Firefighting Trainer

NASA Technical Reports Server (NTRS)

1984-01-01

Firefighting trainees conduct fire control exercises using a prototype simulator known as the Emergency Management Computer Aided Training System (EMCAT). Developed by Marshall Space Flight Center (MFS) in response to a request from the Huntsville (AL) Fire Department, EMCAT enables a trainee to assume the role of fireground commander and make quick decisions on best use of his fire fighting personnel and equipment.

A controlled intervention to promote a healthy body image, reduce eating disorder risk and prevent excessive exercise among trainee health education and physical education teachers.

PubMed

Yager, Zali; O'Dea, Jennifer

2010-10-01

This study examined the impact of two interventions on body image, eating disorder risk and excessive exercise among 170 (65% female) trainee health education and physical education (HE&PE) teachers of mean (standard deviation) age 21.6 (2.3) who were considered an 'at-risk' population for poor body image and eating disorders. In the first year of the study, the control group cohort (n = 49 females, 20 males) received the regular didactic health education curriculum; in the second year of the study, the Intervention 1 cohort (n = 31 females, 21 males) received a self-esteem and media literacy health education program and in the third year of the study, the Intervention 2 cohort (n = 30 females, 19 males) received a combined self-esteem, media literacy and dissonance program using online and computer-based activities. Intervention 2 produced the best results, with males improving significantly in self-esteem, body image and drive for muscularity. Intervention 2 females improved significantly on Eating Disorders Inventory Drive for Thinness, Eating Disorder Examination and excessive exercise. The improvements were consistent at 6-month follow-up for females. It is feasible to promote body image, reduce body dissatisfaction and reduce excessive exercise among trainee HE&PE teachers via a health education curriculum.

Undergraduate Role Players as "Clients" for Graduate Counseling Students.

ERIC Educational Resources Information Center

Anderson, Dana D.; And Others

1989-01-01

Describes two exercises in which undergraduates from abnormal psychology courses act as role-play clients for graduate counselor-trainees. Finds that the exercises seem to be educationally beneficial and may also help decrease undergraduates' negative stereotyping of persons with psychological problems. (KO)

Learning to Observe Young Children in a Bilingual-Multicultural Environment. Bilingual/Bicultural Child Development Associate Pilot Project: Module I.

ERIC Educational Resources Information Center

Coleman, Joyce H.

This Child Development Associate (CDA) training module, the first in a series of 16, provides a course in child behavior observation and systematic recordkeeping skills for bilingual/bicultural preschool teacher trainees. Exercises in observation are designed to lead the trainee from biased ways of looking at children to the use of techniques of…

"Back to Bedside": Residents' and Fellows' Perspectives on Finding Meaning in Work.

PubMed

Hipp, Dustin M; Rialon, Kristy L; Nevel, Kathryn; Kothari, Anai N; Jardine, Lcdr Dinchen A

2017-04-01

Physician burnout is common and associated with significant consequences for physicians and patients. One mechanism to combat burnout is to enhance meaning in work. To provide a trainee perspective on how meaning in work can be enhanced in the clinical learning environment through individual, program, and institutional efforts. "Back to Bedside" resulted from an appreciative inquiry exercise by 37 resident and fellow members of the ACGME's Council of Review Committee Residents (CRCR), which was guided by the memoir When Breath Becomes Air by Paul Kalanithi. The exercise was designed to (1) discover current best practices in existing learning environments; (2) dream of ideal ways to enhance meaning in work; (3) design solutions that move toward this optimal environment; and (4) support trainees in operationalizing innovative solutions. Back to Bedside consists of 5 themes for how the learning environment can enhance meaning in daily work: (1) more time at the bedside, engaged in direct patient care, dialogue with patients and families, and bedside clinical teaching; (2) a shared sense of teamwork and respect among multidisciplinary health professionals and trainees; (3) decreasing the time spent on nonclinical and administrative responsibilities; (4) a supportive, collegial work environment; and (5) a learning environment conducive to developing clinical mastery and progressive autonomy. Participants identified actions to achieve these goals. A national, multispecialty group of trainees developed actionable recommendations for how clinical learning environments can be improved to combat physician burnout by fostering meaning in work. These improvements can be championed by trainees.

Reading the lesson: eliciting requirements for a mammography training application

NASA Astrophysics Data System (ADS)

Hartswood, M.; Blot, L.; Taylor, P.; Anderson, S.; Procter, R.; Wilkinson, L.; Smart, L.

2009-02-01

Demonstrations of a prototype training tool were used to elicit requirements for an intelligent training system for screening mammography. The prototype allowed senior radiologists (mentors) to select cases from a distributed database of images to meet the specific training requirements of junior colleagues (trainees) and then provided automated feedback in response to trainees' attempts at interpretation. The tool was demonstrated to radiologists and radiographers working in the breast screening service at four evaluation sessions. Participants highlighted ease of selecting cases that can deliver specific learning objectives as important for delivering effective training. To usefully structure a large data set of training images we undertook a classification exercise of mentor authored free text 'learning points' attached to training case obtained from two screening centres (n=333, n=129 respectively). We were able to adduce a hierarchy of abstract categories representing classes of lesson that groups of cases were intended to convey (e.g. Temporal change, Misleading juxtapositions, Position of lesion, Typical/Atypical presentation, and so on). In this paper we present the method used to devise this classification, the classification scheme itself, initial user-feedback, and our plans to incorporated it into a software tool to aid case selection.

The European Academy laparoscopic “Suturing Training and Testing’’ (SUTT) significantly improves surgeons’ performance

PubMed Central

Sleiman, Z.; Tanos, V.; Van Belle, Y.; Carvalho, J.L.; Campo, R.

2015-01-01

The efficiency of suturing training and testing (SUTT) model by laparoscopy was evaluated, measuring the suturingskill acquisition of trainee gynecologists at the beginning and at the end of a teaching course. During a workshop organized by the European Academy of Gynecological Surgery (EAGS), 25 participants with three different experience levels in laparoscopy (minor, intermediate and major) performed the 4 exercises of the SUTT model (Ex 1: both hands stitching and continuous suturing, Ex 2: right hand stitching and intracorporeal knotting, Ex 3: left hand stitching and intracorporeal knotting, Ex 4: dominant hand stitching, tissue approximation and intracorporeal knotting). The time needed to perform the exercises is recorded for each trainee and group and statistical analysis used to note the differences. Overall, all trainees achieved significant improvement in suturing time (p < 0.005) as measured before and after completion of the training. Similar significantly improved suturing time differences (p < 0.005) were noted among the groups of trainees with different laparoscopic experience. In conclusion a short well-guided training course, using the SUTT model, improves significantly surgeon’s laparoscopic suturing ability, independently of the level of experience in laparoscopic surgery. Key words: Endoscopy, laparoscopic suturing, psychomotor skills, surgery, teaching, training suturing model. PMID:26977264

STS-72 Mission Specialist Koichi Wakata during ASCAN training

NASA Image and Video Library

1995-01-09

S95-00353 (12-14 September 1992) --- Several 1992 astronaut candidates brush the sand and gravel off one another following one of several phases of parachute familiarization and survival training at Vance Air Force Base in Oklahoma. Recognizable in the picture are Wendy B. Lawrence, Michael E. Lopez-Alegria, Chris A. Hadfield, Winston E. Scott and Koichi Wakata. The trainees had just completed an exercise, which required their jumping off a box into a gravel pit, in order to familiarize them the proper way to meet the ground following an emergency parachute drop.

Formative assessment of GP trainees' clinical skills.

PubMed

Wiener-Ogilvie, Sharon; Begg, Drummond

2012-03-01

Clinical skill assessment (CSA) has been an integral part of the Royal College of General Practitioners' membership examination (MRCGP) since 2008. It is an expensive, high-stakes examination with first time pass rates ranging from 76.4 to 81.3. In this paper we describe the South East Scotland Deanery, NHS Education Scotland, pilot of a formative clinical skills assessment (fCSA) using the principles of formative assessment and OSCE. The purpose of the study was to assess the acceptability of the fCSA and to examine whether trainees, identified during the fCSA as 'at risk of failing the MRCGP CSA exam', are more likely to fail the MRCGP CSA exam later on in the year. Trainees were assessed in four clinical skills stations under exam conditions. After each station they were given verbal feedback and subsequently both trainee and their trainer received written feedback. We assessed the value of the exercise through written feedback from trainees and trainers. Each trainee's performance in fCSA was triangulated with trainer assessment to identify 'flagged trainees'. We compared flagged and non-flagged trainees' performance in MRCGP CSA. Both trainees and trainers highly rated the fCSA. Overall 97% of non-flagged trainees have passed the RCGP CSA exam by May of that year in comparison to 80% of flagged trainees who have passed the RCGP CSA (P = 0.005). Trainers and trainees rated the fCSA as excellent and useful. We were able to demonstrate that the fCSA can be used to identify those trainees likely to fail the RCGP CSA. Contrary to reservations about the potential to demoralise trainees, the fCSA was viewed as a useful and a positive experience by both trainees and trainers. In addition, we suggest that feedback from fCSA was useful in triggering appropriate educational interventions. Early intervention with trainees who are predicted to fail the CSA has the potential to reduce deaneries overall fail rate. Preventing one trainee failure could save over £30 000.

General purpose architecture for intelligent computer-aided training

NASA Technical Reports Server (NTRS)

Loftin, R. Bowen (Inventor); Wang, Lui (Inventor); Baffes, Paul T. (Inventor); Hua, Grace C. (Inventor)

1994-01-01

An intelligent computer-aided training system having a general modular architecture is provided for use in a wide variety of training tasks and environments. It is comprised of a user interface which permits the trainee to access the same information available in the task environment and serves as a means for the trainee to assert actions to the system; a domain expert which is sufficiently intelligent to use the same information available to the trainee and carry out the task assigned to the trainee; a training session manager for examining the assertions made by the domain expert and by the trainee for evaluating such trainee assertions and providing guidance to the trainee which are appropriate to his acquired skill level; a trainee model which contains a history of the trainee interactions with the system together with summary evaluative data; an intelligent training scenario generator for designing increasingly complex training exercises based on the current skill level contained in the trainee model and on any weaknesses or deficiencies that the trainee has exhibited in previous interactions; and a blackboard that provides a common fact base for communication between the other components of the system. Preferably, the domain expert contains a list of 'mal-rules' which typifies errors that are usually made by novice trainees. Also preferably, the training session manager comprises an intelligent error detection means and an intelligent error handling means. The present invention utilizes a rule-based language having a control structure whereby a specific message passing protocol is utilized with respect to tasks which are procedural or step-by-step in structure. The rules can be activated by the trainee in any order to reach the solution by any valid or correct path.

“Back to Bedside”: Residents' and Fellows' Perspectives on Finding Meaning in Work

PubMed Central

Hipp, Dustin M.; Rialon, Kristy L.; Nevel, Kathryn; Kothari, Anai N.

2017-01-01

Background Physician burnout is common and associated with significant consequences for physicians and patients. One mechanism to combat burnout is to enhance meaning in work. Objective To provide a trainee perspective on how meaning in work can be enhanced in the clinical learning environment through individual, program, and institutional efforts. Methods “Back to Bedside” resulted from an appreciative inquiry exercise by 37 resident and fellow members of the ACGME's Council of Review Committee Residents (CRCR), which was guided by the memoir When Breath Becomes Air by Paul Kalanithi. The exercise was designed to (1) discover current best practices in existing learning environments; (2) dream of ideal ways to enhance meaning in work; (3) design solutions that move toward this optimal environment; and (4) support trainees in operationalizing innovative solutions. Results Back to Bedside consists of 5 themes for how the learning environment can enhance meaning in daily work: (1) more time at the bedside, engaged in direct patient care, dialogue with patients and families, and bedside clinical teaching; (2) a shared sense of teamwork and respect among multidisciplinary health professionals and trainees; (3) decreasing the time spent on nonclinical and administrative responsibilities; (4) a supportive, collegial work environment; and (5) a learning environment conducive to developing clinical mastery and progressive autonomy. Participants identified actions to achieve these goals. Conclusions A national, multispecialty group of trainees developed actionable recommendations for how clinical learning environments can be improved to combat physician burnout by fostering meaning in work. These improvements can be championed by trainees. PMID:28439376

The Interacting-Reflecting Training Exercise: Addressing the Therapist's Inner Conversation in Family Therapy Training

ERIC Educational Resources Information Center

Rober, Peter

2010-01-01

In recent years several authors have made a beginning in describing therapeutic conversations from a dialogical perspective. Training and supervision, however, have not yet been addressed from a dialogical perspective. In this article, an experiential training exercise is described that is focused on the basic dialogical skills of the trainee:…

A new virtual-reality training module for laparoscopic surgical skills and equipment handling: can multitasking be trained? A randomized controlled trial.

PubMed

Bongers, Pim J; Diederick van Hove, P; Stassen, Laurents P S; Dankelman, Jenny; Schreuder, Henk W R

2015-01-01

During laparoscopic surgery distractions often occur and multitasking between surgery and other tasks, such as technical equipment handling, is a necessary competence. In psychological research, reduction of adverse effects of distraction is demonstrated when specifically multitasking is trained. The aim of this study was to examine whether multitasking and more specifically task-switching can be trained in a virtual-reality (VR) laparoscopic skills simulator. After randomization, the control group trained separately with an insufflator simulation module and a laparoscopic skills exercise module on a VR simulator. In the intervention group, insufflator module and VR skills exercises were combined to develop a new integrated training in which multitasking was a required competence. At random moments, problems with the insufflator appeared and forced the trainee to multitask. During several repetitions of a different multitask VR skills exercise as posttest, performance parameters (laparoscopy time, insufflator time, and errors) were measured and compared between both the groups as well with a pretest exercise to establish the learning effect. A face-validity questionnaire was filled afterward. University Medical Centre Utrecht, The Netherlands. Medical and PhD students (n = 42) from University Medical Centre Utrecht, without previous experience in laparoscopic simulation, were randomly assigned to either intervention (n = 21) or control group (n = 21). All participants performed better in the posttest exercises without distraction of the insufflator compared with the exercises in which multitasking was necessary to solve the insufflator problems. After training, the intervention group was significantly quicker in solving the insufflator problems (mean = 1.60Log(s) vs 1.70Log(s), p = 0.02). No significant differences between both the groups were seen in laparoscopy time and errors. Multitasking has negative effects on the laparoscopic performance. This study suggests an additional learning effect of training multitasking in VR laparoscopy simulation, because the trainees are able to handle a secondary task (solving insufflator problems) quicker. These results may aid the development of laparoscopy VR training programs in approximating real-life laparoscopic surgery. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Sports medicine and the accident and emergency medicine specialist.

PubMed

Abernethy, L; McNally, O; MacAuley, D; O'Neill, S

2002-05-01

Sport and exercise related injuries are responsible for about 5% of the workload in the accident and emergency (A&E) department, yet training in sports medicine is not a compulsory part of the curriculum for Higher Specialist Training. To determine how A&E medicine consultants and specialist trainees view their role and skill requirements in relation to sports medicine. A modified Delphi study, consisting of two rounds of a postal questionnaire. Participants were invited to rate the importance of statements relating to the role and training of the A&E specialist in relation to sports injuries (six statements) and the need for knowledge and understanding of defined skills of importance in sports medicine (16 statements). VALUE OF RESEARCH: This provides a consensus of opinion on issues in sport and exercise medicine that have educational implications for A&E specialists, and should be considered in the curriculum for Higher Specialist Training. There is also the potential for improving the health care provision of A&E departments, to the exercising and sporting population.

Understanding Trust as an Essential Element of Trainee Supervision and Learning in the Workplace

ERIC Educational Resources Information Center

Hauer, Karen E.; ten Cate, Olle; Boscardin, Christy; Irby, David M.; Iobst, William; O'Sullivan, Patricia S.

2014-01-01

Clinical supervision requires that supervisors make decisions about how much independence to allow their trainees for patient care tasks. The simultaneous goals of ensuring quality patient care and affording trainees appropriate and progressively greater responsibility require that the supervising physician trusts the trainee. Trust allows the…

Who Is My Patient? Use of a Brief Writing Exercise to Enhance Residents' Understanding of Physician-Patient Issues

ERIC Educational Resources Information Center

Wilkinson, Joanne E.

2006-01-01

Writing workshops and narrative experiences for medical trainees can be a useful way to approach certain issues in their education. This article describes a brief writing exercise that can be used for physicians in training to help them recognize issues of countertransference in the doctor-patient relationship. While these issues are generally…

ASCAN WATER SURVIVAL SCHOOL TRAINING VIEW

NASA Image and Video Library

2013-03-05

S78-33689 (1978) ASCAN WATER SURVIVAL SCHOOL TRAINING VIEW 1978. Several new astronaut trainees are seen prior to a training exercise at the water survival school in Florida attended by 16 of the candidates. From far left to right are Shannon W. Lucid, Steven A. Hawley, Jeffrey A. Hoffman, Ronald E. McNair and Rhea Seddon. The overall program, held at Homestead Air Force Base, was designed to prepare the trainees for proper measures to take in the event of ejection from an aircraft over water. NASA Photograph.

Motion Tracking and Identification of Unrestraint Gait Rehabilitation by Use of Elderly Support Robot

NASA Astrophysics Data System (ADS)

Nokata, Makoto; Hirai, Wataru; Itatani, Ryosuke

This paper presents a robotic training system that can exercise the user without bodily restraint, neither markers nor sensors are attached to the trainee. We developed the robot system that has a total of four mounted components: a laser sensor, a camera, a cushion, and an electric motor. This paper have showed the method used for determining whether the trainee was bending forward or backward while walking, and the extent of the tilt, using the recorded image of the back of the trainee's head. A characteristic of our software algorithms has been that the image was divided into 9 quadrants, and each quadrant undergoes Hough transformation. We have verified experimentally that by using our algorithms for the four patterns of forward, backward, diagonally, and crouching, the tilt of the trainee's body have been accurately determined. We created a flowchart for determining the direction of movement according to experimental results. By adjusting the values used to make the distinction according to the position and the angle of the camera, and the width of the back of the trainee's head, we were able to accurately determine the walking condition of the trainee, and achieve early detection of the start of a fall.

High-fidelity, low-cost, automated method to assess laparoscopic skills objectively.

PubMed

Gray, Richard J; Kahol, Kanav; Islam, Gazi; Smith, Marshall; Chapital, Alyssa; Ferrara, John

2012-01-01

We sought to define the extent to which a motion analysis-based assessment system constructed with simple equipment could measure technical skill objectively and quantitatively. An "off-the-shelf" digital video system was used to capture the hand and instrument movement of surgical trainees (beginner level = PGY-1, intermediate level = PGY-3, and advanced level = PGY-5/fellows) while they performed a peg transfer exercise. The video data were passed through a custom computer vision algorithm that analyzed incoming pixels to measure movement smoothness objectively. The beginner-level group had the poorest performance, whereas those in the advanced group generated the highest scores. Intermediate-level trainees scored significantly (p < 0.04) better than beginner trainees. Advanced-level trainees scored significantly better than intermediate-level trainees and beginner-level trainees (p < 0.04 and p < 0.03, respectively). A computer vision-based analysis of surgical movements provides an objective basis for technical expertise-level analysis with construct validity. The technology to capture the data is simple, low cost, and readily available, and it obviates the need for expert human assessment in this setting. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Validity and feasibility of the EMG direct observation tool (EMG-DOT).

PubMed

Leep Hunderfund, Andrea N; Rubin, Devon I; Laughlin, Ruple S; Sorenson, Eric J; Watson, James C; Jones, Lyell K; Juul, Dorthea; Park, Yoon Soo

2016-04-26

To develop a new workplace-based EMG direct observation tool (EMG-DOT) and gather validity evidence supporting its use for assessing electrodiagnostic skills among postgraduate medical trainees. The EMG-DOT was developed by experts using an iterative process. Validity evidence from content, response process, internal structure, relations to other variables, and consequences of testing was collected during the 2013-2014 academic year. Of 3,412 studies performed by trainees during the study period, 299 (9%) were assessed using the EMG-DOT. Of these, 203 (68%) involved a physician rater and 96 (32%) involved a technician rater. The 14-item EMG-DOT had excellent internal-consistency reliability (Cronbach α 0.94). Correlations between individual items and criterion-referenced global ratings of performance ranged from 0.36 to 0.72 (all p < 0.001). Mean total scores increased from 70% to 80% over 4 months of the EMG rotation (p < 0.001) despite a corresponding significant increase in case complexity (0.21-0.74 on a 3-point rating scale; p < 0.001). Trainees reported that the observational assessment exercise improved their knowledge or skills in 82% of encounters (188/230) and that feedback generated by the EMG-DOT improved the quality of care provided to patients in 58% (133/230). Trainees were "satisfied" or "very satisfied" with the observational assessment exercise in 96% of encounters (234/243). This study provides validity evidence supporting the use of EMG-DOT scores to assess electrodiagnostic skills of residents and fellows. The EMG-DOT can be used to inform milestone-based assessments of trainee performance in neurology, child neurology, physical medicine and rehabilitation, neuromuscular, and clinical neurophysiology training programs. © 2016 American Academy of Neurology.

Simulation training for geriatric medicine.

PubMed

Mehdi, Zehra; Ross, Alastair; Reedy, Gabriel; Roots, Angela; Ernst, Thomas; Jaye, Peter; Birns, Jonathan

2014-08-01

Geriatric medicine encompasses a diverse nature of medical, social and ethical challenges, and requires a multidimensional, interdisciplinary approach. Recent reports have highlighted failings in the care of the elderly, and it is therefore vital that specialist trainees in geriatric medicine are afforded opportunities to develop their skills in managing this complex patient population. Simulation has been widely adopted as a teaching tool in medicine; however, its use in geriatric medicine to date has involved primarily role-play or discrete clinical skills training. This article outlines the development of a bespoke, multimodal, simulation course for specialist trainees in geriatric medicine. A 1-day multimodal and interprofessional simulation course was created specifically for specialist trainees in geriatric medicine, using six curriculum-mapped scenarios in which the patient perspective was central to the teaching objectives. Various simulation techniques were used, including high-fidelity human patient manikins, patient actors, with integrated clinical skills using part-task trainers, and role-play exercises. Debriefs by trained faculty members were completed after each scenario. Twenty-six candidates attended four similar courses in 2012. Quantitative analysis of pre- and post-course questionnaires revealed an improvement of self-reported confidence in managing geriatric scenarios (Z = 4.1; p < 0.001), and thematic analysis of candidate feedback was supportive of simulation as a useful teaching tool, with reported benefits for both technical and non-technical skills. Simulation is an exciting and novel method of delivering teaching for specialist trainees in geriatric medicine. This teaching modality could be integrated into the training curriculum for geriatric medicine, to allow a wider application. © 2014 John Wiley & Sons Ltd.

An intelligent training system for space shuttle flight controllers

NASA Technical Reports Server (NTRS)

Loftin, R. Bowen; Wang, Lui; Baffes, Paul; Hua, Grace

1988-01-01

An autonomous intelligent training system which integrates expert system technology with training/teaching methodologies is described. The system was designed to train Mission Control Center (MCC) Flight Dynamics Officers (FDOs) to deploy a certain type of satellite from the Space Shuttle. The Payload-assist module Deploys/Intelligent Computer-Aided Training (PD/ICAT) system consists of five components: a user interface, a domain expert, a training session manager, a trainee model, and a training scenario generator. The interface provides the trainee with information of the characteristics of the current training session and with on-line help. The domain expert (DeplEx for Deploy Expert) contains the rules and procedural knowledge needed by the FDO to carry out the satellite deploy. The DeplEx also contains mal-rules which permit the identification and diagnosis of common errors made by the trainee. The training session manager (TSM) examines the actions of the trainee and compares them with the actions of DeplEx in order to determine appropriate responses. A trainee model is developed for each individual using the system. The model includes a history of the trainee's interactions with the training system and provides evaluative data on the trainee's current skill level. A training scenario generator (TSG) designs appropriate training exercises for each trainee based on the trainee model and the training goals. All of the expert system components of PD/ICAT communicate via a common blackboard. The PD/ICAT is currently being tested. Ultimately, this project will serve as a vehicle for developing a general architecture for intelligent training systems together with a software environment for creating such systems.

An intelligent training system for space shuttle flight controllers

NASA Technical Reports Server (NTRS)

Loftin, R. Bowen; Wang, Lui; Baffles, Paul; Hua, Grace

1988-01-01

An autonomous intelligent training system which integrates expert system technology with training/teaching methodologies is described. The system was designed to train Mission Control Center (MCC) Flight Dynamics Officers (FDOs) to deploy a certain type of satellite from the Space Shuttle. The Payload-assist module Deploys/Intelligent Computer-Aided Training (PD/ICAT) system consists of five components: a user interface, a domain expert, a training session manager, a trainee model, and a training scenario generator. The interface provides the trainee with information of the characteristics of the current training session and with on-line help. The domain expert (Dep1Ex for Deploy Expert) contains the rules and procedural knowledge needed by the FDO to carry out the satellite deploy. The Dep1Ex also contains mal-rules which permit the identification and diagnosis of common errors made by the trainee. The training session manager (TSM) examines the actions of the trainee and compares them with the actions of Dep1Ex in order to determine appropriate responses. A trainee model is developed for each individual using the system. The model includes a history of the trainee's interactions with the training system and provides evaluative data on the trainee's current skill level. A training scenario generator (TSG) designs appropriate training exercises for each trainee based on the trainee model and the training goals. All of the expert system components of PD/ICAT communicate via a common blackboard. The PD/ICAT is currently being tested. Ultimately, this project will serve as a vehicle for developing a general architecture for intelligent training systems together with a software environment for creating such systems.

Intelligent computer-aided training and tutoring

NASA Technical Reports Server (NTRS)

Loftin, R. Bowen; Savely, Robert T.

1991-01-01

Specific autonomous training systems based on artificial intelligence technology for use by NASA astronauts, flight controllers, and ground-based support personnel that demonstrate an alternative to current training systems are described. In addition to these specific systems, the evolution of a general architecture for autonomous intelligent training systems that integrates many of the features of traditional training programs with artificial intelligence techniques is presented. These Intelligent Computer-Aided Training (ICAT) systems would provide, for the trainee, much of the same experience that could be gained from the best on-the-job training. By integrating domain expertise with a knowledge of appropriate training methods, an ICAT session should duplicate, as closely as possible, the trainee undergoing on-the-job training in the task environment, benefitting from the full attention of a task expert who is also an expert trainer. Thus, the philosophy of the ICAT system is to emulate the behavior of an experienced individual devoting his full time and attention to the training of a novice - proposing challenging training scenarios, monitoring and evaluating the actions of the trainee, providing meaningful comments in response to trainee errors, responding to trainee requests for information, giving hints (if appropriate), and remembering the strengths and weaknesses displayed by the trainee so that appropriate future exercises can be designed.

What affects completion of the scholarly project? A survey of RANZCP trainees.

PubMed

Cheung, Gary; Gale, Chris; Menkes, David B

2018-05-01

To explore trainee perception of what facilitates or delays completion of the RANZCP Scholarly Project (SP). Of 182 currently registered New Zealand trainees, 33 (18%) completed an online questionnaire and three open-ended questions. Most trainees agreed or strongly agreed that having protected time for research (87.5%) and access to an appropriate supervisor (87.9%) would facilitate the completion of their SP. Other college requirements were identified by most trainees (87.9%) as a factor delaying completion. Identifying and protecting research time and ensuring adequate supervision appear essential to improve the uptake and completion of this training requirement.

Balancing student/trainee learning with the delivery of patient care in the healthcare workplace: a protocol for realist synthesis

PubMed Central

Sholl, Sarah; Ajjawi, Rola; Allbutt, Helen; Butler, Jane; Jindal-Snape, Divya; Morrison, Jill; Rees, Charlotte

2016-01-01

Introduction A national survey was recently conducted to explore medical education research priorities in Scotland. The identified themes and underlying priority areas can be linked to current medical education drivers in the UK. The top priority area rated by stakeholders was: ‘Understanding how to balance service and training conflicts’. Despite its perceived importance, a preliminary scoping exercise revealed the least activity with respect to published literature reviews. This protocol has therefore been developed so as to understand how patient care, other service demands and student/trainee learning can be simultaneously facilitated within the healthcare workplace. The review will identify key interventions designed to balance patient care and student/trainee learning, to understand how and why such interventions produce their effects. Our research questions seek to address how identified interventions enable balanced patient care-trainee learning within the healthcare workplace, for whom, why and under what circumstances. Methods and analysis Pawson's five stages for undertaking a realist review underpin this protocol. These stages may progress in a non-linear fashion due to the iterative nature of the review process. We will: (1) clarify the scope of the review, identifying relevant interventions and existing programme theories, understanding how interventions act to produce their intended outcomes; (2) search journal articles and grey literature for empirical evidence from 1998 (introduction of the European Working Time Directive) on the UK multidisciplinary team working concerning these interventions, theories and outcomes, using databases such as ERIC, Scopus and CINAHL; (3) assess study quality; (4) extract data; and (5) synthesise data, drawing conclusions. Ethics and dissemination A formal ethical review is not required. These findings should provide an important understanding of how workplace-based interventions influence the balance of trainee learning and service provision. They should benefit various stakeholders involved in workplace-based learning interventions, and inform the medical education research agenda in the UK. PMID:27118289

Genetics objective structured clinical exams at the Maimonides Infants & Children's Hospital of Brooklyn, New York.

PubMed

Altshuler, Lisa; Kachur, Elizabeth; Krinshpun, Shifra; Sullivan, Deborah

2008-11-01

In 2003, the Maimonides Infants & Children's Hospital received a Title VII Residency Training in Primary Care grant to integrate genetic-specific competencies into postgraduate pediatrics education. As part of that endeavor, mandatory yearly genetics objective structured clinical exams (OSCEs) were instituted for third-year residents. This article reports on the first three years of experience with this innovative educational tool.After an overview of genetic concepts, dysmorphology, and communication styles, residents complete a five-station OSCE and receive feedback from standardized patients and from the faculty who observe them. After this clinical exercise, the residents participate in a small-group debriefing session to share strategies for effective communication and clinical case management and to discuss the ethical issues that arise with these genetic cases.In three years, 60 residents have completed the genetics OSCE program. Evaluation data demonstrate that the program has been effective in both introducing genetic-specific challenges and assessing residents' clinical skills. It has helped trainees self-identify both strengths and further training needs. Pre- and postsurveys among the trainees show increased comfort levels in performing 5 of 12 genetic-related clinical tasks.We conclude that genetics OSCEs are an enriching educational tool. Merely providing trainees and practicing physicians with the latest scientific information is unlikely to prepare them for counseling patients about complex genetic issues. Developing proficiency requires focused practice and effective feedback.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

A virtual reality patient simulation system for teaching emergency response skills to U.S. Navy medical providers.

PubMed

Freeman, K M; Thompson, S F; Allely, E B; Sobel, A L; Stansfield, S A; Pugh, W M

2001-01-01

Rapid and effective medical intervention in response to civil and military-related disasters is crucial for saving lives and limiting long-term disability. Inexperienced providers may suffer in performance when faced with limited supplies and the demands of stabilizing casualties not generally encountered in the comparatively resource-rich hospital setting. Head trauma and multiple injury cases are particularly complex to diagnose and treat, requiring the integration and processing of complex multimodal data. In this project, collaborators adapted and merged existing technologies to produce a flexible, modular patient simulation system with both three-dimensional virtual reality and two-dimensional flat screen user interfaces for teaching cognitive assessment and treatment skills. This experiential, problem-based training approach engages the user in a stress-filled, high fidelity world, providing multiple learning opportunities within a compressed period of time and without risk. The system simulates both the dynamic state of the patient and the results of user intervention, enabling trainees to watch the virtual patient deteriorate or stabilize as a result of their decision-making speed and accuracy. Systems can be deployed to the field enabling trainees to practice repeatedly until their skills are mastered and to maintain those skills once acquired. This paper describes the technologies and the process used to develop the trainers, the clinical algorithms, and the incorporation of teaching points. We also characterize aspects of the actual simulation exercise through the lens of the trainee.

In-training assessment for specialist registrars: views of trainees and trainers in the Mersey Deanery

PubMed Central

Bache, John; Brown, Jeremy; Graham, David

2002-01-01

Annual review of specialist registrars and production of a record of in-training assessment (RITA) is a mandatory component of training that has attracted criticism. Mersey Deanery has established a system of review that includes wider evaluation of the trainee's needs and of training requirements. We conducted a survey to ascertain whether this broadened review process was thought beneficial. In one year 1093 questionnaires were distributed to trainees and trainers. 605 (81%) of 744 trainees and 309 (89%) of 349 trainers responded. At least 89% of both groups said that the procedure had been effective in reviewing the previous year and the most recent post and in identifying training requirements. More than 90% rated the overall process positively. Trainees particularly appreciated the advice on future training, on careers and on research. This form of review is expensive in consultant time but was valued by both trainees and trainers. PMID:12461150

Early predictors of need for remediation in the Australian general practice training program: a retrospective cohort study.

PubMed

Magin, Parker; Stewart, Rebecca; Turnock, Allison; Tapley, Amanda; Holliday, Elizabeth; Cooling, Nick

2017-10-01

Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes-remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general (family) practice. We sought to establish early-training assessment instruments predictive of general practice (GP) trainees' subsequently requiring formal remediation. We conducted a retrospective cohort study of trainees from a large Australian regionally-based GP training organization. The outcome factor was requirement for formal remediation. Independent variables were demographic factors and a range of formative assessments conducted immediately prior to or during early-stage training. Analyses employed univariate and multivariate logistic regression of each predictor assessment modality with the outcome, adjusting for potential confounders. Of 248 trainees, 26 (10.5 %) required formal remediation. Performance on the Colleague Feedback Evaluation Tool (entailing feedback from a trainee's clinical colleagues on clinical performance, communication and probity) and External Clinical Teaching Visits (half-day sessions of the trainee's clinical consultations observed directly by an experienced GP), along with non-Australian primary medical qualification, were significantly associated with requiring remediation. There was a non-significant trend for association with performance on the Doctors Interpersonal Skills Questionnaire (patient feedback on interpersonal elements of the consultation). There were no significant associations with entry-selection scores or formative exam or assessment scores. Our finding that 'in vivo' assessments of complex behaviour, but not 'in vitro' knowledge-based assessments, predict need for remediation is consistent with theoretical understanding of the nature of remediation decision-making and should inform remediation practice in GP vocational training.

Promoting a research culture among junior radiation oncologists: outcomes from the introduction of the Australian and New Zealand research requirement in training.

PubMed

Thiruthaneeswaran, N; Turner, S; Milross, C; Gogna, K

2014-03-01

Since 2005, radiation oncology trainees in Australia and New Zealand have had to undertake a piece of original research during training, and submit a manuscript, as first author, for senior peer-review. Satisfactory completion of this requirement is one component of eligibility to sit the Royal Australian and New Zealand College of Radiologists Fellowship examinations. The purpose of this study was to examine the value of this curriculum requirement, including the publication rates and potential barriers to trainee research. An online survey was sent to 116 radiation oncologists/trainees who trained since the mandatory research requirement was introduced (2005-2011). Questions concerned research topics, publications, subsequent research activity, perceptions on barriers to research and aids to conducting research during training. A web-based search of PubMed by author name was carried out to complete and verify publication statistics. In total, 108 (93.1%) of the 116 trainees across 20 centres who submitted their research papers to the Radiation Oncology Faculty Research Committee were successful in meeting the required standard first time. Half of these trainees ultimately published their paper in a peer-reviewed journal. Of trainees responding to the survey, 62% presented their research at a scientific meeting. Most of the studies were either retrospective (62.3%) or dosimetry/physics projects (10.1%). The main problems encountered in conducting projects were competing clinical commitments and lack of dedicated research time. Notably, long ethics approval processes, lack of supervision and statistical support for projects were not considered barriers. This mandatory research requirement ensures trainees initiate and complete at least one project during their training. Since the introduction of this curriculum component, half of the research projects have resulted in publication in a peer-reviewed journal. Increased 'protected time' and training in scientific writing and methods may improve publication rates and quality. This first review of the Australian and New Zealand radiation oncology trainee research requirement highlights areas that need to be addressed to further support and foster a research culture among junior radiation oncologists. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

A Vous de Parler. French Trainee Book.

ERIC Educational Resources Information Center

Cole, Richard

A set of instructional materials for French is designed for Peace Corps volunteer language instruction and geared to the daily language needs of volunteers in Morocco. It consists of 38 units containing mini-dialogues, related grammatical and cultural information, vocabulary, and exercises. Unit topics include introductions, information giving and…

Balancing student/trainee learning with the delivery of patient care in the healthcare workplace: a protocol for realist synthesis.

PubMed

Sholl, Sarah; Ajjawi, Rola; Allbutt, Helen; Butler, Jane; Jindal-Snape, Divya; Morrison, Jill; Rees, Charlotte

2016-04-26

A national survey was recently conducted to explore medical education research priorities in Scotland. The identified themes and underlying priority areas can be linked to current medical education drivers in the UK. The top priority area rated by stakeholders was: 'Understanding how to balance service and training conflicts'. Despite its perceived importance, a preliminary scoping exercise revealed the least activity with respect to published literature reviews. This protocol has therefore been developed so as to understand how patient care, other service demands and student/trainee learning can be simultaneously facilitated within the healthcare workplace. The review will identify key interventions designed to balance patient care and student/trainee learning, to understand how and why such interventions produce their effects. Our research questions seek to address how identified interventions enable balanced patient care-trainee learning within the healthcare workplace, for whom, why and under what circumstances. Pawson's five stages for undertaking a realist review underpin this protocol. These stages may progress in a non-linear fashion due to the iterative nature of the review process. We will: (1) clarify the scope of the review, identifying relevant interventions and existing programme theories, understanding how interventions act to produce their intended outcomes; (2) search journal articles and grey literature for empirical evidence from 1998 (introduction of the European Working Time Directive) on the UK multidisciplinary team working concerning these interventions, theories and outcomes, using databases such as ERIC, Scopus and CINAHL; (3) assess study quality; (4) extract data; and (5) synthesise data, drawing conclusions. A formal ethical review is not required. These findings should provide an important understanding of how workplace-based interventions influence the balance of trainee learning and service provision. They should benefit various stakeholders involved in workplace-based learning interventions, and inform the medical education research agenda in the UK. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Supervised Fieldwork and the Development of Counseling Skills.

ERIC Educational Resources Information Center

Lutwak, Nita; Scheffler, Linda W.

1991-01-01

Examines the relationship between field work and counseling skill development for 73 trainees from 2 master's level counseling programs with different field-work requirements. Trainees with field-work experience respond differently than do inexperienced trainees, with greater empathy, better formulation of clinical impressions, and the ability to…

How to Design a Genetic Mating Scheme: A Basic Training Package for Drosophila Genetics

PubMed Central

Roote, John; Prokop, Andreas

2013-01-01

Drosophila melanogaster is a powerful model organism for biological research. The essential and common instrument of fly research is genetics, the art of applying Mendelian rules in the specific context of Drosophila with its unique classical genetic tools and the breadth of modern genetic tools and strategies brought in by molecular biology, transgenic technologies and the use of recombinases. Training newcomers to fly genetics is a complex and time-consuming task but too important to be left to chance. Surprisingly, suitable training resources for beginners currently are not available. Here we provide a training package for basic Drosophila genetics, designed to ensure that basic knowledge on all key areas is covered while reducing the time invested by trainers. First, a manual introduces to fly history, rationale for mating schemes, fly handling, Mendelian rules in fly, markers and balancers, mating scheme design, and transgenic technologies. Its self-study is followed by a practical training session on gender and marker selection, introducing real flies under the dissecting microscope. Next, through self-study of a PowerPoint presentation, trainees are guided step-by-step through a mating scheme. Finally, to consolidate knowledge, trainees are asked to design similar mating schemes reflecting routine tasks in a fly laboratory. This exercise requires individual feedback but also provides unique opportunities for trainers to spot weaknesses and strengths of each trainee and take remedial action. This training package is being successfully applied at the Manchester fly facility and may serve as a model for further training resources covering other aspects of fly research. PMID:23390611

Development of a novel image-based program to teach narrow-band imaging.

PubMed

Dumas, Cedric; Fielding, David; Coles, Timothy; Good, Norm

2016-08-01

Narrow-band imaging (NBI) is a widely available endoscopic imaging technology; however, uptake of the technique could be improved. Teaching new imaging techniques and assessing trainees' performance can be a challenging exercise during a 1-day workshop. To support NBI training, we developed an online training tool (Medimq) to help experts train novices in NBI bronchoscopy that could assess trainees' performance and provide feedback before the close of the 1-day course. The present study determines whether trainees' capacity to identify relevant pathology increases with the proposed interactive testing method. Two groups of 20 and 18 bronchoscopists have attended an NBI course where they did a pretest and post-test before and after the main lecture, and a follow-up test 4 weeks later to measure retention of knowledge. We measured their ability to mark normal and abnormal 'biopsy size' areas on bronchoscopic NBI images for biopsy. These markings were compared with areas marked by experts on the same images. The first group results were used to pilot the test. After modifications, the results of the improved test for group 2 showed trainees improved by 32% (total class average normalized gain) in detecting normal or abnormal areas. On follow-up testing, Group 2 improved by 23%. The overall class average normalized gain of 32% shows our test can be used to improve trainees' competency in analyzing NBI Images. The testing method (and tool) can be used to measure the follow up 4 weeks later. Better follow-up test results would be expected with more frequent practice by trainees after the course. © The Author(s), 2016.

Intelligent Computerized Training System

NASA Technical Reports Server (NTRS)

Wang, Lui; Baffes, Paul; Loftin, R. Bowen; Hua, Grace C.

1991-01-01

Intelligent computer-aided training system gives trainees same experience gained from best on-the-job training. Automated system designed to emulate behavior of experienced teacher devoting full time and attention to training novice. Proposes challenging training scenarios, monitors and evaluates trainee's actions, makes meaningful comments in response to errors, reponds to requests for information, gives hints when appropriate, and remembers strengths and weaknesses so it designs suitable exercises. Used to train flight-dynamics officers in deploying satellites from Space Shuttle. Adapted to training for variety of tasks and situations, simply by modifying one or at most two of its five modules. Helps to ensure continuous supply of trained specialists despite scarcity of experienced and skilled human trainers.

The East Anglian specialist registrar assessment tool

PubMed Central

Robinson, Susan; Boursicot, Katharine; Hayhurst, Catherine

2007-01-01

Background In our region, it was acknowledged that the process of assessment needed to be improved, but before developing a system for this, there was a need to define the “competent or satisfactory trainee”. Objective To outline the process by which a consensus was achieved on this standard, and how a system for formally assessing competency across a wide range of knowledge skills and attitudes was subsequently agreed on, thus enabling increased opportunities for training and feedback and improving the accuracy of assessment in the region. Methods The opinions of trainees and trainers from across the region were collated, and a consensus was achieved with regard to the minimum acceptable standard for a trainee in emergency medicine, thus defining a competent trainee. The group that set the standard then focused on identifying the assessment methods most appropriate for the evaluation of the knowledge, skills and attitudes required of an emergency medicine trainee. The tool was subsequently trialled for a period of 6 months, and opinion evaluated by use of a questionnaire. Results The use of the tool was reviewed from both the trainers' and trainees' perspectives. 42% (n = 11) of trainers and 31% (n = 8) trainees responded to the questionnaire. In the region, there were 26 trainers and 26 trainees. Five trainees and nine trainers had used the tool. 93% (14/15) of respondents thought that the descriptors used to describe the satisfactory trainee were acceptable; 89% (8/9) of trainers thought that it helped them assess trainees more accurately. 60% (3/5) of trainees thought that, as a result, they had a better understanding of their weak areas. Conclusion We believe that we achieved a consensus across our region as to what defined a satisfactory trainee and set the standard against which all our trainees would subsequently be evaluated. The use of this tool to assess trainees during the pilot period was disappointing; however, we were encouraged that most of those using the tool thought that it allowed an objective assessment of trainees and feedback on areas requiring further work. Those who used the tool identified important reasons that may have hindered widespread use of the assessment tool. PMID:17351222

Effort, performance, and motivation: insights from robot-assisted training of human golf putting and rat grip strength.

PubMed

Duarte, Jaime E; Gebrekristos, Berkenesh; Perez, Sergi; Rowe, Justin B; Sharp, Kelli; Reinkensmeyer, David J

2013-06-01

Robotic devices can modulate success rates and required effort levels during motor training, but it is unclear how this affects performance gains and motivation. Here we present results from training unimpaired humans in a virtual golf-putting task, and training spinal cord injured (SCI) rats in a grip strength task using robotically modulated success rates and effort levels. Robotic assistance in golf practice increased trainees feelings of competence, and, paradoxically, increased their sense effort, even though it had mixed effects on learning. Reducing effort during a grip strength training task led rats with SCI to practice the task more frequently. However, the more frequent practice of these rats did not cause them to exceed the strength gains achieved by rats that exercised less often at higher required effort levels. These results show that increasing success and decreasing effort with robots increases motivation, but has mixed effects on performance gains.

Using Drawings of the Brain Cell to Exhibit Expertise in Neuroscience: Exploring the Boundaries of Experimental Culture

ERIC Educational Resources Information Center

Hay, David B.; Williams, Darren; Stahl, Daniel; Wingate, Richard J.

2013-01-01

This paper explores the research perspective of neuroscience by documenting the brain cell (neuron) drawings of undergraduates, trainee scientists, and leading neuroscience researchers in a single research-intensive university. Qualitative analysis, drawing-sorting exercises, and hierarchical cluster analysis are used to answer two related…

Sugar and Spice, Toads and Mice: Gender Issues in Family Therapy Training.

ERIC Educational Resources Information Center

Roberts, Janine McGill

1991-01-01

Presents methods to help family therapy trainees and clinicians articulate how to address gender in families. Describes four experiential exercises (including gender survival messages, gender framed circular questions, and process observation sheets) for training and use with clients. Can examine learnings about gender from families of origin,…

Promoting Educational Equity through School Libraries: Equity Activity Book.

ERIC Educational Resources Information Center

Arizona State Univ., Tempe.

The activities suggested in this workbook for participants in a continuing education program for inservice school media specialists are designed to develop the trainee's skills in identifying instances of sexism and sex stereotyping in education, and in promoting sex fairness in the library. Exercises and tests on the first module are concerned…

Cross-sectional study of the financial cost of training to the surgical trainee in the UK and Ireland

PubMed Central

O’Callaghan, John; Mohan, Helen M; Sharrock, Anna; Gokani, Vimal; Fitzgerald, J Edward; Williams, Adam P; Harries, Rhiannon L

2017-01-01

Objectives Applications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training. Design Prospective, cross-sectional, questionnaire-based study. Setting/Participants A non-mandatory online questionnaire for UK-based trainees was distributed nationally. A similar national questionnaire was distributed for Ireland, taking into account differences between the healthcare systems. Only fully completed responses were included. Results There were 848 and 58 fully completed responses from doctors based in the UK and Ireland, respectively. Medical students in the UK reported a significant increase in debt on graduation by 55% from £17 892 (2000–2004) to £27 655 (2010–2014) (p<0.01). 41% of specialty trainees in the UK indicated that some or all of their study budget was used to fund mandatory regional teaching. By the end of training, a surgical trainee in the UK spends on average £9105 on courses, £5411 on conferences and £4185 on exams, not covered by training budget. Irish trainees report similarly high costs. Most trainees undertake a higher degree during their postgraduate training. The cost of achieving the mandatory requirements for completion of training ranges between £20 000 and £26 000 (dependent on specialty), except oral and maxillofacial surgery, which is considerably higher (£71 431). Conclusions Medical students are graduating with significantly larger debt than before. Surgical trainees achieve their educational requirements at substantial personal expenditure. To encourage graduates to pursue and remain in surgical training, urgent action is required to fund the mandatory requirements and annual training costs for completion of training and provide greater transparency to inform doctors of what their postgraduate training costs will be. This is necessary to increase diversity in surgery, reduce debt load and ensure surgery remains a popular career choice. PMID:29146646

Case-based Learning Outperformed Simulation Exercises in Disaster Preparedness Education Among Nursing Trainees in India: A Randomized Controlled Trial.

PubMed

Aluisio, Adam R; Daniel, Pia; Grock, Andrew; Freedman, Joseph; Singh, Ajai; Papanagnou, Dimitrios; Arquilla, Bonnie

2016-10-01

In resource-constrained environments, appropriately employing triage in disaster situations is crucial. Although both case-based learning (CBL) and simulation exercises (SEs) commonly are utilized in teaching disaster preparedness to adult learners, there is no substantial evidence supporting one as a more efficacious methodology. This randomized controlled trial (RCT) evaluated the effectiveness of CBL versus SEs in addition to standard didactic instruction in knowledge attainment pertaining to disaster triage preparedness. This RCT was performed during a one-day disaster preparedness course in Lucknow, India during October 2014. Following provision of informed consent, nursing trainees were randomized to knowledge assessment after didactic teaching (control group); didactic plus CBL (Intervention Group 1); or didactic plus SE (Intervention Group 2). The educational curriculum used the topical focus of triage processes during disaster situations. Cases for the educational intervention sessions were scripted, identical between modalities, and employed structured debriefing. Trained live actors were used for SEs. After primary assessment, the groups underwent crossover to take part in the alternative educational modality and were re-assessed. Two standardized multiple-choice question batteries, encompassing key core content, were used for assessments. A sample size of 48 participants was calculated to detect a ≥20% change in mean knowledge score (α=0.05; power=80%). Robustness of randomization was evaluated using X 2, anova, and t-tests. Mean knowledge attainment scores were compared using one- and two-sample t-tests for intergroup and intragroup analyses, respectively. Among 60 enrolled participants, 88.3% completed follow-up. No significant differences in participant characteristics existed between randomization arms. Mean baseline knowledge score in the control group was 43.8% (standard deviation=11.0%). Case-based learning training resulted in a significant increase in relative knowledge scores at 20.8% (P=0.003) and 10.3% (P=.033) in intergroup and intragroup analyses, respectively. As compared to control, SEs did not significantly alter knowledge attainment scores with an average score increase of 6.6% (P=.396). In crossover intra-arm analysis, SEs were found to result in a 26.0% decrement in mean assessment score (P < .001). Among nursing trainees assessed in this RCT, the CBL modality was superior to SEs in short-term disaster preparedness educational translation. Simulation exercises resulted in no detectable improvement in knowledge attainment in this population, suggesting that CBL may be utilized preferentially for adult learners in similar disaster training settings. Aluisio AR , Daniel P , Grock A , Freedman J , Singh A , Papanagnou D , Arquilla B . Case-based learning outperformed simulation exercises in disaster preparedness education among nursing trainees in India: a randomized controlled trial. Prehosp Disaster Med. 2016;31(5):516-523.

Canadian Rheumatology Association Meeting, The Westin Ottawa, Ottawa, Ontario, Canada, February 8-11, 2017.

PubMed

Silverman, Earl D

2017-05-01

The 72nd Annual Meeting of The Canadian Rheumatology Association (CRA) was held at The Westin Ottawa, Ottawa, Ontario, Canada, February 8-11, 2017. The program consisted of presentations covering original research, symposia, awards, and lectures. Highlights of the meeting include the following 2017 award winners: Dr. Vinod Chandran, Young Investigator; Dr. Jacques P. Brown, Distinguished Investigator; Dr. David Robinson, Teacher-Educator; Dr. Michel Zummer, Distinguished Rheumatologist; Ms. Rebecca Gole, Best Abstract on SLE Research by a Trainee - Ian Watson Award; Ms. Bailey Russell, Best Abstract on Clinical or Epidemiology Research by a Trainee - Phil Rosen Award; Dr. Sahil Koppikar and Dr. Henry Averns, Practice Reflection Award; Dr. Shirine Usmani, Best Abstract on Basic Science Research by a Trainee; Ms. Carol Dou, Best Abstract for Research by an Undergraduate Student; Dr. Dania Basodan, Best Abstract on Research by a Rheumatology Resident; Dr. Claire Barber, Best Abstract on Adult Research by Young Faculty; Ms. Audrea Chen, Best Abstract by a Medical Student; Dr. Kun Huang, Best Abstract by a Post-Graduate Resident; and Dr. Ryan Lewinson, Best Abstract by a Post-Graduate Research Trainee. Lectures and other events included a Keynote Lecture by Jonathon Fowles: Exercise is Medicine: Is Exercise a Good or Bad Thing for People with Arthritis?; State of the Art Lecture by Matthew Warman: Insights into Bone Biology and Therapeutics Gleaned from the Sustained Investigation of Rare Diseases; Dunlop-Dottridge Lecture by Allen Steere: Lyme Disease: A New Problem for Rheumatologists in Canada; and the Great Debate: Be it Resolved that the Least Expensive Treatment Should be Chosen. Switch, Switch, Switch! Arguing for: Jonathan Chan and Antonio Avina, and against: Marinka Twilt and Glen Hazlewood. Topics such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren syndrome, psoriatic arthritis, spondyloarthritis, vasculitis, osteoarthritis, fibromyalgia, pediatric rheumatology, and their respective diagnoses, treatments, and outcomes are reflected in the abstracts, which we are pleased to publish in this issue of The Journal .

Counselor Trainees' Views on Their Forthcoming Experiences in Practicum Course

ERIC Educational Resources Information Center

Kurtyilmaz, Yildiz

2015-01-01

Problem Statement: The counseling profession requires specific education and training to equip counselor trainees with necessary knowledge and skills. Therefore, they are required not only to acquire theoretical knowledge but also to integrate it into practice. Especially, the integration of theoretical knowledge into practice is optimally…

Early Predictors of Need for Remediation in the Australian General Practice Training Program: A Retrospective Cohort Study

ERIC Educational Resources Information Center

Magin, Parker; Stewart, Rebecca; Turnock, Allison; Tapley, Amanda; Holliday, Elizabeth; Cooling, Nick

2017-01-01

Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes--remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general…

Team Regulation in a Simulated Medical Emergency: An In-Depth Analysis of Cognitive, Metacognitive, and Affective Processes

ERIC Educational Resources Information Center

Duffy, Melissa C.; Azevedo, Roger; Sun, Ning-Zi; Griscom, Sophia E.; Stead, Victoria; Crelinsten, Linda; Wiseman, Jeffrey; Maniatis, Thomas; Lachapelle, Kevin

2015-01-01

This study examined the nature of cognitive, metacognitive, and affective processes among a medical team experiencing difficulty managing a challenging simulated medical emergency case by conducting in-depth analysis of process data. Medical residents participated in a simulation exercise designed to help trainees to develop medical expertise,…

Usability of virtual-reality simulation training in obstetric ultrasonography: a prospective cohort study.

PubMed

Burden, C; Preshaw, J; White, P; Draycott, T J; Grant, S; Fox, R

2013-08-01

To assess the usability of virtual-reality (VR) simulation for obstetric ultrasound trainees. Twenty-six participants were recruited: 18 obstetric ultrasound trainees (with little formal ultrasonography training) and eight certified experts. All performed five sequential VR-simulated crown-rump length (CRL) scans in a single session and three repetitions of biparietal diameter (BPD), occipitofrontal diameter (OFD) and femur length (FL) measurements. Outcome measures included mean percentage deviation from target for all measurements. Time taken to perform each type of scan was recorded. The mean percentage difference for the first scan was significantly greater for the trainee group than for the expert group for BPD (P = 0.035), OFD (P = 0.010) and FL (P = 0.008) and for time taken for the first CRL (P < 0.001) and fetal biometry (including BPD, OFD and FL measurements) scan (P < 0.001), demonstrating that trainees were initially significantly less accurate and less efficient. Over subsequent scans, the trainees became more accurate for all measurements with a significant improvement shown for OFD and FL (P < 0.05). The time taken for trainees to complete CRL and fetal biometry scans decreased significantly (all P < 0.05) with repetition, to near-expert efficiency. All participants were able to use the simulator and produce clinically meaningful biometry results. With repetition, beginners quickly approached near-expert levels of accuracy and speed. These data demonstrate that obstetricians with minimal experience can improve their ultrasonographic skills with short-phase VR-simulation training. The speed of improvement suggests that VR simulation might be useful as a warm-up exercise before clinical training sessions in order to reduce their impact on clinical service. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

Syncope among U.S. Air Force basic military trainees, August 2012-July 2013.

PubMed

Webber, Bryant J; Cropper, Thomas L; Federinko, Susan P

2013-11-01

Syncope is a common event with many possible etiologies, ranging from benign to severe. Syncopal episodes of any origin, however, may result in traumatic injury due to postural collapse. Based on the prevalence of internal and external stressors during training, basic military trainees may be at increased risk for syncope. Between 1 August 2012 and 31 July 2013, there were 112 unique individuals who experienced syncopal or pre-syncopal events among basic military trainees at Joint Base San Antonio-Lackland, Texas, the only basic training site in the U.S. Air Force. The overall rate was 19.6 cases per 1,000 person-years (18.4 and 36.1 per 1,000 person-years in males and females, respectively). Based upon the findings of electronic chart review of the 112 cases, a majority of events occurred either during or immediately after exercise (n=38) or during a blood draw, immunization, or laceration repair (n=22). The most common etiologies were judged to be neurocardiogenic (n=54) and orthostatic hypotension (n=40), and two cases were attributed to cardiovascular disease. These findings support current preventive measures, including anemia screening during medical in-processing, an emphasis on hydration throughout training, and a padded floor in the trainee vaccination bay.

Audit of anesthetic trainees' 'hands-on' operating room experience in an Australian tertiary children's hospital.

PubMed

Hogan, Bridget; Keating, Matthew; Chambers, Neil A; von Ungern-Sternberg, Britta

2016-05-01

There are no internationally accepted guidelines about what constitutes adequate clinical exposure during pediatric anesthetic training. In Australia, no data have been published on the level of experience obtained by anesthetic trainees in pediatric anesthesia. There is, however, a new ANZCA (Australian and New Zealand College of Anaesthetists) curriculum that quantifies new training requirements. To quantify our trainees' exposure to clinical work in order to assess compliance with new curriculum and to provide other institutions with a benchmark for pediatric anesthetic training. We performed a prospective audit to estimate and quantify our anesthetic registrars' exposure to pediatric anesthesia during their 6-month rotation at our institution, a tertiary pediatric hospital in Perth, Western Australia. Our data suggest that trainees at our institution will achieve the new ANZCA training standards comfortably, in terms of the required volume and breadth of exposure. Experience, however, of some advanced pediatric anesthetic procedures appears limited. Experience gained at our hospital easily meets the new College requirements. Experience of fiber-optic intubation and regional blocks would appear insufficient to develop sufficient skills or confidence. The study provides other institutions with information to benchmark against their own trainee experience. © 2016 John Wiley & Sons Ltd.

Validity and reliability of the robotic objective structured assessment of technical skills

PubMed Central

Siddiqui, Nazema Y.; Galloway, Michael L.; Geller, Elizabeth J.; Green, Isabel C.; Hur, Hye-Chun; Langston, Kyle; Pitter, Michael C.; Tarr, Megan E.; Martino, Martin A.

2015-01-01

Objective Objective structured assessments of technical skills (OSATS) have been developed to measure the skill of surgical trainees. Our aim was to develop an OSATS specifically for trainees learning robotic surgery. Study Design This is a multi-institutional study in eight academic training programs. We created an assessment form to evaluate robotic surgical skill through five inanimate exercises. Obstetrics/gynecology, general surgery, and urology residents, fellows, and faculty completed five robotic exercises on a standard training model. Study sessions were recorded and randomly assigned to three blinded judges who scored performance using the assessment form. Construct validity was evaluated by comparing scores between participants with different levels of surgical experience; inter- and intra-rater reliability were also assessed. Results We evaluated 83 residents, 9 fellows, and 13 faculty, totaling 105 participants; 88 (84%) were from obstetrics/gynecology. Our assessment form demonstrated construct validity, with faculty and fellows performing significantly better than residents (mean scores: 89 ± 8 faculty; 74 ± 17 fellows; 59 ± 22 residents, p<0.01). In addition, participants with more robotic console experience scored significantly higher than those with fewer prior console surgeries (p<0.01). R-OSATS demonstrated good inter-rater reliability across all five drills (mean Cronbach's α: 0.79 ± 0.02). Intra-rater reliability was also high (mean Spearman's correlation: 0.91 ± 0.11). Conclusions We developed an assessment form for robotic surgical skill that demonstrates construct validity, inter- and intra-rater reliability. When paired with standardized robotic skill drills this form may be useful to distinguish between levels of trainee performance. PMID:24807319

'I still have no idea why this patient was here': An exploration of the difficulties GP trainees experience when gathering information.

PubMed

Giroldi, Esther; Veldhuijzen, Wemke; de Leve, Tijme; van der Weijden, Trudy; Bueving, Herman; van der Vleuten, Cees

2015-07-01

Collecting information during patient encounters is essential for the delivery of patient-centered care. To obtain insight into areas that require more attention in medical communication training, this study explores what difficulties GP trainees encounter when gathering information. In this phenomenological study, we observed a morning clinic of 15 GP trainees. To explore trainees' experiences with information-gathering, we held brief interviews after every consultation and a lengthier interview directly after the morning clinic. The resulting data were analyzed using template analysis. From trainees' reflections, we distilled five difficulties that trainees experience when gathering information: (1) Goal conflicts; (2) Ineffectiveness of trained communication skills in specific situations; (3) Trainees' distress hampers open communication; (4) Untrustworthy information; (5) Tunnel vision. Information-gathering is difficult for GP trainees. Current generic communication skills training does not seem to support trainees sufficiently to handle effectively the challenges they encounter during consultations. Medical communication training needs to support trainees in handling their goal-conflicts and feelings that hamper information-gathering, while also providing them with communication strategies adapted to handling specific challenging situations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Measuring the anaesthesia clinical learning environment at the department level is feasible and reliable.

PubMed

Castanelli, D J; Smith, N A

2017-05-01

The learning environment describes the context and culture in which trainees learn. In order to establish the feasibility and reliability of measuring the anaesthetic learning environment in individual departments we implemented a previously developed instrument in hospitals across New South Wales. We distributed the instrument to trainees from 25 anaesthesia departments and supplied summarized results to individual departments. Exploratory and confirmatory factor analyses were performed to assess internal structure validity and generalizability theory was used to calculate reliability. The number of trainees required for acceptable precision in results was determined using the standard error of measurement. We received 172 responses (59% response rate). Suitable internal structure validity was confirmed. Measured reliability was acceptable (G-coefficient 0.69) with nine trainees per department. Eight trainees were required for a 95% confidence interval of plus or minus 0.25 in the mean total score. Eight trainees as assessors also allow a 95% confidence interval of approximately plus or minus 0.3 in the subscale mean scores. Results for individual departments varied, with scores below the expected level recorded on individual subscales, particularly the 'teaching' subscale. Our results confirm that, using this instrument, individual departments can obtain acceptable precision in results with achievable trainee numbers. Additionally, with the exception of departments with few trainees, implementation proved feasible across a training region. Repeated use would allow departments or accrediting bodies to monitor their individual learning environment and the impact of changes such as the introduction of new curricular elements, or local initiatives to improve trainee experience. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Problems in the Application of Behavior Modification Principles for Teaching Job-Required Behaviors to Disadvantaged Manpower Trainees. Special Report.

ERIC Educational Resources Information Center

Feifer, Irwin; And Others

In its attempts to apply behavior modification principles to teaching job-required behaviors to manpower trainees, the Mobilization for Youth-Experimental Manpower Laboratory (MFY-EML), has mounted a number of reinforcement-based Neighborhood Youth Corps training programs. The nature, magnitude and scheduling of reinforcers, the nature of the…

34 CFR 350.65 - What level of participation is required of trainees in an Advanced Rehabilitation Research...

Code of Federal Regulations, 2010 CFR

2010-07-01

... an Advanced Rehabilitation Research Training Project? 350.65 Section 350.65 Education Regulations of... SERVICES, DEPARTMENT OF EDUCATION DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Conditions Must Be Met After an Award? § 350.65 What level of participation is required of trainees in an...

CUSUM method for construction of trainee spinal ultrasound learning curves following standardised teaching.

PubMed

Deacon, A J; Melhuishi, N S; Terblanche, N C S

2014-07-01

Spinal ultrasonography is a promising aid for epidural insertion. We aimed to determine the learning curve of spinal ultrasonography tasks and the number of training scans required to reach competency after undergoing standardised step-wise teaching. Trainees were required to complete a minimum of 60 assessed scans on selected non-pregnant models following attendance at two training sessions, with feedback from an expert after each scan. Learning curves were plotted using the non-risk cumulative summation technique and an acceptable failure rate of 20%. Five trainees completed between 65 and 75 scans each. All trainees were competent at identifying a randomly assigned intervertebral space after a median of five scans (range one to nine) and at measuring the depth from skin to the posterior complex after a median of 10 scans (range 1 to 42). Two trainees were competent at marking an ideal needle insertion point after 55 scans, while three trainees did not attain competency. All trainees were competent after 60 scans if the tolerance was changed from five to eight millimetre for marking the needle insertion point. The average time taken to complete a scan was 163 seconds. Our study showed that after a standardised educational intervention, anaesthetic trainees are able to identify a lumbar interlaminar space easily and can measure the depth to the posterior complex after a reasonable number of additional practice scans, but experienced difficulty accurately marking the needle insertion point whilst using spinal ultrasonography. We confirmed that it was hard to achieve competency in all aspects of spinal ultrasonography, based on assessment using our predefined competency criteria.

The Role of Ultrasound Simulation in Obstetrics and Gynecology Training: A UK Trainees' Perspective.

PubMed

Patel, Hersha; Chandrasekaran, Dhivya; Myriokefalitaki, Eva; Gebeh, Alpha; Jones, Kate; Jeve, Yadava B

2016-10-01

Ultrasonography is a core skill required by all obstetrics and gynecology trainees; however, training opportunities in clinical ultrasound are declining. Simulation ultrasound training has been proposed as a strategy to overcome this.The study aims were to determine the current availability of clinical and simulation ultrasound training in obstetrics and gynecology in the United Kingdom and to explore the trainees' perspective on the role of ultrasound simulation. All obstetrics and gynecology trainees within the East Midlands Local Education Training Board in the United Kingdom were asked to complete an anonymous web-based survey in July 2014. Of 140 trainees, 70 (50%) responded to the survey, and 69% reported rarely having dedicated clinical ultrasound sessions. Fifty percent had failed to achieve ultrasound competencies required for their stage of training, and 83% felt that the pressures of service provision limited their exposure to clinical ultrasound.Seventy-three percent of the trainees considered ultrasound simulation to be an essential component of training, and 69% agreed that it would help improve their clinical skills. Only 50% had access to an ultrasound simulator. Seventy-seven percent of the trainees thought that it would be useful to have ultrasound simulation integrated into training. Trainees are struggling to achieve minimal ultrasound competences with clinical ultrasound training alone. They believe that ultrasound simulation will shorten the learning curve and improve their clinical skills and knowledge. Despite the cost implications of simulation training, we propose that consideration is given to formal integration of ultrasound simulation into the curriculum as a possible way forward.

Face, content, and construct validity of a novel portable ergonomic simulator for basic laparoscopic skills.

PubMed

Xiao, Dongjuan; Jakimowicz, Jack J; Albayrak, Armagan; Buzink, Sonja N; Botden, Sanne M B I; Goossens, Richard H M

2014-01-01

Laparoscopic skills can be improved effectively through laparoscopic simulation. The purpose of this study was to verify the face and content validity of a new portable Ergonomic Laparoscopic Skills simulator (Ergo-Lap simulator) and assess the construct validity of the Ergo-Lap simulator in 4 basic skills tasks. Four tasks were evaluated: 2 different translocation exercises (a basic bimanual exercise and a challenging single-handed exercise), an exercise involving tissue manipulation under tension, and a needle-handling exercise. Task performance was analyzed according to speed and accuracy. The participants rated the usability and didactic value of each task and the Ergo-Lap simulator along a 5-point Likert scale. Institutional academic medical center with its affiliated general surgery residency. Forty-six participants were allotted into 2 groups: a Novice group (n = 26, <10 clinical laparoscopic procedures) and an Experienced group (n = 20, >50 clinical laparoscopic procedures). The Experienced group completed all tasks in less time than the Novice group did (p < 0.001, Mann-Whitney U test). The Experienced group also completed tasks 1, 2, and 4 with fewer errors than the Novice group did (p < 0.05). Of the Novice participants, 96% considered that the present Ergo-Lap simulator could encourage more frequent practice of laparoscopic skills. In addition, 92% would like to purchase this simulator. All of the experienced participants confirmed that the Ergo-Lap simulator was easy to use and useful for practicing basic laparoscopic skills in an ergonomic manner. Most (95%) of these respondents would recommend this simulator to other surgical trainees. This Ergo-Lap simulator with multiple tasks was rated as a useful training tool that can distinguish between various levels of laparoscopic expertise. The Ergo-Lap simulator is also an inexpensive alternative, which surgical trainees could use to update their skills in the skills laboratory, at home, or in the office. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Measuring the development of insight by dental health professionals in training using workplace-based assessment.

PubMed

Prescott-Clements, L E; van der Vleuten, C P M; Schuwirth, L; Gibb, E; Hurst, Y; Rennie, J S

2011-08-01

For health professionals, the development of insight into their performance is vital for safe practice, professional development and self-regulation. This study investigates whether the development of dental trainees' insight, when provided with external feedback on performance, can be assessed using a single criterion on a simple global ratings form such as the Longitudinal Evaluation of Performance or Mini Clinical Evaluation Exercise. Postgraduate dental trainees (N = 139) were assessed using this tool on a weekly basis for 6 months. Regression analysis of the data was carried out using SPSS, and a short trainer questionnaire was implemented to investigate feasibility. Ratings for insight were shown to increase with time in a similar manner to the growth observed in other essential skills. The gradient of the slope for growth of insight was slightly less than that of the other observed skills. Trainers were mostly positive about the new criterion assessing trainees' insight, although the importance of training for trainers in this process was highlighted. Our data suggest that practitioners' insight into their performance can be developed with experience and regular feedback. However, this is most likely a complex skill dependent on a number of intrinsic and external factors. The development of trainees' insight into their performance can be assessed using a single criterion on a simple global ratings form. The process involves no additional burden on evaluators in terms of their time or cost, and promotes best practice in the provision of feedback for trainees. © 2011 John Wiley & Sons A/S.

[Work ability among workers from a condominiun of high technology companies].

PubMed

Fernandes, Angela Cristina Puzzi; Monteiro, Maria Inês

2006-01-01

Remarkable transformation occurred in the last two decades on the industrial sector, such as the use of trainees and outsourced labor. In a epidemiological cross-sectional study 190 workers, aimed at assessing work ability and building up a socio-demographic life styles of workers, outsourced workers and trainees, who work at a corporate condominium comprising high technology companies. The Work Ability Index was employed with a questionnaire concerning lifestyle and demographic data. Gender balance was noticed, with a prevalence of youngsters and single people (63.2%). Few were tobacco smokers (13.2%), 62.6% performed physical exercise. In addition, 44.2% were medically diagnosed with some illness. This study is very important due to their interchangeability and to the general lack of a worker's health service.

The public health leadership certificate: a public health and primary care interprofessional training opportunity.

PubMed

Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

2014-03-01

This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

The effectiveness of incorporating a real-time oculometer system in a commercial flight training program

NASA Technical Reports Server (NTRS)

Jones, D. H.; Coates, G. D.; Kirby, R. H.

1982-01-01

The effectiveness on pilot and trainee performance and scanning behavior of incorporating a real time oculometer system in a commerical flight training program was assessed. Trainees received simulator training in pairs requiring the trainees to alternate the order of training within a session. The 'third day phenomenon' of performance decrement was investigated, including the role of order of training on performance.

A BEME (Best Evidence in Medical Education) review of the use of workplace-based assessment in identifying and remediating underperformance among postgraduate medical trainees: BEME Guide No. 43.

PubMed

Barrett, Aileen; Galvin, Rose; Steinert, Yvonne; Scherpbier, Albert; O'Shaughnessy, Ann; Horgan, Mary; Horsley, Tanya

2016-12-01

The extent to which workplace-based assessment (WBA) can be used as a facilitator of change among trainee doctors has not been established; this is particularly important in the case of underperforming trainees. The aim of this review is to examine the use of WBA in identifying and remediating performance among this cohort. Following publication of a review protocol a comprehensive search of eight databases took place to identify relevant articles published prior to November 2015. All screening, data extraction and analysis procedures were performed in duplicate or with quality checks and necessary consensus methods throughout. Given the study-level heterogeneity, a descriptive synthesis approach informed the study analysis. Twenty studies met the inclusion criteria. The use of WBA within the context of remediation is not supported within the existing literature. The identification of underperformance is not supported by the use of stand-alone, single-assessor WBA events although specific areas of underperformance may be identified. Multisource feedback (MSF) tools may facilitate identification of underperformance. The extent to which WBA can be used to detect and manage underperformance in postgraduate trainees is unclear although evidence to date suggests that multirater assessments (i.e. MSF) may be of more use than single-rater judgments (e.g. mini-clinical evaluation exercise).

State of Adult Trainee Inflammatory Bowel Disease Education in the United States: A National Survey.

PubMed

Cohen, Benjamin L; Ha, Christina; Ananthakrishnan, Ashwin N; Rieder, Florian; Bewtra, Meenakshi

2016-07-01

The fundamentals of inflammatory bowel disease (IBD) education begin during gastroenterology fellowship training. We performed a survey of gastroenterology fellowship program directors (PDs) and trainees with the aim to further examine the current state of IBD training in the United States. A 15-question PD survey and 19-question trainee survey was performed using an online platform. Surveys were completed by 43/161 (27%) PDs and 160 trainees. All trainee years were equally represented. A significant proportion of trainees was unsure or believed that their inpatient (32%) or outpatient (43%) training was inadequate. Only 28% of trainees were satisfied with their current level of IBD exposure during training. Fewer than half the trainees reported comfort in the management of pouch or stoma issues, pregnant patients with IBD, or postoperative management. The proportion of PDs viewing a competency as essential for trainee education strongly correlated with trainee comfort in that area (Pearson's rho = 0.793; P < 0.01). In multivariate logistic regression, monthly IBD didactics was the only variable independently associated with satisfaction with the current level of training (odds ratio, 4.1 95% CI, 1.9-9.0). Over one-third of participating gastroenterology trainees did not feel "confident" or "mostly comfortable" with their level of IBD training, with varying comfort regarding different competencies in IBD management. These findings suggest that specific areas of IBD training may require additional focus during training and can provide the basis for the development of an IBD core competency curriculum.

48 CFR 22.406-4 - Apprentices and trainees.

Code of Federal Regulations, 2011 CFR

2011-10-01

... contractor's employment and payment records of apprentices and trainees made available pursuant to the clause... reject the classification and require the contractor to pay the affected employees at the rates applicable to the classification of the work actually performed. ...

48 CFR 22.406-4 - Apprentices and trainees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... contractor's employment and payment records of apprentices and trainees made available pursuant to the clause... reject the classification and require the contractor to pay the affected employees at the rates applicable to the classification of the work actually performed. ...

Future career intentions of higher specialist trainees in general Paediatrics.

PubMed

Butler, Grainne; Breatnach, Colm; Harty, Sinead; Gavin, Patrick; O'Donnell, Colm; O'Grady, Michael J

2018-03-27

A survey of paediatric higher specialist trainees was carried out in 2002 assessing career intentions and perception of training. Fourteen years later, with increased numbers of trainees and a national model of care and a tertiary paediatric hospital on the horizon, we re-evaluated the career intentions of the current trainee workforce. To assess the career intentions of the current paediatric higher specialist trainees. A 28-item questionnaire was developed based on a previously validated instrument and distributed online using the Royal College of Physicians of Ireland trainee database. We distributed the questionnaire to 118 eligible trainees and received responses from 92 (78%). Seventy-nine (86%) respondents desire a consultant post in Ireland. Seventy-five (82%) indicated that their preferred consultant post location was in a tertiary paediatric centre. Sixty-two trainees (67%) intend to become subspecialists with 25 (27%) planning a career in general paediatrics. This contrasts with the 2002 survey when 76% wished to work in urban centres and 61% of trainees planned a career in general paediatrics. There appears to be a mismatch between the career goals of the future paediatric consultant workforce and the requirements for staffing paediatric units nationally. This has the potential to complicate the proposed expansion of general paediatricians in regional centres and result in a significant proportion of current trainees failing to secure a post in their desired location.

Supporting assistant practitioners during their training.

PubMed

Ripley, Kenneth; Hoad, Bridget

2016-07-27

Assistant practitioners, also known as associate practitioners, provide support to the registered healthcare workforce, practising with advanced knowledge and skills. Assistant practitioners require substantial training to obtain the skills and knowledge required for the role. This article identifies the challenges trainee assistant practitioners may encounter, and makes recommendations for how they can be best supported. The core areas where trainee assistant practitioners require support from their colleagues and mentors are workload, role clarity, mentoring, academic challenge and recognition as learners.

Trainee-Associated Factors and Proficiency at Percutaneous Nephrolithotomy.

PubMed

Aghamir, Seyed Mohammad Kazem; Behtash, Negar; Hamidi, Morteza; Farahmand, Hasan; Salavati, Alborz; Mortaz Hejri, Sara

2017-07-01

Percutaneous nephrolithotomy (PNL) is a complicated procedure for urology trainees. This study was designed to investigate the effect of trainees' ages and previous experience, as well as the number of operated cases, on proficiency at PNL by using patient outcomes. A cross sectional observational study was designed during a five-year period. Trainees in PNL fellowship programs were included. At the end of the program, the trainees' performance in PNL was assessed regarding five competencies and scored 1-5. If the overall score was 4 or above, the trainee was considered as proficient. The trainees' age at the beginning of the program and the years passed from their residency graduation were asked and recorded. Also, the number of PNL cases operated by each trainee was obtained via their logbooks. The age, years passed from graduation, and number of operated cases were compared between two groups of proficient and non-proficient trainees. Univariate and multivariate binary logistic regression analysis was applied to estimate the effect of aforementioned variables on the occurrence of the proficiency. Forty-two trainees were included in the study. The mean and standard deviation for the overall score were 3.40 (out of 5) and 0.67, respectively. Eleven trainees (26.2%) recognized as proficient in performing PNL. Univariate regression analysis indicated that each of three variables (age, years passed from graduation and number of operated cases) had statistically significant effect on proficiency. However, the multivariate regression analysis revealed that just the number of cases had significant effect on achieving proficiency. Although it might be assumed that trainees' age negatively correlates with their scores, in fact, it is their amount of practice that makes a difference. A certain number of cases is required to be operated by a trainee in order to reach the desired competency in PNL.

Designing and implementing a resiliency program for family medicine residents.

PubMed

Brennan, Julie; McGrady, Angele

2015-01-01

Family medicine residents are at risk for burnout due to extended work hours, lack of control over their work schedule, and challenging work situations and environments. Building resiliency can prevent burnout and may improve a resident's quality of life and health behavior. This report describes a program designed to build resiliency, the ability to bounce back from stress, in family medicine residents in a medium sized U.S. residency training program. Interactive sessions emphasized building self-awareness, coping skills, strengths and meaning in work, time management, self-care, and connections in and outside of medicine to support resident well-being. System changes which fostered wellness were also implemented. These changes included increasing the availability of fresh fruits in the conference and call room, purchasing an elliptical exercise machine for the on call room, and offering a few minutes of mindfulness meditation daily to the inpatient residents. Results to date show excellent acceptance of the program by trainees, increased consumption of nutritious foods, more personal exercise, and self-reported decreased overreactions to stress. Resiliency programs can effectively serve to meet accreditation requirements while fostering residents' abilities to balance personal and professional demands. © The Author(s) 2015.

Comprehensive proficiency-based inanimate training for robotic surgery: reliability, feasibility, and educational benefit.

PubMed

Arain, Nabeel A; Dulan, Genevieve; Hogg, Deborah C; Rege, Robert V; Powers, Cathryn E; Tesfay, Seifu T; Hynan, Linda S; Scott, Daniel J

2012-10-01

We previously developed a comprehensive proficiency-based robotic training curriculum demonstrating construct, content, and face validity. This study aimed to assess reliability, feasibility, and educational benefit associated with curricular implementation. Over an 11-month period, 55 residents, fellows, and faculty (robotic novices) from general surgery, urology, and gynecology were enrolled in a 2-month curriculum: online didactics, half-day hands-on tutorial, and self-practice using nine inanimate exercises. Each trainee completed a questionnaire and performed a single proctored repetition of each task before (pretest) and after (post-test) training. Tasks were scored for time and errors using modified FLS metrics. For inter-rater reliability (IRR), three trainees were scored by two raters and analyzed using intraclass correlation coefficients (ICC). Data from eight experts were analyzed using ICC and Cronbach's α to determine test-retest reliability and internal consistency, respectively. Educational benefit was assessed by comparing baseline (pretest) and final (post-test) trainee performance; comparisons used Wilcoxon signed-rank test. Of the 55 trainees that pretested, 53 (96 %) completed all curricular components in 9-17 h and reached proficiency after completing an average of 72 ± 28 repetitions over 5 ± 1 h. Trainees indicated minimal prior robotic experience and "poor comfort" with robotic skills at baseline (1.8 ± 0.9) compared to final testing (3.1 ± 0.8, p < 0.001). IRR data for the composite score revealed an ICC of 0.96 (p < 0.001). Test-retest reliability was 0.91 (p < 0.001) and internal consistency was 0.81. Performance improved significantly after training for all nine tasks and according to composite scores (548 ± 176 vs. 914 ± 81, p < 0.001), demonstrating educational benefit. This curriculum is associated with high reliability measures, demonstrated feasibility for a large cohort of trainees, and yielded significant educational benefit. Further studies and adoption of this curriculum are encouraged.

Workplace based assessment: a step to promote competency based postgraduate training.

PubMed

Singh, Tejinder; Modi, Jyoti Nath

2013-06-08

There has been an increasing emphasis on defining outcomes of medical education in terms of performance of trainees. This is a step beyond the description of outcomes in terms of competence that encompasses mostly potential abilities rather than the actual performance. The contextual adaptations and behavior judgments of the trainees are best assessed by a program of in-training assessment. Workplace based assessment (WPBA) is one of the modalities, which assesses the trainee in authentic settings. Though Postgraduate (PG) medical training in India is said to be competency-based, most institutions do not have any formative or in-training assessment program for the same. The two cardinal elements of WPBA are direct observation and conducted in work place in addition to provision of feedback to the trainee. The WPBA conforms to the highest (Level 4: Does) of Millers pyramid and also has the potential to assess at all four levels. Some of the tools used for WPBA are: Logbooks, Clinical Encounter Cards (CEC), mini-Clinical Evaluation Exercise (mini-CEX), Case based discussions, Direct Observation of Procedural Skills (DOPS), Multisource feedback (peers, co-workers, seniors, patients) etc. These can be documented in the form of a portfolio that provides a longitudinal view of experiences and progress of the trainee. The WPBA scores high on validity and educational impact by virtue of being based on direct observation in real situation and contextual feedback. The feasibility and acceptability is enhanced by making appropriate choices of tools, advance planning, building of mutual trust, and training of assessors. Given the established benefits of WPBA in shaping clinical learning, there is an imminent need for including this mode of assessment in our clinical training programs especially PG training.

Comparison of stress in anaesthetic trainees between Hong Kong and Victoria, Australia.

PubMed

Chia, A C L; Irwin, M G; Lee, P W H; Lee, T H W; Man, S E

2008-11-01

A postal survey was sent to anaesthetic trainees in Hong Kong and Victoria, Australia to compare work-related stress levels. Demographic data were collected. Anaesthetist-specific stressors, Maslach Burnout Inventory and Global Job Satisfaction scores were used for psychological testing. The response rates from Hong Kong and Melbourne were 64 of 133 (48.1%) and 108 of 196 (55.1%), respectively. Victorian respondents were older with greater family commitments, but more advanced in fulfilling training requirements. Hong Kong respondents, being faced with both the challenge of dual College requirements, exhibited consistently higher indices of stress (P < 0.001) and less job satisfaction (P < 0.001). Common occupational stressors related to dealing with critically ill patients and medicolegal concerns. Higher stress scores observed in Hong Kong trainees related to service provision and a perceived lack of resources. Despite the complex nature of stress, its antecedents and manifestations, an inverse relationship between emotional exhaustion and job satisfaction was evident in correlation analysis (P < 0.001). This survey suggests that stress was present in some trainees in both areas. Hong Kong trainees may benefit from local development to address mental wellbeing as being important to fulfil this highly competitive training program.

Use of VR Technology and Passive Haptics for MANPADS Training System

DTIC Science & Technology

2017-09-01

this setup also does not offer a variety of challenging scenarios needed for good training as the aircraft are mostly flying in landing or take-off... customized high-fidelity immersive training facilities are limited. Moreover, low trainee throughput from such high-end facilities is an ongoing obstacle...opportunities allow few operators to fire during live exercises. Simulation training is effective, but customized high-fidelity immersive training

Variation in Aptitude of Trainees in Endoscopic Ultrasonography, Based on Cumulative Sum Analysis

PubMed Central

Wani, Sachin; Hall, Matthew; Keswani, Rajesh N.; Aslanian, Harry R.; Casey, Brenna; Burbridge, Rebecca; Chak, Amitabh; Chen, Ann M.; Cote, Gregory; Edmundowicz, Steven A.; Faulx, Ashley L.; Hollander, Thomas G.; Lee, Linda S.; Mullady, Daniel; Murad, Faris; Muthusamy, Raman; Pfau, Patrick R.; Scheiman, James M.; Tokar, Jeffrey; Wagh, Mihir S.; Watson, Rabindra; Early, Dayna

2017-01-01

BACKGROUND & AIMS Studies have reported substantial variation in the competency of advanced endoscopy trainees, indicating a need for more supervised training in endoscopic ultrasound (EUS). We used a standardized, validated, data collection tool to evaluate learning curves and measure competency in EUS among trainees at multiple centers. METHODS In a prospective study performed at 15 centers, 17 trainees with no prior EUS experience were evaluated by experienced attending endosonographers at the 25th and then every 10th upper EUS examination, over a 12-month training period. A standardized data collection form was used (using a 5-point scoring system) to grade the EUS examination. Cumulative sum analysis was applied to produce a learning curve for each trainee; it tracked the overall performance based on median scores at different stations and also at each station. Competency was defined by a median score of 1, with acceptable and unacceptable failure rates of 10% and 20%, respectively. RESULTS Twelve trainees were included in the final analysis. Each of the trainees performed 265 to 540 EUS examinations (total, 4257 examinations). There was a large amount of variation in their learning curves: 2 trainees crossed the threshold for acceptable performance (at cases 225 and 245), 2 trainees had a trend toward acceptable performance (after 289 and 355 cases) but required continued observation, and 8 trainees needed additional training and observation. Similar results were observed at individual stations. CONCLUSIONS A specific case load does not ensure competency in EUS; 225 cases should be considered the minimum caseload for training because we found that no trainee achieved competency before this point. Ongoing training should be provided for trainees until competency is confirmed using objective measures. PMID:25460557

Variation in Aptitude of Trainees in Endoscopic Ultrasonography, Based on Cumulative Sum Analysis.

PubMed

Wani, Sachin; Hall, Matthew; Keswani, Rajesh N; Aslanian, Harry R; Casey, Brenna; Burbridge, Rebecca; Chak, Amitabh; Chen, Ann M; Cote, Gregory; Edmundowicz, Steven A; Faulx, Ashley L; Hollander, Thomas G; Lee, Linda S; Mullady, Daniel; Murad, Faris; Muthusamy, V Raman; Pfau, Patrick R; Scheiman, James M; Tokar, Jeffrey; Wagh, Mihir S; Watson, Rabindra; Early, Dayna

2015-07-01

Studies have reported substantial variation in the competency of advanced endoscopy trainees, indicating a need for more supervised training in endoscopic ultrasound (EUS). We used a standardized, validated, data collection tool to evaluate learning curves and measure competency in EUS among trainees at multiple centers. In a prospective study performed at 15 centers, 17 trainees with no prior EUS experience were evaluated by experienced attending endosonographers at the 25th and then every 10th upper EUS examination, over a 12-month training period. A standardized data collection form was used (using a 5-point scoring system) to grade the EUS examination. Cumulative sum analysis was applied to produce a learning curve for each trainee; it tracked the overall performance based on median scores at different stations and also at each station. Competency was defined by a median score of 1, with acceptable and unacceptable failure rates of 10% and 20%, respectively. Twelve trainees were included in the final analysis. Each of the trainees performed 265 to 540 EUS examinations (total, 4257 examinations). There was a large amount of variation in their learning curves: 2 trainees crossed the threshold for acceptable performance (at cases 225 and 245), 2 trainees had a trend toward acceptable performance (after 289 and 355 cases) but required continued observation, and 8 trainees needed additional training and observation. Similar results were observed at individual stations. A specific case load does not ensure competency in EUS; 225 cases should be considered the minimum caseload for training because we found that no trainee achieved competency before this point. Ongoing training should be provided for trainees until competency is confirmed using objective measures. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

State of Adult Trainee Inflammatory Bowel Disease Education in the United States: A National Survey

PubMed Central

Cohen, Benjamin L.; Ha, Christina; Ananthakrishnan, Ashwin N; Rieder, Florian; Bewtra, Meenakshi

2016-01-01

Introduction The fundamentals of inflammatory bowel disease (IBD) education begin during gastroenterology (GI) fellowship training. We performed a survey of GI fellowship program directors (PD) and trainees with the aim to further examine the current state of IBD training in the United States. Materials and Methods A 15-question PD survey and 19-question trainee survey was performed using an online platform. Results Surveys were completed by 43/161 (27%) PDs and 160 trainees. All trainee years were equally represented. A significant proportion of trainees was unsure or felt their inpatient (32%) or outpatient (43%) training was inadequate. Only 28% of trainees were satisfied with their current level of IBD exposure during training. Fewer than half the trainees reported comfort in the management of pouch or stoma issues, the pregnant IBD patient, or post-operative management. The proportion of PDs viewing a competency as essential for trainee education strongly correlated with trainee comfort in that area (Pearson’s rho = 0.793, p<0.01). In multivariate logistic regression, monthly IBD didactics was the only variable independently associated with satisfaction with current level of training (OR 4.1, 95% CI 1.9–9.0). Conclusions Over one-third of participating GI trainees did not feel “confident” or “mostly comfortable” with their level of IBD training, with varying comfort regarding different competencies in IBD management. These findings suggest that specific areas of IBD training may require additional focus during training and can provide the basis for the development of an IBD core competency curriculum. PMID:27306068

Postdoctoral training in clinical neuropsychology in America: how did we get here and where do recent applicants suggest we go next?

PubMed

Bodin, Doug; Butts, Alissa M; Grote, Christopher L

2016-11-01

The United States appears to be the only country which typically requires completion of a two-year postdoctoral fellowship for one to be considered competent to practice clinical neuropsychology. We review the history of how this came to be in the United States. Further, we describe obstacles that postdoctoral trainees face during this stage of training. We first describe the most significant events leading to the requirement of a two-year fellowship in clinical neuropsychology. Next, we describe factors that trainees face when selecting and completing postdoctoral training. Finally, we review the results of the most recent annual survey of applicants for postdoctoral training to measure their experiences. Postdoctoral training in the United States is a relatively recent requirement in neuropsychology. Trainees face many obstacles when obtaining a postdoctoral position some of which can be addressed by the field. Training in Clinical Neuropsychology in the United States has evolved considerably over at least the last 45 or so years to the point that a two-year postdoctoral fellowship is now required for one to be a candidate for board certification through the American Board of Clinical Neuropsychology. We review many of the challenges that postdoctoral trainees face and provide survey data to describe their experiences and preferences.

Value of trainees in a radiology department. A retrospective semi-quantitative analysis.

PubMed

Vardhanabhuti, V; Bhatnagar, G; Brown, S; James, J; Shuen, V; Sidhu, H; Thomas, R; Fox, B

2011-07-01

To examine the productivity (both economic and otherwise) of trainees within a radiology department at our institution. Productivity was measured in three ways: (1) independent workload contribution, (2) impact on on-call services, and (3) impact on day-to-day practice as perceived by consultant radiologists. Data were collected using retrospective searches on computerized radiology information system (CRIS), analysis of trainees and consultant rotas, and a questionnaire to consultants and trainees. Where possible, productivity was quantified in terms of number of programmed activities (PAs). The contribution of independent work by trainees in a single week was 52.75 PAs (or 1.45 PAs per trainee per week). In addition, the on-call contribution was 23.1 PAs per week (or 0.93 PAs per trainee per week). When both trainees and consultants report independently, productivity in a single list in most cases increased and can be as much as 197%. On calculating the economic impact, this amounts to significant savings of around £1.2million per year at our institution. Based upon objectively measurable areas of service provision, the employment of trainees yields considerable economic benefit. Furthermore, based upon qualitative methods we have shown that trainees contribute positively in those areas, which are much harder to quantifiably evaluate. These are benefits in addition to fundamental requirement to train future competent radiologists. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Brief Online Mindfulness Training: Immediate Impact.

PubMed

Kemper, Kathi J

2017-01-01

Online training is feasible, but the impact of brief mindfulness training on health professionals needs to be better understood. We analyzed data from health professionals and trainees who completed self-reflection exercises embedded in online mindfulness training between May 2014 and September, 2015; their changes in mindfulness were measured using standardized scales. Participants included nurses (34%), physicians (24%), social workers and psychologists (10%), dietitians (8%), and others (25%); 85% were women, and 20% were trainees. The most popular module was Introduction to Mindfulness (n = 161), followed by Mindfulness in Daily Life (n = 146), and Mindful Breathing and Walking (n = 129); most (68%) participants who took 1 module took all 3 modules. There were no differences in participation in any module by gender, trainee status, or profession. Completing modules was associated with small but significant improvements on the Cognitive and Affective Mindfulness Scale-Revised, the Mindful Attention Awareness Scale, and the Five Facet Mindfulness Questionnaire (P < 0.001 for all). Online training reaches diverse health professionals and is associated with immediate improvements in mindfulness. Additional research is warranted to compare the long-term cost-effectiveness of different doses of online and in-person mindfulness training on clinician burnout and quality of care. © The Author(s) 2016.

Brief Online Mindfulness Training

PubMed Central

Kemper, Kathi J.

2016-01-01

Background. Online training is feasible, but the impact of brief mindfulness training on health professionals needs to be better understood. Methods. We analyzed data from health professionals and trainees who completed self-reflection exercises embedded in online mindfulness training between May 2014 and September, 2015; their changes in mindfulness were measured using standardized scales. Results. Participants included nurses (34%), physicians (24%), social workers and psychologists (10%), dietitians (8%), and others (25%); 85% were women, and 20% were trainees. The most popular module was Introduction to Mindfulness (n = 161), followed by Mindfulness in Daily Life (n = 146), and Mindful Breathing and Walking (n = 129); most (68%) participants who took 1 module took all 3 modules. There were no differences in participation in any module by gender, trainee status, or profession. Completing modules was associated with small but significant improvements on the Cognitive and Affective Mindfulness Scale–Revised, the Mindful Attention Awareness Scale, and the Five Facet Mindfulness Questionnaire (P < 0.001 for all). Conclusion. Online training reaches diverse health professionals and is associated with immediate improvements in mindfulness. Additional research is warranted to compare the long-term cost-effectiveness of different doses of online and in-person mindfulness training on clinician burnout and quality of care. PMID:27002136

Compatibility of scientific research and specialty training in General Practice. A cross-sectional study

PubMed Central

Kötter, Thomas; Carmienke, Solveig; Herrmann, Wolfram J.

2014-01-01

Objective: In many departments of General Practice (GP) in Germany, young doctors who are trainees also work as researchers. Often these trainees work part time at the university and part time as a trainee in clinical practice. However, little is known about the situation of the actors involved. The aim of the study was to investigate the perspectives of GP trainees, heads of departments and GP trainers regarding the combination of research and GP training. Methods: We conducted a web-based survey with the heads of all German departments of General Practice, GP trainees who also conduct research and their GP trainers. The questionnaires consisted of open and closed questions. The results were analyzed using descriptive statistics and qualitative methods. Results: 28 heads of GP departments and 20 GP trainees responded. The trainees were mostly very satisfied with their situation as a trainee. However, the trainees considered the combination of research and GP training as difficult. The respondents name as problems the coordination of multiple jobs and the lack of credibility given to research in General Practice. They name as solutions research-enabling training programs and uniform requirements in training regarding research. Conclusion: The combination of GP training and scientific research activity is perceived as difficult. However, well-organized and designed programs can improve the quality of the combination. PMID:25228933

29 CFR 553.214 - Trainees.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., constitutes engagement in activities under section 7(k) only when the employee meets all the applicable tests... FAIR LABOR STANDARDS ACT TO EMPLOYEES OF STATE AND LOCAL GOVERNMENTS Fire Protection and Law Enforcement Employees of Public Agencies Exemption Requirements § 553.214 Trainees. The attendance at a bona...

29 CFR 553.214 - Trainees.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., constitutes engagement in activities under section 7(k) only when the employee meets all the applicable tests... FAIR LABOR STANDARDS ACT TO EMPLOYEES OF STATE AND LOCAL GOVERNMENTS Fire Protection and Law Enforcement Employees of Public Agencies Exemption Requirements § 553.214 Trainees. The attendance at a bona...

A Review & Critique of Trainee-Oriented Training Programs.

ERIC Educational Resources Information Center

Klein-Konz, Ann; Todd-Mancillas, William R.

This paper reviews literature on trainee-oriented training programs, which assign to individual employees predominant responsibility for diagnosing organizational problems requiring changes in employees' behaviors. A Self-Change, Adaption, and Modification (SCAM) Model is developed. The literature support for the model is written in similar…

[A new age of mass casuality education? : The InSitu project: realistic training in virtual reality environments].

PubMed

Lorenz, D; Armbruster, W; Vogelgesang, C; Hoffmann, H; Pattar, A; Schmidt, D; Volk, T; Kubulus, D

2016-09-01

Chief emergency physicians are regarded as an important element in the care of the injured and sick following mass casualty accidents. Their education is very theoretical; practical content in contrast often falls short. Limitations are usually the very high costs of realistic (large-scale) exercises, poor reproducibility of the scenarios, and poor corresponding results. To substantially improve the educational level because of the complexity of mass casualty accidents, modified training concepts are required that teach the not only the theoretical but above all the practical skills considerably more intensively than at present. Modern training concepts should make it possible for the learner to realistically simulate decision processes. This article examines how interactive virtual environments are applicable for the education of emergency personnel and how they could be designed. Virtual simulation and training environments offer the possibility of simulating complex situations in an adequately realistic manner. The so-called virtual reality (VR) used in this context is an interface technology that enables free interaction in addition to a stereoscopic and spatial representation of virtual large-scale emergencies in a virtual environment. Variables in scenarios such as the weather, the number wounded, and the availability of resources, can be changed at any time. The trainees are able to practice the procedures in many virtual accident scenes and act them out repeatedly, thereby testing the different variants. With the aid of the "InSitu" project, it is possible to train in a virtual reality with realistically reproduced accident situations. These integrated, interactive training environments can depict very complex situations on a scale of 1:1. Because of the highly developed interactivity, the trainees can feel as if they are a direct part of the accident scene and therefore identify much more with the virtual world than is possible with desktop systems. Interactive, identifiable, and realistic training environments based on projector systems could in future enable a repetitive exercise with changes within a decision tree, in reproducibility, and within different occupational groups. With a hard- and software environment numerous accident situations can be depicted and practiced. The main expense is the creation of the virtual accident scenes. As the appropriate city models and other three-dimensional geographical data are already available, this expenditure is very low compared with the planning costs of a large-scale exercise.

24 CFR 585.313 - Labor standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Laborers and mechanics other than Youthbuild Trainees. (1) All laborers and mechanics (other than... such laborers and mechanics on assisted housing shall be subject to the provisions of the Contract Work... standards apply to laborers and mechanics other than Youthbuild trainees to the extent required by the other...

24 CFR 585.313 - Labor standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Laborers and mechanics other than Youthbuild Trainees. (1) All laborers and mechanics (other than... such laborers and mechanics on assisted housing shall be subject to the provisions of the Contract Work... standards apply to laborers and mechanics other than Youthbuild trainees to the extent required by the other...

24 CFR 585.313 - Labor standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Laborers and mechanics other than Youthbuild Trainees. (1) All laborers and mechanics (other than... such laborers and mechanics on assisted housing shall be subject to the provisions of the Contract Work... standards apply to laborers and mechanics other than Youthbuild trainees to the extent required by the other...

24 CFR 585.313 - Labor standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Laborers and mechanics other than Youthbuild Trainees. (1) All laborers and mechanics (other than... such laborers and mechanics on assisted housing shall be subject to the provisions of the Contract Work... standards apply to laborers and mechanics other than Youthbuild trainees to the extent required by the other...

The learning curve to achieve satisfactory completion rates in upper GI endoscopy: an analysis of a national training database.

PubMed

Ward, S T; Hancox, A; Mohammed, M A; Ismail, T; Griffiths, E A; Valori, R; Dunckley, P

2017-06-01

The aim of this study was to determine the number of OGDs (oesophago-gastro-duodenoscopies) trainees need to perform to acquire competency in terms of successful unassisted completion to the second part of the duodenum 95% of the time. OGD data were retrieved from the trainee e-portfolio developed by the Joint Advisory Group on GI Endoscopy (JAG) in the UK. All trainees were included unless they were known to have a baseline experience of >20 procedures or had submitted data for <20 procedures. The primary outcome measure was OGD completion, defined as passage of the endoscope to the second part of the duodenum without physical assistance. The number of OGDs required to achieve a 95% completion rate was calculated by the moving average method and learning curve cumulative summation (LC-Cusum) analysis. To determine which factors were independently associated with OGD completion, a mixed effects logistic regression model was constructed with OGD completion as the outcome variable. Data were analysed for 1255 trainees over 288 centres, representing 243 555 OGDs. By moving average method, trainees attained a 95% completion rate at 187 procedures. By LC-Cusum analysis, after 200 procedures, >90% trainees had attained a 95% completion rate. Total number of OGDs performed, trainee age and experience in lower GI endoscopy were factors independently associated with OGD completion. There are limited published data on the OGD learning curve. This is the largest study to date analysing the learning curve for competency acquisition. The JAG competency requirement for 200 procedures appears appropriate. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A casemix study of patients seen by a dermatology trainee in rural and urban outpatient settings.

PubMed

Tilakaratne, Dev; Warren, Lachlan; Menz, Jennifer

2016-02-01

For 8 years South Australian dermatologists have provided an outreach service to the Northern Territory (NT), including rural and remote areas. In 2012 and 2013, a trainee accompanied a dermatologist on these outreach visits. This is the first prospective study that documents the spectrum of dermatological diseases requiring outpatient specialist input in various settings in the NT, and also the first study to compare the clinical experience of one Australian dermatology trainee in urban and rural settings. Characteristics of patients managed primarily by the outreach dermatology registrar were recorded prospectively from February 2013 to July 2013. The data from the trainee's urban encounters were compared to that of the rural centres. The spectrum of conditions seen in these two settings was placed in the disease categories specified in the Australasian College of Dermatologists (ACD) curriculum. The Royal Adelaide Hospital outpatient experience provided greater exposure to skin neoplasms, lymphoproliferative and myeloproliferative disorders and non-infectious neutrophilic/eosinophilic disorders. The outreach sites provided greater exposure to infections, adnexal diseases and genodermatoses. Both urban and rural experiences provided a broad exposure to the disease categories outlined in the ACD curriculum. The spectrum of disease requiring specialist dermatology input varies between urban South Australia and rural NT. The inclusion of dermatology trainees in outreach visits broadens their clinical exposure. It is recommended that other dermatology service providers in Australia consider documenting clinical casemix comparisons to assess dermatology demand, outcomes and trainee exposure. © 2014 The Australasian College of Dermatologists.

The role of anatomy demonstrators: A surgical trainees' perspective.

PubMed

Smith, C F; Gami, B; Standfield, N; Davies, D C

2018-04-01

Core Surgical Trainees (CST) in the London (UK) Postgraduate School of Surgery receive clinical anatomy teaching in their first year of training, and, in their second year, give 30 sessions of anatomy teaching to medical and other students. This study set out to investigate the role of demonstrators from the perspective of the trainees. A focus group was convened to ascertain trainees' perspectives on demonstrating anatomy and to identify problems and improvement strategies to optimize their ability to enhance students' learning. A questionnaire was formulated and all second-year CST (n = 186-from two cohorts) in the London Postgraduate School of Surgery were invited. A total of 109 out of 186 trainees completed the questionnaire. A high percentage (98%) of trainees that completed the questionnaire responded that demonstrating was an invaluable part of their training. Sixty-two per cent responded that anatomy teaching they received in their first year of core surgical training helped them in their teaching role and 80% responded that it helped them prepare for surgical training. The study also revealed the need for improved communication between trainees and the London Postgraduate School of Surgery/Medical Schools/National Health Service Trusts to address issues such as trainees' perceived difficulty in fulfilling their teaching session requirement. The stakeholders have acknowledged and addressed the outcomes to improve the experience for both surgical trainees and students. The results indicate that anatomy demonstrating delivers important benefits to early surgical trainees, in addition to those received by the students that they teach. Clin. Anat. 31:409-416, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Local Anaesthetic Inguinal Hernia Repair Performed Under Supervision: Early and Long-Term Outcomes

PubMed Central

Sanjay, P; Woodward, A

2009-01-01

INTRODUCTION Local anaesthetic inguinal hernia repair may be technically demanding. There are minimal data regarding the outcomes of local anaesthetic hernia repair by trainees in comparison with consultants. PATIENTS AND METHODS All consecutive local anaesthetic repairs performed by trainees and one consultant over a 9-year period were reviewed. Operation time, volume of local anaesthetic used, early and long-term complications were assessed. A postal survey was conducted to assess chronic groin pain and satisfaction rates. RESULTS A total of 369 repairs were reviewed of which 265 repairs were performed by the consultant and 104 by trainees. The male-to-female ratio was 25:1 and the median age of the study group was 61 years (range, 18–93 years). The volume of local anaesthetic used was significantly higher for trainees than the consultant (42 ml versus 69 ml; P = 0.03). The operative time for the consultant and the trainees was 35 min and 40 min (P = 0.8). The day-case rate was higher for the consultant than the trainees (84% versus 69%; P = 0.02). Three patients operated by trainees required conversion to a general anaesthetic repair. No difference was noted in chronic groin pain (consultant 28% versus trainees 32%; P = 0.52) on the postal survey. The median follow-up was 5 years (range, 2–7 years). CONCLUSIONS Local anaesthetic inguinal hernia repair can be performed safely by surgical trainees under consultant supervision with minimal short- and long-term morbidity. A large volume dilute solution of Lignocaine and Marcaine is recommended when hernia repair is undertaken by trainees. PMID:19785942

Understanding Faculty and Trainee Needs Related to Scholarly Activity in a Large, Nonuniversity Graduate Medical Education Program.

PubMed

Becker, Davida; Garth, Hanna; Hollander, Rachel; Klein, Felice; Klau, Marc

2017-01-01

Graduate medical education (GME) programs must develop curriculum to ensure scholarly activity among trainees and faculty to meet accreditation requirements and to support evidence-based medicine. Test whether research-related needs and interests varied across four groups: primary care trainees, specialty trainees, primary care faculty, and specialty faculty. We surveyed a random sample of trainees and faculty in Kaiser Permanente Southern California's GME programs. We investigated group differences in outcomes using Fisher exact and Kruskal-Wallis tests. Research experiences, skills, barriers, motivators, and interests in specific research skills development. Participants included 47 trainees and 26 faculty (response rate = 30%). Among primary care faculty, 12 (71%) reported little or no research experience vs 1 (11%) for specialty faculty, 14 (41%) for primary care trainees, and 1 (8%) for specialty trainees (p < 0.001). Submission of research to the institutional review board, an abstract to a conference, or a manuscript for publication in the previous year varied across groups (p = 0.001, p = 0.003, and p < 0.001, respectively). Overall self-reported research skills also differed across groups (p < 0.001). Primary care faculty reported the lowest skill level. Research barriers that differed across groups included other work roles taking priority; desire for work-life balance; and lack of managerial support, research equipment, administrative support, and funding. Faculty and trainees in primary care and specialties have differing research-related needs that GME programs should consider when designing curricula to support scholarly activity. Developing research skills of primary care faculty is a priority to support trainees' scholarly activity.

The combined use of Skype and the STORZ CMAC video laryngoscope in field intubation training with the Nebraska National Air Guard.

PubMed

Boedeker, Ben H; Bernhagen, Mary; Miller, David J; Miljkovic, Nikola; Kuper, Gail M; Murray, W Bosseau

2011-01-01

This study examined the feasibility of using Skype technology in basic manikin intubation instruction of Nebraska National Air Guard personnel at a Casualty Training Exercise. Results show that the Skype monitor provided clear sound and visualization of the airway view to the trainees and the combination of VoIP technology and videolaryngoscopy for intubation training was highly valued by study participants.

Nutritional Determination of Bone Health: A Survey of Australian Defence Force (ADF) Trainees

DTIC Science & Technology

2005-07-01

aims to determine the prevalence of key risk factors, including diet, exercise, bone turn-over, bone mineral density and anthropometry , and to relate...incorporated in bone matrix during bone formation. The ratio of undercarboxylated osteocalcin (a protein with low biological activity) to total...serves returned to DSTO- Scottsdale. 2.3 Data Manipulation A ratio of energy intake (EI) to Basal Metabolic Rate (BMR) of 0.9 represents the

Nutritional Determinants of Bone Health: A Survey of Australian Defence Force (ADF) Trainees

DTIC Science & Technology

2005-07-01

aims to determine the prevalence of key risk factors, including diet, exercise, bone turn-over, bone mineral density and anthropometry , and to relate...incorporated in bone matrix during bone formation. The ratio of undercarboxylated osteocalcin (a protein with low biological activity) to total...serves returned to DSTO- Scottsdale. 2.3 Data Manipulation A ratio of energy intake (EI) to Basal Metabolic Rate (BMR) of 0.9 represents the

Computer-Aided Design and 3-Dimensional Printing for Costal Cartilage Simulation of Airway Graft Carving.

PubMed

Ha, Jennifer F; Morrison, Robert J; Green, Glenn E; Zopf, David A

2017-06-01

Autologous cartilage grafting during open airway reconstruction is a complex skill instrumental to the success of the operation. Most trainees lack adequate opportunities to develop proficiency in this skill. We hypothesized that 3-dimensional (3D) printing and computer-aided design can be used to create a high-fidelity simulator for developing skills carving costal cartilage grafts for airway reconstruction. The rapid manufacturing and low cost of the simulator allow deployment in locations lacking expert instructors or cadaveric dissection, such as medical missions and Third World countries. In this blinded, prospective observational study, resident trainees completed a physical simulator exercise using a 3D-printed costal cartilage grafting tool. Participant assessment was performed using a Likert scale questionnaire, and airway grafts were assessed by a blinded expert surgeon. Most participants found this to be a very relevant training tool and highly rated the level of realism of the simulation tool.

Study on the feasibility of provision of distance learning programmes in surgery to Malawi.

PubMed

Mains, Edward A A; Blackmur, James P; Dewhurst, David; Ward, Ross M; Garden, O James; Wigmore, Stephen J

2011-12-01

Medical educational opportunities and resources are considerably limited in the developing world. The expansion of computing and Internet access means that there exists a potential to provide education to students through distance learning programmes. This study investigated the feasibility of providing distance learning course in surgery in Malawi. The study investigated the user requirements, technical requirements and Internet connections in two teaching hospitals in Malawi. In addition the appropriateness of current course material from the Edinburgh Surgical Sciences Qualification to Malawi trainees was assessed. The study found a high degree of interest from Malawian trainees in distance learning. The provision of basic science modules such as anatomy and physiology and the ability to access journals were considered highly desirable. The current ESSQ course would require extensive re-modelling to make it suitable to an African trainee's requirements. Internet speeds remain slow and access is currently expensive. There is considerable interest in distance learning programmes in Malawi but access to them is limited partly because of slow and expensive Internet access. Understanding the needs of trainees in countries such as Malawi will allow better direction of educational aid and resources to support surgical training. Copyright © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Teaching Psychiatric Trainees to Respond to Sexual and Loving Feelings: The Supervisory Challenge

PubMed Central

Bridges, Nancy A.

1998-01-01

The intimate nature of the psychodynamic psychotherapy process requires that trainees be educated to deal competently with sexual and loving feelings that arise during psychotherapy. The absence of substantive teaching on these complex treatment issues places a responsibility on the psychotherapy supervisor to educate trainees about the erotic aspects of transference/countertransference. A model of supervision addressing sexual feelings in treatment relationships is proposed and discussed with reference to clinical vignettes.(The Journal of Psychotherapy Practice and Research 1998; 7:217–226) PMID:9631343

Mentoring in Clinical-Translational Research: A Study of Participants in Master's Degree Programs.

PubMed

McGinn, Aileen P; Lee, Linda S; Baez, Adriana; Zwanziger, Jack; Anderson, Karl E; Seely, Ellen W; Schoenbaum, Ellie

2015-12-01

Research projects in translational science are increasingly complex and require interdisciplinary collaborations. In the context of training translational researchers, this suggests that multiple mentors may be needed in different content areas. This study explored mentoring structure as it relates to perceived mentoring effectiveness and other characteristics of master's-level trainees in clinical-translational research training programs. A cross-sectional online survey of recent graduates of clinical research master's program was conducted. Of 73 surveys distributed, 56.2% (n = 41) complete responses were analyzed. Trainees were overwhelmingly positive about participation in their master's programs and the impact it had on their professional development. Overall the majority (≥75%) of trainees perceived they had effective mentoring in terms of developing skills needed for conducting clinical-translational research. Fewer trainees perceived effective mentoring in career development and work-life balance. In all 15 areas of mentoring effectiveness assessed, higher rates of perceived mentor effectiveness was seen among trainees with ≥2 mentors compared to those with solo mentoring (SM). In addition, trainees with ≥2 mentors perceived having effective mentoring in more mentoring aspects (median: 14.0; IQR: 12.0-15.0) than trainees with SM (median: 10.5; IQR: 8.0-14.5). Results from this survey suggest having ≥2 mentors may be beneficial in fulfilling trainee expectations for mentoring in clinical-translational training. © 2015 Wiley Periodicals, Inc.

Simulation in Urology to Train Non-Technical Skills in Ward Rounds.

PubMed

Somasundram, K; Spence, H; Colquhoun, A J; Mcilhenny, C; Biyani, C S; Jain, S

2018-05-19

We have designed an exercise to train newly appointed Urology trainees in non-technical skills on ward rounds as a part of a simulation 'boot camp'. This paper reports our experience, including a qualitative analysis of participant feedback on the utility of this method of training. The simulations took place in a high-fidelity simulated ward bay. Forty-eight doctors with formal Urology training ranging between 2-60 months (mean 19.1 ± 11.6 months) took part. Thirty-one participants were on a formal Urology specialty training pathway. The remaining participants were core (pre-specialty) surgical trainees. The entry requirement was that participants must be junior-level urologists, ideally at the beginning of specialty training. Participants individually led a simulated ward round, which was devised using actors to play as patients and a simulated 'switchboard' for telephone conversations. Distractions were introduced deliberately for participants to manage an emergent urology-related scenario. 'Freeze-frames' were used to 'pause' the ward-round, whereby observing consultants provided feedback on performance. Following the simulated exercises, a whole-group structured debrief took place. Non-technical skills for surgeons (NOTSS) scores were generated for participants by seven consultant urologists. Participants completed a two-part feedback form. Part-one involved nine questions scored on a Likert scale, and part-two required free-text responses. The mean itemised NOTSS scores for situational awareness, decision-making, communication and teamwork and leadership were 3.01 (SD ± 0.15), 2.95 (SD ± 0.16), 3.05 (SD ± 0.19), 2.98 (SD ± 0.15), respectively. From the thematic analysis, participants commented positively on the number of scenarios per participant, the use of real patient-actors and staff, and the use of 'freeze-frames' for immediate feedback. Residents also provided suggestions for distractions to be considered in the future. This simulated ward round was generally well received by participants, and the obtained feedback provides an insight into how this can be adapted to maximise the benefits for new specialty residents. The mean NOTSS scores indicated that non-technical skills performances could be improved. This supports our rationale to train non-technical skills in a safe environment to bolster career transition into positions of greater decision-making autonomy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Female Representation in the Academic Oncology Physician Workforce: Radiation Oncology Losing Ground to Hematology Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahmed, Awad A.; Hwang, Wei-Ting; Holliday, Emma B.

Purpose: Our purpose was to assess comparative female representation trends for trainees and full-time faculty in the academic radiation oncology and hematology oncology workforce of the United States over 3 decades. Methods and Materials: Simple linear regression models with year as the independent variable were used to determine changes in female percentage representation per year and associated 95% confidence intervals for trainees and full-time faculty in each specialty. Results: Peak representation was 48.4% (801/1654) in 2013 for hematology oncology trainees, 39.0% (585/1499) in 2014 for hematology oncology full-time faculty, 34.8% (202/581) in 2007 for radiation oncology trainees, and 27.7% (439/1584) inmore » 2015 for radiation oncology full-time faculty. Representation significantly increased for trainees and full-time faculty in both specialties at approximately 1% per year for hematology oncology trainees and full-time faculty and 0.3% per year for radiation oncology trainees and full-time faculty. Compared with radiation oncology, the rates were 3.84 and 2.94 times greater for hematology oncology trainees and full-time faculty, respectively. Conclusion: Despite increased female trainee and full-time faculty representation over time in the academic oncology physician workforce, radiation oncology is lagging behind hematology oncology, with trainees declining in recent years in radiation oncology; this suggests a de facto ceiling in female representation. Whether such issues as delayed or insufficient exposure, inadequate mentorship, or specialty competitiveness disparately affect female representation in radiation oncology compared to hematology oncology are underexplored and require continued investigation to ensure that the future oncologic physician workforce reflects the diversity of the population it serves.« less

Female Representation in the Academic Oncology Physician Workforce: Radiation Oncology Losing Ground to Hematology Oncology.

PubMed

Ahmed, Awad A; Hwang, Wei-Ting; Holliday, Emma B; Chapman, Christina H; Jagsi, Reshma; Thomas, Charles R; Deville, Curtiland

2017-05-01

Our purpose was to assess comparative female representation trends for trainees and full-time faculty in the academic radiation oncology and hematology oncology workforce of the United States over 3 decades. Simple linear regression models with year as the independent variable were used to determine changes in female percentage representation per year and associated 95% confidence intervals for trainees and full-time faculty in each specialty. Peak representation was 48.4% (801/1654) in 2013 for hematology oncology trainees, 39.0% (585/1499) in 2014 for hematology oncology full-time faculty, 34.8% (202/581) in 2007 for radiation oncology trainees, and 27.7% (439/1584) in 2015 for radiation oncology full-time faculty. Representation significantly increased for trainees and full-time faculty in both specialties at approximately 1% per year for hematology oncology trainees and full-time faculty and 0.3% per year for radiation oncology trainees and full-time faculty. Compared with radiation oncology, the rates were 3.84 and 2.94 times greater for hematology oncology trainees and full-time faculty, respectively. Despite increased female trainee and full-time faculty representation over time in the academic oncology physician workforce, radiation oncology is lagging behind hematology oncology, with trainees declining in recent years in radiation oncology; this suggests a de facto ceiling in female representation. Whether such issues as delayed or insufficient exposure, inadequate mentorship, or specialty competitiveness disparately affect female representation in radiation oncology compared to hematology oncology are underexplored and require continued investigation to ensure that the future oncologic physician workforce reflects the diversity of the population it serves. Copyright © 2017 Elsevier Inc. All rights reserved.

Adjusting Language Level in Teacher-Talk in ELT Microteachings with Specific Reference to Distance Education Teacher

ERIC Educational Resources Information Center

Sarigoz, Iskender Hakki

2013-01-01

Foreign language teacher education requires microteaching practices carried out by teacher trainees for learning and assessment purposes. During microteachings, teacher trainees operate many teaching skills concurrently. Interlanguage compatible teacher-talk in the target language is essential for the production of student talk at elementary and…

Beliefs and Values about Intra-Operative Teaching and Learning: A Case Study of Surgical Teachers and Trainees

ERIC Educational Resources Information Center

Ong, Caroline C.; Dodds, Agnes; Nestel, Debra

2016-01-01

Surgeons require advanced psychomotor skills, critical decision-making and teamwork skills. Much of surgical skills training involve progressive trainee participation in supervised operations where case variability, operating team interaction and environment affect learning, while surgical teachers face the key challenge of ensuring patient…

Trainee Teachers in Unpaid Teaching Posts: Volunteering, Risk and Vulnerability

ERIC Educational Resources Information Center

Thompson, Ron; Russell, Lisa

2017-01-01

This paper explores the experiences and perceptions of a little-known category of in-service trainee teachers in the Further Education (FE) and Skills sector in England: those who meet the practical teaching requirements of their course mainly through unpaid teaching as "volunteers." The paper reports findings from mixed-methods research…

When should I attempt my centrally administered summative assessments in the RANZCP competency-based training program?

PubMed

Kealy-Bateman, Warren; Kotze, Beth; Lampe, Lisa

2016-12-01

To provide information relevant to decision-making around the timing of attempting the centrally administered summative assessments in the Royal Australian and New Zealand College of Psychiatrists (RANZCP) 2012 Fellowship Program. We consider the new Competency-Based Fellowship Program of the RANZCP and its underlying philosophy, the trainee trajectory within the program and the role of the supervisor. The relationship between workplace-based and external assessments is discussed. The timing of attempting centrally administered summative assessments is considered within the pedagogical framework of medical competencies development. Although successful completion of all the centrally administered summative assessments requires demonstration of a junior consultant standard of competency, the timing at which this standard will most commonly be achieved is likely to vary from assessment to assessment. There are disadvantages attendant upon prematurely attempting assessments, and trainees are advised to carefully consider the requirements of each assessment and match this against their current level of knowledge and skills. Trainees and supervisors need to be clear about the competencies required for each of the external assessments and match this against the trainee's current competencies to assist in decision-making about the timing of assessments and planning for future learning. © The Royal Australian and New Zealand College of Psychiatrists 2016.

The Influence of Trainee Gaming Experience and Computer Self-Efficacy on Learner Outcomes of Videogame-Based Learning Environments

DTIC Science & Technology

2005-06-01

videogame-based training environment. In this research, 413 participants played a first-person-perspective videogame that began with a single- player ...section to introduce game-specific tasks, followed by a multi- player section where participants formed small teams to conduct several collaborative...with over four million registered players . In Janurary 2004, America’s Army was used during a four-day inter-semester game- based training exercise at

Les traces du "recyclage" dans des cahiers d'eleves de Seine-et-Marne et des Hauts-de-Seine (Impact of Teachers' Inservice Training on the Work of Students from the Seine-et-Marne and the Hauts-de-Seine Districts).

ERIC Educational Resources Information Center

Aguttes, Pierrette; Le Goff, Josiane

1980-01-01

Reports the results of an investigation on institutes for elementary school teachers inservice training, based on questionnaires directed to the trainees and the educators, and on an analysis of students' work. Focuses on various aspects of French language teaching and especially on grammar and vocabulary exercises. (MES)

An Assessment of Surgical Experience among Obstetric and Gynaecology SpR Trainees.

PubMed

Gaughan, E; Barry, S; Boyd, W; Walsh, T A

2015-10-01

Changes in gynaecological practice have resulted in a significant reduction in surgical exposure for trainees. We have attempted to assess surgical experience among obstetric and gynaecology SpR's in Ireland using an anonymous on-line questionnaire. Trainees were asked to assess their own ability to perform a variety of general gynaecological procedures. There was a 97% response rate (29/33 trainees). There were 11 trainees who were in the final or penultimate year of the scheme. This group were analysed separately to assess competency rates in those approaching the end of the scheme. They were subdivided in to those who have completed one year in a general hospital doing pure gynaecology and those who have not. Approximately half of this group (6/11) had completed a pure gynaecology year. All of these trainees deemed themselves competent to perform all general gynaecological procedures listed, with the exception of trans-urethral tape procedures, for which 3/6 reported the requirement of direct supervision. Only 2/6 deemed themselves competent to perform a total laparoscopic hysterectomy. Year 4/5 trainees who had not completed a pure gynaecology year displayed significantly lower competency rates for most of the procedures. With the current changes in gynaecological practice, these results highlight the importance of dedicated gynaecological surgical training.

Neonatal resuscitation: a knowledge gap amongst obstetrical trainees. A cross-sectional survey amongst medical graduates of Civil Hospital Karachi.

PubMed

Noor, Tooba; Raza, Natasha; Haq, Gulfishan

2014-07-01

To evaluate the neonatal resuscitation competence of obstetrical trainees to assess the gap in knowledge and to determine training needs. The cross-sectional study was conducted at the Department of Gynaecology and Obstetrics, Civil Hospital, Karachi, from January to March 2013 and comprised House Officers and Postgraduate trainees. A questionnaire was used to test the evaluation skills of different conditions and choice of appropriate action required during neonatal resuscitation. Data was collected and analysed through SPSS 17.0. Of the 102 obstetrical trainees, 44 (43.1%) were House Officers and 58 (56.9%) were Postgraduate trainees with an overall mean age 25.69 +/- 2.3 years. Only 19 (18.6%) subjects cleared the test; 8 (42.1%) of them were House Officers and 11 (57.9%) were Postgraduate trainees. The result did not show any significant difference between those who had previous training or those who had performed neonatal resuscitation and those who had no such exposure. Majority, 92 (90.2%) considered their knowledge inadequate and 99 (97%) favoured that updated neonatal resuscitation programmes should be periodically arranged. The study showed inadequate level of knowledge on neonatal resuscitation amongst obstetrical trainees. There is urgent need of formal training programmes which can make doctors skilful enough to face any adverse neonatal outcome professionally.

Performance in the Duke–Elder ophthalmology undergraduate prize examination and future careers in ophthalmology

PubMed Central

Joshi, L; Shanmuganathan, V A; Kneebone, R L; Amoaku, W

2011-01-01

Aims Cognitive factors (eg, academic achievement) have had a significant role in selecting postgraduate surgical trainees in the past. This project sought to determine the role of a national undergraduate ophthalmology prize examination (Duke–Elder examination) in the selection of postgraduate ophthalmology trainees. This would also serve as a quality assurance exercise for the assessment, in which the ultimate aim is to encourage trainees into ophthalmology. Methods A retrospective analysis of the top 20 ranked candidates in the Duke–Elder examination from 1989 to 2005 (except 1995) was carried out to determine which of them subsequently entered the ophthalmic training and General Medical Council Specialist Registers. Results Out of the top 20 candidates in the exam, 29.5% went into specialist training in ophthalmology. Some appeared in the top 20 more than once, with 56% of them going into ophthalmic training, but they had a similar median time to enter training as those who appeared in the top 20 once. There was no significant evidence to suggest that the overall median ranking scores between the UK medical schools differed (P=0.23; Kruskal–Wallis test). However, there was a marked difference in frequency of top 20 candidates from each medical school, which could not be explained by the size of the medical school alone. Conclusion It is difficult to conclude from these findings the importance that the Duke–Elder examination has in the selection of trainees into ophthalmology. The role of cognitive factors in selection into postgraduate medical/surgical training is discussed, along with the potential academic criteria, which may influence interview scores. PMID:21587276

Promotion of Wellness and Mental Health Awareness Among Physicians in Training: Perspective of a National, Multispecialty Panel of Residents and Fellows.

PubMed

Daskivich, Timothy J; Jardine, Dinchen A; Tseng, Jennifer; Correa, Ricardo; Stagg, Brian C; Jacob, Kristin M; Harwood, Jared L

2015-03-01

Physicians in training are at high risk for depression, and physicians in practice have a substantially elevated risk of suicide compared to the general population. The graduate medical education community is currently mobilizing efforts to improve resident wellness. We sought to provide a trainee perspective on current resources to support resident wellness and resources that need to be developed to ensure an optimal learning environment. The ACGME Council of Review Committee Residents, a 29-member multispecialty group of residents and fellows, conducted an appreciative inquiry exercise to (1) identify existing resources to address resident wellness; (2) envision the ideal learning environment to promote wellness; and (3) determine how the existing infrastructure could be modified to approach the ideal. The information was aggregated to identify consensus themes from group discussion. National policy on resident wellness should (1) increase awareness of the stress of residency and destigmatize depression in trainees; (2) develop systems to identify and treat depression in trainees in a confidential way to reduce barriers to accessing help; (3) enhance mentoring by senior peers and faculty; (4) promote a supportive culture; and (5) encourage additional study of the problem to deepen our understanding of the issue. A multispecialty, national panel of trainees identified actionable goals to broaden efforts in programs and sponsoring institutions to promote resident wellness and mental health awareness. Engagement of all stakeholders within the graduate medical education community will be critical to developing a comprehensive solution to this important issue.

Promotion of Wellness and Mental Health Awareness Among Physicians in Training: Perspective of a National, Multispecialty Panel of Residents and Fellows

PubMed Central

Daskivich, Timothy J.; Jardine, Dinchen A.; Tseng, Jennifer; Correa, Ricardo; Stagg, Brian C.; Jacob, Kristin M.; Harwood, Jared L.

2015-01-01

Background Physicians in training are at high risk for depression, and physicians in practice have a substantially elevated risk of suicide compared to the general population. The graduate medical education community is currently mobilizing efforts to improve resident wellness. Objective We sought to provide a trainee perspective on current resources to support resident wellness and resources that need to be developed to ensure an optimal learning environment. Methods The ACGME Council of Review Committee Residents, a 29-member multispecialty group of residents and fellows, conducted an appreciative inquiry exercise to (1) identify existing resources to address resident wellness; (2) envision the ideal learning environment to promote wellness; and (3) determine how the existing infrastructure could be modified to approach the ideal. The information was aggregated to identify consensus themes from group discussion. Results National policy on resident wellness should (1) increase awareness of the stress of residency and destigmatize depression in trainees; (2) develop systems to identify and treat depression in trainees in a confidential way to reduce barriers to accessing help; (3) enhance mentoring by senior peers and faculty; (4) promote a supportive culture; and (5) encourage additional study of the problem to deepen our understanding of the issue. Conclusions A multispecialty, national panel of trainees identified actionable goals to broaden efforts in programs and sponsoring institutions to promote resident wellness and mental health awareness. Engagement of all stakeholders within the graduate medical education community will be critical to developing a comprehensive solution to this important issue. PMID:26217450

How primary trainee teachers perceive the development of their own scientific knowledge: links between confidence, content and competence?

NASA Astrophysics Data System (ADS)

Shallcross, Tony; Spink, Elaine; Stephenson, Philip; Warwick, Paul

2002-12-01

The significance of subject knowledge in the education of science teachers is much debated nationally and internationally. Part of this debate is about what the term 'science subject knowledge' means. This paper examines two UK research studies, one from Manchester Metropolitan University (MMU) and one from Homerton College, Cambridge, into initial teacher education (ITE) trainees' confidence with their science knowledge. Both surveys revealed the importance of school experience in developing this knowledge. The MMU survey also identified a disproportionate requirement being placed on trainees to teach particular science topics in schools. The paper discusses the implications of these surveys for the design of ITE primary core science programmes in the UK and raises questions about current approaches to the assessment of trainees' subject knowledge in ITE, which are of generic interest. How do we verify trainees' mastery of content? Does such mastery equate with competent teaching? Answers to both questions are proposed.

Diagnosis and management of acute kidney injury: deficiencies in the knowledge base of non-specialist, trainee medical staff.

PubMed

Muniraju, T M; Lillicrap, M H; Horrocks, J L; Fisher, J M; Clark, R M W; Kanagasundaram, N S

2012-06-01

Enhanced education has been recommended to improve non-specialist management of acute kidney injury (AKI). However, the extent of any gaps in knowledge has yet to be defined fully. The aim of this study was to assess understanding of trainee doctors in the prevention, diagnosis and initial management of AKI. An anonymised questionnaire was completed by hospital-based trainees across Newcastle Renal Unit's catchment area. Responses were evaluated against a panel of pre-defined ideal answers. The median score was 9.5 out of 20 (n = 146; range 0-17) and was lower in more junior trainees. Fifty percent of trainees could not define AKI, 30% could not name more than two risk factors for AKI and 37% could not name even one indication for renal referral. These serious gaps in knowledge highlight the need for enhanced education aimed at all training grades. Organisational changes may also be required to optimise patient safety.

Virtual reality laparoscopy: which potential trainee starts with a higher proficiency level?

PubMed

Paschold, M; Schröder, M; Kauff, D W; Gorbauch, T; Herzer, M; Lang, H; Kneist, W

2011-09-01

Minimally invasive surgery requires technical skills distinct from those used in conventional surgery. The aim of this prospective study was to identify personal characteristics that may predict the attainable proficiency level of first-time virtual reality laparoscopy (VRL) trainees. Two hundred and seventy-nine consecutive undergraduate medical students without experience attended a standardized VRL training. Performance data of an abstract and a procedural task were correlated with possible predictive factors providing potential competence in VRL. Median global score requirement status was 86.7% (interquartile range (IQR) 75-93) for the abstract task and 74.4% (IQR 67-88) for the procedural task. Unadjusted analysis showed significant increase in the global score in both tasks for trainees who had a gaming console at home and frequently used it as well as for trainees who felt self-confident to assist in a laparoscopic operation. Multiple logistic regression analysis identified frequency of video gaming (often/frequently vs. rarely/not at all, odds ratio: abstract model 2.1 (95% confidence interval 1.2; 3.6), P = 0.009; virtual reality operation procedure 2.4 (95% confidence interval 1.3; 4.2), P = 0.003) as a predictive factor for VRL performance. Frequency of video gaming is associated with quality of first-time VRL performance. Video game experience may be used as trainee selection criteria for tailored concepts of VRL training programs.

Counterbalancing clinical supervision and independent practice: case studies in learning thoracic epidural catheter insertion.

PubMed

Johnson, T

2010-12-01

Thoracic epidural catheter placement is an example of a demanding and high-risk clinical skill that junior anaesthetists need to learn by experience and under the supervision of consultants. This learning is known to present challenges that require further study. Ten consultant and 10 trainee anaesthetists in a teaching hospital were interviewed about teaching and learning this skill in the operating theatre, and a phenomenological analysis of their experience was performed. Trainee participation was limited by time pressure, lack of familiarity with consultants, and consultants' own need for clinical experience. There was a particular tension between safe and effective consultant practice and permitting trainees' independence. Three distinct stages of participation and assistance were identified from reports of ideal practice: early (part-task or basic procedure, consultant always present giving instruction and feedback), middle (independent practice with straightforward cases without further instruction), and late (skill extension and transfer). Learning assistance provided by consultants varied, but it was often not matched to the trainees' stages of learning. Negotiation of participation and assistance was recognized as being useful, but it did not happen routinely. There are many obstacles to trainees' participation in thoracic epidural catheter insertion, and learning assistance is not matched to need. A more explicit understanding of stages of learning is required to benefit the learning of this and other advanced clinical skills.

Developing leadership as a trainee- opportunities, barriers and potential improvements.

PubMed

Doherty, Rachel; Lawson, Sara; Mc Laughlin, Laura; Donaghy, Grainne; Courtney, Julia; Gardiner, Keith

2018-05-01

The General Medical Council explicitly state that doctors completing training should demonstrate capabilities in leadership and teamwork. 1 However, most trainees receive little formal training in leadership. In March 2017, at the Faculty of Medical Leadership and Management (FMLM) Northern Ireland Regional Conference, a workshop on developing leadership skills as a trainee was hosted and the views of doctors in training regarding current opportunities, potential barriers and improvements were sought. In Northern Ireland presently there are a number of opportunities available for trainees to gain experience in leadership - both by learning through observation and learning through experience. These range from informal activities which do not require significant time commitment to focused, immersive leadership experiences such as ADEPT (Achieve Develop Explore Programme for Trainees) 2 , and the Royal College of Physicians' Chief Registrar scheme. 3 Several barriers to developing leadership have been identified, including limited understanding of what constitutes leadership, a lack of senior support and little formal recognition for trainees leading teams. Time pressures, frequently rotating jobs, limited resources and difficulty upscaling can also undermine the sustainability of improvement and other leadership projects. Incorporating awareness of and training in leadership skills, as well as greater engagement with senior leaders and managers, at an early stage in training could promote understanding and encourage trainees. Formalising leadership roles within training posts may improve experience. Deaneries and Trusts can also enable leadership opportunities by facilitating study leave, raising awareness amongst supervisors, and providing career enhancing incentives for interested trainees.

An adequate level of training for technically competent colonoscopic polypectomy.

PubMed

Boo, Sun-Jin; Jung, Ji Hoon; Park, Jae Ho; Na, Soo-Young; Kim, Seon Ok; Park, Sang Hyoung; Yang, Dong-Hoon; Kim, Kyung-Jo; Ye, Byong Duk; Myung, Seung-Jae; Yang, Suk-Kyun; Kim, Jin-Ho; Byeon, Jeong-Sik

2015-07-01

The purpose of this study is to investigate the learning curve for colonoscopic polypectomy (CP) by trainee endoscopists. The amount of training required to achieve technical competence for CP is uncertain. The CP times and en bloc resection rates of three experienced colonoscopists were obtained from 240 procedures. These data were compared to those of three gastroenterology trainees who performed 750 CP procedures. A trainee procedure was deemed to be a success if en bloc resection was obtained and the CP time was within twice the median CP time of the experienced colonoscopists. Trainees were deemed to be technically competent when they achieved a CP success rate of greater than or equal to 80%. The median CP times and en bloc resection rates for the experienced colonoscopists and trainees were 79 s (range, 20-301 s) and 99.6% (239/240), and 118 s (range, 36-1051 s) and 95.6% (717/750), respectively. The trainee success rate of CP was 72% (540/750). The success rate of the procedure was associated with increased trainee experience (p = 0.003) and reached 80% after 250 procedures. The CP time significantly decreased (p < 0.001) and en bloc resection rate significantly increased (p = 0.011) as trainee experience accumulated. The level of experience was an independent predictor for successful CP. The achievement of technical competence with CP was associated with an accumulation of approximately 250 procedures. These findings suggest that dedicated education and training programs for CP are warranted.

Higher specialty training in genitourinary medicine: A curriculum competencies-based approach.

PubMed

Desai, Mitesh; Davies, Olubanke; Menon-Johansson, Anatole; Sethi, Gulshan Cindy

2018-01-01

Specialty trainees in genitourinary medicine (GUM) are required to attain competencies described in the GUM higher specialty training curriculum by the end of their training, but learning opportunities available may conflict with service delivery needs. In response to poor feedback on trainee satisfaction surveys, a four-year modular training programme was developed to achieve a curriculum competencies-based approach to training. We evaluated the clinical opportunities of the new programme to determine: (1) Whether opportunity cost of training to service delivery is justifiable; (2) Which competencies are inadequately addressed by direct clinical opportunities alone and (3) Trainee satisfaction. Local faculty and trainees assessed the 'usefulness' of the new modular programme to meet each curriculum competence. The annual General Medical Council (GMC) national training survey assessed trainee satisfaction. The clinical opportunities provided by the modular training programme were sufficiently useful for attaining many competencies. Trainee satisfaction as captured by the GMC survey improved from two reds pre- to nine greens post-intervention on a background of rising clinical activity in the department. The curriculum competencies-based approach to training offers an objective way to balance training with service provision and led to an improvement in GMC survey satisfaction.

An evaluation of websites to help neurosurgical trainees learn histopathology.

PubMed

Jeffree, R L

2013-10-01

Knowledge of histopathology is essential for good neurosurgical practice but current pressures on neurosurgical trainees' time restrict opportunities to learn histopathology by traditional methods. The internet offers a possible alternative resource. The aim of this project was to assess the existing, free, internet-based resources for learning histology and histopathology, from the perspective of a neurosurgical trainee. English language websites were evaluated by an expert, and by neurosurgical trainees, for the range of content, academic credibility, quality of the histopathological images, quality of supporting content, educational features and the usability. Thirty-nine websites were examined in detail by the author. Although many websites were useful, no individual website met all the requirements. Five neuropathology websites were clearly superior to the others. These were then assessed by neurosurgical trainees. The results of the assessment, a brief resume of each website, and the characteristics of a good website for the surgical trainees to learn pathology are discussed. The best websites featured a large number of high-quality images, accurate, detailed clinical and pathophysiological information, labelling or description of individual images, and organisation by organ system. Free internet sites can offer a valuable learning resource to supplement textbooks and clinical pathology sessions.

What do UK doctors in training value in a post? A discrete choice experiment.

PubMed

Cleland, Jennifer; Johnston, Peter; Watson, Verity; Krucien, Nicolas; Skåtun, Diane

2016-02-01

Many individual and job-related factors are known to influence medical careers decision making. Medical trainees' (residents) views of which characteristics of a training post are important to them have been extensively studied but how they trade-off these characteristics is under-researched. Such information is crucial for the development of effective policies to enhance recruitment and retention. Our aim was to investigate the strength of UK foundation doctors' and trainees' preferences for training post characteristics in terms of monetary value. We used an online questionnaire study incorporating a discrete choice experiment (DCE), distributed to foundation programme doctors and doctors in training across all specialty groups within three UK regions, in August-October 2013. The main outcome measures were monetary values for training-post characteristics, based on willingness to forgo and willingness to accept extra income for a change in each job characteristic, calculated from regression coefficients. The questionnaire was answered by 1323 trainees. Good working conditions were the most influential characteristics of a training position. Trainee doctors would need to be compensated by an additional 49.8% above the average earnings within their specialty to move from a post with good working conditions to one with poor working conditions. A training post with limited rather than good opportunities for one's spouse or partner would require compensation of 38.4% above the average earnings within their specialty. Trainees would require compensation of 30.8% above the average earnings within their specialty to move from a desirable to a less desirable locality. These preferences varied only to a limited extent according to individual characteristics. Trainees place most value on good working conditions, good opportunities for their partners and desirable geographical location when making career-related decisions. This intelligence can be used to develop alternative models of workforce planning or to develop information about job opportunities that address trainees' values. © 2016 John Wiley & Sons Ltd.

Induction process of trainees in pathology residency

PubMed Central

Siddiqui, Imran; Ali, Natasha

2016-01-01

This article describes the evolution of the induction process of pathology residency at The Aga Khan University hospital. The Department of Postgraduate Medical Education was established in 1985. The induction process is an exhaustive exercise that includes an admission test held simultaneously in Karachi, Hyderabad, Lahore, and Rawalpindi, followed by an interview of the shortlisted candidates. The pathology residency program was started 25 years ago and since then the induction process has undergone major changes with the course of time. PMID:27313487

Catherine G. Coleman at astronaut candidate survival training

NASA Image and Video Library

1993-07-15

S93-38725 (12-14 Sept. 1992) --- Catherine G. Coleman, a member of the 1992 class of astronaut candidates at the Johnson Space Center (JSC), gathers up a parachute. The chute had just been used in one of many exercises experienced by the trainees at a three-day parachute/survival course hosted by Vance Air Force Base near Enid, Oklahoma. EDITOR?S NOTE: Coleman was later named as mission specialist for the United States Microgravity Laboratory (USML-2) mission, scheduled to fly as STS-73 in 1995.

Virtual reality in laparoscopic surgery.

PubMed

Uranüs, Selman; Yanik, Mustafa; Bretthauer, Georg

2004-01-01

Although the many advantages of laparoscopic surgery have made it an established technique, training in laparoscopic surgery posed problems not encountered in conventional surgical training. Virtual reality simulators open up new perspectives for training in laparoscopic surgery. Under realistic conditions in real time, trainees can tailor their sessions with the VR simulator to suit their needs and goals, and can repeat exercises as often as they wish. VR simulators reduce the number of experimental animals needed for training purposes and are suited to the pursuit of research in laparoscopic surgery.

Gaze entropy reflects surgical task load.

PubMed

Di Stasi, Leandro L; Diaz-Piedra, Carolina; Rieiro, Héctor; Sánchez Carrión, José M; Martin Berrido, Mercedes; Olivares, Gonzalo; Catena, Andrés

2016-11-01

Task (over-)load imposed on surgeons is a main contributing factor to surgical errors. Recent research has shown that gaze metrics represent a valid and objective index to asses operator task load in non-surgical scenarios. Thus, gaze metrics have the potential to improve workplace safety by providing accurate measurements of task load variations. However, the direct relationship between gaze metrics and surgical task load has not been investigated yet. We studied the effects of surgical task complexity on the gaze metrics of surgical trainees. We recorded the eye movements of 18 surgical residents, using a mobile eye tracker system, during the performance of three high-fidelity virtual simulations of laparoscopic exercises of increasing complexity level: Clip Applying exercise, Cutting Big exercise, and Translocation of Objects exercise. We also measured performance accuracy and subjective rating of complexity. Gaze entropy and velocity linearly increased with increased task complexity: Visual exploration pattern became less stereotyped (i.e., more random) and faster during the more complex exercises. Residents performed better the Clip Applying exercise and the Cutting Big exercise than the Translocation of Objects exercise and their perceived task complexity differed accordingly. Our data show that gaze metrics are a valid and reliable surgical task load index. These findings have potential impacts to improve patient safety by providing accurate measurements of surgeon task (over-)load and might provide future indices to assess residents' learning curves, independently of expensive virtual simulators or time-consuming expert evaluation.

Impact of child death on paediatric trainees.

PubMed

Hollingsworth, Clare E; Wesley, Carla; Huckridge, Jaymie; Finn, Gabrielle M; Griksaitis, Michael J

2018-01-01

To assess the prevalence of symptoms of acute stress reactions (ASR) and post-traumatic stress disorder (PTSD) in paediatric trainees following their involvement in child death. A survey designed to identify trainees' previous experiences of child death combined with questions to identify features of PTSD. Quantitative interpretation was used alongside a χ 2 test. A p value of <0.05 was considered significant. 604 surveys were distributed across 13 UK health education deaneries. 303/604 (50%) of trainees completed the surveys. 251/280 (90%) of trainees had been involved with the death of a child, although 190/284 (67%) had no training in child death. 118/248 (48%) of trainees were given a formal debrief session following their most recent experience. 203/251 (81%) of trainees reported one or more symptoms or behaviours that could contribute to a diagnosis of ASR/PTSD. 23/251 (9%) of trainees met the complete criteria for ASR and 13/251 (5%) for PTSD. Attending a formal debrief and reporting feelings of guilt were associated with an increase in diagnostic criteria for ASR/PTSD (p=0.036 and p<0.001, respectively). Paediatric trainees are at risk of developing ASR and PTSD following the death of a child. The feeling of guilt should be identified and acknowledged to allow prompt signposting to further support, including psychological assessment or intervention if required. Clear recommendations need to be made about the safety of debriefing sessions as, in keeping with existing evidence, our data suggest that debrief after the death of a child may be associated with the development of symptoms suggestive of ASR/PTSD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Research in surgery and anesthesia: challenges for post-graduate trainees in Uganda.

PubMed

Elobu, Alex E; Kintu, Andrew; Galukande, Moses; Kaggwa, Sam; Mijjumbi, Cephas; Tindimwebwa, Joseph; Roche, Anthony; Dubowitz, Gerald; Ozgediz, Doruk; Lipnick, Michael

2015-01-01

Research is critical to the training and practice of surgery and anesthesia in all settings, regardless of available resources. Unfortunately, the output of surgical and perioperative research from Africa is low. Makerere University College of Health Sciences' (MakCHS) surgical and anesthesia trainees are required to conduct research, though few publish findings or go on to pursue careers that incorporate research. We believe that early career experiences with research may greatly influence physicians' future conduct and utilization of research. We therefore sought to analyze trainee experiences and perceptions of research to identify interventions that could increase production of high-quality, locally led, surgical disease research in our resource-constrained setting. Following ethical approval, a descriptive, cross-sectional survey was conducted among anesthesia and surgery trainees using a pretested, self-administered questionnaire. Data were tabulated and frequency tables generated. Of the 43 eligible trainees, 33 (77%) responded. Ninety-four percent identify research as important to career development, and 85% intend to publish their dissertations. The research dissertation is considered a financial burden by 64%. Also, 49% reported that their departments place low value on their research, and few of the findings are utilized. Trainees report that lack of protected research time, difficulty in finding research topics, and inadequate mentorship are the main challenges to conducting research projects. Our anesthesia and surgery trainees spend considerable resources on research endeavors. Most have significant interest in incorporating research into their careers, and most intend to publish their work in peer-reviewed journals. Here we identify several challenges facing trainees including research project development, financing and mentorship. We hope to use these results to improve support in these areas for our trainees and those in other resource-limited areas.

Integrating Quality Improvement Education into the Nephrology Curricular Milestones Framework and the Clinical Learning Environment Review

PubMed Central

Prince, Lisa K.; Little, Dustin J.; Schexneider, Katherine I.

2017-01-01

The Accreditation Council for Graduate Medical Education requires that trainees show progressive milestone attainment in the practice–based learning and systems–based practice competencies. As part of the Clinical Learning Environment Review, sponsoring hospitals must educate trainees in health care quality improvement, provide them with specialty–specific quality data, and ensure trainee participation in quality improvement activities and committees. Subspecialty–specific quality improvement curricula in nephrology training programs have not been reported, although considerable curricular and assessment material exists for specialty residencies, including tools for assessing trainee and faculty competence. Nephrology–specific didactic material exists to assist nephrology fellows and faculty mentors in designing and implementing quality improvement projects. Nephrology is notable among internal medicine subspecialties for the emphasis placed on adherence to quality thresholds—specifically for chronic RRT shown by the Centers for Medicare and Medicaid Services Quality Incentive Program. We have developed a nephrology-specific curriculum that meets Accreditation Council for Graduate Medical Education and Clinical Learning Environment Review requirements, acknowledges regulatory quality improvement requirements, integrates with ongoing divisional quality improvement activities, and has improved clinical care and the training program. In addition to didactic training in quality improvement, we track trainee compliance with Kidney Disease Improving Global Outcomes CKD and ESRD quality indicators (emphasizing Quality Improvement Program indicators), and fellows collaborate on a yearly multidisciplinary quality improvement project. Over the past 6 years, each fellowship class has, on the basis of a successful quality improvement project, shown milestone achievement in Systems-Based Practice and Practice-Based Learning. Fellow quality improvement projects have improved nephrology clinical care within the institution and introduced new educational and assessment tools to the training program. All have been opportunities for quality improvement scholarship. The curriculum prepares fellows to apply quality improvement principals in independent clinical practice—while showing milestone advancement and divisional compliance with Clinical Learning Environment Review requirements. PMID:28174318

Effects of coaching supervision, mentoring supervision and abusive supervision on talent development among trainee doctors in public hospitals: moderating role of clinical learning environment.

PubMed

Subramaniam, Anusuiya; Silong, Abu Daud; Uli, Jegak; Ismail, Ismi Arif

2015-08-13

Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital. A questionnaire-based critical survey was conducted among trainee doctors undergoing housemanship at six public hospitals in the Klang Valley, Malaysia. Prior permission was obtained from the Ministry of Health Malaysia to conduct the research in the identified public hospitals. The survey yielded 355 responses. The results were analysed using SPSS 20.0 and SEM with AMOS 20.0. The findings of this research indicate that coaching and mentoring supervision are positively associated with talent development, and that there is no significant relationship between abusive supervision and talent development. The findings also support the moderating role of clinical learning environment on the relationships between coaching supervision-talent development, mentoring supervision-talent development and abusive supervision-talent development among public hospital trainee doctors. Overall, the proposed model indicates a 26 % variance in talent development. This study provides an improved understanding on the role of the supervisory styles (coaching and mentoring supervision) on facilitating talent development among public hospital trainee doctors. Furthermore, this study extends the literature to better understand the effects of supervisory styles on trainee doctors' talent development are contigent on the trainee doctors' clinical learning environment. In summary, supervisors are stakeholders with the responsibility of facilitating learning conditions that hold sufficient structure and support to optimise the trainee doctors learning.

Spinal surgery fellowship education in Canada: evaluation of trainee and supervisor perspectives on cognitive and procedural competencies.

PubMed

Malempati, Harsha; Wadey, Veronica M R; Paquette, Scott; Kreder, Hans J; Massicotte, Eric M; Rampersaud, Raja; Fisher, Charles; Dvorak, Marcel F; Fehlings, Michael G; Backstein, David; Yee, Albert

2013-01-01

A cross-sectional survey of spine surgery fellowship educators and trainees. To determine educator and trainee perspectives on the relative importance of core cognitive and procedural competencies in fellowship training. To determine perceptions of confidence in competencies by trainees near the end of their fellowship. Finally, to determine potential differences comparing surgeons by background specialty training (neurosurgical or orthopedic) of their views on competencies. Spine surgery is a growing subspecialty with increasing collaboration among specialists of varied specialty backgrounds involved in education. With the recent implementation of competency-based curricula during specialty training, opportunities may exist in enhancing fellowship education. A questionnaire on cognitive and procedural competencies was administered (online and paper) to fellowship educators and trainees across Canada. A follow-up questionnaire was administered to nonresponders 3 months later. Survey results were summarized using qualitative and descriptive statistics with comparative analyses performed. Of the identified respondents, the response rate was 91%, (15/17 fellow trainees; 47/51 educators). Twelve of the 13 core cognitive skill categories were rated as being important to acquire by the end of fellowship. Trainees were not comfortable performing, and requested additional training in 8 of the 29 less common and technically demanding procedural skills. There were different perceptions on the relative importance of competencies comparing trainees by specialty background as well as different perceptions on the types of competencies where additional training was desired to achieve competency (P < 0.05). Fellowship educators and trainees possessed similar perceptions on the relative importance of core cognitive and procedural competencies required for successful training. Background specialty influenced the perceptions of both fellowship educators and trainees. This study identified potential gaps or perceived deficiencies in the competency of current fellows. Improvements in spine fellowship education should target these areas through developing evidence-based curriculum changes.

Job-sharing in paediatric training in Australia: availability and trainee perceptions.

PubMed

Whitelaw, C M; Nash, M C

2001-04-16

To examine the current availability of job-sharing in paediatric training hospitals in Australia and to evaluate job-sharing from the trainees' perspective. National survey with structured telephone interviews and postal questionnai res. The eight major paediatric training hospitals in Australia. Directors of Paediatric Physician Training (DPPTs) at each hospital (or a staff member nominated by them) provided information by phone interview regarding job-sharing. All paediatric trainees who job-shared in 1998 (n=34) were sent written questionnaires, of which 25 were returned. Hospitals differed in terms of whether a trainee was required to give a reason for wishing to job-share, and what reasons were acceptable. One hospital stated that two specialty units (Intensive Care and Neonatal Intensive Care) were excluded from job-sharing, and another stated that certain units were unlikely to be allocated job-sharers. The remaining six hospitals said that all units were available for job-sharing, but the majority of their trainees disagreed. Only one hospital had a cap on the number of job-share positions available yearly. Trainees perceived benefits of job-sharing to include decreased tiredness, increased enthusiasm for work, and the ability to strike a balance between training and other aspects of life. Trainees believed job-sharing did not adversely affect the quality of service provided to patients, and that part-time training was not of lower quality than full-time training. Job-sharing in Australian paediatric training hospitals varies in terms of the number of positions available, eligibility criteria, and which units are available for job-sharing. In our survey, trainees' experience of job-sharing was overwhelmingly positive.

Developing an Interdisciplinary, Team-Based Quality Improvement Leadership Training Program for Clinicians: The Partners Clinical Process Improvement Leadership Program.

PubMed

Rao, Sandhya K; Carballo, Victoria; Cummings, Brian M; Millham, Frederick; Jacobson, Joseph O

Although there has been tremendous progress in quality improvement (QI) education for students and trainees in recent years, much less has been published regarding the training of active clinicians in QI. The Partners Clinical Process Improvement Leadership Program (CPIP) is a 6-day experiential program. Interdisciplinary teams complete a QI project framed by didactic sessions, interactive exercises, case-based problem sessions, and a final presentation. A total of 239 teams composed of 516 individuals have graduated CPIP. On completion, participant satisfaction scores average 4.52 (scale 1-5) and self-reported understanding of QI concepts improved. At 6 months after graduation, 66% of survey respondents reported sustained QI activity. Three opportunities to improve the program have been identified: (1) increasing faculty participation through online and tiered course offerings, (2) integrating the faculty-focused program with the trainee curriculum, and (3) developing a postgraduate curriculum to address the challenges of sustained improvement.

Students' perspectives on research and assessment of a model template designed to guide beginners in research in a medical school in Cameroon.

PubMed

Tambe, Joshua; Minkande, Jacqueline Ze; Moifo, Boniface; Mbu, Robinson; Ongolo-Zogo, Pierre; Gonsu, Joseph

2014-12-21

Research activities for medical students and residents (trainees) are expected to serve as a foundation for the acquisition of basic research skills. Some medical schools therefore recommend research work as partial requirement for certification. However medical trainees have many difficulties concerning research, for which reason potential remedial strategies need to be constantly developed and tested. The views of medical trainees are assessed followed by their use and appraisal of a novel "self-help" tool designed for the purposes of this study with potential for improvement and a wider application. This study was a cross-sectional survey of volunteering final-year medical students and residents of a medical school in Cameroon. This study surveyed the opinions of a total of 120 volunteers of which 82 (68%) were medical students. Three out of 82 (4%) medical students reported they had participated in research activities with a publication versus 10 out of 38 residents (26%). The reported difficulties in research for these trainees included referencing of material (84%), writing a research proposal (79%), searching for literature (73%) and knowledge of applicable statistical tests (72%) amongst others. All participants declared the "self-help" tool was simple to use, guided them to think and better understand their research focus. Medical trainees require much assistance on research and some "self-help" tools such as the template used in this study might be a useful adjunct to didactic lectures.

Residents' performance in open versus laparoscopic bench-model cholecystectomy in a hands-on surgical course.

PubMed

Nebiker, Christian Andreas; Mechera, Robert; Rosenthal, Rachel; Thommen, Sarah; Marti, Walter Richard; von Holzen, Urs; Oertli, Daniel; Vogelbach, Peter

2015-07-01

Laparoscopy has become the gold standard for many abdominal procedures. Among young surgeons, experience in laparoscopic surgery increasingly outweighs experience in open surgery. This study was conducted to compare residents' performance in laparoscopic versus open bench-model task. In an international surgical skills course, we compared trainees' performance in open versus laparoscopic cholecystectomy in a cadaveric animal bench-model. Both exercises were evaluated by board-certified surgeons using an 8-item checklist and by the trainees themselves. 238 trainees with a median surgical experience of 24 months (interquartile range 14-48) took part. Twenty-two percent of the trainees had no previous laparoscopic and 62% no previous open cholecystectomy experience. Significant differences were found in the overall score (median difference of 1 (95% CI: 1, 1), p < 0.001), gallbladder perforation rate (73% vs. 29%, p < 0.001), safe dissection of the Calot's triangle (98% vs. 90%, p = 0.001) and duration of surgery (42 (13) minutes vs. 26 (10) minutes (mean differences 17.22 (95% CI: 15.37, 19.07), p < 0.001)), all favouring open surgery. The perforation rate in open and laparoscopic cholecystectomies was not consistently decreasing with increasing years of experience or number of previously performed procedures. Self-assessment was lower than the assessment by board-certified surgeons. Despite lower experience in open compared to laparoscopic cholecystectomy, better performance was observed in open task. It may be explained by a wider access with easier preparation. Open cholecystectomy is the rescue manoeuvre and therefore, it is important to provide also enough training opportunities in open surgery. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Lost opportunity cost of surgical training in the Australian private sector.

PubMed

Aitken, R James

2012-03-01

To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Developing a higher specialist training programme in renal medicine in the era of competence-based training.

PubMed

Kamesh, Lavanya; Clapham, Mike; Foggensteiner, Lukas

2012-08-01

Renal specialty medical training in the UK was reformed in August 2007, with an emphasis placed on competency-based training and the publication of a new curriculum and assessment blueprint. This model of training places additional time demands on both trainees and trainers, with implications for job planning and service delivery. We evaluated the resource requirements and impact on service delivery of implementing a high-quality training programme in renal medicine. Each trainee maintained a portfolio containing details of workplace-based assessments. The change in educational environment led to improved trainee satisfaction. The mean total consultant time involved in implementing the training programme was 0.7 programmed activities (PAs) per trainee per week in the first year, which decreased to 0.5 PAs per trainee per week in the second year. This pilot study indicates that it is possible to integrate successful and high-quality specialty training in a busy clinical environment. The model outlined could form a template for postgraduate specialist training delivery in a variety of medical specialties.

Trainee and Client Experiences of Therapeutic Assessment in a Required Graduate Course: A Qualitative Analysis.

PubMed

Smith, Justin D; Egan, Kaitlyn N

2017-01-01

Surveys indicate that practice and training in psychological assessment, and personality assessment (PA) to a lesser degree, has been stable or increasing over the past quarter-century. However, its future arguably remains threatened due to changes in doctoral training programs and beliefs in the field concerning the utility of PA for treatment success. To increase interest in and use of PA, studies of training methods that include trainees' perspectives are needed. This study evaluated the experiences of 10 graduate trainees and their clients who were trained in and conducted a brief Therapeutic Assessment (TA). Qualitative responses to a self-evaluation administered post-TA were coded using directed content analysis. Results indicated that trainees viewed TA/PA as having clinical utility; they had positive feelings about TA/PA, and they desired or intended to use or continue learning about TA/PA. Clients' responses reflected positive feelings about the TA, having gained new self-awareness or understanding, and having a positive relationship with the assessor. The findings suggest that teaching PA from a TA perspective could produce positive benefits for psychology trainees.

Assessment of training capacity in New Zealand general practices: a stocktake in the lower North Island and South Island.

PubMed

Murton, Samantha A; Pullon, Susan Rh

2017-09-22

General practices are providing clinically-based training for rapidly increasing numbers of medical (and other health professional) trainees. This study investigated capacity and intention of general practices to additionally teach junior doctors (now required to undertake community-based attachments by the New Zealand Medical Council) alongside current trainees in their service. A web-based/telephone survey of all general practices was developed and administered November 2015-April 2016. In the Otago study region (lower North Island, South Island), 463 currently operating practices were identified. (A companion Auckland-based study concurrently investigated the upper North Island.) Of the 280/463 (60%) responding practices, 93% (261/280) were currently taking health professional trainees, with 86% (241/280) taking at least one type of medical trainee. Practices indicate that 14% fewer of them will take undergraduate medical students than previously (199 practices down to 162), but more would take junior doctors (42 up to 79) and GP registrars (129 practices up to 142). Most practices in these regions already contribute to teaching. Practices indicated limitations in accommodating continued increases in numbers of trainees in the current poorly coordinated system. Improved support and training for practices is needed to enable practices to take more trainees of multiple types per practice, both concurrently and sequentially.

Research ethics capacity development in Africa: exploring a model for individual success.

PubMed

Ali, Joseph; Hyder, Adnan A; Kass, Nancy E

2012-08-01

The Johns Hopkins-Fogarty African Bioethics Training Program (FABTP) has offered a fully-funded, one-year, non-degree training opportunity in research ethics to health professionals, ethics committee members, scholars, journalists and scientists from countries across sub-Saharan Africa. In the first 9 years of operation, 28 trainees from 13 African countries have trained with FABTP. Any capacity building investment requires periodic critical evaluation of the impact that training dollars produce. In this paper we describe and evaluate FABTP and the efforts of its trainees. Our data show that since 2001, the 28 former FABTP trainees have authored or co-authored 105 new bioethics-related publications; were awarded 33 bioethics-related grants; played key roles on 78 bioethics-related research studies; and participated in 198 bioethics workshops or conferences. Over the past nine years, trainees have collectively taught 48 separate courses related to bioethics and have given 170 presentations on various topics in the field. Many former trainees have pursued and completed doctoral degrees in bioethics; some have become editorial board members for bioethics journals. Female trainees were, on average, less experienced at matriculation and produced fewer post-training outputs than their male counterparts. More comprehensive studies are needed to determine the relationships between age, sex, previous experience and training program outputs. © 2012 Blackwell Publishing Ltd.

Innovative model of delivering quality improvement education for trainees--a pilot project.

PubMed

Ramar, Kannan; Hale, Curt W; Dankbar, Eugene C

2015-01-01

After incorporating quality improvement (QI) education as a required curriculum for our trainees in 2010, a need arose to readdress our didactic sessions as they were too long, difficult to schedule, and resulting in a drop in attendance. A 'flipped classroom' (FC) model to deliver QI education was touted to be an effective delivery method as it allows the trainees to view didactic materials on videos, on their own time, and uses the classroom to clarify concepts and employ learned tools on case-based scenarios including workshops. The Mayo Quality Academy prepared 29 videos that incorporated the previously delivered 17 weekly didactic sessions, for a total duration of 135 min. The half-day session clarified questions related to the videos, followed by case examples and a hands-on workshop on how to perform and utilize a few commonly used QI tools and methods. Seven trainees participated. There was a significant improvement in knowledge as measured by pre- and post-FC model test results [improvement by 40.34% (SD 16.34), p<0.001]. The survey results were overall positive about the FC model with all trainees strongly agreeing that we should continue with this model to deliver QI education. The pilot project of using the FC model to deliver QI education was successful in a small sample of trainees.

Taekwondo trainees' satisfaction towards using the virtual taekwondo training environment prototype

NASA Astrophysics Data System (ADS)

Jelani, Nur Ain Mohd; Zulkifli, Abdul Nasir; Ismail, Salina; Yusoff, Mohd Fitri

2017-10-01

Taekwondo is among the most popular martial arts which have existed more than 3000 years ago and have millions of followers all around the world. The typical taekwondo training session takes place in a hall or large open spaces in the presence of a trainer. Even though this is the most widely used approach of Taekwondo training, this approach has some limitations in supporting self-directed training. Self-directed taekwondo training is required for the trainees to improve their skills and performance. There are varieties of supplementary taekwondo training materials available, however, most of them are still lacking in terms of three-dimensional visualization. This paper introduces the Virtual Taekwondo Training Environment (VT2E) prototype for self-directed training. The aim of this paper is to determine whether the intervention of the new taekwondo training approach using virtual reality contributes to the trainees' satisfaction in self-directed training. Pearson Correlation and Regression analyses were used to determine the effects of Engaging, Presence, Usefulness and Ease of Use on trainees' satisfaction in using the prototype. The results provide empirical support for the positive and statistically significant relationship between Usefulness and Ease of Use and trainees' satisfaction for taekwondo training. However, Engaging and Presence do not have a positive and significant relationship with trainees' satisfaction for self-directed training.

The 2nd Annual Clinical Scientist Trainee Symposium, August 22, 2017, London, Canada.

PubMed

Yin, Charles; Blom, Jessica N; Lewis, James F

2018-03-27

Clinician scientists play a critical role in bridging research and clinical practice. Unfortunately, the neglect of research training in medical schools has created clinicians who are unable to translate evidence from literature to practice. Furthermore, the erosion of research training in medical education has resulted in clinicians who lack the skills required for successful scientific investigation. To counteract this, the Schulich School of Medicine & Dentistry has made an effort to engage trainees, at all levels, in the research process. The 2nd Annual Clinician Scientist Trainee Symposium was held in London, Ontario, Canada on August 22, 2017. Organized each year since 2016 by the Schulich Research Office, the symposium features research being conducted by trainees in Schulich's Clinical Research Training Program. The focus this year was on the current state of clinician-scientist training in Canada and visions for the path ahead.

“Mentoring International Research Ethics Trainees: Identifying Best Practices”

PubMed Central

Loue, Sana; Loff, Bebe

2014-01-01

Mentoring is an important component of training in the basic and clinical sciences due to the increasing complexities associated with establishing a career. Methods Data relating to 466 long term trainees in research ethics training programs were obtained from the Fogarty International Center's database. Data were supplemented with survey data (n=17) and telephone interviews (n=10) of the 21 principal investigators whose programs offered long-term training. The programs most successful with mentoring involved (1) the provision of an orientation to the trainees at the commencement of training; (2) a highly structured process of mentoring that required regular meetings and task achievement timelines; (3) intensive, frequent contact with the PI; and (4) support with personal issues that were troublesome to trainees. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education & Curriculum Development program. PMID:24384516

Factors Influencing Mini-CEX Rater Judgments and Their Practical Implications: A Systematic Literature Review.

PubMed

Lee, Victor; Brain, Keira; Martin, Jenepher

2017-06-01

At present, little is known about how mini-clinical evaluation exercise (mini-CEX) raters translate their observations into judgments and ratings. The authors of this systematic literature review aim both to identify the factors influencing mini-CEX rater judgments in the medical education setting and to translate these findings into practical implications for clinician assessors. The authors searched for internal and external factors influencing mini-CEX rater judgments in the medical education setting from 1980 to 2015 using the Ovid MEDLINE, PsycINFO, ERIC, PubMed, and Scopus databases. They extracted the following information from each study: country of origin, educational level, study design and setting, type of observation, occurrence of rater training, provision of feedback to the trainee, research question, and identified factors influencing rater judgments. The authors also conducted a quality assessment for each study. Seventeen articles met the inclusion criteria. The authors identified both internal and external factors that influence mini-CEX rater judgments. They subcategorized the internal factors into intrinsic rater factors, judgment-making factors (conceptualization, interpretation, attention, and impressions), and scoring factors (scoring integration and domain differentiation). The current theories of rater-based judgment have not helped clinicians resolve the issues of rater idiosyncrasy, bias, gestalt, and conflicting contextual factors; therefore, the authors believe the most important solution is to increase the justification of rater judgments through the use of specific narrative and contextual comments, which are more informative for trainees. Finally, more real-world research is required to bridge the gap between the theory and practice of rater cognition.

European online postgraduate educational programme in neonatology-the way forward?

PubMed

Hall, Michael A; Cuttini, Marina; Flemmer, Andreas W; Greisen, Gorm; Marlow, Neil; Schulze, Andreas; Smith, Susan; Valls-i-Soler, Adolf; Truffert, Patrick; Conole, Gráinne; de Laat, Maarten

2009-04-01

The provision of specialist postgraduate training is increasingly challenging for the acute medical specialties. There are often small numbers of trainees and tutors in any one centre, and service commitments may limit attendance at educational activities. Online learning can provide high-quality education to trainees from large geographical areas. We report the outcomes of an experimental educational project which provided an online postgraduate programme in neonatology. Ninety trainees from 14 countries, primarily European, participated. Six educational modules in neonatal topics were delivered over a 1-year period, within a "Virtual Learning Environment". Trainees were divided into multi-national groups; two online tutors supported each group. Analysis of online activity demonstrated that active participation was high initially (100%) but gradually declined to 46% in the final module; tutor participation followed a similar pattern. Eighty-six trainees were contactable at the end of the programme, and 67 (78%) completed an evaluation questionnaire. Of these, 92% reported that participation had "added value" to their training, attributable to the high-quality curriculum, the educational resources, collaborative networking and the sharing of best practice. Eleven (79%) tutors completed the questionnaire, with all reporting that participation was of educational value. The main limiting factor for trainees and tutors was insufficient time. This project confirms that multi-national online education in neonatology is feasible and transferable, but for this approach to be viable formal accreditation and protected time for both trainees and tutors are required.

Effect of exposure to good vs poor medical trainee performance on attending physician ratings of subsequent performances.

PubMed

Yeates, Peter; O'Neill, Paul; Mann, Karen; Eva, Kevin W

2012-12-05

Competency-based models of education require assessments to be based on individuals' capacity to perform, yet the nature of human judgment may fundamentally limit the extent to which such assessment is accurately possible. To determine whether recent observations of the Mini Clinical Evaluation Exercise (Mini-CEX) performance of postgraduate year 1 physicians influence raters' scores of subsequent performances, consistent with either anchoring bias (scores biased similar to previous experience) or contrast bias (scores biased away from previous experience). Internet-based randomized, blinded experiment using videos of Mini-CEX assessments of postgraduate year 1 trainees interviewing new internal medicine patients. Participants were 41 attending physicians from England and Wales experienced with the Mini-CEX, with 20 watching and scoring 3 good trainee performances and 21 watching and scoring 3 poor performances. All then watched and scored the same 3 borderline video performances. The study was completed between July and November 2011. The primary outcome was scores assigned to the borderline videos, using a 6-point Likert scale (anchors included: 1, well below expectations; 3, borderline; 6, well above expectations). Associations were tested in a multivariable analysis that included participants' sex, years of practice, and the stringency index (within-group z score of initial 3 ratings). The mean rating scores assigned by physicians who viewed borderline video performances following exposure to good performances was 2.7 (95% CI, 2.4-3.0) vs 3.4 (95% CI, 3.1-3.7) following exposure to poor performances (difference of 0.67 [95% CI, 0.28-1.07]; P = .001). Borderline videos were categorized as consistent with failing scores in 33 of 60 assessments (55%) in those exposed to good performances and in 15 of 63 assessments (24%) in those exposed to poor performances (P < .001). They were categorized as consistent with passing scores in 5 of 60 assessments (8.3%) in those exposed to good performances compared with 25 of 63 assessments (39.5%) in those exposed to poor performances (P < .001). Sex and years of attending practice were not associated with scores. The priming condition (good vs poor performances) and the stringency index jointly accounted for 45% of the observed variation in raters' scores for the borderline videos (P < .001). In an experimental setting, attending physicians exposed to videos of good medical trainee performances rated subsequent borderline performances lower than those who had been exposed to poor performances, consistent with a contrast bias.

'Putting it into words': developing the RCGP competency descriptors to include 'at-risk behaviours'.

PubMed

Jones, Tim; Tracey, Sue

2012-11-01

As part of the Royal College of General Practitioners' (RCGP) arrangements to satisfy the GMC's requirement for Work Place Based Assessment (WPBAs) a range of 12 WPBA competencies was drawn up. Further to this the RCGP produced descriptors of the behaviours that would demonstrate a trainee had gained competence in that area. Recently the RCGP have expanded the rating scale available to educational supervisors at the time of a review to allow for a finding of 'Needs Further Development (NFD) - below expectations'. In the North of Scotland Deanery it has been recognised that a number of trainees are struggling to demonstrate competency in WPBA and to complete training. Reviewing how we could help these trainees and their educational supervisors there was recognition that early identification of these trainees would assist remedial action. Additionally, having reliable indicators of behaviours associated with a trainee in difficulty would aid the assessment of a trainee as 'NFD - below expectations'. Although many reliable descriptors of 'at-risk' behaviour exist, within frameworks and systems for doctors felt to be in difficulty these systems lie outwith the WPBA competency framework. This paper describes the work undertaken in the North of Scotland Deanery to modify the original table of descriptors for the 12 WPBA competencies to include an 'NFD - below expectations'/'at-risk' behaviours column. The descriptors of behaviours associated with trainees in difficulty have been aligned to the 12 WPBA competencies and used to populate the additional column in the descriptor table. The expectation is that the expanded table of descriptors will assist both in early identification of trainees' at-risk behaviours so that formative work can be engaged in at an early stage in an attachment, and also in the objective assessment of a trainee at an educational supervisor's review if they're in difficulties.

Fatigue and training of obstetrics and gynaecology trainees in Australia and New Zealand.

PubMed

Tucker, Paige E; Cohen, Paul A; Bulsara, Max K; Acton, Jade

2017-10-01

Several studies have linked doctor fatigue with adverse patient events and an increase in risk to doctors' personal safety and wellbeing. The present study assesses the rostering structure of Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) trainees and its association with trainees' reported fatigue levels, training opportunities and wellbeing, which were secondary outcomes of a larger study of trainee working hours which has been separately reported. An anonymous, online survey of RANZCOG trainees was conducted. Demographic data collected included: age, gender, level of training and current rotation. Data were also collected on hours worked per week, long shifts (>12 h), self-reported fatigue levels, and opinions regarding current rostering and training. A majority (72.9%) of respondents regularly felt fatigued, with higher fatigue levels being associated with more hours worked per week (P = <0.001) and working long shifts (>12 h) (P = 0.007). Fatigue was associated with an increased risk of dozing while driving (P = 0.028), with 56.1% of respondents reporting that this occurs. Trainees appeared to be less confident in achieving their technical skill requirements, with increasing hours not increasing confidence in achieving these skills (P = 0.594). Trainees who worked under 50 h per week were less likely to report fatigue (P = <0.001) and more likely to report greater work enjoyment (P = 0.043), and working hours being conducive to learning (P = 0.015). Fatigue was frequently reported by RANZCOG trainees with increased working hours and long shifts being significant factors in fatigue levels. Strategies should be developed and trialled to enable trainees to obtain adequate case exposure and teaching without compromising patient and doctor safety. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Group 13, 1990 ASCAN Charles J. Precourt at Vance Air Force Base, Oklahoma

NASA Technical Reports Server (NTRS)

1990-01-01

Group 13, 1990 Astronaut Candidate (ASCAN) Charles J. Precourt, suspended in a parachute harness, has just completed a practice parachute jump from a parasail tower during a survival training course exercise at Vance Air Force Base (AFB) in Enid, Oklahoma. The course is designed to familiarize the trainees with procedures to follow in the event of an emergency ejection from a jet aircraft. Precourt, along with 22 other ASCANs, began a year's training and evaluation in July. This session was conducted from 07-29-90 through 07-31-90.

ASCAN Helms simulates parachute jump during VAFB training exercises

NASA Image and Video Library

1990-09-17

S90-48372 (29-31 July 1990) --- Mission specialist astronaut candidate Susan J. Helms simulates a parachute jump during a survival training course at Vance Air Force Base. She is one of 23 astronaut candidates from the Johnson Space Center who have joined military personnel for the special three-day training course. The course is designed to prepare the trainees for proper survival measures to take in the event of an emergency aboard the T-38 jet trainer aircraft they will frequently use once they become full-fledged astronauts.

Engagement and role of surgical trainees in global surgery: Consensus statement and recommendations from the Association of Surgeons in Training.

PubMed

Mohan, Helen M; Fitzgerald, Edward; Gokani, Vimal; Sutton, Paul; Harries, Rhiannon; Bethune, Robert; McDermott, Frank D

2018-04-01

There is a wide chasm in access to essential and emergency surgery between high and low/middle income countries (LMICs). Surgeons worldwide are integral to solutions needed to address this imbalance. Involving surgical trainees, who represent the future of surgery, is vital to this endeavour. The Association of Surgeons in Training (ASiT) is an independent charity that support surgical trainees of all ten surgical specialties in the UK and Ireland. ASiT convened a consensus meeting at the ASiT conference in Liverpool 2016 to discuss trainee engagement with global surgery, including potential barriers and solutions. A face-to-face consensus meeting reviewed the engagement of, and roles for, surgical trainees in global surgery at the ASiT Conference (Liverpool, England), March 2016. Participants self-identified based on experience and interest in the field, and included trainees (residents and students) and consultants (attending grade). Following expert review, seven pre-determined core areas were presented for review and debate. Extensive discussion was facilitated by a consultant and a senior surgical trainee, with expertise in global surgery. The draft derived from these initial discussions was circulated to all those who had participated, and an iterative process of revision was undertaken until a final consensus and recommendations were reached. There is increasing interest from trainee surgeons to work in LMICs. There are however, ethical considerations, and it is important that trainees working in LMICs undertake work appropriate to their training stage and competencies. Visiting surgeons must consider the requirements of the hosting centres rather than just their own objectives. If appropriately organised, both short and long-term visits, can enable development of transferable clinical, organisational, research and education skills. A central repository of information on global surgery would be useful to trainees, to complement existing resources. Challenges to trainees considering a global surgery placement include approval for placements while on a training program, financial cost and dangers inherent in working in a resource poor setting. Currently global surgery experience is generally as an out of program experience and does not count for certificate of completion of training (CCT). Methods to recognise surgical trainee global surgery experience as an integrated part of training should be explored, similar to that seen in other specialties. There is a role for surgical trainees to become involved in Global Surgery, especially in partnership with local surgeons and with appropriate ethical consideration. Trainees develop translational skills in resource poor settings. Development of appropriate pathways for recognition of global surgery experience for CCT should be considered. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

National Institutes of Health Career Development Awards for Cardiovascular Physician-Scientists: Recent Trends and Strategies for Success

PubMed Central

Carlson, Drew E.; Balke, C. William; Jackson, Elizabeth A.; Madhur, Meena S.; Barac, Ana; Abdalla, Marwah; Brittain, Evan L.; Desai, Nihar; Kates, Andrew M.; Freeman, Andrew M.; Mann, Douglas L.

2015-01-01

Nurturing the development of cardiovascular physician-scientist investigators is critical for sustained progress in cardiovascular science and improving human health. The transition from an inexperienced trainee to an independent physician-scientist is a multifaceted process requiring a sustained commitment from the trainee, mentors, and institution. A cornerstone of this training process is a career development (K) award from the National Institutes of Health (NIH). These awards generally require 75% of the awardee’s professional effort devoted to research aims and diverse career development activities carried out in a mentored environment over a 5-year period. We report on recent success rates for obtaining NIH K awards, provide strategies for preparing a successful application and navigating the early career period for aspiring cardiovascular investigators, and offer cardiovascular division leadership perspectives regarding K awards in the current era. Our objective is to offer practical advice that will equip trainees considering an investigator path for success. PMID:26483107

How can surgical training benefit from theories of skilled motor development, musical skill acquisition and performance psychology?

PubMed

McCaskie, Andrew W; Kenny, Dianna T; Deshmukh, Sandeep

2011-05-02

Trainee surgeons must acquire expert status in the context of reduced hours, reduced operating room time and the need to learn complex skills involving screen-mediated techniques, computers and robotics. Ever more sophisticated surgical simulation strategies have been helpful in providing surgeons with the opportunity to practise, but not all of these strategies are widely available. Similarities in the motor skills required in skilled musical performance and surgery suggest that models of music learning, and particularly skilled motor development, may be applicable in training surgeons. More attention should be paid to factors associated with optimal arousal and optimal performance in surgical training - lessons learned from helping anxious musicians optimise performance and manage anxiety may also be transferable to trainee surgeons. The ways in which the trainee surgeon moves from novice to expert need to be better understood so that this process can be expedited using current knowledge in other disciplines requiring the performance of complex fine motor tasks with high cognitive load under pressure.

The pediatric hematology/oncology educational laboratory in-training examination (PHOELIX): A formative evaluation of laboratory skills for Canadian pediatric hematology/oncology trainees.

PubMed

Leung, Elaine; Dix, David; Ford, Jason; Barnard, Dorothy; McBride, Eileen

2015-11-01

Pediatric hematologists/oncologists need to be skilled clinicians, and must also be adept and knowledgeable in relevant areas of laboratory medicine. Canadian training programs in this subspecialty have a minimum requirement for 6 months of training in acquiring "relevant laboratory diagnostic skills." The Canadian pediatric hematology/oncology (PHO) national specialty society, C17, recognized the need for an assessment method in laboratory skills for fellows graduating from PHO training programs. Canadian pediatric hematologists/oncologists were surveyed regarding what were felt to be the essential laboratory-related knowledge and skills deemed necessary for graduating pediatric hematology/oncology trainees. The PHOELIX (Pediatric hematology/oncology educational laboratory in-training examination) was then developed to provide an annual formative evaluation of laboratory skills in Canadian PHO trainees. The majority of PHO respondents (89%) felt that laboratory skills are important in clinical practice. An annual formative examination including review of glass slides was implemented starting in 2010; this provides feedback regarding knowledge of laboratory medicine to both trainees and program directors (PDs). We have successfully created a formative examination that can be used to evaluate and educate trainees, as well as provide PDs with a tool to gauge the effectiveness of their laboratory training curriculum. Feedback has been positive from both trainees and PDs. © 2015 Wiley Periodicals, Inc.

Reliability and validity of procedure-based assessments in otolaryngology training.

PubMed

Awad, Zaid; Hayden, Lindsay; Robson, Andrew K; Muthuswamy, Keerthini; Tolley, Neil S

2015-06-01

To investigate the reliability and construct validity of procedure-based assessment (PBA) in assessing performance and progress in otolaryngology training. Retrospective database analysis using a national electronic database. We analyzed PBAs of otolaryngology trainees in North London from core trainees (CTs) to specialty trainees (STs). The tool contains six multi-item domains: consent, planning, preparation, exposure/closure, technique, and postoperative care, rated as "satisfactory" or "development required," in addition to an overall performance rating (pS) of 1 to 4. Individual domain score, overall calculated score (cS), and number of "development-required" items were calculated for each PBA. Receiver operating characteristic analysis helped determine sensitivity and specificity. There were 3,152 otolaryngology PBAs from 46 otolaryngology trainees analyzed. PBA reliability was high (Cronbach's α 0.899), and sensitivity approached 99%. cS correlated positively with pS and level in training (rs : +0.681 and +0.324, respectively). ST had higher cS and pS than CT (93% ± 0.6 and 3.2 ± 0.03 vs. 71% ± 3.1 and 2.3 ± 0.08, respectively; P < .001). cS and pS increased from CT1 to ST8 showing construct validity (rs : +0.348 and +0.354, respectively; P < .001). The technical skill domain had the highest utilization (98% of PBAs) and was the best predictor of cS and pS (rs : +0.96 and +0.66, respectively). PBA is reliable and valid for assessing otolaryngology trainees' performance and progress at all levels. It is highly sensitive in identifying competent trainees. The tool is used in a formative and feedback capacity. The technical domain is the best predictor and should be given close attention. NA. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Resident Autonomy in the Operating Room: Expectations Versus Reality.

PubMed

Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M

2017-09-01

There is concern about graduating thoracic trainees' independent operative skills due to limited autonomy in training. This study compared faculty and trainee expected levels of autonomy with intraoperative measurements of autonomy for common cardiothoracic operations. Participants underwent frame-of-reference training on the 4-point Zwisch scale of operative autonomy (show and tell → active help → passive help → supervision only) and evaluated autonomy in actual cases using the Zwisch Me!! mobile application. A separate "expected autonomy" survey elicited faculty and resident perceptions of how much autonomy a resident should have for six common operations: decortication, wedge resection, thoracoscopic lobectomy, coronary artery bypass grafting, aortic valve replacement, and mitral valve repair. Thirty-three trainees from 7 institutions submitted evaluations of 596 cases over 18 months (March 2015 to September 2016). Thirty attendings subsequently provided their evaluation of 476 of those cases (79.9% response rate). Expected autonomy surveys were completed by 21 attendings and 19 trainees from 5 institutions. The six operations included in the survey constituted 47% (226 of 476) of the cases evaluated. Trainee and attending expectations did not differ significantly for senior trainees. Both groups expected significantly higher levels of autonomy than observed in the operating room for all six types of cases. Although faculty and trainees both expect similar levels of autonomy in the operating room, real-time measurements of autonomy show a gap between expectations and reality. Decreasing this gap will require a concerted effort by both faculty and residents to focus on the development of independent operative skills. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Proficiency-based laparoscopic and endoscopic training with virtual reality simulators: a comparison of proctored and independent approaches.

PubMed

Snyder, Christopher W; Vandromme, Marianne J; Tyra, Sharon L; Hawn, Mary T

2009-01-01

Virtual reality (VR) simulators for laparoscopy and endoscopy may be valuable tools for resident education. However, the cost of such training in terms of trainee and instructor time may vary depending upon whether an independent or proctored approach is employed. We performed a randomized controlled trial to compare independent and proctored methods of proficiency-based VR simulator training. Medical students were randomized to independent or proctored training groups. Groups were compared with respect to the number of training hours and task repetitions required to achieve expert level proficiency on laparoscopic and endoscopic simulators. Cox regression modeling was used to compare time to proficiency between groups, with adjustment for appropriate covariates. Thirty-six medical students (18 independent, 18 proctored) were enrolled. Achievement of overall simulator proficiency required a median of 11 hours of training (range, 6-21 hours). Laparoscopic and endoscopic proficiency were achieved after a median of 11 (range, 6-32) and 10 (range, 5-27) task repetitions, respectively. The number of repetitions required to achieve proficiency was similar between groups. After adjustment for covariates, trainees in the independent group achieved simulator proficiency with significantly fewer hours of training (hazard ratio, 2.62; 95% confidence interval, 1.01-6.85; p = 0.048). Our study quantifies the cost, in instructor and trainee hours, of proficiency-based laparoscopic and endoscopic VR simulator training, and suggests that proctored instruction does not offer any advantages to trainees. The independent approach may be preferable for surgical residency programs desiring to implement VR simulator training.

38 CFR 21.218 - Methods of furnishing supplies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... facility has designated a supplier. Prior authorization of supplies by the case manager is required, except for standard sets of books, tools, or supplies which the facility requires all trainees or employees...

Development of subliminal persuasion system to improve the upper limb posture in laparoscopic training: a preliminary study.

PubMed

Zhang, Di; Sessa, Salvatore; Kong, Weisheng; Cosentino, Sarah; Magistro, Daniele; Ishii, Hiroyuki; Zecca, Massimiliano; Takanishi, Atsuo

2015-11-01

Current training for laparoscopy focuses only on the enhancement of manual skill and does not give advice on improving trainees' posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limb posture during laparoscopic training like the expert but leads to a lower increment in the workload. A 9-axis inertial measurement unit was used to compute the upper limb posture, and a Detection Reaction Time device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limb posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli. We found that subliminal visual stimulation is a valid method to improve trainees' upper limb posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level. We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limb posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: Subliminal persuasion improved upper limb posture of trainees, with a smaller increase on the overall workload.

Work-family balance by women GP specialist trainees in Slovenia: a qualitative study.

PubMed

Petek, Davorina; Gajsek, Tadeja; Petek Ster, Marija

2016-01-28

Women physicians face many challenges while balancing their many roles: doctor, specialist trainee, mother and partner. The most opportune biological time for a woman to start a family coincides with a great deal of demands and requirements at work. In this study we explored the options and capabilities of women GP specialist trainees in coordinating their family and career. This is a phenomenological qualitative research. Ten GP specialist trainees from urban and rural areas were chosen by the purposive sampling technique, and semi-structured in-depth interviews were conducted, recorded, transcribed and analysed by using thematic analysis process. Open coding and the book of codes were formed. Finally, we performed the process of code reduction by identifying the themes, which were compared, interpreted and organised in the highest analytical units--categories. One hundred fifty-five codes were identified in the analysis, which were grouped together into eleven themes. The identified themes are: types, causes and consequences of burdens, work as pleasure and positive attitude toward self, priorities, planning and help, and understanding of superiors, disburdening and changing in specialisation. The themes were grouped into four large categories: burdens, empowerment, coordination and needs for improvement. Women specialist trainees encounter intense burdens at work and home due to numerous demands and requirements during their specialisation training. In addition, there is also the issue of the work-family conflict. There are many consequences regarding burden and strain; however, burnout stands out the most. In contrast, reconciliation of work and family life and needs can be successful. The key element is empowerment of women doctors. The foremost necessary systemic solution is the reinforcement of general practitioners in primary health care and their understanding of the specialisation training scheme with more flexible possibilities for time adaptations of specialist training.

Face and content validation of a novel three-dimensional printed temporal bone for surgical skills development.

PubMed

Da Cruz, M J; Francis, H W

2015-07-01

To assess the face and content validity of a novel synthetic, three-dimensional printed temporal bone for surgical skills development and training. A synthetic temporal bone was printed using composite materials and three-dimensional printing technology. Surgical trainees were asked to complete three structured temporal bone dissection exercises. Attitudes and impressions were then assessed using a semi-structured questionnaire. Previous cadaver and real operating experiences were used as a reference. Trainees' experiences of the synthetic temporal bone were analysed in terms of four domains: anatomical realism, usefulness as a training tool, task-based usefulness and overall reactions. Responses across all domains indicated a high degree of acceptance, suggesting that the three-dimensional printed temporal bone was a useful tool in skills development. A sophisticated three-dimensional printed temporal bone that demonstrates face and content validity was developed. The efficiency in cost savings coupled with low associated biohazards make it likely that the printed temporal bone will be incorporated into traditional temporal bone skills development programmes in the near future.

Comparing the content of leadership theories and managers' shared perceptions of effective leadership: a Q-method study of trainee managers in the English NHS.

PubMed

Freeman, Tim

2013-08-01

Health service managers face potential conflicts between corporate and professional agendas, a tension sharpened for trainees by their junior status and relative inexperience. While academic leadership theory forms an integral part of contemporary management development programmes, relatively little is known of trainees' patterned subjectivities in relation to leadership theories. The objective of this study was to explore such subjectivities within a cohort of trainees on the National Health Service Graduate Management Training Scheme (NHS GMTS), a 'fast-track' programme which prepares graduate entrants for director-level health service management posts. A Q-method design was used and four shared subjectivities were identified: leadership as collaborative social process ('relational'); leadership as integrity ('moral'); leadership as effective support of subordinates ('team'); and leadership as construction of a credible leadership persona ('identity'). While the factors broadly map onto competencies indicated within the NHS Leadership Qualities Framework which underpin assessments of performance for this student group, it is important not to overstate the governance effect of the assessment regime. Rather, factors reflect tensions between required competencies, namely the mobilisation of diverse interest groups, the ethical base of decisions and the identity work required to convince others of leadership status. Indeed, factor 2 ('moral') effectively defines leadership as the embodiment of public service ethos. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Learners' perspective: where and when pre-residency trainees learn more to achieve their core clinical competencies.

PubMed

Ahn, Eusang; Ahn, Ducksun; Lee, Young-Mee

2016-12-01

While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews. The questionnaire was based on the Accreditation Council for Graduate Medical Education core competencies. The majority of core clinical skills were acquired during their rotations in emergency medicine, general surgery, and cardiothoracic surgery. The semistructured interviews revealed that these departments required their trainees to be highly involved and analytical, and participate in clinical discourse. The common factor among the three departments is an environment in which trainees are highly involved in clinical duties, and are expected to make first-contact patient encounters, participate in clinical discourse, interpret investigative results and arrive at their own conclusions. Work-based learning appear to be key to the trends observed, and further study is warranted to determine whether these findings are indicative of true acquisition of clinical competence.

The Introduction of Standard Operating Procedures to Improve Burn Care in the United Kingdom.

PubMed

Lymperopoulos, Nikolaos Spyros; Jeevan, Ranjeet; Godwin, Lindsey; Wilkinson, Donnas; Shokrollahi, Kayvan; James, Malcolm Ian

2015-01-01

United Kingdom (UK) burn units face substantial new obstacles in delivering high quality care because of the advent of full-shift working patterns, cross-specialty cover arrangements, and increased trainee turnover. Junior trainees rely heavily on senior colleagues, who may not be readily accessible. The authors therefore proposed the introduction of standard operating procedures (SOPs), detailed written instructions used to achieve uniformity in performance and to improve outcomes. After undertaking a preliminary strength, weaknesses, opportunities, and threats analysis of their use locally and nationally, the authors set out to systematically develop burn-specific SOPs. The authors first mapped our existing local SOPs to the newly introduced UK national burn care pathway to specify gaps in coverage. The authors then administered a questionnaire to other UK burn units to identify SOPs already used elsewhere. Finally, the authors developed and piloted a robust pathway for the development, introduction, and auditing of new SOPs. The strength, weaknesses, opportunities, and threats analysis identified significant benefits and minimal risks. The mapping exercise identified specific deficiencies in our coverage of the national pathway. All 26 UK burn units responded to our questionnaire; only 12 had one or more SOPs (mean, 2.1). These covered initial assessment, inhalational injuries, drug prescribing, wound care, and gastric protection; none were audited. Locally, the authors have begun to develop the additional SOPs required. SOPs have not been instituted widely in the UK, despite the shift toward a standardized national care pathway and their association with improved outcomes. The authors hope that the systematic approach to their development and implementation demonstrates the feasibility of their wider use within UK regional burn centers and beyond.

Adaptive leadership curriculum for Indian paramedic trainees.

PubMed

Mantha, Aditya; Coggins, Nathaniel L; Mahadevan, Aditya; Strehlow, Rebecca N; Strehlow, Matthew C; Mahadevan, S V

2016-12-01

Paramedic trainees in developing countries face complex and chaotic clinical environments that demand effective leadership, communication, and teamwork. Providers must rely on non-technical skills (NTS) to manage bystanders and attendees, collaborate with other emergency professionals, and safely and appropriately treat patients. The authors designed a NTS curriculum for paramedic trainees focused on adaptive leadership, teamwork, and communication skills critical to the Indian prehospital environment. Forty paramedic trainees in the first academic year of the 2-year Advanced Post-Graduate Degree in Emergency Care (EMT-paramedic equivalent) program at the GVK-Emergency Management and Research Institute campus in Hyderabad, India, participated in the 6-day leadership course. Trainees completed self-assessments and delivered two brief video-recorded presentations before and after completion of the curriculum. Independent blinded observers scored the pre- and post-intervention presentations delivered by 10 randomly selected paramedic trainees. The third-party judges reported significant improvement in both confidence (25 %, p < 0.01) and body language of paramedic trainees (13 %, p < 0.04). Self-reported competency surveys indicated significant increases in leadership (2.6 vs. 4.6, p < 0.001, d = 1.8), public speaking (2.9 vs. 4.6, p < 0.001, d = 1.4), self-reflection (2.7 vs. 4.6, p < 0.001, d = 1.6), and self-confidence (3.0 vs. 4.8, p < 0.001, d = 1.5). Participants in a 1-week leadership curriculum for prehospital providers demonstrated significant improvement in self-reported NTS commonly required of paramedics in the field. The authors recommend integrating focused NTS development curriculum into Indian paramedic education and further evaluation of the long term impacts of this adaptive leadership training.

Have restricted working hours reduced junior doctors' experience of fatigue? A focus group and telephone interview study.

PubMed

Morrow, Gill; Burford, Bryan; Carter, Madeline; Illing, Jan

2014-03-06

To explore the effects of the UK Working Time Regulations (WTR) on trainee doctors' experience of fatigue. Qualitative study involving focus groups and telephone interviews, conducted in Spring 2012 with doctors purposively selected from Foundation and specialty training. Final compliance with a 48 h/week limit had been required for trainee doctors since August 2009. Framework analysis of data. 9 deaneries in all four UK nations; secondary care. 82 doctors: 53 Foundation trainees and 29 specialty trainees. 36 participants were male and 46 female. Specialty trainees were from a wide range of medical and surgical specialties, and psychiatry. Implementation of the WTR, while acknowledged as an improvement to the earlier situation of prolonged excessive hours, has not wholly overcome experience of long working hours and fatigue. Fatigue did not only arise from the hours that were scheduled, but also from an unpredictable mixture of shifts, work intensity (which often resulted in educational tasks being taken home) and inadequate rest. Fatigue was also caused by trainees working beyond their scheduled hours, for reasons such as task completion, accessing additional educational opportunities beyond scheduled hours and staffing shortages. There were also organisational, professional and cultural drivers, such as a sense of responsibility to patients and colleagues and the expectations of seniors. Fatigue was perceived to affect efficiency of skills and judgement, mood and learning capacity. Long-term risks of continued stress and fatigue, for doctors and for the effective delivery of a healthcare service, should not be ignored. Current monitoring processes do not reflect doctors' true working patterns. The effectiveness of the WTR cannot be considered in isolation from the culture and context of the workplace. On-going attention needs to be paid to broader cultural issues, including the relationship between trainees and seniors.

Establishing High-Quality Prostate Brachytherapy Using a Phantom Simulator Training Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thaker, Nikhil G.; Kudchadker, Rajat J.; Swanson, David A.

2014-11-01

Purpose: To design and implement a unique training program that uses a phantom-based simulator to teach the process of prostate brachytherapy (PB) quality assurance and improve the quality of education. Methods and Materials: Trainees in our simulator program were practicing radiation oncologists, radiation oncology residents, and fellows of the American Brachytherapy Society. The program emphasized 6 core areas of quality assurance: patient selection, simulation, treatment planning, implant technique, treatment evaluation, and outcome assessment. Using the Iodine 125 ({sup 125}I) preoperative treatment planning technique, trainees implanted their ultrasound phantoms with dummy seeds (ie, seeds with no activity). Pre- and postimplant dosimetric parametersmore » were compared and correlated using regression analysis. Results: Thirty-one trainees successfully completed the simulator program during the period under study. The mean phantom prostate size, number of seeds used, and total activity were generally consistent between trainees. All trainees met the V100 >95% objective both before and after implantation. Regardless of the initial volume of the prostate phantom, trainees' ability to cover the target volume with at least 100% of the dose (V100) was not compromised (R=0.99 pre- and postimplant). However, the V150 had lower concordance (R=0.37) and may better reflect heterogeneity control of the implant process. Conclusions: Analysis of implants from this phantom-based simulator shows a high degree of consistency between trainees and uniformly high-quality implants with respect to parameters used in clinical practice. This training program provides a valuable educational opportunity that improves the quality of PB training and likely accelerates the learning curve inherent in PB. Prostate phantom implantation can be a valuable first step in the acquisition of the required skills to safely perform PB.« less

Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance.

PubMed

Gostlow, Hannah; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large-scale surveys, is required to provide more definitive answers to the degree in which various incentives influence trainees' motivations and actual attendance rates. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Surgical activity of first-year Canadian neurosurgical residents.

PubMed

Fallah, Aria; Ebrahim, Shanil; Haji, Faizal; Gillis, Christopher; Girgis, Fady; Howe, Kathryn; Ibrahim, George M; Radic, Julia; Shahideh, Mehdi; Wallace, M Christopher

2010-11-01

Surgical activity is probably the most important component of surgical training. During the first year of surgical residency, there is an early opportunity for the development of surgical skills, before disparities between the skill sets of residents increase in future years. It is likely that surgical skill is related to operative volumes. There are no published guidelines that quantify the number of surgical cases required to achieve surgical competency. The aim of this study was to describe the current trends in surgical activity in a recent cohort of first-year Canadian neurosurgical trainees. This study utilized retrospective database review and survey methodology to describe the current state of surgical training for first-year neurosurgical trainees. A committee of five residents designed this survey in an effort to capture factors that may influence the operative activity of trainees. Nine out of a cohort of 20 first-year Canadian neurosurgical trainees that began training in July of 2008 participated in the study. The median number of cases completed by a resident during the initial three month neurosurgical rotation was 66, within which the trainee was identified as the primary surgeon in 12 cases. Intracranial hemorrhage and cerebrospinal fluid diversion procedures were the most common operations to have the trainee as primary surgeon. Based on this pilot study, it appears that the operative activity of Canadian first-year residents is at least equivalent to the residents of other studied training systems with respect to volume and diversity of surgical activity.

Proposed In-Training Electrocardiogram Interpretation Competencies for Undergraduate and Postgraduate Trainees.

PubMed

Antiperovitch, Pavel; Zareba, Wojciech; Steinberg, Jonathan S; Bacharova, Ljuba; Tereshchenko, Larisa G; Farre, Jeronimo; Nikus, Kjell; Ikeda, Takanori; Baranchuk, Adrian

2018-03-01

Despite its importance in everyday clinical practice, the ability of physicians to interpret electrocardiograms (ECGs) is highly variable. ECG patterns are often misdiagnosed, and electrocardiographic emergencies are frequently missed, leading to adverse patient outcomes. Currently, many medical education programs lack an organized curriculum and competency assessment to ensure trainees master this essential skill. ECG patterns that were previously mentioned in literature were organized into groups from A to D based on their clinical importance and distributed among levels of training. Incremental versions of this organization were circulated among members of the International Society of Electrocardiology and the International Society of Holter and Noninvasive Electrocardiology until complete consensus was reached. We present reasonably attainable ECG interpretation competencies for undergraduate and postgraduate trainees. Previous literature suggests that methods of teaching ECG interpretation are less important and can be selected based on the available resources of each education program and student preference. The evidence clearly favors summative trainee evaluation methods, which would facilitate learning and ensure that appropriate competencies are acquired. Resources should be allocated to ensure that every trainee reaches their training milestones and should ensure that no electrocardiographic emergency (class A condition) is ever missed. We hope that these guidelines will inform medical education programs and encourage them to allocate sufficient resources and develop organized curricula. Assessments must be in place to ensure trainees acquire the level-appropriate ECG interpretation skills that are required for safe clinical practice. © 2017 Society of Hospital Medicine.

Peer mentoring: evaluation of a novel programme in paediatrics.

PubMed

Eisen, Sarah; Sukhani, Seema; Brightwell, Alex; Stoneham, Sara; Long, Andrew

2014-02-01

Mentoring is important for personal and professional development of doctors. Peer mentoring is a core skill in the UK paediatric postgraduate curriculum. However, there is a paucity of peer mentoring programmes aimed at postgraduate doctors in training (postgraduate trainees), and there are no such schemes within paediatrics described in the literature. We developed a regional peer mentoring programme for postgraduate trainees in paediatrics to assess demand and need for peer mentoring and to explore the benefits for both peer mentees and mentors. Junior postgraduate trainees, randomly selected from volunteers, received peer mentoring from more senior trainees for 1 year. Peer mentors were selected by competitive application and undertook tailored training followed by an experiential learning programme. The programme was evaluated using structured questionnaires. 90% (76/84) of first-year postgraduate trainees in paediatrics applied to participate, demonstrating high demand. 18 peer mentor-mentee pairs were matched. Peer mentors and mentees reported high satisfaction rates, acquisition of new and transferable skills and changed behaviours. All peer mentors intended to use the skills in their workplace and, later, as an educational supervisor. Our programme represents a novel approach to meeting the demonstrated demand and the curriculum requirement for peer mentoring, and enabled peer mentors and mentees to develop a valuable and versatile skill set. To our knowledge, it is the first such programme in paediatrics and provides a feasibility model that may be adapted locally to allow education providers to offer this important experience to postgraduate trainees.

Peer mentoring: evaluation of a novel programme in paediatrics

PubMed Central

Eisen, Sarah; Sukhani, Seema; Brightwell, Alex; Stoneham, Sara; Long, Andrew

2014-01-01

Background Mentoring is important for personal and professional development of doctors. Peer mentoring is a core skill in the UK paediatric postgraduate curriculum. However, there is a paucity of peer mentoring programmes aimed at postgraduate doctors in training (postgraduate trainees), and there are no such schemes within paediatrics described in the literature. We developed a regional peer mentoring programme for postgraduate trainees in paediatrics to assess demand and need for peer mentoring and to explore the benefits for both peer mentees and mentors. Programme design Junior postgraduate trainees, randomly selected from volunteers, received peer mentoring from more senior trainees for 1 year. Peer mentors were selected by competitive application and undertook tailored training followed by an experiential learning programme. The programme was evaluated using structured questionnaires. Results 90% (76/84) of first-year postgraduate trainees in paediatrics applied to participate, demonstrating high demand. 18 peer mentor–mentee pairs were matched. Peer mentors and mentees reported high satisfaction rates, acquisition of new and transferable skills and changed behaviours. All peer mentors intended to use the skills in their workplace and, later, as an educational supervisor. Conclusions Our programme represents a novel approach to meeting the demonstrated demand and the curriculum requirement for peer mentoring, and enabled peer mentors and mentees to develop a valuable and versatile skill set. To our knowledge, it is the first such programme in paediatrics and provides a feasibility model that may be adapted locally to allow education providers to offer this important experience to postgraduate trainees. PMID:24152570

Integrating Family as a Discipline by Providing Parent Led Curricula: Impact on LEND Trainees' Leadership Competency.

PubMed

Keisling, Bruce L; Bishop, Elizabeth A; Roth, Jenness M

2017-05-01

Background While the MCH Leadership Competencies and family as a discipline have been required elements of Leadership Education in Neurodevelopmental and related Disabilities (LEND) programs for over a decade, little research has been published on the efficacy of either programmatic component in the development of the next generation of leaders who can advocate and care for Maternal and Child Health (MCH) populations. Objective To test the effectiveness of integrating the family discipline through implementation of parent led curricula on trainees' content knowledge, skills, and leadership development in family-centered care, according to the MCH Leadership Competencies. Methods One hundred and two long-term (≥ 300 h) LEND trainees completed a clinical and leadership training program which featured intensive parent led curricula supported by a full-time family faculty member. Trainees rated themselves on the five Basic and Advanced skill items that comprise MCH Leadership Competency 8: Family-centered Care at the beginning and conclusion of their LEND traineeship. Results When compared to their initial scores, trainees rated themselves significantly higher across all family-centered leadership competency items at the completion of their LEND traineeship. Conclusions The intentional engagement of a full-time family faculty member and parent led curricula that include didactic and experiential components are associated with greater identification and adoption by trainees of family-centered attitudes, skills, and practices. However, the use of the MCH Leadership Competencies as a quantifiable measure of program evaluation, particularly leadership development, is limited.

Critical care trainees' career goals and needs: A Canadian survey.

PubMed

St-Onge, Maude; Mandelzweig, Keren; Marshall, John C; Scales, Damon C; Granton, John

2014-01-01

For training programs to meet the needs of trainees, an understanding of their career goals and expectations is required. Canadian critical care medicine (CCM) trainees were surveyed to understand their career goals in terms of clinical work, research, teaching, administration and management; and to identify their perceptions regarding the support they need to achieve their goals. The online survey was sent to all trainees registered in a Canadian adult or pediatric CCM program. It documented the participants' demographics; their career expectations; the perceived barriers and enablers to achieve their career goals; and their perceptions relating to their chances of developing a career in different areas. A response rate of 85% (66 of 78) was obtained. The majority expected to work in an academic centre. Only approximately one-third (31%) estimated their chances of obtaining a position in CCM as >75%. The majority planned to devote 25% to 75% of their time performing clinical work and <25% in education, research or administration. The trainees perceived that there were limited employment opportunities. Networking and having specialized expertise were mentioned as being facilitators for obtaining employment. They expressed a need for more protected time, resources and mentorship for nonclinical tasks during training. CCM trainees perceived having only limited support to help them to achieve their career goals and anticipate difficulties in obtaining successful employment. They identified several gaps that could be addressed by training programs, including more mentoring in the areas of research, education and administration.

Computer Modeling to Evaluate the Impact of Technology Changes on Resident Procedural Volume.

PubMed

Grenda, Tyler R; Ballard, Tiffany N S; Obi, Andrea T; Pozehl, William; Seagull, F Jacob; Chen, Ryan; Cohn, Amy M; Daskin, Mark S; Reddy, Rishindra M

2016-12-01

As resident "index" procedures change in volume due to advances in technology or reliance on simulation, it may be difficult to ensure trainees meet case requirements. Training programs are in need of metrics to determine how many residents their institutional volume can support. As a case study of how such metrics can be applied, we evaluated a case distribution simulation model to examine program-level mediastinoscopy and endobronchial ultrasound (EBUS) volumes needed to train thoracic surgery residents. A computer model was created to simulate case distribution based on annual case volume, number of trainees, and rotation length. Single institutional case volume data (2011-2013) were applied, and 10 000 simulation years were run to predict the likelihood (95% confidence interval) of all residents (4 trainees) achieving board requirements for operative volume during a 2-year program. The mean annual mediastinoscopy volume was 43. In a simulation of pre-2012 board requirements (thoracic pathway, 25; cardiac pathway, 10), there was a 6% probability of all 4 residents meeting requirements. Under post-2012 requirements (thoracic, 15; cardiac, 10), however, the likelihood increased to 88%. When EBUS volume (mean 19 cases per year) was concurrently evaluated in the post-2012 era (thoracic, 10; cardiac, 0), the likelihood of all 4 residents meeting case requirements was only 23%. This model provides a metric to predict the probability of residents meeting case requirements in an era of changing volume by accounting for unpredictable and inequitable case distribution. It could be applied across operations, procedures, or disease diagnoses and may be particularly useful in developing resident curricula and schedules.

Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries.

PubMed

Waryasz, Gregory R; Daniels, Alan H; Gil, Joseph A; Suric, Vladimir; Eberson, Craig P

2016-09-19

Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor's degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor's degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness.

Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries

PubMed Central

Waryasz, Gregory R.; Daniels, Alan H.; Gil, Joseph A.; Suric, Vladimir; Eberson, Craig P.

2016-01-01

Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness. PMID:27761219

VR-simulation cataract surgery in non-experienced trainees: evolution of surgical skill

NASA Astrophysics Data System (ADS)

Söderberg, Per; Erngrund, Markus; Skarman, Eva; Nordh, Leif; Laurell, Carl-Gustaf

2011-03-01

Conclusion: The current data imply that the performance index as defined herein is a valid measure of the performance of a trainee using the virtual reality phacoemulsification simulator. Further, the performance index increase linearly with measurement cycles for less than five measurement cycles. To fully use the learning potential of the simulator more than four measurement cycles are required. Materials and methods: Altogether, 10 trainees were introduced to the simulator by an instructor and then performed a training program including four measurement cycles with three iterated measurements of the simulation at the end of each cycle. The simulation characteristics was standardized and defined in 14 parameters. The simulation was measured separately for the sculpting phase in 21 variables, and for the evacuation phase in 22 variables. A performance index based on all measured variables was estimated for the sculpting phase and the evacuation phase, respectively, for each measurement and the three measurements for each cycle were averaged. Finally, the performance as a function of measurement cycle was estimated for each trainee with regression, assuming a straight line. The estimated intercept and inclination coefficients, respectively, were finally averaged for all trainees. Results: The performance increased linearly with the number of measurement cycles both for the sculpting and for the evacuation phase.

Basic surgical training in the era of the European Working Time Directive: what are the problems and solutions?

PubMed

Skipworth, R J E; Terrace, J D; Fulton, L A; Anderson, D N

2008-11-01

Imposed reductions in working hours will impact significantly on the ability of surgical trainees to achieve competency. The objective of this study was to obtain the opinions of Scottish surgical trainees concerning the training they receive, in order to inform and guide the development of future, high-standard training programmes. An anonymous questionnaire was sent to basic surgical trainees on the Edinburgh, Aberdeen and Dundee Basic Surgical Rotations commencing after August 2002. Thirty six questionnaire responses were analysed. Very few of the returned comments were complimentary to the existing training structure; indeed, most comments demonstrated significant trainee disappointment. Despite "regular" exposure to operative sessions, training tutorials and named consultant trainers, the most common concern was a perceived lack of high-quality, structured, operative exposure and responsibility. Textbooks and journals remain the most frequently utilised learning tools, with high-tech systems such as teleconferencing, videos, CD-ROMS, and DVDs being poorly exploited. Current surgical training is not meeting the expectation of the majority of its trainees. To solve this problem will require extensive revision of attitudes and current educational format. A greater emphasis on the integration of 21st century learning tools in the training programme may help bridge this gap.

National Institutes of Health Career Development Awards for Cardiovascular Physician-Scientists: Recent Trends and Strategies for Success.

PubMed

Lindman, Brian R; Tong, Carl W; Carlson, Drew E; Balke, C William; Jackson, Elizabeth A; Madhur, Meena S; Barac, Ana; Abdalla, Marwah; Brittain, Evan L; Desai, Nihar; Kates, Andrew M; Freeman, Andrew M; Mann, Douglas L

2015-10-20

Nurturing the development of cardiovascular physician-scientist investigators is critical for sustained progress in cardiovascular science and improving human health. The transition from an inexperienced trainee to an independent physician-scientist is a multifaceted process requiring a sustained commitment from the trainee, mentors, and institution. A cornerstone of this training process is a career development (K) award from the National Institutes of Health (NIH). These awards generally require 75% of the awardee's professional effort devoted to research aims and diverse career development activities carried out in a mentored environment over a 5-year period. We report on recent success rates for obtaining NIH K awards, provide strategies for preparing a successful application and navigating the early career period for aspiring cardiovascular investigators, and offer cardiovascular division leadership perspectives regarding K awards in the current era. Our objective is to offer practical advice that will equip trainees considering an investigator path for success. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Two Models to Conduct Nonphysician-led Exercise Stress Testing in Low to Intermediate Risk Patients.

PubMed

Scott, Adam; Whitman, Mark; McDonald, Alice; Webster, Meghan; Jenkins, Carly

2017-03-01

Exercise stress testing (EST) is a noninvasive procedure that aids the diagnosis and prognosis of a range of cardiac pathologies. Reduced access is recognized as a limiting factor in enabling early access to treatment or safe and appropriate discharge. Increased accessibility can be achieved by utilizing nonphysician health practitioners to supervise tests. To implement nonphysician-led EST in clinical environments, there is a need for the development and administration of feasible and effective models. Via inpatient and outpatient referral, this article aims to present 2 standardized models of care for patients requiring EST for diagnostic and prognostic evaluation of numerous pathologies. An inpatient and outpatient model was implemented at the Royal Brisbane and Women's Hospital and Logan Hospital in Queensland, Australia between July 2013 and December 2015. Tests were performed by 2 cardiac scientists employed by each hospital. All tests were immediately reported by a cardiology advanced trainee registrar or consultant cardiologist. A total of 2095 tests were performed via the 2 models. Overall, 73 had a positive result (3.5%), 120 equivocal (5.7%), 129 inconclusive/submaximal (6.2%), and 1773 negative (85.2%). After further testing, 38 of the patients with positive and equivocal results were diagnosed with flow-limiting coronary artery disease. The remaining patients were resolved as negative through further diagnostic testing or lost to follow up. After implementation of the 2 models, patient flow was improved for earlier discharge, reduced waiting times, or timely identification of possible cardiac pathologies, thereby optimizing patient care.

Childhood cancer survivorship educational resources in North American pediatric hematology/oncology fellowship training programs: a survey study.

PubMed

Nathan, Paul C; Schiffman, Joshua D; Huang, Sujuan; Landier, Wendy; Bhatia, Smita; Eshelman-Kent, Debra; Wright, Jennifer; Oeffinger, Kevin C; Hudson, Melissa M

2011-12-15

Childhood cancer survivors require life-long care by clinicians with an understanding of the specific risks arising from the prior cancer and its therapy. We surveyed North American pediatric hematology/oncology training programs to evaluate their resources and capacity for educating medical trainees about survivorship. An Internet survey was sent to training program directors and long-term follow-up clinic (LTFU) directors at the 56 US and Canadian centers with pediatric hematology/oncology fellowship programs. Perceptions regarding barriers to and optimal methods of delivering survivorship education were compared among training program and LTFU clinic directors. Responses were received from 45/56 institutions of which 37/45 (82%) programs require that pediatric hematology/oncology fellows complete a mandatory rotation focused on survivorship. The rotation is 4 weeks or less in 21 programs. Most (36/45; 80%) offer didactic lectures on survivorship as part of their training curriculum, and these are considered mandatory for pediatric hematology/oncology fellows at 26/36 (72.2%). Only 10 programs (22%) provide training to medical specialty trainees other than pediatric hematology/oncology fellows. Respondents identified lack of time for trainees to spend learning about late effects as the most significant barrier to providing survivorship teaching. LTFU clinic directors were more likely than training program directors to identify lack of interest in survivorship among trainees and survivorship not being a formal or expected part of the fellowship training program as barriers. The results of this survey highlight the need to establish standard training requirements to promote the achievement of basic survivorship competencies by pediatric hematology/oncology fellows. Copyright © 2011 Wiley Periodicals, Inc.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ragan, Eric D; Bowman, Doug A; Scerbo, Siroberto

Virtual reality (VR) systems have been proposed for use in numerous training scenarios, such as room clearing, which require the trainee to maintain spatial awareness. But many VR training systems lack a fully surrounding display, requiring trainees to use a combination of physical and virtual turns to view the environment, thus decreasing spatial awareness. One solution to this problem is to amplify head rotations, such that smaller physical turns are mapped to larger virtual turns, allowing trainees to view the surrounding environment with head movements alone. For example, in a multi-monitor system covering only a 90-degree field of regard, headmore » rotations could be amplified four times to allow the user to see the entire 360-degree surrounding environment. This solution is attractive because it can be used with lower-cost VR systems and does not require virtual turning. However, the effects of amplified head rotations on spatial awareness and training transfer are not well understood. We hypothesized that small amounts of amplification might be tolerable, but that larger amplifications might cause trainees to become disoriented and to have decreased task performance and training transfer. In this paper, we will present our findings from an experiment designed to investigate these hypotheses. The experiment placed users in a virtual warehouse and asked them to move from room to room, counting objects placed around them in space. We varied the amount of amplification applied during these trials, and also varied the type of display used (head-mounted display or CAVE). We measured task performance and spatial awareness. We then assessed training transfer in an assessment environment with a fully surrounding display and no amplification. The results of this study will inform VR training system developers about the potential negative effects of using head rotation amplification and contribute to more effective VR training system design.« less

The Relative Success of a Self-Help and a Group-Based Memory Training Program for Older Adults

PubMed Central

Hastings, Erin C.; West, Robin L.

2011-01-01

This study evaluates self-help and group-based memory training programs to test for their differential impact on memory beliefs and performance. Self-help participants used a manual that presented strategies for name, story, and list recall and practice exercises. Matched content from that same manual was presented by the trainer in 2-hr weekly group sessions for the group-based trainees. Relative to a wait-list control group, most memory measures showed significant gains for both self-help and group-based training, with no significant training condition differences, and these gains were maintained at follow-up. Belief measures showed that locus of control was significantly higher for the self-help and group-based training than the control group; memory self-efficacy significantly declined for controls, increased for group-trained participants, and remained constant in the self-help group. Self-efficacy change in a self-help group may require more opportunities for interacting with peers and/or an instructor emphasizing one's potential for memory change. PMID:19739914

Efficacy and Efficiency of Webcast Orientations Versus Live Resident Orientations: Results of a 2-Year Survey

PubMed Central

Andolsek, Kathryn M.; Murphy, Gwen; Pinheiro, Sandro; Petrusa, Emil; Tuck, Tammy; Weinerth, John

2010-01-01

Background Beginning a graduate medical education training program is associated with a steep learning curve for incoming residents. Objective To compare the efficacy and efficiency of live versus webcast formats for Institutional Orientation. Methods This 2-year non-blinded study, with a nonrandomized cohort, compares outcomes for trainees oriented Summer 2005 in a ‘‘live-lecture’’ format with trainees oriented Summer 2006 using a webcast format. Outcomes include posttest success, the time required, presentation quality and utility, and cost. Results In 2005, 249 trainees attended the live orientation. Of the 211 who completed the posttest; 132 (63%) passed it within 3 attempts. Of the 241 trainees in 2006, 236 completed the posttest. Of these, 215 (91%) passed it within 3 attempts. Compared to the live-lecture cohort, the webcast cohort rated the posttest as more difficult. Despite performing better, significantly fewer trainees in the webcast cohort rated the posttest as “appropriate” (χ2 =  5 28.57, df 5 1, P , .001). There were no significant differences between the 2 groups on their perceptions of quality and utility of the presentations. While the first year cost of the webcast exceeded that of live lectures, the amortized cost was nearly identical to the live-lecture costs. Discussion As corroborated by resident comments, the web-based approach was more effective because it provided trainees flexibility regarding when to study, options on how to view the material, and opportunities to review it if needed for mastery. We plan to continue using the webcast strategy, revising the content as needed. PMID:21975900

Appropriate working hours for surgical training according to Australasian trainees.

PubMed

O'Grady, Gregory; Harper, Simon; Loveday, Benjamin; Adams, Brandon; Civil, Ian D; Peters, Matthew

2012-04-01

The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (<8 per night) because of 24-h calls were defined. These work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work-life balance preferences. Multivariate and univariate analyses were performed. The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55-65) considered their work hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Clinical Reasoning Terms Included in Clinical Problem Solving Exercises?

PubMed Central

Musgrove, John L.; Morris, Jason; Estrada, Carlos A.; Kraemer, Ryan R.

2016-01-01

Background Published clinical problem solving exercises have emerged as a common tool to illustrate aspects of the clinical reasoning process. The specific clinical reasoning terms mentioned in such exercises is unknown. Objective We identified which clinical reasoning terms are mentioned in published clinical problem solving exercises and compared them to clinical reasoning terms given high priority by clinician educators. Methods A convenience sample of clinician educators prioritized a list of clinical reasoning terms (whether to include, weight percentage of top 20 terms). The authors then electronically searched the terms in the text of published reports of 4 internal medicine journals between January 2010 and May 2013. Results The top 5 clinical reasoning terms ranked by educators were dual-process thinking (weight percentage = 24%), problem representation (12%), illness scripts (9%), hypothesis generation (7%), and problem categorization (7%). The top clinical reasoning terms mentioned in the text of 79 published reports were context specificity (n = 20, 25%), bias (n = 13, 17%), dual-process thinking (n = 11, 14%), illness scripts (n = 11, 14%), and problem representation (n = 10, 13%). Context specificity and bias were not ranked highly by educators. Conclusions Some core concepts of modern clinical reasoning theory ranked highly by educators are mentioned explicitly in published clinical problem solving exercises. However, some highly ranked terms were not used, and some terms used were not ranked by the clinician educators. Effort to teach clinical reasoning to trainees may benefit from a common nomenclature of clinical reasoning terms. PMID:27168884

Clinical Reasoning Terms Included in Clinical Problem Solving Exercises?

PubMed

Musgrove, John L; Morris, Jason; Estrada, Carlos A; Kraemer, Ryan R

2016-05-01

Background Published clinical problem solving exercises have emerged as a common tool to illustrate aspects of the clinical reasoning process. The specific clinical reasoning terms mentioned in such exercises is unknown. Objective We identified which clinical reasoning terms are mentioned in published clinical problem solving exercises and compared them to clinical reasoning terms given high priority by clinician educators. Methods A convenience sample of clinician educators prioritized a list of clinical reasoning terms (whether to include, weight percentage of top 20 terms). The authors then electronically searched the terms in the text of published reports of 4 internal medicine journals between January 2010 and May 2013. Results The top 5 clinical reasoning terms ranked by educators were dual-process thinking (weight percentage = 24%), problem representation (12%), illness scripts (9%), hypothesis generation (7%), and problem categorization (7%). The top clinical reasoning terms mentioned in the text of 79 published reports were context specificity (n = 20, 25%), bias (n = 13, 17%), dual-process thinking (n = 11, 14%), illness scripts (n = 11, 14%), and problem representation (n = 10, 13%). Context specificity and bias were not ranked highly by educators. Conclusions Some core concepts of modern clinical reasoning theory ranked highly by educators are mentioned explicitly in published clinical problem solving exercises. However, some highly ranked terms were not used, and some terms used were not ranked by the clinician educators. Effort to teach clinical reasoning to trainees may benefit from a common nomenclature of clinical reasoning terms.

Using Video Modeling with Voiceover Instruction Plus Feedback to Train Staff to Implement Direct Teaching Procedures.

PubMed

Giannakakos, Antonia R; Vladescu, Jason C; Kisamore, April N; Reeve, Sharon A

2016-06-01

Direct teaching procedures are often an important part of early intensive behavioral intervention for consumers with autism spectrum disorder. In the present study, a video model with voiceover (VMVO) instruction plus feedback was evaluated to train three staff trainees to implement a most-to-least direct (MTL) teaching procedure. Probes for generalization were conducted with untrained direct teaching procedures (i.e., least-to-most, prompt delay) and with an actual consumer. The results indicated that VMVO plus feedback was effective in training the staff trainees to implement the MTL procedure. Although additional feedback was required for the staff trainees to show mastery of the untrained direct teaching procedures (i.e., least-to-most and prompt delay) and with an actual consumer, moderate to high levels of generalization were observed.

Student perceptions of workplace-based assessment.

PubMed

Ali, Jason; Goh, Aaron

2017-10-01

Workplace-based assessments (WBAs) have become integrated into postgraduate medical training, although there is much negativity from trainees. The objective of this study was to examine medical student understanding and perceptions towards WBAs. A questionnaire was administered to final-year medical students at a single institution, examining experience, understanding and perceptions towards WBAs. Rating-scale responses were analysed by calculating positivity estimate values, and categorising data for subgroup comparison. Negativity was the most prevalent overall position of students towards participating in WBAs RESULTS: One hundred and fifteen of 162 (71%) students completed the questionnaire. Almost half the students had experience of WBAs and the majority (90%) reported benefiting from them; however, those with experience did not report more positive perceptions towards WBAs. In contrast, those students who seemed to demonstrate a good understanding of WBAs reported strongly positive perceptions. Interestingly, understanding and experience were not correlated. Negativity was the most prevalent overall position of students towards participating in WBAs as future trainees, with similar concerns reported by trainees, such as availability of time, trainer engagement and a feeling that they are simply 'tick-box' exercises. Medical students appear to possess negative perceptions towards WBAs. Although having experience of undertaking WBAs had little impact on their position, possessing an understanding of WBAs seemed to influence perceptions. This suggests that the manner in which medical students are exposed to WBAs should be carefully considered to ensure that it fosters the development of enthusiasm and positivity that can be carried by the students into their professional careers. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

High injury rates among female army trainees: a function of gender?

PubMed

Bell, N S; Mangione, T W; Hemenway, D; Amoroso, P J; Jones, B H

2000-04-01

Studies suggest that women are at greater risk than men for sports and training injuries. This study investigated the association between gender and risk of exercise-related injuries among Army basic trainees while controlling for physical fitness and demographics. Eight hundred and sixty-one trainees were followed during their 8-week basic training course. Demographic characteristics, body composition, and physical fitness were measured at the beginning of training. Physical fitness measures were taken again at the end of training. Multivariate logistic regression analysis was used to evaluate the association between gender and risk of injury while controlling for potential confounders. Women experienced twice as many injuries as men (relative risk [RR] = 2.1, 1.78-2.5) and experienced serious time-loss injuries almost 2.5 times more often than men (RR = 2.4, 1. 92-3.05). Women entered training at significantly lower levels of physical fitness than men, but made much greater improvements in fitness over the training period.In multivariate analyses, where demographics, body composition, and initial physical fitness were controlled, female gender was no longer a significant predictor of injuries (RR = 1.14, 0.48-2.72). Physical fitness, particularly aerobic fitness, remained significant. The key risk factor for training injuries appears to be physical fitness, particularly cardiovascular fitness. The significant improvement in endurance attained by women suggests that women enter training less physically fit relative to their own fitness potential, as well as to men. Remedial training for less fit soldiers is likely to reduce injuries and decrease the gender differential in risk of injuries.

An affordable wearable video system for emergency response training

NASA Astrophysics Data System (ADS)

King-Smith, Deen; Mikkilineni, Aravind; Ebert, David; Collins, Timothy; Delp, Edward J.

2009-02-01

Many emergency response units are currently faced with restrictive budgets that prohibit their use of advanced technology-based training solutions. Our work focuses on creating an affordable, mobile, state-of-the-art emergency response training solution through the integration of low-cost, commercially available products. The system we have developed consists of tracking, audio, and video capability, coupled with other sensors that can all be viewed through a unified visualization system. In this paper we focus on the video sub-system which helps provide real time tracking and video feeds from the training environment through a system of wearable and stationary cameras. These two camera systems interface with a management system that handles storage and indexing of the video during and after training exercises. The wearable systems enable the command center to have live video and tracking information for each trainee in the exercise. The stationary camera systems provide a fixed point of reference for viewing action during the exercise and consist of a small Linux based portable computer and mountable camera. The video management system consists of a server and database which work in tandem with a visualization application to provide real-time and after action review capability to the training system.

Something of Value

ERIC Educational Resources Information Center

Manpower, 1972

1972-01-01

Through relaxed civil service requirements, the Defense Department placed Neighborhood Youth Corps trainees in military installations, with permanent jobs to follow 9 months of training and work experience. (BH)

Northern perspectives on medical elective tourism: a qualitative study.

PubMed

Coke, Sarah; Kuper, Ayelet; Richardson, Lisa; Cameron, Anita

2016-01-01

The Royal College of Physicians and Surgeons of Canada recognizes education to be necessary for doctors to provide culturally safe care. Communities in northern Canada have large populations of Aboriginal people and other marginalized groups. Our goal was to identify the elements of appropriate predeparture curricula for these medical trainees. We conducted our study in Kenora, Ontario. With the help of a core collaborative group and the support of the local Aboriginal Health Access Centre, we interviewed a purposive sample of community members about their interactions with trainees from southern Canada. Aboriginal and non-Aboriginal researchers with roots in northern and southern Canada brought perspectives to the inductive analysis. We conducted 17 semistructured interviews between February and March 2014. Participants felt that southern trainees were inadequately educated in northern politics, society and history. They identified 2 more themes: determinants of health affecting the local Aboriginal population, and provider and patient factors affecting delivery of culturally competent care. Participants also shared ideas on how best to implement this content into curricula. Providing culturally competent care to northern communities is a complex process requiring education. Using a collaborative method, we were able to delineate the experiences of members of a northern community and identify knowledge gaps of southern trainees travelling there. Our results provide a foundation for the content and structure of formal predeparture curricula to enable such trainees to provide culturally safe care.

Are there practical opportunities for developing leadership skills during GP training and beyond? A survey of GP trainees and trainers in South East Scotland.

PubMed

Curry, Nicola; Denney, MeiLing

2016-01-01

There is currently a lack of formal training in leadership skills, particularly during GP training. This study aimed to explore the current training and practical opportunities which exist, specifically exploring the views of GP trainees and trainers. An electronic questionnaire was sent to 266 GP trainees and trainers in south-east Scotland. Questions focused on respondents' experience of leadership-specific training and opportunities to engage with leadership roles. There were a total of 76 respondents (28.6% response rate). Response rate was 19.0% in trainees and 34.6% in trainers. A majority of respondents (80.0%) were established GPs. Of those who had received training in leadership, most (72.1%) underwent this after qualifying as a GP. Respondents identified a range of leadership roles within and outside the practice covering clinical and non-clinical areas. Most were interested in future leadership roles (46.7% moderately interested; 28% very interested). More time, training opportunities and the presence of GP role models were motivating factors in terms of participants' readiness to take on future leadership roles. Signposting trainees, trainers and general practitioners to leadership opportunities and training would be relatively easy but addressing a lack of motivating factors at a local level is essential. The effectiveness of such training and opportunities for experiential learning in leadership roles requires further research.

Northern perspectives on medical elective tourism: a qualitative study

PubMed Central

Coke, Sarah; Kuper, Ayelet; Richardson, Lisa; Cameron, Anita

2016-01-01

Background: The Royal College of Physicians and Surgeons of Canada recognizes education to be necessary for doctors to provide culturally safe care. Communities in northern Canada have large populations of Aboriginal people and other marginalized groups. Our goal was to identify the elements of appropriate predeparture curricula for these medical trainees. Methods: We conducted our study in Kenora, Ontario. With the help of a core collaborative group and the support of the local Aboriginal Health Access Centre, we interviewed a purposive sample of community members about their interactions with trainees from southern Canada. Aboriginal and non-Aboriginal researchers with roots in northern and southern Canada brought perspectives to the inductive analysis. Results: We conducted 17 semistructured interviews between February and March 2014. Participants felt that southern trainees were inadequately educated in northern politics, society and history. They identified 2 more themes: determinants of health affecting the local Aboriginal population, and provider and patient factors affecting delivery of culturally competent care. Participants also shared ideas on how best to implement this content into curricula. Interpretation: Providing culturally competent care to northern communities is a complex process requiring education. Using a collaborative method, we were able to delineate the experiences of members of a northern community and identify knowledge gaps of southern trainees travelling there. Our results provide a foundation for the content and structure of formal predeparture curricula to enable such trainees to provide culturally safe care. PMID:27398374

Supporting newly qualified dental therapists into practice: a longitudinal evaluation of a foundation training scheme for dental therapists (TFT).

PubMed

Bullock, A D; Barnes, E; Falcon, H C; Stearns, K

2013-04-01

Focused on the dental therapists foundation training (TFT) scheme run by the Postgraduate Dental Deaneries of Oxford and Wessex (NHS Education South Central - NESC) the objectives were (1) to evaluate the TFT 2010/11 scheme, identifying strengths, areas for development and drawing comparisons with the 2009 evaluation; and (2) to follow-up previous cohorts, reporting current work and retrospective reflections on the scheme. Data were collected from 2010/11 ('current') trainees (n = 10) through group discussion, questionnaire and portfolio extracts. Eleven past-trainees from 2008/09 and 2009/10 took part in a structured telephone interview or responded to questions via e-mail. Data from 2011 consolidated that collected earlier. The scheme was highly valued. Current participants thought the scheme should be mandatory and all past-participants would recommend it to others. Trainees attributed an increase in confidence and ability in their clinical skills to participation in TFT. Current trainees' concerns about finding therapy work were echoed in past-participants' post-scheme employment. At the point of qualification, trainees do not feel well-prepared for starting work as dental therapists. Opportunity to develop confidence and skills in a supportive environment is a key benefit of the scheme. Maintaining ability in the full range of duties requires continued use of skills and the opportunity to do this remains an ongoing challenge.

Defining our destiny: trainee working group consensus statement on the future of emergency surgery training in the United Kingdom.

PubMed

Sharrock, A E; Gokani, V J; Harries, R L; Pearce, L; Smith, S R; Ali, O; Chu, H; Dubois, A; Ferguson, H; Humm, G; Marsden, M; Nepogodiev, D; Venn, M; Singh, S; Swain, C; Kirkby-Bott, J

2015-01-01

The United Kingdom National Health Service treats both elective and emergency patients and seeks to provide high quality care, free at the point of delivery. Equal numbers of emergency and elective general surgical procedures are performed, yet surgical training prioritisation and organisation of NHS institutions is predicated upon elective care. The increasing ratio of emergency general surgery consultant posts compared to traditional sub-specialities has yet to be addressed. How should the capability gap be bridged to equip motivated, skilled surgeons of the future to deliver a high standard of emergency surgical care? The aim was to address both training requirements for the acquisition of necessary emergency general surgery skills, and the formation of job plans for trainee and consultant posts to meet the current and future requirements of the NHS. Twenty nine trainees and a consultant emergency general surgeon convened as a Working Group at The Association of Surgeons in Training Conference, 2015, to generate a united consensus statement to the training requirement and delivery of emergency general surgery provision by future general surgeons. Unscheduled general surgical care provision, emergency general surgery, trauma competence, training to meet NHS requirements, consultant job planning and future training challenges arose as key themes. Recommendations have been made from these themes in light of published evidence. Careful workforce planning, education, training and fellowship opportunities will provide well-trained enthusiastic individuals to meet public and societal need.

Projecting Personnel Security Investigations (PSI) Requirements: Current Issues, Challenges and a Viable Approach

DTIC Science & Technology

2008-09-01

the DoD components to project annual investigations within 5% of annual submissions in order to properly staff the OPM investigations programa ...Level97E N/ANavigator Trainee92T1 N/APilot Trainee92T0 N/AWing Commander91W N/AGeneral Officer90G N/AAide- De -Camp88A N/ACommand and Control86P N/AUnited...the Navy and Marine Corps can simply reflect inclusion of clearances from individuals who have transitioned from the Selected Reserves to the

Peer Assisted Study Sessions for Research Trainees

ERIC Educational Resources Information Center

Cusick, Anne; Camer, Danielle; Stamenkovic, Alexander; Zaccagnini, Melissa

2015-01-01

Research training should facilitate effective researcher role development. While researcher roles require the performance of specialised knowledge and skill, they also require development of personal research identities within social contexts. Interaction with research peers can provide opportunities for reflective role development. Ad-hoc…

Have restricted working hours reduced junior doctors’ experience of fatigue? A focus group and telephone interview study

PubMed Central

Morrow, Gill; Burford, Bryan; Carter, Madeline; Illing, Jan

2014-01-01

Objective To explore the effects of the UK Working Time Regulations (WTR) on trainee doctors’ experience of fatigue. Design Qualitative study involving focus groups and telephone interviews, conducted in Spring 2012 with doctors purposively selected from Foundation and specialty training. Final compliance with a 48 h/week limit had been required for trainee doctors since August 2009. Framework analysis of data. Setting 9 deaneries in all four UK nations; secondary care. Participants 82 doctors: 53 Foundation trainees and 29 specialty trainees. 36 participants were male and 46 female. Specialty trainees were from a wide range of medical and surgical specialties, and psychiatry. Results Implementation of the WTR, while acknowledged as an improvement to the earlier situation of prolonged excessive hours, has not wholly overcome experience of long working hours and fatigue. Fatigue did not only arise from the hours that were scheduled, but also from an unpredictable mixture of shifts, work intensity (which often resulted in educational tasks being taken home) and inadequate rest. Fatigue was also caused by trainees working beyond their scheduled hours, for reasons such as task completion, accessing additional educational opportunities beyond scheduled hours and staffing shortages. There were also organisational, professional and cultural drivers, such as a sense of responsibility to patients and colleagues and the expectations of seniors. Fatigue was perceived to affect efficiency of skills and judgement, mood and learning capacity. Conclusions Long-term risks of continued stress and fatigue, for doctors and for the effective delivery of a healthcare service, should not be ignored. Current monitoring processes do not reflect doctors’ true working patterns. The effectiveness of the WTR cannot be considered in isolation from the culture and context of the workplace. On-going attention needs to be paid to broader cultural issues, including the relationship between trainees and seniors. PMID:24604482

The supervisory encounter and the senior GP trainee: managing for, through and with.

PubMed

Brown, James; Nestel, Debra; Clement, Tim; Goldszmidt, Mark

2018-02-01

Help-seeking supervisory encounters provide important learning experiences for trainees preparing for independent practice. Although there is a body of expert opinion and theories on how supervisor encounters should happen, supporting empirical data are limited. This is particularly true for the senior general practice (GP) trainee. Without knowing what happens during these encounters, we cannot know how to maximise their educational potential. This study aimed to understand what happens when senior GP trainees call on their supervisor when caring for patients and how learning can be enhanced when this occurs. This is an analysis of data from a multi-case study of five GP supervisory pairs, each with a GP registrar and their supervisor. The data are recordings of 45 supervisory encounters, 78 post-encounter reflections and six interviews. We used Wenger's communities of practice theory and rhetorical genre theory as analytical lenses. The supervisory encounters followed a consistent format, which fitted the form of a genre. Within this genre, three dominant interactional patterns were identified, which we labelled 'managing for', 'managing through' and 'managing with'. Each pattern presented different opportunities and drew on different skills. The primary agenda was always developing a plan for the patient. Education agendas included acquiring knowledge, developing skills and achieving independence. Other agendas were issues of control, credibility and relationship building. Both supervisor and trainee could be purposeful in their supervisory engagement. For supervisors and trainees to achieve the educational potential of their supervisory encounters they require flexibility. This depends on understanding the genre of the supervisory encounter, the agendas at play, the options they have in engaging and having the skills to utilise these options. Educators can facilitate supervisors and trainees in acquiring this understanding and these skills. We recommend further research into the genre of the supervisory encounter. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Workforce planning and training in Obstetrics and Gynaecology across Europe: A survey of national trainee societies.

PubMed

Aabakke, Anna J M; Kristufkova, Alexandra; Boyon, Charlotte; Bune, Laurids T; Van de Venne, Maud

2017-07-01

To describe the infrastructural differences in training in Obstetrics and Gynaecology (ObGyn) across Europe. Descriptive web-based survey of 31 national ObGyn trainee societies representing the 30 member countries of the European Network of Trainees in Obstetrics and Gynaecology. Answers were verified in a telephone interview and only countries which had completed the telephone interview were included in the final analysis. The final analysis included 28 of 31 societies representing 27 countries (response rate 90%). The median formal duration of training was 5 years (range 4-7). There were mandatory requirements in addition to medical school graduation before specialisation could be started in 20 (71%) countries. The job opportunities after completion of training varied and included academic fellowships (n=21 [75%]), clinical fellowships/junior consultancy (n=21 [75%]), consultancy (n=11 [40%]), and private practice (n=23 [82%)]. Training and working as a specialist abroad was uncommon (≤20% in 21 [78%] and 26 [96%] countries respectively). Exams during ObGyn training were offered in 24 (85%) countries. Unemployment after completion of training was rare (<5% in 26 [93%] countries). Assessment of ObGyn specialists took place in 20 (71%) countries. The study illustrates that there are organisational variations in ObGyn training in Europe; A) The requirements to obtain a training post vary causing differences in the qualifications of trainees starting training. B) The duration of training varies. And C) newly trained specialists carry varying levels of responsibility. The results suggest that the content, organisation, and outcome of training differ across Europe. Differences due to political, social and cultural reasons are expected. However, further harmonisation of training across Europe still seems desirable in order to improve women's healthcare and facilitate the mobility of ObGyn trainees and specialists across Europe. There are currently several European initiatives, however, national and local measures are essential for training to improve. Copyright © 2017 Elsevier B.V. All rights reserved.

Medical student appraisal: searching on smartphones.

PubMed

Khalifian, S; Markman, T; Sampognaro, P; Mitchell, S; Weeks, S; Dattilo, J

2013-01-01

The rapidly growing industry for mobile medical applications provides numerous smartphone resources designed for healthcare professionals. However, not all applications are equally useful in addressing the questions of early medical trainees. Three popular, free, mobile healthcare applications were evaluated along with a Google(TM) web search on both Apple(TM) and Android(TM) devices. Six medical students at a large academic hospital evaluated each application for a one-week period while on various clinical rotations. Google(TM) was the most frequently used search method and presented multimedia resources but was inefficient for obtaining clinical management information. Epocrates(TM) Pill ID feature was praised for its clinical utility. Medscape(TM) had the highest satisfaction of search and excelled through interactive educational features. Micromedex(TM) offered both FDA and off-label dosing for drugs. Google(TM) was the preferred search method for questions related to basic disease processes and multimedia resources, but was inadequate for clinical management. Caution should also be exercised when using Google(TM) in front of patients. Medscape(TM) was the most appealing application due to a broad scope of content and educational features relevant to medical trainees. Students should also be cognizant of how mobile technology may be perceived by their evaluators to avoid false impressions.

The "Flipped Classroom" Model for Teaching in the Intensive Care Unit.

PubMed

Tainter, Christopher R; Wong, Nelson L; Cudemus-Deseda, Gaston A; Bittner, Edward A

2017-03-01

The intensive care unit (ICU) is a dynamic and complex learning environment. The wide range in trainee's experience, specialty training, fluctuations in patient acuity and volume, limitations in trainee duty hours, and additional responsibilities of the faculty contribute to the challenge in providing a consistent experience with traditional educational strategies. The "flipped classroom" is an educational model with the potential to improve the learning environment. In this paradigm, students gain exposure to new material outside class and then use class time to assimilate the knowledge through problem-solving exercises or discussion. The rationale and pedagogical foundations for the flipped classroom are reviewed, practical considerations are discussed, and an example of successful implementation is provided. An education curriculum was devised and evaluated prospectively for teaching point-of-care echocardiography to residents rotating in the surgical ICU. Preintervention and postintervention scores of knowledge, confidence, perceived usefulness, and likelihood of use the skills improved for each module. The quality of the experience was rated highly for each of the sessions. The flipped classroom education curriculum has many advantages. This pilot study was well received, and learners showed improvement in all areas evaluated, across several demographic subgroups and self-identified learning styles.

Use of web based systems to support postgraduate medical education.

PubMed

Tochel, C; Beggs, K; Haig, A; Roberts, J; Scott, H; Walker, K; Watson, M

2011-12-01

BACKGROUND To meet the demands of delivering the Foundation programme across a geographically diverse country, two web based systems (ePortfolio and eLearning) were developed to promote accessibility to training material and assessment tools on standardised platforms. This study evaluated the use of both tools throughout an entire academic year. METHODS All Scottish Foundation trainees' online learning and assessment data in 2007/08 were analysed, providing a national breakdown of post specialty, completion rates of mandatory assessments (including summary analysis of anonymised scores), and trainees' use of non-mandatory learning tools. Independent verification of competence data was sought from Deaneries. RESULTS There were high levels of engagement with both the ePortfolio (75-97% assessment completion) and eLearning systems (89-98% induction course completion), and the majority of trainees completed all required elements. There was extensive use of ePortfolio beyond mandatory levels for recording of learning events, including almost 20 000 personal learning records submitted by second year trainees. There was evidence that ePortfolio was used to record achievement of clinical competence rather than to track improvements towards competence (median workplace based assessment scores were 'high' or 'very high'). Online learning modules received positive feedback and its flexible format suited the trainees' working environment. External verification of formal assessment data revealed good correlation with locally stored outcomes, both indicating approximately 99% programme completion rates. CONCLUSIONS Core components of the Foundation programme have been delivered successfully to thousands of trainees across Scotland using web based systems to deliver and support education and assessment. There is great potential for further exploration of this carefully managed, rich dataset at individual, regional, and national levels to inform the future of medical education.

Involving youth with disabilities in the development and evaluation of a new advocacy training: Project TEAM.

PubMed

Kramer, Jessica; Barth, Yishai; Curtis, Katie; Livingston, Kit; O'Neil, Madeline; Smith, Zach; Vallier, Samantha; Wolfe, Ashley

2013-04-01

This paper describes a participatory research process in which six youth with disabilities (Youth Panel) participated in the development and evaluation of a manualized advocacy training, Project TEAM (Teens making Environment and Activity Modifications). Project TEAM teaches youth with disabilities how to identify environmental barriers, generate solutions, and request accommodations. The Youth Panel conducted their evaluation after the university researcher implemented Project TEAM with three groups of trainees. The Youth Panel designed and administered a survey and focus group to evaluate enjoyment and usefulness of Project TEAM with support from an advocate/researcher. Members of the Youth Panel analyzed survey response frequencies. The advocate/researcher conducted a content analysis of the open-ended responses. Sixteen of 21 Project TEAM trainees participated in the evaluation. The evaluation results suggest that the trainees found the interactive and individualized aspects of the Project TEAM most enjoyable and useful. Some instructional materials were difficult for trainees with cognitive disabilities to understand. The Youth Panel's involvement in the development of Project TEAM may explain the relatively positive experiences reported by trainees. Project TEAM should continue to provide trainees with the opportunity to apply concepts in real-life situations. Project TEAM requires revisions to ensure it is enjoyable and useful for youth with a variety of disabilities. • Group process strategies, picture-based data collection materials, peer teamwork, and mentorship from adults with disabilities can enable youth with disabilities to engage in research. • Collaborating with youth with disabilities in the development of new rehabilitation approaches may enhance the relevance of interventions for other youth with disabilities. • Youth with cognitive disabilities participating in advocacy and environment-focused interventions may prefer interactive and experiential learning activities over passive teaching approaches such as powerpoints and videos.

Is the learning value of workplace-based assessment being realised? A qualitative study of trainer and trainee perceptions and experiences.

PubMed

Barrett, Aileen; Galvin, Rose; Scherpbier, Albert J J A; Teunissen, Pim W; O'Shaughnessy, Ann; Horgan, Mary

2017-03-01

Workplace-based assessments (WBAs) were originally intended to inform learning and development by structuring effective observation-based feedback. The success of this innovation has not yet been established due in part to the widely varied tools, implementation strategies and research approaches. Using a conceptual framework of experience, trajectories and reifications in workplace learning, we aimed to explore trainer and trainee experiences and perceptions of the learning value of WBAs. Trainers and trainees who had used at least one WBA in the previous year were invited to participate in semistructured interviews for this phenomenological study. We used a template analysis method to explore and compare the experiences of the two groups, using the emergent themes to develop an understanding of the impact of these experiences on perceptions of learning value. Nine trainers and eight trainees participated in the study. Common themes emerged among the two groups around issues of responsibility and engagement along with (mis)understandings of the purpose of the individual tools. Trainer-specific themes emerged related to the concurrent implementation of a new e-portfolio and perceptions of increased workload. Trainees associated WBA with a training structure support value but could not translate experiences into learning values. WBAs provide trainees with a justified reason to approach trainers for feedback. WBAs, however, are not being reified as the formative assessments originally intended. A culture change may be required to change the focus of WBA research and reconceptualise this set of tools and methods as a workplace learning practice . Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The motivation to teach as a registrar in general practice.

PubMed

Thampy, Harish; Agius, Steven; Allery, Lynne A

2013-07-01

The General Medical Council (GMC) states that teaching should be an integral part of the doctor's role and the Royal College of General Practitioners (RCGP) have incorporated teaching outcomes into the GP training curriculum. However, there are suggestions that the teaching role of a GP trainee declines as they move from hospital posts to the registrar community year. Using doctors in training as near-peer tutors offers multiple advantages. Trainees themselves benefit as teaching others is a strong driver of the tutor's own learning. In addition there are also practical incentives to mobilising this under-utilised pool of primary care clinical teachers given the continuing shift of focusing medical education in the community. This study forms part of a larger body of work exploring the attitudes and perceived learning needs of GP registrars with regards to developing a teaching role. A primary area of investigation was trainees' motivation to teach. This paper describes our attempts to establish: a) how strongly motivated are GP registrars to take on teaching roles? b) in consequence how strongly motivated are they to learn more about teaching? c) what are the factors which affect motivation to teach? Three themes emerged from the data. First, teaching was felt to be of low priority in comparison to competing clinical learning needs. Secondly, the clinical dominance to both formative and summative assessment during training further compounded this situation. Thirdly, registrars identified a number of practical barriers and incentives that influenced their teaching engagement. This included potential negative views from trainers as to their trainee's ability and requirement to be involved with teaching activities.
By understanding and addressing these issues, it is hoped that GP trainees' engagement with teaching activities can be better engendered with subsequent benefits for both the trainee and those they teach.

What motivates residents to teach? The Attitudes in Clinical Teaching study.

PubMed

Dotters-Katz, Sarah; Hargett, Charles W; Zaas, Aimee K; Criscione-Schreiber, Lisa G

2016-07-01

Graduate medical trainees have a critical role in the teaching of other trainees. Improving their teaching requires an understanding of their attitudes towards teaching and their motivation to teach. Both have been incompletely explored in this population. We aimed to better understand graduate medical trainees' attitudes towards teaching and motivation to teach in the clinical setting in order to inform modifications to resident-as-teacher (RAT) programmes and enhance teaching practices. We applied Q methodology, an established sorting method, to identify and quantify the factors that have an impact on trainees' engagement in teaching. We invited house officers at our institution to rank-order 47 statements regarding their attitudes to and motivation for teaching. Respondents explained their Q-sort rankings in writing and completed a demographic questionnaire. By-person factor analysis yielded groups of individuals with similar attitudes. One hundred and seven trainees completed the Q-sort. We found three primary groups of attitudes towards teaching in the clinical setting: enthusiasm, reluctance and rewarded. Enthusiastic teachers are committed and make time to teach. Teaching increases their job satisfaction. Reluctant teachers have enthusiasm but are earlier in training and feel limited by clinical workload and unprepared. Rewarded teachers feel teaching is worthwhile and derive satisfaction from the rewards and recognition they receive for teaching. This improved understanding of common attitudes shared by groups of residents will help curriculum designers create RAT programmes to further reinforce and encourage attitudes that promote teaching as well as improve trainees' motivation to teach. Designing RAT programmes that acknowledge the attitudes to and motivations for teaching should help develop effective teachers to improve educational outcomes. Directed efforts to enhance motivation for reluctant teachers and encourage more positive attitudes in rewarded teachers may lead to improved teaching behaviours among residents. © 2016 John Wiley & Sons Ltd.

Educational utility of advanced three-dimensional virtual imaging in evaluating the anatomical configuration of the frontal recess.

PubMed

Agbetoba, Abib; Luong, Amber; Siow, Jin Keat; Senior, Brent; Callejas, Claudio; Szczygielski, Kornel; Citardi, Martin J

2017-02-01

Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups. Each subject underwent learning of frontal recess anatomy with both traditional 2-dimensional (2D) learning methods using a standard Digital Imaging and Communications in Medicine (DICOM) viewing software (RadiAnt Dicom Viewer Version 1.9.16) and 3-dimensional (3D) learning utilizing a novel preoperative virtual planning software (Scopis Building Blocks), with one half learning with the 2D method first and the other half learning with the 3D method first. Four questionnaires that included a total of 20 items were scored for subjects' self-assessment on knowledge of frontal recess and frontal sinus drainage pathway anatomy following each learned modality. A 2-sample Wilcoxon rank-sum test was used in the statistical analysis comparing the 2 groups. Most trainees (89%) believed that the virtual 3D planning software significantly improved their understanding of the spatial orientation of the frontal sinus drainage pathway. Incorporation of virtual 3D planning surgical software may help augment trainees' understanding and spatial orientation of the frontal recess and sinus anatomy. The potential increase in trainee proficiency and comprehension theoretically may translate to improved surgical skill and patient outcomes and in reduced surgical time. © 2016 ARS-AAOA, LLC.

Radiation Oncology Training Program Curriculum developments in Australia and New Zealand: Design, implementation and evaluation--What next?

PubMed

Turner, Sandra; Seel, Matthew; Berry, Martin

2015-12-01

The Australian and New Zealand Radiation Oncology Training Program has undergone major changes to align with pedagogical principles and best-evidence practice. The curriculum was designed around the Canadian Medical Education Directives for Specialists framework and involved structural programme changes and new in-training assessment. This paper summarises the work of programme design and implementation and presents key findings from an evaluation of the revised programme. An independent team conducted the evaluation during the last year of the first 5-year curriculum cycle. Opinions were sought from trainees, supervisors and directors of training (DoTs) through online surveys, focused interviews and group consultations. One hundred nineteen participated in surveys; 211 participated in consultations. All training networks were represented. The new curriculum was viewed favourably by most participants with over 90% responding that it 'provided direction in attaining competencies'. Most (87/107; 81%) said it 'promotes regular, productive interaction between trainees and supervisors'. Adequacy of feedback to trainees was rated as only 'average' by trainees/trainers in one-third of cases. Consultations revealed this was more common where trainers were less familiar with curriculum tools. Half of DoTs/supervisors felt better supported. Nearly two-third of all responders (58/92; 63%) stated that clinical service requirements could be met during training; 17/92 (18.5%) felt otherwise. When asked about 'work-readiness', 59/90 (66%) respondents, including trainees, felt this was improved. Findings suggest that the 'new' curriculum has achieved many of its aims, and implementation has largely been successful. Outcomes focus future work on better supporting trainers in using curriculum tools and providing useful feedback to trainees. © 2015 The Royal Australian and New Zealand College of Radiologists.

Do trainees feel that they belong to a team?

PubMed

Price, Sophie; Lusznat, Rosie

2018-06-01

Postgraduate medical education has undergone significant reorganisation in recent years, with changes to the traditional apprenticeship model and an increasing reliance on shift working. The importance of teamwork in clinical care is well established; however, there is little literature on the extent to which trainees actually feel part of a team in the context of current working patterns. This is a qualitative study using semi-structured interviews of medical and surgical trainees. Data were analysed thematically using an inductive qualitative approach. Fifteen trainees who had worked in a range of hospitals across the UK participated. Emerging themes fell into several categories: what constitutes the team; the effect of shift patterns on the team; the role of the team in education, support and well-being; and influences on team rapport. Whilst in general interviewees felt part of a team, this was not true for all posts. The nature of the team was also highly variable, and had evolved from the traditional 'Firm' structure to a more nebulous concept. Shift-working patterns could result in the fragmentation of the team, which had implications for patient care as well as for training. The team played an important role in both education and well-being for trainees, and several factors were identified that could engender a more supportive team. With an ageing population and with increasing demands on limited resources, the requirement for shift work is likely to increase, and there is a fundamental need to maintain support for the next generation of doctors. There is little literature on the extent to which trainees actually feel part of a team. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Part-time general surgical training in South Australia: its success and future implications (or: pinnacles, pitfalls and lessons for the future).

PubMed

Neuhaus, Susan; Igras, Emma; Fosh, Beverley; Benson, Sarah

2012-12-01

Flexible training options are sought by an increasing number of Australasian surgical trainees. Reasons include increased participation of women in the surgical workforce, postgraduate training and changing attitudes to family responsibilities. Despite endorsement of flexible training by the Royal Australasian College of Surgeons and Board in General Surgery, part-time (PT) training in General Surgery in Australia and New Zealand is not well established. A permanent 'stand-alone' PT training position was established at the Royal Adelaide Hospital in 2007 under the Surgical Education and Training Program. This position offered 12 months of General Surgical training on a 0.5 full-time (FT) equivalent basis with pro rata emergency and on-call commitments and was accredited for 6 months of General Surgical training. This paper reviews the PT training experience in South Australia. De-identified logbook data were obtained from the South Australian Regional Subcommittee of the Board in General Surgery with consent of each of the trainees. Totals of operative cases were compared against matched FT trainees working on the same unit. Overall, PT trainees achieved comparable operative caseloads compared with their FT colleagues. All trainees included in this review have subsequently passed the Royal Australasian College of Surgeons Fellowship Examination in General Surgery and returned to FT workforce positions. This paper presents two validated models of PT training. Training, resource and regulatory requirements and individual and institutional barriers to flexible training are substantial. Successful PT models offer positive and beneficial training alternatives for General Surgical trainees and contribute to workforce flexibility. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

A national survey into desirable personality traits in anaesthesia trainees in a developing country.

PubMed

Khan, Fauzia Anis; Minai, Fauzia

2010-03-01

To explore personality traits considered to be important in selection of trainees by consultant anaesthetists in a developing country. A questionnaire listing 28 traits was sent to 125 consultant anaesthetists. The raters were asked to mark each trait on a scale of 1 to 10, with one being least desirable and 10 as most desirable. Listing of five most desirable and one least desirable trait was also required. The response rate was 79%. The most desirable trait was identified as reliability by 40%, followed by honesty 17%, functionality under stress 9%, punctuality 7%, and discipline 4%. The least desirable trait was considered as resourcefulness (21%), sense of humour (20%), unassuming mannerism (15%), high self esteem (11%), inquisitive (5%) and expedious (5%). Some traits have been identified as more desirable than others for trainees in our country. We plan to assess these in structured behavioural interviews in our residency programme.

Smartphones in orthopaedics.

PubMed

Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said

2012-08-01

With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to immediately complete work-based assessments, in the absence of computers, hopefully increasing completion rates and reliability. Some journals now provide podcasts and video tutorials which may be accessed on smartphones, which is useful for higher examinations. Smartphones can also be used in the clinical setting to take photographs of wounds. Smartphones are enjoying increased uptake and application in the workplace and we review their use for orthopaedic surgeons and trainees to allow them to make the most out of their training opportunities.

Competency-Based Objectives in Global Underserved Women's Health for Medical Trainees.

PubMed

Chen, Chi Chiung Grace; Dougherty, Anne; Whetstone, Sara; Mama, Saifuddin T; Larkins-Pettigrew, Margaret; Raine, Susan P; Autry, Amy M

2017-10-01

The Association of Professors of Gynecology and Obstetrics Committee on Global Health developed an inclusive definition of global women's health and competency-based objectives that reflected work internationally, as well as with U.S. vulnerable and underserved populations, such as refugee and immigrant populations or those who would otherwise have compromised access to health care. The knowledge, skill, and attitude-based competencies required to fulfill each learning objective were mapped to the Accreditation Council for Graduate Medical Education Outcomes Project's educational domains and the Consortium of Universities for Global Health competency domains. The proposed global women's health definition and competency-based learning objective framework is a first step in ensuring quality standards for educating trainees to address global women's health needs. By proposing these objectives, we hope to guide future program development and spark a broader conversation that will improve health for vulnerable women and shape educational, ethical, and equitable global health experiences for medical trainees.

Intelligent cooperation: A framework of pedagogic practice in the operating room.

PubMed

Sutkin, Gary; Littleton, Eliza B; Kanter, Steven L

2018-04-01

Surgeons who work with trainees must address their learning needs without compromising patient safety. We used a constructivist grounded theory approach to examine videos of five teaching surgeries. Attending surgeons were interviewed afterward while watching cued videos of their cases. Codes were iteratively refined into major themes, and then constructed into a larger framework. We present a novel framework, Intelligent Cooperation, which accounts for the highly adaptive, iterative features of surgical teaching in the operating room. Specifically, we define Intelligent Cooperation as a sequence of coordinated exchanges between attending and trainee that accomplishes small surgical steps while simultaneously uncovering the trainee's learning needs. Intelligent Cooperation requires the attending to accurately determine learning needs, perform real-time needs assessment, provide critical scaffolding, and work with the learner to accomplish the next step in the surgery. This is achieved through intense, coordinated verbal and physical cooperation. Copyright © 2017 Elsevier Inc. All rights reserved.

Attachment styles and clinical communication performance in trainee doctors.

PubMed

Fletcher, Ian; McCallum, Rachel; Peters, Sarah

2016-11-01

To investigate the relationship between trainee doctors' attachment style and their performance in qualifying clinical and communication skills assessments. Participants were 190 undergraduate medical students whose performance was assessed by examiners across two areas (communication and clinical skills) during their qualifying Objective Structured Clinical Examination (OSCE). Simulated patients also rated communication skills. Participants' attachment style was rated across two dimensions, avoidance and anxiety, using the Relationship Questionnaire (RQ). Lower levels of attachment avoidance and anxiety significantly predicted higher performance in both communication and clinical skills. Trainee doctors' attachment styles are associated with patient communication and clinical performance. Further research is needed to investigate the impact of attachment on consultations between doctors and patients within clinical settings. Attachment theory can inform our understanding why, for some student doctors, interacting with patients may be particularly challenging and require additional support by medical educators. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Incorporating simulation in vascular surgery education.

PubMed

Bismuth, Jean; Donovan, Michael A; O'Malley, Marcia K; El Sayed, Hosam F; Naoum, Joseph J; Peden, Eric K; Davies, Mark G; Lumsden, Alan B

2010-10-01

The traditional apprenticeship model introduced by Halsted of "learning by doing" may just not be valid in the modern practice of vascular surgery. The model is often criticized for being somewhat unstructured because a resident's experience is based on what comes through the "door." In an attempt to promote uniformity of training, multiple national organizations are currently delineating standard curricula for each trainee to govern the knowledge and cases required in a vascular residency. However, the outcomes are anything but uniform. This means that we graduate vascular specialists with a surprisingly wide spectrum of abilities. Use of simulation may benefit trainees in attaining a level of technical expertise that will benefit themselves and their patients. Furthermore, there is likely a need to establish a simulation-based certification process for graduating trainees to further ascertain minimum technical abilities. Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Avoiding Focus Shifts in Surgical Telementoring Using an Augmented Reality Transparent Display.

PubMed

Andersen, Daniel; Popescu, Voicu; Cabrera, Maria Eugenia; Shanghavi, Aditya; Gomez, Gerardo; Marley, Sherri; Mullis, Brian; Wachs, Juan

2016-01-01

Conventional surgical telementoring systems require the trainee to shift focus away from the operating field to a nearby monitor to receive mentor guidance. This paper presents the next generation of telementoring systems. Our system, STAR (System for Telementoring with Augmented Reality) avoids focus shifts by placing mentor annotations directly into the trainee's field of view using augmented reality transparent display technology. This prototype was tested with pre-medical and medical students. Experiments were conducted where participants were asked to identify precise operating field locations communicated to them using either STAR or a conventional telementoring system. STAR was shown to improve accuracy and to reduce focus shifts. The initial STAR prototype only provides an approximate transparent display effect, without visual continuity between the display and the surrounding area. The current version of our transparent display provides visual continuity by showing the geometry and color of the operating field from the trainee's viewpoint.

How do you define body image? Exploring conceptual gaps in understandings of body image at an exercise facility.

PubMed

Bailey, K Alysse; Gammage, Kimberley L; van Ingen, Cathy

2017-12-01

The definition of body image has evolved within research; however, less is known about the layperson's understanding of the construct. This study explored how members and student trainees of an exercise facility (designed for older adults, people with physical disability, and those with cardiac complications) defined body image. Nineteen participants completed a one-on-one interview, and seven of those participants took part in six additional focus group meetings. The following main themes were found: stereotypical assumptions about body image (e.g., it is solely a person's weight or merely a woman's issue), body image continua for positive and negative body image, degree of complexity of body image dimensions, broad considerations of body image (e.g., it is self-esteem), and limited knowledge about body image. These findings suggest a need for knowledge translation between researchers and the general public which informs future body image program design. Copyright © 2017 Elsevier Ltd. All rights reserved.

Physical activity, quality of life, and burnout among physician trainees: the effect of a team-based, incentivized exercise program.

PubMed

Weight, Christopher J; Sellon, Jacob L; Lessard-Anderson, Collette R; Shanafelt, Tait D; Olsen, Kerry D; Laskowski, Edward R

2013-12-01

To prospectively study the effects of an incentivized exercise program on physical activity (PA), quality of life (QOL), and burnout among residents and fellows (RFs) in a large academic medical center. In January 2011, all RFs at Mayo Clinic in Rochester, Minnesota (N=1060), were invited to participate in an elective, team-based, 12-week, incentivized exercise program. Both participants and nonparticipants had access to the same institutional exercise facilities. Regardless of participation, all RFs were invited to complete baseline and follow-up (3-month) assessments of PA, QOL, and burnout. Of the 628 RFs who completed the baseline survey (59%), only 194 (31%) met the US Department of Health and Human Services recommendations for PA. Median reported QOL was 70 on a scale of 1 to 100, and 182 (29%) reported at least weekly burnout symptoms. A total of 245 individuals (23%) enrolled in the exercise program. No significant differences were found between program participants and nonparticipants with regard to baseline demographic characteristics, medical training level, PA, QOL, or burnout. At study completion, program participants were more likely than nonparticipants to meet the Department of Health and Human Services recommendations for exercise (48% vs 23%; P<.001). Quality of life was higher in program participants than in nonparticipants (median, 75 vs 68; P<.001). Burnout was lower in participants than in nonparticipants, although the difference was not statistically significant (24% vs 29%; P=.17). A team-based, incentivized exercise program engaged 23% of RFs at our institution. After the program, participants had higher PA and QOL than nonparticipants who had equal exercise facility access. Residents and fellows may be much more sedentary than previously reported. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Professionalism in residency training: is there a generation gap?

PubMed

Borrero, Sonya; McGinnis, Kathleen A; McNeil, Melissa; Frank, Janine; Conigliaro, Rosemarie L

2008-01-01

Teaching and evaluating professionalism is part of the Accreditation Council for Graduate Medical Education's training requirements for postgraduate education. Defining what constitutes professional behavior is the first step in this endeavor. Difficulty in teaching and evaluating professionalism may stem from generational differences between teachers and trainees in their definition of professional behavior. We sought to explore the magnitude of generational differences by asking faculty and residents to evaluate behaviors along a continuum of professionalism. A questionnaire composed of 16 vignettes describing unprofessional behaviors was distributed to a sample of internal medicine trainees and faculty. For each specific behavior described, participants were asked to rate the severity of the infraction on a 4-point scale. Within each group, responses were distributed across severity categories for most vignettes. There were no significant differences in the responses of trainees versus faculty for any of the vignettes except two. There is little consensus for determining the severity of unprofessional behaviors among faculty and trainees at one urban university training program. However, this lack of consensus does not appear to have a generational basis. Attributing difficulties in teaching and assessing professionalism cannot be blamed on differences between the generations.

Milestone-compatible neurology resident assessments: A role for observable practice activities.

PubMed

Jones, Lyell K; Dimberg, Elliot L; Boes, Christopher J; Eggers, Scott D Z; Dodick, David W; Cutsforth-Gregory, Jeremy K; Leep Hunderfund, Andrea N; Capobianco, David J

2015-06-02

Beginning in 2014, US neurology residency programs were required to report each trainee's educational progression within 29 neurology Milestone competency domains. Trainee assessment systems will need to be adapted to inform these requirements. The primary aims of this study were to validate neurology resident assessment content using observable practice activities (OPAs) and to develop assessment formats easily translated to the Neurology Milestones. A modified Delphi technique was used to establish consensus perceptions of importance of 73 neurology OPAs among neurology educators and trainees at 3 neurology residency programs. A content validity score (CVS) was derived for each neurology OPA, with scores ≥4.0 determined in advance to indicate sufficient content validity. The mean CVS for all OPAs was 4.4 (range 3.5-5.0). Fifty-seven (78%) OPAs had a CVS ≥4.0, leaving 16 (22%) below the pre-established threshold for content validity. Trainees assigned a higher importance to individual OPAs (mean CVS 4.6) compared to faculty (mean 4.4, p = 0.016), but the effect size was small (η(2) = 0.10). There was no demonstrated effect of length of education experience on perceived importance of neurology OPAs (p = 0.23). Two sample resident assessment formats were developed, one using neurology OPAs alone and another using a combination of neurology OPAs and the Neurology Milestones. This study provides neurology training programs with content validity evidence for items to include in resident assessments, and sample assessment formats that directly translate to the Neurology Milestones. Length of education experience has little effect on perceptions of neurology OPA importance. © 2015 American Academy of Neurology.

Improving physical fitness and health status perception in community-dwelling older adults through a structured program for physical activity promotion in the city of Naples, Italy: A randomized controlled trial.

PubMed

Gallè, Francesca; Di Onofrio, Valeria; Romano Spica, Vincenzo; Mastronuzzi, Roberto; Russo Krauss, Pio; Belfiore, Patrizia; Buono, Pasqualina; Liguori, Giorgio

2017-10-01

To evaluate the efficacy and feasibility of a physical activity promotion intervention in community-dwelling older adults based on a free program of exercise adapted for older adults aged ≥60 years managed by trainees from the Movement Sciences degree course. A total of 160 adults aged 60-82 years were randomly allocated into the intervention and control group. The exercise program consisted of 1-h sessions carried out twice a week for a year. Control participants received recommendations about an active lifestyle from their physicians. Senior Fitness Tests and the 12-item Short Form Health Survey were used to assess six functional fitness domains of participants and perception of their health status, respectively. Body mass index was also evaluated. A total of 62 participants completed the exercise path. At the end of the intervention, they showed a significant body mass index decrease (from 27.9 ± 1.6 to 25.1 ± 1.8 kg/m 2 , P < 0.01), and a significant improvement in functional domains, mainly aerobic fitness (+33.9%, P < 0.01) and agility (+24.2%, P < 0.01), and in good health status perception (+38.7%, P < 0.05). Similar variations were not observed in the control group (P > 0.05). A high acceptance of the intervention was registered among participants (>88.7%); staff competence and gratuitousness were the most appreciated features (>85.5%). The structured program represented a useful opportunity to promote physical activity among participants, and it was effective in improving their physical fitness and health status perception. Similar interventions are required to sensitize the whole older population, and experts in Movement Sciences might represent a key figure in this context. Geriatr Gerontol Int 2017; 17: 1421-1428. © 2016 Japan Geriatrics Society.

24 CFR 585.313 - Labor standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... assistance is involved. However, where the trainees' performance of public and Indian housing work is subject... such laborers and mechanics on assisted housing shall be subject to the provisions of the Contract Work... and HUD rules, regulations and requirements. (2) The labor standards requirements in paragraph (b)(1...

Neurosurgery simulation in residency training: feasibility, cost, and educational benefit.

PubMed

Gasco, Jaime; Holbrook, Thomas J; Patel, Achal; Smith, Adrian; Paulson, David; Muns, Alan; Desai, Sohum; Moisi, Marc; Kuo, Yong-Fan; Macdonald, Bart; Ortega-Barnett, Juan; Patterson, Joel T

2013-10-01

The effort required to introduce simulation in neurosurgery academic programs and the benefits perceived by residents have not been systematically assessed. To create a neurosurgery simulation curriculum encompassing basic and advanced skills, cadaveric dissection, cranial and spine surgery simulation, and endovascular and computerized haptic training. A curriculum with 68 core exercises per academic year was distributed in individualized sets of 30 simulations to 6 neurosurgery residents. The total number of procedures completed during the academic year was set to 180. The curriculum includes 79 simulations with physical models, 57 cadaver dissections, and 44 haptic/computerized sessions. Likert-type evaluations regarding self-perceived performance were completed after each exercise. Subject identification was blinded to junior (postgraduate years 1-3) or senior resident (postgraduate years 4-6). Wilcoxon rank testing was used to detect differences within and between groups. One hundred eighty procedures and surveys were analyzed. Junior residents reported proficiency improvements in 82% of simulations performed (P < .001). Senior residents reported improvement in 42.5% of simulations (P < .001). Cadaver simulations accrued the highest reported benefit (71.5%; P < .001), followed by physical simulators (63.8%; P < .001) and haptic/computerized (59.1; P < .001). Initial cost is $341,978.00, with $27,876.36 for annual operational expenses. The systematic implementation of a simulation curriculum in a neurosurgery training program is feasible, is favorably regarded, and has a positive impact on trainees of all levels, particularly in junior years. All simulation forms, cadaver, physical, and haptic/computerized, have a role in different stages of learning and should be considered in the development of an educational simulation program.

Automated near-real-time clinical performance feedback for anesthesiology residents: one piece of the milestones puzzle.

PubMed

Ehrenfeld, Jesse M; McEvoy, Matthew D; Furman, William R; Snyder, Dylan; Sandberg, Warren S

2014-01-01

Anesthesiology residencies are developing trainee assessment tools to evaluate 25 milestones that map to the six core competencies. The effort will be facilitated by development of automated methods to capture, assess, and report trainee performance to program directors, the Accreditation Council for Graduate Medical Education and the trainees themselves. The authors leveraged a perioperative information management system to develop an automated, near-real-time performance capture and feedback tool that provides objective data on clinical performance and requires minimal administrative effort. Before development, the authors surveyed trainees about satisfaction with clinical performance feedback and about preferences for future feedback. Resident performance on 24,154 completed cases has been incorporated into the authors' automated dashboard, and trainees now have access to their own performance data. Eighty percent (48 of 60) of the residents responded to the feedback survey. Overall, residents "agreed/strongly agreed" that they desire frequent updates on their clinical performance on defined quality metrics and that they desired to see how they compared with the residency as a whole. Before deployment of the new tool, they "disagreed" that they were receiving feedback in a timely manner. Survey results were used to guide the format of the feedback tool that has been implemented. The authors demonstrate the implementation of a system that provides near-real-time feedback concerning resident performance on an extensible series of quality metrics, and which is responsive to requests arising from resident feedback about desired reporting mechanisms.

Automated Near Real-Time Clinical Performance Feedback for Anesthesiology Residents: One Piece of the Milestones Puzzle

PubMed Central

Ehrenfeld, Jesse M.; McEvoy, Matthew D.; Furman, William R.; Snyder, Dylan; Sandberg, Warren S.

2014-01-01

Background Anesthesiology residencies are developing trainee assessment tools to evaluate 25 milestones that map to the 6 core competencies. The effort will be facilitated by development of automated methods to capture, assess, and report trainee performance to program directors, the Accreditation Council for Graduate Medical Education and the trainees themselves. Methods We leveraged a perioperative information management system to develop an automated, near-real-time performance capture and feedback tool that provides objective data on clinical performance and requires minimal administrative effort. Prior to development, we surveyed trainees about satisfaction with clinical performance feedback and about preferences for future feedback. Results Resident performance on 24,154 completed cases has been incorporated into our automated dashboard, and trainees now have access to their own performance data. Eighty percent (48 of 60) of our residents responded to the feedback survey. Overall, residents ‘agreed/strongly agreed’ that they desire frequent updates on their clinical performance on defined quality metrics and that they desired to see how they compared to the residency as a whole. Prior to deployment of the new tool, they ‘disagreed’ that they were receiving feedback in a timely manner. Survey results were used to guide the format of the feedback tool that has been implemented. Conclusions We demonstrate the implementation of a system that provides near real-time feedback concerning resident performance on an extensible series of quality metrics, and which is responsive to requests arising from resident feedback about desired reporting mechanisms. PMID:24398735

Individualized grid-enabled mammographic training system

NASA Astrophysics Data System (ADS)

Yap, M. H.; Gale, A. G.

2009-02-01

The PERFORMS self-assessment scheme measures individuals skills in identifying key mammographic features on sets of known cases. One aspect of this is that it allows radiologists' skills to be trained, based on their data from this scheme. Consequently, a new strategy is introduced to provide revision training based on mammographic features that the radiologist has had difficulty with in these sets. To do this requires a lot of random cases to provide dynamic, unique, and up-to-date training modules for each individual. We propose GIMI (Generic Infrastructure in Medical Informatics) middleware as the solution to harvest cases from distributed grid servers. The GIMI middleware enables existing and legacy data to support healthcare delivery, research, and training. It is technology-agnostic, data-agnostic, and has a security policy. The trainee examines each case, indicating the location of regions of interest, and completes an evaluation form, to determine mammographic feature labelling, diagnosis, and decisions. For feedback, the trainee can choose to have immediate feedback after examining each case or batch feedback after examining a number of cases. All the trainees' result are recorded in a database which also contains their trainee profile. A full report can be prepared for the trainee after they have completed their training. This project demonstrates the practicality of a grid-based individualised training strategy and the efficacy in generating dynamic training modules within the coverage/outreach of the GIMI middleware. The advantages and limitations of the approach are discussed together with future plans.

Workplace-based assessment: a review of user perceptions and strategies to address the identified shortcomings.

PubMed

Massie, Jonathan; Ali, Jason M

2016-05-01

Workplace based assessments (WBAs) are now commonplace in postgraduate medical training. User acceptability and engagement is essential to the success of any medical education innovation. To this end, possessing an insight into trainee and trainer perceptions towards WBAs will help identify the major problems, permitting strategies to be introduced to improve WBA implementation. A review of literature was performed to identify studies examining trainee and trainer perceptions towards WBAs. Studies were excluded if non-English or sampling a non-medical/dental population. The identified literature was synthesised for the purpose of this critical narrative review. It is clear that there is widespread negativity towards WBAs in the workplace. This has negatively impacted on the effectiveness of WBA tools as learning aids. This negativity exists in trainees but also to an extent in their trainers. Insight gained from the literature reveals three dominant problems with WBA implementation: poor understanding as to the purpose of WBAs; insufficient time available for undertaking these assessments; and inadequate training of trainers. Approaches to addressing these three problems with WBA implementation are discussed. It is likely that a variety of solutions will be required. The prevalence of negativity towards WBAs is substantial in both trainees and trainers, eroding the effectiveness of learning that is consequent upon them. The educational community must now listen to the concerns being raised by the users and consider the range of strategies being proposed to improve the experiences of trainees, and their trainers.

Viewpoint matters: objective performance metrics for surgeon endoscope control during robot-assisted surgery.

PubMed

Jarc, Anthony M; Curet, Myriam J

2017-03-01

Effective visualization of the operative field is vital to surgical safety and education. However, additional metrics for visualization are needed to complement other common measures of surgeon proficiency, such as time or errors. Unlike other surgical modalities, robot-assisted minimally invasive surgery (RAMIS) enables data-driven feedback to trainees through measurement of camera adjustments. The purpose of this study was to validate and quantify the importance of novel camera metrics during RAMIS. New (n = 18), intermediate (n = 8), and experienced (n = 13) surgeons completed 25 virtual reality simulation exercises on the da Vinci Surgical System. Three camera metrics were computed for all exercises and compared to conventional efficiency measures. Both camera metrics and efficiency metrics showed construct validity (p < 0.05) across most exercises (camera movement frequency 23/25, camera movement duration 22/25, camera movement interval 19/25, overall score 24/25, completion time 25/25). Camera metrics differentiated new and experienced surgeons across all tasks as well as efficiency metrics. Finally, camera metrics significantly (p < 0.05) correlated with completion time (camera movement frequency 21/25, camera movement duration 21/25, camera movement interval 20/25) and overall score (camera movement frequency 20/25, camera movement duration 19/25, camera movement interval 20/25) for most exercises. We demonstrate construct validity of novel camera metrics and correlation between camera metrics and efficiency metrics across many simulation exercises. We believe camera metrics could be used to improve RAMIS proficiency-based curricula.

Nutrition Education in an Era of Global Obesity and Diabetes: Thinking Outside the Box.

PubMed

Eisenberg, David M; Burgess, Jonathan D

2015-07-01

In an era when rates of obesity, diabetes, and other lifestyle-related diseases challenge medical educators and governments worldwide, it is necessary to consider novel educational strategies, both didactic and experiential, whereby current and future health professionals can be better prepared to proactively advise and teach patients enhanced self-care skills (e.g., diet, movement, stress management, and enhanced behavioral change).In this Perspective, the authors summarize current circumstances involving rising rates of obesity and diabetes worldwide, the lack of nutrition- and lifestyle-related curricular requirements for professional medical certification, societal trends regarding modern food culture and food availability in health care settings, and the misalignment of financial incentives to promote health.The authors assess what elements of self-care should or should not be required within future curricula and certification exams. They consider how best to educate trainees about diet and how to "translate" nutrition, exercise, and behavioral science knowledge into practical advice. They explore several ideas for reforming nutrition education, including "teaching kitchens" as required laboratory classes for nutrition and lifestyle instruction, wearable technologies for tracking behaviors and physiological data relating to lifestyle choices, and the prospect of hospitals and other medical venues serving as exemplars of healthy, delicious food options. Finally, the authors argue that "salutogenesis"-the study of the creation and maintenance of health and well-being-should assume its rightful position alongside the study of "pathogenesis"-disease diagnosis and treatment-in medical education and practice.

Neurosurgical Resident Training in Germany.

PubMed

Stienen, Martin N; Gempt, Jens; Gautschi, Oliver P; Demetriades, Andreas K; Netuka, David; Kuhlen, Dominique E; Schaller, Karl; Ringel, Florian

2017-07-01

Introduction  Efficient neurosurgical training is of paramount importance to provide continuing high-quality medical care to patients. In this era of law-enforced working hour restrictions, however, maintaining high-quality training can be a challenge and requires some restructuring. We evaluated the current status of resident training in Germany. Methods  An electronic survey was sent to European neurosurgical trainees between June 2014 and March 2015. The responses of German trainees were compared with those of trainees from other European countries. Logistic regression analysis was performed to assess the effect size of the relationship between a trainee being from Germany and the outcome (e.g., satisfaction, working time). Results  Of 532 responses, 95 were from German trainees (17.8%). In a multivariate analysis corrected for baseline group differences, German trainees were 29% as likely as non-German trainees to be satisfied with clinical lectures given at their teaching facility (odds ratio [OR]: 0.29; 95% confidence interval [CI]: 0.18-0.49; p  < 0.0001). The satisfaction rate with hands-on operating room exposure was 73.9% and equal to the rate in Europe (OR: 0.94; 95% CI, 0.56-1.59; p  = 0.834). German trainees were 2.3 times as likely to perform a lumbar spine intervention as the primary surgeon within the first year of training (OR: 2.27; 95% CI, 1.42-3.64; p  = 0.001). However, they were less likely to perform a cervical spine procedure within 24 months of training (OR: 0.38; 95% CI, 0.17-0.82; p  = 0.014) and less likely to perform a craniotomy within 36 months of training (OR: 0.49; 95% CI, 0.31-0.79; p  = 0.003). Only 25.6% of German trainees currently adhere to the weekly limit of 48 hours as requested from the European Working Time Directive 2003/88/EC, and in an international comparison, German trainees were twice as likely to work > 50 hours per week (OR: 2.13; 95% CI, 1.25-3.61; p  = 0.005). This working time, however, is less spent in the operating suite (OR: 0.26; 95% CI, 0.11-0.59; p  = 0.001) and more doing administrative work (OR: 1.83; 95% CI, 1.13-2.96; p  = 0.015). Conclusion  Some theoretical and practical aspects of neurosurgical training are superior, but a considerable proportion of relevant aspects are inferior in Germany compared with other European countries. The present analyses provide the opportunity for a critical review of the local conditions in German training facilities. Georg Thieme Verlag KG Stuttgart · New York.

Educational approaches for discouraging plagiarism.

PubMed

Fischer, Beth A; Zigmond, Michael J

2011-01-01

Suggested approaches to reduce the occurrence of plagiarism in academia, particularly among trainees. These include (1) educating individuals as to the definition of plagiarism and its consequences through written guidelines, active discussions, and practice in identifying proper and improper citation practices; (2) distributing checklists that break the writing task into more manageable steps, (3) requiring the submission of an outline and then a first draft prior to the deadline for a paper; (4) making assignments relevant to individual interests; and (5) providing trainees with access to software programs that detect plagiarism. Copyright © 2011 Elsevier Inc. All rights reserved.

Polyurethane Foam-Filled Skull Replica of Craniosynostosis for Surgical Training.

PubMed

Jeong, Yeon Jin; Lee, Jun Yong

2016-05-01

Craniosynostosis has a relatively low incidence in the general population and its treatment requires cautious approaches. For these reasons, patients are usually referred to several specialists or a medical center. Therefore, most trainees and young surgeons do not have any chances to experience patients of craniosynostosis, but learn about it only from textbooks. And for a surgeon who tries to operate on a craniosynostosis patient, it is hard to make a proper preoperative plan.The authors suggest a polyurethane foam-filled skull replica of craniosynostosis for trainees that can also be used in planning a craniosynostosis operation.

Competency Testing for Pediatric Cardiology Fellows Learning Transthoracic Echocardiography: Implementation, Fellow Experience, and Lessons Learned.

PubMed

Levine, Jami C; Geva, Tal; Brown, David W

2015-12-01

There is currently great interest in measuring trainee competency at all levels of medical education. In 2007, we implemented a system for assessing cardiology fellows' progress in attaining imaging skills. This paradigm could be adapted for use by other cardiology programs. Evaluation consisted of a two-part exercise performed after years 1 and 2 of pediatric cardiology training. Part 1: a directly observed evaluation of technical skills as fellows imaged a normal subject (year 1) and a patient with complex heart disease (year 2). Part 2: fellows interpreted and wrote reports for two echocardiograms illustrating congenital heart disease. These were graded for accuracy and facility with communicating pertinent data. After 5 years of testing, fellows were surveyed about their experience. In 5 years, 40 fellows were tested at least once. Testing identified four fellows who underperformed on the technical portion and four on the interpretive portion. Surveys were completed by 33 fellows (83 %). Most (67 %) felt that intermittent observation by faculty was inadequate for assessing skills and that procedural volume was a poor surrogate for competency (58 %). Posttest feedback was constructive and valuable for 90, and 70 % felt the process helped them set goals for skill improvement. Overall, fellows felt this testing was fair and should continue. Fellow performance and responses identified programmatic issues that were creating barriers to learning. We describe a practical test to assess competency for cardiology fellows learning echocardiography. This paradigm is feasible, has excellent acceptance among trainees, and identifies trainees who need support. Materials developed could be easily adapted to help track upcoming ACGME-mandated metrics.

Computer-enhanced laparoscopic training system (CELTS): bridging the gap.

PubMed

Stylopoulos, N; Cotin, S; Maithel, S K; Ottensmeye, M; Jackson, P G; Bardsley, R S; Neumann, P F; Rattner, D W; Dawson, S L

2004-05-01

There is a large and growing gap between the need for better surgical training methodologies and the systems currently available for such training. In an effort to bridge this gap and overcome the disadvantages of the training simulators now in use, we developed the Computer-Enhanced Laparoscopic Training System (CELTS). CELTS is a computer-based system capable of tracking the motion of laparoscopic instruments and providing feedback about performance in real time. CELTS consists of a mechanical interface, a customizable set of tasks, and an Internet-based software interface. The special cognitive and psychomotor skills a laparoscopic surgeon should master were explicitly defined and transformed into quantitative metrics based on kinematics analysis theory. A single global standardized and task-independent scoring system utilizing a z-score statistic was developed. Validation exercises were performed. The scoring system clearly revealed a gap between experts and trainees, irrespective of the task performed; none of the trainees obtained a score above the threshold that distinguishes the two groups. Moreover, CELTS provided educational feedback by identifying the key factors that contributed to the overall score. Among the defined metrics, depth perception, smoothness of motion, instrument orientation, and the outcome of the task are major indicators of performance and key parameters that distinguish experts from trainees. Time and path length alone, which are the most commonly used metrics in currently available systems, are not considered good indicators of performance. CELTS is a novel and standardized skills trainer that combines the advantages of computer simulation with the features of the traditional and popular training boxes. CELTS can easily be used with a wide array of tasks and ensures comparability across different training conditions. This report further shows that a set of appropriate and clinically relevant performance metrics can be defined and a standardized scoring system can be designed.

Informatics in radiology: use of a C-arm fluoroscopy simulator to support training in intraoperative radiography.

PubMed

Bott, Oliver Johannes; Dresing, Klaus; Wagner, Markus; Raab, Björn-Werner; Teistler, Michael

2011-01-01

Mobile image intensifier systems (C-arms) are used frequently in orthopedic and reconstructive surgery, especially in trauma and emergency settings, but image quality and radiation exposure levels may vary widely, depending on the extent of the C-arm operator's knowledge and experience. Current training programs consist mainly of theoretical instruction in C-arm operation, the physical foundations of radiography, and radiation avoidance, and are largely lacking in hands-on application. A computer-based simulation program such as that tested by the authors may be one way to improve the effectiveness of C-arm training. In computer simulations of various scenarios commonly encountered in the operating room, trainees using the virtX program interact with three-dimensional models to test their knowledge base and improve their skill levels. Radiographs showing the simulated patient anatomy and surgical implants are "reconstructed" from data computed on the basis of the trainee's positioning of models of a C-arm, patient, and table, and are displayed in real time on the desktop monitor. Trainee performance is signaled in real time by color graphics in several control panels and, on completion of the exercise, is compared in detail with the performance of an expert operator. Testing of this computer-based training program in continuing medical education courses for operating room personnel showed an improvement in the overall understanding of underlying principles of intraoperative radiography performed with a C-arm, with resultant higher image quality, lower overall radiation exposure, and greater time efficiency. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.313105125/-/DC1. Copyright © RSNA, 2011.

Cognate Facilitation in Sentence Context--Translation Production by Interpreting Trainees and Non-Interpreting Trilinguals

ERIC Educational Resources Information Center

Lijewska, Agnieszka; Chmiel, Agnieszka

2015-01-01

Conference interpreters form a special case of language users because the simultaneous interpretation practice requires very specific lexical processing. Word comprehension and production in respective languages is performed under strict time constraints and requires constant activation of the involved languages. The present experiment aimed at…

Analysing the operative experience of basic surgical trainees in Ireland using a web-based logbook

PubMed Central

2011-01-01

Background There is concern about the adequacy of operative exposure in surgical training programmes, in the context of changing work practices. We aimed to quantify the operative exposure of all trainees on the National Basic Surgical Training (BST) programme in Ireland and compare the results with arbitrary training targets. Methods Retrospective analysis of data obtained from a web-based logbook (http://www.elogbook.org) for all general surgery and orthopaedic training posts between July 2007 and June 2009. Results 104 trainees recorded 23,918 operations between two 6-month general surgery posts. The most common general surgery operation performed was simple skin excision with trainees performing an average of 19.7 (± 9.9) over the 2-year training programme. Trainees most frequently assisted with cholecystectomy with an average of 16.0 (± 11.0) per trainee. Comparison of trainee operative experience to arbitrary training targets found that 2-38% of trainees achieved the targets for 9 emergency index operations and 24-90% of trainees achieved the targets for 8 index elective operations. 72 trainees also completed a 6-month post in orthopaedics and recorded 7,551 operations. The most common orthopaedic operation that trainees performed was removal of metal, with an average of 2.90 (± 3.27) per trainee. The most common orthopaedic operation that trainees assisted with was total hip replacement, with an average of 10.46 (± 6.21) per trainee. Conclusions A centralised web-based logbook provides valuable data to analyse training programme performance. Analysis of logbooks raises concerns about operative experience at junior trainee level. The provision of adequate operative exposure for trainees should be a key performance indicator for training programmes. PMID:21943313

Evaluation of trainees' ability to perform obstetrical ultrasound using simulation: challenges and opportunities.

PubMed

Chalouhi, Gihad E; Bernardi, Valeria; Gueneuc, Alexandra; Houssin, Isabelle; Stirnemann, Julien J; Ville, Yves

2016-04-01

Evaluation of trainee's ability in obstetrical ultrasound is a time-consuming process, which requires involving patients as volunteers. With the use of obstetrical ultrasound simulators, virtual reality could help in assessing competency and evaluating trainees in this field. The objective of the study was to test the validity of an obstetrical ultrasound simulator as a tool for evaluating trainees following structured training by comparing scores obtained on obstetrical ultrasound simulator with those obtained on volunteers and by assessing correlations between scores of images and of dexterity given by 2 blinded examiners. Trainees, taking the 2013 French national examination for the practice of obstetrical ultrasound were asked to obtain standardized ultrasound planes both on volunteer pregnant women and on an obstetrical ultrasound simulator. These planes included measurements of biparietal diameter, abdominal circumference, and femur length as well as reference planes for cardiac 4-chamber and outflow tracts, kidneys, stomach/diaphragm, spine, and face. Images were stored and evaluated subsequently by 2 national examiners who scored each picture according to previously established quality criteria. Dexterity was also evaluated and subjectively scored between 0 and 10. The Raghunathan's modification of Pearson, Filon's z, Spearman's rank correlation, and analysis of variance tests were used to assess correlations between the scores by the 2 examiners and scores of dexterity and also to compare the final scores between the 2 different methods. We evaluated 29 trainees. The mean dexterity scores in simulation (6.5 ± 2.0) and real examination (5.9 ± 2.3) were comparable (P = .31). Scores with an obstetrical ultrasound simulator were significantly higher than those obtained on volunteers (P = .027). Nevertheless, there was a good correlation between the scores of the 2 examiners judging on simulation (R = 0.888) and on volunteers (R = 0.873) (P = .81). An obstetrical ultrasound simulator is as good a method as volunteer-based examination for evaluating practical skills in trainees following structured training in obstetrical ultrasound. The threshold for success/failure should, however, be adapted as candidates obtain higher scores on the simulator. Advantages of the obstetrical ultrasound simulator include the absence of location and time constraints without the need to involve volunteers or to interfere with the running of ultrasound clinics. However, an obstetrical ultrasound simulator still lacks the ability to evaluate the trainees' ability to interact with patients. Copyright © 2016 Elsevier Inc. All rights reserved.

48 CFR 52.222-7 - Withholding of Funds.

Code of Federal Regulations, 2012 CFR

2012-10-01

... mechanics, including apprentices, trainees, and helpers, employed by the Contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic...

48 CFR 52.222-7 - Withholding of Funds.

Code of Federal Regulations, 2011 CFR

2011-10-01

... mechanics, including apprentices, trainees, and helpers, employed by the Contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic...

48 CFR 52.222-7 - Withholding of Funds.

Code of Federal Regulations, 2013 CFR

2013-10-01

... mechanics, including apprentices, trainees, and helpers, employed by the Contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic...

48 CFR 52.222-7 - Withholding of Funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... mechanics, including apprentices, trainees, and helpers, employed by the Contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic...

"Run-through" training at specialist training year 1 and uncoupled core surgical training for oral and maxillofacial surgery in the United Kingdom: a snapshot survey.

PubMed

Garg, M; Collyer, J; Dhariwal, D

2018-05-01

Training in oral and maxillofacial surgery (OMFS) in the UK has undergone considerable changes during the last 10years, and "core" surgical training has replaced "basic" surgical training. In 2014 a pilot "run-through" training programme from specialist training year one (ST1)-ST7 was introduced to facilitate early entry into the speciality. Run-through training guarantees that a trainee, after a single competitive selection process and satisfactory progress, will be given training that covers the entire curriculum of the speciality, whereas uncoupled training requires a second stage of competitive recruitment after the first one (for OMFS only) or two years of "core" training to progress to higher specialty training. The first two years of run-through training (ST1-ST2) are the same as for core surgical training. Dual-qualified maxillofacial aspirants and those in their second degree course are curious to know whether they should go for the uncoupled core surgical training or the run-through programme in OMFS. The General Medical Council (GMC) has now agreed that run-through training can be rolled out nationally in OMFS. To assess the two pathways we used an online questionnaire to gain feedback about the experience from all OMFS ST3 and run-through trainees (ST3/ST4) in 2016-2017. We identified and contacted 21 trainees, and 17 responded, including seven run-through trainees. Eleven, including five of the run-through trainees, recommended the run-through training programme in OMFS. Six of the seven run-through trainees had studied dentistry first. The overall mean quality of training was rated as 5.5 on a scale 0-10 by the 17 respondents. This survey gives valuable feedback from the current higher surgical trainees in OMFS, which will be useful to the GMC, Health Education England, OMFS Specialist Advisory Committee, and those seeking to enter higher surgical training in OMFS. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Surgical Training and the Early Specialization Program: Analysis of a National Program.

PubMed

Klingensmith, Mary E; Potts, John R; Merrill, Walter H; Eberlein, Timothy J; Rhodes, Robert S; Ashley, Stanley W; Valentine, R James; Hunter, John G; Stain, Steven C

2016-04-01

The Early Specialization Program (ESP) in surgery was designed by the American Board of Surgery, the American Board of Thoracic Surgery, and the Residency Review Committees for Surgery and Thoracic Surgery to allow surgical trainees dual certification in general surgery (GS) and either vascular surgery (VS) or cardiothoracic surgery (CTS) after 6 to 7 years of training. After more than 10 years' experience, this analysis was undertaken to evaluate efficacy. American Board of Surgery and American Board of Thoracic Surgery records of VS and CTS ESP trainees were queried to evaluate qualifying exam and certifying exam performance. Case logs were examined and compared with contemporaneous non-ESP trainees. Opinions of programs directors of GS, VS, and CTS and ESP participants were solicited via survey. Twenty-six CTS ESP residents have completed training at 10 programs and 16 VS ESP at 6 programs. First-time pass rates on American Board of Surgery qualifying and certifying exams were superior to time-matched peers; greater success in specialty specific examinations was also found. Trainees met required case minimums for GS despite shortened time in GS. By survey, 85% of programs directors endorsed satisfaction with ESP, and 90% endorsed graduate readiness for independent practice. Early Specialization Program participants report increased mentorship and independence, greater competence for practice, and overall satisfaction with ESP. Individuals in ESP programs in VS and CTS were successful in passing GS and specialty exams and achieving required operative cases, despite an accelerated training track. Programs directors and participants report satisfaction with the training and confidence that ESP graduates are prepared for independent practice. This documented success supports ESP training in any surgical subspecialty, including comprehensive GS. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

An economic evaluation of the costs of training a medical scribe to work in Emergency Medicine.

PubMed

Walker, Katherine J; Dunlop, Will; Liew, Danny; Staples, Margaret P; Johnson, Matt; Ben-Meir, Michael; Rodda, Hamish Gordon; Turner, Ian; Phillips, David

2016-12-01

To undertake a cost analysis of training medical scribes in an ED. This was a pilot, observational, single-centre study at Cabrini ED, Melbourne, Australia, studying the costs of initiating a scribe programme from the perspective of the hospital and Australian Health sector. Recruitment and training occurred between August 2015 and February 2016 and comprised of a prework course (1 month), prework training sessions and clinical training shifts for scribe trainees (2-4 months, one shift per week) who were trained by emergency physicians. Costs of start-up, recruitment, administration, preclinical training, clinical training shifts and productivity changes for trainers were calculated. 10 trainees were recruited to the prework course, 9 finished, 6 were offered clinical training after simulation assessment, 5 achieved competency. Scribes required clinical training ranging from 68 to 118 hours to become competent after initial classroom training. Medical students (2) required 7 shifts to become competent, premedical students (3) 8-16 shifts, while a trainee from an alternative background did not achieve competency. Based on a scribe salary of US$15.91/hour (including 25% on-costs) plus shift loadings, costs were: recruitment and start-up US$3111, education US$1257, administration US$866 and clinical shift costs US$1137 (overall cost US$6317 per competent scribe). Physicians who trained the clinical trainee scribes during shifts did not lose productivity. Training scribes outside the USA is feasible using an on-line training course and local physicians. It makes economic sense to hire individuals who can work over a long period of time to recoup training costs. ACTRN12615000607572. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Sport medicine].

PubMed

Epstein, Yoram

2012-02-01

It is only since the late 20th century that Sport and Exercise Medicine has emerged as a distinct entity in health care. In Israel, sports medicine is regulated by a State Law and a sport physician is certified after graduating a structured program. In the past, sports medicine was related to the diagnosis and treatment of injuries encountered by top athletes. In recent years, the scope of sport medicine has broadened to reflect the awareness of modern society of the dangers of physical inactivity. In this perspective the American College of Sport Medicine (ACSM) recently launched a program--"Exercise is Medicine", to promote physical activity in order to improve health and well-being and prevention of diseases through physical activity prescriptions. This program is from doctors and healthcare providers, adjusted to the patient or trainee. The sport physician does not replace a medical specialist, but having a thorough understanding about the etiology of a sport-related injury enables him to better focus on treatment and prevention. Therefore, Team Physicians in Elite Sport often play a role regarding not only the medical care of athletes, but also in the physiological monitoring of the athlete and correcting aberrations, to achieve peak physical performance. The broad spectrum of issues in sport and exercise medicine cannot be completely covered in one issue of the Journal. Therefore, the few reports that are presented to enhance interest and understanding in the broad spectrum of issues in sports and exercise medicine are only the tip of the iceberg.

Knowledge, skills and attitude of evidence-based medicine among obstetrics and gynaecology trainees: a questionnaire survey.

PubMed

Jeve, Yadava Bapurao; Doshani, Angi; Singhal, Tanu; Konje, Justin

2013-12-01

To determine current evidence-based medicine skills and practice among trainees. Questionnaire study. Electronic survey was sent to all obstetrics and gynaecology trainees in East Midlands South Deanery, and responses collected were anonymous. All obstetrics and gynaecology trainees in East Midland South Deanery. Self-reported attitude, skills and knowledge in various components of evidence-based medicine. 69 trainees were included in the study of which 35 responded. Among all respondents, almost 72% of trainees use non-evidence-based methods to find answers for their clinical questions, whereas only 18% use appropriate evidence-based medicine practice for such queries. Just 35% of trainees have minimum skills of literature searching. Most of the trainees struggle to understand various components of evidence-based medicine. Nearly 80% of trainees do not have formal education or training with regard to evidence-based medicine. This study highlights the inadequacy of evidence-based medicine skills among trainees and urges that evidence-based medicine be incorporated in formal training along with specialty study modules.

General medical training in gastroenterology: views from specialist trainees on the challenges of dual accreditation.

PubMed

Neale, James R; Basford, Peter J

2015-02-01

Higher specialist training in general internal medicine (GIM) and the medical specialties has been subject to many changes and increasing subspecialisation in recent years. The 'Shape of Training' review proposes 'broad-based specialty training', shortening of training by one year, and subspecialisation to be undertaken after the certificate of specialty training is obtained. All higher level gastroenterology trainees based in the UK were invited to complete an online survey between July and September 2012 to assess their experience of gastroenterology and GIM training. Overall, 72.7% of trainees expressed satisfaction with their training in gastroenterology but significantly fewer (43.5%) expressed satisfaction with their training in GIM. Satisfaction with gastroenterology training thus is good, but satisfaction with GIM training is lower and levels of dissatisfaction have increased significantly since 2008. Up to 50% of trainees are not achieving the minimum recommended number of colonoscopy procedures for their stage of training. Experience in GIM is seen as service orientated, with a lack of training opportunities. There is a worrying difficulty in gaining the minimum required experience in endoscopy. If the length of specialist training is shortened and generalised, training in key core specialist skills such as endoscopy may be compromised further. © 2015 Royal College of Physicians.

Survey of the learning activities of Australasian radiation oncology specialist trainees.

PubMed

Holt, T; Bydder, S; Bloomfield, L

2008-12-01

Trainee radiation oncologists must master a substantial body of skills and knowledge to become competent specialists. The resources available to support this are limited. We surveyed the 90 registrars enrolled in the Royal Australian and New Zealand College of Surgeons (RANZCR) radiation oncology training programme to obtain a range of information about their learning activities (with a significant focus on part 1 teaching). Responses were received from 59 registrars (66% of those eligible). Trainees reported spending a median 2.5 h per week (range 0-10 h) in formal teaching activities. With regard to part 1 exam preparation, 83% reported having had physics teaching--the median quality was 5/7; 88% had radiobiology teaching--the median quality was 4/7; 52% had anatomy teaching--the median quality was 3/7. Registrars training within the RANZCR radiation oncologists training programme perceive their own clinical learning environment as generally good; however' 50% of respondents felt that more teaching was needed for part 1 subjects. This compared with only 19% of respondents who felt that more teaching was required for part 2 exam preparation. Innovative solutions, such as centralized web-based teaching, may help to address weaknesses in part 1 teaching. With increasing demands on radiation oncologists and trainees it will be important to monitor learning environments.

Quality of colonoscopy performance among gastroenterology and surgical trainees: a need for common training standards for all trainees?

PubMed

Leyden, J E; Doherty, G A; Hanley, A; McNamara, D A; Shields, C; Leader, M; Murray, F E; Patchett, S E; Harewood, G C

2011-11-01

Cecal intubation and polyp detection rates are objective measures of colonoscopy performance. Minimum cecal intubation rates greater than 90% have been endorsed by the American Society for Gastrointestinal Endoscopy (ASGE) and the Joint Advisory Group (JAG) UK. Performance data for medical and surgical trainee endoscopists are limited, and we used endoscopy quality parameters to compare these two groups. Retrospective review of all single-endoscopist colonoscopies done by gastroenterology and surgical trainees ("registrars," equivalent to fellows, postgraduate year 5) with more than two years' endoscopy experience, in 2006 and 2007 at a single academic medical center. Completion rates and polyp detection rates for endoscopists performing more than 50 colonoscopies during the study period were audited. Colonoscopy withdrawal time was prospectively observed in a representative subset of 140 patients. Among 3079 audited single-endoscopist colonoscopies, seven gastroenterology trainees performed 1998 procedures and six surgery trainees performed 1081. The crude completion rate was 82%, 84% for gastroenterology trainees and 78% for surgery trainees (P < 0.0001). Adjusted for poor bowel preparation quality and obstructing lesions, the completion rate was 89%; 93% for gastroenterology trainees, and 84% for surgical trainees (P < 0.0001). The polyp detection rate was 19% overall, with 21% and 14% for gastroenterology and surgical trainees, respectively (P < 0.0001). The adenoma detection rate in patients over 50 was 12%; gastroenterology trainees 14% and surgical trainees 9% (P = 0.0065). In the prospectively audited procedures, median withdrawal time was greater in the gastroenterology trainee group and polyp detection rates correlated closely with withdrawal time (r = 0.99). The observed disparity in endoscopic performance between surgical and gastroenterology trainees suggests the need for a combined or unitary approach to endoscopy training for specialist medical and surgical trainees. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical biochemistry education, training and continuing professional development in the United Kingdom.

PubMed

Beastall, Graham H

2008-07-01

Education and training to become a senior professional in UK clinical biochemistry is coordinated at national level and is largely dependent upon completion of the MRCPath examination. The number of training commissions is regulated to accord with workforce planning requirements. Both medical and science graduates are eligible to undertake this training and the core curriculum is similar for both groups. Medical trainees have the option of including additional clinical training in metabolic medicine. Increasingly, with the introduction of new methods of assessment, the MRCPath examination is becoming a measure of competence rather than knowledge. Structured CPD is mandatory for career grade doctors and scientists as part of the requirements for them to maintain their individual licence to practice and in order that the laboratory in which they work may be accredited. The education, training and assessment of trainees in clinical biochemistry enable the production of a flexible workforce that is competent and designed to be fit for purpose. The requirement for structured CPD is one part of maintaining competence.

Quality of life of surgical oncology residents and fellows across Europe.

PubMed

Mordant, Pierre; Deneuve, Sophie; Rivera, Caroline; Carrabin, Nicolas; Mieog, J Sven; Malyshev, Nikolay; Van Der Vorst, Joost R; Audisio, Riccardo A

2014-01-01

Data are currently lacking regarding the quality of life of surgical oncology (SO) trainees. We sought to assess the training conditions and quality of life of SO residents and fellows across Europe. Members of the European Society for Surgical Oncology were invited to complete a Web-based survey that included a questionnaire specifically designed for SO trainees. Demographics, timing, and incentive to choose for SO, quality of life, and symptoms of fatigue, sleepiness, depression, and burnout, as well as self-reported medical errors, were assessed using validated instruments. The survey was completed by 109 residents and 53 fellows (mean age 34.6 ± 8.2). The mean Linear Analog Scale Assessment score for quality of life was 34.8 ± 8.6 out of a possible 50. A low level of fatigue was declared by 60% of the trainees. However, 44% scored an abnormal Epworth Sleepiness score, which was mostly related to in-hospital work time and lack of educational programs. High positive screenings regarding depression (51%) and burnout (25%) were associated with resident status and lack of mentorship, respectively. Major medical errors during the last 3 months were self-reported by 20% of the trainees. In Europe, the perceived quality of life is overall acceptable among trainees in SO. However, the present study demonstrated a high level of sleepiness, depression, and burnout symptoms. Additional work is required to identify and overcome the underlying causes of these symptoms. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Trainee and training issues.

PubMed

Redfern, Nancy; Bartley, Catherine

2006-12-01

This chapter deals with the obligations of trainers and trainees to each other, the responsibilities of the programme and the conflicts of providing a service while training. Management of trainees with differing needs, such as those working part-time or returning to training after sickness, is reviewed. Assessment of performance and the obligation of consultants to identify, manage and support struggling trainees are discussed. Ethical discussion is based on the principles of autonomy, non-maleficence, beneficence, and justice to which fidelity is added. Case studies illustrating the application of ethical principles to work and decision-making are presented to stimulate debate. Opinions vary as to which principle carries more weight in individual cases, and how best to balance the conflicting requirements of the parties involved (patient, trainee,.trainer, employer, society). For all healthcare practitioners, the needs of patients remain our first concern. Acting in a consequentialist way, we must "maximise the good" and minimise the attendant harms in training. However, deontology states that certain sacrosanct rules and principles should never be breached. Doctors must abide by the duties of a doctor described in Good Medical Practice, maintaining standards in a way that ensures professional qualifications are respected. For the patient, there are advantages and disadvantages to receiving care in an educational setting. A 'teaching environment' tends to encourage and maintain high standards of practice from senior clinicians, but it also exposes patients to new learners, who are less efficient and polished and perhaps more prone to make errors. Learning has to fit round and complement the clinical and emotional needs of patients.

Status of Microsurgical Simulation Training in Plastic Surgery: A Survey of United States Program Directors.

PubMed

Al-Bustani, Saif; Halvorson, Eric G

2016-06-01

Various simulation models for microsurgery have been developed to overcome the limitations of Halstedian training on real patients. We wanted to assess the status of microsurgery simulation in plastic surgery residency programs in the United States. Data were analyzed from responses to a survey sent to all plastic surgery program directors in the United States, asking for type of simulation, quality of facilities, utilization by trainees, evaluation of trainee sessions, and perception of the relevance of simulation. The survey response rate was 50%. Of all programs, 69% provide microsurgical simulation and 75% of these have a laboratory with microscope and 52% provide live animal models. Half share facilities with other departments. The quality of facilities is rated as good or great in 89%. Trainee utilization is once every 3 to 6 months in 82% of programs. Only in 11% is utilization monthly. Formal evaluation of simulation sessions is provided by 41% of programs. All program directors agree simulation is relevant to competence in microsurgery, 60% agree simulation should be mandatory, and 43% require trainees to complete a formal microsurgery course prior to live surgery. There seems to be consensus that microsurgical simulation improves competence, and the majority of program directors agree it should be mandatory. Developing and implementing standardized simulation modules and assessment tools for trainees across the nation as part of a comprehensive competency-based training program for microsurgery is an important patient safety initiative that should be considered. Organizing with other departments to share facilities may improve their quality and hence utilization.

Job variation in advanced training in adult neurology in Australia and New Zealand: a follow-up study.

PubMed

Burrell, J R; Parratt, K; Lueck, C J

2014-06-01

Six years ago, a survey of Australian trainees in neurology highlighted several differences in the training offered by the various positions. There has been a subsequent increase in trainee numbers. This survey aimed to re-examine the workload and exposure provided by individual positions and to compare training in Australia and New Zealand. A questionnaire was circulated in 2012 to all advanced trainees in core adult neurology positions in Australia and New Zealand, looking at ward work, outpatient clinics, neurophysiology exposure and on-call commitments. The response rate was 85.7%. There was a 48.7% increase in the number of core training positions in Australia, but an average increase in inpatient workload of 56%. General neurology clinic numbers were unchanged while specialist clinic exposure had risen from 1.0 to 1.8 clinics/week. In some cases, exposure to neurophysiology had fallen. The requirement for out-of-hours on-call had fallen. There were no major differences between positions in Australia and New Zealand. There have been significant improvements in advanced training in adult neurology in the 5 years between 2007 and 2012: numbers of trainees have increased, on-call commitments have fallen and exposure to specialist clinics has risen. However, inpatient workload has increased significantly, accompanied by a slight reduction in exposure to training in neurophysiology in some cases. Overall, the changes are encouraging, but more work is still needed to ensure that individual positions meet the training needs of trainees. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

Apprentice and Trainee Destinations 2010: Technical Notes. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

"Apprentice and Trainee Destinations" presents information about the destinations of apprentices and trainees approximately nine months after leaving their training. Information in this publication is derived from the Apprentice and Trainee Destinations Survey that covered apprentices and trainees who, between April and June 2009, either…

33 CFR 105.220 - Drill and exercise requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.220 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of facility personnel in assigned...

33 CFR 104.230 - Drill and exercise requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.230 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of vessel personnel in assigned...

33 CFR 104.230 - Drill and exercise requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.230 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of vessel personnel in assigned...

33 CFR 105.220 - Drill and exercise requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.220 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of facility personnel in assigned...

33 CFR 105.220 - Drill and exercise requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.220 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of facility personnel in assigned...

33 CFR 104.230 - Drill and exercise requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.230 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of vessel personnel in assigned...

33 CFR 104.230 - Drill and exercise requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.230 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of vessel personnel in assigned...

33 CFR 104.230 - Drill and exercise requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.230 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of vessel personnel in assigned...

33 CFR 105.220 - Drill and exercise requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.220 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of facility personnel in assigned...

33 CFR 105.220 - Drill and exercise requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Drill and exercise requirements... MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.220 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of facility personnel in assigned...

Guide for the Training and Qualification of Welding Personnel. Level III - Expert Welders.

ERIC Educational Resources Information Center

American Welding Society, Miami, FL.

This guide is designed to help education and training facilities develop and administer competency-based training programs to qualify and certify trainees in accordance with American Welding Society (AWS) requirements for level III (expert) welders. Presented first are the scope/objectives/requirements of the AWS qualification/certification…

Guide for the Training and Qualification of Welding Personnel. Level II - Advanced Welders.

ERIC Educational Resources Information Center

American Welding Society, Miami, FL.

This guide is designed to help education and training facilities develop and administer competency-based training programs to qualify and certify trainees in accordance with the American Welding Society (AWS) requirements for level II (advanced) welders. Presented first are the scope, objectives, and requirements of the AWS…

Fire Fighter Level I-II-III [and] Practical Skills Test. Wisconsin Fire Service Certification Series. Final Revision.

ERIC Educational Resources Information Center

Pribyl, Paul F.

Practical skills tests are provided for fire fighter trainees in the Wisconsin Fire Service Certification Series, Fire Fighter Levels I, II, and III. A course introduction appears first and contains this information: recommended instructional sequence, required facilities, instructional methodology, requirements for certification, course…

Training for single port video assisted thoracoscopic surgery lung resections.

PubMed

McElnay, Philip J; Lim, Eric

2015-11-01

With many surgical training programmes providing less time for training it can be challenging for trainees to acquire the necessary surgical skills to perform complex video assisted thoracoscopic surgery (VATS) lung resections. Indeed as the utilization of single port operations increases the need to approach the operating theatre with already-existing excellent hand-eye coordination skills increases. We suggest that there are a number of ways that trainees can begin to develop these necessary skills. Firstly, using computer games that involve changing horizons and orientations. Secondly, utilizing box-trainers to practice using the thoracoscopic instruments. Thirdly, learning how essential tools such as the stapler work. Trainees will then be able to progress to meaningfully assisting in theatre and indeed learning how to perform the operation themselves. At this stage is useful to observe expert surgeons whilst they operate-to watch both their technical and non-technical skills. Ultimately, surgery is a learned skill and requires implementation of these techniques over a sustained period of time.

33 CFR 106.225 - Drill and exercise requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Drill and exercise requirements...) Facility Security Requirements § 106.225 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the proficiency of facility personnel in assigned security duties at all MARSEC Levels...

How surgical mentors teach: a classification of in vivo teaching behaviors part 2: physical teaching guidance.

PubMed

Sutkin, Gary; Littleton, Eliza B; Kanter, Steven L

2015-01-01

To study surgical teaching captured on film and analyze it at a fine level of detail to categorize physical teaching behaviors. We describe live, filmed, intraoperative nonverbal exchanges between surgical attending physicians and their trainees (residents and fellows). From the films, we chose key teaching moments and transcribed participants' utterances, actions, and gestures. In follow-up interviews, attending physicians and trainees watched videos of their teaching case and answered open-ended questions about their teaching methods. Using a grounded theory approach, we examined the videos and interviews for what might be construed as a teaching behavior and refined the physical teaching categories through constant comparison. We filmed 5 cases in the operating suite of a university teaching hospital that provides gynecologic surgical care. We included 5 attending gynecologic surgeons, 3 fellows, and 5 residents for this study. More than 6 hours of film and 3 hours of interviews were transcribed, and more than 250 physical teaching motions were captured. Attending surgeons relied on actions and gestures, sometimes wordlessly, to achieve pedagogical and surgical goals simultaneously. Physical teaching included attending physician-initiated actions that required immediate corollary actions from the trainee, gestures to illustrate a step or indicate which instrument to be used next, supporting or retracting tissues, repositioning the trainee's instruments, and placement of the attending physicians' hands on the trainees' hands to guide them. Attending physicians often voiced surprise at the range of their own teaching behaviors captured on film. Interrater reliability was high using the Cohen κ, which was 0.76 for the physical categories. Physical guidance is essential in educating a surgical trainee, may be tacit, and is not always accompanied by speech. Awareness of teaching behaviors may encourage deliberate teaching and reflection on how to innovate pedagogy for the teaching operating room. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Milestone-Based Assessments Are Superior to Likert-Type Assessments in Illustrating Trainee Progression

PubMed Central

Bartlett, Kathleen W.; Whicker, Shari A.; Bookman, Jack; Narayan, Aditee P.; Staples, Betty B.; Hering, Holly; McGann, Kathleen A.

2015-01-01

Background The Pediatrics Milestone Project uses behavioral anchors, narrative descriptions of observable behaviors, to describe learner progression through the Accreditation Council for Graduate Medical Education competencies. Starting June 2014, pediatrics programs were required to submit milestone reports for their trainees semiannually. Likert-type scale assessment tools were not designed to inform milestone reporting, creating a challenge for Clinical Competency Committees. Objective To determine if milestone-based assessments better stratify trainees by training level compared to Likert-type assessments. Methods We compared assessment results for 3 subcompetencies after changing from a 5-point Likert scale to milestone-based behavioral anchors in July 2013. Program leadership evaluated the new system by (1) comparing PGY-1 mean scores on Likert-type versus milestone-based assessments; and (2) comparing mean scores on the Likert-type versus milestone-based assessments across PGY levels. Results Mean scores for PGY-1 residents were significantly higher on the prior year's Likert-type assessments than milestone-based assessments for all 3 subcompetencies (P < .01). Stratification by PGY level was not observed with Likert-type assessments (eg, interpersonal and communication skills 1 [ICS1] mean score for PGY-1, 3.99 versus PGY-3, 3.98; P  =  .98). In contrast, milestone-based assessments demonstrated stratification by PGY level (eg, the ICS1 mean score was 3.06 for PGY-1, 3.83 for PGY-2, and 3.99 for PGY-3; P < .01 for PGY-1 versus PGY-3). Significantly different means by trainee level were noted across 21 subcompetencies on milestone-based assessments (P < .01 for PGY-1 versus PGY-3). Conclusions Initial results indicate milestone-based assessments stratify trainee performance by level better than Likert-type assessments. Average PGY-level scores from milestone-based assessments may ultimately provide guidance for determining whether trainees are progressing at the expected pace. PMID:26217427

The "global surgeon": is it time for modifications in the American surgical training paradigm?

PubMed

Ginwalla, Rashna F; Rustin, Rudolph B

2015-01-01

"Global surgery" is becoming an increasingly popular concept not only for new trainees, but also for established surgeons. The need to provide surgical care in low-resource settings is laudable, but the American surgical training system currently does not impart the breadth of skills required to provide quality care. We propose one possible model for a surgical fellowship program that provides those trainees who desire to practice in these settings a comprehensive experience that encompasses not only broad technical skills but also the opportunity to engage in policy and programmatic development and implementation. This is a descriptive commentary based on personal experience and a review of the literature. The proposed model is 2 years long, and can either be done after general surgery training as an additional "global surgery" fellowship or as part of a 3 + 2 general surgery + global surgery system. It would incorporate training in general surgery as well as orthopedics, urology, obstetrics & gynecology, neurosurgery, plastics & reconstructive surgery, as well as dedicated time for health systems training. Incorporating such training in a low-resource setting would be a requirement of such a program, in order to obtain field experience. Global surgery is a key word these days in attracting young trainees to academic surgical residency programs, yet they are subsequently inadequately trained to provide the required surgical services in these low-resource settings. Dedicated programmatic changes are required to allow those who choose to practice in these settings to obtain the full breadth of training needed to become safe, competent surgeons in such environments. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

In search of work/life balance: trainee perspectives on part-time obstetrics and gynaecology specialist training.

PubMed

Henry, Amanda; Clements, Sarah; Kingston, Ashley; Abbott, Jason

2012-01-10

Part-time training (PTT) is accessed by approximately 10% of Australian obstetrics and gynaecology trainees, a small but increasing minority which reflects the growing demand for improved work/life balance amongst the Australian medical workforce. This survey reports the attitudes and experiences of both full-time and part-time trainees to PTT. An email-based anonymous survey was sent to all Australian obstetrics and gynaecology trainees in April 2009, collecting demographic and training status data, data on personal experiences of PTT and/or trainees, and attitudes towards PTT. 105 responses were received (20% response rate). These indicated strong support (90%) from both full-time (FT) and part-time (PT) trainees for the availability of PTT. PT trainees were significantly more likely than FT trainees to be female with children. Improved morale was seen as a particular advantage of PTT; decreased continuity of care as a disadvantage. Although limited by poor response rate, both PT and FT Australian obstetric trainees were supportive of part-time training. Both groups recognised important advantages and disadvantages of this mode of training. Currently, part-time training is accessed primarily by female trainees with family responsibilities, with many more trainees considering part-time training than the number that access it.

In search of work/life balance: trainee perspectives on part-time obstetrics and gynaecology specialist training

PubMed Central

2012-01-01

Background Part-time training (PTT) is accessed by approximately 10% of Australian obstetrics and gynaecology trainees, a small but increasing minority which reflects the growing demand for improved work/life balance amongst the Australian medical workforce. This survey reports the attitudes and experiences of both full-time and part-time trainees to PTT. Methods An email-based anonymous survey was sent to all Australian obstetrics and gynaecology trainees in April 2009, collecting demographic and training status data, data on personal experiences of PTT and/or trainees, and attitudes towards PTT. Results 105 responses were received (20% response rate). These indicated strong support (90%) from both full-time (FT) and part-time (PT) trainees for the availability of PTT. PT trainees were significantly more likely than FT trainees to be female with children. Improved morale was seen as a particular advantage of PTT; decreased continuity of care as a disadvantage. Conclusions Although limited by poor response rate, both PT and FT Australian obstetric trainees were supportive of part-time training. Both groups recognised important advantages and disadvantages of this mode of training. Currently, part-time training is accessed primarily by female trainees with family responsibilities, with many more trainees considering part-time training than the number that access it. PMID:22233566

The Value of Trainee Networks in Pediatric Surgical Research.

PubMed

Skerritt, Clare; Hall, Nigel J

2015-12-01

In 2007, the first trainee-led surgical research network was founded in the United Kingdom (UK). The West Midlands Research Collaborative was started by a group of enthusiastic adult surgical trainees who saw the benefits of altruistic collaboration to generate high quality, multicenter research. Seeing the success of their research projects, including randomized controlled trials, trainees in other regions and specialties were spurred on to founding their own research collaboratives. The Pediatric Surgical Trainee Research Network was started in 2011 by a group of UK trainees with the aim to promote, facilitate, and encourage trainee-led research in pediatric surgery. This article summarizes the history and evolution of the trainee collaborative surgical research. It examines the challenges which multicenter research entails and the steps the collaboratives have taken to overcome them. We describe some of the projects which have been successfully completed and the benefits that the trainee networks have for patients and surgeons alike. Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of effect on skills of GP trainees taking time out of programme (OOP) in developing countries.

PubMed

Kiernan, Patrick; O'Dempsey, Tim; Kwalombota, Kwalombota; Elliott, Lynne; Cowan, Lesley

2014-03-01

The London School of General Practice Time Out of Programme (OOP) provides general practice (GP) trainees with an opportunity to enhance clinical experience and develop a range of skills and competencies, which are often not achievable in a three-year training programme, that are relevant and transferable to their practice in the UK. The programme offers one-year posts in the developing world to trainees between years ST2/3. This study builds on the work of the International Health Links Centre and London Deanery report (2011) and is designed to assess the skills and competencies of GP trainees on an OOP scheme. The study evaluated the impact of the OOP scheme on: • GP trainees? clinical skills • GP trainees' decision-making, management and leadership skills • Any other competencies. London GP trainees and trainers. Data were gathered using structured interview schedules developed for GP trainees and GP trainers and mapped against the RCGP Trainee e-portfolio Competence Areas. Our findings show that trainees and trainers reported an increase in skill levels in the more generic competencies. The study shows that the OOP scheme provides GP trainees with an excellent opportunity to develop clinical skills and more generic skills such as leadership, management and decision-making, as well as effective use of resources. However, not all clinical skill improvements were directly transferable to trainees' clinical work on return to the UK.

Regulatory Organizations and Their Requirements. MAS-113. Waste Isolation Division (WID). Management and Supervisor Training (MAST) Program.

ERIC Educational Resources Information Center

Westinghouse Electric Corp., Carlsbad, NM.

This learning module, which is part of a management and supervisor training program for managers and supervisors employed at the Department of Energy's Waste Isolation Division, is designed to enable trainees to identify regulatory organizations and oversight groups and monitor and provide guidance in the implementation of the requirements of…

Special Programs in Medical Library Education, 1957-1971: Part III. The Trainees *†

PubMed Central

Roper, Fred W.

1974-01-01

This report describes the personal characteristics of the former trainees and their opinions about their training program experiences. More of the degree program trainees were under thirty (71%) than was the case with the internship program trainees (45%). The male-female ratio for each of the two groups is approximately 1:4. Approximately 60% of the degree program trainees entered their training with majors in the natural or health sciences, while less than 50% of the total group hold degrees in the natural or health sciences. Slightly less than 60% of the total group of trainees were employed in medical libraries in 1971. However, 68.5% of the internship program trainees as compared to 46.0% of the degree program trainees held positions in medical libraries. The reasons cited most often for leaving medical librarianship were the lack of available positions and student status. The major reasons indicated by the former trainees for entering the medical library education programs were an interest in the biomedical subject fields, the availability of funds, and the desire to gain experience. The reactions of the former trainees to their training program experiences were favorable. PMID:4462687

The role of trainees as clinical teachers of medical students in psychiatry.

PubMed

Hickie, Catherine; Nash, Louise; Kelly, Brian

2013-12-01

To consider the role of specialty trainees as clinical teachers of medical students in psychiatry. We discuss the role of specialty trainees as teachers and approaches to improving their skills and capacity, giving examples from the local and international literature and our own experience as psychiatry medical educators. Good clinical teaching is crucial for medical students' learning but sharp increases in numbers combined with economic and workforce pressures have stretched capacity. Specialty trainees do much of the medical student teaching during their clinical placements but infrequently receive instruction on how to teach. The two common approaches to increasing capacity are, first, establishing education rotations for individual trainees and, second, providing workshops to improve trainees' confidence and skill. Psychiatry trainees surveyed in New South Wales welcomed the role of teacher and the opportunity to improve their teaching capacity. Further support from supervisors, health services and medical schools is needed to assist trainees in their teaching role. The role that trainees play as clinical teachers should be acknowledged and supported. Further development of research and scholarship in medical education is needed to determine how best to teach trainees to teach.

Lung ultrasound training: curriculum implementation and learning trajectory among respiratory therapists.

PubMed

See, K C; Ong, V; Wong, S H; Leanda, R; Santos, J; Taculod, J; Phua, J; Teoh, C M

2016-01-01

Guidelines recommend teaching of lung ultrasound for critical care, though little information exists on how much training is required for independent practice, especially for non-physician trainees. We thus aimed to elucidate a threshold number of cases above which competency for independent practice may be attained for respiratory therapists (RTs). We conducted a prospective audit of lung ultrasound training between July 2014 and April 2015 in our 20-bed medical intensive care unit. Following theoretical instruction and self-learning, trainees acquired images from 12 lung zones under direct supervision and classified images into six patterns. Assistance during image acquisition and correct interpretation of ultrasound images were recorded. Eleven ultrasound-naïve RTs scanned an average of 15 patients each (170 patients in total). Among supervisor-adjudicated lung ultrasound findings, 35.5% were abnormal. Blinded verification of the adjudicated findings was done for the first 92 patients (1104 images), with an agreement of 95.4%. As RTs scanned more patients, there was a significant decrease in the proportion of images requiring supervisor assistance (Cuzick's P < 0.001), and a significant increase in the proportion of correctly identified images (Cuzick's P = 0.008). After trainees performed at least ten scans, less than 2% of images required assistance with acquisition and less than 5% were wrongly interpreted. Our training method allowed RTs to independently perform lung ultrasound after at least ten directly supervised scans. Given that RTs are likely to have less ultrasound knowledge and less clinical know-how compared to physicians, we believe that the same threshold number of scans may be also safely applied to the latter.

Impact of an Interactive Vascular Surgery Web-Based Educational Curriculum on Surgical Trainee Knowledge and Interest.

PubMed

Zayed, Mohamed A; Lilo, Emily A; Lee, Jason T

The surgical council on resident education developed an online competency-based self-study curriculum for general surgery residency trainees. Vascular surgery trainees are yet to have a similarly validated and readily accessible self-study curriculum. We sought to determine the effect of an interactive online vascular surgery curriculum on trainee knowledge and interest in vascular surgery. Over 15 months, 53 trainees (36 medical students and 16 surgical residents) performing a vascular surgery rotation were enrolled in a prospective, randomized, 2-cohort study. Before starting a 4-week rotation, trainee baseline demographics were collected, and a pretest was administered to evaluate baseline vascular surgery knowledge. During the same study period, 31 trainees (GROUP 1) were randomized to an interactive online curriculum with weekly reading assignments, and 21 trainees (GROUP 2) did not have access to the online curriculum. At the conclusion, all trainees received a posttest and survey to evaluate any change in vascular surgery knowledge and interest. Although 26.8% of trainees predicted that online computer modules would be a beneficial learning tool, most of trainees indicated textbook reading and case discussions are preferred. Analysis of GROUPS 1 and 2 revealed no significant differences in the average trainee age, training level, sex, or number of surgical cases observed during the rotation. Improvement in vascular surgery knowledge in GROUP 1 was significantly higher compared to GROUP 2 (average increase in posttest scores of 16.1% vs 6.6%, p = 0.009). New interest in vascular surgery was increased by 22.2% in GROUP 1, but was decreased by 40% in GROUP 2 (p < 0.001). Basic vascular surgery principles can be efficiently introduced through an interactive online curriculum. This type of self-study can improve trainee knowledge, and foster interest in vascular surgery. As in other specialties, a standardized and validated online vascular surgery curriculum should be developed for emerging trainees. Published by Elsevier Inc.

Palliative and end-of-life educational practices in US pulmonary and critical care training programs.

PubMed

Richman, Paul S; Saft, Howard L; Messina, Catherine R; Berman, Andrew R; Selecky, Paul A; Mularski, Richard A; Ray, Daniel E; Ford, Dee W

2016-02-01

To describe educational features in palliative and end-of-life care (PEOLC) in pulmonary/critical care fellowships and identify the features associated with perceptions of trainee competence in PEOLC. A survey of educational features in 102 training programs and the perceived skill and comfort level of trainees in 6 PEOLC domains: communication, symptom control, ethical/legal, community/institutional resources, specific syndromes, and ventilator withdrawal. We evaluated associations between perceived trainee competence/comfort in PEOLC and training program features, using regression analyses. Fifty-five percent of program directors (PDs) reported faculty with training in PEOLC; 30% had a written PEOLC curriculum. Neither feature was associated with trainee competence/comfort. Program directors and trainees rated bedside PEOLC teaching highly. Only 20% offered PEOLC rotations; most trainees judged these valuable. Most PDs and trainees reported that didactic teaching was insufficient in communication, although sufficient teaching of this was associated with perceived trainee competence in communication. Perceived trainee competence in managing institutional resources was rated poorly. Program directors reporting significant barriers to PEOLC education also judged trainees less competent in PEOLC. Time constraint was the greatest barrier. This survey of PEOLC education in US pulmonary/critical care fellowships identified associations between certain program features and perceived trainee skill in PEOLC. These results generate hypotheses for further study. Copyright © 2015 Elsevier Inc. All rights reserved.

Are Canadian postgraduate training programs meeting the health advocacy needs of obstetrics and gynaecology residents?

PubMed

Hakim, Julie; Black, Amanda; Gruslin, Andrée; Fleming, Nathalie

2013-06-01

Health advocacy (HA) is a core competency in Canadian obstetrics and gynaecology postgraduate programs. Our objectives were to assess awareness and understanding of the health advocate role among trainees, their current HA training and exposure, and the desire and needs for future HA training. An anonymous, cross-sectional, Internet-based, self-reported health advocacy questionnaire was distributed to Canadian obstetrics and gynaecology trainees. Descriptive analysis was conducted for all study variables. Chi-square tests, Cochran-Armitage trend test, and Fisher exact test were performed where appropriate. Most trainees (93.9% of respondents) were aware of the CanMEDS HA role and that it is a training objective (92.9%). Only 52.4% had clear objectives while 58.4% understood the role requirements. Most trainees (95.1% of respondents) felt HA was important to address during training. Only 30.4% had HA training, and just 36.3% felt their training needs were addressed. Training included teaching sessions (11.9%), clinical teaching (4.7%), and role modelling (4.7%). Although 82.9% of respondents had HA opportunities with patients, there were fewer opportunities at community (45.1%) and societal (30.0%) levels. Awareness of community groups and activities was low (28.6%), and few (20.0%) had participated in community advocacy programs during their residency. Incorporating advocacy activities into training was valued (80.0%). Many residents supported mandatory HA training (60.0%), more training time on HA experiences (66.3%), and HA experiences during protected time (71.3%). Awareness of and interest in the HA role is high, but clear objectives and training are lacking or inadequate. A standardized curriculum would ensure health advocacy exposure and emphasize active participation in community and societal activities. Trainees support this training during protected time.

Cohort profile: the Welsh Geriatric Registrar-Led Research Network (WeGeN): rationale, design and description.

PubMed

Jelley, Benjamin; Long, Sara; Butler, John; Hewitt, Jonathan

2017-02-14

Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit. The Welsh Geriatricians Network (WeGeN) has been created with the aims of facilitating collaborative, trainee-led research within Geriatric Medicine in Wales, promoting research engagement and improving the research evidence base for older patients. By coordinating collaborative research projects across different sites within Wales, trainees continue existing projects at new sites, allowing completion of projects and establishing the long-term infrastructure and experienced personnel needed for high-quality research data to be gathered. WeGeN has facilitated 4 national audits, all of which are intended for peer review publication. The first project considers the service provision for the older person in the emergency department, the second Parkinson's disease, the third reviews delirium management and the fourth project considers epidemiology of surgical disease in older people. The objective of this project is to further establish and develop WeGeN as a group which facilitates high-quality research and provides the opportunity for geriatric trainees to engage in research activity. It is anticipated that the establishment of this research platform will provide a blueprint for the development of other such networks in the UK and beyond. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Accuracy of computer-aided diagnosis based on narrow-band imaging endocytoscopy for diagnosing colorectal lesions: comparison with experts.

PubMed

Misawa, Masashi; Kudo, Shin-Ei; Mori, Yuichi; Takeda, Kenichi; Maeda, Yasuharu; Kataoka, Shinichi; Nakamura, Hiroki; Kudo, Toyoki; Wakamura, Kunihiko; Hayashi, Takemasa; Katagiri, Atsushi; Baba, Toshiyuki; Ishida, Fumio; Inoue, Haruhiro; Nimura, Yukitaka; Oda, Msahiro; Mori, Kensaku

2017-05-01

Real-time characterization of colorectal lesions during colonoscopy is important for reducing medical costs, given that the need for a pathological diagnosis can be omitted if the accuracy of the diagnostic modality is sufficiently high. However, it is sometimes difficult for community-based gastroenterologists to achieve the required level of diagnostic accuracy. In this regard, we developed a computer-aided diagnosis (CAD) system based on endocytoscopy (EC) to evaluate cellular, glandular, and vessel structure atypia in vivo. The purpose of this study was to compare the diagnostic ability and efficacy of this CAD system with the performances of human expert and trainee endoscopists. We developed a CAD system based on EC with narrow-band imaging that allowed microvascular evaluation without dye (ECV-CAD). The CAD algorithm was programmed based on texture analysis and provided a two-class diagnosis of neoplastic or non-neoplastic, with probabilities. We validated the diagnostic ability of the ECV-CAD system using 173 randomly selected EC images (49 non-neoplasms, 124 neoplasms). The images were evaluated by the CAD and by four expert endoscopists and three trainees. The diagnostic accuracies for distinguishing between neoplasms and non-neoplasms were calculated. ECV-CAD had higher overall diagnostic accuracy than trainees (87.8 vs 63.4%; [Formula: see text]), but similar to experts (87.8 vs 84.2%; [Formula: see text]). With regard to high-confidence cases, the overall accuracy of ECV-CAD was also higher than trainees (93.5 vs 71.7%; [Formula: see text]) and comparable to experts (93.5 vs 90.8%; [Formula: see text]). ECV-CAD showed better diagnostic accuracy than trainee endoscopists and was comparable to that of experts. ECV-CAD could thus be a powerful decision-making tool for less-experienced endoscopists.

Psychiatry trainees' views and educational needs regarding the care of patients with a life-limiting illness.

PubMed

Forster, Benjamin C; Proskurin, Helen; Kelly, Brian; Lovell, Melanie R; Ilchef, Ralf; Clayton, Josephine M

2017-04-01

People with a life-limiting physical illness experience high rates of significant psychological and psychiatric morbidity. Nevertheless, psychiatrists often report feeling ill-equipped to respond to the psychiatric needs of this population. Our aim was to explore psychiatry trainees' views and educational needs regarding the care of patients with a life-limiting physical illness. Using semistructured interviews, participants' opinions were sought on the role of psychiatrists in the care of patients with a life-limiting illness and their caregivers, the challenges faced within the role, and the educational needs involved in providing care for these patients. Interviews were audiotaped, fully transcribed, and then subjected to thematic analysis. A total of 17 psychiatry trainees were recruited through two large psychiatry training networks in New South Wales, Australia. There were contrasting views on the role of psychiatry in life-limiting illness. Some reported that a humanistic, supportive approach including elements of psychotherapy was helpful, even in the absence of a recognizable mental disorder. Those who reported a more biological and clinical stance (with a reliance on pharmacotherapy) tended to have a nihilistic view of psychiatric intervention in this setting. Trainees generally felt ill-prepared to talk to dying patients and felt there was an educational "famine" in this area of psychiatry. They expressed a desire for more training and thought that increased mentorship and case-based learning, including input from palliative care clinicians, would be most helpful. Participants generally feel unprepared to care for patients with a life-limiting physical illness and have contrasting views on the role of psychiatry in this setting. Targeted education is required for psychiatry trainees in order to equip them to care for these patients.

Implementation of laparoscopic virtual-reality simulation training in gynaecology: a mixed-methods design.

PubMed

Burden, Christy; Appleyard, Tracy-Louise; Angouri, Jo; Draycott, Timothy J; McDermott, Leanne; Fox, Robert

2013-10-01

Virtual-reality (VR) training has been demonstrated to improve laparoscopic surgical skills in the operating theatre. The incorporation of laparoscopic VR simulation into surgical training in gynaecology remains a significant educational challenge. We undertook a pilot study to assess the feasibility of the implementation of a laparoscopic VR simulation programme into a single unit. An observational study with qualitative analysis of semi-structured group interviews. Trainees in gynaecology (n=9) were scheduled to undertake a pre-validated structured training programme on a laparoscopic VR simulator (LapSim(®)) over six months. The main outcome measure was the trainees' progress through the training modules in six months. Trainees' perceptions of the feasibility and barriers to the implementation of laparoscopic VR training were assessed in focus groups after training. Sixty-six percent of participants completed six of ten modules. Overall, feedback from the focus groups was positive; trainees felt training improved their dexterity, hand-eye co-ordination and confidence in theatre. Negative aspects included lack of haptic feedback, and facility for laparoscopic port placement training. Time restriction emerged as the main barrier to training. Despite positive perceptions of training, no trainee completed more than two-thirds of the modules of a self-directed laparoscopic VR training programme. Suggested improvements to the integration of future laparoscopic VR training include an additional theoretical component with a fuller understanding of benefits of VR training, and scheduled supervision. Ultimately, the success of a laparoscopic VR simulation training programme might only be improved if it is a mandatory component of the curriculum, together with dedicated time for training. Future multi-centred implementation studies of validated laparoscopic VR curricula are required. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A mixed methods evaluation of paediatric trainee preparedness to manage cardiopulmonary arrests.

PubMed

Walsh, Órla; Lydon, Sinéad; O'Connor, Paul

2017-12-01

Paediatric cardiopulmonary arrest (CPA) survival rates are strongly linked to the training of the doctors responding to the event. This study sought to characterise the level of experience in managing CPAs among paediatric trainees and to investigate the nontechnical (NTS) required to effectively lead a paediatric CPA team. A mixed-methods research design was used. For the quantitative phase, a questionnaire was developed to assess training, confidence, and experiences related to CPA management. During the qualitative phase, 17 paediatric trainees participated in a series of critical incident technique (CIT) interviews to explore the NTS used during the management of paediatric CPAs. A total of 56 of 131 (37.1% response rate) trainees responded to the preparedness questionnaire. A total of 48.2% of respondents expressed low confidence in their skill as a team leader during the management of a CPA. The CIT interviews highlighted deficiencies in specific NTS (identifying options, prioritising, and identifying and utilising resources). Our results indicate that there is a desire for more training in CPA management among paediatric trainees, in particular as a team leader, which includes a focus on key NTS. What is Known • Levels of preparedness to be a paediatric cardiopulmonary arrests team member/leader are generally lower than desirable. • The importance of nontechnical skills to the effective performance of adult cardiopulmonary arrests teams has been identified. What is New • Levels of preparedness to be a cardiopulmonary arrests team member were higher than reported in US studies. • There is a need for greater training in cardiopulmonary arrest management which includes a focus on key nontechnical skills to include identifying options, prioritising, identifying and utilising resources.

Attitudes towards shared learning of trainee dental technicians and undergraduate dental students.

PubMed

Reeson, Michael G; Walker-Gleaves, Caroline; Ellis, Ian

2015-01-01

The challenges of health care are increasingly complex and subject to frequent change. Meeting these demands requires that health professionals work in partnership with each other and the patient. One way of contributing to this is for students to learn together. However, effective teamwork requires an education system that helps to foster understanding among all those entering the health workforce. The purpose of this study was to investigate the attitudes towards shared learning of undergraduate dental students and trainee dental technicians in a university dental school/hospital in the United Kingdom. Twenty-five trainee dental technicians and 75 undergraduate dental students took part in the study over five academic years. Data were collected using structured questionnaires. A 100% response rate was achieved from the questionnaires. The results indicated the majority of students recognized the benefits of shared learning and viewed the acquisition of teamworking skills as useful for their future working lives, beneficial to the care of their patients, and likely to enhance professional working relationships. The study also found a positive association of being valued as an individual in the dental team by all student groups. Future dental curricula should provide opportunities to develop effective communication between these two groups and encourage teamworking opportunities. These opportunities need to be systematically developed in the dental curriculum to achieve the desired goals.

Personality differences among junior postgraduate trainees in the United Kingdom.

PubMed

Martinou, Eirini; Allan, Hayley; Vig, Stella

2015-01-01

An early understanding of the personality profiles of junior trainees may be valuable for supporting the professional and educational development of tomorrow's doctors. This study aims to describe the personality profile of junior trainees and to explore whether the personality profiles differed according to the level of training, specialty choice, or gender. The Mental Muscle Diagram Indicator was distributed electronically. South West London, Health Education England South London. A total of 157 junior trainees completed the personality questionnaire. Specifically, there were core surgical (n = 40), core medical (n = 24), and foundation trainees (n = 93). The preferential profile across all groups was Extroversion (E), Sensing (S), Feeling (F), and Perception (P). More foundation doctors favored an extrovert and sensing personality when compared with core trainees (72% vs 60.4% and 77.4% vs 57.5%, respectively). More core surgical trainees appeared to prefer Extroversion when compared with their medical counterparts (66.7% vs 54.2%). More core medical trainees favored an intuitive behavior when compared with their surgical colleagues (50% vs 35%). Significantly, more female trainees (83.3%) displayed an extrovert personality than male trainees (66.7%) did. According to the Mental Muscle Diagram Indicator analysis, this work shows that the more junior the trainees are in their career, the more they tend to enjoy human interaction and to favor acting before thinking. The most junior trainees tend to be slightly more interested in dealing with facts rather than ideas and favor a flexible approach of life. The reducing ratio of Extroversion and Sensing in the core trainees when compared with foundation doctors may suggest that clinical experience has an effect on personality. As trainees begin to progress, they may tend to reflect more on their practice and to start thinking about more long term. These results suggest that a greater understanding of their personality preferences and how they might change with experience may help trainees to develop a greater personal and professional insight. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The objective structured clinical examination revisited for postgraduate trainees in general practice.

PubMed

Schoenmakers, Birgitte; Wens, Johan

2014-03-04

To investigate if the psychometric qualities of an OSCE consisting of more complex simulated patient encounters remain valid and reliable in the assessment of postgraduate trainees in general practice. In this intervention study without control group, the traditional OSCE was formally replaced by the new, complex version. The study population was composed by all postgraduate trainees (second and third phase) in general practice during the ongoing academic year. Data were handled and collected as part of the formal assessment program. Univariate analyses, the variance of scores and multivariate analyses were performed to assess the test qualities. A total of 340 students participated. Average final scores were slightly higher for third-phase students (t-test, p =0.05). Overall test scores were equally distributed on station level, circuit level and phase level. A multiple regression analysis revealed that test scores were dependent on the stations and circuits, but not on the master phase. In a changing learning environment, assessment and evaluation strategies require reorientation. The reliability and validity of the OSCE remain subject to discussion. In particular, when it comes to content and design, the traditional OSCE might underestimate the performance level of postgraduate trainees in general practice. A reshaping of this OSCE to a more sophisticated design with more complex patient encounters appears to restore the validity of the test results.

Preliminary development and validation of the Supervisee Attachment Strategies Scale (SASS).

PubMed

Menefee, Deleene S; Day, Susan X; Lopez, Frederick G; McPherson, Robert H

2014-04-01

The influence of counselor trainees' adult attachment orientations in the context of supervision has the potential to inform both training and supervision practice. However, the pursuit of such research requires the availability of appropriate assessment tools. The present study describes the development and validation of the Supervisee Attachment Strategies Scale (SASS), a theory-based measure of counseling trainees' attachment orientations toward their clinical supervisors. Participants were recruited online through their training directors at Association of Psychology Postdoctoral and Internship Centers member programs. Data were nationally collected from 352 trainees representing programs in the United States and Canada. Exploratory factor analysis yielded 2 interpretable factors along the adult attachment dimensions of avoidance vs. engagement and rejection concern vs. security. These 2 factors accounted for 55.85% of the interitem variance in the rotated solution of the 22-item SASS scale. SASS subscale scores were negatively correlated with the supervisory working alliance and predicted greater endorsement of role conflict and role ambiguity in the current supervisory relationship. Higher avoidance (but not rejection concern) predicted diminished perceptions of satisfaction with the overall training experience. Findings from this study suggest that trainees who engaged in adaptive attachment strategies may be more likely to address conflict, negotiate additional explorative opportunities in training, and seek out their supervisors in times of uncertainty. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

The ethics and safety of medical student global health electives

PubMed Central

Dell, Evelyn M.; Varpio, Lara; Petrosoniak, Andrew; Gajaria, Amy

2014-01-01

Objectives To explore and characterize the ethical and safety challenges of global health experiences as they affect medical students in order to better prepare trainees to face them. Methods Semi-structured interviews were conducted with 23 Canadian medical trainees who had participated in global health experiences during medical school. Convenience and snowball sampling were utilized. Using Moustakas’s transcendental phenomenological approach, participant descriptions of ethical dilemmas and patient/trainee safety problems were analyzed. This generated an aggregate that illustrates the essential meanings of global health experience ethical and safety issues faced. Results We interviewed 23 participants who had completed 38 electives (71%, n=27, during pre-clinical years) spend-ing a mean 6.9 weeks abroad, and having visited 23 countries. Sixty percent (n=23) had pre-departure training while 36% (n=14) had post-experience debriefing. Three macro-level themes were identified: resource disparities and provision of care; navigating clinical ethical dilemmas; and threats to trainee safety. Conclusions Medical schools have a responsibility to ensure ethical and safe global health experiences. However, our findings suggest that medical students are often poorly prepared for the ethical and safety dilemmas they encounter during these electives. Medical students require intensive pre-departure training that will prepare them emotionally to deal with these dilemmas. Such training should include discussions of how to comply with clinical limitations. PMID:25341214

Assessing the surgical skills of trainees in the operating theatre: a prospective observational study of the methodology.

PubMed

Beard, J D; Marriott, J; Purdie, H; Crossley, J

2011-01-01

To compare user satisfaction and acceptability, reliability and validity of three different methods of assessing the surgical skills of trainees by direct observation in the operating theatre across a range of different surgical specialties and index procedures. A 2-year prospective, observational study in the operating theatres of three teaching hospitals in Sheffield. The assessment methods were procedure-based assessment (PBA), Objective Structured Assessment of Technical Skills (OSATS) and Non-technical Skills for Surgeons (NOTSS). The specialties were obstetrics and gynaecology (O&G) and upper gastrointestinal, colorectal, cardiac, vascular and orthopaedic surgery. Two to four typical index procedures were selected from each specialty. Surgical trainees were directly observed performing typical index procedures and assessed using a combination of two of the three methods (OSATS or PBA and NOTSS for O&G, PBA and NOTSS for the other specialties) by the consultant clinical supervisor for the case and the anaesthetist and/or scrub nurse, as well as one or more independent assessors from the research team. Information on user satisfaction and acceptability of each assessment method from both assessor and trainee perspectives was obtained from structured questionnaires. The reliability of each method was measured using generalisability theory. Aspects of validity included the internal structure of each tool and correlation between tools, construct validity, predictive validity, interprocedural differences, the effect of assessor designation and the effect of assessment on performance. Of the 558 patients who were consented, a total of 437 (78%) cases were included in the study: 51 consultant clinical supervisors, 56 anaesthetists, 39 nurses, 2 surgical care practitioners and 4 independent assessors provided 1635 assessments on 85 trainees undertaking the 437 cases. A total of 749 PBAs, 695 NOTSS and 191 OSATSs were performed. Non-O&G clinical supervisors and trainees provided mixed, but predominantly positive, responses about a range of applications of PBA. Most felt that PBA was important in surgical education, and would use it again in the future and did not feel that it added time to the operating list. The overall satisfaction of O&G clinical supervisors and trainees with OSATS was not as high, and a majority of those who used both preferred PBA. A majority of anaesthetists and nurses felt that NOTSS allowed them to rate interpersonal skills (communication, teamwork and leadership) more easily than cognitive skills (situation awareness and decision-making), that it had formative value and that it was a valuable adjunct to the assessment of technical skills. PBA demonstrated high reliability (G > 0.8 for only three assessor judgements on the same index procedure). OSATS had lower reliability (G > 0.8 for five assessor judgements on the same index procedure). Both were less reliable on a mix of procedures because of strong procedure-specific factors. A direct comparison of PBA between O&G and non-O&G cases showed a striking difference in reliability. Within O&G, a good level of reliability (G > 0.8) could not be obtained using a feasible number of assessments. Conversely, the reliability within non-O&G cases was exceptionally high, with only two assessor judgements being required. The reasons for this difference probably include the more summative purpose of assessment in O&G and the much higher proportion of O&G trainees in this study with training concerns (42% vs 4%). The reliability of NOTSS was lower than that for PBA. Reliability for the same procedure (G > 0.8) required six assessor judgements. However, as procedure-specific factors exerted a lesser influence on NOTSS, reliability on a mix of procedures could be achieved using only eight assessor judgements. NOTSS also demonstrated a valid internal structure. The strongest correlations between NOTSS and PBA or OSATS were in the 'decision-making' domain. PBA and NOTSS showed better construct validity than OSATS, the year of training and the number of recent index procedures performed being significant independent predictors of performance. There was little variation in scoring between different procedures or different designations of assessor. The results suggest that PBA is a reliable and acceptable method of assessing surgical skills, with good construct validity. Specialties that use OSATS may wish to consider changing the design or switching to PBA. Whatever workplace-based assessment method is used, the purpose, timing and frequency of assessment require detailed guidance. NOTSS is a promising tool for the assessment of non-technical skills, and surgical specialties may wish to consider its inclusion in their assessment framework. Further research is required into the use of health-care professionals other than consultant surgeons to assess trainees, the relationship between performance and experience, the educational impact of assessment and the additional value of video recording.

The positive impact of structured teaching in the operating room.

PubMed

Leung, Yee; Salfinger, Stuart; Mercer, Annette

2015-12-01

A survey of obstetric and gynaecology trainees in Australia found the trainee's opinion of the consultants' teaching ability for laparoscopic procedures and procedures dealing with complications as 'poor' in 21.2% and 23.4% of responses, respectively (Aust NZ J Obstet Gynaecol 2009; 49: 84). Surgical caseload per trainee is falling for a variety of reasons. Strategies need to be adopted to enhance the surgical learning experience of trainees in the operating room. We describe the use of a structured encounter template to facilitate the teaching of surgery in the operating room and report the response of the trainees to this intervention. Trainees attached to a gynaecologic surgery unit all underwent surgical training using a set format based on the surgical encounter template, including briefing, goal setting and intra-operative teaching aims as well as debriefing. Data on the trainees' experience and perception of their learning experience were then collected and analysed as quantitative and qualitative data sets. The trainees reported satisfaction with the use of a structured encounter template to facilitate the surgical teaching in the operating room. Some trainees had not received such clarity of feedback or the opportunity to complete a procedure independently prior to using the structured encounter template. A structured surgical encounter template based on andragogy principles to focus consultant teaching in the operating room is highly acceptable to obstetric and gynaecology trainees in Australia. Allowing the trainee the opportunity to set objectives and receive feedback empowers the trainee and enhances their educational experience. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Survey of UK radiology trainees in the aftermath of ‘Modernising Medical Careers’

PubMed Central

2012-01-01

Background Following implementation of Modernising Medical Careers (MMC) in the UK, potential radiology trainees must decide on their career and apply sooner than ever before. We aimed to determine whether current trainees were sufficiently informed to make an earlier career decision by comparing the early radiology experiences of Traditional and Foundation Trainees. Methods 344 radiology trainees were appointed through MMC in 2007/08. This cohort was surveyed online. Results Response rate was 174/344 (51%). Traditional Trainees made their career decision 2.6 years after graduation compared with 1.2 years for Foundation Trainees (57/167, 34%). Nearly half of responders (79/169, 47%) experienced no formal radiology teaching as undergraduates. Most trainees regularly attended radiology meetings, spent time in a radiology department and/or performed radiology research. Many trainees received no career advice specific to radiology (69/163, 42%) at any point prior to entering the specialty; this includes both formal and informal advice. Junior doctor experiences were more frequently cited as influencing career choice (98/164, 60%). An earlier career decision was associated with; undergraduate radiology projects (-0.72 years, p = 0.018), career advice (-0.63 years, p = 0.009) and regular attendance at radiology meetings (-0.65 years, p = 0.014). Conclusion Early experience of radiology enables trainees to make an earlier career decision, however current radiology trainees were not always afforded relevant experiences prior to entering training. Radiologists need to be more proactive in encouraging the next generation of trainees. PMID:23031228

Measuring Professional Identity Development among Counselor Trainees

ERIC Educational Resources Information Center

Prosek, Elizabeth A.; Hurt, Kara M.

2014-01-01

This study examined the differences in professional identity development between novice and advanced counselor trainees (N = 161). Multivariate analyses of variance indicated significant differences between groups. Specifically, advanced counselor trainees demonstrated greater professional development compared with novice counselor trainees. No…

Intraprofessional collaboration and learning between specialists and general practitioners during postgraduate training: a qualitative study.

PubMed

Meijer, Loes J; de Groot, Esther; Blaauw-Westerlaken, Mirjam; Damoiseaux, Roger A M J

2016-08-11

During postgraduate training, general practitioners and other specialists must learn how to deliver shared care to patients; however, the development of formal intraprofessional education is often hampered by curricular constraints. Delivering shared care in everyday work provides trainees with opportunities for informal learning from, about and with one another. Twelve semi-structured interviews were undertaken with trainee general practitioners and specialists (internal medicine or surgery). A thematic analysis of the input was undertaken and a qualitative description developed. Trainees from different disciplines frequently interact, often by telephone, but generally they learn in a reactive manner. All trainees are highly motivated by the desire to provide good patient care. Specialist trainees learn about the importance of understanding the background of the patient from GPs, while GP trainees gain medical knowledge from the interaction. Trainees from different disciplines are not very motivated to build relationships with each other and have fewer opportunities to do so. Supervisors can play an important role in providing intraprofessional learning opportunities for trainees. During postgraduate training, opportunities for intraprofessional learning occur, but there is much room for improvement. For example, supervisors could increase the involvement of trainees in collaborative tasks and create more awareness of informal learning opportunities. This could assist trainees to learn collaborative skills that will enhance patient care.

General Practitioner (GP) trainees' experience of a '1-h protected supervision model' given during psychiatry placements in the United Kingdom.

PubMed

Thomas, Gareth; McNeill, Helen

2018-01-05

Background A '1-hour protected supervision model' is well established for Psychiatry trainees. This model is also extended to GP trainees who are on placement in psychiatry. To explore the experiences of the '1-hour protected supervision model' for GP trainees in psychiatry placements in the UK. Methods Using a mixed methods approach, an anonymous online questionnaire was sent to GP trainees in the North West of England who had completed a placement in Psychiatry between February and August 2015. Results Discussing clinical cases whilst using the e-portfolio was the most useful learning event in this model. Patient care can potentially improve if a positive relationship develops between trainee/supervisor, which is impacted by the knowledge of this model at the start of the placement. Trainees found that clinical pressures were impacting on the occurrence of supervision. Conclusion The model works best when both GP trainees and their supervisors understand the model. The most frequently used and educationally beneficial aspect for GP trainees in psychiatry is the exploration of clinical cases using the learning portfolio as an educational tool. For effective delivery of this model of supervision, organisations must reflect on the balance between service delivery and allowing the supervisor and trainee adequate time for it to occur.

Can the Functional Movement Screen™ be used to capture changes in spine and knee motion control following 12 weeks of training?

PubMed

Frost, David M; Beach, Tyson A C; Campbell, Troy L; Callaghan, Jack P; McGill, Stuart M

2017-01-01

To examine whether objective measures of spine and frontal plane knee motion exhibited during Functional Movement Screen™ (FMS) task performance changed following a movement-guided fitness (MOV) and conventional fitness (FIT) exercise intervention. Secondary analysis of a randomized controlled experiment. Before and after 12 weeks of exercise, participants' kinematics were quantified while performing the FMS and a series of general whole-body movement tasks. Biomechanics laboratory. Fifty-two firefighters were assigned to MOV, FIT, or a control (CON) group. Peak lumbar spine flexion/extension, lateral bend and axial twist, and frontal plane knee motion. The post-training kinematic changes exhibited by trainees while performing the FMS tasks were similar in magnitude (effect size < 0.8) to those exhibited by CON. However, when performing the battery of general whole-body movement tasks, only MOV showed significant improvements in spine and frontal plane knee motion control (effect size > 0.5). Whether graded qualitatively, or quantitatively via kinematic analyses, the FMS may not be a viable tool to detect movement-based exercise adaptations. Amendments to the FMS tasks and/or scoring method are needed before it can be used for reasons beyond appraising the ability to move freely, symmetrically, and without pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

Electronic patient data confidentiality practices among surgical trainees: questionnaire study.

PubMed

Mole, Damian J; Fox, Colin; Napolitano, Giulio

2006-10-01

The objective of this work was to evaluate the safeguards implemented by surgical trainees to protect the confidentiality of electronic patient data through a structured questionnaire sent to Northern Ireland surgical trainees. A group of 32 basic and higher surgical trainees attending a meeting of the Northern Ireland Association of Surgeons-in-Training were invited to complete a questionnaire regarding their computer use, UK Data Protection Act, 1988 registration and electronic data confidentiality practices. Of these 32 trainees, 29 returned completed questionnaires of whom 26 trainees regularly stored sensitive patient data for audit or research purposes on a computer. Only one person was registered under the Data Protection Act, 1988. Of the computers used to store and analyse sensitive data, only 3 of 14 desktops, 8 of 19 laptops and 3 of 14 hand-held computers forced a password logon. Of the 29 trainees, 16 used the same password for all machines, and 25 of 27 passwords were less than 8 characters long. Two respondents declined to reveal details of their secure passwords. Half of all trainees had never adjusted their internet security settings, despite all 14 desktops, 16 of 19 laptops and 5 of 14 hand-helds being routinely connected to the internet. Of the 29 trainees, 28 never encrypted their sensitive data files. Ten trainees had sent unencrypted sensitive patient data over the internet, using a non-secure server. Electronic data confidentiality practices amongst Northern Ireland surgical trainees are unsafe. Simple practical measures to safeguard confidentiality are recommended.

Implementation of a standardized electronic tool improves compliance, accuracy, and efficiency of trainee-to-trainee patient care handoffs after complex general surgical oncology procedures.

PubMed

Clarke, Callisia N; Patel, Sameer H; Day, Ryan W; George, Sobha; Sweeney, Colin; Monetes De Oca, Georgina Avaloa; Aiss, Mohamed Ait; Grubbs, Elizabeth G; Bednarski, Brian K; Lee, Jeffery E; Bodurka, Diane C; Skibber, John M; Aloia, Thomas A

2017-03-01

Duty-hour regulations have increased the frequency of trainee-trainee patient handoffs. Each handoff creates a potential source for communication errors that can lead to near-miss and patient-harm events. We investigated the utility, efficacy, and trainee experience associated with implementation of a novel, standardized, electronic handoff system. We conducted a prospective intervention study of trainee-trainee handoffs of inpatients undergoing complex general surgical oncology procedures at a large tertiary institution. Preimplementation data were measured using trainee surveys and direct observation and by tracking delinquencies in charting. A standardized electronic handoff tool was created in a research electronic data capture (REDCap) database using the previously validated I-PASS methodology (illness severity, patient summary, action list, situational awareness and contingency planning, and synthesis). Electronic handoff was augmented by direct communication via phone or face-to-face interaction for inpatients deemed "watcher" or "unstable." Postimplementation handoff compliance, communication errors, and trainee work flow were measured and compared to preimplementation values using standard statistical analysis. A total of 474 handoffs (203 preintervention and 271 postintervention) were observed over the study period; 86 handoffs involved patients admitted to the surgical intensive care unit, 344 patients admitted to the surgical stepdown unit, and 44 patients on the surgery ward. Implementation of the structured electronic tool resulted in an increase in trainee handoff compliance from 73% to 96% (P < .001) and decreased errors in communication by 50% (P = .044) while improving trainee efficiency and workflow. A standardized electronic tool augmented by direct communication for higher acuity patients can improve compliance, accuracy, and efficiency of handoff communication between surgery trainees. Copyright © 2016 Elsevier Inc. All rights reserved.

Core trainee boot camp-A method for improving technical and non-technical skills of novice surgical trainees. A before and after study.

PubMed

Bamford, R; Langdon, L; Rodd, C A; Eastaugh-Waring, S; Coulston, J E

2018-04-10

The transition to surgical training can be a stressful time for trainees and is most evident during national handover periods where new graduates start and senior trainees rotate to new programmes. During this time, patient mortality can increase and Hospital efficiency reduces. This influence is compounded by the impact of working time directives. Intensive, simulation rich training programmes or "Boot Camps" have been postulated as a solution. This article highlights the development of a surgical boot camp for novice surgical trainees and the impact this can have on training. A novel surgical boot camp was developed for all trainees within a surgical training region including nine acute NHS trusts. Participating cohort of trainees completed pre and post course questionnaires to assess technical and non-technical skills. 25 trainees attended and completed the pre and post boot camp questionnaire. Significant improvements were seen with technical skills (p = 0.0429), overall non-technical skills (p < 0.001) including leadership (p = 0.022), communication (p = 0.010), situational awareness (p = 0.022), patient handover (p = 0.003), ward round skills (p = 0.005) and outpatient skill (p = 0.002). Trainees reported significantly increased ability to assess and manage a critically unwell patient (p = 0.001) and a trauma patient (p = 0.001). 96% of trainees have utilised the skills they learnt on Boot Camp and all trainees would recommend it as an induction programme. Surgical Boot Camps offer a timely chance to develop technical and non-technical skills whilst enhancing a trainee's confidence and knowledge and reduce the patient safety impact of the handover period. Copyright © 2018. Published by Elsevier Ltd.

Urology residents experience comparable workload profiles when performing live porcine nephrectomies and robotic surgery virtual reality training modules.

PubMed

Mouraviev, Vladimir; Klein, Martina; Schommer, Eric; Thiel, David D; Samavedi, Srinivas; Kumar, Anup; Leveillee, Raymond J; Thomas, Raju; Pow-Sang, Julio M; Su, Li-Ming; Mui, Engy; Smith, Roger; Patel, Vipul

2016-03-01

In pursuit of improving the quality of residents' education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The workshop involves performing a robotic live porcine nephrectomy as well as virtual reality robotic training modules. The aim of this study was to evaluate workload levels of urology residents when performing a live porcine nephrectomy and the virtual reality robotic surgery training modules employed during this workshop. Twenty-one residents from 14 SES AUA programs participated in 2015. On the first-day residents were taught with didactic lectures by faculty. On the second day, trainees were divided into two groups. Half were asked to perform training modules of the Mimic da Vinci-Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, USA) for 4 h, while the other half performed nephrectomy procedures on a live porcine model using the da Vinci Si robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). After the first 4 h the groups changed places for another 4-h session. All trainees were asked to complete the NASA-TLX 1-page questionnaire following both the MdVT simulation and live animal model sessions. A significant interface and TLX interaction was observed. The interface by TLX interaction was further analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significant difference was observed for frustration, which was significantly higher at the simulation than the animal model, t (20) = 4.12, p = 0.001. This could be due to trainees' familiarity with live anatomical structures over skill set simulations which remain a real challenge to novice surgeons. Another reason might be that the simulator provides performance metrics for specific performance traits as well as composite scores for entire exercises. Novice trainees experienced substantial mental workload while performing tasks on both the simulator and the live animal model during the robotics course. The NASA-TLX profiles demonstrated that the live animal model and the MdVT were similar in difficulty, as indicated by their comparable workload profiles.

The impact of the European Working Time Regulations on Ophthalmic Specialist Training--a national trainee survey.

PubMed

O'Gallagher, M K; Lewis, G; Mercieca, K; Moutray, T

2013-01-01

To assess ophthalmic trainees' perspective of the impact of the European Working Time Regulations (EWTR) on their training. All trainees in ophthalmology in the UK were emailed a link to an electronic survey asking about their experiences of the EWTR. 324 trainees (46% of those invited) responded to the survey. 44.4% of trainees reported that their posts were compliant with the EWTR. 40.7% felt that training had been adversely affected. 49.1% thought that ophthalmic trainees should opt out of the EWTR to work more than 48 h per week, with 57 the mean number of hours suggested appropriate. Many ophthalmic trainees in the United Kingdom are working in rotas which are not compliant with the European Working Time Directive. Many trainees feel that implementation of the EWTD has had a negative effect on training and feel it would be acceptable to work a higher number of hours per week. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Trainee perspectives on postdoctoral recruitment in clinical neuropsychology: reflections on commentaries by Bodin and Grote (2016) and Nelson et al. (2016).

PubMed

Towns, S J; Hahn-Ketter, A E; Halpern, J; Block, C K

2018-01-01

The aim of the current invited paper is to provide the trainees' perspective on recent commentaries on recruitment for postdoctoral fellowship in clinical neuropsychology. The current system of recruitment includes both a match and non-match process and has been problematic for trainees and training programs alike. The author team completed a non-systematic review of previously published commentaries on the current state of postdoctoral fellowship recruitment, which are briefly summarized in the current paper. The trainee perspective is addressed using both survey data and anecdotal experiences of the authors. Trainees report high levels of dissatisfaction with the current dual recruitment system; however, there is no clear preference from trainees for either a match or non-match system. Trainees from both recruitment systems report high levels of satisfaction with their training experience. It seems that either a match or non-match approach, if it led to a unified system, would improve trainee satisfaction.

Views from GP and Psychiatric trainees about getting experience in each other's specialty during training: A way to develop a shared culture?

PubMed

Butler, Sophie; Mullin, Juliette; Zacharia, Tharun; Howe, Andrew; Mirvis, Ross; Jeffries-Chung, Camilla; Mirzadeh, Damian; Holt, Clare; Couppis, Orestes

2015-09-01

The need to deliver holistic medical care that addresses both physical and mental health requirements has never been more important. The UK medical training system has been designed to provide all medical graduates with a broad experience of different medical specialities and psychiatry prior to entering specialist training. Furthermore there is a distinct crossover between Psychiatric and General Practice training, with programmes providing trainees with the opportunity to work alongside each other in the care of mental health patients. The video presentation will explain the UK medical training system in more detail, before going on to explore how the organisation of training may foster a shared culture among different specialities and how it could form a model for improving parity of esteem of medical and physical health care. In addition it will discuss the strengths and weaknesses of this system from a trainee perspective and will conclude with comments from eminent Psychiatrists whom have special interests in medical training and developingparity of mental and physical health care.

Neuro-Ophthalmology: Transitioning From Old to New Models of Health Care Delivery.

PubMed

Frohman, Larry P

2017-06-01

In contradiction to fundamental laws of supply and demand, 2 decades of payment policies have led to some medical specialties experiencing declines in both manpower and reimbursement. This paradox has resulted in increasingly long wait times to see some specialists, some specialties becoming less attractive to potential trainees, and a dearth of new trainees entering these fields. Evolving models of health care delivery hold the promise of increasing patient access to most providers and may diminish costs and improve outcomes for most patients/conditions. However, patients who need care in understaffed fields may, in the future, be unable to quickly access a specialist with the requisite expertise. Impeding the sickest and most complex patients from seeing physicians with appropriate expertise may lead to increased costs and deleterious outcomes-consequences contrary to the goals of health care reform. To ensure appropriate access for these patients requires 2 conditions: 1. Compensation models that do not discourage trainees from pursuing nonprocedural specialties, and 2. A care delivery model that expediently identifies and routes these patients to the appropriate specialist.

Effects of the European Working Time Directive on anaesthetic training in the United Kingdom.

PubMed

Sim, D J; Wrigley, S R; Harris, S

2004-08-01

Decreases in the hours worked by trainee anaesthetists are being brought about by both the New Deal for Trainees and the European Working Time Directive. Anticipated improvements in health and safety achieved by a decrease in hours will be at the expense of training time if the amount of night-time work remains constant. This audit examined the effects of a change from a partial to a full shift system on a cohort of trainee anaesthetists working in a large district general hospital in the South-west of England. Logbook and list analyses were performed for two 10-week periods: one before and one after the decrease in hours. An 18% decrease in the number of cases done and an 11% decrease in the number of weekly training lists were found for specialist registrars. A 22% decrease in the number of cases done and a 14% decrease in the number of weekly training lists were found for senior house officers. Furthermore, a decrease of one service list per specialist registrar per week was seen, which will have implications for consultant manpower requirements.

Core principles of assessment in competency-based medical education.

PubMed

Lockyer, Jocelyn; Carraccio, Carol; Chan, Ming-Ka; Hart, Danielle; Smee, Sydney; Touchie, Claire; Holmboe, Eric S; Frank, Jason R

2017-06-01

The meaningful assessment of competence is critical for the implementation of effective competency-based medical education (CBME). Timely ongoing assessments are needed along with comprehensive periodic reviews to ensure that trainees continue to progress. New approaches are needed to optimize the use of multiple assessors and assessments; to synthesize the data collected from multiple assessors and multiple types of assessments; to develop faculty competence in assessment; and to ensure that relationships between the givers and receivers of feedback are appropriate. This paper describes the core principles of assessment for learning and assessment of learning. It addresses several ways to ensure the effectiveness of assessment programs, including using the right combination of assessment methods and conducting careful assessor selection and training. It provides a reconceptualization of the role of psychometrics and articulates the importance of a group process in determining trainees' progress. In addition, it notes that, to reach its potential as a driver in trainee development, quality care, and patient safety, CBME requires effective information management and documentation as well as ongoing consideration of ways to improve the assessment system.

Surgical simulation in orthopaedic skills training.

PubMed

Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

2012-07-01

Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

Trainee and Client Experiences of Therapeutic Assessment in a Required Graduate Course: A Qualitative Analysis

PubMed Central

Smith, Justin D.; Egan, Kaitlyn N.

2015-01-01

Surveys indicate that practice and training in psychological assessment, and personality assessment (PA) to a lesser degree, has been stable or increasing over the past quarter century. However, its future arguably remains threatened due to changes in doctoral training programs and beliefs in the field concerning the utility of PA for treatment success. In order to increase interest in and use of PA, studies of training methods that include trainees’ perspectives are needed. This study evaluated the experiences of ten graduate trainees and their clients who were trained in and conducted a brief Therapeutic Assessment (TA). Qualitative responses to a self-evaluation administered post-TA were coded using directed content analysis. Results indicated that trainees’ viewed TA/PA as having clinical utility; they had positive feelings about TA/PA, and they desired or intended to use or continue learning about TA/PA. Clients’ responses reflected positive feelings about the TA, having gained new self-awareness or understanding, and having a positive relationship with the assessor. The findings suggest that teaching PA from a TA perspective could produce positive benefits for psychology trainees. PMID:26407831

Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

PubMed

Wong, Kenneth; Duncan, Tristram; Pearson, Andrew

2007-07-01

Open appendicectomy is the traditional standard treatment for appendicitis. Laparoscopic appendicectomy is perceived as a procedure with greater potential for complications and longer operative times. This paper examines the hypothesis that unsupervised laparoscopic appendicectomy by surgical trainees is a safe and time-effective valid alternative. Medical records, operating theatre records and histopathology reports of all patients undergoing laparoscopic and open appendicectomy over a 15-month period in two hospitals within an area health service were retrospectively reviewed. Data were analysed to compare patient features, pathology findings, operative times, complications, readmissions and mortality between laparoscopic and open groups and between unsupervised surgical trainee operators versus consultant surgeon operators. A total of 143 laparoscopic and 222 open appendicectomies were reviewed. Unsupervised trainees performed 64% of the laparoscopic appendicectomies and 55% of the open appendicectomies. There were no significant differences in complication rates, readmissions, mortality and length of stay between laparoscopic and open appendicectomy groups or between trainee and consultant surgeon operators. Conversion rates (laparoscopic to open approach) were similar for trainees and consultants. Unsupervised senior surgical trainees did not take significantly longer to perform laparoscopic appendicectomy when compared to unsupervised trainee-performed open appendicectomy. Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

5 CFR 532.265 - Special wage schedules for apprentices and shop trainees.

Code of Federal Regulations, 2012 CFR

2012-01-01

... and shop trainees. 532.265 Section 532.265 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... schedules for apprentices and shop trainees. (a) Agencies may establish special wage schedules for apprentices and shop trainees who are included in: (1) Formal apprenticeship programs involving training for...

5 CFR 532.265 - Special wage schedules for apprentices and shop trainees.

Code of Federal Regulations, 2013 CFR

2013-01-01

... and shop trainees. 532.265 Section 532.265 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... schedules for apprentices and shop trainees. (a) Agencies may establish special wage schedules for apprentices and shop trainees who are included in: (1) Formal apprenticeship programs involving training for...

5 CFR 532.265 - Special wage schedules for apprentices and shop trainees.

Code of Federal Regulations, 2014 CFR

2014-01-01

... and shop trainees. 532.265 Section 532.265 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... schedules for apprentices and shop trainees. (a) Agencies may establish special wage schedules for apprentices and shop trainees who are included in: (1) Formal apprenticeship programs involving training for...

5 CFR 532.265 - Special wage schedules for apprentices and shop trainees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and shop trainees. 532.265 Section 532.265 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... schedules for apprentices and shop trainees. (a) Agencies may establish special wage schedules for apprentices and shop trainees who are included in: (1) Formal apprenticeship programs involving training for...

Assessing Changes in Counselor Trainees' Multicultural Competence Related to Service Learning

ERIC Educational Resources Information Center

Lee, Debbiesiu L.; Rosen, Adam D.; McWhirter, J. Jeffries

2014-01-01

This mixed methods study examined changes in self-reported multicultural competence and distress reactions of 32 counselor trainees engaged in service learning. Whereas 3 trainees significantly increased in self-reported multicultural competence, 5 significantly decreased. Trainees who significantly increased in multicultural competence reported…

45 CFR 1210.4 - Early termination procedures for National Grant Trainees and Volunteers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Trainees and Volunteers. 1210.4 Section 1210.4 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES National Grant Trainees and Volunteers § 1210.4 Early termination procedures for...

45 CFR 1210.4 - Early termination procedures for National Grant Trainees and Volunteers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Trainees and Volunteers. 1210.4 Section 1210.4 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES National Grant Trainees and Volunteers § 1210.4 Early termination procedures for...

45 CFR 1210.4 - Early termination procedures for National Grant Trainees and Volunteers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Trainees and Volunteers. 1210.4 Section 1210.4 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES National Grant Trainees and Volunteers § 1210.4 Early termination procedures for...

Online Training: The Value of Capturing Trainee Reactions

ERIC Educational Resources Information Center

Long, Lori K.; DuBois, Cathy Z.; Faley, Robert H.

2008-01-01

Purpose: Despite years of advice from researchers that trainee reactions provide training evaluation information that is of very limited use, trainee reactions remain the most commonly used measure of training effectiveness. Because the technology that supports online training facilitates the collection of trainee reaction information during and…

5 CFR 532.265 - Special wage schedules for apprentices and shop trainees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and shop trainees. 532.265 Section 532.265 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT... schedules for apprentices and shop trainees. (a) Agencies may establish special wage schedules for apprentices and shop trainees who are included in: (1) Formal apprenticeship programs involving training for...

Research in higher surgical training--the West Midlands view.

PubMed

Kmiot, W A; Neoptolemos, J P; Temple, J G

1993-09-01

A questionnaire on the role of research in higher surgical training was posted to all in-post NHS Consultants (n = 96) and Higher Surgical Trainees (n = 42) in the West Midlands Region. Replies were received from 80 consultants (83 per cent) and 37 trainees (88 per cent). Over 95 per cent of responders had undertaken some research activity previously. The vast majority of consultants (90 per cent) and trainees (95 per cent) thought that their research period had been beneficial; most would undertake research again even if not essential for higher surgical training (consultants 80 per cent, trainees 70 per cent). Research was felt to be essential for all trainees by 50 per cent of respondents in both groups; 78 per cent of consultants and 86 per cent of trainees also thought that all potential academics should obtain a degree by thesis. Most of the study participants thought that the appropriate time for research activity was as a post-FRCS registrar (consultants 72 per cent, trainees 80 per cent); 80 per cent of consultants and 67 per cent of trainees felt that this research period should be funded by the NHS. A planned, supervised and funded one-year period of research was favoured by the majority of consultants (54 per cent) and trainees (73 per cent) for non-academic general surgical trainees in the future.

North American Pediatric Gastroenterology Fellowship Needs Assessment in Inflammatory Bowel Disease: Trainee and Program Director Perspectives.

PubMed

Dotson, Jennifer L; Falaiye, Tolulope; Bricker, Josh B; Strople, Jennifer; Rosh, Joel

2016-07-01

Pediatric inflammatory bowel disease (IBD) care is complex and rapidly evolving. The Crohn's and Colitis Foundation of America and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition cosponsored a needs assessment survey of pediatric gastroenterology trainees and program directors (PDs) to inform on educational programming. A Web-based, self-completed survey was provided to North American trainees and PDs during the 2013-2014 academic year. Standard descriptive statistics summarized demographics and responses. One hundred sixty-six of 326 (51%) trainees (62% female) and 37 of 74 (50%) PDs responded. Median trainees per program = 5 and median total faculty = 10 (3 IBD experts); 15% of programs did not have a self-identified "IBD expert" faculty member. Sixty-nine percent of trainees were confident/somewhat confident in their IBD inpatient training, whereas 54% were confident/somewhat confident in their outpatient training. Trainees identified activities that would most improve their education, including didactics (55%), interaction with national experts (50%), trainee-centered IBD Web resources (42%), and increased patient exposure (42%). Trainees were most confident in managing inpatient active Crohn's disease/ulcerative colitis, phenotype classification, managing biological therapies, and using clinical disease activity indices. They were least confident in managing J-pouch complications, performing pouchoscopy, managing extraintestinal manifestations, and ostomy-related complications. Eighty-five percent would like an IBD-focused training elective. Most directors (86%) would allow trainees to do electives at other institutions. This IBD needs assessment survey of pediatric gastroenterology trainees and PDs demonstrated a strong resource commitment to IBD training and clinical care. Areas for educational enrichment emerged, including pouch and ostomy complications.

Electronic Patient Data Confidentiality Practices Among Surgical Trainees: Questionnaire Study

PubMed Central

Mole, Damian J; Fox, Colin; Napolitano, Giulio

2006-01-01

INTRODUCTION The objective of this work was to evaluate the safeguards implemented by surgical trainees to protect the confidentiality of electronic patient data through a structured questionnaire sent to Northern Ireland surgical trainees. PARTICIPANTS AND METHODS A group of 32 basic and higher surgical trainees attending a meeting of the Northern Ireland Association of Surgeons-in-Training were invited to complete a questionnaire regarding their computer use, UK Data Protection Act, 1988 registration and electronic data confidentiality practices. RESULTS Of these 32 trainees, 29 returned completed questionnaires of whom 26 trainees regularly stored sensitive patient data for audit or research purposes on a computer. Only one person was registered under the Data Protection Act, 1988. Of the computers used to store and analyse sensitive data, only 3 of 14 desktops, 8 of 19 laptops and 3 of 14 hand-held computers forced a password logon. Of the 29 trainees, 16 used the same password for all machines, and 25 of 27 passwords were less than 8 characters long. Two respondents declined to reveal details of their secure passwords. Half of all trainees had never adjusted their internet security settings, despite all 14 desktops, 16 of 19 laptops and 5 of 14 hand-helds being routinely connected to the internet. Of the 29 trainees, 28 never encrypted their sensitive data files. Ten trainees had sent unencrypted sensitive patient data over the internet, using a non-secure server. CONCLUSIONS Electronic data confidentiality practices amongst Northern Ireland surgical trainees are unsafe. Simple practical measures to safeguard confidentiality are recommended. PMID:17059715

The safe use of surgical energy devices by surgeons may be overestimated.

PubMed

Ha, Ally; Richards, Carly; Criman, Erik; Piaggione, Jillian; Yheulon, Christopher; Lim, Robert

2018-03-01

Surgical energy injuries are an underappreciated phenomenon. Improper use of surgical energy or poor attention to patient safety can result in operating room fires, tissue injuries, and interferences with other electronic devices, while rare complications can be devastatingly severe. Despite this, there is no current standard requirement for educating surgeons on the safe use of energy-based devices or evaluation of electrosurgery (ES) education in residency training, credentialing, or practice. The study aimed to assess the current baseline knowledge of surgeons and surgical trainees with regards to ES across varying experiences at a tertiary level care center. Surgeons and surgical trainees from seven surgical specialties (General Surgery, Cardiothoracic Surgery, Vascular Surgery, Obstetrics/Gynecology, Orthopedic Surgery, Urology, and Otorhinolaryngology) at a tertiary level care hospital were tested. Testing included an evaluation regarding their background training and experiences with ES-related adverse events and a 15 multiple-choice-question exam testing critical knowledge of ES. A total of 134 surveys were sent out with 72 responses (53.7%). The mean quiz score was 51.5 ± 15.5% (passing score was 80%). Of staff surgeons, 33/65 (50.8%) completed the survey with mean and median scores of 54.9 and 53.3%, respectively (range 33.3-86.7%). Of surgical trainees, 39/69 (56.5%) completed the survey with mean and median scores of 48.6 and 46.7%, respectively (range 13.3-80.0%). There were no statistically significant differences based on training status (p = 0.08), previous training (p = 0.24), number of cases (p = 0.06), or specialty (p = 0.689). Surgeons and surgical trainees both have a significant knowledge gap in the safe and effective use of surgical energy devices, regardless of surgical specialty and despite what they feel was adequate training. The knowledge gap is not improved with experience. A formal surgical energy education program should be a requirement for residency training or credentialing.

Learning Strategies and Learning-Related Emotions among Teacher Trainees

ERIC Educational Resources Information Center

Wittmann, Simone

2011-01-01

Teacher trainees are questioned about their strategic and emotional relationships with a key area of their future activity, learning. Characteristics of German teacher trainees are identified through comparisons with German students on a related course of study (educational science), and through comparisons with Swedish teacher trainees. N = 875…

A Proficiency Based Stepwise Endovascular Curricular Training (PROSPECT) Program Enhances Operative Performance in Real Life: A Randomised Controlled Trial.

PubMed

Maertens, H; Aggarwal, R; Moreels, N; Vermassen, F; Van Herzeele, I

2017-09-01

Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions. All subjects performed two endovascular interventions treating patients with symptomatic iliac and/or superficial femoral artery stenosis under supervision. Primary outcomes were technical performances (Global Rating Scale [GRS]; Examiner Checklist), operative metrics, and patient outcomes, adjusted for case difficulty and trainee experience. Secondary outcomes included knowledge and technical performance after 6 weeks and 3 months. Thirty-two general surgical trainees were randomised into three groups. Besides traditional training, the first group (n = 11) received e-learning and simulation training (PROSPECT), the second group (n = 10) only had access to e-learning, while controls (n = 11) did not receive supplementary training. Twenty-nine trainees (3 dropouts) performed 58 procedures. Trainees who completed PROSPECT showed superior technical performance (GRS 39.36 ± 2.05; Checklist 63.51 ± 3.18) in real life with significantly fewer supervisor takeovers compared with trainees receiving e-learning alone (GRS 28.42 ± 2.15; p = .001; Checklist 53.63 ± 3.34; p = .027) or traditional education (GRS 23.09 ± 2.18; p = .001; Checklist 38.72 ± 3.38; p = .001). Supervisors felt more confident in allowing PROSPECT trained physicians to perform basic (p = .006) and complex (p = .003) procedures. No differences were detected in procedural parameters (such as fluoroscopy time, DAP, procedure time, etc.) or complications. Proficiency levels were maintained up to 3 months. A structured, stepwise, proficiency based endovascular curriculum including e-learning and simulation based training should be integrated early into training programs to enhance trainee performance. Copyright © 2017. Published by Elsevier Ltd.

Mobile technology supporting trainee doctors' workplace learning and patient care: an evaluation.

PubMed

Hardyman, Wendy; Bullock, Alison; Brown, Alice; Carter-Ingram, Sophie; Stacey, Mark

2013-01-21

The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded "iDoc", a project offering trainee doctors a Smartphone library of medical textbooks. Data on trainee doctors' (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use. Most frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p < 0.01). Foundation Year 1 (newly qualified) was judged the most useful time to have a Smartphone library because of increased responsibility and lack of knowledge/experience.Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors' discussions with seniors; independent practice; patient care; and this 'just-in-time' access to reliable information supported confident and efficient decision-making. A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge.By supporting accurate prescribing and treatment planning, the electronic library contributed to enhanced patient care. Trainees were more rapidly able to medicate patients to reduce pain and more quickly call for specific assessments. However, clinical decision-making often requires dialogue: what Smartphone technology can do is augment, not replace, discussion with their colleagues in the community of practice.

The MD Blues: Under-Recognized Depression and Anxiety in Medical Trainees.

PubMed

Mousa, Omar Y; Dhamoon, Mandip S; Lander, Sarah; Dhamoon, Amit S

2016-01-01

Mental health disease is under recognized in medical professionals. To screen medical students (MS), residents and fellows for major depressive disorder (MDD) and generalized anxiety disorder (GAD) under the new era of work hour reform with age-matched controls from a large representative cross-sectional survey. We conducted an anonymous online survey at a medical university in 2013-2014. We incorporated the Patient Health Questionnaire 2 (PHQ-2) to screen for MDD and the generalized anxiety disorder scale (GAD-7) to screen for GAD, along with additional questions on life stressors and academic performance. We compared these results to age-matched controls from the National Health and Nutrition Examination Survey (NHANES) database. 126 residents/fellows and 336 medical students participated voluntarily. 15.1% and 15.9% of postgraduates as well as 16.4% and 20.3% of MS screened positive for MDD and GAD, respectively. When compared to national estimates, the prevalence of a positive screen for MDD was over five-fold higher in medical trainees compared to age-matched controls (16% vs. 2.8%, p<0.0001). Similarly, the prevalence of a positive screen for GAD was over eight-fold higher in medical trainees (19% vs. 2.3%, p<0.0001).The prevalence was consistently higher within age strata. 33.3% of postgraduates and 32% of MS believe there is a significant impact of depression or anxiety on their academic performance. For stress relief, one fifth of residents/fellows as well as MS reported alcohol use. The stresses of medical education and practice may predispose trainees to psychopathological consequences that can affect their academic performance and patient care. The current study showed a significantly higher rate of MDD and GAD positive screens in medical trainees than the prevalence in an age-matched U.S. population, despite significant work hour reform for medical trainees. Increased awareness and support services are required at all levels of medical training. We propose that the ACGME and the Institute of Medicine may consider these findings when implementing future changes to work hour regulations.

14 CFR 1250.104 - Assurances.

Code of Federal Regulations, 2010 CFR

2010-01-01

... for research, training, or educational programs. (1) In the case of application by an institution of... which involves participation by students, fellows or trainees, including but not limited to assistance for research, training, or the provision of facilities, the assurance required by this § 1250.104...

14 CFR 1250.104 - Assurances.

Code of Federal Regulations, 2011 CFR

2011-01-01

... for research, training, or educational programs. (1) In the case of application by an institution of... which involves participation by students, fellows or trainees, including but not limited to assistance for research, training, or the provision of facilities, the assurance required by this § 1250.104...

14 CFR 1250.104 - Assurances.

Code of Federal Regulations, 2013 CFR

2013-01-01

... for research, training, or educational programs. (1) In the case of application by an institution of... which involves participation by students, fellows or trainees, including but not limited to assistance for research, training, or the provision of facilities, the assurance required by this § 1250.104...

14 CFR 1250.104 - Assurances.

Code of Federal Regulations, 2012 CFR

2012-01-01

... for research, training, or educational programs. (1) In the case of application by an institution of... which involves participation by students, fellows or trainees, including but not limited to assistance for research, training, or the provision of facilities, the assurance required by this § 1250.104...

22 CFR 139.5 - Qualifications required for selection as a trainee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... participant in the IPPCTP, a person must: (a) Be between 18 and 35 years of age; and (b) Have been physically... learning for a student in that institution who needs on the job experience to qualify for a degree or...

22 CFR 139.5 - Qualifications required for selection as a trainee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... participant in the IPPCTP, a person must: (a) Be between 18 and 35 years of age; and (b) Have been physically... learning for a student in that institution who needs on the job experience to qualify for a degree or...

Foreign Language Teacher Education. ERIC Digest.

ERIC Educational Resources Information Center

Jarvis, Gilbert A.; Bernhardt, Elizabeth B.

Foreign language education professionals agree that the profession lacks an established theory and methodological consistency. Foreign language teacher education has not changed much since the 1960s. Most programs consist of subject-matter content, general education requirements, and specialized education courses. Teacher trainee supervisors do…

A proposed new test for aptitude screening of air traffic controller applicants.

DOT National Transportation Integrated Search

1972-05-01

The study concerns the development and experimental validation of a novel aptitude test, referred to as 'Directional Headings' (or DHT), for the selection of Air Traffic Control Specialist (ATCS) trainees. The test requires the subject to rapidly int...

Work stress and risk factors for health management trainees in canakkale, Turkey.

PubMed

Tanışman, Beyhan; Cevizci, Sibel; Çelik, Merve; Sevim, Sezgin

2014-10-01

This study aims to investigate the general mental health situation, work-related stress and risk factors of health management trainees. This cross-sectional study was conducted on Health Management Musters students (N=96) in Canakkale Onsekiz Mart University Health Sciences Institute, May-June 2014. A total of 58 students who voluntarily participated in the study were reached (60.42%). Participants completed a 22-question sociodemographic survey form and a 12-item General Health Questionnaire in a face-to-face interview. Data were analyzed using the SPSS software version 20.0. The average age of participants was 36.4±6.2 (Min:24-Max:62) years. Thirty five of the participants were female (60.3%), 23 were male (39.7%). The number of people using cigarettes and alcohol were 23 (39.7%) and 9 (15.8%) respectively. In our study group according to GHQ scale 32 people (55.2%) were in the group at risk of depression. Eighty-six percent of participants reported experiencing work stress. The most frequently reported sources of stress were superiors (56.8%), work itself (41.3%), and work colleagues (25.8%). There was no significant difference between those at risk of depression and those not at risk in terms of gender, marital status, educational level, age, work-related factors (daily work, computer use, duration of sitting at desk), sleep duration, presence of chronic disease, substance use (cigarettes, alcohol), regular exercise, regular meals, fast-food consumption, sufficient family time and vacations (p>0.05). Our study results indicated that majority of participants reported experiencing work stress with more than half at high risk of developing depression. The most reported risk factors were superiors, the work itself and colleagues in the present study. Psychosocial risk factors at work environment should be investigated in terms of psychological, sociological and ergonomics in more detail to reduce the risk of health management trainees experiencing work stress and mental health problems.

Work Stress and Risk Factors For Health Management Trainees in Canakkale, Turkey

PubMed Central

Tanışman, Beyhan; Cevizci, Sibel; Çelik, Merve; Sevim, Sezgin

2014-01-01

Aim: This study aims to investigate the general mental health situation, work-related stress and risk factors of health management trainees. Methods: This cross-sectional study was conducted on Health Management Musters students (N=96) in Canakkale Onsekiz Mart University Health Sciences Institute, May-June 2014. A total of 58 students who voluntarily participated in the study were reached (60.42%). Participants completed a 22-question sociodemographic survey form and a 12-item General Health Questionnaire in a face-to-face interview. Data were analyzed using the SPSS software version 20.0. Results: The average age of participants was 36.4±6.2 (Min:24-Max:62) years. Thirty five of the participants were female (60.3%), 23 were male (39.7%). The number of people using cigarettes and alcohol were 23 (39.7%) and 9 (15.8%) respectively. In our study group according to GHQ scale 32 people (55.2%) were in the group at risk of depression. Eighty-six percent of participants reported experiencing work stress. The most frequently reported sources of stress were superiors (56.8%), work itself (41.3%), and work colleagues (25.8%). There was no significant difference between those at risk of depression and those not at risk in terms of gender, marital status, educational level, age, work-related factors (daily work, computer use, duration of sitting at desk), sleep duration, presence of chronic disease, substance use (cigarettes, alcohol), regular exercise, regular meals, fast-food consumption, sufficient family time and vacations (p>0.05). Conclusions: Our study results indicated that majority of participants reported experiencing work stress with more than half at high risk of developing depression. The most reported risk factors were superiors, the work itself and colleagues in the present study. Psychosocial risk factors at work environment should be investigated in terms of psychological, sociological and ergonomics in more detail to reduce the risk of health management trainees experiencing work stress and mental health problems. PMID:25568633

Evaluation of robotic cardiac surgery simulation training: A randomized controlled trial.

PubMed

Valdis, Matthew; Chu, Michael W A; Schlachta, Christopher; Kiaii, Bob

2016-06-01

To compare the currently available simulation training modalities used to teach robotic surgery. Forty surgical trainees completed a standardized robotic 10-cm dissection of the internal thoracic artery and placed 3 sutures of a mitral valve annuloplasty in porcine models and were then randomized to a wet lab, a dry lab, a virtual reality lab, or a control group that received no additional training. All groups trained to a level of proficiency determined by 2 expert robotic cardiac surgeons. All assessments were evaluated using the Global Evaluative Assessment of Robotic Skills in a blinded fashion. Wet lab trainees showed the greatest improvement in time-based scoring and the objective scoring tool compared with the experts (mean, 24.9 ± 1.7 vs 24.9 ± 2.6; P = .704). The virtual reality lab improved their scores and met the level of proficiency set by our experts for all primary outcomes (mean, 24.9 ± 1.7 vs 22.8 ± 3.7; P = .103). Only the control group trainees were not able to meet the expert level of proficiency for both time-based scores and the objective scoring tool (mean, 24.9 ± 1.7 vs 11.0 ± 4.5; P < .001). The average duration of training was shortest for the dry lab and longest for the virtual reality simulation (1.6 hours vs 9.3 hours; P < .001). We have completed the first randomized controlled trial to objectively compare the different training modalities of robotic surgery. Our data demonstrate the significant benefits of wet lab and virtual reality robotic simulation training and highlight key differences in current training methods. This study can help guide training programs in investing resources in cost-effective, high-yield simulation exercises. Copyright © 2016 The American Association for Thoracic Surgery. All rights reserved.

33 CFR 106.225 - Drill and exercise requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Drill and exercise requirements...) Facility Security Requirements § 106.225 Drill and exercise requirements. (a) General. (1) Drills and... Security Officer (FSO) to identify any related security deficiencies that need to be addressed. (2) A drill...

33 CFR 106.225 - Drill and exercise requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Drill and exercise requirements...) Facility Security Requirements § 106.225 Drill and exercise requirements. (a) General. (1) Drills and... Security Officer (FSO) to identify any related security deficiencies that need to be addressed. (2) A drill...

33 CFR 106.225 - Drill and exercise requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Drill and exercise requirements...) Facility Security Requirements § 106.225 Drill and exercise requirements. (a) General. (1) Drills and... Security Officer (FSO) to identify any related security deficiencies that need to be addressed. (2) A drill...

33 CFR 106.225 - Drill and exercise requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Drill and exercise requirements...) Facility Security Requirements § 106.225 Drill and exercise requirements. (a) General. (1) Drills and... Security Officer (FSO) to identify any related security deficiencies that need to be addressed. (2) A drill...

E-learning teaches attendings "how to" objectively assess pediatric urology trainees' surgery skills for orchiopexy.

PubMed

Fernandez, Nicolas; Maizels, Max; Farhat, Walid; Smith, Edwin; Liu, Dennis; Chua, Michael; Bhanji, Yasin

2018-04-01

Established methods to train pediatric urology surgery by residency training programs require updating in response to administrative changes such as new, reduced trainee duty hours. Therefore, new objective methods must be developed to teach trainees. We approached this need by creating e-learning to teach attendings objective assessment of trainee skills using the Zwisch scale, an established assessment tool. The aim of this study was to identify whether or not e-learning is an appropriate platform for effective teaching of this assessment tool, by assessing inter-rater correlation of assessments made by the attendings after participation in the e-learning. Pediatric orchiopexy was used as the index case. An e-learning tool was created to teach attending surgeons objective assessment of trainees' surgical skills. First, e-learning content was created which showed the assessment method videotape of resident surgery done in the operating room. Next, attendings were enrolled to e-learn this method. Finally, the ability of enrollees to assess resident surgery skill performance was tested. Namely, test video was made showing a trainee performing inguinal orchiopexy. All enrollees viewed the same online videos. Assessments of surgical skills (Zwisch scale) were entered into an online survey. Data were analyzed by intercorrelation coefficient kappa analysis (strong correlation was ICC ≥ 0.7). A total of 11 attendings were enrolled. All accessed the online learning and then made assessments of surgical skills trainees showed on videotapes. The e-learning comprised three modules: 1. "Core concepts," in which users learned the assessment tool methods; 2. "Learn to assess," in which users learned how to assess by watching video clips, explaining the assessment method; and 3. "Test," in which users tested their skill at making assessments by watching video clips and then actively inputting their ratings of surgical and global skills as viewed in the video clips (Figure). A total of 89 surgical skill ratings were performed with 56 (65%) exact matches between raters and 89 (100%) matched within one rank. Interclass correlation coefficient (ANOVA) showed statistically significant correlation. (r = 0.725, 95% CI 0.571-0.837, F = 3.976, p ≤ 0.00001). Kappa analysis of inter-rater reliability showed strong consensus between attendings for average measures with ICC = 0.71, 95% CI 0.46-0.95 (p = 0.03). We launched e-learning to teach pediatric urology attendings "how to" assess trainee surgical skills objectively (Zwisch scale). After e-learning, there was strong inter-rater correlation in assessments made. We plan to extend such e-learning to pediatric urology surgical training programs. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

What do gastroenterology trainees want: recognition, remuneration or recreation?

PubMed

Harewood, G C; Pardi, D S; Hansel, S L; Corr, A E; Aslanian, H; Maple, J

2011-06-01

Occupational psychologists have identified three factors important in motivating physicians: financial reward, academic recognition, time off. To assess motivators among gastroenterology (GI) trainees. A questionnaire was distributed to GI trainees to assess their motivators: (1) work fewer hours for less lucrative rate, (2) reduction in salary/increase in hours for academic protected time, and (3) work longer hours for higher total salary, but less lucrative hourly rate. Overall, 61 trainees responded; 52% of trainees would work shorter hours for less lucrative rate; 60% would accept a disproportionate reduction in salary/increase in hours for academic protected time; 54% would work longer hours for more money but less lucrative rate. Most trainees (93%) accepted at least one scenario. Most GI trainees are willing to modify their job description to align with their personal values. Tailoring job descriptions according to these values can yield economic benefits to GI Divisions.

ENT audit and research in the era of trainee collaboratives.

PubMed

Smith, Matthew E; Hardman, John; Ellis, Matthew; Williams, Richard J

2018-05-26

Large surgical audits and research projects are complex and costly to deliver, but increasingly surgical trainees are delivering these projects within formal collaboratives and research networks. Surgical trainee collaboratives are now recognised as a valuable part of the research infrastructure, with many perceived benefits for both the trainees and the wider surgical speciality. In this article, we describe the activity of ENT trainee research collaboratives within the UK, and summarise how INTEGRATE, the UK National ENT Trainee Research Network, successfully delivered a national audit of epistaxis management. The prospective audit collected high-quality data from 1826 individuals, representing 94% of all cases that met the inclusion criteria at the 113 participating sites over the 30-day audit period. It is hoped that the audit has provided a template for subsequent high-quality and cost-effective national studies, and we discuss the future possibilities for ENT trainee research collaboratives.

78 FR 71615 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-29

...TM Program (Hands-on, Online, Blended models). Trainee Reaction Survey-- 180 1 15/60 Hands-On Model. Trainee Reaction Survey-- 180 1 15/60 Online Model. Trainee Reaction Survey-- 180 1 15/60 Blended Model... Program (Train-the- Participant Survey. Trainer model). Trainee Reaction Survey-- 30 1 15/60 Train-the...

Final Technical Report for DOE Grant DE-SC0017198

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jurisson, Silvia

This grant supported students, postdocs and trainees from US institutions to attend the 22nd International Symposium on Radiopharmaceutical Sciences (ISRS). The trainees supported all presented their research at ISRS2017 held in Dresden, Germany from 14-19 May 2017. All trainees performed their research at US institutions. Ten trainees were supported.

General practice training environment and its impact on preparedness.

PubMed

Wiener-Ogilvie, Sharon; Bennison, Jenny; Smith, Victor

2014-01-01

The notion of preparedness for practice is poorly defined in medical education literature. It is unclear what preparedness means and how the training environment impacts on preparedness for practice. This paper aims to explore the meaning that GP trainees and newly qualified GPs attach to the notion of preparedness, and to examine the ways in which they perceive their training environment to impact on preparedness. We used a qualitative interpretive approach and conducted 27 in-depth semi-structured interviews with 15 newly qualified GPs and 12 GP trainees at the end of their training. Two central categories describing preparedness emerged; 'confidence' and 'adaptability'. Inclusive training practices, characterised by non-hierarchical relationships between the doctors, particularly vis-à-vis trainees, were reported to be more 'progressive' and were better at preparing trainees. The way the training practice can impact on preparedness can be explained drawing on Lave and Wenger's theory of 'situated learning'. The role of the trainer was also pivotal in preparing trainees. Supervision tailored to trainees' needs, and guided decision making enhanced confidence of trainees in their ability to work independently in the future. We suggest that for GP trainees to be better prepared it is not enough to extend GP training; rather it is important that GP trainees' time is spent in inclusive training environments.

Vocational trainees' views and experiences regarding the learning and teaching of communication skills in general practice.

PubMed

Van Nuland, Marc; Thijs, Gabie; Van Royen, Paul; Van den Noortgate, Wim; Goedhuys, Jo

2010-01-01

To explore the views and experiences of general practice (GP) vocational trainees regarding communication skills (CS) and the teaching and learning of these skills. A purposive sample of second and third (final) year GP trainees took part in six focus group (FG) discussions. Transcripts were coded and analysed in accordance with a grounded theory approach by two investigators using Alas-ti software. Finally results were triangulated by means of semi-structured telephone interviews. The analysis led to three thematic clusters: (1) trainees acknowledge the essential importance of communication skills and identified contextual factors influencing the learning and application of these skills; (2) trainees identified preferences for learning and receiving feedback on their communication skills; and (3) trainees perceived that the assessment of communication skills is subjective. These themes are organised into a framework for a better understanding of trainees' communication skills as part of their vocational training. The framework helps in leading to a better understanding of the way in which trainees learn and apply communication skills. The unique context of vocational training should be taken into account when trainees' communication skills are assessed. The teaching and learning should be guided by a learner-centred approach. The framework is valuable for informing curricular reform and future research.

Formative assessment of oncology trainees' communication with cancer patients about internet information.

PubMed

Bylund, Carma L; Sperka, Miryam; D'Agostino, Thomas A

2015-04-01

Cancer patients and their caregivers often turn to the internet for information and support following a cancer diagnosis. Research shows a need for improvement in doctors' communication with patients about internet information. The purpose of this formative assessment was to evaluate oncology trainees' skills in talking about internet information with cancer patients. Thirty-nine oncology trainees were evaluated in a baseline standardized patient assessment as part of their participation in the Comskil Training Program. As part of the assessment, standardized patients were instructed to raise the topic of internet information they had read. Transcriptions of the video-recorded assessments were coded for patient statements and trainee responses. Fifty-six percent of trainees used a probe to get more information before addressing the content of the internet search, while 18% addressed it immediately. Eighteen percent of trainees warned the patient about using the internet, and 8% warned about and also encouraged internet use. Thirteen percent of trainees praised the patient for seeking out information on the internet. This formative assessment indicated that the majority of trainees addressed the content of the internet search, while a minority addressed the internet as a tool and praised patients' efforts. Research in this area should examine the effectiveness of educational interventions for trainees to improve discussions about internet information.

Review of laparoscopic training in pediatric surgery in the United Kingdom.

PubMed

Stormer, Emma J; Sabharwal, Atul J

2009-04-01

To review the exposure pediatric surgery trainees have to laparoscopic surgery in the United Kingdom (UK). A confidential postal questionnaire was sent to all trainees working at registrar level in centers responsible for pediatric surgical training in the UK. Questions assessed the number of consultants with an interest in laparoscopic surgery, types of cases performed laparoscopically, and trainees' role in laparoscopic appendicectomy (LA). Questionnaires were sent to 112 trainees with a 55% response rate (62 replies). At least one response was received from each unit. Based on responses, 49 to 67 consultants in 21 training centers have an interest in laparoscopic surgery (0%-100% of consultants per unit). LA was offered in 20 out of 21 training centers. There was no significant difference in the proportion of appendicectomies performed laparoscopically by junior (years 1-3) and senior (years 4-6) trainees. A significantly higher proportion of junior trainees had not performed any LAs (P = 0.02). Seventy-three percent of trainees were the principal operator. For trainees who were principal operators, the cameraperson was a consultant in 52% and a junior trainee in 17%. The time of day affected the likelihood of a procedure being carried out laparoscopically in 43 (81%) responses. The majority of trainees' exposure to laparoscopic surgery could be viewed as suboptimal; however, the exposure gained varies significantly between different units throughout the UK. In an age moving in favor of minimal access surgery, all units must be in a position to offer pediatric laparoscopic surgical training.

Evaluation of an established learning portfolio.

PubMed

Vance, Gillian; Williamson, Alyson; Frearson, Richard; O'Connor, Nicole; Davison, John; Steele, Craig; Burford, Bryan

2013-02-01

The trainee-held learning portfolio is integral to the foundation programme in the UK. In the Northern Deanery, portfolio assessment is standardised through the Annual Review of Competence Progression (ARCP) process. In this study we aimed to establish how current trainees evaluate portfolio-based learning and ARCP, and how these attitudes may have changed since the foundation programme was first introduced. Deanery-wide trainee attitudes were surveyed by an electronic questionnaire in 2009 and compared with perceptions recorded during the pilot phase (2004-2005).  Many trainees continue to view the e-portfolio negatively. Indeed, significantly fewer trainees in 2009 thought that the e-portfolio was a 'good idea' or a 'worthwhile investment of time' than in 2005. Trainees remain unconvinced about the educational value of the e-portfolio: fewer trainees in 2009 regarded it as a tool that might help focus on training or recognise individual strengths and weaknesses. Issues around unnecessary bureaucracy persist. Current trainees tend to understand how to use the e-portfolio, but many did not know how much, or what evidence to collect. Few supervisors were reported to provide useful guidance on the portfolio. ARCP encouraged portfolio completion but did not give meaningful feedback to drive future learning.   Continued support is needed for both trainees and supervisors in portfolio-building skills and in using the e-portfolio as an educational tool. Trainee-tailored feedback is needed to ensure that portfolio-based assessment promotes lifelong, self-directed and reflective learners. © Blackwell Publishing Ltd 2013.

A multisource feedback tool to assess ward round leadership skills of senior paediatric trainees: (2) Testing reliability and practicability.

PubMed

Goodyear, Helen M; Lakshminarayana, Indumathy; Wall, David; Bindal, Taruna

2015-05-01

A five-domain multisource feedback (MSF) tool was previously developed in 2009-2010 by the authors to assess senior paediatric trainees' ward round leadership skills. To determine whether this MSF tool is practicable and reliable, whether individuals' feedback varies over time and trainees' views of the tool. The MSF tool was piloted (April-July 2011) and field tested (September 2011-February 2013) with senior paediatric trainees. A focus group held at the end of field testing obtained trainees' views of the tool. In field testing, 96/115 (84%) trainees returned 633 individual assessments from three different ward rounds over 18 months. The MSF tool had high reliability (Cronbach's α 0.84, G coefficient 0.8 for three raters). In all five domains, data were shifted to the right with scores of 3 (good) and 4 (excellent). Consultants gave significantly lower scores (p<0.001), as did trainees for self-assessment (p<0.001). There was no significant change in MSF scores over 18 months but comments showed that trainees' performance improved. Trainees valued these comments and the MSF tool but had concerns about time taken for feedback and confusion about tool use and the paediatric assessment strategy. A five-domain MSF tool was found to be reliable on pilot and field testing, practicable to use and liked by trainees. Comments on performance were more helpful than scores in giving trainees feedback. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Video-assisted palatopharyngeal surgery: a model for improved education and training.

PubMed

Allori, Alexander C; Marcus, Jeffrey R; Daluvoy, Sanjay; Bond, Jennifer

2014-09-01

Objective : The learning process for intraoral procedures is arguably more difficult than for other surgical procedures because of the assistant's severely limited visibility. Consequently, trainees may not be able to adequately see and follow all steps of the procedure, and attending surgeons may be less willing to entrust trainees with critical portions of the procedure. In this report, we propose a video-assisted approach to intraoral procedures that improves lighting, visibility, and potential for effective education and training. Design : Technical report (idea/innovation). Setting : Tertiary referral hospital. Patients : Children with cleft palate and velopharyngeal insufficiency requiring surgery. Interventions : Video-assisted palatoplasty, sphincteroplasty, and pharyngoplasty. Main Outcome Measures : Qualitative and semiquantitative educational outcomes, including learner perception regarding "real-time" (video-assisted surgery) and "non-real-time" (video-library-based) surgical education. Results : Trainees were strongly in favor of the video-assisted modality in "real-time" surgical training. Senior trainees identified more opportunities in which they had been safely entrusted to perform critical portions of the procedure, corresponding with satisfaction with the learning process scores, and they showed greater comfort/confidence scores related to performing the procedure under supervision and alone. Conclusions : Adoption of the video-assisted approach can be expected to markedly improve the learning curve for surgeons in training. This is now standard practice at our institution. We are presently conducting a full educational technology assessment to better characterize the effect on knowledge acquisition and technical improvement.

Self-practice and self-reflection in cognitive behaviour therapy training: what factors influence trainees' engagement and experience of benefit?

PubMed

Bennett-Levy, James; Lee, Nicole K

2014-01-01

Previous studies of self-practice/self-reflection (SP/SR) CBT training have found that trainees report significant benefits from practising CBT techniques on themselves (self-practice) and reflecting on their experience (self-reflection) as a formal part of their CBT training. However, not all trainees experience the same level of benefit from SP/SR and not all types of training course produce benefits to the same extent. This paper examines the question: What factors influence trainees' reported benefit from SP/SR? The aim was to develop a model to maximize the value of SP/SR training. The authors used a grounded theory analysis of four SP/SR training courses, varying along several dimensions, to derive a model that could account for the data. A model was derived comprising of seven elements: Two outcomes - "Experience of Benefit" and "Engagement with the Process" - that mutually influence one another; and five other influencing factors - "Course Structure and Requirements", "Expectation of Benefit", "Feeling of Safety with the Process", "Group Process", and "Available Personal Resources" - that mediate the impact on Engagement with the Process and Experience of Benefit from SP/SR. A model that provides guidance about the best ways to set up and develop SP/SR programs has been developed. This model may now be subject to empirical testing by trainers and researchers. Implications and recommendations for the design and development of future SP/SR programs are discussed.

A Web-Based Education Program for Colorectal Lesion Diagnosis with Narrow Band Imaging Classification.

PubMed

Aihara, Hiroyuki; Kumar, Nitin; Thompson, Christopher C

2018-04-19

An education system for narrow band imaging (NBI) interpretation requires sufficient exposure to key features. However, access to didactic lectures by experienced teachers is limited in the United States. To develop and assess the effectiveness of a colorectal lesion identification tutorial. In the image analysis pretest, subjects including 9 experts and 8 trainees interpreted 50 white light (WL) and 50 NBI images of colorectal lesions. Results were not reviewed with subjects. Trainees then participated in an online tutorial emphasizing NBI interpretation in colorectal lesion analysis. A post-test was administered and diagnostic yields were compared to pre-education diagnostic yields. Under the NBI mode, experts showed higher diagnostic yields (sensitivity 91.5% [87.3-94.4], specificity 90.6% [85.1-94.2], and accuracy 91.1% [88.5-93.7] with substantial interobserver agreement [κ value 0.71]) compared to trainees (sensitivity 89.6% [84.8-93.0], specificity 80.6% [73.5-86.3], and accuracy 86.0% [82.6-89.2], with substantial interobserver agreement [κ value 0.69]). The online tutorial improved the diagnostic yields of trainees to the equivalent level of experts (sensitivity 94.1% [90.0-96.6], specificity 89.0% [83.0-93.2], and accuracy 92.0% [89.3-94.7], p < 0.001 with substantial interobserver agreement [κ value 0.78]). This short, online tutorial improved diagnostic performance and interobserver agreement. © 2018 S. Karger AG, Basel.

Lessons learnt from incidents reported by postgraduate trainees in Dutch general practice. A prospective cohort study.

PubMed

Zwart, Dorien L M; Heddema, Wendelien S; Vermeulen, Margit I; van Rensen, Elizabeth L J; Verheij, Theo J M; Kalkman, Cor J

2011-10-01

There is an inherent tension between allowing trainees in general practice (GP) to feel comfortable to report and learn from errors in a blame-free environment while still assuring high-quality and safe patient care. Unfortunately, little is known about the types and potential severity of incidents that may confront GP trainees. Furthermore, incident reporting by resident trainees is hindered by their concern that such transparency might result in more negative performance evaluations. To explore the number and nature of incidents that were reported by GP trainees and to determine whether there were differences between the reporters and non-reporters based on their performance evaluations. Prospective cohort study. Confidential and voluntary incident reporting was implemented in GP vocational training of the University Medical Center Utrecht, the Netherlands. Seventy-nine GP trainees were asked to report incidents over 6 months. Mixed methods were used to analyse the data. 24 trainees reported a total of 44 incidents. 23 incidents concerned the work process and 17 concerned problems with diagnosis or therapy. Three-quarters (34/44) of incidents were determined to be not specifically related to the inexperience of the GP trainees. While actual patient harm was determined to be minimal or absent in two-thirds of incidents (29/44), the potential for moderate, major, or catastrophic harm was 89% (39/44). Trainees performing best on their performance assessment in the domain of clinical expertise reported incidents more often (43% vs 18%, p<0.03) than those who performed at a lower level. GP trainees rated highly by their faculty voluntarily reported incidents in the delivery of clinical care when given a safe, blame-free, and confidential reporting process. Most incidents were not found to be directly related to the inexperience of the trainee, but were caused by failing organisational processes in the healthcare delivery system. Moreover, the trainees who tended to report these incidents were those whose performance was highly evaluated in the domain of clinical expertise.

Specialist training in obstetrics and gynaecology: a survey on work-life balance and stress among trainees in UK.

PubMed

Thangaratinam, S; Yanamandra, S R; Deb, S; Coomarasamy, A

2006-05-01

The object of this study was to evaluate perceptions about work-life balance and levels of stress in obstetrics and gynaecology trainees in the UK. This was a questionnaire survey conducted at the National Obstetric and Gynaecology Specialist Registrar Meeting (SpROGs 2004, Birmingham, UK). A total of 190 trainees in obstetrics and gynaecology attended the meeting. Trainees at the meeting were given a questionnaire to fill in regarding their perception of work-life balance, stress at work and their attitude to training in obstetrics and gynaecology. The response rate was 128/190 (67%). Half of the trainees (64/128, 50%) felt that they had achieved satisfactory work-life balance. There was a trend towards more men achieving this balance compared with women (25/42 (60%) vs 38/83 (46%), p = 0.19). Unsatisfactory social life (82%) and scarce time with the family (74%) were cited as the most common reasons for not achieving a satisfactory work-life balance. More than two-thirds of the trainees (83/128, 65%) found their work moderately or very stressful. Senior trainees (years 4 or more of specialist training) found work more stressful than junior trainees (years 1 - 3 of specialist training) (29/35 (83%) vs 54/93 (58%), p = 0.01). However, 77/128 (60%) of trainees would still recommend a career in obstetrics and gynaecology to medical students. A majority (85/128, 66%) claimed that they would choose obstetrics and gynaecology again if given a second chance. A large number of trainees (110/128, 86%) were looking forward to their future in this field. In spite of the high levels of perceived work-life imbalance and stress at work, most trainees would choose the same specialty given another chance and would recommend the same to others, indicating a certain level of satisfaction with the specialty. However, our study shows that improvements in the working lives of obstetrics and gynaecology trainees are still needed, especially given the current context of difficulty with recruitment and retention of trainees.

Justice, Courage, and Truthfulness: Virtues That Medical Trainees Can and Must Learn.

PubMed

Karches, Kyle E; Sulmasy, Daniel P

2016-07-01

Medical educators and powerful physician organizations agree on the importance of professionalism for the formation of good physicians. However, the many definitions of professionalism found in the literature lack content and differ significantly, undermining attempts to describe and implement professionalism curricula. The work of the contemporary moral philosopher Alasdair MacIntyre on the virtues may help provide some of the content that the concept of professionalism currently lacks. MacIntyre shows the importance of the virtues, particularly justice, courage, and truthfulness, for the success of any "practice," defined as a form of cooperative human activity. Medicine fits his definition of a practice, and accordingly, medical trainees require these virtues, among others, to succeed. This analysis may provide a foundation for a new form of ethical instruction, in which excellent clinician-educators model the virtues for students and residents, thereby combating the "hidden curriculum" that sometimes corrodes these values. This educational model resembles the way in which masters of other practices, such as music, teach their students and help them become lifelong learners. Such an approach requires leaders at academic medical centers to commit to the establishment of communities in which the virtues flourish. Instruction in the virtues could supplement the emphasis on principles and rule following that predominates in medical education. It would also allow physicians and students to engage with the various cultural and religious traditions in which virtue ethics has flourished, enriching the diversity of medical ethics education and promoting trainees' professional development.

MAP as a model for practice-based learning and improvement in child psychiatry training.

PubMed

Kataoka, Sheryl H; Podell, Jennifer L; Zima, Bonnie T; Best, Karin; Sidhu, Shawn; Jura, Martha Bates

2014-01-01

Not only is there a growing literature demonstrating the positive outcomes that result from implementing evidence based treatments (EBTs) but also studies that suggest a lack of delivery of these EBTs in "usual care" practices. One way to address this deficit is to improve the quality of psychotherapy teaching for clinicians-in-training. The Accreditation Council for Graduate Medical Education (ACGME) requires all training programs to assess residents in a number of competencies including Practice-Based Learning and Improvements (PBLI). This article describes the piloting of Managing and Adapting Practice (MAP) for child psychiatry fellows, to teach them both EBT and PBLI skills. Eight child psychiatry trainees received 5 full days of MAP training and are delivering MAP in a year-long outpatient teaching clinic. In this setting, MAP is applied to the complex, multiply diagnosed psychiatric patients that present to this clinic. This article describes how MAP tools and resources assist in teaching trainees each of the eight required competency components of PBLI, including identifying deficits in expertise, setting learning goals, performing learning activities, conducting quality improvement methods in practice, incorporating formative feedback, using scientific studies to inform practice, using technology for learning, and participating in patient education. A case example illustrates the use of MAP in teaching PBLI. MAP provides a unique way to teach important quality improvement and practice-based learning skills to trainees while training them in important psychotherapy competence.

Rural neurosurgical and spinal laboratory setup.

PubMed

Smith, Adam; Gagliardi, Filippo; Pelzer, Nicholas Robert; Hampton, Jacob; Chau, Anthony Minh Tien; Stewart, Fiona; Mortini, Pietro; Gragnaniello, Cristian

2015-12-01

Increasing focus has been placed on the use of simulation in neurosurgical and spinal surgical training worldwide, with the establishment of many surgical laboratories dedicated to such purpose. So far, the opportunities for hands-on cadaveric training in the areas of neurosurgery and spine surgery remain limited in Australia, owing to various factors, including the abolition of dissection in many medical schools, high maintenance requirements and widespread geographical distribution of surgical trainees. We established a cadaver-based neurosurgical laboratory based at the medical school of the University of New England in Armidale, Australia, which is used by the surgical dissection course for junior surgical trainees offered by the university. We reported our experiences in setting up a neurosurgical research laboratory, and explored the feasibility of establishing a cost-effective anatomical research facility in a rural setting in Australia. We found that Genelyn(TM)-fixed cadavers had limited movements of the head as required for adequate surgical positioning and exposure. Furthermore, we discovered that bodies embalmed via the femoral vein had poorly perfused heads after surgical exposure, and thus decapitation had to be performed unfortunately for our purpose. Cadaver samples and surgical equipment were sourced from various veterinary practices and commercial companies. Using human and animal cadavers, this laboratory provided trainees with hands-on opportunities to improve their surgical skills and neuroanatomical knowledge, as well as develop familiarity with highly specialized surgical equipment. We demonstrated the feasibility of establishing a cost-effective neurosurgical research laboratory in Australia and discussed various aspects of its maintenance.

14 CFR § 1250.104 - Assurances.

Code of Federal Regulations, 2014 CFR

2014-01-01

... for research, training, or educational programs. (1) In the case of application by an institution of... which involves participation by students, fellows or trainees, including but not limited to assistance for research, training, or the provision of facilities, the assurance required by this § 1250.104...

Emergency Medical Dispatch. National Standard Curriculum. Instructor Guide. Trainee Guide.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This guide contains all instructor materials and requirements for the National Highway Traffic Safety Administration (NHTSA), Emergency Medical Dispatch (EMD) National Standard Curriculum. It includes lesson plans, instructional aids, and tools and supporting information designed to elevate trained and experienced public safety telecommunicators…

42 CFR 86.13 - Project requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the applicant has established good cause for its omission. (1) Provision of a method for development... method for implementation of the needed training; (3) Provision of an evaluation methodology, including... the training program; and (4) Provision of a method by which trainees will be selected. (b) In...

42 CFR 86.13 - Project requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the applicant has established good cause for its omission. (1) Provision of a method for development... method for implementation of the needed training; (3) Provision of an evaluation methodology, including... the training program; and (4) Provision of a method by which trainees will be selected. (b) In...

42 CFR 86.13 - Project requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the applicant has established good cause for its omission. (1) Provision of a method for development... method for implementation of the needed training; (3) Provision of an evaluation methodology, including... the training program; and (4) Provision of a method by which trainees will be selected. (b) In...

42 CFR 86.13 - Project requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the applicant has established good cause for its omission. (1) Provision of a method for development... method for implementation of the needed training; (3) Provision of an evaluation methodology, including... the training program; and (4) Provision of a method by which trainees will be selected. (b) In...

Access to healthcare by psychiatrists, psychiatric trainees and overseas trained psychiatrists: findings from the RANZCP welfare study.

PubMed

Jenkins, Kym

2017-04-01

To understand the challenges faced by psychiatrists and psychiatry trainees in accessing healthcare. An online survey was distributed to all members (fellows, associates and affiliates) of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and a number of focus groups were held across Australia and New Zealand. A total of 1051 members responded to the survey and nine focus groups were held. Almost all respondents indicated they had a personal general practitioner. However, there were varying factors affecting access to healthcare and the ability to take leave when unwell. There are numerous barriers facing RANZCP members in looking after their own health. Addressing these barriers will require action at multiple points in the system.

Practical barriers to the implementation of early goal directed therapy in the UK: trainee skills and awareness.

PubMed

McNally, S J; MacKinnon, M; Hawkins, M

2009-08-01

The Surviving Sepsis Campaign (SSC) recommends Early Goal Directed Therapy (EGDT) in the treatment of septic shock, which requires key critical care skills and knowledge. This study evaluates the availability of these skills in Specialist Registrars in acute hospital specialities in the UK. A questionnaire was sent to Specialist Registrars in Anaesthetics, General Surgery and General Medicine throughout Scotland. One hundred and eighty five responses were obtained. One hundred percent of anaesthetists, 70% of surgeons and 51% of physicians were aware of EGDT Only 62 trainees (6% of surgeons, 79% of anaesthetists, 19% of physicians) had the full complement of skills and knowledge to implement EGDT. This study demonstrates that non-anaesthetic registrars in the UK lack both knowledge and skills required to provide EGDT. The main deficit was in awareness, demonstrating that knowledge of EGDT is not penetrating into specialities beyond anaesthesia. It is now time for the SSC to specifically target non-anaesthetic specialities.

A Qualitative Investigation of Trainees' Adjustment in Japan: A Case Study of Trainees from Indonesia

ERIC Educational Resources Information Center

Maemura, Naoka; Kato, Junzo; Fujihara, Takehiro

2009-01-01

In Japan, there is a residence status known as "the trainee". This is the status for residents who undertake "activities to learn and acquire the technology, skills, or knowledge at public or private organizations in Japan". With the introduction of the Industrial Training Program in 1993, trainees have been permitted to extend…

Australian Apprentices and Trainees, 1997: Apprentices and Trainees TAFE Courses. An Overview.

ERIC Educational Resources Information Center

National Centre for Vocational Education Research, Leabrook (Australia).

Records from the quarterly collection of data on Australia's apprentices and trainees were matched with the annual data from vocational education and training providers (VET). The results provide information on the courses and modules undertaken as part of off-the-job training of apprentices and trainees who had a contract of training with an…

Developing Skilled Doctor-Patient Communication in the Workplace: A Qualitative Study of the Experiences of Trainees and Clinical Supervisors

ERIC Educational Resources Information Center

Giroldi, Esther; Veldhuijzen, Wemke; Geelen, Kristel; Muris, Jean; Bareman, Frits; Bueving, Herman; van der Weijden, Trudy; van der Vleuten, Cees

2017-01-01

To inform the development of recommendations to facilitate learning of skilled doctor-patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees' learning in the workplace. We conducted a qualitative study in a…

Reasons for Non-Completion and Dissatisfaction among Apprentices and Trainees: A Regional Case Study

ERIC Educational Resources Information Center

Hart, Alison; Snell, Darryn

2008-01-01

Skills shortages have reinvigorated ongoing debate and concern about high attrition rates among Australian apprentices and trainees. Low apprentice and trainee wages have often been cited to explain this ongoing problem. This paper discusses the factors contributing to non-completion among apprentices and trainees in regional Victoria, and how the…

[Demography and training of residents in gynaecology and obstetrics: results of a national survey].

PubMed

Bendifallah, S; Hudry, D; Niangoh Timoh, K; Yaribakht, S; Boyon, C; Wafo, E

2012-01-01

To survey French trainees in obstetrics and gynaecology on the general demographic evolution and the quality of training. A questionnaire was sent to the 919 trainees in obstetrics and gynaecology during the academic year 2010-2011. Answer rate was 38.5%. Almost all trainees (99.4%) wish to have a two-year hospital position before applying for consultant or beginning a private practice; 60.4% of these trainees declare this option realistic. Trainees demography is marked by an increasing number of young doctors to train and a feminization. The need of a debate is crucial to assure quality of training after the recent increase in the number of residents and trainees reforms. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

How Trainees Would Disclose Medical Errors: Educational Implications for Training Programs

PubMed Central

White, Andrew A.; Bell, Sigall K.; Krauss, Melissa J; Garbutt, Jane; Dunagan, W. Claiborne; Fraser, Victoria J.; Levinson, Wendy; Larson, Eric B.; Gallagher, Thomas H.

2012-01-01

Background Disclosing harmful errors to patients is recommended, but appears to be uncommon. Understanding how trainees disclose errors and how those practices evolve during training could help educators design programs to address this gap. Purpose To determine how trainees would disclose medical errors. Methods A survey of 758 trainees (488 students and 270 residents) in internal medicine at two academic medical centers. Surveys depicted one of two harmful error scenarios that varied by how apparent the error would be to the patient. We measured attitudes and disclosure content using scripted responses. Results Trainees reported their intent to disclose the error as “definitely” (43%) “probably” (47%) “only if asked by patient” (9%), and “definitely not” (1%). Trainees were more likely to disclose obvious errors in comparison with ones patients were unlikely to recognize (55% vs. 30%, P<0.01). Respondents varied widely in what information they would disclose. Fifty percent of trainees chose statements explicitly stating an error occurred rather than only an adverse event. Regarding apologies, trainees were split between a general expression of regret (52%) and an explicit apology (46%). Respondents at higher levels of training were less likely to use explicit apologies (Trend P<0.01). Prior disclosure training was associated with increased willingness to disclose errors (OR 1.40, P=0.03). Conclusions Trainees may not be prepared to disclose medical errors to patients, and worrisome trends in trainee apology practices were observed across levels of training. Medical educators should intensify efforts to enhance trainees’ skills at meeting patients’ expectations for open disclosure of harmful medical errors. PMID:21401685

The Development of Scientific Communication Skills: A Qualitative Study of the Perceptions of Trainees and Their Mentors

PubMed Central

Cameron, Carrie; Collie, Candice L.; Baldwin, Constance D.; Bartholomew, L. Kay; Palmer, J. Lynn; Greer, Marilyn; Chang, Shine

2013-01-01

Purpose Scientific communication, both written and oral, is the cornerstone of success in biomedical research, yet formal instruction is rarely provided. Trainees with little exposure to Standard Academic English may find developing scientific communication skills challenging. In this exploratory, hypothesis-generating qualitative study, the authors examined the process by which mentored junior researchers learn scientific communication skills, their feelings about the challenges, and their mentor’s role in the process. Method In 2010, the authors conducted semi-structured focus groups and interviews to explore research trainees’ and faculty mentors’ perceptions and practices regarding scientific communication skills development, as part of the development phase of a larger quantitative study. The facilitator took detailed notes and verified their accuracy with participants during the sessions; a second member of the research team observed and verified the recorded notes. Three coders performed a thematic analysis, and the other authors reviewed it. Results Forty-three trainees and 50 mentors participated. Trainees and mentors had diverging views on the role of mentoring in fostering communication skills development. Trainees expressed varying levels of self-confidence but considerable angst. Mentors felt that most trainees have low self-confidence. Trainees expressed interest in learning scientific communication skills, but mentors reported that some trainees were insufficiently motivated and seemed resistant to guidance. Both groups agreed that trainees found mentors’ feedback difficult to accept. Conclusions The degree of distress, dissatisfaction, and lack of mutual understanding between mentors and trainees was striking. These themes have important implications for best practices and resource development. PMID:23969363

The Future LGBT Health Professional: Perspectives on Career and Personal Mentorship.

PubMed

Sánchez, Nelson F; Callahan, Edward; Brewster, Cheryl; Poll-Hunter, Norma; Sánchez, John Paul

2018-04-01

Mentorship is a critical factor contributing to career success. There is limited research on the quality of mentoring relationships for LGBT health professionals. This study explores facilitators of, obstacles to, and strategies for successful mentorship for LGBT health professional trainees. We applied a convenience sampling strategy to collect quantitative and qualitative data among LGBT health professional trainees. The authors identified trends in data using bivariate analyses and Consensual Qualitative Research methods. Seventy-five LGBT trainees completed surveys and a subset of 23 survey respondents also participated in three focus groups. Among survey participants, 100% identified along the queer spectrum; 10.7% identified along the trans spectrum; 36.0% identified as a racial or ethnic minority; and 61.3% were in MD/DO-granting programs. Eighty-eight percent of trainees reported working with at least one mentor and 48.5% of trainees had at least one mentor of the same sexual orientation. Seventy-two percent of trainees endorsed the importance of having an LGBT-identified mentor for personal development. Qualitative data showed that trainees valued such a mentor for positive role modeling and shared understanding of experiences. Fifty-nine percent of trainees felt it was important to have an LGBT-identified mentor for career development. LGBT peer networking and LGBT-related professional advice were cited as unique benefits in the qualitative findings. LGBT health professional trainees have unique personal and career development needs that may benefit from LGBT mentorship. Academic health centers that facilitate LGBT mentorship could enhance LGBT health trainees' academic productivity and personal development.

GP supervisors' experience in supporting self-regulated learning: a balancing act.

PubMed

Sagasser, Margaretha H; Kramer, Anneke W M; van Weel, Chris; van der Vleuten, Cees P M

2015-08-01

Self-regulated learning is essential for professional development and lifelong learning. As self-regulated learning has many inaccuracies, the need to support self-regulated learning has been recommended. Supervisors can provide such support. In a prior study trainees reported on the variation in received supervisor support. This study aims at exploring supervisors' perspectives. The aim is to explore how supervisors experience self-regulated learning of postgraduate general practitioners (GP) trainees and their role in this, and what helps and hinders them in supervising. In a qualitative study using a phenomenological approach, we interviewed 20 supervisors of first- and third-year postgraduate GP trainees. Supervisors recognised trainee activity in self-regulated learning and adapted their coaching style to trainee needs, occasionally causing conflicting emotions. Supervisors' beliefs regarding their role, trainees' role and the usefulness of educational interventions influenced their support. Supervisors experienced a relation between patient safety, self-regulated learning and trainee capability to learn. Supervisor training was helpful to exchange experience and obtain advice. Supervisors found colleagues helpful in sharing supervision tasks or in calibrating judgments of trainees. Busy practice occasionally hindered the supervisory process. In conclusion, supervisors adapt their coaching to trainees' self-regulated learning, sometimes causing conflicting emotions. Patient safety and entrustment are key aspects of the supervisory process. Supervisors' beliefs about their role and trainees' role influence their support. Supervisor training is important to increase awareness of these beliefs and the influence on their behaviour, and to improve the use of educational instruments. The results align with findings from other (medical) education, thereby illustrating its relevance.

Effects of Fatigue on Driving Safety: A Comparison of Brake Reaction Times in Night Float and Postcall Physicians in Training.

PubMed

Talusan, Paul G; Long, Theodore; Halim, Andrea; Guliani, Laura; Carroll, Nicole; Reach, John

2014-12-01

Concerns about duty hour and resident safety have fostered discussion about postshift fatigue and driving impairment. We assessed how converting to a night float schedule for overnight coverage affected driving safety for trainees. Brake reaction times were measured for internal medicine and orthopaedic surgery resident volunteers after a traditional 28-hour call shift and after a night float shift. We conducted matched paired t tests of preshift and postshift reaction time means. Participants also completed the Epworth Sleepiness Scale pre- and postshift. From June to July 2013, we enrolled 58 interns and residents (28 orthopaedic surgery, 30 internal medicine). We included 24 (41%) trainees on night float rotations and 34 (59%) trainees on traditional 28-hour call shifts. For all residents on night float rotations, there was no significant difference pre- and postshift. An increase in reaction times was noted among trainees on 28-hour call rotations. This included no effect on reaction times for internal medicine trainees pre- and postshift, and an increase in reaction times for orthopaedic trainees. For both night float and traditional call groups, there were significant increases in the Epworth Sleepiness Scale. Trainees on traditional 28-hour call rotations had significantly worse postshift brake reaction times, whereas trainees on night float rotations had no difference. Orthopaedic trainees had significant differences in brake reaction times after a traditional call shift.

Context factors in consultations of general practitioner trainees and their impact on communication assessment in the authentic setting.

PubMed

Essers, Geurt; van Dulmen, Sandra; van Es, Judy; van Weel, Chris; van der Vleuten, Cees; Kramer, Anneke

2013-12-01

Acquiring adequate communication skills is an essential part of general practice (GP) specialty training. In assessing trainee proficiency, the context in which trainees communicate is usually not taken into account. The present paper aims to explore what context factors can be found in regular GP trainee consultations and how these influence their communication performance. In a randomly selected sample of 44 videotaped, real-life GP trainee consultations, we searched for context factors previously identified in GP consultations and explored how trainee ratings change if context factors are taken into account. Trainee performance was rated twice using the MAAS-Global, first without and then with incorporating context factors. Item score differences were calculated using a paired samples t-test and effect sizes were computed. All previously identified context factors were again observed in GP trainee consultations. In communication assessment scores, we found a significant difference in 5 out of 13 MAAS-Global items, mostly in a positive direction. The effect size was moderate (0.57). GP trainee communication is influenced by contextual factors; they seem to adapt to context in a professional way. GP specialty training needs to focus on a context-specific application of communication skills. Communication raters need to be taught how to incorporate context factors into their assessments. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Fact or Infection: Do Surgical Trainees Know Enough About Infection Control?

PubMed Central

Brady, RRW; McDermott, C; Gibb, AP; Paterson-Brown, S

2008-01-01

INTRODUCTION There exists a high level of non-compliance with basic infection control measures by medical staff. One explanation may be a lack of familiarity with contemporary infection control guidelines. As surgical trainees represent a key group of stakeholders responsible for the delivery of recommended infection control practice, we assessed knowledge of infection control guidelines amongst current UK surgical trainees. MATERIALS AND METHODS Without warning, during the annual meeting of the UK Association of Surgeons in Training (ASiT), participating surgical trainees were asked to complete a questionnaire examining their basic knowledge of infection control and methicillin-resistant Staphylococcus aureus (MRSA) based on recently published guidelines. RESULTS A total of 52 trainees (13 higher surgical trainees [HSTs]; 39 basic surgical trainees [BSTs]) returned completed questionnaires in the study. BSTs demonstrated a higher level of knowledge of infection control, outperforming the HSTs in 7 out of 11 questions. Of surgical trainees, 61.5% were misinformed regarding the prevalence of MRSA blood-stream infections and 69% were unaware of policies for transfer of MRSA-positive patients. Analysis revealed areas of concern in regards to an adequate general level of knowledge of infection control in surgical trainees, particularly in some key areas. CONCLUSIONS To ensure patient safety and reduce hospital-acquired infections, it is vital that focused, co-ordinated programmes of education, in this rapidly changing field, are prioritised and formalised into surgical training, selection and assessment. PMID:18990279

Detecting, reporting, and analysis of priority diseases for routine public health surveillance in Liberia.

PubMed

Frimpong, Joseph Asamoah; Amo-Addae, Maame Pokuah; Adewuyi, Peter Adebayo; Hall, Casey Daniel; Park, Meeyoung Mattie; Nagbe, Thomas Knue

2017-01-01

Public health officials depend on timely, complete, and accurate surveillance data for decision making. The quality of data generated from surveillance is highly dependent on external and internal factors which may either impede or enhance surveillance activities. One way of identifying challenges affecting the quality of data generated is to conduct a data quality audit. This case study, based on an audit conducted by residents of the Liberia Frontline Field Epidemiology Training Program, was designed to be a classroom simulation of a data quality audit in a health facility. It is suited to enforce theoretical lectures in surveillance data quality and auditing. The target group is public health trainees, who should be able to complete this exercise in approximately 2 hours and 30 minutes.

The evolution of sports medicine in Singapore.

PubMed

Tan, Benedict

2013-10-01

Sports medicine is a relatively new subspecialty in Singapore. This commentary chronicles its evolution in Singapore from 1969, through various milestones, to the present day. The first sports medicine clinic in Singapore was established in 1971 at Farrer Park. Notable institutions that followed include the Sports Medicine and Research Centre (1973), Soldier Performance Centre, Changi Sports Medicine Centre (2003), Singapore Sports Medicine Centre (2006), and other multidisciplinary centres of restructured hospitals. Formal groundwork to establish sports medicine as a subspecialty began in 2005, with its first trainee commencing traineeship at the Changi Sports Medicine Centre in 2007, and culminated in the subspecialty register at the beginning of 2011. Also captured in this discussion are the broader scopes of sports medicine, including military sports medicine, the sports sciences, exercise medicine, and event medical coverage.

Virtual reality simulators: valuable surgical skills trainers or video games?

PubMed

Willis, Ross E; Gomez, Pedro Pablo; Ivatury, Srinivas J; Mitra, Hari S; Van Sickle, Kent R

2014-01-01

Virtual reality (VR) and physical model (PM) simulators differ in terms of whether the trainee is manipulating actual 3-dimensional objects (PM) or computer-generated 3-dimensional objects (VR). Much like video games (VG), VR simulators utilize computer-generated graphics. These differences may have profound effects on the utility of VR and PM training platforms. In this study, we aimed to determine whether a relationship exists between VR, PM, and VG platforms. VR and PM simulators for laparoscopic camera navigation ([LCN], experiment 1) and flexible endoscopy ([FE] experiment 2) were used in this study. In experiment 1, 20 laparoscopic novices played VG and performed 0° and 30° LCN exercises on VR and PM simulators. In experiment 2, 20 FE novices played VG and performed colonoscopy exercises on VR and PM simulators. In both experiments, VG performance was correlated with VR performance but not with PM performance. Performance on VR simulators did not correlate with performance on respective PM models. VR environments may be more like VG than previously thought. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Self-Esteem and Emotional Intelligence among B.Ed Trainees of Tsunami Affected Coastal Belt

ERIC Educational Resources Information Center

Babu M, Sameer

2008-01-01

Through this study the author investigates the relationship between self-esteem and emotional intelligence among B.Ed trainees of Tsunami affected coastal belt of Alappey district of Kerala, India. Stream of study, marital status and age based comparisons were made among the B.Ed trainees. 92 B.Ed trainees were the participants in the study. It…

Training Program for Cooperative Student Trainees in Professional Career Options; GS-Trainee-2 to Trainee GS-7.

ERIC Educational Resources Information Center

Coast Guard, Washington, DC. Office of Personnel.

The Student Trainee Work-Study Training and Promotion Plan is designed to furnish the Coast Guard with a long-range program for recruiting, developing, and retaining the best potential professional talent available. Students are selected for participation in the program on the basis of demonstrated scholastic ability and must maintain a relatively…

Primary Teacher Trainee Perspectives on a Male-Only Support Group: Moving Male Trainee Teachers beyond the "Freak Show"

ERIC Educational Resources Information Center

Warwick, Jane; Warwick, Paul; Hopper, Bev

2012-01-01

This paper reports the perspectives of male trainees on mechanisms instituted to support them during their Post-Graduate Certificate of Education in Early Years and Primary Education in England. The male trainees were interviewed towards the end of their training, using semi-structured interviews that provided scope for pursuing several lines of…

Assessment and modelling of general practice and community setting capacity for medical trainees in northern New Zealand.

PubMed

Goodyear-Smith, Felicity; Al-Murrani, Abbas

2017-09-22

To estimate the capacity of general practice to accommodate undergraduate and postgraduate medical trainees, and model efficient ways to utilise identified capacity and increase capacity. We conducted an online survey, with phone follow-up to non-responders, of all general practices in the northern half of New Zealand. The main outcome measures were current placements and future intentions for taking medical trainees; factors influencing decisions and possible incentives to take trainees. Sixty percent of existing practices take no medical trainees. On average, practices take trainees for 50% of available cycles per year. Postgraduate trainees displace undergraduate student placements due to space limitations. Only 1.9% practices demonstrate current capacity for full vertical training by taking all three types of trainee (undergraduate, PGY, registrar). Modelling on current use means 69 additional practices will be needed to be recruited by 2020. A number of strategies are presented aimed at increasing short-term undergraduate teaching practice capacity in New Zealand, but also relevant to Australia and elsewhere. In the long-term, establishment of the proposed School of Rural Health would enable integrated vertical teaching and address the GP training capacity issues.

The knowledge and attitudes of orthodontic trainees towards orthodontic therapists: a national survey.

PubMed

Patel, Sameer; Mack, Gavin

2017-09-01

To assess the knowledge and attitudes of orthodontic trainees towards orthodontic therapists (OTs) in the UK. Cross-sectional survey. UK-based orthodontic trainees. An electronic survey was sent to all members of the Training Grades Group of the British Orthodontic Society assessing exposure to OTs and their knowledge regarding current supervision guidelines and scope of practice. Attitudes towards OTs were also explored. Seventy-six responses (response rate 57%) were returned. Nearly 90% of trainees had no formal training regarding OTs. A total of 15.5% were aware of the correct current supervision guidelines and there was large variation in the knowledge of OTs' scope of practice. The majority of trainees were happy to supervise OTs, but only 22.4% felt prepared for this during training. In total, 63% of trainees felt that OTs could impact their own future job prospects. Currently, there is minimal formal training provided to trainees regarding the role of OTs. This is reflected in the lack of knowledge regarding supervision guidelines and scope of practice. Overall, trainees felt OTs were positive for the workforce but were concerned regarding the impact of their own future employment.

Changing patterns in endotracheal intubation for anaesthesia trainees: a retrospective analysis of 80,000 cases over 10 years.

PubMed

Smith, N A; Tandel, A; Morris, R W

2011-07-01

Several overseas studies have suggested that opportunities for anaesthesia trainees to learn and practise endotracheal intubation have decreased over time. We analysed the operating theatre data collection system at a large Australian metropolitan teaching hospital from 1998 to 2008 to determine if numbers for trainees' caseloads in general, and endotracheal intubation in particular had changed. The total caseload per trainee of approximately 800 cases per year was stable throughout the study period. The number of gastrointestinal endoscopies per trainee increased significantly with a corresponding decrease in the number of other cases. The mean number of endotracheal intubations per trainee per year fell by 10% and of supraglottic devices by 16%, neither of which was statistically significant. Endotracheal intubation for caesarean sections did however fall significantly from an average of nine to an average of six cases per trainee per year. Our findings contrast with other reports of much larger decreases in the number of endotracheal intubations performed by trainees over the last decade, but suggest that our local practice is similar to the international experience of decreasing opportunities for endotracheal intubation in obstetric anaesthesia.

Storekeeper 1 and C: Rate Training Manual. Revised.

ERIC Educational Resources Information Center

Naval Education and Training Command, Pensacola, FL.

The training manual is designed to help the trainee meet the occupational qualifications for performance of duties and for advancement to Storekeeper First Class (SKI) and Chief Storekeeper (SKC). Chapter one provides introductory information (requirements for advancement, sources of information, billets, customer relations, and rewards and…

Ghanaian Teacher Trainees' Conceptual Understanding of Stoichiometry

ERIC Educational Resources Information Center

Hanson, Ruby

2015-01-01

Chemical stoichiometry is a conceptual framework that encompasses other concepts such as the mole, writing of chemical equations in word and representative form, balancing of equations and the equilibrium concept. The underlying concepts enable students to understand relationships among entities of matter and required amounts for use when…

Ghanaian Teacher Trainees' Conceptual Understanding of Stoichiometry

ERIC Educational Resources Information Center

Hanson, Ruby

2016-01-01

Chemical stoichiometry is a conceptual framework that encompasses other concepts such as the mole, writing of chemical equations in word and representative form, balancing of equations and the equilibrium concept. The underlying concepts enable students to understand relationships among entities of matter and required amounts for use when…

An analysis of the delivery of anaesthetic training sessions in the United Kingdom.

PubMed

Green, A; Tatham, K C; Yentis, S M; Wilson, J; Cox, M

2017-11-01

We analysed data from the electronic rota system CLWRota, covering 2,689,962 anaesthetic sessions between 01/01/2014 and 31/12/2015, in 91 UK Trusts, in order to investigate trainees' supervision. There were 8209 trainee attachments analysed, during which 618,695 sessions were undertaken by trainees. The number of supervised sessions per week that trainees worked varied considerably (median (IQR [range]) 2.6 (1.6-3.6 [0-10]) for all grades combined), with senior trainees more likely than junior trainees to be supervised for fewer than the three sessions per week mandated by the Royal College of Anaesthetists. The number of supervised sessions was unrelated to Trusts' size, suggesting that trainees in smaller hospitals receive the same level of supervision as in larger teaching hospitals. Analysis of a dataset of this size should be a good reflection of the delivery of anaesthesia training in the UK. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

An exploratory study of death anxiety and trainees' choice of theoretical orientation.

PubMed

Belviso, Francesco; Gaubatz, Michael D

2013-01-01

This study investigated the association between therapist trainees' death anxiety and their preference for "objective" (i.e., quantitative and rational) over "subjective" (i.e., experiential and symbolic) theoretical orientations. In this correlational investigation, 303 clinical psychology and counseling trainees at a Midwestern school of professional psychology completed instruments assessing their fear of personal death and their endorsement of superordinate dimensions of psychotherapy orientations. As hypothesized, trainees who reported higher levels of death anxiety displayed a stronger preference for objective over subjective orientations, a relationship that was found in post hoc analyses to be particularly salient for male trainees. These findings suggest that trainees' death anxiety, and their attempts to control it, could influence their choice of a theoretical orientation. Potential implications for training institutions are discussed.

An exploratory study of death anxiety and trainees' choice of theoretical orientation.

PubMed

Belviso, Francesco; Gaubatz, Michael D

This study investigated the association between therapist-trainees' death anxiety and their preference for "objective" (i.e., quantitative and rational) over "subjective" (i.e., experiential and symbolic) theoretical orientations. In this correlational investigation, 303 clinical psychology and counseling trainees at a Midwestern school of professional psychology completed instruments assessing their fear of personal death and their endorsement of superordinate dimensions of psychotherapy orientations. As hypothesized, trainees who reported higher levels of death anxiety displayed a stronger preference for objective over subjective orientations, a relationship that was found in post-hoc analyses to be particularly salient for male trainees. These findings suggest that trainees' death anxiety, and their attempts to control it, could influence their choice of a theoretical orientation. Potential implications for training institutions are discussed.

A comparison of work stressors in higher and lower resourced emergency medicine health settings.

PubMed

de Haan, Sebastian; Lamprecht, Hein; Howlett, Michael K; Fraser, Jacqueline; Sohi, Dylan; Adisesh, Anil; Atkinson, Paul R

2018-04-06

CLINICIAN'S CAPSULE What is known about the topic? Emergency physicians and trainees have high rates of stress and burnout. What did this study ask? How do reported stressors for emergency physicians and trainees differ between high and low resource settings? What did this study find? Trainees in the low resource setting reported higher stressors. Trainees reported higher levels of stressors than specialists in general. Why does this study matter to clinicians? High levels of reported stressors among trainees, and in low resource settings should be acknowledged and mitigated where possible.

[Verbundweiterbildung(plus) Baden-Württemberg: Development of educational meetings and implications for the implementation of family medicine training programmes in Germany].

PubMed

Flum, Elisabeth; Magez, Julia; Aluttis, Frank; Hoffmann, Mariell; Joos, Stefanie; Ledig, Thomas; Oeljeklaus, Lydia; Simon, Monica; Szecsenyi, Joachim; Steinhäuser, Jost

2016-01-01

The German Society of General Practice and Family Medicine (DEGAM) has defined educational seminars during post-graduate training as a core element to improve trainees' specific knowledge and competencies. Furthermore, these seminars facilitate networking among trainees and support the process of identity formation in family medicine. Since its implementation in 2009, the Verbundweiterbildung(plus) Baden-Württemberg (VWB(plus) Ba-Wü) has offered educational seminars. Aim of this article is to analyse the content of these educational seminars and to derive implications for other family medicine training programmes in Germany. From 2009 to 2015, the data from all educational seminars was descriptively analysed. Furthermore, two researchers categorised the seminar contents independently of each other and assigned them to the competence-based curriculum for family medicine training (Kompetenzbasiertes Curriculum Allgemeinmedizin, KCA). Until 2015, 600 trainees participated in a starter seminar of the VWB(plus) Ba-Wü. In total, 1,116 teaching units and 160 different seminars covered all relevant topics of the KCA. A restructuring of organisational processes and seminars was necessary to handle the increase in the number of participants, including the development of specific software for electronic support. Of all these seminars, 56% were held by specialists or trainees in family medicine. The participating trainees rated the educational seminars in general and the possibility for networking as (very) good. The contents of the educational seminars included in family medicine training programs will have to be specifically based on family medicine and cover all relevant aspects of the KCA - medical expertise, competencies and procedures. In order to ensure a common standard concerning didactic methods and qualifications of teachers, a didactic guideline is to be developed. The increasing demand of family medicine training programmes requires (further) development of the software eSchoolab, including integration of the KCA. Copyright © 2016. Published by Elsevier GmbH.

Expert-led didactic versus self-directed audiovisual training of confocal laser endomicroscopy in evaluation of mucosal barrier defects.

PubMed

Huynh, Roy; Ip, Matthew; Chang, Jeff; Haifer, Craig; Leong, Rupert W

2018-01-01

 Confocal laser endomicroscopy (CLE) allows mucosal barrier defects along the intestinal epithelium to be visualized in vivo during endoscopy. Training in CLE interpretation can be achieved didactically or through self-directed learning. This study aimed to compare the effectiveness of expert-led didactic with self-directed audiovisual teaching for training inexperienced analysts on how to recognize mucosal barrier defects on endoscope-based CLE (eCLE).  This randomized controlled study involved trainee analysts who were taught how to recognize mucosal barrier defects on eCLE either didactically or through an audiovisual clip. After being trained, they evaluated 6 sets of 30 images. Image evaluation required the trainees to determine whether specific features of barrier dysfunction were present or not. Trainees in the didactic group engaged in peer discussion and received feedback after each set while this did not happen in the self-directed group. Accuracy, sensitivity, and specificity of both groups were compared. Trainees in the didactic group achieved a higher overall accuracy (87.5 % vs 85.0 %, P  = 0.002) and sensitivity (84.5 % vs 80.4 %, P  = 0.002) compared to trainees in the self-directed group. Interobserver agreement was higher in the didactic group (k = 0.686, 95 % CI 0.680 - 0.691, P  < 0.001) than in the self-directed group (k = 0.566, 95 % CI 0.559 - 0.573, P  < 0.001). Confidence (OR 6.48, 95 % CI 5.35 - 7.84, P  < 0.001) and good image quality (OR 2.58, 95 % CI 2.17 - 2.82, P  < 0.001) were positive predictors of accuracy.  Expert-led didactic training is more effective than self-directed audiovisual training for teaching inexperienced analysts how to recognize mucosal barrier defects on eCLE.

The benefits of working abroad for British General Practice trainee doctors: the London deanery out of programme experience in South Africa.

PubMed

Reardon, Candice; George, Gavin; Enigbokan, Oluwatobi

2015-10-14

The value of international health experience for doctors from developed nations is well recognised. Provisions have been made for medical staff in the United Kingdom to embark on work experiences abroad during their careers in the National Health Service. The London Deanery and Africa Health Placements provide an Out of Programme Experience for British General Practice trainee doctors wanting to work for a year in rural hospitals in South Africa. A qualitative study was conducted among fifteen British General Practice trainees who participated in the programme. The research aim was to understand the perceived benefit and value of their experience and their opinions about the structure of the programme. The data was analysed using thematic analysis. Their experience provided an accelerated year of learning and development that contributed to their professional and personal development. In addition to their general development, their improved ability to work in resource limited settings, enhancement of soft skills, a greater appreciation for the National Health Service and a better understanding of working within foreign health care systems were important gains. The timing of the experience, the security of re-employment on their return, assistance with administrative requirements of destination countries and the opportunity to gain varied, hands-on experience were highly valued components of the Out of Programme Experience. The value and benefits derived from the doctors' experience in South Africa are discussed in relation to another evaluation of the Out of Programme Experience, as well as issues of transferability of skills and competencies and future impacts on career decisions. This study provides evidence to suggest programmes such as the OOPE have the potential to create substantial benefits for trainee doctors, both in terms of their medical skills and competencies and through the development of softer skills. This programme, through the supply of scarce skills, further benefits the host country and specifically the health facilities and communities served by these trainee doctors.

Adapting operational research training to the Rwandan context: the Intermediate Operational Research Training programme

PubMed Central

Odhiambo, Jackline; Amoroso, Cheryl L.; Barebwanuwe, Peter; Warugaba, Christine; Hedt-Gauthier, Bethany L.

2017-01-01

ABSTRACT Background: Promoting national health research agendas in low- and middle-income countries (LMICs) requires adequate numbers of individuals with skills to initiate and conduct research. Recently, non-governmental organizations (NGOs) have joined research capacity building efforts to increase research leadership by LMIC nationals. Partners In Health, an international NGO operating in Rwanda, implemented its first Intermediate Operational Research Training (IORT) course to cultivate Rwandan research talent and generate evidence to improve health care delivery. Objective: This paper describes the implementation of IORT to share experiences with other organizations interested in developing similar training programmes. Methods: The Intermediate Operational Research Training utilized a deliverable-driven training model, using learning-by-doing pedagogy with intensive hands-on mentorship to build research skills from protocol development to scientific publication. The course had short (two-day) but frequent training sessions (seven sessions over eight months). Trainees were clinical and programme staff working at the district level who were paired to jointly lead a research project. Results: Of 10 trainees admitted to the course from a pool of 24 applicants, nine trainees completed the course with five research projects published in peer-reviewed journals. Strengths of the course included supportive national and institutional research capacity guidelines, building from a successful training model, and trainee commitment. Challenges included delays in ethical review, high mentorship workload of up to 250 hours of practicum mentorship, lack of access to literature in subscription journals and high costs of open access publication. Conclusions: The IORT course was an effective way to support the district-based government and NGO staff in gaining research skills, as well as answering research questions relevant to health service delivery at district hospitals. Other NGOs should build on successful programmes while adapting course elements to address context-specific challenges. Mentorship for LMIC trainees is critical for effectiveness of research capacity building initiatives. PMID:29119872

Adapting operational research training to the Rwandan context: the Intermediate Operational Research Training programme.

PubMed

Odhiambo, Jackline; Amoroso, Cheryl L; Barebwanuwe, Peter; Warugaba, Christine; Hedt-Gauthier, Bethany L

2017-01-01

Promoting national health research agendas in low- and middle-income countries (LMICs) requires adequate numbers of individuals with skills to initiate and conduct research. Recently, non-governmental organizations (NGOs) have joined research capacity building efforts to increase research leadership by LMIC nationals. Partners In Health, an international NGO operating in Rwanda, implemented its first Intermediate Operational Research Training (IORT) course to cultivate Rwandan research talent and generate evidence to improve health care delivery. This paper describes the implementation of IORT to share experiences with other organizations interested in developing similar training programmes. The Intermediate Operational Research Training utilized a deliverable-driven training model, using learning-by-doing pedagogy with intensive hands-on mentorship to build research skills from protocol development to scientific publication. The course had short (two-day) but frequent training sessions (seven sessions over eight months). Trainees were clinical and programme staff working at the district level who were paired to jointly lead a research project. Of 10 trainees admitted to the course from a pool of 24 applicants, nine trainees completed the course with five research projects published in peer-reviewed journals. Strengths of the course included supportive national and institutional research capacity guidelines, building from a successful training model, and trainee commitment. Challenges included delays in ethical review, high mentorship workload of up to 250 hours of practicum mentorship, lack of access to literature in subscription journals and high costs of open access publication. The IORT course was an effective way to support the district-based government and NGO staff in gaining research skills, as well as answering research questions relevant to health service delivery at district hospitals. Other NGOs should build on successful programmes while adapting course elements to address context-specific challenges. Mentorship for LMIC trainees is critical for effectiveness of research capacity building initiatives.

Biosafety Level 3 Recon Training

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dickens, Brian Scott; Chavez, Melanie Ann; Heimer, Donovan J.

The Biosafety Level 3 Recon training is a 3D virtual tool developed for the Counter WMD Analysis Cell (CWAC) and the Asymmetric Warfare Group (AWG) by the Application Modeling and Development Team within the NEN-3 International Threat Reduction Group. The training simulates a situation where friendly forces have secured from hostile forces a suspected bioweapons development laboratory. The trainee is a squad member tasked to investigate the facility, locate laboratories within the facility, and identify hazards to entrants and the surrounding area. Before beginning the 3D simulation, the trainee must select the appropriate MOPP level for entering the facility. Themore » items in the simulation, including inside and outside the bioweapon facility, are items that are commonly used by scientists in Biosafety Level (BSL) laboratories. Each item has clickable red tags that, when activated, give the trainee a brief description of the item and a controllable turn-around view. The descriptions also contain information about potential hazards the item can present. Trainees must find all tagged items in order to complete the simulation, but can also reference descriptions and turn-around view of the items in a glossary menu. Training is intended to familiarize individuals whom have little or no biology or chemistry background with technical equipment used in BSL laboratories. The revised edition of this simulation (Biosafety Level 3 Virtual Lab) changes the trainee into a investigator instead of a military combatant. Many doors now require a virtual badge swipe to open. Airlock doors may come in sets such that the open door must be closed before the next door in the set can be opened. A user interface was added so that the instructor can edit the information about the items (the brief descriptions mentioned above) using the simulation software instead of the previous method of manually entering the material in xml settings files. Facility labels, such as "No Parking" and "Men's room", were changed from Korean, into English. No other changes were made.« less

Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum.

PubMed

Ayodeji, I D; Schijven, M; Jakimowicz, J; Greve, J W

2007-09-01

The goal of our study was to determine expert and referent face validity of the LAP Mentor, the first procedural virtual reality (VR) laparoscopy trainer. In The Netherlands 49 surgeons and surgical trainees were given a hands-on introduction to the Simbionix LAP Mentor training module. Subsequently, a standardized five-point Likert-scale questionnaire was administered. Respondents who had performed over 50 laparoscopic procedures were classified as "experts." The others constituted the "referent" group, representing nonexperts such as surgical trainees. Of the experts, 90.5% (n = 21) judge themselves to be average or above-average laparoscopic surgeons, while 88.5% of referents (n = 28) feel themselves to be less-than-average laparoscopic surgeons (p = 0.000). There is agreement between both groups on all items concerning the simulator's performance and application. Respondents feel strongly about the necessity for training on basic skills before operating on patients and unanimously agree on the importance of procedural training. A large number (87.8%) of respondents expect the LAP Mentor to enhance a trainee's laparoscopic capability, 83.7% expect a shorter laparoscopic learning curve, and 67.3% even predict reduced complication rates in laparoscopic cholecystectomies among novice surgeons. The preferred stage for implementing the VR training module is during the surgeon's residency, and 59.2% of respondents feel the surgical curriculum is incomplete without VR training. Both potential surgical trainees and trainers stress the need for VR training in the surgical curriculum. Both groups believe the LAP Mentor to be a realistic VR module, with a powerful potential for training and monitoring basic laparoscopic skills as well as full laparoscopic procedures. Simulator training is perceived to be both informative and entertaining, and enthusiasm among future trainers and trainees is to be expected. Further validation of the system is required to determine whether the performance results agree with these favorable expectations.

A Call for New Communication Channels for Gynecological Oncology Trainees: A Survey on Social Media Use and Educational Needs by the European Network of Young Gynecological Oncologists.

PubMed

Zalewski, Kamil; Lindemann, Kristina; Halaska, Michael J; Zapardiel, Ignacio; Laky, Rene; Chereau, Elisabeth; Lindquist, David; Polterauer, Stephan; Sukhin, Vladislav; Dursun, Polat

2017-03-01

The aim of the study was to assess patterns in the use of social media (SM) platforms and to identify the training needs among European gynecologic oncology trainees. In 2014, a web-based survey was sent to 633 trainees from the European Network of Young Gynaecological Oncologists (ENYGO) database. The 14-item questionnaire (partially using a 1- to 5-point Likert scale) assessed respondents' use of SM and preference for workshop content and organization. Descriptive analysis was used to describe the mean scores reported for different items, and the internal reliability of the questionnaire was assessed by Cronbach α. In total, 170 ENYGO members (27%) responded to the survey. Of those, 91% said that they use SM platforms, mostly for private purposes. Twenty-three percent used SM professionally and 43% indicated that they would consider SM to be a clinical discussion forum. The respondents said that they would like updates on conferences and professional activities to be shared on SM platforms. Complication management, surgical anatomy, and state of the art in gynecologic oncology were identified as preferred workshops topics. The most frequently indicated hands-on workshops were laparoscopic techniques and surgical anatomy. Consultants attached a higher level of importance to palliative care education and communication training than trainees. The mean duration of the workshop preferred was 2 days. This report highlights the significance of ENYGO trainees' attachment to SM platforms. Most respondents expect ENYGO to use these online channels for promoting educational activities and other updates. Using SM for clinical discussion will require specific guidelines to secure professional and also consumer integrity. This survey confirms surgical management and the state of the art as important knowledge gaps, and ENYGO has tailored its activities according to these results. Future activities will further direct attention and resources to education in palliative care and molecular tumor biology.

Targeted Feedback in the Milestones Era: Utilization of the Ask-Tell-Ask Feedback Model to Promote Reflection and Self-Assessment.

PubMed

French, Judith C; Colbert, Colleen Y; Pien, Lily C; Dannefer, Elaine F; Taylor, Christine A

2015-01-01

The Accreditation Council for Graduate Medical Education's Milestones Project focuses trainee education on the formation of valued behaviors and skills believed to be necessary for trainees to become independent practitioners. The development and refinement of behaviors and skills outlined within the milestones will require learners to monitor, reflect, and assess their own performance over time. External feedback provides an opportunity for learners to recalibrate their self-assessments, thereby enabling them to develop better self-monitoring and self-assessment skills. Yet, feedback to trainees is frequently generic, such as "great job," "nice work," or "you need to read more." In this article, we describe a feedback model that faculty can use to provide specific feedback, while increasing accountability for learners. We offer practical examples of its use in a variety of settings in the milestone era. The Ask-Tell-Ask (ATA) patient communication skills strategy, which was adapted for use as a trainee feedback model 10 years ago at our institution, is a learner-centered approach for reinforcing and modifying behaviors. The model is efficient, promotes learner accountability, and helps trainees develop reflection and self-assessment skills. A feedback agreement further enhances ATA by establishing a shared understanding of goals for the educational encounter. The ATA feedback model, combined with a feedback agreement, encourages learners to self-identify strengths and areas for improvement, before receiving feedback. Personal monitoring, reflection, self-assessment, and increased accountability make ATA an ideal learner-centered feedback model for the milestones era, which focuses on performance improvement over time. We believe the introduction of the ATA feedback model in surgical training programs is a step in the right direction towards meaningful programmatic culture change. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

An Analysis of Future Publications, Career Choices, and Practice Characteristics of Research Presenters at an American College of Surgeons State Conference: A 15-Year Review.

PubMed

Ahmad, Humera F; Jarman, Benjamin T; Kallies, Kara J; Shapiro, Stephen B

The Accreditation Council for Graduate Medical Education requires scholarly activity within general surgery residency programs. The association between in-training research presentations and postgraduation publications is unknown. We hypothesized that surgical trainee presentations at an American College of Surgeons (ACS) state chapter meeting resulted in peer-reviewed publications and future scholarly activity. The ACS Wisconsin state chapter meeting agendas from 2000 to 2014 were reviewed to identify all trainees who delivered podium presentations. A literature search was completed for subsequent publications. Program coordinators were queried and an electronic search was performed to determine practice location and type for each residency graduate. Wisconsin state chapter ACS meeting. General surgery residents, fellows, and medical students in Wisconsin. There were 288 podium presentations by trainees (76% residents, 20% medical students, and 4% fellows). Presentations were clinical (79.5%) and basic science (20.5%). There were 204 unique presenters; 25% presented at subsequent meetings. Of these unique presenters, 46% published their research and 31% published additional research after residency. Among presenters who completed residency or fellowship (N = 119), 34% practiced in a university setting, and 61% practiced in a community setting; 31% practiced in Wisconsin. When comparing clinical vs basic science presenters, there was no difference in fellowship completion (37% vs 44%; p = 0.190) or practice type (38% vs 46% in a university setting; p = 0.397). Repeat presenters were more likely to pursue a fellowship vs those presenting once (76% vs 37%; p = 0.001). Research presentations by surgical trainees at an ACS state chapter meeting frequently led to peer-reviewed publications. Presenters were likely to pursue research opportunities after residency. Repeat presenters were more likely to pursue a fellowship. ACS Wisconsin chapter meetings provide an excellent opportunity for scholarly activity. These outcomes should encourage ACS chapters and ACS members to support trainee research. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Advancing non-directive pregnancy options counseling skills: A pilot Study on the use of blended learning with an online module and simulation.

PubMed

Lupi, Carla; Ward-Peterson, Melissa; Chang, Winnie

2016-10-01

Limitations on didactic time pose barriers to teaching non-directive pregnancy options counseling. This study set out to explore the use of an online module to support trainee performance in a pregnancy options counseling standardized-patient exercise implemented among third-year medical students, and to examine the effect of clinical experience on student performance. An online module was developed. A convenience sample of forty-six student performances in a family medicine clerkship participated in a standardized patient exercise. Trained faculty rated performances. Students completed a self-assessment and provided feedback on the online module. Chi-square and Mann-Whitney-U tests were used to analyze data. Three coders qualitatively examined narrative student comments. Thirty-four students passed, 11 achieved a minimal pass, and one failed. The mean global rating from faculty was 2.8 (pass). Students with prior clinical experience significantly outperformed those without on the global rating scale with mean scores of 3.1 compared to 2.7, respectively (p=.044). All students agreed that the online module helped prepare them for the exercise. Qualitative analysis of students' feedback on the module revealed strengths in content and pedagogy. In their self-assessments, all but two students referred to content explicitly conveyed in the module. All students agreed that an online module supported their performance of non-directive pregnancy options counseling skills. Prior clinical experience was associated with improved performance. This module, along with the simulated exercise, can be implemented as a blended learning exercise without additional faculty teaching effort in standardized patient resource centers. Students agreed that an online module facilitates simulated performance of non-directive pregnancy options counseling skills. Future work should compare the impact of this approach to others, and explore the additional training needed to maintain and build on initial learning. Copyright © 2016 Elsevier Inc. All rights reserved.

Differences in residents' self-reported confidence and case experience between two post-graduate rotation curricula: results of a nationwide survey in Japan.

PubMed

Ohde, Sachiko; Deshpande, Gautam A; Takahashi, Osamu; Fukui, Tsuguya

2014-07-12

In Japan, all trainee physicians must begin clinical practice in a standardized, mandatory junior residency program, which encompasses the first two years of post-graduate medical training (PGY1 - PGY2). Implemented in 2004 to foster primary care skills, the comprehensive rotation program (CRP) requires junior residents to spend 14 months rotating through a comprehensive array of clinical departments including internal medicine, surgery, anesthesiology, obstetrics-gynecology (OBGYN), pediatrics, psychiatry, and rural medicine. In 2010, Japan's health ministry relaxed this curricular requirement, allowing training programs to offer a limited rotation program (LRP), in which core departments constitute 10 months of training, with electives geared towards residents' choice of career specialty comprising the remaining 14 months. The effectiveness of primary care skill acquisition during early training warrants evaluation. This study assesses self-reported confidence with clinical competencies, as well as case experience, between residents in CRP versus LRP curricula. A nation-wide cross-sectional study of all PGY2 physicians in Japan was conducted in March 2011. Primary outcomes were self-report confidence for 98 clinical competency items, and number of cases experienced for 85 common diseases. We compared confidence scores and case experience between residents in CRP and LRP programs, adjusting for parameters relevant to training. Among 7506 PGY2 residents, 5052 replied to the survey (67.3%). Of 98 clinical competency items, CRP residents reported higher confidence in 12 items compared to those in an LRP curriculum, 10 of which remained significantly higher after adjustment. CRP trainees reported lower confidence scores in none of the items. Out of 85 diseases, LRP residents reported less experience with 11 diseases. CRP trainees reported lower case experience with one disease, though this did not remain significant on adjusted analysis. Confidence and case experience with OBGYN- and pediatrics-related items were particularly low among LRP trainees. Residents in the specialty-oriented LRP curriculum showed less confidence and less case experience compared to peers training in the broader CRP residency curriculum. In order to foster competence in independent primary care practice, junior residency programs requiring experience in a breadth of core departments should continue to be mandated to ensure adequate primary care skills.

Information for New Trainees and Fellows

Cancer.gov

Fellows and cancer research trainees will find information to support their onboarding at NCI, including stipend and tax information and NIH rules and regulations. Learn more about orientation for NCI trainees.

Planning for Crew Exercise for Future Deep Space Mission Scenarios

NASA Technical Reports Server (NTRS)

Moore, Cherice; Ryder, Jeff

2015-01-01

Providing the necessary exercise capability to protect crew health for deep space missions will bring new sets of engineering and research challenges. Exercise has been found to be a necessary mitigation for maintaining crew health on-orbit and preparing the crew for return to earth's gravity. Health and exercise data from Apollo, Space Lab, Shuttle, and International Space Station missions have provided insight into crew deconditioning and the types of activities that can minimize the impacts of microgravity on the physiological systems. The hardware systems required to implement exercise can be challenging to incorporate into spaceflight vehicles. Exercise system design requires encompassing the hardware required to provide mission specific anthropometrical movement ranges, desired loads, and frequencies of desired movements as well as the supporting control and monitoring systems, crew and vehicle interfaces, and vibration isolation and stabilization subsystems. The number of crew and operational constraints also contribute to defining the what exercise systems will be needed. All of these features require flight vehicle mass and volume integrated with multiple vehicle systems. The International Space Station exercise hardware requires over 1,800 kg of equipment and over 24 m3 of volume for hardware and crew operational space. Improvements towards providing equivalent or better capabilities with a smaller vehicle impact will facilitate future deep space missions. Deep space missions will require more understanding of the physiological responses to microgravity, understanding appropriate mitigations, designing the exercise systems to provide needed mitigations, and integrating effectively into vehicle design with a focus to support planned mission scenarios. Recognizing and addressing the constraints and challenges can facilitate improved vehicle design and exercise system incorporation.

Breast Cancer Research Training Grant.

DTIC Science & Technology

1996-10-01

review the Program and its requirements and opportunities, and to answer questions and plan each student’s curriculum. Trainees are encouraged to...course requirements and plans to take the qualifying exmaination in summer, 1997. Yvette is an African- American. Laurie Hafer (BS, Microbiology...breast cancer research and plans to work with Dr. Fenton in studies of macrophage function. She was a co-author on Laurie Hafer’s poster at the AACR

Strengthening the career development of clinical translational scientist trainees: a consensus statement of the Clinical Translational Science Award (CTSA) Research Education and Career Development Committees.

PubMed

Meyers, Frederick J; Begg, Melissa D; Fleming, Michael; Merchant, Carol

2012-04-01

The challenges for scholars committed to successful careers in clinical and translational science are increasingly well recognized. The Education and Career Development (EdCD) of the national Clinical and Translational Science Award consortium gathered thought leaders to propose sustainable solutions and an agenda for future studies that would strengthen the infrastructure across the spectrum of pre- and postdoctoral, MD and PhD, scholars. Six consensus statements were prepared that include: (1) the requirement for career development of a qualitatively different investigator; (2) the implications of interdisciplinary science for career advancement including institutional promotion and tenure actions that were developed for discipline-specific accomplishments; (3) the need for long-term commitment of institutions to scholars; (4) discipline-specific curricula are still required but curricula designed to promote team work and interdisciplinary training will promote innovation; (5) PhD trainees have many pathways to career satisfaction and success; and (6) a centralized infrastructure to enhance and reward mentoring is required. Several themes cut across all of the recommendations including team science, innovation, and sustained institutional commitment. Implied themes include an effective and diverse job force and the requirement for a well-crafted public policy that supports continued investments in science education. © 2012 Wiley Periodicals, Inc.

Improvements in primary care skills and knowledge with a vocational training program - a pre-post survey.

PubMed

Djalali, Sima; Tandjung, Ryan; Rosemann, Thomas; Markun, Stefan

2017-01-01

Facing the upcoming shortage of primary care physicians (PCPs), medical and governmental organizations have recently made major investments to foster vocational training programs in Switzerland, designed to provide context-specific training for trainees in primary care practices. Less is known about the impact of these programs on the skills and specific knowledge of trainees. We aimed to evaluate the Cantonal program for vocational primary care training in the Canton of Zurich, Switzerland's largest Canton. We undertook a pretest-posttest study and surveyed physicians before and after participating in the Cantonal program for vocational primary care training in the Swiss Canton of Zurich. All trainees who participated in the program from 2013 until the end of 2015 were eligible. Primary outcome was the proportion of trainees being confident about their professional, organizational, examination and management skills before and after completing vocational training. Secondary outcomes were the proportion of trainees stating knowledge gain in entrepreneurship and the proportion of trainees being motivated to pursue a career as PCP. Data of 47 trainees participating in the vocational training between 2013 and 2015 were eligible. In total, 35 (74.5%) participated in the T1 survey and 34 (72.3%) in the T2 survey. At T2, significantly more trainees (T1: 11%-89%, T2: 79%-100%) stated to be at least "slightly confident" about their skills ( p <0.05 for each individual skill). Knowledge gain in entrepreneurship was highly expected and experienced by the trainees (55%-77% of respondents) in case of medicine-specific contents, but hardly expected in case of general business contents (≤47% of respondents). Concerning trainees' motivation to pursue a career as PCP, we observed only a minimal, statistically insignificant change, suggesting that the vocational training did not alter trainees' preconceived career plans as PCP. Given the measured increase in confidence, evaluation of training programs should focus on operationalizing key skills of PCPs. Given the lack of change in trainees' motivation; however, statements about the effect of program implementation on national shortage of PCPs cannot be made.

Are Surgeons Born or Made? A Comparison of Personality Traits and Learning Styles Between Surgical Trainees and Medical Students.

PubMed

Preece, Ryan A; Cope, Alexandra C

2016-01-01

Medical students and surgical trainees differ considerably in both their preferential learning styles and personality traits. This study compares the personality profiles and learning styles of surgical trainees with a cohort of medical students specifically intent on pursuing a surgical career. A cross-sectional study was conducted contrasting surgical trainees with medical students specifying surgical career intent. The 50-item International Personality Item Pool Big-Five Factor Marker (FFM) questionnaire was used to score 5 personality domains (extraversion, conscientiousness, agreeableness, openness to experience, and neuroticism). The 24-item Learning Style Inventory (LSI) Questionnaire was used to determine the preferential learning styles (visual, auditory, or tactile). χ(2) Analysis and independent samples t-test were used to compare LSI and FFM scores, respectively. Surgical trainees from several UK surgical centers were contrasted to undergraduate medical students. A total of 53 medical students who had specifically declared desire to pursue a surgical career and were currently undertaking an undergraduate intercalated degree in surgical sciences were included and contrasted to 37 UK core surgical trainees (postgraduate years 3-4). The LSI questionnaire was completed by 53 students and 37 trainees. FFM questionnaire was completed by 29 medical students and 34 trainees. No significant difference for learning styles preference was detected between the 2 groups (p = 0.139), with the visual modality being the preferred learning style for both students and trainees (69.8% and 54.1%, respectively). Neuroticism was the only personality trait to differ significantly between the 2 groups, with medical students scoring significantly higher than trainees (2.9 vs. 2.6, p = 0.03). Medical students intent on pursuing a surgical career exhibit similar personality traits and learning styles to surgical trainees, with both groups preferring the visual learning modality. These findings facilitate future research into potential ways of improving both the training and selection of students and junior trainees onto residency programs. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

"Beginning with the end in mind": imagining personal retirement speeches to promote professionalism.

PubMed

Yu, Eunice; Wright, Scott M

2015-06-01

The goal of teaching professionalism in medicine is to transform a theoretical concept into an internalized and actualized identity. Many trainees struggle with professionalism in the abstract, particularly when instruction methods are didactic and disconnected from personal experience. The authors aim to demonstrate the feasibility of having interns frame a personal definition of professionalism based on a reflective technique called "beginning with the end in mind." Interns composed remarks that might be used to introduce them at their own retirement ceremony following a career in medicine. This "career eulogies" exercise was introduced to groups of six interns during the first third of the internship year as part of a two-week curriculum focused on professional development. Two investigators independently coded the written introductions, identifying emergent themes through content analysis. Of the 19 interns in an internal medicine residency program (2012-13), 17 participated in the exercise. Six themes emerged from the data: aligning behaviors with core values, achieving excellence in medicine, changing the world and giving back, valuing teamwork and relationships, realizing work-life balance, and appreciating a career in medicine. These themes correlate with accepted published definitions of professionalism. The personal reflections produced through this exercise allow physicians to begin to formulate their professional self-conception. Extensions of this work might include linking such forms of critical reflection to individualized learning plans and updating the speeches over time. Further research on "reflecting forward" may determine its impact as a complement to traditional narrative reflection.

Identification of translational dermatology research priorities in the U.K.: results of an electronic Delphi exercise.

PubMed

Healy, E; Brown, S J; Langan, S M; Nicholls, S G; Shams, K; Reynolds, N J

2015-11-01

Translational research is the direct application of basic and applied research to patient care. It is estimated that there are at least 2000 different skin diseases; thus, there are considerable challenges in seeking to undertake research on each of these disorders. This electronic Delphi (e-Delphi) exercise was conducted in order to generate a list of translational dermatology research questions that are regarded as a priority for further investigations. During the first phase of the e-Delphi exercise, 228 research questions were generated by an expert panel that included clinical academic dermatologists, clinical dermatologists, nonclinical scientists, dermatology trainees and representatives from patient support groups. Following completion of the second and third phases, 40 questions on inflammatory skin disease, 20 questions on structural skin disorders/genodermatoses, 37 questions on skin cancer and eight miscellaneous questions were designated as priority translational dermatology research questions (PRQs). In addition to PRQs on a variety of disease areas (including multiple PRQs on psoriasis, eczema, squamous cell carcinoma and melanoma), there were a number of cross-cutting themes that identified a need to investigate mechanisms/pathogenesis of disease and the necessity to improve treatments for patients with skin disease. It is predicted that this list of PRQs will help to provide a strategic direction for translational dermatology research in the U.K. and that addressing this list of questions will ultimately provide clinical benefit for substantial numbers of patients with skin disorders. © 2015 British Association of Dermatologists.

Learning, technology and intellectual property: a survey of the philosophies and preferences of our trainees and peers.

PubMed

Bedoya, Maria A; Back, Susan J; Scanlon, Mary H; Delgado, Jorge; Darge, Kassa; Reid, Janet R

2016-12-01

Increasing workloads threaten the quality of teaching in academic radiology practices. There is a wealth of unfiltered educational resources for radiology on the internet. As a digital native, today's radiology trainee may have differing opinions from teachers about learning and intellectual property. To identify the preferences and philosophies regarding learning, technology and intellectual property toward the future development of an innovative radiology curriculum. An electronic survey with 22 questions was sent to 2,010 members of the Society for Pediatric Radiology and 100 radiology trainees. Three hundred sixty-one of the 2,110 surveys were returned. All questions were completed in 342 surveys. Fifty-three respondents were trainees (residents and fellows) and 289 respondents were radiologists (teachers). Time needed for a single learning activity in both groups is <30 min, but teachers spend less time (P=0.007). The preferred learning environments were point-of-care and outside work hours for both groups. Ideal lecture durations were 31-45 min for trainees and 21-30 min for teachers (P=0.001). Adoption of new technology showed late majority and laggard trends for both groups (P=0.296). Interest in gadgets was greater in trainees (17%) than teachers (2%) (P<0.001). Interest in lecture recording was greater in trainees (84%) than teachers (61%) (P=0.008). More trainees (61%) than teachers (42%) would not charge money for educational materials (P=0.028); 27% versus 13%, respectively, disagreed with dissemination of those materials beyond the institution (P=0.013). While millennial trainees are adult learners with a stronger comfort with technology, learning styles of trainees and teachers are more similar than was previously believed. Trainees and teachers hold conflicting philosophies about intellectual property. Results herein speak favorably for revising our teaching portfolio to include practical learning materials of short duration available at point-of-care.

Involvement of surgical trainees in surgery for colorectal cancer and their effect on outcome.

PubMed

Borowski, D W; Ratcliffe, A A; Bharathan, B; Gunn, A; Bradburn, D M; Mills, S J; Wilson, R G; Kelly, S B

2008-10-01

Surgical training in the UK is undergoing substantial changes. This study assessed: 1) the training opportunities available to trainees in operations for colorectal cancer, 2) the effect of colorectal specialization on training, and 3) the effect of consultant supervision on anastomotic complications, postoperative stay, operative mortality and 5-year survival. Unadjusted and adjusted comparisons of outcomes were made for unsupervised trainees, supervised trainees and consultants as the primary surgeon in 7411 operated patients included in the Northern Region Colorectal Cancer Audit between 1998 and 2002. Surgery was performed in 656 (8.8%) patients by unsupervised trainees and in 1578 (21.3%) patients by supervised trainees. Unsupervised operations reduced from 182 (12.4%) in 1998 to 82 (6.1%) in 2002 (P < 0.001). Consultants with a colorectal specialist interest were more likely than nonspecialists to be present at surgical resections (OR 1.35, 1.12-1.63, P = 0.001) and to provide supervised training (OR 1.34, 1.17-1.53, P < 0.001). Patients operated on by unsupervised trainees were more often high-risk patients, however, consultant presence was not significantly associated with operative mortality (OR 0.83, 0.63-1.09, P = 0.186) or survival (HR 1.02, 0.92-1.13, P = 0.735) in risk-adjusted analysis. Supervised trainees had a case-mix similar to consultants, with shorter length of hospital stay (11.4 vs 12.4 days, P < 0.001), but similar mortality (OR 0.90, 0.71-1.16, 0.418) and survival (HR 0.96, 0.89-1.05, P = 0.378). One third of patients were operated on by trainees, who were more likely to perform supervised resections in colorectal teams. There was no difference in anastomotic leaks rates, operative mortality or survival between unsupervised trainees, supervised trainees and consultants when case-mix adjustment was applied. This study would suggest that there is considerable underused training capacity available.

Peer mentoring for core medical trainees: uptake and impact.

PubMed

Webb, Jessica; Brightwell, Alexandra; Sarkar, Pamela; Rabbie, Roy; Chakravorty, Indranil

2015-04-01

To assess the uptake and impact of a peer mentoring scheme for core medical trainees on both mentors and mentees. All second year core medical trainees in the Southwest London Training programme in September 2012 were invited to mentor a first year core medical trainee. In parallel, all first year core medical trainees were invited to be mentored. Both potential mentors and mentees were asked to submit personal statements, to attend a three-session mentoring training programme and to be matched into mentoring pairs. The impact of the mentoring scheme on trainees' behaviour and outlook was assessed through questionnaires distributed at the start and at the end of the year. 31 of 72 (43%) core medical trainees submitted personal statements and 40 of 72 (56%) attended training sessions. 42 trainees (58%) participated in the scheme (21 mentor/mentee pairs were established). Of the trainees who participated, 23 of 42 (55%) completed the end of year questionnaire. Participating trainees viewed the scheme positively. Reported benefits included changes in their behaviour and acquiring transferable skills that might help them in later career roles, such as an educational supervisor. The end of year questionnaire was sent to all trainees and 10 responded who had not participated. They were asked why they had not participated and their reasons included lack of time, lack of inclination and a desire for more senior mentors. Their suggestions for improvement included more structured sessions to allow the mentor/mentee pairs to meet. This simple peer mentoring scheme was popular despite busy workloads and benefited all concerned. It is a simple effective way of supporting doctors. More work is needed to improve training for mentors and to improve access to mentoring. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Self-guided training for deep brain stimulation planning using objective assessment.

PubMed

Holden, Matthew S; Zhao, Yulong; Haegelen, Claire; Essert, Caroline; Fernandez-Vidal, Sara; Bardinet, Eric; Ungi, Tamas; Fichtinger, Gabor; Jannin, Pierre

2018-04-04

Deep brain stimulation (DBS) is an increasingly common treatment for neurodegenerative diseases. Neurosurgeons must have thorough procedural, anatomical, and functional knowledge to plan electrode trajectories and thus ensure treatment efficacy and patient safety. Developing this knowledge requires extensive training. We propose a training approach with objective assessment of neurosurgeon proficiency in DBS planning. To assess proficiency, we propose analyzing both the viability of the planned trajectory and the manner in which the operator arrived at the trajectory. To improve understanding, we suggest a self-guided training course for DBS planning using real-time feedback. To validate the proposed measures of proficiency and training course, two experts and six novices followed the training course, and we monitored their proficiency measures throughout. At baseline, experts planned higher quality trajectories and did so more efficiently. As novices progressed through the training course, their proficiency measures increased significantly, trending toward expert measures. We developed and validated measures which reliably discriminate proficiency levels. These measures are integrated into a training course, which quantitatively improves trainee performance. The proposed training course can be used to improve trainees' proficiency, and the quantitative measures allow trainees' progress to be monitored.

How to improve mental health competency in general practice training?--a SWOT analysis.

PubMed

van Marwijk, Harm

2004-06-01

It is quite evident there is room for improvement in the primary care management of common mental health problems. Patients respond positively when GPs adopt a more proactive role in this respect. The Dutch general practice curriculum is currently being renewed. The topics discussed here include the Strengths, Weaknesses, Opportunities and Threats (SWOT) of present primary mental healthcare teaching. What works well and what needs improving? Integrated teaching packages are needed to help general practice trainees manage various presentations of psychological distress. Such packages comprise training videotapes, in which models such as problem-solving treatment (PST) are demonstrated, as well as roleplaying material for new skills, self-report questionnaires for patients, and small-group video feedback of consultations. While GP trainees can effectively master such skills, it is important to query the level of proficiency required by registrars. Are these skills of use only to connoisseur GPs, or to all? More room for specialisation and differentiation among trainees may be the way forward. We have just developed a new curriculum for the obligatory three-month psychiatry housemanship. It is competency oriented, self-directed and assignment driven. This new curriculum will be evaluated in due course.

Lead Exposure in Military Outdoor Firing Ranges.

PubMed

Greenberg, Nili; Frimer, Ron; Meyer, Robert; Derazne, Estella; Chodick, Gabrial

2016-09-01

Several studies have reported significant airborne lead exposures during training at indoor firing ranges. Scarce attention has been given to airborne lead exposures in outdoor shooting ranges with automatic weapons. To assess the prevalence and magnitude of airborne and blood lead levels (BLL) among firing instructors and shooters in military outdoor ranges. Exposure assessment, for both trainees and instructors, included airborne and BLL during basic and advanced training at outdoor firing ranges. Personal airborne samples were collected in both day and night shooting during both training periods. During basic training, there is 95% likelihood that up to 25% of instructors and 99% likelihood that up to 5% of trainees might be exposed above the action level (AL) (25 μg/m(3)). During advanced training, there is 90% likelihood that 10% of instructors and 99% likelihood that up to 10% of trainees might be exposed above the AL. Military personnel participating in automatic weapon marksmanship training can be exposed to considerable levels of airborne lead during outdoor firing range training. As a result, the Israel Defense Force Medical Corp has classified firing range instructors as workers that require periodic medical examinations. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Implementation of electronic logbook for trainees of general surgery in Thailand.

PubMed

Aphinives, Potchavit

2013-01-01

All trainees are required to keep a record of their surgical skill and experiences throughout the trainingperiod in a logbook format. Paper-based logbook has several limitations. Therefore, an electronic logbook was introduced to replace the paper-based logbook. An electronic logbook program was developed in November 2005. This program was designed as web-based application based upon PHP scripts beneath Apache web server and MySQL database implementation. Only simpliJfied and essential data, such as hospital number diagnosis, surgical procedure, and pathological findings, etc. are recorded. The electronic logbook databases between Academic year 2006 and 2011 were analyzed. The annual recordedsurgical procedures gradually increasedfrom 41,214 procedures in 2006 to 66,643 procedures in 2011. Around one-third of all records were not verified by attending staffs, i.e. 27.59% (2006), 31.69% (2007), 18.06% (2008), 28.42% (2009), 30.18% (2010), and 31.41% (2011). On the Education year 2011, the three most common procedural groups included colon, rectum & anus group, appendix group, and vascular group, respectively. Advantages of the electronic logbook included more efficient data access, increased ability to monitor trainees and trainers, and analysis of procedural varieties among the training institutes.

Courses and Fellowships for Trainees

Cancer.gov

Cancer research fellows and trainees at NCI can take advantage of scientific and professional development courses. Current and prospective trainees will also find a listing of fellowships opportunities. Learn more about courses and fellowships.

Burnout syndrome among psychiatric trainees in 22 countries: Risk increased by long working hours, lack of supervision, and psychiatry not being first career choice.

PubMed

Jovanović, N; Podlesek, A; Volpe, U; Barrett, E; Ferrari, S; Rojnic Kuzman, M; Wuyts, P; Papp, S; Nawka, A; Vaida, A; Moscoso, A; Andlauer, O; Tateno, M; Lydall, G; Wong, V; Rujevic, J; Platz Clausen, N; Psaras, R; Delic, A; Losevich, M A; Flegar, S; Crépin, P; Shmunk, E; Kuvshinov, I; Loibl-Weiß, E; Beezhold, J

2016-02-01

Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout. In an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout. This is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8-65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (P<0.001), without children (P=0.010), and had not opted for psychiatry as a first career choice (P=0.043). After adjustment for socio-demographic characteristics, years in training and country differences in burnout, severe burnout remained associated with long working hours (P<0.001), lack of supervision (P<0.001), and not having regular time to rest (P=0.001). Main findings were replicated in a sensitivity analysis with countries with response rate above 50%. Besides previously described risk factors such as working hours and younger age, this is the first evidence of negative influence of lack of supervision and not opting for psychiatry as a first career choice on trainees' burnout. Copyright © 2016. Published by Elsevier Masson SAS.

Paediatric trainee supervision: management changes and perceived education value.

PubMed

van den Boom, Mirjam; Pinnock, Ralph; Weller, Jennifer; Reed, Peter; Shulruf, Boaz

2012-07-01

Supervision in postgraduate training is an under-researched area. We measured the amount, type and effect of supervision on patient care and perceived education value in a general paediatric service. We designed a structured observation form and questionnaire to document the type, duration and effect of supervision on patient management and perceived education value. Most supervision occurred without the paediatrician confirming the trainee's findings. Direct observation of the trainee was rare. Management was changed in 30% of patients seen on the inpatient ward round and in 42% of the patients discussed during the chart reviews but not seen by the paediatrician. Management was changed in 48% of the cases when the paediatrician saw the patient with the trainee in outpatients but in only 21% of patients when the patient was but not seen. Changes made to patient management, understanding and perceived education value, differed between inpatient and out patient settings. There was more impact when the paediatrician saw the patient with the trainee in outpatients; while for inpatients, the opposite was true. Trainees rated the value of the supervision more highly than their supervisors did. Trainees' comments on what they learnt from their supervisor related almost exclusively to clinical knowledge rather than professional behaviours. We observed little evidence of supervisors directly observing trainees and trainees learning professional behaviours. A review of supervisory practices to promote more effective learning is needed. Communicating to paediatricians the value their trainees place on their input could have a positive effect on their engagement in supervision. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department.

PubMed

Thomas, Anita A; Uspal, Neil G; Oron, Assaf P; Klein, Eileen J

2016-12-01

Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills ( P  < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use ( P  = .30, paired difference -0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use ( P  < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use ( P  < .05, paired difference -0.4 points). Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training.

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department

PubMed Central

Thomas, Anita A.; Uspal, Neil G.; Oron, Assaf P.; Klein, Eileen J.

2016-01-01

Background  Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. Objective  We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Methods  Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Results  Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills (P < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use (P = .30, paired difference −0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use (P < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use (P < .05, paired difference −0.4 points). Conclusions  Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training. PMID:28018542

Working hours and roster structures of surgical trainees in Australia and New Zealand.

PubMed

O'Grady, Gregory; Loveday, Benjamin; Harper, Simon; Adams, Brandon; Civil, Ian D; Peters, Matthew

2010-12-01

The working hours of surgical trainees are a subject of international debate. Excessive working hours are fatiguing, and compromise performance, learning and work-life balance. However, reducing hours can impact on continuity of care, training experience and service provision. This study defines the current working hours of Australasian trainees, to inform the working hours debate in our regions. An online survey was conducted of all current Australasian trainees. Questions determined hours spent at work (AW) and off-site on-call (OC) per week, and roster structures were evaluated by training year, specialty and location. The response rate was 55.3%. Trainees averaged 61.4 ± 11.7 h/week AW, with 5% working ≥80 h. OC shifts were worked by 73.5%, for an average of 27.8 ± 14.3 h/week. Trainees of all levels worked similar hours (P= 0.10); however, neurosurgical trainees worked longer hours than most other specialties (P < 0.01). Tertiary centre rotations involved longer AW hours (P= 0.01) and rural rotations more OC (P < 0.001). Long days (>12 h) were worked by 86%; median frequency 1:4.4 days; median duration 15 h. OC shifts of 24-h duration were worked by 75%; median frequency 1:4.2 days; median sleep: 5-7 h/shift; median uninterrupted sleep: 3-5 h/shift. This study has quantified the working hours and roster structures of Australasian surgical trainees. By international standards, Australasian trainee working hours are around average. However, some rosters demand long hours and/or induce chronic sleep loss, placing some trainees at risk of fatigue. Ongoing efforts are needed to promote safe rostering practices. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

Auckland regional emergency medicine trainee mentoring uptake survey.

PubMed

Nicholls, Gordon Michael Mike; Lawrey, Emma; Jones, Peter

2017-10-01

The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring. Online survey of EM trainees in the Auckland region in June 2015. Of 61 potential respondents, 40 (65.6%) respondents replied to the survey. Of the 40, 38 (95%; 95% confidence interval (CI) 82.6-99.5) respondents indicated they would like some form of mentoring system, and of the 38, 25 (65.8%; 95% CI 49.8-78.9) preferred this to be formal. Of the 38, 19 (50%; 95% CI 34.9-65.2) currently wanted assistance obtaining a mentor. Of the 40, 30 (75%; 95% CI 59.6-86.0) are not currently in any form of mentoring relationship. Respondents believed that mentors would be most beneficial in critical incidents, career development and with work/life balance. The attributes participants considered most important in a mentor were respecting confidentiality, being honest and the ability to provide constructive feedback. Many EM trainees in Auckland want a formal mentoring system and would like a mentor. Appropriate mentor-mentee matching through a formalised voluntary system, with adequate mentor training, may enable the Auckland region to develop a suitable mentoring programme for EM trainees. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Influences of Radiology Trainees on Screening Mammography Interpretation.

PubMed

Hawley, Jeffrey R; Taylor, Clayton R; Cubbison, Alyssa M; Erdal, B Selnur; Yildiz, Vedat O; Carkaci, Selin

2016-05-01

Participation of radiology trainees in screening mammographic interpretation is a critical component of radiology residency and fellowship training. The aim of this study was to investigate and quantify the effects of trainee involvement on screening mammographic interpretation and diagnostic outcomes. Screening mammograms interpreted at an academic medical center by six dedicated breast imagers over a three-year period were identified, with cases interpreted by an attending radiologist alone or in conjunction with a trainee. Trainees included radiology residents, breast imaging fellows, and fellows from other radiology subspecialties during breast imaging rotations. Trainee participation, patient variables, results of diagnostic evaluations, and pathology were recorded. A total of 47,914 mammograms from 34,867 patients were included, with an overall recall rate for attending radiologists reading alone of 14.7% compared with 18.0% when involving a trainee (P < .0001). Overall cancer detection rate for attending radiologists reading alone was 5.7 per 1,000 compared with 5.2 per 1,000 when reading with a trainee (P = .517). When reading with a trainee, dense breasts represented a greater portion of recalls (P = .0001), and more frequently, greater than one abnormality was described in the breast (P = .013). Detection of ductal carcinoma in situ versus invasive carcinoma or invasive cancer type was not significantly different. The mean size of cancers in patients recalled by attending radiologists alone was smaller, and nodal involvement was less frequent, though not statistically significantly. These results demonstrate a significant overall increase in recall rate when interpreting screening mammograms with radiology trainees, with no change in cancer detection rate. Radiology faculty members should be aware of this potentiality and mitigate tendencies toward greater false positives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Reconciling the professional and student identities of clinical psychology trainees.

PubMed

McKenzie, Karen; Cossar, Jill A; Fawns, Tim; Murray, Aja L

2013-10-01

The study explored the ways in which qualified and trainee clinical psychologists perceived professional behaviour, as illustrated in a series of short vignettes, in student and clinical practice contexts. Comparisons were made to identify the extent to which ideas of professionalism differed across different learning contexts and between qualified and unqualified staff, with the aim of adding to the literature on which factors influence the development of professional identity in health professionals. An online questionnaire depicting a range of potentially unprofessional behaviours was completed by 265 clinical psychology trainees and 106 qualified clinical psychologists. The data were analysed using a general linear model with simultaneous entry in which rater (trainee vs qualified clinical psychologist), setting (student vs placement) and their interaction predicted acceptability ratings. We found that, in general, trainees and qualified staff agreed on those behaviours that were potentially unprofessional, although where significant differences were found, these were due to trainees rating the same behaviours as more professionally acceptable than qualified clinical psychologists. Despite trainees identifying a range of behaviours as professionally unacceptable, some percentage reported having engaged in a similar behaviour in the past. Irrespective of the status of the rater, the same behaviours tended to be viewed as more professionally unacceptable when in a placement (clinical) setting than in a student (university) setting. Generally, no support was found for a rater by setting interaction. The study suggests that trainee clinical psychologists are generally successful at identifying professional norms, although they do not always act in accordance with these. Conflicting student and professional norms may result in trainees viewing some potentially unprofessional behaviour as less severe than qualified staff. Health professional educators should be aware of this fact and take steps to shape trainee norms to be consistent with that of the professional group.

20 CFR 702.507 - Vocational rehabilitation; maintenance allowance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Director that a trainee is not complying reasonably with the terms of the training plan or is absenting... meet additional costs by reason of being in training. (b) When required by reason of personal illness or hardship, limited periods of absence from training may be allowed without terminating the...

New Careers in Private Industry.

ERIC Educational Resources Information Center

Urban League of Greater New York, NY.

The career-oriented training system discussed at the conference requires (1) visible extra benefits for the new employee beyond the guarantee of a steady job, (2) a highly developed structure of social services designed to attack the unique problems of the newly-employed disadvantaged trainee, (3) specialized training of administrators and…

Ten Benefits of Participant Action Planning.

ERIC Educational Resources Information Center

Youker, Robert B.

1985-01-01

Describes the Participant Action Planning Approach (PAPA) process that requires each trainee to prepare a list of concrete actions or changes he or she plans to make back on the job once the training program is over. Benefits of PAPA are discussed, including transfer of learning, verbalization, and commitment. (CT)

Computer-Based Assessment in Safety-Critical Industries: The Case of Shipping

ERIC Educational Resources Information Center

Gekara, Victor Oyaro; Bloor, Michael; Sampson, Helen

2011-01-01

Vocational education and training (VET) concerns the cultivation and development of specific skills and competencies, in addition to broad underpinning knowledge relating to paid employment. VET assessment is, therefore, designed to determine the extent to which a trainee has effectively acquired the knowledge, skills, and competencies required by…

Driver Improvement Analyst; Basic Training Program. Student Study Guide.

ERIC Educational Resources Information Center

Hale, Allen

As part of the training package for Driver Improvement Analysts, this study guide is designed to serve as the basic reference source for the students/trainees. It reinforces and supplements subject material presented in the Instructor's Lesson Plans. Subjects covered are objectives and requirements, psychology of driving, characteristics of the…

77 FR 47076 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-07

... five-year funding period. Pre-test and follow-up versions of the survey are expected to require... from the respondents pre-test (e.g., demographics, agency type) in order to further expedite completion... respondents respondent per response hours IAATP: Trainee Survey Pre-Test Administration... 1,200 1 0.15 180...

36 CFR 1210.25 - Revision of budget and program plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... may, at its option, restrict the transfer of funds among direct cost categories or programs, functions... or the objective of the project or program (even if there is no associated budget revision requiring... funds allotted for training allowances (direct payment to trainees) to other categories of expense. (8...

Treatment of Childhood Encopresis: Full Cleanliness Training

ERIC Educational Resources Information Center

Arnold, Susan; Doleys, Daniel M.

1975-01-01

Full Cleanliness Training (a procedure in which the trainee is required to correct the results of inappropriate toileting behavior by cleaning himself and his clothing) was used in combination with positive reinforcement to deal with a trainable retarded 8 year old boy with encopresis and a toilet phobia. (Author/CL)

Challenges of Trainees in a Multidisciplinary Research Program: Nano-Biotechnology

ERIC Educational Resources Information Center

Kriegel, Christina; Koehne, Jessica; Tinkle, Sally; Maynard, Andrew D.; Hill, Rodney A.

2011-01-01

The breadth of knowledge required for the multidisciplinary field of nanotechnology challenges and extends traditional concepts of multidisciplinary graduate education. There is a paucity of information, both general reporting and peer-reviewed studies, on the challenges for graduate students working in this multidisciplinary paradigm, from the…

The Trainer's Handbook. The AMA Guide to Effective Training. Second Edition.

ERIC Educational Resources Information Center

Mitchell, Garry

This trainer's handbook is designed to be a desktop reference on the nature of training and the procedures involved in training preparation and provision. Part 1 covers the essential interaction skills required of trainers (maintaining leadership, creating learning associations, planning lessons, controlling training groups, analyzing trainees,…

Attitudes towards attrition among UK trainees in obstetrics and gynaecology.

PubMed

Gafson, Irene; Currie, Jane; O'Dwyer, Sabrina; Woolf, Katherine; Griffin, Ann

2017-06-02

Physician dissatisfaction in the workplace has consequences for patient safety. Currently in the UK, 1 in 5 doctors who enter specialist training in obstetrics and gynaecology leave the programme before completion. Trainee attrition has implications for workforce planning, organization of health-care services and patient care. The authors conducted a survey of current trainees' and former trainees' views concerning attrition and 'peri-attrition' - a term coined to describe the trainee who has seriously considered leaving the specialty. The authors identified six key themes which describe trainees' feelings about attrition in obstetrics and gynaecology: morale and undermining; training processes and paperwork; support and supervision; work-life balance and realities of life; NHS environment; and job satisfaction. This article discusses themes of an under-resourced health service, bullying, lack of work-life balance and poor personal support.

Trainee experiences of intellectual disability psychiatry and an innovative leaderless support group: a qualitative study

PubMed Central

Spackman, Ross; Toogood, Hannah; Kerridge, Jayne; Nash, Jon; Anderson, Elizabeth; Rai, Dheeraj

2017-01-01

Aims and method There is very little research into the challenges of training in intellectual disability psychiatry or into interventions which may address these challenges. Using focus groups, we explored the experiences of intellectual disability psychiatry trainees, and evaluated a leaderless trainee support group developed in Bristol. Results Five distinct themes were identified via framework analysis: that trainees felt unprepared for the difference from previous posts; the need for support; the value of the group; that trainees were concerned about judgement in supervision; that the group structure was valued. Clinical implications Our findings highlight the support needs specific to intellectual disability psychiatry trainees. Leaderless peer support groups may be a valued resource to address such issues, and may be a useful model to be considered by other training schemes. PMID:28811919

Does interpersonal behavior of psychotherapy trainees differ in private and professional relationships?

PubMed

Fincke, Janna I; Möller, Heidi; Taubner, Svenja

2015-01-01

The present study aimed to evaluate the effect of trainees' interpersonal behavior on work involvement (WI) and compared their social behavior within professional and private relationships as well as between different psychotherapeutic orientations. The interpersonal scales of the Intrex short-form questionnaire and the Work Involvement Scale (WIS) were used to evaluate two samples of German psychotherapy trainees in psychoanalytic, psychodynamic, and cognitive behavioral therapy training. Trainees from Sample 1 (N = 184) were asked to describe their interpersonal behavior in relation to their patients when filling out the Intrex, whereas trainees from Sample 2 (N = 135) were asked to describe the private relationship with a significant other. Interpersonal affiliation in professional relationships significantly predicted the level of healing involvement, while stress involvement was predicted by interpersonal affiliation and interdependence in trainees' relationships with their patients. Social behavior within professional relationships provided higher correlations with WI than private interpersonal behavior. Significant differences were found between private and professional relation settings in trainees' interpersonal behavior with higher levels of affiliation and interdependence with significant others. Differences between therapeutic orientation and social behavior could only be found when comparing trainees' level of interdependence with the particular relationship setting. Trainees' interpersonal level of affiliation in professional relationships is a predictor for a successful psychotherapeutic development. Vice versa, controlling behavior in professional settings can be understood as a risk factor against psychotherapeutic growth. Both results strengthen an evidence-based approach for competence development during psychotherapy training.

Increasing radiology capacity within the lung cancer pathway: centralised work-based support for trainee chest X-ray reporting radiographers.

PubMed

Woznitza, Nick; Steele, Rebecca; Piper, Keith; Burke, Stephen; Rowe, Susan; Bhowmik, Angshu; Maughn, Sue; Springett, Kate

2018-05-27

Diagnostic capacity and time to diagnosis are frequently identified as a barrier to improving cancer patient outcomes. Maximising the contribution of the medical imaging workforce, including reporting radiographers, is one way to improve service delivery. An efficient and effective centralised model of workplace training support was designed for a cohort of trainee chest X-ray (CXR) reporting radiographers. A comprehensive schedule of tutorials was planned and aligned with the curriculum of a post-graduate certificate in CXR reporting. Trainees were supported via a hub and spoke model (centralised training model), with the majority of education provided by a core group of experienced CXR reporting radiographers. Trainee and departmental feedback on the model was obtained using an online survey. Fourteen trainees were recruited from eight National Health Service Trusts across London. Significant efficiencies of scale were possible with centralised support (48 h) compared to traditional workplace support (348 h). Trainee and manager feedback overall was positive. Trainees and managers both reported good trainee support, translation of learning to practice and increased confidence. Logistics, including trainee travel and release, were identified as areas for improvement. Centralised workplace training support is an effective and efficient method to create sustainable diagnostic capacity and support improvements in the lung cancer pathway. © 2018 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Current status and future perspective of general surgical trainees in the Netherlands.

PubMed

Wijnhoven, Bas P L; Watson, David I; van den Ende, Esther D

2008-01-01

The opinions of general surgical trainees about their current training program and their future career plans are important because such information can inform any redesign of surgical training programs as well as future surgical manpower planning. A structured questionnaire was sent to 392 general surgical trainees in the Netherlands in 2005. A total of 239 (61%) questionnaires were returned by 66 (28%) women and 173 (72%) men, mean age 31.3 years. On average, trainees worked in the hospital 55 hours per week (range: 22-80 h). The mean number of operative cases performed per year was 195 (range 35-450), and this had been stable since the year 2000. The quality of the supervision by staff surgeons was rated satisfactory. The vast majority of the trainees are also satisfied with the current single year of differentiation/specialized training into one of the subspecialties, although most trainees (83%) would like to enroll in a fellowship before taking a job as a consultant. There was also a desire to take maternity/paternity leave during training. Both male and female trainees expressed the wish to work an average of 52 hours per week as a consultant, and they want these hours to occur in 4.1 days of work per week. Dutch general surgery trainees are satisfied with their training. They expressed a strong wish for specialization during and after their training. All trainees favored reduced working hours and days of work per week as fully qualified surgeons in the future.

Effects of Fatigue on Driving Safety: A Comparison of Brake Reaction Times in Night Float and Postcall Physicians in Training

PubMed Central

Talusan, Paul G.; Long, Theodore; Halim, Andrea; Guliani, Laura; Carroll, Nicole; Reach, John

2014-01-01

Background Concerns about duty hour and resident safety have fostered discussion about postshift fatigue and driving impairment. Objective We assessed how converting to a night float schedule for overnight coverage affected driving safety for trainees. Methods Brake reaction times were measured for internal medicine and orthopaedic surgery resident volunteers after a traditional 28-hour call shift and after a night float shift. We conducted matched paired t tests of preshift and postshift reaction time means. Participants also completed the Epworth Sleepiness Scale pre- and postshift. Results From June to July 2013, we enrolled 58 interns and residents (28 orthopaedic surgery, 30 internal medicine). We included 24 (41%) trainees on night float rotations and 34 (59%) trainees on traditional 28-hour call shifts. For all residents on night float rotations, there was no significant difference pre- and postshift. An increase in reaction times was noted among trainees on 28-hour call rotations. This included no effect on reaction times for internal medicine trainees pre- and postshift, and an increase in reaction times for orthopaedic trainees. For both night float and traditional call groups, there were significant increases in the Epworth Sleepiness Scale. Conclusions Trainees on traditional 28-hour call rotations had significantly worse postshift brake reaction times, whereas trainees on night float rotations had no difference. Orthopaedic trainees had significant differences in brake reaction times after a traditional call shift. PMID:26140113

Practice and attitudes regarding double gloving among staff surgeons and surgical trainees.

PubMed

Lipson, Mark E; Deardon, Rob; Switzer, Noah J; de Gara, Chris; Ball, Chad G; Grondin, Sean C

2018-06-01

Despite supporting evidence, many staff surgeons and surgical trainees do not routinely double glove. We performed a study to assess rates of and attitudes toward double gloving and the use of eye protection in the operating room. We conducted an electronic survey among all staff surgeons and surgical trainees at 2 tertiary care centres in Alberta between September and November 2015.We analyzed the data using log-binomial regression for binary outcomes to account for multiple independent variables and interactions. For 2-group comparisons, we used a 2-group test of proportions. The response rate was 34.3% (361/1051); 205/698 staff surgeons (29.4%) and 156/353 surgical trainees (44.2%) responded. Trainees were more likely than staff surgeons to ever double glove in the operating room ( p = 0.01) and to do so routinely ( p = 0.01). Staff surgeons were more likely than trainees to never double glove ( p = 0.01). A total of 300/353 respondents (85.0%) reported using eye protection routinely in the operating room. Needle-stick injury was common (184 staff surgeons [92.5%], 115 trainees [74.7%]). Reduced tactile feedback, decreased manual dexterity and discomfort/poor fit were perceived barriers to double gloving. Rates of double gloving leave room for improvement. Surgical trainees were more likely than staff surgeons to double glove. Barriers remain to routine double gloving among staff surgeons and trainees. Increased education on the benefits of double gloving and early introduction of this practice may increase uptake.

Exploring the process of professional socialisation and development during pharmacy pre-registration training in England.

PubMed

Jee, Samuel D; Schafheutle, Ellen I; Noyce, Peter R

2016-08-01

To explore the process of professional socialisation in pharmacy trainees during pre-registration training. A prospective, longitudinal qualitative design was used. A purposive sample of 20 trainees from community and hospital pharmacy in North West England was recruited. A total of 79 semi-structured interviews were conducted with trainees on three occasions during training and once four months after training. Data were analysed thematically using template analysis. Early on in training, non-pharmacists played a significant role in socialising trainees into the work setting; pharmacists played the stronger role towards the end. Pre-registration tutors were strong role models throughout training. Training experiences differed between settings, where services provided and patient mix varied. Hospital trainees learnt about specialist medicines on ward rotations. Community trainees developed knowledge of over-the-counter, and less complex, medicines. In hospital, trainees were exposed to a range of role models in comparison to community where this was generally limited to a small pharmacy team. Newly qualified pharmacists were challenged by having full responsibility and accountability. This study showed the experiences encountered by trainees that affect their professional socialisation. More standardisation across training sites may reduce the variation in experiences and professional socialisation and development. Formal training for pre-registration tutors and support staff that play a key role in supporting trainees could be considered. Support for newly qualified pharmacists may allay the challenging transition they face when entering practice. © 2016 Royal Pharmaceutical Society.

Choosing a career in paediatrics: do trainees' views change over the first year of specialty training?

PubMed

Goodyear, Helen M; Lakshminarayana, Indumathy; Wall, David; Bindal, Taruna

2014-09-01

To look at why a regional cohort of UK doctors chose a paediatric career and to ascertain views on their career near the end of training year one. A 20-item questionnaire was sent to all new regional paediatric specialty trainees. Three focus groups were held with trainees near the end of year one to elicit key themes. West Midlands Deanery, UK. Twenty-nine new regional paediatric specialty trainees in year one completed the questionnaire. A total of 15 trainees participated in the focus groups near the end of year one training. Reasons for choosing a paediatric career and factors which further influence career choice for trainees during their first specialty training year. Key influencing factors for choosing paediatrics were enjoying working with children and positive undergraduate experience of the specialty. All trainees had paediatrics as their first choice specialty and undertook a paediatric Foundation post. Near the end of year one, doubts were cast on career aspirations due to seeing middle grade colleagues struggling with work-life balance and a growing feeling that family came first. Senior trainees need to be aware that they act as powerful role models for their more junior colleagues and therefore have an influential role on how juniors perceive a paediatric career. Family friendly flexible working patterns in paediatrics are vital to retain junior trainees. All paediatric staff are role models and need to be enthusiastic, keen to teach and to promote a positive working environment.

Annual planning meetings: views and perceptions.

PubMed

Bindal, Taruna; Wall, David; Goodyear, Helen

2014-12-01

In 2009, annual face to face planning meetings (APMs) were introduced as an optional meeting for all paediatric trainees. APMs are a formative assessment process whereby the trainee meets with a panel of consultants and sets the agenda for discussion. A questionnaire about APMs was given to all participating trainees and trainers in 2011. The response rate was 93 per cent (139/150) and 67 per cent (12/18) for trainees and trainers, respectively. All trainers had received panel member training. Ninety-one per cent of trainees (126/139) felt adequately prepared for the meeting. Issues discussed included career plans (93%), future training placements (73%), ePortfolio (61%) and previous training posts (61%). Trainees felt that the APM was a helpful formative assessment process (with a mean score of five on a six-point Likert scale: 1, strongly disagree; 6, strongly agree), and that panels were fair, supportive, communicated clearly, listened to concerns and focused on individual learning needs. Sixty-seven per cent (8/12) of trainers would have liked more information about the process beforehand. The main benefits of APMs were trainees feeling supported in their training and better informed regarding career options. APMs would be of value to all specialties to enable annual formative assessment to be undertaken at a different time to the summative assessment process. APMs facilitate reflection on learning needs, and the formulation of personal development plans and career goals for trainees. Trainees felt that the APM was a helpful formative assessment process. © 2014 John Wiley & Sons Ltd.

Feasibility of Virtual Tablet-Based Group Exercise Among Older Adults in Siberia: Findings From Two Pilot Trials

PubMed Central

2018-01-01

Background Regular physical activity has a positive effect on physical health, well-being, and life satisfaction of older adults. However, engaging in regular physical activity can be challenging for the elderly population because of reduced mobility, low motivation, or lack of the proper infrastructures in their communities. Objective The objective of this paper was to study the feasibility of home-based online group training—under different group cohesion settings—and its effects on adherence and well-being among Russian older adults. We focused particularly on the technology usability and usage and on the adherence to the training (in light of premeasures of social support, enjoyment of physical activity, and leg muscle strength). As a secondary objective, we also explored the effects of the technology-supported intervention on subjective well-being and loneliness. Methods Two pilot trials were carried out exploring two different group cohesion settings (weak cohesion and strong cohesion) in the period from 2015 to 2016 in Tomsk, Russian Federation. A total of 44 older adults (59-83 years) participated in the two pilots and followed a strength and balance training program (Otago) for 8 weeks with the help of a tablet-based virtual gym app. Participants in each pilot were assigned to an interaction condition, representing the online group exercising, and an individual condition, representing a home-based individual training. Both conditions featured persuasion strategies but differed in the ability to socialize and train together. Results Both interaction and individual groups reported a high usability of the technology. Trainees showed a high level of technology acceptance and, particularly, a high score in intention to future use (4.2-5.0 on a 5-point Likert scale). Private texting (short service message [SMS]) was used more than public texting, and the strong cohesion condition resulted in more messages per user. Joint participations to training sessions (copresence) were higher for the social group with higher cohesion. The overall adherence to the training was 74% (SD 27%). Higher levels of social support at baseline were associated with higher adherence in the low cohesion condition (F1,18=5.23, P=.03), whereas in the high cohesion, such association was not found. Overall improvement in the satisfaction with life score was observed between pre and post measures (F1,31=5.85, P=.02), but no decrease in loneliness. Conclusions Online group exercising was proven feasible among healthy independently living older adults in Russia. The pilots suggest that a physical training performed in a virtual environment positively affect the life satisfaction of the trainees, but it does not provide support for a decrease in loneliness. High cohesion groups are preferable for group exercising, especially to mitigate effects of low social support on adherence. Further research in motivating group interactions in training settings is needed. PMID:29487045

Trainee Teachers' Perspectives on Play Characteristics and Their Role in Children's Play: An International Comparative Study amongst Trainees in the Netherlands, Wales, Germany and Finland

ERIC Educational Resources Information Center

van der Aalsvoort, Geerdina; Prakke, Bette; Howard, Justine; König, Anke; Parkkinen, Terttu

2015-01-01

An international comparative research project was carried out in the Netherlands, Wales, Germany and Finland to understand how trainee teachers reflect upon play. Data was collected among 31 Dutch, 37 Welsh, 40 German and 19 Finnish teacher trainees. They watched four videotaped sequences of preschoolers engaged in an activity. Next, they answered…

2015 American Academy of Clinical Neuropsychology (AACN) student affairs committee survey of neuropsychology trainees.

PubMed

Whiteside, Douglas M; Guidotti Breting, Leslie M; Butts, Alissa M; Hahn-Ketter, Amanda E; Osborn, Katie; Towns, Stephanie J; Barisa, Mark; Santos, Octavio A; Smith, Daniel

2016-07-01

Surveys of practicing neuropsychologists have been conducted for years; however, there have been no comprehensive surveys of neuropsychology trainees, which may result in important issues being overlooked by the profession. This survey assessed trainees' experiences in areas such as student debt, professional development, and training satisfaction. Survey items were written by a task force of the AACN Student Affairs Committee (SAC), and neuropsychology trainees were recruited via neuropsychology-focused listservs. In total, 344 trainees completed the survey (75% female) and included participants from every region of the US and Canada. Based on the survey questions, nearly half of all trainees (47%) indicated financial factors were the greatest limitation in their training. Student debt had a bimodal distribution; 32.7% had minimal debt, but 45% had debt >$100,000. In contrast, expected starting salaries were modest, but consistent with findings ($80-100,000). While almost all trainees intended to pursue board certification (97% through ABPP), many were 'not at all' or only 'somewhat' familiar with the process. Results indicated additional critical concerns beyond those related to debt and lack of familiarity with board certification procedures. The results will inform SAC conference programming and the profession on the current 'state of the trainees' in neuropsychology.

How can educators support general practice (GP) trainees to develop resilience to prevent burnout?

PubMed

Sales, Bryony; Macdonald, Alexandra; Scallan, Samantha; Crane, Sue

2016-11-01

Burnout impacts adversely on professional and personal life, and holds implications for patient care. Current research on burnout mainly focuses on established general practitioners but it is unclear how early the signs of burnout really start. This work seeks to identify whether specific GP trainee groups are particularly at risk of burnout and the aspects of training they find stressful. A longitudinal cohort study, collecting qualitative and quantitative data through a single mode of data collection (questionnaire) took place with trainees from all GP training years (ST1-3), across a vocational training scheme (n = 48). Data gathered included the Oldenburg Burnout Inventory (OLBI). Higher than anticipated levels of burnout were displayed by all trainees. A sub-group self reporting higher levels of burnout comprised all-female, UK-trained-at-undergraduate GP trainees, with a partner but no children. Top reported stressors included knowledge/uncertainty, workload/time pressures and ePortfolio. Less than 50% of trainees perceived their burnout levels to be as high as their OLBI showing potential lack of insight. This research demonstrates that high levels of burnout are experienced in GP trainees as early as the first year of training. Early identification of burnout amongst trainees is essential by GP educators to help protect the future GP workforce.

Knowledge structures and the acquisition of a complex skill.

PubMed

Day, E A; Arthur, W; Gettman, D

2001-10-01

The purpose of this study was to examine the viability of knowledge structures as an operationalization of learning in the context of a task that required a high degree of skill. Over the course of 3 days, 86 men participated in 9 training sessions and learned a complex video game. At the end of acquisition, participants' knowledge structures were assessed. After a 4-day nonpractice interval, trainees completed tests of skill retention and skill transfer. Findings indicated that the similarity of trainees' knowledge structures to an expert structure was correlated with skill acquisition and was predictive of skill retention and skill transfer. However, the magnitude of these effects was dependent on the method used to derive the expert referent structure. Moreover, knowledge structures mediated the relationship between general cognitive ability and skill-based performance.

A temporal bone surgery simulator with real-time feedback for surgical training.

PubMed

Wijewickrema, Sudanthi; Ioannou, Ioanna; Zhou, Yun; Piromchai, Patorn; Bailey, James; Kennedy, Gregor; O'Leary, Stephen

2014-01-01

Timely feedback on surgical technique is an important aspect of surgical skill training in any learning environment, be it virtual or otherwise. Feedback on technique should be provided in real-time to allow trainees to recognize and amend their errors as they occur. Expert surgeons have typically carried out this task, but they have limited time available to spend with trainees. Virtual reality surgical simulators offer effective, repeatable training at relatively low cost, but their benefits may not be fully realized while they still require the presence of experts to provide feedback. We attempt to overcome this limitation by introducing a real-time feedback system for surgical technique within a temporal bone surgical simulator. Our evaluation study shows that this feedback system performs exceptionally well with respect to accuracy and effectiveness.

Comparison of cardiothoracic surgery training in USA and Germany.

PubMed

Tchantchaleishvili, Vakhtang; Mokashi, Suyog A; Rajab, Taufiek K; Bolman, R Morton; Chen, Frederick Y; Schmitto, Jan D

2010-11-26

Training of cardiothoracic surgeons in Europe and the United States has expanded to incorporate new operative techniques and requirements. The purpose of this study was to compare the current structure of training programs in the United States and Germany. We thoroughly reviewed the existing literature with particular focus on the curriculum, salary, board certification and quality of life for cardiothoracic trainees. The United States of America and the Federal Republic of Germany each have different cardiothoracic surgery training programs with specific strengths and weaknesses which are compared and presented in this publication. The future of cardiothoracic surgery training will become affected by technological, demographic, economic and supply factors. Given current trends in training programs, creating an efficient training system would allow trainees to compete and grow in this constantly changing environment.

Impact of the Libby Zion case on graduate medical education in internal medicine.

PubMed

Brensilver, J M; Smith, L; Lyttle, C S

1998-09-01

Residency training in New York State was substantially altered by the Libby Zion case. Work-hour limitations and augmented supervisory requirements changed the patterns of training--particularly in internal medicine--but with uncertain impacts on the quality of education and patient care. In this historical analysis, we review another major effect of the case: a substantial augmentation of the number of trainees. The need to maintain adequate inpatient staffing--within the ground rules of the Residency Review Committee, and in consideration of the reimbursement formulae and financial climate of New York State--conspired to promote substantial residency program expansion. Similar forces contributed to a national trend to increase the number of trainees. The history, cost and impact of these personnel changes are reviewed.

Medical Trainees’ Experiences of Treating People With Chronic Pain: A Lost Opportunity for Medical Education

PubMed Central

Rice, Kathleen; Ryu, Jae Eun; Whitehead, Cynthia; Katz, Joel

2018-01-01

Purpose Evidence suggests that physicians’ opinions about patients with chronic pain become progressively negative over the course of medical training, leading to decline in empathy for these patients. Few qualitative studies have focused on this issue, and thus the experiences shaping this process remain unexplored. This study addressed how medical trainees learn about chronic pain management through informal and formal curricula. Method This study adopted a constructive qualitative approach informed by the theoretical lens of the hidden curriculum. Thirteen open-ended interviews were conducted with medical students and residents at various training stages; interviewees had experience treating patients with chronic pain, shadowing the care of these patients, or both. Interviews elicited information about stage of medical training, general descriptions of work, and concrete experiences of managing patients with chronic pain. All interviews were collected in Toronto between June and August 2015. Results Most interviewees described the management of chronic pain as challenging and unrewarding and attributed this at least in part to their perception that pain was subjective. Trainees also recounted that their inability to cure chronic pain left them confused about how to provide care, and voiced a perception that preceptors seemed to view these patients as having little educational value. Conclusions Specifically because chronic pain is subjective and incurable, listening and communication become crucial for patient care. Instead of sheltering trainees, medical educators should be offered the opportunity to reflect on the skills that are required to provide patient-centered care for this population. This approach has the potential to greatly benefit both trainees and patients. PMID:29140917

Teaching and assessment of ethics and professionalism: a survey of pediatric program directors.

PubMed

Cook, Alyssa F; Sobotka, Sarah A; Ross, Lainie F

2013-01-01

The Accreditation Council for Graduate Medical Education requires residency programs to provide instruction in and evaluation of competency in ethics and professionalism. We examined current practices and policies in ethics and professionalism in pediatric training programs, utilization of newly available resources on these topics, and recent concerns about professional behavior raised by social media. From May to August 2012, members of the Association of Pediatric Program Directors identified as categorical program directors in the APPD database were surveyed regarding ethics and professionalism practices in their programs, including structure of their curricula, methods of trainee assessment, use of nationally available resources, and policies regarding social media. The response rate was 61% (122 of 200). Most pediatric programs continue to teach ethics and professionalism in an unstructured manner. Many pediatric program directors are unaware of available ethics and professionalism resources. Although most programs lack rigorous evaluation of trainee competency in ethics and professionalism, 30% (35 of 116) of program directors stated they had not allowed a trainee to graduate or sit for an examination because of unethical or unprofessional conduct. Most programs do not have formal policies regarding social media use by trainees, and expectations vary widely. Pediatric training programs are slowly adopting the educational mandates for ethics and professionalism instruction. Resources now exist that can facilitate curriculum development in both traditional content areas such as informed consent and privacy as well as newer content areas such as social media use. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The working relationship between midwives and junior doctors: a questionnaire survey of Yorkshire trainees.

PubMed

Pinki, P; Sayasneh, A; Lindow, S W

2007-05-01

Recruitment to obstetrics and gynaecology has fallen dramatically over the last decade. Surveys of medical students and junior doctors have suggested that apart from work/life imbalance, other factors such as poor job satisfaction and an unfriendly environment can significantly affect the choice of career. We conducted a questionnaire survey for Yorkshire trainees to evaluate current working and professional relationships between junior doctors and midwives. A total of 68 trainees participated in the study. Some 22% of trainees found midwives to be disrespectful to and argumentative with junior doctors. A total of 69% did not get a chance to examine patients on the labour wards because of the midwives. Midwives when compared with consultants were less courteous towards trainees and 53% of trainees felt that there is a communication problem that needs to be addressed. Our study results suggest a high level of dissatisfaction among trainees of the Yorkshire region and point at an area that needs further work to bring about a change to a better work environment for future junior doctors.