Slade, Steve; Ross, Shelley; Lawrence, Kathrine; Archibald, Douglas; Mackay, Maria Palacios; Oandasan, Ivy F.
Abstract Objective To examine trends in family medicine training at a time when substantial pedagogic change is under way, focusing on factors that relate to extended family medicine training. Design Aggregate-level secondary data analysis based on the Canadian Post-MD Education Registry. Setting Canada. Participants All Canadian citizens and permanent residents who were registered in postgraduate family medicine training programs within Canadian faculties of medicine from 1995 to 2013. Main outcome measures Number and proportion of family medicine residents exiting 2-year and extended (third-year and above) family medicine training programs, as well as the types and numbers of extended training programs offered in 2015. Results The proportion of family medicine trainees pursuing extended training almost doubled during the study period, going from 10.9% in 1995 to 21.1% in 2013. Men and Canadian medical graduates were more likely to take extended family medicine training. Among the 5 most recent family medicine exit cohorts (from 2009 to 2013), 25.9% of men completed extended training programs compared with 18.3% of women, and 23.1% of Canadian medical graduates completed extended training compared with 13.6% of international medical graduates. Family medicine programs vary substantially with respect to the proportion of their trainees who undertake extended training, ranging from a low of 12.3% to a high of 35.1% among trainees exiting from 2011 to 2013. Conclusion New initiatives, such as the Triple C Competency-based Curriculum, CanMEDS–Family Medicine, and Certificates of Added Competence, have emerged as part of family medicine education and credentialing. In acknowledgment of the potential effect of these initiatives, it is important that future research examine how pedagogic change and, in particular, extended training shapes the care family physicians offer their patients. As part of that research it will be important to measure the breadth and uptake of
O'Donnell, R. W.
This satirical essay proposes an institution of higher learning that would prepare students to become swimmers" and swimming instructors. Curriculum, teaching methods, student selection and evaluation are modelled on certain contemporary teacher-training institutes. (PD)
Yager, Joel; Greden, John; Abrams, Michael; Riba, Michelle
Objective: The National Institute of Mental Health (NIMH) determined that declines in the psychiatrist-researcher workforce are harming public needs and that significant steps are necessary to alter current trends. Method: The NIMH commissioned the Institute of Medicine (IOM) to examine the undersupply and recommend solutions. The NIMH…
Mohler, S R
In the U. S. there are 23 recognized medical specialty boards. One of these is preventive medicine. Within preventive medicine there are three areas: Aerospace Medicine, Occupational Medicine, and Public Health/General Preventive Medicine. The preventive medicine specialties have a common core of required training including biostatistics, epidemiology, health services administration and environmental health. These, plus associated topics are covered during year one of training. Year two of training involves clinical rotations specifically tailored to the eye, ear, heart, lungs and brain, plus flight training to the private pilot level, and a Masters Degree research project for the required thesis. During year three the physicians in aerospace medicine practice full-time aerospace medicine in a NASA or other government laboratory or a private facility. To date, more than 40 physicians have received aerospace medicine training through the Wright State University School of Medicine program. Among these are physicians from Japan, Australia, Taiwan, Canada and Mexico. In addition to the civilian program at Wright State University, there are programs conducted by the U. S. Air Force and Navy. The Wright State program has been privileged to have officers from the U. S. Army, Navy and Air Force. A substantial supporter of the Wright State program is the National Aeronautics and Space Administration and a strong space component is contained in the program.
Jagosh, Justin J.
In 2004, members of the McGill University Faculty of Medicine began implementing a new curriculum for undergraduate medical education entitled, Physicianship: The Physician as Professional and Healer. The initiative underscores the idea that physician training entails cultivating not only scientific knowledge and technical skill, but a mindset guided by intrinsic principles of doctoring. Although the McGill case exemplifies a wide-spread paradigm shift in medical teaching, there is a dearth of analysis concerning the degree of congruency between the objectives of formal undergraduate curricular revision and the so-called 'hidden curriculum' of the hospital training environment. With Physicianship as a point of departure, this dissertation maps evolutionary patterns in clinical medicine and, using qualitative methods, analyzes the perspectives of twenty physician-educators on curricular reform and the transforming clinical training environment. Physicians interviewed were generally supportive of the new curricular initiative. Concerns were raised, however, that many recent changes within the teaching hospital environment interfere with students' cultivation of professional and healer attributes. These changes were organized into three main themes: scientific, institutional, and social. Physicians expressed concern that what is often considered beneficial for patients is often detrimental for medical training. For example, increased use of diagnostic technologies has improved patient care but reduces opportunities for trainees' clinical skill development. Concern was raised that the concept of selfless service has been undermined through recent shift-work regulations and a culture gap between older and younger generation physicians. Alternatively, some perceived new policies of the clinical environment to be more conducive to physicians' self-care and quality of life. Younger trainees were often described as more competent in managing medical information, more open
Touze, Jean-Étienne; Laroche, Roland
Tropical medicine was a key element of the medical structures provided by France to our former colonies and, later; to countries within the scope of our international cooperation. hI recent decades, France has drastically reduced its bilateral commitments to countries in the tropics, and especially in sub-Saharan Africa. At the same time, the teaching of tropical medicine, which was highly regarded even beyond our borders, has lost a good deal of its expertise. Initially available in a few large French centers, and ensured by teachers with extensive field experience, training in tropical medicine is now offered in many universities. However; their programs and educational objectives, focusing mainly on infectious and parasitic diseases, no longer meet the healthcare priorities of southern countries, which are facing an epidemiological transition and the rise of non communicable diseases. Few teachers now have recognized expertise in tropical medicine. These changes have had negative consequences for research programs in tropical medicine and for the image of French assistance to developing countries. In this context, the followving perspectives should be considered: 1) training in tropical medicine should be enhanced by the creation of a national diploma recognized by international bodies. 2) The creation of a doctoral course in tropical medicine is a prerequisite for achieving this goal, and the future diploma must include a significant research component. 3) Teaching in tropical medicine must become more practical and be ensured by teachers with extensive field experience. 4) Training in tropical medicine should be part of a bilateral relationship with countries in the tropics, each party contributing its expertise while respecting that of its partners. 5) Training in tropical medicine should be backed uip by high-level scientific research based on enhanced synergy of our current networks (Institute for Research and Development, Network of overseas Pasteur
Nawaz, Haq; Via, Christina M.; Ali, Ather; Rosenberger, Lisa D.
Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents’ attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907
The impact of the transition to training packages (TPs) on institutionally based training in Australia was examined. Information was gathered from 14 case studies of registered trade organizations (RTOs) delivering qualifications to institutionally based students in TPs in the following areas: administration, beauty therapy, community services,…
Whyte, John; Boninger, Michael; Helkowski, Wendy; Braddom-Ritzler, Carolyn
Physician scientists are seen as important in healthcare research. However, the number of physician scientists and their success in obtaining National Institutes of Health funding have been declining for many years. The shortage of physician scientists in Physical Medicine and Rehabilitation is particularly severe and can be attributed to many of the same factors that affect physician scientists in general, as well as to the lack of well-developed models for research training. In 1995, the Rehabilitation Medicine Scientist Training Program was funded by a K12 grant from the National Center for Medical Rehabilitation Research, as one strategy for increasing the number of research-productive physiatrists. The Rehabilitation Medicine Scientist Training Program's structure was revised in 2001 to improve the level of preparation of incoming trainees and to provide a stronger central mentorship support network. We describe the original and revised structure of the Rehabilitation Medicine Scientist Training Program and review subjective and objective data on the productivity of the trainees who have completed the program. These data suggest that Rehabilitation Medicine Scientist Training Program trainees are, in general, successful in obtaining and maintaining academic faculty positions and that the productivity of the cohort trained after the revision, in particular, shows impressive growth after about 3 yrs of training.
Vieira, Rosário; Costa, Gracinda
Nuclear medicine in Portugal has been an autonomous speciality since 1984. In order to obtain the title of Nuclear Medicine Specialist, 5 years of training are necessary. The curriculum is very similar to the one approved under the auspices of the European Union of Medical Specialists, namely concerning the minimum recommended number of diagnostic and therapeutic procedures. There is a final assessment, and during the training the resident is in an approved continuing education programme. Departments are accredited by the Medical College in order to verify their capacity to host nuclear medicine residencies.
We outline the aims and content of an inter-university academic training program in insurance medicine in Flanders, Belgium. The program leads to the diploma of "Master of Insurance Medicine and Medico-legal Expertise." The program was re-organized in 2005-2006 and is accessible for physicians who want to practice social and/or private insurance medicine as their main medical profession or as an accessory activity. The aim of education is to prepare insurance physicians to provide high quality assessments, advice and decisions. The combined education in both social and private insurance medicine offers a broad perspective on the discipline and promotes collaboration within the specialty. The recent recognition of Insurance Medicine as a medical specialty in Belgium strengthens the position of insurance physicians as they collaborate with other medical specialists and with the management of insurance companies or the social security institute.
Simmons, Guy H.; Alexander, George W.
This manual was prepared for a training program in Nuclear Medicine Technology at the University of Cincinnati. Instructional materials for students enrolled in these courses in the training program include: Nuclear Physics and Instrumentation, Radionuclide Measurements, Radiation Protection, and Tracer Methodology and Radiopharmaceuticals. (CS)
The Colorado Training Institute (CTI), established in 1980, is a non-profit, instructional program devoted to promoting hazardous materials safety through education. It has trained over 3,000 emergency response personnel and industry officials and is a unique example of the private and public sectors working together to protect the public from…
Wolfrom, Brent; Hodgetts, Geoff; Kotecha, Jyoti; Pollock, Emily; Martin, Mary; Han, Han; Morissette, Pierre
Abstract Objective To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. Design A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. Setting Canada. Participants General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters. Main outcome measures Satisfaction with and time spent in 7 domains of training: trauma, critical care, emergency medicine, psychiatry, occupational health, sports medicine, and base clinic training. Overall preparedness for leading a health care team, caring for a military population, working in isolated and challenging environments, and being deployed were evaluated on a 5-point Likert scale. Results Among the survey respondents (n = 135, response rate 54%), 77% agreed or strongly agreed that their family medicine residency training was relevant to their role as a general duty medical officer. Most respondents were either satisfied or very satisfied with their emergency medicine training (77%) and psychiatry training (63%), while fewer were satisfied or very satisfied with their sports medicine (47%), base clinic (41%), and critical care (43%) training. Even fewer respondents were satisfied or very satisfied with their trauma (26%) and occupational health (12%) training. Regarding overall preparedness, 57% believed that they were adequately prepared to care for a military patient population, and 52% of respondents believed they were prepared for their first posting. Fewer respondents (38%) believed they were prepared to work in isolated, austere, or challenging environments, and even fewer (32%) believed that residency training prepared them to lead a health care team. Conclusion General duty medical officers were satisfied with many aspects of
Mason-Suares, Heather; Sweetser, David A.; Lindeman, Neal I.; Morton, Cynthia C.
The era of personalized medicine has arrived, and with it a need for leaders in this discipline. This generation of trainees requires a cadre of new skill sets to lead the implementation of personalized medicine into mainstream healthcare. Traditional training programs no longer provide trainees with all the skills they will need to optimize implementation of this revolution now underway in medicine. Today’s trainees must manage clinical teams, act as clinical and molecular diagnostic consultants, train other healthcare professionals, teach future generations, and be knowledgeable about clinical trials to facilitate genomic-based therapies. To prepare trainees for the transition to junior faculty positions, contemporary genomic training programs must emphasize the development of these management, teaching, and clinical skills. PMID:26751479
Mason-Suares, Heather; Sweetser, David A; Lindeman, Neal I; Morton, Cynthia C
The era of personalized medicine has arrived, and with it a need for leaders in this discipline. This generation of trainees requires a cadre of new skill sets to lead the implementation of personalized medicine into mainstream healthcare. Traditional training programs no longer provide trainees with all the skills they will need to optimize implementation of this revolution now underway in medicine. Today's trainees must manage clinical teams, act as clinical and molecular diagnostic consultants, train other healthcare professionals, teach future generations, and be knowledgeable about clinical trials to facilitate genomic-based therapies. To prepare trainees for the transition to junior faculty positions, contemporary genomic training programs must emphasize the development of these management, teaching, and clinical skills.
In the Netherlands the specialization Intellectual Disability Medicine started in 2000. The main reasons for its existence are the unmet health needs of people with intellectual disability. The discipline has developed rapidly, from general practitioner-plus to a specialist in comorbidity next to the general practitioner. The specialization takes 3 years. Training hospitals can be found all over the Netherlands. The trainees follow the weekly educational activities at the national training institute that is linked to the Erasmus Medical Centre in Rotterdam. Given the great diversity of health questions that specialists in intellectual disability medicine (Dutch acronym: AVGs) have to deal with in their training, aside from clinical issues, a lot of attention is devoted to such topics as how to work methodically, medical-ethical questions and network development. About 220 AVGs are currently registered.
Carpenter, James W; Miller, R Eric
The American College of Zoological Medicine (ACZM) is dedicated to excellence in furthering the health and well-being of both captive and free-ranging wild animals. Currently there are 14 ACZM-approved residency programs in zoological medicine. In addition, eight non-approved residencies and 15 internships in North America provide training opportunities in this field. This article outlines some of the training opportunities for both veterinary students and graduate veterinarians that would best position them for entry into a zoological medicine training program. Although there is a growing number of opportunities for individuals to serve in captive and free-ranging wildlife health positions, existing training programs are inadequate to meet these needs. It is also acknowledged that there is an increasing number of veterinary students entering veterinary schools with an interest in zoological medicine and that the job market is still limited. However, positions and opportunities in zoological medicine are available for those individuals with the drive, dedication, and passion to succeed.
Morahan, Page S.; Kasperbauer, Dwight; McDade, Sharon A.; Aschenbrener, Carol A.; Triolo, Pamela K.; Monteleone, Patricia L.; Counte, Michael; Meyer, Michael J.
Reviews need for internal leadership training programs at academic health centers and describes three programs. Elements common to the programs include small classes, participants from many areas of academic medicine and health care, building on prior experience and training, training conducted away from the institution, short sessions, faculty…
Ludwig, S; Fleisher, G; Henretig, F; Ruddy, R
Endorsed emergency medicine (EM) residency programs were surveyed as to the nature and extent of training they provided in pediatric emergency care (PEC). In the surveys returned (82%) there were several important findings. The amount of time in PEC training was generally two months per year of training. This accounted for 16% of training time. However, the volume of pediatric patients was 25% of the overall patient population. There was wide variation in the sites of PEC training. Didactic sessions often did not cover even core topics. The training program directors were equally divided in their satisfaction with this aspect of their programs. Changes were recommended by 80% of the directors. Changes most often suggested were increasing pediatric patient exposure and obtaining PEC specialists as trainers.
... technician, medical records administrator, physical therapist or dental technician shall be assessed as... training or on-job training. (a) Medical-dental internships and residencies. (1) Medical residencies (other than residencies in podiatric medicine), dental residencies, and osteopathic internships...
May, Fredric C., Comp.
The Occupational Safety and Health Administration Training Institute's series of courses for 1978 is presented in this catalog. Most courses are designed for occupational safety or health professionals who are federal or state employees; two are available for personnel from the private sector. The schedule includes courses required for newly hired…
... approved as institutional training or on-job training. 21.4265 Section 21.4265 Pensions, Bonuses, and... training or on-job training. (a) Medical-dental internships and residencies. (1) Medical residencies (other...) of this section. If the course is not so accredited such practical or on-the-job training...
Lockhart, Peter B.; And Others
Carolinas Medical Center (North Carolina) initiated a behavioral training program for general practice dental residents to develop skills in handling patient anxiety/stress, obesity, and depression. The program includes monthly seminars, a clinical rotation in behavioral medicine with additional related seminars, and a month-long clinical rotation…
Objectives: To devise and develop a structured questionnaire addressing important issues relating to specialist registrar training in emergency medicine in the UK, and to then administer this questionnaire nationally to higher trainees in order to establish current practice and opinion regarding those issues. Methods: Informal interviews with current trainees were undertaken to identify themes which might be of wider importance in relation to training. The transcriptions were incorporated into a discussion questionnaire which was circulated to other trainees and to members of the Joint Committee on Higher Training in Accident and Emergency. A postal survey was developed from this draft and distributed to all trainees currently registered with the Faculty of Accident and Emergency Medicine. Results: The response rate was 75%. Collective responses to certain aspects of training are demonstrated in order to reflect current practice and opinion among UK specialist registrars and to allow further debate. Conclusion: Development of a structured questionnaire allows issues in relation to training in emergency medicine to be assessed. The findings of the survey allow national data to be presented which will be of interest to trainees and trainers in the UK as well as overseas. PMID:12954958
Haber, Paul S; Murnion, Bridin P
Barriers to entering addiction medicine (AM) have led to a persisting workforce shortage. To address this problem, the Chapter of Addiction Medicine (AChAM) was formed in 2001 as a subdivision of the Royal Australasian College of Physicians (RACP). Through consultation, AChAM has identified the scope of practice and offered fellowship to suitable established practitioners. The Chapter successfully applied to the Australian Government for recognition of AM as a medical specialty, which was finalized in November 2009. Specialist reimbursement item numbers were incorporated into that decision process and commence operating in November 2010. AChAM has designed and implemented a training scheme using a model similar to that of the RACP internal medicine training program. This comprises 3 years of basic general medical training post internship followed by 3 years of discipline-specific supervised training. The training is broadly based, with experience in both ambulatory care and inpatient care, and including physical health as well as mental health. Assessment is continuous and competency based. There is no exit examination. The overriding clinical approach rests upon the harm minimization framework consistent with long-established national drug policy in Australia and favors evidence-based treatment.
Medical School graduates can enter a medicine subspecialty training program upon completion of a 3 year Internal Medicine residency. The Ministry of Health has contributed to postgraduate training by defining the type of physician the country needs, and by financial support of specially (Internal Medicine) training. Before 1995, when applicants began being charged a fee, finding for subspecialty training was provided exclusively by the universities. Currently, 450 training post are available for 550 graduates from all medical schools. Of these, 59 are in Internal Medicine and 58 in its subspecialties. A quantitative analysis of 40 years of training programs in Internal Medicine by the traditional medical schools shows that only the Catholic University of Chile Medical School privileges subspecially training whereas all other schools favor general Internal Medicine training. A high number of Internal Medicine trainees never take final examination. Nevertheless, training through practice, not necessarily in a university setting, accounts for 67% of Autonomous National Corporation for Certification of Medical Specialties. CONACEM accredited subspecialists. About 63% of those who finish an Internal Medicine training program decide to go into subspecialization. It is felt that subspecialization involves technical as well as non-professional aspects, such as a philosophical stance towards the search for truth through research and creativity. An integral education in a subspecialty can only be given by the university. Non-university centers, however, can contribute to subspecialization by allowing trainees to gain access to newer technology or to larger numbers of patients. A critical question is how many subspecialists should exist in relation to the number of generalists and according to the country's health requirements. In my personal view, the proportion of subspecialists is excessive. The decision to subspecialize should not be exclusively a personal choice, but
... approved as institutional training or on-job training. 21.4265 Section 21.4265 Pensions, Bonuses, and... training or on-job training. (a) Medical-dental internships and residencies. (1) Medical residencies (other... an affiliated hospital, clinic, laboratory, or medical center as a part of a medical or...
This article overviews the training of nuclear medicine technologists in chosen European countries, the United States and Canada. There are basically two types of training: at medical schools following secondary school, without any university degree, usually on a 2- or 3-year basis, or else as a university course, leading to a BSc degree after 3 years, and in some countries to an MSc degree after an additional 2 years. In the United States both systems coexist, while in Europe the picture varies from country to country. The number of hours devoted to nuclear medicine also varies between curricula. Some efforts are being made to unify this system by transition to the university model of education in many European countries.
Teresińska, Anna; Birkenfeld, Bożena; Królicki, Leszek; Dziuk, Mirosław
In Poland, nuclear medicine (NM) has been an independent specialty since 1988. At the end of 2013, the syllabus for postgraduate specialization in NM has been modified to be in close accordance with the syllabus approved by the European Union of Medical Specialists and is expected to be enforced before the end of 2014. The National Consultant in Nuclear Medicine is responsible for the specialization program in NM. The Medical Center of Postgraduate Training is the administrative body which accepts the specialization programs, supervises the training, organizes the examinations, and awards the specialist title. Specialization in NM for physicians lasts for five years. It consists of 36 months of training in a native nuclear medicine department, 12 months of internship in radiology, 3 months in cardiology, 3 months in endocrinology, 3 months in oncology, and 3 months in two other departments of NM. If a NM trainee is a specialist of a clinical discipline and/or is after a long residency in NM departments, the specialization in NM can be shortened to three years. During the training, there are obligatory courses to be attended which include the elements of anatomy imaging in USG, CT, and MR. Currently, there are about 170 active NM specialists working for 38.5 million inhabitants in Poland. For other professionals working in NM departments, it is possible to get the title of a medical physics specialist after completing 3.5 years of training (for those with a master's in physics, technical physics or biomedical engineering) or the title of a radiopharmacy specialist after completing 3 years of training (for those with a master's in chemistry or biology). At present, the specialization program in NM for nurses is being developed by the Medical Centre of Postgraduate Education. Continuing education and professional development are obligatory for all physicians and governed by the Polish Medical Chamber. The Polish Society of Nuclear Medicine (PTMN) organizes regular
Castellanos-Ortega, A; Rothen, H U; Franco, N; Rayo, L A; Martín-Loeches, I; Ramírez, P; Cuñat de la Hoz, J
The medical training model is currently immersed in a process of change. The new paradigm is intended to be more effective, more integrated within the healthcare system, and strongly oriented towards the direct application of knowledge to clinical practice. Compared with the established training system based on certification of the completion of a series or rotations and stays in certain healthcare units, the new model proposes a more structured training process based on the gradual acquisition of specific competences, in which residents must play an active role in designing their own training program. Training based on competences guarantees more transparent, updated and homogeneous learning of objective quality, and which can be homologated internationally. The tutors play a key role as the main directors of the process, and institutional commitment to their work is crucial. In this context, tutors should receive time and specific formation to allow the evaluation of training as the cornerstone of the new model. New forms of objective summative and training evaluation should be introduced to guarantee that the predefined competences and skills are effectively acquired. The free movement of specialists within Europe is very desirable and implies that training quality must be high and amenable to homologation among the different countries. The Competency Based training in Intensive Care Medicine in Europe program is our main reference for achieving this goal. Scientific societies in turn must impulse and facilitate all those initiatives destined to improve healthcare quality and therefore specialist training. They have the mission of designing strategies and processes that favor training, accreditation and advisory activities with the government authorities.
... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Practical training... Administration of Educational Assistance Programs Courses § 21.4265 Practical training approved as institutional... objective of practical nurse, practical trained nurse, or licensed practical nurse will be assessed...
Berger, Sarah; Szecsenyi, Joachim; Marquard, Sabine
Introduction For the effective and safe management of complex care needs for patients in community settings, high quality family medicine (FM) training programmes are needed. In less primary care oriented countries, training standards statements for FM postgraduate training are less commonly found. The aim of this study was to review international training standards statements in FM postgraduate training and to catalogue these statements to be used as a best practice standard guide for FM training programs in Germany. Materials and Methods A structured three-tiered search was performed: a systematic literature search in MEDLINE®; a search of international indicator databases; and a search in grey literature, consisting of a survey of international experts and a search in “Google (Scholar)”. From all identified documents, training standards statements were extracted, translated and summarized into categories referring to the same quality aspect. Results The search strategy revealed 25 relevant documents (MEDLINE® n = 15, databases n = 2, experts n = 7, “Google” n = 1), containing 337 training standards statements. These were summarized into 80 statements. They covered structure quality (n = 35); process quality (n = 43); and two training standards statements referred to outcome quality (n = 2). Conclusion A broad range of internationally sourced training standards statements for FM postgraduate training could be identified from countries with well-established primary care systems. Only few statements internationally referred to outcome quality, expressing the difficulty in assessing outcome. The resulting inventory of training standards statements for FM postgraduate training can serve as a resource for institutions seeking to formalise and systematise FM training at regional or national levels. PMID:27459714
Menchik, Daniel A
Over the last half century, changes in the structure of medicine have shifted the relationship between the profession of medicine and social institutions. In this paper, I uncover ideas for retheorizing this relationship by analyzing a review by Georg Simmel that has been previously overlooked. In an analytical overview and critical appraisal of Simmel's text, I argue that he considered preventative medical knowledge more influential when this knowledge is located outside the physician-patient relationship. Simmel suggests we need to identify how such knowledge is injected into medical and non-medical settings by the mixtures of professional-, market-, and state-based institutions governing medicine, and pay attention to how these institutions shift. His goals show continuity with a social medicine movement in Germany previously thought to be stalled, and are unique too in their focus on targeting institutions over individuals. Through a close analysis of Simmel's ideas, we can see the relationship of public health with social structural studies of medicine in theoretically innovative ways.
de Wilde, Sofieke; Guchelaar, Henk-Jan; Herberts, Carla; Lowdell, Mark; Hildebrandt, Martin; Zandvliet, Maarten; Meij, Pauline
In the rapidly evolving fields of cellular immunotherapy, gene therapy and regenerative medicine, a wide range of promising cell therapy medicinal products are in clinical development. Most products originate from academic research and are explored in early exploratory clinical trials. However, the success rate toward approval for regular patient care is disappointingly low. In this paper, we define strengths and hurdles applying to the development of cell therapy medicinal products in academic institutes, and analyze why only a few promising cell therapies have reached late-stage clinical development. Subsequently, we provide recommendations to stakeholders involved in development of cell therapies to exploit their potential clinical benefit.
Rasyidi, Ernest; Wilkins, Jeffery N; Danovitch, Itai
Within the United States there exists a profound discrepancy between the significant public health problem of substance abuse and the access to treatment for addicted individuals. Part of the insufficient access to treatment is a function of relatively low levels or professional experts in addiction medicine. Part of the low levels of professional addiction experts is the result of inadequate addiction medicine training of medical students and residents. This article outlines deficits in addiction medicine training among medical students and residents, yet real change in the addiction medicine training process will always be subject to the complexity of producing alterations across multiple credentialing institutions as well as the keen competition between educators for “more time” for their particular subject. Other hurdles include the broad-based issue of stigma regarding alcoholism and other substance abuse that likely impact all systems that regulate physician addiction medicine training. As noted in the discussion of psychiatry residency, even psychiatry residents manifest stigma regarding substance abusing patients. Five currently active processes may allow for fundamental change to the inertia in physician addiction medicine training while also potentially impacting stigma: 1. We appear to be at the beginning of the integration of addiction into traditional medicine through the formation of a legitimized addiction medicine subspecialty. 2. The training of primary care trainees and practitioners in the use of SBIRT is accelerating, thus creating another process of addiction integration into traditional medicine. 3. The PCMH is being established as a model for primary care 4. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) became effective for group health care plan years beginning on or after July 1, 2010; thereby, substance abuse benefits and cost are to be the same as general medical or surgical
Ibrahim, Mohd Zuhdi; Ab Rahman, Mohd Nizam; Yasin, Ruhizan M.
The purpose of this study is to examine students' perception of quality of service offered in Malaysian skills training institutes and how it influences overall satisfaction. This study employed a questionnaire survey involving seven skills training institutes in Klang Valley, Malaysia. From 600 questionnaires distributed, 419 were returned (69.8…
Dunlap and Associates, Inc., Darien, CT.
Five regional training institutes were held in the spring of 1972 to develop a cadre to teach the National Highway Traffic Safety Administration curriculum package, "Basic Training Program for Breath Examiner Specialist." Emphasis of the institutes was on the development of teaching skills, rather than breath testing skills. Enrollees…
Westra, Michel; de Haan, Hein A; Arends, Marleen T; van Everdingen, Jannes J E; Klazinga, Niek S
In the Netherlands, the policy on care for prisoners who are addicted to opiates is still heterogeneous. The recent guidelines entitled 'Medicinal care for drug addicts in penal institutions' should contribute towards unambiguous and more evidence-based treatment for this group. In addition, it should improve and bring the care pathways within judicial institutions and mainstream healthcare more into line with one another. Each rational course of medicinal treatment will initially be continued in the penal institution. In penal institutions the help on offer is mainly focused on abstinence from illegal drugs while at the same time limiting the damage caused to the health of the individual user. Methadone is regarded at the first choice for maintenance therapy. For patient safety, this is best given in liquid form in sealed cups of 5 mg/ml once daily in the morning. Recently a combination preparation containing buprenorphine and naloxone - a complete opiate antagonist - has become available. On discontinuation of opiate maintenance treatment intensive follow-up care is necessary. During this period there is considerable risk of a potentially lethal overdose. Detoxification should be coupled with psychosocial or medicinal intervention aimed at preventing relapse. Naltrexone is currently the only available opiate antagonist for preventing relapse. In those addicted to opiates, who also take benzodiazepines without any indication, it is strongly recommended that these be reduced and discontinued. This can be achieved by converting the regular dosage into the equivalent in diazepam and then reducing this dosage by a maximum of 25% a week.
Keevil, Stephen F.
Physics in Medicine and Biology is one of three journals owned by the UK based Institute of Physics and Engineering in Medicine (IPEM), along with Physiological Measurement and Medical Engineering and Physics. IPEM is a charity and journal revenues are a vital part of our income stream. By subscribing to our journals, you are helping to support the work of IPEM, so you may be interested to learn more about who we are and what we do. IPEM aims to advance physics and engineering applied to medicine and biology for the public good. Our membership comprises over 4000 physicists, engineers and technologists working in healthcare, academia and industry. Most of our work depends on these members generously volunteering their expert knowledge and extensive experience to work in the following areas. Promoting research and innovation Along with the scientific journals mentioned above, we also regularly produce scientific reports. There are currently 40 IPEM reports in print, as well as reference books such as The Gamma Camera—A Comprehensive Guide and the recently published Physicists and Physicians: A History of Medical Physics from the Renaissance to Röntgen. Publishing is just one way in which we encourage R&D and increase the uptake of new knowledge and innovations. We also support scientific conferences, such as the International Conference on Medical Physics 50th anniversary meeting, which we hosted in 2013 on behalf of the International Organization for Medical Physics (IOMP). This four-day event explored the contribution that physics and engineering can make to healthcare and showcased the latest developments via 312 international speakers, 212 posters and an exhibition. Our awards, travel bursaries and grants enable us to facilitate, recognize and reward the work of our members. In 2012 we awarded almost #95 000 (around 155 000) this way. Championing the sector IPEM provides a unified voice with which to represent the views of our membership and raise the
... Administration Advisory Committee on Training in Primary Care Medicine and Dentistry AGENCY: Health Resources and... the cancellation of the Advisory Committee on Training in Primary Care Medicine and...
Kamínek, Milan; Koranda, Pavel
Nuclear medicine in the Czech Republic is a full specialty with an exclusive practice. Since the training program was organized and structured in recent years, residents have had access to the specialty of nuclear medicine, starting with a two-year general internship (in internal medicine or radiology). At present, nuclear medicine services are provided in 45 departments. In total, 119 nuclear medicine specialists are currently registered. In order to obtain the title of Nuclear Medicine Specialist, five years of training are necessary; the first two years consist of a general internship in internal medicine or radiology. The remaining three years consist of training in the nuclear medicine specialty itself, but includes three months of practice in radiology. Twenty-one physicians are currently in nuclear medicine training and a mean of three specialists pass the final exam per year. The syllabus is very similar to that of the European Union of Medical Specialists (UEMS), namely concerning the minimum recommended numbers for diagnostic and therapeutic procedures. In principle, the Czech law requires continuous medical education for all practicing doctors. The Czech Medical Chamber has provided a continuing medical education (CME) system. Other national CMEs are not accepted in Czech Republic.
Robens, J. F.; Buck, W. B.
Presented are an American Board of Veterinary Toxicology survey and evaluation of the training resources available in graduate programs in toxicology located in colleges of veterinary medicine. Regulatory toxicology, number of toxicologists needed, and curriculum are also discussed. (JMD)
Vieira, Rebecca L; Hsu, Deborah; Nagler, Joshua; Chen, Lei; Gallagher, Rachel; Levy, Jason A
The importance of point-of-care emergency ultrasound (EUS) to the practice of emergency medicine (EM) is well established, and mounting research continues to demonstrate how EUS can benefit pediatric emergency department (ED) patients. As members of the EM community, pediatric EM (PEM) physicians should understand the potential value of EUS and seek opportunities to incorporate EUS into their daily practice. Currently, EUS education and training is at an early developmental stage for PEM fellows and varies greatly between programs. The goal of this article is to provide consensus education guidelines and to describe a sample curriculum that can be used by PEM fellowship programs when developing or revising their US training curricula. The authors recognize that programs may be at different stages of EUS development and will consequently need to tailor curricula to individual institutional needs and capabilities. This guideline was developed through a collaborative process between EUS educators and members of the American Academy of Pediatrics Section of EM Fellowship Directors Subcommittee. The guideline includes the following topics: important considerations regarding EUS in PEM, PEM US program framework, PEM US curriculum, PEM US education program, and competency assessment.
Tanji, Jeffrey L.
Describes the development of a hands-on sports medicine training program for residents at the University of California, Davis, Medical Center. Education strategies include clinical teaching, on-the-field education, experiential learning, and didactic instruction. Programs focusing exclusively on sports medicine are needed because the number of…
Blanken, Terry G.
This investigation was inspired by the researcher's desire to pursue psychoanalytic training subsequent to completion of her PhD in clinical psychology and the discovery that no comprehensive resource existed to assist prospective psychoanalytic candidates with identifying or evaluating psychoanalytic training opportunities. This dissertation therefore aspires to provide a comprehensive guide to analytic training in the United States today. The researcher presents the expanding horizons of depth-oriented training leading to certification as an analyst, including training based on those schools of thought that resulted from early splits with Freud (Adlerian and Jungian) as well as training based on thought that has remained within the Freudian theoretical umbrella (e.g., classical, object relations, self psychology, etc.). Employing a heuristic approach and using hermeneutics and systems theory methodologies, the study situates analytic training in its historical context, explores contemporary issues, and considers its future. The study reviews the various analytic schools of thought and traces the history of psychoanalytic theory from its origins with Freud through its many permutations. It then discusses the history of psychoanalytic training and describes political, social, and economic factors influencing the development of training in this country. The centerpiece of the dissertation is a guidebook offering detailed information on each of 107 training institutes in the United States. Tables provide contact data and information which differentiate the institutes in terms of such parameters as size; length of program, theoretical orientation, and accreditation. A narrative of each institute summarizes the unique aspects of the program, including its admissions policy, the requirements for the training analysis and supervised clinical work, and the didactic curriculum, along with lists of courses offered. Child and adolescent psychoanalytic training is also
Dubois, Michel Y; Follett, Kenneth A
Over the last 30 years, pain has become one of the most dynamic areas of medicine and a public health issue. According to a recent Institute of Medicine report, pain affects approximately 100 million Americans at an estimated annual economic cost of $560 to $635 billion and is poorly treated overall. The American Board of Medical Specialties (ABMS) recognizes a pain subspecialty, but pain care delivery has struggled with increasing demand and developed in an inconsistent and uncoordinated fashion. Pain education is insufficient and highly variable. Multiple pain professional organizations have led to fragmentation of the field and lack of interdisciplinary agreement, resulting in confusion regarding who speaks for pain medicine. In this Perspective, the authors argue that ABMS recognition of pain medicine as an independent medical specialty would provide much needed structure and oversight for the field and would generate credibility for the specialty and its providers among medical peers, payers, regulatory and legislative agencies, and the public at large. The existing system, managed by three ABMS boards, largely excludes other specialties that contribute to pain care, fails to provide leadership from a single professional organization, provides suboptimal training exposure to pain medicine, and lengthens training, which results in inefficient use of time and educational resources. The creation of a primary ABMS conjoint board in pain medicine with its own residency programs and departments would provide better coordinated training, ensure the highest degree of competence of pain medicine specialists, and improve the quality of pain care and patient safety.
Haber, Paul S.; Murnion, Bridin P.
Barriers to entering addiction medicine (AM) have led to a persisting workforce shortage. To address this problem, the Chapter of Addiction Medicine (AChAM) was formed in 2001 as a subdivision of the Royal Australasian College of Physicians (RACP). Through consultation, AChAM has identified the scope of practice and offered fellowship to suitable…
This article gives the history and purpose of the Navy Preventive Medicine Technician (PMT) School, overviews the program's goals, and summarizes the program of study. PMT students receive 26 weeks of intensive didactic and practical instruction in preventive medicine and environmental health. Graduates receive 421/2 semester hours of college…
Pourriat, Jean-Louis; Dahan, Benjamin; Lapandry, Claude
French (AP-HP) and Chinese (Beijing Health Office) hospitals, with support from the French company Total, collaborated in order to improve Chinese doctors' knowledge of emergency and disaster medicine prior to the Beijing Olympic Games. A Sino-French emergency and disaster medicine training center was subsequently opened in Beijing in 2008, with the aim of providing high-level continuous medical training for Chinese specialists in emergency medicine. Teaching in the management of critical situations was based on the use of a latest-generation simulator (Sim 3G; Laerdal). This collaboration has had both pedagogical and diplomatic benefits.
Society for Health and Human Values, Philadelphia, PA.
This document is a compilation of reports of persons involved in the fellowship program offered by the Institute of Health and Human Values. The fellowship program centers around recognition of a need to support faculty development so that appropriately trained people can be available for emerging programs that teach human values as part of health…
Moallem, Abbas; Moallem, Mahnaz
The Specialized Vocational Training Institutions known as Institut Medico-Professionel (IMPro) in France are faced with increasing demands to provide quality services to adolescents with intellectual disabilities. This article describes the process of organizational changes in IMPro including the model, methods, tools, and techniques used in…
Australian older adults were trained to act as advocates and role models to inform peers on effective use of medicines. Trainees reported difficulties experienced by older learners when training is too concentrated. Many noted increased self-esteem and personal growth as a result of their involvement. (SK)
Lindeman, Lynn William; Boerner, Hank
The manufacture of generic drugs is a growing industry, generally composed of small companies that are more dependent than brand-name companies on hiring entry-level workers. To provide standardized training for employees in the generic drug manufacturing field, the Generic Pharmaceutical Training Institute (GPTI) was established by a partnership…
Reisman, Yacov; Eardley, Ian; Porst, Hartmut
INTRODUCTION.: The past 12 months have been historic ones for the field of Sexual Medicine in that we have seen the creation of the European Board examination in Sexual Medicine with the title of "Fellow of the European Committee on Sexual Medicine" (FECSM) offered to successful candidates. AIM.: The study aims to promote a high standard of care in Sexual Medicine. METHODS.: An important way of promoting high standards of care is by the development of training, regulation, and assessment framework. The background to these developments and the recent educational activities of the European Society for Sexual Medicine (ESSM) are described in this article. RESULTS.: The creation of the Multidisciplinary Joint Committee on Sexual Medicine (MJCSM) under the auspices of the European Union of Medical Specialists, with the primary purpose to develop the highest possible standards of training in Sexual Medicine in Europe, made it possible to create a process for qualification in Sexual Medicine. The ESSM educational activities created opportunities to support trainees in Sexual Medicine and the first MJCSM exam was held in Amsterdam with a high overall success rate. CONCLUSION.: These activities are intended to improve quality. The FECSM examination is the first of its type and provides a real opportunity for Sexual Medicine physicians to demonstrate and document their knowledge.
Smith-Coggins, Rebecca; Carius, Michael L; Collier, Robert E; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Korte, Robert C
The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency training programs and the residents in those programs. We present the 2012 annual report on the status of US emergency medicine training programs.
Marco, Catherine A; Baren, Jill M; Beeson, Michael S; Carius, Michael L; Counselman, Francis L; Gausche-Hill, Marianne; Goyal, Deepi G; Kowalenko, Terry; Muelleman, Robert L; Wahl, Robert P; Joldersma, Kevin B
The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents training in those programs. We present the 2016 annual report on the status of US emergency medicine training programs.
Hilgert, Norma I; Gil, Guillermo E
are: the family medicine, the midwife, and the formal doctors. Plants have an important role; however there is a lack of total agreement among the families who use them. Reluctance to institutional deliveries may be due to the weak relationship between patients and doctors, and the lack of logistic assistance to delivering mothers coming from far away locations. PMID:17475013
Smith-Coggins, Rebecca; Baren, Jill M; Beeson, Michael S; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Nelson, Lewis S; Wahl, Robert P; Korte, Robert C
The American Board of Emergency Medicine gathers extensive background information on emergency medicine residency programs and the residents in them. We present the 2014 annual report on the status of US emergency medicine training programs.
Smith-Coggins, Rebecca; Baren, Jill M; Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Wahl, Robert P; Korte, Robert C
The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents in those programs. We present the 2013 annual report on the status of US emergency medicine training programs.
Pereira, E A C; Madder, H; Millo, J; Kearns, C F
The authors describe a novel 4-month clinical placement in neurosciences intensive care medicine (NICM) undertaken in the first specialty registrar (ST1) year of neurosurgical training as part of a clinical neurosciences themed training year. Neurosurgery is unique among British surgical specialties in having pioneered themed early years in run-through training to replace basic surgical training in general surgical specialties as part of Modernising Medical Careers. After describing events leading to the new neurosurgical training, the knowledge, skills and attitudes acquired in NICM are highlighted alongside discussion of logistic aspects and future directions from an inaugural experience.
Ozcan, Zehra; Bozkurt, M Fani; Erbas, Belkıs; Durak, Hatice
Nuclear medicine applications in Turkey started in the early 1950s, grew as an independent medical discipline and finally were recognized by the Ministry of Health in 1973. Later on, the professional organization of nuclear medicine physicians and other related professionals including radiopharmacists and technologists under the Turkish Society of Nuclear Medicine were established in 1975. Recently after completing more than a half century in Turkey, nuclear medicine has proved to be a strong and evolving medical field with more than 600 physicians serving for the changing needs of clinical practice throughout these years. This article describes past and present facts in this field and attempts to provide insights into the future which hopefully will be brighter than before.
Zhang, Ziqun; Zhao, Jiaao
Experimenting in medicine can be accomplished by virtual reality system. VRML is a tool to build virtual object and scenes which can realize static and animated applications in medicine. However, to creat a real environment, the demanded level of interactivity and dynamics is difficult to achieve. In this paper we describe some approaches and techniques which can realize dynamic 3D. Our demonstration is based on the implementation of a virtual baby model, whose character can be accomplished by external JAVA applications.
Barker, Philip; Manji, Karim
Discussion of issues related to computer-assisted learning (CAL) and computer-based training (CBT) describes approaches to electronic learning; principles underlying courseware development to support these approaches; and a plan for creation of a CAL/CBT development center, including its functional role, campus services, staffing, and equipment…
Watson, S J; Benson, J A; Joy, J E
In response to public pressure to allow the medical use of marijuana, the Office of National Drug Control Policy, Washington, DC, funded a study by the Institute of Medicine evaluating the scientific evidence for benefits and risks of using marijuana as a medicine. The report used scientific reviews, public hearings, and reports from other agencies, and was evaluated by knowledgeable advisors and reviewers. It called for heavier investment in research on the biology of cannabinoid systems, careful clinical studies of cannabinoids in clinical syndromes, analysis of cannabinoids' psychological effects on symptoms, and evaluations of the health consequences of heavy marijuana use; recommends against the use of smoked marijuana in medicine and for the development of a medical cannabinoid inhaler; and recommends that compassionate use of marijuana be considered under carefully reviewed protocols. Finally, the report evaluates the abuse potential, tolerance, withdrawal, and gateway risks of medical use of cannabinoid drugs.
Khubchandani, Jagdish; Price, James H; Dake, Joseph A
Preventive medicine plays a central role in the reducing the number of deaths due to preventable causes of premature deaths. General Preventive Medicine Residency programs have not been studied in relation to training in this area. A three-wave mail survey was conducted with email and telephone follow-ups. The outcome measures were the portion of program directors involved in training residents on firearm injury prevention issues and their perceived benefits and barriers of training residents on firearm injury prevention issues. Only 25% of the programs provided formal training on firearm injury prevention. Program directors who provided formal training perceived significantly higher number of benefits to offering such training than did directors who did not provide such training but no significant difference was found between the two for number of perceived barriers. If preventive medicine residency graduates are to play a role in reducing premature morbidity and mortality from firearms it will require more residencies to offer formal training in this area. The Association for Prevention Teaching and Research needs to develop guidelines on specific curriculum topics regarding firearm injury prevention.
teaching. In A.C. Ornstein (Ed.), Teaching: Theory into practice (pp. 98-115). Boston: Allyn and Bacon . Corno, L. (2008). On teaching...Learning, training, and development in organizations (pp. 3-64). New York: Routledge Taylor and Francis Group. Hailikari, T., Nevgi, A., & Komulainen
Gossa, Weyinshet; Wondimagegn, Dawit; Mekonnen, Demeke; Eshetu, Wondwossen; Abebe, Zerihun; Fetters, Michael D
As a very low-income country, Ethiopia faces significant development challenges, though there is great aspiration to dramatically improve health care in the country. Family medicine has recently been recognized through national policy as one potential contributor in addressing Ethiopia’s health care challenges. Family medicine is a new specialty in Ethiopia emerging in the context of family medicine development in Sub-Saharan Africa. The Addis Ababa University family medicine residency program started in 2013 and is the first and the only family medicine program in the country as of March 2016. Stakeholders on the ground feel that family medicine is off to a good start and have great enthusiasm and optimism for its success. While the Ministry of Health has a vision for the development of family medicine and a plan for rapid upscaling of family medicine across the country, significant challenges remain. Continuing discussion about the potential roles of family medicine specialists in Ethiopia and policy-level strategic planning to place family medicine at the core of primary health care delivery in the country is needed. In addition, the health care-tier system needs to be restructured to include the family medicine specialists along with appropriately equipped health care facilities for training and practice. Key stakeholders are optimistic that family medicine expansion can be successful in Ethiopia through a coordinated effort by the Ministry of Health and collaboration between institutions within the country, other Sub-Saharan African countries, and international partners supportive of establishing family medicine in Ethiopia. PMID:27175100
Finn, R.; Fowler, J.
This panel was organized to address the current and anticipated future shortage of chemists with advanced training to fill positions in the nuclear medicine field. Although hard data and statistics are difficult to acquire, we will attempt to highlight the impact of chemistry on nuclear medicine and to describe the growth of the field which has led to an increasing need for chemists resulting in the current manpower shortage. We also will make recommendations for attracting Ph.D. chemists to careers in nuclear medicine research and possible mechanisms for postgraduate training. Solving this problem and establishing a long term committment and mechanism for advanced training is critically important to meet the current needs of the profession and to assure future growth and innovation. 3 tabs.
Rafferty, Michael F
There has been little consensus between the pharmaceutical industry and academic communities concerning the best approach to train medicinal chemists for drug discovery. For decades the pharmaceutical industry has shown preference for synthetic organic graduates over candidates with degrees from medicinal chemistry programs on the assumption that medicinal chemistry expertise will be acquired on the job. However, ongoing changes to pharmaceutical drug discovery organizations and practices threaten to undermine this training model. There is a compelling argument to be made for establishment of a strong industry-academic partnership to train new candidates with sophisticated knowledge of contemporary drug design concepts and techniques to ensure that the future needs of both industry and academic drug discovery research can be served.
Christensen, Mark; Christensen, Heidi K
Residency training clearly impacts physicians' approach toward fellowship in Primary Care Sports Medicine. Although the Accreditation Council for Graduate Medical Education sets strict standards for all programs, family medicine and emergency medicine training differ a great deal in general and provide physicians from both backgrounds varied perspectives and skill sets. The family physician acquires a substantial amount of experience in continuity of care and integration of health care into a patient's everyday life. On the other hand, the emergency physician receives exceptional training in the management of acutely ill and injured patients and leadership of a large health care team. Furthermore, while the emergency physician may be skilled in procedures such as fracture reduction and diagnostic ultrasound, the family physician is proficient in developing patient rapport and compliance with a treatment plan. Although physicians from different backgrounds may start with many differences, fellowship training is essential in bridging those gaps.
Andreatta, Pamela; Frankel, Jennifer; Boblick Smith, Sara; Bullough, Alexandra; Marzano, David
The objective of this study was to evaluate the impact of an interdisciplinary team-training program in obstetric emergencies on identifying unsupportive institutional policies and systems-based practices. We implemented a qualitative study design with a purposive sample of interdisciplinary physicians, nurses, and ancillary allied health professionals from 4 specialties (n = 79) to conduct a 6-month, weekly simulation-based intervention for managing obstetric emergencies. Debriefing focused on identifying discrepancies between clinical practice and institutional policies. Our data yielded 5 categories of discrepancies between institutional or departmental policy and actual clinical practice. Specific institutional policies and system-based practices were recommended to health system administration for reevaluation. Simulation-based interdisciplinary team training can inform system-wide quality improvement objectives that could lead to increased patient safety.
Talbot, Yves R.; Tannenbaum, David
Teaching about the family has become an important part of the family medicine curriculum. The family orientation index, a 39-item questionnaire, was designed to evaluate the family orientation of services and care provided as well as the teaching and research. The questionnaire was distributed to 55 program directors at 16 Canadian universities. The response rate was 84%. The results indicate that the family orientation of services is less than optimal. PMID:21233938
Jason, Leonard A; Sunnquist, Madison; Brown, Abigail; McManimen, Stephanie; Furst, Jacob
The Institute of Medicine (IOM) in the United States has recently proposed that the term systemic exertion intolerance disease (SEID) replace chronic fatigue syndrome. In addition, the IOM proposed a new case definition for SEID, which includes substantial reductions or impairments in the ability to engage in pre‑illness activities, unrefreshing sleep, postexertional malaise, and either cognitive impairment or orthostatic intolerance. Unfortunately, these recommendations for a name change were not vetted with patient and professional audiences, and the new criteria were not evaluated with data sets of patients and controls. A recent poll suggests that the majority of patients reject this new name. In addition, studies have found that prevalence rates will dramatically increase with the new criteria, particularly due to the ambiguity revolving around exclusionary illnesses. Findings suggest that the new criteria select more patients who have less impairment and fewer symptoms than several other criteria. The implications of these findings are discussed in the current review.
Westcott, Wayne L
Inactive adults experience a 3% to 8% loss of muscle mass per decade, accompanied by resting metabolic rate reduction and fat accumulation. Ten weeks of resistance training may increase lean weight by 1.4 kg, increase resting metabolic rate by 7%, and reduce fat weight by 1.8 kg. Benefits of resistance training include improved physical performance, movement control, walking speed, functional independence, cognitive abilities, and self-esteem. Resistance training may assist prevention and management of type 2 diabetes by decreasing visceral fat, reducing HbA1c, increasing the density of glucose transporter type 4, and improving insulin sensitivity. Resistance training may enhance cardiovascular health, by reducing resting blood pressure, decreasing low-density lipoprotein cholesterol and triglycerides, and increasing high-density lipoprotein cholesterol. Resistance training may promote bone development, with studies showing 1% to 3% increase in bone mineral density. Resistance training may be effective for reducing low back pain and easing discomfort associated with arthritis and fibromyalgia and has been shown to reverse specific aging factors in skeletal muscle.
Švab, Igor; Allen, Justin; Žebiene, Egle; Petek Šter, Marija; Windak, Adam
Family medicine teachers require specific educational skills. A framework for their professional development is essential for future development of the discipline in Europe. EURACT developed a framework on educational expertise, and subsequently applied it in a curriculum of teaching-skills courses of various levels. The aim of this article is to describe the development of the teaching framework, and of an international three-level course programme for 'teaching-the-teachers'. Furthermore, we describe our experiences and lessons learned, in particular with regard to the level-three programme for proficient teachers, which was new. We conclude that it is possible to develop a theoretical framework of family medicine teaching expertise and to apply it in an international high-level educational programme for future experts in family medicine education. Research evidence of the usefulness of this approach is needed, and the threats for its further development into a sustainable activity are its high teacher/student ratio associated with relatively high costs and difficulties in recruiting suitable participants.
Casas Patiño, Donovan; Jarillo Soto, Edgar; Rodríguez Torres, Alejandra
The central ideas of this research paper are related to the practice of family medicine as a specialty. It focuses in its origins, problems, unique characteristics, limitations, scope, management, and processes within the context of primary care of the Mexican Social Security System. This approach was based on a qualitative, hermeneutical study closely related to the Structural Functionalism Theory. Within this framework, medical practice is seen as an equation: Meaning = action + function/structure. This offers an approach to the understanding of reality through surveys and observations in five categories: identity, activity, purpose, values/norms, and power/relationship. The practice of family medicine is defined as a medical act in the Mexican Social Security Institute. This act is limited to a brief encounter and a prescription, which makes it a short, fleeting, medicalized interaction. The result is a negative social imaginary of the physician, the patient and the whole of society. Thus, individuals and society host a negative social imaginary bestowed on doctors and users of the health system.
Stevens, Rosemary; Vermeulen, Joan
The purpose of the study was to bring together available materials on the location, activity, and function of more than 63,000 foreign trained physicians in the United States; to review the political, economic, and organizational factors which have led to the current manpower situation; and to analyze these data in terms of physician manpower,…
Shofler, David; Chuang, Taijung; Argade, Nina
The podiatric medicine and surgery residency is currently characterized by 3 years of comprehensive training. Contemporary issues have recently influenced the direction of training in the profession of podiatric medicine. Formal investigation into the residency training experience has, nonetheless, been limited. The purpose of the present study was to conduct a learning needs assessment of podiatric residency training. An electronic survey was developed, with comparable versions for program directors and residents. The specific topics investigated included the use of minimum activity volume numbers, learning resources, duty hours, strengths and weaknesses of residents, motivation of hosting student externship positions, noncognitive residency traits, meetings between residents and directors, resident satisfaction, and director satisfaction. A total of 197 program directors nationwide were sent the survey electronically, and 109 (53%) responded. Of 230 residents receiving the survey, 159 (78%) responded. Several statistically significant differences, and notable similarities, were observed between the 2 groups encompassing many aspects of the survey. A majority opinion, among both directors and residents, was found that the use of procedural assessment tools might improve resident evaluation. The responding directors and residents agreed that the following 3 topics were weaknesses in podiatric training: practice management, biomechanics, and performing podiatric research. Direct feedback immediately after surgery was the most valuable learning resource reported by the residents. The results of our study reflect the current status of the podiatric medicine and surgery residency and could facilitate improvement in the residency training experience.
Rutherford, Kimberly; Oda, Joanna
Background Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Method Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Results Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one’s work is valued and rotations in family medicine. Conclusions The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors. PMID:26451218
Gallagher, Erin; Moore, Ainsley; Schabort, Inge
Abstract Objective To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Design Cross-sectional quantitative survey. Setting Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. Participants A total of 152 first- and second-year family medicine residents. Main outcome measures Family medicine residents’ attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Results Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement “I am a leader” received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. Conclusion The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. PMID:28292816
Lebel, D.; Hogg, W.
A survey of family medicine residents trained at community-based or hospital-based centres suggested differences in experience and in career plans. Community-based residents saw more patients in the same family, believed they knew the community better, made more housecalls, expected to use allied health professionals more frequently, and were more likely to choose a small community practice. PMID:8499787
Onate, John; Hales, Robert; McCarron, Robert; Han, Jaesu; Pitman, Dorothy
Objective: A unique rotation was developed to address limited outpatient internal medicine training in psychiatric residency by the University of California, Davis, Department of Psychiatry and Behavioral Sciences, which provides medical care to patients with mental illness. Methods: The number of patients seen by the service and the number of…
Lester, Juliette N.
This report, annually prepared by the Executive Director of National Occupational Information Coordinating Committee (NOICC) for the NOICC Career Development Training Institute, provides current information on its performance. It identifies issues that require attention, and informs the Board of any NOICC management or policy decisions that may…
Civil Service Commission, Chicago, IL. Regional Training Center.
The document describes the supervisory course offerings of the General Management Training Institute. It contains a general information sheet, a curriculum calendar for 1976, and course descriptions for the following courses: basic management functions, basic management methods and skills, communicating and counseling, increasing (improving)…
In this article Tanika Simpson reflects on her experience at the 2012 three-day ZERO TO THREE National Training Institute (NTI) held in Los Angeles, California. The week began with a two-day pre-NTI retreat convening a national league of state Infant Mental Health Associations that are intensely committed to the work of implementing Michigan's…
Carswell, Jim; Mateer, Anne
This training model outlines methods school systems can use to implement Summer Inservice Institutes for elementary and secondary teachers of regular and exceptional education students. Procedural information is included that explains the philosophy and assists in the initiation, supervision, evaluation and continuation of the Summer Institute…
Hospital Research and Educational Trust, Chicago, IL.
This basic handbook for personnel development through training and continuing education within health care institutions describes the techniques involved in developing programs, from needs determination to evaluation. It covers how to make a skill inventory and a survey of learning needs; how to state learning objectives; how to design a specific…
Taylor, Robert E., Ed.; And Others
These 19 papers from the second annual Policy Forum on Employability Development explore the responsiveness of various educational and training institutions to changing labor market demands. The first three papers provide an overview of the forum. They summarize the proceedings and policy considerations and address how vocational education and…
Cleven, Arlene M.; Fucigna, Joseph T.
The National Highway Traffic Safety Association (NHTSA) has supported the development of a training program for school bus drivers in the form of a curriculum package (instructor's, course, and trainee study guides). To assist the States in making the program operational, NHTSA in 1974 supported the conduct of five five-day institutes to explain…
The instructor training institutes were conducted to familiarize State and local emergency medical instructional personnel with National Highway Traffic Safety Administration (NHTSA) curriculum materials and to enhance their instructional capabilities with this material. Thirty-hour courses, correlated with the content of the Emergency Medical…
Cleven, Arlene M.
The purpose of the study was to expose key individuals to the National Highway Traffic Safety Administration (NHTSA) developed curriculum materials for police traffic services supervisors and to teach them how to teach. The objective was accomplished through the conduct of five 30-hour instructor training institutes conducted in various areas of…
A six-week summer training institute designed to provide participants with the skills and understanding needed to help student teachers and beginning teachers to perform successfully in racially mixed schools and classrooms was attended by 119 elementary and secondary school teachers and administrators (approximately half Negro and half white)…
Connell, Erin; Arsintescu, Lucia
The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1
Arons, Judith; Epstein, Ann; Sklan, Susan
The Infant Parent Training Institute (IPTI) at Jewish Family and Children's Service of Greater Boston offers integrated clinical and theoretical infant mental health training. The curriculum reflects the belief that nurturing and reflective relationships promote optimal learning and growth. A specialty in infant mental health requires knowledge…
Williams, Marc S.; Ritchie, Marylyn D.; Payne, Philip R.O.
The proposed Precision Medicine Initiative has the potential to transform medical care in the future through a shift from interventions based on evidence from population studies and empiric response to ones that account for a range of individual factors that more reliably predict response and outcomes for the patient. Many things are needed to realize this vision, but one of the most critical is an informatics workforce that has broad interdisciplinary training in basic science, applied research and clinical implementation. Current approaches to informatics training do not support this requirement. We present a collaborative model of training that has the potential to produce a workforce prepared for the challenges of implementing precision medicine. PMID:27054076
Smith-Coggins, Rebecca; Marco, Catherine A; Baren, Jill M; Beeson, Michael S; Carius, Michael L; Counselman, Francis L; Heller, Barry N; Kowalenko, Terry; Muelleman, Robert L; Nelson, Lewis S; Wahl, Robert P; Korte, Robert C; Joldersma, Kevin B
The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents in those programs. We present the 2015 annual report on the status of US emergency medicine training programs.
Flausino, Gustavo de Freitas; Nunes, Flávio Ferreira; Cioffi, Júnia Guimarães Mourão; Proietti, Anna Bárbara de Freitas Carneiro
The current curricula in medical schools and hospital residence worldwide lack exposure to blood transfusion medicine, and require the reformulation of academic programs. In many countries, training in blood transfusion is not currently offered to medical students or during residency. Clinical evidence indicates that blood transfusions occur more frequently than recommended, contributing to increased risk due to this procedure. Therefore, the rational use of blood and its components is essential, due to the frequent undesirable reactions, to the increasing demand of blood products and the cost of the process. Significant improvements in knowledge of and skills in transfusion medicine are needed by both students and residents. Improvements are needed in both background knowledge and the practical application of this knowledge to improve safety. Studies prove that hemovigilance has an impact on transfusion safety and helps to prevent the occurrence of transfusion-related adverse effects. To ensure that all these aspects of blood transfusion are being properly addressed, many countries have instituted hospital transfusion committees. From this perspective, the interventions performed during the formation of medical students and residents, even the simplest, have proven effective in the acquisition of knowledge and medical training, thereby leading to a reduction in inappropriate use of blood. Therefore, we would like to emphasize the importance of the exposure of medical students and residents to blood services and transfusion medicine in order for them to acquire adequate medical training, as well as to discuss some changes in the current medical curricula regarding transfusion medicine that we judge critical. PMID:25638770
Mancuso, James D; Hickey, Patrick W; Coldren, Rodney L; Korman, Amy K; Keep, Lisa W; DeFraites, Robert F; Smith, Maria; Mancuso, Luke J; Sanchez, Jose L
In 1999, the Department of Defense developed a tropical medicine training program (TMTP) to train military physicians, medical students, and scientists in performing surveillance activities in an overseas environment. This review describes the competencies, educational approach, program participants, institutional collaborations, and process outcomes of the TMTP from 2000 to 2015. TMTP-sponsored rotations addressed a wide variety of interdisciplinary competencies, many of which have military-unique applications. Rotations consisted of both didactic and experiential (overseas) components. The program provided 282 rotations for 260 trainees between 2006 and 2015, the years for which data were available. The Department of Defense accrues benefits from this training program in three main ways: (1) building a cadre of health care professionals who will go on to work at the overseas research laboratories, (2) supporting force health protection and readiness through experiential tropical medicine training, and (3) engaging in global health collaborations and partnerships. The primary challenges include funding, health and security, trainee and site heterogeneity, supervision, trainee engagement, and burden on the host institution. The program will continue to focus on improvement in these areas, with special attention to trainee preparation, communication with both trainees and host sites, and increasing reciprocity with host sites and their faculty.
Day, Susan C.; And Others
In response to the perceived need for primary care physicians, two major changes in internal medicine training have occurred: (1) a third year of general training was required for internal medicine board certification and (2) many hospitals developed primary care internal medicine residencies with an increased emphasis on ambulatory training.…
Blazer, Kathleen R.; MacDonald, Deborah J.; Culver, Julie O.; Huizenga, Carin R.; Morgan, Robert J.; Uman, Gwen C.; Weitzel, Jeffrey N.
Purpose To assess the impact of a multi-modal interdisciplinary course in genetic cancer risk assessment (GCRA) and research collaboration for community-based clinicians. Clinicians are increasingly requested to conduct GCRA, but many are inadequately prepared to provide these services. Methods A prospective analysis of 131 participants (48 physicians, 41 advanced-practice nurses and 42 genetic counselors) from community settings across the U.S. The course was delivered in three phases: distance didactic learning, face-to-face training and 12 months of Web-based professional development activities to support integration of skills into practice. Cancer genetics knowledge, skills, professional self-efficacy and practice changes were measured at baseline, immediate- and 14-months-post course. Results Knowledge, skills and self-efficacy scores were significantly different between practice disciplines; however, post scores increased significantly overall and for each discipline (p<.001). Fourteen-month practice outcomes reflect significant increases in provision of GCRA services (p=.018), dissemination of cancer prevention information (p=.005) and high-risk screening recommendations (p=.004) to patients, patient enrollment in research (p=.013), and educational outreach about GCRA (p=.003). Conclusions Results support the efficacy of the multi-modal course as a tool to develop a genetically literate workforce. Sustained alumni participation in Web-based professional development activities has evolved into a distance-mediated Community of Practice in clinical cancer genetics, modeling the lifelong learning goals envisioned by leading CME stakeholders. PMID:21629123
Kates, Nick; Toews, John; Leichner, Pierre
Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement—particularly in finding psychiatrists with a better understanding of family practice, in integrating the teaching to a greater degree with clinical work, thereby increasing its relevance, and in utilizing more suitable clinical settings. PMID:21279156
Min, Robert J; Comerota, Anthony J; Meissner, Mark H; Carman, Teresa L; Rathbun, Suman W; Jaff, Michael R; Wakefield, Thomas W; Feied, Craig F
The major venous societies in the United States share a common mission to improve the standards of medical practitioners, the educational goals for teaching and training programs in venous disease, and the quality of patient care related to the treatment of venous disorders. With these important goals in mind, a task force made up of experts from the specialties of dermatology, interventional radiology, phlebology, vascular medicine, and vascular surgery was formed to develop a consensus document describing the Core Content for venous and lymphatic medicine and to develop a core educational content outline for training. This outline describes the areas of knowledge considered essential for practice in the field, which encompasses the study, diagnosis, and treatment of patients with acute and chronic venous and lymphatic disorders. The American Venous Forum and the American College of Phlebology have endorsed the Core Content. PMID:25059735
Kelley, Amy S; Back, Anthony L; Arnold, Robert M; Goldberg, Gabrielle R; Lim, Betty B; Litrivis, Evgenia; Smith, Cardinale B; O'Neill, Lynn B
Expert communication is essential to high-quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence-based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques before the course. Geriatric and palliative medicine fellows were recruited to participate in the course and 100% (n = 18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on a 5-point scale). After the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, P < .001). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, customized for the specific needs of geriatric and palliative medicine fellows, improved fellows' self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills.
Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian
Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the
Kintu, Denis; Kyakula, Michael; Kikomeko, Joseph
Several industrial accidents, some of them fatal, have been reported in Uganda. Causes could include training gaps in vocational training institutions (VTIs) and workplaces. This study investigated how occupational safety training in VTIs and workplaces is implemented. The study was carried out in five selected VTIs and workplaces in Kampala. Data were collected from instructors, workshop technicians, students, workshop managers, production supervisors, machine operators and new technicians in the workplaces. A total of 35 respondents participated in the study. The results revealed that all curricula in VTIs include a component of safety but little is practiced in VTI workshops; in workplaces no specific training content was followed and there were no regular consultations between VTIs and industry on safety skills requirements, resulting in a mismatch in safety skills training. The major constraints to safety training include inadequate funds to purchase safety equipment and inadequate literature on safety.
Duke, Pauline; Curran, Vernon; Hollett, Ann
Abstract Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents’ satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same level of knowledge and confidence as residents completing an inpatient-ambulatory rotation. Intraprofessional collaboration, flexibility in scheduling, and the support of pediatric preceptors are key factors in the organization and implementation of an ambulatory rotation. PMID:21321160
Jackel, D; Attia, J; Pickles, R
Recent years have seen a rapid growth in the number of advanced trainees pursuing general medicine as a specialty. This reflects an awareness of the need for broader training experiences to equip future consultant physicians with the skills to manage the healthcare challenges arising from the demographic trends of ageing and increasing comorbidity. The John Hunter Hospital training programme in general medicine has several characteristics that have led to the success in producing general physicians prepared for these challenges. These include support from a core group of committed general physicians, an appropriate and sustainable funding model, flexibility with a focus on genuine training and developing awareness of a systems approach, and strong links with rural practice.
Perez, Jose A., Jr.; Greer, Sharon
The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…
... Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Committee on Training in Primary Care, Medicine and Dentistry . Dates and Times: November 7, 2011, 8:30 a.m.... Purpose: The Advisory Committee on Training in Primary Care Medicine and Dentistry (``Advisory...
Society for Health and Human Values, Philadelphia, PA.
The document relates the proceedings of the Institute on Human Values in Medicine, which explored issues involving human values (humanities) and medicine. The purpose of the first conference is to investigate some of the questions involving this relationship and to see if there is a need for better interpolation of the knowledge of the humanities…
Simunovic, Vladimir J; Hozo, Izet; Rakic, Mladen; Jukic, Marko; Tomic, Snjezana; Kokic, Slaven; Ljutic, Dragan; Druzijanic, Nikica; Grkovic, Ivica; Simunovic, Filip; Marasovic, Dujomir
Clinical skills' training is arguably the weakest point in medical schools' curriculum. This study briefly describes how we at the Split University School of Medicine cope with this problem. We consider that, over the last decades, a considerable advancement in teaching methodologies, tools, and assessment of students has been made. However, there are many unresolved issues, most notably: (i) the institutional value system, impeding the motivation of the teaching staff; (ii) lack of a strong mentoring system; (iii) organization, timing, and placement of training in the curriculum; (iv) lack of publications pertinent to training; and (v) unwillingness of patients to participate in student training. To improve the existing training models we suggest increased institutional awareness of obstacles, as well as willingness to develop mechanisms for increasing the motivation of faculty. It is necessary to introduce changes in the structure and timing of training and to complement it with a catalog, practicum, and portfolio of clinical skills. At Split University School of Medicine, we developed a new paradigm aimed to improve the teaching of clinical skills called "Neptune-CSS," which stands for New Paradigm in Training of Undergraduate Clinical Skills in Split.
... Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a) (2) of the Federal... Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD). Dates and Times: May 20, 2013...
Harolds, Jay A; Smith, Gary T; Baker, Stephen R
The introduction of positron emission tomography/computed tomography (CT), single photon-emission CT/CT, and software packages for multimodality imaging has accelerated the need for nuclear medicine physicians to obtain more training in cross-sectional imaging, especially in CT. In recent years, the Nuclear Regulatory Commission, the Accreditation Council for Graduate Medical Education, the American Board of Radiology, and the American Board of Nuclear Medicine have promulgated new rules and regulations. In addition, the Society of Nuclear Medicine, the American College of Radiology, and the American College of Cardiology Foundation have crafted new guidelines and training requirements. All these changes have consequences for the education of physicians in nuclear medicine. Self-referral and concerns about radiation exposure from nuclear medicine examinations and CT are also affecting the education of physicians practicing nuclear medicine. The authors examine the impact of these developments on training and certification in nuclear medicine and suggest another pathway to train some nuclear medicine physicians.
Wheeler, David L.
The director of the Duke Clinical Research Institute (North Carolina) is committed to making better use of patient information for medical research, and is building a database from the institute's clinical trials. His approach is to provide biomedical researchers with daily involvement in medicine rather than management. (MSE)
Hansen, K.; Mann, R.
The instructors describe the solar installation training program operated since 1979 by the Home Builders Institute, the Educational Arm of the National Association of Home Builders for the US Department of Labor, Job Corps in San Diego, CA. The authors are the original instructors and have developed the program since its inception by a co-operative effort between the Solar Energy Industries Association, NAHB and US DOL. Case studies of a few of the 605 students who have gone to work over the years after the training are included. It is one of the most successful programs under the elaborate Student Performance Monitoring Information System used by all Job Corps programs. Job Corps is a federally funded residential job training program for low income persons 16--24 years of age. Discussion details the curriculum and methods used in the program including classroom, shop and community service projects. Solar technologies including all types of hot water heating, swimming pool and spa as well as photovoltaics are included.
McLeod, P J; Meagher, T W
OBJECTIVE: To determine the status of ambulatory care training of core internal medicine residents in Canada. DESIGN: Mail survey. PARTICIPANTS: All 16 program directors of internal medicine residency training programs in Canada. OUTCOME MEASURES: The nature and amount of ambulatory care training experienced by residents, information about the faculty tutors, and the sources and types of patients seen by the residents. As well, the program directors were asked for their opinions on the ideal ambulatory care program and the kinds of teaching skills required of tutors. RESULTS: All of the directors responded. Fifteen stated that the ambulatory care program is mandatory, and the other stated that it is an elective. Block rotations are more common than continuity-of-care assignments. In 12 of the programs 10% or less of the overall training time is spent in ambulatory care. In 11 the faculty tutors comprise a mixture of generalists and subspecialists. The tutors simultaneously care for patients and teach residents in the ambulatory care setting in 14 of the schools. Most are paid through fee-for-service billing. The respondents felt that the ideal program should contain a mix of general and subspecialty ambulatory care training. There was no consensus on whether it should be a block or continuity-of-care experience, but the directors felt that consultation and communication skills should be emphasized regardless of which type of experience prevails. CONCLUSIONS: Although there is a widespread commitment to provide core internal medicine residents with experience in ambulatory care, there is little uniformity in how this is achieved in Canadian training programs. PMID:8324688
Stevens, Brenda J; Gruen, Margaret E
Shelter medicine is a rapidly developing field of great importance, and shelters themselves provide abundant training opportunities for veterinary medical students. Students trained in shelter medicine have opportunities to practice zoonotic and species-specific infectious disease control, behavioral evaluation and management, primary care, animal welfare, ethics, and public policy issues. A range of sheltering systems now exists, from brick-and-mortar facilities to networks of foster homes with no centralized facility. Exposure to a single shelter setting may not allow students to understand the full range of sheltering systems that exist; a community-classroom approach introduces students to a diverse array of sheltering systems while providing practical experience. This article presents the details and results of a series of 2-week elective clinical rotations with a focus on field and service learning in animal shelters. The overall aim was to provide opportunities that familiarized students with sheltering systems and delivered primary-care training. Other priorities included increasing awareness of public health concerns and equipping students to evaluate shelters on design, operating protocols, infectious disease control, animal enrichment, and community outreach. Students were required to participate in rounds and complete a project that addressed a need recognized by them during the rotation. This article includes costs associated with the rotation, a blueprint for how the rotation was carried out at our institution, and details of shelters visited and animals treated, including a breakdown of treatments provided. Also discussed are the student projects and student feedback on this valuable clinical experience.
Sabath, Bruce F.; Singh, Gurkeerat
Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution – a community hospital – in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes. We also review the growing evidence of the application of ultrasound in the diagnosis of a myriad of conditions encountered in general internal medicine as well as the mounting data on the ability of internal medicine residents to apply this technology accurately at the bedside. We advocate that the literature has sufficiently established the role of POC ultrasonography in general internal medicine that there should no longer be any delay in giving this an official place in the development of internal medicine trainees. This may be particularly useful in the community hospital setting where 24-h echocardiography or other sonography may not be readily available. PMID:27802866
National Inst. of Mental Health (DHEW), Bethesda, MD.
The annotated bibliography of periodical literature through August of 1967 is the third in the series of four pertaining to inservice mental health training for personnel in residential institutions. It includes materials on training in mental hospitals, institutions for the mentally retarded, child care residential institutions, and nursing…
Qureshi, Ahmad Zaheer
There has been a growing demand for rehabilitation services in Pakistan in recent years, likely due to increasing prevalence of disability. Physical Medicine and Rehabilitation (PM&R) is a branch of medicine which deals with the prevention, diagnosis, and treatment of functional impairments resulting from neuro-musculoskeletal disorders. Physiatrists are physicians who specialize in the specialty of PM&R. College of Physicians and Surgeons of Pakistan started FCPS training in PM&R in the late 1990s. There are various training institutes within and outside Pakistan which are accredited for FCPS training in PM&R. There is a huge vacuum in this specialty in the country likely due to lack of awareness among health care providers. It is considered to be the specialty of the future due to its rapid growth potential, opportunities for sub specializations and unique skills.
... HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine... personal privacy. Name of Committee: National Center for Complementary and Alternative Medicine Special... and Training in Complementary and Alternative Medicine, National Institutes of Health, HHS)...
... HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine... personal privacy. Name of Committee: National Center for Complementary and Alternative Medicine Special.... 93.213, Research and Training in Complementary and Alternative Medicine, National Institutes...
Eastin, Travis R; Bernard, Aaron W
Purpose Emergency Medicine (EM) residents take the American Board of Emergency Medicine (ABEM) in-training exam, and performance on this exam has been shown to correlate to performance on the ABEM qualifying exam. Though many residencies have in-training exam preparation activities, there is little data on the effectiveness of these efforts. This study aimed to elicit resident perspectives about the exam and exam preparation in order to generate hypotheses and better inform future preparation efforts. Methods Second- and third-year EM residents at a single institution were interviewed using a semi-structured format. Qualitative methodology was used to analyze the data. Results Thirteen EM residents participated in the study. Eight major themes and 18 sub-themes were identified. These were further characterized as relating to the exam itself or to exam preparation. Residents generally value the in-training exam. Sixty-nine percent noted that it provided an assessment of their current knowledge and deficiencies. Thirty-eight percent noted that it improved familiarity with the qualifying exam. Regarding exam preparation, residents stated that a question format was preferred, especially when accompanying explanations were of high quality. Additionally, practical considerations, such as portability, impacted resident selection of study tools. Conclusion Residents value the in-training exam as a marker of their academic progress and for their ability to gain familiarity with the qualifying exam. They prefer question-based preparation over text-based learning, as long as there is a detailed explanation of each answer. Educators creating structured in-training review may want to focus on question-based material with detailed explanations. PMID:24062620
As a consultant for dermatology with special interested in tropical diseases, I accepted my employers offer (German Armed Forces) to start my training in tropical medicine and tropical dermatology in Africa. The dermatological part of the training was completed at the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania. This was followed by tropical medicine training at the Presbyterian Hospital in Agogo, Ghana. In this article, I report on my experiences in Africa and present selected case reports.
Braczkowska, B; Jabłoński, L
The Department of Occupational Hygiene, State School of Hygiene at the National Institute of Hygiene was established in 1926/27. Prof. Brunon Nowakowski was its founder and the first Director. Teaching and providing of highly qualified personnel for occupational medicine institutions was the main area of the Department's activity. The Department also carried out scientific research focusing on organisation of labour hygiene in Poland, and occupational diseases, lead poisoning in particular. The results of studies carried out by the Department provided the basis for the elaboration of numerous legal regulations in the area of occupational medicine.
Gagne, Albert H.
Training and education can increase the effectiveness with which new technology can be introduced in medicine. However, the use of technology in the education and training itself can be the vehicle for that increased effectiveness. The most effective way that education and training can be improved by technology is through the use of simulation. Examples are given from, first, the historical perspective in aircrew and spacecrew flight training; an anesthesiology training simulator; and a laparoscopic surgery training simulator.
Pandolf, Kent B; Francesconi, Ralph; Sawka, Michael N; Cymerman, Allen; Hoyt, Reed W; Young, Andrew J; Zambraski, Edward J
The United States Army Research Institute of Environmental Medicine (USARIEM) celebrated its 50th anniversary on July 1, 2011. This article reviews its history, evolution, and transition of its research programs as well as its scientific and military accomplishments, emphasizing the past 25 yr. During the 1990s, USARIEM published a series of pocket guides providing guidance for sustaining Warfighter health and performance in Southwest Asia, Somalia, the former Republic of Yugoslavia, Rwanda, and Haiti. Issues identified during Operation Desert Storm elicited research that improved nutritional guidelines for protracted desert operations; safer use of nuclear, chemical, and biological protective clothing; equipment, development, and fielding of efficient microclimate cooling systems; and effective evaluation of pharmaceuticals to protect soldiers from chemical and biological threats. During the first decade of the 21st century, USARIEM and the Department of the Army published official medical/performance doctrines for operations in the heat and cold and at high altitude. The current Global War on Terrorism focused research to improve doctrines for hot, cold, and high-altitude operations, reduce musculoskeletal training injuries, provide improved field nutrition, more efficient planning for operational water requirements, and improve both military clothing and materiel. This article also describes the critically important interactions and communications between USARIEM and deployed units and the benefits to Warfighters from this association. This report presents USARIEM's unique and world-class facilities, organizational changes, scientific and support personnel, and major research accomplishments, including the publication of 2,200 scientific papers over the past 25 yr.
Brawley, Stephen; Fairbanks, Keith; Nguyen, William; Blivin, Steve; Frantz, Earl
A transition from traditional problem-based clinics to the Sports Medicine and Reconditioning Team (SMART) clinic model was completed by January 2009 at Marine Corps Base Camp Lejeune. The SMART clinic model allows for more patients to be seen and enhances coordinated care between providers. The objective of this research is to show the advantages of implementing a training room team approach for the care of musculoskeletal injuries in active duty members by comparing the number of patients seen, the number of limited duty (LIMDU) periods, the number of physical evaluation boards (PEBs), and the percentage of orthopedic referrals. Electronic medical records for patients seen at sports medicine clinics between January 1, 2007 and December 31, 2010 were reviewed. Naval Hospital Camp Lejeune provided a database of patients placed on LIMDU and PEB from 2007 through 2010. Fifty-eight and twenty-four percent more encounters occurred in 2009 and 2010, respectively, than that in 2007. The percentage of LIMDU referred for PEB in 2010 was reduced to 9% compared to that in 2007. In conclusion, the SMART clinic model allows for more patients to be seen and a reduction in the percentage of patients recommended for PEB from LIMDU.
officers and health care planners with the systematic evaluation of the environmental threats to health and performance. Analysis of the environmental ...unified environmental preventive medicine decision aid for military health care planners and staff officers. It exploits USARIEM’s institutional... health and performance in Somalia: guidance for small unit leaders. Natick, MA: U.S. Army Research Institute of Environmental Medicine, Technical Note
Faigenbaum, Avery D.; Mediate, Patrick
The purpose of this study was to examine the effects of medicine ball training on the fitness performance of high-school physical education students. Sixty-nine high-school students participated in a 6-week medicine training program during the first 10 to 15 minutes of each physical education class. A group of 49 students who participated in…
Standard-Goldson, A; Williams-Green, P; Smith, K; Segree, W; James, K; Eldemire-Shearer, D
This paper recounts the development of family medicine postgraduate training in Jamaica, the challenges faced and lessons learned. A self-administered questionnaire was completed by past trainees exploring the perceived usefulness, strengths and weaknesses of the programme. The results of this study helped guide the strengthening of family medicine training in a resource-limited setting.
Maya-Álvarez, Jorge Arturo; Lechuga-García, Rafael; Querevalú-Murillo, Walter
The cadaveric or donor-related transplant is a worldwide priority program. In Mexico, the human hospitalary resources primarily assigned to issues about donation and transplant are scarce. In our country, recent legal changes permit that undergraduate medicine students under University linking programs can be integrated in activities that guarantee a social profit, for example, the hospitalary donation coordination of the Mexican Institute of Social Security. This is a proposal with a legal framework, based in experiences of the Barcelona Provincial Hospital Clínic, that integrate undergraduate medicine students as monitors in the Hospitalary Donation Coordination area of the Mexican Institute of Social Security who are available 24 hours. During this social service stage, undergraduate medical students can benefit their community by optimizing potential for transplants via hospital organ donations.
Weltman, Gershon; Lamon, Jonathan; Freedy, Elan; Chartrand, Donald
The objective of this case study was to test the impact in law enforcement personnel of an innovative self-regulation and resilience building program delivered via an iPad (Apple Inc, Cupertino, California) app and personal mentoring. The Stress Resilience Training System (SRTS) app includes training on stress and its effects, HRV coherence biofeedback, a series of HeartMath self-regulation techniques (The Institute of HeartMath, Boulder Creek, California), and HRV-controlled games. The stressful nature of law enforcement work is well established, and the need for meaningful and effective stress resilience training programs is becoming better understood, as it has been in the military. Law enforcement and military service share many stress-related features including psychological stressors connected with the mission, extended duty cycles, and exposure to horrific scenes of death and injury. San Diego (California) Police Department personnel who participated in the study were 12 sworn officers and 2 dispatchers, 10 men and 4 women. The SRTS intervention comprised an introductory 2-hour training session, 6 weeks of individualized learning and practice with the SRTS app, and four 1-hour telephone mentoring sessions by experienced HeartMath mentors spread over a four week period. Outcome measures were the Personal and Organizational Quality Assessment (POQA) survey, the mentors' reports of their observations, and records of participants' comments from the mentoring sessions. The POQA results were overwhelmingly positive: All four main scales showed improvement; Emotional Vitality improved by 25% (P=.05) and Physical Stress improved by 24% (P=.01). Eight of the nine subscales showed improvement, with the Stress subscale, perhaps the key measure of the study, improving by approximately 40% (P=.06). Participant responses were also uniformly positive and enthusiastic. Individual participants praised the program and related improvements in both on-the-job performance and
Cavallari, Larisa H; Weitzel, Kristin W; Elsey, Amanda R; Liu, Xinyue; Mosley, Scott A; Smith, Donald M; Staley, Benjamin J; Winterstein, Almut G; Mathews, Carol A; Franchi, Francesco; Rollini, Fabiana; Angiolillo, Dominick J; Starostik, Petr; Clare-Salzler, Michael J; Nelson, David R; Johnson, Julie A
The University of Florida (UF) Health Personalized Medicine Program launched in 2012 with CYP2C19 genotyping for clopidogrel response at UF Health Shands Hospital. We have since expanded CYP2C19 genotyping to UF Health Jacksonville and established the infrastructure at UF Health to support clinical implementation for five additional gene-drug pairs: TPMT-thiopurines, IFNL3 (IL28B)-PEG IFN-α-based regimens, CYP2D6-opioids, CYP2D6/CYP2C19-antidepressants and CYP2C19-proton pump inhibitors. We are contributing to the evidence based on outcomes with genotype-guided therapy through pragmatic studies of our clinical implementations. In addition, we have developed a broad array of educational programs for providers, trainees and students that incorporate personal genotype evaluation to enhance participant learning.
Stein, David H.; Salive, Marcel E.
A survey of 797 preventive medicine residency graduates found that improvements are needed in the curricula for health administration, environmental health, health education, and occupational medicine. Women found their training less adequate than men did in all areas except clinical preventive medicine. Graduates tended to practice ultimately in…
... Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD). Date and Time: June 13, 2011, 1 p.m... Secretary, Division of Medicine and Dentistry, Bureau of Health Professions, Health Resources and...
... Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Committee on Training in Primary CareMedicine and Dentistry (ACTPCMD). Date and Time: April 22, 2010, 8 a.m... of Health Professions, Division of Medicine and Dentistry. In the plenary session, the...
... Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Committee on Training in Primary Care, Medicine and Dentistry (ACTPCMD). Date and Time: November 15, 2010, 8... Secretary, Division of Medicine and Dentistry, Bureau of Health Professions, Health Resources and...
... Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Committee on Training in Primary Care, Medicine and Dentistry (ACTPCMD). Dates and Times: July 19, 2012, 8..., 2012, will begin with an update on the Division of Medicine and Dentistry's development of...
The field of adolescent medicine, having developed from the specialty of Pediatrics, encompasses a holistic and developmental approach from its very origin. While its foundations were in medicine, early leaders in the field emphasized the importance of mental health care as well as nutrition, public health, and social justice. As the specialty became further established in the US with the creation of an academic society, board certification and training program accreditation, the interdisciplinary nature of adolescent medicine practice and training became formalized. This formal recognition brought with it strict guidelines with regards training and board certification. Despite the often Byzantinian training requirements, an interdisciplinary approach forms the core of adolescent medicine practice, and the incorporation of interdisciplinary training is a necessity for graduate medical education programs in the field of adolescent medicine.
Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian
Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine’s report, entitled “Resident duty hours: Enhancing sleep, supervision and safety”, published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation’s teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release
Pandolf, Kent B.; Francesconi, Ralph; Sawka, Michael N.; Cymerman, Allen; Hoyt, Reed W.; Young, Andrew J.; Zambraski, Edward J.
The United States Army Research Institute of Environmental Medicine (USARIEM) celebrated its 50th anniversary on July 1, 2011. This article reviews its history, evolution, and transition of its research programs as well as its scientific and military accomplishments, emphasizing the past 25 yr. During the 1990s, USARIEM published a series of…
Field, Marilyn J.
This brief article introduces several papers originally presented at a symposium responding to the Institute of Medicine's 1995 report on the current status and future needs of dental education in the United States. It notes the range of reactions to the original report ranging from mostly positive support to caution and disagreement on some…
The University of California, San Diego (UCSD) was established in 1961 as a new research university that emphasizes innovation, excellence, and interdisciplinary research and education. It has a School of Medicine (SOM) and the Jacobs School of Engineering (JSOE) in close proximity, and both schools have national rankings among the top 15. In 1991, with the support of the Whitaker Foundation, the Whitaker Institute of Biomedical Engineering was formed to foster collaborations in research and education. In 2008, the university extended the collaboration further by establishing the Institute of Engineering in Medicine (IEM), with the mission of accelerating the discoveries of novel science and technology to enhance health care through teamwork between engineering and medicine, and facilitating the translation of innovative technologies for delivery to the public through clinical application and commercialization.
Goh, Lee Gan; Ong, Chooi Peng
This review provides an update of education and training in family medicine in Singapore and worldwide. Family medicine has progressed much since 1969 when it was recognised as the 20th medical discipline in the United States. Three salient changes in the local healthcare landscape have been noted over time, which are of defining relevance to family medicine in Singapore, namely the rise of noncommunicable chronic diseases, the care needs of an expanding elderly population, and the care of a larger projected population in 2030. The change in the vision of family medicine into the future refers to a new paradigm of one discipline in many settings, and not limited to the community. Family medicine needs to provide a patient-centred medical home, and the discipline's education and training need to be realigned. The near-term training objectives are to address the service, training and research needs of a changing and challenging healthcare landscape.
Goh, Lee Gan; Ong, Chooi Peng
This review provides an update of education and training in family medicine in Singapore and worldwide. Family medicine has progressed much since 1969 when it was recognised as the 20th medical discipline in the United States. Three salient changes in the local healthcare landscape have been noted over time, which are of defining relevance to family medicine in Singapore, namely the rise of noncommunicable chronic diseases, the care needs of an expanding elderly population, and the care of a larger projected population in 2030. The change in the vision of family medicine into the future refers to a new paradigm of one discipline in many settings, and not limited to the community. Family medicine needs to provide a patient-centred medical home, and the discipline’s education and training need to be realigned. The near-term training objectives are to address the service, training and research needs of a changing and challenging healthcare landscape. PMID:24664375
Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.
Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…
Harkness, Beth A; Allison, Jerry D; Clements, Jessica B; Coffey, Charles W; Fahey, Frederic H; Gress, Dustin A; Kinahan, Paul E; Nickoloff, Edward L; Mawlawi, Osama R; MacDougall, Robert D; Pizzutiello, Robert J
The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics Training. The mission of this task force was to assemble a representative group of stakeholders to:• Estimate the demand for board-certified nuclear medicine physicists in the next 5-10 years,• Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and• Identify approaches that may be considered to facilitate the training of nuclear medicine physicists.As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face-to-face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission.
Harkness, Beth A; Allison, Jerry D; Clements, Jessica B; Coffey, Charles W; Fahey, Frederic H; Gress, Dustin A; Kinahan, Paul E; Nickoloff, Edward L; Mawlawi, Osama R; MacDougall, Robert D; Pizzuitello, Robert J
The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics Training. The mission of this task force was to assemble a representative group of stakeholders to: Estimate the demand for board-certified nuclear medicine physicists in the next 5-10 years, Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and Identify approaches that may be considered to facilitate the training of nuclear medicine physicists. As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face-to-face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission. PACS number: 01.40.G.
Society for Health and Human Values, Philadelphia, PA.
To further supplement the larger conference proceedings held by the Society for Health and Human Values, a smaller Southwest Regional Institute was held in October of 1973. Conference participants examined the rationale for including human values as an area of study in health professional education, the process by which this kind of teaching can…
Office of Educational Research and Improvement (ED), Washington, DC.
The U.S. Department of Education has awarded just over one million dollars to support institutes or training workshops primarily for school and public librarians. Under the Library Education and Human Resource Development Program, 15 institutions of higher education or library organizations nationwide have received funding for institutes that…
Rukavishnikov, V S; Shaiakhmetov, S F; Gus'kova, T M
The article covers main steps of establishment and development of Research Institute for Occupational medicine and Human ecology with Siberian Division of RAMSc over 50 years of activities, major results of research, contribution of the Institute personnel into development of hygienic science and practical medicine in Siberia.
Tokarev, V F; Razsolov, N A; Mohler, S R; Nicogossian, A E
The Union of Soviet Socialist Republics and the United States of America operate major aerospace medicine programs; each country has taken specific measures to assure the development of an adequate number of trained aerospace medicine physicians. This jointly prepared paper emphasizes the training of aerospace medicine physicians related to civil aerospace activities. Those working in the field of aerospace medicine will find of interest the aerospace medical approaches taken by the U.S.S.R. and the U.S.A. in achieving their respective aerospace objectives.
Sherman, Charles B; Carter, E Jane; Braendli, Otto; Getaneh, Asqual; Schluger, Neil W
Despite an extensive burden of lung disease in East Africa, there are remarkably few pulmonary physicians in the region and no pulmonary subspecialty training programs. We developed a unique training program for pulmonary medicine in Ethiopia. The East African Training Initiative (EATI) is a 2-year fellowship program at Tikur Anbessa (Black Lion) Specialized Teaching Hospital, the largest public hospital in Ethiopia and the teaching hospital for the Addis Ababa University School of Medicine. The first year is devoted to clinical care and procedural skills. Lectures, conferences, daily inpatient and outpatient rounds, and procedure supervision by visiting faculty provide the clinical knowledge foundation. In the second year, training in clinical research is added to ongoing clinical training. Before graduation, fellows must pass rigorous written and oral examinations and achieve high marks on faculty evaluations. Funding derives from several sources. Ethiopian trainees are paid by the Ethiopian Ministry of Health and the Addis Ababa University School of Medicine. The World Lung Foundation and the Swiss Lung Foundation supply travel and housing costs for visiting faculty, who receive no other stipend. The first two trainees graduated in January 2015, and a second class of three fellows completed training in January 2016. All five presented research abstracts at the annual meetings of the International Union Against Tuberculosis and Lung Disease in 2014 and 2015. The EATI has successfully provided pulmonary medicine training in Ethiopia and has capacity for local leadership. We believe that EATI could be a model for other resource-limited countries.
Weiner, Debra K; Turner, Gregory H; Hennon, John G; Perera, Subashan; Hartmann, Susanne
A survey of U.S. geriatric medicine fellowship training programs was performed to assess the status of teaching about chronic pain evaluation and management and identify opportunities for improvement. After an initial e-mail query, 43 of 96 programs agreed to participate. A self-administered questionnaire, with items adapted from a 2002 consensus panel statement, was mailed to their 171 fellows-in-training and 43 fellowship directors. Thirty-two programs (33% of nationwide sample) including 79 fellows (30% of nationwide sample) and 25 directors (26% of nationwide sample) returned surveys; 21 institutions returned both faculty and fellow surveys. Overall, directors endorsed the 19 items identified by the consensus panel as essential components of fellowship training, but fellows identified deficiencies, both before and during fellowship training. Specific areas of undereducation included comprehensive musculoskeletal assessment, neuropathic pain evaluation, indications for low back pain imaging, the role of multidisciplinary pain clinics and nonpharmacological modalities, the effect of physical and psychosocial comorbidities in formulating treatment goals, and the effect of aging on analgesic metabolism and prescription. Both groups were generally positive about fellows' abilities to implement pain-related clinical skills. Discrepancies existed between fellowship directors' ratings of importance of teaching individual items and the degree to which teaching was actually done, as well as faculty versus fellow assessments of whether some of the 19 items were taught. Primary care training programs (e.g., internal medicine, family medicine, geriatric medicine) should pay more systematic attention to educating trainees about chronic pain to optimize patient care, decrease suffering, and diminish healthcare expenditures.
Karasawa, Kensuke; Kamiyama, Hiroshi; Hashimoto, Teisuke; Koizumi, Kiyoshi
Under the auspices of the Japanese Society of Pediatric Nuclear Medicine, an annual aggregate from a 5-year period, 2007 to 2011, of a survey questionnaire of pediatric nuclear medicine examinations performed at 14 institutes in the Kanto region was conducted. The subjects were pediatric patients 15 years old or younger. The survey questions included the determination method for administered dose of radiopharmaceuticals, the items examined and number of examinations. Of 14 institutes, 11 determined administered doses using the formula: adult dose X (age +1) / (age+7), while the remaining 3 used the adult dose as the maximum dose and used a conversion formula based on age and physical condition. In 2011, in a total of 3,884 pediatric patients, renoscintigraphy accounted for 41.5%, brain 14.4%, pulmonary scintigraphy 12.9%, oncology 9.0%, hepatobiliary scintigraphy 6.3%, gastrointestinal scintigraphy 4.8%, musculoskeletal scintigraphy 4.3%, cardiology 2.5%, and other 4.9% of all nuclear medicine examinations. Pediatric nuclear medicine examinations in general hospitals accounted for only 3.4% of all examinations. A similar trend was observed in previous years. Since pediatric patients have a longer reproductive term and higher sensitivity to radiation exposure, pediatric nuclear medicine requires a strict selection of appropriate studies and administered dose. These results show the current practice and would warrant further consideration.
Lipman, Grant S; Weichenthal, Lori; Stuart Harris, N; McIntosh, Scott E; Cushing, Tracy; Caudell, Michael J; Macias, Darryl J; Weiss, Eric A; Lemery, Jay; Ellis, Mark A; Spano, Susanne; McDevitt, Marion; Tedeschi, Christopher; Dow, Jennifer; Mazzorana, Vicki; McGinnis, Henderson; Gardner, Angela F; Auerbach, Paul S
Wilderness medicine is the practice of resource-limited medicine under austere conditions. In 2003, the first wilderness medicine fellowship was established, and as of March 2013, a total of 12 wilderness medicine fellowships exist. In 2009 the American College of Emergency Physicians Wilderness Medicine Section created a Fellowship Subcommittee and Taskforce to bring together fellowship directors, associate directors, and other interested stakeholders to research and develop a standardized curriculum and core content for emergency medicine (EM)-based wilderness medicine fellowships. This paper describes the process and results of what became a 4-year project to articulate a standardized curriculum for wilderness medicine fellowships. The final product specifies the minimum core content that should be covered during a 1-year wilderness medicine fellowship. It also describes the structure, length, site, and program requirements for a wilderness medicine fellowship.
Carr, Brendan G; Asplin, Brent R
The 2010 Academic Emergency Medicine consensus conference on regionalization in emergency care began with an update on the Institute of Medicine (IOM) reports on the Future of Emergency Care. This was followed by two presentations from federal officials, focusing on regionalization from the perspective of the White House National Security Staff and the Emergency Care Coordination Center. This article summarizes the content of these presentations. It should be noted that this summary is the perspective of the authors and does not represent the official policy of the U.S. government.
Billings, Charles E
Between 1955 and 1977, The Ohio State University sponsored what is believed to be the first residency training program in aviation medicine. The training program was instigated by Richard Meiling, M.D., the associate dean of the College of Medicine, who had been a U.S. Army flight surgeon during World War II. Dr. Meiling was active after the war in a committee of physicians that advocated establishment of a residency training program and certification of aviation medicine as an approved specialty. From 1955 to 1977, 51 physicians were trained at Ohio State in aviation (later aerospace) and occupational medicine. The programs were located in the Department of Preventive Medicine and directed by William F. Ashe, M.D., chairman. It was a 3-yr residency: the first was an academic year that included full-time coursework and research, and a second year was also devoted to advanced coursework and field experience, during which the resident finished conducting research and submitted a thesis. The third year was a practicum in which the residents were located at any of a number of academic, aeronautical, or industrial sites under supervision of faculty members. They were then qualified to take the examinations of the American Board of Preventive Medicine in either aviation or occupational medicine. A number of graduates took both examinations during the first years of practice following their training; several continued to practice in both specialties throughout their careers.
Archbald, L. F.; Hagstad, H. V.
At Louisiana State University School of Veterinary Medicine, training in preventive medicine is incorporated into all four years of the curriculum. The curriculum is described with focus on the fourth year practical course that involves problem solving, using various herds in the area. (JMD)
The veterinary curriculum at the LSU School of Veterinary Medicine has developed an undergraduate professional training program in companion animal preventive medicine--a new area of specialization--as a field of clinical practice. Curricula for years three and four are described. (Author/MLW)
Kunz, Kevin; Wiegand, Timothy
Addiction medicine (ADM) is an emerging medical field. It will soon be recognized by the American Board of Medical Specialties as a multispecialty subspecialty, sponsored by the American Board of Preventive Medicine. Certification and maintenance of certification in ADM are available currently through the American Board of Addiction Medicine (ABAM). There is an urgent need for trained and certified ADM physicians to serve the needs of patients and society. Thirty-seven addiction medicine fellowships of 12 months duration are now available, and their number is increasing. Physicians specializing in medical toxicology have educational, training, and practice overlap with addiction medicine. Medical toxicology physicians usually meet ADM examination eligibility requirements, based on clinical practice experience and continuing medical education activities. Those with fellowship training or in a fellowship bring training experience which has commonalities to ADM fellowship training, and therefore are particularly prepared for examination and practice in ADM. There are opportunities for partnerships in training, practice, and leadership between addiction medicine and medical toxicology.
Lumadi, Mutendwahothe Walter
In 2004 South Africa embarked on a mission of reforming its higher education system, merging and incorporating small universities into larger institutions, and renaming all higher education institutions university. The democratic country's universities and technikons, which were incorporated with others and thus no longer exist, will be mentioned…
Florida State Univ., Tallahassee. Dept. of Adult Education.
The overall objective of the project was to train a group of highly selected teacher-trainers and master teachers in the theory and principles of ABE, who would, in turn, provide for the pre-service and inservice training of classroom teachers and teacher-aides through state and local community clinics and workshops. More than 70 participants took…
O'Sullivan, Dermot A.
Describes a six-week program designed to give scientists from developing countries advanced training in biotechnology methods. Stresses the need to provide the participants with "hands-on" experiences to enhance their ability to contribute to biotechnology programs in their home countries and to train others locally. (TW)
The United States National Cancer Institute (NCI) supports complementary and alternative medicine (CAM) research which includes different methods and practices (such as nutrition therapies) and other medical systems (such as Chinese medicine). In recent years, NCI has spent around $120 million each year on various CAM-related research projects on cancer prevention, treatment, symptom/side effect management and epidemiology. The categories of CAM research involved include nutritional therapeutics, pharmacological and biological treatments, mind-body interventions, manipulative and body based methods, alternative medical systems, exercise therapies, spiritual therapies and energy therapies on a range of types of cancer. The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) supports various intramural and extramural cancer CAM research projects. Examples of these cancer CAM projects are presented and discussed. In addition, OCCAM also supports international research projects.
Kim, Sang-Kyun; Han, Jeong-Min; Song, Mi-Young
We in this paper propose a social network based on ontology in Korea Institute of Oriental Medicine (KIOM). By using the social network, researchers can find collaborators and share research results with others so that studies in Korean Medicine fields can be activated. For this purpose, first, personal profiles, scholarships, careers, licenses, academic activities, research results, and personal connections for all of researchers in KIOM are collected. After relationship and hierarchy among ontology classes and attributes of classes are defined through analyzing the collected information, a social network ontology are constructed using FOAF and OWL. This ontology can be easily interconnected with other social network by FOAF and provide the reasoning based on OWL ontology. In future, we construct the search and reasoning system using the ontology. Moreover, if the social network is activated, we will open it to whole Korean Medicine fields.
The field of regenerative medicine has been revolutionized by breakthroughs in stem cell biology, gene engineering, and whole-genome sequencing. These advances are not only scientific or medical but have also advanced how we conceptualize regenerative medicine. The progenitive research that proceeded as well as a substantial part of the funding that supported these discoveries were provided by the National Institutes of Health (NIH). Now, perhaps more than ever, the NIH has a vital role to play in the translation of science into clinical practice. The NIH is uniquely positioned to coordinate interactions between the different institutes and other arms of the government, as well as international organizations. Efforts of researchers in the United States both within and without the NIH are supported by a number of mechanisms, including specialized workshops, and the support of developing small-scale industry. Additionally, the NIH has stepped up to provide necessary infrastructure in areas of regenerative medicine where the medical need might be apparent but might be currently infeasible or unattractive to private-sector investment. This article will discuss these perhaps lesser-known activities of the NIH, which I believe have continued and will continue to contribute to the role of stem cell research in translating science into regenerative medicine.
Expedition and wildeness medicine is a term that combines rescue medicine, sport medicine as well as more specific branches as polar or high altitude medicine. It is being intensively studied both at the reaserch institutes and on expeditions. Ophtalmologists are concentrated on the reaserch of HARH (High Altitude Retinal Hemorrhage), neurologists on HACE reaserch (High Altitude Cerebral Edema), psychologists are developing tests to decsribe cognitive functions and many physicians are being trained to work in extreme enviroment. The result of all this effort are numerous new findings in pathophysiology and therapy of altitude illness, increased security on expedition and further development of expeditionism.
Povar, Gail J.; Keith, Karla J.
A survey on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine is discussed. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. (Author/MLW)
Makogon, S I; Kuziakin, G V
The objective of the study was to estimate the functional parameters of the organ of vision in Military Training Institute entrants. Eight hundred and twenty school-leavers--Military Training Institute entrants (2006-2007) aged 17 to 19 years were examined. The integral procedure of their examination could characterize the state of refraction and accommodation: decreased visual acuity, refraction shift towards myopia, worse accommodation function. Prerequisites for the development and progression of myopia were found in higher law educational establishment entrants.
Pinxten, W J L; De Jong, C; Hidayat, T; Istiqomah, A N; Achmad, Y M; Raya, R P; Norviatin, D; Siregar, I M P
Indonesia has one of the fastest growing, injecting drugs user-driven, human immunodeficiency virus (HIV) epidemics in Asia. Coverage of needle and syringe programs (NSPs), opioid substitution therapy (OST), and antiretroviral treatment (ART) is increasing, but is still low, whereas professional training in addiction medicine is not yet established. Urgent development and scaling-up of professional capacity in comprehensive, evidence-based addiction medicine is needed. In this article the results of the first step is presented, being the training needs assessment (TNA) and the process of further developing a national evidence- and competence-based addiction medicine curriculum in Indonesia.
Sung, Lillian; Crowther, Mark; Byrd, John; Gitlin, Scott D; Basso, Joe; Burns, Linda
The American Society of Hematology developed the Clinical Research Training Institute (CRTI) to address the lack of training in patient-oriented research among hematologists. As the program continues, we need to consider metrics for measuring the benefits of such a training program. This article addresses the benefits of clinical research training programs. The fundamental and key components are education and mentorship. However, there are several other benefits including promotion of collaboration, job and advancement opportunities, and promotion of work-life balance. The benefits of clinical research training programs need to be measured so that funders and society can judge if they are worth the investment in time and resources. Identification of elements that are important to program benefit is essential to measuring the benefit of the program as well as program planning. Future work should focus on the constructs which contribute to benefits of clinical research training programs such as CRTI.
Ford, Deborah Kilgore
"Nobody wants to get one. Nobody wants to give one." The problem was that the supervisors and managers of the Rehabilitation Institute of Chicago (RIC) did not know how to use the Institute's new performance management system and had not been trained on how to prepare and deliver effective performance appraisals. The problem further…
Appelshaeuser, Michèle; Sengel, Danièle
A system of collaboration around simulation, between a health care facility and a training institute, has been put in place. It has enabled the challenges for both institutions to be identified, thereby confirming the need to continue this project. In this context, interprofessionalality and intergenerationality are key elements.
This article presents research that was conducted at the Autism Institute, an organization serving children with autism and their families in the People's Republic of China. The article examines and highlights aspects of the teacher training model at the Autism Institute that have led to the preparation of highly qualified, enthusiastic, and…
New Hampshire State Dept. of Postsecondary Technical Education, Concord.
This 1994 annual report for the New Hampshire Technical Colleges and Institute System (NHTC&IS) includes information on enrollments, outcomes, job placement, average salaries, transfer institutions, work force training, the Police Academy, finances, future directions, and governance. Introductory material highlights the following…
Ron, Pnina; Lowenstein, Ariela
Paraprofessional staff in six Israeli institutions for the elderly received training in psychological and social aspects of aging, loneliness and loss, communication, multiprofessional staff work, and elders with disabilities. They expressed a need for additional training in following up on physiotherapy. (Contains 18 references.) (SK)
Yeh, I-Chen; Chang, Chia-Ming; Chen, Ko-Chia; Hong, Wei-Chin; Lu, Yu-Hsiung
According to an investigation done by Taiwan Ministry of the Interior in 2013, there was more than 90% of the disability care institutions mainly based on life care. Previous studies have shown that individuals can effectively improve physical and cognitive training, improved in independent living and everyday competence. The purpose of the study was to investigate influence of the intervention program applying functional fitness and cognitive training to disabled residents in the institution. The subjects were disabled persons of a care institution in southern Taiwan and were randomly divided into training and control groups, both having 17 subjects. The age of the subjects was between 56 and 98 years with a mean age of 79.08 ± 10.04 years; the subjects of training group implemented 12 weeks of training on physical and cognitive training, while the control group subjects did not have any training program. The results revealed that subjects of the training group have significantly improved their functional shoulder rotation flexibility of left and right anterior hip muscle group flexibility of right, sitting functional balance of left and right, naming, attention, delayed recall, orientation, and Montreal cognitive assessment (MOCA). The study suggested developing physical fitness programs and physical and cognitive prescriptions for the disabled people of the institutions. PMID:25756064
Donohue, Brad; Conway, Debbie; Beisecker, Monica; Murphy, Heather; Farley, Alisha; Waite, Melissa; Gugino, Kristin; Knatz, Danielle; Lopez-Frank, Carolina; Burns, Jack; Madison, Suzanne; Shorty, Carrie
Ninety-two adolescents, predominantly ethnic minority high school students, participated in a structured Summer Business Institute (SBI). Participating youth were randomly assigned to receive either job social skills or financial management skills training components. Students who additionally received the job social skills training component were…
Konstantinov, O K
Within the framework of international collaboration, the E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine (IMPTM), I.M. Sechenov First Moscow State Medical University, assisted the Public Health System of the Republic of Guinea in detecting, diagnosing, studying, and preventing tropical infections of viral, bacterial, and parasitic etiologies, and in training national scientific manpower. The work was under way in the Soviet-Guinea Research Microbiology and Virology Laboratory, USSR Ministry of Health, in the Republic of Guinea (now the Pasteur Institute in Guinea (PIG)) in 1978-1991. The circulation of pathogens of a number of tropical infections, the fauna of vectors and carriers of transmissible infections, and their involvement of the circulation of pathogens of these diseases were found in this period. Consultative-and-methodological and medical assistance was given; national higher- and middle-level brainpower trained. It is expedient to restore scientific ties between the IMPTM and the PIG.
Cook, R T
The emergency medical technician, the paramedic, and the emergency physician, as well as emergency physicians who have additional expertise in emergency medical service (EMS) prehospital care or pediatric emergency medicine (through experience or formal fellowship training), will all find the Institute of Medicine's report, Emergency Medical Services for Children (EMS-C), to be an invaluable background resource as well as a guide for EMS system and EMS-C-related planning. With both breadth and depth, it reviews many of the issues in EMS-C today from many perspectives and provides practical information to enable these care givers to understand better the "big picture" of EMS-C as well as to assist them in continuing to make a difference in the day-to-day emergency care for children. It is well referenced, engenders respect for all members of the team within the broad continuum of EMS-C, and provides encouragement to them to work together to identify and address issues and solve problems to improve the quality of care for our nation's children.
Background There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students’ perspectives on specialization training in Malawi. Methods We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an “editing approach” to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. Results We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Conclusions Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country’s healthcare workforce and the needs of their
Pietiainen, Vilja; Saarela, Jani; von Schantz, Carina; Turunen, Laura; Ostling, Paivi; Wennerberg, Krister
The High Throughput Biomedicine (HTB) unit at the Institute for Molecular Medicine Finland FIMM was established in 2010 to serve as a national and international academic screening unit providing access to state of the art instrumentation for chemical and RNAi-based high throughput screening. The initial focus of the unit was multiwell plate based chemical screening and high content microarray-based siRNA screening. However, over the first four years of operation, the unit has moved to a more flexible service platform where both chemical and siRNA screening is performed at different scales primarily in multiwell plate-based assays with a wide range of readout possibilities with a focus on ultraminiaturization to allow for affordable screening for the academic users. In addition to high throughput screening, the equipment of the unit is also used to support miniaturized, multiplexed and high throughput applications for other types of research such as genomics, sequencing and biobanking operations. Importantly, with the translational research goals at FIMM, an increasing part of the operations at the HTB unit is being focused on high throughput systems biological platforms for functional profiling of patient cells in personalized and precision medicine projects.
Hollenberg, C H
Although Canadian health care reform has constrained costs and improved efficiency, it has had a profound and mixed effect on Canadian academic medicine. Teaching hospitals have been reduced in number and size, and in patient programs have shifted to ambulatory and community settings. Specialized care programs are now multi-institutional and multidisciplinary. Furthermore, the influence of regional planning bodies has grown markedly. Although these changes have likely improved clinical service, their impact on the quality of clinical education is uncertain. Within the academic clinical department, recruitment of young faculty has been greatly complicated by constraints on licensing, billing numbers, fee-for-service income and research funding. The departmental practice plan based on university funds and fee-for-service income is being replaced by less favourable funding arrangements. However, emphasis on multidisciplinary programs has rendered these departments more flexible in structure. The future of Canadian academic medicine depends on an effective alliance with government. Academia and government must agree, particularly on human-resource requirements, research objectives and the delivery of clinical and academic programs in regional and community settings. The establishment of focal points for academic health sciences planning within academic health sciences centres and within governments would assist in these developments. Finally, government and the academic health sciences sector must work together to remove the current impediments to the recruitment of highly qualified young faculty. PMID:8624998
A survey of the role of the UK physicist in nuclear medicine: a report of a joint working group of the British Institute of Radiology, British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine.
Tindale, W B; Thorley, P J; Nunan, T O; Lewington, V; Shields, R A; Williams, N R
Guidelines for the provision of physics support to nuclear medicine were published in 1999 by a joint working group of the British Institute of Radiology, the British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine. Following publication of the guidelines, a survey was conducted by the working group to gather data on the actual level of physicist support in UK hospitals of different types and on the activities undertaken by physicists. The data were collected in the 12 months following the publication of guidelines and cover different hospital models and seven UK regions. The results provide evidence that many of the smaller units - small teaching hospitals and, particularly, small district general hospitals - have insufficient physics support. Although, on average, there is good agreement between the guidelines and the survey data for medium and large district general hospitals, there is wide variation in the level of physics provision between hospitals delivering apparently similar services. This emphasizes the need for national guidelines, against which institutions may be bench-marked and which may be used as a recommendation for the staffing levels necessary to ensure services are delivered safely and standards are not compromised. The complexity and variety of workload is an important factor in determining the level of physics support. As services develop, it is vital that this aspect is recognized to ensure that appropriate resources are available for the required physics input, even if any new service represents only a modest clinical throughput in terms of patient numbers.
Mash, Robert J; de Villiers, Marietjie R; Moodley, Kalay; Nachega, Jean B
Africa's health care challenges include a high burden of disease, low life expectancy, health workforce shortages, and varying degrees of commitment to primary health care on the part of policy makers and government officials. One overarching goal of the Medical Education Partnership Initiative (MEPI) is to develop models of medical education in Sub-Saharan Africa. To do this, MEPI has created a network of universities and other institutions that, among other things, recognizes the importance of supporting training programs in family medicine. This article provides a framework for assessing the stage of the development of family medicine training in Africa, including the challenges that were encountered and how educational organizations can help to address them. A modified "stages of change" model (precontemplation, contemplation, action, maintenance, and relapse) was used as a conceptual framework to understand the various phases that countries go through in developing family medicine in the public sector and to determine the type of assistance that is useful at each phase.
Cleven, Arlene M.
The purpose of this study was to expose key individuals to the National Highway Traffic Safety Administration (NHTSA)-developed curriculum materials for crash injury management and to teach them how to teach. The scope of the training effort is described using a detailed discussion and separate conclusions for the following tasks: planning,…
Burgener, V. E.; Reese, Dorothy
A series of five national instructor training workshops were planned for traffic court judges and administrators. A curriculum package which had been previously prepared was used to orient selected key personnel toward highway safety. Technical Education Research Centers (Midwest Center) conducted the conferences from October 23 to December 12,…
Daugherty, Ronald D.; And Others
To assist States in implementing Highway Safety Program Standard 18, "Accident Investigation and Reporting", the National Highway Traffic Safety Administration funded an instructor training program for a new occupational field in highway safety, accident investigation technician. The Center for Vocational and Technical Education executed this…
Conner, David; Estrin, Hans; Becot, Florence
This article discusses High School Harvest (HSH), an Extension educator-led project in five Vermont schools to provide students with job training and food system education and to provide lightly processed produce to school lunch programs. One hundred and twenty-one students participated, logging 8,752 hours growing, harvesting, and processing…
... HUMAN SERVICES Food and Drug Administration Center for Devices and Radiological Health 510(k) Clearance Process; Institute of Medicine Report: ``Medical Devices and the Public's Health, The FDA 510(k) Clearance... Medicine (IOM) report entitled: ``Medical Devices and the Public's Health, The FDA 510(k) Clearance...
... HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine... personal privacy. Name of Committee: National Center for Complementary and Alternative Medicine Special... Assistance Program Nos. 93.213, Research and Training in Complementary and Alternative Medicine,...
Doarn, Charles R; Mohler, Stanley R
The training of U.S. physicians in aviation medicine closely followed the development of reliable airplanes. This training has matured as aviation and space travel have become more routine over the past several decades. In the U.S., this training began in support of military pilots who were flying increasingly complex aircraft in the early part of the 20th century. As individuals reached into the stratosphere, low Earth orbit, and eventually to the Moon, physicians were trained not only through military efforts but in academic settings as well. This paper provides an historical summary of how physician training in aerospace medicine developed in the U.S., citing both the development of the military activities and, more importantly, the perspectives of the academic programs. This history is important as we move forward in the development of commercial space travel and the needs that such a business model will be required to meet.
Manolio, Teri A
Increasing knowledge about the influence of genetic variation on human health and growing availability of reliable, cost-effective genetic testing have spurred the implementation of genomic medicine in the clinic. As defined by the National Human Genome Research Institute (NHGRI), genomic medicine uses an individual's genetic information in his or her clinical care, and has begun to be applied effectively in areas such as cancer genomics, pharmacogenomics, and rare and undiagnosed diseases. In 2011 NHGRI published its strategic vision for the future of genomic research, including an ambitious research agenda to facilitate and promote the implementation of genomic medicine. To realize this agenda, NHGRI is consulting and facilitating collaborations with the external research community through a series of "Genomic Medicine Meetings," under the guidance and leadership of the National Advisory Council on Human Genome Research. These meetings have identified and begun to address significant obstacles to implementation, such as lack of evidence of efficacy, limited availability of genomics expertise and testing, lack of standards, and difficulties in integrating genomic results into electronic medical records. The six research and dissemination initiatives comprising NHGRI's genomic research portfolio are designed to speed the evaluation and incorporation, where appropriate, of genomic technologies and findings into routine clinical care. Actual adoption of successful approaches in clinical care will depend upon the willingness, interest, and energy of professional societies, practitioners, patients, and payers to promote their responsible use and share their experiences in doing so.
Zarifis, George K.
Reviews developments in vocational education in Greece, especially the 1993 establishment of vocational training institutes as a response to the need for competitiveness and economic development. Identifies problems and concerns about whether they are fulfilling their role after 10 years. (Contains 31 references.) (SK)
Wang, Xiao-yun; Liang, Zhao-hui; Huang, Hui-ling; Liang, Wei-xiong
As one of the significant parts of medical science research in China, the research on Chinese medicine (CM) reflects the essence of healthcare tradition in the country both theoretically and clinically, and embodies the values of Chinese culture. Therefore, in the practice of ethics review on CM research protocols, besides abiding by the contemporary prevalent international principles and guidelines on bioethics, which emphasizes the scientific and bioethical value of the study, we should also stress the CM theoretical background and relevant clinical experience in the framework of Chinese culture and values. In this paper, we went over the traits of CM clinical research and the experience from the practice of ethics review by the institution review board for bioethics, and then attempted to summarize the key points for the bioethics review to CM researches in China, so as to serve as reference for the bioethics review to traditional and alternative medicine researches.
Kadar, Gena E; Vosko, Andrew; Sackett, Michael; Thompson, H Garrett Rush
A survey of the constituents of a complementary and alternative medicine (CAM) institution was conducted to identify perceptions of interprofessional education (IPE) and practice (IPP). A 22 question survey was developed and administered to: chiropractic students, acupuncture and oriental medicine students, faculty and alumni of both professions, staff and administrators. The majority of the 321 respondents demonstrated positive perceptions of IPE and IPP, however many reported a lack of understanding of the distinct roles of select healthcare professions. The study also suggested that the campus community is not homogenous in its understanding of CAM or allopathic professions, or is it homogenous in its understanding of IPE and IPP. While the overall positive attitudes toward IPE and IPP imply a willingness to improve collaboration between these groups, the lack of understanding of profession-specific roles must be addressed to support effective implementation of IPE.
Federal Interagency Committee on Education, Washington, DC. Student Support Study Group.
This report presents data concerning predoctoral students supported under training grants of the National Institutes of Health (NIH) and the National Institute of Mental Health (NIMH). The report offers a discussion of the training grant and a comparison of it to other forms of support, a discussion of the students and the fields of study…
Seltz, Judith S.
The pharmaceutical detail man, in bringing information about new drugs to physicians, hospitals and pharmacists, performs a complex and sensitive task. Does his training fit him to meet the challenge? (Author)
Dacre, J; Richardson, J; Noble, L; Stephens, K; Parker, N
It has long been accepted that communication is of central importance in healthcare, and a core aspect of clinical competence. Many educational institutions and Royal Colleges now reflect this and consider communication skills a priority in postgraduate examination. The new examination "Practical Assessment of Clinical and Examination Skills" has replaced the Royal College of Physicians MRCP part 2 clinical and oral examination. This examination now consists of five clinical stations, two of which focus on communication skills. A short course for postgraduate trainees has been designed to address the communication skills requirements of the part 2 clinical examination. The aims, development, and content of the course are described. Emphasis is placed on candidates practising skills with patients and receiving feedback during the course. Evidence suggests that practice with feedback is an essential ingredient of communication skills courses, and is more effective than other methods such as observing experts or video examples, or simply discussing issues in communication. Results of a preliminary evaluation indicate that the course was perceived as valuable by candidates and that the aims, format, and content were appropriate. Although the preliminary evaluation was largely positive, it could be argued that the acid test of the effectiveness of a course is an objective evaluation of skills, observed before and after the course, a development that is being considered for future evaluation of the course. Recommendations for applying this type of training to postgraduate trainees in any branch of medicine are given.
Kakoma, Jean Baptiste
The area of Human Resources for Health (HRH) is the most critical challenge for the achievement of health related development goals in countries with limited resources. This is even exacerbated in a post conflict environment like Rwanda. The aim of this commentary is to report and share the genesis and outcomes of an exciting experience about training of qualified health workers in medicine and public health as well as setting - up of a research culture for the last nine years (2006 - 2014) in Rwanda. Many initiatives have been taken and concerned among others training of qualified health workers in medicine and public health. From 2006 to 2014, achievements were as follows: launching and organization of 8 Master of Medicine programmes (anesthesiology, family and community medicine, internal medicine, obstetrics & gynecology, otorhinolaryngology, pediatrics, psychiatry and surgery) and 4 Master programmes in public health (MPH, MSc Epidemiology, MSc Field Epidemiology & Laboratory Management, and Master in Hospital and Healthcare Administration); training to completion of more than 120 specialists in medicine, and 200 MPH, MSc Epidemiology, and MSc Field Epidemiology holders; revival of the Rwanda Medical Journal; organization of graduate research training (MPhil and PhD); 3 Master programmes in the pipeline (Global Health, Health Financing, and Supply Chain Management); partnerships with research institutions of great renown, which contributed to the reinforcement of the institutional research capacity and visibility towards excellence in leadership, accountability, and self sustainability. Even though there is still more to be achieved, the Rwanda experience about postgraduate and research programmes is inspiring through close interactions between main stakeholders. This is a must and could allow Rwanda to become one of the rare examples to other more well-to-do Sub - Saharan countries, should Rwanda carry on doing that.
Kakoma, Jean Baptiste
The area of Human Resources for Health (HRH) is the most critical challenge for the achievement of health related development goals in countries with limited resources. This is even exacerbated in a post conflict environment like Rwanda. The aim of this commentary is to report and share the genesis and outcomes of an exciting experience about training of qualified health workers in medicine and public health as well as setting - up of a research culture for the last nine years (2006 - 2014) in Rwanda. Many initiatives have been taken and concerned among others training of qualified health workers in medicine and public health. From 2006 to 2014, achievements were as follows: launching and organization of 8 Master of Medicine programmes (anesthesiology, family and community medicine, internal medicine, obstetrics & gynecology, otorhinolaryngology, pediatrics, psychiatry and surgery) and 4 Master programmes in public health (MPH, MSc Epidemiology, MSc Field Epidemiology & Laboratory Management, and Master in Hospital and Healthcare Administration); training to completion of more than 120 specialists in medicine, and 200 MPH, MSc Epidemiology, and MSc Field Epidemiology holders; revival of the Rwanda Medical Journal; organization of graduate research training (MPhil and PhD); 3 Master programmes in the pipeline (Global Health, Health Financing, and Supply Chain Management); partnerships with research institutions of great renown, which contributed to the reinforcement of the institutional research capacity and visibility towards excellence in leadership, accountability, and self sustainability. Even though there is still more to be achieved, the Rwanda experience about postgraduate and research programmes is inspiring through close interactions between main stakeholders. This is a must and could allow Rwanda to become one of the rare examples to other more well-to-do Sub - Saharan countries, should Rwanda carry on doing that. PMID:27303587
Agadzhanian, N A
The paper gives an account of the scientific-and-practical activity of the prominent Soviet physiologist V. V. Streltsov, Head of the Fourth Sector, Research Sanitary Institute, and the initiator of the Aviation Medicine Institute. He was a brilliant experimenter, innovator, organizer of unique researches who developed the physiological aspects of high altitude, speedy, night and instrumental blind flights, the problems of stratospheric aviation. He made the first experimental ascent in the altitude chamber. He was one of the first aviation physicians who made a parachute jump. He was the first inflight medical investigator who tested the on-board oxygen equipment in group cross-country flight on the closed route Moscow-Kharkov-Moscow.
In an agreeable shadow of the great 650th anniversary of Charles University foundation (1348-1998), arising of the first Institute of Sports Medicine round the world on Medical Faculty in Prague (1948-1998) was commemorated by scientific session. Since J. E. Purkynĕ (1850) have gone idea of favourable effect of body training for human health by representatives of Prague Medical Faculty, till Doctor J. Král, who started lectures for medical students in this discipline in 1933. Rise of Institute of Sports Medicine was approved in 1934, but its realization thanks to Professor Král, was performed after 2nd World War in 1948. From the beginning, students have lectures within the framework of daily study of whole wide of the branche, including practical exercises and closing examine. First text book of sports medicine and first book about clinic in sports medicine was written (J. Král). Members of Institute lectured on many foreign universities and scientific congresses and published more than 2,500 scientific works, some of them have world priority. For example first wireless transmission of heart frequency (V. Seliger, V. Kruta), cardiologic observations during big sports load (J. Král, Z. Hornof), discoveries at biochemical laboratory (J. Král, A. Zenísek), at medical functional anthropologic laboratory (V. Novotný), introducing of remedial exercises in clinical practice (L. Schmid, M. Zintlová, J. Chrástek) etc. In the set out choice of literary citation it is put on only fragment of publications which document scientific activity of jubileeing Institute. For period of duration of Institute more than hundred thousand patients were examined--both sportives and non-sportives, young and old. Contemporary trend goes from classic care about sportsmen towards preventive medicine. Attention is focused first of all to testing of middle aged and older patients in sense of prevention of cardiovascular and metabolic diseases and indication for specific movement load
Gathright, Molly Marie; Krain, Lewis P.; Sparks, Shane E.; Thrush, Carol R.
Objective: Few data exist on the topic of internal hiring of trainees in academic medicine. This study examines nationally representative data to determine the frequency of faculty psychiatrists who are employed in the same department in which they completed their residency training. Method: Estimates of internal faculty hiring were obtained by…
Tshitenge, Stephane; Setlhare, Vincent; Tsima, Billy; Adewale, Ganiyu; Parsons, Luise
Background Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported. Aims This study explored and assessed residents’ experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents. Methods A descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB. Results Eight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents’ potential solutions included an increase in staff, the acquisition of equipment at teaching sites and emphasis on FM core topics teachings. They had different views regarding how certain future career paths will be. Conclusions Despite the general dissatisfaction among residents because of challenges faced by the training programme, we have learnt that residents are capable of valuable inputs for improvement of their programme when engaged. There is need for the Department of Family Medicine to work with the Ministry of Health to set a clear career pathway for future graduates and to reflect on residents’ input for possible implementation. PMID:27796117
Timmerman, Henk; de Souza, Noel J
Bridging the gap: The differences between medicinal chemistry at the industrial and academic levels raises the question: Is there a significant gap between the two spheres that requires attention, or should such differences be deemed natural, without the need to close the gap? Herein we provide perspectives on this issue, based in part on opinions expressed at a forum discussion held at ISMC 2008 in Vienna.
Deutsch, Jonathan; Patinella, Stefania; Freudenberg, Nicholas
The institutional food sector—including food served in schools, child care settings, hospitals, and senior centers—is a largely untapped resource for public health that may help to arrest increasing rates of obesity and diet-related health problems. To make this case, we estimated the reach of a diverse institutional food sector in 1 large municipality, New York City, in 2012, and explored the potential for improving institutional food by building the skills and nutritional knowledge of foodservice workers through training. Drawing on the research literature and preliminary data collected in New York City, we discuss the dynamics of nutritional decision-making in these settings. Finally, we identify opportunities and challenges associated with training the institutional food workforce to enhance nutrition and health. PMID:23865653
Chun, Maria B J; Jackson, David S; Lin, Susan Y; Park, Elyse R
The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and÷or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility - more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area.
Health Services and Mental Health Administration (DHEW), Bethesda, MD.
This annotated bibliography presents 86 entries classified into the following sections: (1) Regional Conferences, (National Institute of Mental Health planning conferences on inservice training held in 1963), (2) Multidiscipline, Multilevel Training, (3) Professionals (administrators, psychiatrists, psychologists, psychiatric nurses), (4) Child…
Knowlton, Anne A.; Rainwater, Julie A.; Chiamvimonvat, Nipavan; Bonham, Ann C.; Robbins, John A.; Henderson, Stuart; Meyers, Frederick J.
There is a need for successful models of how to recruit, train, and retain bench scientists at the earliest stages of their careers into translational research. One recent, promising model is the University of California Davis Howard Hughes Medical Institute Integrating Medicine into Basic Science (HHMI-IMBS) program, part of the HHMI Med into Grad initiative. This article outlines the HHMI-IMBS program’s logic, design, and curriculum that guide the goal of research that moves from bedside to bench. That is, a curriculum that provides graduate students with guided translational training, clinical exposure, team science competencies and mentors from diverse disciplines that will advance the students careers in clinical translational research and re-focusing of research to answer clinical dilemmas. The data indicate that this training program provides an effective, adaptable model for training future translational researchers. HHMI-IMBS students showed improved confidence in conducting translational research, greater interest in a future translational career, and higher levels of research productivity and collaborations than a comparable group of pre-doctoral students. PMID:24127920
Knowlton, Anne A; Rainwater, Julie A; Chiamvimonvat, Nipavan; Bonham, Ann C; Robbins, John A; Henderson, Stuart; Meyers, Frederick J
There is a need for successful models of how to recruit, train, and retain bench scientists at the earliest stages of their careers into translational research. One recent, promising model is the University of California Davis Howard Hughes Medical Institute Integrating Medicine into Basic Science (HHMI-IMBS) program, part of the HHMI Med into Grad initiative. This paper outlines the HHMI-IMBS program's logic, design, and curriculum that guide the goal of research that moves from bedside to bench. That is, a curriculum that provides graduate students with guided translational training, clinical exposure, team science competencies, and mentors from diverse disciplines that will advance the students careers in clinical translational research and re-focusing of research to answer clinical dilemmas. The authors have collected data on 55 HHMI-IMBS students to date. Many of these students are still completing their graduate work. In the current study the authors compare the initial two cohorts (15 students) with a group of 29 control students to examine the program success and outcomes. The data indicate that this training program provides an effective, adaptable model for training future translational researchers. HHMI-IMBS students showed improved confidence in conducting translational research, greater interest in a future translational career, and higher levels of research productivity and collaborations than a comparable group of predoctoral students.
Raskin, Rose E
Two institutions with different residency training formats in clinical pathology are compared with respect to application procedures, learning and teaching opportunities, learning resources, research training, publication requirements, and assessment methods of the program and trainees. The University of Florida and Purdue University programs are both based on an emphasis in morphologic recognition and interpretation of disease processes as well as training in basic science and applied research principles. The progress of trainees through each program is carefully monitored to meet individual needs as well as to meet the training requirements to allow candidates to sit for the certifying examination in clinical pathology. Periodic mock board exams are a critical tool to assess trainee progress and learning. The differences in format focus on coursework and publication requirements as well as on program assessment tools. While one program provides training in the form of 75% clinical diagnostic service, the other uses a mixture of 50% coursework and 50% clinical diagnostic training. Despite the contrast between a pure residency training program and one combining residency training with an MS degree, both institutions provide a solid program structure, ample learning resources, and adequate faculty mentorship to produce a high pass rate of board-certified specialists, the major focus for both programs. Numbers of post-training employment positions for both institutions are similar for those selecting faculty positions at veterinary schools. During the period studied, however, the combined residency and MS graduate program at Purdue University produced more graduates employed in pharmaceutical and biotechnology companies, while the residency program at the University of Florida produced more graduates employed by diagnostic laboratories.
MCKEE, DELBERT A.
A SUMMER INSTITUTE IN INSTRUMENTATION TECHNOLOGY WAS HELD TO PROVIDE TEACHERS WITH CURRENT KNOWLEDGE ON AUTOMATIC, PROCESS-CONTROL INSTRUMENTATION. A PREVIOUSLY DEVELOPED GUIDE FOR A 2-YEAR, POST-HIGH SCHOOL CURRICULUM PROVIDED THE BASIS FOR INSTRUCTION AND DISCUSSION DURING THE INSTITUTE. THREE COURSES IN MEASUREMENT AND INSTRUMENT SHOP…
Ungar, Lea; Alperin, Mordechai; Amiel, Gilad E; Beharier, Zvi; Reis, Shmuel
Previous research has shown that physicians experience incompetence and difficulty in dealing with patients' feelings after they have broken bad news to them. During the past 10 years, we have implemented a longitudinal training program targeting these issues. The present article describes this training and discusses its contribution to doctors' skills at approaching distressed patients. In order to cope with breaking bad news to patients and their families, physicians should be skilled at crisis intervention and communication techniques. They should also be aware of their personal attitudes and emotional reactions when breaking bad news. Each session encompassed these areas, as well as the most prominent issues arising when breaking bad news. In a 1-5 Likert scale, the course received an overall score of 4.47 (S.D. 0.51). Participants noted that they had gained relevant communication skills for future patient encounters.
Haag, Martin; Bauch, Matthias; Garde, Sebastian; Heid, Jörn; Weires, Thorsten; Leven, Franz-Josef
Computer-based training (CBT) systems can efficiently support modern teaching and learning environments. In this paper, we demonstrate on the basis of the case-based CBT system CAMPUS that current learning theories and design principles (Bloom's Taxonomy and practice fields) are (i) relevant to CBT and (ii) are feasible to implement using computer-based training and adequate learning environments. Not all design principles can be fulfilled by the system alone, the integration of the system in adequate teaching and learning environments therefore is essential. Adequately integrated, CBT programs become valuable means to build or support practice fields for learners that build domain knowledge and problem-solving skills. Learning theories and their design principles can support in designing these systems as well as in assessing their value.
Pinxten, W. J. L.; De Jong, C.; Hidayat, T.; Istiqomah, A. N.; Achmad, Y. M.; Raya, R. P.; Norviatin, D.; Siregar, I. M. P.
Indonesia has one of the fastest growing, injecting drugs user-driven, human immunodeficiency virus (HIV) epidemics in Asia. Coverage of needle and syringe programs (NSPs), opioid substitution therapy (OST), and antiretroviral treatment (ART) is increasing, but is still low, whereas professional training in addiction medicine is not yet…
Bell, Paul F.; Semelka, Michael W.; Bigdeli, Laleh
Background Despite well-established negative consequences, high rates of substance use and related disorders continue to be reported. Physicians in training are not immune from this, or the associated risks to their health and careers, while impaired physicians are a threat to patient safety. Objective We surveyed family medicine residency programs' practices relating to drug testing of medical students and incoming residents. The survey asked about the extent to which residency programs are confronted with trainees testing positive for prohibited substances, and how they respond. Methods The survey was sent to the directors of family medicine residency programs. A total of 205 directors (47.2%) completed the survey. Results A majority of the responding programs required drug testing for incoming residents (143, 68.9%). Most programs did not require testing of medical students (161, 81.7%). Few programs reported positive drug tests among incoming residents (9, 6.5%), and there was only 1 reported instance of a positive result among medical students (1, 3.3%). Respondents reported a range of responses to positive results, with few reporting that they would keep open training spots or offer supportive services for a medical student who tested positive. Conclusions Changing laws legalizing certain drugs may require corresponding changes in the focus on drug testing and associated issues in medical training; however, many residency program directors were not aware of their institution's current policies. Programs will need to reexamine drug testing policies as new generations of physicians, growing up under altered legal circumstances concerning drug use, progress to clinical training. PMID:26217424
Profato, Jessica; Gordon, Erynn S; Dixon, Shannan; Kwan, Andrea
Medical genetics has entered a period of transition from genetics to genomics. Genetic counselors (GCs) may take on roles in the clinical implementation of genomics. This study explores the perspectives of program directors (PDs) on including genomic medicine in GC training programs, as well as the status of this integration. Study methods included an online survey, an optional one-on-one telephone interview, and an optional curricula content analysis. The majority of respondents (15/16) reported that it is important to include genomic medicine in program curricula. Most topics of genomic medicine are either "currently taught" or "under development" in all participating programs. Interview data from five PDs and one faculty member supported the survey data. Integrating genomics in training programs is challenging, and it is essential to develop genomics resources for curricula.
Kaufman, Gretchen E; Epstein, Jonathan H; Paul-Murphy, Joanne; Modrall, Jennifer D
New challenges to human, animal, and ecosystem health demand novel solutions: New diseases are emerging from new configurations of humans, their domestic animals and wildlife; new pressures on once robust and resilient ecosystems are compromising their integrity; synthetic compounds and engineered organisms, new to the natural world, are spreading unpredictably around the globe. Globalization provides opportunities for infectious organisms to gain access to new hosts, changing in distribution and virulence. What type of training should be developed to provide professionals with the right tools to meet these challenges? In this article, we offer recommendations for developing academic programs in conservation medicine. We discuss the need for, and the advantages to, using a conservation medicine approach to address real world situations and present illustrations of how this is applied today. We suggest a core set of skills that are needed in a conservation medicine practitioner, and recommend key considerations for designing new conservation medicine training programs. We review existing programs that offer conservation medicine content, and provide examples of where opportunities exist for those interested in pursuing a conservation medicine career.
Young physicians in Germany often criticize the advanced training programme, especially the lack of structure and the insufficient rotations. The Medical Association in each Bundesland/federal state require to include a proposal for advanced training and rotation in a trainer's aplication for an educational license. However, there is no systematic scrutiny of these concepts and therefore the criteria stated outcomes are often only incompletely met. Trainers engage too little in training methods and medical didactics. They rarely evaluate learning outcomes, and structured assessments based on workplace are exceptions. The reasons are deeply rooted in Germany's education system: Resources for specialist training are not provided, and there is no funding for a commitment in continued medical education. In addition, teaching is not assigned a quantifiable value. However, during the last decade awareness has arisen that good training programmes are an important part of quality assurance and the validation of a hospital. Better planning, structuring and evaluation of training programmes is necessary. New learning methods should be incorporated in training programmes. The German Respiratory Society (DGP) wishes to contribute to the improvement of advanced training: for example with "train the trainer" seminars for teachers, with a structured educational course programme for the trainees, with assessments such as the HERMES (Harmonized Education in Respiratory Medicine for European Specialists) exam and with support for the accreditation as a Respiratory Training Centre of the ERS (European Respiratory Society) and EBAP (European Board for Accreditation in Pneumology).
Shattuck, Julie; Dubins, Bobbi; Zilberman, Diana
This article reports on an inter-institutional project to design, develop, pilot, and evaluate a state-wide online training course for higher education adjunct faculty who are preparing to teach their first online course. We begin with a brief literature review to contextualize the stated problem the project sought to address: the need for…
... Institute Education Center and deliver standard classroom instruction on a regional basis. State or local... regarding classrooms, laboratories, and testing facilities available; and organization's ability to provide standard classroom training across the OSHA Region in which the organization is physically located....
Nijhof, Wim J., Ed.; Heikkinen, Anja, Ed.; Nieuwenhuis, Loek F. M., Ed.
This collection of essays, which is arranged in four sections, concerns flexibility in the Vocational Education and Training (VET) systems of Europe. The first section, "Introduction," includes the following chapter: "Shaping Conditions for a Flexible VET" (Nieuwenhuis et al.). The second section, "Institutional and…
After the presentation of three references to Information and communication technology (ICT) skills, the capacity of trainers training institute in nursing are explored through a survey of opinion. The use in the professional practice of these skills is captured by a dichotomous terms question.
Holmes, Marvin C.; Ingram, Cregg F.
Presented is the final report of a project to develop a consortium of Kentucky training institutions prepared to teach educational personnel for handicapped populations. Brief sections cover the following topics: purposes of the project (such as the establishment of a comprehensive statewide data base for student populations); the procedures and…
National Inst. of General Medical Sciences (NIH), Bethesda, MD.
The study predicts future requirements for biological scientists by specialty area, future supply within area, and the effects of National Institutes of Health program alternatives on requirements and supply measures. At present and for the forseeable future, approved training grants for critical shortage areas are funded as rapidly as centers of…
Texas Tech Univ., Lubbock. Dept. of Park Administration and Landscape Architecture.
In the first section of this report, summaries are presented of the papers delivered at the General Session of the meeting of the Southwest Park and Recreation Training Institute. The topics were: (1) Risk Aspect of Parks and Recreation; (2) All You Need To Know about Boards and Commissions, but Were Afraid To Ask; (3) Leadership and…
Institute for State Educational Planners, Mankato, Minn.
This document includes the papers presented at an inservice training institute for planners from State education agencies. Guidelines concerning information analysis techniques and basic pupil, personnel, and fiscal information needs are covered in papers by Stanley Hecker, John J. Stiglmeier, Paul Bethke, Robert L. Hopper, and Burton D. Friedman.…
Temples, Beryline; Simons, Paula; Atkinson, Timothy N.
By providing training from the Central Sponsored Programs Office (SPO), departments, and colleges at Predominantly Undergraduate Institutions (PUIs) can increase compliance with grant requirements. PUIs usually do not focus on department- or college-level grants administration and lack monetary resources to support this function. However, at the…
Latchaw, Truly Trousdale, Comp.; Miller, G. Dean, Comp.
The directory of Minnesota institutions providing paramedical training is organized by categories of paramedical occupations: child care specialist, dental assistant and hygienist, dietetic assistant, electro medical technician, hospital service coordinator or hospital station secretary, inhalation therapist, laboratory assistant and technician,…
OECD Publishing (NJ3), 2012
Rapid growth of tertiary education is partly due to the expansion of post-secondary vocational education and training (PSV). A well developed post-secondary PSV system and links between universities and VET institutions improve skills and employment opportunities. What is post-secondary PSV and how does it relate to other components of the…
Polcyn, Kenneth A.
By pooling resources and using communication satellites to access quality regional or national programs and personnel, institutions may be able to determine inmate aptitudes and career options, receive career counselling for inmates based on job trends, access educational and vocational training programs that match the inmates' capabilities and…
Vermeulen, B; Carron, P-N
The study of dynamics in relation to performing in small groups has increased pedagogic knowledge about teamwork. The successful management of patients with life-threatening pathologies depends highly from a succession of teams with a specific mission as: the call centre 144, Paramedics, the ED, the Operating Theatre and the Intensive care. To enable each team to operate successfully, it is essential to coordinate their qualifications and synergism. This can be efficiently attained by simulating real situations and by following protocols dedicated to teamwork. Emergency Medicine, which is on the brink of acquiring its proper curriculum, must adopt this concept to integrate knowledge and know-how, and the art of being and doing. At this stage, the Emergency Physician will have the competence which will enable him to be a real "team leader".
Wende, Ilja; Grittner, Ulrike
Background Traditional teaching concepts in medical education do not take full advantage of current information technology. We aimed to objectively determine the impact of Tablet PC enhanced training on learning experience and MKSAP® (medical knowledge self-assessment program) exam performance. Methods In this single center, prospective, controlled study final year medical students and medical residents doing an inpatient service rotation were alternatingly assigned to either the active test (Tablet PC with custom multimedia education software package) or traditional education (control) group, respectively. All completed an extensive questionnaire to collect their socio-demographic data, evaluate educational status, computer affinity and skills, problem solving, eLearning knowledge and self-rated medical knowledge. Both groups were MKSAP® tested at the beginning and the end of their rotation. The MKSAP® score at the final exam was the primary endpoint. Results Data of 55 (tablet n = 24, controls n = 31) male 36.4%, median age 28 years, 65.5% students, were evaluable. The mean MKSAP® score improved in the tablet PC (score Δ + 8 SD: 11), but not the control group (score Δ- 7, SD: 11), respectively. After adjustment for baseline score and confounders the Tablet PC group showed on average 11% better MKSAP® test results compared to the control group (p<0.001). The most commonly used resources for medical problem solving were journal articles looked up on PubMed or Google®, and books. Conclusions Our study provides evidence, that tablet computer based integrated training and clinical practice enhances medical education and exam performance. Larger, multicenter trials are required to independently validate our data. Residency and fellowship directors are encouraged to consider adding portable computer devices, multimedia content and introduce blended learning to their respective training programs. PMID:28369063
Lauria, Michael J; Rush, Stephen; Weingart, Scott D; Brooks, Jason; Gallo, Isabelle A
Psychological skills training (PST) is the systematic acquisition and practice of different psychological techniques to improve cognitive and technical performance. This training consists of three phases: education, skills acquisition and practice. Some of the psychological skills developed in this training include relaxation techniques, focusing and concentration skills, positive 'self-suggestion' and visualisation exercises. Since the middle of the 20th century, PST has been successfully applied by athletes, performing artists, business executives, military personnel and other professionals in high-risk occupations. Research in these areas has demonstrated the breadth and depth of the training's effectiveness. Despite the benefits realised in other professions, medicine has only recently begun to explore certain elements of PST. The present paper reviews the history and evidence behind the concept of PST. In addition, it presents some aspects of PST that have already been incorporated into medical training as well as implications for developing more comprehensive programmes to improve delivery of emergency medical care.
Flin, R; Maran, N
The aviation domain provides a better analogy for the "temporary" teams that are found in acute medical specialities than industrial or military teamwork research based on established teams. Crew resource management (CRM) training, which emphasises portable skills (for whatever crew a pilot is rostered to on a given flight), has been recognised to have potential application in medicine, especially for teams in the operating theatre, intensive care unit, and emergency room. Drawing on research from aviation psychology that produced the behavioural marker system NOTECHS for rating European pilots' non-technical skills for teamwork on the flightdeck, this paper outlines the Anaesthetists Non-Technical Skills behavioural rating system for anaesthetists working in operating theatre teams. This taxonomy was used as the design basis for a training course, Crisis Avoidance Resource Management for Anaesthetists used to develop these skills, based in an operating theatre simulator. Further developments of this training programme for teams in emergency medicine are outlined.
Spitzer, E D; Pierce, G F; McDonald, J M
We describe a laboratory medicine residency training program that includes ongoing interaction with both clinical laboratories and clinical services as well as significant research experience. Laboratory medicine residents serve as on-call consultants in the interpretation of test results, design of testing strategies, and assurance of test quality. The consultative on-call beeper system was evaluated and is presented as an effective method of clinical pathology training that is well accepted by the clinical staff. The research component of the residency program is also described. Together, these components provide training in real-time clinical problem solving and prepare residents for the changing technological environment of the clinical laboratory. At the completion of the residency, the majority of the residents are qualified laboratory subspecialists and are also capable of running an independent research program.
Flin, R; Maran, N
The aviation domain provides a better analogy for the "temporary" teams that are found in acute medical specialities than industrial or military teamwork research based on established teams. Crew resource management (CRM) training, which emphasises portable skills (for whatever crew a pilot is rostered to on a given flight), has been recognised to have potential application in medicine, especially for teams in the operating theatre, intensive care unit, and emergency room. Drawing on research from aviation psychology that produced the behavioural marker system NOTECHS for rating European pilots' non-technical skills for teamwork on the flightdeck, this paper outlines the Anaesthetists Non-Technical Skills behavioural rating system for anaesthetists working in operating theatre teams. This taxonomy was used as the design basis for a training course, Crisis Avoidance Resource Management for Anaesthetists used to develop these skills, based in an operating theatre simulator. Further developments of this training programme for teams in emergency medicine are outlined. PMID:15465960
The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures.
Narouze, Samer N; Provenzano, David; Peng, Philip; Eichenberger, Urs; Lee, Sang Chul; Nicholls, Barry; Moriggl, Bernhard
The use of ultrasound in pain medicine for interventional axial, nonaxial, and musculoskeletal pain procedures is rapidly evolving and growing. Because of the lack of specialty-specific guidelines for ultrasonography in pain medicine, an international collaborative effort consisting of members of the Special Interest Group on Ultrasonography in Pain Medicine from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies developed the following recommendations for education and training in ultrasound-guided interventional pain procedures. The purpose of these recommendations is to define the required skills for performing ultrasound-guided pain procedures, the processes for appropriate education, and training and quality improvement. Training algorithms are outlined for practice- and fellowship-based pathways. The previously published American Society of Regional Anesthesia and Pain Medicine and European Society of Regional Anaesthesia and Pain Therapy education and teaching recommendations for ultrasound-guided regional anesthesia served as a foundation for the pain medicine recommendations. Although the decision to grant ultrasound privileges occurs at the institutional level, the committee recommends that the training guidelines outlined in this document serve as the foundation for educational training and the advancement of the practice of ultrasonography in pain medicine.
Viseltear, A. J.
This paper considers the antecedent events that led to the development of Yale's Institute of Human Relations, the program of interdisciplinary research and teaching established, and the principal protagonists, James Rowland Angell, President of Yale University, and Milton C. Winternitz, Dean of the School of Medicine, both of whom were committed to the concept that medicine is a social science. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 PMID:6399650
Current projections indicate that in addition to the 10,100 technician positions and 6100 existing operator positions in the nuclear power industry, another 9100 technicians and 9700 operators will be required over the next decade. With 56 nuclear plants currently in operation and an additional 35 plants under construction, it is essential that trained technical personnel be available for employment in the nuclear utilities. Because of the growing demand for technicians in the nuclear utility industry, this report has been prepared to identify the nuclear-related, less-than-baccalaureate, technical educational programs provided by academic institutions and to ascertain both the current number of students and the maximum number that could be trained, given present staff and facilities. The data serve as a gauge for the proportion of technician training required by the nuclear industry that can be provided by academic institutions.
Rubin, Carol; Myers, Tanya; Stokes, William; Dunham, Bernadette; Harris, Stic; Lautner, Beth; Annelli, Joseph
Human health is inextricably linked to the health of animals and the viability of ecosystems; this is a concept commonly known as One Health. Over the last 2 decades, the Institute of Medicine (IOM) and the National Research Council (NRC) have published consensus reports and workshop summaries addressing a variety of threats to animal, human, and ecosystem health. We reviewed a selection of these publications and identified recommendations from NRC and IOM/NRC consensus reports and from opinions expressed in workshop summaries that are relevant to implementation of the One Health paradigm shift. We grouped these recommendations and opinions into thematic categories to determine if sufficient attention has been given to various aspects of One Health. We conclude that although One Health themes have been included throughout numerous IOM and NRC publications, identified gaps remain that may warrant targeted studies related to the One Health approach.
Stark, Margaret M; Norfolk, Guy A
As clinical forensic medicine (CFM) is not currently recognised as a speciality in the UK there are no nationally agreed mandatory standards for training forensic physicians in either general forensic (GFM) or sexual offence medicine (SOM). The General Medical Council (GMC), the medical regulator in the UK, has issued clear standards for training in all specialities recommending that "trainees must be supported to acquire the necessary skills and experience through induction, effective educational supervision, an appropriate workload and time to learn". In order to evaluate the current situation in the field of clinical forensic medicine, doctors who have recently (within the last two years) started working in the field "trainees" (n = 38), and trainers (n = 61) with responsibility for clinical and educational supervision of new trainees, were surveyed by questionnaire to gather their perceptions of how the relevant GMC standards are being met in initial on-the-job training. Telephone interviews were performed with eleven doctors working as clinical or medical directors to determine their views. It is clear that currently the quality of training in CFM is sub-standard and inconsistent and that the published standards, as to the minimum requirement for training that must be met by post-graduate medical and training providers at all levels, are not being met. The Faculty of Forensic and Legal Medicine (FFLM) needs to set explicit minimum standards which will comply with the regulator and work to pilot credentialing for forensic physicians. A number of recommendations are made for urgent FFLM development.
Campion, MaryAnn W.; Bhasin, Robina M.; Beaudette, Donald J.; Shann, Mary H.; Benjamin, Emelia J.
Purpose Faculty vitality is integral to the advancement of higher education. Strengthening vitality is particularly important for mid-career faculty, who represent the largest and most dissatisfied segment. The demands of academic medicine appear to be another factor that may put faculty at risk of attrition. To address these issues, we initiated a ten-month mid-career faculty development program. Methods A mixed-methods quasi-experimental design was used to evaluate the program's impact on faculty and institutional vitality. Pre/post surveys compared participants with a matched reference group. Quantitative data were augmented by interviews and focus groups with multiple stakeholders. Results At the program's conclusion, participants showed statistically significant gains in knowledge, skills, attitudes, and connectivity when compared to the referents. Conclusion Given that mid-career faculty development in academic medicine has not been extensively studied, our evaluation provides a useful perspective to guide future initiatives aimed at enhancing the vitality and leadership capacity of mid-career faculty. PMID:27942418
Objective: To identify and disclose publications from Turkey with the greatest “genuine” contributons to medicine in the past 50 years. Material and Methods: Based on the data of Web of Science, publications originating from Turkey’s institutions that were received by May, 2013, ≥72 citations were identified, after excluding papers having more than a minor share by international authors. Results: Primary authors numbering 223 generated 271 medical papers, each receiving ≥72 (95% CI 72; 263) citations. The articles cited herein were of a level of top global 8–10% papers. Half of the articles were published in 1997–2004. Compared with about 25–28 papers annually 10 years previously, it is estimated that currently only 20 papers are generated in Turkey annually, representing a global share of only 1.5 per thousand. The rate of rise registered in the period 1995–2004 may be anticipated to attenuate. Internal medicine, led by rheumatology, cardiology and hematology, and neurosciences were represented at 1.8-fold odds higher than the overall average. Led by Behçet’s disease, health issues encountered more widely than in other populations, formed frequent topics of contribution. Led by the Medical Faculties of Istanbul, Hacettepe, Ankara Universities and the Military Medical Academy, only 33 medical faculties and 14 public and private hospitals constituted sources. Conclusion: Since the elicited results are unsatisfactory, compared with Turkey’s potential, much more concerted efforts should be directed to rebuild a milieu favorable to promote research likely to contribute to medicine. PMID:25931859
Arevalo-Perez, Julio; Paris, Manuel; Graham, Michael M.; Osborne, Joseph R.
Nuclear Medicine has evolved from a medical subspecialty using quite basic tests to one using elaborate methods to image organ physiology and has truly become “Molecular Imaging”. Concurrently, there has also been a timely debate about who has to be responsible for keeping pace with all of the components of the developmental cycle; imaging, radiopharmaceuticals and instrumentation. Since the foundation of the ABNM, the practice of Nuclear Medicine and the process toward certification have undergone major revisions. At present, the debate is focused on the inevitable future convergence of Radiology and Nuclear Medicine. The potential for further cooperation or fusion of the American Board of Radiology (ABR) and the American Board of Nuclear Medicine (ABNM) is likely to bring about a new path for Nuclear Medicine and Molecular Imaging training. If the merger is done carefully, respecting the strengths of both partners equally, there is an excellent potential to create a hybrid Nuclear Medicine – Radiology specialty that combines Physiology and Molecular Biology with detailed anatomic imaging that will sustain the innovation that has been central to nuclear medicine residency and practice. Herein, we also introduce a few basic trends in imaging utilization in the United States. These trends do not predict future utilization, but highlight the need for an appropriately credentialed practitioner to interpret these examinations and provide value to the healthcare system. PMID:26687859
Objectives To assess the evidence showing that a specific method of toilet training (TT) is more effective than others, as any method of TT recommended by a physician faces obstacles because parents rarely request advice on TT from physicians, and TT practices vary tremendously across cultures and socioeconomic levels. Methods Reports on the natural course of urinary incontinence in children and different methods of TT, published in English between 1946 and 2012, were reviewed. Specifically investigated were historical recommendations on TT, the prevalence of urinary incontinence during childhood, the outcome of TT methods, and the effect of culture and socioeconomic status on the choice of TT method and timing. Results TT now occurs at later ages than it did previously. This progression reflects changing ideas about normal childhood physiology and psychology. The prevalence of urinary incontinence in European countries progressively decreased in children aged between 6–7 years and 16–17 years old. TT methods change with increasing socioeconomic levels to ‘child-centred’ techniques applied at older ages, but the prevalence of urinary incontinence after ‘parent-centred’ techniques of TT at younger ages has not been studied. There is currently no evidence that a specific timing or method of TT is more effective or prevents voiding dysfunction. Conclusions Follow-up studies of urinary continence in children toilet trained at 6–12 months of age might provide evidence for whether a given method or timing of TT is beneficial to prevent voiding dysfunction. The recommendations of physicians might be more readily adopted if they fit culturally accepted ideas of good parenting techniques. PMID:26579239
Ewain, Saleh A. S.
The Institute of Public Administration (IPA), in Saudi Arabia, is a well renowned training institution designated for training civil servants in the Kingdom of Saudi Arabia. This paper mainly discusses the uses of technologies in the administrative aspects of the IPA. The author also points out the obstacles faced and lessons learned from the…
Drislane, Frank W.; Akpalu, Albert; Wegdam, Harry H.J.
Ghana, a developing country in West Africa, has major medical burdens in taking care of a large population with limited resources. Its three medical schools produce more than 200 graduates per year, but most emigrate to developed lands after training. Ghana is working to educate and retain locally trained physicians, but it is difficult to get them to work in rural settings where the need is greatest. This article details the establishment of a General Medicine residency at a 150-bed hospital in rural Ghana. Early training comprises 6 months each in Medicine, Surgery, OB/GYN, and Pediatrics; the hospital in Techiman also has a Surgery residency. House officers choose the program for more hands-on experience than they can get in larger centers. They perform many tasks, including surgery, sooner and more independently than do residents in developed countries. The training program includes a morning report, clinical teaching rounds, and rotations on in-patient wards and in the Emergency Department and clinics. Teaching focuses on history, physical examination, good communication, and proper follow-up, with rigorous training in the OR and some clinical research projects pertinent to Ghana. Trainees work hard and learn from one another, from a dedicated faculty, and by evaluating and treating very sick patients. Ghana’s rural residencies offer rigorous and attractive training, but it is too soon to tell whether this will help stem the “brain drain” of young physicians out of West Africa. PMID:25191148
Wong, Teck Yee; Chong, Phui Nah; Chng, Shih Kiat; Tay, Ee Guan
Postgraduate Family Medicine (FM) training is important to train future primary care doctors to provide accessible and cost effective healthcare. In Singapore, a structured postgraduate FM training programme has been available for 20 years. This programme is characterised by involvement of both FM and non-FM doctors, well written modules and a rigorous assessment process. However, challenges faced by both the current healthcare system and training structure underlie the need to review the training structure to ensure its relevancy for future Family Physicians (FPs) to manage the needs of their patients. A workgroup was formed to review the current FM postgraduate programme and to explore the possibility of using the Accreditation Council for Graduate Medical Education (ACGME) framework to enhance our current system. The workgroup felt that broad-based training and comprehensive coverage of topics are areas that are important to retain in any new FM residency programme. Weaknesses identified included a lack of early FM exposure and the need to strengthen formative assessments. New organisational structures such as Family Medicine Centres (FMC) need to be established and the involvement of the private sector in any FM residency progammes could be enhanced. The implementation of the FM Residency Programme in 2011 presented a unique opportunity to realign FM postgraduate education in line with the national objectives and to equip FPs with the necessary knowledge and skills for managing the future healthcare needs of Singaporeans.
Kellina, O I; Strelkova, M V
The paper assesses the investigations on leishmaniases at the E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine in 1920 to 2009. The analysis includes papers on biology, ecology, taxonomy, and experimental transmission of the agents of leishmaniases via the bites of sand flies, the principle in the control of zoonotic cutaneous leishmaniasis (ZCL) during the agricultural development of extensive territories in the Karshin steppe, on quantitative approaches in the epidemiology of ZCL, a search for Russian effective medicaments to treat patients with this disease and the development of criteria for selecting L. major strains for individual and mass vaccinations against ZCL, the revision of Leishmania circulating in great gerbil populations, and the description of the new species L. turanica, an important parasite for L. major persistence from one transmission season to the next. The first investigations on leishmaniasis were made by Prof. E.I. Martsinovsky, the founder and the first director of the Institute in the early 20th century.
Hemmersbach, Ruth; Hendrik Anken, Ralf; Hauslage, Jens; von der Wiesche, Melanie; Baerwalde, Sven; Schuber, Marianne
In order to investigate the influence of altered gravity on biological systems and to identify gravisensitive processes, various experimental platforms have been developed, which are useful to simulate weightlessness or are able to produce hypergravity. At the Institute of Aerospace Medicine, DLR Cologne, a broad spectrum of applications is offered to scientists: clinostats with one rotation axis and variable rotation speeds for cultivation of small objects (including aquatic organisms) in simulated weightlessness conditions, for online microscopic observations and for online kinetic measurements. Own research concentrates on comparative studies with other kinds of methods to simulate weightlessness, also available at the institute: Rotating Wall Vessel (RWV) for aquatic studies, Random Positioning Machine (RPM; manufactured by Dutch Space, Leiden, The Netherlands). Correspondingly, various centrifuge devices are available to study different test objects under hypergravity conditions -such as NIZEMI, a slow rotating centrifuge microscope, and MUSIC, a multi-sample centrifuge. Mainly for experiments with human test subjects (artificial gravity), but also for biological systems or for testing various kinds of (flight-) hardware, the SAHC, a short arm human centrifuge -loaned by ESA -was installed in Cologne and completes our experimental scenario. Furthermore, due to our specific tasks such as providing laboratories during the German Parabolic Flight Experiments starting from Cologne and being the Facility Responsible Center for BIOLAB, a science rack in the Columbus module aboard the ISS, scientists have the possibility for an optimal preparation of their flight experiments.
Since the year-2000, a French-speaking Institute for Tropical Medicine (French acronym, IFMT) has been operating in Lao PDR through funding provided by the Agence Universitaire de la Francophonie. The IFMT is a postgraduate teaching centre dedicated to improving skills of health care professionals in clinical sciences, epidemiology, public health and management as well as to research and health care intervention. These activities are conducted in the capital as well as provinces and districts throughout Laos with special focus on priority health issues facing developing countries in tropical regions. The IFMT organizes a 4-semester international course taught in French to medical doctors from Southeast Asia, mainly Laos, Cambodia, Vietnam and Southern China, but also from other countries. To date, a total of 72 students have graduated from the IFMT. In 2005 the Institute delivers a master degree. This article describes the course objectives and some features of the curriculum. It also presents a general overview of health, teaching, and research facilities in Southeast Asia as well as of the major challenges now confronting the region.
Arntfield, Shannon L.; Slesar, Kristen; Dickson, Jennifer; Charon, Rita
Objective This study sought to explore the perceived influence of narrative medicine training on clinical skill development of fourth-year medical students, focusing on competencies mandated by ACGME and the RCPSC in areas of communication, collaboration, and professionalism. Methods Using grounded-theory, three methods of data collection were used to query twelve medical students participating in a one-month narrative medicine elective regarding the process of training and the influence on clinical skills. Iterative thematic analysis and data triangulation occurred. Results Response rate was 91% (survey), 50% (focus group) and 25% (follow-up). Five major findings emerged. Students perceive that they: develop and improve specific communication skills; enhance their capacity to collaborate, empathize, and be patient-centered; develop personally and professionally through reflection. They report that the pedagogical approach used in narrative training is critical to its dividends but misunderstood and perceived as counter-culture. Conclusion/Practice implications Participating medical students reported that they perceived narrative medicine to be an important, effective, but counter-culture means of enhancing communication, collaboration, and professional development. The authors contend that these skills are integral to medical practice, consistent with core competencies mandated by the ACGME/RCPSC, and difficult to teach. Future research must explore sequelae of training on actual clinical performance. PMID:23462070
Butt, Aamir W; Soomro, Nabila; Akhtar, Noreen
Pakistan is one of the three countries in South East Asia that has an active postgraduate physical medicine and rehabilitation (PM&R) training program. College of Physicians and Surgeons Pakistan (CPSP) offers a four-year structured training program in PM&R. It consists of clinical teaching, lectures, rotations in other specialties, and writing a research dissertation. The aim of this survey was to provide an objective analysis of the current PM&R training program, including the facilities available for training, the participation of residents in academic activities, and their participation in different PM&R procedures. Hospital ethics committee approval was obtained. The questionnaire had sections on informed consent; basic demographics; the different components of residency training; and self-assessement of competence in different procedural skills. It was approved by the dean of PM&R at CPSP. There are six accredited training centers in Pakistan. Twelve residents are undergoing residency training at four different centers (Dec 2015). Key persons were nominated at each center to facilitate data collection. All residents (100% response rate) completed the survey. Almost all had read the CPSP training manual. Most had submitted the research dissertation. Training facilities varied across different centers, with the military center being the best equipped. The self-assessed competence of residents in different PM&R procedures varied among different centers, but overall it conformed to the competency levels specified in the training manual. Overall PM&R residency training in Pakistan is satisfactory, but there is a need to strengthen the weak areas and standardize the training across all centers in the country. PMID:28286724
Rathore, Farooq A; Butt, Aamir W; Soomro, Nabila; Akhtar, Noreen
Pakistan is one of the three countries in South East Asia that has an active postgraduate physical medicine and rehabilitation (PM&R) training program. College of Physicians and Surgeons Pakistan (CPSP) offers a four-year structured training program in PM&R. It consists of clinical teaching, lectures, rotations in other specialties, and writing a research dissertation. The aim of this survey was to provide an objective analysis of the current PM&R training program, including the facilities available for training, the participation of residents in academic activities, and their participation in different PM&R procedures. Hospital ethics committee approval was obtained. The questionnaire had sections on informed consent; basic demographics; the different components of residency training; and self-assessement of competence in different procedural skills. It was approved by the dean of PM&R at CPSP. There are six accredited training centers in Pakistan. Twelve residents are undergoing residency training at four different centers (Dec 2015). Key persons were nominated at each center to facilitate data collection. All residents (100% response rate) completed the survey. Almost all had read the CPSP training manual. Most had submitted the research dissertation. Training facilities varied across different centers, with the military center being the best equipped. The self-assessed competence of residents in different PM&R procedures varied among different centers, but overall it conformed to the competency levels specified in the training manual. Overall PM&R residency training in Pakistan is satisfactory, but there is a need to strengthen the weak areas and standardize the training across all centers in the country.
Paeglis, Roberts; Bluss, Kristaps; Rudzitis, Andris; Spunde, Andris; Brice, Tamara; Nitiss, Edgars
We recorded eye movements of eight elite junior basketball players. We hypothesized that a more stable gaze is correlated to a better shot rate. Upon preliminary testing we invited male juniors whose eyes could be reliably tracked in a game situation. To these ends, we used a head-mounted video-based eye tracker. The participants had no record of ocular or other health issues. No significant differences were found between shots made with and without the tracker cap, Paired samples t-test yielded p= .130 for the far and p=..900 > .050 for the middle range shots. The players made 40 shots from common far and middle range locations, 5 and 4 meters respectively for aged 14 years As expected, a statistical correlation was found between gaze fixation (in milliseconds) for the far and middle range shot rates, r=.782, p=.03. Notably, juniors who fixated longer before a shot had a more stable fixation or a lower gaze dispersion (in tracker's screen pixels), r=-.786, p=.02. This finding was augmented by the observation that the gaze dispersion while aiming at the basket was less (i.e., gaze more stable) in those who were more likely to score. We derived a regression equation linking fixation duration to shot success. We advocate infra-red eye tracking as a means to monitor player selection and training success.
The integrated chain of treatment of the most severe clinical cases that require hyperbaric oxygen therapy (HBOT) assumes that intensive care is continued while inside the hyperbaric chamber. Such an approach needs to take into account all the risks associated with transportation of the critically ill patient from the ICU to the chamber and back, changing of ventilator circuits and intravascular lines, using different medical devices in a hyperbaric environment, advanced invasive physiological monitoring as well as medical procedures (infusions, drainage, etc) during long or frequently repeated HBOT sessions. Any medical staff who take care of critically ill patients during HBOT should be certified and trained according to both emergency/intensive care and hyperbaric requirements. For any HBOT session, the number of staff needed for any HBOT session depends on both the type of chamber and the patient's status--stable, demanding or critically ill. For a critically ill patient, the standard procedure is a one-to-one patient-staff ratio inside the chamber; however, the final decision whether this is enough is taken after careful risk assessment based on the patient's condition, clinical indication for HBOT, experience of the personnel involved in that treatment and the available equipment.
ZIOL, FRANK J.
AN INSTITUTE WAS CONDUCTED TO ASSIST IN THE DEVELOPMENT OF KNOWLEDGES AND SKILLS ESSENTIAL FOR TEACHING SPECIALIZED TECHNICAL COURSES. THE PARTICIPANTS WERE 16 TEACHERS IN THE TECHNICAL-VOCATIONAL AREA OF INSTRUMENTATION. THE ACTIVITY INCLUDED LECTURE AND DISCUSSION, DEMONSTRATION, LABORATORY WORK, AND FIELD TRIPS. THE SCOPE OF THE PROGRAM…
This proposal requests continued support for the program of activities to be undertaken by the Ames-Stanford Joint Institute for Aeronautics and Acoustics during the one-year period October 1, 1997 to September 30, 1998. The emphasis in this program is on training and research in experimental and computational methods with application to aerodynamics, acoustics and the important interactions between them. The program comprises activities in active flow control, Large Eddy Simulation of jet noise, flap aerodynamics and acoustics, high lift modeling studies and luminescent paint applications. During the proposed period there will be a continued emphasis on the interaction between NASA Ames, Stanford University and Industry, particularly in connection with the noise and high lift activities. The program will be conducted within the general framework of the Memorandum of Understanding (1976) establishing the Institute, as updated in 1993. As outlined in the agreement, the purposes of the Institute include the following: (1) To conduct basic and applied research; (2) to promote joint endeavors between Center scientists and those in the academic community; (3) to provide training to graduate students in specialized areas of aeronautics and acoustics through participation in the research programs of the Institute; (4) to provide opportunities for Post-Doctoral Fellows to collaborate in research programs of the Institute; and (5) to disseminate information about important aeronautical topics and to enable scientists and engineers of the Center to stay abreast of new advances through symposia, seminars and publications.
This proposal requests continued support for the program of activities to be undertaken by the Ames-Stanford Joint Institute for Aeronautics and Acoustics during the one-year period October 1, 1996 to September 30, 1997. The emphasis in this program is on training and research in experimental and computational methods with application to aerodynamics, acoustics and the important interactions between them. The program comprises activities in active flow control, Large Eddy Simulation of jet noise, flap aerodynamics and acoustics, high lift modeling studies and luminescent paint applications. During the proposed period there will be a continued emphasis on the interaction between NASA Ames, Stanford University and Industry, particularly in connection with the noise and high lift activities. The program will be conducted within the general framework of the Memorandum of Understanding (1976) establishing the Institute, as updated in 1993. As outlined in the agreement, the purposes of the institute include the following: To conduct basic and applied research. To promote joint endeavors between Center scientists and those in the academic community To provide training to graduate students in specialized areas of aeronautics and acoustics through participation in the research programs of the Institute. To provide opportunities for Post-Doctoral Fellows to collaborate in research programs of the Institute. To disseminate information about important aeronautical topics and to enable scientists and engineers of the Center to stay abreast of new advances through symposia, seminars and publications.
Background The Implementation Research Institute (IRI) provides two years of training in mental health implementation science for 10 new fellows each year. The IRI is supported by a National Institute of Mental Health (NIMH) R25 grant and the Department of Veterans Affairs (VA). Fellows attend two annual week-long trainings at Washington University in St. Louis. Training is provided through a rigorous curriculum, local and national mentoring, a ‘learning site visit’ to a federally funded implementation research project, pilot research, and grant writing. Methods This paper describes the rationale, components, outcomes to date, and participant experiences with IRI. Results IRI outcomes include 31 newly trained implementation researchers, their new grant proposals, contributions to other national dissemination and implementation research training, and publications in implementation science authored by the Core Faculty and fellows. Former fellows have obtained independent research funding in implementation science and are beginning to serve as mentors for more junior investigators. Conclusions Based on the number of implementation research grant proposals and papers produced by fellows to date, the IRI is proving successful in preparing new researchers who can inform the process of making evidence-based mental healthcare more available through real-world settings of care and who are advancing the field of implementation science. PMID:24007290
Dauer, Lawrence T; St Germain, Jean
This paper examines the educational philosophy of radiation safety education programs at medical institutions. The regulatory mandates for radiation safety training have traditionally emphasized competency-based training. This emphasis led to the adoption of a behaviorist philosophy that requires predetermined responses to certain situations. The behaviorist approach determines the roles of teacher and learner as well as the methods to be used. This paper examines these roles and methods and the influence of a highly regulated environment on the adoption of the behaviorist model. The paper also suggests that other educational philosophies, such as the progressive philosophy, should be examined to provide a rich foundation for improving the educational experience and outcomes.
In this study, we examined if children’s food selections met the School Meals Initiative (SMI) standards, and the recently released Institute of Medicine (IOM) recommendations. Mean food selection, plate waste, and food intake were also examined. Food intake of 2,049 4th-6th grade students were meas...
In this study, we examined if children’s food selection met the School Meals Initiative (SMI) standards, and the recently released Institute of Medicine (IOM) recommendations. Mean food selection, plate waste, and food intake were also examined. Food intake of 2,049 4th-6th grade students were measu...
The objective of this study was to compare the school lunch consumption of Texas middle-school students with the 2009 Institute of Medicine's (IOM) school meal report recommendations. These new lunch menu patterns increase fruit to one serving and vegetables to two servings, with 50 percent wholegra...
Pellmar, Terry C.; Brandt, Edward N., Jr.; Baird, Macaran A.
An Institute of Medicine committee examined the links between biological, psychosocial, and behavioral factors and health; reviewed effective applications of behavioral interventions (individual behavior, families, organizations, communities, and society); and discussed the production and maintenance of behavior change. The paper presents a…
Martin, Dawn; Nasmith, Louise; Takahashi, Susan Glover; Harvey, Bart J.
Background The shift from undergraduate to postgraduate education signals a new phase in a doctor’s training. This study explored the resident’s perspective of how the transition from undergraduate to postgraduate (PGME) training is experienced in a Family Medicine program as they first meet the reality of feeling and having the responsibility as a doctor. Methods Qualitative methods explored resident experiences using interpretative inquiry through monthly, individual in-depth interviews with five incoming residents during the first six months of training. Focus groups were also held with residents at various stages of training to gather their reflection about their experience of the first six months. Residents were asked to describe their initial concerns, changes that occurred and the influences they attributed to those changes. Results Residents do not begin a Family Medicine PGME program knowing what it means to be a Family Physician, but learn what it means to fulfill this role. This process involves adjusting to significant shifts in responsibility in the areas of Knowledge, Practice Management, and Relationships as they become more responsible for care outcomes. Conclusion This study illuminated the resident perspective of how the transition is experienced. This will assist medical educators to better understand the early training experiences of residents, how these experiences contribute to consolidating their new professional identity, and how to better align teaching strategies with resident learning needs. PMID:28344713
Kortekaas, M F; Bartelink, M E L; Zuithoff, N P A; van der Heijden, G J M G; de Wit, N J; Hoes, A W
Objectives Evidence-based medicine (EBM) is an important element in the general practice (GP) specialty training. Studies show that integrating EBM training into clinical practice brings larger benefits than stand-alone modules. However, these studies have neither been performed in GP nor assessed EBM behaviour of former trainees in daily clinical practice. Setting GP specialty training in the Netherlands. Participants All 82 third year GP trainees who started their final third year in 2011 were approached for inclusion, of whom 79 (96%) participated: 39 in the intervention group and 40 in the control group. Intervention Integrated EBM training, in which EBM is embedded closely within the clinical context by joint assignments for the trainee and supervisor in daily practice, and teaching sessions based on dilemmas from actual patient consultations. Comparison Stand-alone EBM training at the institute only. Primary and secondary outcomes Our primary outcome was EBM behaviour, assessed by measuring guideline adherence (incorporating rational, motivated deviation) and information-seeking behaviour. Our secondary outcomes were EBM attitude and EBM knowledge. Data were acquired using logbooks and questionnaires, respectively. Analyses were performed using mixed models. Results Logbook data were available from 76 (96%) of the participating trainees at baseline (7614 consultations), 60 (76%) at the end of the third year (T1, 4973 consultations) and 53 (67%) 1 year after graduation (T2, 3307 consultations). We found no significant differences in outcomes between the 2 groups, with relative risks for guideline adherence varying between 0.96 and 0.99 (95% CI 0.86 to 1.11) at T1, and 0.99 and 1.10 (95% CI 0.92 to 1.25) at T2, and for information-seeking behaviour between 0.97 and 1.16 (95% CI 0.70 to 1.91) and 0.90 and 1.10 (95% CI 0.70 to 1.32), respectively. Conclusions Integrated EBM training compared with stand-alone EBM training does not improve EBM behaviour, attitude
Lowe, David J; Ireland, Alastair J; Ross, Al; Ker, Jean
Non-technical skills (NTS) are gaining increasing prominence within the field of emergency medicine. Situational awareness (SA), one key component of NTS, is a key skill for emergency physicians (EPs) during initial training and throughout their career. Furthermore, the majority of frameworks used to evaluate clinical performance incorporate SA as one key component. This review seeks to define and explore the concept of SA within the context of emergency medicine. We describe SA at an individual, team and departmental level. Development of this ability enables EPs to function effectively within the challenging environment of the emergency department (ED). Enhancing our understanding of SA may develop the cognitive process that underpins our clinical performance. We propose a model for consideration to support evaluation and training of SA within the ED, linking the model to the novice expert continuum.
Abu Zuhairah, Ammar R.; Al-Dawood, Kasim M.; Khamis, Amar H.
Aims: The aim was to compare Eastern, Makkah, and Asir regions in term of residents’ perception of the achievement of training objectives, and to assess various rotations based on residents’ perception. Settings and Design: This cross-sectional study was done among family medicine residents in the Eastern, Makkah, and Asir regions. Methodology: A questionnaire was developed by the investigator and validated by two experts. All residents, except R1 residents, were included. All data were collected by the investigator by direct contact with the residents. Statistical Analysis Used: Cronbach's alpha, analysis of variance, t-test, and univariate regression model as appropriate, were used. Results: Reliability of the questionnaire was found to be 75.4%. One hundred and seven (response rate: 83.6%) residents completed the questionnaire. There were 51 (47.7%), 27 (25.2%), and 29 (27.1%) residents in the program in the Eastern region, Makkah, and Asir, respectively. The mean age was 29.1 ± 2.5 years; half of the residents were male, most of (83.2%) were married, and more than half (54.2%) of had worked in primary health care before joining the program. Overall, 45% of the residents perceived that they had achieved the training objectives. The highest rotations as perceived by the residents were psychiatry and otolaryngology while the lowest were orthopedics and ophthalmology. There were significant differences among the study regions with regard to the rotations in family medicine, internal medicine, orthopedics, general surgery, and emergency medicine. Conclusions: Overall, a good percentage of the residents perceived that they had achieved the training objectives. The rotations differed in the studied regions. Psychiatry and otolaryngology had the highest percentage of family medicine residents who perceived that they had achieved the training objectives while lowest was in internal medicine and obstetrics and gynecology. The highest rotations as perceived by the
Mooser, Vincent; Currat, Christine
Breakthrough technologies which now enable the sequencing of individual genomes will irreversibly modify the way diseases are diagnosed, predicted, prevented and treated. For these technologies to reach their full potential requires, upstream, access to high-quality biomedical data and samples from large number of properly informed and consenting individuals and, downstream, the possibility to transform the emerging knowledge into a clinical utility. The Lausanne Institutional Biobank was designed as an integrated, highly versatile infrastructure to harness the power of these emerging technologies and catalyse the discovery and development of innovative therapeutics and biomarkers, and advance the field of personalised medicine. Described here are its rationale, design and governance, as well as parallel initiatives which have been launched locally to address the societal, ethical and technological issues associated with this new bio-resource. Since January 2013, inpatients admitted at Lausanne CHUV University Hospital have been systematically invited to provide a general consent for the use of their biomedical data and samples for research, to complete a standardised questionnaire, to donate a 10-ml sample of blood for future DNA extraction and to be re-contacted for future clinical trials. Over the first 18 months of operation, 14,459 patients were contacted, and 11,051 accepted to participate in the study. This initial 18-month experience illustrates that a systematic hospital-based biobank is feasible; it shows a strong engagement in research from the patient population in this University Hospital setting, and the need for a broad, integrated approach for the future of medicine to reach its full potential.
Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan
Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. PMID:24857843
Fraser, Traci N; Blumenthal, Daniel M; Bernard, Kenneth; Iyasere, Christiana
Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included "leading a team" (98% of residents), "confronting problem employees" (93%), "coaching and developing others" (93%), and "resolving interpersonal conflict" (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees.
Goroll, Allan H
Current U.S. primary care workforce shortages and trainees' declining interest in primary care residency training, especially regarding primary care internal medicine, have many parallels with circumstances in the early 1970s, when modern adult primary care first emerged. Rediscovery of the lessons learned and the solutions developed at that time and applying them to the current situation have the potential to help engage a new generation of young physicians in the primary care mission.The author compares the internal medicine residency primary care track at the University of New Mexico, described by Brislen and colleagues in this issue, with the nation's first three-year primary care internal medicine residency track introduced at Massachusetts General Hospital in 1973. Strategies for addressing the challenges of primary care practice and improving learner attitudes toward the field are discussed. The author suggests that primary care physicians should be likened to "quarterbacks" rather than "gatekeepers" or "providers" to underscore the intensity of training, level of responsibility, degree of professionalism, and amount of compensation required for this profession. The advent of multidisciplinary team practice, modern health information technology, and fundamental payment reform promises to dramatically alter the picture of primary care, restoring its standing as one of the best job descriptions in medicine.
Galardi, Nicholas; Ciminero, Matthew; Thaller, Seth; Salgado, Christopher
The Visiting Educational Scholarship Training Program, started by the University of Miami's Division of Plastic and Reconstructive Surgery, was designed to uphold the institution's founding mission: the education of our future medical leaders as well as the promotion of health of our local, regional, national, and international communities. It offers the opportunity for international medical students and training physicians to be educated and get exposure to the field of plastic surgery in a United States training institution.
Nyce, James M; Timpka, Toomas
Social medicine deals with the interplay between medicine and society. An awareness of how analytical categories have emerged historically can strengthen the role the discipline can play in the societal reinventions of health care now under way around the world. This study examines the categories that informed social medicine in Sweden during the 20th century. An anthropological field study was conducted over a 12-year period in a Swedish academic clinical setting. Historical documents were used to link local-level issues with macro-level (here, national and European) contexts. Social medicine, modernity, and social democracy were found to share a common history and a common vision of what society should be. As a result, concepts from politics, ideology, economy, and science tended to be conflated. As a clinician at the study site explained, "samhälle [community] is both society and state". The consequence for social medicine is that culture has become neglected as an analytical category. This institutional amnesia has strongly influenced how 21st century social medicine, in this region of the world, has defined itself and its interests. To return a cultural perspective to social medicine, a critical distance must be kept between the analyses the discipline undertakes and the prevailing societal ideologies.
Mocumbi, Ana Olga; Carrilho, Carla; Aronoff-Spencer, Eliah; Funzamo, Carlos; Patel, Sam; Preziosi, Michael; Lederer, Philip; Tilghman, Winston; Benson, Constance A; Badaró, Roberto; Nguenha, A; Schooley, Robert T; Noormahomed, Emília V
With approximately 4 physicians per 100,000 inhabitants, Mozambique faces one of the most severe health care provider shortages in Sub-Saharan Africa. The lack of sufficient well-trained medical school faculty is one of Mozambique's major barrier to producing new physicians annually. A partnership between the Universidade Eduardo Mondlane and the University of California, San Diego, has addressed this challenge with support from the Medical Education Partnership Initiative. After an initial needs assessment involving questionnaires and focus groups of residents, and working with key members from the Ministry of Health, the Medical Council, and Maputo Central Hospital, a set of interventions was designed. The hospital's internal medicine residency program was chosen as the focus for the plan. Interventions included curriculum design, new teaching methodologies, investment in an informatics infrastructure for access to digital references, building capacity to support clinical research, and providing financial incentives to retain junior faculty. The number of candidates entering the internal medicine residency program has increased, and detailed monitoring and evaluation is measuring the impact of these changes on the quality of training. These changes are expected to improve the long-term quality of postgraduate training in general through dissemination to other departments. They also have the potential to facilitate equitable distribution of specialists nationwide by expanding postgraduate training to other hospitals and universities.
Eichbaum, Quentin; Shan, Hua; Goncalez, Thelma T; Duits, A J; Knox, Patricia; Reilly, Jim; Andrews, David
Education and training in transfusion medicine have improved over the past decade in developing countries but are still generally deficient for the purpose of maintaining the safety of the global blood supply. In 2009, the World Health Organization global database on blood safety indicated that only 72% of countries in the world were able to meet their training needs necessary for maintaining the safety of their local blood supply. Educational approaches in transfusion medicine vary widely between continents and world regions. In this article, we summarize a session on global health education and training in developing countries that took place at the 2012 AABB conference. The panel consisted of transfusion representatives from South America (Brazil), Asia (China), Africa (South Africa), and the Caribbean (Curaçao), as well as a description of capacitation issues in postearthquake Haiti and the pivotal role of the US President's Emergency Plan for AIDS Relief (PEPFAR) in transfusion training and education in Africa. We present here summaries of each of these panel presentations.
von Wurmb-Schwark, Nicole; Simeoni, Eva; Poetsch, Micaela; Banaschak, Sibylle; Mályusz, Victoria; Schwark, Thorsten
This investigation presents the retrospective evaluation of paternity testing done as a "second opinion" in the last four years at the Institutes of Legal Medicine in Jena, Greifswald, and Kiel (Germany). All analyses were court-ordered and were preceded by paternity tests of "private" labs. The cases were selected in chronological order without any further exclusion criteria. A total of 59 cases, in which "private" laboratories from all regions of Germany had already performed paternity tests, were evaluated. In all cases, analyses were mainly done by PCR-based STR-typing (8 - 20 STRs). 18 % of the investigated "private" expert opinions showed a false determination of alleles. In two cases, paternity was wrongly confirmed or excluded. The reasons for the mistakes of private laboratories were hard to analyse, since most labs did not provide sufficient information (e.g. alleles, kits and chemicals used) in the written test results. In several cases, not even the typing results were revealed. Furthermore, in paternity testing of "private" labs the identity of the persons examined was usually not assured (e. g. by photo documentation or fingerprints) adding to the problem of insufficient test result reliability.
The stem cell domain of the regenerative medicine field has seen fundamental changes initiated by seminal discoveries in cell biology, genetic engineering, and whole genome sequencing. Many of these discoveries were funded in part by the National Institutes of Health (NIH), and the NIH remains a leader in supporting research in the United States. However, as the field has developed, the NIH has responded proactively to identify roadblocks and to develop solutions that will accelerate translation of basic discoveries to the clinical setting. These activities range from organizing specialized workshops and coordinating activities among international organizations and the different arms of the government to funding small-scale industry. In addition, the NIH has been a key driver in providing needed infrastructure in areas in which the private sector has been unable to, or does not believe it can, invest. These activities of the NIH are as important as its traditional funding role, and I believe they have contributed to the innovation and rapid pace of discovery in this field.
Epstein, Richard A
The 2003 Institute of Medicine (IOM) study on Unequal Treatment takes the strong position that many of the current disparities in health care by race are attributable to forms of conscious and unconscious discrimination by health care providers. The study, however, is flawed by imprecise definitions of discrimination that fail to distinguish between differences in treatment due to breakdown in communications and differences in the treated population that are prompted by invidious motives of health care providers. It is doubtful that hidden forms of discrimination are prevalent in a profession whose professional norms are set so strongly against it. In addition, the IOM relies too uncritically on similar studies in unrelated fields to show the ostensible forms of discrimination. These errors have adverse social consequences. A false diagnosis of discrimination where none exists will send a false signal to members of racial minorities that may induce them to avoid receiving needed medical care and instead pursue costly and ineffective remedial devices that will take away funds better spent on providing direct health care.
Das, K K; Lerner, B H
The Institute of Medicine's recent report, Organ Donation: Opportunities for Action, studies the current problems facing organ donation in the USA, making suggestions for quality improvement and analyzing various proposals of incentivized donation and presumed consent (PC). Although the report deals with the donation of several solid organs, this mini review examines the findings from the perspective of kidney transplantation. The committee's recommendations to move from circulatory to neurologic criteria for cadaveric donation and to increase opportunities for donor decision making are prudent. We agree with the committee's arguments against providing incentives for donation because of the inherent distributional inequalities and imperfect information; the intrinsic difficulties in establishing market equilibrium for such heterogeneous and perishable goods; the implied commoditization of the human body; and the inadequate data regarding the long-term risks of living donation. However, we question the committee's firm opposition to PC, especially given recent data from 22 European countries showing a 25-30% increase in organ supply attributable to a PC policy. If this simple change in the default position on donation has the potential to increase organ supply, decrease the need for living donation, reduce the burden on grieving families, maintain familial authority over the deceased, and respect patient autonomy, at least a pilot program of PC seems warranted.
Barbería, Eneko; Xifró, Alexandre; Suelves, Josep María; Arimany-Manso, Josep
The main mission of Spanish Institutes of Legal Medicine (ILMs) is to serve the justice system. We review the potential broader role of the work done by ILMs, with an emphasis on forensic pathology. The relevance of forensic information to increase the quality of mortality statistics is highlighted, taking into account the persistence of the low validity of the external causes of death in the Mortality Register that was already detected more than a decade ago. The new statistical form and reporting system for the deaths under ILMs jurisdiction, as introduced by the Spanish Instituto Nacional de Estadística in 2009, are also described. The IMLs role in the investigation of the following mortality causes and of their determinants is reviewed in detail: traffic accidents, suicide, drugs of abuse, child deaths and sudden deaths. We conclude that an important public role of IMLs is emerging beyond their valuable service to the justice system, mainly through the gathering of data critical to assess and prevent several medical and public health and safety issues of great social impact and through their participation in epidemiologic research and surveillance.
Nydam, Charles W; Nydam, Daryl V; Guard, Charles L; Gilbert, Robert O
Food supply veterinarians who intend to enter dairy cattle practice or other related career activities are in need of up-graded skills to better serve the dairy industry as it continues to evolve. The time available for students to increase their abilities within the conventional professional curriculum is scarce, especially as those with food-supply interests are a minority of students competing for time and resources. The dairy industry has need of skilled veterinarians who are not only well versed in their traditional capabilities, but who also have an understanding of the complete picture of that industry as a "farm-to-fork" experience. Society at large also stands to benefit from the presence of skilled dairy veterinarians contributing to the production of safe, affordable dairy foodstuffs in a manner deemed sustainable and humane. Veterinarians in practice can and do acquire the necessary skills to make themselves relevant to their clients and consumers; however, better preparation of entry-level veterinarians could increase their value to their employers, clients, themselves, and society in a more timely manner. Cornell University's College of Veterinary Medicine developed the Summer Dairy Institute to provide an avenue for advancing the skills of new veterinarians as a means to address the current and future needs of the dairy industry. This article describes the need for, concept of, and experience with that program.
Staton, Lisa J; Estrada, Carlos; Panda, Mukta; Ortiz, David; Roddy, Donna
Background Cultural competence training in residency is important to improve learners' confidence in cross-cultural encounters. Recognition of cultural diversity and avoidance of cultural stereotypes are essential for health care providers. Methods We developed a multimethod approach for cross-cultural training of Internal Medicine residents and evaluated participants' preparedness for cultural encounters. The multimethod approach included (1) a conference series, (2) a webinar with a national expert, (3) small group sessions, (4) a multicultural social gathering, (5) a Grand Rounds presentation on cross-cultural training, and (6) an interactive, online case-based program. Results The program had 35 participants, 28 of whom responded to the survey. Of those, 16 were white (62%), and residents comprised 71% of respondents (n=25). Following training, 89% of participants were more comfortable obtaining a social history. However, prior to the course only 27% were comfortable caring for patients who distrust the US system and 35% could identify religious beliefs and customs which impact care. Most (71%) believed that the training would help them give better care for patients from different cultures, and 63% felt more comfortable negotiating a treatment plan following the course. Conclusions Multimethod training may improve learners' confidence and comfort with cross-cultural encounters, as well as lay the foundation for ongoing learning. Follow-up is needed to assess whether residents' perceived comfort will translate into improved patient outcomes.
Khoja, Abdullah T.
Objectives: The study was conducted to evaluate the educational environment (EE) in Family Medicine Training Programs. Materials and Methods: A cross-sectional survey, The Postgraduate Hospital Educational Environment Measure (PHEEM), was distributed to all residents at the four training centers in the central region. Cronbach's alpha was used to test the reliability. The mean and standard deviation (SD) for each item, the overall score and the three domains were calculated. A multiple linear regression model was developed with PHEEM scores as an outcome. The Mann–Whitney–Wilcoxon test was used to compare each item based on the selected factors. Results: The overall score was 67.1/160 (SD: 20.1). The PHEEM's domains scores: 24.2/56 (SD: 7.13) for perception of role autonomy; 25.3/60 (SD: 8.88), for perception of teaching; and 17/44 (SD: 5.6), for perception of social support. Training center and Level of training were the significant outcome predictors. Centre 1 (Joint Program) significantly had better scores than Centre 2. The instrument showed great reliability with a Cronbach's alpha of 0.92. Conclusions: There are many problems in the training program. Urgent actions are needed to improve the residents' learning experience particularly during rotations. Also, the curriculum should be restructured, and effective training methods introduced using the Best Evidence in Medical Education to meet the expectations and learning needs of family physicians. PMID:25657612
Mash, Robert; Essuman, Akye; Flinkenflögel, Maaike
Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education) network meeting held in Nairobi from 21 to 24 May 2016. At this meeting the delegates spent time presenting and discussing the current state of undergraduate training at 18 universities in the region and shared lessons on how to successfully implement undergraduate training. This article reports on the rationale for, information presented, process followed and conclusions reached at the conference. PMID:28155289
Cancedda, Corrado; Riviello, Robert; Wilson, Kim; Scott, Kirstin W; Tuteja, Meenu; Barrow, Jane R; Hedt-Gauthier, Bethany; Bukhman, Gene; Scott, Jennifer; Milner, Danny; Raviola, Giuseppe; Weissman, Barbara; Smith, Stacy; Nuthulaganti, Tej; McClain, Craig D; Bierer, Barbara E; Farmer, Paul E; Becker, Anne E; Binagwaho, Agnes; Rhatigan, Joseph; Golan, David E
A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country's health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda. In this Article, the authors describe how U.S. academic institutions (focusing on the seven Harvard-affiliated institutions participating in the HRH Program-Harvard Medical School, Brigham and Women's Hospital, Harvard School of Dental Medicine, Boston Children's Hospital, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, and Massachusetts Eye and Ear Infirmary) have also benefited: (1) by providing opportunities to their faculty and trainees to engage in global health activities; (2) by establishing long-term, academic partnerships and collaborations with Rwandan academic institutions; and (3) by building the administrative and mentorship capacity to support global health initiatives beyond the HRH Program. In doing this, the authors describe the seven Harvard-affiliated institutions' contributions to the HRH Program, summarize the benefits accrued by these institutions as a result of their participation in the program, describe the challenges they encountered in implementing the program, and outline potential solutions to these challenges that may inform similar future health professional training initiatives.
According to the Institute of Medicine Relieving Pain in America Report and the soon to be released National Pain Strategy, pain affects over 100 million Americans and costs our country in over $500 billion per year. We have a greater appreciation for the complex nature of pain and that it can develop into a disease in itself. As such, we need more efforts on prevention of chronic pain and for interdisciplinary approaches. For precision pain medicine to be successful, we need to link learning health systems with pain biomarkers (eg, genomics, proteomics, patient reported outcomes, brain markers) and its treatment.
Baldwin, P. J.; Newton, R. W.; Buckley, G.; Roberts, M. A.; Dodd, M.
OBJECTIVES: To describe working conditions for senior house officers in medicine in Scotland and to relate these to the quality of clinical training they receive. DESIGN: Postal questionnaire survey. SUBJECTS: All senior house officers in medicine and related specialties in post in Scotland in October 1995 (n = 437); 252 (58%) respondents. MAIN OUTCOME MEASURES: Questionnaires covered hours, working patterns, measures of workload, an attitudes to work scale, and experience of education and training. RESULTS: In the week before the questionnaire, doctors on rotas had worked a mean of 7.4 (95% confidence interval 5.8 to 9.0) hours in excess of their contracts, compared with 3.7 (2.0 to 5.5) hours for those on partial shifts. The most common reason for this was "the needs of the patients or the service." Those on partial shifts reported significantly less continuity of care with patients than those on rotas (Mann-Whitney U test, z = -4.2, P < 0.0001) or full shifts (z = -2.08, P = 0.03). Doctors in general medicine reported significantly higher measures of workload (number of acute admissions, number of times called out, and fewest hours' uninterrupted sleep) than those in subspecialties. Consultants' clinical teaching and style of conducting a ward round were significantly related to factors extracted from the attitudes to work scale. CONCLUSIONS: The quality of senior house officers' training is detrimentally affected by a variety of conditions, especially the need for closer support and supervision, the need for greater feedback, and the lack of time that consultants have to dedicate to clinical training. Efforts should be made to improve these conditions and to reinforce a close working relationship between trainee and supervising consultant. PMID:9116556
Kerpel-Fronius, Sandor; Rosenkranz, Bernd; Allen, Elizabeth; Bass, Rolf; Mainard, Jacques D; Dodoo, Alex; Dubois, Dominique J; Hela, Mandisa; Kern, Steven; Massud, Joao; Silva, Honorio; Whitty, Jeremy
The aim of this satellite workshop held at the 17th World Congress of Basic and Clinical Pharmacology (WCP2014) was to discuss the needs, optimal methods and practical approaches for extending education and teaching of medicines development, regulation, and clinical research to Low and Middle Income Countries (LMICs). It was generally agreed that, for efficiently treating the rapidly growing number of patients suffering from non-communicable diseases, modern drug therapy has to become available more widely and with a shorter time lag in these countries. To achieve this goal many additional experts working in medicines development, regulation, and clinical research have to be trained in parallel. The competence-oriented educational programs designed within the framework of the European Innovative Medicine Initiative-PharmaTrain (IMI-PhT) project were developed with the purpose to cover these interconnected fields. In addition, the programs can be easily adapted to the various local needs, primarily due to their modular architecture and well defined learning outcomes. Furthermore, the program is accompanied by stringent quality assurance standards which are essential for providing internationally accepted certificates. Effective cooperation between international and local experts and organizations, the involvement of the industry, health care centers and governments is essential for successful education. The initiative should also support the development of professional networks able to manage complex health care strategies. In addition it should help establish cooperation between neighboring countries for jointly managing clinical trials, as well as complex regulatory and ethical issues.
Kerpel-Fronius, Sandor; Rosenkranz, Bernd; Allen, Elizabeth; Bass, Rolf; Mainard, Jacques D.; Dodoo, Alex; Dubois, Dominique J.; Hela, Mandisa; Kern, Steven; Massud, Joao; Silva, Honorio; Whitty, Jeremy
The aim of this satellite workshop held at the 17th World Congress of Basic and Clinical Pharmacology (WCP2014) was to discuss the needs, optimal methods and practical approaches for extending education and teaching of medicines development, regulation, and clinical research to Low and Middle Income Countries (LMICs). It was generally agreed that, for efficiently treating the rapidly growing number of patients suffering from non-communicable diseases, modern drug therapy has to become available more widely and with a shorter time lag in these countries. To achieve this goal many additional experts working in medicines development, regulation, and clinical research have to be trained in parallel. The competence-oriented educational programs designed within the framework of the European Innovative Medicine Initiative-PharmaTrain (IMI-PhT) project were developed with the purpose to cover these interconnected fields. In addition, the programs can be easily adapted to the various local needs, primarily due to their modular architecture and well defined learning outcomes. Furthermore, the program is accompanied by stringent quality assurance standards which are essential for providing internationally accepted certificates. Effective cooperation between international and local experts and organizations, the involvement of the industry, health care centers and governments is essential for successful education. The initiative should also support the development of professional networks able to manage complex health care strategies. In addition it should help establish cooperation between neighboring countries for jointly managing clinical trials, as well as complex regulatory and ethical issues. PMID:25926798
... HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine... personal privacy. Name of Committee: National Center for Complementary and Alternative Medicine Special... Federal Domestic Assistance Program Nos. 93.213, Research and Training in Complementary and...
... HUMAN SERVICES National Institutes of Health National Center for Complementary and Alternative Medicine... personal privacy. Name of Committee: National Center for Complementary and Alternative Medicine Special... Federal Domestic Assistance Program Nos. 93.213, Research and Training in Complementary and...
... HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine... personal privacy. Name of Committee: National Center for Complementary and Alternative Medicine Special... Domestic Assistance Program Nos. 93.213, Research and Training in Complementary and Alternative...
Grudzen, Corita R; Emlet, Lillian L; Kuntz, Joanne; Shreves, Ashley; Zimny, Erin; Gang, Maureen; Schaulis, Monique; Schmidt, Scott; Isaacs, Eric; Arnold, Robert
The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing and small group learning with constructive feedback from master clinicians. Here, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice.
Ozcan, Tulin; Bacak, Stephen J; Zozzaro-Smith, Paula; Li, Dongmei; Sagcan, Seyhan; Seligman, Neil; Glantz, Christopher J
Objective The objective is to estimate the impact of maternal weight gain outside the 2009 Institute of Medicine recommendations on perinatal outcomes in twin pregnancies. Study Design Twin pregnancies with two live births between January 1, 2004 and December 31, 2014 delivered after 23 weeks Finger Lakes Region Perinatal Data System (FLRPDS) and Central New York Region Perinatal Data System were included. Women were classified into three groups using pre-pregnancy body mass index (BMI). Perinatal outcomes in women with low or excessive weekly maternal weight gain were assessed using normal weekly weight gain as the referent in each BMI group. Results Low weight gain increased the risk of preterm delivery, birth weight less than the 10th percentile for one or both twins and decreased risk of macrosomia across all BMI groups. There was a decreased risk of hypertensive disorders in women with normal pre-pregnancy weight and an increased risk of gestational diabetes with low weight gain in obese women. Excessive weight gain increased the risk of hypertensive disorders and macrosomia across all BMI groups and decreased the risk of birth weight less than 10th percentile one twin in normal pre-pregnancy BMI group. Conclusion Among twin pregnancies, low weight gain is associated with low birth weight and preterm delivery in all BMI groups and increased risk of gestational diabetes in obese women. Our study did not reveal any benefit from excessive weekly weight gain with potential harm of an increase in risk of hypertensive disorders of pregnancy. Normal weight gain per 2009 IOM guidelines should be encouraged to improve pregnancy outcome in all pre-pregnancy BMI groups.
Neupane, Shristi; Knohl, Stephen J
In the present article we aim to bring forward the apparent disconnect between two US government-sponsored entities - the Institute of Medicine (IOM) and the Food and Drug Administration (FDA) - regarding the safe upper limit of Ca intake. In light of the 2011 US Congress-appointed IOM report indicating an upper limit of elemental Ca intake of 2000-2500 mg/d in adults (based on age group), it is perplexing that the FDA has not yet required a change on the labelling of over-the-counter Ca-containing antacids, some of which indicate an upper limit of elemental Ca intake of 2800-3000 mg/d. Even more concerning is that Ca intake is rarely from supplementation in isolation. National Health and Nutrition Examination Survey (NHANES) data from 2003-2006 indicate that mean dietary Ca intakes for males ranged from 871 to 1266 mg/d and for females from 748 to 968 mg/d depending on the age group. The estimated total Ca (diet + supplements) intake exceeded the upper limit in 5 % of the population older than 50 years. Furthermore, NHANES data from 1999-2000 indicate that when Ca is taken as part of an antacid preparation, patients often fail to report this as Ca intake. Thus, individuals taking the maximum allowable dose of supplemental Ca as antacids are at high risk for complications associated with excess Ca intake. Our hope is that by describing Ca homeostasis and highlighting the risks and dangers of Ca overload, the FDA will align its recommendation with the IOM and solve the current Ca conundrum in the USA for the sake of patient safety.
Howson, C P; Fineberg, H V
In August 1991, the Institute of Medicine released a report entitled Adverse Effects of Pertussis and Rubella Vaccines, which examined 18 adverse events in relation to diphtheria-tetanus-pertussis (DTP) vaccine and four adverse events in relation to the currently used rubella vaccine strain, RA 27/3. The committee spent 20 months reviewing a wide range of information sources, including case series and individual case reports, both published and unpublished, epidemiologic studies, studies in animals, and other laboratory studies. The committee found that the evidence indicates a causal relation between DTP vaccine and anaphylaxis and between the pertussis component of DTP vaccine and extended periods of inconsolable crying or screaming. The committee also reported that the evidence indicates a causal relation between the rubella vaccine and acute arthritis in adult women. The committee found the available evidence weaker but still consistent with a causal relation between DTP vaccine and two conditions--acute encephalopathy and hypotonic, hyporesponsive episodes--and between rubella vaccine and chronic arthritis in adult women. Estimated incidence rates of these adverse events following vaccination are provided, where possible. The committee found that the evidence does not indicate a causal relation between the DTP vaccine and infantile spasms, hypsarrhythmia, Reye's syndrome, and sudden infant death syndrome. The committee found insufficient evidence to indicate either the presence or absence of a causal relation between DTP vaccine and chronic neurologic damage, aseptic meningitis, erythema multiforme or other rash, Guillain-Barré syndrome, hemolytic anemia, juvenile diabetes, learning disabilities and attention-deficit disorder, peripheral mononeuropathy, or thrombocytopenia, and between rubella vaccine and radiculoneuritis and other neuropathies or thrombocytopenic purpura. The committee's evaluative methods are briefly described and a summary of research
Ross, Randal G.; Greco-Sanders, Linda; Laudenslager, Mark; Reite, Martin
Objective: The National Institute of Mental Health funds institutional National Research Service Awards (NRSA) to provide postdoctoral research training. While peer-reviewed publications are the most common outcome measure utilized, there has been little discussion of how publications should be counted or what factors impact the long-term…
Hamid, Siri Sena Baba; Nadzar, Fuziah Mohd; Dollah, Wan Ab. Kadir Wan
Our case study examined and assessed the quality and effectiveness of information literacy training employed by teacher trainees in their follow-on research process. A sample of teacher trainees enrolled in selected Malaysian Teacher Education Institutes located in the northern region of Malaysia was surveyed. These Institutes' mission is to…
Through a case study of Quebec's general and vocational colleges (cegeps), this article analyzes the role that institutions play in internationalizing the in-service training they provide to their teachers, and explains how partnerships with educational institutions in developing countries contribute to this process. Data from a questionnaire…
National Academy of Sciences - National Research Council, Washington, DC. Inst. of Lab. Animal Resources.
The Committee on Education Programs in Laboratory Animal Science (EPLAS) has prepared this guide to aid institutions in implementing an education and training program that will meet the expectations of the Public Health Service (PHS). This guide was designed to fulfill several purposes. First, it is intended to assist institutional officials and…
Distance Education and Training Council, 2007
In April 2007 the Distance Education and Training Council (DETC) surveyed 67 of its accredited institutions to determine current aspects of the distance study educational practice. (Military and international institutions were omitted.) This report is a collection and summary of the data received. This survey contained questions in the following…
Ministerio de Cultura y Educacion, Buenos Aires (Argentina). Centro National de Documentacion e Informacion Educativa.
This booklet describes and explains the Argentine educational reform, instituted in March 1971, concerning the training of elementary school teachers in institutions of higher learning. The legislation cited here establishes areas of study and qualifications. The document also contains a discussion of previous teacher education and the bases and…
Pumipuntu, Natawut; Kidrakarn, Pachoen; Chetakarn, Somchock
This research aimed to develop the model of Web-based Collaborative (WBC) Training model for enhancing human performances on ICT for students in Banditpattanasilpa Institute. The research is divided into three phases: 1) investigating students and teachers' training needs on ICT web-based contents and performance, 2) developing a web-based…
Zholdasbekova, Saule; Nurzhanbayeva, Zhanet; Mavedov, Rixsibai; Saipov, Amangeldi; Zhiyentayeva, Begaim; Tlemissova, Alja
The purpose of the article consists in representation to discussion by specialists of the revealed didactic conditions of enhancement of preparation of the pedagogical personnel in higher education institution to dual training in the system of vocational and educational training. Modeling, aspect system, comparative and structural analyses…
This proposal requests continued support for the program of activities to be undertaken by the Ames-Stanford Joint Institute for Aeronautics and Acoustics during the period 1 Oct. 1995 - 30 Sept. 1996. The emphasis in this program is on training and research in experimental and computational methods with application to aerodynamics, acoustics and the important interactions between them. The program comprises activities in active flow control, Large Eddy Simulation of jet noise, flap aerodynamics and acoustics and high lift modeling studies. During the proposed period there will be a continued emphasis on the interaction between NASA Ames, Stanford University and Industry, particularly in connection with the high lift activities.
Arlt, Sebastian P; Haimerl, Peggy; Heuwieser, Wolfgang
In current veterinary education, skills such as retrieving, critically appraising, interpreting, and applying the results of published scientific studies are rarely taught. In this study, the authors tested the concept of team-based development of critically appraised topics (CATs) in training students in evidence-based veterinary medicine (EBVM). The 116 participants were in their fifth year and attending the clinical rotation at the Clinic for Animal Reproduction. Students developed 18 CATs of varying quality on topics of their choice. Preparing the CATs in teams stimulated discussion on the topic and the quality of the retrieved papers. Evaluation of the project revealed that more than 90% of the students endorsed training in critical appraisal of information in veterinary education. In addition, more than 90% considered the development of CATs an effective exercise for assessing the quality of scientific literature. A provided literature evaluation form was perceived as a useful tool for systematically summarizing a publication's quality. In conclusion, team-based development of CATs during clinical rotations is highly valuable for training in EBVM. Learning and intrinsic motivation seem to be enhanced by creating a situation similar to veterinary practice because the task is embedded into an authentic clinical problem. This approach to clinical training helps to prepare students to integrate evidence from literature into practice.
Bacharova, L; Hlavacka, S; Rusnakova, V
This study reports the findings of the first survey of the knowledge and needs for training in evidence based medicine (EBM) of health-care workers in Slovakia. This study was primarily qualitative and based on a triangular approach, which included: analysis of the situation in pre- and postgraduate education in Slovakia aimed at estimating needs in EBM and critical appraisal skills (CAS) training; analysis of questionnaires distributed in a sample of medical doctors and university educated public health workers undergoing postgraduate training; and focus group discussions. The findings revealed a real gap in knowledge in EBM and CAS in Slovakia and identified several areas as the focus for intervention. The results showed also some important behavioural and cultural aspects, including low individual responsibility for education; tendency to delegate responsibility to authorities (experts, top management, Ministry of Health); and persistence of the state paternalistic type of education. Concludes that managers planning to implement EBM in Slovakia should therefore consider a broader behavioural and cultural context for change, not just introduction of a training EBM module.
Zhang, Hongwei; Yin, Jianhua; Tan, Xiaojie; Chang, Wenjun; Ding, Yibo; Han, Yifang; Cao, Guangwen
Background Disaster is a serious public health issue. Health professionals and community residents are main players in disaster responses but their knowledge levels of disaster medicine are not readily available. This study aimed to evaluate knowledge levels and training needs of disaster medicine among potential disaster responders and presented a necessity to popularize disaster medicine education. Methods A self-reporting questionnaire survey on knowledge level and training needs of disaster medicine was conducted in Shanghai, China, in 2012. A total of randomly selected 547 health professionals, 456 medical students, and 1,526 local residents provided intact information. The total response rate was 93.7%. Results Overall, 1.3% of these participants have received systematic disaster medicine training. News media (87.1%) was the most common channel to acquire disaster medicine knowledge. Although health professionals were more knowledgeable than community residents, their knowledge structure of disaster medicine was not intact. Medical teachers were more knowledgeable than medical practitioners and health administrators (p = 0.002). Clinicians performed better than public health physicians (p<0.001), whereas public health students performed better than clinical medical students (p<0.001). In community residents, education background significantly affected the knowledge level on disaster medicine (p<0.001). Training needs of disaster medicine were generally high among the surveyed. ‘Lecture’ and ‘practical training’ were preferred teaching methods. The selected key and interested contents on disaster medicine training were similar between health professionals and medical students, while the priorities chosen by local residents were quite different from health professionals and medical students (p<0.001). Conclusions Traditional clinical-oriented medical education might lead to a huge gap between the knowledge level on disaster medicine and the current
The Author describes the various phases of the teaching of microbiology in the Faculty of Medicine of the University, of Rome, from the unity of Italy to the end of the twentieth century. A regular course of Bacteriology was started only in the academic year 1905/1906 as separate teaching from that of Hygiene and the Institute of Bacteriology was created in 1924. It was centered in Piazza del Viminale in Rome, in the same building as the Institute of Hygiene. Prof Vittorio Puntoni was the first Director of the Institute, also in its new site of the Città Universitaria which was inaugurated in 1935. In the meantime the old name of Bacteriology was changed to Microbiology and prof Puntoni remained as Director until 1943. The bombing during the war produced heavy damage to the new Institute and with the appointment of prof Aldo Cimmino as a new Director in 1946 the Institute of Microbiology began a long period of reconstruction and development. An astonishing improvement was achieved in the availability of human and technical resources, many groups of research workers were created and several pupils became professor of Microbiology in different Italian Universities. In 1981 prof Cimmino definitely retired, leaving, the teaching of Microbiology in the Faculty of Medicine of the University of Rome "La Sapienza" to five of his pupils. One of them, prof Garaci, a few years later passed to the new University of Rome "Tor Vergata", becoming also Rector. The other four professor (Orsi, Filadoro, Pezzi, del Piano) continued their teaching in the successive years, with the collaboration of several associate professors, whose status was created by the law 382 in 1980. A later law on the short degree course required also the official participation of many researchers to the new teaching. Finally in 2001 the official activity of the Institute of Microbiology ceased and was incorporated in the Department of Public Health Sciences.
Hansen, Helena; Metzl, Jonathan M
Structural competency provides a language and theoretical framework to promote institutional-level interventions by clinical practitioners working with community organizations, non-health-sector institutions, and policy makers. The special collection of articles on structural competency in this issue of Academic Medicine addresses the need to move from theory to an appraisal of core educational interventions that operationalize the goals of and foster structural competency. In this Commentary, the authors review the role of clinical practitioners in enhancing population-level health outcomes through collaborations with professionals in fields outside medicine, including the social sciences and law. They describe the core elements of structural competency in preclinical and clinical education, as illustrated by the articles of this special collection: perceiving the structural causes of patients' disease, envisioning structural interventions, and cultivating alliances with non-health-sector agencies that can implement structural interventions. Finally, the authors argue that preparing trainees to form partnerships will empower them to influence the social determinants of their patients' health and reduce health inequalities.
Schrijver, Iris; Natkunam, Yasodha; Galli, Stephen; Boyd, Scott D
Next-generation sequencing methods provide an opportunity for molecular pathology laboratories to perform genomic testing that is far more comprehensive than single-gene analyses. Genome-based test results are expected to develop into an integral component of diagnostic clinical medicine and to provide the basis for individually tailored health care. To achieve these goals, rigorous interpretation of high-quality data must be informed by the medical history and the phenotype of the patient. The discipline of pathology is well positioned to implement genome-based testing and to interpret its results, but new knowledge and skills must be included in the training of pathologists to develop expertise in this area. Pathology residents should be trained in emerging technologies to integrate genomic test results appropriately with more traditional testing, to accelerate clinical studies using genomic data, and to help develop appropriate standards of data quality and evidence-based interpretation of these test results. We have created a genomic pathology curriculum as a first step in helping pathology residents build a foundation for the understanding of genomic medicine and its implications for clinical practice. This curriculum is freely accessible online.
Rudolphi, Josie M; Donham, Kelley J
ABSTRACT The University of Iowa began training health care professionals to care for farmers' occupational health needs since 1974. In order to geographically expand this training to practicing health and safety professionals, the "Building Capacity: A National Resource of Agricultural Medicine Professionals" program was developed and launched in 2006. The model began in 1987 as a program of Iowa's Center for Agricultural Safety and Health. In 2006, with funding from the National Institute for Occupational Safety and Health (NIOSH), Great Plains Center for Agricultural Health (GPCAH), the program was expanded beyond the Iowa borders. The principal component of the program, the 40-hour course, Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals-the Core Course (AMCC) is now being offered to health and safety professionals in nine states in the United States, in Australia, and a modified version presented in Turkey. An initial paper evaluated the first phase of the program, years 2007-2010. This paper compares the first phase (2007-2010) with the second phase (2011-2013), which has involved over 500 health and safety professionals. This paper also describes evaluation of the course and changes resulting from the evaluation. Finally, this paper describes best practices for operating this program and makes recommendations for future courses, as well as other trainings within the field.
Stone, S.; Parker, M. S.; Howe, B.; Lazowska, E.
Rapid advances in technology are transforming nearly every field from "data-poor" to "data-rich." The ability to extract knowledge from this abundance of data is the cornerstone of 21st century discovery. At the University of Washington eScience Institute, our mission is to engage researchers across disciplines in developing and applying advanced computational methods and tools to real world problems in data-intensive discovery. Our research team consists of individuals with diverse backgrounds in domain sciences such as astronomy, oceanography and geology, with complementary expertise in advanced statistical and computational techniques such as data management, visualization, and machine learning. Two key elements are necessary to foster careers in data science: individuals with cross-disciplinary training in both method and domain sciences, and career paths emphasizing alternative metrics for advancement. We see persistent and deep-rooted challenges for the career paths of people whose skills, activities and work patterns don't fit neatly into the traditional roles and success metrics of academia. To address these challenges the eScience Institute has developed training programs and established new career opportunities for data-intensive research in academia. Our graduate students and post-docs have mentors in both a methodology and an application field. They also participate in coursework and tutorials to advance technical skill and foster community. Professional Data Scientist positions were created to support research independence while encouraging the development and adoption of domain-specific tools and techniques. The eScience Institute also supports the appointment of faculty who are innovators in developing and applying data science methodologies to advance their field of discovery. Our ultimate goal is to create a supportive environment for data science in academia and to establish global recognition for data-intensive discovery across all fields.
Pagels, Patti; Kindratt, Tiffany B; Reyna, Guadalupe; Lam, Kenrick; Silver, Mandy; Gimpel, Nora E
In 2012, the USPSTF updated its guidelines and now recommends that all women of childbearing age be screened for IPV and services provided for women who screen positive. Based on these recommendations, objectives of this study were to (1) evaluate IPV knowledge, attitudes, and practices of physicians from different specialties and (2) determine significant differences by medical specialty. We recruited (n = 183) Internal Medicine, Emergency Medicine, Family Medicine (FM) and Obstetrics/Gynecology (OB/GYN) residents and attending physicians to complete a 15-question online survey assessing knowledge, attitudes and current IPV screening practices. We evaluated associations between medical specialty and knowledge, attitudes and practice measures before and after controlling for covariates. Knowledge of how often IPV occurs in society, community resources, and screening tools were significantly different by specialty (all p's < 0.05). A majority of FM physicians (88%) reported that it is a physician's responsibility to find and treat IPV and 97% reported that IPV should be included in their training. Compared to OB/GYN physicians in multivariate analyses, FM physicians were less likely to report they were comfortable discussing IPV with their patients in crude (OR = 0.35; 95% CI = 0.13, 0.94) and adjusted models (OR = 0.20; 95% CI = 0.06, 0.60). FM physicians were also less likely to report screening female patients for IPV before (OR = 0.25; 95% CI = 0.08, 0.86) and after adjusting for confounders (OR = 0.11; 95% CI = 0.03, 0.47). Our results indicate that FM physicians have positive attitudes towards finding and treating IPV yet need enhanced training to improve their comfort level with screening for and discussing IPV with their patients.
Oeldenberger, S.; Khaled, K. B.
The African Geospatial Sciences Institute (AGSI) is currently being established in Tunisia as a non-profit, non-governmental organization (NGO). Its objective is to accelerate the geospatial capacity development in North-Africa, providing the facilities for geospatial project and management training to regional government employees, university graduates, private individuals and companies. With typical course durations between one and six months, including part-time programs and long-term mentoring, its focus is on practical training, providing actual project execution experience. The AGSI will complement formal university education and will work closely with geospatial certification organizations and the geospatial industry. In the context of closer cooperation between neighboring North Africa and the European Community, the AGSI will be embedded in a network of several participating European and African universities, e. g. the ITC, and international organizations, such as the ISPRS, the ICA and the OGC. Through a close cooperation with African organizations, such as the AARSE, the RCMRD and RECTAS, the network and exchange of ideas, experiences, technology and capabilities will be extended to Saharan and sub-Saharan Africa. A board of trustees will be steering the AGSI operations and will ensure that practical training concepts and contents are certifiable and can be applied within a credit system to graduate and post-graduate education at European and African universities. The geospatial training activities of the AGSI are centered on a facility with approximately 30 part- and full-time general staff and lecturers in Tunis during the first year. The AGSI will operate a small aircraft with a medium-format aerial camera and compact LIDAR instrument for local, community-scale data capture. Surveying training, the photogrammetric processing of aerial images, GIS data capture and remote sensing training will be the main components of the practical training courses
Domarle, O; Randrianarivelojosia, M; Duchemin, J B; Robert, V; Ariey, F; Hommel, M
The Malaria Workshop organized by Institut Pasteur de Madagascar is an original course that applies innovative concepts to training of health professionals involved in malaria control in endemic countries. Course objectives are to enhance the skills needed to fight malaria (transversal competencies, critical approach, and position statement), to reinforce project cycle management proficiency, and to demonstrate how the Internet can be used as a source of documentation to compensate for geographical isolation. The Malaria Workshop is a six-consecutive-week full-day course that has been presented once a year since 2003. Seventy-six researchers, physicians or health ministry officials have already benefited from this training. Teaching methods emphasize andragogy that facilitates a learner/mentor relationship promoting exchange rather than transmission of knowledge and problem-based learning that engages learners to take an active part in gathering information. These methods in combination with the diverse backgrounds and experience of course participants foster a positive dynamic environment for learning that is monitored by weekly progress evaluation. Follow-up surveys have confirmed the positive effect of this training on the professional performance of former participants who become more involved in program development and fund-raising efforts. A professional network is growing and learners are starting to their experience. In this report workshop organizers describe the course's origins and concepts and present the conclusions drawn based on the first five yearly sessions.
Spitalnik, Steven L; Triulzi, Darrell; Devine, Dana V; Dzik, Walter H; Eder, Anne F; Gernsheimer, Terry; Josephson, Cassandra D; Kor, Daryl J; Luban, Naomi L C; Roubinian, Nareg H; Mondoro, Traci; Welniak, Lisbeth A; Zou, Shimian; Glynn, Simone
On March 25 and 26, 2015, the National Heart, Lung, and Blood Institute sponsored a meeting on the State of the Science in Transfusion Medicine on the National Institutes of Health (NIH) campus in Bethesda, Maryland, which was attended by a diverse group of 330 registrants. The meeting's goal was to identify important research questions that could be answered in the next 5 to 10 years and which would have the potential to transform the clinical practice of transfusion medicine. These questions could be addressed by basic, translational, and/or clinical research studies and were focused on four areas: the three "classical" transfusion products (i.e., red blood cells, platelets, and plasma) and blood donor issues. Before the meeting, four working groups, one for each area, prepared five major questions for discussion along with a list of five to 10 additional questions for consideration. At the meeting itself, all of these questions, and others, were discussed in keynote lectures, small-group breakout sessions, and large-group sessions with open discourse involving all meeting attendees. In addition to the final lists of questions, provided herein, the meeting attendees identified multiple overarching, cross-cutting themes that addressed issues common to all four areas; the latter are also provided. It is anticipated that addressing these scientific priorities, with careful attention to the overarching themes, will inform funding priorities developed by the NIH and provide a solid research platform for transforming the future practice of transfusion medicine.
Eldredge, Jonathan D.; Bear, David G.; Wayne, Sharon J.; Perea, Paul P.
Background: Student peer assessment (SPA) has been used intermittently in medical education for more than four decades, particularly in connection with skills training. SPA generally has not been rigorously tested, so medical educators have limited evidence about SPA effectiveness. Methods: Experimental design: Seventy-one first-year medical students were stratified by previous test scores into problem-based learning tutorial groups, and then these assigned groups were randomized further into intervention and control groups. All students received evidence-based medicine (EBM) training. Only the intervention group members received SPA training, practice with assessment rubrics, and then application of anonymous SPA to assignments submitted by other members of the intervention group. Results: Students in the intervention group had higher mean scores on the formative test with a potential maximum score of 49 points than did students in the control group, 45.7 and 43.5, respectively (P = 0.06). Conclusions: SPA training and the application of these skills by the intervention group resulted in higher scores on formative tests compared to those in the control group, a difference approaching statistical significance. The extra effort expended by librarians, other personnel, and medical students must be factored into the decision to use SPA in any specific educational context. Implications: SPA has not been rigorously tested, particularly in medical education. Future, similarly rigorous studies could further validate use of SPA so that librarians can optimally make use of limited contact time for information skills training in medical school curricula. PMID:24163593
Smith, Donald F; Hagstrom, Melena R
This paper provides a 50-year overview of research and clinical advances in AAVMC member colleges in four representative fields of veterinary medicine: oncology, vaccine development, production medicine, and public health. Though emphasis is on the progress since the mid-1960s, the salient background and associated personnel in each field are also identified to the extent that their description informs more recent events. Advances in board certification and post-graduate clinical and research educational opportunities are also described.
Torrence, John Thomas
Excluding military installations, training programs in state and federal penal institutions were surveyed, through a mailed checklist, to test the hypotheses that (1) training programs in penal institutions were not related to the unfilled job openings by major occupations in the United States, and (2) that training programs reported would have a…
NAVY Quida C. Upchurch, Capt., NC, USN Program Manager Education and Training R&D Bureau of Medicine and Surgery (Code 71G) fo I.t as I ie a s s n d...of what the health care personnel in the Navy’s Medical Department, Bureau of Medicine and Surgery actually do in their occupations; improving the...in vitro counting and scanning instrumentation (Criteria) On tecnical review by supervisor, studies are determined to be accurate; performed
Sanders, Benjamin; Dilorenzo, Paul; Zordan, Victor; Bakal, Donald
The use of breath in healing is poorly understood by patients and professionals alike. Dysfunctional breathing is a characteristic of many unexplained symptoms and mind/body medical professionals seek methods for breath training to alleviate such problems. Our approach is to re-purpose and evolve a recently developed anatomically inspired respiration simulation which was created for synthesizing motion in entertainment for the use of visualization in breath training. In mind/body medicine, problems are often created from patients being advised to breathe according to some standard based on pace or volume. However, a breathing pattern that is comfortable and effortless for one person may not have the same benefits for the next person. The breathing rhythm which is most effortless for each person needs to be dynamically identified. To this end, in this chapter, we employ optimization to modify a generic model of respiration to fit the breath patterns of specific individuals. In practice, the corresponding visualization which is specific to individual patients could be used to train proper breath behavior, both by showing specific (abnormal) practice and recommended modification(s).
Cimrin, Arif H; Topacoglu, Hakan; Karcioglu, Ozgur; Ozsarac, Murat; Ayrik, Cuneyt
This intervention study was designed to determine the current level of basic life support knowledge and skills of residents in a university-based emergency medicine residency program, and to investigate the potential benefit derived by these residents from a standardized theoretical and practical training session. All residents underwent tests before and after the training session. The residents were asked to perform basic life support on a recording cardiopulmonary resuscitation mannequin. Assessments were made using a 10-item checklist, with the highest score being 17. Each step performed by the resident was scored by an emergency physician for accuracy and effectiveness. Twenty-eight residents participated in the study. According to the modified Berden scale, the pretest and posttest scores were 11.2 +/- 2.9 and 15.6 +/- 1.0, respectively, and the mean difference was 4.36 +/- 2.9 (t test, P<.001). Only 11 residents (39.3%) were rated as "good" or "very good" in the pretest, whereas the corresponding figure in the posttest was 27 (96.4%) (P<.001). Skills, such as checking the airway patency (P<.001), checking breathing (P<.001), appropriate compression rate (P<.003), and delivering 2 effective breaths (P<.001), improved significantly. Depth of chest compression (P<.023) was improved significantly only in residents with fewer than 2 years of experience. The training process should comprise standardized courses to facilitate acquisition of the desired skills.
Strelnick, A H; Swiderski, Debbie; Fornari, Alice; Gorski, Victoria; Korin, Eliana; Ozuah, Philip; Townsend, Janet M; Selwyn, Peter A
Founded in 1970 to train physicians to practice in community health centers and underserved areas, the Residency Program in Social Medicine (RPSM) of Montefiore Medical Center, Bronx, New York, has graduated 562 board-eligible family physicians, general internists, and pediatricians whose careers fulfill this mission. The RPSM was a model for federal funding for primary care residency programs and has received Title VII grants during most of its history. The RPSM has tailored its mission and structured its curriculum to promote a community and population orientation and to provide the requisite knowledge and skills for integrating social medicine into clinical practice. Six unique hallmarks of RPSM training are (1) mission-oriented resident recruitment/selection and self-management, (2) interdisciplinary collaborative training among primary care professionals, (3) community-health-center-based and community-oriented primary care education, (4) biopsychosocial and ecological family systems curriculum, (5) the social medicine core curriculum and projects, and (6) grant support through Title VII. These hallmark curricular, training, and funding elements, in which population health is deeply embedded, have been carefully evaluated, regularly revised, and empirically validated since the program's inception. Practice outcomes for RPSM graduates as leaders in and advocates for population health and the care of underserved communities are described and discussed in this case study.
Synopsis According to the Institute of Medicine Relieving Pain in America Report and the subsequently released National Pain Strategy, pain affects over 100 million Americans and costs our country in excess of half a trillion dollars per year. We are having a greater appreciation for the complex nature of pain and that it can develop into a disease in itself. As such, we need to focus more efforts on prevention of chronic pain and the need for interdisciplinary approaches particularly for the most persistent pain problems. For the goal of precision pain medicine to be successful, we need to link learning health systems with biomarkers (e.g. genomics, proteomics, patient reported outcomes, brain markers) of chronic pain and its treatment. PMID:26611393
The 9th annual INDUS-EM 2013 Emergency Medicine Summit, “Principles, Practices, and Patients,” a level one international meeting, Kerala University of Health Sciences and Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India, October 23–27, 2013
INDUS-EM is India’s only level one conference imparting and exchanging quality knowledge in acute care. Specifically, in general and specialized emergency care and training in trauma, burns, cardiac, stroke, environmental and disaster medicine. It provides a series of exchanges regarding academic development and implementation of training tools related to developing future academic faculty and residents in Emergency Medicine in India. The INDUS-EM leadership and board of directors invited scholars from multiple institutions to participate in this advanced educational symposium that was held in Thrissur, Kerala in October 2013. PMID:24884923
The wars in Iraq and Afghanistan have resulted in the most severe survivable war injuries ever seen in prolonged conflict. The Armed Forces Institute of Regenerative Medicine (AFIRM) was conceived as a way to deliver solutions to the existing gaps in military trauma care. The AFIRM is a collaborative effort between the Department of Defense, academia and private industry to accelerate the development of critically needed technology for the treatment of severely wounded warriors, and to restore to meaningful form and function those who have followed orders into harm's way.
Warshaw, Gregg A; Bragg, Elizabeth J; Shaull, Ruth W; Goldenhar, Linda M; Lindsell, Christopher J
This report documents the development and growth of geriatric medicine fellowship training in the United States through 2002. A cross-sectional survey of geriatric medicine fellowship programs was conducted in the fall 2001. All allopathic (119) and osteopathic (7) accredited geriatric medicine fellowship-training programs in the United States were involved. Data were collected using self-administered mailed and Web-based survey instruments. Longitudinal data from the American Medical Association (AMA) and the Association of American Medical Colleges' (AAMC) National Graduate Medical Education (GME) Census, the Accreditation Council for Graduate Medical Education (ACGME), and the American Osteopathic Association (AOA) were also analyzed. The survey instrument was designed to gather data about faculty, fellows, program curricula, and program directors (PDs). In addition, annual AMA/AAMC data from 1991 to the present was compiled to examine trends in the number of fellowship programs and the number of fellows. The overall survey response rate was 76% (96 of 126 PDs). Most (54%) of the PDs had been in their current position 4 or more years (range: <1-20 years), and 59% of PDs reported that they had completed formal geriatric medicine fellowship training. The number of fellowship programs and the number of fellows entering programs has slowly increased over the past decade. During 2001-02, 338 fellows were training in allopathic programs and seven in osteopathic programs (all years of training). Forty-six percent (n = 44) of responding programs offered only 1-year fellowship-training experiences. PDs reported that application rates for fellowship positions were stable during the academic years (AYs) 1999-2002, with the median number of applications per first year position available in AY 2000-01 being 10 (range: 1-77). In 2001-02, data from the AMA/AAMC National GME Census indicated a fill rate for first-year geriatric medicine fellowship positions of 69% (259 first
Institute of Tropical Medicine, Nagasaki University (NEKKEN) and National Institute of Hygiene and Epidemiology, Vietnam (NIHE) jointly conducted a project from 2006 on Emerging and Re-emerging Infectious Diseases (ERID) granted by the Ministry of Education, Science, Culture and Technology (MEXT) of Japan. Fifteen independent researches have been carried out by 7 scientists who stationed in the Vietnam Research Station (VRS), and by approximately 60 visiting scientists. A wide variety of viruses have been studied in the research activities in the VRS, of those, topics of'' Nipah virus infection in bats in Vietnam'', ''Nam Dinh virus, a newly discovered insect nidovirus'', and'' Risk factors of dengue fever in southern Vietnam'' were summarized. It is important to develop a mechanism to facilitate young scientists to use the VRS in their research works, and then a scope to establish the VRS as a gateway to a successful career path for young scientists in the field of the infectious diseases would be realized.
Mao, Xin; Yang, Yue
The study aims to explore the challenges and the gaps faced by Chinese Drug Control Institutes in achieving the standards of World Health Organization (WHO) Medicine Prequalification. The study was undertaken with 6 Provincial Drug Control Institutes in China from November 2012 to November 2013. The study assessed key elements required to comply with WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL). For GPPQCL, the study found gaps in quality management system, control of documentation, data-processing equipment, premises and equipment, contracts, reagents (water), reference substances and reference materials, calibration, verification of performance and qualification of equipment, instruments and other devices, analytical worksheet, evaluation of test results, personnel, and validation of analytical procedures. The study indicates that gaps are attributed to differences between the standards of Chinese Accreditation Standards and WHO-GPPQCL.
Zerah, Simone; McMurray, Janet; Bousquet, Bernard; Baum, Hannsjorg; Beastall, Graham H; Blaton, Vic; Cals, Marie-Josèphe; Duchassaing, Danielle; Gaudeau-Toussaint, Marie-Françoise; Harmoinen, Aimo; Hoffmann, Hans; Jansen, Rob T; Kenny, Desmond; Kohse, Klaus P; Köller, Ursula; Gobert, Jean-Gérard; Linget, Christine; Lund, Erik; Nubile, Giuseppe; Opp, Matthias; Pazzagli, Mario; Pinon, Georges; Queralto, José M; Reguengo, Henrique; Rizos, Demetrios; Szekeres, Thomas; Vidaud, Michel; Wallinder, Hans
The EC4 Syllabus for Postgraduate Training is the basis for the European Register of Specialists in Clinical Chemistry and Laboratory Medicine. The syllabus: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. The syllabus is not primarily meant to be a training guide, but on the basis of the overview given (common minimal programme), national societies should formulate programmes that indicate where knowledge and experience is needed. The main points of this programme are: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory management; and Quality insurance management. The aim of this version of the syllabus is to be in accordance with the Directive of Professional Qualifications published on 30 September 2005. To prepare the common platforms planned in this directive, the disciplines are divided into four categories: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory
Toninelli, E; Fostinelli, J; Rosen, M A; Lucchini, R; Apostoli, P
This paper describes the experience of the School of Occupational Medicine of the University of Brescia at the current edition of the New York and New Jersey Education and Research Center--Historical Perspectives Tour on Occupational Safety and Health, that involved 5 different industrial and environmental sites, appropriate for understanding the complex occupational health and safety problems. In every site, the participants have interacted with workers and professionals and discussed about the specific work processes, to better understand the risk faced by the workers, occupational pathologies that can occur, personal protective equipment used and preventive measures adopted. This experience has been successful in provide interdisciplinary educations to occupational safety and health professionals in training in order to prepare them for the collaboration and cooperation required to solve the complex occupational health and safety problems they will face in their future careers.
Ailon, Jonathan; Mourad, Ophyr; Nadjafi, Maral; Cavalcanti, Rodrigo
Background Point-of-care ultrasound (POCUS) is increasingly used on General Internal Medicine (GIM) inpatient services, creating a need for defined competencies and formalized training. We evaluated the extent of training in POCUS and the clinical use of POCUS among Canadian GIM residency programs. Method Internal Medicine trainees and GIM Faculty at the University of Toronto were surveyed on their clinical use of POCUS and the extent of their training. We separately surveyed Canadian IM Program Directors and Division Directors on the extent of POCUS training in their programs, barriers in the implementation of POCUS curricula, and recommendations for POCUS competencies in IM. Results A majority of IM trainees (90/118, 76%) and GIM Faculty (15/29, 52%) used POCUS clinically. However, the vast majority of resident (111/117, 95%) and GIM Faculty (18/28, 64%) had received limited training. Of the Program Leaders surveyed, half (9/17, 53%) reported POCUS clinical use by their trainees; however only one quarter (4/16, 25%) reported offering formal curricula. Most respondents agreed that POCUS training should be incorporated into IM residency curricula, specifically for procedural guidance. Conclusions A considerable discrepancy exists between the clinical use of POCUS and the extent of formal training among Canadian IM residents and GIM Faculty. We propose that formalized POCUS training should be incorporated into IM residency programs, GIM fellowships, and Faculty development sessions, and identify POCUS skills that could be incorporated into future IM curricula. PMID:28344693
Mumbo, Hazel M; Kinaro, Joyce W
The World Health Organization lists Kenya among African countries experiencing health workforce crisis catalysed through immigration, underproduction, inconsistent quality of production and unequal distribution. Strengthening health training institutions to increase production of high-quality health workers is acknowledged as a measure to mitigate the crisis.IntraHealth International's USAID-funded FUNZOKenya Project (2012-2017) undertook an assessment to identify the bottlenecks to increasing the number and quality of pre-service graduates in Kenya. The assessment, a cross-sectional descriptive study, collected data through structured respondent interviews among faculty, students in health training institutions, key informants and desk review. The assessment purposively selected 14 institutions from 18 institutions identified for initial collaboration with the project towards strengthening health workforce training. The statistical package for social sciences (SPSS) application helped analyse quantitative data and quotes used to illustrate perceptions on the quality of curricula.The findings revealed major gaps in quality and adequacy of curricula in the training institutions. A national standard framework to guide curricula review process is lacking. Further, curricula did not adequately prepare students for clinical placement, as most failed to directly respond to national health needs. The study recommended reviews of curricula to ensure their responsiveness to emerging issues in the health sector, the formation of curriculum committees to review curricula, development of official curricula review standards and an integrated mechanism to disseminate policies and guidelines.
Korocsec, D; Holobar, A; Divjak, M; Zazula, D
Medicine is a difficult thing to learn. Experimenting with real patients should not be the only option; simulation deserves a special attention here. Virtual Reality Modelling Language (VRML) as a tool for building virtual objects and scenes has a good record of educational applications in medicine, especially for static and animated visualisations of body parts and organs. However, to create computer simulations resembling situations in real environments the required level of interactivity and dynamics is difficult to achieve. In the present paper we describe some approaches and techniques which we used to push the limits of the current VRML technology further toward dynamic 3D representation of virtual environments (VEs). Our demonstration is based on the implementation of a virtual baby model, whose vital signs can be controlled from an external Java application. The main contributions of this work are: (a) outline and evaluation of the three-level VRML/Java implementation of the dynamic virtual environment, (b) proposal for a modified VRML Timesensor node, which greatly improves the overall control of system performance, and (c) architecture of the prototype distributed virtual environment for training in neonatal resuscitation comprising the interactive virtual newborn, active bedside monitor for vital signs and full 3D representation of the surgery room.
Veras, Mirella; Pottie, Kevin; Ramsay, Tim; Welch, Vivian; Tugwell, Peter
Background There is an increased interest in global health among medical students, family medicine residents, and medical educators. This paper is based on research to assess confidence in knowledge and skills in global health in family medicine residents in five universities across Ontario. Methods A web-based survey was sent to 166 first-year family medicine residents from five universities within Ontario. Descriptive statistics were used to analyze residents’ confidence in their knowledge and skills in global health. The strength of association between each of the self-perceived knowledge and skills variables was assessed by the Spearman correlation coefficient Results The response rate ranged from 29% to 66% across the five universities. Self-perceived knowledge scores revealed that 34.3% of the respondents were very confident, 51.9% were somewhat confident, and 13.8% were not at all confident about their global health knowledge. Participants’ confidence scores were lower in relation to knowledge of access to health care for low income nations (44.3%), and were better on their global health skills related to working in a team (70.9%) and listening actively to patients’ concerns (64.6%). Conclusions The global health competency scale has identified key areas of strengths and weaknesses of family medicine programs in global health education. This can be used to evaluate and analyze progress over time. PMID:26451209
... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...
Phillips, Karran A; Cofrancesco, Joseph; Sisson, Stephen; Wu, Albert W; Bass, Eric B; Berkenblit, Gail
Routine HIV screening is recommended by the Centers for Disease Control and Prevention (CDC), but it is unknown how well internal medicine residents are trained in HIV risk assessment, testing, counseling, and initial management of HIV patients. We sought to determine internal medicine residents' attitudes about HIV training and the factors that influence their HIV care performance utilizing a cross-sectional survey of 321 second- and third-year internal medicine residents from four programs in Baltimore, Boston, Detroit, and New York City between March and June 2006. Measurements included HIV care experience; attitudes, competency, and adequacy of HIV training; and basic HIV care performance and factors impacting performance. Two hundred twenty-three residents (69%) completed the survey. While 50% of residents reported over 30 HIV inpatient encounters in the past year, the majority of residents had limited outpatient exposure providing care for only 1-5 HIV outpatients. Managing HIV patients was rated an excellent educational opportunity by 89% of residents and 77% planned to care for HIV patients in the future. However, 39% stated that they did not feel competent to provide HIV outpatient care. Higher rates of residents reported deficiency in outpatient HIV training compared to outpatient non-HIV training (p < 0.05) or inpatient HIV training (p < 0.05). Residents reported substandard HIV risk assessment, testing, counseling, and initial management performance. Self-reported proficiency correlated with the number of HIV outpatients cared for and perceived training adequacy. Current residency training in HIV care remains largely inpatient-based and residents frequently rate HIV outpatient training as inadequate.
MacLellan, Anne-Marie; Brailovsky, Carlos; Rainsberry, Paul; Bowmer, Ian; Desrochers, Micheline
ABSTRACT OBJECTIVE To review the success of international medical graduates (IMGs) who are pursuing or have completed a Quebec residency training program and examinations. DESIGN We retrospectively reviewed IMGs’ success rates on the pre-residency Collège des médecins du Québec medical clinical sciences written examination and objective structured clinical examination, as well as on the post-residency Certification Examination in Family Medicine. SETTING Quebec. PARTICIPANTS All IMGs taking their examinations between 2001 and 2008, inclusive, and Canadian and American graduates taking their examinations during this same period. MAIN OUTCOME MEASURES Success rates for IMGs on the pre-residency and post-residency examinations, compared with success rates for Canadian and American graduates. RESULTS Success rates on the pre-residency clinical examinations remained below 50% from 2001 to 2008 for IMGs. Similarly, during the same period, the average success rate on the Certification examination was 56.0% for IMGs, compared with 93.5% for Canadian and American medical graduates. CONCLUSION Despite pre-residency competency screening and in-program orientation and supports, a substantial number of IMGs in Quebec are not passing their Certification examinations. Another study is under way to analyze reasons for some IMGs’ lack of success and to find ways to help IMGs complete residency training successfully and pass the Certification examination. PMID:20841596
Maggio, Lauren A; Durieux, Nancy; Tannery, Nancy H
This study aims to describe librarians' roles in evidence-based medicine (EBM) from the librarian perspective, identify how librarians are trained to teach, and highlight preferences for professional development. A multiinstitution qualitative study was conducted. Nine medical librarians identified by their faculty as integrated into EBM training were interviewed. Participants' descriptions indicated that they were active in curriculum development, deployment (including teaching activities), and assessment to support EBM. Participants identified direct experience and workshop participation as primary methods of learning to teach. Participants desired continuing development as teachers and requested opportunities for in-person workshops, shadowing physicians, and online training.
Spitalnik, Steven L.; Triulzi, Darrell; Devine, Dana V.; Dzik, Walter H.; Eder, Anne F.; Gernsheimer, Terry; Josephson, Cassandra D.; Kor, Daryl J.; Luban, Naomi L. C.; Roubinian, Nareg H.; Mondoro, Traci; Welniak, Lisbeth A.; Zou, Shimian; Glynn, Simone
On March 25-26, 2015, the National Heart, Lung, and Blood Institute sponsored a meeting on the State of the Science in Transfusion Medicine on the NIH campus in Bethesda, MD, which was attended by a diverse group of 330 registrants. The meeting's goal was to identify important research questions that could be answered in the next 5-10 years, and which would have the potential to transform the clinical practice of transfusion medicine. These questions could be addressed by basic, translational, and/or clinical research studies and were focused on four areas: the three “classical” transfusion products (i.e., red blood cells, platelets, and plasma) and blood donor issues. Prior to the meeting, four Working Groups, one for each area, prepared five major questions for discussion along with a list of 5-10 additional questions for consideration. At the meeting itself, all of these questions, and others, were discussed in Keynote lectures, small group breakout sessions, and large group sessions with open discourse involving all meeting attendees. In addition to the final lists of questions, provided herein, the meeting attendees identified multiple overarching, cross-cutting themes that addressed issues common to all four areas; the latter are also provided. It is anticipated that addressing these scientific priorities, with careful attention to the overarching themes, will inform funding priorities developed by the NIH and provide a solid research platform for transforming the future practice of transfusion medicine. PMID:26260861
Sklare, Daniel A.
This presentation will provide information on the research training and career development programs of the National Institute on Deafness and Other Communication Disorders (NIDCD). The predoctoral and postdoctoral fellowship (F30, F31, F32) programs and the research career development awards for clinically trained individuals (K08/K23) and for individuals trained in the quantitative sciences and in engineering (K25) will be highlighted. In addition, the role of the NIDCD Small Grant (R03) in transitioning postdoctoral-level investigators to research independence will be underscored.
Gil-Borrelli, Christian Carlo; Latasa, Pello; Reques, Laura; Alemán, Guadalupe
This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries.
Chase, Sabrina M.; Miller, William L.; Shaw, Eric; Looney, Anna; Crabtree, Benjamin F.
Purpose Incorporating quality improvement (QI) into resident education and clinical care is challenging. This report explores key characteristics shaping the relative success or failure of QI efforts in seven primary care practices serving as family medicine residency training sites. Method The authors used data from the 2002–2008 Using Learning Teams for Reflective Adaptation (ULTRA) study to conduct a comparative case analysis. This secondary data analysis focused on seven residency training practices' experiences with RAP (reflective adaptive process), a 12-week intensive QI process. Field notes, meeting notes, and audiotapes of RAP meetings were used to construct case summaries. A matrix comparing key themes across practices was used to rate practices' QI progress during RAP on a scale of 0 to 3. Results Three practices emerged as unsuccessful (scores of 0–1) and four as successful (scores of 2–3). Larger practices with previous QI experience, faculty with extensive exposure to QI literature, and an office manager, residency director, or medical director who advocated for the process made substantial progress during RAP, succeeding at QI. Smaller practices without these characteristics were unable to do so. Successful practices also engaged residents in the QI process and identified serious problems as potential crises; unsuccessful practices did not. Conclusions Larger residency training practices are more likely to have the resources and characteristics that permit them to create a QI-supportive culture leading to QI success. The authors suggest, however, that smaller practices may increase their chances of success by adopting a developmental approach to QI. PMID:22030767
Employment and Training Administration (DOL), Washington, DC. Office of Youth Programs.
Designed to provide basic information on the linkages achieved under the Youth Employment and Demonstration Projects Act (YEDPA), this report focuses on education/Comprehensive Employment and Training Act (CETA) linkages, the vocational education/CETA connection, and the role of postsecondary institutions (particularly minority colleges) in…
Castleberry, Terry Lane
The specific objective of this project was to train coordinators to open new extension classes and effectively facilitate existing extension classes offered by the Assemblies of God Bible Institute (AGBI) in Belize. Extensive biblical and literary research and a thorough evaluation of current extension classes led to the development of a…
Burgio, Louis D.; Burgio, Kathryn L.
Asserts that, if long-term care is to progress from custodial model to therapeutic model of rehabilitation, role of nursing assistants must be redesigned. Reviews current methods of institutional staff training and management and proposes model for geriatric, long-term care facilities. Discusses organizational resistance and offers suggestions for…
Jama, Mohamed A. F.
This study sought to evaluate the mathematics curriculum of the Halane Teacher Training Institute in Somalia with a view toward: (1) determining its weaknesses and recommending measures for improvement; (2) examining its relevance to the present needs of the Somali society; (3) determining the suitability of instructional materials and other…
Society for Health and Human Values, Philadelphia, PA.
This document contains descriptions of 19 teaching programs which share the common goal of emphasizing human values as an important area of education in the health professions. This listing is the result and expansion of the Institute on Health and Human Values Conference. Three broad areas are outlined which the 19 schools emphasize in their…
National Academy of Sciences, Washington, DC.
The 1976 Anglo-American Conference on Care of the Elderly examined many issues related to the development, management, and possible prevention of functional dependency among the elderly. A number of conference participants subsequently expressed interest in specifying the implications of these issues for public policy. The Institute of Medicine…
Katz, Steven J; Oswald, Anna E
The objective of this study was to determine self-confidence of internal medicine (IM) residents regarding rheumatology clinical skills and factors that may affect their confidence. Permission was sought to e-mail a web-based survey to IM residents at all 13 English language Canadian internal medicine programs. Residents were asked to rank self-confidence in rheumatology, cardiology, respirology, and gastroenterology skills. Further questions included site and year of training, career interests, rheumatology experiences, learning opportunities, and assessment frequency. These factors were analyzed by univariate and multivariate analyses. Two hundred sixteen residents (21.8%) from all 13 sites responded to the survey. Resident self-confidence in rheumatology diagnoses was 5.24/10, lower than all three comparator subspecialties. Increasing teaching exposure had a more significant impact on confidence in rheumatology than on comparator subspecialties. Increasing year of training had no association with higher self-confidence for rheumatology, in contrast to the increase in confidence seen with increased year of training for each comparator subspecialty. Further analysis demonstrated that the completion of a rheumatology rotation, increasing learning opportunities, annual assessment, and career interest were associated with greater resident self-confidence. Resident self-confidence for rheumatology skills is cautious at best and is lower than other common subspecialties. Self confidence improves with targeted rheumatology clinical experience and teaching, but does not improve solely with higher year of IM training. Furthermore, the impact of rheumatology teaching is greater than that of other common IM subspecialties. This information is critical to the planning and implementation of effective rheumatology curricula within internal medicine residency programs.
[Research Scientific Centre of Military Medicine, Military-medical Techniques and Pharmacy of State Research Scientific Institute of Military Medicine of Ministry of Defence of RF celebrates 80 years].
Bukhtiiarov, I V; Varlachev, A V; Medvedev, V R
The history of the 80-year activity of the Institute of Military Medicine, established in the Workers and Peasants, Red Army, Soviet Union. The Institute was founded in 1930 in Moscow and was originally called the Military Sanitary Institute. In a subsequent Institute repeatedly reformed, had different names, with the first years of its existence, has made and continues to contribute significantly to the development of means of medical services and other medical devices. The concrete results of operations and information about the staff are established.
Comeau, Dawn L; Escoffery, Cam; Freedman, Ariela; Ziegler, Thomas R; Blumberg, Henry M
A major impediment to improving the health of communities is the lack of qualified clinical and translational research (CTR) investigators. To address this workforce shortage, the National Institutes of Health (NIH) developed mechanisms to enhance the career development of CTR physician, PhD, and other doctoral junior faculty scientists including the CTR-focused K12 program and, subsequently, the KL2-mentored CTR career development program supported through the Clinical and Translational Science Awards (CTSAs). Our evaluation explores the impact of the K12/KL2 program embedded within the Atlanta Clinical and Translational Science Institute (ACTSI), a consortium linking Emory University, Morehouse School of Medicine and the Georgia Institute of Technology. We conducted qualitative interviews with program participants to evaluate the impact of the program on career development and collected data on traditional metrics (number of grants, publications). 46 combined K12/KL2 scholars were supported between 2002 and 2016. 30 (65%) of the 46 K12/KL2 scholars are women; 24 (52%) of the trainees are minorities, including 10 (22%) scholars who are members of an underrepresented minority group. Scholars reported increased research skills, strong mentorship experiences, and positive impact on their career trajectory. Among the 43 scholars who have completed the program, 39 (91%) remain engaged in CTR and received over $89 000 000 as principal investigators on federally funded awards. The K12/KL2 funding provided the training and protected time for successful career development of CTR scientists. These data highlight the need for continued support for CTR training programs for junior faculty.
The 2014 Academic College of Emergency Experts in India's Education Development Committee (EDC) White Paper on establishing an academic department of Emergency Medicine in India – Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training
Aggarwal, Praveen; Galwankar, Sagar; Kalra, Om Prakash; Bhalla, Ashish; Bhoi, Sanjeev; Sundarakumar, Sundarajan
Emergency medicine services and training in Emergency Medicine (EM) has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI) has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers’ eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India) has been a powerful advocate for developing Academic EM in India. The ACEE's Education Development Committee (EDC) was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE) to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM. PMID:25114431
Blajchman, Morris A; Carson, Jeffrey L; Eikelboom, John W; Heddle, Nancy M; Lacroix, Jacques; Lauer, Michael S; Platt, Richard; Tilley, Barbara; Triulzi, Darrell; Vickers, Andrew J; Yusuf, Salim; Glynn, Simone; Mondoro, Traci Heath; Wagner, Elizabeth
Comparative effectiveness research (CER) is the study of existing treatments or ways to deliver health care to determine what intervention works best under specific circumstances. CER evaluates evidence from existing studies or generates new evidence, in different populations and under specific conditions in which the treatments are actually used. CER does not embrace one research design over another but compares treatments and variations in practice using methods that are most likely to yield widely generalizable results that are directly relevant to clinical practice. Treatments used in transfusion medicine (TM) are among the most widely used in clinical practice, but are among the least well studied. High-quality evidence is lacking for most transfusion practices, with research efforts hampered by regulatory restrictions and ethical barriers. To begin addressing these issues, the National Heart, Lung, and Blood Institute convened a workshop in June 2011 to address the potential role of CER in the generation of high-quality evidence for TM decision making. Workshop goals were to: 1) evaluate the current landscape of clinical research, 2) review the potential application of CER methods to clinical research, 3) assess potential barriers to the use of CER methodology, 4) determine whether pilot or vanguard studies can be used to facilitate planning of future CER research, and 5) consider the need for and delivery of training in CER methods for researchers.
De Grauwe, Anton, Ed.; Naidoo, Jordan P., Ed.
The papers brought together in this volume are a selection from among those presented at the seminar organized in Kuala Lumpur, in July 2002 by the Asian Network of Training and Research Institutions in Educational Planning (ANTRIEP). The network consists of institutions whose main mandate includes training and research in educational planning and…
Emmett, E A; Green-McKenzie, J
We describe a competency-based training program that allows physicians employed full-time in occupational and environmental medicine to satisfy the supervised practicum year of training required by the American Board of Preventive Medicine (ABPM). The program is designed for trainees with greater clinical experience than the 1 clinical year required by the ABPM. To date, 25 physicians from clinic-based, academic, corporate, and government employment across most geographic regions of the United States have been admitted into the program. Most completed a master's in public health (MPH) in a distance-learning, on-job, on-campus, or executive program. The practicum-year training has been highly successful, as evidenced by improvements in resident self-assessment of competency, resident satisfaction with the training, faculty evaluation of resident performance, and success rate in the ABPM examination. The program has opened a new pathway for physicians making a mid-career shift to occupational and environmental medicine to obtain high-quality, in-depth education and board certification.
Leung, Elaine Yl; Malick, Sadia M; Khan, Khalid S
Clinical scientists are at the unique interface between laboratory science and frontline clinical practice for supporting clinical partnerships for evidence-based practice. In an era of molecular diagnostics and personalised medicine, evidence-based laboratory practice (EBLP) is also crucial in aiding clinical scientists to keep up-to-date with this expanding knowledge base. However, there are recognised barriers to the implementation of EBLP and its training. The aim of this review is to provide a practical summary of potential strategies for training clinician-scientists of the next generation. Current evidence suggests that clinically integrated evidence-based medicine (EBM) training is effective. Tailored e-learning EBM packages and evidence-based journal clubs have been shown to improve knowledge and skills of EBM. Moreover, e-learning is no longer restricted to computer-assisted learning packages. For example, social media platforms such as Twitter have been used to complement existing journal clubs and provide additional post-publication appraisal information for journals. In addition, the delivery of an EBLP curriculum has influence on its success. Although e-learning of EBM skills is effective, having EBM trained teachers available locally promotes the implementation of EBM training. Training courses, such as Training the Trainers, are now available to help trainers identify and make use of EBM training opportunities in clinical practice. On the other hand, peer-assisted learning and trainee-led support networks can strengthen self-directed learning of EBM and research participation among clinical scientists in training. Finally, we emphasise the need to evaluate any EBLP training programme using validated assessment tools to help identify the most crucial ingredients of effective EBLP training. In summary, we recommend on-the-job training of EBM with additional focus on overcoming barriers to its implementation. In addition, future studies evaluating the
Ayuela Azcárate, J M; Clau-Terré, F; Vicho Pereira, R; Guerrero de Mier, M; Carrillo López, A; Ochagavia, A; López Pérez, J M; Trenado Alvarez, J; Pérez, L; Llompart-Pou, J A; González de Molina, F J; Fojón, S; Rodríguez Salgado, A; Martínez Díaz, M C; Royo Villa, C; Romero Bermejo, F J; Ruíz Bailén, M; Arroyo Díez, M; Argueso García, M; Fernández Fernández, J L
Ultrasound has become an essential tool in assisting critically ill patients. His knowledge, use and instruction requires a statement by scientific societies involved in its development and implementation. Our aim are to determine the use of the technique in intensive care medicine, clinical situations where its application is recommended, levels of knowledge, associated responsibility and learning process also implement the ultrasound technique as a common tool in all intensive care units, similar to the rest of european countries. The SEMICYUC's Working Group Cardiac Intensive Care and CPR establishes after literature review and scientific evidence, a consensus document which sets out the requirements for accreditation in ultrasound applied to the critically ill patient and how to acquire the necessary skills. Training and learning requires a structured process within the specialty. The SEMICYUC must agree to disclose this document, build relationships with other scientific societies and give legal cover through accreditation of the training units, training courses and different levels of training.
Bazyka, D; Sushko, V; Chumak, A; Buzunov, V; Talko, V; Yanovich, L
Research activities and scientific advance achieved in 2014 at the State Institution "National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine" (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report.Epidemiological cohort studies found increased incidence (1990-2012 gg.) of thyroid cancer in victims of Chernobyl accident (liquidators - in 4.6 times, evacuated - in 4.0 times, residents of contaminated areas - in 1.3 times) and increased incidence of breast cancer in female workers of 1986-1987. (in the 1994-2012 biennium. SIR = 160,0%, 95% CI: 142,4-177,6). Retrospective studies of thyroid cancer ("case control") in cohorts and 152 thousand of liquidators were continued together with the US National Cancer Institute. Radiation risks of multiple myeloma and chronic lymphocytic leukemia were found.Molecular effects of remote period after radiation exposure include changes in gene expression TERF1, TERF2, CCND1, telomere length, the protein expression of cyclin D1, histone gamma H2AX. An association of molecular changes with cognitive deficits were defined. Genetic polymorphisms of rs2981582 gene FGFR2, rs12443621 gene TNRC9, rs3817198 gene LSP1, rs3803662 gene TNRC9, rs889312 gene MAP3K1 and their association with breast can cer were studied; the expression by tumor cells of estrogen and progesterone receptor, antigens of c kit, cytoker atins 5/6, TP53 and ki67, amplification status of the gene Her2 / neu, mutation status of the genes BRCA1 (muta tions 185delAG and 5382insC) and BRCA2 (mutation 6174delT) were studied. The possibility of persistence of radi ation modified hidden chromosomal instability in consecutive generations of human somatic cells was proven.The status of reproductive function and peculiarities
Mozzini, Chiara; Garbin, Ulisse; Fratta Pasini, Anna Maria; Cominacini, Luciano
The importance of focused cardiac ultrasound (FCU) in Internal Medicine care has been recognized by the American Society of Echocardiography. The aim of this study was to test what realistic skill targets could be achieved in FCU, with a relatively short training (theoretical and practical) of 9 h offered to Internal Medicine certification board attending students, and if the addition of further 9 h of training could significantly improve the level of competence. Kappa statistic was used to calculate the inter-observer agreement (trainees/tutor). The agreement between the trainees (who completed the entire training) and the tutor was, respectively, "substantial" (k = 0.71) for the identification of pericardial effusion, "moderate" (k = 0.56-0.54) for the identification of marked right ventricular and left ventricular enlargement, "substantial" (k = 0.77) for the assessment of global cardiac systolic function by visual inspection and "fair" (k = 0.35) for the assessment of size and respiratory change in the diameter of the inferior cave vein (IVC). 18 h training in FCU provided proficiency in obtaining adequate images from the parasternal window without providing the ability to correctly master the apical and subcostal windows. As concerns the interpretative skills, only pericardial effusion and visual estimation of global systolic function could be correctly identified, while ventricular enlargement and IVC prove to be more difficult to evaluate. This study supports incorporating FCU into Internal Medicine fellowship training programs, and should facilitate the design of other similar training courses.
Ali, Mohammed K.; Venkat Narayan, K.M.
In the wake of dynamic economic and political transitions worldwide, the Institute of Medicine recently released its report advocating investments in global health from the United States (US). The expert panel reinforces the ‘transnational and interdisciplinary’ nature of global health research and practice as an endeavor ‘to improve health and achieve greater equity for all people worldwide.’ This report was judiciously timed given the growing recognition of global health, and is also acknowledged for incorporating themes that are particularly pertinent to the twenty-first century. New paradigms are introduced, denouncing the dichotomous distinction between rich and poor countries with the rapidly transitioning countries emerging as global powers, and affirming the need for models of respectful partnership and wider translation of science into practice. Cultivating sustainable partnerships and investing in the understanding and combat of diseases worldwide will become increasingly important for the US to maintain its global competitiveness, and may offer lessons in innovation, efficiency, and organization of institutions and human resources. PMID:20027251
Patterson, Heather E; Nunez, Margarita; Philotheou, Geraldine M; Hutton, Brian F
Many countries have made significant investments in nuclear medicine (NM) technology with the acquisition of modern equipment and establishment of facilities, however, often appropriate training is not considered as part of these investments. Training for NM professionals is continually evolving, with a need to meet changing requirements in the workforce. Even places where established higher education courses are available, these do not necessarily cater to the practical component of training and the ever-changing technology that is central to medical imaging. The continuing advances in NM technology and growth of applications in quantitative clinical assessment place increases the pressure on technologists to learn and practice new techniques. Not only is training to understand new concepts limited but often there is inadequate training in the basics of NM and this can be a major constraint to the effective use of the evolving technology. Developing appropriate training programs for the broader international NM community is one of the goals of the International Atomic Energy Agency (IAEA). A particularly successful and relevant development has been the program on 'distance assisted training (DAT) for NM professionals'. The development of DAT was initiated in the 1990s through Australian Government funding, administered under auspices of the IAEA through its Regional Cooperative Agreement, involving most countries in Asia that are Member States of the IAEA. The project has resulted in the development of a set of training modules which are designed for use under direct supervision in the workplace, delivered through means of distance-learning. The program has undergone several revisions and peer reviews with the current version providing a comprehensive training package that is now available online. DAT has been utilized widely in Asia or the Pacific region, Latin America, and parts of Africa and Europe. Currently there are approximately 1000 registered participants
Zuckerman, Judith; van der Schalie, Barbara; Cahill, Kelly
Background Data Safety Monitoring Boards primarily review accumulating data on clinical trials and provide recommendations to sponsors on whether a protocol should continue as planned, be modified, or be terminated. Data Safety Monitoring Boards often provide their recommendations based upon accumulating data to which only their members are given access. Despite the substantial responsibilities assumed by Data Safety Monitoring Board members, there is limited information in the literature about the unique knowledge they must possess and, consequently, the training content needs that are required in order for them to fulfill their obligations. Purpose This article describes how the National Institute of Allergy and Infectious Diseases identified the knowledge that Data Safety Monitoring Board members should acquire and the computer-based training they developed to address the learning needs of the National Institute of Allergy and Infectious Diseases assembled Data Safety Monitoring Board members. Methods The National Institute of Allergy and Infectious Diseases conducted a comprehensive literature search and interviewed Data Safety Monitoring Board subject matter experts, including Data Safety Monitoring Board members and chairs from academic institutions, pharmaceutical companies, and the National Institutes of Health to (1) assess whether Data Safety Monitoring Board training is an identified need, (2) evaluate whether Data Safety Monitoring Board training has been developed, and (3) formulate suitable learning objectives. Data Safety Monitoring Board training modules were developed based on the identified learning objectives identified from the interviews. Results Three Data Safety Monitoring Board training modules were developed and formatted for web-based access, which is free of charge to the public at https://dsmblearningcenter.niaid.nih.gov. The modules include the following: an introduction to the objectives and purpose of Data Safety Monitoring Boards
The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Advanced Rehabilitation Research Training (ARRT) Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for an ARRT on Advanced Rehabilitation Research Policy Fellowship. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to strengthen the capacity of the disability and rehabilitation fields to train researchers to conduct advanced policy research in the areas of rehabilitation and disability.
Recent studies by the Institute of Medicine, part of the National Academy of Sciences, and the Rand Corporation have suggested that most physicians in the United States are inadequately trained to cope with the care of the elderly, in spite of the fact that over 11% of the population is over age 65. At present, nearly 30% of all health care…
Austin, Ryan E; Wanzel, Kyle R
BACKGROUND: Applications to surgical residency programs have declined over the past decade. Even highly competitive programs, such as plastic surgery, have begun to witness these effects. Studies have shown that early surgical exposure has a positive influence on career selection. OBJECTIVE: To review plastic surgery application trends across Canada, and to further investigate medical student exposure to plastic surgery. METHODS: To examine plastic surgery application trends, national data from the Canadian Resident Matching Service database were analyzed, comparing 2002 to 2007 with 2008 to 2013. To evaluate plastic surgery exposure, a survey of all undergraduate medical students at the University of Toronto (Toronto, Ontario) during the 2012/2013 academic year was conducted. RESULTS: Comparing 2002 to 2007 and 2008 to 2013, the average number of national plastic surgery training positions nearly doubled, while first-choice applicants decreased by 15.3%. The majority of Canadian academic institutions experienced a decrease in first-choice applicants; 84.7% of survey respondents indicated they had no exposure to plastic surgery during their medical education. Furthermore, 89.7% believed their education had not provided a basic understanding of issues commonly managed by plastic surgeons. The majority of students indicated they receive significantly less plastic surgery teaching than all other surgical subspecialties. More than 44% of students not considering plastic surgery as a career indicated they may be more likely to with increased exposure. CONCLUSION: If there is a desire to grow the specialty through future generations, recruiting tactics to foster greater interest in plastic surgery must be altered. The present study suggests increased and earlier exposure for medical students is a potential solution. PMID:25821773
Background Community-based education (CBE) is part of the training curriculum for most health workers in Uganda. Most programs have a stated purpose of strengthening clinical skills, medical knowledge, communication skills, community orientation of graduates, and encouragement of graduates to work in rural areas. This study was undertaken to assess the scope and nature of community-based education for various health worker cadres in Uganda. Methods Curricula and other materials on CBE programs in Uganda were reviewed to assess nature, purpose, intended outcomes and evaluation methods used by CBE programs. In-depth and key informant interviews were conducted with people involved in managing CBE in twenty-two selected training institutions, as well as stakeholders from the community, Ministry of Health, Ministry of Education, civil society organizations and local government. Visits were made to selected sites where CBE training was conducted to assess infrastructure and learning resources being provided. Results The CBE curriculum is implemented in the majority of health training institutions in Uganda. CBE is a core course in most health disciplines at various levels – certificate, diploma and degree and for a range of health professionals. The CBE curriculum is systematically planned and implemented with major similarities among institutions. Organization, delivery, managerial strategies, and evaluation methods are also largely similar. Strengths recognized included providing hands-on experience, knowledge and skills generation and the linking learners to the communities. Almost all CBE implementing institutions cited human resource, financial, and material constraints. Conclusions The CBE curriculum is a widely used instructional model in Uganda for providing trainee health workers with the knowledge and skills relevant to meet community needs. Strategies to improve curricula and implementation concerns need further development. It is still uncertain whether
Dancer, Sandy; Brown, Allen J; Yanase, Lisa Rietz
The National Institutes of Health Stroke Scale (NIHSS) is commonly used in Comprehensive Stroke Centers, but it has not been easily implemented in smaller centers. The aim of this study was to assess whether nurse providers who were naive to stroke assessment scales could obtain accurate stroke severity scores using our previously validated NIH Stroke Scale in Plain English (NIHSS-PE) with minimal or no training.
Avetisyan, Albert; Avagyan, Robert; Kerobyan, Ivetta; Dallakyan, Ruben; Harutyunyan, Gevorg; Melkonyan, Aleksandr
Accelerator-based 99mTc and 123I isotopes production technologies were created and developed at A.Alikhanyan National Science Laboratory (former Yerevan Physics Institute - YerPhI). The method involves the irradiation of natural molybdenum (for 99mTc production) and natural xenon (for 123I production) using high-intensity bremsstrahlung photons from the electron beam of the LUE50 linear electron accelerator located at the YerPhI. We have developed and tested the extraction of 99mTc and 123I from the irradiated natural MoO3 and natural Xe, respectively. The production method has been developed and shown to be successful. The current activity is devoted to creation and development of the technology of direct production 99mTc on the 100Mo as target materials using the proton beam from an IBA C18/18 cyclotron. The proton cyclotron C18/18 (producer - IBA, Belgium) was purchased and will be installed nearby AANL (YerPhI) till end 2014. The 18 MeV protons will be used to investigate accelerator-based schemes for the direct production of 99mTc. Main topics of studies will include experimental measurement of 99mTc production yield for different energies of protons, irradiation times, intensities, development of new methods of 99mTc extraction from irradiated materials, development of target preparation technology, development of target material recovery methods for multiple use and others.
This article summarizes the new 2011 report on dietary requirements for calcium and vitamin D from the Institute of Medicine (IOM). An IOM Committee, charged with determining the population needs for these nutrients in North America, conducted a comprehensive review of the evidence for both skeletal...
The objective of this article is to evaluate high-circulation US and Canadian newspaper coverage of the Institute of Medicine (IOM) report Dietary Reference Intakes for Calcium and Vitamin D and assess pre-report and post-report reporter-specific vitamin D-related coverage. Two independent reviewers...
Wright, Victoria Ann; Vaughan, Brendan W; Laurent, Thomas; Lopez, Rodrigo; Brooksbank, Cath; Schneider, Maria Victoria
Today's molecular life scientists are well educated in the emerging experimental tools of their trade, but when it comes to training on the myriad of resources and tools for dealing with biological data, a less ideal situation emerges. Often bioinformatics users receive no formal training on how to make the most of the bioinformatics resources and tools available in the public domain. The European Bioinformatics Institute, which is part of the European Molecular Biology Laboratory (EMBL-EBI), holds the world's most comprehensive collection of molecular data, and training the research community to exploit this information is embedded in the EBI's mission. We have evaluated eLearning, in parallel with face-to-face courses, as a means of training users of our data resources and tools. We anticipate that eLearning will become an increasingly important vehicle for delivering training to our growing user base, so we have undertaken an extensive review of Learning Content Management Systems (LCMSs). Here, we describe the process that we used, which considered the requirements of trainees, trainers and systems administrators, as well as taking into account our organizational values and needs. This review describes the literature survey, user discussions and scripted platform testing that we performed to narrow down our choice of platform from 36 to a single platform. We hope that it will serve as guidance for others who are seeking to incorporate eLearning into their bioinformatics training programmes.
Davis, Mellar P; Walsh, Declan; LeGrand, Susan B; Lagman, Ruth L; Harrison, Betty; Rybicki, Lisa
Financial comparisons of acute care hospital services are possible using the Centers for Medicare & Medicaid Services case mix index (CMI) and All Patient Refined-Diagnosis Related Group (APR-DRG) data. We compared The Cleveland Clinic's Inpatient Palliative Medicine (CCIPM) acute care unit's CMI and APR-DRG data with national and peer institution data. Total mean charges per admission to the CCIPM unit were 7,800 dollars lower than at other peer institutions despite an equivalent severity of illness and longer length of stay and higher mortality in the CCIPM unit. The lower charges were due primarily to lower laboratory and pharmaceutical charges. We conclude that an acute inpatient palliative medicine unit operating within a comprehensive integrated palliative medicine program is cost-effective in providing specialized care for people with advanced disease.
Pagels, Patti; Kindratt, Tiffany; Arnold, Danielle; Brandt, Jeffrey; Woodfin, Grant; Gimpel, Nora
Introduction. Future health care providers need to be trained in the knowledge and skills to effectively communicate with their patients with limited health literacy. The purpose of this study is to develop and evaluate a curriculum designed to increase residents' health literacy knowledge, improve communication skills, and work with an interpreter. Materials and Methods. Family Medicine residents (N = 25) participated in a health literacy training which included didactic lectures and an objective structured clinical examination (OSCE). Community promotoras acted as standardized patients and evaluated the residents' ability to measure their patients' health literacy, communicate effectively using the teach-back and Ask Me 3 methods, and appropriately use an interpreter. Pre- and postknowledge, attitudes, and postdidactic feedback were obtained. We compared OSCE scores from the group that received training (didactic group) and previous graduates. Residents reported the skills they used in practice three months later. Results. Family Medicine residents showed an increase in health literacy knowledge (p = 0.001) and scored in the adequately to expertly performed range in the OSCE. Residents reported using the teach-back method (77.8%) and a translator more effectively (77.8%) three months later. Conclusions. Our innovative health literacy OSCE can be replicated for medical learners at all levels of training.
Henze, Tonja M; Allison, Sarah O; Criley, Jennifer M; Myers, Sara J; Goodly, Lyndon J
The University of Illinois at Urbana–Champaign maintains physically separated animal care facilities under centralized management by the Division of Animal Resources. As part of a land-grant institution, the animal care and use program operates several animal units in key locations for specific disciplines within the campus, all of which have the core mission to teach, conduct research, and engage in public service. Populations of research animals vary with the levels of research funding, the number of research investigators on staff, research direction, and animal availability. Accordingly, the requirement for animal care staffing in each unit may vary widely also. To best use the existing animal care staff and remain fiscally responsible, cross-training of staff was implemented to allow staff to travel from units with small animal populations to units with larger populations or short-term staffing shortages. Here we detail and describe the system we used to assess the needs for cross-training, identify the staff to train, and implement the training plan. We believe this information will assist other programs, particularly those with large or complex organization (for example, land-grant institutions) that experience similar fluctuations in animal use. PMID:27657717
Dumas, Michel; Preux, Pierre-Marie
In France, research in tropical medicine is carried out by the Institute for Research and Development (IRD), university-affiliated institutes, and other research organizations such as INSERM, CNRS and the Pasteur Institute. Currently, this research is highly fragmented and therefore inefficient. As a result, despite significant financial means, French research in this field is not sufficiently competitive. This research activity should be coordinated by creating a "federation ", that would 1) facilitate the sharing of material and human resources, thereby improving efficiency and resulting in cost savings; 2) valorize French research in tropical medicine and its expert know-how, thus favoring the nomination of French experts in large international research programs (French experts in tropical medicine are currently under-recognized); 3) attract young researchers from France and elsewhere; and 4) adapt to the ongoing demographic and economic evolution of tropical countries. The creation of a Federation of French researchers would also make research in tropical medicine more visible. The objectives to which it leads already must include 1) a better understanding of the priorities of countries in the southern hemisphere, taking into account the social, cultural and economic contexts and ensuring the consistency of current and future projects ; 2) strengthening of research networks in close and equal partnership with researchers in the southern hemisphere, with pooling of resources (scientific, human and material) to reach the critical mass required for major projects ; 3) promoting the emergence of centers of excellence for health research in tropical countries ; and 4) contributing more effectively to training, because there can be no training without research, and no research without training This consolidation will help to empower research in tropical medicine, as in other Western countries, and will allow France to recover the place it deserves. The specific
Lau, Iris; Kirkwood, Allison
Background: An adverse drug event (ADE) is a noxious, unintended response to a drug, occurring at doses used in humans for prophylaxis, diagnosis, or treatment of disease or for modification of physiological function. ADEs account for about one-quarter of all adverse events in Canadian hospitals. Canadian data on specific types of ADEs and commonly implicated drugs are lacking. In particular, there is a paucity of data on ADEs that occur during hospital admissions. Objectives: The primary objective was to identify the incidence of ADEs in a sample of adult general medicine inpatients over a 1-year period. The secondary objective was to identify the 5 drugs most frequently responsible for ADEs in this setting. Methods: A retrospective chart analysis was conducted for general medicine patients discharged from St Paul’s Hospital in Vancouver, British Columbia, from January to December 2011. ADEs were identified using the Institute for Healthcare Improvement (IHI) Trigger Tool for Measuring Adverse Drug Events. The Naranjo criteria were applied to assess causality, and a physician independently authenticated the ADEs for preventability and harm using the categories of harm set out by the US National Coordinating Council for Medication Error Reporting and Prevention. Results: Of the 204 patient encounters reviewed, 15 involved ADEs, which represented an incidence of 7% over the 1-year study period. The 5 drugs most frequently implicated in ADEs were vancomycin, ciprofloxacin, ceftriaxone, piperacillin–tazobactam, and moxifloxacin. Conclusions: The rate of ADEs during hospital admissions was substantial. These events may necessitate additional investigations and interventions and may prolong the hospital stay. The authors do not recommend the IHI Trigger Tool for Measuring Adverse Drug Events for efficient prospective detection of ADEs in manual chart reviews. Possible modifications to improve the utility of this tool might include incorporating it into a compatible
Rosen, Michael A; Salas, Eduardo; Wu, Teresa S; Silvestri, Salvatore; Lazzara, Elizabeth H; Lyons, Rebecca; Weaver, Sallie J; King, Heidi B
The growing complexity of patient care requires that emergency physicians (EPs) master not only knowledge and procedural skills, but also the ability to effectively communicate with patients and other care providers and to coordinate patient care activities. EPs must become good team players, and consequently an emergency medicine (EM) residency program must systematically train these skills. However, because teamwork-related competencies are relatively new considerations in health care, there is a gap in the methods available to accomplish this goal. This article outlines how teamwork training for residents can be accomplished by employing simulation-based training (SBT) techniques and contributes tools and strategies for designing structured learning experiences and measurement tools that are explicitly linked to targeted teamwork competencies and learning objectives. An event-based method is described and illustrative examples of scenario design and measurement tools are provided.
perpetrated against U.S. citizens and U.S. interests. Historically, the FBI has played a leadership role in providing training to international...its training curriculum, CEPDU and the Training Division must play leadership roles in changing the mindset of the organization as well as...development of employee skills, leadership development, and the enhancement of the work environment to facilitate the mission. The examples outlined by
Grodman, Randy H.
The Organization for Rehabilitation through Training (ORT) is a private, nonprofit, nongovernmental organization that operates a worldwide network of vocational education and technical assistance programs. ORT has provided training to more than 2 million people around the world. There are two facets of ORT: a network of educational institutions…
A study was conducted of the training programs used by plants with Computer Automated Design/Computer Automated Manufacturing (CAD/CAM) to help their employees adapt to automated manufacturing. The study sought to determine the relative priorities of manufacturing establishments for training certain workers in certain skills; the status of…
Rich, Valerie J.; Kedrowski, Jonathan J.; Richter, Scott
Context: Educational reform has recently become common thread in athletic training education. The National Athletic Trainers' Association (NATA) Education Task force suggests that Athletic Training Education Programs (ATEPs) align within colleges of health-related professions and offer academic majors. Objective: To provide a current profile of…
Maziarz, Richard T; Arthurs, Jane; Horwitz, Edwin
The International Society for Cellular Therapy is a global association driving the translation of scientific research to deliver innovative cellular therapies to patients. Established in 1992, its membership and leadership comprises world-class scientists, clinicians, technologists, biotech/pharma and regulatory professionals from 40 countries focused on preclinical and translational aspects of developing cell therapy products. The International Society for Cellular Therapy has evolved in alignment with the maturation of the field of cell therapy and regenerative medicine to create forums for discussion of shared concerns for commercialization of cell therapies and of development of consensus standards, recognizing that true commercialization depends upon the translational scientific community, the regional regulatory and policy institutions, and the technology support and capital investment from industry. It exists to facilitate the international work of many, to spawn new initiatives, and to synergize with other stakeholders to create the best outcome for the many patients across the world depending on the answers and improved health that cellular therapeutics will provide them.
Oliveira, Tatiana Costa; Vasconcelos, Simao Dias
Increasing rates of unsolved homicides in Brazil prompt the need for applied entomological data to be used as a complementary tool by criminal investigators. In that context, we analyzed the occurrence of forensically important insect species (Order Diptera) on 14 cadavers taken into the Institute of Legal Medicine (ILM), in Pernambuco, Brazil, according to the conditions of the body and the pattern of colonisation by insects. Simultaneously, we surveyed the diversity of insects in the surrounding environment using bait traps. Five species were present on cadavers: Chrysomya albiceps, Chrysomya megacephala and Cochliomyia macellaria (Calliphoridae), Oxysarcodexia riograndensis and Ravinia belforti (Sarcophagidae). A total of 4689 adult insects belonging to 24 species of seven dipteran families (Calliphoridae, Sarcophagidae, Muscidae, Fanniidae, Phoridae, Anthomyiidae and Stratiomyidae) was collected at the ILM premises. C. albiceps was the most frequent species on the corpses and the most abundant in the traps. Species referred to as of forensic importance, such as Lucilia eximia, Chrysomya putoria, Oxysarcodexia modesta and Ophyra chalcogaster were collected on traps, but not on cadavers. There seems to be a limited colonisation of cadavers at the scene of the death, despite the ubiquity of necrophagous species in the area. The results contribute to differentiate between species that are involved in decomposition and those found in and around the mortuary installations of the ILM, thus providing potential clues about the locality of death and the post-mortem interval.
Dreher, Melanie C; Clinton, Patricia; Sperhac, Arlene
The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate.
Ellerbe, Suellyn; Regen, Debra
The current health care environment has heightened the importance of achieving positive patient outcomes and excellent customer satisfaction. To remain competitive, health care organizations must adapt quickly to changing regulatory requirements, quality improvement initiatives, and customer expectations. To ensure nursing practice at the Saint Clare's Health System in Northwest New Jersey is at the forefront of leading change, the nursing staff has embraced the Institute of Medicine report The Future of Nursing: Leading Change. The empowered nursing team has applied Benner's Novice to Expert model and McCauley's Careful Nursing Theory as the foundation for nursing practice. The ability to apply evidence-based nursing research and cultivate professional development at the bedside has resulted in retention of expert nurses at the bedside. Engaging the nursing team has resulted in increased patient satisfaction and improved clinical outcomes. Advanced practice nurses play an important role to mentor the nursing staff and promote an interdisciplinary, collaborative relationship between all health care disciplines and community support programs. Nurses are recognized for their accomplishments and encouraged to obtain specialty certification, advanced degrees, and earn state and national recognition through professional organizations. The professional nurses at the Saint Clare's Health System are prepared to work in whatever environment the new normal creates.
Tarbet, E Bart; Dorward, James T; Day, Craig W; Rashid, Kamal A
In the event of an influenza pandemic, vaccination will be the best method to limit virus spread. However, lack of vaccine biomanufacturing capacity means there will not be enough vaccine for the world's population. The U.S. Department of Health and Human Services, Biomedical Advanced Research and Development Authority (BARDA) provides support to the World Health Organization to enhance global vaccine production capacity in developing countries. However, developing a trained workforce in some of those countries is necessary. Biomanufacturing is labor-intensive, requiring unique skills not found in traditional academic programs. Employees must understand the scientific basis of biotechnology, operate specialized equipment, and work in an environment regulated by good manufacturing practices (cGMP). Therefore, BARDA supported development of vaccine biomanufacturing training at Utah State University. The training consisted of a three-week industry-focused course for participants from institutions supported by the BARDA and WHO influenza vaccine production capacity building program. The curriculum was divided into six components: (1) biosafety, (2) cell culture and growth of cells in bioreactors, (3) virus assays and inactivation, (4) scale-up strategies, (5) downstream processing, and (6) egg- and cell-based vaccine production and cGMP. Lectures were combined with laboratory exercises to provide a balance of theory and hands-on training. The initial course included sixteen participants from seven countries including: Egypt, Romania, Russia, Serbia, South Korea, Thailand, and Vietnam. The participant's job responsibilities included: Production, Quality Control, Quality Assurance, and Research; and their education ranged from bachelors to doctoral level. Internal course evaluations utilized descriptive methods including surveys, observation of laboratory activities, and interviews with participants. Generally, participants had appropriate academic backgrounds, but
McGrath, Jillian; Barrie, Michael; Way, David P.
Introduction The first formal orientation program for incoming emergency medicine (EM) residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States. Methods In autumn of 2014, we surveyed all U.S. EM residency program directors (n=167). We adapted our survey instrument from one used by Brillman (1995). The survey was designed to assess the orientation program’s purpose, structure, content, and teaching methods. Results The survey return rate was 63% (105 of 167). Most respondents (77%) directed three-year residencies, and all but one program offered intern orientation. Orientations lasted an average of nine clinical (Std. Dev.=7.3) and 13 non-clinical days (Std. Dev.=9.3). The prototypical breakdown of program activities was 27% lectures, 23% clinical work, 16% skills training, 10% administrative activities, 9% socialization and 15% other activities. Most orientations included activities to promote socialization among interns (98%) and with other members of the department (91%). Many programs (87%) included special certification courses (ACLS, ATLS, PALS, NRP). Course content included the following: use of electronic medical records (90%), physician wellness (75%), and chief complaint-based lectures (72%). Procedural skill sessions covered ultrasound (94%), airway management (91%), vascular access (90%), wound management (77%), splinting (67%), and trauma skills (62%). Conclusion Compared to Brillman (1995), we found that more programs (99%) are offering formal orientation and allocating more time to them. Lectures remain the most common educational activity. We found increases in the use of skills labs and specialty
Adamson, Rosemary; Goodman, Richard B; Kritek, Patricia; Luks, Andrew M; Tonelli, Mark R; Benditt, Joshua
The University of Washington was the first pulmonary and critical care medicine fellowship training program accredited by the Accreditation Council for Graduate Medical Education to create a dedicated clinician-educator fellowship track that has its own National Residency Matching Program number. This track was created in response to increasing demand for focused training in medical education in pulmonary and critical care. Through the Veterans Health Administration we obtained a stipend for a clinician-educator fellow to dedicate 12 months to training in medical education. This takes place predominantly in the second year of fellowship and is composed of several core activities: fellows complete the University of Washington's Teaching Scholars Program, a professional development program designed to train leaders in medical education; they teach in a variety of settings and receive feedback on their work from clinician-educator faculty and the learners; and they engage in scholarly activity, which may take the form of scholarship of teaching, integration, or investigation. Fellows are guided throughout this process by a primary mentor and a mentoring committee. Since funding became available in 2009, two of the three graduates to date have successfully secured clinician-educator faculty positions. Graduates uniformly believe that the clinician-educator track met their training goals better than the research-based track would have.
Vogel, Amanda L; Feng, Annie; Oh, April; Hall, Kara L; Stipelman, Brooke A; Stokols, Daniel; Okamoto, Janet; Perna, Frank M; Moser, Richard; Nebeling, Linda
Over the past several decades, there has been burgeoning interest and investment in large transdisciplinary (TD) team science initiatives that aim to address complex societal problems. Despite this trend, TD training opportunities in the health sciences remain limited, and evaluations of these opportunities are even more uncommon due to funding constraints. We had the unique opportunity to conduct an exploratory study to examine the potential outcomes and impacts of TD training in a National Cancer Institute-supported initiative for TD research and training-the Transdisciplinary Research on Energetics and Cancer I (TREC I) initiative. This study used a retrospective mixed-methods approach leveraging secondary analysis of existing data sources to learn about TREC trainees' experiences with TREC training, TD research competencies, changes in scholarly productivity, and the associations among these domains. Results indicated that, on average, TREC trainees were satisfied with their TREC mentoring experiences and believed that TREC training processes were effective, in general. Participation in TREC training was associated with TD research competencies, including TD research orientation, positive general attitude toward TD training, development of scientific skills for TD research, and intrapersonal/interpersonal competencies for collaboration. There was also a significant increase in trainees' scholarly productivity from before to after starting in TREC training, as indicated by average annual number of publications and presentations and average number of coauthors per publication. Perceived effectiveness of TREC training was positively correlated with change in average annual number of research presentations from before to after starting in TREC training (r = 0.65, p < 0.05, N = 12), as well as TD research orientation (r = 0.36, p < 0.05), general attitude toward TD training (0.39, p < 0.05), scientific skills for TD research (r = 0
Blank, Wolfgang A.; Blankenfeld, Hannes; Beck, Anton J.; Frangoulis, Anna-Maria; Vorderwülbecke, Florian; Fleischmann, Andreas
Introduction: Traditional university teaching formats are of limited use when it comes to conveying the inner workings and specific remit of general medicine in a practical way. Small supervised groups present themselves as a plausible and effective alternative for learning to interact with patients in low prevalence areas. Description of the project: A frontal lecture was transformed into an interactive seminar-like lecture for 280 students. Short kick-off presentations served as an introduction to rotating circuit stations. Knowledge, skills and professional attitude specific to general and family medicine were intensively trained by 28 small groups in and around the auditorium by means of activating didactic methods. The small groups were supervised by experienced GP’s trained as tutors. During six days, consisting of 3.5 hour sessions per day, working methods, a large variety of common medical conditions, preventive primary care and care for the elderly were amongst the topics addressed. Results: This new format was successfully implemented and developed with regards to content as well as organisation. Well over 90% of the 274 participating students evaluated tutors’ commitment, coherent delivery of content, learner-oriented atmosphere and practical focus positively. Given the advantages of a small-group learning situation, the somewhat cramped conditions were accepted by 92%. Discussion: The innovative concept was able to work successfully within the specific framework of patient care in a general and family medicine setting. A creative approach to the lack of space managed to mobilise resources for practical small-group work. Being able to work on specific general practice problems in a small-group setting and immediately reflect upon them was rated positively overall. Conclusions: Responsibilities and specific working methods in general practice / family medicine can be trained successfully even with large groups of students when limited space is used
Steffenson, Martin B., Ed.; Larason, Larry D., Ed.
A federally funded Library Training Institute was held to explore the user/system interface in academic libraries. The institute was composed of 50 librarians including 20% administrators, 20% educators, and 60% public services librarians. Speakers from a number of disciplines including sociology, psychology, criminal justice, and marketing…
Israël, Liora; Vanneuville, Rachel
The article examines the nature of contemporary legal training in two French elite higher education institutions--one dedicated to prepare for legal careers in the economic field, the other one to train top civil servants--in order to assess the role of legal knowledge in the shaping of French contemporary elites. Based on observations of law…
The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Rehabilitation Research and Training Center (RRTC) Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for an RRTC on Vocational Rehabilitation Practices for Youth and Young Adults. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend for this priority to contribute to improved outcomes for youth and young adults with disabilities in the State Vocational Rehabilitation Services program.
Eckstein, T E; Teitelbaum, H S
Well-rounded instruction in occupational medicine as part of family medicine residency training is feasible through a program that balances a longitudinal curriculum of monthly occupational and environmental medicine (OEM) lectures, community-based OEM patient care, and worksite assessment. Such training would help equip family medicine residents to integrate occupational medicine into their practices, which, in light of a shortage of board-certified practitioners in OEM, would help fill community needs. The Intern-Resident Training Committee of Carson City Hospital in rural Michigan established both learner and institutional goals and objectives for such a program of instruction. A learner-needs assessment found appreciable interest among the residents for occupational medicine training. In addition, results of a survey of the occupational health community suggested there is inadequate coverage of OEM in medical schools and residencies. Furthermore, a focus group of occupational health managers revealed that clarity of communication and standardization of reporting were paramount concerns. Instruments for standardized OEM history and for OEM case management were developed for use within the residency continuity clinic. The curriculum was implemented with a variety of teaching strategies, including worksite assessment. Practice-based, case-oriented instruction was subsequently phased into the program as residents assumed responsibility for managing cases under the supervision of family medicine preceptors knowledgeable in OEM. An occupational medicine rotation was developed that included focused clinical exposure to OEM patients and studies that would lead to eligibility for a certificate of additional qualification in occupational medicine. Learner evaluations included chart reviews and patient satisfaction surveys. Program evaluations included interviews with occupational health managers. The residents were judged by their preceptors to have performed well. The
O'Donnell, Christopher J; Nabel, Elizabeth G
The inaugural issue of Circulation: Cardiovascular Genetics arrives at a remarkable time in the history of genetic research and cardiovascular medicine. Despite tremendous progress in knowledge gained, cardiovascular disease(CVD) remains the leading cause of death in the United States,1 and it has overcome infectious diseases as the leading cause of death worldwide.2 In addition, rates of CVD remain higher in black and Hispanic populations in the United States.1 The recent Strategic Plan of the National Heart, Lung,and Blood Institute (NHLBI) emphasizes research areas to fill the significant knowledge gaps needed to improve the diagnosis,treatment, and control of known risk factors and clinically apparent disease. Simultaneously, the NHLBI Strategic Plan recognizes a tremendous opportunity that is available for use of genetic and genomic research to generate new knowledge that might reduce the morbidity and mortality from CVD in US populations.3 Public availability of vast amounts of detailed sequence information about the human genome, completed sequence data on dozens of other animal genomes, and private sector development of high-throughput genetic technologies has transformed in a few short years the conduct of cardiovascular genetics and genomics research from a primary focus on mendelian disorders to a current emphasis on genome-wide association studies (GWAS; Figure1). In this review, we describe the rationale for the current emphasis on large-scale genomic studies, summarize the evolving approaches and progress to date, and identify immediate-term research needs. The National Institutes of Health (NIH) and the NHLBI are supporting a portfolio of large-scale genetic and genomic programs in diverse US populations with the longer-term objective of translating knowledge into the prediction, prevention, and preemption of CVD, as well as lung, sleep, and blood disorders. Underlying this portfolio is a strong commitment to make available participant-level data and
Martin, Corby K; Thomson, Jessica L; LeBlanc, Monique M; Stewart, Tiffany M; Newton, Robert L; Han, Hongmei; Sample, Alicia; Champagne, Catherine M; Williamson, Donald A
In this study, we examined if children's food selection met the School Meals Initiative (SMI) standards and the recently released Institute of Medicine (IOM) recommendations. Mean food selection, plate waste, and food intake were also examined. Food intake of 2049 4th-6th grade students was measured objectively at lunch over 3 d with digital photography in 33 schools. The percent of children whose food selection met the SMI standards and IOM recommendations for energy (kJ), fat and saturated fat, calcium, iron, and vitamin A and C were calculated. The SMI standards provide lower limits for most nutrients; the IOM provides a range of values, including an upper limit for energy. Seventy-seven percent of children's energy selection met the SMI lower limit, but only 16% of children met the IOM's recommended range and 74% of children exceeded the upper limit. More than 70% of children exceeded the SMI and IOM's saturated fat recommendations. Children selected (mean +/- SD) 3168 +/- 621 kJ, discarded 882 +/- 581 kJ, and consumed 2286 +/- 716 kJ. Children were less likely to discard fat than carbohydrate, resulting in proportionally more fat being consumed. Most children met SMI and IOM recommendations for protein, calcium, iron, and vitamin A. With few exceptions, energy selection was similar among groups of children, but plate waste differed (P < 0.001), resulting in greater energy intake among boys compared with girls, Caucasians compared with African Americans, and heavier compared with lighter children. Children's selection was high in saturated fat and, based on IOM criteria, included excess energy.
Bolechała, Filip; Trela, Franciszek; Trepińskaz, Janina; Piotrowicz, Katarzyna; Bakowski, Rafał; Polewka, Andrzej
The study presents the results of research into completed suicide. The authors have analyzed cases of completed suicide committed in Cracow and it's environs in the years 1991-2000. The aim of the research is to describe some features of this phenomenon with it's transformations in the last periods. The presented material bases on archival data of postmortem examinations made in Cracow's Institute of Forensic Medicine. Analyses' were executed in reference of victims' sex, age and place of residence, number and frequency of suicides in Cracow population, methods, predictors and possible motives. The authors also present a sketch of the bibliography regarding the topic, and the comparison between the results of the present study and the results of earlier studies from Cracow environs of the phenomenon of suicide. 1933 cases of completed suicides were analysed, from what over a half concerned occupants of our city. The average coefficient for 100 000 occupants carried out 13.2. There were 1485 men and 448 women among victims, in age from 13 to 95 years. Male to female avarage ratio carried out 3.3:1 in the described period.. Average age carried out 45.5 years, for men 44.5, and for women 48.8 years. The superiority of men is strongly visible in groups of young persons and in "middle age". Results from archival data show that, hanging was the the most frequent way of suicide. In studied material there were more then 63% cases of suicidal hanging. Falls from height, poisonings and drownings were next in line. In very considerable number of cases (almost 60%) the presence of mental disorder in anamnesis was affirmed. This concerned particularly women where the most frequent were depression disorders. For men, first of all factors was dependence from acohol. Over one third of the victims were pensioners and unemployeds. The level of ethanol in blood in 718 cases was crossed 0.5 promille.
Van Den Broucke, Steven; Kanobana, Kirezi; Polman, Katja; Soentjens, Patrick; Vekemans, Marc; Theunissen, Caroline; Vlieghe, Erika; Van Esbroeck, Marjan; Jacobs, Jan; Van Den Enden, Erwin; Van Den Ende, Jef; Van Gompel, Alfons; Clerinx, Jan; Bottieau, Emmanuel
Although infection with Toxocara canis or T. catis (commonly referred as toxocariasis) appears to be highly prevalent in (sub)tropical countries, information on its frequency and presentation in returning travelers and migrants is scarce. In this study, we reviewed all cases of asymptomatic and symptomatic toxocariasis diagnosed during post-travel consultations at the reference travel clinic of the Institute of Tropical Medicine, Antwerp, Belgium. Toxocariasis was considered as highly probable if serum Toxocara-antibodies were detected in combination with symptoms of visceral larva migrans if present, elevated eosinophil count in blood or other relevant fluid and reasonable exclusion of alternative diagnosis, or definitive in case of documented seroconversion. From 2000 to 2013, 190 travelers showed Toxocara-antibodies, of a total of 3436 for whom the test was requested (5.5%). Toxocariasis was diagnosed in 28 cases (23 symptomatic and 5 asymptomatic) including 21 highly probable and 7 definitive. All but one patients were adults. Africa and Asia were the place of acquisition for 10 and 9 cases, respectively. Twelve patients (43%) were short-term travelers (< 1 month). Symptoms, when present, developed during travel or within 8 weeks maximum after return, and included abdominal complaints (11/23 symptomatic patients, 48%), respiratory symptoms and skin abnormalities (10 each, 43%) and fever (9, 39%), often in combination. Two patients were diagnosed with transverse myelitis. At presentation, the median blood eosinophil count was 1720/μL [range: 510-14160] in the 21 symptomatic cases without neurological complication and 2080/μL [range: 1100-2970] in the 5 asymptomatic individuals. All patients recovered either spontaneously or with an anti-helminthic treatment (mostly a 5-day course of albendazole), except both neurological cases who kept sequelae despite repeated treatments and prolonged corticotherapy. Toxocariasis has to be considered in travelers returning
Kanchongkittiphon, Watcharoot; Gaffin, Jonathan M.; Wang, Grace; Phipatanakul, Wanda
G, Phipatanakul W. 2015. Indoor environmental exposures and exacerbation of asthma: an update to the 2000 review by the Institute of Medicine. Environ Health Perspect 123:6–20; http://dx.doi.org/10.1289/ehp.1307922 PMID:25303775
adopted the categories of association used for previous reports re- garding the fi rst Gulf War and health , and Agent Orange and health , based on...pit sites, and further investigation of possible long-term health effects . Strengths of the study included the ability to use com- prehensive...Veterans Af- fairs (VA) asked the Institute of Medicine (IOM)* to: Determine the long-term health effects from exposure to burn pits in Iraq and Afghanistan
Green, Daniel J
Exercise training decreases cardiovascular risk, but effects on traditional risk factors do not fully account for this benefit. Exercise directly impacts upon arterial shear stress, a stimulus to antiatherogenic adaptation in vascular function and remodeling. This review considers the impact of exercise training on vascular adaptation in large and small arteries in humans.
Marty, Melissa Catherine
Peer assessment/feedback is clearly occurring in athletic training education programs. However, it remains unclear whether students would improve their ability to assess their peers and provide corrective feedback if they received formal training in how to do so. The purpose of this study was to determine the following: (1) if a peer…
Talarico, Ernest F., Jr.
As human cadavers are widely used in basic sciences, medical education, and other training and research venues, there is a real need for experts trained in anatomy and dissection. This article describes a program that gives individuals interested in clinical and basic sciences practical experience working with cadavers. Participants are selected…
Reynolds, P Preston
This article reviews the legislative history of Title VII of the United States Public Health Service Act. It describes three periods of federal support for health professions training in medicine and dentistry. During the first era, 1963 to 1975, federal support led to an increase in the overall production of physicians and dentists, primarily through grants for construction, renovation, and expansion of schools. The second period, 1976 to 1991, witnessed a shift in federal support to train physicians, dentists, and physician assistants in the fields of primary care defined as family medicine, general internal medicine, and general pediatrics. During this era, divisions of general internal medicine and general pediatrics, and departments of family medicine, were established in nearly every medical and osteopathic medical school. All three disciplines conducted primary care residencies, medical student clerkships, and faculty development programs. The third period, 1992 to present, emphasized the policy goals of caring for vulnerable populations, greater diversity in the health professions, and curricula innovations to prepare trainees for the future practice of medicine and dentistry. Again, Title VII grantees met these policy goals by designing curricula and creating clinical experiences to teach care of the homeless, persons with HIV, the elderly, and other vulnerable populations. Many grantees recruited underrepresented minorities into their programs as trainees and as faculty, and all of them designed and implemented new curricula to address emerging health priorities.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.
The State of Florida has recently established a new center of excellence in advanced core laser technologies, associated with the College of Optics & Photonics. This center, dedicated in 2007 in tribute to the pioneering work of Charles Townes, whose insight lead to the development of the maser and the laser, will invest in next generation laser technologies for applications to medicine, advanced manufacturing and defense. It joins the cluster of photonics-related centers at UCF, adding a focused national center for the education and training of scientists and engineers in laser technology. This paper describes the mission and objectives of the Townes Institute, the educational and training programs it is creating, its current investments and opportunities, and the future institutional and industrial partnerships and global reach it hopes to create.
Wieringa, Gijsbert; Zerah, Simone; Jansen, Rob; Simundic, Ana-Maria; Queralto, José; Solnica, Bogdan; Gruson, Damien; Tomberg, Karel; Riittinen, Leena; Baum, Hannsjörg; Brochet, Jean-Philippe; Buhagiar, Gerald; Charilaou, Charis; Grigore, Camelia; Johnsen, Anders H; Kappelmayer, Janos; Majkic-Singh, Nada; Nubile, Giuseppe; O'Mullane, John; Opp, Matthias; Pupure, Silvija; Racek, Jaroslav; Reguengo, Henrique; Rizos, Demetrios; Rogic, Dunja; Špaňár, Július; Štrakl, Greta; Szekeres, Thomas; Tzatchev, Kamen; Vitkus, Dalius; Wallemacq, Pierre; Wallinder, Hans
Laboratory medicine's practitioners across the European community include medical, scientific and pharmacy trained specialists whose contributions to health and healthcare is in the application of diagnostic tests for screening and early detection of disease, differential diagnosis, monitoring, management and treatment of patients, and their prognostic assessment. In submitting a revised common syllabus for post-graduate education and training across the 27 member states an expectation is set for harmonised, high quality, safe practice. In this regard an extended 'Core knowledge, skills and competencies' division embracing all laboratory medicine disciplines is described. For the first time the syllabus identifies the competencies required to meet clinical leadership demands for defining, directing and assuring the efficiency and effectiveness of laboratory services as well as expectations in translating knowledge and skills into ability to practice. In a 'Specialist knowledge' division, the expectations from the individual disciplines of Clinical Chemistry/Immunology, Haematology/Blood Transfusion, Microbiology/ Virology, Genetics and In Vitro Fertilisation are described. Beyond providing a common platform of knowledge, skills and competency, the syllabus supports the aims of the European Commission in providing safeguards to increasing professional mobility across European borders at a time when demand for highly qualified professionals is increasing and the labour force is declining. It continues to act as a guide for the formulation of national programmes supplemented by the needs of individual country priorities.
Harrison, Suzanne; Gimbel, Julie Fisher
This paper describes a professional and institutional partnership formed to facilitate access to Fast ForWord, a computerized approach to receptive language and auditory processing remediation. The program works best for children aged 4-14 with such classifications as communication handicapped (receptive-expressive language impairments), dyslexia,…
SCHNELLE, KARL B., JR.
AN EVALUATION WAS MADE TO DETERMINE THE ADEQUACY AND THE EFFECTIVENESS OF A 1966 SUMMER INSTITUTE HELD AT THE STATE UNIVERSITY OF NEW YORK AGRICULTURAL AND TECHNICAL COLLEGE, MORRISVILLE, NEW YORK. FURTHER OBJECTIVES WERE TO CONSTRUCTIVELY CRITICIZE THE APPROACH TAKEN, TO SUGGEST CHANGES FOR SUCCEEDING PROGRAMS, AND TO FORMULATE PLANS FOR THE…
New York State Education Dept., Albany. Bureau of Basic Continuing Education.
Designed to expose teachers of Asian populations to innovative teaching techniques and to help them develop teaching skills and a deeper cross-cultural awareness and appreciation of Asian cultures, a 2-week institute covered skills in teaching English as a second language and aspects of Asian culture and language that significantly affect language…
KISHKUNAS, LOUIS J.
APPENDIXES TO THE "FINAL REPORT," VOLUME I (VT 005 511), ARE INCLUDED--(1) A SCHEMATIC REPRESENTATION OF CURRICULUM DEVELOPMENT, (2) TECHNICAL BEHAVIOR CHECKLISTS, (3) PERFORMANCE INVENTORY FORMS USED IN ON-THE-JOB OBSERVATIONS, (4) REPORT FORM FOR TYPICAL JOB BEHAVIOR OF EMPLOYEE, (5) COOPERATING AREA HEALTH INSTITUTIONS, (6) TABLES OF Z SCORES…
for public release; distribution is unlimited. U.S. Army Research Institute for the Behavioral and Social Sciences Department of the Army...Distribution Statement A: Approved for public release; distribution is unlimited. 13. SUPPLEMENTARY NOTES Contracting Officer’s Representative and...Street, Bldg. 1464 Fort Belvoir, Virginia 22060 February 2013 Approved for public release; distribution is unlimited. iv
Utah Univ., Salt Lake City. Graduate School of Education.
A workshop held December 7, 8, and 9, 1970, was the second phase of a three-part program which aims to organize and develop Adult Basic Education (ABE) teacher preparation programs in institutions of higher education. The goals of the workshop were to: (1) inform participants about the need for professional preparation in teaching Adult Basic…
Andersen, Charles J.
Planning major research programs requires accurate information about funding and personnel. Since reliable baseline data for plant biology have not been available, a study was conducted to provide such data by measuring the total plant biology effort at major doctorate-granting institutions with graduate programs in botany during fall 1982.…
Texas Tech Univ., Lubbock. Dept. of Park Administration and Landscape Architecture.
After presenting introductory material about the Institute and its participants, this document offers brief summaries of workshops held at this conference. Workshop topics were: (1) solar energy; (2) nonverbal communication; (3) land acquisition; (4) employee orientation and counseling; (5) neighborhood parks; (6) Arbor Day; (7) trees in the urban…
Ford, D. R.
A study was made of the relationship between attendance by tribal peasant farmers and leaders at one-week courses in agricultural development held at Domboshawa Training Centre and subsequent changes in the Mtoko district of Rhodesia. The broad aim of the courses was to enable tribesmen to gain a better understanding of the causes of erosion due…
Wanjiku, Julliet; Mairura, Franklin; Place, Frank
The following survey was undertaken in 2005 to assess the effectiveness of professional training activities in international agricultural research organizations that were undertaken between 1999 and 2002 at ICRAF (International Centre for Research in Agroforestry), now World Agroforestry Centre, Nairobi. Trainees were randomly selected from…
Segal, David R.; Bachman, Jerald G.
Data in this survey indicate that high school seniors are more likely to expect or desire job training or education than they are to expect or desire to go into the military. More males expected to serve than wanted to, while more females wanted to serve than expected to. (Author/WI)
Dunn, Laura B.; Moutier, Christine; Hammond, Katherine A. Green; Lehrmann, Jon; Roberts, Laura Weiss
Objective: The personal health care issues of residents are important but have received minimal study. Available evidence suggests that residents experience difficulties obtaining care, partly related to both the demands of medical training and concerns about confidentiality and privacy. Methods: A self-report survey was distributed in 2000-2001…
Alekseeva, Larisa; Shkolyar, Luidmila; Savenkova, Luibov
The authors reveal an innovative approach to training and education of preschool children. This approach is called "GARDEN OF CHILDHOOD". It is based on the idea that the development of the preschool child's personality should be joyous and free "cultural self-creation" in terms of the collective co-creation, where adults and…
Carney, Patricia A.; Bar-on, Miriam E.; Grayson, Martha S.; Klein, Martin; Cochran, Nan; Eliassen, M. Scottie; Gambert, Steven R.; Gupta, Krishan L.; Labrecque, Mary C.; Munson, Paul J.; Nierenberg, David W.; O'Donnell, Joseph F.; Whitehurst-Cook, Michelle; Willett, Rita M.
Funded by the Generalist Physician Initiative, Dartmouth Medical School (New Hampshire), Virginia Commonwealth University, and New York Medical College adopted early community-based training models for longitudinal clinical experiences. The three programs, the methods used to evaluate an aspect of the program, lessons learned about early clinical…
HILL, WALKER H.
THIS STUDY IS AN EXPLORATION OF THE GENERAL CHARACTER AND VALIDITY OF PRESENT-DAY RADIO AND TELEVISION EDUCATION IN COLLEGES AND UNIVERSITIES AS REPORTED BY REPRESENTATIVE GROUPS OF EDUCATORS, GRADUATES, AND BROADCASTERS. OF THE SEVEN OBJECTIVES REPORTED FOR TRAINING PROGRAMS, THE ONE MOST OFTEN STATES WAS "TO DEVELOP PROFESSIONAL COMPETENCE…
Powell, Justin J. W.; Solga, Heike
Given ongoing economic, political and social transformation, skill formation systems are under pressure to change. This is acknowledged in European declarations--Bologna for higher education and Copenhagen for vocational training--and various national reform processes. The omnipresent convergence hypothesis is that these international pressures…
Smith, Rosslyn, Ed.; And Others
This collection contains 16 papers that focus on various problems and challenges relating to the design and implementation of training programs for international or foreign teaching assistants (ITAs or FTAs). It includes: (1) "An Outline of Analysis for Program Design" (Larry L. Loeher); (2) "A Survey of ITA Orientation Programs:…
Ferreira, António Gomes; Mota, Luís
We evoke here events that took place in an ordinary school, the Teacher Training College in Coimbra (Portugal), during the on-going revolutionary process ("processo revolucionário em curso"; PREC), in an attempt to understand people's actions within the collective becoming of a certain time and place, and to grasp how memory works as a…
Bureau of Labor Statistics (DOL), Washington, DC.
Selected from the "Occupational Outlook Handbook," the listings included in this document represent a number of occupations for which junior college or other special training is useful. Each listing, grouped under a broader occupational area, provides a specific occupational title, number employed in the occupation in 1974, qualifications and…
Burganova, Roza I.; Abdugalina, Sairan E.; Shaiheslyamova, Kazyna O.
The article is devoted to the problem of professional competence formation in the specialists' training process at the university in contemporary socio-economic and socio-cultural conditions originating in the Republic of Kazakhstan. The emphasis is laid on new scientific and pedagogical approaches to its solution. Special attention is paid to the…
Except for the people living with the disease, no others have so immersed themselves in Cuba's world of HIV/AIDS as Dr Jorge Pérez. It is a world of Cuban returnees from Angola's war against apartheid South Africa, gay and bisexual men, housewives, transactional sex workers, rebellious teenagers, and infected surgeons and scientists-a cultural kaleidoscope reflecting all the faces of AIDS. To more than one international author, he is simply "Cuba's AIDS doctor." Speaking to his patients at the Pedro Kourí Tropical Medicine Institute in Havana, it is easy to see why, but also to appreciate the courage, compassion, and persistent search for new knowledge that characterize the Institute's staff as a whole. Dr Pérez's story-now told in two books based on his diaries-is not his alone. MEDICC Review held two interview sessions with Jorge Pérez just days apart at the beginning of April: one before and one after his designation as the new Director of the Tropical Medicine Institute, where he previously served as Deputy Director and Chief of Hospital Services. More than strictly medical matters, the conversation turned to the human dimension of HIV/AIDS, the depth to which it has touched many directly and affected Cuban society as a whole, and the challenges ahead for Cuba's flagship institution for research and treatment of infectious diseases.
Himmel, W; Kühne, I; Chenot, J-F; Scheer, N; Primas, I; Sigle, J
Effective from spring 2004, new regulations for undergraduate medical education in Germany require a two-week practical training in general practice. Similar to other forms of medical education, this practical training should be regularly evaluated by students. With regard to special conditions of the training, we preferred a web based evaluation. Since adequate models were not available, we designed, implemented and tested an electronic way of evaluation. The following aspects turned out to be of special importance: teamwork, time, data protection and cost. Meanwhile, the evaluation is established and still accessible as demo-version for visitors of the home page. This electronic evaluation of medical training in general practice is highly appropriate for a timely evaluation allowing us to obtain a comparison between students' expectations and actual experience as well as a continuous supervision and to provide feedback to the participating practices. This is an important step for quality assurance of medical education in practices inside and outside the university.
Errors in health care that compromise patient safety are tied to latent failures in the structure and function of systems. Teams of people perform most care delivered today, yet training often remains focused on individual responsibilities. Training programmes for all healthcare workers need to increase the educational experience of working in interdisciplinary teams. The complexities of team training require a multifunctional (systems) approach, which crosses organisational divisions to allow communication, accountability, and creation and maintenance of interdisciplinary teams. This report identifies challenges for medical education in performing the research, identifying performance measurements, and modifying educational curricula for the advancement of interdisciplinary teams, based on the complexity of team training identified in commercial aviation. PMID:15465959
Kerwin, Chris; Tommaso, Laura; Kulstad, Erik
Objective. Wall-motion abnormality on echocardiogram is more sensitive in detecting cardiac ischemia than the electrocardiogram, but the use of bedside echocardiography by emergency physicians (EPs) for this purpose does not appear to be widespread, apparently due to limited data on proficiency of EPs for this task. We sought to determine the effect of a brief training module on the ability of EPs to recognize wall motion abnormalities on echocardiograms. Methods. We developed a brief training and testing module and presented it to EPs. After baseline testing of 15 echocardiograms, we presented the 30-minute training module, and administered a new test of 15 different echocardiograms. Physicians were asked to interpret the wall motion as normal or abnormal. Results. 35 EPs over two separate sessions showed significant improvement recognition of wall-motion abnormalities after the brief training module. Median score on the baseline test was 67%, interquartile range (IQR) 53% to 80%, while the median score on the posttraining test was 87%, IQR 80% to 87%, P < .001, independent of time in practice or prior training. Conclusion. With only brief training on how to recognize wall motion abnormalities on echocardiograms, EPs showed significant improvement in ability to identify wall motion abnormalities.
Nicholson, Laura J.; Warde, Carole M.; Boker, John R.
Introduction: Evidence-based medicine (EBM) integrates published clinical evidence with patient values and clinical expertise, the output of which is informed medical decision making. Key skills for evidence-based practice include acquisition and appraisal of clinical information. Faculty clinicians often lack expertise in these skills and are…
Bains, Serena; Kitutu, Freddy E.; Rahhal, Ala’a; Abu Samaha, Rana; Wilby, Kyle J.
Background: Although pharmacists have great potential to modify and optimize drug therapy in pregnancy and lactation, current literature demonstrates that they do not routinely provide this care and often feel ill equipped to do so. The objective of this study was to determine pharmacists’ knowledge and perceptions of maternal-fetal medicine in Canada, Uganda and Qatar. Secondary objectives were to determine factors associated with pharmacists’ knowledge and to characterize training opportunities and resources available to practising pharmacists. Methods: A cross-sectional survey using online software (SurveyMonkey) was sent to the e-mails of potential research participants. Practising pharmacists and resident pharmacists in British Columbia, Canada; the country of Qatar; and the country of Uganda were eligible for inclusion. The survey was designed to assess knowledge and perceptions, and to create a baseline inventory of current practice and information resources used in practice. Results: The mean knowledge assessment scores of pharmacists in Canada, Qatar and Uganda were 62.9%, 53.3%, and 57.7%, respectively (p < 0.05). Pharmacists in British Columbia scored higher on knowledge assessment than pharmacists in Qatar (p < 0.05), but other country comparisons were not significant. No predefined factors (gender, years of experience, practice area or parental status) were found to be significant in determining the knowledge score. More than two-thirds of pharmacists expressed interest in participating in continuing education opportunities in maternal-fetal medicine. Conclusion: Pharmacists have differing levels of knowledge in the area of maternal-fetal medicine. Continuing education and degree curricula should be reviewed and developed to fill the knowledge gaps of student pharmacists and practising pharmacists in maternal-fetal medicine. PMID:25364351
rather than empirical as in the transfer studies. The results of the validity studies and the rational capabilities analysis will indicate which...the device was judged capable. Second, if descriptions of the device physical characteristics and hardware indicated that the device could be...The results of OT II and the rational capabilities analysis will indicate which tasks the devices may be used for in initial and sustain- ment training
Levey, G S
The number of foreign national medical graduates entering internal medicine residency training programs in the United States has doubled since 1986. A rigorous, standardized preresidency evaluation of the basic clinical skills and language abilities of international medical graduates should be implemented. Those found to have significant deficits should undertake a preparatory curriculum designed to meet special educational needs before entry into the formal training program. A relevant curriculum might include formal lectures, reading assignments, physical diagnosis sessions, language classes, patient encounter sessions, and a tutorial on U.S medical culture that includes medical ethics and the basics of the our health care system. All or only some of these may be required for any given individual. The Educational Commission for Foreign Medical Graduates (ECFMG) could provide many of the methods needed for an evaluation program and work collaboratively with program directors. This new approach to training of international medical graduates will require an evaluation system to to measure its effectiveness. Important questions about the funding of graduate medical education for international medical graduates must also be addressed.
Objectives. This study was designed to compare the trainees' perception of emergency medicine (EM) training in the United States (US) and Saudi Arabia (SA) and to identify residents' levels of confidence and points of satisfaction in education, procedural skills, and work environment. Method. An IRB-exempt anonymous web-based survey was distributed to five EM residency training programs in the USA and three residency regions in SA. Results. 342 residents were polled with a 20% response rate (16.8% USA and 25.8% SA). The Saudi residents responded less positively to the questions about preparation for their boards' examinations, access to multiple educational resources, and weekly academic activities. The Saudi trainees felt less competent in less common procedures than US trainees. American trainees also more strongly agree that they have more faculty interest in their education compared to the Saudi trainees. The Saudi residents see more patients per hour compared to their US peers. Conclusion. These findings may be due to the differences in training techniques including less formal didactics and simulation experience in SA and more duty hour regulations in the USA. PMID:24563784
Professor Eugen Cerkovnikov, PhD (Kamenska, Russia, 1904- Rijeka, Croatia 1985) graduated in chemical technology from the Faculty of Engineering in Zagreb in 1929. His first job was at the School of Medicine in Paris in 1930, and then he moved to Zagreb to the Department of Organic Chemistry of the Faculty of Engineering run by our Nobel Prize winner Vladimir Prelog (1935-1938). There he took his PhD degree with a dissertation on piperidine gamma derivatives. From 1938 to 1947 he was a research associate at an institute established by the pharmaceutical company Kastel (later Pliva). This is when he became a lecturer at the Faculty of Pharmacy in Zagreb and the first director of the Institute of Organic Chemistry, established in 1946/47. In 1948 he became reader, and in 1956 (full) professor. In 1957 he moved to the newly established School of Medicine in Rijeka, and set up the Institute of Chemistry and Biochemistry. He ran the Institute until retirement in 1975. He was the second dean of the Rijeka University School of Medicine and a pioneer of quantum chemistry and medical cybernetics in undergraduate and (post)graduate courses. His scientific work consists of over 200 papers published at home and abroad, 60 professional papers, 20 book reviews, three works of translation, and 27 volumes of lecture notes. In 1958, professor Cerkovnikov established the Croatian Chemical Society and the Rijeka and Istria branches of the nation's Association of Chemists and Chemical Engineers, chairing them until 1974. In addition, he was one of the founding fathers, and the first chair of the Health Culture Studies Association in Rijeka (that preceded today's Croatian Scientific Society for the History of Health Culture), established in 1965.
Flaherty, Gerard; O'Connor, Rory; Johnston, Niall
High altitude training is regarded as an integral component of modern athletic preparation, especially for endurance sports such as middle and long distance running. It has rapidly achieved popularity among elite endurance athletes and their coaches. Increased hypoxic stress at altitude facilitates key physiological adaptations within the athlete, which in turn may lead to improvements in sea-level athletic performance. Despite much research in this area to date, the exact mechanisms which underlie such improvements remain to be fully elucidated. This review describes the current understanding of physiological adaptation to high altitude training and its implications for athletic performance. It also discusses the rationale and main effects of different training models currently employed to maximise performance. Athletes who travel to altitude for training purposes are at risk of suffering the detrimental effects of altitude. Altitude illness, weight loss, immune suppression and sleep disturbance may serve to limit athletic performance. This review provides an overview of potential problems which an athlete may experience at altitude, and offers specific training recommendations so that these detrimental effects are minimised.
Raji, J Beulah; Velavan, Jachin; Anbarasi, Sahaya; Grant, Liz
There is irrefutable evidence that health systems perform best when supported by a Family Physician network. Training a critical mass of highly skilled Family Physicians can help developing countries to reach their Millennium Development Goals and deliver comprehensive patient-centered health care to their population. The challenge in developing countries is the need to rapidly train these Family Physicians in large numbers, while also ensuring the quality of the learning, and assuring the quality of training. The experience of Christian Medical College (CMC), Vellore, India and other global examples confirm the fact that training large numbers is possible through well-designed blended learning programs. The question then arises as to how these programs can be standardized. Globally, the concept of the "credit system" has become the watch-word for many training programs seeking standardization. This article explores the possibility of introducing incremental academic certifications using credit systems as a method to standardize these blended learning programs, gives a glimpse at the innovation that CMC, Vellore is piloting in this regard partnering with the University of Edinburgh and analyses the possible benefits and pitfalls of such an approach.
Considering how I studied Russian, I can honestly say that I.... a. did as much work as the next person b. will pass on the basis of sheer luck or...intelligence, because I did very little work c. worked very hard to learn Russian d. [Not applicable--we were not required to study outside of class.] 49. If my...ELEMENT. PROJECT, TASK U.S. Army Research Institute Field Unit at the AREA & WORK UNIT NUMBERS Presidio of Monterey 2Q263743A794 PO Box 5787, Presidio of
Background Evidence-based medicine (EBM) has been widely integrated into residency curricula, although results of randomized controlled trials and long term outcomes of EBM educational interventions are lacking. We sought to determine if an EBM workshop improved internal medicine residents' EBM knowledge and skills and use of secondary evidence resources. Methods This randomized controlled trial included 48 internal medicine residents at an academic medical center. Twenty-three residents were randomized to attend a 4-hour interactive workshop in their PGY-2 year. All residents completed a 25-item EBM knowledge and skills test and a self-reported survey of literature searching and resource usage in their PGY-1, PGY-2, and PGY-3 years. Results There was no difference in mean EBM test scores between the workshop and control groups at PGY-2 or PGY-3. However, mean EBM test scores significantly increased over time for both groups in PGY-2 and PGY-3. Literature searches, and resource usage also increased significantly in both groups after the PGY-1 year. Conclusions We were unable to detect a difference in EBM knowledge between residents who did and did not participate in our workshop. Significant improvement over time in EBM scores, however, suggests EBM skills were learned during residency. Future rigorous studies should determine the best methods for improving residents' EBM skills as well as their ability to apply evidence during clinical practice. PMID:20807453
The SEAMEO TROPMED Network is a regional cooperative network established in 1967 for education, training and research in tropical medicine and public health under the Southeast Asia Ministers of Education Organization. The Network operates through four Regional Centers with respective areas of specialization and host institutions: Community Nutrition/Tropmed Indonesia; Microbiology, Parasitology and Entomology/Tropmed Malaysia; Public Health/Tropmed Philippines; and Tropical Medicine/Tropmed Thailand. To train health workers, to support research on endemic and newly emerging diseases, and to advocate relevant health policies are the main functions of these centers. SEAMEO TROPMED Network in collaboration with the Faculty of Tropical Medicine, Mahidol University and other institutions has regularly organized the Seminar on Food-borne Parasitic Zoonoses every 3-5 years over the past 15 years. The Faculty of Tropical Medicine has organized the annual Joint International Tropical Medicine Meeting since 1996. Full papers of the presentations at these two meetings have been published as supplementary issues to the Southeast Asian Journal of Tropical Medicine and Public Health, an in-house journal of SEAMEO TROPMED Network. Recently, the Parasitology Association of ASEAN Countries has rotated the hosting of the ASEAN Congress of Parasitology and Tropical Medicine. These institutional and conference networks will enable closer links, to promote the health of people in the Southeast Asian region.
Vasiliev, Michael; Neverov, Ruslan; Vin, Aung Tun
New training programme developed in Moscow Institute of Physics and Technology for Russian and foreign students is presented. The programme is intended to master degree applicants in the field of the aerospace and industrial technologies and represents the achievements in the electron-beam plasma systems development. The programme is based on the system approach to the beam-plasma systems and on the life-circle support of these systems including development, operation and maintenance during customer-use period. Two examples of the research projects that students carry out at the final stages of the programme are described in detail. They are plasmachemical techniques of bioactive materials production and ground tests of various satellite on-board sensors.
Baerga Duperoy, Rachel; Castro Rojas, Nydia; Orta Rodríguez, Brenda; González Caraballo, Enid; Cruz González, Angel; Vázquez Fernández, José; Oliver Vázquez, Marlén
The purpose of this qualitative study was to explore and identify the basic training needs of nursing home staff, in terms of attitudes, knowledge and skills required to work effectively with geriatric patients. Three focus groups were performed, two groups of employees, and a group of elderly residents of the institution, in order to explore issues pertaining to the following topics: personal attributes required to work with geriatric patients, basic knowledge and skills needed to provide effective services. Group discussions were transcribed and themes were extracted through consensus reached by the investigators. Results indicated that the interviewed staff lack of formal preparation or continuing education in gerontology or geriatrics. Needs identified were the following: the aging process, caring behaviors, management of common health conditions, administration of medications, transference and mobility of residents, among others. Finding were use to design an educational program aimed in assisting nursing home staff in providing an effective service to their geriatric patients.
Volzhanin, V M; Bulan'kov, Iu I; Bolekhan, V N; Vasil'ev, V V; Orlova, E S
The analysis of results of laboratorial diagnostics of HIV-infection in multiprofile treatment institute of the Ministry of Defense of RF, questioning of medical staff on the questions of diagnostics and treatment of HIV-infection discovered several disadvantages in the system of training of the physicians in this sphere. Insufficient level of knowledge of practical aspects of HIV-infection causes baseless quantity of screening laboratorial tests (up to 70%). It leads to grand material inputs of the Ministry of Defense of RF. The authors propose an elaborated guidance manual for teachers, attending physicians and students of academies on studying questions of HIV-infection, based on the principle of "transparent study", on broad engaging of different departments to the process of teaching, on consideration of profiles of cycles of studying, of levels of adoption, types of lessons, volume of study time.
Carlson, Charles R.; Hoyle, Rick H.
Conducted quantitative review of research in which abbreviated progressive muscle relaxation training (APRT) was used as intervention for psychophysiological and stress-related disorders. Calculated strength of association between APRT and outcome measures for 29 experiments published after 1980. APRT was most strongly associated with improvement…
Hakkarainen, Kai Pekka; Wires, Susanna; Keskinen, Jenni; Paavola, Sami; Pohjola, Pasi; Lonka, Kirsti; Pyhältö, Kirsi
The purpose of the present study was to investigate knowledge-creating agency by examining doctoral students' accounts of their pursuits, using structured interviews. We examined all of the talk apparently related to agency of 13 doctoral students taking part in collective doctoral training in two, highly regarded Finnish research communities…
... HUMAN SERVICES Health Resources and Service Administration Advisory Committee on Training in Primary... Department of Health and Human Services; the Committee on Health, Education, Labor, and Pensions of the... Resources and Services Administration, in any one of the following three ways: (1) Send a request to...
... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Training in Primary... to the Secretary of the Department of Health and Human Services; the Committee on Health, Education... Resources and Services Administration, Room 9A-27, Parklawn Building, 5600 Fishers Lane, Rockville,...
Krumholz, Harlan M
Big data in medicine--massive quantities of health care data accumulating from patients and populations and the advanced analytics that can give those data meaning--hold the prospect of becoming an engine for the knowledge generation that is necessary to address the extensive unmet information needs of patients, clinicians, administrators, researchers, and health policy makers. This article explores the ways in which big data can be harnessed to advance prediction, performance, discovery, and comparative effectiveness research to address the complexity of patients, populations, and organizations. Incorporating big data and next-generation analytics into clinical and population health research and practice will require not only new data sources but also new thinking, training, and tools. Adequately utilized, these reservoirs of data can be a practically inexhaustible source of knowledge to fuel a learning health care system.
Continuous advances in medical laboratory technology have driven major changes in the practice of laboratory medicine over the past two decades. The importance of the overall quality of a medical laboratory has been ever-increasing in order to improve and ensure the quality and safety of clinical practice by physicians in any type of medical facility. Laboratory physicians and professional staff should challenge themselves more than ever in various ways to cooperate and contribute with practicing physicians for the appropriate utilization of laboratory testing. This will certainly lead to a decrease in inappropriate or unnecessary laboratory testing, resulting in reducing medical costs. In addition, not only postgraduate, but also undergraduate medical education/training systems must be markedly innovated, considering recent rapid progress in electronic information and communication technologies.
Statewide Police Command and Supervisory Training -- Three Demonstration Projects: New Jersey Mobile Training Units; North Carolina Police Management Institute; Arkansas Regional Courses for Police Supervisors.
New Jersey Police Training Commission, Trenton.
Three police training programs varied markedly and present a selection of models appropriate to different circumstances and training needs. The New Jersey Police Training Commission provides for supervisory training through the use of mobile classrooms staffed with trained professional teams, equipped with modern teaching aids, and experimenting…
Wolkow, Thomas D.; Durrenberger, Lisa T.; Maynard, Michael A.; Harrall, Kylie K.
Early research experiences must be made available to all undergraduate students, including those at 2-yr institutions who account for nearly half of America's college students. We report on barriers unique to 2-yr institutions that preclude the success of an early course-based undergraduate research experience (CURE). Using a randomized study design, we evaluated a CURE in equivalent introductory biology courses at a 4-yr institution and a 2-yr institution within the same geographic region. We found that these student populations developed dramatically different impressions of the experience. Students at the 4-yr institution enjoyed the CURE significantly more than the traditional labs. However, students at the 2-yr institution enjoyed the traditional labs significantly more, even though the CURE successfully produced targeted learning gains. On the basis of course evaluations, we enhanced instructor, student, and support staff training and reevaluated this CURE at a different campus of the same 2-yr institution. This time, the students reported that they enjoyed the research experience significantly more than the traditional labs. We conclude that early research experiences can succeed at 2-yr institutions, provided that a comprehensive implementation strategy targeting instructor, student, and support staff training is in place. PMID:25452494
Guyer, B; Smith, D R; Chalk, R
Federal, state, and private-sector investments in vaccine purchases and immunization programs are lagging behind emerging opportunities to reduce the risks of vaccine-preventable disease. Although federal assistance to the states for immunization programs and data collection efforts rapidly expanded in the early part of the 1990s, significant cutbacks have occurred in the last 5 years that have reduced the size of state grant awards by more than 50% from their highest point. During this same period, the vaccine delivery system for children and adults has become more complex and fragmented. This combination of new challenges and reduced resources has led to instability in the public health infrastructure that supports the U. S. immunization system. Many states have reduced the scale of their immunization programs and currently lack adequate strength in areas such as data collection among at-risk populations, strategic planning, program coordination, and assessment of immunization status in communities that are served by multiple health care providers. If unmet immunization needs are not identified and addressed, states will have difficulty in achieving the national goal of 90% coverage by the year 2010 for completion of the childhood immunization series for young children. Furthermore, state and national coverage rates, which reached record levels for vaccines in widespread use (79%, 1998), can be expected to decline and preventable disease outbreaks may occur as a result, particularly among persons who are vulnerable to vaccine-preventable disease because of their underimmunization status. The Institute of Medicine (IOM) Committee on Immunization Finance Policies and Practices has therefore concluded that a renewal and strengthening of the federal and state immunization partnership is necessary. The goal of this renewed partnership is to prevent infectious disease; to monitor, sustain, and improve vaccine coverage rates for child and adult populations within more
Kuznetsov, D. N.; Syryamkin, V. I.
Modern technologies play a very important role in our lives. It is hard to imagine how people can get along without personal computers, and companies - without powerful computer centers. Nowadays, many devices make modern medicine more effective. Medicine is developing constantly, so introduction of robots in this sector is a very promising activity. Advances in technology have influenced medicine greatly. Robotic surgery is now actively developing worldwide. Scientists have been carrying out research and practical attempts to create robotic surgeons for more than 20 years, since the mid-80s of the last century. Robotic assistants play an important role in modern medicine. This industry is new enough and is at the early stage of development; despite this, some developments already have worldwide application; they function successfully and bring invaluable help to employees of medical institutions. Today, doctors can perform operations that seemed impossible a few years ago. Such progress in medicine is due to many factors. First, modern operating rooms are equipped with up-to-date equipment, allowing doctors to make operations more accurately and with less risk to the patient. Second, technology has enabled to improve the quality of doctors' training. Various types of robots exist now: assistants, military robots, space, household and medical, of course. Further, we should make a detailed analysis of existing types of robots and their application. The purpose of the article is to illustrate the most popular types of robots used in medicine.
Maggio, Lauren A.; Kung, Janice Y.
Objectives: This study describes how information retrieval skills are taught in evidence-based medicine (EBM) at the undergraduate medical education (UGME) level. Methods: The authors systematically searched MEDLINE, Scopus, Educational Resource Information Center, Web of Science, and Evidence-Based Medicine Reviews for English-language articles published between 2007 and 2012 describing information retrieval training to support EBM. Data on learning environment, frequency of training, learner characteristics, resources and information skills taught, teaching modalities, and instructor roles were compiled and analyzed. Results: Twelve studies were identified for analysis. Studies were set in the United States (9), Australia (1), the Czech Republic (1), and Iran (1). Most trainings (7) featured multiple sessions with trainings offered to preclinical students (5) and clinical students (6). A single study described a longitudinal training experience. A variety of information resources were introduced, including PubMed, DynaMed, UpToDate, and AccessMedicine. The majority of the interventions (10) were classified as interactive teaching sessions in classroom settings. Librarians played major and collaborative roles with physicians in teaching and designing training. Unfortunately, few studies provided details of information skills activities or evaluations, making them difficult to evaluate and replicate. Conclusions: This study reviewed the literature and characterized how EBM search skills are taught in UGME. Details are provided on learning environment, frequency of training, level of learners, resources and skills trained, and instructor roles. Implications: The results suggest a number of steps that librarians can take to improve information skills training including using a longitudinal approach, integrating consumer health resources, and developing robust assessments. PMID:25031559
Research programs from the medical science division of the Oak Ridge Institute for Science and Education (ORISE) are briefly described in the following areas: Biochemistry, cytogenetics, microbiology, center for epidemiologic research, radiation medicine, radiation internal dose information center, center for human reliability studies, facility safety, occupational medicine, and radiation emergency assistance center/training site.
teach the management of multiple-traumatized patients. The ACLS, PALS, and BLS courses are sponsored by the American Heart Association (AHA). These...facilities had to obtain their cardiac resuscitative training from either local American Heart Association affiliates (BLS and ACLS) or from the American Red...in the DOD was completed in late 1982. In 1981 an agreement was prepared between the American Heart Association and the DCD Health Council establishing
minimum 2 pilot courses for each course developed Collection and analysis of assessment data Preliminary review of findings and determination of next...Delivery of a minimum 2 pilot courses for each course developed Collection and analysis of assessment data; preliminary review of findings and...Point. The pilot training program developed in this program will be delivered to the target groups (local responders, health care agencies, public
Smeekens, M.; Baru, C.; Keller, G. R.; Arrowsmith, R.; Crosby, C. J.
The Cyberinfrastructure Summer Institute for Geoscientists (CSIG) has been conducted each year since 2004 under sponsorship of the GEON project that is funded by the NSF. The goal of the institute, which is broadly advertised to the Geoscience community, is to introduce geoscientists to Computer Science concepts and commonly-used as well as emergent information technology tools. The week-long program originally covered topics ranging from Data Modeling, Web Services, and Geographic Information Systems, to brief introductions to key concepts in Grid Computing, Parallel Programming, and Scientific Workflows. However, the program as well as the composition and expectations of the audience have evolved over time. Detailed course and instructor evaluations provide valuable feedback on course content and presentation approaches, and are used to plan future CSIG curriculum. From an initial emphasis on Geoscience graduate students and postdocs, the selection process has evolved to encourage participation by individuals with backgrounds in Geoscience as well as Computer Science from academia, government agencies, and industry. More recently, there has been an emphasis on selecting junior faculty and those interested in teaching Geoinformatics courses. While the initial objective of CSIG was to provide an overview of information technology topics via lectures and demonstrations, over time attendees have become more interested in specific instruction in how informatics and cyberinfrastructure (CI) capabilities could be utilized to address issues in Earth Science research and education. There have been requests over the years for more in-depth coverage on some topics and hands-on exercises. The program has now evolved to include a “Build Track”, focused on IT issues related to the development and implementation of Geoinformatics systems, and an “Education Track”, focused on use of Geoinformatics resources in education. With increasing awareness of CI projects, the
Kieć-Swierczyńska, M; Krecisz, B
The causes of occupational dermatosis were analysed in 27 dental nurses examined at The Nofer Institute of Occupational Medicine during the years 1995-99. Contact sensitisation (at least one positive epidermal test) was found in 18 subjects (66.7%). Occupational allergic dermatitis was induced most frequently by: glutaraldehyde (7 positive patch tests), nickel (7), benzalkonium (4), formaldehyde (4), fragrances (4), chromium compounds (3), glyoxal (3), and thiuram (3). In the authors' opinion, dental nurses are nowadays sensitised to other chemical compounds than it used to be in the past. The present components of disinfectants (aldehydes, quaternary ammonium bases), metals and rubber are the major etiologic agents that induce occupational allergy.
Trigg, Lisa J
This research analyzes how discourse constituting the currently proposed National Health Information Infrastructure (NHII) may reproduce existing social inequality in healthcare. Textually oriented critical discourse analysis and corpus linguistics methods compare 3 executive summaries from the Institute of Medicine reports: the Quality Chasm and Insuring Health series, and the stand-alone report Unequal Treatment. These methods proved effective in studying the social action of language used in those summaries and will be useful in studying a larger corpus of discourse constituting the NHII. Further research will provide information to prevent or mitigate the reproduction of social inequality in healthcare through the proposed NHII.
Tiwari, S. N. (Principal Investigator); Massenberg, Samuel E. (Technical Monitor)
The 'Institute for Scientific and Educational Technology' has been established to provide a mechanism through which universities and other research organizations may cooperate with one another and with different government agencies and industrial organizations to further and promote research, education, and training programs in science, engineering, and related fields. This effort has been undertaken consistent with the national vision to 'promote excellence in America s educational system through enhancing and expanding scientific and technological competence.' The specific programs are directed in promoting and achieving excellence for individuals at all levels (elementary and secondary schools, undergraduate and graduate education, and postdoctoral and faculty research). The program is consistent with the existing activities of the Institute for Computational and Applied Mechanics (ICAM) and the American Society for Engineering Education (ASEE) at NASA Langley Research Center (LaRC). The efforts will be directed to embark on other research, education, and training activities in various fields of engineering, scientific, and educational technologies. The specific objectives of the present program may be outlined briefly as follows: 1) Cooperate in the various research, education, and technology programs of the Office of Education at LaRC. 2) Develop procedures for interactions between precollege, college, and graduate students, and between faculty and students at all levels. 3) Direct efforts to increase the participation by women and minorities in educational programs at all levels. 4) Enhance existing activities of ICAM and ASEE in education, research, and training of graduate students and faculty. 5) Invite distinguished scholars as appropriate and consistent with ISET goals to spend their summers and/or sabbaticals at NASA Langley andor ODU and interact with different researchers and graduate students. Perform research and administrative activities as needed
Nawaz, Haq; Petraro, Paul V.; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M.
Background The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. Objective To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Methods Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents’ progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. Results A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents’ discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Conclusion Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits. PMID:27507540
Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A.; Ferrell, Betty
ExCEL in Social Work : Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program’s curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers - the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers. PMID:25146345
Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A; Ferrell, Betty
ExCEL in Social Work: Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program's curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers--the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers.
possible. A life raft with an inflatable floor and a canopy provides good protection against -i chill. Frequent practice drills and experience of the...and equLpeant that will protect him from the coldl but military experience has shown that succems In such adverse onditions depends far nor* upon the...under such extreme conditions comes mainly from experience and training in that particular environmant and inKprovevents in mental and manual
Arienti, Vincenzo; Di Giulio, Rosella; Cogliati, Chiara; Accogli, Esterita; Aluigi, Leonardo; Corazza, Gino Roberto
In recent years, thanks to the development of miniaturized ultrasound devices, comparable to personal computers, tablets and even to smart phones, we have seen an increasing use of bedside ultrasound in internal medicine departments as a novel kind of ultrasound stethoscope. The clinical ultrasound-assisted approach has proved to be particularly useful in assessing patients with nodules of the neck, dyspnoea, abdominal pain, and with limb edema. In several cases, it has allowed a simple, rapid and precise diagnosis. Since 2005, the Italian Society of Internal Medicine and its Ultrasound Study Group has been holding a Summer School and training courses in ultrasound for residents in internal medicine. A national network of schools in bedside ultrasound was then organized for internal medicine specialists who want to learn this technique. Because bedside ultrasound is a user-dependent diagnostic method, it is important to define the limits and advantages of different new ultrasound devices, to classify them (i.e. Echoscopy and Point of Care Ultrasound), to establish appropriate different levels of competence and to ensure their specific training. In this review, we describe the point of view of the Italian Internal Medicine Society on these topics.
Reyes, Juan A; Greenberg, Larrie; Amdur, Richard; Gehring, James; Lesky, Linda G
Continuity is critical for safe patient care and its absence is associated with adverse outcomes. Continuity requires handoffs between physicians, but most published studies of educational interventions to improve handoffs have focused primarily on residents, despite interns expected to being proficient. The AAMC core entrustable activities for graduating medical students includes handoffs as a milestone, but no controlled studies with students have assessed the impact of training in handoff skills. The purpose of this study was to assess the impact of an educational intervention to improve third-year medical student handoff skills, the durability of learned skills into the fourth year, and the transfer of skills from the simulated setting to the clinical environment. Trained evaluators used standardized patient cases and an observation tool to assess verbal handoff skills immediately post intervention and during the student's fourth-year acting internship. Students were also observed doing real time sign-outs during their acting internship. Evaluators assessed untrained control students using a standardized case and performing a real-time sign-out. Intervention students mean score demonstrated improvement in handoff skills immediately after the workshop (2.6-3.8; p < 0.0001) that persisted into their fourth year acting internship when compared to baseline performance (3.9-3.5; p = 0.06) and to untrained control students (3.5 vs. 2.5; p < 0.001, d = 1.2). Intervention students evaluated in the clinical setting also scored higher than control students when assessed doing real-time handoffs (3.8 vs. 3.3; p = 0.032, d = 0.71). These findings should be useful to others considering introducing handoff teaching in the undergraduate medical curriculum in preparation for post-graduate medical training. Trial Registration Number NCT02217241.
Background Community-based education (CBE) can provide contextual learning that addresses manpower scarcity by enabling trainees acquire requisite experiences, competence, confidence and values. In Uganda, many health professional training institutions conduct some form of community-based education (CBE). However, there is scanty information on the nature of the training: whether a curriculum exists (objectives, intended outcomes, content, implementation strategy), administration and constraints faced. The objective was to make a comprehensive assessment of CBE as implemented by Ugandan health professional training institutions to document the nature of CBE conducted and propose an ideal model with minimum requirements for health professional training institutions in Uganda. Methods We employed several methods: documentary review of curricula of 22 institutions, so as to assess the nature, purpose, outcomes, and methods of instruction and assessment; site visits to these institutions and their CBE sites, to assess the learning environment (infrastructure and resources); in-depth interviews with key people involved in running CBE at the institutions and community, to evaluate CBE implementation, challenges experienced and perceived solutions. Results CBE was perceived differently ranging from a subject, a course, a program or a project. Despite having similar curricula, institutions differ in the administration, implementation and assessment of CBE. Objectives of CBE, the curricula content and implementation strategies differ in similar institutions. On collaborative and social learning, most trainees do not reside in the community, though they work on group projects and write group reports. Lectures and skills demonstrations were the main instruction methods. Assessment involved mainly continuous assessment, oral or written reports and summative examination. Conclusion This assessment identified deficiencies in the design and implementation of CBE at several health
Vaughan, L. Preseason strength and flexibility imbalances associated with athletic injuries in female collegiate athletes . American Journal of Sports...Medicine, 19:76-81, 1991. One hundred thirty-eight female collegiate athletes , participating in eight weight bearing varsity sports, were...the body. These data demonstrate that specific strength and flexibility imbalances are associated with lower extremity injuries in female collegiate
An objective of the Department of State's Foreign Service Institute (FSI) in its agenda for change is diplomacy for global competitiveness (DGC). For the language school, this means training to enable students to actively and skillfully represent the United States abroad, take leadership roles furthering U.S. competitiveness, understand the target…
Marylhurst Coll., OR.
The Institute was held for school librarians who had experience in organizing and administering the printed media programs, but needed training in selection, organization and use of non-book materials, under a grant from the U.S. Office of Education. The criteria for selection of particpants required eight semester hours of library science, one…
Education is the main resource for obtaining employment for young people entering the labor market. European countries differ widely in the institutional structure of their education and training systems and labor markets in that different resources are provided to school-leavers entering into working life in different countries and these new…
Coppus, Sjors FPJ; Emparanza, Jose I; Hadley, Julie; Kulier, Regina; Weinbrenner, Susanne; Arvanitis, Theodoros N; Burls, Amanda; Cabello, Juan B; Decsi, Tamas; Horvath, Andrea R; Kaczor, Marcin; Zanrei, Gianni; Pierer, Karin; Stawiarz, Katarzyna; Kunz, Regina; Mol, Ben WJ; Khan, Khalid S
Background Over the last years key stake holders in the healthcare sector have increasingly recognised evidence based medicine (EBM) as a means to improving the quality of healthcare. However, there is considerable uncertainty about the best way to disseminate basic knowledge of EBM. As a result, huge variation in EBM educational provision, setting, duration, intensity, content, and teaching methodology exists across Europe and worldwide. Most courses for health care professionals are delivered outside the work context ('stand alone') and lack adaptation to the specific needs for EBM at the learners' workplace. Courses with modern 'adaptive' EBM teaching that employ principles of effective continuing education might fill that gap. We aimed to develop a course for post-graduate education which is clinically integrated and allows maximum flexibility for teachers and learners. Methods A group of experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions from eight European countries participated. We used an established methodology of curriculum development to design a clinically integrated EBM course with substantial components of e-learning. An independent European steering committee provided input into the process. Results We defined explicit learning objectives about knowledge, skills, attitudes and behaviour for the five steps of EBM. A handbook guides facilitator and learner through five modules with clinical and e-learning components. Focussed activities and targeted assignments round off the learning process, after which each module is formally assessed. Conclusion The course is learner-centred, problem-based, integrated with activities in the workplace and flexible. When successfully implemented, the course is designed to provide just-in-time learning through on-the-job-training, with the potential for teaching and learning to directly impact on practice. PMID:18042271
Duncan, Gregg A.; Lockett, Angelia; Villegas, Leah R.; Almodovar, Sharilyn; Gomez, Jose L.; Flores, Sonia C.; Tigno, Xenia T.
Rationale: Committed to its mission of conducting and supporting research that addresses the health needs of all sectors of the nation's population, the Division of Lung Diseases, National Heart, Lung, and Blood Institute of the National Institutes of Health (NHLBI/NIH) seeks to identify issues that impact the training and retention of underrepresented individuals in the biomedical research workforce. Objectives: Early-stage investigators who received grant support through the NIH Research Supplements to Promote Diversity in Health Related Research Program were invited to a workshop held in Bethesda, Maryland in June, 2015, in order to (1) assess the effectiveness of the current NHLBI diversity program, (2) improve its strategies towards achieving its goal, and (3) provide guidance to assist the transition of diversity supplement recipients to independent NIH grant support. Methods: Workshop participants participated in five independent focus groups to discuss specific topics affecting underrepresented individuals in the biomedical sciences: (1) Socioeconomic barriers to success for diverse research scientists; (2) role of the academic research community in promoting diversity; (3) life beyond a research project grant: non–primary investigator career paths in research; (4) facilitating career development of diverse independent research scientists through NHLBI diversity programs; and (5) effectiveness of current NHLBI programs for promoting diversity of the biomedical workforce. Measurements and Main Results: Several key issues experienced by young, underrepresented biomedical scientists were identified, and solutions were proposed to improve on training and career development for diverse students, from the high school to postdoctoral trainee level, and address limitations of currently available diversity programs. Although some of the challenges mentioned, such as cost of living, limited parental leave, and insecure extramural funding, are also likely faced by
Klein, Michael; Reynolds, J. L.; Boucher, Francois; Malus, Michael; Rosenberg, Ellen
Family practice obstetricians are an endangered species. Our practices and teaching sites must provide the correct attitudinal as well as technical messages to result in a practitioner who will be able to meet the psychosocial and medical needs of the pregnant couple. Family practice obstetrics can be as safe as care given by obstetricians provided that the family practice group functions well, that obstetrical consultants are available and supportive, and assuming that technical approaches are reserved for those truly in need. In rural areas, obstetrical ability is essential, whilst in the urban setting it helps the family physician maintain a practice involving young families. Those trainees who fail to learn basic obstetrical skills (including family centered attitudes and approaches) may in any setting come to feel, belatedly, that their training programs failed in this respect. PMID:21279123
Eymann, Alfredo; Perez, Lucía; Busaniche, Julio; Cacchiarelli, Nicolás; Ceriani Cernadas, Clara; Wahren, Carlos
Research is important during university education. The objective was to describe the teaching of an exercise in clinical research and its perception by students. Medical students conducted a research work in groups coordinated by a tutor. We evaluated the importance the students gave to research learning and we assessed the satisfaction of having participated in the activity in a scale from 1 to 10. Eighty-one students developed 14 research exercises, 44.4% reported having received training in research methodology before and 11.1% had participated in some research study. They assigned a score of 8 out of 10 to the importance of research and 9 out of 10 to the satisfaction of having participated in the activity. The aspects of the exercise in clinical research perceived as positive were that it favoured teamwork and helped students to understand how to conduct a research study.
Blajchman, Morris A; Glynn, Simone A; Josephson, Cassandra D; Kleinman, Steve H
The use of blood products to support patients undergoing the large variety of medical and surgical interventions requiring such support has continued to escalate very significantly over time. Relevantly, significant practice variation in the use of blood products exists among practitioners and institutions, largely because of the lack of robust clinical trial data, in many instances, which are critical for providing practitioners with evidence-based guidelines for appropriate blood product utilization. Recognizing this gap, the National Heart, Lung, and Blood Institute recently established a State-of-the-Science Symposium to help define areas of clinical trial research that would enhance the opportunity for developing appropriate practice guidelines for both Transfusion Medicine and Hemostasis/Thrombosis. Such a Symposium was held in September 2009 to identify important clinical trial research issues in these 2 subject areas of endeavor. The aims of this Symposium were to specifically identify phase 2 and 3 clinical trials that, if conducted over the next 5 to 10 years, could impact the treatment of patients with hemostatic and other disorders as well as to optimize the use of blood products in patients who need such interventions. This article reports on the deliberations that were held relating to the various clinical trial concepts developed by 7 Transfusion Medicine subcommittees. This Symposium generated a rich assortment of clinical trial proposals that will undergo further refinement before final implementation into pilot or full randomized clinical trials. The various proposals identified many opportunities for clinical trial research and most importantly underscored the ongoing need for well-developed evidence-based clinical trial research in the field of Transfusion Medicine.
Choi, Mehee; Fuller, Clifton D.; Thomas, Charles R.
Purpose: Advancement in academic radiation oncology is largely contingent on research productivity and the perceived external influence of an individual's scholarly work. The purpose of this study was to use the Hirsch index (h-index) to estimate the research productivity of current radiation oncology faculty at U.S. academic institutions between 1996 and 2007. Methods and Materials: We performed bibliometric citation database searches for available radiation oncology faculty at domestic residency-training institutions (n = 826). The outcomes analyzed included the total number of manuscripts, total number of citations, and the h-index between 1996 and 2007. Analysis of overall h-index rankings with stratification by academic ranking, junior vs. senior faculty status, and gender was performed. Results: Of the 826 radiation oncologists, the mean h-index was 8.5. Of the individuals in the top 10% by the h-index, 34% were chairpersons, 88% were senior faculty, and 13% were women. A greater h-index was associated with a higher academic ranking and senior faculty status. Recursive partitioning analysis revealed an h-index threshold of 15 (p <0.0001) as an identified breakpoint between the senior and junior faculty. Overall, women had lower h-indexes compared with men (mean, 6.4 vs. 9.4); however, when stratified by academic ranking, the gender differential all but disappeared. Conclusion: Using the h-index as a partial surrogate for research productivity, it appears that radiation oncologists in academia today comprise a prolific group, however, with a highly skewed distribution. According to the present analysis, the h-index correlated with academic ranking. Thus, it potentially has utility in the process of promotion decisions. Overall, women in radiation oncology were less academically productive than men; the possible reasons for the gender differential are discussed.
Smoking is still a common habit in Poland. Nowadays, it is the way of coping with stress, it is used to become calm. It is also widely accepted by people from various backgrounds included medicine environment. Unfortunately, the number of young people--tobacco addicts is increasing. Survey proceeding in University implementing of the health promotion's program was to estimate the phenomenon of spreading smoking cigarettes among the students and accomplishing their knowledge and awareness about threats resulting from tobacco smoking. The study was performed among 501 students. They answered questions concerning smoking and knowledge about nicotine dependence. The research touched such questions as conviction about damage caused by smoking, the source of information, causes and effects of smoking, about environment whether they are, the interviewee's smoking preventive activities. Implanting health promotion's program is an interdisciplinary subject which glue together such sciences as medicine, psychology, sociology, social politics and many others.
Ford Carleton, Penny; Parrish, John A.; Collins, John M.; Crocker, J. Benjamin; Dixon, Ronald F.; Edgman-Levitan, Susan; Lewandrowski, Kent B.; Stahl, James E.; Klapperich, Catherine; Cabodi, Mario; Gaydos, Charlotte A.; Rompalo, Anne M.; Manabe, Yukari; Wang, Tza-Huei; Rothman, Richard; Geddes, Chris D.; Widdice, Lea; Jackman, Joany; Mathura, Rishi A.; Lash, Tiffani Bailey
To advance the development of point-of-care technology (POCT), the National Institute of Biomedical Imaging and Bioengineering established the POCT Research Network (POCTRN), comprised of Centers that emphasize multidisciplinary partnerships and close facilitation to move technologies from an early stage of development into clinical testing and patient use. This paper describes the POCTRN and the three currently funded Centers as examples of academic-based organizations that support collaborations across disciplines, institutions, and geographic regions to successfully drive innovative solutions from concept to patient care. PMID:27730014
Training Home Economists for Rural Development. Report of a Global Study on the Development of Criteria for Establishing Training Institutions for Home Economics Staff in Rural Development. FAO Economic and Social Development Paper 6.
Cornell Univ., Ithaca, NY.
In 1973 a global study aimed toward the development of criteria for establishing institutions for training home economists for rural development programs was initiated by the Home Economics and Social Programmes Services of the Food and Agriculture Organization of the U.N. As a first step, a survey was developed on the variety of roles appropriate…
Hackney, Anthony Carl
The Overtraining Syndrome (OTS) is a physically debilitating medical condition that results in athletes being totally compromised in their capacity to perform and compete. Many physiological systems are affected by the process of overtraining and the development of the OTS which results from it; but one system in particular, the immune, is highly susceptible to degradation resulting in a reduction in overall health and physical performance. The aim of this paper is to review; 1) the evidence-based proactive steps and actions to take to greatly reduce the risk of development of an infection or a compromised immune system in athletes; and 2) the course of action for clinicians to take when they are dealing with an athlete displaying overt signs of an infection and, or inflammation. Evidenced reported here within support that it is essential for clinicians to take practical preventative and management steps - actions with athletes (involved in intensive exercise training) in order to help preserve and maintain a healthy and robust immune system if they are going to perform optimally.
Calhoun, Byron C; Goode, Jeff; Simmons, Kathy
Application of Six-Sigma methodology and Change Acceleration Process (CAP)/Work Out (WO) tools to track pap smear results in an outpatient clinic in a hospital-based residency-training program. Observational study of impact of changes obtained through application of Six-Sigma principles in clinic process with particular attention to prevention of sentinel events. Using cohort analysis and applying Six-Sigma principles to an interactive electronic medical record Soarian workflow engine, we designed a system of timely accession and reporting of pap smear and pathology results. We compared manual processes from January 1, 2007 to February 28, 2008 to automated processes from March 1, 2008 to December 31, 2009. Using the Six-Sigma principles, CAP/WO tools, including "voice of the customer" and team focused approach, no outlier events went untracked. Applying the Soarian workflow engine to track prescribed 7 day turnaround time for completion, we identified 148 pap results in 3,936, 3 non-gynecological results in 15, and 41 surgical results in 246. We applied Six-Sigma principles to an outpatient clinic facilitating an interdisciplinary team approach to improve the clinic's reporting system. Through focused problem assessment, verification of process, and validation of outcomes, we improved patient care for pap smears and critical pathology.
Tabriziani, Hossein; Hatcher, Myron; Heetebry, Irene
Medicine Department Safe training is a computer based review program named de'medici and it is an employee training program. This annual review packet serves as a generic training tool. All health-care providers with direct patient care are required by state law to complete a group of 11 modules and pass a mandatory training test to assess proficiency in these areas. They include emergency preparedness, life and fire safety, electrical safety, working safety with hazardous materials, back safety, violence in the workplace, latex allergy prevention, preventing TB in the workplace, preventing AIDS and hepatitis B and C in the workplace, radiation safety, and age related care for health-care workers.
Orozco, Allan; Morera, Jessica; Jiménez, Sergio; Boza, Ricardo
Today, Bioinformatics has become a scientific discipline with great relevance for the Molecular Biosciences and for the Omics sciences in general. Although developed countries have progressed with large strides in Bioinformatics education and research, in other regions, such as Central America, the advances have occurred in a gradual way and with little support from the Academia, either at the undergraduate or graduate level. To address this problem, the University of Costa Rica's Medical School, a regional leader in Bioinformatics in Central America, has been conducting a series of Bioinformatics workshops, seminars and courses, leading to the creation of the region's first Bioinformatics Master's Degree. The recent creation of the Central American Bioinformatics Network (BioCANET), associated to the deployment of a supporting computational infrastructure (HPC Cluster) devoted to provide computing support for Molecular Biology in the region, is providing a foundational stone for the development of Bioinformatics in the area. Central American bioinformaticians have participated in the creation of as well as co-founded the Iberoamerican Bioinformatics Society (SOIBIO). In this article, we review the most recent activities in education and research in Bioinformatics from several regional institutions. These activities have resulted in further advances for Molecular Medicine, Agriculture and Biodiversity research in Costa Rica and the rest of the Central American countries. Finally, we provide summary information on the first Central America Bioinformatics International Congress, as well as the creation of the first Bioinformatics company (Indromics Bioinformatics), spin-off the Academy in Central America and the Caribbean.
The Department of Energy (DOE) proposes to authorize the University of Medicine and Dentistry of New Jersey to proceed with the design, construction, and equipping of the proposed Clinical Treatment and Research Facility of the University of New Jersey on the New Brunswick campus. The facility will provide for the integration of new and existing clinical outpatient cancer treatment with basic and clinical research to expedite the application of new discoveries in cancer treatment. Based on the analysis in the environmental assessment, DOE has determined that the proposed action is not a major Federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act (NEPA).
Li, Aihua; Meyre, David
The rapid decline of sequencing costs brings hope that personal genome sequencing will become a common feature of medical practice. This series of three reviews aim to help non-geneticist clinicians to jump into the fast-moving field of personalized genetic medicine. In the first two articles, we covered the fundamental concepts of molecular genetics and the methodologies used in genetic epidemiology. In this third article, we discuss the evolution of personalized medicine and illustrate the most recent success in the fields of Mendelian and complex human diseases. We also address the challenges that currently limit the use of personalized medicine to its full potential. PMID:25598768
The Establishment of the First Cancer Tissue Biobank at a Hispanic-Serving Institution: A National Cancer Institute–Funded Initiative between Moffitt Cancer Center in Florida and the Ponce School of Medicine and Health Sciences in Puerto Rico
Flores, Idhaliz; Muñoz-Antonia, Teresita; Matta, Jaime; García, Miosotis; Fenstermacher, David; Gutierrez, Sylvia; Seijo, Edward; Torres-Ruiz, Jose’; Pledger, W. Jack
Population-based studies are important to address emerging issues in health disparities among populations. The Partnership between the Moffitt Cancer Center (MCC) in Florida and the Ponce School of Medicine and Health Sciences (PSMHS) in Puerto Rico (the PSMHS-MCC Partnership) was developed to facilitate high-quality research, training, and community outreach focusing on the Puerto Rican population in the island and in the mainland, with funding from the National Cancer Institute. We report here the establishment of a Tissue Biobank at PSMHS, modeled after the MCC tissue biorepository, to support translational research projects on this minority population. This facility, the Puerto Rico Tissue Biobank, was jointly developed by a team of basic and clinical scientists from both institutions in close collaboration with the administrators and clinical faculty of the tissue accrual sites. The efforts required and challenges that needed to be overcome to establish the first functional, centralized cancer-related biobank in Puerto Rico, and to ensure that it continuously evolves to address new needs of this underserved Hispanic population, are described. As a result of the collaborative efforts between PSMHS and MCC, a tissue procurement algorithm was successfully established to acquire, process, store, and conduct pathological analyses of cancer-related biospecimens and their associated clinical-pathological data from Puerto Rican patients with cancer recruited at a tertiary hospital setting. All protocols in place are in accordance with standard operational procedures that ensure high quality of biological materials and patient confidentiality. The processes described here provide a model that can be applied to achieve the establishment of a functional biobank in similar settings. PMID:24836632
The purpose of this paper is to examine the significance of recruiting underrepresented minorities in medicine (URM). This would include African Americans, Hispanics, and Native Americans. The research findings support the belief that URMs, upon graduating, are more likely to become practitioners in underserved communities, thereby becoming a resource that prompts us to find effective ways to help increase their college enrollments statewide. This paper analyzes the recruitment challenges for institutions, followed by a review of creative and effective approaches used by organizations and universities. The results have shown positive outcomes averaging a 50% increase in minority enrollments and retention. In other areas, such as cognitive development, modest gains were achieved in programs that were shorter in duration. The results nevertheless indicated steps in the right direction inspiring further program developments.
Hayes, S; Taylor, R; Paterson, A
Forensic facial approximation involves building a likeness of the head and face on the skull of an unidentified individual, with the aim that public broadcast of the likeness will trigger recognition in those who knew the person in life. This paper presents an overview of the collaborative practice between Ronn Taylor (Forensic Sculptor to the Victorian Institute of Forensic Medicine) and Detective Sergeant Adrian Paterson (Victoria Police Criminal Identification Squad). This collaboration involves clay modelling to determine an approximation of the person's head shape and feature location, with surface texture and more speculative elements being rendered digitally onto an image of the model. The advantages of this approach are that through clay modelling anatomical contouring is present, digital enhancement resolves some of the problems of visual perception of a representation, such as edge and shape determination, and the approximation can be easily modified as and when new information is received.