* Nassau Community College Corning Garden City Dutchess Community College Niagara County Community College Poughkeepsie Niagara Falls Erie Community College Onondaga Community College Buffalo Syracuse Fulton-Montgomery Community Orange County Community College College Middletown Johnstown Pace College, Manhattan Genesee Community College New York Batavia Pace .College, Westchester* Hostos Community College Pleasantville Bronx State University of New York, Hudson Valley Community Agricultural and Technical College College of Alfred Troy Alfred Jamestown Community College State University of New York, Jamestown Agricultural and Technical College of Canton Jefferson Community College Canton Watertown State University of New York, Junior College of Albany Agricultural and Technical College Albany of Farmingdale Farmingdale Maria College of Albany Albany State University of New York, Agricultural and Technical College Mohawk Valley Community of Morrisville College Morrisville Utica State University of New York, Monroe Community College* Rockland Community College Rochester Suffern .145 APPENDIX D (continued) Nursing State University of New York, Guilford Technical Institute Upstate Medical Center Jamestown Syracuse James Sprunt Institute* Suffolk County Community Kenansville College* Selden Rockingham Community College Wentworth Trocaire College Buffalo Rowan Technical Institute Salisbury Ulster County Community College Sampson Technical Institute Stone Ridge Clinton North Carolina Sandhills Community College Asheville-Buncombe Technical Southern Pines Institute As heville Southereastern Community College Whiteville Beaufort County Technical Institute* Surry Community College Washington Dobson Central Piedmont Community University of North Carolina at College Wilmington Charlotte Wilmington College of the Albemarle Wayne Community College Elizabeth City Goldsboro Davidson County Community Western Piedmont Community College Morganton College X Lexington North Dakota Fayetteville Technical Institute Dickinson State College Fayetteville Dickinson Gardner-Webb College* North Dakota State University Boiling Springs Fargo 146 APPENDIX D (continued) Nursinq Ohio Michael J. Owens Technical College Allen County Technical College Perrysburg Lima North Central Technical College Ashtabula Regional Campus Mansfield at Kent State University Ashtabula Ohio University, Portsmouth Portsmouth Clark County Technical Institute Sinclair Community College Springfield Dayton Columbus Technical Institute Tuscarawas Regional Campus of Columbus Kent State University New Philadelphia Cuyahoga Community College, Metropolitan Campus University Community Technical Cleveland College, University of Toledo Toledo Cuyahoga Community College, Western Campus* University of Cincinnati, Raymond Parma Walters General and Technical College Kettering College of Medical Cincinnati Arts Kettering Youngstown State University Youngstown Lakeland Community College* Mentor Oklahoma Bacone College Lorain County Community Bacone College Eiyria Cameron State College Lawton Marion County Technical Institute Eastern Oklahoma State College Marion Wilburton Miami University, Hamilton Murray State College Hamilton Tishomingo 147 APPENDIX D (continued) Nursing Northern Oklahoma College* Community College of Allegheny Tonkawa County, Allegheny Campus Pittsburgh Oklahoma State University- Technical Institute Community College of Allegheny Oklahoma City County, South Campus West Mifflin Seminole Junior College Seminole Community College of Beaver County Monaca Tulsa Junior College Tulsa Community College of Philadelphia Philadelphia Oregon Chemeketa Community College* Deleware County Community College Salem Media Lane Community College Gwynedd-Mercy College Eugene Gwynedd Valley Linn-Benton Community College Harrisburg Area Community College Albany Harrisburg Mt. Hood Community College* Montgomery County Community Gresham College Blue Bell Oregon Technical Institute Klamath Falls Mount Aloysious Junior College Cresson Portland Community College* Portland Northampton County Area Com munity College Southern Oregon College Bethlehem Ashland Rhode Island Pennsylvania Rhode Island Junior College Bucks County Community Providence College Newton South Carolina Baptist College at Charleston Clarion State College Charleston Oil City 148 APPENDIX D (continued) Nursing Clemson University Belmont College Clemson Nashville Florence-Darlington Tech Cleveland State Community College nical Education Center Cleveland Florence Columbia State Community College Greenville Technical Columbia Education Center Greenville East Tennessee State University Bristol Lander College Memphis State University Greenwood Memphis University of South Carolina, Middle Tennessee State University Aiken Regional Campus Murfreesboro Aiken Southern Missionary College University of South Carolina, Collegedale Coastal Carolina Regional Campus Tennessee State University* Conway Nashville University of South Carolina, Union University* College of General Studies Jackson Columbia University of Tennessee at Martin University of South Carolina, Martin Spartanburg Regional Campus Spartanburg University of Tennessee at Nashville Nashville South Dakota Texas Presentation College* Alvin Junior College Aberdeen Alvin University of South Dakota Amarillo College Vermillion Amarillo Tennessee Austin Peay State University Angelina College Clarksville Lufkin 149 APPENDIX D (continued) Nursinq Del Mar College Utah Corpus Christi Brigham Young University Salt Lake City El Centro College Dallas Weber State College* Ogden Galveston College Galveston Vermont Castleton State College Grayson County College Castleton Denison University of Vermont* Kilgore College Burlington Kilgore Vermont College Laredo Junior College Montpelier Laredo Virginia McLennan Community College Germanna Community College Waco Fredericksburg Odessa College John Tyler Community College Odessa Chester Pan American University Marymount College of Virginia Edinburg Arlington Paris Junior College Norfolk State College Paris Norfolk San Antonio College Northern Virginia Community College San Antonio Annandale San Jacinto College Patrick Henry Community College Pasadena Martinsville Tarrant County Junior College Shenandoah College Fort Worth Winchester Texarkana Community College Thomas Nelson Community College Texarkana Hampton 150 APPENDIX D (continued) Nursing Tidewater Community College Shoreline Community College Portsmouth Seattle Virginia Highlands-Southwest Spokane Community College Virginia Community College Spokane Abingdon Walla Walla Community College* Virginia Western Community Walla Walla College Roanoke Yakima Valley College* Yakima Wytheville Community College* Wytheville West Virginia Bluefield State College* Washington Bluefield Bellevue Community College Bellevue Fairmont State College Fairmont Clark College Vancouver Marshall University Huntington Columbia Basin College Pasco Morris Harvey College Charleston Everett Community College* Everett Parkersburg Community College* Parkersburg Highline Community College Midway Salem College Clarksburg Lower Columbia Community College Salem College Longview Salem Olympic College West Liberty State College Bremerton West Libery Seattle Central Community West Virginia Institute of Tech College nology Seattle Montgomery 151 APPENDIX D (continued) Nursing Wisconsin North Central Technical Institute* Kenosha Technical Institute Wausau Kenosha Wyoming Milwaukee Area Technical Casper College College Casper Milwaukee Radiologie Technology Alabama Franklin Hospital & Medical Center, Jefferson State Junior College San Francisco; affiliated with City Birming ham College of San Francisco Arizona Fresno Community Hospital Good Samaritan Hospital Fresno; affiliated with Fresno City Phoenix; affiliated with College Maricopa County Junior College & Arizona State University Harkness Community Hospital & Medical Center, San Francisco; Maricopa County General affiliated with City College of San Hospital, Phoenix; affiliated Francisco with Maricopa County Junior College Kaiser Foundation Hospital Fontana; affiliated with Chaffey California College Antelope Valley Hospital Lancaster; affiliated with Kaiser Foundation Hospital, Los Antelope Valley College Angeles; affiliated with Los Angeles City College Children's Hospital & Adult Medical Center, San Francisco; Loma Linda University affiliated with City College Loma Linda of San Francisco Long Beach City College* Doctor's Hospital, San Long Beach Leandro; affiliated with Merritt College Los Angeles County-Habor General Hospital; Torrance; affiliated with Foothill Community College El Camino College* Los Altos 152 APPENDIX D (continued) Radiologic Technology Marin General Hospital Salinas Valley Memorial Hospital Greenbrae; affiliated with Salinas; affiliated with Hartnell City College of San Francisco Junior College Merced General Hospital San Diego Mesa College Merced; affiliated with Merced San Diego Community College San Leandro Memorial Hospital Mt. San Antonio College San Leandro; affiliated with Walnut Merritt College Mt. Zion Hospital & Medical Santa Ana Community Hospital Santa Ana; affiliated with Orange Center, San Francisco; Coast College* affiliated with City College of San Francisco Santa Barbara City College Santa Barbara Orange County Medical Center Orange; affiliated with Orange Santa Cruz General Hospital, Santa Coast College and Fullerton Cruz; affiliated with Cabrillo College Junior College* Santa Rosa Memorial Hospital Presbyterian Intercommunity Santa Rosa; affiliated with Santa Hospital, Whittier; affiliated Rosa Junior College* with Fullerton Junior College* Vallejo General Hospital, Vallejo; St. Francis Memorial Hospital affiliated with Merritt College San Francisco; affiliated with City College of San Francisco Valley Medical Center, Fresno; affiliated with Fresno City College St. Joseph's Hospital San Francisco; affiliated with Yuba College City College of San Francisco Marysville Colorado St. Jude Hospital, Fullerton Community College of Denver* affiliated with Fullerton Junior Denver College Connecticut St. Mary's Hospital, San Fran Middlesex Memorial Hospital cisco; affiliated with City Middletown; affiliated with College of San Francisco Middlesex Community College 153 APPENDIX D (continued) Radiologic Technology- District of Columbia Little Company of Mary Hospital Providence Hospital Evergreen Park; affiliated with Washington; affiliated with Moraine Valley Community College Montgomery College and Washington Technical Institute Memorial Hospital of DuPage County, Elmhurst; affiliated with Florida College of DuPage* Broward Community College Ft. Lauderdale St. Joseph Mercy Hospital, Aurora; affiliated with College of DuPage* Sante Fe Junior College Gainesville Sauk Valley College Dixon Georgia Dekalb Community College Thornton Community College* Clarkston South Holland Hawaii Triton College St. Francis Hospital River Grove Honolulu; affiliated with Kapiolani Community College Wilbur Wright College* Chicago Illinois Carl Sandburg College Indiana Galesburg Elkart General Hospital, Elkart; affiliated with Indiana University Centreville Township Hospital East St. Louis; affiliated with Indiana University Medical Center* Belleville Area College Indianapolis College of Du Page Lutheran Hospital, Ft. Wayne; Glen Ellyn affiliated with Indiana University Kishwaukee Junior College* Memorial Hospital, South Bend; Malta affiliated with Indiana University Lincoln Land Community Methodist Hospital, Gary; College affiliated with Indiana University Springfield 154 APPENDIX D (continued) Radiologic Technology Northern Indiana School of Massachusetts Radiologic Technology* Addison Gilbert Hospital Michigan City Gloucester; affiliated with North Shore Community College Our Lady of Mercy Hospital Dyer; affiliated with Indiana Beverly Hospital, Beverly; University affiliated with North Shore Community College Parkview Memorial Hospital Ft. Wayne; affiliated with Boston City Hospital, Boston; Indiana University* affiliated with Northeastern University St. Joseph Memorial Hospital Kokomo; affiliated with Charles Choate Memorial Hospital Indiana University Woburn; affiliated with Northeastern University St. Joseph's Hospital Ft. Wayne, affiliated with Framingham Union Hospital Indiana University Framingham; affiliated with North eastern University St. Margaret Hospital Hammond; affiliated with Lawrence Memorial Hospital Indiana University Medford; affiliated with North eastern University University of Evansville Evansville Lynn Hospital, Lynn; affiliated with North Shore Community College Kansas Mercy Hospital, Springfield; Labette County Medical affiliated with Holyoke Community Center* College Parsons Providence Hospital, Holyoke; Kentucky affiliated with Holyoke Community University of Kentucky College Medical Center Lexington Cuinsigamond Community College* Worcester Maryland Community College of St. Joseph's Hospital, Lowell; af Baltimore filiated with Middlesex Community Baltimore College* 155 APPENDIX D (continued) Radiologic Technology Salem Hospital, Salem; Missouri affiliated with North Shore Depaul Hospital, St. Louis; Community College affiliated with Forest Park Community College Saugus General Hospital Saugus; affiliated with North Forest Park Community College Shore Community College St. Louis South Shore Hospital Penn Valley Community College South Weymouth; affiliated Kansas City with Northeastern University* St. Mary's Hospital, Kansas City, Springfield Technical affiliated with Metropolitan Community College* Junior College* Springfield Nebraska Union Hospital, Lynn; University of Nebraska Medical affiliated with North Shore Center Community College Omaha University Hospital, Inc. Boston; affiliated with North Nevada eastern University Rose De Lima Hospital, Henderson; affiliated with University of Nevada Michigan Delta College University of Nevada* University Center Las Vegas Ferris State College* New Hampshire Big Rapids New Hampshire Technical Institute* Kellogg Community College Concord Battle Creek New Jersey Middlesex County College Lake Michigan College Edison Benton Harbor New York Northern Michigan University Broome Community College Marquette Binghamton Washtenaw Community College Bronx Community College Ann Arbor Bronx 156 APPENDIX D (continued) Radiologie Technology Hudson Valley Community McLeod Infirmary, Florence; College affiliated with Florence-Darlington Troy Education Center State University of New York- Oconee Memorial Hospital, Seneca; Upstate Medical Center* affiliated with Greenville Tech Syracuse nical Education Center Trocaire College Spartanburg County Technical Buffalo Education Center Spartanburg Weschester Community College York County General Hospital, Rock Valhalla Hill; affiliated with York County Technical Education Center North Carolina Carteret General Hospital Tennessee Morehead City; affiliated with Jackson State Community College* Jackson Carteret Technical Institute Texas Ohio Amarillo College University of Cincinnati Amarillo Cincinnati El Centro Junior College Loraine County Community Dallas College Harris Hospital Elyria Fort Worth Oregon John Peter Smith Hospital Oregon Technical Institute* Fort Worth Klamath Falls Odessa College* Portland Community College Odessa Portland St. Joseph's Hospital, Fort Worth; University of Oregon Medical Affiliated with Tarrant County Junior School College Portland St. Joseph's Hospital; Paris; South Carolina affiliated with Paris Junior College Greenville Technical Education Center Greenville 157 APPENDIX D (continued) Radiologic Technology University of Texas Medical St. Luke's Hospital, Bellingham; Branch affiliated with Oregon Technical Galveston Institute Utah Skagit Valley Hospital, Mt. Vernon; McKay-Dee Hospital Center affiliated with Oregon Technical Ogden; affiliated with Weber Institute State College* Swedish Hospital Medical Center* St. Benedict's Hospital Seattle; affiliated with Bellevue Ogden; affiliated with Community College Weber State College Tacoma General Hospital, Tacoma; Virginia affiliated with Tacoma Community Central Virginia Community College College Lync hburg Wenatchee Valley College* Wenatchee Virginia Commonwealth Univers ity Yakima Valley College Richmond Yakima Washington West Virginia Bellevue Community College Williamson Appalacian Regional Bellevue Hospital, Williamson; affiliated with Marshall University General Hospital of Everett Everett, affiliated with Oregon Technical Institute St. Joseph's Hospital Bellingham; affiliated with Oregon Technical Institute * Indicates respondents who had experience with core curriculum. (One respondent who answered "yes" requested that her program not be identified.) APPENDIX E Responses by States Dental Hygiene Nursing Radiologic Technology Questionnaires Questionnaires Questionnaires State Sent Responses Sent Responses Sent Responses Alabama 0 0 8 4 1 1 Alaska 0 0 1 1 0 0 Arizona 1 0 13 7 2 1 Arkansas ]. 0 8 5 0 0 California 8 5 56 35 32 18 Colorado 1 0 6 4 1 1 Connecticut 1 0 3 2 1 I Deleware 0 0 1 1 0 0 District of Columbia 1 1 1 0 I 0 Florida 5 3 21 10 2 1 Georgia 5 2 16 9 1 0 Hawaii 1 1 2 1 1 0 Idaho 1 1 5 2 0 0 Illinois 8 7 29 17 12 8 Indiana 4 3 11 8 12 8 Iowa 0 0 10 7 0 0 Kansas 2 2 7 3 1 1 Kentucky 3 1 13 6 1 1 Louisiana 1 1 2 1 0 0 Maine 0 0 2 1 0 0 Maryland 2 2 11 6 1 0 Massachusetts 5 5 17 10 17 7 Michigan 8 5 18 12 6 6 Minnesota 3 2 7 5 0 0 Mississippi 0 0 10 4 0 0 Missouri 1 0 12 7 4 2 APPENDIX E (continued) Questionnaires Questionnaires Questionnaires State Sent Responses Sent Responses Sent Responses Montana 0 0 2 2 0 0 Nebraska 1 0 2 1 1 0 Nevada 0 0 2 2 2 1 New Hampshire 1 1 1 0 1 1 New Jersey 5 0 13 8 1 1 New Mexico 1 1 3 3 0 0 New York 8 2 37 16 6 4 North Carolina 7 5 18 13 1 0 North Dakota 1 1 2 0 0 0 Ohio 6 3 19 13 2 2 Oklahoma 2 1 8 3 0 0 Oregon 5 4 7 5 3 3 Pennsylvania 4 1 12 7 0 0 Rhode Island 1 0 1 0 0 0 South Carolina 2 0 9 4 5 1 South Dakota 1 0 2 1 0 0 Tennessee 4 4 12 9 1 1 Texas 10 7 17 11 8 3 Utah 0 0 2 1 2 1 Vermont 1 1 3 3 0 0 Virginia 1 0 12 4 2 1 Washington 3 1 12 8 9 5 West Virginia 1 0 9 5 1 1 Wisconsin 3 3 3 3 0 0 Wyoming 1 1 1 1 0 0 Cn LD 160 APPENDIX F Graphs Depicting Emphasis by Programs Legend ______Dental Hygiene ______Nursing ...... Radiologic Technology I. Disease Process I. A. General Causes of I. B. Changes Produced in the Disease Body by Disease Per Per 73 73 d d 73 73c 0 c 0 (0 0 0 0 0 o 0 0 ¿ . O> O> u, O' O' O' s_ ÿ E S? (73 (73 0 O ® 0 0 o O O > U. o O S-i -r—» K* ^-4 (-1 -1“^ 0 O 0 0 0 O 0) S' O 0 0 S' S ÍÚ S' 2 2 < s> s-, -Q > > 2 < 0 <£ 0 < ,2; < 0 < 161 APPENDIX F (continued) I. C. General Methods of I. D. Methods of Disease Therapy Prevention II. A. Health Care System II. B. Members of the Health Team in the United States "O G d TJ G 73 fÜ G G ta G G G G G o G en Cn en en Cn S-t n 0 n ° i-t O ° > fO .° > G G o G (0 G -r—> t-l l-l .° > S-, .2. > U, S-. G (0 'g ° (D ta 2 G G G ° G G 2 Q) ¿e -Q > — -Q > > <=-! -Q > ¿ï -Q s S < S < > > fO G <£ 2 G (0 162 APPENDIX F (continued) II. C Relationships Among II. D. Medical Terminology Health Team Members Per Per 73 73 G G 73 (0 73 G G G G G G CD G O G G t Z1X O* < Z,» o» o» u, Sm O O > S £ o 2?S O > £ £ G o g '£? O G G G O G '¡g O G G H ~Q > X3 > > L, -Q > .£ -Q > > 2 < G 2 < G < 2 < G L; < g < III. Pharmacology III. A. General Classification III. B. Computing Fractional of Drugs Dosages 163 APPENDIX F (continued) III. C. Indications for Use of III. D. Contraindications for Use Specific Drugs of Specific Drugs Per Per cent 100 90 80 70 60 50 40 30 20 10 0 Emphasis 73 73 0d d 0 ■y 164 APPENDIX F (continued) V. Safety Factors V. A. Caring for the Anesthetized V. B. Caring for Very Young or Patient Elderly Patients V. C. Observation of Patients for Signs of Shock Per cent G G G G î-< en en en o O > G ë 2 G G ■1“^ S-, S-. Sm G G G G > > > S S < G 2 < ta < 165 APPENDIX F (continued) VI. Application of Technical Skills VI. A. Positioning of Patients for VI. B. Carrying Out Techniques Treatments and Examinations for Patients in Isolation Per Per cent, 100 90 80 70 60 50 40 30 20 10 0 Emphasis 73 G 73 G G G G G G G G G G Cn Di Si Cn Cn cn i-i I. G 9? G G ® G G o O t-i > Si l-l O o S2 $-1 i-t G G G G G G G O G O VI. C. Insertion of Needle into VI; D. Using Sterile Technique a Vein (Venipuncture) Per Per cent 100 90 80 70 60 50 40 30 20 10 0 Emphasis 73 73 G G 73 G 73 G G G G G G G G G G G u Cn /' Cn Cn Si Si t3> (31 G G 2 G G >2 G G O o > Si O > i, ii o O li li G G O G G O G G G O G O G G « -Q > « -Q > > 2 JO > G > > G < G < ^i G -3. G 166 APPENDIX F (continued) VI. E. Suctioning Patients VI. E. Washing Hands Per Per cent cent 100 100 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 Emphasis Emphasis 73 G G 73 G 73 G C G G G G G G G G G O' Cn (3> Cn cn Cn S-I G G U. O O G -2, > G G o > G G ® G G '!-*% > G G G •«O—I G o > G (0 (0 o G G O G G (0 G ° G G G X! > > > 2 X3 > 2 _Q > > 2 G 2 < G 2 2 VI. G. Taking a Blood Pressure VI. H. Irrigating a Body Cavity Per Per cent cent 100 100 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 Emphasis Emphasis 73 73 1—( 73 G 73 G G G G G G G G G G G cn cn Cn Ut G Cn u Cn Cn u G G G ® G G G G .2 > G G O O G O G O -rO*-> > 5_i G G •r—\ > G > G G O G O G G G G O G G O G G {0 (0 2 X! X5 > X! > > X! > > > 2 2 2 G 2 < G < G VI. I. Taking Temperature, Pulse and Respirations Per cent 100- 90 80 70 60 50 40 30 20 10 0- Emphasis 73 d 73 0 d 0 0 0 0 O' O' O' u* S-. 0 5-1 0 O O 0 O 0 0 ■1—V > i-i •r—> > u l-t <0 iO o 0 (0 o 0 0 XI 2 2 > XI > > < 0 < 0 VII. Technician-Patient Relations VII. A. Identification of Patient VII. B. Interviewing Patient Before Performing Procedures Per Per cent cent 100 10C 90 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 - 0 0 Emphasis 73 Emphasis 73 d d 73 0 73 0 d d 0 0 0 0 0 0 0 0 O' O' O' S-i O' O' O' Ui S-< U. o l-t Ui O O 2 O >22 •I—\ o 2 O >22 -r—» 0 -t—t 0 0 W 0 O 0 0 0 0 S' O 0 0 > fO o 2 > > 2 3 0 2 3 0 VII. C. Legal Implication of VII. D. Ethical Implications of Patient Care Patient Care G G VII. E. Courtesy to Patients VII. F. Explanation of Procedures to Patients Per cen 100 90 80 70 60 50 40 30 20 10 0 Emï 73 73 C 73 G 73 G G d G G G G G G G G Cn en en en en G 0 G g) G G en 2 > G .2 > G G O G O > G G G G G ■r—> > G G G O G G ° G G G O G G G S X! > .2 X! > X! > > > 2 < > 2 < G 2 < G G G lÊâ APPENDIX F (continued) VII. G. Instruction of Patients Per Cent 100 90 80 70 60 50 40 30 20 10 0' Emp____ X5 G T3 G G ta o G G in U, Cn . * en Cn G G G G o o > S-i •2. > S-. S-. !a (O O 0) a o G G > 5 -G > > 2 3 <0 S < G <