Cameron, Brian H.; Rambaran, Madan; Sharma, Deen P.; Taylor, Robert H.
Background Like many developing countries, Guyana has a severe shortage of surgeons. Rather than rely on overseas training, Guyana developed its own Diploma in Surgery and asked for assistance from the Canadian Association of General Surgeons (CAGS). This paper reviews the initial results of Guyana’s first postgraduate training program. Methods We assisted with program prerequisites, including needs assessment, proposed curriculum, University of Guyana and Ministry of Health approval, external partnership and funding. We determined the outputs and outcomes of the program after 2 years, and we evaluated the impact of the program through a quantitative/qualitative questionnaire administered to all program participants. Results Five residents successfully completed the 2-year program and are working in regional hospitals. Another 9 residents are in the training program. Twenty-four modules or short courses have been facilitated, alternating Guyanese with visiting Canadian surgical faculty members coordinated through CAGS. A postgraduate structure, including an Institute for Health Sciences Education and Surgical Postgraduate Education Committee, has been developed at the Georgetown Public Hospital Corporation (GPHC). An examination structure similar to Canada’s has been established. Hospital staff morale is greater, surgical care is more standardized and academic opportunities have been enhanced at GPHC. Four regional hospitals have welcomed the new graduates, and surgical services have already improved. Canadian surgeons have a greater understanding of and commitment to surgical development in low-income countries. Conclusion Guyana has proven that, with visiting faculty assistance, it can mount its own postgraduate training suitable to national needs and will provide a career path to encourage its own doctors to remain and serve their country. PMID:20100407
Pollett, William G; Waxman, Bruce P
Canada and Australia share similar cultural origins and current multicultural societies and demographics but there are differences in climate and sporting pursuits. Surgeons and surgeon teachers similarly share many of the same challenges, but the health care and health-care education systems differ in significant ways. The objective of this review is to detail the different postgraduate surgical training programs with a focus on general surgery and how the programs of each country may benefit from appreciating the experiences of the other. The major differences relate to entry requirements, the role of universities in governance of training, mandatory skills courses in early training, the accreditation process, remuneration for surgical teachers and the impact of private practice. Many of the differences are culturally entrenched in their respective medical systems and unlikely to change substantially. Direct entry into specialty training without an internship per se is now firmly established in Canada just as delayed entry after internship is mandated by the Australian Medical Board. Both recognize the importance of establishing goals and objectives, modular curricular and the emerging role of online educational resources and how these may impact on assessments. The Royal Australasian College of Surgeons is unlikely to cede much responsibility to the universities but alternative academic models are emerging. Private health care in the two countries differs, but there are increasing opportunities for training in the private sector in Australia. In spite of the differences, both provide excellent health care and surgical training opportunities in an environment with significant fiscal, technological and societal challenges.
Surgical care is recognized as an important component of public health, however, many low- and middle- income countries (LMICs) are faced with a shortage of trained personnel. In response to this unmet need, many countries have developed local postgraduate training programs in surgery. This study aims to characterize general surgery postgraduate education in LMICs. PubMed, EMBASE, and Global Index Medicus databases were searched for articles related to postgraduate general surgery education in LMICs. Studies in other surgical specialties and those published prior to 1990 were excluded. Data were collected on the characteristics of postgraduate training programs. Sixty-four articles discussed postgraduate surgical education in LMICs. Programs in 34 different countries and 6 different regions were represented. Nine countries were low-income, 12 were low-middle-income, and 13 were upper-middle-income countries. Sixty-four articles described aspects of the local postgraduate training program. Prior to postgraduate training, residents complete an undergraduate medical degree with 19 programs describing a pre-training experience such as internship. Surgical curricula were broad-based to prepare trainees to work in low-resource settings. At the completion of postgraduate training, examination formats varied including oral, written, and clinical exams. Postgraduate general surgery programs ranged from 2.5 to 7 years. Postgraduate surgical education is one mechanism to increase surgical capacity in LMICs. Different strategies have been employed to improve surgical education in LMICs and learning from these programs can optimize surgical education across teaching sites.
Beer, André-Michael; Fey, Stefan; Siebolds, Marcus; Kiwitt, Paul
Following structured forms of postgraduate training, which are already in use internationally, there are more and more reports on operationalised procedures of postgraduate training in Germany as well. The transparency, which is required by law in order to make medical postgraduate training demonstrable in terms of Sect. 8 of the new regulation on postgraduate training, creates a demand for evaluations. However, only 10 to 20% of the participants in postgraduate training use these evaluations to demonstrate their results scientifically. The aim of the present paper was to show that--with regard to content--the conceptual integration of operationalised programmes for postgraduate training is able to compensate for the given limited time frames and formally tightened structures of postgraduate training in the sense of the quality assurance required by the legislator. The evaluation showed that this can be made possible through ensuring the participants' satisfaction and achieving the goals of postgraduate training.
This review traces the evolution of modern medical education in India on the one hand and the formation of the Indian Psychiatric Society and the progress of postgraduate psychiatric education on the other hand, all in the context of Indian psychiatry. The topic is covered under the headings standard of psychiatric education, the goals, competencies required, impact of psychiatric disorders, relation of medicine to psychiatry, and the directions for the future of postgraduate psychiatric training. PMID:21836724
This three-year study of research training policy and practice involved government and university executives, and university academics from the Philippines. A total of 53 participants were involved: two officials from the Commission on Higher Education, six directors of research centres, 28 university executives and 17 academic staff. Seven public…
Alotaibi, Fawaz S
This paper presents a review to explore the literature focusing on portfolio in postgraduate general practice (GP) training, and to examine the impact of implementation of portfolio on learning process, as well as proposing recommendations for its implementation in postgraduate GP training. An electronic search was carried out on several databases for studies addressing portfolio in postgraduate GP training. Six articles were included to address specifically the effectiveness of portfolio in postgraduate GP training. Five of them described successful experiences of portfolio-based learning implementation. Only one article addressed portfolio-based assessment in postgraduate GP training. The existing evidence provides various benefits of professional portfolio-based learning. It does appear to have advantages of stimulating reflective learning, promoting proactive learning, and bridging the hospital experiences of the learners to GP. Moreover, the challenges to implementation of portfolio-based learning are often based on orientation and training of stakeholders.
Alloni, Rossana; Binetti, Paola; Coppola, Roberto; Arullani, Augusto
The Postgraduate Surgical education is in an era of transition, in order to create physicians with skills and attitudes needed by modern health care. Many studies have examined the impact of surgical tutoring in surgical residency programs in USA Medical Schools, while few experiences are reported from European Universities. The new Italian guidelines for post-graduate education require a structured clinical learning with the supervision of a tutor ("attending surgeon" for surgical residency); it is a challenge to describe the role of this teacher and educator, and to implement an effective evaluation of operating room teachers. Confidential survey was administered to 14 surgical residents of the Authors' University. Questions were related to their surgical activity and their perception of educational role of tutors in operating room and tutors' teaching behaviors. Residents pointed out five behaviors they perceive as signs of tutor excellence in clinical and operating room setting. According with studies from other Universities, residents need a tutor with competency but also with good teaching skills and a mature self-perception as educator. Faculty would provide training programs for surgeons in order to improve their teaching skills and behaviors.
Hussaini, Sobia S; Bushardt, Reamer L; Gonsalves, Wanda C; Hilton, Virginia O; Hornberger, Brad J; Labagnara, Frank A; OʼHara, Kevin M; Sasek, Cody; Smith, Benjamin J; Williams, Jennifer S
No consensus definition exists for postgraduate physician assistant (PA) training. This report from the AAPA Task Force on Accreditation of Postgraduate PA Training Programs describes the types of clinical training programs and their effects on hiring and compensation of PAs. Although completing a postgraduate program appears to have no effect on compensation, PAs who complete these programs may be favored in the hiring process and frequently report greater confidence in their skills. More research is needed and program accreditation is key to monitoring the effectiveness of these programs.
Rashid, Prem; Narra, Maruthi; Woo, Henry
Surgical mentors have helped trainees develop fulfilling and academically productive careers, while supervisors are formally assigned to impart skills and oversee training. This paper reviews the comparative roles of the supervisor and mentor and how they overlap, while exploring the impact of the 'unknown' mentor. While the supervisor's role in directing the student is formally recognized, the mentee will personally select a mentor who successfully models the career and life balance to which the mentee aspires. The unknown mentor is known only to the mentee. The mentee's commitment to communicating with both mentor and supervisor is crucial to success. Better processes can be used to guide the mentor relationship. Confusion between the two roles - mentor and supervisor - is due to their complementary nature as well as an overlap in roles. Both remain essential to the growth and development of the surgical trainee. The unknown mentor could give detached advice and guidance to the student, while acting as a positive role model.
Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar
Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.
Brazin, Lillian R
This is the biennial update listing directories, journal articles, Web sites, and general books that aid the librarian, house officer, or medical student in finding information on medical residency and fellowship programs. The World Wide Web provides the most current and complete source of information about postgraduate training programs and specialties. This update goes beyond postgraduate training resources to include selected Web sites and books on resume writing, practice management, personal financial issues, the "Match," exam preparation, job hunting, and the DEA license application process. Print resources are included if they provide information not on the Internet or have features that are particularly useful. The Internet continues to be a major marketing tool for hospitals seeking to recruit the best and brightest for their residency and fellowship programs. Even the smallest community hospital usually has a presence on the 'Net.
Sayana, M K; Ashraf, M; O'Byrne, J
Traditionally, the UK and Ireland have followed the same postgraduate surgical training of orthopaedic surgeons. Modernising medical careers (MMC) and European Working Time Directive (EWTD) have radically changed the way surgical training is delivered in the UK. In Ireland, however, the traditional structure of surgical training system continues with an emphasis to modernise the training with more objective assessment tools. The aim of this review is to highlight the current differences in the higher surgical training in Orthopaedics in the UK and Ireland.
Teshome, Mediget; Kuerer, Henry M
Breast surgical oncology is a defined sub-specialty of general surgery with focus on the surgical management of breast disease and malignancy within a multidisciplinary context. Much of the training of breast surgical oncologists in the United States exists within a fellowship training structure with oversight and approval by the Society of Surgical Oncology (SSO). Rapid continuous changes in breast oncology practice have further substantiated dedicated expertise in breast surgical oncology. Training programs are structured to develop proficiency in fellows for advanced surgical techniques and clinical decision-making as well as exposure to the multidisciplinary aspects of breast cancer management. Components of a successful program include an intense multidisciplinary curriculum, engagement in clinical research and attention to strong mentorship. National curriculum and training requirements as well as supplemental resources assist in standardizing the fellowship experience. As surgical training and the field of breast oncology continues to evolve, so do fellowship training programs to ensure high quality breast surgical oncologists equipped to deliver high quality evidence based patient care while continuing to drive future research and trainee education.
Stringer, Mark D; Lyall, Patrick
After careful planning, a postgraduate Diploma in Surgical Anatomy was launched in 2009. This report describes the structure of the program, the challenges encountered in implementing and running the course, and results of evaluations. The qualification is targeted at junior doctors intending to become surgeons or radiologists and aims to equip them with a sound understanding of regional anatomy relevant to common diagnostic and therapeutic procedures, together with an understanding of common/important anatomical variations. The course is delivered by: (1) 24 weeks' distance learning, comprising selected readings, podcasts, multiple choice questions (MCQs), and research informed essays; and (2) two separate two-week periods of intensive campus-based learning and whole body dissection (four students per cadaver) assessed by oral examination, a class presentation of an anatomical variation, and formal MCQ examination. Campus-based instruction is delivered by two surgical anatomists with additional input from a broad range of specialist surgeons and radiologists. Anonymous student evaluations over three successive courses show that all components of the course were highly rated. The success of the program may relate to several factors: an emphasis on clinically relevant anatomy, clear learning objectives, personalized student feedback, a low student to cadaver ratio, restricted class size, a wide range of supportive material, a dedicated team of surgical/radiological instructors, efficient course administration, and endorsement by the Royal Australasian College of Surgeons. Establishing a Diploma in Surgical Anatomy program requires a dedicated team of individuals, the setting and maintenance of appropriate educational standards, and collaboration with the professional body regulating the training of surgeons.
Stringer, Mark D.; Lyall, Patrick
After careful planning, a postgraduate Diploma in Surgical Anatomy was launched in 2009. This report describes the structure of the program, the challenges encountered in implementing and running the course, and results of evaluations. The qualification is targeted at junior doctors intending to become surgeons or radiologists and aims to equip…
Schneider, Jorge; Wilkerson, Douglas; Solomon, Brenda; Perlman, Caryle; Duval, Denise; Shelby, Dennis; Witten, Molly
This exploratory study looks at the training and postgraduate experience of the 2008-2014 graduates of the Chicago Institute for Psychoanalysis. It follows our former study of all living graduates through the year 2007 (Schneider et al., 2014). The survey developed and used in the first study, with a few additional questions added to increase our understanding of the training experience, was sent to 38 graduates with a return rate of 58%. As with the first survey, graduates were invited to assess, among other training experiences, their training analysis, classroom work, and supervision, and to tell of their post-graduation involvement in teaching, supervising, study groups and other professional endeavors. They were also asked to rate their satisfaction with themselves as psychoanalysts and with their analytic career. The questions added to the previous survey related to the graduates' theoretical orientation, the influence on their training experiences of the change in gender distribution, and of the diversity of professions now represented in the analytic training program. They were also encouraged to provide spontaneous narrative data. The data from our second survey showed important differences when compared with our first. In the first survey male respondents were in the majority; in the second, women held the majority. Of the professions represented in the training program, psychiatry was the majority in the first survey, psychology and social work held the majority in the second. Most respondents claimed an object-relation theoretical orientation. Analytic immersion continues to decrease, with most respondents having two patients at the time of graduation and one at the time of the survey.
Bosman, Fred T; van den Tweel, Jan G
With the free movement of people in the European Union, medical mobility has increased significantly. This is notably the case for disciplines for which shortage of well-trained staff has occurred. Pathology is among those specialties and effectively the discipline is confronted with a striking increase in mobility among trainees and qualified specialists. The presumption underlying unlimited mobility is that the competencies of the medical specialists in the European countries are more or less equal, including significant similarities in the postgraduate training programs. In order to assess whether reality corresponds with this presumption, we conducted a survey of the content and practice requirements of the curricula in the EU and affiliated countries. The results indicate a striking heterogeneity in the training program content and practice requirements. To name a few elements: duration of the training program varied between 4 and 6 years; the number of autopsies required varied between none at all and 300; the number of biopsies required varied between none at all and 15,000. We conclude that harmonization of training outcomes in Europe is a goal that needs to be pursued. This will be difficult to reach through harmonization of training programs, as these are co-determined by political, cultural, and administrative factors, difficult to influence. Harmonization might be attained by defining the general and specific competencies at the end of training and subsequent testing them through a test to which all trainees in Europe are subjected.
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
Dydykin, Sergey; Kapitonova, Marina
Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia.
Postgraduate medical education and training in many specialties, including Clinical Radiology, is undergoing major changes. In part this is to ensure that shorter training periods maximise the learning opportunities but it is also to bring medical education in line with broader educational theory. Learning outcomes need to be defined so that there is no doubt what knowledge, skills, attitudes and behaviours are expected of those in training. Curricula should be developed into competency or outcome based models and should state the aims, objectives, content, outcomes and processes of a training programme. They should include a description of the methods of learning, teaching, feedback and supervision. Assessment systems must be matched to the curriculum and must be fair, reliable and valid. Workplace based assessments including the use of multisource feedback need to be developed and validated for use during radiology training. These should be used in a formative and developmental way, although the overall results from a series of such assessments can be used in a more summative way to determine progress to the next phase of training. Formal standard setting processes need to be established for ‘high stakes’ summative assessments such as examinations. In addition the unique skills required of a radiologist in terms of image interpretation, pattern recognition, deduction and diagnosis need to be evaluated in robust, reliable and valid ways. Through a combination of these methods we can be assured that decisions about trainees’ progression through training is fair and standardised and that we are protecting patients by establishing national standards for training, curricula and assessment methods. PMID:21614310
Leser, Casey P; Jepsen, Shawn A
Performing surgical procedures on the mandible can present many challenges due to the anatomy and the limited access available to the various areas of the mandibular arch. The experience of the surgeon and the complexity of the surgery must be considered before attempting treatment. A static mandibular training model provides dentists with the opportunity to practice multiple surgical procedures to develop the skills that are necessary to treat patients competently and comprehensively. The mandible's unique anatomy presents a number of challenges when performing surgical procedures. A surgical model that makes it possible to practice multiple techniques benefits the surgeon by building the confidence to attempt more complex surgical procedures and thus provide patients with additional treatment options. This mandibular surgical model serves as a learning tool and provides an avenue for learning different surgical techniques that may be performed in various areas of the mandible. A number of procedures can be performed on the model, including the extraction of third molars, incision and drainage of a vestibular/buccal swelling, excisional biopsy of intrabony lesions, tori removal, initial implant alignment procedures, and suturing/flap designs. A number of these procedures can be performed on one model.
Borel-Rinkes, Inne H M; Gouma, Dirk J; Hamming, Jaap F
Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nationwide programme has been modernized further and now involves a systematic, competency-based education with structural training courses, formalized assessment and room for reflection by residents under the supervision of surgical teaching groups. To this end, a uniform web-based digital portfolio is being introduced to facilitate monitoring of the individual resident's progress. Though requiring inspirational leadership, commitment, and determination, this modernization has sparked enthusiasm among trainees and teachers.
Lester, S E; Robson, A K R
Lesson plans in surgery enable trainers and trainees to agree on goals that balance training needs with service commitments. Lesson plans are individualised to the trainee and encourage ownership of learning. They are based on SMART criteria and therefore have a sound educational footing. Most of the work in creating a lesson plan falls to the trainee. The total time for creation of each plan is approximately 20 min. Our use of lesson plans for surgical training has been met with favourable response from both trainer and trainees.
Sinn, H P; Andrulis, M; Mogler, C; Schirmacher, P
As with conventional microscopy, virtual microscopy permits histological tissue sections to be viewed on a computer screen with a free choice of viewing areas and a wide range of magnifications. This, combined with the possibility of linking virtual microscopy to E-Learning courses, make virtual microscopy an ideal tool for teaching and postgraduate training in pathology. Uses of virtual microscopy in pathology teaching include blended learning with the presentation of digital teaching slides in the internet parallel to presentation in the histology lab, extending student access to histology slides beyond the lab. Other uses are student self-learning in the Internet, as well as the presentation of virtual slides in the classroom with or without replacing real microscopes. Successful integration of virtual microscopy depends on its embedding in the virtual classroom and the creation of interactive E-learning content. Applications derived from this include the use of virtual microscopy in video clips, podcasts, SCORM modules and the presentation of virtual microscopy using interactive whiteboards in the classroom.
Kabanova, S A; Lozhkevich, I Iu
The research was held within Petrovsky National surgery center and revealed certain regularities and trends testifying the necessity of further strategic and tactic development of training of graduated specialists through the innovative optimization of effectiveness of post-graduate training of medical personnel. The inclusion of social psychological monitoring of educational process is obligatory. The implementation of sociological monitoring in any institution providing post-graduate training has to be a powerful tool for enhancing quality and efficiency of training of medical professionals. This approach presupposes modernization of training programs accounting the innovations and research data.
Schröder, W; Welcker, K
The present analyses of different surgical training systems show that training of surgical residents significantly contributes to hospital costs. These are predominantly caused by prolonged operation times of residents with increased work load for other staff members in the operating room. In addition, the productivity of surgical residents is less compared to experienced surgeons. On the other hand, hospital managements save money by the lower standard wages paid to the residents. The amount of educational costs is difficult to determine because surgical training takes place as on the job training. Therefore, from an economic point of view, the two products patient care and surgical training are difficult to separate. There are no reliable cost analyses available for the German training system. At present surgical training is indirectly financed by the DRG (diagnosis-related groups) flat rates of the health insurance. Possible options of financing the surgical training are additional funding from the health department or redistribution with supplemental payment for those surgical departments which contribute significantly more to the residents' training. Statements of medical associations, health departments and health insurances demonstrate the difficulty to come to an agreement concerning the finances of the training system. Despite this controversial discussion it should be taken into consideration that there is no alternative to a high quality surgical training as this is the basis for an effective health system.
Silvennoinen, Minna; Helfenstein, Sacha; Ruoranen, Minna; Saariluoma, Pertti
Computer-based surgical training simulators are instrumental in skill-based training and performance measurement. However, to date, the educational employment of these tools lacks empirically founded insights and effective practical guidelines. This study examined surgical residents during computer-based simulator training of basic laparoscopic…
Hirata, SoIchiro; Okawa, Yoshikazu; Sugito, Hiroki; Mataki, Shiro; Sakayori, Takaharu; Maki, Yoshinobu; Ishii, Takuo
Postgraduate clinical training for dentists has been mandatory in Japan since 2006. Hirata et al. reported that the geographic distribution of postgraduate dental trainees by prefecture in 2006 was worse than that of practicing dentists. This suggests that the postgraduate clinical training system could intensify the problem of distribution of dentists. In this study, therefore, we reviewed the geographic distribution of postgraduate dental trainees and practicing dentists between 2006 and 2010 in detail by city, ward, town and village by using the Lorenz curve and Gini coefficient. The results showed that while there was no significant worsening of geographic distribution of postgraduate dental trainees, the distribution of practicing dentists continued to deteriorate. A number of reasons may explain these findings: the clinical training system is based on a one-year employment contract, and dentists subsequently relocate as driven by the market; and geographic distribution among cities, towns and villages has worsened as a result of the merger of municipalities. The geographic distribution of practicing dentists is expected to deteriorate further if the number of dentists takes a downward turn in the future. Therefore, it is necessary to continuously review the distribution of postgraduate dental trainees.
Dhanda, Jagtar; Opie, Niel; Webster, Keith; Tanday, Ajit; Mumtaz, Shadaab; Visram, Semina
Modernising Medical Careers (MMC) is a programme for change that aims to improve the quality of patients' care through improvement in postgraduate medical education and training. Its introduction had far reaching affects and many shortcoming due to its failure to take into account the craft specialties. The aim of this paper is to illustrate the impact of MMC on oral and maxillofacial surgical (OMFS) training. An online questionnaire was distributed to OMFS trainees, and data were gathered about current position, year of training, duration and specialties worked during basic surgical training, stage of completion of examinations and courses, and overall satisfaction with training. Comparisons were made between those who had been trained before and after MMC was introduced. Ninety-five trainees (68%) responded. Of these 66 (69%) had basic surgical training before the introduction of MMC and 29 (31%) afterwards. MMC shortened overall time spent on basic surgical training of OMFS trainees by half, to only 1 year. There were similarities between the two groups in terms of the range of specialties experienced. MMC also resulted in more trainees starting higher surgical training without their Membership of the Royal College of Surgeons. There was greater satisfaction with BST for the pre-MMC group than the post-MMC group. It is hoped that the recent changes to training that were implemented after this study will address some of the shortcomings that we have identified.
Stiefel, Doris J.; Truelove, Edmond L.
A five-year project of postgraduate training in dentistry for patients with severe disabilities resulted in significant cognitive and confidence gains for the participating dentists, dental hygienists, and assistants. Over 75 percent of the graduates were found to actively apply their training, especially in academic dentistry. (MSE)
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.
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.
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
The 1978 report of the Working Group of Postgraduate Training in Clinical Oncology, convened by the World Health Organization (WHO) Regional Office for Europe in collaboration with the government of The Netherlands, is presented. The groups analyzed models of postgraduate training in clinical oncology and evaluated their suitability in relation to…
Wan, Yizhou Carl; Wan, Yize Isalina
The need for comprehensive surgical care for China's vast population is evident in improving patient treatment outcomes. Rapid economic development has meant that China has become a developing country with a unique opportunity to formulate and strategise training of its surgeons to build a firm foundation for the advancement of clinical surgery and the surgical sciences. Currently deployed within the three-tiered health care system, surgical training in China is complex. Medical school education is variable in duration from 3-8 years yet the possibility of surgical training is not open to all graduates. Postgraduate training, known as Standard Surgical Training (SST) lasts for approximately five years and is separated into two phases by the central government, however there is no central regulation of the training progression and certification is organised at a local level. Academic requirements are high and research output is mandatory at higher level training, with doctorates able to fast-track through surgical training. There are major concerns with equality and disparity in training resources and opportunities as well as actually addressing clinical needs of local patient populations. Despite this, surgical training in China is undergoing constant development and its future will prove important observations of international medical education strategies.
Sandmeier, Dominique; Bosman, Fred; Fiche, Maryse
Training future pathologists is an important mission of many hospital anatomic pathology departments. Apprenticeship--a process in which learning and teaching tightly intertwine with daily work, is one of the main educational methods in use in postgraduate medical training. However, patient care, including pathological diagnosis, often comes first, diagnostic priorities prevailing over educational ones. Recognition of the unique educational opportunities is a prerequisite for enhancing the postgraduate learning experience. The aim of this paper is to draw attention of senior pathologists with a role as supervisor in postgraduate training on the potential educational value of a multihead microscope, a common setting in pathology departments. After reporting on an informal observation of senior and junior pathologists' meetings around the multihead microscope in our department, we review the literature on current theories of learning to provide support to the high potential educational value of these meetings for postgraduate training in pathology. We also draw from the literature on learner-centered teaching some recommendations to better support learning in this particular context. Finally, we propose clues for further studies and effective instruction during meetings around a multihead microscope.
Ehses, Markus; Veith, Michael
In 1999, the International Research Training Group "GRK532" was founded as a pilot project for cross-border European postgraduate education along the German/French/Luxembourg borders. The project consists of an interdisciplinary research programme on synthesis, isolation and characterization of new materials accompanied by an ambitious…
Alexandrov, Anne W Wojner; Brethour, Mary; Cudlip, Fern; Swatzell, Victoria; Biby, Sharon; Reiner, Dana; Kiernan, Terri-Ellen; Handler, Diane; Tocco, Susan; Yang, Joanna
The Neurovascular Education and Training in Stroke Management and Acute Reperfusion Therapy (NET SMART) program for advanced practice nursing (APN) offers a first-of-its-kind, academic, postgraduate, fellowship program for APNs that is modeled after physician academic fellowship programs but supported by a flexible Internet-based platform. This article details the rationale, methods, and preliminary results of the NET SMART APN experience, which serves as a unique template for the development of academic postgraduate nursing fellowship programs across a variety of specialty practices.
For most surgeons and surgical educators, e-learning is relatively new and confusing. This article attempts to explain the key concepts behind e-learning, as well as its benefits and risks. E-learning has become a fixed feature within Higher and Professional Education and has been prioritized by Universities around the world, as well as all six Surgical Royal Colleges. Trainees have grown up with virtual learning environments and expect similar provision for their postgraduate studies, but have a greater need for basic science learning. Dispersal of trainees across duty rotas and geographically makes e-learning more attractive, but preserving peer and trainer communication is as important as content. Recent changes in surgical education and training have also made electronic and distance learning more attractive than previously. Initial work by the Colleges is now being evaluated and important lessons have emerged. The UK Department of Health has made medical e-learning a priority and it is now the largest e-learning provider in Europe. Changes in the World Wide Web, with a shift to more social-networking activity in education and to web-based delivery to small, ubiquitous portable devices will increase opportunities for surgical e-learning.
Cunningham, Wayne K; Dovey, Susan M
INTRODUCTION Since 1991 the University of Otago, Dunedin, New Zealand has offered postgraduate qualifications specifically designed to educate general practitioners (GPs) about their unique work environment. AIM To determine motivations and impacts of postgraduate education for practising GPs. METHODS Survey of the 100 graduates of the University of Otago, Dunedin postgraduate general practice programme. Ninety five living graduates were approached and 70 (73.7%) responded. Quantitative data about disposition of respondents before enrolling and after completion of the programme were analysed using chi-square and paired t-tests. Free text responses about motivations, impacts and outcomes of the program were thematically analysed. RESULTS 64 GPs graduated with a postgraduate diploma and 36 with a masters degree in general practice. Although the mean number of graduates was 3.5 and 2.0 (respectively), annual enrolments averaged 25.1. Most graduates (60.9%) were aged in their 40s when they started studying and most (94.3%) had a spouse and/or children at home. DISCUSSION This voluntary postgraduate medical education complements traditional medical training but has low external value despite personal, practising and professional benefits. Graduates valued engagement above completion of a qualification. KEYWORDS Medical education; general practitioners; scholarship; professionalism.
Nousiainen, Markku T.; Latter, David A.; Backstein, David; Webster, Fiona; Harris, Kenneth A.
This paper examines current issues concerning surgical fellowship training in Canada. Other than information from a few studies of fellowship training in North America, there are scant data on this subject in the literature. Little is known about the demographic characteristics of those who pursue fellowship training in Canada, what the experiences and expectations are of fellows and their supervisors with respect to the strengths and weaknesses of this level of training, or how this level of education fits in with Canadian undergraduate and postgraduate medical training. We summarize current knowledge about fellowship training in Canada as it pertains to demographic characteristics, finances, work hours, residency training, preparation for clinical and research work and satisfaction with training. Most information on surgical fellowship training comes from the United States. As such, we used information from American studies to supplement the Canadian data. Because a surgical fellowship experience in Canada may be different from that in the United States, we propose that Canadian surgical fellows and their supervisors should be surveyed to gain an understanding of such information. This knowledge could be used to improve surgical fellowship training in Canada. PMID:22269304
Mayer, S; van der Gaag, R J; Dom, G; Wassermann, D; Gaebel, W; Falkai, P; Schüle, C
The European Union Free Movement Directive gives professionals the opportunity to work and live within the European Union, but does not give specific requirements regarding how the specialists in medicine have to be trained, with the exception of a required minimum of 4 years of education. Efforts have been undertaken to harmonize post-graduate training in psychiatry in Europe since the Treaty of Rome 1957, with the founding of the European Union of Medical Specialists (UEMS) and establishment of a charter outlining how psychiatrists should be trained. However, the different curricula for post-graduate training were only compared by surveys, never through a systematic review of the official national requirements. The published survey data still shows great differences between European countries and unlike other UEMS Boards, the Board of Psychiatry did not introduce a certification for specialists willing to practice in a foreign country within Europe. Such a European certification could help to keep a high qualification level for post-graduate training in psychiatry all over Europe. Moreover, it would make it easier for employers to assess the educational level of European psychiatrists applying for a job in their field.
Evans, Charity H; Schenarts, Kimberly D
Training competent and professional surgeons efficiently and effectively requires innovation and modernization of educational methods. Today's medical learner is quite adept at using multiple platforms to gain information, providing surgical educators with numerous innovative avenues to promote learning. With the growth of technology, and the restriction of work hours in surgical education, there has been an increase in use of simulation, including virtual reality, robotics, telemedicine, and gaming. The use of simulation has shifted the learning of basic surgical skills to the laboratory, reserving limited time in the operating room for the acquisition of complex surgical skills".
Bobrov, V A; Davydova, I V; Bilinskiĭ, E A; Beziuk, N N; Shlykova, N A; Zaĭtseva, V I; Kozlovskiĭ, V I; Aleksandrova, L A
Described in the article is one of the forms of optimization of the instructional process in the postgraduation physician training--"business-like games". Highly skilled, competent position of the teacher who conducts a business-like game secures an active participation in learning of students, helps in opening the mind, broadening the outlook on the problem under consideration, gives much incentive to further independent work on the discussed issues.
Hetaimish, Bandar M.
Sawbones are artificial bones designed to simulate the bone architecture, as well as the bone’s physical properties. The incorporation of sawbones simulation laboratories in many orthopedic training programs has provided the residents with flexibility in learning and scheduling that align with their working hour limitations. This review paper deliberates the organization of sawbones simulation in orthopedic surgical training to enhance trainee’s future learning. In addition, it explores the implications of sawbones simulation in orthopedic surgical teaching and evaluation. It scrutinizes the suitability of practicing on sawbones at the simulation laboratory to improve orthopedic trainee’s learning. This will be followed with recommendations for future enhancement of sawbones simulation-based learning in orthopedic surgical training. PMID:27052276
Hallinan, Christine M; Hegarty, Kelsey L
The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the
Higginson, I; Corner, J
Higher research degrees, such as the PhD, MPhil and MD, have existed within universities for 80 years or more, although the differences between the MD and PhD remain confused. A higher research degree training provides individuals with greater research knowledge and skills, and benefits the specialty. Concern exists about the levels of supervision sometimes provided, failure to complete degrees, and the variable levels of research knowledge and skills attained. We propose that higher research degrees in palliative care have four functions: extending personal scholarship, generating knowledge, training for the individual and contributing to the growth of the specialty. Such an approach may include: a formalised first year with taught components such as in research MSc programmes, formal supervision and progress assessment. In palliative care, clinical and academic approaches need greater integration. Multiprofessional learning is essential. To allow individuals to undertake higher research degree programmes, fellowships or specific funding are needed.
Harries, Rhiannon L; Williams, Adam P; Ferguson, Henry J M; Mohan, Helen M; Beamish, Andrew J; Gokani, Vimal J
ASiT has long maintained that in order to provide the best quality care to patients in the UK and Republic of Ireland, it is critical that surgeons are trained to the highest standards. In addition, it is imperative that surgery remains an attractive career choice, with opportunities for career progression and job satisfaction to attract and retain the best candidates. In 2013, the Shape of Training review report set out recommendations for the structure and delivery of postgraduate training in light of an ever increasingly poly-morbid and ageing population. This consensus statement outlines ASIT's position regarding recommendations for improving surgical training and aims to help guide discussions with regard to future proposed changes to surgical training.
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
Krones, C J; Binnebösel, M; Stumpf, M; Schumpelick, V
The Aachen model is a practical mode in teaching and advanced training, which is closely geared to the areas of academic acquisition and training. During medical education optional student courses with constitutive curricula offer practical points of contact to the surgical department at all times. Besides improvement of manual training the aims are enhancing interests and acquisition of talents. This guided structure will be intensified with progression into advanced education. Next to the formal guidelines of the curriculum, education logbook and progression conversations, quality, transparency and reliability are particularly emphasized. An evaluation of both the reforms and the surgical trainers is still to be made. In addition procurement of an affirmative occupational image is essential.
Robinson, Daniel; Speedie, Marilyn
Few things are more fundamental to the purpose of health professions training than to prepare practice-ready health professionals. The Accreditation Council of Pharmacy Education (ACPE) Standards 2016 address graduate readiness to 1) provide direct patient care in a variety of health care settings (practice-ready) and 2) contribute as a member of an interprofessional collaborative patient care team (team-ready). ACPE Standards 2007 states that graduates should be prepared to deliver direct patient care. This includes the ability to design, implement, monitor, evaluate, and adjust pharmacy care plans that are patient specific and to function effectively as a member of an interprofessional team. Yet, controversy remains within the profession regarding the practice-readiness of PharmD graduates, which has been further fueled by the recent ACCP White Paper on Collaborative Drug Therapy Management and Comprehensive Medication Management - 2015. This commentary makes the case that PharmD graduates are practice-ready and it offers a solution that may settle this lingering controversy.
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.
Brazin, Lillian R
This is the final biennial update listing directories, journal articles, Web sites, and general books that aid the librarian, house officer, or medical student in finding information on medical residency and fellowship programs. The World Wide Web provides the most complete and up-to-date source of information about postgraduate training programs and specialties. This update continues to go beyond postgraduate training resources to include selected Web sites and books on curriculum vitae writing, practice management, personal finances, the "Match," certification and licensure examination preparation, lifestyle issues, job hunting, and the DEA license application process. Print resources are included if they provide information not on the Internet, have features that are particularly useful, or cover too many relevant topics in depth to be covered in a journal article or on a Web site. The Internet is a major marketing tool for hospitals seeking to recruit the best and brightest physicians for their training programs. Even the smallest community hospital has a Web site.
The purpose of this qualitative study was to investigate graduates' perceptions of a purposefully-implemented Peer-Assisted Learning (PAL) pedagogy in their undergraduate athletic training education and the impact of that experience in their first job post-graduation. This was the first research in athletic training education that…
Viney, Rowena; Needleman, Sarah; Griffin, Ann
Objectives Explore trainee doctors’ experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Design Qualitative semistructured focus group and interview study. Setting Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. Participants 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad. Results Most trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work–life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising. Conclusions BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on
Alonso, Silvia; Dürr, Salome; Fahrion, Anna; Harisberger, Myriam; Papadopoulou, Christina; Zimmerli, Urs
Residents of the European College of Veterinary Public Health (ECVPH) carried out a survey to explore the expectations and needs of potential employers of ECVPH diplomates and to assess the extent to which the ECVPH post-graduate training program meets those requirements. An online questionnaire was sent to 707 individuals working for universities, government organizations, and private companies active in the field of public health in 16 countries. Details on the structure and activities of the participants' organizations, their current knowledge of the ECVPH, and potential interest in employing veterinary public health (VPH) experts or hosting internships were collected. Participants were requested to rate 22 relevant competencies according to their importance for VPH professionals exiting the ECVPH training. A total of 138 completed questionnaires were included in the analysis. While generic skills such as "problem solving" and "broad horizon and inter-/multidisciplinary thinking" were consistently given high grades by all participants, the importance ascribed to more specialized skills was less homogeneous. The current ECVPH training more closely complies with the profile sought in academia, which may partly explain the lower employment rate of residents and diplomates within government and industry sectors. The study revealed a lack of awareness of the ECVPH among public health institutions and demonstrated the need for greater promotion of this veterinary specialization within Europe, both in terms of its training capacity and the professional skill-set of its diplomates. This study provides input for a critical revision of the ECVPH curriculum and the design of post-graduate training programs in VPH.
Benamer, Hani T S
Neurological disorders are increasingly recognised as a major public health problem, especially in the developing world. Having adequate neurology expertise to tackle this issue is essential. A 17-item survey was conducted to gather information about the number, training and location of neurologists and supportive facilities available to them in the 16 middle- and high-income Arab countries. Data about the availability of postgraduate training programmes was collected. Surveys were returned from all targeted countries. The population per neurologist ranges from 35,000 to just over two million, and the most neurologists are based in large cities. Most of the practising neurologists had received extensive training in neurology and/or passed specialty exams. The majority had all or part of their training abroad. Neuro-radiological and neuro-physiological investigations are generally available in most surveyed countries but neuro-genetics and neuro-immunology services are lacking. Neurology training programmes are available in ten Arab countries with a total of 504-524 trainees. The availability of neurologists, supportive services and training programmes varies between Arab countries. Further development of neurology expertise and local training programmes are needed.
Samalavicius, Narimantas Evaldas; Mineikyte, Ramune; Janulionis, Ernestas; Liutkeviciute-Navickiene, Jurgita; Atkocius, Vydmantas
The purpose of this article is to discuss Lithuanian postgraduate cancer education according to the data of 2013. In Lithuania, a specialization in an area called clinical oncology is absent; as independent specialities in oncology, there are both medical oncologists and radiation oncologists. These types of oncologists complete rigorous residency training in the clinics. Separate courses are provided in different residency programmes. Currently, there are two medical oncology and radiation oncology programmes for 3rd-, 4th- and 5th-year residents, one at the National Cancer Institute and another at the Lithuanian University of Health Sciences and Kaunas Clinics. Today, there are only 45 radiation oncologists and 56 medical oncologists licensed in Lithuania. This means that each radiation oncologist and medical oncologist is providing for 397 and 319 new cancer cases per year, respectively, or there are 0.3 practising in the major specialties of oncology per 10,000 population. Most other medical residency programmes expose their trainees to oncology for only 1 month either in the 1st or the 2nd year of residency. Due to the growing number of new cancer cases worldwide, these programmes have to be extended, especially for family and internal medicine residents. Lithuanian postgraduate cancer education and training is in the process of harmonization according to the EU rules. All the Lithuanian residency programmes are certificated by an independent public agency and are recognized by a number of countries, including all the countries of the EU.
van der Valk, Paul
It might seem self-evident that in the transition from a supervised trainee to an independent professional who is no longer supervised, formal assessment of whether the trainee knows his/her trade well enough to function independently is necessary. This would then constitute an end of training examination. Such examinations are practiced in several countries but a rather heterogeneous situation exists in the EU countries. In the Netherlands, the training program is not concluded by a summative examination and reasons behind this situation are discussed. Quality assurance of postgraduate medical training in the Netherlands has been developed along two tracks: (1) not a single testing moment but continuous evaluation of the performance of the trainee in 'real time' situations and (2) monitoring of the quality of the offered training program through regular site-visits. Regular (monthly and/or yearly) evaluations should be part of every self-respecting training program. In the Netherlands, these evaluations are formative only: their intention is to provide the trainee a tool by which he or she can see whether they are on track with their training schedule. In the system in the Netherlands, regular site-visits to training programs constitute a crucial element of quality assurance of postgraduate training. During the site-visit, the position and perceptions of the trainee are key elements. The perception by the trainee of the training program, the institution (or department) offering the training program, and the professionals involved in the training program is explicitly solicited and systematically assessed. With this two-tiered approach high-quality postgraduate training is assured without the need for an end of training examination.
Giles, James A
The introduction of European Working Time Directive, limiting doctors' working hours to 48 per week, has caused recent controversy within the profession. The Royal College of Surgeons of England in particular has been one of the loudest critics of the legislation. One of the main concerns is regarding the negative impact on training hours for those embarking on surgical careers. Simulation technology has been suggested as a method to overcome this reduction in hospital training hours, and research suggests that this is a good substitute for operative training in a theatre. However, modern educational theory emphasises the power of informal workplace learning in postgraduate education, and the essential role of experience in training future surgeons.
Howlett, Mike; MacKay, Jacqueline; Fraser, Jacqueline; Ross, Peter
Background The distribution of postgraduate medical training (residency) positions in Canada is administered by medical schools and universities in conjunction with individual provinces. In Atlantic Canada, the Maritime provinces are considered a single unit under Dalhousie University in Nova Scotia (NS), although distributed medical undergraduate education through Dalhousie and Sherbrooke has enabled medical students to complete their entire course of study in New Brunswick (NB). It is unclear if postgraduate medical education has been distributed in a similar fashion in Atlantic Canada, particularly in New Brunswick and Prince Edward Island (PE). Methods Data on the number of R1 residency positions was obtained from the Canadian Resident Matching Service (CaRMS) database. The distribution of R1 positions was described and compared nationally and through the Atlantic provinces. The analysis was completed using MS Excel and Prism. Results Rates of R1 positions per million persons varied widely; the national median rate was 97 positions per million persons, with a range of 34 to 138. The combined Maritime provinces rate of R1 positions was 71 per million persons and the rate in Newfoundland (NL) was 138 positions per million. The NS rate was 106 positions per million while the NB rate was 54 per million and the PE rate 34 per million. Sixty-four percent of all residency training positions in Atlantic Canada were based in the two most urban areas of Halifax, NS or St John’s, NL. Royal College (specialty) positions were more likely to be based at the main university campus city than family medicine training positions (97 vs. 3%; 33 vs. 67%, respectively). Conclusion There is a high level of variation in available residency positions among the individual provinces, especially in Atlantic Canada. The lower prevalence of opportunities in NB and PE may influence the ability of these provinces to recruit and retain new physicians. PMID:27200227
Dansie, Chase O; Park, Jae Hyun; Makin, Inder Raj S
This study was designed to determine if orthodontic residents are being trained to use lasers in the postgraduate orthodontic residency programs of the United States and Canada. An anonymous electronic survey was sent to the program director/chair of each of the seventy orthodontic residency programs, and thirty-seven (53 percent) of the programs responded. Of these thirty-seven programs, twenty-eight (76 percent) reported providing patient treatment with lasers in the orthodontic graduate program, eight (22 percent) said they do not provide treatment in the orthodontic graduate program, and one program (3 percent) reported providing laser training but not using lasers on patients. Gingivectomy and canine exposure were reported as the most common procedures that residents perform with a laser, while debonding of orthodontic brackets was the least common procedure performed with a laser. A diode laser was the most common type of laser used. Of the eight programs (22 percent) not offering laser training, four indicated having no plans to begin using lasers or training on their use. The other four indicated that they have plans to incorporate laser use in the future.
Tötsch, M; Cuvelier, C; Vass, L; Fassina, A
After more than five years discussion the UEMS Section/Board of Pathology agreed a specification of requirements for recognition of post-graduate training in pathology, which is the key to the future of our discipline. The document published here, subject to ratification by UEMS Council, was voted on and accepted by the Pathology Board at the UEMS Paris meeting of 9 June 2012. Cytopathology is regarded as integral part of pathology: in general, training in pathology takes five years and maintains a common trunk of four (minimum three) years where surgical pathology, autopsy pathology and basic knowledge of neuropathology, dermatopathology and cytopathology are adequately trained and assessed. Training in so-called 'areas of interests' covers the remaining 12-24 months. Certificates of 'advanced level of competence' remain within the authority of national boards. As senior members of its Executive Board, we believe that the European Federation of Cytology Societies (EFCS) should take responsibility for establishing 1) standards in the quality of cytopathology training, 2) training guidelines and qualification for advanced levels of competence in cytopathology, 3) manpower planning, 4) tutorials for pathologists and cytotechnologists and 4) standards of cytotechnologist training.
Danilewitz, Marlon; McLean, Laurie
Background There is growing recognition of the importance of physician leadership in healthcare. At the same time, becoming an effective leader requires significant training. While educational opportunities for practicing physicians exist to develop their leadership skills, there is a paucity of leadership opportunities for post graduate trainees. In response to this gap, both the Royal College of Physicians and Surgeons of Canada and the Association of Faculties of Medicine of Canada have recommended that leadership training be considered a focus in Post Graduate Medical Education (PGME). However, post-graduate leadership curricula and opportunities in PGME training programs in Canada are not well described. The goal of this study was to determine the motivation for PGME leadership training, the opportunities available, and educational barriers experienced by PGME programs at the University of Ottawa. Methods An electronic survey was distributed to all 70 PGME Program Directors (PDs) at the University of Ottawa. Two PDs were selected, based on strong leadership programs, for individual interviews. Results The survey response rate was 55.7%. Seventy-seven percent of responding PDs reported resident participation in leadership training as being “important,” while only 37.8% of programs incorporated assessment of resident leadership knowledge and/or skills into their PGME program. Similarly, only 29.7% of responding residency programs offered chief resident leadership training. Conclusions While there is strong recognition of the importance of training future physician leaders, the nature and design of PGME leadership training is highly variable. These data can be used to potentially inform future PGME leadership training curricula. PMID:28344692
Singh, Tejinder; Modi, Jyoti Nath
There has been an increasing emphasis on defining outcomes of medical education in terms of performance of trainees. This is a step beyond the description of outcomes in terms of competence that encompasses mostly potential abilities rather than the actual performance. The contextual adaptations and behavior judgments of the trainees are best assessed by a program of in-training assessment. Workplace based assessment (WPBA) is one of the modalities, which assesses the trainee in authentic settings. Though Postgraduate (PG) medical training in India is said to be competency-based, most institutions do not have any formative or in-training assessment program for the same. The two cardinal elements of WPBA are direct observation and conducted in work place in addition to provision of feedback to the trainee. The WPBA conforms to the highest (Level 4: Does) of Millers pyramid and also has the potential to assess at all four levels. Some of the tools used for WPBA are: Logbooks, Clinical Encounter Cards (CEC), mini-Clinical Evaluation Exercise (mini-CEX), Case based discussions, Direct Observation of Procedural Skills (DOPS), Multisource feedback (peers, co-workers, seniors, patients) etc. These can be documented in the form of a portfolio that provides a longitudinal view of experiences and progress of the trainee. The WPBA scores high on validity and educational impact by virtue of being based on direct observation in real situation and contextual feedback. The feasibility and acceptability is enhanced by making appropriate choices of tools, advance planning, building of mutual trust, and training of assessors. Given the established benefits of WPBA in shaping clinical learning, there is an imminent need for including this mode of assessment in our clinical training programs especially PG training.
Wall, James; Hellman, Eva; Denend, Lyn; Rait, Douglas; Venook, Ross; Lucian, Linda; Azagury, Dan; Yock, Paul G; Brinton, Todd J
Stanford Biodesign launched its Innovation Fellowship in 2001 as a first-of-its kind postgraduate training experience for teaching biomedical technology innovators a need-driven process for developing medical technologies and delivering them to patients. Since then, many design-oriented educational programs have been initiated, yet the impact of this type of training remains poorly understood. This study measures the career focus, leadership trajectory, and productivity of 114 Biodesign Innovation Fellowship alumni based on survey data and public career information. It also compares alumni on certain publicly available metrics to finalists interviewed but not selected. Overall, 60% of alumni are employed in health technology in contrast to 35% of finalists interviewed but not selected. On leadership, 72% of alumni hold managerial or higher positions compared to 48% of the finalist group. A total of 67% of alumni reported that the fellowship had been "extremely beneficial" on their careers. As a measure of technology translation, more than 440,000 patients have been reached with technologies developed directly out of the Biodesign Innovation Fellowship, with another 1,000,000+ aided by solutions initiated by alumni after their training. This study suggests a positive impact of the fellowship program on the career focus, leadership, and productivity of its alumni.
Brinton, Todd J.; Kurihara, Christine Q.; Camarillo, David B.; Pietzsch, Jan B.; Gorodsky, Julian; Zenios, Stefanos A.; Doshi, Rajiv; Shen, Christopher; Kumar, Uday N.; Mairal, Anurag; Watkins, Jay; Popp, Richard L.; Wang, Paul J.; Makower, Josh; Krummel, Thomas M.; Yock, Paul G.
The Stanford Biodesign Program began in 2001 with a mission of helping to train leaders in biomedical technology innovation. A key feature of the program is a full-time postgraduate fellowship where multidisciplinary teams undergo a process of sourcing clinical needs, inventing solutions and planning for implementation of a business strategy. The program places a priority on needs identification, a formal process of selecting, researching and characterizing needs before beginning the process of inventing. Fellows and students from the program have gone on to careers that emphasize technology innovation across industry and academia. Biodesign trainees have started 26 companies within the program that have raised over $200 Million and led to the creation of over 500 new jobs. More importantly, although most of these technologies are still at a very early stage, several projects have received regulatory approval and so far more than 150,000 patients have been treated by technologies invented by our trainees. This paper reviews the initial outcomes of the program and discusses lessons learned and future directions in terms of training priorities. PMID:23404074
Brinton, Todd J; Kurihara, Christine Q; Camarillo, David B; Pietzsch, Jan B; Gorodsky, Julian; Zenios, Stefanos A; Doshi, Rajiv; Shen, Christopher; Kumar, Uday N; Mairal, Anurag; Watkins, Jay; Popp, Richard L; Wang, Paul J; Makower, Josh; Krummel, Thomas M; Yock, Paul G
The Stanford Biodesign Program began in 2001 with a mission of helping to train leaders in biomedical technology innovation. A key feature of the program is a full-time postgraduate fellowship where multidisciplinary teams undergo a process of sourcing clinical needs, inventing solutions and planning for implementation of a business strategy. The program places a priority on needs identification, a formal process of selecting, researching and characterizing needs before beginning the process of inventing. Fellows and students from the program have gone on to careers that emphasize technology innovation across industry and academia. Biodesign trainees have started 26 companies within the program that have raised over $200 million and led to the creation of over 500 new jobs. More importantly, although most of these technologies are still at a very early stage, several projects have received regulatory approval and so far more than 150,000 patients have been treated by technologies invented by our trainees. This paper reviews the initial outcomes of the program and discusses lessons learned and future directions in terms of training priorities.
ten Cate, Olle; Scheele, Fedde
The introduction of competency-based postgraduate medical training, as recently stimulated by national governing bodies in Canada, the United States, the United Kingdom, The Netherlands, and other countries, is a major advancement, but at the same time it evokes critical issues of curricular implementation. A source of concern is the translation of general competencies into the practice of clinical teaching. The authors observe confusion around the term competency, which may have adverse effects when a teaching and assessment program is to be designed. This article aims to clarify the competency terminology. To connect the ideas behind a competency framework with the work environment of patient care, the authors propose to analyze the critical activities of professional practice and relate these to predetermined competencies. The use of entrustable professional activities (EPAs) and statements of awarded responsibility (STARs) may bridge a potential gap between the theory of competency-based education and clinical practice. EPAs reflect those activities that together constitute the profession. Carrying out most of these EPAs requires the possession of several competencies. The authors propose not to go to great lengths to assess competencies as such, in the way they are abstractly defined in competency frameworks but, instead, to focus on the observation of concrete critical clinical activities and to infer the presence of multiple competencies from several observed activities. Residents may then be awarded responsibility for EPAs. This can serve to move toward competency-based training, in which a flexible length of training is possible and the outcome of training becomes more important than its length.
Mphahlele, M. J.; Tafesse, F.
The University of South Africa's (UNISA) College of Science, Engineering and Technology (CSET) stands unique in the world by offering laboratory-based disciplines through Open Distance Learning (ODL) at both undergraduate and postgraduate levels. Lack of postgraduate programmes in chemistry at the very few ODL institutions offering undergraduate…
Mitchell, Erica L; Arora, Sonal; Moneta, Gregory L
Approval of the primary certificate in vascular surgery eliminated the requirement for certification in general surgery before vascular surgery certification. New training paradigms for training in vascular surgery have emerged driven by the desire to offer greater flexibility of training and to shorten the length of training. Many of these changes are based upon "expert opinion," promise, and "logic" without objective evaluation of the residents or the training programs themselves. To be on the forefront of surgical education, vascular surgery will need to adopt methods of curriculum development firmly grounded in educational principles and use modern assessment tools for the evaluation of competence and performance. This report presents the evolution and challenges to the current vascular surgical training model and then argues for a more rigorous and scientific approach to training in vascular surgery. It presents an analysis of potential avenues for placing education and training in vascular surgery on the forefront of modern surgical education.
Driessen, Erik; Scheele, Fedde
Workplace-based assessment is more commonly given a lukewarm than a warm welcome by its prospective users. In this article, we summarise the workplace-based assessment literature as well as our own experiences with workplace-based assessment to derive lessons that can facilitate acceptance of workplace-based assessment in postgraduate specialty training. We propose to shift the emphasis in workplace-based assessment from assessment of trainee performance to the learning of trainees. Workplace-based assessment should focus on supporting supervisors in taking entrustment decisions by complementing their "gut feeling" with information from assessments and focus less on assessment and testability. One of the most stubborn problems with workplace-based assessment is the absence of observation of trainees and the lack of feedback based on observations. Non-standardised observations are used to organise feedback. To make these assessments meaningful for learning, it is essential that they are not perceived as summative by their users, that they provide narrative feedback for the learner and that there is a form of facilitation that helps to integrate the feedback in trainees' self-assessments.
Rosta, Judith; Aasland, Olaf G
Objectives To examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work–home balance, and in relation to the requirements of the European Working Time Directive (EWTD). Design Panel study based on postal questionnaires. Setting Norway. Participants Unbalanced cohort of 1300–1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012. Outcome measures Self-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors. Results From 1994 to 2012, the number of weekly working hours was stable for senior (46–47 h) and junior (45–46 h) hospital doctors. In 2012, significantly more senior (27–35%) than junior (11–20%) doctors reported suboptimal work–home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer. Conclusions The weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations. PMID:25311038
Ryan, Stephen; Doucet, Gregory; Murphy, Deanna; Turner, Jacqueline
Introduction A realistic hemorrhagic cervical cancer model was three-dimensionally (3D) printed and used in a postgraduate medical simulation training session. Materials and methods Computer-assisted design (CAD) software was the platform of choice to create and refine the cervical model. Once the prototype was finalized, another software allowed for the addition of a neoplastic mass, which included openings for bleeding from the neoplasm and cervical os. 3D printing was done using two desktop printers and three different materials. An emergency medicine simulation case was presented to obstetrics and gynecology residents who were at varying stages of their training. The scenario included history taking and physical examination of a standardized patient. This was a hybrid simulation; a synthetic pelvic task trainer that allowed the placement of the cervical model was connected to the standardized patient. The task trainer was placed under a drape and appeared to extend from the standardized patient’s body. At various points in the simulation, the standardized patient controlled the cervical bleeding through a peripheral venous line. Feedback forms were completed, and the models were discussed and evaluated with staff. Results A final cervical model was created and successfully printed. Overall, the models were reported to be similar to a real cervix. The models bled well. Most models were not sutured during the scenarios, but overall, the value of the printed cervical models was reported to be high. Discussion The models were well received, but it was suggested that more colors be integrated into the cervix in order to better emphasize the intended pathology. The model design requires further improvement, such as the addition of a locking mechanism, in order to ensure that the cervix stays inside the task trainer throughout the simulation. Adjustments to the simulated blood product would allow the bleeding to flow more vigorously. Additionally
Windsor, John A
There are several challenges facing surgical education and training that simulation may help to address. A conceptual framework is required to allow the appropriate application of simulation to a given level and type of surgical skill and this should be driven by educational imperatives and not by technological innovation. Simple simulation is required for core skills training. Cognitive simulation is introduced as a way in which procedural skills training can be achieved. Virtual world simulation opens up significant opportunities for team skills training. A role for simulation in surgical education and training appears assured, but its success will be determined by the extent to which it is integral to high quality curricula, its importance determined by its contribution to both learning and assessment, and its sustainability determined by evidence of its advantages and cost-effectiveness.
Sinclair, P; Fitzgerald, J E F; McDermott, F D; Derbyshire, L; Shalhoub, J
Mentoring has been present within surgical training for many years, albeit in different forms. There is evidence that formal mentoring can improve patient outcomes and facilitate learning and personal growth in the mentee. The Association of Surgeons in Training (ASiT) is an independent educational charity working to promote excellence in surgical training. This document recommends the introduction of a structured mentoring programme, which is readily accessible to all surgical trainees. A review of the available evidence--including an ASiT-led survey of its membership--highlights the desire of surgical trainees to have a mentor, whilst the majority do not have access to one. There is also limited training for those in mentoring roles. In response, ASiT have implemented a pilot mentoring scheme, with surgical trainees acting both as mentors and mentees. Based on the existing literature, survey data and pilot experience, ASiT formalises in this document consensus recommendations for mentoring in surgical training.
Despinoy, Fabien; Bouget, David; Forestier, Germain; Penet, Cedric; Zemiti, Nabil; Poignet, Philippe; Jannin, Pierre
Dexterity and procedural knowledge are two critical skills that surgeons need to master to perform accurate and safe surgical interventions. However, current training systems do not allow us to provide an in-depth analysis of surgical gestures to precisely assess these skills. Our objective is to develop a method for the automatic and quantitative assessment of surgical gestures. To reach this goal, we propose a new unsupervised algorithm that can automatically segment kinematic data from robotic training sessions. Without relying on any prior information or model, this algorithm detects critical points in the kinematic data that define relevant spatio-temporal segments. Based on the association of these segments, we obtain an accurate recognition of the gestures involved in the surgical training task. We, then, perform an advanced analysis and assess our algorithm using datasets recorded during real expert training sessions. After comparing our approach with the manual annotations of the surgical gestures, we observe 97.4% accuracy for the learning purpose and an average matching score of 81.9% for the fully automated gesture recognition process. Our results show that trainees workflow can be followed and surgical gestures may be automatically evaluated according to an expert database. This approach tends toward improving training efficiency by minimizing the learning curve.
Background With the “ASIA-LINK” program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. Methods The curriculum was developed and implemented in three steps: 1) an experimental phase to build a future teacher group; 2) a joint training program for future teachers and German teachers; and 3) training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Results Regional training centers were formed in China (Shanghai), Vietnam (Ho Chi Minh City and Hue) and Laos (Vientiane). A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the participants were necessary
Stutchfield, B M; Harrison, E M; Wigmore, S J; Parks, R W; Garden, O J
With recent 'working-time'-related changes to surgical training structure, the value of dedicated research during surgical training has been questioned. Online survey examining career and academic outcomes following a period of surgically related dedicated research at a Scottish University between 1972 and 2007. Of 58 individuals identified, contact details were available for 49 and 43 (88%) responded. Ninety-five percent (n = 41) of respondents continue to pursue a career in surgery and 41% (n = 17) are currently in academic positions. Ninety-one percent (n = 39) had published one or more first-author peer-reviewed articles directly related to their research, with 53% (n = 23) publishing three or more. Respondents with a clinical component to their research published significantly more papers than those with purely laboratory-based research (P = 0.04). Eighty-one percent (n = 35) thought that research was necessary for career progression, but only 42% (n = 18) felt research should be integral to training. In conclusion, the majority of surgical trainees completing a dedicated research period, published papers and continued to pursue a surgical career with a research interest. A period of dedicated research was thought necessary for career progression, but few thought dedicated research should be integral to surgical training.
Background In 1997, regional specialist training was established in Fiji, consisting of one-year Postgraduate Diplomas followed by three-year master’s degree programs in anesthesia, internal medicine, obstetrics/gynecology, pediatrics and surgery. The evolution of these programs during the first 12 years is presented. Case description A case study utilizing mixed methods was carried out, including a prospective collection of enrolment and employment data, supplemented by semi-structured interviews. Between 1997 and 2009, 207 doctors (113 from Fiji and 94 from 13 other countries or territories in the Pacific) trained to at least the Postgraduate Diploma level. For Fiji graduates, 29.2% migrated permanently to developed countries, compared to only 8.5% for regional graduates (P <0.001). Early years of the program were characterized by large intakes and enthusiasm, but also uncertainty. Many resignations took place following a coup d’etat in 2000. By 2005, interviews suggested a dynamic of political instability initially leading to resignations, leading to even heavier workloads, compounded by academic studies that seemed unlikely to lead to career benefit. This was associated with loss of hope and downward spirals of further resignations. After 2006, however, Master’s graduates generally returned from overseas placements, had variable success in career progression, and were able to engage in limited private practice. Enrolments and retention stabilized and increased. Discussion and evaluation Over time, all specialties have had years when the viability and future of the programs were in question, but all have recovered to varying degrees, and the programs continue to evolve and strengthen. Prospective clarification of expected career outcomes for graduates, establishment of career pathways for diploma-only graduates, and balancing desires for academic excellence with workloads that trainees were able to bear may have lessened ongoing losses of trainees and
Mahmud, Saadia; Bretag, Tracey
Findings from a study on academic integrity at Australian universities challenge the presumption that postgraduate research students have prior knowledge of academic integrity. A review of online academic integrity policy in 39 Australian universities found that one in five policies had no mention of higher degree by research (HDR) students.…
Valdiri, Linda A; Andrews-Arce, Virginia E; Seery, Jason M
Since the late 1980s, the US Army has been deploying forward surgical teams to the most intense areas of conflict to care for personnel injured in combat. The forward surgical team is a 20-person medical team that is highly mobile, extremely agile, and has relatively little need of outside support to perform its surgical mission. In order to perform this mission, however, team training and trauma training are required. The large majority of these teams do not routinely train together to provide patient care, and that training currently takes place at the US Army Trauma Training Center (ATTC). The training staff of the ATTC is a specially selected 10-person team made up of active duty personnel from the Army Medical Department assigned to the University of Miami/Jackson Memorial Hospital Ryder Trauma Center in Miami, Florida. The ATTC team of instructors trains as many as 11 forward surgical teams in 2-week rotations per year so that the teams are ready to perform their mission in a deployed setting. Since the first forward surgical team was trained at the ATTC in January 2002, more than 112 forward surgical teams and other similar-sized Department of Defense forward resuscitative and surgical units have rotated through trauma training at the Ryder Trauma Center in preparation for deployment overseas.
Collins, John P; Civil, Ian D; Sugrue, Michael; Balogh, Zsolt; Chehade, Mellick J
Surgical education for medical students in Australia and New Zealand is provided by 19 universities in Australia and 2 in New Zealand. One surgical college is responsible for managing the education, training, assessment, and professional development programs for surgeons throughout both countries. The specialist surgical associations and societies act as agents of the college in the delivery of these programs, the extent of which varies among specialties. Historically, surgical training was divided into basic and specialist components with selection required for each part. In response to a number of factors, a new surgical education and training program has been developed. The new program incorporates a single merit-based national selection directly into the candidate's specialty of choice. The existing curriculum for each of the nine specialties has been remodeled to a competence-based format in line with the competence required to undertake the essential roles of a surgeon. New standards and criteria have been produced for accreditation of health care facilities used for training. A new basic surgical skills education and training course has been developed, with simulation playing an increasing role in all courses. Trainees' progress is assessed by workplace-based assessment and formal examinations, including an exit examination. The sustained production of sufficient competent surgeons to meet societal needs encompasses many challenges including the recruitment of appropriate graduates and the availability of adequate educational and clinical resources to train them. Competence-based training is an attractive educational philosophy, but its implementation has brought its own set of issues, many of which have yet to be resolved.
Shaharan, Shazrinizam; Neary, Paul
AIM: To assess where we currently stand in relation to simulator-based training within modern surgical training curricula. METHODS: A systematic literature search was performed in PubMed database using keywords “simulation”, “skills assessment” and “surgery”. The studies retrieved were examined according to the inclusion and exclusion criteria. Time period reviewed was 2000 to 2013. The methodology of skills assessment was examined. RESULTS: Five hundred and fifteen articles focussed upon simulator based skills assessment. Fifty-two articles were identified that dealt with technical skills assessment in general surgery. Five articles assessed open skills, 37 assessed laparoscopic skills, 4 articles assessed both open and laparoscopic skills and 6 assessed endoscopic skills. Only 12 articles were found to be integrating simulators in the surgical training curricula. Observational assessment tools, in the form of Objective Structured Assessment of Technical Skills (OSATS) dominated the literature. CONCLUSION: Observational tools such as OSATS remain the top assessment instrument in surgical training especially in open technical skills. Unlike the aviation industry, simulation based assessment has only now begun to cross the threshold of incorporation into mainstream skills training. Over the next decade we expect the promise of simulator-based training to finally take flight and begin an exciting voyage of discovery for surgical trainees. PMID:25228946
Davis, Christopher R; Bates, Anthony S; Toll, Edward C; Cole, Matthew; Smith, Frank C T; Stark, Michael
Undergraduate training in surgical safety is essential to maximize patient safety. This national review quantified undergraduate surgical safety training. Training of 2 international safety initiatives was quantified: (1) World Health Organization (WHO) "Guidelines for Safe Surgery" and (2) Department of Health (DoH) "Principles of the Productive Operating Theatre." Also, 13 additional safety skills were quantified. Data were analyzed using Mann-Whitney U tests. In all, 23 universities entered the study (71.9% response). Safety skills from WHO and DoH documents were formally taught in 4 UK medical schools (17.4%). Individual components of the documents were taught more frequently (47.6%). Half (50.9%) of the additional safety skills identified were taught. Surgical societies supplemented safety training, although the total amount of training provided was less than that in university curricula (P < .0001). Surgical safety training is inadequate in UK medical schools. To protect patients and maximize safety, a national undergraduate safety curriculum is recommended.
Sakai, Rie; Wang, Wei; Yamaguchi, Norihiro; Tamura, Hiroshi; Goto, Rei; Kawachi, Ichiro
Objective Inequity in physician distribution poses a challenge to many health systems. In Japan, a new postgraduate training program for all new medical graduates was introduced in 2004, and researchers have argued that this program has increased inequalities in physician distribution. We examined the trends in the geographic distribution of pediatricians as well as all physicians from 1996 to 2010 to identify the impact of the launch of the new training program. Methods The Gini coefficient was calculated using municipalities as the study unit within each prefecture to assess whether there were significant changes in the intra-prefectural distribution of all physicians and pediatricians before and after the launch of the new training program. The effect of the new program was quantified by estimating the difference in the slope in the time trend of the Gini coefficients before and after 2004 using a linear change-point regression design. We categorized 47 prefectures in Japan into two groups: 1) predominantly urban and 2) others by the definition from OECD to conduct stratified analyses by urban-rural status. Results The trends in physician distribution worsened after 2004 for all physicians (p value<.0001) and pediatricians (p value = 0.0057). For all physicians, the trends worsened after 2004 both in predominantly urban prefectures (p value = 0.0012) and others (p value<0.0001), whereas, for pediatricians, the distribution worsened in others (p value = 0.0343), but not in predominantly urban prefectures (p value = 0.0584). Conclusion The intra-prefectural distribution of physicians worsened after the launch of the new training program, which may reflect the impact of the new postgraduate program. In pediatrics, changes in the Gini trend differed significantly before and after the launch of the new training program in others, but not in predominantly urban prefectures. Further observation is needed to explore how this difference in trends affects
Satava, Richard M; Hunter, Anne Marie
Team training and interprofessional training have recently emerged as critical new simulations that enhance performance by coordinating communication, leadership, professional, and, to a certain extent, technical skills. In describing these new training tools, the term choreography has been loosely used, but no critical appraisal of the role of the science of choreography has been applied to a surgical procedure. By analogy, the surgical team, including anesthetists, surgeons, nurses, and technicians, constitutes a complete ensemble, whose physical actions and interactions constitute the "performance of surgery." There are very specific "elements" (tools) that are basic to choreography, such as space, timing, rhythm, energy, cues, transitions, and especially rehearsal. This review explores whether such a metaphor is appropriate and the possibility of applying the science of choreography to the surgical team in the operating theater.
Surgery as a profession requires significant training to improve both clinical decision making and psychomotor proficiency. In the medical knowledge domain, tools have been developed, validated, and accepted for evaluation of surgeons' competencies. However, assessment of the psychomotor skills still relies on the Halstedian model of…
Pandey, Vikas A; Wolfe, John H N
Simulation technology has a well-defined role in nonmedical professions such as aviation and over the last two decades has permeated medical training. The most successful surgical simulation is in the fields of laparoscopic and endovascular surgery. These two-dimensional scenarios, as in the aviation industry, lend themselves to simulation. Open simulators have been met with more resistance than their laparoscopic counterparts because of the difficulties in simulating the three-dimensional field. Engaging in persistent practice is what makes the expert and all trainees should aspire to this. Without knowing, all surgical trainees have engaged in deliberate practice when first learning to tie surgical knots. This deliberate practice should be used in all aspects of vascular surgical practice, and it is no longer acceptable to perform procedures such as arterial anastomoses for the first time on patients. Simulators exist for all aspects of vascular surgical training and vary in complexity and price. Some of these simulators are suitable for use at home or in a skills laboratory whereas others are more suitable for use in a specialized skills center. Training on these simulators can be offered at a local level or at a regional level in the skills center. Where surgical procedures are not commonly performed or expertise is required for a new innovation, it is more appropriate to have national or internationally based workshops under the auspices of surgical boards or societies. Simulation of crisis management, well known in aviation, has also been applied to vascular surgical practice and can offer benefit to senior trainees even when their performance on a noncrisis simulator has reached a plateau. This article identifies the areas where simulation in open vascular surgery can benefit the trainee.
Dydykin, Sergey; Kapitonova, Marina
Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating…
Memon, Breda; Memon, Muhammed Ashraf
Effective mentoring has an invaluable role in the development of surgeons at various levels and is frequently perceived vital in achieving career success. Its role therefore is only second to credentialing. However, the formal role of mentoring and learner support in surgical training remains non-existent. This is reflected in a paucity of…
Kitto, Simon C.; Gruen, Russell L.; Smith, Julian A.
In recent years increasing attention has been paid to issues of professionalism in surgery and the content and structure of continuing professional development for surgeons; however, little attention has been paid to interprofessional education (IPE) in surgical training. Imagining the form(s) of IPE and/or continuing interprofessional education…
Ahmadi, Hamed; Liu, Jen-Jane
Minimally invasive partial nephrectomy (MIPN) is now considered the procedure of choice for small renal masses largely based on functional advantages over traditional open surgery. Lack of haptic feedback, the need for spatial understanding of tumor borders, and advanced operative techniques to minimize ischemia time or achieve zero-ischemia PN are among factors that make MIPN a technically demanding operation with a steep learning curve for inexperienced surgeons. Surgical simulation has emerged as a useful training adjunct in residency programs to facilitate the acquisition of these complex operative skills in the setting of restricted work hours and limited operating room time and autonomy. However, the majority of available surgical simulators focus on basic surgical skills, and procedure-specific simulation is needed for optimal surgical training. Advances in 3-dimensional (3-D) imaging have also enhanced the surgeon's ability to localize tumors intraoperatively. This article focuses on recent procedure-specific simulation models for laparoscopic and robotic-assisted PN and advanced 3-D imaging techniques as part of pre- and some cases, intraoperative surgical planning.
Smith, Andrew J; Aggarwal, Rajesh; Warren, Oliver J; Paraskeva, Paraskevas
Training in surgical disciplines in the United Kingdom has undergone tremendous change over the past two decades. The introduction of specialist training programmes, working time directives, quality ratings and a drive toward ambulatory and minimal access surgery have led to challenges with respect to training and service commitments of healthcare professionals. A structured and centralised training system was introduced, with the concept of core followed by specialty-specific progression, in an openly competitive manner. Within this system is the need to commence training on simulation models, and to demonstrate proficiency prior to performance of tasks on patients. This should be underpinned by objective measures such as video or dexterity-based tools. There is also a clear need to provide personal, professional and leadership development in the form of mentorship and appraisal systems. Though continuing to develop, the profession must be mindful of current and future advances to ensure the delivery of surgeons for the future who aspire toward excellence.
Plint, Simon; Patterson, Fiona
The UK national recruitment process into general practice training has been developed over several years, with incremental introduction of stages which have been piloted and validated. Previously independent processes, which encouraged multiple applications and produced inconsistent outcomes, have been replaced by a robust national process which has high reliability and predictive validity, and is perceived to be fair by candidates and allocates applicants equitably across the country. Best selection practice involves a job analysis which identifies required competencies, then designs reliable assessment methods to measure them, and over the long term ensures that the process has predictive validity against future performance. The general practitioner recruitment process introduced machine markable short listing assessments for the first time in the UK postgraduate recruitment context, and also adopted selection centre workplace simulations. The key success factors have been identified as corporate commitment to the goal of a national process, with gradual convergence maintaining locus of control rather than the imposition of change without perceived legitimate authority.
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.
Takarada, Tohru; Asada, Tetsunosuke; Sumi, Yoshihisa; Higuchi, Yoshinori
In Japan, the increasing frequency of mental health problems in postgraduate dental trainees has recently become apparent. To our knowledge, there has been no previous research to investigate the influence of the type of training program on the mental health of dental residents during one year of postgraduate clinical training. Therefore, the purpose of this study was to compare changes in the mental health of two groups of dental trainees at Kyushu University Hospital, Fukuoka, Japan: those who undertook a rotation training program and those who trained solely in one department (the control group). Study subjects in both groups completed the Profile of Mood States (POMS) and the General Health Questionnaire (GHQ) at five intervals throughout the postgraduate training year. Analysis of the questionnaire responses were performed by Student's t-test, analysis of variance, Bonferroni's test, and the chi-square test. Statistical tests showed differences in the mean scores of POMS-30 subscales and GHQ-28. The mood of anger was the factor that seemed to best describe the trainees' response to stress. The study results led to the conclusion that dental trainees' mental health is influenced by the type of training program and that dental trainees in rotation training programs may need more mental health support.
Nestel, Debra; Harlim, Jennifer; Bryant, Melanie; Rampersad, Rajay; Hunter-Smith, David; Spychal, Bob
The landscape of surgical training is changing. The anticipated increase in the numbers of surgical trainees and the shift to competency-based surgical training places pressures on an already stretched health service. With these pressures in mind, we explored trainers' and trainees' experiences of surgical training in a less traditional rotation, an outer metropolitan hospital. We considered practice-based learning theories to make meaning of surgical training in this setting, in particular Actor-network theory. We adopted a qualitative approach and purposively sampled surgical trainers and trainees to participate in individual interviews and focus groups respectively. Transcripts were made and thematically analysed. Institutional human research ethics approval was obtained. Four surgical trainers and fourteen trainees participated. Almost without exception, participants' report training needs to be well met. Emergent inter-related themes were: learning as social activity; learning and programmatic factors; learning and physical infrastructure; and, learning and organizational structure. This outer metropolitan hospital is suited to the provision of surgical training with the current rotational system for trainees. The setting offers experiences that enable consolidation of learning providing a rich and varied overall surgical training program. Although relational elements of learning were paramount they occurred within a complex environment. Actor-network theory was used to give meaning to emergent themes acknowledging that actors (both people and objects) and their interactions combine to influence training quality, shifting the focus of responsibility for learning away from individuals to the complex interactions in which they work and learn.
Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A
Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons.
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.
Kalsi, H K; Kalsi, J S; Fisher, N L
Workplace-based assessments (WBAs) are trainee-led formative assessments that measure the highest level of competence of the ability to do a task. So far WBAs are the only available assessment tools to measure performance integrated into practice. Over the years, WBAs have become an integral part of dental foundation and specialty training. The numerous WBAs available can be broadly categorised into three types. The first type involves observation of clinical encounters, for example mini-clinical evaluation exercises; direct observation of procedural skills; and dental evaluation of performance and procedure-based assessments. The second type involves discussion of clinical cases, such as case-based discussions. Finally, the third type includes the mini-peer assessment tool, team assessment of behaviour, 360° assessments and multi-source feedback, and all involve receiving feedback from a combination of colleagues, staff and patients. This article describes the WBAs currently used in postgraduate dental training and explores their strengths, weaknesses, perceived value by trainees and trainers and how these tools can be used in a reliable and valid way.
Jefferies, Ann; Simmons, Brian; Ng, Eugene; Skidmore, Martin
Competency based medical education involves assessing physicians-in-training in multiple roles. Training programs are challenged by the need to introduce appropriate yet feasible assessment methods. We therefore examined the utility of a structured oral examination (SOE) in the assessment of the 7 CanMEDS roles (Medical Expert, Communicator,…
Ali, Jason M
Workplace based assessments (WBA) are integral to the competence-based surgical training curriculum that currently exists in the UK. The GMC emphasise the value of WBA's as assessments for learning (formative), rather than as assessments of learning (summative). Current implementation of WBA's in the workplace though, is at odds with their intended use, with the formative functions often being overlooked in favour of the summative, as exemplified by the recent announcement that trainees are required to complete a minimum of 40 WBA's a year, an increase from 24. Even before this increase, trainees viewed WBA's as tick-box exercises that negatively impact upon training opportunities. As a result, the tools are commonly misused, often because both trainees and trainers lack understanding of the benefits of full engagement with the formative learning opportunities afforded by WBA's. To aid the transition in mind-set of trainees and trainers to the purpose of assessment in the workplace, the GMC propose the introduction of 'supervised learning events' and 'assessments of performance' to supersede 'WBA's'. The impact of this change and how these will be integrated into surgical training is yet to be seen, but is likely to be a step in the right direction.
Background Recently introduced regulatory changes have expanded the Tutor role to include their primary responsibility for Postgraduate Medical Training (PMT). However, accreditation and recognition of that role has been devolved to the autonomic regions. The opinions of the RT may be relevant to future decisions; Methods A comprehensive questionnaire, including demographic characteristics, academic and research achievement and personal views about their role, was sent to 201 RTs in the Murcia Region of Spain. The responses are described using median and interquartile ranges (IQR); Results There were 147 replies (response rate 73%), 69% male, mean age 45 ± 7 yrs. RTs perception of the residents' initial knowledge and commitment throughout the program was 5 (IQR 4-6) and 7 (IQR 5-8), respectively. As regards their impact on the PMT program, RTs considered that their own contribution was similar to that of senior residents. RTs perception of how their role was recognised was 5 (IQR 3-6). Only 16% did not encounter difficulties in accessing specific RT training programs. Regarding the RTs view of their various duties, supervision of patient care was accorded the greatest importance (64%) while the satisfactory completion of the PMT program and supervision of day-to-day activities were also considered important (61% and 59% respectively). The main RT requirements were: a greater professional recognition (97%), protected time (95%), specific RT training programs (95%) and financial recognition (86%); Conclusions This comprehensive study, reflecting the feelings of our RTs, provides a useful insight into the reality of their work and the findings ought to be taken into consideration in the imminent definitive regulatory document on PMT. PMID:20540814
... AND WATER GENERAL FORESTRY REGULATIONS Forestry Education, Education Assistance, Recruitment and... Indian and Alaska Native graduate foresters and trained forestry technicians into the Bureau of Indian Affairs forestry program or forestry programs conducted by a tribe, tribal forest enterprise or...
... AND WATER GENERAL FORESTRY REGULATIONS Forestry Education, Education Assistance, Recruitment and... Indian and Alaska Native graduate foresters and trained forestry technicians into the Bureau of Indian Affairs forestry program or forestry programs conducted by a tribe, tribal forest enterprise or...
... AND WATER GENERAL FORESTRY REGULATIONS Forestry Education, Education Assistance, Recruitment and... Indian and Alaska Native graduate foresters and trained forestry technicians into the Bureau of Indian Affairs forestry program or forestry programs conducted by a tribe, tribal forest enterprise or...
Jauhar, P; Mossey, P A; Popat, H; Seehra, J; Fleming, P S
Background Undergraduate orthodontic teaching has been focused on developing an understanding of occlusal development in an effort to equip practitioners to make appropriate referrals for specialist-delivered care. However, there is a growing interest among general dentists in delivering more specialised treatments, including short-term orthodontic alignment. This study aimed to assess the levels of knowledge of occlusal problems among final year undergraduate dental students, as well as their interest in various orthodontics techniques and training.Methods A 36-item electronic questionnaire was sent to all final year undergraduate students in four dental institutes in the UK (Barts and the London, Kings College London, Cardiff and Dundee). The questionnaire explored satisfaction with undergraduate orthodontic teaching; students' perception of knowledge, based on General Dental Council learning outcomes; perceptions of the need for specialist involvement in the management of dental problems; interest in further training in orthodontics; and potential barriers to undertaking specialist training.Results The overall response rate was 66% (239/362). The majority of students (84.1%) were aware of GDC guidance in terms of undergraduate teaching. Students reported a preference for case-based and practical teaching sessions in orthodontics, with less interest in lectures or problem-based learning approaches. A high percentage were interested in further teaching in interceptive orthodontics (60.3%) and fixed appliance therapy (55.7%). Further training including specialist orthodontic training (36.4%), Invisalign (59%) and Six Month Smiles (41%) courses appealed to undergraduates. Levels of student debt, course fees and geographical issues were seen as potential barriers to formal, specialist training pathways.Conclusions Satisfaction with undergraduate orthodontic teaching is high and interest in further training, including specialist training pathways, continues to be high
Mohan, Helen M; Gokani, Vimal J; Williams, Adam P; Harries, Rhiannon L
Consultant Outcomes Publication (COP) has the longest history in cardiothoracic surgery, where it was introduced in 2005. Subsequently COP has been broadened to include all surgical specialties in NHS England in 2013-14. The Association of Surgeons in Training (ASiT) fully supports efforts to improve patient care and trust in the profession and is keen to overcome potential unintended adverse effects of COP. Identification of these adverse effects is the first step in this process: Firstly, there is a risk that COP may lead to reluctance by consultants to provide trainees with the necessary appropriate primary operator experience to become skilled consultant surgeons for the future. Secondly, COP may lead to inappropriately cautious case selection. This adjusted case mix affects both patients who are denied operations, and also limits the complexity of the case mix to which surgical trainees are exposed. Thirdly, COP undermines efforts to train surgical trainees in non-technical skills and human factors, simply obliterating the critical role of the multidisciplinary team and organisational processes in determining outcomes. This tunnel vision masks opportunities to improve patient care and outcomes at a unit level. It also misinforms the public as to the root causes of adverse events by failing to identify care process deficiencies. Finally, for safe surgical care, graduate retention and morale is important - COP may lead to high calibre trainees opting out of surgical careers, or opting to work abroad. The negative effects of COP on surgical training and trainees must be addressed as high quality surgical training and retention of high calibre graduates is essential for excellent patient care.
Eyre, Harris A; Mitchell, Rob D; Milford, Will; Vaswani, Nitin; Moylan, Steven
Portfolio careers in medicine can be defined as significant involvement in one or more portfolios of activity beyond a practitioner's primary clinical role, either concurrently or in sequence. Portfolio occupations may include medical education, research, administration, legal medicine, the arts, engineering, business and consulting, leadership, politics and entrepreneurship. Despite significant interest among junior doctors, portfolios are poorly integrated with prevocational and speciality training programs in Australia. The present paper seeks to explore this issue. More formal systems for portfolio careers in Australia have the potential to increase job satisfaction, flexibility and retention, as well as diversify trainee skill sets. Although there are numerous benefits from involvement in portfolio careers, there are also risks to the trainee, employing health service and workforce modelling. Formalising pathways to portfolio careers relies on assessing stakeholder interest, enhancing flexibility in training programs, developing support programs, mentorship and coaching schemes and improving support structures in health services.
Sacks, Gordon S
The quantity of formalized nutrition education is shrinking in curricula of health professions, such as physicians, nurses, dietitians, and pharmacists. The current nutrition education being taught in U.S. schools of healthcare professionals does not appropriately prepare students for identification of patients at nutrition risk or management of undernourished hospitalized patients with specialized nutrition therapies. In U.S. schools of pharmacy, parenteral nutrition is considered a highly specialized and advanced practice so little time is devoted to this area and more attention is focused on chronic disease state management (ie, hypertension, diabetes mellitus, and congestive heart failure). Nutrition support fellowships for physicians and nutrition support residency programs for pharmacists have dwindled in number over the years so that only a handful of these healthcare professionals are produced each year from the remaining formalized programs. Physicians, nurses, pharmacists, and dietitians can positively affect patient care, but each profession must first determine how best to integrate basic and applied nutrition concepts into their professional curricula and training programs. There must also be consensus among the healthcare professions as to the depth of nutrition education and the stage of training at which these integrations should occur. Only by having these crucial conversations among all disciplines will we be able to develop new strategies to expand nutrition education in the training of future medical practitioners.
Harries, Rhiannon L; Gokani, Vimal J; Smitham, Peter; Fitzgerald, J Edward F
Objectives Generational changes in lifestyle expectations, working environments and the feminisation of the medical workforce have seen an increased demand in postgraduate less than full-time training (LTFT). Despite this, concerns remain regarding access to, and information about, flexible training for surgeons. This study aimed to assess the opinions and experiences of LTFT for surgical trainees. Design Prospective, questionnaire-based cross-sectional study. Setting/participants An electronic, self-administered questionnaire was distributed in the UK and Republic of Ireland through mailing lists via the Association of Surgeons in Training and British Orthopedic Trainee Association. Results Overall, 876 completed responses were received, representing all grades of trainee across all 10 surgical specialties. Median age was 33 years and 63.4% were female. Of those who had undertaken LTFT, 92.5% (148/160) were female. Most worked 60% of a full-time post (86/160, 53.8%). The reasons for either choosing or considering LTFT were childrearing (82.7%), caring for a dependent (12.6%) and sporting commitments (6.8%). Males were less likely to list childrearing than females (64.9% vs 87.6%; p<0.0001). Only 38% (60/160) found the application process easy and 53.8% (86/160) experienced undermining behaviour from workplace staff as a result of undertaking LTFT. Of all respondents, an additional 53.7% (385/716) would consider LTFT in future; 27.5% of which were male (106/385). Overall, only 9.9% of all respondents rated current LTFT information as adequate. Common sources of information were other trainees (47.3%), educational supervisors (20.6%) and local postgraduate school website (19.5%). Conclusions Over half of surgical trainees working LTFT have experienced undermining behaviour as a result of their LTFT. Despite a reported need for LTFT in both genders, this remains difficult to organise, access to useful information is poor and negative attitudes among staff remain
Gokani, Vimal J; Peckham-Cooper, Adam; Bunting, David; Beamish, Andrew J; Williams, Adam; Harries, Rhiannon L
Changes in the delivery of the healthcare structure have led to the expansion of the non-medical workforce (NMW). The non-medical practitioner in surgery (a healthcare professional without a medical degree who undertakes specialist training) is a valuable addition to a surgical firm. However, there are a number of challenges regarding the successful widespread implementation of this role. This paper outlines a number of these concerns, and makes recommendations to aid the realisation of the non-medical practitioner as a normal part of the surgical team. In summary, the Association of Surgeons in Training welcomes the development of the non-medical workforce as part of the surgical team in order to promote enhanced patient care and improved surgical training opportunities. However, establishing a workforce of independent/semi-independent practitioners who compete for the same training opportunities as surgeons in training may threaten the UK surgical training system, and therefore the care of our future patients.
In postgraduate training courses to develop superior surgeons with both general and subspecialty surgery competence, board-certifying systems play an important role as guideposts. The board-certified surgeon designation of the Japan Surgical Society as the first guidepost has provided the foundations for board-certified surgeon systems of subspecialty surgical societies as the second guidepost. A committee consisting of representatives from nine surgical societies has been working actively to make these board-certifying systems more reasonable and consistent.
Bacon, James; Tardella, Neil; Pratt, Janey; Hu, John; English, James
Under contract with the Telemedicine & Advanced Technology Research Center (TATRC), Energid Technologies is developing a new XML-based language for describing surgical training exercises, the Surgical Simulation and Training Markup Language (SSTML). SSTML must represent everything from organ models (including tissue properties) to surgical procedures. SSTML is an open language (i.e., freely downloadable) that defines surgical training data through an XML schema. This article focuses on the data representation of the surgical procedures and organ modeling, as they highlight the need for a standard language and illustrate the features of SSTML. Integration of SSTML with software is also discussed.
DeGennaro, Vincent A; DeGennaro, Vincent A; Kochhar, Amit; Nathan, Nirmal; Low, Christopher; Avashia, Yash J; Thaller, Seth R
In general, university-based global health initiatives have tended to focus on expanding access to primary care. In the past, surgical programs may have been characterized by sporadic participation with little educational focus. However, there have been some notable exceptions with plastic surgery volunteer missions. We offer another model of regularly scheduled surgical trips to rural Haiti in plastic and general surgery. The goal of these trips is to reduce the burden of surgical disease and ultimately repair every cleft lip/palate in Haiti. Another principal objective is to accelerate the training of American residents through increased case load and personal interaction with attending surgeons in a concentrated period. Diversity of the case load and the overall number of surgeries performed by residents in a typical surgical trip outpaces the experiences available during a typical week in an American hospital setting. More importantly, we continue to provide ongoing training to Haitian nurses and surgeons in surgical techniques and postoperative care. Our postoperative complication rate has been relatively low. Our follow-up rates have been lower than 70% despite intensive attempts to maintain continued communication with our patients. Through our experiences in surgical care in rural Haiti, we were able to quickly ramp up our trauma and orthopedic surgical care immediately after the earthquake. Project Medishare and the University of Miami continue to operate a trauma and acute care hospital in Port au Prince. The hospital provides ongoing orthopedic, trauma, and neurosurgical expertise from the rotating teams of American surgeons and training of Haitian surgeons in modern surgical techniques. We believe that surgical residencies in the United States can improve their training programs and reduce global surgical burden of disease through consistent trips and working closely with country partners.
Fitzgerald, J E F; Giddings, C E B; Khera, G; Marron, C D
In the past decade surgical training in the United Kingdom (UK) has seen radical overhaul with the introduction of formal training curricula, competency based assessment, and a new Core Surgical Training programme. Despite this, and in common with many other countries, numerous threats remain to sustaining high-quality surgical training and education in the modern working environment. These include service delivery pressures and the reduction in working hours. There are numerous areas for potential improvement and dissemination of best training practice, from incentivising training within the National Health Service (NHS) through top-down government initiatives, to individualised information and feedback for trainees at the front-line. This document sets out the current structure of surgical training in the UK, and describes the contribution to the current debate by the Association of Surgeons in Training. Highlighting areas for improvement at national, regional, local and individual levels, the Association proposes 34 action points to enhance surgical training and education. Adoption of these will ensure future practice continues to improve on, and learn from, the longstanding history of training provided under the guidance of the Royal Surgical Colleges.
Richards, T; Pittathankal, AA; Kahn, PY; Magee, TR; Lewis, MH; Galland, RB
INTRODUCTION We wished to assess whether pattern and impact of emergency vascular surgical referrals has altered since a previous study in 1990. Following introduction of shift working patterns, we wished to assess how these changes may affect vascular training and vascular on-call cover. PATIENTS AND METHODS Prospective survey of emergency vascular referrals at two district general hospitals (DGH-R and DGH-L) in 2003. DGH-R received only regional referrals whereas DGH-L also received ‘next day’ referrals from a smaller hospital. Results were compared between centres and with a previous study undertaken at DGH-R in 1990. RESULTS From 1990 to 2003 emergency vascular referrals at DGH-R increased by 51% (53 to 80). The number seen at DGH-R and DGH-L were similar in 2003. There were significantly more out-of-hours referrals in DGH-R than DGH-L (59% versus 35%; P = 0.0123). Referrals were more likely to be seen initially by the vascular team at DGH-L than DGH-R (80% versus 47%, P < 0.0001). CONCLUSIONS Vascular emergency referrals have increased. A trainee was likely to see more emergency referrals at DGH-L than DGH-R. This may impact on future training. PMID:17132313
Smart Dry Lab (SDL) is a low-cost, AR-based surgical training box, using the ARToolKit API. This is an add-on function for existing surgical training box, which enables quantitative evaluation of forceps maneuver and simulation of soft tissue deformation. In this paper we demonstrate functionality of our prototype system.
Austin, Ryan E; Wanzel, Kyle R
Despite increases in medical school enrolment, applications to surgical residency programs in Canada have been in decline over the past decade, with an increasing number of unmatched surgical residency positions. We examined the current status of surgical residency in Canada and analyzed application trends (2002–2013) for surgical training programs across Canada. Our findings suggest that most undergraduate medical schools across Canada are having difficulty fostering interest in surgical careers. We propose that a lack of adequate early exposure to the surgical specialties during undergraduate training is a critical factor. Moving forward, we must examine how the best-performing institutions and surgical programs have maintained interest in pursuing surgical careers and adapt our recruitment methods to both maintain and grow future interest. As Mary Engelbreit said, "If you don't like something, change it; if you can't change it, change the way you think about it."
Zweigenthal, Virginia E.M.; Marquez, Emma; London, Leslie
Background Public health (PH) approaches underpin the management and transformation of health systems in low- and middle-income countries. Despite the Master of Public Health (MPH) rarely being a prerequisite for health service employment in South Africa, many physicians pursue MPH qualifications. Objectives This study identifies their motivations and career intentions and explored MPH programme strengths and gaps in under- and post-graduate PH training. Design A cross-sectional study using an online questionnaire was completed by physicians graduating with an MPH between 2000 and 2009 and those enrolled in the programme in 2010 at the University of Cape Town. Results Nearly a quarter of MPH students were physicians. Of the 65 contactable physicians, 48% responded. They were mid-career physicians who wished to obtain research training (55%), who wished to gain broader perspectives on health (32%), and who used the MPH to advance careers (90%) as researchers, policy-makers, or managers. The MPH widened professional opportunities, with 62% changing jobs. They believed that inadequate undergraduate exposure should be remedied by applying PH approaches to clinical problems in community settings, which would increase the attractiveness of postgraduate PH training. Conclusions The MPH allows physicians to transition from pure clinical to research, policy and/or management work, preparing them to innovate changes for effective health systems, responsive to the health needs of populations. Limited local job options and incentives are important constraining factors. Advocacy for positions requiring qualifications and benchmarking exit competencies of programmes nationally may promote enrolment. PMID:27741958
The Implementation of Modern Information and Documentation Systems and Services with Special Reference to Information Needs in Eastern Africa. Advanced Postgraduate Training Course (3rd, Great Britain and the Federal Republic of Germany, June 22-August 1, 1980).
German Foundation for International Development, Bonn (West Germany).
The 7-week Advanced Postgraduate Training Course for Information Specialists from Eastern and Southern Africa described in this document was part of a long term training program designed to provide senior librarians, documentalists, and archivists with information on recent developments in methodology and technology in their special field of work.…
Different information sources, namely National Strategy for Higher Education to 2030 (Ireland), Introduction to Primary School Curriculum (1999), (Ireland), Primary Professional Development Service--Differentiation in Action, Ireland's official postgraduate study website, the Strategic Plan 2012-2016 of Mary Immaculate College, Limerick…
[Role of a credit system in the development of continuous postgraduate training of physicians within the framework of the innovation educational space formation program of the I. M. Sechenov Moscow Medical Academy].
Vyzhigina, M A; Buniatian, A A; Sizova, Zh M; Protopopova, T A; Zaugol'nikova, T V; Zhukova, S G
Russia 's joining the European higher educational space and an increase in the international competitive capacity of the European higher educational system envisage first of all that the European credit test system (ECTS) should be accepted and introduced into all national higher educational schools, which ensures both credit test and cumulative functions and guarantees the academic recognition of the education abroad. The issues of modernization of approaches to reforming the continuous postgraduate training of physicians, by using the credit test system, as well as new forms and technologies for an educational process in accordance with the European educational system principles are under discussion. The novelty of the proposed development is that the credit test system is first applied to the continuous postgraduate training of physicians within the framework of the Russian higher medical educational system. The Russian continuous postgraduate medical training pattern that is common in form and content is proposed in accordance with the Bologna declaration principles; approaches have been developed to incorporating the European educational traditions into the Russian national continuous postgraduate medical training system, by employing the credit test system; criteria have been elaborated for adapting the European credit test system at all stages of reformation of the Russian educational system; guidelines have been worked out for the conversion of academic load of various forms of the continuous postgraduate training of physicians to the credit test system; ways of introducing the new forms and technologies into an educational process have been proposed in accordance with the European education system principles, by taking into account the credit test system. The introduction of new technologies of an educational process, by using the credit test system will contribute to personality formation in a physician who has a high competence, a capacity for valuable
Ratzmann, Anja; Ruge, Sebastian; Ostendorf, Kristin; Kordaß, Bernd
Introduction: The decision to consolidate European higher education was reached by the Bologna Conference. Based on the Anglo-American system, a two-cycle degree program (Bachelor and Master) has been introduced. Subjects culminating in a state examination, such as Medicine and Dentistry, were excluded from this reform. Since the state examination is already comparable in its caliber to a Master’s degree in Medicine or Dentistry, only advanced Master’s degree programs with post-graduate specializations come into consideration for these subjects. In the field of dentistry numerous post-graduate study programs are increasingly coming into existence. Many different models and approaches are being pursued. Method: Since the 2004-2005 winter semester, the University of Greifswald has offered the Master’s degree program in Dental Functional Analysis and Therapy. Two and a half years in duration, this program is structured to allow program participation while working and targets licensed dentists who wish to attain certified skills for the future in state-of-the-art functional analysis and therapy. Aim: The design of this post-graduate program and the initial results of the evaluation by alumni are presented here. Conclusion: Our experiences show that the conceptual idea of an advanced Master’s program has proved successful. The program covers a specialty which leads to increased confidence in handling challenging patient cases. The sharing of experiences among colleagues was evaluated as being especially important. PMID:24872853
Dovgalev, A S; Astanina, S Yu; Malakhov, V N; Serdyuk, A P; Imamkuliev, K D; Gorbunova, Yu P; Pautova, E A; Prodeus, T V; Semenova, T A; Fedyanina, L V
Within the framework of the Federal External Quality Assessment (EQA) System and in the context of postgraduate training improvement for health workers in 2010-2014, specialists from the laboratories of the therapeutic-prophylactic organizations and institutions of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare were examined for their professional competence in microscopically identifying the pathogens of parasitic diseases in feces. The virtual remote educational computer technology tools that included different combinations of 16 helminthic species, 5 intestinal protozoan species, and a number of artefacts, were used. The specialists from 984 laboratories of multidisciplinary therapeutic-prophylactic organizations and hygiene and epidemiology centers in all Federal Districts of the Russian Federation were covered. A total of 8245 replies were analyzed. The detection rate for helminths was 64.0%, including those by a taxonomic group (nematodes, 65.0%; cestodes, 72.0%; trematodes, 55.1%). There was a dynamic decrease in the above indicators. There were low detection rates for trematodes parasitizing the small intestine (Metagonimus, 10.2%; Nanophyetus, 26.2%) and hepatobiliary organs (Fasciola, 59.6%; Clonorchis, 34.9%). The similar trend was seen in the detection rates for the pathogens of geohelminthisms (ascariasis, trichocephaliasis, etc.) and contagious helminthisms (enterobiasis, hymenolepiasis). The level of competence in detecting and identifying intestinal protozoa was much lower than the similar rates for helminthism pathogens. EQA for the laboratory diagnosis of the pathogens of parasitic diseases, by using the virtual tools is a leading element of the postgraduate training system for laboratory specialists. The results of EQA for the laboratory diagnosis of the pathogens of parasitic diseases are a basic material for the development, and improvement of training modernization programs, by applying a modular
Eckstein, Hans-Henning; Schmidli, Jürg; Schumacher, Hardy; Gürke, Lorenz; Klemm, Klaus; Duschek, Nikolaus; Meile, Toni; Assadian, Afshin
Vascular surgical training currently has to cope with various challenges, including restrictions on work hours, significant reduction of open surgical training cases in many countries, an increasing diversity of open and endovascular procedures, and distinct expectations by trainees. Even more important, patients and the public no longer accept a "learning by doing" training philosophy that leaves the learning curve on the patient's side. The Vascular International (VI) Foundation and School aims to overcome these obstacles by training conventional vascular and endovascular techniques before they are applied on patients. To achieve largely realistic training conditions, lifelike pulsatile models with exchangeable synthetic arterial inlays were created to practice carotid endarterectomy and patch plasty, open abdominal aortic aneurysm surgery, and peripheral bypass surgery, as well as for endovascular procedures, including endovascular aneurysm repair, thoracic endovascular aortic repair, peripheral balloon dilatation, and stenting. All models are equipped with a small pressure pump inside to create pulsatile flow conditions with variable peak pressures of ~90 mm Hg. The VI course schedule consists of a series of 2-hour modules teaching different open or endovascular procedures step-by-step in a standardized fashion. Trainees practice in pairs with continuous supervision and intensive advice provided by highly experienced vascular surgical trainers (trainer-to-trainee ratio is 1:4). Several evaluations of these courses show that tutor-assisted training on lifelike models in an educational-centered and motivated environment is associated with a significant increase of general and specific vascular surgical technical competence within a short period of time. Future studies should evaluate whether these benefits positively influence the future learning curve of vascular surgical trainees and clarify to what extent sophisticated models are useful to assess the level of
Gambadauro, Pietro; Magos, Adam
Surgical training is undergoing drastic changes, and new strategies should be adopted to keep quality standards. The authors review and advocate the use of surgical recordings as a useful complement to current training, assessment, and revalidation modalities. For trainees, such recordings would promote quality-based and competence-based surgical training and allow for self-evaluation. Video logbooks could be used to aid interaction between trainer and trainee, and facilitate formative assessment. Recordings of surgery could also be integrated into trainees' portfolios and regular assessments. Finally, such recordings could make surgeons' revalidation more sensible. The routine use of records of surgical procedures could become an integral component of the standard of care. This would have been an unattractive suggestion until recently, as analogue recording techniques are inconvenient, cumbersome, and time consuming. Today, however, with the advent of inexpensive digital technologies, such a concept is realistic and is likely to improve patient care.
Liu, James K C; Kshettry, Varun R; Recinos, Pablo F; Kamian, Kambiz; Schlenk, Richard P; Benzel, Edward C
Surgical education has been forced to evolve from the principles of its initial inception, in part due to external pressures brought about through changes in modern health care. Despite these pressures that can limit the surgical training experience, training programs are being held to higher standards of education to demonstrate and document trainee competency through core competencies and milestones. One of the methods used to augment the surgical training experience and to demonstrate trainee proficiency in technical skills is through a surgical skills laboratory. The authors have established a surgical skills laboratory by acquiring equipment and funding from nondepartmental resources, through institutional and private educational grants, along with product donations from industry. A separate educational curriculum for junior- and senior-level residents was devised and incorporated into the neurosurgical residency curriculum. The initial dissection curriculum focused on cranial approaches, with spine and peripheral nerve approaches added in subsequent years. The dissections were scheduled to maximize the use of cadaveric specimens, experimenting with techniques to best preserve the tissue for repeated uses. A survey of residents who participated in at least 1 year of the curriculum indicated that participation in the surgical skills laboratory translated into improved understanding of anatomical relationships and the development of technical skills that can be applied in the operating room. In addition to supplementing the technical training of surgical residents, a surgical skills laboratory with a dissection curriculum may be able to help provide uniformity of education across different neurosurgical training programs, as well as provide a tool to assess the progression of skills in surgical trainees.
Jones, Jeremiah; Sidwell, Richard A
Independent academic medical centers have been training surgeons for more than a century; this environment is distinct from university or military programs. There are several advantages to training at a community program, including a supportive learning environment with camaraderie between residents and faculty, early and broad operative experience, and improved graduate confidence. Community programs also face challenges, such as resident recruitment and faculty engagement. With the workforce needs for general surgeons, independent training programs will continue to play an integral role.
Tu, Yaqing; Yang, Huiyue; Shu, Li; Tu, Wangshu; Chen, Baoxin
Innovative talent training is an important task of postgraduate education. From the survey of innovative postgraduate training in China, we conclude that there is still much room for improvement in the innovative postgraduate cultivation. The survey shows that insufficient professional practice, simplex training mode and a mismatch between…
Whittick, William G.
The undergraduate surgery course of the Faculty of Veterinary Medicine and Animal Science, Universiti Pertanian Malaysia, is described with focus on its experential method of teaching surgical techniques. Also discussed are the benefits of veterinary school cooperation with a large city Society for the Prevention of Cruelty to Animals (SPCA). (JMD)
Cavalini, Worens Luiz Pereira; Claus, Christiano Marlo Paggi; Dimbarre, Daniellson; Cury, Antonio Moris; Bonin, Eduardo Aimoré; Loureiro, Marcelo de Paula; Salvalaggio, Paolo
Objective To assess the acquisition of basic laparoscopic skills of Medical students trained on a surgical simulator. Methods First- and second-year Medical students participated on a laparoscopic training program on simulators. None of the students had previous classes of surgical technique, exposure to surgical practice nor training prior to the enrollment in to the study. Students´ time were collected before and after the 150-minute training. Skill acquisition was measured comparing time and scores of students and senior instructors of laparoscopic surgery Results Sixty-eight students participated of the study, with a mean age of 20.4 years, with a predominance of first-year students (62%). All students improved performance in score and time, after training (p<0,001). Score improvement in the exercises ranged from 294.1 to 823%. Univariate and multivariate analyses identified that second-year Medical students have achieved higher performance after training. Conclusions Medical students who had never been exposed to surgical techniques can acquire basic laparoscopic skills after training in simulators. Second-year undergraduates had better performance than first-year students. PMID:25628198
Raikos, Athanasios; Smith, Janie Dade
Sound knowledge of anatomy and Anatomical variations plays an integral role in surgical and radiology specialties. This study investigated the current teaching and assessment trends on Anatomical variations in various surgical and radiology specialty training curricula in Canada and Australia. A survey was sent to 122 Program Directors and Chairs of specialty committees in Canada and Directors of Training/Education in Australia of selected surgical and radiology specialties. A total of 80.7% of respondents report that their training curricula include Anatomical variations. The highest rated classes of variations included in the curriculum are arterial (76%), venous (68%), followed by organs (64%). All trainees learn about Anatomical variations from surgeons and radiologists (100%) and via suggested textbooks of the specialty (87.1%). A total of 54.8% report that specialty training curricula do not suggest specific anatomical variation classifications for the trainees to learn, and 16.1% are uncertain if the colleges provide such kind of instruction. Trainees typically communicated findings of variations in case presentations and clinic's meetings. About 32.3% of respondents report that Anatomical variations are not assessed in their training curriculum. About 39.3% of experienced clinicians in the study report they encounter variations on a monthly basis and 25 and 21.4% on a weekly and daily basis, respectively. Surgical and radiology colleges need to investigate for hidden curriculum in their specialty training programs to ensure there are no gaps in knowledge and training related to Anatomical variations. Most educational leaders surveyed believe more teaching on Anatomical variations in the first 4 years of training would benefit resident doctors.
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
Hoffman, Rebecca L; Morris, Jon B; Kelz, Rachel R
The past two decades have been witness to some of the most dynamic changes that have occurred in surgical education in all of its history. Political policies, social revolution, and the competing priorities of a new generation of surgical trainees are defining the needs of modern training paradigms. Although the university-based academic program's tripartite mission of clinical service, research, and education has remained steadfast, the mechanisms for achieving success in this mission necessitate adaptation and innovation. The resource-rich learning environment and the unique challenges that face university-based programs contribute to its ability to generate the future leaders of the surgical workforce.
Wongkietkachorn, Apinut; Boonyawong, Pangpoom; Rhunsiri, Peera; Tantiphlachiva, Kasaya
Most patient education involves passive learning. To improve patient education regarding surgery, an active learning workshop-based teaching method is proposed. The objective of this study was to assess level of patient surgical knowledge, achievement of workshop learning objectives, patient apprehension about future surgery, and participant workshop satisfaction after completing a surgical training workshop. A four-station workshop (surgical scrub, surgical suture, laparoscopic surgery, and robotic surgery) was developed to teach four important components of the surgical process. Healthy, surgery-naive adolescents were enrolled to attend this 1-h workshop-based training program. Training received by participants was technically and procedurally identical to training received by actual surgeons. Pre- and post-workshop questionnaires were used to assess learning outcomes. There were 1312 participants, with a mean age 15.9 ± 1.1 years and a gender breakdown of 303 males and 1009 females. For surgical knowledge, mean pre-workshop and post-workshop scores were 6.1 ± 1.5 and 7.5 ± 1.5 (out of 10 points), respectively (p < 0.001). Out of 5 possible points, achievement of learning objectives, decreased apprehension about future surgery, and overall workshop satisfaction scores were all higher than 4.5. Active, hands-on patient education is an effective way to improve understanding of surgery-related processes. This teaching method may also decrease apprehension that patients or potential patients harbor regarding a future surgical procedure.
Gallagher, Anthony G; Leonard, Gerald; Traynor, Oscar J
The practice of Surgery has undergone major changes in the past 20 years and this is likely to continue. Knowledge, judgement and good technical skills will no longer be enough to safely practice surgery and interventional procedures. Fundamental abilities (e.g. psychomotor skills, visuospatial ability and depth perception) are critically important for catheter-based interventions, NOTES, robotic surgery and other procedural interventions of the future. Not all individuals possess the same amount of these innate fundamental abilities and those less endowed are likely to struggle during surgical training and thereafter in surgical practice. In contrast to other high-skill professions/industries (e.g. aviation) we do not have a tradition of testing prospective surgical trainees for abilities/attributes that we now recognize as being important for surgical practice. Instead, we continue to rely on surrogate markers of future potential (e.g. academic record). However, many studies have shown that psychomotor ability is an important predictor of both learning rate and performance for complex laparoscopic tasks. Psychomotor skills, visuospatial ability and depth perception can all be tested objectively by validated tests. At the Royal College of Surgeons in Ireland, all short-listed candidates for Higher Surgical Training now undergo formal testing of both technical skills and fundamental abilities (psychomotor skills, visuospatial ability and depth perception). Reports on each candidate's performance are supplied to the interview committee. Furthermore, a prospective database is being kept for correlation with future surgical performance. We believe that selection into surgical training should take account of attributes that we know are important for safe and efficient surgical practice.
Lukish, Jeffrey; Cruess, David
The specific aim of this study was to summarize the viewpoints of the Resident and Associate Society of the American College of Surgeons (RAS-ACS) membership regarding current training and quality of life-related issues prior to implementation of the new duty-hour guidelines. The goal was to gain insight of the members that may be useful to recruit and guide the future training of surgical residents. An Internet-based survey was developed to evaluate the viewpoints of RAS-ACS. The survey was administered by Esurveymaker.com via the ACS Web page from 2000 to 2003. RAS-ACS member participation was voluntary and anonymous. Analyses were performed to determine the frequency of response for each survey item. Two hundred thirty-five members completed the survey representing 5 per cent of RAS-ACS. Eighty-four per cent were general surgery residents. Personal satisfaction (64%) and mentorship (49%) were top factors for respondents to pursue surgical training; discussion with colleagues and future income was less important. Forty-five per cent reported that job performance was their most important concern during residency. A rewarding surgical career and family life were ranked as the most important expectations. Eighty-six per cent reported that they were satisfied with their residency, and 66 per cent reported that work hours should be limited. Personal satisfaction and mentorship were critical factors for members of the RAS-ACS to seek surgical training. Although most of the members report that work hours should be limited, an overwhelming majority reports satisfaction with surgical training prior to institution of the new duty-hour guidelines. Further emphasis on mentorship and work-hour reform may be beneficial in recruiting medical students into surgical residencies.
Brown, Kilian G M; Storey, Catherine E
There have been at least 10 major revisions of the medical curriculum since the inauguration of the Faculty of Medicine at the University of Sydney in 1883. This study traced the evolution of the teaching of surgery at our institution by examination of the set curriculum of each period; the expectations of student knowledge in the final examination as well as examining some of the insights provided by past students of their surgical experience through their writings. In the early years, medical graduates were qualified to perform operative surgery without any further training, whereas the modern postgraduate medical curriculum provides students with the basis for further surgical training.
Beard, Jonathan; Rowley, David; Bussey, Maria; Pitts, David
The Royal Colleges of Surgeons and Surgical Specialty Associations in the UK have introduced competence-based syllabi and curricula for surgical training. The syllabi of the Intercollegiate Surgical Curriculum Programme (ISCP) and Orthopaedic Curriculum and Assessment Programme (OCAP) define the core competencies, that is, the observable and measureable behaviours required of a surgical trainee. The curricula define when, where and how these will be assessed. Procedure-based assessment (PBA) has been adopted as the principal method of assessing surgical skills. It combines competencies specific to the procedure with generic competencies such as safe handling of instruments. It covers the entire procedure, including preoperative and postoperative planning. A global summary of the level at which the trainee performed the assessed elements of the procedure is also included. The form has been designed to be completed quickly by the assessor (clinical supervisor) and fed-back to the trainee between operations. PBA forms have been developed for all index procedures in all surgical specialties. The forms are intended to be used as frequently as possible when performing index procedures, as their primary aim is to aid learning. At the end of a training placement the aggregated PBA forms, together with the logbook, enable the Educational Supervisor and/or Programme Director to make a summary judgement about the competence of a trainee to perform index procedures to a given standard.
Cristancho, Sayra M; Moussa, Fuad; Dubrowski, Adam
The goal of simulation-based medical education and training is to help trainees acquire and refine the technical and cognitive skills necessary to perform clinical procedures. When designers incorporate simulation into programs, their efforts should be in line with training needs, rather than technology. Designers of simulation-augmented surgical training programs, however, face particular problems related to identifying a framework that guides the curricular design activity to fulfill the particular requirements of such training programs. These problems include the lack of (1) an objective identification of training needs, (2) a systematic design methodology to match training objectives with simulation resources, (3) structured assessments of performance, and (4) a research-centered view to evaluate and validate systematically the educational effectiveness of the program. In this report, we present a process called "Aim - FineTune - FollowThrough" to enable the connection of the identified problems to solutions, using frameworks from psychology, motor learning, education and experimental design.
Galasko, Charles S. B.
John Hunter's many contributions to surgery include the development of the scientific approach and possibly the first use of evidence-based medicine. This oration, concentrates on two other areas ? first, some of his contributions to orthopaedics and secondly past, present and future surgical training and competence. PMID:16395820
Hu, Yinin; Kim, Helen; Mahmutovic, Adela; Choi, Joanna; Le, Ivy; Rasmussen, Sara
Simulation-based surgical skills training during preclinical education is a persistent challenge due to time constraints of trainees and instructors alike. Self-directed practice is resource-efficient and flexible; however, insight into technical proficiency among trainees is often lacking. The purpose of this study is to prospectively assess the…
Marroig, Bruno; Fortes, Marco Antonio Q. R.; Pereira-Sampaio, Marco; Sampaio, Francisco J. B.; Favorito, Luciano A.
ABSTRACT Introduction and objectives: Flexible ureteroscopy is a common procedure nowadays. Most of the training programs use virtual reality simulators. The aim of this study was to standardize the building of a three-dimensional silicone mold (cavity) of the collecting system, on the basis of polyester resin endocasts, which can be used in surgical training programs. Materials and Methods: A yellow polyester resin was injected into the ureter to fill the collecting system of 24 cadaveric fresh human kidneys. After setting off the resin, the kidneys were immersed in hydrochloric acid until total corrosion of the organic matter was achieved and the collecting system endocasts obtained. The endocasts were used to prepare white color two-part silicone molds, which after endocasts withdrawn, enabled a ureteroscope insertion into the collecting system molds (cavities). Also, the minor calices were painted with different colors in order to map the access to the different caliceal groups. The cost of the materials used in the molds is $30.00 and two days are needed to build them. Results: Flexible ureteroscope could be inserted into all molds and the entire collecting system could be examined. Since some anatomical features, as infundular length, acute angle, and perpendicular minor calices may difficult the access to some minor calices, especially in the lower caliceal group, surgical training in models leads to better surgical results. Conclusions: The two-part silicone mold is feasible, cheap and allows its use for flexible ureteroscopy surgical training. PMID:27564302
Ilgner, Justus; Kawai, Takashi; Westhofen, Martin; Shibata, Takashi
Stereoscopic video teaching can facilitate understanding for current minimally-invasive operative techniques. This project was created to set up a digital stereoscopic teaching environment for training of ENT residents and medical students. We recorded three ENT operative procedures (tympanoplasty, paranasal sinus operation and laser chordectomy) at the University Hospital Aachen. The material was edited stereoscopically at the Waseda University and converted into a streaming 3-D video format, which does not depend on PAL or NTSC signal standards. Video clips were evaluated by 5 ENT specialists and 11 residents in single sessions on an LCD monitor (8) and a CRT monitor (8). Emphasis was laid on depth perception, visual fatigue and time to achieve stereoscopic impression. Qualitative results were recorded on a visual analogue scale, ranging from 1 (excellent) to 5 (bad). The overall impression was rated 2,06 to 3,13 in the LCD group and 2,0 to 2,62 in the CRT group. The depth impression was rated 1,63 to 2,88 (LCD) and 1,63 to 2,25 (CRT). Stereoscopic video teaching was regarded as useful in ENT training by all participants. Further points for evaluation will be the quantification of depth information as well as the information gain in teaching junior colleagues.
Tang, Wen; Wan, Tao Ruan
Most of surgical simulators employ a linear elastic model to simulate soft tissue material properties due to its computational efficiency and the simplicity. However, soft tissues often have elaborate nonlinear material characteristics. Most prominently, soft tissues are soft and compliant to small strains, but after initial deformations they are very resistant to further deformations even under large forces. Such material characteristic is referred as the nonlinear material incompliant which is computationally expensive and numerically difficult to simulate. This paper presents a constraint-based finite-element algorithm to simulate the nonlinear incompliant tissue materials efficiently for interactive simulation applications such as virtual surgery. Firstly, the proposed algorithm models the material stiffness behavior of soft tissues with a set of 3-D strain limit constraints on deformation strain tensors. By enforcing a large number of geometric constraints to achieve the material stiffness, the algorithm reduces the task of solving stiff equations of motion with a general numerical solver to iteratively resolving a set of constraints with a nonlinear Gauss-Seidel iterative process. Secondly, as a Gauss-Seidel method processes constraints individually, in order to speed up the global convergence of the large constrained system, a multiresolution hierarchy structure is also used to accelerate the computation significantly, making interactive simulations possible at a high level of details. Finally, this paper also presents a simple-to-build data acquisition system to validate simulation results with ex vivo tissue measurements. An interactive virtual reality-based simulation system is also demonstrated.
Grover, Sonal; Tan, Gerald Y; Srivastava, Abhishek; Leung, Robert A; Tewari, Ashutosh K
The advent of laparoscopic and robotic techniques for management of urologic malignancies marked the beginning of an ever-expanding array of minimally invasive options available to cancer patients. With the popularity of these treatment modalities, there is a growing need for trained surgical oncologists who not only have a deep understanding of the disease process and adept surgical skills, but also show technical mastery in operating the equipment used to perform these techniques. Establishing a robotic prostatectomy program is a tremendous undertaking for any institution, as it involves a huge cost, especially in the purchasing and maintenance of the robot. Residency programs often face many challenges when trying to establish a balance between costs associated with robotic surgery and training of the urology residents, while maintaining an acceptable operative time. Herein we describe residency training program paradigms for teaching robotic surgical skills to urology residents. Our proposed paradigm outlines the approach to compensate for the cost involved in robotic training establishment without compromising the quality of education provided. With the potential advantages for both patients and surgeons, we contemplate that robotic-assisted surgery may become an integral component of residency training programs in the future.
Tasir, Zaidatun; Abour, Khawla Mohammed El Amin; Halim, Noor Dayana Abd; Harun, Jamalludin
There are three main variables that would make the integration of ICT tools as an easy process. Those three variables are teachers' ICT competency, teachers' confidence level in using ICT, and teachers' satisfaction on ICT training programmes. This study investigated the relationships among these three variables and measured the levels of the…
Roberts, Martin J.; Gale, Thomas C. E.; McGrath, John S.; Wilson, Mark R.
The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an…
Caron, Nadine; Iglesias, Stuart; Friesen, Randall; Berjat, Vanessa; Humber, Nancy; Falk, Ryan; Prins, Mark; Haines, Victoria Vogt; Geller, Brian; Janke, Fred; Woollard, Robert; Batchelor, Bret; Van Bussel, Jared
Summary Rural western Canada relies heavily on family physicians with enhanced surgical skills (ESS) for surgical services. The recent decision by the College of Family Physicians of Canada (CFPC) to recognize ESS as a “community of practice” section offers a potential home akin to family practice anesthesia and emergency medicine. To our knowledge, however, a skill set for ESS in Canada has never been described formally. In this paper the Curriculum Committee of the National ESS Working Group proposes a generic curriculum for the training and evaluation of the ESS skill set. PMID:26574835
Ma, Carolyn; Tokumaru, Sheri; Goo, Roy; Ciarleglio, Anita
Residency training is designed to provide recent pharmacy school graduates who have the profession's terminal Doctor of Pharmacy (PharmD) degree with accelerated growth beyond entry-level professional competence. Placement into residency programs is highly competitive through an application and match process. These programs provide additional training in patient-centered care with advancement of skills in clinical judgment, pharmacy operations, clinical research, project management, and leadership. Approximately 20% of a pharmacy graduating class will apply for a residency. With increasing numbers of pharmacy schools across the country, the availability of residency programs is falling behind applicants. The establishment of the Daniel K. Inouye College of Pharmacy (DKICP) has addressed the shortage of pharmacists within the state. In recent years, resident positions in Hawai'i have doubled to a total of ten first year residency (PGY1) and two second year (PGY2) specialty residencies. Given the limited availability of positions in Hawai'i, graduates continue to return to the continental US to seek positions, thus increasing the likelihood of them not returning to practice in Hawai'i. Establishing residency programs is essential to elevate the level of pharmacy practice toward innovation and adherence to best practices, academia/teaching and scholarly research. This descriptive paper will detail the general components and types of pharmacy practice residency, the unique components of the Hawai'i programs, the career placement of Hawai'i's programs graduates and future challenges.
Ghiabi, Edmond; Taylor, K Lynn
This project aimed at documenting the surgical training curricula offered by North American graduate periodontics programs. A survey consisting of questions on teaching methods employed and the content of the surgical training program was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. The chi-square test was used to assess whether the residents' clinical experience was significantly (P<0.05) influenced by having a) a structured preclinical program or b) another dental residency program in the institution. Thirty-four programs (59 percent) responded to the survey. Twenty-six programs (76 percent of respondents) reported offering a structured preclinical component. Traditional teaching methods such as slides, live demonstration, DVD/CD, and animal cadavers were the most common teaching methods used, whereas online courses, computer simulation, and various surgical mannequins were least commonly used. The most commonly performed surgical procedures were conventional flaps, periodontal plastic procedures, hard tissue grafts, and implants. Furthermore, residents in programs offering a structured preclinical component performed significantly more procedures (P=0.012) using lasers than those in programs not offering a structured preclinical program. Devising new and innovative teaching methods is a clear avenue for future development in North American graduate periodontics programs.
Blume, S.; Amsterdamska, O.
Major changes in postgraduate education since the 1970s in countries belonging to the Organisation for Economic Cooperation and Development (OECD) are examined. Postgraduate education refers to specialized or research training after the receipt of a university degree. The basis of analysis includes: analyses provided by authorities in Australia,…
de Feijter, Jeantine M; de Grave, Willem S; Dornan, Tim; Koopmans, Richard P; Scherpbier, Albert J J A
Evidence that medical error can cause harm to patients has raised the attention of the health care community towards patient safety and influenced how and what medical students learn about it. Patient safety is best taught when students are participating in clinical practice where they actually encounter patients at risk. This type of learning is referred to as workplace learning, a complex system in which various factors influence what is being learned and how. A theory that can highlight potential difficulties in this complex learning system about patient safety is activity theory. Thirty-four final year undergraduate medical students participated in four focus groups about their experiences concerning patient safety. Using activity theory as analytical framework, we performed constant comparative thematic analysis of the focus group transcripts to identify important themes. We found eight general themes relating to two activities: learning to be a doctor and delivering safe patient care. Simultaneous occurrence of these two activities can cause contradictions. Our results illustrate the complexity of learning about patient safety at the workplace. Students encounter contradictions when learning about patient safety, especially during a transitional phase of their training. These contradictions create potential learning opportunities which should be used in education about patient safety. Insight into the complexities of patient safety is essential to improve education in this important area of medicine.
Inclan, Paul M; Hyde, Adam S; Hulme, Michael; Carter, Jeffrey E
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons. By comparing generalist and subspecialist career values, we determined that cardiovascular (NPV = 698,931), pediatric (430,964), thoracic (239,189), bariatric (166,493), vascular (96,071), and transplant (46,669) fellowships improve career value. Alternatively, trauma (11,374), colorectal (44,622), surgical oncology (203,021), and breast surgery (326,465) fellowships all reduce career value. In orthopedic surgery, spine (505,198), trauma (123,250), hip and joint (60,372), and sport medicine (56,167) fellowships improve career value, whereas shoulder and elbow (4,539), foot and ankle (173,766), hand (366,300), and pediatric (489,683) fellowships reduce career NPV. In obstetrics and gynecology, reproductive endocrinology (352,854), and maternal and fetal medicine (322,511) fellowships improve career value, whereas gynecology oncology (28,101) and urogynecology (206,171) fellowships reduce career value. These data indicate that the financial return of fellowship is highly variable.
Kirkpatrick, Andrew W.; Tien, Homer; LaPorta, Anthony T.; Lavell, Kit; Keillor, Jocelyn; Wright Beatty, Heather E.; McKee, Jessica Lynn; Brien, Susan; Roberts, Derek J.; Wong, Jonathan; Ball, Chad G.; Beckett, Andrew
BACKGROUND Hemorrhage is the leading cause of preventable posttraumatic death. Many such deaths may be potentially salvageable with remote damage-control surgical interventions. As recent innovations in information technology enable remote specialist support to point-of-care providers, advanced interventions, such as remote damage-control surgery, may be possible in remote settings. METHODS An anatomically realistic perfused surgical training mannequin with intrinsic fluid loss measurements (the “Cut Suit”) was used to study perihepatic packing with massive liver hemorrhage. The primary outcome was loss of simulated blood (water) during six stages, namely, incision, retraction, direction, identification, packing, and postpacking. Six fully credentialed surgeons performed the same task as 12 military medical technicians who were randomized to remotely telementored (RTM) (n = 7) or unmentored (UTM) (n=5) real-time guidance by a trauma surgeon. RESULTS There were no significant differences in fluid loss between the surgeons and the UTM group or between the UTM and RTM groups. However, when comparing the RTM group with the surgeons, there was significantly more total fluid loss (p = 0.001) and greater loss during the identification (p = 0.002), retraction (p = 0.035), direction (p = 0.014), and packing(p = 0.022) stages. There were no significant differences in fluid loss after packing between the groups despite differences in the number of sponges used; RTM group used more sponges than the surgeons and significantly more than the UTM group (p = 0.048). However, mentoring significantly increased self-assessed nonsurgeon procedural confidence (p = 0.004). CONCLUSION Perihepatic packing of an exsanguinating liver hemorrhage model was readily performed by military medical technicians after a focused briefing. While real-time telementoring did not improve fluid loss, it significantly increased nonsurgeon procedural confidence, which may augment the feasibility of the
Waterman, Brian R; Martin, Kevin D; Cameron, Kenneth L; Owens, Brett D; Belmont, Philip J
Although virtual reality simulators have established construct validity, no studies have proven transfer of skills from a simulator to improved in vivo surgical skill. The current authors hypothesized that simulation training would improve residents' basic arthroscopic performance and safety. Twenty-two orthopedic surgery trainees were randomized into simulation or standard practice groups. At baseline testing, all of the participants performed simulator-based testing and a supervised, in vivo diagnostic shoulder arthroscopy with video recording. The simulation group subsequently received 1 hour of total instruction during a 3-month period, and the standard practice group received no simulator training. After intervention, both groups were reevaluated with simulator testing and a second recorded diagnostic shoulder arthroscopy. Two blinded, independent experts evaluated arthroscopic performance using the anatomic checklist, Arthroscopic Surgery Skill Evaluation Tool (ASSET) score, and total elapsed time. All outcome measures were compared within and between groups. After intervention, mean time required by the simulation group to complete the simulator task (30.64 seconds) was 8±1.2 seconds faster than the time required by the control group (38.64 seconds; P=.001). Probe distance (51.65 mm) was improved by 41.2±6.08 mm compared with the control (92.83 mm; P=.001). When comparing ASSET safety scores, the simulation group was competent (3.29) and significantly better than the control group (3.00; P=.005) during final arthroscopic testing. This study establishes transfer validity for an arthroscopic shoulder simulator model. Simulator training for residents in training can decrease surgical times, improve basic surgical skills, and confer greater patient safety during shoulder arthroscopy. [Orthopedics. 2016; 39(3):e479-e485.].
Admiraal, Wilfried; Lockhorst, Ditte; Smit, Ben; Weijers, Sanne
This study examined technology in post-graduate teacher training programs in the Netherlands. A questionnaire was completed by 111 teacher educators from 12 Dutch universities with a post-graduate teacher training program. The general view of the use of technology in Dutch post-graduate teacher education was quite conventional. Basic technology…
Langebæk, R; Berendt, M; Pedersen, L T; Jensen, A L; Eika, B
For practical, ethical and economic reasons, veterinary surgical education is becoming increasingly dependent on models for training. The limited availability and high cost of commercially produced surgical models has increased the need for useful, low-cost alternatives. For this reason, a number of models were developed to be used in a basic surgical skills course for veterinary students. The models were low fidelity, having limited resemblance to real animals. The aim of the present study was to describe the students' learning experience with the models and to report their perception of the usefulness of the models in applying the trained skills to live animal surgery. One hundred and forty-six veterinary fourth-year students evaluated the models on a four-point Likert scale. Of these, 26 additionally participated in individual semistructured interviews. The survey results showed that 75 per cent of the students rated the models 'useful'/'very useful'. Interviews revealed that tactile, dimensional, visual, situational and emotional features are important to students' perception of a successful translation of skills from models to live animal. In conclusion, low-fidelity models are useful educational tools in preparation for live animal surgery. However, there are specific features to take into account when developing models in order for students to perceive them as useful.
Riviello, Robert; Ozgediz, Doruk; Hsia, Renee Y; Azzie, Georges; Newton, Mark; Tarpley, John
The global disparities in both surgical disease burden and access to delivery of surgical care are gaining prominence in the medical literature and media. Concurrently, there is an unprecedented groundswell in idealism and interest in global health among North American medical students and trainees in anesthesia and surgical disciplines. Many academic medical centers (AMCs) are seeking to respond by creating partnerships with teaching hospitals overseas. In this article we describe six such partnerships, as follows: (1) University of California San Francisco (UCSF) with the Bellagio Essential Surgery Group; (2) USCF with Makerere University, Uganda; (3) Vanderbilt with Baptist Medical Center, Ogbomoso, Nigeria; (4) Vanderbilt with Kijabe Hospital, Kenya; (5) University of Toronto, Hospital for Sick Children with the Ministry of Health in Botswana; and (6) Harvard (Brigham and Women's Hospital and Children's Hospital Boston) with Partners in Health in Haiti and Rwanda. Reflection on these experiences offers valuable lessons, and we make recommendations of critical components leading to success. These include the importance of relationships, emphasis on mutual learning, the need for "champions," affirming that local training needs to supersede expatriate training needs, the value of collaboration in research, adapting the mission to locally expressed needs, the need for a multidisciplinary approach, and the need to measure outcomes. We conclude that this is an era of cautious optimism and that AMCs have a critical opportunity to both shape future leaders in global surgery and address the current global disparities.
Within the context of postgraduate research education and training in the higher education sector, drafting might be understood as "not quite the final product" produced by the student who is "not yet the final product" of the university. In this paper, I turn this assumption "off centre" to argue instead that writing and subjectivity are mutually…
Fleming, Kenneth; Pugh, Christopher; Best, Denise
Postgraduate medical education in the UK has gone through a maelstrom of change in the last 20 years; many components have disadvantaged clinical academic training in particular. In this article we summarise some of the changes and describe the advantages of the creation of a dedicated clinical academic graduate school as a response to these changes.
Savelyeva, M. V.; Shumakova, N. A.
The research analyses the issues of competency-based approach implementation in connection with practical experience gained in SibSAU in teaching English for scientific purposes to postgraduate students. The article focuses on IT application for the objectives of both class room and independent work of post graduates organization.
Ferguson, H J M; Fitzgerald, J E F; Reilly, J; Beamish, A J; Gokani, V J
Objectives Increasing numbers of minor surgical procedures are being performed in the community. In the UK, general practitioners (family medicine physicians) with a specialist interest (GPwSI) in surgery frequently undertake them. This shift has caused decreases in available cases for junior surgeons to gain and consolidate operative skills. This study evaluated GPwSI's case-load, procedural training and perceptions of offering formalised operative training experience to surgical trainees. Design Prospective, questionnaire-based cross-sectional study. Setting/participants A novel, 13-item, self-administered questionnaire was distributed to members of the Association of Surgeons in Primary Care (ASPC). A total 113 of 120 ASPC members completed the questionnaire, representing a 94% response rate. Respondents were general practitioners practising or intending to practice surgery in the community. Results Respondents performed a mean of 38 (range 5–150) surgical procedures per month in primary care. 37% (42/113) of respondents had previously been awarded Membership or Fellowship of a Surgical Royal College; 22% (25/113) had completed a surgical certificate or diploma or undertaken a course of less than 1 year duration. 41% (46/113) had no formal British surgical qualifications. All respondents believed that surgical training in primary care could be valuable for surgical trainees, and the majority (71/113, 63%) felt that both general practice and surgical trainees could benefit equally from such training. Conclusions There is a significant volume of surgical procedures being undertaken in the community by general practitioners, with the capacity and appetite for training of prospective surgeons in this setting, providing appropriate standards are achieved and maintained, commensurate with current standards in secondary care. Surgical experience and training of GPwSI's in surgery is highly varied, and does not yet benefit from the quality assurance secondary care
Crofts, T. J.; Griffiths, J. M.; Sharma, S.; Wygrala, J.; Aitken, R. J.
The reduction in doctors' hours and the introduction of specialist training have reduced general surgical training by 60%. This study assessed the implications for a single health board. A questionnaire listing 13 representative operations was sent to 44 trainees and 52 trainers to determine the number of operations a trainee should perform. The total number of operations required for training was compared against the total actually performed across the health board. Operating times for five representative operations were audited prospectively. Trainers and trainees recommended a similar and conservative number of operations. The total number of operations available for training (4913) was 38% less than the number recommended (7946). Trainees required 50-75% more operating time than consultants. To increase the proportion of operations undertaken by trainees from the current 30% to 70% would require an extra 270 theatre days (of pounds 1.3m) yearly. The minimum number of operations required for training must be defined and the proportion of supervised operations undertaken by trainees substantially increased. Service and financial implications will have to be addressed. Action is needed urgently, as the first trainees will become consultants in less than five years. PMID:9093109
Kidney, Beverly A; Dial, Sharon M; Christopher, Mary M
The Education Committee of the American Society for Veterinary Clinical Pathology has identified a need for improved structure and guidance of training residents in clinical pathology. This article is the third in a series of articles that address this need. The goals of this article are to describe learning objectives and competencies in knowledge, abilities, and skills in cytopathology and surgical pathology (CSP); provide options and ideas for training activities; and identify resources in veterinary CSP for faculty, training program coordinators, and residents. Guidelines were developed in consultation with Education Committee members and peer experts and with evaluation of the literature. The primary objectives of training in CSP are: (1) to develop a thorough, extensive, and relevant knowledge base of biomedical and clinical sciences applicable to the practice of CSP in domestic animals, laboratory animals, and other nondomestic animal species; (2) to be able to reason, think critically, investigate, use scientific evidence, and communicate effectively when making diagnoses and consulting and to improve and advance the practice of pathology; and (3) to acquire selected technical skills used in CSP and pathology laboratory management. These guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary CSP and will provide a useful framework for didactic and clinical activities in resident-training programs.
Cooke, Steven J.; Wagner, Glenn N.; Brown, Richard S.; Deters, Katherine A.
Training is a fundamental part of all scientific and technical disciplines. This is particularly true for all types of surgeons. For surgical procedures, a number of skills are necessary to reduce mistakes. Trainees must learn an extensive yet standardized set of problem-solving and technical skills to handle challenges as they arise. There are currently no guidelines or consistent training methods for those intending to implant electronic tags in fish; this is surprising, considering documented cases of negative consequences of fish surgeries and information from studies having empirically tested fish surgical techniques. Learning how to do fish surgery once is insufficient for ensuring the maintenance or improvement of surgical skill. Assessment of surgical skills is rarely incorporated into training, and is needed. Evaluation provides useful feedback that guides future learning, fosters habits of self-reflection and self-remediation, and promotes access to advanced training. Veterinary professionals should be involved in aspects of training to monitor basic surgical principles. We identified attributes related to knowledge, understanding, and skill that surgeons must demonstrate prior to performing fish surgery including a “hands-on” assessment using live fish. Included is a summary of common problems encountered by fish surgeons. We conclude by presenting core competencies that should be required as well as outlining a 3-day curriculum for training surgeons to conduct intracoelomic implantation of electronic tags. This curriculum could be offered through professional fisheries societies as professional development courses.
Blencowe, N S; Parsons, B A; Hollowood, A D
BACKGROUND There is concern across all medical specialties that shift patterns and reduced working hours are detrimental to training, and that craft specialties have been most affected. This study aimed to examine the effects of these changes to training on the quantity of operating performed by surgical trainees in a UK teaching hospital. METHODS This retrospective study of prospectively collected computerised theatre data examined elective and emergency general surgical operations performed over four time periods: 1996 (Calman), 2001 (New Deal), 2004 and 2009 (European Working Time Directive). Procedures were analysed according to grade of surgeon and time of day. RESULTS In 1996, most appendicectomies (72.2%) were performed by senior house officers (SHOs), compared with 3.8% in 2009. By 2009, SHOs did not perform any emergency procedures other than abscess drainage and appendicectomy. The proportion of emergency operating performed by specialist registrar (SpRs) has remained constant, but elective operating has reduced from 34.6% (1996) to 15.7% (2009). Supervision of both SHOs and SpRs has increased between 1996 and 2009 in both elective and emergency work. CONCLUSIONS The proportion of operating performed by SpRs and SHOs has fallen over the last decade, coinciding with implementation of structural changes to training, the advent of minimally invasive techniques, and the drive for a consultant led health service. Trainees may therefore require increased supervision as well as protected theatre sessions to balance operative training with ward based duties. Education must be integrated into working practice in order for trainees to achieve expected competencies and ultimately produce adequately experienced consultants.
In our unprecedented ageing society, high quality pharmacy practices are recommended; the activities of pharmacists who have received novel education are therefore expected. Although advanced education before graduation is important, postgraduate education is also required because the knowledge and skill required by pharmacists are increasing and are progressing everyday. The period of pharmacist education has been six years, and the new educational system produces next generation pharmacists. Postgraduate education should be established with the education contents corresponding to the new education system. The career path has an important role in postgraduate education, which consists of fundamental to advanced training through the various stages according to pharmacist experience. Clinical academic societies and some pharmacists' organizations provide accreditation systems for pharmacist specialties. This system will play an important role as a route in the career path. It is necessary to accredit pharmacist specialties to establish postgraduate education and research in cooperation with pharmaceutical institutions. It is thought that the responsibility of universities of pharmaceutical science will become more important to improve pharmacist ability and pharmacy practice. Universities of pharmaceutical science should collaborate with pharmaceutical institutions to establish postgraduate education and research into clinical pharmacy practice.
Mitchell, Katrina B; Giiti, Geofrey; Kotecha, Vihar; Chandika, Alphonce; Pryor, Kane O; Härtl, Roger; Gilyoma, Japhet
Global surgery initiatives increasingly are focused on strengthening education and local health care systems to build surgical capacity. The goal of this education project was to support local health care providers in augmenting the surgical curriculum at a new medical school, thus promoting long-term local goals and involvement. Working with local surgeons, residents, and medical and assistant medical officer students, we identified the most common surgical conditions presenting to Weill Bugando Medical Centre in Mwanza, Tanzania, and the areas of greatest need in surgical education. We developed an 8-week teaching schedule for undergraduate students and an electronic database of clinical surgery topics. In addition, we started teaching basic surgical skills in the operating theatre, bridging to an official and recurring workshop through a supporting international surgery organization. The medical and assistant medical officer students reported increased satisfaction with their clinical surgery rotations and mastery of key educational subjects. The initiation of an Essential Surgical Skills workshop through the Canadian Network for International Surgery showed students had improved comfort with basic surgical techniques. Short-term surgical missions may appear to fill a void in the shortage of health care in the developing world. However, we conclude that global health resources are more appropriately used through projects giving ownership to local providers and promoting education as a foundation of development. This results in better coordination among local and visiting providers and greater impact on education and long-term growth of health care capacity.
Bruce, Adrienne N.; Battista, Alexis; Plankey, Michael W.; Johnson, Lynt B.; Marshall, M. Blair
Background Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women's perceptions of gender-based discrimination in the surgical training and working environment. Methods Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons. Results We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men. Conclusions The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons. PMID:25652117
Milburn, J A; Khera, G; Hornby, S T; Malone, P S C; Fitzgerald, J E F
The utility of simulation in surgical training is now well-established, with proven validity and demonstrable transfer of skills to the clinical setting. Through a reduction in the technical learning curve, simulation can prepare surgeons for actual practice and in doing so it has the potential to improve both patient safety and service efficiency. More broadly, multi-disciplinary simulation of the theatre environment can aid development of non-technical skills and assist in preparing theatre teams for infrequently encountered scenarios such as surgical emergencies. The role of simulation in the formal training curriculum is less well-established, and availability of facilities for this is currently unknown. This paper reviews the contemporary evidence supporting simulation in surgical training and reports trainee access to such capabilities. Our national surgical trainee survey with 1130 complete responses indicated only 41.2% had access to skills simulator facilities. Of those with access, 16.3% had availability out-of-hours and only 54.0% had local access (i.e. current work place). These results highlight the paucity in current provision of surgical skills simulator facilities, and availability (or awareness of availability) varies widely between region, grade and specialty. Based on these findings and current best-evidence, the Association of Surgeons in Training propose 22 action-points for the introduction, availability and role of simulation in surgical training. Adoption of these should guide trainers, trainees and training bodies alike to ensure equitable provision of appropriate equipment, time and resources to allow the full integration of simulation into the surgical curriculum.
Huri, Emre; Ezer, Mehmet; Chan, Eddie
Laparoscopic surgery is routinely used to treat many urological conditions and it is the gold standard treatment option for many surgeries such as radical nephrectomy. Due to the difficulty of learning, laparoscopic training should start outside the operating room. Although it is a very different model of laparoscopic training; the aim of this review is to show the value of human cadaveric model for laparoscopic training and present our experience in this area. Fresh frozen cadaveric model in laparoscopic training, dry lab, cadaveric model, animal models and computer based simulators are the most commonly used models for laparoscopic training. Cadaveric models mimic the live setting better than animal models. Also, it is the best way in demonstrating important anatomic landmarks like prostate, bladder, and pelvic lymph nodes templates. However, cadaveric training is expensive, and should be used by multiple disciplines for higher efficiency. The laparosopic cadaveric training starts with didactic lectures with introduction of pelvic surgical anatomy. It is followed by hands-on dissection. A typical pelvic dissection part can be completed in 6 hours. Surgical robot and some laparoscopy platforms are equipped with 3-D vision. In recent years, we have use the stereoscopic laparoscopy system for training purposes to show exact anatomic landmarks. Cadavers are removed from their containers 3 to 5 days prior to training session to allow enough time for thawing. Intracorporeal suturing is an important part of laparoscopic training. We believe that suturing must be practiced in the dry lab, which is significantly cheaper than cadaveric models. Cadaveric training model should focus on the anatomic dissection instead. In conclusion, fresh-frozen cadaveric sample is one of the best 3D simulation models for laparoscopic training purposes. Major aim of cadaveric training is not only mimicking the surgical technique but also teaching true anatomy. Lack of availability and higher
Shepherd, J P; Brickley, M
All surgical procedures are characterised by a sequence of steps and instrument changes. Although surgical efficiency and training in operative technique closely relate to this process, few studies have attempted to analyse it quantitatively. Because efficiency is particularly important in day surgery and lower third molar removal is a high-volume procedure, the need for which is responsible for particularly long waiting-lists in almost all UK health regions, this operation was selected for evaluation. A series of 80 consecutive procedures, carried out for 43 day-stay patients under general anaesthesia by seven junior staff (senior house officers and registrars: 39 procedures) and four senior staff (senior registrars and consultants: 41 procedures) were analysed. Median operating time for procedures which required retraction of periosteum was 9.5 min (range 2.7-23.3 min). Where these steps were necessary, median time for incision was 25 s (range 10-90 s); for retraction of periosteum, 79 s (range 5-340 s); for bone removal, 118 s (range 10-380 s); for tooth excision, 131 s (range 10-900 s); for debridement, 74 s (range 5-270 s); and for suture, 144 s (range 25-320 s). Junior surgeons could be differentiated from senior surgeons on the basis of omission, repetition and duration of these steps. Juniors omitted retraction of periosteum in 10% of procedures (seniors 23%) and suture in 13% (seniors 32%). Juniors repeated steps in 47% of operations; seniors, 14%. Junior surgeons took significantly more time than senior surgeons for incision, bone removal and tooth excision. No significant differences between junior and senior surgeons were found in relation to the incidence of altered lingual and labial sensation at 7 days. It was concluded that activity analysis may be a useful measure of the effectiveness of surgical training and the efficiency of operative technique.
Hayashi, Shogo; Naito, Munekazu; Kawata, Shinichi; Qu, Ning; Hatayama, Naoyuki; Hirai, Shuichi; Itoh, Masahiro
Traditionally, surgical training meant on-the-job training with live patients in an operating room. However, due to advancing surgical techniques, such as minimally invasive surgery, and increasing safety demands during procedures, human cadavers have been used for surgical training. When considering the use of human cadavers for surgical training, one of the most important factors is their preservation. In this review, we summarize four preservation methods: fresh-frozen cadaver, formalin, Thiel's, and saturated salt solution methods. Fresh-frozen cadaver is currently the model that is closest to reality, but it also presents myriad problems, including the requirement of freezers for storage, limited work time because of rapid putrefaction, and risk of infection. Formalin is still used ubiquitously due to its low cost and wide availability, but it is not ideal because formaldehyde has an adverse health effect and formalin-embalmed cadavers do not exhibit many of the qualities of living organs. Thiel's method results in soft and flexible cadavers with almost natural colors, and Thiel-embalmed cadavers have been appraised widely in various medical disciplines. However, Thiel's method is relatively expensive and technically complicated. In addition, Thiel-embalmed cadavers have a limited dissection time. The saturated salt solution method is simple, carries a low risk of infection, and is relatively low cost. Although more research is needed, this method seems to be sufficiently useful for surgical training and has noteworthy features that expand the capability of clinical training. The saturated salt solution method will contribute to a wider use of cadavers for surgical training.
Nunnink, L; Welsh, A M; Abbey, M; Buschel, C
Emergency chest reopen of the post cardiac surgical patient in the intensive care unit is a high-stakes but infrequent procedure which requires a high-level team response and a unique skill set. We evaluated the impact on knowledge and confidence of team-based chest reopen training using a patient simulator compared with standard video-based training. We evaluated 49 medical and nursing participants before and after training using a multiple choice questions test and a questionnaire of self-reported confidence in performing or assisting with emergency reopen. Both video- and simulation-based training significantly improved results in objective and subjective domains. Although the post-test scores did not differ between the groups for either the objective (P = 0.28) or the subjective measures (P = 0.92), the simulation-based training produced a numerically larger improvement in both domains. In a multiple choice question out of 10, participants improved by a mean of 1.9 marks with manikin-based training compared to 0.9 with video training (P = 0.03). On a questionnaire out of 20 assessing subjective levels of confidence, scores improved by 3.9 with manikin training compared to 1.2 with video training (P = 0.002). Simulation-based training appeared to be at least as effective as video-based training in improving both knowledge and confidence in post cardiac surgical emergency resternotomy.
Weston, Matthew; Weston, Kathryn L; Prentis, James M; Snowden, Chris P
The advancement of perioperative medicine is leading to greater diversity in development of pre-surgical interventions, implemented to reduce patient surgical risk and enhance post-surgical recovery. Of these interventions, the prescription of pre-operative exercise training is gathering momentum as a realistic means for enhancing patient surgical outcome. Indeed, the general benefits of exercise training have the potential to pre-operatively optimise several pre-surgical risks factors, including cardiorespiratory function, frailty and cognitive function. Any exercise programme incorporated into the pre-operative pathway of care needs to be effective and time efficient in that any fitness gains are achievable in the limited period between the decision for surgery and operation (e.g. 4 weeks). Fortunately, there is a large volume of research describing effective and time-efficient exercise training programmes within the discipline of sports science. Accordingly, the objective of our commentary is to synthesise contemporary exercise training research, both from non-clinical and clinical populations, with the overarching aim of informing the development of effective and time-efficient pre-surgical exercise training programmes. The development of such exercise training programmes requires the careful consideration of several key principles, namely frequency, intensity, time, type and progression of exercise. Therefore, in light of more recent evidence demonstrating the effectiveness and time efficiency of high-intensity interval training-which involves brief bouts of intense exercise interspersed with longer recovery periods-the principles of exercise training programme design will be discussed mainly in the context of such high-intensity interval training programmes. Other issues pertinent to the development, implementation and evaluation of pre-operative exercise training programmes, such as individual exercise prescription, training session monitoring and potential
Akhlaghi, Mohammad Reza; Vafamehr, Vajiheh; Dadgostarnia, Mohammad; Dehghani, Alireza
Introduction: In this study, by using a problem-oriented approach in the needs assessment, identifying the defects and deficiencies in emergency health training centers has been determined as the basis for the requirements. The main objective of the study was the implementation of surgical emergencies integration of the five surgical groups (general surgery, urology, orthopedics, neurosurgery, and ENT) to meet the needs and determining its efficacy. Materials and Methods: This interventional study was conducted in three phases: (1) Phase I (design and planning): Needs assessment, recognition of implementation barriers and providing the objectives and training program for integrated emergencies. (2) Phase II (implementation): Justification of the main stakeholders of the project, preparation of students’ duties in the emergency department, preparation of on-duty plans, supervising the implementation of the program, and reviewing the plan in parallel with the implementation based on the problems. (3) Phase III (evaluation): Reviewing the evidences based on the amount of efficiency of the plan and justification for its continuation. In the first and the second phase, the data were collected through holding focus group meetings and interviews. In the third phase, the opened-reply and closed-reply researcher-made questionnaires were used. The questionnaire face and content validity were confirmed by experts and the reliability was assessed by calculating the Cronbach's alpha. Results: According to the views of the interns, assistants, teachers, and emergency personnel, the positive features of the plan included the following: Increasing the patients’ satisfaction, reducing the patients’ stay in the Emergency Department, increasing the speed of handling the patients, balancing the workloads of the interns, direct training of interns by young teachers of emergency medicine, giving the direct responsibility of the patient to the intern, practical and operational
Koh, Denise; Zawi, Mohd Khairi
Most postgraduate programmes, that have research components, require students to take at least one course of research statistics. Not all postgraduate programmes are science based, there are a significant number of postgraduate students who are from the social sciences that will be taking statistics courses, as they try to complete their…
Seoane, Juan; Varela-Centelles, Pablo; Cerero-Lapiedra, Rocío; Seoane-Romero, Juan M.; Diz, Pedro
Objectives: To describe a new bench model for oral precancer/cancer biopsy training and to assess its effectiveness in terms of trainees’ perception. Study design: Cross-sectional, descriptive, performed on 424 general dental practitioners (GDP) who undertook biopsies on a pig tongue. The participants were assessed by direct observation for 2.5 hours using specific check-lists and by means of a self-applied questionnaire. Results: The workshop was perceived as “very interesting” even by those with previous surgical experience (Xi - Xj = 0.07; 95%CI= -0.20-0.09). Most GDPs considered themselves able to undertake oral biopsies on real patients after the workshop. Those who had previously received theoretical continuous education courses on oral biopsy scored higher values within the group (Xi - Xj = 0.20; 95%CI= 0.04-0.37). Conclusions: There is a need for including clinical abilities workshops when instructing on oral biopsy techniques. More studies are needed to validate the procedure and to address cognitive and communication skills. Key words:Models, animal, education, dental, continuing, biopsy, oral cancer, oral surgical procedures. PMID:23385492
Chen, Yan; Dong, Leng; Gale, Alastair G.; Rees, Benjamin; Maxwell-Armstrong, Charles
Laparoscopic surgery is a difficult perceptual-motor task and effective and efficient training in the technique is important. Viewing previously recorded laparoscopic operations is a possible available training technique for surgeons to increase their knowledge of such minimal access surgery (MAS). It is not well known whether this is a useful technique, how effective it is or what effect it has on the surgeon watching the recorded video. As part of an on-going series of studies into laparoscopic surgery, an experiment was conducted to examine whether surgical skill level has an effect on the visual search behaviour of individuals of different surgical experience when they examine such imagery. Medically naive observers, medical students, junior surgeons and experienced surgeons viewed a laparoscopic recording of a recent operation. Initial examination of the recorded eye movement data indicated commonalities between all observers, largely irrespective of surgical experience. This, it is argued, is due to visual search in this situation largely being driven by the dynamic nature of the images. The data were then examined in terms of surgical steps and also in terms of interventions when differences were found related to surgical experience. Consequently, it is argued that monitoring the eye movements of trainee surgeons whilst they watch pre-recorded operations is a potential useful adjunct to existing training regimes.
Sockalingam, Sanjeev; Tehrani, Hedieh; Kacikanis, Anna; Tan, Adrienne; Hawa, Raed; Anderson, Ruthie; Okrainec, Allan; Abbey, Susan
The high incidence of delirium in surgical units is a serious quality concern, given its impact on morbidity and mortality. While successful delirium management depends upon interdisciplinary care, training needs for surgical teams have not been studied. A needs assessment of surgical units was conducted to determine perceived comfort in managing delirium, and interprofessional training needs for team-based care. We administered a survey to 106 General Surgery healthcare professionals (69% response rate) with a focus on attitudes towards delirium and team management. Although most respondents identified delirium as important to patient outcomes, only 61% of healthcare professionals indicated that a team-based approach was always observed in practice. Less than half had a clear understanding of their role in delirium care, while just over half observed team communication of delirium care plans during handover. This is the first observation of clear gaps in perceived team performance in a General Surgery setting.
Cope, Daron H; Fenton-Lee, Douglas
Selection for surgical training in Australia is currently based on assessment of a structured curriculum vitae, referral reports from selected clinicians and an interview. The formal assessment of laparoscopic psychomotor skill and ability to attain skills is not currently a prerequisite for selection. The aim of this study was to assess the innate psychomotor skills of interns and also to compare interns with an interest in pursuing a surgical career to interns with those with no interest in pursuing a surgical career. Twenty-two interns were given the opportunity to carry out tasks on the Minimal Invasive Surgical Trainer, Virtual Reality (Mentice, Gothenburg, Sweden) Simulator. The candidates were required to complete six tasks, repeated six times each. Scores for each task were calculated objectively by the simulator software. Demographic data were similar between the two groups. Although some candidates who were interested in pursuing a surgical career performed poorly on the simulator, there was no significant difference when comparing the two groups. The Minimal Invasive Surgical Trainer, Virtual Reality (Mentice) Simulator provides an objective and comparable assessment of laparoscopic psychomotor skills. We can conclude that interns have varying inherent ability as judged by the simulator and this does not seem to have an influence on their career selection. There was no significant difference in the scores between the two groups. Interns with and without inherent abilities have aspirations to pursue surgical careers and their aptitude does not seem to influence this decision. Surgical colleges could use psychomotor ability assessments to recruit candidates to pursue a career in surgery. Trainees needing closer monitoring and additional training could be identified early and guided to achieve competency.
Sivan, Manoj; McKimm, Judy; Held, Sam
Clinical supervision in postgraduate medical training is vital in producing competent and safe health-care practitioners. Effective communication between supervisors and trainees at an interpersonal and professional level determines the quality of the supervision process. Transactional analysis, a theory of personality, can be used to enhance understanding of interpersonal interactions and improve the outcomes of clinical training.
Hedman, Leif; Felländer-Tsai, Li
Objectives To investigate whether surgical simulation performance and previous video gaming experience would correlate with higher motivation to further train a specific simulator task and whether visual-spatial ability would rank higher in importance to surgical performance than the above. It was also examined whether or not motivation would correlate with a preference to choose a surgical specialty in the future and if simulator training would increase the interest in choosing that same work field. Methods Motivation and general interest in surgery was measured pre- and post-training in 30 medical students at Karolinska Institutet who were tested in a laparoscopic surgical simulator in parallel with measurement of visual-spatial ability and self-estimated video gaming experience. Correlations between simulator performance metrics, visual-spatial ability and motivation were statistically analyzed using regression analysis. Results A good result in the first simulator trial correlated with higher self-determination index (r =-0.46, p=0.05) in male students. Visual-spatial ability was the most important underlying factor followed by intrinsic motivation score and finally video gaming experience (p=0.02, p=0.05, p=0.11) regarding simulator performance in male students. Simulator training increased interest in surgery when studying all subjects (p=0.01), male subjects (p=0.02) as well as subjects with low video gaming experience (p=0.02). Conclusions This preliminary study highlights individual differences regarding the effect of simulator training on motivation that can be taken into account when designing simulator training curricula, although the sample size is quite small and findings should be interpreted carefully. PMID:26897701
Radford, P D; Derbyshire, L F; Shalhoub, J; Fitzgerald, J E F
Government-mandated publication of named surgeon-specific outcome data (SSD) has recently been introduced across nine surgical speciality areas in England. This move is the first time that such national data has been released in any country, and it promises to provide a significant advancement in health service transparency. Data is derived from nine preexisting national surgical audit databases. However, eight of these were not originally designed for this purpose, and there is considerable controversy surrounding data quality, risk adjustment, patient use and interpretation, and surgeons' subsequent case selection. Concerns also surround the degree to which these results truly reflect the individual consultant, or the wider hospital team and accompanying resources. The potential impact on surgical training has largely been overlooked. This paper investigated the background to SSD publication and controversies surrounding this, the potential impact on surgical training and the response to these concerns from medical and surgical leaders. As SSD collection continues to be refined, the most appropriate outcomes measurements need to be established, and risk adjustment requires ongoing improvement and validation. Prospective evaluation of changes in surgical training should be undertaken, as any degradation of will have both short and long-term consequences for patients and surgeons alike. It is important that the literature supporting the safety of supervised trainee practice is also promoted in order to counterbalance any potential concerns that might detract from trainee operating opportunities. Finally, it is important that outcomes data is communicated to patients in the most meaningful way in order to facilitate their understanding and interpretation given the complexities of the data and analysis involved.
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Tobbell, Jane; O'Donnell, Victoria L.
This paper explores and examines the distal and proximal systems which construct social science postgraduate study in the UK and analyses the emergent identities of postgraduate students as they negotiate the multiple and interacting practices in their transition to study. The data represent part of a one-year research project, funded by the…
Simo, R; Robson, A; Woodwards, B; Niblock, P; Matteucci, P
Since the previous edition of these guidelines, significant changes have taken place in the training and assessment of surgeons and oncologists who treat patients with head and neck cancer. For those intending to become head and neck surgeons, a fellowship in head and neck surgery is virtually mandatory. This paper summarises the current career structure to specialise in head and neck oncology and surgery in the UK. Recommendation • Trainees applying for head and neck surgical oncology consultant posts should have completed additional training in the subspecialty.
Hirata, SoIchiro; Mataki, Shiro; Akiyama, Hitoshi; Nitta, Hiroshi; Okada, Mahito; Sakayori, Takaharu; Sugito, Hiroki; Ishii, Takuo
Postgraduate clinical training for dentists in Japan became mandatory in April 2006. Mandatory postgraduate clinical training for physicians has been criticized as having accelerated the imbalance in distribution of physicians. This suggests the danger that the same phenomenon might occur in distribution of dentists. It is also necessary to investigate the geographic distribution of dental trainees and practicing dentists in Japan. In this study, the number of dental trainees enrolled in each clinical training program and number that had actually received clinical training at each facility were compared by prefecture. The results suggest that disparities in the number of dental trainees among prefectures are being compensated for by movement across prefectural borders under the clinical training facilities-group system. Postgraduate dental trainees, however, showed a significantly greater imbalance in geographic distribution than practicing dentists. Continuation of the postgraduate clinical training for dentists under the existing system may accelerate this imbalance in distribution of dentists. To prevent this, practical measures should be taken in accordance with the coming review of the system, based on research regarding changes in geographic distribution of dental trainees.
Lairmore, Michael D; Oglesbee, Michael; Weisbrode, Steve E; Wellman, Maxey; Rosol, Thomas; Stromberg, Paul
Recent reports project a deficiency of veterinary pathologists, indicating a need to train highly qualified veterinary pathologists, particularly in academic veterinary medicine. The need to provide high-quality research training for veterinary pathologists has been recognized by the veterinary pathology training program of the Ohio State University (OSU) since its inception. The OSU program incorporates elements of both residency training and graduate education into a unified program. This review illustrates the components and structure of the training program and reflects on future challenges in training veterinary pathologists. Key elements of the OSU program include an experienced faculty, dedicated staff, and high-quality students who have a sense of common mission. The program is supported through cultural and infrastructure support. Financial compensation, limited research funding, and attractive work environments, including work-life balance, will undoubtedly continue to be forces in the marketplace for veterinary pathologists. To remain competitive and to expand the ability to train veterinary pathologists with research skills, programs must support strong faculty members, provide appropriate infrastructure support, and seek active partnerships with private industry to expand program opportunities. Shortages of trained faculty may be partially resolved by regional cooperation to share faculty expertise or through the use of communications technology to bridge distances between programs. To foster continued interest in academic careers, training programs will need to continue to evolve and respond to trainees' needs while maintaining strong allegiances to high-quality pathology training. Work-life balance, collegial environments that foster a culture of respect for veterinary pathology, and continued efforts to reach out to veterinary students to provide opportunities to learn about the diverse careers offered in veterinary pathology will pay long
Nowell, David E.
Compares the aims, structure, and methods of postgraduate training in Britain, Canada, and the United States and discusses common problems confronting students. Makes suggestions for smoothing the abrupt transition from undergraduate to postgraduate life in Britain so that degree completion rates will improve without sacrificing the quality of…
Brindley, Peter G.; Jones, Daniel B.; Grantcharov, Teodor; de Gara, Christopher
At its 2009 annual symposium, chaired by Dr. William (Bill) Pollett, the Canadian Association of University Surgeons brought together speakers with expertise in surgery and medical education to discuss the role of surgical simulation for improving surgical training and safety. Dr. Daniel Jones, of Harvard University and the 2009 Charles Tator Lecturer, highlighted how simulation has been used to teach advanced laparoscopic surgery. He also outlined how the American College of Surgeons is moving toward competency assessments as a requirement before surgeons are permitted to perform laparoscopic surgery on patients. Dr. Teodor Grantcharov, from the University of Toronto, highlighted the role of virtual reality simulators in laparoscopic surgery as well as box trainers. Dr. Peter Brindley from the University of Alberta, although a strong proponent of simulation, cautioned against an overzealous adoption without addressing its current limitations. He also emphasized simulation’s value in team training and crisis resource management training. Dr. Chris de Gara, also from the University of Alberta, questioned to what extent simulators should be used to determine competency. He raised concerns that if technical skills are learned in isolation, they may become “decontextualized,” and therefore simulation might become counterproductive. He outlined how oversimplification can have an “enchanting” effect, including a false sense of security. As a result, simulation must be used appropriately and along the entire education continuum. Furthermore, far more needs to be done to realize its role in surgical safety. PMID:22854147
Kallinowski, F; Mehrabi, A; Glückstein, C; Benner, A; Lindinger, M; Hashemi, B; Leven, F J; Herfarth, C
Computer-based training (CBT) programs teach the material of a specific field and at the same time offer various ways of objectively checking the knowledge gained. The interactive use of multimedia components, such as text, graphics, animation, sound, digital slide shows, videos and quizzes, facilitates the learning process. The aim of this study was the development and evaluation of a CBT program for use by surgeons teaching students. Using SuperCard, a teaching module for distal radius fracture (DRF) was developed, containing detailed clinical information. Video clips and vivid animation combine theoretical knowledge with practical experience. Fourth-year medical students (n = 103) were tested after using the module for 90 min. Other students (n = 47) served as the control group. In a 90-min lecture, DRF was discussed. In all evaluated criteria (distinctness, detailed description, presentation of materials, structure, motivation to learn, time saved while learning and memory retention), CBT gained 15-20% better scores than the lecture. Although 87% of the students stated that their experience with computers was limited or insufficient, 100% found the use of CBT systems helpful in student teaching. Most of them suggested the use of such programs as a exam preparation/self study method (90%) or as a supplement to a lecture (40%). Based on these evaluations, it is clear that CBT modules are an appropriate future teaching and learning system that will be well accepted. In conclusion, CBT programs should be integrated into medical education as a valuable supplement. With this aim, CBT systems should be developed and used at universities as an information system for the surgical residency program.
Hayashi, Shogo; Homma, Hiroshi; Naito, Munekazu; Oda, Jun; Nishiyama, Takahisa; Kawamoto, Atsuo; Kawata, Shinichi; Sato, Norio; Fukuhara, Tomomi; Taguchi, Hirokazu; Mashiko, Kazuki; Azuhata, Takeo; Ito, Masayuki; Kawai, Kentaro; Suzuki, Tomoya; Nishizawa, Yuji; Araki, Jun; Matsuno, Naoto; Shirai, Takayuki; Qu, Ning; Hatayama, Naoyuki; Hirai, Shuichi; Fukui, Hidekimi; Ohseto, Kiyoshige; Yukioka, Tetsuo; Itoh, Masahiro
Abstract This article evaluates the suitability of cadavers embalmed by the saturated salt solution (SSS) method for surgical skills training (SST). SST courses using cadavers have been performed to advance a surgeon's techniques without any risk to patients. One important factor for improving SST is the suitability of specimens, which depends on the embalming method. In addition, the infectious risk and cost involved in using cadavers are problems that need to be solved. Six cadavers were embalmed by 3 methods: formalin solution, Thiel solution (TS), and SSS methods. Bacterial and fungal culture tests and measurement of ranges of motion were conducted for each cadaver. Fourteen surgeons evaluated the 3 embalming methods and 9 SST instructors (7 trauma surgeons and 2 orthopedists) operated the cadavers by 21 procedures. In addition, ultrasonography, central venous catheterization, and incision with cauterization followed by autosuture stapling were performed in some cadavers. The SSS method had a sufficient antibiotic effect and produced cadavers with flexible joints and a high tissue quality suitable for SST. The surgeons evaluated the cadavers embalmed by the SSS method to be highly equal to those embalmed by the TS method. Ultrasound images were clear in the cadavers embalmed by both the methods. Central venous catheterization could be performed in a cadaver embalmed by the SSS method and then be affirmed by x-ray. Lungs and intestines could be incised with cauterization and autosuture stapling in the cadavers embalmed by TS and SSS methods. Cadavers embalmed by the SSS method are sufficiently useful for SST. This method is simple, carries a low infectious risk, and is relatively of low cost, enabling a wider use of cadavers for SST. PMID:25501070
Hayashi, Shogo; Homma, Hiroshi; Naito, Munekazu; Oda, Jun; Nishiyama, Takahisa; Kawamoto, Atsuo; Kawata, Shinichi; Sato, Norio; Fukuhara, Tomomi; Taguchi, Hirokazu; Mashiko, Kazuki; Azuhata, Takeo; Ito, Masayuki; Kawai, Kentaro; Suzuki, Tomoya; Nishizawa, Yuji; Araki, Jun; Matsuno, Naoto; Shirai, Takayuki; Qu, Ning; Hatayama, Naoyuki; Hirai, Shuichi; Fukui, Hidekimi; Ohseto, Kiyoshige; Yukioka, Tetsuo; Itoh, Masahiro
This article evaluates the suitability of cadavers embalmed by the saturated salt solution (SSS) method for surgical skills training (SST). SST courses using cadavers have been performed to advance a surgeon's techniques without any risk to patients. One important factor for improving SST is the suitability of specimens, which depends on the embalming method. In addition, the infectious risk and cost involved in using cadavers are problems that need to be solved. Six cadavers were embalmed by 3 methods: formalin solution, Thiel solution (TS), and SSS methods. Bacterial and fungal culture tests and measurement of ranges of motion were conducted for each cadaver. Fourteen surgeons evaluated the 3 embalming methods and 9 SST instructors (7 trauma surgeons and 2 orthopedists) operated the cadavers by 21 procedures. In addition, ultrasonography, central venous catheterization, and incision with cauterization followed by autosuture stapling were performed in some cadavers. The SSS method had a sufficient antibiotic effect and produced cadavers with flexible joints and a high tissue quality suitable for SST. The surgeons evaluated the cadavers embalmed by the SSS method to be highly equal to those embalmed by the TS method. Ultrasound images were clear in the cadavers embalmed by both the methods. Central venous catheterization could be performed in a cadaver embalmed by the SSS method and then be affirmed by x-ray. Lungs and intestines could be incised with cauterization and autosuture stapling in the cadavers embalmed by TS and SSS methods. Cadavers embalmed by the SSS method are sufficiently useful for SST. This method is simple, carries a low infectious risk, and is relatively of low cost, enabling a wider use of cadavers for SST.
Cheng, Xiao; Wang, Lin; Guo, Kaihua; Liu, Shu; Li, Feng; Chu, Guoliang; Zhou, Li-Hua
Postgraduate fellowship training programs are expanding at Chinese universities. This growing cadre of advanced trainees calls for the development of new learning and training models wherein postgraduate fellows have an ample opportunity to teach more junior learners, thereby expanding their own knowledge base and competitiveness for future…
Hedman, Leif; Schlickum, Marcus; Felländer-Tsai, Li
We investigated if engagement modes and perceived self-efficacy differed in surgical novices before and after randomized training in two different video games during five weeks, and a control group with no training. The control group expressed to a higher extent negative engagement modes during training in MIST-VR and GI Mentor II than the experimental groups. No statistically significant differences in self-efficacy were identified between groups. Both engagement modes and self-efficacy showed a positive correlation with previous and present video game experience. It is suggested that videogame training could have a framing effect on surgical simulator performance. EM and SE might be important intermediate variables between the strength of relationship between current videogame experience and simulator performance.
Amsellem-Ouazana, Delphine; Van Pee, Dominique; Godin, Veronique
We chose to introduce a portfolio as a learning and assessment tool in a practical training session of urological surgery for undergraduate medical students. Our primary objectives were to develop the students' self reflexive ability in front of complex medical cases and to teach them how to identify their learning needs in a short period of time, on a specific topic. Students completed, during their training session, a portfolio on a urological topic under the constant supervision of a tutor. The students were evaluated on their portfolio's presentation with a 20-point grade grid known in advance. Even in a surgical training session, a portfolio can be a useful learning and assessment tool. It clearly encourages self-reflection and pre-professional practice.
Murphy, Douglas J.; Bruce, David A.; Mercer, Stewart W.; Eva, Kevin W.
To investigate the reliability and feasibility of six potential workplace-based assessment methods in general practice training: criterion audit, multi-source feedback from clinical and non-clinical colleagues, patient feedback (the CARE Measure), referral letters, significant event analysis, and video analysis of consultations. Performance of GP…
Ismail, Affero; Abiddin, Norhasni Zainal; Hassan, Aminuddin
Research and supervision have become a vital process in the successful of postgraduate studies. Building an academic career path after Higher National Degree or Bachelor Degree needs intensive training and preparation. This culminates in writing of thesis or dissertation. In this process, the supervisor is designated to facilitate the student's…
For the past eight years postgraduate science teachers in training (approximately 50 each year) have been given Assessment of Performance Unit (APU) questions under strict test conditions as part of an initial learning experience in an education course. The APU questions were originally devised to explore the range of understanding of 15-year-old…
Nikravanfard, Nazila; Khorasanizadeh, Faezeh; Zendehdel, Kazem
Research ethics training during post-graduate education is necessary to improve ethical standards in the design and conduct of biomedical research. We studied quality and quantity of research ethics training in the curricula of post-graduate programs in the medical science in I.R. Iran. We evaluated curricula of 125 post-graduate programs in medical sciences in I.R. Iran. We qualitatively studied the curricula by education level, including the Master and PhD degrees and analyzed the contents and the amount of teaching allocated for ethics training in each curriculum. We found no research ethics training in 72 (58%) of the programs. Among the 53 (42%) programs that considered research ethics training, only 17 programs had specific courses for research ethics and eight of them had detailed topics on their courses. The research ethics training was optional in 25% and mandatory in 76% of the programs. Post-graduate studies that were approved in the more recent years had more attention to the research ethics training. Research ethics training was neglected in most of the medical post-graduate programs. We suggest including sufficient amount of mandatory research ethics training in Master and PhD programs in I.R. Iran. Further research about quality of research ethics training and implementation of curricula in the biomedical institutions is warranted.
Pető, Katalin; Németh, Norbert; Lesznyák, Tamás; Furka, István; Mikó, Irén
The authors provide a review about the main parameters of the gradual and postgradual educational activity of the Department of Operative Techniques and Surgical Research between 2000-2013. In this period of time several new subjects and courses have been introduced. The thematics have been widened, and the educational topics underwent a significant change and development: new teaching videos, revised note-books and a new textbook have been prepared through these years. Further, new training models (surgical training models, phantom and biomodels) have also been evolved. The educational activity of the Department was supported significantly several times (financial, contribution, grants) from the University of Debrecen, partner companies, HEFOP and TÁMOP grants. Infrastructural development in conjunction with the above increased the quality of educational standards in gradual and postgradual education, too. All these changes and developments were presented on various professional meetings and published in relevant journals, as part ofinternal quality control.
Zakirova, A. A.; Ganiev, B. A.; Mullin, R. I.
The lack of visible and approachable ways of training surgical skills is one of the main problems in medical education. Existing simulation training devices are not designed to teach students, and are not available due to the high cost of the equipment. Using modern technologies such as virtual reality and hands movements fixation technology we want to create innovative method of learning the technics of conducting operations in 3D game format, which can make education process interesting and effective. Creating of 3D format virtual simulator will allow to solve several conceptual problems at once: opportunity of practical skills improvement unlimited by the time without the risk for patient, high realism of environment in operational and anatomic body structures, using of game mechanics for information perception relief and memorization of methods acceleration, accessibility of this program.
Raque, Jessica; Goble, Adam; Jones, Veronica M; Waldman, Lindsey E; Sutton, Erica
With the introduction of Fundamentals of Endoscopic Surgery, training methods in flexible endoscopy are being augmented with simulation-based curricula. The investment for virtual reality simulators warrants further research into its training advantage. Trainees were randomized into bedside or simulator training groups (BED vs SIM). SIM participated in a proficiency-based virtual reality curriculum. Trainees' endoscopic skills were rated using the Global Assessment of Gastrointestinal Endoscopic Skills (GAGES) in the patient care setting. The number of cases to reach 90 per cent of the maximum GAGES score and calculated costs of training were compared. Nineteen residents participated in the study. There was no difference in the average number of cases required to achieve 90 per cent of the maximum GAGES score for esophagogastroduodenoscopy, 13 (SIM) versus11 (BED) (P = 0.63), or colonoscopy 21 (SIM) versus 4 (BED) (P = 0.34). The average per case cost of training for esophagogastroduodenoscopy was $35.98 (SIM) versus $39.71 (BED) (P = 0.50), not including the depreciation costs associated with the simulator ($715.00 per resident over six years). Use of a simulator appeared to increase the cost of training without accelerating the learning curve or decreasing faculty time spent in instruction. The importance of simulation in endoscopy training will be predicated on more cost-effective simulators.
Din, Nizar; Smith, Phillip; Emeriewen, Krisztina; Sharma, Anant; Jones, Simon; Wawrzynski, James; Tang, Hongying; Sullivan, Paul; Caputo, Silvestro; Saleh, George M
This study aimed to address two queries: firstly, the relationship between two cataract surgical feedback tools for training, one human and one software based, and, secondly, evaluating microscope control during phacoemulsification using the software. Videos of surgeons with varying experience were enrolled and independently scored with the validated PhacoTrack motion capture software and the Objective Structured Assessment of Cataract Surgical Skill (OSACCS) human scoring tool. Microscope centration and path length travelled were also evaluated with the PhacoTrack software. Twenty-two videos correlated PhacoTrack motion capture with OSACCS. The PhacoTrack path length, number of movements, and total procedure time were found to have high levels of Spearman's rank correlation of -0.6792619 (p = 0.001), -0.6652021 (p = 0.002), and -0.771529 (p = 0001), respectively, with OSACCS. Sixty-two videos evaluated microscope camera control. Novice surgeons had their camera off the pupil centre at a far greater mean distance (SD) of 6.9 (3.3) mm, compared with experts of 3.6 (1.6) mm (p ≪ 0.05). The expert surgeons maintained good microscope camera control and limited total pupil path length travelled 2512 (1031) mm compared with novices of 4049 (2709) mm (p ≪ 0.05). Good agreement between human and machine quantified measurements of surgical skill exists. Our results demonstrate that surrogate markers for camera control are predictors of surgical skills.
Smith, Phillip; Sharma, Anant; Jones, Simon; Sullivan, Paul
This study aimed to address two queries: firstly, the relationship between two cataract surgical feedback tools for training, one human and one software based, and, secondly, evaluating microscope control during phacoemulsification using the software. Videos of surgeons with varying experience were enrolled and independently scored with the validated PhacoTrack motion capture software and the Objective Structured Assessment of Cataract Surgical Skill (OSACCS) human scoring tool. Microscope centration and path length travelled were also evaluated with the PhacoTrack software. Twenty-two videos correlated PhacoTrack motion capture with OSACCS. The PhacoTrack path length, number of movements, and total procedure time were found to have high levels of Spearman's rank correlation of −0.6792619 (p = 0.001), −0.6652021 (p = 0.002), and −0.771529 (p = 0001), respectively, with OSACCS. Sixty-two videos evaluated microscope camera control. Novice surgeons had their camera off the pupil centre at a far greater mean distance (SD) of 6.9 (3.3) mm, compared with experts of 3.6 (1.6) mm (p ≪ 0.05). The expert surgeons maintained good microscope camera control and limited total pupil path length travelled 2512 (1031) mm compared with novices of 4049 (2709) mm (p ≪ 0.05). Good agreement between human and machine quantified measurements of surgical skill exists. Our results demonstrate that surrogate markers for camera control are predictors of surgical skills. PMID:27867658
Vulliamy, Paul; Junaid, Islam
Background Peer-mentoring has attracted substantial interest in various healthcare professions, but has not been formally integrated into postgraduate surgical training. This study aimed to assess the feasibility and acceptability of a peer-mentor scheme among junior surgical trainees in the United Kingdom. Method Trainees entering the first year of core surgical training (CST) in a single postgraduate school of surgery were allocated a mentor in the second year of CST. Allocation was based on location of the initial clinical placement. An anonymised questionnaire regarding the mentorship scheme was sent to all participants in the third month following its introduction. Results 18 trainees participated in the scheme, of whom 12 (67%) responded to the questionnaire. All respondents had made contact with their allocated mentor or mentee, and no trainees had opted out of the scheme. Areas in which the mentees received guidance included examinations (83%), CV development (67%), and workplace-based assessments (67%). All respondents felt that the mentor scheme was a good addition to CST. Suggestions for improvement of the scheme included introduction of structured meetings and greater engagement with allocated mentors. Conclusions A pilot peer-mentoring scheme was well received by junior surgical trainees. Consideration should be given to expansion of this scheme and more rigorous assessment of its value.
Wild, J R L; Ferguson, H J M; McDermott, F D; Hornby, S T; Gokani, V J
The 2012 General Medical Council National Trainees' Survey found that 13% of UK trainees had experienced undermining or bullying in the workplace. The Association of Surgeons in Training subsequently released a position statement raising concerns stemming from these findings, including potential compromise to patient safety. This article considers the impact of such behaviour on the NHS, and makes recommendations for creating a positive learning environment within the NHS at national, organisational, and local levels. The paper also discusses the nature of issues within the UK, and pathways through which trainees can seek help.
Wells,.; Wilde , C 0 Dimensional analysis J. Undergraduate Math. and its Applications, vol. 2, no. 3, p. 97-123, (Sept., 1981). 74 NAVAl POSTGRADUATE...cgrammi nq prob lem Nlaval Postgraduate ,co (NPS-55-82-008) , Feb., 1982. 21 p. Giordano, F Ri Wells, N; Wilde , C 0 Disensional analysis The Under...Garwood, W in.e: ulation of seventeen years of mixed layer evolution at Ocean Station Papa AGU Fal. Mtg. , San Francisco, Calif., Dec. 10, 1982. B oyle, P J
Dyer, Judith Sandra
The purpose of this case study was to explore how low-skilled workers who participated in a health care training program learned to acquire the technical, cognitive, and developmental competencies they needed to gain skilled employment in higher-level positions in the field and thus advance their careers. The data methods used were: (1) in-depth…
Jepsen, Denise M.; Varhegyi, Melinda M.
Many university administrators, academics and marketers expend time and financial resources promoting postgraduate study options, yet scant scholarly research has addressed students' attraction to postgraduate study. This study examines awareness and knowledge of, and intentions to pursue postgraduate study from the perspective of current…
Humphrey, Robin; McCarthy, Peter
Examines the academic and social needs of the increasing numbers of full-time postgraduate students. Analysis of a survey of 636 full-time postgraduates at the University of Newcastle (England) identifies distinct sub-groups of postgraduates. Notes respondents' desires for separate facilities and more favorable treatment than the rest of the…
Rasmussen, Sebastian R; Konge, Lars; Mikkelsen, Peter T; Sørensen, Mads S; Andersen, Steven A W
Cognitive load (CL) theory suggests that working memory can be overloaded in complex learning tasks such as surgical technical skills training, which can impair learning. Valid and feasible methods for estimating the CL in specific learning contexts are necessary before the efficacy of CL-lowering instructional interventions can be established. This study aims to explore secondary task precision for the estimation of CL in virtual reality (VR) surgical simulation and also investigate the effects of CL-modifying factors such as simulator-integrated tutoring and repeated practice. Twenty-four participants were randomized for visual assistance by a simulator-integrated tutor function during the first 5 of 12 repeated mastoidectomy procedures on a VR temporal bone simulator. Secondary task precision was found to be significantly lower during simulation compared with nonsimulation baseline, p < .001. Contrary to expectations, simulator-integrated tutoring and repeated practice did not have an impact on secondary task precision. This finding suggests that even though considerable changes in CL are reflected in secondary task precision, it lacks sensitivity. In contrast, secondary task reaction time could be more sensitive, but requires substantial postprocessing of data. Therefore, future studies on the effect of CL modifying interventions should weigh the pros and cons of the various secondary task measurements.
Boisvert, Jonathan; Poirier, Guillaume; Borgeat, Louis; Godin, Guy
Intraoperative management of bleeding is a critical skill all surgeons must possess. It is, however, very challenging to create a safe and realistic learning environment for its acquisition. In this paper, we propose a simple and efficient approach to integrate blood circulation to computerized surgical simulation systems and allow for real-time processing of punctures, ruptures, and cauterization of blood vessels. Blood pressures and flows are calculated using a system of ordinary differential equations, which can be simulated very efficiently. The equation system itself is constructed using a graph of the vessels' connectivity extracted from magnetic resonance angiograms (MRA) and completed with virtual vessels deduced from the principle of minimum work. Real-time performances of the method are assessed and results are demonstrated on ten patients who underwent a MRA before removal of a brain tumor.
Scerbo, Mark W; Bliss, James P; Schmidt, Elizabeth A; Hanner-Bailey, Hope S; Weireter, Leonard J
The present study examined the performance of a surgical procedure under simulated combat conditions. Eleven residents performed a cricothyroidotomy on a mannequin-based simulator in a fully immersive virtual environment running a combat simulation with a virtual sniper under both day and night time lighting conditions. The results showed that completion times improved between the first and second attempt and that differences between day and night time conditions were minimal. However, three participants were killed by the virtual sniper before completing the procedure. These results suggest that some participants' ability to allocate attention to the task and their surroundings was inappropriate even under simulated hazardous conditions. Further, this study shows that virtual environments offer the chance to study a wider variety of medical procedures performed under an unlimited number of conditions.
Sadideen, Hazim; Goutos, Ioannis; Kneebone, Roger
Burns education appears to be under-represented in UK undergraduate curricula. However current postgraduate courses in burns education provide formal training in resuscitation and management. Simulation has proven to be a powerful modality to advance surgical training in both technical and non-technical skills. We present a literature review that summarises the format of current burns education, and provides detailed insight into historic, current and novel advances in burns simulation for both technical and non-technical skills, that can be used to augment surgical training. Addressing the economic and practical limitations of current immersive surgical simulation is important, and this review proposes future directions for integration of innovative simulation strategies into training curricula.
Angell, Robert J.; Heffernan, Troy W.; Megicks, Phil
Purpose: Measuring service quality in higher education is increasingly important for attracting and retaining tuition-based revenues. Nonetheless, whilst undergraduates have received substantial academic exposure, postgraduate-based research has been scant. Consequently, the objectives of this paper are threefold: first, to identify the service…
Price, A J; Erturan, G; Akhtar, K; Judge, A; Alvand, A; Rees, J L
Despite being one of the most common orthopaedic operations, it is still not known how many arthroscopies of the knee must be performed during training in order to develop the skills required to become a Consultant. A total of 54 subjects were divided into five groups according to clinical experience: Novices (n = 10), Junior trainees (n = 10), Registrars (n = 18), Fellows (n = 10) and Consultants (n = 6). After viewing an instructional presentation, each subject performed a simple diagnostic arthroscopy of the knee on a simulator with visualisation and probing of ten anatomical landmarks. Performance was assessed using a validated global rating scale (GRS). Comparisons were made against clinical experience measured by the number of arthroscopies which had been undertaken, and ROC curve analysis was used to determine the number of procedures needed to perform at the level of the Consultants. There were marked differences between the groups. There was significant improvement in performance with increasing experience (p < 0.05). ROC curve analysis identified that approximately 170 procedures were required to achieve the level of skills of a Consultant. We suggest that this approach to identify what represents the level of surgical skills of a Consultant should be used more widely so that standards of training are maintained through the development of an evidenced-based curriculum.
Bhattarai, M D
The learners have to take active parts in the teaching learning activities. To make them aware and to help them develop the skills required, the need of the study skills course in medical education early in the part of their training has been realized for the postgraduate residents. The important areas of the study skills course focusing in the requirement of clinical components of the postgraduate residents are 1) Interpersonal and communications skills, 2) Teaching, learning and presentation skills, 3) Language, reading and computer use, 4) Evidence based medicine and diagnosis and management, 5) Assessment principles and strategies, 6) Time management strategies to get the best out of the training, 7) Reflection, portfolio and self-directed lifelong learning, and 8) Follow-up presentation. The methodologies that could be used in such study skills course are interactive lectures, brainstorming, presentations by the trainees, demonstration to and by the trainees, small group discussion, group work and presentation, group and individual feedback, practice sessions, role play, short relevant video movies, video recording of the trainees and viewing with feedback. With their already tight training schedule and posting and other similar other mandatory courses required for the postgraduate residents, much time cannot be allocated for the study skills course in medical education alone. Similar study skills course in medical education may need to be arranged for the undergraduate medical students as well.
Rosenberg, Henry; Polonsky, Binnie
Advantages of using non-physician consultants in postgraduate anesthesiology training programs are presented, including using their expertise in teaching, training, curriculum design, evaluation, program planning, and interpersonal communications. Successful use of a nonphysician consultant by the Department of Anesthesiology at Hahnemann…
Bolton, Neil; Unwin, Lorna; Stephens, Kate
A survey of 977 postgraduate distance-learning students in the United Kingdom investigated student perceptions of library needs. This article examines how students felt they were treated, need for libraries, library training (previous experience and nature and extent of training), problems of distance and time, costs for texts and charges for…
Mühler, Konrad; Tietjen, Christian; Ritter, Felix; Preim, Bernhard
Application development is often guided by the usage of software libraries and toolkits. For medical applications, the toolkits currently available focus on image analysis and volume rendering. Advance interactive visualizations and user interface issues are not adequately supported. Hence, we present a toolkit for application development in the field of medical intervention planning, training, and presentation--the MEDICALEXPLORATIONTOOLKIT (METK). The METK is based on the rapid prototyping platform MeVisLab and offers a large variety of facilities for an easy and efficient application development process. We present dedicated techniques for advanced medical visualizations, exploration, standardized documentation, adn interface widgets for common tasks. These include, e.g., advanced animation facilities, viewpoint selection, several illustrative rendering techniques, and new techniques for object selection in 3D surface models. No extended programming skills are needed for application building, since a graphical programming approach can be used. the toolkit is freely available and well documented to facilitate the use and extension of the toolkit.
In 1899 the British Medical Journal enthusiastically announced that a new postgraduate teaching college was to open in London. The aim of the Medical Graduates’ College and Polyclinic (MGC) was to provide continuing education to general practitioners. It drew upon emerging specialisms and in so doing built upon the generalist training received at an undergraduate level. Courses were intended to refresh knowledge and to introduce general practitioners to new knowledge claims and clinical practices. The establishment of postgraduate institutions such as the MGC marked an important stage in the development of medical education in England. Yet these institutions, and the emergence of postgraduate medical education more broadly, have been largely overlooked by historians. Moreover the history of venereological training among medical undergraduates and postgraduates alike has been overlooked. The study of such special subjects characterised postgraduate study. This article examines the dissemination of venereological knowledge among subscribers to MGC as an important case study for the development of institutionalised postgraduate medical education in England at the turn of the twentieth century. PMID:25766540
Mehrabi, A; Glückstein, C; Benner, A; Hashemi, B; Herfarth, C; Kallinowski, F
Computer-based training (CBT) programs teach the material of a specific field and at the same time offer various ways of objectively assessing the knowledge gained. The interactive use of multi-media components such as text, graphics, animation, sound, digital slide shows, and videos as well as quizzes can theoretically facilitate the learning process. The aim of this study was the development and evaluation of a CBT-program by surgeons for student training. Using SuperCard, a teaching module for Distal Radius Fracture (DRF) was developed, which contains detailed clinical information. Video clips and vivid animations combine theoretical knowledge with practical experience. Fourth-year medical students (n = 103) were tested after using the module for 90 min. Other students (n = 47) served as the control group. In a 90 min lecture, DRF was discussed. CBT gained in all evaluated criteria (distinctiveness, detailed description, presentation of materials, structure, motivation for learning, time saved learning and memory retention) 15-20% better scores than the lecture. Although 82% of the students stated that their experience with computers was limited or insufficient, 100% found the use of CBT systems useful in student teaching. Most of them suggested the use of such programs as a method of exam preparation/self study (90%) or as a supplement to a lecture (40%). Based on these evaluations, CBT modules are an appropriate future teaching and learning system that is well accepted. In conclusion, the results of this study show that CBT-programs could be a valuable supplement to medical education. In addition, further development of CBT-programs and their use as information systems for surgical residency programs at universities can be suggested.
Developing future surgical workforce structures: a review of post-training non-Consultant grade specialist roles and the results of a national trainee survey from the Association of Surgeons in Training.
Shalhoub, J; Giddings, C E B; Ferguson, H J M; Hornby, S T; Khera, G; Fitzgerald, J E F
The optimal workforce model for surgery has been much debated historically; in particular, whether there should be a recognised role for those successfully completing training employed as non-Consultant grade specialists. This role has been termed the 'sub-consultant' grade. This paper discusses historical and future career structures in surgery, draws international comparisons, and presents the results of a national trainee survey examining the post-Certificate of Completion of Training (CCT) non-consultant specialist grade. Junior doctors in surgical training (i.e. pre-CCT) were invited to participate in an electronic, 38-item, self-administered national training survey. Of 1710 questionnaires submitted, 1365 were appropriately completed and included in the analysis. Regarding the question 'Do you feel that there is a role in the surgical workforce for a post-CCT non-consultant specialist ("sub-consultant") grade in surgery?', 56.0% felt there was no role, 31.1% felt there was a role and 12.8% were uncertain. Only 12.6% of respondents would consider applying for such a post, while 72.4% would not and 15.0% were uncertain. Paediatric (23.3%), general (15.7%) and neurosurgery (11.6%) were the specialties with the highest proportions of trainees prepared to consider applying for such a role. For both questions, there was a significant gender difference in responses (p < 0.0001, Chi-square test) with female trainees more likely to consider applying. Overall 50.8% of respondents felt that the introduction of a post-CCT non-consultant specialist grade would impact positively upon service provision, however, only 21.6% felt it would have a positive impact on patient care, 13.9% a positive impact on surgical training, 11.1% a positive impact on the surgical profession and just 7.9% a positive impact on their surgical career. This survey indicates that the introduction of a 'sub-consultant' grade for surgeons who have completed training would be unpopular, with the
Govender, K. K.
The objective of this article is to develop a conceptual model aimed at improving the postgraduate research students' experience. Since postgraduate students "vote with their feet" an improved understanding of the postgraduate research service encounter may result in improving the quality of the encounter and so increasing throughput and…
Lambert, Sarah; Brewer, Chris
In order to meet the demands of postgraduate students who were time poor and unable to regularly attend face-to-face classes, one lecturer in the Faculty Law at the University of Wollongong (UOW) sought the assistance of a Learning Designer to redesign the Postgraduate Practical Legal Training (PLT) program into a flexible blended learning format,…
Purpose: The paper aims to describe the application of two key service quality frameworks for improving the delivery of postgraduate research supervision. The services quality frameworks are used to identify key areas of overlap between services marketing practice and postgraduate supervision that can be used by the supervisor to improve research…
This article is the result of scientific comparative-pedagogical research, which purpose was to highlight the main features of postgraduate professional pedagogical education in Mexico. The author found that the postgraduate professional pedagogical education in Mexico is performed by public and private higher education institutions: higher…
Bunni, J; McCarthy, K; Hewitt, J
Introduction Many older surgical patients are exposed to high risks of morbidity and mortality when undergoing both elective and emergency surgery. Methods We provide an overview of perioperative care teams and the educational opportunities available to surgeons who undertake surgery in the older person. Findings The number of older people undergoing surgery is increasing at a rate faster than the proportion of older people in the overall population. Management of the older surgical patient throughout the surgical pathway forms part of the Specialty Training Curriculum for Geriatric Medicine. While ‘surgery in childhood’ continues to form part of the general surgical higher training syllabus, surgery in the later years of life does not. There are limited postgraduate courses and training opportunities currently available to surgeons in this field. There is clear societal need to address perioperative care for older surgical patients, which has proved successful in some centers. Moreover, surgical trainees support the inclusion of geriatric medicine issues into their training. Conclusions The ageing population requires a multidisciplinary perioperative approach, with dedicated and appropriately trained clinicians and allied health care professionals to improve outcomes. PMID:27269239
Pearce, L; Bunni, J; McCarthy, K; Hewitt, J
Introduction Many older surgical patients are exposed to high risks of morbidity and mortality when undergoing both elective and emergency surgery. Methods We provide an overview of perioperative care teams and the educational opportunities available to surgeons who undertake surgery in the older person. Findings The number of older people undergoing surgery is increasing at a rate faster than the proportion of older people in the overall population. Management of the older surgical patient throughout the surgical pathway forms part of the Specialty Training Curriculum for Geriatric Medicine. While 'surgery in childhood' continues to form part of the general surgical higher training syllabus, surgery in the later years of life does not. There are limited postgraduate courses and training opportunities currently available to surgeons in this field. There is clear societal need to address perioperative care for older surgical patients, which has proved successful in some centers. Moreover, surgical trainees support the inclusion of geriatric medicine issues into their training. Conclusions The ageing population requires a multidisciplinary perioperative approach, with dedicated and appropriately trained clinicians and allied health care professionals to improve outcomes.
Kitago, Minoru; Kitagawa, Yuko
Board-certifying systems play an important role as guideposts in postgraduate training courses to develop superior surgeons with both general and subspecialty surgery competence. The board-certified surgeon designation of the Japan Surgical Society (JSS) as the first guidepost has provided the foundations for board-certified surgeon systems of subspecialty surgical societies as the second guidepost. In April 2010, the National Clinical Database (NCD) was founded by the JSS and other societies. Data on surgery and treatment have been entered into the NCD from January 1, 2011, and more than 1 million cases were submitted to the NCD in that year. The NCD is an unprecedented, advanced activity. The data will be used for the authorization of board-certified surgeons of subspecialty surgical societies as well as that of the JSS. The data will be also used for benchmarking, and clinical research teams will cooperate with the NCD.
Bindroo, Sandiya; Saraf, Rakesh
Surgical audit is a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognized standards. It is used to improve surgical practice with the ultimate goal of improving patient care. As the pattern of surgical care is different in the developing world, we analyzed mortalities in a referral medical institute of India to suggest interventions for improvement. An analysis of total admissions, different surgeries, and mortalities over 1 year in an urban referral medical institute of northern India was performed, followed by "peer review" of the mortalities. Mortality rates as outcomes and classification was done to provide comparative results. Of 10,005 surgical patients, 337 (male = 221, female = 116) deaths were reported over 1 year. The overall mortality rate was 3.36%, while mortality in operative cases was 1.76%. Total deaths were classified into (1) Viable: 153 (45%), (2) Nonviable: 174 (52%), and (3) Indeterminate: 10 (3%). Exclusion of the nonviable group reduced the mortality rate from 3.36% to 1.62%. Trauma was the major cause of mortality (n = 235; 70%) as compared to other surgical patients (n = 102; 30%). Increased mortality was also associated with emergency procedures (3.66%) as compared to elective surgeries (0.34%). In conclusion, audit of mortality and morbidity helps in initiating and implementing preventive strategies to improve surgical practice and patient care, and to reduce mortality rates. The mortality and morbidity forum is an important educational activity. It should be considered a mandatory activity in all postgraduate training programs.
Buttery, Ernest Alan; Richter, Ewa Maria; Filho, Walter Leal
Purpose: To outline the role of the group supervision model in postgraduate training, especially its advantages in respect of research involving industry sponsors. Design/methodology/approach: The paper considers the various categories of supervision and the pivotal role played by the supervisor. It analyses indicators of supervisor effectiveness…
Brew, Angela; Peseta, Tai
New research training agendas necessarily bring with them renewed attention on the professional development of research supervisors. This paper charts specific aspects of the University of Sydney's Postgraduate Supervision Development Programme, particularly the development of a new innovation called the Recognition Module. The Recognition Module…
Jiménez Eguizábal, Alfredo; Palmero Cámara, Carmen; Luis Rico, Isabel
The aim of this paper is to identify and analyse the ways educational policy is understood, taught and practiced as a training discipline at postgraduate level in the European context. We have validated its epistemological solvency through a quantitative, comparative and ethnographic study of its main features as a discipline--such as ideological…
Macphee, Paula-Louise; Fitz-Gerald, Ann
This paper argues for the importance, benefits and wider impact of a donor-funded, locally supported postgraduate programme in security sector management (SSM) for government officials in Ethiopia. With the exception of specialised education and training programmes within the field of peace and conflict studies, the role of education in…
Moonen-van Loon, J. M. W.; Overeem, K.; Donkers, H. H. L. M.; van der Vleuten, C. P. M.; Driessen, E. W.
In recent years, postgraduate assessment programmes around the world have embraced workplace-based assessment (WBA) and its related tools. Despite their widespread use, results of studies on the validity and reliability of these tools have been variable. Although in many countries decisions about residents' continuation of training and…
Ting, Daniel Shu Wei; Sim, Shaun Sebastian Khung Peng; Yau, Christine Wen Leng; Rosman, Mohamad; Aw, Ai Tee; Yeo, Ian Yew San
This is a review education paper on the current ophthalmology simulators utilized worldwide for undergraduate and postgraduate training. At present, various simulators such as the EYE Exam Simulator (Kyoto Kagaku Co. Ltd., Kyoto, Japan), Eyesi direct ophthalmoscope simulator (VRmagic, GmbH, Mannheim, Germany), Eyesi indirect ophthalmoscope simulator (VRmagic, GmbH, Mannheim, Germany) and Eyesi cataract simulators (VRmagic, GmbH, Mannheim, Germany). These simulators are thought to be able to reduce the initial learning curve for the ophthalmology training but further research will need to be conducted to assess the effectiveness of the simulation-assisted Ophthalmology training. Future research will be of great value to assess the medical students and residents' responses and performance regarding the usefulness of the individual eye simulator. PMID:27366698
Fichtner, Andreas; Haupt, Elke; Karwath, Tobias; Wullenk, Katharina; Pöhlmann, Christoph; Jatzwauk, Lutz
The standardized training of practical competences in skills labs is relatively new among German Medical Faculties. The broad acceptance and outstanding evaluation results do not provide objective data on the efficiency and cost-efficiency of these trainings. This study aims on the quantification of the teaching effect of the surgical scrubbing technique EN1500 and its comparison with clinical references of OR personnel. Methods: 161 4th year medical students were randomized into intervention and control group. The intervention group received a 45 minute standardized peer-teaching training of practical competences necessary in the OR including the scrubbing according to EN1500. Fluorescence dye was mixed in the disinfectant solution. After hand disinfection, standardized fotographs and semi-automated digital processing resulted in quantification of the insufficiently covered hand area. These results were compared with the control group that received the training after the test. In order to provide information on the achieved clinical competence level, the results were compared with the two clinical reference groups. Results: The intervention group remained with 4,99% (SD 2,34) insufficiently covered hand area after the training compared to the control group 7,33% (SD 3,91), p<0,01. There was no significant difference between control group and reference groups: surgeons 9,32% (SD 4,97), scrub nurses 8,46% (SD 4,66). The student intervention group showed results that were significantly better than the clinical references. The methodic mistake remained negligible. In the sub-group analysis, the students with low or medium experience in surgical scrubbing and hand disinfection derived highest benefit from the training, whereas students with no or high experience did benefit less. All participants showed better results on hand palms compared to back of hand areas. Discussion: A single standardized peer-teaching of surgical scrubbing and hand disinfection according to EN
This paper provides a basic framework for those embarking upon a postgraduate dissertation. The dissertation experience can offer many opportunities for self and academic development once ethical approval has been obtained. A good dissertation is the result of a sound methodological framework, where some thought has been given to the strengths and weaknesses of qualitative and quantitative methods of inquiry. The research question needs to be given careful consideration so that the aims and objectives of the postgraduate research project are fulfilled.
Carlos, A Palacio A
The research component and the acquisition of skills related to the generation of knowledge in the training of medical and surgical specialists in the country is an issue that has recently begun to be discussed. For over 50 years this training has included only the area of professionalism as a copy of an educational model from the mid-twentieth century. Currently the country requires specialists with critical and analytical skills to question their actions and knowledge and generate alternative clinical care to apply to the general population in the search of bettering their own welfare. This article is a review in which the current situation of the teaching of psychiatry and the inclusion of research in the academic processes of our medical specialties in the country are analyzed.
Students on the MSc Physiotherapy (pre-registration) programme at Manchester Metropolitan University work at postgraduate level, whilst studying to become physiotherapists. To facilitate the transition to postgraduate attainment, students participated in two sessions designed to inform them about assessment processes and standards. The hypothesis…
Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...
Schulz, Kristine; Puscas, Liana; Tucci, Debara; Woodard, Charles; Witsell, David; Esclamado, Ramon M; Lee, Walter T
Introduction Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents. Methods As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership 'Basic Training' is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this 'Basic Training'. Results Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (p<0.001) in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on 'Basic Training'. All residents responded in the post-test that the STEPP program was valuable, up from 56%. Conclusions A virtue-based approach is valued by residents as a part of leadership training during residency.
Theodoraki, M N; Ledderose, G J; Becker, S; Leunig, A; Arpe, S; Luz, M; Stelter, K
The use of image-guided navigation systems in the training of FESS is discussed controversy. Many experienced sinus surgeons report a better spatial orientation and an improved situational awareness intraoperatively. But many fear that the navigation system could be a disadvantage in the surgical training because of a higher mental demand and a possible loss of surgical skills. This clinical field study investigates mental and physical demands during transnasal surgery with and without the aid of a navigation system at an early stage in FESS training. Thirty-two endonasal sinus surgeries done by eight different trainee surgeons were included. After randomization, one side of each patient was operated by use of a navigation system, the other side without. During the whole surgery, the surgeons were connected to a biofeedback device measuring the heart rate, the heart rate variability, the respiratory frequency and the masticator EMG. Stress situations could be identified by an increase of the heart rate frequency and a decrease of the heart rate variability. The mental workload during a FESS procedure is high compared to the baseline before and after surgery. The mental workload level when using the navigation did not significantly differ from the side without using the navigation. Residents with more than 30 FESS procedures already done, showed a slightly decreased mental workload when using the navigation. An additional workload shift toward the navigation system could not be observed in any surgeon. Remarkable other stressors could be identified during this study: the behavior of the supervisor or the use of the 45° endoscope, other colleagues or students entering the theatre, poor vision due to bleeding and the preoperative waiting when measuring the baseline. The mental load of young surgeons in FESS surgery is tremendous. The application of a navigation system did not cause a higher mental workload or distress. The device showed a positive effort to engage
Shabani, Jacob; Taché, Stephanie; Mohamoud, Gulnaz; Mahoney, Megan
Background and objectives Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC) curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya. Method Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC educators, practitioners and academic stakeholders in two family medicine postgraduate programmes in Kenya. Discussions were transcribed, inductively coded and thematically analysed. Results Two focus groups with eight family medicine postgraduate students and interviews with five faculty members at two universities were conducted. Two broad themes emerged from the analysis: expected learning outcomes and important community-based enablers. Three learning outcomes were (1) making a community diagnosis, (2) understanding social determinants of health and (3) training in participatory research. Three community-based enablers for sustainability of COPC were (1) partnerships with community health workers, (2) community empowerment and engagement and (3) institutional financial support. Conclusions Our findings illustrate the expected learning outcomes and important community-based enablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya. PMID:28155322
Agliullin, Arthur F.; Gusev, Valery F.; Morozov, Oleg G.; Samigullin, Rustem R.; Akul'Shin, Alexander, IV.; Bagapov, Nail N.
The program of courses is recommended for the experts working in endoscopy area, surgery, diagnostics, to developers of optical, optoelectronic and electronic equipment, and also for students and the post-graduate students of telecommunication high schools in addition trained on specializations of biomedical engineering. It urged to help the future researcher, engineer and doctor to understand mechanisms of images formation and display, to understand more deeply procedures of their processing and transfer on telecommunication channels of the various natures, to master modern reports of record and video and audio information reproduction. The separate section is devoted to questions of designing of surgical toolkit compatible with fiber-optical endoscopes.
Agliullin, Arthur F.; Gusev, Valery F.; Morozov, Oleg G.; Samigullin, Rustem R.; Akul'shin, Alexander, Iv.; Bagapov, Nail N.
The program of courses is recommended for the experts working in endoscopy area, surgery, diagnostics, to developers of optical, optoelectronic and electronic equipment, and also for students and the post-graduate students of telecommunication high schools in addition trained on specializations of biomedical engineering. It urged to help the future researcher, engineer and doctor to understand mechanisms of images formation and display, to understand more deeply procedures of their processing and transfer on telecommunication channels of the various natures, to master modern reports of record and video and audio information reproduction. The separate section is devoted to questions of designing of surgical toolkit compatible with fiber-optical endoscopes.
Giri, Purushottam A.; Bangal, Vidyadhar B.; Phalke, Deepak B.
Background: Health research training is an essential component of medical education and a vital exercise to help develop physician research skills. Objectives: This study was carried out to assess the knowledge, attitude, and practices towards health research amongst the postgraduate students of Pravara Institute of Medical Sciences University of central India. Materials and Methods: A cross-sectional study was carried out from August to October 2012. A total of 116 postgraduate students were interviewed. Knowledge, attitude, and practices related to health research were assessed using a predesigned, pretested and validated questionnaire. Results were analyzed in the form of percentage and proportions whenever appropriate. Results: In present study, the concept of research hypothesis was known to only 18.9% of the postgraduate students, whereas 17.2 and 21.5% students knew the full form of MEDLARS and MEDLINE respectively. Majority (91.4%) students believed that patient outcome improves with continued medical research and 70.7% are willing to participate in workshop for research methodology. Lack of time due to vast curriculum of postgraduate subjects (59.5%), lack of research curriculum (25%), and inadequate facilities (25.8%) were stated as major obstacles for pursuing research. Conclusion: Postgraduate students have inadequate knowledge, but have positive attitudes towards health research. Postgraduate training and research facilities at the institution need to undergo major transformation in order to encourage meaningful research by postgraduate trainees. PMID:24791231
Faye, Abhijeet; Kalra, Gurvinder; Swamy, Rajeev; Shukla, Aniket; Subramanyam, Alka; Kamath, Ravindra
Objectives: The important domains of emotional intelligence (EI) are self-awareness and control of emotions, motivating oneself, and empathy. These are necessary to handle any relationship. This study aims to (i) assess emotional intelligence focusing specifically on empathy; (ii) to study the level of anger; and (iii) correlating level of anger with (a) EI and (b) empathy in medical postgraduates. Materials and Methods: Subjects were assessed randomly after obtaining informed consent, through semi-structured proforma and various scales, including Emotional Quotient Self-Assessment Checklist, Multi-Dimensional Emotional Empathy Scale, and Clinical Anger Scale. Data was analyzed using multivariate analysis with analysis of covariance test. Results: On Emotional Quotient Self-Assessment checklist, more than 70% had poor emotional intelligence. Married males in the study were more confident and empathizing. Those with some major problem at home were more aware of their own emotions and other's feelings. Residents who had voluntarily chosen their specialty postgraduation training course (eg, medicine, surgery, and others), those who had less work load, those who had time for recreational activities, and exercise had scored high on EI. Good control of emotions in self was associated with good relationship with superiors and colleagues. Score on Clinical anger was moderate to severe in 10.6% of the subjects. EI and clinical anger correlated negatively. PMID:21772646
Unsworth, Kerrie L.; Turner, Nick; Williams, Helen M.; Piccin-Houle, Sarah
Successful postgraduate supervision is often dependent upon the quality of the relationship between postgraduates and their supervisors. This article reports on two studies that focus on grateful affect and grateful expression within low- and high-trust postgraduate-supervisor working relationships. In Study 1, a sample of Canadian postgraduates…
Jangland, Eva; Yngman Uhlin, Pia; Arakelian, Erebouni
The position of Nurse Practitioner is a new role in Nordic countries. The transition from a registered nurse to the Nurse Practitioner role has been reported to be a personal challenge. This study, guided by the Nordic theoretical model for use in the education of advanced practice nurses, represents a unique opportunity to describe this transition for newly graduated Nurse Practitioners in an interprofessional surgical care team in Sweden. The aim was to explore how the first Nurse Practitioners in surgical care experienced the transition into a new role and what competences they used in the team. Eight new Nurse Practitioners with parallel work in clinical practice were interviewed twice around the time of their graduation. The qualitative analyses show that the participants integrated several central competences, but the focus in this early stage in their new role was on direct clinical praxis, consultation, cooperation, case management, and coaching. Transition from the role of clinical nurse specialist to nurse practitioner was a challenging process in which the positive response from patients was a driving force for the new Nurse Practitioners. The participants felt prepared for and determined to solve the challenging situations they approached working in the interprofessional team.
Minowa, Chika; Koitabashi, Kikuyo
Psychological stress among breast cancer patients can inhibit immune function and contribute to disease progression. We investigated the effects of autogenic training (AT), a relaxation method for reducing stress, on salivary immunoglobulin A (sIgA) in breast cancer surgery patients. Thirty patients scheduled to undergo breast cancer surgery were randomly assigned to an AT or control group (usual care). Patients in the AT group underwent training for 7 days after surgery. Salivary IgA and heart rate variability were assessed on the day before surgery, and on the third and seventh postoperative days. Levels of sIgA were significantly higher on the seventh postoperative day in the AT group (n = 7) compared to the control group (n = 7) (p = 0.049). These findings suggest that AT may improve immune function in breast surgery patients.
Karlsson, J.; Balfour, R.; Moletsane, R.; Pillay, G.
This article is about the national project to gather together information about postgraduate education research (PPER) in South Africa conducted over a ten-year period, namely 1995-2004, being the first decade in the democratic era for South Africa. The ideas informing the PPER Project are provided and the complex process of developing the PPER…
van Rijsselt, Rene J. T.; Parkatti, Terttu; Troisi, Joseph
This paper describes three innovative European initiatives in postgraduate education in gerontology. The first is the European Masters Program in Gerontology (EuMaG), developed as an interdisciplinary joint program, supported and delivered by 22 European universities. Second, the Nordplus initiative to increase mobility of students and staff in…
Javed, Muhammad; Nawaz, Muhammad Atif; Qurat-Ul-Ain, Ansa
This paper addresses to assess the critical thinking ability of postgraduate students. The target population was the male and female students at University level in Pakistan. A small sample of 45 male and 45 female students were selected randomly from The Islamia University of Bahawalpur, Pakistan. Cornell Critical Thinking Test Series, The…
The importance of reading for academic study cannot be overemphasized. At the postgraduate level, students are faced with complex text interpretation processes. Yet, while concerns have been expressed regarding the English as a second language literacy (Fitzgerald, 1995), few international students have been asked for their views on their…
Interdisciplinary research teams and departments are seen by some as a way of addressing problems that cannot be understood using a traditionally narrow and uniform approach rooted in a particular discipline. This paper presents a postgraduate perspective by discussing the positive and negative impacts on Ph.D. research of this type of work and…
Welsh, Jennifer M.
The way in which graduate students attending British universities approach their one year of research study and the problems they encounter as graduate students were studied as part of an investigation into postgraduate education undertaken at the University of Aberdeen. Of the 77 students, 56 (39 Ph.D., 17 Master's candidates) were registered in…
Coughlin, Mary Ann; Laguilles, Jerold S.; Kelly, Heather A.; Walters, Allison M.
This chapter provides a big-picture view of the postgraduate outcomes landscape. In an effort to promote understanding and to communicate the value of a higher education credential to various stakeholders, five national efforts are described, each of which provides a different perspective for defining, measuring, and collecting postgraduate…
The postgraduate education program of the "Landesärztekammer" describes the aims to qualify for the "Facharzt" for anesthesiology and plays a key role in ensuring a high quality of medical care. The "Bundesärztekammer" was assigned by the "Deutsche Ärztetag" to develop and improve postgraduate training. The German Society of Anaesthesiology and Intensive Care Medicine launched in 2011 a committee to develop this new training program. In 2013 the results of the committee were presented and submitted to the "Bundesärztekammer". The principle purpose of this paper was to describe all the new aspects related to this program and to describe all the qualifications needed to finish this program.
Cox, J D; Flynn, D F; Pittman, D D; Brady, L W; del Regato, J A
The fourteenth survey of postgraduate medical education in radiation oncology in the United States was conducted in the first three months of 1988. It revealed stability in the number of approved programs, positions offered, and physicians in training compared with 1986. The proportion of trainees who were U.S. citizens by birth rose to an all-time high of 88%, and the proportion of foreign medical graduates decreased to 9%. The proportion of women in residency has remained unchanged (24%) over the past 6 years. At present, approximately 150 physicians complete residency and enter practice each year, one-third of whom commence in an academic setting. A high proportion of recent graduates of approved programs successfully completes the examinations and becomes certified by the American Board of Radiology.
College , or Air Force Institute of Technology. However, the unique mission and organizational structure of NPS may be a limitation in implementing...Education Services. However, it must be noted that not all of Education & Training can be strategically sourced because Education & Training– Tuition ...Registration/Membership Fees is money spent on tuition for Navy personnel attending civilian institutions obtaining postgraduate degrees. This makes up
Liss, Michael A; McDougall, Elspeth M
Robotic surgery has undergone exponential growth and has ever developing utilization. The explosion of new technologies and regulation have led to challenges in training surgeons who desire this skill set. We review the current state of robotic simulation and incorporation of simulation into surgical training curricula. In addition to the literature review, results of a questionnaire survey study of 21 expert and novice surgeons attending a Urologic Robotic Oncology conference using 3 different robotic skill simulation devices are discussed. An increasing number of robotic surgery simulators have had some degree of validation study of their use in surgical education curricula and proficiency testing. Although simulators are advantageous, confirmation of construct and predictive validity of robotic simulators and their reliability as a training tool will be necessary before they are integrated into the surgical credentialing process.
Shelat, Vishal G.; Ahmed, Saleem; Chia, Clement L. K.; Cheah, Yee Lee
Application of minimal access surgery in acute care surgery is limited due to various reasons. Laparoscopic omental patch repair (LOPR) for perforated peptic ulcer (PPU) surgery is safe and feasible but not widely implemented. We report our early experience of LOPR with emphasis on strict selection criteria. This is a descriptive study of all patients operated on for PPU at academic university-affiliated institutes from December 2010 to February 2012. All the patients who were operated on for LOPR were included as the study population and their records were studied. Perioperative outcomes, Boey score, Mannheim Peritonitis Index (MPI), and physiologic and operative severity scores for enumeration of mortality and morbidity (POSSUM) scores were calculated. All the data were tabulated in a Microsoft Excel spreadsheet and analyzed using Stata Version 8.x. (StataCorp, College Station, TX, USA). Fourteen patients had LOPR out of a total of 45 patients operated for the PPU. Mean age was 46 years (range 22−87 years). Twelve patients (86%) had a Boey score of 0 and all patients had MPI < 21 (mean MPI = 14). The predicted POSSUM morbidity and mortality were 36% and 7%, respectively. Mean ulcer size was 5 mm (range 2−10 mm), mean operating time was 100 minutes (range 70−123 minutes) and mean length of hospital stay was 4 days (range 3−6 days). There was no morbidity or mortality pertaining to LOPR. LOPR should be offered by acute care surgical teams when local expertise is available. This can optimize patient outcomes when strict selection criteria are applied. PMID:25692444
Derossis, Anna M.; Antoniuk, Maureen; Fried, Gerald M.
Objective To evaluate laparoscopic technical skill in surgical residents over a 2-year period. Design The laparoscopic technical skills of general surgical residents were evaluated using the MISTELS program. This provides an objective evaluation of laparoscopic skill, taking into account precision and speed. Setting Inanimate laparoscopic skills centre. Participants Ten general surgical residents (5 PGY1, 3 PGY2 and 2 PGY3 residents) who were required to complete 3 structured laparoscopic tasks. Outcome measures A composite score incorporating precision and timing was assigned to each task. The paired t-test was used to compare performance of each resident at the 2 levels of their residency training for each task. Linear regression analysis was used to correlate level of training and total score (sum of all tasks). Results Linear regression analysis demonstrated a highly significant correlation between level of training and total score (r = 0.82, p < 0.01). There was a significant increase in scores in the cutting and suturing task over the 2-year period (p < 0.01). Transferring skills did not improve significantly (p = 0.11). Conclusions Performance in the simulator improved over residency training and was correlated highly with postgraduate year. This simulator model is a valuable teaching tool for training and evaluation of basic laparoscopic tasks in laparoscopic surgery. PMID:10459330
Nagengast, Eric S; Ramos, Margarita S; Sarma, Hiteswar; Deshpande, Gaurav; Hatcher, Kristin; Magee, William P; Campbell, Alex
Surgical training is facing new obstacles. As advancements in medicine are made, surgeons are expected to know more and to be able to perform more procedures. In the western world, increasing restrictions on residency work hours are adding a new hurdle to surgical training. In low-resource settings, a low attending-to-resident ratio results in limited operative experience for residents. Advances in telemedicine may offer new methods for surgical training. In this article, the authors share their unique experience using live video broadcasting of surgery for educational purposes at a comprehensive cleft care center in Guwahati, India.
1 A NAVAL POSTGRADUATE DENTAL SCHOOL ANALYSIS OF INITIAL ENDODONTIC TREATMENT by Rodney V. Scott LCDR, DC, USN...A thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental School Uniformed Services...Clinical Research A Naval Postgraduate Dental School Analysis of Initial Endodontic Treatment Rodney V. Scott, DDS
Group supervision was initiated in order to meet the training needs of psychiatric postgraduates. The experience of the group was surveyed at the end of one year. It was found that the use of groups as an adjunct to individual supervision was an eminently practical and acceptable method of facilitating training, accessing peer group support and auditing clinical care. PMID:21407927
The Drinking Water Academy provides online training and information to ensure that water professionals, public officials, and involved citizens have the knowledge and skills necessary to protect our drinking water supply.
Maeshiro, Masao; Izutsu, Satoru; Connolly, Kathleen Kihmm
The University of Hawai'i (UH) has been collaborating with Okinawa Prefectural Chubu Hospital for over 46 years. This collaboration started as a post-World War II effort to increase the physician workforce. At the initiation of the US Army and State Department, the University of Hawai'i was recruited, in cooperation with the government of the Ryukyus and USCAR, to initiate a US style postgraduate clinical training program. The Postgraduate Medical Training Program of University of Hawai'i at Okinawa Chubu Hospital introduced a style of training similar to that in the US by offering a rotating internship. The initial contract had UH establish and run the Postgraduate Medical Training Program of University of Hawaii at Okinawa Central Hospital. After Okinawa's reversion to Japan, under a new contract, UH physicians participated as consultants by providing lectures at "grand rounds" and guidance to faculty, staff, and students. To date, 895 physicians have completed the University of Hawai'i Postgraduate Medical Training Program with 74 currently training. Approximately 662 (74%) of the trainees have remained in Okinawa Prefecture to practice medicine. As a result, the program has enhanced the physician workforce for the islands of Okinawa and neighbor archipelagos of Miyako and Yaeyama Islands.
Clifton, Matthew S; Wulkan, Mark L
Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.
Grosfeld, Klaus; Lohmann, Gerrit; Ladstätter-Weißenmayer, Annette; Burrows, John; Sprengel, Claudia; Bijma, Jelle
Today's graduate and postgraduate education in the field of Earth System and Environmental Science is a highly interdisciplinary and inter-institutional challenge. The integration of observations, palaeoclimate data, and climate modelling requires networks and collaborations of experts and specialists in order to better understand natural climate variations over a broad range of timescales and disciplines, and to cope with the challenges of recent climate change. The existing research infrastructure at the Alfred-Wegener-Institut Bremerhaven (AWI), University of Bremen, and Jacobs University Bremen offers a unique research environment in north-western Germany to study past, present and future changes of the climate system, with special focus on high latitudinal processes. It covers all kind of disciplines, climate science, geosciences and biosciences, and provides a consistent framework for education and qualification of a new generation of expertly trained, internationally competitive master and PhD students. On postgraduate level, the Postgraduate Programme Environmental Physics (PEP) at the University of Bremen (www.pep.uni-bremen.de) educates the participants on the complex relationship between atmosphere, hydrosphere (ocean), cryosphere (ice region) and solid earth (land). Here, the learning of experimental methods in environmental physics at the most advanced level, numerical data analysis using supercomputers, and data interpretation via sophisticated methods prepare students for a scientific career. Within cooperation with the Ocean University of China (OUC) students are participating one year in the PEP programme during their master studies since 2006, to get finally a double degree of both universities. Based on this successful cooperation a similar programme is in preparation with the Lulea University of Technology, Sweden. The Earth System Science Research School (ESSReS) (www.earth-system-science.org) at the AWI enables PhD students from a variety of
Grosfeld, K.; Lohmann, G.; Ladstätter-Weißenmayer, A.; Burrows, J.; Sprengel, C.; Bijma, J.
Today's graduate and postgraduate education in the field of Earth System and Environmental Science is a highly interdisciplinary and inter-institutional challenge. The integration of observations, palaeoclimate data, and climate modelling requires networks and collaborations of experts and specialists in order to better understand natural climate variations over a broad range of timescales and disciplines, and to cope with the challenges of recent climate change. The existing research infrastructure at the Alfred-Wegener-Institut Bremerhaven (AWI), University of Bremen (Uni-HB), and Jacobs University Bremen offers a unique research environment in north-western Germany to study past, present and future changes of the climate system, with special focus on high latitudinal processes. It covers all kind of disciplines, climate science, geosciences and biosciences, and provides a consistent framework for education and qualification of a new generation of expertly trained, internationally competitive master and PhD students. On postgraduate level, the Postgraduate Programme Environmental Physics (PEP) at University of Bremen (www.pep.uni-bremen.de) educates the participants on the complex relationship between atmosphere, hydrosphere (ocean), cryosphere (ice region) and solid earth (land). Here, the learning of experimental methods in environmental physics at the most advanced level, numerical data analysis using supercomputers, and data interpretation via sophisticated methods prepare students for a scientific career. The foundation of an Earth System Research School (ESSReS) (www.earth-system-science.org) at the AWI enables PhD students from a variety of disciplines to cooperate and exchange views on the common theme of ‘linking data and modelling', leading to a better understanding of local processes within a global context. Computational and conceptual models of the Earth system provide the ability to investigate different scenarios in biogeochemistry, such as the
University, Palo Alto , California, December 1990. 27. Postgraduate School Instruction 5010.3F, Class Scheduling Procedures, 26 April 1976. 28. Postgraduate...ABDEL-HAMID, T. RA RAMESH. BALA AL ALLION, DENNIS G., CDR RC ROBERTS. NANCY C. BC BARRIOS -CHOPLIN, ROBERT RO ROBERTS. BENJAMIN J. BD BUI. TUNG X. SA
Storch, Neomy; Tapper, Joanna
This study assessed the impact of completing an English for Academic Purposes (EAP) course on the writing of postgraduate learners. We begin this paper by describing a course offered for credit to postgraduate international students at a university in Australia, and then report on a large-scale study (n = 69) which investigated the improvement (if…
Dizon, Fernan R.; Sagun, Karryl Kim A.; Alfiler-Macalalad, Ana Grace P.
The paper intends to shed light on the predicament faced by many Filipino. Librarians: the lack of local institutions offering a library and information science (LIS) postgraduate degree. The paper aims to reveal the state of Philippine LIS postgraduate education by considering the number of librarians who have pursued and are still pursuing…
Ion, Georgeta; Iucu, Romita
This paper analyses the perceptions of teachers involved in postgraduate studies of the importance of their study programme for their profession, describes the benefits of postgraduate studies for their practice and examines the strategies used to enhance the impact research they undertake on their teaching. A questionnaire was administered to 161…
McLay, Allan F.
Scholarship parameters, in relation to postgraduate coursework studies, are developed against the expectations of the Boyer classifications of scholarship (Boyer, 1990) with particular emphasis on the role of minor thesis development. An example is presented in which postgraduate coursework students are required to undertake a three semester minor…
Fergie, Gillian; Beeke, Suzanne; McKenna, Colleen; Creme, Phyllis
Traditional views of the writing process as a solitary and painstaking task can inhibit postgraduate students from pursuing useful conversations about their writing. Recent research has suggested that spaces for opening discussion on writing are needed and are important in supporting postgraduate writers to develop their academic identity…
Foote, Kenneth; Bednarz, Sarah; Monk, Janice; Solem, Michael; Stoltman, Joseph
Postgraduate geography education in the USA is growing and changing. In recent years, the number of postgraduate programs has increased at both the doctoral and master's levels. Interest in improving and reforming doctoral education has increased dramatically both inside and outside geography, and geography has been involved in these reforms.…
This study, aimed to determine the variables that have a role in the emergence of individual demand for postgraduate educational sciences programs, is a descriptive one. The sample of the study consisted of 222 postgraduate students from Ankara University, a developed university, and Gaziosmanpasa University, a developing university. The data was…
Rathor, H R; Mnzava, A; Bile, K M; Hafeez, A; Zaman, S
The Health Services Academy has launched a 12-month postgraduate diploma course in medical entomology and disease vector control. The objective is to create a core of experts trained to prevent and control vector-borne diseases. The course is a response to the serious health and socioeconomic burden caused by a number of vector-borne diseases in Pakistan. The persistence, emergence and re-emergence of these diseases is mainly attributed to the scarcity of trained vector-control experts. The training course attempts to fill the gap in trained manpower and thus reduce the morbidity and mortality due to these diseases, resulting in incremental gains to public health. This paper aims to outline the steps taken to establish the course and the perceived challenges to be addressed in order to sustain its future implementation.
Universities of Technology are mandated to provide career-orientated programmes preparing graduates for the workplace, doing research aimed at identifying societal and industrial needs, and finding solutions. Universities of Technology interweave technology with university endeavours; focusing on the know-how for the fabrication of things, and the…
Klaiman, M H
Abuses in labor practices affecting hospital housestaff (residents) have become better understood with the 2002 filing of a federal lawsuit challenging U.S. resident hiring practices. Other initiatives to redress residency employment abuses have included labor action (unionization) and legislative initiatives at both the state and federal levels. This Article suggests that all such initiatives are fated to have limited success because they fail to take into account the economics of the residency system. The author argues that, in several key respects, the U.S. residency employment system resembles the self-perpetrating bonded labor systems of rural Asia. Consequently the Article proposes a radical restructuring of U.S. housestaff employment.
Kaspersma, J. M.; Alaerts, G. J.; Slinger, J. H.
A framework is introduced, describing three aggregate competences for technical issues, management and governance, and a meta-competence for continuous learning and innovation, for the water sector. The four competences are further organised in a T-shaped competence profile. The framework and an assessment methodology were tested in a case study on post-graduate water education for professional staff in the Directorate General Water Resources (DGWR) in Indonesia. Though DGWR professionals have a firmly "technical" orientation, both the surveys and interviews show strong interest in the other competences: in particular the learning meta-competence, as well as the aggregate competence for management. The aggregate competence for governance systematically scores lower. A discrepancy appears to exist between the competences that staff perceive as needed in daily work, and those that could be acquired during post-graduate water education. In both locally-based and international post-graduate water education, the aggregate competences for management as well as governance are reportedly addressed modestly, if at all. With only little competence in these disciplines, it will be difficult for professionals to communicate and collaborate effectively in an interdisciplinary way. As a result, the horizontal bar of the T-shaped profile remains weakly developed. In international post-graduate education, this seems partly compensated by the attention for continuous learning and innovation. The exposure to a different culture and learning format is reported as fundamentally formative. The policies of DGWR have gone through three distinct phases. In the first phase (1970-1987) technical competence and learning were valued highly and training was arranged effectively; in the current phase the need to develop new competences is raising new challenges.
Mills, Joseph L
The purpose of this report is to succinctly review the history, evolution, and accreditation process of postgraduate surgical training programs in the United States, with emphasis on recent dramatic changes in vascular surgery training. Vascular surgery became a distinct specialty of surgery on March 17, 2005, when the American Board of Surgery (ABS) received approval from the American Board of Medical Specialties (ABMS) to offer a Primary Certificate in Vascular Surgery. The traditional requirement for 5 years of training and certification in general surgery was eliminated. Effective July 1, 2006, the ABS converted its certificate in vascular surgery from a subspecialty certificate to a specialty (primary) certificate. These landmark changes allowed the simultaneous development of new training paradigms. Multiple flexible training pathways leading to either dual certification (Traditional 5-2; Early Specialization Program 4-2) or vascular surgery certification alone (Integrated 0-5; Independent 3-3) now exist. New pathways require a minimum of 2 years of core surgery training and 3 years of advanced vascular training. There are currently 96 accredited traditional 5-2 programs, five 4-2 programs, and 11 0-5 integrated programs, with multiple additional institutions in the process of submitting 0-5 applications. The main obstacle preventing more rapid transition to the new pathways seems to be difficulty in obtaining funding for additional resident positions. Multiple flexible training paradigms are likely to coexist as vascular surgery continues to evolve.
The complexity of spectacle lenses has increased enormously over the last three decades. The advent of aspheric lenses for the normal power range and the, now commonplace, progressive lenses for the correction of presbyopia, are just two examples of 21st Century technology. Freeform surfaces are now employed to personalize lenses to wearer's needs and these may be both progressive and atoroidal in nature. At the same time, optometry has taken a sideways step from optics and physics into a more general primary health care profession with an ever-increasing amount of biological and medical content added to an already brimming curriculum, hence the need for persons without optometry training to undertake the study of spectacle lenses. Some years ago a post-graduate course was designed for opticians who had a good grasp of mathematics and the ability to pay close attention to detail in the lengthy trigonometric ray-tracing techniques employed in lens design calculations. The year-long course, is undertaken by distance learning, and has been undertaken via the internet by students from many countries around the world. Final assessment is by means of examination held by the Association of British Dispensing Opticians and takes the form of two three-hour papers, Paper One consisting of the determination of the aberrations of a spectacle lens by accurate trigonometric ray tracing and the second, a general paper on the optics of ophthalmic lenses. It leads to the professional qualification, ABDO (Hons) SLD.
Background In 2004, the Malawian Ministry of Health declared a human resource crisis and launched a six year Emergency Human Resources Programme. This included salary supplements for key health workers and a tripling of doctors in training. By 2010, the number of medical graduates had doubled and significantly more doctors were working in rural district hospitals. Yet there has been little research into the views of this next generation of doctors in Malawi, who are crucial to the continuing success of the programme. The aim of this study was to explore the factors influencing the career plans of medical students and recent graduates with regard to four policy-relevant aspects: emigration outside Malawi; working at district level; private sector employment and postgraduate specialisation. Methods Twelve semi-structured interviews were conducted with fourth year medical students and first year graduates, recruited through purposive and snowball sampling. Key informant interviews were also carried out with medical school faculty. Recordings were transcribed and analysed using a framework approach. Results Opportunities for postgraduate training emerged as the most important factor in participants’ career choices, with specialisation seen as vital to career progression. All participants intended to work in Malawi in the long term, after a period of time outside the country. For nearly all participants, this was in the pursuit of postgraduate study rather than higher salaries. In general, medical students and young doctors were enthusiastic about working at district level, although this is curtailed by their desire for specialist training and frustration with resource shortages. There is currently little intention to move into the private sector. Conclusions Future resourcing of postgraduate training opportunities is crucial to preventing emigration as graduate numbers increase. The lesser importance put on salary by younger doctors may be an indicator of the success
Bitzer, E. M.
Publications about postgraduate studies and the supervision address issues and concerns such as supervisory orientations and strategies, ways to handle postgraduate students, challenging postgraduate education practices, factors related to success in postgraduate studies, the benefits of advanced studies, transition to independent research and…
Wong, Wei-Wah Claudia
The demand for communication skills training for science research postgraduates (RPGs) has been increasing over the years. Many potential scientists and researchers in the industry are under enormous pressure to get published (Cargill, O'Connor & Li, 2012) and to attend conferences and seminars. In light of the aforementioned needs, all…
Smith, Bradley R; Park, Jae Hyun; Cederberg, Robert A
The purpose of this study was to evaluate the use of cone-beam computed tomography (CBCT) in postgraduate orthodontic residency programs. An anonymous electronic survey was sent to the program director/chair of each of the sixty-nine United States and Canadian postgraduate orthodontic programs, with thirty-six (52.2 percent) of these programs responding. Overall, 83.3 percent of programs reported having access to a CBCT scanner, while 73.3 percent reported regular usage. The vast majority (81.8 percent) used CBCT mainly for specific diagnostic purposes, while 18.2 percent (n=4) used CBCT as a diagnostic tool for every patient. Orthodontic residents received both didactic and practical (hands-on) training or solely didactic training in 59.1 percent and 31.8 percent of programs, respectively. Operation of the CBCT scanner was the responsibility of radiology technicians (54.4 percent), both radiology technicians and orthodontic residents (31.8 percent), and orthodontic residents alone (13.6 percent). Interpretation of CBCT results was the responsibility of a radiologist in 59.1 percent of programs, while residents were responsible for reading and referring abnormal findings in 31.8 percent of programs. Overall, postgraduate orthodontic program CBCT accessibility, usage, training, and interpretation were consistent in Eastern and Western regions, and most CBCT use was for specific diagnostic purposes of impacted/supernumerary teeth, craniofacial anomalies, and temporomandibular joint (TMJ) disorders.
Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael
This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308
Toyota, Brian D
Medical subspecialization is a response to rapidly expanding technology and knowledge. Although beneficial to patient care, it poses a challenge to the current infrastructure of resident education. This article analyzes the advent of subspecialization, the current template of postgraduate neurosurgical education, the impact of subspecialization on postgraduate neurosurgical education, and, finally, suggests strategies to optimize professional education in the face of an increasingly subspecialized field.
West Washington, D.C. 20008 8. Lt.Col. Jose Pedro P. Goncalves 5 EMFA la Divisio Av. Leite de Vasconcelos - Alfragide 2700 Amadora Portugal 9. Library...Master’s Thesis the Naval Postgraduate School December 1984 S. PERFORMING ORG. REPORT NUMBER 7. AUTHOR() S. CONTRACT OR GRANT NUMBER(e) Jose / Pedro Pereira...distribution is unlimited. International Students’ Perceptions of the Naval Postgraduate School - by Jose ’ Pedro Pereira Gongalves Lieutenant Colonel
Some colleges have substantial endowments, while others are non-existent. For this reason, the printed tuition price on college websites is not...always equivalent to the cost. Nonetheless, using these college tuition prices as references provides insight to where the Naval Postgraduate School...ABSTRACT (maximum200words) The Naval Postgraduate School is required to report activity costs and set tuition rates annually. The requirement to
Pinto, Gabriela S; Nascimento, Gustavo G; Mendes, Matheus S; Ogliari, Fabrício A; Demarco, Flávio F; Correa, Marcos B
This study aimed to evaluate the factors associated with the decision to attend an academic post-graduation program by dental students. A cross-sectional study was conducted in 2012, last-year undergraduate students from Dental Schools of Southern Brazil. A closed questionnaire was applied including questions grouped in three different blocks: pre-graduate, undergraduate period and future perspectives. The outcome was the decision to pursuit an academic post-graduation degree. Associations were tested using chi-squared test and chi-squared test for linear trends when appropriate. Multivariate Poisson regression was also performed. The sample was composed by 671 students (response rate of 69.9%, n=467). In relation to future perspectives, 68% of the interviewed students intended to attend a post-graduation program, but only 17.5% would choose a program with academic and research post-graduation program (Master and PhD programs). In the final model, students from public universities (PR 2.08, 95%CI 1.41-3.08) and students that received scientific initiation scholarship (PR 1.93 95%CI 1.14-3.27) presented a twice greater prevalence to seek academic post-graduate programs. Students with higher family incomes showed a lower prevalence to seek these programs (PR 0.50, 95%IC 0.28-0.90). Scholarships seem to encourage undergraduate students to pursue stricto sensu post-graduation.
Schröder, W; Krones, C J
The radical economisation of the German health-care system has caused an increasing cost awareness. Following this trend, medical education has been identified as a possible expense factor. The theoretical and practical training of young doctors needs time and costs money. However, a detailed cost analysis is still not available, since the complex daily work schedule of young professionals only allows the calculation of single cost factors. Investigations in the USA estimate the costs of surgical training at US$ 80 000 per year and per resident. At present in Germany, surgical training is indirectly financed by the DRG flat rates of the health insurance companies. Possible alternatives include the implementation of a "training fond" which is financed by a percentage fee of the DRG's as well as an on-top funding by the federal government. This "training fond" would support only those surgical units that offer a structured and certified training to surgical residents. However, a systematic cost analysis of such a structured curriculum is necessary for any further discussion.
Gibson, Christine; Ladak, Farah; Shrestha, Ashis; Yadav, Bharat; Thu, Kyaw; Aye, Tin
Family medicine is an integral part of primary care within health systems. Globally, training programmes exhibit a great degree of variability in content and skill acquisition. While this may in part reflect the needs of a given setting, there exists standard criteria that all family medicine programmes should consider core activities. WONCA has provided an open-access list of standards that their expert community considers essential for family medicine (GP) post-graduate training. Evaluation of developing or existing training programmes using these standards can provide insight into the degree of variability, gaps within programmes and equally as important, gaps within recommendations. In collaboration with the host institution, two family medicine programmes in Nepal and Myanmar were evaluated based on WONCA global standards. The results of the evaluation demonstrated that such a process can allow for critical review of curriculum in various stages of development and evaluation. The implications of reviewing training programmes according to WONCA standards can lead to enhanced training world-wide and standardisation of training for post-graduate family medicine.
Patrick, J.; Gregov, A.; Halliday, P.
Describes two exploratory studies of undergraduate and postgraduate students concerning the difficulties of learning to perform HTA (hierarchical task analysis) and how those difficulties might be overcome through proper training. Errors occurred with respect to all HTA criteria, suggesting that carrying out HTR itself is a complex cognitive task.…
Walker, Isabeau A
Medical migration is damaging health systems in developing countries and anesthesia delivery is critically affected, particularly in sub-Saharan Africa. 'Within country' postgraduate anesthesia training needs to be supported to encourage more doctors into the specialty. Open-ended training programs to countries that do not share the same spectrum of disease should be discouraged. Donor agencies have an important role to play in supporting sustainable postgraduate training programs.
The format of urological training in India has changed little since its inception. The dogma of tradition has perhaps failed to consider the paradigm shifts in the science. A system that was relevant 50 years ago may not be so relevant today. The majority of procedures are endourological and laparoscopic, to which an average surgical resident has minimal exposure. Yet, the fundamentals of surgical craft are best learnt prior to any sub-specialty training. This is an apparent contradiction that has to be bridged if our training programs seek to be the foremost in the world. A single restructured training program that combines the core surgical curriculum to an extended exposure to the subspecialty will perhaps best address this issue.
Adeli, Mehdi; Hendaus, Mohamed A; Abdurrahim, Lukman I; Alhammadi, Ahmed H
Background Food allergy is an increasing public health burden, and is considered among the most common chronic noncommunicable diseases in children. Proper diagnosis and management of food allergy by a health care provider is crucial in keeping affected children safe while simultaneously averting unnecessary avoidance. Objective The rationale of the study was to estimate the knowledge of pediatric residents and academic general pediatric fellows with regard to food allergies in children. Methods A cross-sectional and prospective study was carried out at Hamad Medical Corporation, the only tertiary care, academic and teaching hospital in the State of Qatar. The study took place between January 1, 2015 and September 30, 2015. Results Out of the 68 questionnaires distributed, 68 (100%) were returned by the end of the study. Among the participants, 15 (22%) were in post-graduate year-1 (PGY-1), 16 (23.5%) in PGY-2, 17 (25%) in PGY-3, 12 (16%) in PGY-4, and 8 (12%) were academic general pediatric fellows. Our trainees answered 60.14% of knowledge based questions correctly. In the section of treatment and management of food allergy in childhood, 23 (34%) of respondents’ main concern when taking care of a patient with food allergies was making sure the patient is not exposed to food allergen, while 22 (33%) reported no concerns. In the section of treatment and management of food allergy in childhood, 22 (33%) of participants reported no concerns in taking care of a child with food allergy, while 23 (34%) of respondents’ main concern was making sure the patient is not exposed to food allergen. In the teaching and training section, 56% of participants stated that they have not received formal education on how to recognize and treat food allergies, while 59% claimed not being trained on how to administer injectable epinephrine. Furthermore, approximately 60% of all participants expressed the need of additional information about recognizing and treating food allergies and
Navratil, Leos; Kymplova, Jaroslava; Navratilova, Blanka
Non-invasive lasertherapy became today an appreciated treatment method. To avoid its degradation, it is necessary that every physician, who indicates it, would pass out the basic course in these problems. So the error danger by its application would be reduced. As we have verified, in every country the education process is different; we don't consider this fact as right. In the Czech Republic the Radiobiologic Society of Czech Medical Society J. E. Purkynje in co-operation with the Institute of Further Physician's Education, having wide experiences in postgraduate education, organizes already five years such courses. The basic course has 20 lessons, in which the graduates are acquainted with physical base of laser, hygienic rulings for working with laser and biologic changes induced by low level laser in the tissue in vivo. A considerable attention is dedicated to clinical practice and practical education on clinical departments in the fields of dermatology, physiotherapy, stomatology and gynaecology. This course is completed with a lecture of the recent marketing in health service. Participants document their knowledge's in the closing test. Every physician can perfect his knowledge's in a continuation course. Our experiences proved that the education in phototherapy in Czech Republic is on high level in comparison with number of other countries.
George, Arvin K; Hartman, Christopher; Kavoussi, Louis R
Comparison of surgical techniques must be critically and objectively evaluated, ideally in the context of prospective trials. Comprehensive surgical training ensures that patients are offered the most appropriate treatment and highest clinical care.
Carney, Stuart; Bhugra, Dinesh K.
Background/Objective: Recent training and education changes have raised important issues in delivery of psychiatric education at all levels. In this article, the authors describe the current status of mental health education in the training of all doctors and postgraduate training and education in psychiatry in the U.K. Method: The authors explore…
Laparoscopic Trainer (Simbionix) Trainer for laparoscopic skill includes haptics and cholecystectomy W81XWH-06-1-0529 Page 7 of 11 ___LapSim...30PM: CompanyParticipants for Hands-on: METI STEP / HPS Haptica ProMIS Immersion Laparoscopic Simulation Workstation MISTELS Fundamentals of... Laparoscopic Surgery Simbionix Lap Mentor , GI Mentor, UroMentor Surgical Science LapSim RealSim Systems LTS 2000 Verefi Technologies EndoTower
Evgeniou, Evgenios; Loizou, Peter
The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators.
Tolhurst, B G; Bonner, A
This paper explores the development and implementation of specific criteria to determine the level of clinical performance of postgraduate nursing students during the first year of a Master of Nursing course. The authors describe two commonly used clinical skill assessment tools and identify limitations of these tools for postgraduate nursing students. As a result of these limitations, Clinical Assessment Criteria (CAC) utilising the framework of Benner (1984) was developed. Inherent within the CAC is four levels of clinical nursing performance, which enable the nurse teacher and student to monitor the progression from novice to proficient levels of practice within a specialty area. Following a successful pilot study, the CAC was incorporated into clinical assessments in nine specialty postgraduate courses. Furthermore, the framework developed for the CAC can also be integrated into a variety of professional development domains.
Chittawar, Sachin; Dubey, T. N.; Sharma, Jitendra; Khandare, Sagar
Introduction: Adrenal disorders could be a life-threatening emergency, hence requires immediate therapeutic management. For this awareness regarding its diagnosis, management, and treatment is prime important. Aims and Objective: To study the awareness of adrenal disorders among interns and postgraduates students of Hamidia Hospital, Bhopal. Materials and Methods: A cross-sectional questionnaire-based study was performed. Fifty-six participants, i.e., 1st, 2nd, and 3rd years postgraduate residents of general medicine (n = 14 × 3) and interns (n = 14) were included in the study. There were 12 questions on adrenal insufficiency, adrenal adenoma, congenital adrenal hyperplasia (CAH), nonclassical CAH (NCCAH), pheochromocytoma, and Conn's syndrome. One mark was awarded for each correct response. Results: In the present study, 14 (25%) participants scored < 5 marks, 33 (58.9%) scored between 6 and 9, and 9 (16.1%) scored between 10 and 12. The mean score among the participants was 6.38 ± 2.505, with a range from 2 to 11 marks. The number of correct answers by postgraduates residents of 1st year was 101, 2nd year was 95, and 3rd year was 93 and interns scored 68 out of total 168 questions in each group. Mean awareness score for residents of 1st, 2nd, 3rd years participants and interns was 7.21 ± 2.806, 6.79 ± 2.119, and 6.64 ± 2.818 and 6.63 ± 2.505, respectively. Most of the participants recorded correct responses related to diagnosis (57.7%) followed by responses related to treatment (64.3%). Answers to a question regarding how commonly is adrenal insufficiency diagnosed in medical Intensive Care Unit, none of the individuals responded correctly. Conclusion: There was a lack of awareness regarding diagnosis, management, and treatment of adrenal disorders in central India. We need to prioritize training related to these illnesses in our postgraduate teaching curriculum in practice. PMID:28217529
Poulton, Alexander; Rose, Heather
Background Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada’s CanMEDS competency framework. Method A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. Results The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Conclusions Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada. PMID:27004077
Singh, Tejinder; Modi, Jyoti Nath; Kumar, Vinay; Dhaliwal, Upreet; Gupta, Piyush; Sood, Rita
In India, a single national level entrance examination for admission to undergraduate and postgraduate medical courses has been introduced. This is largely an effort towards alleviating financial corruption in admission process, improving logistics and ease of examination for students, and resource efficacy in conduction of examination. Unfortunately, the possible educational impact of such single high stakes examination has not been overtly discussed. A major handicap in doing so is the lack of documentation and analysis of our own experience with multiple entrance examinations over many years. One adverse aspect of a single high stakes single examination, especially the Postgraduate entrance examination, is that the students' learning priorities get redefined to being 'examination-oriented' rather than 'competencydevelopment oriented'. Hence, we must draw lessons from admission processes in other countries that have gone through similar course. Two key effective practices in these countries include giving weightage to prior academic performance, and use of a combination of some form of cognitive testing, aptitude testing and non-cognitive assessment, for taking selection decisions. It is prudent to modify our existent examination processes utilizing the same principles. There is a need to improve the formative assessments and the end-of-training certification examinations and possibly also include them as inputs for the admission process.
Ananthakrishnan, N; Arora, N K; Chandy, G; Gitanjali, B; Sood, R; Supe, A; Nagarajan, S
In spite of the existence of a dual system of postgraduation, one under the Medical Council of India (MCI) and the other on a parallel track under the National Board of Examinations, postgraduate medical education in India is beset with several problems. For example, the curriculum has not been revised comprehensively for several decades. The diploma course under the MCI has become unpopular and is largely a temporary refuge for those who do not get admission to degree courses. The level of skills of the outgoing graduate is falling and the increase in the number of seats is taking place in a haphazard manner, without reference to the needs. In spite of increase in seats, there is a shortage of specialists at the secondary and tertiary care levels, especially in medical colleges, to share teaching responsibilities. Further, the distribution of specialists is skewed, with some states having far more than others. To remedy these ills and fulfil the requirements of the country over the next two decades, a working group appointed by the erstwhile governors of the MCI was asked to suggest suitable modifications to the existing postgraduate system. After an extensive review of the lacunae in the present system, the needs at various levels and the pattern of postgraduate education in other countries, it was felt that a competency-based model of a 2-year postgraduate course across all specialties, the use of offsite facilities for training and a criterion-based evaluation system entailing continuous monitoring would go a long way to correct some of the deficiencies of the existing system. The details of the proposal and its merits are outlined for wider discussion and to serve as a feedback to the regulatory agencies engaged in the task of improving the medical education system in India. We feel that the adoption of the proposed system would go a long way in improving career options, increasing the availability of teachers and dissemination of specialists to the secondary
de Bruijn, Ferdi J.; Ashford, Edward W.; Larson, Wiley J.
SpaceTech is a postgraduate program geared primarily for mid-career space professionals seeking to gain or improve their expertise in space systems engineering and in business engineering. SpaceTech provides a lifelong impact on its participants by broadening their capabilities, encouraging systematic "end-to-end" thinking and preparing them for any technical or business-related engineering challenges they may encounter. This flexible 1-year program offers high competency gain and increased business skills. It is held in attractive locations in a flexible, multi-cultural environment. SpaceTech is a highly effective master's program certified by the esteemed Technical University of Delft (TUD), Netherlands. SpaceTech provides expert instructors who place no barriers between themselves and participants. The program combines innovative and flexible new approaches with time-tested methods to give participants the skills required for future missions and new business, while allowing participants to meet their work commitments at the same time as they study for their master's degree. The SpaceTech program is conducted in separate sessions, generally each of 2-week duration, separated by periods of some 6-8 weeks, during which time participants may return to their normal jobs. It also includes introductory online course material that the participants can study at their leisure. The first session is held at the TUD, with subsequent sessions held at strategic space agency locations. By participating at two or more of these sessions, attendees can earn certificates of satisfactory completion from TU Delft. By participating in all of the sessions, as well as taking part in the companion Central Case Project (CCP), participants earn an accredited and highly respected master's degree in Space Systems Engineering from the TUD. Seven distinct SpaceTech modules are provided during these sessions: Space Mission Analysis and Design, Systems Engineering, Business Engineering
The global growth in postgraduate (PG) study since the mid-1990s has been attributed to the expansion in Masters by Coursework participation (Bekhradnia, B. (2005). Postgraduate education in the UK: Trends and challenges higher education policy institute. Paper presented at a conference "The future of postgraduate education supporting the…
... 25 Indians 1 2010-04-01 2010-04-01 false Who can get assistance for postgraduate studies? 166.905... assistance for postgraduate studies? (a) The purpose of the postgraduate studies program is to enhance the... professionals working for an approved organization so that the best possible service is provided to Indian...
Sivakumaran, Lojan; Ayinde, Tasha; Hamadini, Fadi; Meterissian, Sarkis; Razek, Tarek; Puckrin, Robert; Munoz, Johanna; O’Hearn, Shawna; Deckelbaum, Dan L
Background Global health electives offer medical trainees the opportunity to broaden their clinical horizons. Canadian universities have been encouraged by regulatory bodies to offer institutional support to medical students going abroad; however, the extent to which such support is available to residents has not been extensively studied. Methods We conducted a survey study of Canadian universities examining the institutional support available to post-graduate medical trainees before, during, and after global health electives. Results Responses were received from 8 of 17 (47%) Canadian institutions. Results show that trainees are being sent to diverse locations around the world with more support than recommended by post-graduate regulatory bodies. However, we found that the content of the support infrastructure varies amongst universities and that certain components—pre-departure training, best practices, risk management, and post-return debriefing—could be more thoroughly addressed. Conclusion Canadian universities are encouraged to continue to send their trainees on global health electives. To address the gaps in infrastructure reported in this study, the authors suggest the development of comprehensive standardized guidelines by post-graduate regulatory/advocacy bodies to better ensure patient and participant safety. We also encourage the centralization of infrastructure management to the universities’ global health departments to aid in resource management. PMID:28344708
Postgraduate medical education (PGME) is currently transitioning to a competency-based framework. This model clarifies the desired outcome of residency training - competence. However, since the popularization of Ericsson's work on the effect of time and deliberate practice on performance level, his findings have been applied in some areas of residency training. Though this may be grounded in a noble effort to maximize patient well-being, it imposes unrealistic expectations on trainees. This work aims to demonstrate the fundamental flaws of this application and therefore the lack of validity in using Ericsson's work to develop training benchmarks at the postgraduate level as well as expose potential harms in doing so.
Said, Abdul Hadi
Objectives Dyslipidaemia is one of the main risk factors for cardiovascular disease, the leading cause of death in Malaysia. This study assessed the awareness, knowledge and practice of lipid management among primary care physicians undergoing postgraduate training in Malaysia. Design Cross sectional study. Setting Postgraduate primary care trainees in Malaysia. Participants 759 postgraduate primary care trainees were approached through email or hard copy, of whom 466 responded. Method A self-administered questionnaire was used to assess their awareness, knowledge and practice of dyslipidaemia management. The total cumulative score derived from the knowledge section was categorised into good or poor knowledge based on the median score, where a score of less than the median score was categorised as poor and a score equal to or more than the median score was categorised as good. We further examined the association between knowledge score and sociodemographic data. Associations were considered significant when p<0.05. Results The response rate achieved was 61.4%. The majority (98.1%) were aware of the national lipid guideline, and 95.6% reported that they used the lipid guideline in their practice. The median knowledge score was 7 out of 10; 70.2% of respondents scored 7 or more which was considered as good knowledge. Despite the majority (95.6%) reporting use of guidelines, there was wide variation in their clinical practice whereby some did not practise based on the guidelines. There was a positive significant association between awareness and the use of the guideline with knowledge score (p<0.001). However there was no significant association between knowledge score and sociodemographic data (p>0.05). Conclusions The level of awareness and use of the lipid guideline among postgraduate primary care trainees was good. However, there were still gaps in their knowledge and practice which are not in accordance with standard guidelines. PMID:28249849
Lonie, Anne-Louise; Andrews, Trish
At Rangelands Australia, a centre in the School of Natural and Rural Systems Management at the University of Queensland, we have recently trialled virtual classroom technology for the delivery of postgraduate support courses. We wanted to explore the capacity of this learning modality to provide collaborative, interactive, synchronous learning…
McKeown, Tui; Anderson, Mary
Purpose: While educators and students alike are increasingly moving to use on-line technologies, there is still much to be learned about how these tools influence student learning. The purpose of this paper is to present a comparative investigation of the online use of one undergraduate (UG) and two postgraduate (PG) student cohorts undertaking…
Steele, Godfrey A.
New postgraduate students' feedback on their learning offers insights into engagement. Student feedback to students and teachers can contribute to teacher feedback to students. When this happens, students can feel engaged or connected to their learning experiences. Adopting a more inclusive notion of feedback on learning, this paper explores the…
The article deals with peculiarities of undergraduate and postgraduate linguistic courses at Lancaster University. It has been stated that the latter is considered to be one of the best higher education institutions both in the UK and worldwide. Being a relatively new higher education institution (founded in 1964), it can already boast its…
Kember, David; Ho, Amaly; Leung, Doris Y. P.
There is a need for a questionnaire designed specifically to evaluate taught postgraduate (TPg) awards for quality assurance or enhancement purposes. Comparison of undergraduate and TPg awards suggests that as the former have broadened their ambit to better nurture generic graduate attributes, TPg awards have concentrated on advanced specialised…
White, Toy; Coetzee, Elsabe
Supervisors at higher education institutions cannot ignore the possibilities created by technology, and for the sake of this article, e-mail, as an aid for supervision on postgraduate level. After completing the modules for the Magister Technologiae (M Tech): Education qualification, students are required to complete a dissertation of limited…
Adriaansen, Marian J. M.; Frederiks, Carla M. A.
A postgraduate course on palliative nursing includes four class sessions and four peer review meetings in which students discuss case studies and assignments. The course is intended to prepare nurses for the bureaucratic, biomedical, social-therapeutic, and informal roles of terminal care. (SK)
Hook, Genine A.
This paper aims to examine some of ways sole parents sought recognition as postgraduate students in Australian universities. Judith Butler's theory of recognition notes that recognition is always partial and any account we give of ourselves must be given to another. Participants articulated that supervisors were critical in the process of…
Wisker, Gina; Robinson, Gillian; Trafford, Vernon; Creighton, Emma; Warnes, Mark
Most research indicating dissonant forms of student learning engagement, leading to problems in the achievement of learning outcomes, is with undergraduates. Action research at Anglia Polytechnic University involving questionnaires, focus groups, and supervisory dialogues, conducted with Israeli and British postgraduate students between 1998 and…
Within Australia most Departments of Geography have been merged with programmes in Environmental Studies or Earth Sciences, and have been cast as multidisciplinary contributors to the increasingly vocational concerns of universities. One outcome is that named Geography programmes for postgraduates are not growing in institutional prominence in…
McCallin, Antoinette; Nayar, Shoba
Changes in the funding and delivery of research programmes at the university level have, in recent years, resulted in significant changes to research supervision. This paper critically reviews key influences effecting postgraduate supervision. Analysis draws on literature spanning 2000-2010 to determine the appropriateness of traditional models of…
Bitusikova, Alexandra; Bohrer, Janet; Borosic, Ivana; Costes, Nathalie; Edinsel, Kerim; Hollander, Karoline; Jacobsson, Gunilla; Jakopovic, Ivan Filip; Kearney, Mary-Louise; Mulder, Fred; Negyesi, Judith; Pietzonka, Manuel
The present report follows an ENQA (European Association for Quality Assurance in Higher Education) Workshop on Quality Assurance and Postgraduate Education, hosted by the Romanian Agency for Quality Assurance in Higher Education (ARACIS) in Brasov, Romania on 12-13 March 2009. The workshop was an excellent opportunity for ENQA members to exchange…
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Rae, David; Woodier-Harris, Naomi
Purpose: International postgraduate education in business-related subjects has grown substantially in the UK. Both MBA and specialist Masters' programmes increasingly offer entrepreneurship as a core or option. The purpose of this paper is to explore the effectiveness of entrepreneurship education in meeting the expectations and motivations of…
Laguilles, Jerold S.
This chapter describes the background and process for collecting postgraduation outcomes data at a 4-year not-for-profit private college. The strategies, analyses, and reporting of this data-collection effort are highlighted with the use of a case study.
Stewart, Jim; Keegan, Anne; Stevens, Pam
Purpose: This paper aims to explore how teaching and assessing reflective learning skills can support postgraduate practitioners studying organisational change and explores the challenges for tutors in assessing these journals. Design/methodology/approach: Assessment criteria were developed from the literature on reflective practice and…
Hook, Genine A.
This paper draws on research that considers how gender and agency influence the engagement of sole parent postgraduates within the Australian academy. I argue that parental care responsibilities critically influence participation in higher education for sole parents. I suggest that the gendered construct of caring for children is a feminine…
Lessing, A. C.; Schulze, S.
After determining the perceptions of postgraduate students at a distance education institution of the guidance they had experienced, a research project was launched to determine "lecturers'" views on supervision at the same institution. Data collection methods included focus groups, individual interviews and document analysis. Findings…
Strang, Kenneth David
The internet has led to an increasing number of international students enrolling for postgraduate degrees. The literature confirms that there have been problems such as attrition, motivation, supervision and others. Professors struggle to appease international student learning styles, while simultaneously international students strain to…
Gonnella, Joseph S.; Hojat, Mohammadreza
The hypothesis that the relationship between medical school achievement and postgraduate performance would vary by specialty was confirmed in a comparison of grades, standardized medical exams, and ratings in four areas of competence (medical knowledge, data-gathering skills, clinical judgment, and professional attitudes) in internal medicine,…
Strauss, Pat; Mooney, Shelagh
Currently postgraduate hospitality courses are attracting large numbers of international students, many of whom do not speak English as a first language. In addition, these programmes are also popular with first language students drawn from non-traditional academic backgrounds. Both cohorts experience difficulties with the academic genre…
Scott, Jon; Maw, Stephen J.
There has been much recent interest in the extent to which the teaching in higher education delivered by non-academic staff has increased in the recent past. Within the Biosciences there has always been a tradition of engaging postgraduate students to support the delivery of some forms of teaching. In this paper we report on the findings of a…
Bos, Daniel; Finlay, Robin; Hopkins, Peter; Lloyd, Jenny; Richardson, Michael
The Economic and Social Research Council (ESRC) in the UK is one of the main sources of funding for postgraduate study in human geography. For some years now, the ESRC has offered funded students the opportunity to apply to undertake a short internship in a government department or with a Non-Governmental Organization (NGO). This paper provides a…
Fortuijn, Joos Droogleever
This paper discusses reforms in postgraduate education in geography in the Netherlands in the context of Europeanization and globalization. Europeanization and globalization have resulted in challenges as well as opportunities for students and universities. In terms of internationalization, Europeanization and the global economic crisis have…
Monk, Janice; Foote, Kenneth; Solem, Michael
This symposium brings together multi-national assessments of the current state of and challenges facing postgraduate education in geography. Contributors from Europe, Australia, South Africa and the USA identify ways in which restructuring of educational systems and wider political contexts affect programmes within the field. While highlighting…
Souadka, Amine; Naya, Mohammed Sayed; Serji, Badr; El Malki, Hadj Omar; Mohsine, Raouf; Ifrine, Lahsen; Belkouchi, Abdelkader; Benkabbou, Amine
INTRODUCTION: Resident participation in laparoscopic cholecystectomy (LC) is one of the first steps of laparoscopic training. The impact of this training is not well-defined, especially in developing countries. However, this training is of critical importance to monitor surgical teaching programmes. OBJECTIVE: The aim of this study was to determine the impact of seniority on operative time and short-term outcome of LC. DESIGNS AND SETTINGS: We performed a retrospective study of all consecutive laparoscopic cholecystectomies for gallbladder lithiasis performed over 2 academic years in an academic Surgical Department in Morocco. PARTICIPANTS: These operations were performed by junior residents (post-graduate year [PGY] 4–5) or senior residents (PGY 6), or attending surgeons assisted by junior residents, none of whom had any advanced training in laparoscopy. All data concerning demographics (American Society of Anesthesiologists, body mass index and indications), surgeons, operative time (from skin incision to closure), conversion rate and operative complications (Clavien–Dindo classification) were recorded and analysed. One-way analysis of variance, Student's t-test and Chi-square tests were used as appropriate with statistical significance attributed to P < 0.05. RESULTS: One hundred thirty-eight LC were performed. No differences were found on univariate analysis between groups in demographics or diagnosis category. The overall rate of operative complications or conversions and hospital stay were not significantly different between the three groups. However, mean operative time was significantly longer for junior residents (n = 27; 115 ± 24 min) compared to senior residents (n = 37; 77 ± 35 min) and attending surgeons (n = 66; 55 ± 17 min) (P < 0.001). CONCLUSION: LC performed by residents appears to be safe without a significant difference in complication rate; however, seniority influences operative time. This information supports early resident involvement
Braeckman, Lutgart A; Fieuw, Ann M; Van Bogaert, Herman J
Many Belgian postgraduate students in occupational medicine already work in the field although they have had little training or experience. To direct their learning in line with professional needs, an interactive web-based program was developed and evaluated. On-line multiple-choice questions and real-life cases were used as an add-on to the master course in occupational medicine. Students' perceptions were obtained by questionnaire. Trainees felt that the multiple-choice questions with immediate feedback and automatic scoring increased their factual knowledge. The case studies were well received because they were realistic and of appropriate difficulty level. Students preferred the combination of face-to-face teaching and e-learning to a whole course online and were in favor of more active communication between teachers and users. These findings may inform further collaborative developments in educational technology in occupational health.
Tucker, Scott; Cevidanes, Lucia; Styner, Martin; Kim, Hyungmin; Reyes, Mauricio; Proffit, William; Turvey, Timothy
Purpose The advent of imaging software programs have proved to be useful for diagnosis, treatment planning, and outcome measurement, but precision of 3D surgical simulation still needs to be tested. This study was conducted to determine if the virtual surgery performed on 3D models constructed from Cone-beam CT (CBCT) can correctly simulate the actual surgical outcome and to validate the ability of this emerging technology to recreate the orthognathic surgery hard tissue movements in 3 translational and 3 rotational planes of space. Methods Construction of pre- and post-surgery 3D models from CBCTs of 14 patients who had combined maxillary advancement and mandibular setback surgery and 6 patients who had one-piece maxillary advancement surgery was performed. The post-surgery and virtually simulated surgery 3D models were registered at the cranial base to quantify differences between simulated and actual surgery models. Hotelling T-test were used to assess the differences between simulated and actual surgical outcomes. Results For all anatomic regions of interest, there was no statistically significant difference between the simulated and the actual surgical models. The right lateral ramus was the only region that showed a statistically significant, but small difference when comparing two- and one-jaw surgeries. Conclusions Virtual surgical methods were reliably reproduced, oral surgery residents could benefit from virtual surgical training, and computer simulation has the potential to increase predictability in the operating room. PMID:20591553
McDonald, Ian; Mayouf, Mohammad; Rowe, Sophie Grace; Charles, Rachel-Ann; Sultan, Fahad; Patel, Karen; Forkert, Kirsten; Ochonogor, Kene Kelikume
At many new universities, research is often seen as a fringe and/or niche activity, which falls well behind learning and teaching in the list of priorities of such institutions. This issue has major effects on the research experience of postgraduate researchers (PGRs), especially when the research community is small and fragmented across campuses.…
Fichtner, Andreas; Haupt, Elke; Karwath, Tobias; Wullenk, Katharina; Pöhlmann, Christoph; Jatzwauk, Lutz
Die standardisierte Schulung klinisch-praktischer Fertigkeiten in sog. Skills Labs ist erst seit wenigen Jahren an deutschen Universitäten verbreitet. Den zumeist umfangreichen und sehr guten Evaluationsergebnissen stehen kaum Untersuchungen zur Effektquantifizierung und Kosten-Nutzen-Analyse gegenüber. In der vorliegenden Studie soll eine Methode zur digitalen Quantifizierung der Güte der chirurgischen Händedesinfektion vorgestellt werden sowie das Skills-Lab-Training der standardisierten Einreibemethode nach EN1500 auf seinen Effekt hin untersucht und mit OP-Pflegepersonal und Operateuren als klinische Referenzgruppen verglichen werden.Methode: 161 Studierende der Medizin eines 8. Semesters wurden in Kontroll- und Interventionsgruppe randomisiert. Die Interventionsgruppe erhielt ein 45-minütiges standardisiertes Training durch geschulte Mitstudierende zum Verhalten im OP mit dem Teilaspekt der chirurgischen Händedesinfektion nach EN1500. Dem Desinfektionsmittel wurde Fluoreszenzfarbstoff beigemischt. Nach der Desinfektion wurden die 4 Handflächen eines jeden Probanden digital fotografiert und teilautomatisiert die nicht ausreichend benetzte Handfläche bestimmt. Die Ergebnisse aller studentischer Probanden wurden verglichen, sowie das Kompetenzniveau anhand zweier klinischer Referenzgruppen eingeordnet.Ergebnisse: Die Interventionsgruppe erreichte nach dem studentisch angeleiteten Training eine zu durchschnittlich 4,99% (SD 2,34) der gesamten vier Handflächen nicht sicher ausreichende Benetzung und war damit hoch signifikant (p<0,01) besser als die Kontrollgruppe mit 7,33% (SD 3,91). Im Vergleich zu den Referenzgruppen konnte in der Kontrollgruppe kein signifikanter Unterschied gezeigt werden, die Interventionsgruppe zeigte aber im Vergleich zu beiden Referenzgruppen hoch signifikant bessere Ergebnisse: Operateure 9,32% (SD 4,97), OP-Pflege 8,46% (SD 4,66). Der Methodenfehler ist vernachlässigbar gering. In der Subgruppenanalyse hinsichtlich der
Vinden, Christopher; Ott, Michael C.
Summary The Canadian College of Family Physicians recently decided to recognize family physicians with enhanced surgical skills (ESS) and has proposed a 1-year curriculum of surgical training. The purpose of this initiative is to bring or enhance surgical services to remote and underserviced areas. We feel that this proposed curriculum is overly ambitious and unrealistic and that it is unlikely to produce surgeons, or a system, capable of delivering high-quality surgical services. The convergence of a new training curriculum for general surgeons, coupled with the current oversupply of surgeons, provide an alternate pathway to meet the needs of these communities. A long-term solution will also require alternate funding models, a sophisticated and coordinated national locum service and a national review of the population and infrastructure requirements necessary for both sustainable resident surgical services and surgical outreach services. PMID:26574827
Blane, Howard T.
This paper describes four elements of a leadership training program in alcoholism that distinguish it from other postgraduate programs. These four elements are: (1) clinical teams composed of and led by trainees with leadership rotating periodically among trainees; (2) weekly experience group meetings of each team to maximize understanding at…
Haase, G M
Prospective clinical trials are used to evaluate therapeutic interventions. Because surgery is involved in the diagnosis, staging, and therapy of solid malignancies, active surgical leadership in these cancer studies is important. There are currently barriers to widespread surgical participation in clinical trials. This report defines the obstacles as well as documents efforts to overcome them and improve surgical quality assurance in cooperative group research. The surgical leadership of several clinical cooperative groups sponsored by the National Cancer Institute (NCI) were interviewed. Cooperative group reports were analyzed with respect to internal audits, quality assurance and activities of surgical monitoring committees. Minutes from meetings of the NCI's workshops on "Surgeons in Clinical Trials" were reviewed. Six concerns present impediments to surgical quality in clinical trials. To address these, substantive surgical leadership is being developed throughout the cooperative group system. Surgical co-principal investigators for institutions and protocols are being appointed. Uniform surgical standards and operative guidelines are being developed. Surgical data review occur at the local institution as well as through central audits and surgical monitoring committees. Coordinators in surgical data management are being trained. Surgical education is organized at cooperative group meetings and disseminated to the surgical community by seminars, workshops, audiovisual teaching sessions, and scientific publications. Surgeons are playing increasing leadership roles in the cancer trials performed by cooperative groups. Surgical leaders are dedicated to a broad-scale quality assurance effort. Enhanced surgical commitment, widespread clinical participation, and focused leadership should affect a high level of surgical quality care in clinical trials research.
The Taiwan Society of Clinical Pathologists (TSCP) plays a central role in postgraduate education of laboratory medicine and the certification/re-certification of clinical pathologists in Taiwan. For the certification of clinical pathologists, TSCP establishes "Guidelines and Scope of Resident Training" and "Standards for Training Hospitals in Clinical Pathology(CP)", administers board examinations, and issues board certifications/re-certifications. There are two types of CP resident training programs, including a straight CP program with 3 years of CP training for a CP certificate and a combined program with 3 years of Anatomic Pathology training and 2 years of CP training for both the CP and AP certificates. The core curriculum for CP training includes: (1) Clinical Chemistry (at least 4 months), (2) Clinical Microscope with Parasitology (at least 3 months), (3) Clinical Hematology (at least 4 months), and (4) Clinical Microbiology with Clinical Virology (at least 4 months), (5) Immunohematology and Blood Banking (Transfusion Medicine) (at least 3 months), (6) Clinical Serology and Immunology(at least 4 months), and (7) Laboratory Management (at least 2 months). The curriculum for third-year training is not specified and may be in any field. In recent years, the board examination has emphasized the topics of Molecular Biology and Laboratory Informatics. The TSCP has also established an accreditation and inspection program for the CP resident raining hospitals. Each accredited CP training hospital is required to have a detailed teaching protocol of CP training. Quotas are assigned according to the available CPs of the accredited hospitals. The accreditation period is 3 years. Through sponsoring scientific and educational programs, the TSCP offers credit hours of education in laboratory medicine, which are required for re-certification of CPs in Taiwan. The members of the TSCP meet at least twice a year for scientific presentations and seminars. In addition, two to
This article describes training approaches in disaster recovery for social workers, allied workers, and volunteers. Recovery workers from diverse disciplines require specific training in the theoretical constructs, interventions, tasks, and policy to undertake their roles. The article links the knowledge and skills base of disaster recovery to core social work professional education. Current debates in disaster recovery practice are discussed. An undergraduate and postgraduate program developed for Singaporean social work students is outlined in detail. Other models of training are described, including interagency programs, ongoing professional development, workshops after impact, specific training for volunteers, and training for the community itself.
Greene, Charles S; Stockstill, John; Rinchuse, Donald; Kandasamy, Sanjivan
In a previous article, we reported the results of a survey of American and Canadian orthodontic postgraduate programs to determine how the topics of occlusion, temporomandibular joint, and temporomandibular disorders were currently being taught. Based on the finding of considerable diversity among those programs, we decided to write a curriculum proposal for temporomandibular disorders that would be compatible with and satisfy the current curriculum guidelines for postgraduate orthodontic programs. These guidelines arose from a combination of the requirements published by the American Dental Association's Commission on Dental Accreditation and the written guide (July 2010) of the American Board of Orthodontics for the its clinical examination. The proposed curriculum, based on the latest scientific evidence in the temporomandibular disorder field, gives program directors a template for covering these subjects thoroughly. At the same time, they can focus on related orthodontic issues, so that their future graduates will be prepared to deal with patients who either have or later develop temporomandibular disorder problems.
major dust storm of 25-27 March 2003 on OIF aviation operations (Figure 4). Note the large number of canceled sorties (mostly due to weather) in the...major storms on military operations is well known. In December 1944 during World War II, THE NAVAL POSTGRADUATE SCHOOL’S DEPARTMENT OF METEOROLOGY...less important, ways. Turbulence in the atmo- sphere impacts laser propagation and modes of communica- tion. Atmospheric aerosols, dust , and sand
University of the Health Sciences in partial fulfillment of the requirements for the degree of Master of Science in Oral Biology July 2015 Naval...Postgraduate Dental School Uniformed Services University of the Health Sciences Bethesda, Maryland CERTIFICATE OF APPROVAL MASTER’S THESIS This is to...Salehrabi and Rotstein evaluated root canal treatments completed by practitioners in a dental insurance network and reported a 97% survival rate of
Schrader, Mark Hoyer , and Arthur Bullock, all of the RAND Corporation, for their continuing support of the RSAS at the Naval Postgraduate School (NPS...into national decision-making procedures. b. Green Agent. The Green Agent is the RSAS model of non- superpower states which simulates national behavior ...forces are deployed and operated in accordance with expected behavior of each individual nation. The RSAS all-ows the employ- ment of forces in other
Beeman, Pamela Butler; Waterhouse, Julie Keith
The academic and nonacademic factors that influence nursing students' success on the licensure exam have been widely reported. However, many questions remain as to why certain candidates fail the exam. This pilot study explores postgraduation influences on the NCLEX-RN.(R) Factors such as length and type of study, work hours, review course participation, sleep, and stress were recorded using the newly developed NCLEX Preparation Survey. Results suggest both expected and unexpected relationships between these factors and NCLEX-RN mastery.
Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital.
Lang, Nicholas P
A review of the dramatic changes in society, science and medicine that have affected the time we have available for education of students and residents. Reference is made to distance learning, educational efficiency and mental practice as concepts that may aid educators in the quest to provide the public with well trained surgeons. Surgical educators are urged to look outside of traditional models of teaching and evaluating for tools that have been successfully used by industry or business.
Atasoy, S; Cologlu, A S; Abaci-Kalfoglu, E; Polat, O
Legal medicine in Turkey, has an educational background that goes back to 1839 and the first autopsy in modern terms was performed in 1841. In the early days, it was common practice for those involved in this work to extend their investigative knowledge into areas not directly concerned with medical matters. However forensic medical investigations cannot be entrusted in the hands of single investigators, but should rather be dealt with by cooperative groups of experts nowadays. This need was the major force for the establishment of the Institute of Legal Medicine and Forensic Sciences by a special article of the law (section 2547) as a training and research center in 1982. The Institute being the first and only institution giving master's and doctorate degrees in Forensic Sciences, has 3 major departments: 1) Medical Sciences Department, 2) Basic Sciences Department and 3) Social Sciences Department. Graduates of various fields ranging from medical doctors specialized in any field, biologists, chemists to lawyers, district attorneys, psychologists and other related fields are composing the multidisciplinary structure of the institute. The main research fields of the Institute are: population genetics, paternity investigation, child abuse, and identification of human remains.
Kalra, Ruchi; Modi, Jyoti Nath; Vyas, Rashmi
Background: Lecture is a common traditional method for teaching, but it may not stimulate higher order thinking and students may also be hesitant to express and interact. The postgraduate (PG) students are less involved with undergraduate (UG) teaching. Team based small group active learning method can contribute to better learning experience. Aim: To-promote active learning skills among the UG students using small group teaching methods involving PG students as facilitators to impart hands-on supervised training in teaching and managerial skills. Methodology: After Institutional approval under faculty supervision 92 UGs and 8 PGs participated in 6 small group sessions utilizing the jigsaw technique. Feedback was collected from both. Observations: Undergraduate Feedback (Percentage of Students Agreed): Learning in small groups was a good experience as it helped in better understanding of the subject (72%), students explored multiple reading resources (79%), they were actively involved in self-learning (88%), students reported initial apprehension of performance (71%), identified their learning gaps (86%), team enhanced their learning process (71%), informal learning in place of lecture was a welcome change (86%), it improved their communication skills (82%), small group learning can be useful for future self-learning (75%). Postgraduate Feedback: Majority performed facilitation for first time, perceived their performance as good (75%), it was helpful in self-learning (100%), felt confident of managing students in small groups (100%), as facilitator they improved their teaching skills, found it more useful and better identified own learning gaps (87.5%). Conclusions: Learning in small groups adopting team based approach involving both UGs and PGs promoted active learning in both and enhanced the teaching skills of the PGs. PMID:26380201
Shevchenko, Iu L
The Military Medical Academy is a military educational institution which carries out the primary profile training of physicians for the Armed Services and all types of post-graduation training and advanced training of the scientific-pedagogical and medical specialists. Internship as a first stage of the post-graduation training is intended to improve practical medical training of the graduates of the Russian Military Medical Academy and other medico-military educational institutions by means of their primary specialization in one of the clinical or profile branches of medicine. The reforming of the post-graduation training rest system in the Military Medical Academy aims at its further development and putting specialists' training system into accordance with the Armed Forces reorganizations. This will make it possible to ensure high professional qualification of military doctors at the level of national and international standards.
Peters, S.; Kanniah, K. D.; Rahman, A. A.
Studying at Universiti Teknologi Malaysia (UTM) will ensure academic and technological excellence. The Faculty of Geoinformation and Real Estate (FGHT), established in 1972, focus on education and research for undergraduate as well as postgraduate programs in the related disciplines such as geomatic engineering, geoinformatics, remote sensing, property management and land administration & development. FGHT strives to be a leading academic center in geoinformation and real estate in Southeast Asia. Graduates and alumni form major strong professional societies and work force in the related industries. Many of our graduates end up with good jobs not just in Malaysia but also in other countries (Asian, Middle East, Africa and Europe). The strong team and knowledgeable academic members in this faculty provide excellent ingredients for the success of the programs (i.e. with the relevant and up-to-date curriculum and syllabus). FGHT is continuously working to provide and offer first-class geoinformation and real estate education and research in the country and be at a par with other leading institutions in other parts of the globe. The Department of Geoinformation at FGHT runs a Bachelor of Engineering in Geomatic and a Bachelor of Science in Geoinformatics. At the postgraduate levels, namely M.Sc. and PhD programs, the offered disciplines are Geomatic Engineering, Geoinformatics and Remote Sensing. In the following, the state of the art of FGHT's postgraduate education in Geoinformation is presented, including a comparison with other universities in Malaysia, program content and curriculum information, alumni statistics as well as future strategies.
Toribio, Jenny-Ann L M L; Forsyth, Hannah; Laxton, Ruth; Whittington, Richard J
The past decade has seen a substantially increased need for animal health professionals who have advanced education in areas that impact on veterinary public health (VPH). The University of Sydney has made a significant contribution to the international capacity for training in this field by developing an online, distance program in Veterinary Public Health Management. This paper describes the distinctive characteristics of this program, which combines technical material in a range of units that influence VPH with leadership and project management. It then describes the educational model developed for delivery of its course material, including the four modalities that are structured to support engaged learning by busy animal health professionals who are working full-time (self-led, facilitator-led, peer-led, and assessment-led instructional approaches). Finally, having reflected on the efficacy of this model for post-graduate training in VPH, we discuss the progress of the program since its inception in 2002, reflecting on the challenges it has encountered and defining the factors that are critical to the success of this program.
Tamatey, Martin; Edwin, Frank
Ghana is one of the few low-to-middle-income countries in sub-Saharan Africa able to consistently sustain a cardiothoracic program with locally trained staff for more than two decades. Cardiothoracic surgery practice in Ghana started in 1964 but faltered from a combination of political and the economic problems. In 1989, Dr. Kwabena Frimpong-Boateng, a Ghanaian cardiothoracic surgeon trained in Hannover, rekindled interest in cardiothoracic surgery and in establishing a National Cardiothoracic Centre. His vision and leadership has brought cardiothoracic surgery practice in Ghana to its current high level. As a result, the medical landscape of what is achievable locally in both pediatric and adult patients has changed substantially: outbound medical travel that used to be common among Ghanaian cardiovascular patients has been reduced drastically. Ghana’s National Cardiothoracic Center (NCTC), the only tertiary center in the country for cardiothoracic surgical pathology manages all such patients that were previously referred abroad. The NCTC has become a medical/surgical hub in the West African sub-region providing service, training, and research opportunities to neighboring countries. The Centre is accredited by the West African College of Surgeons as a center of excellence for training specialists in cardiothoracic surgery. Expectedly, practicing cardiothoracic surgery in such a resource-poor setting has peculiar challenges. This review focuses on the history, practice, successes, and challenges of cardiovascular and thoracic surgery in Ghana. PMID:27904844
Eliyas, S; Vere, J; Ali, Z; Harris, I
Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.
Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.
Boston, Mark; Horlbeck, Drew
Humanitarian surgical missions can provide much needed care for those who are otherwise unable to receive such care because of limited local health care resources and cost. These missions also offer excellent training opportunities and can be life-changing experiences for those who participate in them. A successful humanitarian surgical mission requires careful planning and coordination and can be challenging for those tasked with the responsibilities to organize and lead these missions. This article addresses many of the issues and challenges encountered when planning and leading humanitarian surgical missions and offers a template to be used by those who take on these challenges.
Broekman, Marike L.; Carrière, Michelle E.; Bredenoord, Annelien L.
Abstract The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation. Although the call for evidence-based practice in surgery is increasingly high on the agenda, most surgeons feel that the format of the randomized controlled trial is not suitable for surgery. Innovation in surgery has aspects of, but should be distinguished from both research and clinical care and raises its own ethical challenges. To answer the question “What are the main ethical aspects of surgical innovation?”, we systematically searched PubMed and Embase. Papers expressing an opinion, point of view, or position were included, that is, normative ethical papers. We included 59 studies discussing ethical aspects of surgical innovation. These studies discussed 4 major themes: oversight, informed consent, learning curve, and vulnerable patient groups. Although all papers addressed the ethical challenges raised by surgical innovation, surgeons hold no uniform view of surgical innovation, and there is no agreement on the distinction between innovation and research. Even though most agree to some sort of oversight, they offer different alternatives ranging from the formation of new surgical innovation committees to establishing national registries. Most agree that informed consent is necessary for innovative procedures and that surgeons should be adequately trained to assure their competence to tackle the learning curve problem. All papers agree that in case of vulnerable patients, alternatives must be found for the informed consent procedure. We suggest that the concept of the learning health care system might provide guidance for thinking about surgical innovation. The underlying rationale of the learning health care system is to improve the quality of health care by embedding research within clinical care. Two aspects of a learning health
7 D -RI51 721 SUMM RY OF’THE N AVAlL POSTOR DU TE SCHOOL RESE RCH 1/4PROGRAM(U) NAVAL POSTGRADUATE SCHOOL MONTEREY CAJUN 84 NPS-012-84...0 - D . . , . i-i._-ovost UN CLASS I F .ED SECURITY CLASSIFICATION OF THIS PAGE ( on Daa Bnte red) R REPORT DOCUMENTATION PAGE REAO INSTRUCTIONS R...substantially larger fraction of the R& D effort at NPS is in the -" exploratory development category than would be found in most univer- -.- sities. This is a
Santos, Tânia Cristina Franco; Gomes, Maria da Luz Barbosa
The present text had a purpose of reflect about the connections between postgraduation an nursing research courses in Brazil. The origins used were magazines, with distinction for Revista Brasileira de Enfermagem and Escola Anna Nery-Revista de Enfermagem, annals of conferences, seminaries and research forums, like the oral deposition of the teacher Emerita EEAN/UFRJ, the doctor Vilma de Carvalho. Note, in this analysis, that the courses of post graduation gave effective impulse at scientific production for the nursing, permitting the advance in a critic valuation of the professional practice.
Illana Esteban, Emilio
In clinical practice, there are many diverse ways to name each instrument. Some names consist of local terms related to the shape or the use of an instrument; others have their origin in confusing references; few of these names tend to be related to known nomenclature. This causes a serious inconvenience for someone who wishes to learn about the intra-surgical medium in an organized manner. Undoubtedly this is an inconvenience for the untrained person who discovers he/she is incapable of retaining an enormous volume of names, often presented without any logic whatsoever This also causes an inconvenience for the trained professional; it is difficult to understand terms since, depending on which surgical ward one refers to, the name for the same instrument changes.
Mansouri, S. Afshin; Piki, Andriani
The research draws from four case studies to investigate the impact of using blogs within postgraduate education. The study explores how postgraduate business students engage with blogs, whether students' learning preferences correlate with their degree of contribution and how student participation relates with overall achievement. A mixed…
Henderson, Michael; Finger, Glenn; Selwyn, Neil
This article explores the digital technologies that taught postgraduate students engage with during their studies, what these technologies are used for and how useful they are perceived to be. The article draws upon data gathered from a survey of 253 masters and postgraduate diploma/certificate students across two universities in Australia.…
Swanwick, Ruth; Kitchen, Ruth; Jarvis, Joy; McCracken, Wendy; O'Neil, Rachel; Powers, Steve
This paper presents a flexible framework of principles for teaching critical thinking and reflective practice skills at the postgraduate level. It reports on a collaborative project between four UK institutions providing postgraduate programmes in deaf education. Through a critical review of current theories of critical thinking and reflective…
Based on the analysis of the questionnaire survey on learning motivation and learning needs of postgraduates and their demands and suggestions on English teaching, the paper makes a beneficial exploration on English course model for postgraduates in agricultural universities. Under the guidance of academic game theory, the "language skills+…
Bean, G. Elizabeth
Universities have several approaches for attracting student feedback, both qualitative and quantitative, and this paper describes three processes as they affect postgraduate students. The paper considers whether the issues that postgraduate students state need improvement are consistent with those issues contained in the recommendations made by…
Pearn, Sophie M.
Higher education (HE) in the UK is undergoing extensive changes. One key change is the increasing prominence of postgraduate education. Higher demands on employees create the desire for more qualifications and greater skills. This increasingly consumer-oriented focus to postgraduate education has created a need for information about quality and…
Bartlett, Alison, Ed.; Mercer, Gina, Ed.
This anthology explores the relationships between postgraduate research candidates and their supervisors. Through stories from candidates and supervisors, the collection proposes alternatives to the prevailing models of postgraduate research supervision. The chapters are: (1) "Introduction" (Alison Bartlett and Gina Mercer); (2) "Dirty Work: 'A…
Many African countries are concerned with the targeting of international postgraduate students by developed countries for skilled migration. Increased provision of postgraduate studies within the continent would go a long way in dealing with the problem. Success will however depend on the ability of countries in the continent to attract…
... Department of the Navy Subcommittee Meeting of the Board of Advisors to the President, Naval Postgraduate... the following meeting of the aforementioned subcommittee will be held. (Parent Committee is: Board of Advisors (BOA) to the Presidents of the Naval Postgraduate School and the Naval War College (NPS)....
... Department of the Navy Subcommittee Meeting of the Board of Advisors to the President, Naval Postgraduate... the following meeting of the aforementioned subcommittee will be held. (Parent Committee is: Board of Advisors to the Presidents of the Naval Postgraduate School and the Naval War College). This meeting...
Ugwu, Dorothy N.; Adamuti-Trache, Maria
This study examines the post-graduation plans of international science and engineering doctoral students at a public research-intensive university, and the extent to which graduate school experiences influence post-graduation plans. The study is grounded in Tinto's Integration Model as well as Berry's Acculturation Model. Study findings highlight…
This thesis reports a survey study of the autonomous L2 learning by 100 first-year non-English-major Chinese post-graduates via the instruments of a questionnaire and semi-structured interview after the questionnaire. It attends to address the following research question: To what extent do Chinese postgraduate students conduct autonomous L2…
Owusu-Manu, D.; Badu, E.; Edwards, D. J.
Procurement in the corporate world is increasingly complex, multi-faceted and interdisciplinary. This paper explores existing knowledge specifications relating to procurement management competencies and proposes a new procurement management competency framework (PMCF) and a competency-based postgraduate programme for postgraduate students in…
Yang, Chih-Hai; Lin, Chun-Hung A.; Lin, Chien-Ru
This paper analyzes the dynamics of rate of returns for postgraduate education and the determinants of wage premiums for postgraduate labor, especially for the impact of higher education expansions, in terms of quantity and quality, since the late 1990s in Taiwan. Utilizing quasi-panel data over the 1990-2004 period and employing the double fixed…
Education and Training beyond the Doctoral Degree. Proceedings of the American Psychological Association National Conference on Postdoctoral Education and Training in Psychology (Norman, Oklahoma, 1994).
American Psychological Association, Washington, DC.
These conference proceedings address a broad range of issues related to postgraduate education and training beyond the doctoral degree for maintaining expertise in all areas of psychology. They focus on six general issues: (1) models for education and training beyond the doctoral degree; (2) societal needs, changing demographics, and national…
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
Busing, Nick; Harris, Ken; MacLellan, Anne-Marie; Moineau, Geneviève; Oandasan, Ivy; Rourke, James; Saxena, Anurag
The Future of Medical Education in Canada Postgraduate (FMEC PG) Project was launched in 2010 by a consortium of four organizations: the Association of Faculties of Medicine of Canada, the Collège des Médecins du Québec, the College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada. The FMEC PG study set out to review the state of the Canadian postgraduate medical education (PGME) system and make recommendations for improvements and changes. The extensive process included literature reviews, commissioned papers, stakeholder interviews, international consultations, and dialogue with the public and learners. The resulting key findings and 10 recommendations, published in a report in 2012, represent the collective vision of the consortium partner organizations for PGME in Canada. Implementation of the recommendations began in 2013 and will continue beyond 2016.In this article, the authors describe the complex process of developing the recommendations, highlight several recommendations, consider implementation processes and issues, and share lessons learned to date. They reflect on the ways in which the transformation of a very complex and complicated PGME system has required many stakeholders to work together on multiple interventions simultaneously. Notwithstanding the challenges for the participating organizations, changes have been introduced and sustainability is being forged. Throughout this process, the consortium partners and other stakeholders have continued to address the social accountability role of all physicians with respect to the public they serve.
Simsen, B J; Holroyd, E; Sellick, K
Tertiary education for nurses in Hong Kong is in its early development. With many overseas universities competing to secure Asian students, the need for locally developed programmes to meet Hong Kong's needs can be overlooked. In this survey 705 nurses with degree level qualifications working for the major public and private employing agencies completed a questionnaire designed to obtain details of postgraduate study plans and preferences for the type, focus and mode of postgraduate programmes. Analysis of responses showed 50% of the graduates surveyed intended to pursue further study in the next two years with a clear preference for course work masters, degree programmes (55%), studies with a specialist (71%) rather than a generalist focus, and programmes offered locally (85%) on a part-time basis (86%). Future educational needs were also found to vary according to gender, marital status, place of employment and nursing post. The findings from this survey have considerable implications for educational and professional nursing developments and planning to meet the future health care needs of Hong Kong. In addition, the information may inform the planning of other countries newly embarked on tertiary education for nurses.
Kasparian, Andres C; Martinez, A C; JoverClos, R J; Chércoles, R A
Introducción: La adquisición de habilidades quirúrgicas constituye un factor central en la formación de todo cirujano. Sin embargo, la evaluación de las habilidades técnicas es uno de los factores más débiles y menos desarrollados. En la actualidad los recursos para evaluar las competencias técnicas adolecen de subjetividad, falta de confiabilidad y validez. La observación directa, método de evaluación más frecuentemente utilizado en nuestro medio, presenta inconvenientes instrumentales y está fuertemente influenciada por las relaciones intersubjetivas y los rasgos de personalidad. El objetivo de esta investigación es proponer creación y el uso de un instrumento objetivo para evaluar el desempeño técnico y determinar su confiabilidad y validez.Material y método: se seleccionaron dos procedimientos: colecistectomía laparoscópica y hernioplastia inguinal (técnica de Lichtenstein). Se constituyeron tres grupos de comparación según la experiencia quirúrgica: inicial, intermedio, y expertos. Se filmaron las cirugías en tiempo real, sin identificación del paciente ni del cirujano. Las filmaciones sin edición fueron asignadas a dos cirujanos expertos en forma aleatoria por sorteo y con sobres sin identificación. Para la evaluación se propuso el uso de un instrumento objetivo (explicitación de pasos a evaluar y cuantificación mediante escala de Likert) y específico para cada procedimiento. Así mismo se utilizó la escala global OSATS (R. Reznick). Se aplicó análisis de varianza no paramétrico para determinar validez. Valores de p menores a 0.05 fueron considerados estadísticamente significativos. Valores superiores a 0,80 del Coeficiente alfa de Cronbach aseguraron confiabilidad. Resultados: Desde Abril del 2010 hasta Diciembre del 2012 se filmaron 36 colecistectomías videolaparoscópicas y 31 hernioplastias inguinales. Se encontraron diferencias significativas entre los grupos en todos los ítems evaluados p<0.05. El coeficiente ? de Crohnbach fue mayor a 0,80 para ambas técnicas. No hubo diferencias significativas entre las calificaciones de ambos evaluadores. No hubo diferencias entre nuestro instrumento específico y la escala global OSATS. Discusión: Es posible y útil aplicar un instrumento objetivo de evaluación del desempeño técnico en cirugía. La herramienta presentó validez de constructo y confiabilidad aceptables. La filmación confiere perdurabilidad a un evento efímero: la cirugía. La objetividad se basa en la enunciación y cuantificación explícita de cada paso, y en la aleatorización y anonimato de la muestra. La uniformidad de criterios entre los evaluadores es fundamental para obtener resultados satisfactorios. Evaluarsiempreimplicaráunrecorte de la realidad.
Bauer, Florian; Rommel, Niklas; Koerdt, Steffen; Fichter, Andreas; Wolff, Klaus-Dietrich; Kesting, Marco R
Interest in a surgical career is declining among medical students, and many more need to commit themselves to becoming surgeons to cope with this. We have therefore developed a one-day practical lesson in surgical skills to find out whether a short course such as this can make students more enthusiastic about surgery, and about subsequently pursuing a career in one of its subspecialties. Fifty-four randomly-selected medical students did a one-day practical course in the skills required for maxillofacial surgical specialties. The 4 subdivisions involved - traumatology, resection of a tumour (cancer surgery), plastic surgery (microsurgery), and cleft lip and palate surgery. All students took written tests and completed an evaluation form about their interest in a surgical career before and after training. There was a significant increase in test scores in almost all categories at the end of the course, and significantly more students were prepared to consider a surgical career or a career in maxillofacial surgery after the training. This study shows that a one-day training course in surgical skills can significantly improve medical students' surgical knowledge, and might encourage them to enter a surgical career. We recommend the integration of a short training course such as this into the medical school curriculum. Only time and further evaluation will tell whether this increased exposure to surgical techniques can be transformed into additional surgeons.
Grosfeld, Klaus; Lohmann, Gerrit; Ladstätter-Weißenmayer, Annette; Burrows, John
Promoting young researchers is a major priority of the German Helmholtz Association. Since more than five years graduate and postgraduate education in the field of Earth System and Environmental Science has been established in Bremen and Bremerhaven, north-western Germany. Using the network and collaboration of experts and specialists on observational and paleoclimate data as well as on statistical data analysis and climate modelling from two Universities and the Helmholtz research institute on Polar and Marine Research, master and PhD students are trained to understand, decipher and cope with the challenges of recent climate change on an highly interdisciplinary and inter-institutional level. The existing research infrastructure at the Alfred Wegener Institute in Bremerhaven (AWI), University of Bremen, and Jacobs University Bremen offers a unique research environment to study past, present and future changes of the climate system, with special focus on high latitudinal processes. It covers all kind of disciplines, climate science, geosciences and biosciences, and provides a consistent framework for education and qualification of a new generation of expertly trained, internationally competitive master and PhD students. On postgraduate level, the Postgraduate Programme Environmental Physics (PEP) at the University of Bremen (www.pep.uni-bremen.de) educates the participants on the complex relationship between atmosphere, hydrosphere (ocean), cryosphere (ice region) and solid earth (land). Here, the learning of experimental methods in environmental physics at the most advanced level, numerical data analysis using supercomputers, and data interpretation via sophisticated methods prepare students for a scientific career. Within cooperation with the Ocean University of China (OUC) students are participating one year in the PEP programme during their master studies since 2006, to get finally a double degree of both universities. At the Alfred Wegener Institute for Polar
McDermott, M P; Cobb, M A; Tischler, V A; Robbé, I J; Dean, R S
A survey was conducted among veterinary practitioners in the UK and the USA in 2012/2013. Thematic analysis was used to identify underlying reasons behind answers to questions about the importance of communication skills and the desire to participate in postgraduate communication skills training. Lack of training among more experienced veterinary surgeons, incomplete preparation of younger practitioners and differences in ability to communicate all contribute to gaps in communication competency. Barriers to participating in further communication training include time, cost and doubts in the ability of training to provide value. To help enhance communication ability, communication skills should be assessed in veterinary school applicants, and communication skills training should be more thoroughly integrated into veterinary curricula. Continuing education/professional development in communication should be part of all postgraduate education and should be targeted to learning style preferences and communication needs and challenges through an entire career in practice.
Chen, Xianling; Chen, Buyuan; Li, Xiaofan; Song, Qingxiao; Chen, Yuanzhong
Hematology is difficult for students to learn. A beneficial education method for hematology clerkship training is required to help students develop clinical skills. Foreign medical students often encounter communication issues in China. To address this issue, Chinese post-graduates from our institute are willing to assist with educating foreign students. Therefore, we propose a mixed team-based learning method (MTBL) which might overcome communication problems in hematology clerkship. Twenty-two foreign medical Students attended a 2-week hematology clerkship in Fujian Medical University Union Hospital. Twenty-one foreign African medical students were assigned randomly into two groups. Fourteen foreign African medical students were assigned to MTBL group. Each MTBL team included two foreign African medical students and one Chinese post-graduate. Seven foreign African medical students were assigned to lecture-based learning method (LBL) group, which had a foreign medical classmate from Hong Kong or Chinese intern volunteers to serve as translators. The practice test scores of MTBL were significantly higher than LBL group (p < 0.05). The MTBL group had increased motivation to prepare before class, an engaged classroom atmosphere, and an improvement in their understanding of difficult topics. Interestingly, the Chinese post-graduates also benefited from this setting, as they found that this interaction improved their communication in the English language. The mixed team-based learning method overcomes communication problems in hematology clerkship. Foreign medical students and Chinese post-graduates alike can benefit from MTBL. © 2016 by The International Union of Biochemistry and Molecular Biology, 45(2):93-96, 2017.
Jamieson, Jean L.; Webber, Eric M.; Sivertz, Kristin S.
ABSTRACT OBJECTIVE To identify and quantify the reasons general practitioners and family physicians consider retraining and their reasons for not pursuing further training. DESIGN Population-based mailed survey. SETTING British Columbia. PARTICIPANTS Family physicians and general practitioners identified by the College of Physicians and Surgeons of British Columbia. MAIN OUTCOME MEASURES Practising physicians’ level of awareness of the University of British Columbia’s re-entry training program, the number and demographic characteristics of those who had considered retraining, their specialties of interest, and the barriers and possible inducements to retraining. RESULTS Only half of the survey respondents were aware of the re-entry training program at the University of British Columbia. A small but substantial number of practising general practitioners and family physicians were interested in taking specialty training from the Royal College of Physicians and Surgeons of Canada. While several training programs were particularly popular (ie, anesthesia and psychiatry—18.5% of respondents for each), almost every specialty training program was mentioned. Physicians identified the length and hours of training, financial issues, family issues, and the need for relocation as obstacles to retraining. The availability of part-time training, regional training, and return-of-service financial assistance were all identified as potential inducements. CONCLUSION To meet the needs of practising physicians, re-entry training programs will need to consider flexibility, where feasible, with regard to choice of specialty, intensity, and location of postgraduate training. PMID:20547505
Polychronopoulou, Argy; Eliades, Theodore; Taoufik, Konstantina; Papadopoulos, Moschos A; Athanasiou, Athanasios E
The purpose of this study was to explore the level of knowledge in biostatistics of orthodontic postgraduate students. A four-section questionnaire, which included a knowledge test/quiz on biostatistics and epidemiology, was developed. This questionnaire was distributed to postgraduate programme directors of European universities to be delivered to students for completion under mock examination conditions (in-class session). The frequency distributions of demographic characteristics were examined, the percentages of participants who agreed or strongly agreed with each attitudinal statement were calculated, and the percentages of participants who felt fairly to highly confident for each statement were determined. Knowledge scores were calculated by the percentage of correct answers; missing values were counted as incorrect answers. The Student's t-test or one-way analysis of variance, where appropriate, was utilized to determine the participants' characteristics associated with mean knowledge scores. Data were further analysed with multiple linear regression modelling to determine the adjusted/unconfounded effect of possible knowledge score predictors. A two-tailed P-value of 0.05 was considered statistically significant with a 95 percent confidence interval (CI). One hundred and twenty seven from a total of 129 orthodontic students who replied completed the questionnaire. The mean correct answers of the participants were 43.8 percent with a 95 percent CI of 40.2-47.3 percent. This score was not influenced by gender, years elapsed from graduation, other advanced degree, or year of study; the sole parameter, which seemed to influence this score was attendance at a biostatistics/epidemiology course (51.9 versus 39.5 percent score of participants who had previously taken a course versus those who had not, P<0.001). A surprising finding was the inability of the responders to identify the appropriate use of the chi-square test (11.8 percent, 95 percent CI: 6
In the article the peculiarities in organization of postgraduate teacher training in foreign countries have been highlighted; the basic problems and prospects for advanced training which stipulate for reforming the relevant national systems have been revealed; common and distinctive trends in their development have been justified. In Russia there…
Leslie, W. Bruce
Given American higher education's origins in British practice, it is surprising that training in the traditional "learned" professions follows such different patterns. Most strikingly, such training is post-graduate in the United States while it is often a first degree programme in Britain. Intriguingly, in the middle nineteenth century,…
Rahi, J.; Lynn, R.
A survey of a sample of UK paediatricians was carried out to identify the practices and determine the training of those involved in routine surveillance examinations to detect ophthalmic disorders in infants. The findings indicate important variation in current practices and raise concerns about both undergraduate and postgraduate training in ophthalmic assessment of infants. PMID:9623402
Dowton, S Bruce
Factors to be considered in planning our medical workforce to meet future needs include: Need for outcomes-based curricular designs in medical schools and postgraduate training. Shortening the length of medical training. Improving career flexibility to permit professional re-invention. Developing awareness within the profession about how innovation happens.
ET Worldwide, 1991
This periodic compendium of environmental training opportunities includes information about educational opportunities for noncredit, and undergraduate through postgraduate studies around the world. The areas of study include the following: environmental science; agriculture education and science; wildlife management; natural resources, land use,…
Younis, Abdul Razeq
Provides background on the library movement in Jordan since the 1950s and describes the main categories of library education in Jordan: (1) short-training courses; (2) subprofessional education offered by two-year colleges; and (3) professional postgraduate education. The roles of the Jordan Library Association and other institutions are…
Nichol, Jon; Watson, Kate
Describes the use of video tutoring for distance education within the context of a post-graduate teacher training course at the University of Exeter. Analysis of the tapes used a protocol based on non-verbal communication research, and findings suggest that the interaction of participants was significantly different from face-to-face…
NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited IDENTIFYING ROADS AND...identifying roads and trails hidden under dense jungle and forest canopies. The four analyzed regions include the Elkhorn Slough in Central California ...canopies. The four analyzed regions include the Elkhorn Slough in Central California (2005), Kahuku Training Area on the North side of Oahu Island in Hawaii
ET Worldwide, 1994
This periodic compendium of environmental training opportunities includes information about educational opportunities for noncredit, and undergraduate through postgraduate studies around the world. The areas of study include the following: environmental education; environmental science; environmental management; Africa and global change;…
report will consider both pedagogies but will be constrained to dispersed applications with synchronous modes of interaction (Figure 3). Where relatable ...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT FACTORS AFFECTING TRAINING EFFECTIVENESS IN SYNCHRONOUS, DISPERSED...VIRTUAL ENVIRONMENTS By: William Spears June 2014 Advisors: Kathryn Aten, Marco DiRenzo Approved for public release; distribution is unlimited
Atchison, Kathryn A.; Bachand, William; Buchanan, C. Richard; Lefever, Karen H.; Lin, Sylvia; Engelhardt, Rita
Compared the program characteristics of the postgraduate general dentistry (PGD) training programs sponsored by the military and the Veterans Health Administration (VA). Gathered information on program infrastructure and emphasis, resident preparation prior to entering the program, and patients served and types of services provided. Programs…
Scialfa, Charles T.; Lyndon, Jaci
As part of a Canadian Institutes for Health Research (CIHR)-funded Strategic Training Grant, we have developed and delivered a brief course in research ethics directed toward postgraduate students in experimental gerontology. In this paper, we report on the initial offering, its content and delivery, and student reactions to the course. We…
Gorman, P J; Meier, A H; Krummel, T M
Rapid change is under way on several fronts in medicine and surgery. Advances in computing power have enabled continued growth in virtual reality, visualization, and simulation technologies. The ideal learning opportunities afforded by simulated and virtual environments have prompted their exploration as learning modalities for surgical education and training. Ongoing improvements in this technology suggest an important future role for virtual reality and simulation in surgical education and training.
Surgical education continues to evolve from the master-apprentice model. Newer methods of the process need to be used to manage the dual challenges of educating while providing safe surgical care. This requires integrating adult learning concepts into delivery of practical training and education in busy clinical environments. A narrative review aimed at outlining and integrating adult learning and surgical education theory was undertaken. Additionally, this information was used to relate the practical delivery of surgical training and education in day-to-day surgical practice. Concepts were sourced from reference material. Additional material was found using a PubMed search of the words: ‘surgical education theory’ and ‘adult learning theory medical’. This yielded 1351 abstracts, of which 43 articles with a focus on key concepts in adult education theory were used. Key papers were used to formulate structure and additional cross-referenced papers were included where appropriate. Current concepts within adult learning have a lot to offer when considering how to better deliver surgical education and training. Better integration of adult learning theory can be fruitful. Individual teaching surgical units need to rethink their paradigms and consider how each individual can contribute to the education experience. Up skilling courses for trainers can do much to improve the delivery of surgical education. Understanding adult learning concepts and integrating these into day-to-day teaching can be valuable. PMID:28357046
Surgical education continues to evolve from the master-apprentice model. Newer methods of the process need to be used to manage the dual challenges of educating while providing safe surgical care. This requires integrating adult learning concepts into delivery of practical training and education in busy clinical environments. A narrative review aimed at outlining and integrating adult learning and surgical education theory was undertaken. Additionally, this information was used to relate the practical delivery of surgical training and education in day-to-day surgical practice. Concepts were sourced from reference material. Additional material was found using a PubMed search of the words: 'surgical education theory' and 'adult learning theory medical'. This yielded 1351 abstracts, of which 43 articles with a focus on key concepts in adult education theory were used. Key papers were used to formulate structure and additional cross-referenced papers were included where appropriate. Current concepts within adult learning have a lot to offer when considering how to better deliver surgical education and training. Better integration of adult learning theory can be fruitful. Individual teaching surgical units need to rethink their paradigms and consider how each individual can contribute to the education experience. Up skilling courses for trainers can do much to improve the delivery of surgical education. Understanding adult learning concepts and integrating these into day-to-day teaching can be valuable.
Schellhas, Helmut F.; Barnes, Alfonso E.
Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.
The Overseas Doctors Training Scheme needs appraisal. Set up 10 years ago to improve the quality of postgraduate training that overseas (non-European) doctors receive in Britain, the scheme has been popular, but it is questionable how far it has achieved its aims. If Britain is to continue to employ large numbers of overseas doctors in training grades, both through the scheme and through independent arrangements, the apparent mismatch between their expectations and the reality of what Britain offers must be tackled. Images p1629-a PMID:7993422
Hercigonja-Szekeres, Mira; Simić, Diana; Božikov, Jadranka; Vondra, Petra
Paper presents an overview of the EU funded Project of Curriculum Development for Interdisciplinary Postgraduate Specialist Study in Medical Informatics named MEDINFO to be introduced in Croatia. The target group for the program is formed by professionals in any of the areas of medicine, IT professionals working on applications of IT for health and researchers and teachers in medical informatics. In addition to Croatian students, the program will also provide opportunity for enrolling students from a wider region of Southeast Europe. Project partners are two faculties of the University of Zagreb - Faculty of Organization and Informatics from Varaždin and School of Medicine, Andrija Štampar School of Public Health from Zagreb with the Croatian Society for Medical Informatics, Croatian Chamber of Economy, and Ericsson Nikola Tesla Company as associates.
Price, Raymond; Sergelen, Orgoi; Unursaikhan, Chadraabal
The W. C. Swanson Family Foundation selected Mongolia to help improve access to affordable quality surgical and medical care in 2000. Over the last 12 years of partnering with the Health Sciences University of Mongolia, three major concepts have been identified that have promoted sustainable progress in expanding and improving surgical care throughout the healthcare system-including urban and rural areas. Understanding and targeting the needs identified by the Mongolian surgical community has cultivated a critical working environment that has had a profound effect on expanding surgical care in Mongolia. Integrating modern surgical care training with basic emergency and essential surgical and medical initiatives created a trusting foundation providing many unforeseen educational opportunities. Lastly, the educational model introduced, including long-term capacity-building programs, has helped enable the local Mongolian surgeons, nurses, biotechnicians, administrators, and educators to continue pioneering independent efforts to further expand modern surgical care in Mongolia.
Rees-Lee, Jacqueline; Kneebone, Roger
Competency based surgical training uses proficiency of technical skills to quantify surgical competency. We believe this is an over simplification of what is required to be a competent surgeon. This work aims to illuminate the attributes of a mature, competent, thinking surgeon. A bespoke (or custom) tailor is highly trained craftsman who produces…
Becker, Horst Peter; Gerngross, Heinz; Schwab, Robert
Now that field hospitals and rescue stations have been provided with state-of-the-art equipment, it is important to tailor the medical qualifications of military surgeons to the specific requirements of missions outside Germany. The objective of this article is to provide guidelines for a new training model. Einsatzchirurgie is defined as surgical treatment provided under restricted conditions in an unfamiliar environment. Its purpose is, first and foremost, to provide emergency treatment. The spectrum of Einsatzchirurgie, however, also encompasses maximum medical treatment on a case-by-case basis and emergency surgical treatment in a mass casualty situation. Training, for example, may consist of a 6-year basic training course in surgery followed by specialist training in abdominal surgery, traumatology, and courses in further disciplines--e.g., urology, gynecology, or neurosurgery. In addition to the qualifications required by the Landesärztekammem (professional organizations of German physicians at the federal countries level), military surgeons who are to become senior medical officers should also be qualified to provide immediate non-surgical emergency care. In these times, the education of military surgeons remains a great challenge. Motivation to work as a surgeon in the armed forces with multiple deployments during the career requires enthusiasm and professionalism. The attractiveness of the training institution and the home hospital is key for successful work as a military surgeon.
internal /external rotation (Figure 1.3 (c)), medial/lateral placement (Figure 1.3 (d)), tibial component varus/valgus (Figure 1.4 (a)), internal /external...b) varus/valgus, (c) internal /external rotation and (d) medial/lateral alignment. Figure 1.4. Trainee specified tibial component targets: (a...varus/valgus, (b) internal /external rotation and (c) tibial slope Valgus + Varus - External + Internal - (a) (b) (c) (d) External + Internal - (a
Thesis 4. TITLE AND SUBTITLE A Training Transfer Study of Simulation Games 6. AUTHOR( S ) Ben Brown 5. FUNDING NUMBERS 7. PERFORMING...ORGANIZATION NAME( S ) AND ADDRESS(ES) Naval Postgraduate School Monterey, CA 93943-5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING...MONITORING AGENCY NAME( S ) AND ADDRESS(ES) N/A 10. SPONSORING/MONITORING AGENCY REPORT NUMBER 11. SUPPLEMENTARY NOTES The views expressed in this
Meggers, Helge; Hanfland, Claudia; Sprengel, Claudia; Grosfeld, Klaus; Lohmann, Gerrit; Bijma, Jelle; Ladstätter-Weißenmayer, Annette; Burrows, John
Postgraduate education is gaining increasing importance and has been identified as one instrument to foster quality and promote networking, both in research and in education. Exchange and co-operation between graduate programmes that have related topics produce added value for all. Students have access to a range of research facilities, course offers, and a broad scientific community from which they can start building their individual scientific network. Larger events like PhD conferences, career symposia or cost-intensive trainings are more easily tackled by joining forces of various players. The postgraduate programmes ESSReS-PEP-POLMAR are part of a larger network of marine and climate science programmes in the north-western region of Germany and together host up 180 (23 ESSReS, 130 POLMAR, 30 PEP) PhD/Master students in their respective programmes. Here, we will present a number of joint activities from this collaboration. Today, the PhD education is completely different to that from 15 years ago due to a variety of different scientific offerings including e.g. excursions, soft skill courses and special seminars. In the framework of the ESSReS-PEP-POLMAR concept the Postgraduate Programme Environmental Physics (PEP) at the University of Bremen educates the participants on the complex relationship between atmosphere, hydrosphere (ocean), cryosphere (ice region) and solid earth (land). Here, the learning of experimental methods in environmental physics at the most advanced level, numerical data analysis using supercomputers, and data interpretation via sophisticated methods prepare students for a scientific career. Within cooperation with the Ocean University of China (OUC) students are participating one year in the PEP programme during their master studies since 2006, to get finally a double degree of both universities. Two different ways to further graduation are currently possible at the Alfred Wegener Institute. The Helmholtz Graduate School for Polar and
Changes to the surgical workforce and the continued development of health policy have perpetuated the requirement for innovative perioperative roles. The surgical care practitioner is a nurse or allied health professional who works within a surgical team and has advanced perioperative skills, including the ability to undertake surgical interventions.With only limited literature evaluating this role, any benefits of their inclusion to a surgical team are largely anecdotal. This article presents the findings of an autoethnographic inquiry that explored the experiences of surgical team members who worked with the nurse researcher in her role as surgical care practitioner. Surgeons identified the provision of a knowledgeable, competent assistant and operator who enhanced patient care, helped maintain surgical services and supported the training of junior doctors. The professional, ethical and legal obligations of advanced perioperative practice were upheld. Interprofessional collaboration was improved, as was service provision. This further enhanced the patient experience. The traditional viewpoint that nurses who undertake tasks previously associated with medicine should be working to the standard of a doctor is challenged but requires further examination.
Bambakidis, Nicholas C; Selman, Warren R; Sloan, Andrew E
Surgical training has remained remarkably similar in many respects since the early days of halstedian training. Neurosurgery is a demanding field that requires extensive cognitive, perceptive, and technical training. Surgical simulation is a promising approach to facilitate acquiring proficiency in neurosurgical procedures. Simulation can permit mentoring trainees in a "safe" environment. By incorporating images that depict specific abnormalities in actual patients, simulation can provide realistic rehearsal for any given case for both novice and experienced surgeons in much the same way that data acquired from drones can be used to allow pilots to rehearse mission-critical maneuvers in a simulator before taking flight. Most neurosurgical simulators to date have focused on endovascular procedures, spinal procedures, temporal bone dissection, and stereotactic procedures. The use of simulator technology for microsurgery is in its infancy. This article describes a novel simulator technology developed by Surgical Theater LLC (http://www.surgicaltheater.net/home.html) called the Selman Surgical Rehearsal Platform. The platform shows promise for use in intracranial microvascular procedures, which require experience that is becoming increasingly limited for trainees who have to become proficient in more procedures in much less time than ever before.
Rosenbaum, Paul-Erik Lillholm; Mikalsen, Oyvind; Lygre, Henning; Solheim, Einar; Schjøtt, Jan
Postgraduate courses in clinical pharmacology are important for dentists to be updated on drug therapy and information related to their clinical practice, as well as knowledge of relevant adverse effects and interactions. A traditional approach with classroom delivery as the only method to teaching and learning has shortcomings regarding flexibility, individual learning preferences, and problem based learning (PBL) activities compared to online environments. This study examines a five week postgraduate course in clinical pharmacology with 15 hours of lectures and online learning activities, i.e. blended course design. Six postgraduate dental students participated and at the end of the course they were interviewed. Our findings emphasize that a blended learning course design can be successfully used in postgraduate dental education. Key matters for discussion were time flexibility and location convenience, change in teacher's role, rein-forced learning strategies towards professional needs, scarcity in online communication, and proposed future utilization of e-learning components.
Mahmud, Saadia; Bretag, Tracey
Postgraduate research students have a unique position in the debate on integrity in research as students and novice researchers. To assess how far policies for integrity in postgraduate research meet the needs of students as "research trainees," we reviewed online policies for integrity in postgraduate research at nine particular Australian universities against the Australian Code for Responsible Conduct of Research (the Code) and the five core elements of exemplary academic integrity policy identified by Bretag et al. (2011 ), i.e., access, approach, responsibility, detail, and support. We found inconsistency with the Code in the definition of research misconduct and a lack of adequate detail and support. Based on our analysis, previous research, and the literature, we propose a framework for policy and support for postgraduate research that encompasses a consistent and educative approach to integrity maintained across the university at all levels of scholarship and for all stakeholders.
Comola, Gilbert M
In 2012 the Division of Urologic Surgery at Washington University School of Medicine developed and piloted a 12-month post-graduate nurse practitioner fellowship. The author completed this fellowship. This is a report on the experiences.
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Hudson, James D
This article will consider prosthodontic specialty training in the United States. The history of prosthodontics as a specialty and the requirements necessary to be considered a prosthodontist will be explored. Today, a three-year postgraduate program is necessary to be considered an educationally qualified prosthodontist. Currently, there are 46 accredited advanced specialty education programs in the United States and approximately 3200 prosthodontists. The standards and training required for completion of these programs will be considered.
Ansorg, J; Krüger, M; Vallböhmer, D
A state of the art surgical training is crucial for the attraction of surgery as a medical profession. The German surgical community can only succeed in overcoming the shortage of young surgeons by the development of an attractive and professional training environment. Responsibility for surgical training has to be taken by the heads of department as well as by the surgical societies. Good surgical training should be deemed to be part of the corporate strategy of German hospitals and participation in external courses has to be properly funded by the hospital management. On the other hand residents are asked for commitment and flexibility and should keep records in logbooks and take part in assessment projects to gain continuing feedback on their learning progress. The surgical community is in charge of developing a structured but flexible training curriculum for each of the eight surgical training trunks. A perfect future curriculum has to reflect and cross-link local hospital training programs with a central training portfolio of a future Academy of German Surgeons, such as workshops, courses and e-learning projects. This challenge has to be dealt with in close cooperation by all surgical boards and societies. A common sense of surgery as a community in diversity is crucial for the success of this endeavour.
Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.
Blaginin, A A; Lizogub, I N
Authors consider the trends of training doctors in the specialty "physician in aerospace medicine". First level is initial training for faculty training of doctors. The higher level is vocational retraining and advanced training in the departments of postgraduate and further education. It solved the issues of preparation of specialists in various areas of aviation medicine: medical-chairman of the Flight Commission, an expert medical doctor-flight expert committee, a specialist laboratory (Cabinet) of Aviation Medicine, the Medical Director of Aviation (enterprise, organization), etc. The highest level of training is residency. The necessity of legislative consolidation of an independent direction for the organization of training and medical support of aviation operations is proved.
Edgerton, M T; Jane, J A
The surgical correction of vertical malpositions of the human eye has been made relatively safe and reliable by recent surgical techniques. The authors define this condition as vertical orbital dystopia and review the etiology of this deformity in 38 recent consecutive cases that were surgically treated at the Craniofacial Anomalies Center of The University of Virginia. Some new and useful tests are described that are of value to the plastic surgeon in analysis of the facial deformity and in planning the appropriate surgical procedure to correct the vertical dystopia of one or both eyes. Several cases are illustrated that describe the principal surgical methods of moving the eye up or down without loss of vision. The vertical eye shifts in this series have been in the range of 2 to 3 mm to over 22 mm. No loss of vision was produced by these corrections. The most common difficulties and complications of orbital dystopia corrections are described. The implications of this type of surgery in terms of visual physiology are suggested. The authors conclude that surgical correction of vertical orbital dystopias is possible, safe, and rewarding to the patients. However, they advise that the correction is best performed in young children and by a specially trained team of plastic surgeons, neurosurgeons, and ophthalmologists.
Nixon, Garry; Blattner, Katharina; Williamson, Martyn; McHugh, Patrick; Reid, James
Targeted postgraduate training increases the likelihood young doctors will take up careers in rural generalist medicine. This article describes the postgraduate pathways that have evolved for these doctors in New Zealand. The Cairns consensus statement 2014 defined rural medical generalism as a scope of practice that encompasses primary care, hospital or secondary care, emergency care, advanced skill sets and a population-based approach to the health needs of rural communities. Even as work goes on to define this role different jurisdictions have developed their own training pathways for these important members of the rural healthcare workforce. In 2002 the University of Otago developed a distance-taught postgraduate diploma aimed at the extended practice of rural general practitioners (GPs) and rural hospital medical officers. This qualification has evolved into a 4-year vocational training program in rural hospital medicine, with the university diploma retained as the academic component. The intentionally flexible and modular nature of the rural hospital training program and university diploma allow for a range of training options. The majority of trainees are taking advantage of this by combining general practice and rural hospital training. Although structured quite differently the components of this combined pathway looks similar to the Australian rural generalist pathways. There is evidence that the program has had a positive impact on the New Zealand rural hospital medical workforce.
Kurien, Matthew; Azmy, Iman A F; Sanders, David S
Out-of-programme (OOP) activities enable postgraduate trainees to undertake an experience outside of their individual subspecialty training programmes. Activities vary but may include a period of research, additional clinical experiences or time for a planned career break. Determining whether to go OOP is a common dilemma faced by many trainees as they progress through postgraduate training. This review assesses the options trainees have with regards to going OOP, evaluates the potential advantages and disadvantages and also provides advice for those considering an OOP activity.
Georgia Univ., Athens. Dept. of Vocational Education.
This surgical technology program guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a surgical technology program. The program guide is designed to relate primarily to the development of those skills needed by individuals in the field to provide services in the…
Surgical site infections (SSIs) are recognized as a common surgical complication, occurring in about 2-5% of all surgical procedures. SSIs represent the third most frequent nosocomial infection, accounting for 14-16% of all infections observed in hospitalized patients and up to 38% of those observed among surgical patients. Knowledge of incidence, epidemiology, classification, process of wound healing, and pathogenesis of surgical site infection is of great importance. Given the high economic burden that infections provoke, beyond the increased morbidity and mortality, it appears mandatory to improve our tools in order to reduce their incidence, as a reduction of only 0.1% can result in a considerable saving of economic resources to be allocated to other activities, such as screening and prevention programs.
McEwen, Laura A; Griffiths, Jane; Schultz, Karen
The use of portfolios in postgraduate medical residency education to support competency development is increasing; however, the processes by which these assessment systems are designed, implemented, and maintained are emergent. The authors describe the needs assessment, development, implementation, and continuing quality improvement processes that have shaped the Portfolio Assessment Support System (PASS) used by the postgraduate family medicine program at Queen's University since 2009. Their description includes the impetus for change and contextual realities that guided the effort, plus the processes used for selecting assessment components and developing strategic supports. The authors discuss the identification of impact measures at the individual, programmatic, and institutional levels and the ways the department uses these to monitor how PASS supports competency development, scaffolds residents' self-regulated learning skills, and promotes professional identity formation. They describe the "academic advisor" role and provide an appendix covering the portfolio elements. Reflection elements include learning plans, clinical question logs, confidence surveys, and reflections about continuity of care and significant incidents. Learning module elements cover the required, online bioethics, global health, and consult-request modules. Assessment elements cover each resident's research project, clinical audits, presentations, objective structured clinical exam and simulated office oral exam results, field notes, entrustable professional activities, multisource feedback, and in-training evaluation reports. Document elements are the resident's continuing medical education activities including procedures log, attendance log, and patient demographic summaries.The authors wish to support others who are engaged in the systematic portfolio-design process or who may adapt aspects of PASS for their local programs.
Tanimoto, Miguel A; Torres-Villalobos, Gonzalo; Fujita, Rikiya; Santillan-Doherty, Patricio; Albores-Saavedra, Jorge; Chable-Montero, Fredy; Martin-Del-Campo, Luis A; Vasquez, Lucia; Bravo-Reyna, Carlos; Villanueva, Octavio; Villalobos, Jose J; Uribe, Misael; Valdovinos, Miguel A
Aim. Evaluate the feasibility to overcome the learning curve in a western training center of the en bloc circumferential esophageal (ECE-) ESD in an in vivo animal model. Methods. ECE-ESD was performed on ten canine models under general anesthesia on artificial lesions at the esophagus marked with coagulation points. After the ESD each canine model was euthanized and surgical resection of the esophagus and stomach was carried out according to "the Principles of Humane Experimental Technique, Russel and Burch." The specimen was fixed with needles on cork submerged in formalin with the esophagus and stomach then delivered to the pathology department to be analyzed. Results. ECE-ESD was completed without complications in the last 3/10 animal models. Mean duration for the procedures was 192 ± 35 minutes (range 140-235 minutes). All the procedures were done at the animal lab surgery room with cardio pulmonary monitoring and artificial ventilation by staff surgery members and a staff member of the Gastroenterology department trained during 1999-2001 at the Fujigaoka hospital of the Showa U. in Yokohama, Japan, length (range 15-18 mm) and 51 ± 6.99 width (range 40-60 mm). Conclusion. ECE-ESD training is feasible in canine models for postgraduate endoscopy fellows.
Tanimoto, Miguel A.; Torres-Villalobos, Gonzalo; Fujita, Rikiya; Santillan-Doherty, Patricio; Albores-Saavedra, Jorge; Chable-Montero, Fredy; Martin-del-Campo, Luis A.; Vasquez, Lucia; Bravo-Reyna, Carlos; Villanueva, Octavio; Villalobos, Jose J.; Uribe, Misael; Valdovinos, Miguel A.
Aim. Evaluate the feasibility to overcome the learning curve in a western training center of the en bloc circumferential esophageal (ECE-) ESD in an in vivo animal model. Methods. ECE-ESD was performed on ten canine models under general anesthesia on artificial lesions at the esophagus marked with coagulation points. After the ESD each canine model was euthanized and surgical resection of the esophagus and stomach was carried out according to “the Principles of Humane Experimental Technique, Russel and Burch.” The specimen was fixed with needles on cork submerged in formalin with the esophagus and stomach then delivered to the pathology department to be analyzed. Results. ECE-ESD was completed without complications in the last 3/10 animal models. Mean duration for the procedures was 192 ± 35 minutes (range 140–235 minutes). All the procedures were done at the animal lab surgery room with cardio pulmonary monitoring and artificial ventilation by staff surgery members and a staff member of the Gastroenterology department trained during 1999–2001 at the Fujigaoka hospital of the Showa U. in Yokohama, Japan, length (range 15–18 mm) and 51 ± 6.99 width (range 40–60 mm). Conclusion. ECE-ESD training is feasible in canine models for postgraduate endoscopy fellows. PMID:21976950
Card, Sharon Elizabeth; Ward, Heather A; Chipperfield, Dylan; Sheppard, M Suzanne
Knowing one's own role is a key collaboration competency for postgraduate trainees in the Canadian competency framework (CanMEDS®). To explore methods to teach collaborative competency to internal medicine postgraduate trainees, baseline role knowledge of the trainees was explored. The perceptions of roles (self and others) at patient discharge from an acute care internal medicine teaching unit amongst 69 participants, 34 physicians (25 internal medicine postgraduate trainees and 9 faculty physicians) and 35 health care professionals from different professions were assessed using an adapted previously validated survey (Jenkins et al., 2001). Internal medicine postgraduate trainees agreed on 8/13 (62%) discharge roles, but for 5/13 (38%), there was a substantial disagreement. Other professions had similar lack of clarity about the postgraduate internal medicine residents' roles at discharge. The lack of interprofessional and intraprofessional clarity about roles needs to be explored to develop methods to enhance collaborative competence in internal medicine postgraduate trainees.
Bullock, Alison; Webb, Katie
The influence of technology in medical workplace learning is explored by focusing on three uses: m-learning (notably apps), simulation and social media. Smartphones with point-of-care tools (such as textbooks, drug guides and medical calculators) can support workplace learning and doctors’ decision-making. Simulations can help develop technical skills and team interactions, and ‘in situ’ simulations improve the match between the virtual and the real. Social media (wikis, blogs, networking, YouTube) heralds a more participatory and collaborative approach to knowledge development. These uses of technology are related to Kolb's learning cycle and Eraut's intentions of informal learning. Contentions and controversies with these technologies exist. There is a problem with the terminology commonly adopted to describe the use of technology to enhance learning. Using learning technology in the workplace changes the interaction with others and raises issues of professionalism and etiquette. Lack of regulation makes assessment of app quality a challenge. Distraction and dependency are charges levelled at smartphone use in the workplace and these need further research. Unless addressed, these and other challenges will impede the benefits that technology may bring to postgraduate medical education. PMID:26341127
Bullock, Alison; Webb, Katie
The influence of technology in medical workplace learning is explored by focusing on three uses: m-learning (notably apps), simulation and social media. Smartphones with point-of-care tools (such as textbooks, drug guides and medical calculators) can support workplace learning and doctors' decision-making. Simulations can help develop technical skills and team interactions, and 'in situ' simulations improve the match between the virtual and the real. Social media (wikis, blogs, networking, YouTube) heralds a more participatory and collaborative approach to knowledge development. These uses of technology are related to Kolb's learning cycle and Eraut's intentions of informal learning. Contentions and controversies with these technologies exist. There is a problem with the terminology commonly adopted to describe the use of technology to enhance learning. Using learning technology in the workplace changes the interaction with others and raises issues of professionalism and etiquette. Lack of regulation makes assessment of app quality a challenge. Distraction and dependency are charges levelled at smartphone use in the workplace and these need further research. Unless addressed, these and other challenges will impede the benefits that technology may bring to postgraduate medical education.
Heidemann, D; Harzer, W
The dental curriculum in Germany is still based on a concept from 1955 with some revisions in certain aspects. All groups involved are interested in a new and more current version. In doing this, the compatibility with European concepts should be a main goal. The Association for Dental Education in Europe (ADEE), to which about 160 of the 200 European dental education associations are members, is in charge of coordinating projects to create a network of European universities, which intends to harmonize higher education in Europe and to create a core curriculum for the dentistry program. Based on a visitation and evaluation program at more than 50 oral and maxillofacial surgery centers, a paper for the profiles and competencies for future European dentists was formulated for the creation of a modular curriculum, for the integration of the ECT (European Credit Transfer) system, and for quality assurance of the dentistry curriculum. Especially for the situation in Germany, consequences must be drawn for further dentistry and postgraduate educational concepts, which are not completely identical with the ADEE concepts, but which can use elements of the basic Bologna concepts.
Szumacher, Ewa Warner, Eiran; Zhang Liying; Kane, Gabrielle; Ackerman, Ida; Nyhof-Young, Joyce; Agboola, Olusegun; Metz, Catherine de; Rodrigues, George; Rappolt, Susan
Purpose: To assess radiation oncology residents' needs and satisfaction in their first postgraduate year (PGY-1) in the province of Ontario. Methods and Materials: Of 62 radiation oncology residents, 58 who had completed their PGY-1 and were either enrolled or had graduated in 2006 were invited to participate in a 31-item survey. The questionnaire explored PGY-1 residents' needs and satisfaction in four domains: clinical workload, faculty/learning environment, stress level, and discrimination/harassment. The Fisher's exact and Wilcoxon nonparametric tests were used to determine relationships between covariate items and summary scores. Results: Of 58 eligible residents, 44 (75%) responded. Eighty-four percent of residents felt that their ward and call duties were appropriate. More than 50% of respondents indicated that they often felt isolated from their radiation oncology program. Only 77% agreed that they received adequate feedback, and 40% received sufficient counseling regarding career planning. More than 93% of respondents thought that faculty members had contributed significantly to their learning experience. Approximately 50% of residents experienced excessive stress and inadequate time for leisure or for reading the medical literature. Less than 10% of residents indicated that they had been harassed or experienced discrimination. Eighty-three percent agreed or strongly agreed that their PGY-1 experience had been outstanding. Conclusions: Most Ontario residents were satisfied with their PGY-1 training program. More counseling by radiation oncology faculty members should be offered to help residents with career planning. The residents might also benefit from more exposure to 'radiation oncology' and an introduction to stress management strategies.
Quinton, John; Haygarth, Phil; Black, Helaina; Allton, Kathryn
Many of the PhD students starting Soil Science PhDs have only a limited understanding of the wider importance of soils, the state -of-art in other sub disciplines, and have often never seen a soil profile in the field. As the number of students nationally in the UK is also small compared to some other disciplines there is also a need to build a cohort of early career researchers. To address these issues, Lancaster University and the James Hutton Institute together with support from the British Society of Soil Science and the Natural Environment Research Council (NERC), ran a 5 day residential foundation soil science 'Summer School' in March 2015. The training school was an intense programme for ambitious and energetic post-graduate students. The course was specifically designed for students who were keen to develop skills in the development of inter-disciplinary research ideas and proposals. Specifically the course addressed: • the different functions in land uses and across landscapes • novel approaches for investigating how soils function • the basics of making a soil description and soil sampling in the field; • the current key challenges in soil science research • the requirements of, and approaches to, soil science research that requires multi-disciplinary and interdisciplinary approaches • the essentials of developing and planning a research project Our approach was to provide a space for the students to both learn from, but also work with some of the leading UK Soil Science experts. We used workshop style lectures, including some delivered via the internet, combined with student research teams working alongside research mentors to produce research proposals to be 'pitched' to a panel at the end of the course. These proposals formed the focus for engagement with the 'experts' making the time the students spent with them concentrated and productive. Feedback from the students was excellent and a variant of the course will be repeated by Cranfield
Chang, Johnny Yau Cheung; Tsui, Lok Yee; Yeung, Keith Siu Kay; Yip, Stefanie Wai Ying; Leung, Gilberto Ka Kit
Google Glass is, in essence, a smartphone in the form of a pair of spectacles. It has a display system, a bone conduction "speaker," video camera, and connectivity via WiFi or Bluetooth technologies. It can also be controlled by voice command. Seizing Google Glass' capabilities as windows of opportunity, surgeons have been the first group of doctors trying to incorporate the technology into their daily practices. Experiences from different groups have demonstrated Google Glass' potential in improving perioperative care, intraoperative communication and documentation, surgical outcome as well as surgical training. On the other hand, the device has technical limitations, notably suboptimal image qualities and a short battery life. Its operational functions also bring forth concerns on the protection of patient privacy. Nonetheless, the technological advances that this device embodies hold promises in surgical innovations. Further studies are required, and surgeons should explore, investigate, and embrace similar technologies with keen and informed anticipation.
of “inter-professional” training as a critical component of performance as a team (infra vida ), but also to include documentation of training to...surgeons when returning from a prolonged absence (infra vida ). But more important than improving the quality and efficiency of training, implicit in...implementing the new mandates, technologies and processes. Mandates: The current mandates and policies (supra vida ) are limited to the Surgical
Târcoveanu, E; Moldovanu, R; Bradea, C; Dimofte, G; Lupaşcu, C; Georgescu, St; Andronic, D; Lotz, J C; Vlad, N; Vasilescu, A
The classic apprenticeship model for surgical training takes place into the operating theater under the strict coordination of a senior surgeon. During the time and especially after the introduction of minimally invasive techniques as gold standard treatment for many diseases, other methods were developed to successful fulfill the well known three stages of training: skill-based behavior, rule-based behavior and knowledge-based behavior. The skills needed for minimally invasive surgery aren't easily obtained using classical apprenticeship model due to ethical, medico-legal and economic considerations. In this way several types of simulators have been developed. Nowadays simulators are worldwide accepted for laparoscopic surgical training and provide formative feedback which allows an improvement of the performances of the young surgeons. The simulators currently used allow assimilating only skill based behavior and rule-based behavior. However, the training using animal models as well as new virtual reality simulators and augmented reality offer the possibility to achieve knowledge-based behavior. However it isn't a worldwide accepted laparoscopic training curriculum. We present our experience with different types of simulators and teaching methods used along the time in our surgical unit. We also performed a review of the literature data.
Background The challenge of imparting a large amount of knowledge within a limited time period in a way it is retained, remembered and effectively interpreted by a student is considerable. This has resulted in crucial changes in the field of medical education, with a shift from didactic teacher centered and subject based teaching to the use of interactive, problem based, student centered learning. This study tested the hypothesis that learning styles (visual, auditory, read/write and kinesthetic) and approaches to learning (deep, strategic and superficial) differ among first and final year undergraduate medical students, and postgraduates medical trainees. Methods We used self administered VARK and ASSIST questionnaires to assess the differences in learning styles and approaches to learning among medical undergraduates of the University of Colombo and postgraduate trainees of the Postgraduate Institute of Medicine, Colombo. Results A total of 147 participated: 73 (49.7%) first year students, 40 (27.2%) final year students and 34(23.1%) postgraduate students. The majority (69.9%) of first year students had multimodal learning styles. Among final year students, the majority (67.5%) had multimodal learning styles, and among postgraduates, the majority were unimodal (52.9%) learners. Among all three groups, the predominant approach to learning was strategic. Postgraduates had significant higher mean scores for deep and strategic approaches than first years or final years (p < 0.05). Mean scores for the superficial approach did not differ significantly between groups. Conclusions The learning approaches suggest a positive shift towards deep and strategic learning in postgraduate students. However a similar difference was not observed in undergraduate students from first year to final year, suggesting that their curriculum may not have influenced learning methodology over a five year period. PMID:23521845
Reid, Simon A.; McKenzie, Joanna; Woldeyohannes, Solomon M.
Purpose of the review This review was performed to create a repository of information on One Health research and training in Australia and New Zealand (ANZ). The review sought to determine 1) how many training activities there are in ANZ, 2) how much research on zoonotic diseases is undertaken by multidisciplinary teams, and 3) how collaborative and integrated they are. Recent findings There are few opportunities for training in One Health in ANZ. The majority require enrolment in a postgraduate degree programme, and there is only one postgraduate level course that is also available for continuing professional development (CPD). Of the broad range of One Health research performed in ANZ, the majority is performed by teams with limited disciplinary diversity, although diversity is improving. Summary Progress has been made in building collaboration between human, animal, and environmental health professions. However, the lack of clearly defined competencies and agreed purpose for One Health may be impeding collaboration. PMID:27906122
Tugrul Zeyrek, C; Akbiyik, Hayri
A personal dosimetry service that evaluates the occupational doses for external and internal radiation of the radiation workers is one of the main components of radiation protection programme. The education and training (E&T) activities in this field are basic aspects of the optimisation of all exposures to radiation. The E&T activities in the field of occupational radiation protection at the national and international level are of main interest and implemented by the Ankara Nuclear Research and Training Center. This study describes the Turkish experience in E&T of the staff of dosimetry services, postgraduate students and medical physics experts. In Turkey, the first individual monitoring training course was conducted in 2012. The aim of this study is to provide a structured description of postgraduate courses that are addressed to qualified experts and medical physics experts, and the modules are mainly dedicated to individual monitoring.
For 150 years members of the surgical team have been washing their hands with solutions designed to remove micro-organisms and therefore reduce surgical site infections in patients. This article discusses the evidence surrounding aspects of surgical hand antisepsis.
Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L
A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.
Background Medical mentoring is becoming increasingly complex with the evolving needs of trainees and the complexities of their personal and social lives. The Internet is an enabling technology, which increasingly facilitates interaction with multiple people at a distance. Web 2.0 and 3.0 technology shows promise in furthering this facilitation. Objective The objective of our study was to establish opinions among doctors in postgraduate surgical training regarding mentoring and whether these doctors would readily accept virtual mentoring following a brief experience. Methods On the 12th of February 2012, an introductory teaching class was arranged by The London Postgraduate School of Surgery for doctors in training. Participants were introduced to a novel virtual mentoring system and asked to complete a questionnaire regarding their opinions before and after the demonstration. Results A total of 57 junior doctors attended. Among them, 35 completed questionnaires pre- and postdemonstration. Regarding usefulness of a 3D virtual environment for mentoring, 6/35 (17%) agreed or strongly agreed and 20/35 (57%) were unsure prior to the session. Following 20 minutes using MentorSL, this significantly increased to 14/35 (40%) agreeing or strongly agreeing with 11/35 (31%) unsure (P<.001). Prior to using MentorSL, regarding usefulness of voice communication for virtual mentoring, 11/35 (31%) agreed or strongly agreed and 18/35 (51%) were unsure. Following 20 minutes using MentorSL, 19/35 (54%) agreed or strongly agreed and 10/35 (29%) were unsure of usefulness. Regarding ease of use of navigation, search mentor, meeting scheduling, and voice communication features, 17/35 (49%), 13/35 (37%), 15/35 (43%), and 16/35 (46%) participants agreed or strongly agreed, respectively. Regarding usefulness of telementoring, 24/35 (69%) agreed or strongly agreed, increasing to 28/35 (80%) following the introduction. For usefulness of multiple mentors, initially 24/35 (69%) agreed or
Launer, J; Lindsey, C
A new course at the Tavistock Clinic offers general practitioners (GPs) and primary care nurses a training based on family therapy principles but directed at developing skills and conceptualization across the whole range of general practice work. The course may point to a new way forward for postgraduate training in general practice, creating links with the social sciences and giving doctors and nurses appropriate training for the 'postmodern' world. PMID:9281876
Munro, A; Park, K G; Atkinson, D; Day, R P; Capperauld, I
A simulated skin preparation is described which is made by bonding siliconized rubber to a latex foam base. This composite material, which simulates both the dermis/epidermis and subcutaneous fat, provides a realistic model which can be used to teach excision of skin lesions and a variety of suturing methods. We believe that this simulator is of value not only for surgeons in-training but also will allow general practitioners to improve their technical skills in performing minor surgical procedures.
Agbo, S P
Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding.
Kaelble, D. H.
Method of selecting biocompatible materials for surgical implants uses fracture mechanic relationships and surface energies of candidate materials in presence of blood plasma. Technique has been used to characterize 190 materials by parameters that reflect their biocompatibility.
Huang, Huan; Yang, Lih-Mei; Bai, Shuang; Liu, Jian
A laser-induced breakdown spectroscopy (LIBS) guided smart surgical tool using a femtosecond fiber laser is developed. This system provides real-time material identification by processing and analyzing the peak intensity and ratio of atomic emissions of LIBS signals. Algorithms to identify emissions of different tissues and metals are developed and implemented into the real-time control system. This system provides a powerful smart surgical tool for precise robotic microsurgery applications with real-time feedback and control.
Huang, Huan; Yang, Lih-Mei; Bai, Shuang; Liu, Jian
A laser-induced breakdown spectroscopy (LIBS) guided smart surgical tool using a femtosecond fiber laser is developed. This system provides real-time material identification by processing and analyzing the peak intensity and ratio of atomic emissions of LIBS signals. Algorithms to identify emissions of different tissues and metals are developed and implemented into the real-time control system. This system provides a powerful smart surgical tool for precise robotic microsurgery applications with real-time feedback and control.
Goyal, Aditi; Tanveer, Nadeem; Sharma, Pooja
Introduction: Postgraduate students spend a sizeable proportion of their time on social media platforms such as WhatsApp and Facebook. This change in our social interaction needs to be accommodated in our teaching methods. To engage them and arouse their curiosity, WhatsApp is an ideal platform. Digital photography by cell phone cameras has made it possible to share cases and discuss them with students round the clock. Objective: The primary aim of the study was to develop sharing and discussion of images using WhatsApp. It also aimed at gathering feedback by means of a questionnaire from pathology residents about their views about the use of WhatsApp for teaching purpose. Materials and Methods: A WhatsApp group by the name “Pathology on the Go” was created with the authors of this study as group administrators and all junior and senior resident doctors (69) as members. The group was used to discuss interesting cases, quiz questions, and other pathology-related academic issues. At the end of 4 weeks, a questionnaire was distributed among the members, and feedback was sought regarding their experience in the group. Results: Over a 4-week period, 16 cases were discussed with 647 posts. A total of 45 participants out of 69 were active participants, and they had an average of 14 posts over the 4-week period. Majority of the participants found the discussions very useful with minimal disruption of the daily routine. Conclusion: There is a need to incorporate Web 2.0 tools such as WhatsApp in our teaching methods to capture as much screen time of the students as possible.
The International Polar Year (IPY) 2007-2008 will be a hallmark scientific effort between scientists and nations around the world. It will be an intense, coordinated campaign of polar observations, research, and analysis that will be multidisciplinary in scope and international in participation. The IPY 2007-2008 follows in the tradition of three international science endeavors during the last 125 years (IPY 1882-1883; IPY 1932-1933; IGY 157-1958), when nations around the world united to advance scientific discovery in ways that single countries or scientists could not do alone. Each of these seminal events led to discoveries that have fashioned modern Earth and space science as we know it today. The National Academies' Polar Research Board formed the U.S. National Committee (USNC) for the IPY (http://us-ipy.org) to facilitate and coordinate IPY planning in the United States and develop an initial report outlining some U.S. interests in the IPY. This report noted that programs in education and outreach should be developed for IPY that build on the inherent public interest of the polar regions and provide a broad lay audience with a deeper understanding of the polar regions. The IPY also should develop the next generation of scientists, engineers, and leaders and include underrepresented groups and minorities, and also provide mechanisms for individuals, early-career researchers and small teams to contribute to the IPY. This presentation briefly highlights some of the education ideas for the IPY, and focuses specifically on the development of post-graduate mechanisms for the IPY modeled after the highly successful Dissertations Initiative for the Advancement of Climate Change Research (DISCCRS).
McDonald, Stuart; Willis, Gail; Fourie, Willem; Hedgecock, Bronwyn
The first year of practice is usually a challenging time for nursing graduates. In New Zealand most undertake a Nursing Entry to Practice (NETP) programme aimed at socialising them into their new role and work environment. Some of these programmes now have embedded postgraduate courses. This means that graduates undertake higher education while at the same time adjusting to a new role and work environment. Using a cross-sectional survey design the purpose of this study was to explore graduate nurses' experiences of postgraduate education within a NETP programme. Overall, participants felt well prepared for postgraduate studies at academic, personal and professional levels, although most suggested that NETP programmes could allow for a stand-down period of three to four months before postgraduate education is introduced. This would give the graduate an opportunity to adjust to the clinical environment. They also highlighted the importance of making expectations clear from the outset. This study revealed that the number and nature of postgraduate courses offered in a NETP programme requires further investigation.
Ng, Linda; Eley, Robert; Tuckett, Anthony
The aim of this study was to explore the factors influencing registered nurses' pursuit of postgraduate education in specialty nursing practice in Australia. Despite the increased requirement for postgraduate education for advanced practice, little has been reported on the contributory factors involved in the decision to undertake further education. The Nurses' Attitudes Towards Postgraduate Education instrument was administered to 1632 registered nurses from the Nurses and Midwives e-Cohort Study across Australia, with a response rate of 35.9% (n = 568). Data reduction techniques using principal component analysis with varimax rotation were used. The analysis identified a three-factor solution for 14 items, accounting for 52.5% of the variance of the scale: "facilitators," "professional recognition," and "inhibiting factors." Facilitators of postgraduate education accounted for 28.5% of the variance, including: (i) improves knowledge; (ii) increases nurses' confidence in clinical decision-making; (iii) enhances nurses' careers; (iv) improves critical thinking; (v) improves nurses' clinical skill; and (vi) increased job satisfaction. This new instrument has potential clinical and research applications to support registered nurses' pursuit of postgraduate education.
Considering the dearth of professional nurses in South Africa today, and the fact that postgraduate nursing education can contribute towards enhancing the competences of those in the profession, I shall examine some of the challenges faced by a group of previously enrolled postgraduate nursing students which resulted in their non-completion of a formal qualification. The focus of this investigation was a 2008 cohort of students that did not complete their non-clinical postgraduate diplomas at the institution where I work. Of the 29 students who did not complete their studies, I have selected a group of 8 students through a purposive non-random sample with the objective to ascertain some of the reasons for them not completing their diploma. My aim was to examine some of the reasons as to why postgraduate nursing students do not complete their qualification and to suggest ways as to how the curriculum can be reconstructed as to counteract some of students' pitfalls. Based on my qualitative interpretive analysis, I shall argue that these students did not complete their diplomas on the grounds of, having experienced a lack of institutional and social support; their inability to cope with the demands of academic rigour; their experiences of isolation and exclusion; and, the inability to cope with unimagined realities. My contention is that if postgraduate nursing is not adequately attended to, the possibility that nursing education would not contribute to the transformation of the profession, is highly possible.
Koda-Kimble, Mary Anne; Batz, Forrest R.
In a University of California continuing pharmacy education course in diabetes care, practicing pharmacists lived as patients with diabetes for two days and role-played in small groups. One year later, participants reported making changes in their diabetes care-related practice, suggesting its effectiveness in improving practitioners' skill…
Hyland, Paul; Sloan, Terry; Beckett, Ron
A master of technology management degree program was offered to aerospace employees on site; many completed modules and 20 completed degrees. Responses from 38.5% of 65 participants indicated both personal and company benefits (improved capacity for change, movement toward a learning culture), but some experienced problems in applying learning on…
Hakim, Julie; Black, Amanda; Gruslin, Andrée; Fleming, Nathalie
Objectifs : La promotion de la santé (PS) est une compétence de base qui figure dans les programmes canadiens d’études supérieures en obstétrique-gynécologie. Nous avions pour objectif d’évaluer la connaissance et la compréhension du rôle de promoteur de la santé chez les stagiaires, la formation actuellement vouée à la PS et l’exposition des stagiaires à ce concept à l’heure actuelle, ainsi que les souhaits et les besoins pour ce qui est de l’avenir de la formation vouée à la PS. Méthodes : Un questionnaire en ligne, transversal, autodéclaré et anonyme a été distribué aux stagiaires canadiens en obstétrique-gynécologie. Une analyse descriptive a été menée pour toutes les variables à l’étude. Des tests de chi carré, un test de tendance de Cochran-Armitage et un test exact de Fisher ont été menés, lorsque cela s’avérait approprié. Résultats : La plupart des stagiaires (93,9 % des répondants) connaissaient le rôle PS CanMEDS et savaient qu’il s’agissait d’un objectif de formation (92,9 %). Seulement 52,4 % d’entre eux disposaient d’objectifs clairs à ce sujet, tandis que 58,4 % comprenaient les exigences de ce rôle. La plupart des stagiaires (95,1 % des répondants) estimaient que la PS constituait un sujet important à aborder dans le cadre de la formation. Seulement 30,4 % des stagiaires disposaient d’une formation en PS et tout juste 36,3 % d’entre eux estimaient que leurs besoins de formation étaient satisfaits. Dans le cadre de la formation, on trouvait les sessions d’enseignement (11,9 %), l’enseignement clinique (4,7 %) et l’imitation de rôles (4,7 %). Bien que 82,9 % des répondants aient disposé d’occasions de PS auprès des patientes, les occasions de ce genre étaient moins nombreuses aux niveaux communautaire (45,1 %) et sociétal (30,0 %). La connaissance des activités et des groupes communautaires était faible (28,6 %), et peu de répondants (20,0 %) avaient participé à des programmes communautaires de promotion de la santé au cours de leur résidence. L’intégration des activités de promotion de la santé à la formation était appréciée (80,0 %). De nombreux résidents soutenaient la formation obligatoire en PS (60,0 %), l’octroi d’un plus grand nombre d’heures de formation aux expériences de PS (66,3 %) et la tenue d’expériences de PS au cours du temps réservé (71,3 %). Conclusion : Bien que la connaissance du rôle de PS et l’intérêt envers ce dernier soient élevés, il existe des lacunes en matière de formation et d’octroi d’objectifs clairs. Un curriculum standardisé permettrait d’assurer l’exposition des stagiaires au concept de la promotion de la santé et faciliterait leur participation active à des activités communautaires et sociétales. Les stagiaires soutiennent l’offre d’une telle formation dans le cadre du temps réservé.
Perkin, G D
A case analysis has been performed on 4000 successive outpatient referrals to one consultant neurologist, representing 72% of all referrals to Charing Cross Hospital and 82% to Hillingdon Hospital. A specific diagnosis was not possible in 1013 patients (25.3%). Amongst the remainder certain diagnoses were predictably common: for example, migraine (241), tension headaches (296) and epilepsy (470). Based on data obtained for the incidence of various neurological disorders in the community, an attempt has been made to assess what proportion of patients with certain diagnoses are likely to be seen by a neurologist. The rarity with which certain classical conditions, for example syringomyelia, is encountered is stressed and the implications for teaching discussed.
This article explores the development of a comprehensive and systemic approach to entrepreneurship education at a research-intensive university in the United Kingdom. The exploration is based on two key conceptual challenges: (a) taking entrepreneurship to mean something more than new business creation and (b) differentiating between…
After centuries of protectionism in international trade, the course is inexorably set for trade amongst nations without borders. More and more countries are joining the World Trade Organization and companies are repositioning themselves for the conduct of their activities in an environment free from physical borders and national legislative…
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
Grover, Brandon T; Kothari, Shanu N
Surgical subspecialties are now well established, and many surgery residents pursue fellowship training for various reasons. Fellowships can bridge the gaps found in many residency programs by providing graduating residents with opportunities to master surgical skills, gain confidence and progressive autonomy, and receive further mentorship. The experience also eases the transition to independent practice by allowing surgeons to tailor their training to coincide with personal interests and future practice goals. It is unlikely that the number of surgery residents pursuing fellowship training will decrease, so it is important to provide the infrastructure, oversight, and opportunities to meet their needs.
Farquharson, David I M
Subspeciality training in obstetrics and gynaecology in the United Kingdom was introduced more than 25 years ago following a report published by a working party of the Royal College of Obstetricians and Gynaecologists (RCOG) in 1982. There are now over 400 accredited subspecialists and over 150 approved subspeciality training programmes. It is timely to consider whether there are sufficient or too many subspeciality training programmes and whether some of the training resource should be directed towards delivery of advanced training skills modules (ATSMs). It is 5 years since the establishment of the Postgraduate Medical Education and Training Board (PMETB), which has responsibility for all postgraduate medical education and training, which includes the subspecialities. This has changed the way that new centres are approved and training programmes monitored and assessed. The RCOG has the expertise and experience to ensure that programmes deliver high-quality training to develop doctors for the future who will become leaders in their field. Changes to the curriculum and methods of assessment of trainees need to be integrated into the structures developed by PMETB.
Khan, Shaheen Akhtar; Sharma, Veena
The study was conducted to assess computer-related health problems among post-graduate nursing students and to develop a Self Instructional Module for prevention of computer-related health problems in a selected university situated in Delhi. A descriptive survey with co-relational design was adopted. A total of 97 samples were selected from different faculties of Jamia Hamdard by multi stage sampling with systematic random sampling technique. Among post-graduate students, majority of sample subjects had average compliance with computer-related ergonomics principles. As regards computer related health problems, majority of post graduate students had moderate computer-related health problems, Self Instructional Module developed for prevention of computer-related health problems was found to be acceptable by the post-graduate students.
Zhu, Yuan; Zhang, Chun-jie; Hu, Cheng-liang
Though postgraduate education started before the founding of new China in 1949, it was not until the implementation of the policy reform and the opening-up in 1978 that China's postgraduate productivity began to take off. Since the introduction of Regulations of the People's Republic of China on Academic Degrees in 1981, the number of graduate students enrolled each year has increased 50 times since 1978. China is now the second largest producer of publications indexed by the database of Science Citation Index (SCI) (Web of Science™, Thomson Reuters), which reflects great strides being made in the postgraduate education. In this paper, we discuss the relationship between the increasingly high enrollments of graduate students and the quantity (the number) and quality (the academic impact and the originality) of their publications, to see whether there is a correlation.
Oyewole, Olawale; Adetimirin, Airen
Lecturers and postgraduates are among the users of the university libraries and their perception of the libraries has influence on utilization of the information resources, hence the need for this study. Survey method was adopted for the study and simple random sampling method was used to select sample size of 38 lecturers and 233 postgraduates.…
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE Department of the Navy Meeting of the Board of Advisors (BOA) to the President, Naval Postgraduate School... NPS BOA, contact Ms. Jaye Panza, Naval Postgraduate School, 1 University Circle, Monterey, CA...
Pillay, G.; Balfour, R. J.
Supervision might be understood as the provision usually by an academic to a student of either the expert guidance in subject knowledge or genre knowledge in relation to postgraduate thesis development. The Project for Postgraduate Educational Research (PPER) team members, in the course of their field visits, sought to interview supervisors of…
Kaye, Linda K.; Brewer, Gayle
The current study examined approaches to teaching in a postgraduate psychology sample. This included considering teaching-focused (information transfer) and student-focused (conceptual changes in understanding) approaches to teaching. Postgraduate teachers of psychology (N = 113) completed a questionnaire measuring their use of a teacher- or…
... also through the Board of Advisors (BOA) to the Presidents of NPS and Naval War College report on... Department of the Navy Meeting of the Board of Advisors to the Presidents of the Naval Postgraduate School and Naval War College, Naval Postgraduate School Subcommittee AGENCY: Department of the Navy,...
Onwuegbuzie, Anthony J.; Collins, Kathleen M. T.; Jiao, Qun G.
This study investigated the degree that social interdependence predicted the achievement of 26 cooperative learning groups. Social interdependence was assessed in terms of postgraduate students' individual orientation (that is, cooperative, competitive, and individualistic). Participants were 84 postgraduate students enrolled in an…
Friedrich-Nel, Hesta; Mac Kinnon, Joyce
The purpose of this study was to investigate formative postgraduate assessment from an international perspective while acknowledging the two countries' differing cultures and environments. Using a case study approach, data were collected from research supervisors of postgraduate work at a university in the United States (USA) and a university in…
Ho, Amaly; Kember, David; Hong, Celina
There has been a substantial rise in the number of students enrolling in part-time taught postgraduate awards. This study investigates the reasons or motivation for students to spend significant amounts on tutorial fees and find time alongside work, family and social commitments to take a taught postgraduate award. Data were gathered through…
Ohlen, J.; Berg, L.; Bramberg, E. Bjork; Engstrom, A.; Millberg, L. German; Hoglund, I.; Jacobsson, C.; Lepp, M.; Liden, E.; Lindstrom, I.; Petzall, K.; Soderberg, S.; Wijk, H.
In an academic programme, completion of a postgraduate degree project could be a significant means of promoting student learning in evidence- and experience-based practice. In specialist nursing education, which through the European Bologna process would be raised to the master's level, there is no tradition of including a postgraduate degree…
Roberts, Rachel M; Davis, Melissa C
There is a need for an evidence-based approach to training professional psychologists in the administration and scoring of standardized tests such as the Wechsler Adult Intelligence Scale (WAIS) due to substantial evidence that these tasks are associated with numerous errors that have the potential to significantly impact clients' lives. Twenty three post-graduate psychology students underwent training in using the WAIS-IV according to a best-practice teaching model that involved didactic teaching, independent study of the test manual, and in-class practice with teacher supervision and feedback. Video recordings and test protocols from a role-played test administration were analyzed for errors according to a comprehensive checklist with self, peer, and faculty member reviews. 91.3% of students were rated as having demonstrated competency in administration and scoring. All students were found to make errors, with substantially more errors being detected by the faculty member than by self or peers. Across all subtests, the most frequent errors related to failure to deliver standardized instructions verbatim from the manual. The failure of peer and self-reviews to detect the majority of the errors suggests that novice feedback (self or peers) may be ineffective to eliminate errors and the use of more senior peers may be preferable. It is suggested that involving senior trainees, recent graduates and/or experienced practitioners in the training of post-graduate students may have benefits for both parties, promoting a peer-learning and continuous professional development approach to the development and maintenance of skills in psychological assessment.
Wiet, Gregory J.; Stredney, Don; Wan, Dinah
This article focuses on key issues surrounding the needs and application of simulation technologies for technical skills training in otolaryngology. The discussion includes an overview of key topics in training and learning, the application of these issues in simulation environments, and the subsequent applications of these simulation environments to the field of otolaryngology. Examples of past applications are presented, with discussion of how the interplay of cultural changes in surgical training in general, along with the rapid advancements in technology have shaped and influenced their adoption and adaptation. The authors conclude with emerging trends and potential influences advanced simulation and training will have on technical skills training in otolaryngology. PMID:22032486
Xu, Yifan; Zhu, Zheng; Wang, Liyu
An anonymous questionnaire was used to investigate the status quo of ethics review of human subject experiments among postgraduate students in clinical practice with the main conclusions as follows: Human subject experiments make up a large ratio of clinical research; the construction of an ethics review has been initially formulated, but there exists a gap in ethics awareness between advisors and the postgraduates with the desperate need to receive ethics review. It is necessary to realize the importance of informed consent and to strengthen the strict supervision of placebo application.
O'Brien, Jennifer M
By recognizing symbols of research culture in postgraduate medical education, educators and trainees can gain a deeper understanding of the existing culture and mechanisms for its transformation. First, I identify symbolic manifestations of the research culture through a case narrative of a single anesthesia residency program, and I offer a visual conceptualization of the research culture. In the second part, I theorize the application of Senge's (1994) disciplines of a learning organization and discuss leverage for enhancing research culture. This narrative account is offered to inform the work of enhancing the broader research culture in postgraduate medical education.