International educational partnerships for doctors in training: a collaborative framework with the RCP.

PubMed

Thomson, George A; Foster, Matthew; Sheriff, Rezvi; Mendis, Lalitha; Fernando, Devaka J S; Blundell, Caroline; Worrall, Jeffrey; Black, Carol

2005-01-01

The UK offers excellent postgraduate medical education, and overseas doctors in training often covet a period of training in the UK. Some overseas training authorities make UK training mandatory prior to appointment as a consultant. Unfortunately, the organisation of such training often proves to be ad hoc, and may lack educational value. UK training faces challenges as a result of reduced hours of work, more structured and intensive educational needs, and pressures of increasing clinical demand. A plethora of new 'trust' posts have developed, often with limited educational value, creating a risk that training quality for overseas doctors is reduced. Against this background, such posts can be used to create international training partnerships such as that at Sherwood Forest Hospitals NHS Trust (SFHT), providing high-quality general and specialty training. Given the success of this strategy, it would be desirable for other UK trusts to provide similar schemes offering specialties not covered at SFHT.

Method and apparatus for in-process sensing of manufacturing quality

DOEpatents

Hartman, Daniel A [Santa Fe, NM; Dave, Vivek R [Los Alamos, NM; Cola, Mark J [Santa Fe, NM; Carpenter, Robert W [Los Alamos, NM

2005-02-22

A method for determining the quality of an examined weld joint comprising the steps of providing acoustical data from the examined weld joint, and performing a neural network operation on the acoustical data determine the quality of the examined weld joint produced by a friction weld process. The neural network may be trained by the steps of providing acoustical data and observable data from at least one test weld joint, and training the neural network based on the acoustical data and observable data to form a trained neural network so that the trained neural network is capable of determining the quality of a examined weld joint based on acoustical data from the examined weld joint. In addition, an apparatus having a housing, acoustical sensors mounted therein, and means for mounting the housing on a friction weld device so that the acoustical sensors do not contact the weld joint. The apparatus may sample the acoustical data necessary for the neural network to determine the quality of a weld joint.

Method and Apparatus for In-Process Sensing of Manufacturing Quality

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

Hartman, D.A.; Dave, V.R.; Cola, M.J.

2005-02-22

A method for determining the quality of an examined weld joint comprising the steps of providing acoustical data from the examined weld joint, and performing a neural network operation on the acoustical data determine the quality of the examined weld joint produced by a friction weld process. The neural network may be trained by the steps of providing acoustical data and observable data from at least one test weld joint, and training the neural network based on the acoustical data and observable data to form a trained neural network so that the trained neural network is capable of determining themore » quality of a examined weld joint based on acoustical data from the examined weld joint. In addition, an apparatus having a housing, acoustical sensors mounted therein, and means for mounting the housing on a friction weld device so that the acoustical sensors do not contact the weld joint. The apparatus may sample the acoustical data necessary for the neural network to determine the quality of a weld joint.« less

Employee Training Interview Guide. Judging the Quality and Effectiveness of Training Providers. Workforce Tools.

ERIC Educational Resources Information Center

Bergman, Terri

This guide, which is intended for businesspersons and/or labor representatives, contains guidelines and questions for determining whether prospective training providers have the skills to develop/deliver successful employee training programs tailored to a particular firm's needs. The guide is divided into eight sections. Section 1 explains the…

Guide for Improving NRS Data Quality: Procedures for Data Collection and Training.

ERIC Educational Resources Information Center

Condelli, Larry; Castillo, Laura; Seburn, Mary; Deveaux, Jon

This guide for improving the quality of National Reporting System for Adult Education (NRS) data through improved data collection and training is intended for local providers and state administrators. Chapter 1 explains the guide's purpose, contents, and use and defines the following components of data quality: objectivity; integrity;…

Comparison of Canadian and Swiss Surgical Training Curricula: Moving on Toward Competency-Based Surgical Education.

PubMed

Hoffmann, Henry; Oertli, Daniel; Mechera, Robert; Dell-Kuster, Salome; Rosenthal, Rachel; Reznick, Richard; MacDonald, Hugh

Quality of surgical training in the era of resident duty-hour restrictions (RDHR) is part of an ongoing debate. Most training elements are provided during surgical service. As exposure to surgical procedures is important but time-consuming, RDHR may affect quality of surgical training. Providing structured training elements may help to compensate for this shortcoming. This binational anonymous questionnaire-based study evaluates frequency, time, and structure of surgical training programs at 2 typical academic teaching hospitals with different RDHR. Departments of Surgery of University of Basel (Basel, Switzerland) and the Queen's University (Kingston, Ontario, Canada). Surgical consultants and residents of the Queen's University Hospital (Kingston, Ontario, Canada) and the University Hospital Basel (Basel, Switzerland) were eligible for this study. Questionnaire response rate was 37% (105/284). Queen's residents work 80 hours per week, receiving 7 hours of formal training (8.8% of workweek). Basel residents work 60 hours per week, including 1 hour of formal training (1.7% of working time). Queen's faculty and residents rated their program as "structured" or "rather structured" in contrast to Basel faculty and residents who rated their programs as "neutral" in structure or "unstructured." Respondents identified specific structured training elements more frequently at Queen's than in Basel. Two-thirds of residents responded that they seek out additional surgical experiences through voluntary extra work. Basel participants articulated a stronger need for improvement of current surgical training. Although Basel residents and consultants in both institutions fear negative influence of RDHR on the training program, this was not the case in Queen's residents. Providing more structured surgical training elements may be advantageous in providing optimal-quality surgical education in an era of work-hour restrictions. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The influence of staff training and education on prosthetic and orthotic service quality: A scoping review.

PubMed

Forghany, Saeed; Sadeghi-Demneh, Ebrahim; Trinler, Ursula; Onmanee, Pornsuree; Dillon, Michael P; Baker, Richard

2018-06-01

Education and training in prosthetics and orthotics typically comply with International Society for Prosthetics and Orthotics standards based on three categories of prosthetic and orthotic professionals. This scoping study sought to describe the evidence base available to answer the question, How are prosthetic and orthotic services influenced by the training of staff providing them? Scoping review. A structured search of the peer-reviewed literature catalogued in major electronic databases yielded 3039 papers. Following review of title and abstract, 93 articles were considered relevant. Full-text review reduced this number to 25. Only two articles were identified as providing direct evidence of the effects of training and education on service provision. While both suggested that there was an impact, it is difficult to see how the more specific conclusions of either could be generalised. The other 23 articles provide a useful background to a range of issues including the specification of competencies that training programmes should deliver (3 articles), descriptions of a range of training programmes and the effects of training and education on student knowledge and skills. Although it is considered axiomatic, the service quality is dependent on practitioner education and training. There is insufficient evidence to establish whether levels of training and education in prosthetics and orthotics have an effect on the quality of prosthetic and orthotic services. Clinical relevance There is very little evidence about the effects of training and education of prosthetists and orthotists on service quality. While this is a somewhat negative finding, we feel that it is important to bring this to the attention of the prosthetics and orthotics community.

Tribal Air Quality Monitoring.

ERIC Educational Resources Information Center

Wall, Dennis

2001-01-01

The Institute for Tribal Environmental Professionals (ITEP) (Flagstaff, Arizona) provides training and support for tribal professionals in the technical job skills needed for air quality monitoring and other environmental management tasks. ITEP also arranges internships, job placements, and hands-on training opportunities and supports an…

Novice teen driving : education and training administrative standards.

DOT National Transportation Integrated Search

2009-10-09

The Novice Teen Driver Education and Training Administrative Standards set forth in this document serve to guide all novice teen driver education and training programs in States striving to provide quality, consistent driver education and training. W...

Benefits of Exercise Training in Multiple Sclerosis.

PubMed

Motl, Robert W; Sandroff, Brian M

2015-09-01

Exercise training represents a behavioral approach for safely managing many of the functional, symptomatic, and quality of life consequences of multiple sclerosis (MS). This topical review paper summarizes evidence from literature reviews and meta-analyses, supplemented by recent individual studies, indicating that exercise training can yield small but important improvements in walking, balance, cognition, fatigue, depression, and quality of life in MS. The paper highlights limitations of research on exercise training and its consequences and future research directions and provides an overview for promotion of exercise training in MS based on recent prescriptive guidelines. Collectively, the evidence for the benefits of exercise training in MS suggests that the time is ripe for the promotion of exercise by healthcare providers, particularly neurologists as a central part of the clinical care and management of MS patients.

Development Strategies for Online Volunteer Training Modules: A Team Approach

ERIC Educational Resources Information Center

Robideau, Kari; Vogel, Eric

2014-01-01

Volunteers are central to the delivery of 4-H programs, and providing quality, relevant training is key to volunteer success. Online, asynchronous modules are an enhancement to a training delivery menu for adult volunteers, providing consistent, accessible options traditionally delivered primarily face to face. This article describes how Minnesota…

“Booster” training: Evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest

PubMed Central

Sutton, Robert M.; Niles, Dana; Meaney, Peter A.; Aplenc, Richard; French, Benjamin; Abella, Benjamin S.; Lengetti, Evelyn L.; Berg, Robert A.; Helfaer, Mark A.; Nadkarni, Vinay

2013-01-01

Objective To investigate the effectiveness of brief bedside “booster” cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Design Prospective, randomized trial. Setting General pediatric wards at Children’s Hospital of Philadelphia. Subjects Sixty-nine Basic Life Support–certified hospital-based providers. Intervention CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Measurements and Main Results Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min−1 and <120 min−1); 71% met minimum depth targets (depth, >38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p < .02]; automated feedback only: rate, 70% to 96% [p = .02], depth, 61% to 100% [p < .01], and overall CPR compliance, 35% to 96% [p < .01]; and instructor training combined with automated feedback: rate 48% to 100% [p < .01], depth, 78% to 100% [p < .02], and overall CPR compliance, 30% to 100% [p < .01]). Conclusions Before booster CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests. PMID:20625336

"Booster" training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest.

PubMed

Sutton, Robert M; Niles, Dana; Meaney, Peter A; Aplenc, Richard; French, Benjamin; Abella, Benjamin S; Lengetti, Evelyn L; Berg, Robert A; Helfaer, Mark A; Nadkarni, Vinay

2011-05-01

To investigate the effectiveness of brief bedside "booster" cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Prospective, randomized trial. General pediatric wards at Children's Hospital of Philadelphia. Sixty-nine Basic Life Support-certified hospital-based providers. CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min(-1) and <120 min(-1)); 71% met minimum depth targets (depth, >38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p < .02]; automated feedback only: rate, 70% to 96% [p = .02], depth, 61% to 100% [p < .01], and overall CPR compliance, 35% to 96% [p < .01]; and instructor training combined with automated feedback: rate 48% to 100% [p < .01], depth, 78% to 100% [p < .02], and overall CPR compliance, 30% to 100% [p < .01]). Before booster CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests.

Hospital-wide education committees and high-quality residency training : A qualitative study.

PubMed

Silkens, Milou E W M; Slootweg, Irene A; Scherpbier, Albert J J A; Heineman, Maas Jan; Lombarts, Kiki M J M H

2017-12-01

High-quality residency training is of utmost importance for residents to become competent medical specialists. Hospital-wide education committees have been adopted by several healthcare systems to govern postgraduate medical education and to support continuous quality improvement of residency training. To understand the functioning and potential of such committees, this study examined the mechanisms through which hospital-wide education committees strive to enable continuous quality improvement in residency training. Focus group studies with a constructivist grounded theory approach were performed between April 2015 and August 2016. A purposeful sample of hospital-wide education committees led to seven focus groups. Hospital-wide education committees strived to enable continuous quality improvement of residency training by the following mechanisms: creating an organization-wide quality culture, an organization-wide quality structure and by collaborating with external stakeholders. However, the committees were first and foremost eager to claim a strategic position within the organization they represent. All identified mechanisms were interdependent and ongoing. From a governance perspective, the position of hospital-wide education committees in the Netherlands is uniquely contributing to the call for institutional accountability for the quality of residency training. When implementing hospital-wide education committees, shared responsibility of the committees and the departments that actually provide residency training should be addressed. Although committees vary in the strategies they use to impact continuous quality improvement of residency training, they increasingly have the ability to undertake supporting actions and are working step by step to contribute to high-quality postgraduate medical education.

Barriers to providing quality emergency obstetric care in Addis Ababa, Ethiopia: Healthcare providers' perspectives on training, referrals and supervision, a mixed methods study.

PubMed

Austin, Anne; Gulema, Hanna; Belizan, Maria; Colaci, Daniela S; Kendall, Tamil; Tebeka, Mahlet; Hailemariam, Mengistu; Bekele, Delayehu; Tadesse, Lia; Berhane, Yemane; Langer, Ana

2015-03-29

Increasing women's access to and use of facilities for childbirth is a critical national strategy to improve maternal health outcomes in Ethiopia; however coverage alone is not enough as the quality of emergency obstetric services affects maternal mortality and morbidity. Addis Ababa has a much higher proportion of facility-based births (82%) than the national average (11%), but timely provision of quality emergency obstetric care remains a significant challenge for reducing maternal mortality and improving maternal health. The purpose of this study was to assess barriers to the provision of emergency obstetric care in Addis Ababa from the perspective of healthcare providers by analyzing three factors: implementation of national referral guidelines, staff training, and staff supervision. A mixed methods approach was used to assess barriers to quality emergency obstetric care. Qualitative analyses included twenty-nine, semi-structured, key informant interviews with providers from an urban referral network consisting of a hospital and seven health centers. Quantitative survey data were collected from 111 providers, 80% (111/138) of those providing maternal health services in the same referral network. Respondents identified a lack of transportation and communication infrastructure, overcrowding at the referral hospital, insufficient pre-service and in-service training, and absence of supportive supervision as key barriers to provision of quality emergency obstetric care. Dedicated transportation and communication infrastructure, improvements in pre-service and in-service training, and supportive supervision are needed to maximize the effective use of existing human resources and infrastructure, thus increasing access to and the provision of timely, high quality emergency obstetric care in Addis Ababa, Ethiopia.

The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study.

PubMed

Cheng, Adam; Lin, Yiqun; Nadkarni, Vinay; Wan, Brandi; Duff, Jonathan; Brown, Linda; Bhanji, Farhan; Kessler, David; Tofil, Nancy; Hecker, Kent; Hunt, Elizabeth A

2018-01-01

We aimed to explore whether a) step stool use is associated with improved cardiopulmonary resuscitation (CPR) quality; b) provider adjusted height is associated with improved CPR quality; and if associations exist, c) determine whether just-in-time (JIT) CPR training and/or CPR visual feedback attenuates the effect of height and/or step stool use on CPR quality. We analysed data from a trial of simulated cardiac arrests with three study arms: No intervention; CPR visual feedback; and JIT CPR training. Step stool use was voluntary. We explored the association between 1) step stool use and CPR quality, and 2) provider adjusted height and CPR quality. Adjusted height was defined as provider height + 23 cm (if step stool was used). Below-average height participants were ≤ gender-specific average height; the remainder were above average height. We assessed for interaction between study arm and both adjusted height and step stool use. One hundred twenty-four subjects participated; 1,230 30-second epochs of CPR were analysed. Step stool use was associated with improved compression depth in below-average (female, p=0.007; male, p<0.001) and above-average (female, p=0.001; male, p<0.001) height providers. There is an association between adjusted height and compression depth (p<0.001). Visual feedback attenuated the effect of height (p=0.025) on compression depth; JIT training did not (p=0.918). Visual feedback and JIT training attenuated the effect of step stool use (p<0.001) on compression depth. Step stool use is associated with improved compression depth regardless of height. Increased provider height is associated with improved compression depth, with visual feedback attenuating the effects of height and step stool use.

Effectiveness of a Voice Training Program for Student Teachers on Vocal Health.

PubMed

Richter, Bernhard; Nusseck, Manfred; Spahn, Claudia; Echternach, Matthias

2016-07-01

The effectiveness of a preventive training program on vocal health for German student teachers was investigated on specific vocal parameters. The voice quality as described by the Dysphonia Severity Index of 204 student teachers (training group: n = 123; control group: n = 81) was measured at the beginning and at the end of the student teachers training period (duration 1.5 years). Additionally, for investigating the voice-carrying capacity, a vocal loading test (VLT) was performed. Finally, participants had to provide a subjective judgment of a possible Voice Handicap Index. The training program improved the voice quality of the trained group compared with that of the control group, whose voice quality declined. The trained group was also able to better sustain their voice quality across the VLT than the control group. Both groups, however, reported a similar increase in subjective vocal strain. The presented training program clearly showed a positive impact on the voice quality and the vocal capacity. The results maintain the importance of such a training program to be integrated in the education and occupational routine of teachers. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

76 FR 47262 - Brookwood-Sago Mine Safety Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... industry during the current reporting period. Pre-test and post- test results of trainees. Course... funding ends. 2. Agency creates training Increase number of Pre-test and post- materials and improves quality educational test results of the safety. materials developed. training materials. Provide quality...

Lessons learned from implementing a wet laboratory molecular training workshop for beach water quality monitoring.

PubMed

Verhougstraete, Marc Paul; Brothers, Sydney; Litaker, Wayne; Blackwood, A Denene; Noble, Rachel

2015-01-01

Rapid molecular testing methods are poised to replace many of the conventional, culture-based tests currently used in fields such as water quality and food science. Rapid qPCR methods have the benefit of being faster than conventional methods and provide a means to more accurately protect public health. However, many scientists and technicians in water and food quality microbiology laboratories have limited experience using these molecular tests. To ensure that practitioners can use and implement qPCR techniques successfully, we developed a week long workshop to provide hands-on training and exposure to rapid molecular methods for water quality management. This workshop trained academic professors, government employees, private industry representatives, and graduate students in rapid qPCR methods for monitoring recreational water quality. Attendees were immersed in these new methods with hands-on laboratory sessions, lectures, and one-on-one training. Upon completion, the attendees gained sufficient knowledge and practice to teach and share these new molecular techniques with colleagues at their respective laboratories. Key findings from this workshop demonstrated: 1) participants with no prior experience could be effectively trained to conduct highly repeatable qPCR analysis in one week; 2) participants with different desirable outcomes required exposure to a range of different platforms and sample processing approaches; and 3) the collaborative interaction amongst newly trained practitioners, workshop leaders, and members of the water quality community helped foster a cohesive cohort of individuals which can advocate powerful cohort for proper implementation of molecular methods.

Lessons Learned from Implementing a Wet Laboratory Molecular Training Workshop for Beach Water Quality Monitoring

PubMed Central

Verhougstraete, Marc Paul; Brothers, Sydney; Litaker, Wayne; Blackwood, A. Denene; Noble, Rachel

2015-01-01

Rapid molecular testing methods are poised to replace many of the conventional, culture-based tests currently used in fields such as water quality and food science. Rapid qPCR methods have the benefit of being faster than conventional methods and provide a means to more accurately protect public health. However, many scientists and technicians in water and food quality microbiology laboratories have limited experience using these molecular tests. To ensure that practitioners can use and implement qPCR techniques successfully, we developed a week long workshop to provide hands-on training and exposure to rapid molecular methods for water quality management. This workshop trained academic professors, government employees, private industry representatives, and graduate students in rapid qPCR methods for monitoring recreational water quality. Attendees were immersed in these new methods with hands-on laboratory sessions, lectures, and one-on-one training. Upon completion, the attendees gained sufficient knowledge and practice to teach and share these new molecular techniques with colleagues at their respective laboratories. Key findings from this workshop demonstrated: 1) participants with no prior experience could be effectively trained to conduct highly repeatable qPCR analysis in one week; 2) participants with different desirable outcomes required exposure to a range of different platforms and sample processing approaches; and 3) the collaborative interaction amongst newly trained practitioners, workshop leaders, and members of the water quality community helped foster a cohesive cohort of individuals which can advocate powerful cohort for proper implementation of molecular methods. PMID:25822486

Quality of life and sleep quality are similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: A randomized clinical trial.

PubMed

S Delevatti, Rodrigo; Schuch, Felipe Barreto; Kanitz, Ana Carolina; Alberton, Cristine L; Marson, Elisa Corrêa; Lisboa, Salime Chedid; Pinho, Carolina Dertzbocher Feil; Bregagnol, Luciana Peruchena; Becker, Maríndia Teixeira; Kruel, Luiz Fernando M

2018-05-01

To compare the effects of two aerobic training models in water and on dry-land on quality of life, depressive symptoms and sleep quality in patients with type 2 diabetes. Randomized clinical trial. Thirty-five patients with type 2 diabetes were randomly assigned to aquatic aerobic training group (n=17) or dry-land aerobic training group (n=18). Exercise training length was of 12 weeks, performed in three weekly sessions (45min/session), with intensity progressing from 85% to 100% of heart rate of anaerobic threshold during interventions. All outcomes were evaluated at baseline and 12 weeks later. In per protocol analysis, physical and psychological domains of quality of life improved in both groups (p<0.05) without between-group differences. Overall quality of life and sleep quality improved in both groups (p<0.05), without between-group differences in per protocol and intention to treat analysis. No changes on depressive symptoms were observed in both groups at follow-up. Aerobic training in an aquatic environment provides similar effects to aerobic training in a dry-land environment on quality of life, depressive symptoms and sleep quality in patients with type 2 diabetes. Clinical trial reg. no. NCT01956357, clinicaltrials.gov. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Usalpharma: A Cloud-Based Architecture to Support Quality Assurance Training Processes in Health Area Using Virtual Worlds

PubMed Central

García-Peñalvo, Francisco J.; Pérez-Blanco, Jonás Samuel; Martín-Suárez, Ana

2014-01-01

This paper discusses how cloud-based architectures can extend and enhance the functionality of the training environments based on virtual worlds and how, from this cloud perspective, we can provide support to analysis of training processes in the area of health, specifically in the field of training processes in quality assurance for pharmaceutical laboratories, presenting a tool for data retrieval and analysis that allows facing the knowledge discovery in the happenings inside the virtual worlds. PMID:24778593

Participation in Training for Depression Care Quality Improvement: A Randomized Trial of Community Engagement or Technical Support.

PubMed

Chung, Bowen; Ngo, Victoria K; Ong, Michael K; Pulido, Esmeralda; Jones, Felica; Gilmore, James; Stoker-Mtume, Norma; Johnson, Megan; Tang, Lingqi; Wells, Kenneth Brooks; Sherbourne, Cathy; Miranda, Jeanne

2015-08-01

Community engagement and planning (CEP) could improve dissemination of depression care quality improvement in underresourced communities, but whether its effects on provider training participation differ from those of standard technical assistance, or resources for services (RS), is unknown. This study compared program- and staff-level participation in depression care quality improvement training among programs enrolled in CEP, which trained networks of health care and social-community agencies jointly, and RS, which provided technical support to individual programs. Matched programs from health care and social-community service sectors in two communities were randomly assigned to RS or CEP. Data were from 1,622 eligible staff members from 95 enrolled programs. Primary outcomes were any staff trained (for programs) and total hours of training (for staff). Secondary staff-level outcomes were hours of training in specific depression collaborative care components. CEP programs were more likely than RS programs to participate in any training (p=.006). Within health care sectors, CEP programs were more likely than RS programs to participate in training (p=.016), but within social-community sectors, there was no difference in training by intervention. Among staff who participated in training, mean training hours were greater among CEP programs versus RS programs for any type of training (p<.001) and for training related to each component of depression care (p<.001) except medication management. CEP may be an effective strategy to promote staff participation in depression care improvement efforts in underresourced communities.

The impact of transmural multiprofessional simulation-based obstetric team training on perinatal outcome and quality of care in the Netherlands

PubMed Central

2014-01-01

Background Perinatal mortality and morbidity in the Netherlands is relatively high compared to other European countries. Our country has a unique system with an independent primary care providing care to low-risk pregnancies and a secondary/tertiary care responsible for high-risk pregnancies. About 65% of pregnant women in the Netherlands will be referred from primary to secondary care implicating multiple medical handovers. Dutch audits concluded that in the entire obstetric collaborative network process parameters could be improved. Studies have shown that obstetric team training improves perinatal outcome and that simulation-based obstetric team training implementing crew resource management (CRM) improves team performance. In addition, deliberate practice (DP) improves medical skills. The aim of this study is to analyse whether transmural multiprofessional simulation-based obstetric team training improves perinatal outcome. Methods/Design The study will be implemented in the south-eastern part of the Netherlands with an annual delivery rate of over 9,000. In this area secondary care is provided by four hospitals. Each hospital with referring primary care practices will form a cluster (study group). Within each cluster, teams will be formed of different care providers representing the obstetric collaborative network. CRM and elements of DP will be implemented in the training. To analyse the quality of care as perceived by patients, the Pregnancy and Childbirth Questionnaire (PCQ) will be used. Furthermore, self-reported collaboration between care providers will be assessed. Team performance will be measured by the Clinical Teamwork Scale (CTS). We employ a stepped-wedge trial design with a sequential roll-out of the trainings for the different study groups. Primary outcome will be perinatal mortality and/or admission to a NICU. Secondary outcome will be team performance, quality of care as perceived by patients, and collaboration among care providers. Conclusion The effect of transmural multiprofessional simulation-based obstetric team training on perinatal outcome has never been studied. We hypothesise that this training will improve perinatal outcome, team performance, and quality of care as perceived by patients and care providers. Trial registration The Netherlands National Trial Register, http://www.trialregister.nl/NTR4576, registered June 1, 2014 PMID:25145317

Paradental Training Contract.

ERIC Educational Resources Information Center

Lane Community Coll., Eugene, OR.

This report describes institutional, faculty, and student activities and problems resulting from Lane Community College's acceptance of a federal contract to develop a paradental training program designed specifically to provide training/retraining required to quality military-trained dental corpsmen for examination by the Oregon State Board of…

Enhancing the role of nutrition professionals in weight management: A cross sectional survey

PubMed Central

Bleich, Sara N.; Bandara, Sachini; Bennett, Wendy; Cooper, Lisa A.; Gudzune, Kimberly A.

2014-01-01

Objective 1) To determine the non-physician health profession perceived as best qualified to provide weight management; 2) To examine nutrition professionals’ current practice characteristics and perceived challenges and solutions for obesity care; and 3) To examine the association between nutrition professionals’ quality of training and self-efficacy in weight management. Design and methods We analyzed a 2014 national cross-sectional online survey of 500 U.S. non-physician health professionals (100 from each: nutrition, nursing, behavioral/mental health, exercise, pharmacy). Results Nutrition professionals most commonly self-identified as the most qualified group to help patients lose weight (92%), sentiments supported by other health professionals (57%). The most often cited challenge was lack of patient adherence (87%). Among nutrition professionals, 77% reported receiving high quality training in weight loss counseling. Nutrition professionals who reported high quality training were significantly more likely to report confidence (95% vs. 48%) and success (74% vs. 50%) in helping obese patients lose weight (p<0.05) than those reporting lower quality training. Conclusion Across all non-physician health professionals, nutrition professionals were identified as best suited to provide routine weight management counseling to obese patients. Yet, nutrition professionals’ receipt of high quality weight management training appears critical to their success in helping patients lose weight. PMID:25445319

Compassion training in healthcare: what are patients' perspectives on training healthcare providers?

PubMed

Sinclair, Shane; Torres, Mia-Bernadine; Raffin-Bouchal, Shelley; Hack, Thomas F; McClement, Susan; Hagen, Neil A; Chochinov, Harvey M

2016-07-11

The purpose of this qualitative study was to investigate advanced cancer patients' perspectives on the importance, feasibility, teaching methods, and issues associated with training healthcare providers in compassionate care. This study utilized grounded theory, a qualitative research method, to develop an empirical understanding of compassion education rooted in direct patient reports. Audio-recorded semi-structured interviews were conducted to obtain an in-depth understanding of compassion training from the perspectives of hospitalized advanced cancer patients (n = 53). Data were analyzed in accordance with grounded theory to determine the key elements of the underlying theory. Three overarching categories and associated themes emerged from the data: compassion aptitude, cultivating compassion, and training methods. Participants spoke of compassion as an innate quality embedded in the character of learners prior to their healthcare training, which could be nurtured through experiential learning and reflective practices. Patients felt that the innate qualities that learners possessed at baseline were further fashioned by personal and practice experiences, and vocational motivators. Participants also provided recommendations for compassion training, including developing an interpersonal relationship with patients, seeing the patient as a person, and developing a human connection. Teaching methods that patients suggested in compassion training included patient-centered communication, self-reflection exercises, and compassionate role modeling. This study provides insight on compassion training for both current and future healthcare providers, from the perspectives of the end recipients of healthcare provider training - patients. Developing a theoretical base for patient centred, evidence-informed, compassion training is a crucial initial step toward the further development of this core healthcare competency.

Quality Assurance Specifications for Planetary Protection Assays

NASA Astrophysics Data System (ADS)

Baker, Amy

As the European Space Agency planetary protection (PP) activities move forward to support the ExoMars and other planetary missions, it will become necessary to increase staffing of labo-ratories that provide analyses for these programs. Standardization of procedures, a comprehen-sive quality assurance program, and unilateral training of personnel will be necessary to ensure that the planetary protection goals and schedules are met. The PP Quality Assurance/Quality Control (QAQC) program is designed to regulate and monitor procedures performed by labora-tory personnel to ensure that all work meets data quality objectives through the assembly and launch process. Because personnel time is at a premium and sampling schedules are often de-pendent on engineering schedules, it is necessary to have flexible staffing to support all sampling requirements. The most productive approach to having a competent and flexible work force is to establish well defined laboratory procedures and training programs that clearly address the needs of the program and the work force. The quality assurance specification for planetary protection assays has to ensure that labora-tories and associated personnel can demonstrate the competence to perform assays according to the applicable standard AD4. Detailed subjects included in the presentation are as follows: • field and laboratory control criteria • data reporting • personnel training requirements and certification • laboratory audit criteria. Based upon RD2 for primary and secondary validation and RD3 for data quality objectives, the QAQC will provide traceable quality assurance safeguards by providing structured laboratory requirements for guidelines and oversight including training and technical updates, standardized documentation, standardized QA/QC checks, data review and data archiving.

Horse Training and Management: Program of Excellence.

ERIC Educational Resources Information Center

Lane, Marvin

This report on Lamar Community College's Horse Training and Management (HTM) program assesses the quality of the educational experience provided by the program, the quality of the faculty and students, institutional financial commitment to the program, contribution of the HTM program to state and local economic development, and external funding…

Taking the Pulse of Training Transfer: Instructor Quality and EMT Certification Examination Results

ERIC Educational Resources Information Center

Russ-Eft, Darlene F.; Dickison, Phil; Levine, Roger

2010-01-01

The Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) provides a representative sampling of EMTs throughout the United States. The present study adds to the transfer of training literature by examining the relationship between instructor quality and National Registry of Emergency Medical Technicians certification…

Train-the-Trainer for Adult Education. Quality Professional Development Project.

ERIC Educational Resources Information Center

Florida Community Coll., Jacksonville.

This manual aids professional development adult education (AE) facilitators in conducting AE workshops using Quality Professional Development (QPD) Project materials. A workshop outline is provided. Six sections correspond to the six manuals in the training package. Section components are as follows: objectives for five or six units; activities;…

Implementing the European Quality Assurance in Vocational Education and Training (EQAVET) at National Level: Some Insights from the PEN Leonardo Project

ERIC Educational Resources Information Center

Gatt, Suzanne; Faurschou, Kim

2016-01-01

EQAVET, the quality assurance tool in vocational and educational training, was developed in response to the need for a supply of a trained workforce for labour market needs. Implementation of EQAVET at national level, however, remains a challenge. The research reported here focused on the implementation of QA processes by VET providers in 4…

Perceived Self-Efficacy of Licensed Counselors to Provide Substance Abuse Counseling

ERIC Educational Resources Information Center

Chandler, Nichelle; Balkin, Richard S.; Perepiczka, Michelle

2011-01-01

This nationwide, quantitative study documented licensed counselors' perceived self-efficacy of adequately providing substance abuse services. Despite their lack of substance abuse training, counselors were highly confident in their ability to provide quality substance abuse services. Counselor training implications are discussed. (Contains 3…

Training to Perform Ankle-Brachial Index: Systematic Review and Perspectives to Improve Teaching and Learning.

PubMed

Chaudru, S; de Müllenheim, P-Y; Le Faucheur, A; Kaladji, A; Jaquinandi, V; Mahé, G

2016-02-01

To conduct a systematic review focusing on the impact of training programs on ankle-brachial index (ABI) performance by medical students, doctors and primary care providers. Lower extremity peripheral artery disease (PAD) is a highly prevalent disease affecting ∼202 million people worldwide. ABI is an essential component of medical education because of its ability to diagnose PAD, and as it is a powerful prognostic marker for overall and cardiovascular related mortality. A systematic search was conducted (up to May 2015) using Medline, Embase, and Web of Science databases. Five studies have addressed the impact of a training program on ABI performance by either medical students, doctors or primary care providers. All were assigned a low GRADE system quality. The components of the training vary greatly either in substance (what was taught) or in form (duration of the training, and type of support which was used). No consistency was found in the outcome measures. According to this systematic review, only few studies, with a low quality rating, have addressed which training program should be performed to provide the best way of teaching how to perform ABI. Future high quality researches are required to define objectively the best training program to facilitate ABI teaching and learning. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Organizational and provider level factors in implementation of trauma-informed care after a city-wide training: an explanatory mixed methods assessment.

PubMed

Damian, April Joy; Gallo, Joseph; Leaf, Philip; Mendelson, Tamar

2017-11-21

While there is increasing support for training youth-serving providers in trauma-informed care (TIC) as a means of addressing high prevalence of U.S. childhood trauma, we know little about the effects of TIC training on organizational culture and providers' professional quality of life. This mixed-methods study evaluated changes in organizational- and provider-level factors following participation in a citywide TIC training. Government workers and nonprofit professionals (N = 90) who participated in a nine-month citywide TIC training completed a survey before and after the training to assess organizational culture and professional quality of life. Survey data were analyzed using multiple regression analyses. A subset of participants (n = 16) was interviewed using a semi-structured format, and themes related to organizational and provider factors were identified using qualitative methods. Analysis of survey data indicated significant improvements in participants' organizational culture and professional satisfaction at training completion. Participants' perceptions of their own burnout and secondary traumatic stress also increased. Four themes emerged from analysis of the interview data, including "Implementation of more flexible, less-punitive policies towards clients," "Adoption of trauma-informed workplace design," "Heightened awareness of own traumatic stress and need for self-care," and "Greater sense of camaraderie and empathy for colleagues." Use of a mixed-methods approach provided a nuanced understanding of the impact of TIC training and suggested potential benefits of the training on organizational and provider-level factors associated with implementation of trauma-informed policies and practices. Future trainings should explicitly address organizational factors such as safety climate and morale, managerial support, teamwork climate and collaboration, and individual factors including providers' compassion satisfaction, burnout, and secondary traumatic stress, to better support TIC implementation.

Introduction to ISO 15189: a blueprint for quality systems in veterinary laboratories.

PubMed

Freeman, Kathleen P; Bauer, Natali; Jensen, Asger L; Thoresen, Stein

2006-06-01

A trend in human and veterinary medical laboratory management is to achieve accreditation based on international standards. The International Organization for Standardization (ISO) 15189 standard is the first developed especially for accreditation of medical laboratories, and emphasizes the laboratory-client interface. European veterinary laboratories seeking to train candidates for the certification examination of the European College of Veterinary Clinical Pathology (ECVCP) require approval by the ECVCP Laboratory Standards Committee, which bases its evaluation in part on adherence to quality systems described in the ISO 15189 standards. The purpose of this article was to introduce the latest ISO quality standard and describe its application to veterinary laboratories in Europe, specifically as pertains to accreditation of laboratories involved in training veterinary clinical pathologists. Between 2003 and 2006, the Laboratory Standards Committee reviewed 12 applications from laboratories (3 commercial and 9 university) involved in training veterinary clinical pathologists. Applicants were asked to provide a description of the facilities for training and testing, current methodology and technology, health and safety policy, quality assurance policy (including internal quality control and participation in an external quality assurance program), written standard operating procedures (SOPs) and policies, a description of the laboratory information system, and personnel and training. Also during this time period multiple informal and formal discussions among ECVCP diplomates took place as to current practices and perceived areas of concern with regard to laboratory accreditation requirements. Areas in which improvement most often was needed in veterinary laboratories applying for ECVCP accreditation were the written quality plan, defined quality requirements for the tests performed, written SOPs and policies, training records, ongoing audits and competency assessments, and processes for identifying and addressing opportunities for improvement. Recommendations were developed for a stepwise approach towards achieving ISO 15189 standards, including 3 levels of quality components. The ISO 15189 standard provides a sound framework for veterinary laboratories aspiring to meet international quality standards.

Developing and fostering a dynamic program for training in veterinary pathology and clinical pathology: veterinary students to post-graduate education.

PubMed

Lairmore, Michael D; Oglesbee, Michael; Weisbrode, Steve E; Wellman, Maxey; Rosol, Thomas; Stromberg, Paul

2007-01-01

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-term dividends for the future of the profession.

Developing and Fostering a Dynamic Program for Training in Veterinary Pathology and Clinical Pathology: Veterinary Students to Post-graduate Education

PubMed Central

Lairmore, Michael D.; Oglesbee, Michael; Weisbrode, Steve E.; Wellman, Maxey; Rosol, Thomas; Stromberg, Paul

2011-01-01

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-term dividends for the future of the profession. PMID:18287474

Standards to Assure Quality in Tertiary Education: The Case of Tanzania

ERIC Educational Resources Information Center

Manyaga, Timothy

2008-01-01

Purpose: The purpose of this paper is to provide information on development of standards in Tanzania which may be of help to training providers in other countries as they seek to improve the quality and standards of their provision. Design/methodology/approach: The need to provide quality assured tertiary qualifications in Tanzania to win both…

Implementing Total Quality Management in Vocational Education.

ERIC Educational Resources Information Center

Navaratnam, K. K.; Mountney, Peter

In an internationally competitive training environment, implementation of Total Quality Management (TQM) in vocational education can provide a comparative advantage in preparing the type of work force required for micro and macro economic reforms. The concept of TQM can be used as a management tool to improve the standards of vocational training.…

High Tech Training at Arthur Andersen and Co.

ERIC Educational Resources Information Center

Dennis, Verl E.

1984-01-01

Discusses Arthur Andersen and Company's reasons for using high technology in job training, including its ability to improve productivity, provide training on demand, reduce training costs, and keep educational quality consistent. A Life Cycle Model which is used to integrate high technology into this accounting company's educational programs is…

The National Conservation Training Center.

ERIC Educational Resources Information Center

Cohn, Jeffrey P.

2000-01-01

Describes the National Conservation Training Center (NCTC) which provides a host of benefits for fish and wildlife pros and includes classrooms, laboratories, and residential lodges. Provides information about some of the courses offered such as how to use global positioning systems and water quality testing. (ASK)

Low-Dose, High-Frequency CPR Training Improves Skill Retention of In-Hospital Pediatric Providers

PubMed Central

Niles, Dana; Meaney, Peter A.; Aplenc, Richard; French, Benjamin; Abella, Benjamin S.; Lengetti, Evelyn L.; Berg, Robert A.; Helfaer, Mark A.; Nadkarni, Vinay

2011-01-01

OBJECTIVE: To investigate the effectiveness of brief bedside cardiopulmonary resuscitation (CPR) training to improve the skill retention of hospital-based pediatric providers. We hypothesized that a low-dose, high-frequency training program (booster training) would improve CPR skill retention. PATIENTS AND METHODS: CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated arrest. Basic life support–certified, hospital-based providers were randomly assigned to 1 of 4 study arms: (1) instructor-only training; (2) automated defibrillator feedback only; (3) instructor training combined with automated feedback; and (4) control (no structured training). Each session (time: 0, 1, 3, and 6 months after training) consisted of a pretraining evaluation (60 seconds), booster training (120 seconds), and a posttraining evaluation (60 seconds). Excellent CPR was defined as chest compression (CC) depth ≥ one-third anterior-posterior chest depth, rate ≥ 90 and ≤120 CC per minute, ≤20% of CCs with incomplete release (>2500 g), and no flow fraction ≤ 0.30. MEASUREMENTS AND MAIN RESULTS: Eighty-nine providers were randomly assigned; 74 (83%) completed all sessions. Retention of CPR skills was 2.3 times (95% confidence interval [CI]: 1.1–4.5; P = .02) more likely after 2 trainings and 2.9 times (95% CI: 1.4–6.2; P = .005) more likely after 3 trainings. The automated defibrillator feedback only group had lower retention rates compared with the instructor-only training group (odds ratio: 0.41 [95% CI: 0.17–0.97]; P = .043). CONCLUSIONS: Brief bedside booster CPR training improves CPR skill retention. Our data reveal that instructor-led training improves retention compared with automated feedback training alone. Future studies should investigate whether bedside training improves CPR quality during actual pediatric arrests. PMID:21646262

Bystander first aid in trauma - prevalence and quality: a prospective observational study.

PubMed

Bakke, H K; Steinvik, T; Eidissen, S-I; Gilbert, M; Wisborg, T

2015-10-01

Bystander first aid and basic life support can likely improve victim survival in trauma. In contrast to bystander first aid and out-of-hospital cardiac arrest, little is known about the role of bystanders in trauma response. Our aim was to determine how frequently first aid is given to trauma victims by bystanders, the quality of this aid, the professional background of first-aid providers, and whether previous first-aid training affects aid quality. We conducted a prospective 18-month study in two mixed urban-rural Norwegian counties. The personnel on the first ambulance responding to trauma calls assessed and documented first aid performed by bystanders using a standard form. A total of 330 trauma calls were included, with bystanders present in 97% of cases. Securing an open airway was correctly performed for 76% of the 43 patients in need of this first-aid measure. Bleeding control was provided correctly for 81% of 63 patients for whom this measure was indicated, and prevention of hypothermia for 62% of 204 patients. Among the first-aid providers studied, 35% had some training in first aid. Bystanders with documented first-aid training gave better first aid than those where first-aid training status was unknown. A majority of the trauma patients studied received correct pre-hospital first aid, but still there is need for considerable improvement, particularly hypothermia prevention. Previous first-aid training seems to improve the quality of first aid provided. The effect on patient survival needs to be investigated. © 2015 The Authors. The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

The impact of a quality-improvement package on reproductive health services delivered by private providers in Uganda.

PubMed

Agha, Sohail

2010-09-01

This study assesses the effectiveness of a quality-improvement (QI) package designed to enable small-scale commercial reproductive health (RH) service providers to improve the services they offer. The study was conducted among midwives who are members of the Uganda Private Midwives Association. A pretest-post-test quasi-experimental panel study design was used wherein midwife clinics were allocated to two experimental groups and one control group. Baseline and follow-up measurements of structural and process attributes of quality were taken at the clinics by means of a facility inventory, interviews with midwives, and observations of client-provider interactions. Nearly 70 percent of the midwives who were trained to use the package reported that it was easy to use. Among clinics in which midwives received training in the use of the self-assessment tool and in developing action plans, structural and process attributes of quality improved only among those clinics in which the midwives' supervisors received training in finding solutions to the problems identified through self-assessments. The QI package may be implemented with small-scale private providers of RH services who are part of a professional association, network, or franchise that supervises their performance.

Impact of Family Planning and Business Trainings on Private-Sector Health Care Providers in Nigeria.

PubMed

Ugaz, Jorge; Leegwater, Anthony; Chatterji, Minki; Johnson, Doug; Baruwa, Sikiru; Toriola, Modupe; Kinnan, Cynthia

2017-06-01

Private health care providers are an important source of modern contraceptives in Sub-Saharan Africa, yet they face many challenges that might be addressed through targeted training. This study measures the impact of a package of trainings and supportive supervision activities targeted to private health care providers in Lagos State, Nigeria, on outcomes including range of contraceptive methods offered, providers' knowledge and quality of counseling, recordkeeping practices, access to credit and revenue. A total of 965 health care facilities were randomly assigned to treatment and control groups. Facilities in the treatment group-but not those in the control group-were offered a training package that included a contraceptive technology update and interventions to improve counseling and clinical skills and business practices. Multivariate regression analysis of data collected through facility and mystery client surveys was used to estimate effects. The training program had a positive effect on the range of contraceptive methods offered, with facilities in the treatment group providing more methods than facilities in the control group. The training program also had a positive impact on the quality of counseling services, especially on the range of contraceptive methods discussed by providers, their interpersonal skills and overall knowledge. Facilities in the treatment group were more likely than facilities in the control group to have good recordkeeping practices and to have obtained loans. No effect was found on revenue generation. Targeted training programs can be effective tools to improve the provision of family planning services through private providers.

FY 1991 safety program status report

NASA Technical Reports Server (NTRS)

1991-01-01

In FY 1991, the NASA Safety Division continued efforts to enhance the quality and productivity of its safety oversight function. Recent initiatives set forth in areas such as training, risk management, safety assurance, operational safety, and safety information systems have matured into viable programs contributing to the safety and success of activities throughout the Agency. Efforts continued to develop a centralized intra-agency safety training program with establishment of the NASA Safety Training Center at the Johnson Space Center (JSC). The objective is to provide quality training for NASA employees and contractors on a broad range of safety-related topics. Courses developed by the Training Center will be presented at various NASA locations to minimize travel and reach the greatest number of people at the least cost. In FY 1991, as part of the ongoing efforts to enhance the total quality of NASA's safety work force, the Safety Training Center initiated development of a Certified Safety Professional review course. This course provides a comprehensive review of the skills and knowledge that well-rounded safety professionals must possess to qualify for professional certification. FY 1992 will see the course presented to NASA and contractor employees at all installations via the NASA Video Teleconference System.

Training Sessional Academic Staff to Provide Quality Feedback on University Students' Assessment: Lessons from a Faculty of Law Learning and Teaching Project

ERIC Educational Resources Information Center

Richards, Kelly; Bell, Tamara; Dwyer, Angela

2017-01-01

The quality of feedback provided to university students has long been recognised as the most important predictor of student learning and satisfaction. However, providing quality feedback to students is challenging in the current context, in which universities increasingly rely on casualised and inexperienced academic staff to assess undergraduate…

Quality assurance in postgraduate pathology training the Dutch way: regular assessment, monitoring of training programs but no end of training examination.

PubMed

van der Valk, Paul

2016-01-01

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.

Training, Quality Assurance Factors, and Tools Investigation: a Work Report and Suggestions on Software Quality Assurance

NASA Technical Reports Server (NTRS)

Lee, Pen-Nan

1991-01-01

Previously, several research tasks have been conducted, some observations were obtained, and several possible suggestions have been contemplated involving software quality assurance engineering at NASA Johnson. These research tasks are briefly described. Also, a brief discussion is given on the role of software quality assurance in software engineering along with some observations and suggestions. A brief discussion on a training program for software quality assurance engineers is provided. A list of assurance factors as well as quality factors are also included. Finally, a process model which can be used for searching and collecting software quality assurance tools is presented.

A systematic review of the effects of residency training on patient outcomes

PubMed Central

2012-01-01

Background Residents are vital to the clinical workforce of today and tomorrow. Although in training to become specialists, they also provide much of the daily patient care. Residency training aims to prepare residents to provide a high quality of care. It is essential to assess the patient outcome aspects of residency training, to evaluate the effect or impact of global investments made in training programs. Therefore, we conducted a systematic review to evaluate the effects of relevant aspects of residency training on patient outcomes. Methods The literature was searched from December 2004 to February 2011 using MEDLINE, Cochrane, Embase and the Education Resources Information Center databases with terms related to residency training and (post) graduate medical education and patient outcomes, including mortality, morbidity, complications, length of stay and patient satisfaction. Included studies evaluated the impact of residency training on patient outcomes. Results Ninety-seven articles were included from 182 full-text articles of the initial 2,001 hits. All studies were of average or good quality and the majority had an observational study design. Ninety-six studies provided insight into the effect of 'the level of experience of residents' on patient outcomes during residency training. Within these studies, the start of the academic year was not without risk (five out of 19 studies), but individual progression of residents (seven studies) as well as progression through residency training (nine out of 10 studies) had a positive effect on patient outcomes. Compared with faculty, residents' care resulted mostly in similar patient outcomes when dedicated supervision and additional operation time were arranged for (34 out of 43 studies). After new, modified or improved training programs, patient outcomes remained unchanged or improved (16 out of 17 studies). Only one study focused on physicians' prior training site when assessing the quality of patient care. In this study, training programs were ranked by complication rates of their graduates, thus linking patient outcomes back to where physicians were trained. Conclusions The majority of studies included in this systematic review drew attention to the fact that patient care appears safe and of equal quality when delivered by residents. A minority of results pointed to some negative patient outcomes from the involvement of residents. Adequate supervision, room for extra operation time, and evaluation of and attention to the individual competence of residents throughout residency training could positively serve patient outcomes. Limited evidence is available on the effect of residency training on later practice. Both qualitative and quantitative research designs are needed to clarify which aspects of residency training best prepare doctors to deliver high quality care. PMID:22742521

Mental Health Care for LGBT Older Adults in Long-Term Care Settings: Competency, Training, and Barriers for Mental Health Providers.

PubMed

Smith, Ronald W; Altman, Jennifer K; Meeks, Suzanne; Hinrichs, Kate Lm

2018-06-07

To assess mental health providers' experience with LGBT older adults in long-term care (LTC) settings and perceived barriers to quality care. Providers (N = 57) completed an online survey on demographics and practice characteristics. They were also asked about: number of LGBT residents they've worked with, relevance of LGBT issues to their practice, preparedness, willingness to learn, hours of formal/informal training, and barriers to providing care to LGBT patients. Respondents were 63% psychologists, 16% social workers, 14% psychiatrists, and 5% nurses, most of whom practiced in LTC consulting roles. Most providers felt working with LGBT issues was relevant to their practice and felt well-prepared and willing to learn, though they were unaware of evidence based practices (EBTs), especially for LTC settings. They had little coursework on LGBT issues, and identified lack of training, stigma, and residents concealing their identity as the greatest barriers to quality care. Mental health providers in LTC facilities would benefit from more training in LGBT-specific mental health problems and evidence-based treatments, and efforts to destigmatize LGBT identities in these settings might improve access to mental health care. LGBT-specific training and EBTs are needed. Facilities need to address stigma with residents and providers.

Dynamics of Russian Employers' Perceptions on the Training Quality of Specialists in the System of Secondary Vocational Education

ERIC Educational Resources Information Center

Vlasova, Tatiana; Krasnova, Evgenia; Abraukhova, Valentina; Safontseva, Natalya

2018-01-01

The paper deals with the evaluation of specialists' professional training quality within the framework of intersectoral, transborder, public and private models of social partnership described in theories by foreign and Russian scientists. Special attention is paid to providing methodological grounds for cooperation between the total subjects…

Acute effects of verbal feedback on upper-body performance in elite athletes.

PubMed

Argus, Christos K; Gill, Nicholas D; Keogh, Justin Wl; Hopkins, Will G

2011-12-01

Argus, CK, Gill, ND, Keogh, JWL, and Hopkins, WG. Acute effects of verbal feedback on upper-body performance in elite athletes. J Strength Cond Res 25(12): 3282-3287, 2011-Improved training quality has the potential to enhance training adaptations. Previous research suggests that receiving feedback improves single-effort maximal strength and power tasks, but whether quality of a training session with repeated efforts can be improved remains unclear. The purpose of this investigation was to determine the effects of verbal feedback on upper-body performance in a resistance training session consisting of multiple sets and repetitions in well-trained athletes. Nine elite rugby union athletes were assessed using the bench throw exercise on 4 separate occasions each separated by 7 days. Each athlete completed 2 sessions consisting of 3 sets of 4 repetitions of the bench throw with feedback provided after each repetition and 2 identical sessions where no feedback was provided after each repetition. When feedback was received, there was a small increase of 1.8% (90% confidence limits, ±2.7%) and 1.3% (±0.7%) in mean peak power and velocity when averaged over the 3 sets. When individual sets were compared, there was a tendency toward the improvements in mean peak power being greater in the second and third sets. These results indicate that providing verbal feedback produced acute improvements in upper-body power output of well-trained athletes. The benefits of feedback may be greatest in the latter sets of training and could improve training quality and result in greater long-term adaptation.

SESD TRAINING ACTIVITIES: JUNE 2004 - SEPT. 2005

EPA Science Inventory

Each year, SESD provides training and technical assistance to hundreds of students in EPA Region 4. Training courses are presented to Region 4 employees, Region 4 States, Indian Tribes, Universities and other Federal Agencies in the areas of Air Quality Monitoring, Hazardous Wast...

Development of a computer-based training (CBT) course for the FSUTMS comprehensive modeling workshop.

DOT National Transportation Integrated Search

2008-09-01

FSUTMS training is a major activity of the Systems Planning Office of the Florida Department of : Transportation (FDOT). The training aims to establish and maintain quality assurance for consistent : statewide modeling standards and provide up-to-dat...

Medical improvisation training to enhance the antenatal counseling skills of neonatologists and neonatal fellows: a pilot study.

PubMed

Sawyer, Taylor; Fu, Belinda; Gray, Megan; Umoren, Rachel

2017-08-01

Neonatologists must be skilled at providing antenatal counseling to expectant parents of premature infants at the limits of viability. We conducted a medical improvisation workshop with the objective of enhancing antenatal counseling skills. Pre- and postworkshop questionnaires were collected to examine the impact of the training. A follow-up survey was distributed 3 months after the workshop to examine the impact of the training on antenatal counseling skills. Nine neonatologists and three neonatal fellows participated in the workshop. Participants reported the skills learned in the workshop could enhance the quality of antenatal counseling. On follow-up survey, 90% of subjects reported improvements in the quality of their antenatal counseling. Participation in a medical improvisation workshop resulted in enhancements of self-perceived antenatal counseling skills. Medical improvisation training may provide a feasible and effective method of communication training for neonatologists. Further research into this innovative method are needed.

Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments.

PubMed

D'Haene, Ina; Vander Stichele, Robert H; Pasman, H Roeline W; Noortgate, Nele Van den; Bilsen, Johan; Mortier, Freddy; Deliens, Luc

2009-12-30

The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. A cross-sectional mail survey was sent to all acute hospitals (67 main campuses) in Flanders (Belgium). The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%). While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%). More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Most Flemish acute hospitals have developed a policy on end-of-life practices. However, communication, training and the education of health care providers about these policies is not always provided, and quality assessment tools are used in less than half of the hospitals.

High Fidelity: Investing in Evaluation Training. Ask the Team

ERIC Educational Resources Information Center

Fetters, Jenni

2013-01-01

High-quality training is a crucial investment in establishing and maintaining implementation fidelity as well as building educators' trust in the new process. Training approaches for educator evaluation vary both in format (i.e., how it's delivered) and content (i.e., what is provided). Train-the-trainer sessions, online professional learning…

Learning environment: the impact of clerkship location on instructional quality.

PubMed

Prunuske, Jacob P; Deci, David M

2013-03-01

Students provide variable feedback on instructional quality at ambulatory training sites. We hypothesized several strengths and weaknesses of placing students at resident and non-resident training sites, including differences in faculty behaviors, patient characteristics, work environment, learning opportunities, and levels of student engagement. We systematically assessed for differences in learning quality between clerkship sites with and without residents. Students completed the MedED IQ, a validated survey assessing four domains of instructional quality, after completing a required primary care rotation. We calculated descriptive and summary statistics and two sample tests of proportion analyzing student agreement with each MedEd IQ item with respect to the presence or absence of resident learners. Of 149 total, 113 (75.8%) students completed the MedEd IQ site survey. A greater percentage of students at resident training sites (25.8%) than at non-resident sites (7.3%) agreed with the statement "The opportunities were too diverse, preventing me from developing proficiency." A greater percentage of students at resident training sites (19.4%) than at non-resident sites (1.2%) agreed with the statement "The health care team was not supportive of my learning." There were no differences between sites with or without residents on 14 items measuring preceptor actions or seven items measuring student involvement. Ambulatory clerkship sites with and without residents provide comparable quality learning experiences and precepting. Students placed at resident training sites may be overwhelmed with diverse opportunities and have a less supportive learning environment than students placed at non-resident sites. Future research should evaluate the impact of health care team development programs designed to foster a more supportive training environment for medical students. Ways of aligning residency and medical student education goals within the training setting should be explored.

A Systematic Review of End-of-Life Care Communication Skills Training for Generalist Palliative Care Providers: Research Quality and Reporting Guidance.

PubMed

Brighton, Lisa Jane; Koffman, Jonathan; Hawkins, Amy; McDonald, Christine; O'Brien, Suzanne; Robinson, Vicky; Khan, Shaheen A; George, Rob; Higginson, Irene J; Selman, Lucy Ellen

2017-09-01

End-of-life care (EoLC) communication skills training for generalist palliative care providers is recommended in policy guidance globally. Although many training programs now exist, there has been no comprehensive evidence synthesis to inform future training delivery and evaluation. To identify and appraise how EoLC communication skills training interventions for generalist palliative care providers are developed, delivered, evaluated, and reported. Systematic review. Ten electronic databases (inception to December 2015) and five relevant journals (January 2004 to December 2015) were searched. Studies testing the effectiveness of EoLC communication skills training for generalists were included. Two independent authors assessed study quality. Descriptive statistics and narrative synthesis are used to summarize the findings. From 11,441 unique records, 170 reports were identified (157 published, 13 unpublished), representing 160 evaluation studies of 153 training interventions. Of published papers, eight were of low quality, 108 medium, and 41 high. Few interventions were developed with service user involvement (n = 7), and most were taught using a mixture of didactics (n = 123), reflection and discussion (n = 105), and role play (n = 86). Evaluation designs were weak: <30% were controlled, <15% randomized participants. Over half (n = 85) relied on staff self-reported outcomes to assess effectiveness, and 49% did not cite psychometrically validated measures. Key information (e.g., training duration, participant flow) was poorly reported. Despite a proliferation of EoLC communication skills training interventions in the literature, evidence is limited by poor reporting and weak methodology. Based on our findings, we present a CONSORT statement supplement to improve future reporting and encourage more rigorous testing. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Resources and quality of care in services for the elderly.

PubMed

Winsløw, Jacob Hilden; Borg, Vilhelm

2008-05-01

To investigate the association between resources of the workplace and the quality of care in municipal long-term care. At the municipal level, the resources comprised the proportion of care workers with a long period of professional training and the relative availability of care-giving manpower. At the level of the organizational unit, the resources comprised aspects of the psychosocial working environment. A survey of 7,500 care workers in 36 municipalities in Denmark was performed. Quality of care was measured by seven standardized questions in a questionnaire. Data on the psychosocial resources of the workplace were aggregated responses from the care workers to questions from the Copenhagen Psychosocial Questionnaire. Data on the training and relative availability of care workers were derived by combining information from payroll lists and data available from government databases. There was a positive association between psychosocial resources at the level of the organizational unit and the quality of care provided by the individual care worker. There was no association between the level of professional training of the municipal workforce of care-givers and the quality of care provided by the individual care worker. There was a complex relationship between the relative availability of care-giving manpower at the municipal level and the quality of care provided by the individual care worker. Improving the psychosocial working environment of care workers is one key to securing sufficient caring staff for the long-term care sector; increasing manpower or increasing the proportion of highly trained staff are not in themselves such keys.

Educational interventions to train healthcare professionals in end-of-life communication: a systematic review and meta-analysis.

PubMed

Chung, Han-Oh; Oczkowski, Simon J W; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

2016-04-29

Practicing healthcare professionals and graduates exiting training programs are often ill-equipped to facilitate important discussions about end-of-life care with patients and their families. We conducted a systematic review to evaluate the effectiveness of educational interventions aimed at providing healthcare professionals with training in end-of-life communication skills, compared to usual curriculum. We searched MEDLINE, Embase, CINAHL, ERIC and the Cochrane Central Register of Controlled Trials from the date of inception to July 2014 for randomized control trials (RCT) and prospective observational studies of educational training interventions to train healthcare professionals in end-of-life communication skills. To be eligible, interventions had to provide communication skills training related to end-of-life decision making; other interventions (e.g. breaking bad news, providing palliation) were excluded. Our primary outcomes were self-efficacy, knowledge and end-of-life communication scores with standardized patient encounters. Sufficiently similar studies were pooled in a meta-analysis. The quality of evidence was assessed using GRADE. Of 5727 candidate articles, 20 studies (6 RCTs, 14 Observational) were included in this review. Compared to usual teaching, educational interventions to train healthcare professionals in end-of-life communication skills were associated with greater self-efficacy (8 studies, standardized mean difference [SMD] 0.57;95% confidence interval [CI] 0.40-0.75; P < 0.001; very low quality evidence), more knowledge (4 studies, SMD 0.76;95% CI 0.40-1.12; p < 0.001; low quality evidence), and improvements in communication scores (8 studies, SMD 0.69; 95% CI 0.41-0.96; p < 0.001; very low quality evidence). There was insufficient evidence to determine whether these educational interventions affect patient-level outcomes. Very low to low quality evidence suggests that end-of-life communication training may improve healthcare professionals' self-efficacy, knowledge, and EoL communication scores compared to usual teaching. Further studies comparing two active educational interventions are recommended with a continued focus on contextually relevant high-level outcomes. PROSPERO CRD42014012913.

Blending Key Ingredients to Assure Quality in Home Health Care.

ERIC Educational Resources Information Center

Griffith, Deloris G.

1986-01-01

Careful staff selection, training, and review are among the methods the author recommends to home care agencies striving to provide top-notch services. Discusses measuring the quality of care employees are providing, accreditation, and the benefits of accreditation. (CT)

The importance of continuing education for transplant coordination staff.

PubMed

Tokalak, Ibrahim; Emiroğlu, Remzi; Karakayali, Hamdi; Bilgin, Nevzat; Haberal, Mehmet

2005-06-01

Continuous quality improvement activities are necessary to achieve excellence at any institution. The Başkent University Hospitals have implemented continuous in-service training programs to improve all health services provided. Also, continuing medical education programs are being instituted in organ procurement and transplantation centers. In addition to receiving basic orientation and training upon hiring, transplant coordination staff complete forms that detail their current training status, further job training needed, and other courses of interest. The information is used to monitor skill levels, to determine the success of educational programs, and to identify further education that is needed. Our aim is to improve the quality of transplant coordination activities and increase organ donation at the hospitals in our network through effective monitoring and evaluation of continuous in-service training. These training programs enhance staff members' understanding of and participation in procedures related to transplantation and improves the total quality of the transplantation process. In the near future, this training model may be used to improve the donor hospital education program in Turkey.

Dissemination and Implementation of Cognitive Behavioral Therapy for Stimulant Dependence: A Randomized Trial Comparison of Three Approaches

PubMed Central

Rawson, Richard A.; Rataemane, Solomon; Rataemane, Lusanda; Ntlhe, Nomvuyo; Fox, Ruthlyn Sodano; McCuller, Jason; Brecht, Mary-Lynn

2012-01-01

This study evaluated the effectiveness of 3 approaches to transferring cognitive behavioral therapy (CBT) to addiction clinicians in the Republic of South Africa (RSA). Clinicians (N = 143) were assigned to 3 training conditions: (1) An in vivo (IV) approach in which clinicians received in-person training and coaching; (2) A distance learning (DL) approach providing training via video conference and coaching through teleconferencing; and (3) A control condition (C) providing a manual and 2-hour orientation. Frequency of use of CBT skills increased significantly with the IV and DL approaches compared to the C approach, and the IV approach facilitated greater use of CBT skills than the DL approach. During the active phase of the study, skill quality declined significantly for clinicians trained in the C condition, whereas those in the DL approach maintained skill quality and those in the IV approach improved skill quality. After coaching was discontinued, clinicians in the IV and DL approaches declined in skill quality. However, those in the IV approach maintained a higher level of skill quality compared to the other approaches. Cost of the IV condition was double that of the DL condition and 10 times greater than the C condition. PMID:23577903

Feasibility of Expanding Services for Very Young Children in the Public Mental Health Setting

ERIC Educational Resources Information Center

Knapp, Penelope K.; Ammen, Sue; Arstein-Kerslake, Cindy; Poulsen, Marie Kanne; Mastergeorge, Ann

2007-01-01

Objective: A quality-improvement study evaluated the feasibility of training mental health providers to provide mental health screening and relationship-based intervention to expand services for children 0 to 5 years of age in eight California county mental health systems from November 2002 to June 2003. State-level training was provided to more…

Investigating the Impact of Peer Feedback in Foreign Language Writing

ERIC Educational Resources Information Center

Levi Altstaedter, Laura

2018-01-01

The present quasi-experimental study aimed at investigating the impact of trained and untrained peer feedback on students' written comment types and writing quality. Significant differences were found in terms of comment types provided: trained students provided a significantly higher number of comments focused on organization and content (global…

Will a Short Training Session Improve Multiple-Choice Item-Writing Quality by Dental School Faculty? A Pilot Study.

PubMed

Dellinges, Mark A; Curtis, Donald A

2017-08-01

Faculty members are expected to write high-quality multiple-choice questions (MCQs) in order to accurately assess dental students' achievement. However, most dental school faculty members are not trained to write MCQs. Extensive faculty development programs have been used to help educators write better test items. The aim of this pilot study was to determine if a short workshop would result in improved MCQ item-writing by dental school faculty at one U.S. dental school. A total of 24 dental school faculty members who had previously written MCQs were randomized into a no-intervention group and an intervention group in 2015. Six previously written MCQs were randomly selected from each of the faculty members and given an item quality score. The intervention group participated in a training session of one-hour duration that focused on reviewing standard item-writing guidelines to improve in-house MCQs. The no-intervention group did not receive any training but did receive encouragement and an explanation of why good MCQ writing was important. The faculty members were then asked to revise their previously written questions, and these were given an item quality score. The item quality scores for each faculty member were averaged, and the difference from pre-training to post-training scores was evaluated. The results showed a significant difference between pre-training and post-training MCQ difference scores for the intervention group (p=0.04). This pilot study provides evidence that the training session of short duration was effective in improving the quality of in-house MCQs.

Quality Interviews with Adult Students and Trainees. A Communications Course in Student Personnel and In-Service Training.

ERIC Educational Resources Information Center

Neely, Margery A.

This book has the following objectives: (1) to sharpen the skills of interviewers to increase the quality of the interview process used with diverse populations; (2) to describe the dynamics of the occupations that use a brief interview in the education and training service-producing industry; and (3) to provide measurement for statistical process…

Implementation of a Clinical Documentation Improvement Curriculum Improves Quality Metrics and Hospital Charges in an Academic Surgery Department.

PubMed

Reyes, Cynthia; Greenbaum, Alissa; Porto, Catherine; Russell, John C

2017-03-01

Accurate clinical documentation (CD) is necessary for many aspects of modern health care, including excellent communication, quality metrics reporting, and legal documentation. New requirements have mandated adoption of ICD-10-CM coding systems, adding another layer of complexity to CD. A clinical documentation improvement (CDI) and ICD-10 training program was created for health care providers in our academic surgery department. We aimed to assess the impact of our CDI curriculum by comparing quality metrics, coding, and reimbursement before and after implementation of our CDI program. A CDI/ICD-10 training curriculum was instituted in September 2014 for all members of our university surgery department. The curriculum consisted of didactic lectures, 1-on-1 provider training, case reviews, e-learning modules, and CD queries from nurse CDI staff and hospital coders. Outcomes parameters included monthly documentation completion rates, severity of illness (SOI), risk of mortality (ROM), case-mix index (CMI), all-payer refined diagnosis-related groups (APR-DRG), and Surgical Care Improvement Program (SCIP) metrics. Financial gain from responses to CDI queries was determined retrospectively. Surgery department delinquent documentation decreased by 85% after CDI implementation. Compliance with SCIP measures improved from 85% to 97%. Significant increases in surgical SOI, ROM, CMI, and APR-DRG (all p < 0.01) were found after CDI/ICD-10 training implementation. Provider responses to CDI queries resulted in an estimated $4,672,786 increase in charges. Clinical documentation improvement/ICD-10 training in an academic surgery department is an effective method to improve documentation rates, increase the hospital estimated reimbursement based on more accurate CD, and provide better compliance with surgical quality measures. Copyright © 2016 American College of Surgeons. All rights reserved.

The ISTSS/Rand guidelines on mental health training of primary healthcare providers for trauma-exposed populations in conflict-affected countries.

PubMed

Eisenman, David; Weine, Stevan; Green, Bonnie; de Jong, Joop; Rayburn, Nadine; Ventevogel, Peter; Keller, Allen; Agani, Ferid

2006-02-01

Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations.

Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

PubMed

Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

2017-11-21

Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in sites offering community outreach and those trained in intervention year two. The number of in-person contacts was significantly associated with achievement of three of four measures. Post-training support holds promise for strengthening health worker performance. Further research is needed to compare this intervention with other approaches and assess how post-training contacts could be incorporated into current health system supervision.

Bulletin of Courses, July 1970 to December 1971, Water Pollution Control Training Program.

ERIC Educational Resources Information Center

Department of the Interior, Washington, DC. Federal Water Pollution Control Administration.

This bulletin describes the courses offered at the five Federal Water Quality Administration training centers in the U.S. from July 1970 to December 1971. Information for applicants, applications for training forms and addresses of related Environmental Training Programs are included. The objective of the program is to provide specialized training…

Training and Support of Sessional Staff to Improve Quality of Teaching and Learning at Universities.

PubMed

Knott, Gillian; Crane, Linda; Heslop, Ian; Glass, Beverley D

2015-06-25

Sessional staff is increasingly involved in teaching at universities, playing a pivotal role in bridging the gap between theory and practice for students, especially in the health professions, including pharmacy. Although sessional staff numbers have increased substantially in recent years, limited attention has been paid to the quality of teaching and learning provided by this group. This review will discuss the training and support of sessional staff, with a focus on Australian universities, including the reasons for and potential benefits of training, and structure and content of training programs. Although sessional staff views these programs as valuable, there is a lack of in-depth evaluations of the outcomes of the programs for sessional staff, students and the university. Quality assurance of such programs is only guaranteed, however, if these evaluations extend to the impact of this training and support on student learning.

Linking Community Hospital Initiatives With Osteopathic Medical Students' Quality Improvement Training: A Pilot Program.

PubMed

Brannan, Grace D; Russ, Ronald; Winemiller, Terry R; Mast, Eric

2016-01-01

Quality improvement (QI) continues to be a health care challenge, and the literature indicates that osteopathic medical students need more training. To qualify for portions of managed care reimbursement, hospitals are required to meet measures intended to improve quality of care and patient satisfaction, which may be challenging for small community hospitals with limited resources. Because osteopathic medical training is grounded on community hospital experiences, an opportunity exists to align the outcomes needs of hospitals and QI training needs of students. In this pilot program, 3 sponsoring hospitals recruited and mentored 1 osteopathic medical student each through a QI project. A mentor at each hospital identified a project that was important to the hospital's patient care QI goals. This pilot program provided osteopathic medical students with hands-on QI training, created opportunities for interprofessional collaboration, and contributed to hospital initiatives to improve patient outcomes.

How To Work with Small Businesses: Advice and Guidance for Providers of Training and Business Support.

ERIC Educational Resources Information Center

Allen, Anne Marie, Ed.

This publication provides guidance on good practice to help training providers in the United Kingdom improve the quality and relevance of services to small and medium-sized enterprises (SMEs). Section 1 focuses on key research findings regarding SMEs' needs and SME-college collaboration, including trading conditions for SMEs; services on offer by…

Associations between state regulations, training length, perceived quality and job satisfaction among certified nursing assistants: cross-sectional secondary data analysis.

PubMed

Han, Kihye; Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy; Johantgen, Meg; Gartrell, Kyungsook

2014-08-01

In the U.S., there are federal requirements on how much training and annual continuing education a certified nursing assistant must complete in order to be certified. The requirements are designed to enable them to provide competent and quality care to nursing home residents. Many states also require additional training and continuing education hours as improved nursing home quality indicators have been found to be related to increased training. This study investigated the associations among state level regulations, initial training quality and focus, and job satisfaction in certified nursing assistants. Cross-sectional secondary data analysis. This study used the National Nursing Home Survey and National Nursing Assistant Survey as well as data on state regulations of certified nursing assistant training. 2897 certified nursing assistants in 580 nursing homes who were currently working at a nursing home facility, who represented 680,846 certified nursing assistants in US. State regulations were related to initial training and job satisfaction among certified nursing assistants using chi square tests and binomial logistic regression models. Analyses were conducted using SAS-callable SUDAAN to correct for complex sampling design effects in the National Nursing Home Survey and National Nursing Assistant Survey. Models were adjusted for personal and facility characteristics. Certified nursing assistants reporting high quality training were more likely to work in states requiring additional initial training hours (p=0.02) and were more satisfied with their jobs (OR=1.51, 95% CI=1.09-2.09) than those with low quality training. In addition, those with more training focused on work life skills were 91% more satisfied (OR=1.91, 95% CI=1.41-2.58) whereas no relationship was found between training focused on basic care skills and job satisfaction (OR=1.36, 95% CI=0.99-1.84). Certified nursing assistants with additional initial training were more likely to report that their training was of high quality, and this was related to job satisfaction. Job satisfaction was also associated with receiving more training that focused on work life skills. Federal training regulations should reconsider additional hours for certified nursing assistant initial training, and include work life skills as a focus. As job satisfaction has been linked to nursing home turnover, attention to training may improve satisfaction, ultimately reducing staff turnover. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluator Training: Content and Topic Valuation in University Evaluation Courses

ERIC Educational Resources Information Center

Davies, Randall; MacKay, Kathryn

2014-01-01

Quality training opportunities for evaluators will always be important to the evaluation profession. While studies have documented the number of university programs providing evaluation training, additional information is needed concerning what content is being taught in current evaluation courses. This article summarizes the findings of a survey…

Employee Upgrading for a Quality Workforce.

ERIC Educational Resources Information Center

Drier, Harry N.; And Others

This training program is a model for recruiting and training counselors to address the career development and educational planning needs of current employees. Section A is directed to the instructor who will train counselors to provide career development assistance to employees of an organization. It describes the program concept and discusses…

Evaluating the MESSAGE Communication Strategies in Dementia training for use with community-based aged care staff working with people with dementia: a controlled pretest-post-test study.

PubMed

Conway, Erin R; Chenery, Helen J

2016-04-01

The study aims to evaluate the effects of a communication skills training programme on community aged care staff's knowledge of communication support in dementia and on staff's care experience. Dementia can lead to impairments in communication. Therefore, quality community-based dementia care requires that staff be skilled communicators, equipped to facilitate interactions with people with dementia. The current investigation evaluated the effectiveness of the MESSAGE Communication Strategies in Dementia for Care Staff training programme with respect to knowledge of communication support and the staff/caregiver experience. A multi-centre controlled pretest/post-test design with randomised cohort allocation was used. Outcome measures were completed at baseline, immediately after training (training group only), and at three-month follow-up. Thirty-eight care staff working in community aged care participated and completed all outcome measures (training = 22; control = 16).Training and control groups completed the following outcome measures: knowledge of communication support strategies, self-efficacy, preparedness to provide care, strain in nursing care and attitude to dementia care. Staff in the training group provided written feedback on the training. A significant improvement in knowledge scores from baseline was found for the training group both immediately after training and at three-month follow-up. There was also a significant training effect for self-efficacy and preparedness to provide care. No significant difference was found for the control group for any measure. No significant training effects were found for measures of strain or attitudes to dementia care. Feedback from staff suggests that the training was well received. The MESSAGE training was positively received by staff and had a significant effect on care staff knowledge, and confidence to provide care for people with dementia. The easily accessible multimedia training programme is well received by staff and has the potential to improve quality of care. © 2016 John Wiley & Sons Ltd.

Quality of Malaysian Teachers Based on Education and Training: A Benefit and Earnings Returns Analysis Using Human Capital Theory

ERIC Educational Resources Information Center

Ismail, Ramlee; Awang, Marinah

2017-01-01

Purpose: The purpose of this paper is to investigate how the quality of teachers based on education and training provided under new reform policies in Malaysia affects their earnings outcomes. The study conducted a benefit and returns analysis guided by human capital theory. Design/methodology/approach: The study used survey research methods to…

[Private medical education in Germany].

PubMed

Schwörer, Beatrix; Wissing, Frank

2018-02-01

Through the years, a range of privately funded medical training opportunities has been established in Germany. Only a few of them operate along the German Medical Licensure Act and thus underlie quality assurance regulations in Germany. Most of the courses are a result of German hospitals cooperating with universities from other EU countries. The content of the courses and the examinations underlie the regulations of the university's home country. This article aims to give an overview of the private medical training opportunities offered in Germany and to show differences compared to state funded German medical schools. The authors discuss the opportunities of private medical training as well as its challenges and risks. Basic principles concerning finances and quality assurance of national and international private medical training are provided. Regardless of their mode of financing, the superior goal of the training, according to the German Medical Licensure Act, should always be to enable young doctors to pursue further professional training, so that they can maintain the best possible quality in patient care, research, and medical education.

Continuing Training Providers: Activities, Aims and Publics.

ERIC Educational Resources Information Center

Charraud, Anne-Marie; And Others

1996-01-01

The variety and growing number of continuing training providers in France have led the government to question whether these bodies constitute full-fledged service producers functioning in a market situation. In the absence of quality standards and rules governing competition, many questions arise as to the ways it is to be implemented and…

Entry Level Skills for the Event Management Profession: Implications for Curriculum Development

ERIC Educational Resources Information Center

Fletcher, Donna; Dunn, Julie; Prince, Rosemary

2009-01-01

The rapid growth of the event industry has resulted in a world-wide demand for education and training programs in event management. While the professional associations in event management have provided providing quality training and credentialing for their members, the 140 colleges and universities preparing students for entry level positions in…

Assessment of an intervention to train teaching hospital care providers in quality management

PubMed Central

Francois, P; Vinck, D; Labarere, J; Reverdy, T; Peyrin, J

2005-01-01

Background: Successful implementation of continuous quality improvement (CQI) programs in hospitals remains rare in all countries, making it necessary to experiment with implementation methods while considering the cultural factors of resistance to change. Objective: To assess the impact of an educational intervention on involvement of clinical department staff in the quality process. Setting: Twelve voluntary clinical departments (six experimental and six controls) in a French 2000-bed university hospital comprising 40 clinical departments. Intervention: Three day training seminar to a group of 12–20 staff members from each department. Design: Quasi-experimental post-test only design study with control group conducted 12 months after the intervention with a questionnaire completed in a face-to-face interview. Subjects: 98 trained staff and 100 untrained staff from the six experimental departments and 100 staff from the six control departments. Principal measurements: Declared knowledge of the CQI methods and participation in quality management activities. Results: 286 people (96%) were involved in the study. More of the trained staff knew the CQI methods (62.4%) than staff in the control departments (16.5%) (adjusted odds ratio (ORa) = 10.6 (95% CI 4.97 to 22.62)). More trained staff also participated in quality improvement work groups than control department staff (76.3% v 14.0%; ORa = 27.4 (95% CI 11.6 to 64.4)). In the experimental departments the untrained staff's knowledge of CQI methods and their participation in work groups did not differ from that of control department staff. Conclusions: A continuing education intervention can involve care providers in CQI. Dissemination of knowledge from trained personnel to other staff members remains limited. PMID:16076785

Developing Patient-Centered Communication Skills Training for Oncologists: Describing the Content and Efficacy of Training

ERIC Educational Resources Information Center

Brown, Richard F.; Bylund, Carma L.; Gueguen, Jennifer A.; Diamond, Catherine; Eddington, Julia; Kissane, David

2010-01-01

Communication Skills Training (CST) is a proven aid to help oncologists achieve high quality patient-centered communication. No research studies have provided clear guidelines for developing the content of CST. The aim of this work is to describe a method of developing such content and evaluation of effectiveness of CST training workshops (based…

Training and Assessment (TAA40104) in Community Providers in New South Wales: Participant Intentions and Outcomes. Occasional Paper

ERIC Educational Resources Information Center

Walker, Ruth

2010-01-01

Five years after implementation, the Certificate IV in Training and Assessment (TAA40104, and hereafter also referred to as the Certificate IV) remains a pivotal qualification in the national vocational education and training (VET) system. Under the Australian Quality Training Framework (AQTF) it is the qualification required by both workplace…

Practical strategies for increasing efficiency and effectiveness in critical care education.

PubMed

Joyce, Maurice F; Berg, Sheri; Bittner, Edward A

2017-02-04

Technological advances and evolving demands in medical care have led to challenges in ensuring adequate training for providers of critical care. Reliance on the traditional experience-based training model alone is insufficient for ensuring quality and safety in patient care. This article provides a brief overview of the existing educational practice within the critical care environment. Challenges to education within common daily activities of critical care practice are reviewed. Some practical evidence-based educational approaches are then described which can be incorporated into the daily practice of critical care without disrupting workflow or compromising the quality of patient care. It is hoped that such approaches for improving the efficiency and efficacy of critical care education will be integrated into training programs.

Plastic Surgery Training Worldwide: Part 1. The United States and Europe

PubMed Central

Kamali, Parisa; van Paridon, Maaike W.; Ibrahim, Ahmed M. S.; Paul, Marek A.; Winters, Henri A.; Martinot-Duquennoy, Veronique; Noah, Ernst Magnus; Pallua, Norbert

2016-01-01

Background: Major differences exist in residency training, and the structure and quality of residency programs differ between different countries and teaching centers. It is of vital importance that a better understanding of the similarities and differences in plastic surgery training be ascertained as a means of initiating constructive discussion and commentary among training programs worldwide. In this study, the authors provide an overview of plastic surgery training in the United States and Europe. Methods: A survey was sent to select surgeons in 10 European countries that were deemed to be regular contributors to the plastic surgery literature. The questions focused on pathway to plastic surgery residency, length of training, required pretraining experience, training scheme, research opportunities, and examinations during and after plastic surgery residency. Results: Plastic surgery residency training programs in the United States differ from the various (selected) countries in Europe and are described in detail. Conclusions: Plastic surgery education is vastly different between the United States and Europe, and even within Europe, training programs remain heterogeneous. Standardization of curricula across the different countries would improve the interaction of different centers and facilitate the exchange of vital information for quality control and future improvements. The unique characteristics of the various training programs potentially provide a basis from which to learn and to gain from one another. PMID:27257571

Quality of child healthcare at primary healthcare facilities: a national assessment of the Integrated Management of Childhood Illnesses in Afghanistan.

PubMed

Mansoor, Ghulam Farooq; Chikvaidze, Paata; Varkey, Sherin; Higgins-Steele, Ariel; Safi, Najibullah; Mubasher, Adela; Yusufi, Khaksar; Alawi, Sayed Alisha

2017-02-01

To assess quality of the national Integrated Management of Childhood Illness (IMCI) program services provided for sick children at primary health facilities in Afghanistan. Mixed methods including cross-sectional study. Thirteen (of thirty-four) provinces in Afghanistan. Observation of case management and re-examination of 177 sick children, exit interviews with caretakers and review of equipment/supplies at 44 health facilities. Introduction and scale up of Integrated Management of Childhood Illnesses at primary health care facilities. Care of sick children according to IMCI guidelines, health worker skills and essential health system elements. Thirty-two (71%) of the health workers were trained in IMCI and five (11%) received supervision in clinical case management during the past 6 months. On average, 5.4 out of 10 main assessment tasks were performed during cases observed, the index being higher in children seen by trained providers than untrained (6.3 vs 3.5, 95% CI 5.8-6.8 vs 2.9-4.1). In all, 74% of the 104 children who needed oral antibiotics received prescriptions, while 30% received complete and correct advice and 30% were overprescribed, and more so by untrained providers. Home care counseling was associated with provider training status (41.3% by trained and 24.5% by untrained). Essential oral and pre-referral injectable medicine and equipment/supplies were available in 66%, 23%, and 45% of health facilities, respectively. IMCI training improved assessment, rational use of antibiotics and counseling; further investment in IMCI in Afghanistan, continuing provider capacity building and supportive supervision for improved quality of care and counseling for sick children is needed, especially given high burden treatable childhood illness. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Are you good enough for your patients? The European certification model in laparoscopic surgery

PubMed Central

Campo, R.; Molinas, C.R.; De Wilde, R.L.; Brolmann, H.; Brucker, S.; Mencaglia, L.; Odonovan, P.; Wallwiener, D.; Wattiez, A.

2012-01-01

Quality control, training and education in gynaecological surgery are challenged and urgent measures are emerging. The implementation of a structured and validated program for training and quality control seems the most urgent measurement to be taken. The European Academy of Gynaecological Surgery has made a first attempt to do so. Through a practical and theoretical tests system, the skills of an individual surgeon is measured and the conditions to enter the different level of expertise are clearly defined. This certification system based on the best possible level of scientific evidence provides a first practical tool, universally implementable for a decent quality control and structured training program in Gynaecological laparoscopic surgery. PMID:24753896

Automatic assessment of voice quality according to the GRBAS scale.

PubMed

Sáenz-Lechón, Nicolás; Godino-Llorente, Juan I; Osma-Ruiz, Víctor; Blanco-Velasco, Manuel; Cruz-Roldán, Fernando

2006-01-01

Nowadays, the most extended techniques to measure the voice quality are based on perceptual evaluation by well trained professionals. The GRBAS scale is a widely used method for perceptual evaluation of voice quality. The GRBAS scale is widely used in Japan and there is increasing interest in both Europe and the United States. However, this technique needs well-trained experts, and is based on the evaluator's expertise, depending a lot on his own psycho-physical state. Furthermore, a great variability in the assessments performed from one evaluator to another is observed. Therefore, an objective method to provide such measurement of voice quality would be very valuable. In this paper, the automatic assessment of voice quality is addressed by means of short-term Mel cepstral parameters (MFCC), and learning vector quantization (LVQ) in a pattern recognition stage. Results show that this approach provides acceptable results for this purpose, with accuracy around 65% at the best.

Aquatic exercise training and stable heart failure: A systematic review and meta-analysis.

PubMed

Adsett, Julie A; Mudge, Alison M; Morris, Norman; Kuys, Suzanne; Paratz, Jennifer D

2015-01-01

A meta-analysis and review of the evidence was conducted to determine the efficacy of aquatic exercise training for individuals with heart failure compared to traditional land-based programmes. A systematic search was conducted for studies published prior to March 2014, using MEDLINE, PUBMED, Cochrane Library, CINAHL and PEDro databases. Key words and synonyms relating to aquatic exercise and heart failure comprised the search strategy. Interventions included aquatic exercise or a combination of aquatic plus land-based training, whilst comparator protocols included usual care, no exercise or land-based training alone. The primary outcome of interest was exercise performance. Studies reporting on muscle strength, quality of life and a range of haemodynamic and physiological parameters were also reviewed. Eight studies met criteria, accounting for 156 participants. Meta-analysis identified studies including aquatic exercise to be superior to comparator protocols for 6 minute walk test (p < 0.004) and peak power (p < 0.044). Compared to land-based training programmes, aquatic exercise training provided similar benefits for VO(2peak), muscle strength and quality of life, though was not superior. Cardiac dimensions, left ventricular ejection fraction, cardiac output and BNP were not influenced by aquatic exercise training. For those with stable heart failure, aquatic exercise training can improve exercise capacity, muscle strength and quality of life similar to land-based training programmes. This form of exercise may provide a safe and effective alternative for those unable to participate in traditional exercise programmes. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

Hazardous Materials Management and Emergency Response Training Center at Hanford

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

Ollero, J.; Muth, G.; Bergland, R.

1994-12-31

The Hanford Site will provide high-fidelity training using simulated job-site situations to prepare workers for known and unknown hazards. Hanford is developing the Hazardous Materials Management and Emergency Response (HAMMER) Training Center to operate as a user facility for the site, region and international labor unions. The center will focus on providing hands-on, realistic training situations. The Training Center is a partnership among U.S. Department of Energy (DOE); its contractors; labor; local, state, and tribal governments; Xavier and Tulane Universities of Louisiana and other Federal agencies. The hands-on training aids at HAMMER is justified based on regulatory training requirements, themore » desire for enhanced safety, and the commitment to continuous improvement of training quality.« less

Effects of respite care training on respite provider knowledge and confidence, and outcomes for family caregivers receiving respite services.

PubMed

Ackerman, Lynn; Sheaffer, Lois

2018-01-01

Respite services are vital in supporting informal caregivers in need of a break from their caregiving duties. A respite training program aimed at developing respite provider competence and improving caregiver well-being was evaluated. Trainees experienced significant growth in their perceived respite knowledge and confidence to deliver respite from pretraining to posttraining. An objective core competency assessment confirmed posttraining knowledge in 10 core areas of respite. Family caregivers provided more favorable ratings on various measures of their well-being while receiving respite from a trained provider compared to before respite began and if respite were to end. Findings suggest that formal training prepares providers to deliver quality respite resulting in improved caregiver outcomes.

Effects on centre-based training and home-based training on physical function, quality of life and fall incidence in community dwelling older adults.

PubMed

Kwok, Thomas M K; Tong, C Y

2014-05-01

This was a quasi-experimental study to compare the effects of center-based training with home-based training on physical function, quality of life and fall incidence in older adults. Fifty older adults were recruited to receive exercise training for 6 months. Participants in the center-based group received training under supervision of a physiotherapist at the day training center. Those in the home-based group received training assisted by a care worker at home. The outcome measures were the Elderly Mobility Scale (EMS), Berg Balance Scale (BBS), Numeric Pain Rating Scale (NPRS), Short-form 12 (SF-12) and fall incidence. Assessments were performed on all participants before and after the 6-month intervention period. Center-based training supervised by a physiotherapist was found to have beneficial effects on physical function, quality of life and fall incidence while home-based training assisted by a care worker had no effect on physical condition and self-rated health status in community dwelling older adults. Service agents should provide center-based or home-based training to the ageing population in a user-friendly way with consideration of factors such as rehabilitation potential and accessibility of transportation.

Strength training for athletes: does it really help sports performance?

PubMed

McGuigan, Michael R; Wright, Glenn A; Fleck, Steven J

2012-03-01

The use of strength training designed to increase underlying strength and power qualities in elite athletes in an attempt to improve athletic performance is commonplace. Although the extent to which strength and power are important to sports performance may vary depending on the activity, the associations between these qualities and performance have been well documented in the literature. The purpose of this review is to provide a brief overview of strength training research to determine if it really helps improve athletic performance. While there is a need for more research with elite athletes to investigate the relationship between strength training and athletic performance, there is sufficient evidence for strength training programs to continue to be an integral part of athletic preparation in team sports.

Competence and Competency-based Training: What the Literature Says

ERIC Educational Resources Information Center

Guthrie, Hugh

2009-01-01

This literature review, commissioned by the National Quality Council, provides a historical account of the development of competency-based training in Australia and summarises the issues arising from the range of reviews conducted on elements of the national training system. It also explores the variety of ways in which competence is conceived…

Evaluation of erosion and sedimentation associated with tracked vehicle training

Treesearch

Jackie F. Crim; Jon E. Schoonover; Karl W.J. Williard; John W. Groninger; James J. Zaczek; Charles M. Ruffner

2011-01-01

A project was designed to assess erosion and sedimentation associated with tracked vehicle training in the Ft. Knox Military Reservation in Kentucky. The project provided an extensive physical and biotic characterization of the training area, including hydrology, water quality, soils, and vegetation. To determine any changes in channel morphology, cross sections were...

Institute for Business, Industry and Government: Serving Training Needs Locally.

ERIC Educational Resources Information Center

Gramm, Linda A.

The Institute for Business, Industry and Government was established at Orange County Community College (New York) in April 1984 for the purpose of providing high quality, cost-effective training taught by qualified professionals at convenient locations and to develop methods of measuring training effectiveness. Since its first year of offering…

A Comprehensive Planning Model and Delivery System for Leadership Training Programs.

ERIC Educational Resources Information Center

Janosik, Steven M.; Sina, Julie A.

1988-01-01

Presents an eight-step planning model that operationally defines a comprehensive delivery systems approach to campuswide leadership training. Lists four goals of the model: to increase efficiency of leadership training through shared resources, to decrease costs, to provide quality control, and to increase impact of programming effort by creating…

Defining the Engaging Learning Experience from the Athletic Training Student Perspective

ERIC Educational Resources Information Center

Mazerolle, Stephanie M.; Bowman, Thomas G.; Benes, Sarah S.

2014-01-01

Context: Clinical experiences are an integral part of athletic training education and are where students gain the hands-on, practical knowledge and skills necessary to provide quality patient care in the field. However, some clinical education experiences may not allow athletic training students to become clinically integrated. Objective: To…

Creative Partnership Structures: Innovative Ways To Link Colleges and Employers.

ERIC Educational Resources Information Center

Meighan, John E.

To provide cost effective, quality training to businesses and industrial organizations in central Ohio, Columbus State Community College (CSCC) established the Business and Industry Training Division (BITD) in 1986. The Division has increased the sales of training programs and the number of credit and non-credit class sections, and in 1994,…

Early years postgraduate surgical training programmes in the UK are failing to meet national quality standards: An analysis from the ASiT/BOTA Lost Tribe prospective cohort study of 2,569 surgical trainees.

PubMed

2018-04-01

This study aimed to assess training of Senior House Officer-grade equivalent doctors in postgraduate surgical training or service (SHO-DIPST) in surgical specialties across the United Kingdom (UK), against nationally agreed Joint Committee on Surgical Training Quality Indicators (JCST QIs). Specific recommendations are made, with a view to improving quality of training, workforce retention and recruitment to Higher Surgical Training. Prospective, observational, multicentre study conducted by the Association of Surgeons in Training, using the UK National Research Collaborative model. Any centres in the UK providing acute surgical services were eligible. SHO-DIPST with a permanent contract, on out-of-hours 'on-call rota' were included across four, one-week data capture periods (September to October 2016, February to March 2017). Adherence to five quality indicators was reported using descriptive statistics. P-values were calculated using Student's t-test for continuous data, with a 5% level of significance. 2569 SHO-DIPST were included from all ten surgical specialties in 141 NHS trusts across all 16 Local Education and Training Boards in the UK. 960 SHO-DIPST were in registered 'training' posts (37.3%). The median number of SHO-DIPST per rota was 7.0 (IQR 5.0-9.0). Adherence to the five included JCST QIs ranged from 6.0 to 53.1%. Only four SHO-DIPST posts across the study population met all five JCST QIs (0.3%). The total number of training sessions was higher for those in registered training posts (p < 0.001), with significant specialty and regional variation. Only four early years postgraduate surgical training posts in the UK meet nationally approved minimum quality standards. Specific recommendations are made to improve training in this cohort and to bolster recruitment and retention into Higher Surgical Training. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

BASINS Tutorials and Training

EPA Pesticide Factsheets

A series of lectures and exercises on how to use BASINS for water quality modeling and watershed assessment. The lectures follow sequentially. Companion exercises are provided for users to practice different BASINS water quality modeling techniques.

A cost-effectiveness study of ICT training among the visually impaired in the Netherlands.

PubMed

Patty, Nathalie J S; Koopmanschap, Marc; Holtzer-Goor, Kim

2018-04-17

Due to the ageing population, the number of visually impaired people in the Netherlands will increase. To ensure the future availability of services in rehabilitative eye care, we aim to assess the cost-effectiveness of information and communication technology (ICT) training among visually impaired adults from a societal perspective, using primary data from two large rehabilitative eye care providers in the Netherlands. Participants were asked to fill in a questionnaire, which used six different instruments at three different time points: pre training, post training and three months post training. We investigated whether the participants' quality of life and well-being improved after the training and whether this improvement persisted three months post training. Economic evaluation was conducted by comparing costs and outcomes before and after training. Quality of life and well-being were derived from the EQ-5D and ICECAP-O, respectively. Costs for productivity losses and medical consumption were obtained from the questionnaires. Information regarding the costs of training sessions was provided by the providers. Thirty-eight participants filled in all three questionnaires. The mean age at baseline was 63 years (SD = 16). The effect of ICT training on ICT skills and participants' well-being was positive and persisted three months after the last training session. Assuming these effects remain constant for 10 years, this would result in an incremental cost-effectiveness ratio (ICER) of € 11,000 per quality-adjusted life-year (QALY) and € 8000 per year of well-being gained, when only the costs of ICT training are considered. When the total costs of medical consumption are included, the ICER increases to € 17,000 per QALY gained and € 12,000 per year of well-being gained. Furthermore, when the willingness-to-pay threshold is € 20,000 per year of well-being, the probability that ICT training will be cost-effective is 75% (91% when including only the costs of ICT training). Our study suggests that ICT training among the visually impaired is cost-effective when the effects of ICT training on well-being persist for several years. However, further research involving a larger sample and incorporating long-term effects should be conducted.

IMMUNISATION TRAINING NEEDS IN MALAWI.

PubMed

Tsega, A Y; Hausi, H T; Steinglass, R; Chirwa, G Z

2014-09-01

The Malawi Ministry of Health (MOH) and its immunisation partners conducted a training needs assessment in May 2013 to assess the current status of immunisation training programmemes in health training institutions, to identify unmet training needs, and to recommend possible solutions for training of health workers on a regular basis. A cross-sectional, descriptive study. Health training institutions in Malawi, a developing country that does not regularly update its curricula to include new vaccines and management tools, nor train healthcare workers on a regular basis. Researchers interviewed Malawi's central immunisation manager, three zonal immunisation officers, six district officers, 12 health facility immunisation coordinators, and eight principals of training institutions. All health training institutions in Malawi include immunisation in their preservice training curricula. However, the curriculum is not regularly updated; thus, the graduates are not well equipped to provide quality services. In addition, the duration of the training curriculum is inadequate, and in-service training sessions for managers and service providers are conducted only on an ad hoc basis. All levels of Malawi's health system have not met sufficient training needs for providing immunisations, and the health training institutions teach their students with outdated materials. It is recommended that the training institutions update their training curricula regularly and the service providers are trained on a regular basis.

Remote tele-mentored ultrasound for non-physician learners using FaceTime: A feasibility study in a low-income country.

PubMed

Robertson, Thomas E; Levine, Andrea R; Verceles, Avelino C; Buchner, Jessica A; Lantry, James H; Papali, Alfred; Zubrow, Marc T; Colas, L Nathalie; Augustin, Marc E; McCurdy, Michael T

2017-08-01

Ultrasound (US) is a burgeoning diagnostic tool and is often the only available imaging modality in low- and middle-income countries (LMICs). However, bedside providers often lack training to acquire or interpret US images. We conducted a study to determine if a remote tele-intensivist could mentor geographically removed LMIC providers to obtain quality and clinically useful US images. Nine Haitian non-physician health care workers received a 20-minute training on basic US techniques. A volunteer was connected to an intensivist located in the USA via FaceTime. The intensivist remotely instructed the non-physicians to ultrasound five anatomic sites. The tele-intensivist evaluated the image quality and clinical utility of performing tele-ultrasound in a LMIC. The intensivist agreed (defined as "agree" or "strongly agree" on a five-point Likert scale) that 90% (57/63) of the FaceTime images were high quality. The intensivist felt comfortable making clinical decisions using FaceTime images 89% (56/63) of the time. Non-physicians can feasibly obtain high-quality and clinically relevant US images using video chat software in LMICs. Commercially available software can connect providers in institutions in LMICs to geographically removed intensivists at a relatively low cost and without the need for extensive training of local providers. Copyright © 2017 Elsevier Inc. All rights reserved.

The Effects of Training Institution Practice Costs, Quality, and Other Characteristics on Future Practice

PubMed Central

Phillips, Robert L.; Petterson, Stephen M.; Bazemore, Andrew W.; Wingrove, Peter; Puffer, James C.

2017-01-01

PURPOSE Medicare beneficiary spending patterns reflect those of the 306 Hospital Referral Regions where physicians train, but whether this holds true for smaller areas or for quality is uncertain. This study assesses whether cost and quality imprinting can be detected within the 3,436 Hospital Service Areas (HSAs), 82.4 percent of which have only 1 teaching hospital, and whether sponsoring institution characteristics are associated. METHODS We conducted a secondary, multi-level, multivariable analysis of 2011 Medicare claims and American Medical Association Masterfile data for a random, nationally representative sample of family physicians and general internists who completed residency between 1992 and 2010 and had more than 40 Medicare patients (3,075 physicians providing care to 503,109 beneficiaries). Practice and training locations were matched with Dartmouth Atlas HSAs and categorized into low-, average-, and high-cost spending groups. Practice and training HSAs were assessed for differences in 4 diabetes quality measures. Institutional characteristics included training volume and percentage of graduates in rural practice and primary care. RESULTS The unadjusted, annual, per-beneficiary spending difference between physicians trained in high- and low-cost HSAs was $1,644 (95% CI, $1,253–$2,034), and the difference remained significant after controlling for patient and physician characteristics. No significant relationship was found for diabetes quality measures. General internists were significantly more likely than family physicians to train in high-cost HSAs. Institutions with more graduates in rural practice and primary care produced lower-spending physicians. CONCLUSIONS The “imprint” of training spending patterns on physicians is strong and enduring, without discernible quality effects, and, along with identified institutional features, supports measures and policy options for improved graduate medical education outcomes. PMID:28289113

Improving access to services and interactions with clients in Guatemala: the value of distance learning.

PubMed

Brambila, Carlos; Lopez, Felipe; Garcia-Colindres, Julio; Donis, Marco Vinicio

2005-04-01

To develop and test a distance-learning programme to improve the quality and efficiency of family planning services in Guatemala. The setting was rural family planning services in Guatemala. The study design was quasi-experimental with one intervention and one control group and with pre- and post-intervention measures. Two staff members from each of 20 randomly selected health districts were trained as leaders of the training programme. In turn, the 40 trainers trained a total of 240 service providers, under the supervision of four health area facilitators. The results were compared with 20 randomly selected control health districts. The intervention was a distance-learning programme including 40 in-class hours followed by 120 inservice practice hours spread over a 4-month period. Distinctively, the programme used a cascade approach to training, intensive supervision, and close monitoring and evaluation. Patient flow analysis was used to determine number of contacts, waiting times, and the interaction time between service providers and clients. Consultation observations were used to assess the quality and completeness of reproductive health information and services received by clients. The intervention showed a positive impact on reducing the number of contacts before the consultation and client waiting times. More complete services and better quality services were provided at intervention clinics. Some, but not all, of the study objectives were attained. The long-term impact of the intervention is as yet unknown. Distance-learning programmes are an effective methodology for training health professionals in rural areas.

How trained volunteers can improve the quality of hospital care for older patients. A qualitative evaluation within the Hospital Elder Life Program (HELP).

PubMed

Steunenberg, Bas; van der Mast, Roos; Strijbos, Marije J; Inouye, Sharon K; Schuurmans, Marieke J

The aim of this study was to investigate, using a mixed-methods design, the added value of a trained Hospital Elder Life Program (HELP) volunteer to the quality of hospital care in the Netherlands. The trained volunteers daily stimulate older patients, at risk of a delirium, to eat, to drink, and to exercise, and they provide walking assistance and cognitive stimulation. This study showed that each group appreciated the extra attention and service from the volunteers. The positive effect on feelings of loneliness during the hospital stay was an unexpected outcome. The volunteers themselves appreciated their work. In conclusion, a HELP volunteer should be provided to every older hospital patient. Copyright © 2016 Elsevier Inc. All rights reserved.

United States Pharmacopeial Convention

MedlinePlus

... Online USP Compounding USP Donor Portal Chromatographic Columns Social Media Linked In Twitter Facebook You Tube QualityMatters Blog ... Events & Training Get Involved Partner Volunteer Provide Input Social Media Linked In Twitter Facebook You Tube QualityMatters Blog ...

14 CFR 60.5 - Quality management system.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.5 Quality... regular basis as described in QPS appendix E of this part. (b) The QMS program must provide a process for...

Guidelines for software inspections

NASA Technical Reports Server (NTRS)

1983-01-01

Quality control inspections are software problem finding procedures which provide defect removal as well as improvements in software functionality, maintenance, quality, and development and testing methodology is discussed. The many side benefits include education, documentation, training, and scheduling.

The Efficacy of Auditory Perceptual Training for Tinnitus: A Systematic Review

PubMed Central

Stacey, Paula C.; Hall, Deborah A.

2010-01-01

Auditory perceptual training affects neural plasticity and so represents a potential strategy for tinnitus management. We assessed the effects of auditory perceptual training on tinnitus perception and/or its intrusiveness via a systematic review of published literature. An electronic database search using the keywords ‘tinnitus and learning’ or ‘tinnitus and training’ was conducted, updated by a hand search. The ten studies identified were reviewed independently by two reviewers, data were extracted, study quality was assessed according to a number of specific criteria and the information was synthesised using a narrative approach. Nine out of the ten studies reported some significant change in either self-reported or psychoacoustic outcome measures after auditory training. However, all studies were quality rated as providing low or moderate levels of evidence for an effect. We identify a need for appropriately randomised and controlled studies that will generate high-quality unbiased and generalisable evidence to ascertain whether or not auditory perceptual training has a clinically relevant effect on tinnitus. PMID:20668974

Using a Design-Based Research Study to Identify Principles for Training Instructors to Teach Online

ERIC Educational Resources Information Center

Shattuck, Julie; Anderson, Terry

2013-01-01

Within the overall framework of design-based research, this paper reports on a study that focused on evaluating an online training course for online instructors. This intervention was designed as a possible solution to the problem facing some higher education institutions of how to provide quality, accessible training for mostly part-time…

Introducing Active Learning Pedagogy into a Technical and Vocational Education and Training Academy in Kurdistan, Iraq

ERIC Educational Resources Information Center

Dickson, Martina; Ladefoged, Svend Erik

2017-01-01

This article focuses on a teaching methodology project which investigated issues of teaching quality at a technical and vocational education and training (TVET) academy in Kurdistan, Northern Iraq. The academy was established in 2012 to provide unemployed youth with TVET, particularly workplace-relevant training. A needs analysis showed that the…

Pre-Service Music Teachers Perceptions of Teaching and Teacher Training

ERIC Educational Resources Information Center

Legette, Roy M.; McCord, Dawn H.

2015-01-01

The purpose of this study was to examine perceptions of pre-service music teachers (n = 104) regarding school music teaching and the quality of their teacher training. Research questions were: 1) What are the perceptions of pre-service music teachers regarding skills and knowledge provided by their teacher training programs? 2) What aspects of the…

Strengthening pre-service training for skilled birth attendance - An evaluation of the maternal and child health aide training programme in Sierra Leone.

PubMed

Jones, Susan A; Sam, Betty; Bull, Florence; James, Margaret; Ameh, Charles A; van den Broek, Nynke R

2016-06-01

The high maternal mortality rate in Sierra Leone combined with an ongoing shortage of midwives has led to the introduction of new cadres of healthcare workers. Maternal and Child Health Aides are one such cadre and now provide 56% of patient care. The quality of the education training programme for MCHA is therefore of paramount importance if high quality maternal care is to be provided. To conduct an evaluation of the MCHAide training programme in Sierra Leone. Mapping of programme and focus group discussions (FGDs) with key informants. Analysis of data using a thematic approach and formulation of recommendations for national, district and individual levels. All 14 MCHAide schools across Sierra Leone. The National Coordinator, Coordinators from 14 MCHAide schools and District Health Sisters from District Health Management Teams. Focus group discussions were held with tutors facilitated by a group member to encourage a free flowing discussion. Participants were divided into 4 groups, one for each province, with 5-8 participants per group and 50min for the discussion. Strengths, weaknesses and opportunities of the MCHAide training programme were identified. Four major themes were identified; the need for autonomy and support within the programme from stakeholders; the effect of poor infrastructure on teaching and student learning; the need to ensure rigorous academic quality including teaching quality, curricula content and the academic ability of the students; and the benefits of community support. It is important that the key personnel be involved in the development and introduction of training programmes for new cadres of staff from the earliest stages of development. On-going programme review and development is essential and those implementing the programme are the best placed to lead and contribute to this. Gathering the experiences and perceptions of key informants helps provide an in-depth examination that can inform recommendations. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

MAKING THE WEASELS WILD AGAIN: ENSURING FUTURE AIR DOMINANCE THROUGH EFFECTIVE SEAD TRAINING

DTIC Science & Technology

2016-06-01

both multi-mission design series (MMDS) and joint SEAD training as well as improve the capabilities of its electronic warfare (EW) ranges in order...USAF units to train for multi-mission design series (MMDS) SEAD operations.14 MMDS training includes the use of multiple USAF airborne platforms...not provided SEAD aircrews with either the quantity or quality of training required to conduct effective operations.2 At that time , Major Jon Norman

Quality engineering as a discipline of study.

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

Kolb, Rachel R.; Hoover, Marcey L.

2012-12-01

The current framework for quality scholarship in the United States ranges from the training and education of future quality engineers, managers, and professionals to focused and sustained research initiatives that, through academic institutions and other organizations, aim to improve the knowledge and application of quality across a variety of sectors. Numerous quality journals also provide a forum for professional dissemination of information.

The eighth NASA total quality management accomplishments report, 1990

NASA Technical Reports Server (NTRS)

1990-01-01

The eighth annual accomplishments report provides numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. NASA's continuous improvement efforts can provide insight for others to succeed in their own endeavors. The report covers: top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.

Raising the Quality and Image of TVET: Lower-Level Training or Motor for Inclusive and Sustainable Growth?

ERIC Educational Resources Information Center

Brennan, Paul

2014-01-01

Though viewed as second-class until fairly recently, Canada's system for providing technical and vocational education and training (TVET) now provides relevant post-secondary education that meets the needs of highly skilled professionals in all job categories. As the system evolved, it changed the public view of skills education. This article…

A Program Evaluation of the Experiences Provided to Novice Teachers through M School District's Teacher-Mentor Training Program

ERIC Educational Resources Information Center

Puryear, Pamela Ann

2012-01-01

Novice teachers often lack effective teaching strategies and exhibit poor classroom management, which creates disruptions in the classroom that lessen the quality of instructional time for students. The purpose of this program evaluation was to examine a teacher-mentor training program and the experiences provided to participants to gain a deeper…

A Comparison of Traditional and Self-Paced Instruction: Knowledge Gained in a Food Safety Certification Course

ERIC Educational Resources Information Center

Sexton, Julie S.; Schilling, Jennifer K.; Taylor, Jan C.

2009-01-01

The prevention of foodborne illness in childcare centers is a major public health concern. One prevention mechanism is the education of childcare providers. Because of the very diverse population in the childcare profession, the constant turnover rate and the need for high-quality, accessible training, providing this training proves to be an…

Hazardous Materials Management and Emergency Response training Center needs assessment

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

McGinnis, K.A.; Bolton, P.A.; Robinson, R.K.

1993-09-01

For the Hanford Site to provide high-quality training using simulated job-site situations to prepare the 4,000 Site workers and 500 emergency responders for known and unknown hazards a Hazardous Materials Management and Emergency Response Training Center is needed. The center will focus on providing classroom lecture as well as hands-on, realistic training. The establishment of the center will create a partnership among the US Department of Energy; its contractors; labor; local, state, and tribal governments; and Xavier and Tulane Universities of Louisiana. This report presents the background, history, need, benefits, and associated costs of the proposed center.

[Ambulant compression therapy for crural ulcers; an effective treatment when applied skilfully].

PubMed

de Boer, Edith M; Geerkens, Maud; Mooij, Michael C

2015-01-01

The incidence of crural ulcers is high. They reduce quality of life considerably and create a burden on the healthcare budget. The key treatment is ambulant compression therapy (ACT). We describe two patients with crural ulcers whose ambulant compression treatment was suboptimal and did not result in healing. When the bandages were applied correctly healing was achieved. If correctly applied ACT should provide sufficient pressure to eliminate oedema, whilst taking local circumstances such as bony structures and arterial qualities into consideration. To provide pressure-to-measure regular practical training, skills and regular quality checks are needed. Knowledge of the properties of bandages and the proper use of materials for padding under the bandage enables good personalised ACT. In trained hands adequate compression and making use of simple bandages and dressings provides good care for patients suffering from crural ulcers in contrast to inadequate ACT using the same materials.

Assessing image quality of low-cost laparoscopic box trainers: options for residents training at home.

PubMed

Kiely, Daniel J; Stephanson, Kirk; Ross, Sue

2011-10-01

Low-cost laparoscopic box trainers built using home computers and webcams may provide residents with a useful tool for practice at home. This study set out to evaluate the image quality of low-cost laparoscopic box trainers compared with a commercially available model. Five low-cost laparoscopic box trainers including the components listed were compared in random order to one commercially available box trainer: A (high-definition USB 2.0 webcam, PC laptop), B (Firewire webcam, Mac laptop), C (high-definition USB 2.0 webcam, Mac laptop), D (standard USB webcam, PC desktop), E (Firewire webcam, PC desktop), and F (the TRLCD03 3-DMEd Standard Minimally Invasive Training System). Participants observed still image quality and performed a peg transfer task using each box trainer. Participants rated still image quality, image quality with motion, and whether the box trainer had sufficient image quality to be useful for training. Sixteen residents in obstetrics and gynecology took part in the study. The box trainers showing no statistically significant difference from the commercially available model were A, B, C, D, and E for still image quality; A for image quality with motion; and A and B for usefulness of the simulator based on image quality. The cost of the box trainers A-E is approximately $100 to $160 each, not including a computer or laparoscopic instruments. Laparoscopic box trainers built from a high-definition USB 2.0 webcam with a PC (box trainer A) or from a Firewire webcam with a Mac (box trainer B) provide image quality comparable with a commercial standard.

EBT Fidelity Trajectories Across Training Cohorts Using the Interagency Collaborative Team Strategy

PubMed Central

Hecht, Debra; Aarons, Greg; Fettes, Danielle; Hurlburt, Michael; Ledesma, Karla

2015-01-01

The Interdisciplinary Collaborative Team (ICT) strategy uses front-line providers as adaptation, training and quality control agents for multi-agency EBT implementation. This study tests whether an ICT transmits fidelity to subsequent provider cohorts. SafeCare was implemented by home visitors from multiple community-based agencies contracting with child welfare. Client-reported fidelity trajectories for 5,769 visits, 957 clients and 45 providers were compared using three-level growth models. Provider cohorts trained and live-coached by the ICT attained benchmark fidelity after 12 weeks, and this was sustained. Hispanic clients reported high cultural competency, supporting a cultural adaptation crafted by the ICT. PMID:25586878

EBT Fidelity Trajectories Across Training Cohorts Using the Interagency Collaborative Team Strategy.

PubMed

Chaffin, Mark; Hecht, Debra; Aarons, Greg; Fettes, Danielle; Hurlburt, Michael; Ledesma, Karla

2016-03-01

The Interdisciplinary Collaborative Team (ICT) strategy uses front-line providers as adaptation, training and quality control agents for multi-agency EBT implementation. This study tests whether an ICT transmits fidelity to subsequent provider cohorts. SafeCare was implemented by home visitors from multiple community-based agencies contracting with child welfare. Client-reported fidelity trajectories for 5,769 visits, 957 clients and 45 providers were compared using three-level growth models. Provider cohorts trained and live-coached by the ICT attained benchmark fidelity after 12 weeks, and this was sustained. Hispanic clients reported high cultural competency, supporting a cultural adaptation crafted by the ICT.

Quality Indicators for Single-Case Research on Social Skill Interventions for Children with Autistic Spectrum Disorder

ERIC Educational Resources Information Center

Wang, Shin-Yi; Parrila, Rauno

2008-01-01

In this paper, we describe a quality checklist that parents, teachers, clinicians, and policy-makers with basic research skills can use to systematically evaluate the methodological quality of single-case studies on social skill training of children with autistic spectrum disorder (ASD). We provide a rationale for included quality indicators, and…

Provider training and experience for people living with HIV/AIDS.

PubMed

Rackal, Julia M; Tynan, Anne-Marie; Handford, Curtis D; Rzeznikiewiz, Damian; Agha, Ayda; Glazier, Richard

2011-06-15

The complexity of HIV/AIDS raises challenges for the effective delivery of care. It is important to ensure that the expertise and experience of care providers is of high quality. Training and experience of HIV/AIDS providers may impact not only individual patient outcomes but increasingly on health care costs as well. The objective of this review is to assess the effects of provider training and experience on people living with HIV/AIDS on the following outcomes: immunological (ie. viral load, CD4 count), medical (ie. mortality, proportion on antiretrovirals), psychosocial (ie. quality of life measures) and economic outcomes (ie health care costs). We searched MEDLINE, EMBASE, Dissertation Abstracts International (DAI), CINAHL, HealthStar, PsycInfo, PsycLit, Social Sciences Abstracts, and Sociological Abstracts from January 1, 1980 through May 29, 2009.  Electronic searches were performed for abstracts from major international AIDS conferences. Reference lists from pertinent articles, books and review articles were retrieved and reviewed. Randomized controlled trials (RCTs), controlled clinical trials, cohort, case control, cross-sectional studies and controlled before and after designs that examined the qualifications/training and patient volume of HIV/AIDS care of providers caring for persons known to be infected with HIV/AIDS were included. At least two authors independently assessed trial quality and extracted data. Study authors were contacted for further information as required. Assessment of confounding factors was undertaken independently by two reviewers. A total of four studies (one randomized controlled trial, three non- randomized studies) involving 8488 people living with HIV/AIDS were included. The main findings of this review demonstrated a trend to improved outcomes when treated by a provider with more training/expertise in HIV/AIDS care in the outpatient (clinic) setting. Due to the heterogeneity of the included studies, we could not perform a meta-analysis. We present a descriptive review of the results. The results demonstrate improved medical outcomes when treated by a provider with more training/expertise in HIV/AIDS care in the outpatient (clinic) setting. Since all of these studies were conducted in North America, this does not address any issues regarding the level of training/expertise required by providers working in countries with more limited resources. Practitioners who do not consider themselves 'experts' in HIV/AIDS care and care for few of these patients need to seriously consider this review which demonstrates a trend towards worse patient outcomes when receiving care by those with low caseloads/training in HIV/AIDS care.

ISES Training Class - Continuous Measurements

EPA Science Inventory

Features of Continuous Monitoring•Provides for high definition of temporal resolution•Provides means for discerning primary exposure events•Provides means for critically examining data quality rather than just an average point•Applicable to any measure of inte...

Providing Culturally Competent Care for LGBTQ Youth in School-Based Health Centers: A Needs Assessment to Guide Quality of Care Improvements.

PubMed

Garbers, Samantha; Heck, Craig J; Gold, Melanie A; Santelli, John S; Bersamin, Melina

2017-01-01

School-based health centers (SBHCs) can take specific steps to provide culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, potentially impacting well-being. A needs assessment survey was conducted among a convenience sample of SBHC administrators and medical directors to assess climates and actions supportive of LGBTQ quality medical care. Half (53%) of the SBHCs surveyed ( N = 66) reviewed print materials for negative LGBTQ stereotypes, and 27.3% conducted exhaustive materials review. Regional differences were detected: 46.2% of Southern SBHCs conducted any materials review compared to 91.3% in the West and all in the East and Midwest (χ 2 , p < .001). In the last academic year, 45.5% conducted no medical provider trainings, and 54.5% conducted no general staff trainings on providing care for LGBTQ youth. On intake forms, 85.4% included preferred names, but only 23.5% included preferred pronoun. There are significant gaps in the extent to which SBHCs provide culturally competent care. These findings can guide future training and advocacy.

[The influence of pedagogic and discipline training on the teaching quality of university professors].

PubMed

Troncoso G, Diego; Pérez V, Cristhian; Vaccarezza G, Giulietta; Aguilar A, César; Muñoz N, Nadia

2017-05-01

University teachers prioritize acquiring knowledge about their disciplines over pedagogic training. However, the latter is becoming increasingly important in the present teaching scenario. To relate pedagogic practices with pedagogic training of teachers from health care careers of public and private universities. Pedagogic practice and training activities participation questionnaires were answered by 296 teachers of undergraduate students from Chilean public and private universities. There was a direct correlation between discipline training and all pedagogic practice factors. However, pedagogic training correlated with all the factors with the exception of teacher centered learning. Teachers with a master degree had higher scores in factors related to teaching planning and process assessment. Having a doctor degree had no impact on these factors. A multiple regression analysis showed that both discipline and pedagogic training and having a master degree were associated with pedagogic practices of teachers. Both pedagogic and discipline training influence the quality of teaching provided by undergraduate teachers.

Developing European guidelines for training care professionals in mental health promotion.

PubMed

Greacen, Tim; Jouet, Emmanuelle; Ryan, Peter; Cserhati, Zoltan; Grebenc, Vera; Griffiths, Chris; Hansen, Bettina; Leahy, Eithne; da Silva, Ksenija Maravic; Sabić, Amra; De Marco, Angela; Flores, Paz

2012-12-27

Although mental health promotion is a priority mental health action area for all European countries, high level training resources and high quality skills acquisition in mental health promotion are still relatively rare. The aim of the current paper is to present the results of the DG SANCO-funded PROMISE project concerning the development of European guidelines for training social and health care professionals in mental health promotion. The PROMISE project brought together a multidisciplinary scientific committee from eight European sites representing a variety of institutions including universities, mental health service providers and public health organisations. The committee used thematic content analysis to filter and analyse European and international policy documents, scientific literature reviews on mental health promotion and existing mental health promotion programmes with regard to identifying quality criteria for training care professionals on this subject. The resulting PROMISE Guidelines quality criteria were then subjected to an iterative feedback procedure with local steering groups and training professionals at all sites with the aim of developing resource kits and evaluation tools for using the PROMISE Guidelines. Scientific committees also collected information from European, national and local stakeholder groups and professional organisations on existing training programmes, policies and projects. The process identified ten quality criteria for training care professionals in mental health promotion: embracing the principle of positive mental health; empowering community stakeholders; adopting an interdisciplinary and intersectoral approach; including people with mental health problems; advocating; consulting the knowledge base; adapting interventions to local contexts; identifying and evaluating risks; using the media; evaluating training, implementation processes and outcomes. The iterative feedback process produced resource kits and evaluation checklists linked with each of these quality criteria in all PROMISE languages. The development of generic guidelines based on key quality criteria for training health and social care professionals in mental health promotion should contribute in a significant way to implementing policy in this important area.

A framework for revising preservice curriculum for nonphysician clinicians: The mozambique experience.

PubMed

Freistadt, Fernanda; Branigan, Erin; Pupp, Chris; Stefanutto, Marzio; Bambo, Carlos; Alexandre, Maria; Pinheiro, Sandro O; Ballweg, Ruth; Dgedge, Martinho; O'Malley, Gabrielle; de Oliveira, Justine Strand

2014-01-01

Mozambique, with approximately 0.4 physicians and 4.1 nurses per 10,000 people, has one of the lowest ratios of health care providers to population in the world. To rapidly scale up health care coverage, the Mozambique Ministry of Health has pushed for greater investment in training nonphysician clinicians, Tιcnicos de Medicina (TM). Based on identified gaps in TM clinical performance, the Ministry of Health requested technical assistance from the International Training and Education Center for Health (I-TECH) to revise the two-and-a-half-year preservice curriculum. A six-step process was used to revise the curriculum: (i) Conducting a task analysis, (ii) defining a new curriculum approach and selecting an integrated model of subject and competency-based education, (iii) revising and restructuring the 30-month course schedule to emphasize clinical skills, (iv) developing a detailed syllabus for each course, (v) developing content for each lesson, and (vi) evaluating implementation and integrating feedback for ongoing improvement. In May 2010, the Mozambique Minister of Health approved the revised curriculum, which is currently being implemented in 10 training institutions around the country. Key lessons learned: (i) Detailed assessment of training institutions' strengths and weaknesses should inform curriculum revision. (ii) Establishing a Technical Working Group with respected and motivated clinicians is key to promoting local buy-in and ownership. (iii) Providing ready-to-use didactic material helps to address some challenges commonly found in resource-limited settings. (iv) Comprehensive curriculum revision is an important first step toward improving the quality of training provided to health care providers in developing countries. Other aspects of implementation at training institutions and health care facilities must also be addressed to ensure that providers are adequately trained and equipped to provide quality health care services. This approach to curriculum revision and implementation teaches several key lessons, which may be applicable to preservice training programs in other less developed countries.

Caring for Preschool Children: A Competency-Based Training Program. Volumes I and II. Second Edition [and] a Trainer's Guide.

ERIC Educational Resources Information Center

Dodge, Diane Trister; Koralek, Derry Gosselin; Pizzolongo, Peter J.; Al-Salam, Debra

The "Caring for Preschool Children" program was designed as a personalized training program to help adults working with preschool children acquire the skills and knowledge needed to provide a high quality preschool program. This two-volume training manual is comprised of 13 modules corresponding to the areas of the Child Development…

Palliative care for respiratory disease: An education model of care.

PubMed

Bowman, Brynn; Meier, Diane E

2018-02-01

That palliative care improves quality of life for seriously ill patients and their families is well known - but how can healthcare providers ensure that the palliative needs of all patients are being assessed and addressed? A growing number of curricula in core palliative care practices have been developed to ensure that clinicians from all specialties and disciplines have the necessary training to manage pain and symptoms and discuss care goals with patients and families. Through broad-based training in core palliative care skills, combined with referral to specialty palliative care for high-need patients, providers can improve quality of life for their patients with respiratory disease.

Rural maternity care.

PubMed

Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer

2012-10-01

To provide an overview of current information on issues in maternity care relevant to rural populations. Medline was searched for articles published in English from 1995 to 2012 about rural maternity care. Relevant publications and position papers from appropriate organizations were also reviewed. This information will help obstetrical care providers in rural areas to continue providing quality care for women in their communities. Recommendations 1. Women who reside in rural and remote communities in Canada should receive high-quality maternity care as close to home as possible. 2. The provision of rural maternity care must be collaborative, woman- and family-centred, culturally sensitive, and respectful. 3. Rural maternity care services should be supported through active policies aligned with these recommendations. 4. While local access to surgical and anaesthetic services is desirable, there is evidence that good outcomes can be sustained within an integrated perinatal care system without local access to operative delivery. There is evidence that the outcomes are better when women do not have to travel far from their communities. Access to an integrated perinatal care system should be provided for all women. 5. The social and emotional needs of rural women must be considered in service planning. Women who are required to leave their communities to give birth should be supported both financially and emotionally. 6. Innovative interprofessional models should be implemented as part of the solution for high-quality, collaborative, and integrated care for rural and remote women. 7. Registered nurses are essential to the provision of high-quality rural maternity care throughout pregnancy, birth, and the postpartum period. Maternity nursing skills should be recognized as a fundamental part of generalist rural nursing skills. 8. Remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by providers in rural settings. Remuneration models should facilitate interprofessional collaboration. 9. Practitioners skilled in neonatal resuscitation and newborn care are essential to rural maternity care. 10. Training of rural maternity health care providers should include collaborative practice as well as the necessary clinical skills and competencies. Sites must be developed and supported to train midwives, nurses, and physicians and provide them with the skills necessary for rural maternity care. Training in rural and northern settings must be supported. 11. Generalist skills in maternity care, surgery, and anaesthesia are valued and should be supported in training programs in family medicine, surgery, and anaesthesia as well as nursing and midwifery. 12. All physicians and nurses should be exposed to maternity care in their training, and basic competencies should be met. 13. Quality improvement and outcome monitoring should be integral to all maternity care systems. 14. Support must be provided for ongoing, collaborative, interprofessional, and locally provided continuing education and patient safety programs.

ED Proposed Regulations to Title II of HEA: Comments from the Data Quality Campaign

ERIC Educational Resources Information Center

Data Quality Campaign, 2015

2015-01-01

States are uniquely positioned to provide feedback to teacher preparation programs (TPPs) on the effectiveness of the teachers they train, and to provide information about the quality of TPPs to the public. States have been building the significant data capacity to reliably and securely link teachers with their students' achievement and growth…

Women's Stake in Improving the Availability, Affordability, and Quality of Child Care and Early Education.

ERIC Educational Resources Information Center

National Women's Law Center, Washington, DC.

This report discusses women's need as parents for affordable, high-quality child care, and women's need as providers of child care services for compensation, training, and advancement opportunities that reflect the value of the important work they undertake. Regarding mothers' needs, the report provides a discussion of statistics on: (1) mothers…

Toward High Quality Family Day Care for Infants and Toddlers. Final Report.

ERIC Educational Resources Information Center

Rauch, Marian D.; Crowell, Doris C.

Reported were the results of a project which established a cluster of family day care homes in Hawaii in which caregivers were selected, trained, and provided with supportive services and salaries. The primary objective of the program was to provide a replicable, high quality program for preschool children that would maximize social, emotional,…

Training a Chest Compression of 6-7 cm Depth for High Quality Cardiopulmonary Resuscitation in Hospital Setting: A Randomised Controlled Trial.

PubMed

Oh, Jaehoon; Lim, Tae Ho; Cho, Youngsuk; Kang, Hyunggoo; Kim, Wonhee; Chee, Youngjoon; Song, Yeongtak; Kim, In Young; Lee, Juncheol

2016-03-01

During cardiopulmonary resuscitation (CPR), chest compression (CC) depth is influenced by the surface on which the patient is placed. We hypothesized that training healthcare providers to perform a CC depth of 6-7 cm (instead of 5-6 cm) on a manikin placed on a mattress during CPR in the hospital might improve their proper CC depth. This prospective randomised controlled study involved 66 premedical students without CPR training. The control group was trained to use a CC depth of 5-6 cm (G 5-6), while the experimental group was taught to use a CC depth of 6-7 cm (G 6-7) with a manikin on the floor. All participants performed CCs for 2 min on a manikin that was placed on a bed 1 hour and then again 4 weeks after the training without a feedback. The parameters of CC quality (depth, rate, % of accurate depth) were assessed and compared between the 2 groups. Four students were excluded due to loss to follow-up and recording errors, and data of 62 were analysed. CC depth and % of accurate depth were significantly higher among students in the G 6-7 than G 5-6 both 1 hour and 4 weeks after the training (p<0.001), whereas CC rate was not different between two groups (p>0.05). Training healthcare providers to perform a CC depth of 6-7 cm could improve quality CC depth when performing CCs on patients who are placed on a mattress during CPR in a hospital setting.

Best practices in bioinformatics training for life scientists.

PubMed

Via, Allegra; Blicher, Thomas; Bongcam-Rudloff, Erik; Brazas, Michelle D; Brooksbank, Cath; Budd, Aidan; De Las Rivas, Javier; Dreyer, Jacqueline; Fernandes, Pedro L; van Gelder, Celia; Jacob, Joachim; Jimenez, Rafael C; Loveland, Jane; Moran, Federico; Mulder, Nicola; Nyrönen, Tommi; Rother, Kristian; Schneider, Maria Victoria; Attwood, Teresa K

2013-09-01

The mountains of data thrusting from the new landscape of modern high-throughput biology are irrevocably changing biomedical research and creating a near-insatiable demand for training in data management and manipulation and data mining and analysis. Among life scientists, from clinicians to environmental researchers, a common theme is the need not just to use, and gain familiarity with, bioinformatics tools and resources but also to understand their underlying fundamental theoretical and practical concepts. Providing bioinformatics training to empower life scientists to handle and analyse their data efficiently, and progress their research, is a challenge across the globe. Delivering good training goes beyond traditional lectures and resource-centric demos, using interactivity, problem-solving exercises and cooperative learning to substantially enhance training quality and learning outcomes. In this context, this article discusses various pragmatic criteria for identifying training needs and learning objectives, for selecting suitable trainees and trainers, for developing and maintaining training skills and evaluating training quality. Adherence to these criteria may help not only to guide course organizers and trainers on the path towards bioinformatics training excellence but, importantly, also to improve the training experience for life scientists.

Best practices in bioinformatics training for life scientists

PubMed Central

Blicher, Thomas; Bongcam-Rudloff, Erik; Brazas, Michelle D.; Brooksbank, Cath; Budd, Aidan; De Las Rivas, Javier; Dreyer, Jacqueline; Fernandes, Pedro L.; van Gelder, Celia; Jacob, Joachim; Jimenez, Rafael C.; Loveland, Jane; Moran, Federico; Mulder, Nicola; Nyrönen, Tommi; Rother, Kristian; Schneider, Maria Victoria; Attwood, Teresa K.

2013-01-01

The mountains of data thrusting from the new landscape of modern high-throughput biology are irrevocably changing biomedical research and creating a near-insatiable demand for training in data management and manipulation and data mining and analysis. Among life scientists, from clinicians to environmental researchers, a common theme is the need not just to use, and gain familiarity with, bioinformatics tools and resources but also to understand their underlying fundamental theoretical and practical concepts. Providing bioinformatics training to empower life scientists to handle and analyse their data efficiently, and progress their research, is a challenge across the globe. Delivering good training goes beyond traditional lectures and resource-centric demos, using interactivity, problem-solving exercises and cooperative learning to substantially enhance training quality and learning outcomes. In this context, this article discusses various pragmatic criteria for identifying training needs and learning objectives, for selecting suitable trainees and trainers, for developing and maintaining training skills and evaluating training quality. Adherence to these criteria may help not only to guide course organizers and trainers on the path towards bioinformatics training excellence but, importantly, also to improve the training experience for life scientists. PMID:23803301

Techniques and Training.

ERIC Educational Resources Information Center

Davies, Maire Messenger

1992-01-01

Provides an overview of articles included in this issue that address automatic evaluation of public service announcements about AIDS that are aimed at high-risk, low-literacy individuals; how children construe television programs; the concept of quality in broadcasting; and the use of video for inservice teacher training. (LRW)

Application of ISO 9000 Standards to Education and Training.

ERIC Educational Resources Information Center

Van den Berghe, Wouter

1998-01-01

ISO 9000 certification has the advantages of a measurable framework for quality efforts, continuous improvement, and better customer service. Drawbacks for education and training providers include volume of paperwork, ongoing cost, risk of a growing bureaucracy, and the difficulty of making changes quickly. (SK)

Can the feedback of patient assessments, brief training, or their combination, improve the interpersonal skills of primary care physicians? A systematic review.

PubMed

Cheraghi-Sohi, Sudeh; Bower, Peter

2008-08-21

Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i) feedback of real patient assessments of interpersonal care skills, (ii) brief training focused on the improvement of interpersonal care (iii) interventions combining both (i) and (ii) Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase) and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form. Nine studies were included (two patient based feedback studies and seven brief training studies). Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect. There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback and brief training interventions is required before these interventions are routinely introduced to improve patient satisfaction with interpersonal care in primary care. The interventions to be tested in future research should consider using insights from the wider literature on communication outside primary care, might benefit from a clearer theoretical basis, and should examine the use of combined brief training and feedback.

A survey of assistive technology service providers in the USA.

PubMed

Arthanat, Sajay; Elsaesser, Linda-Jeanne; Bauer, Stephen

2017-11-01

This study investigates perspectives of assistive technology service (ATS) providers regarding their education and training, interdisciplinary standards of practice, use of a common language framework, funding policies, utilization of evidence and outcomes measurement. A survey underpinned by AT legislations and established guidelines for practice was completed by 318 certified AT providers. More than 30% of the providers reported their education and training as inadequate to fulfil four of the seven primary roles of ATS. Nearly 90% of providers expressed awareness of the International Classification of Functioning, Disability and Health (ICF) domains for interdisciplinary communication. However, only 45% felt that they could effectively utilize the ICF in their documentation. About 75% of the providers acknowledged the lack of a recognized standard for the provision of services. Prevailing inadequacies in funding were negatively impacting the quality of ATS, as expressed by 88% of respondents. Translation of evidence to practice was identified as a major challenge by 41% of service providers. Providers were predominantly documenting outcomes through informal interviews (54%) or non-standard instruments (26%). Findings support the need for strengthening professional curriculum, pre-service and in-service training and an established standard to support effective, interdisciplinary AT services and data collection to support public policy decisions. Implications for Rehabilitation This study validates the need to strengthen education and training of AT service providers by enhancing professional curriculum as well as their engagement in pre-service and in-service training activities. This study draws attention to health care funding policies and practices that critically impact the quality of AT services. This study signifies the need for an established interdisciplinary standard among AT professionals to support effective communication, service coordination and outcomes measurement.

Public stewardship of private for-profit healthcare providers in low- and middle-income countries

PubMed Central

Wiysonge, Charles S; Abdullahi, Leila H; Ndze, Valantine N; Hussey, Gregory D

2016-01-01

Background Governments use different approaches to ensure that private for-profit healthcare services meet certain quality standards. Such government guidance, referred to as public stewardship, encompasses government policies, regulatory mechanisms, and implementation strategies for ensuring accountability in the delivery of services. However, the effectiveness of these strategies in low- and middle-income countries (LMICs) have not been the subject of a systematic review. Objectives To assess the effects of public sector regulation, training, or co-ordination of the private for-profit health sector in low- and middle-income countries. Search methods For related systematic reviews, we searched the Cochrane Database of Systematic Reviews (CDSR) 2015, Issue 4; Database of Abstracts of Reviews of Effectiveness (DARE) 2015, Issue 1; Health Technology Assessment Database (HTA) 2015, Issue 1; all part of The Cochrane Library, and searched 28 April 2015. For primary studies, we searched MEDLINE, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, MEDLINE Daily and MEDLINE 1946 to Present, OvidSP (searched 16 June 2016); Science Citation Index and Social Sciences Citation Index 1987 to present, and Emerging Sources Citation Index 2015 to present, ISI Web of Science (searched 3 May 2016 for papers citing included studies); Cochrane Central Register of Controlled Trials (CENTRAL), 2015, Issue 3, part of The Cochrane Library (including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register) (searched 28 April 2015); Embase 1980 to 2015 Week 17, OvidSP (searched 28 April 2015); Global Health 1973 to 2015 Week 16, OvidSP (searched 30 April 2015); WHOLIS, WHO (searched 30 April 2015); Science Citation Index and Social Sciences Citation Index 1975 to present, ISI Web of Science (searched 30 April 2015); Health Management, ProQuest (searched 22 November 2013). In addition, in April 2016, we searched the reference lists of relevant articles, WHO International Clinical Trials Registry Platform, Clinicaltrials.gov, and various electronic databases of grey literature. Selection criteria Randomised trials, non-randomised trials, interrupted time series studies, or controlled before-after studies. Data collection and analysis Two authors independently assessed study eligibility and extracted data, comparing their results and resolving discrepancies by consensus. We expressed study results as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI), where appropriate, and assessed the certainty of the evidence using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). We did not conduct meta-analysis because of heterogeneity of interventions and study designs. Main results We identified 20,177 records, 50 of them potentially eligible. We excluded 39 potentially eligible studies because they did not involve a rigorous evaluation of training, regulation, or co-ordination of private for-profit healthcare providers in LMICs; five studies identified after the review was submitted are awaiting assessment; and six studies met our inclusion criteria. Two included studies assessed training alone; one assessed regulation alone; three assessed a multifaceted intervention involving training and regulation; and none assessed co-ordination. All six included studies targeted private for-profit pharmacy workers in Africa and Asia. Three studies found that training probably increases sale of oral rehydration solution (one trial in Kenya, 106 pharmacies: RR 3.04, 95% CI 1.37 to 6.75; and one trial in Indonesia, 87 pharmacies: RR 1.41, 95% CI 1.03 to 1.93) and dispensing of anti-malarial drugs (one trial in Kenya, 293 pharmacies: RR 8.76, 95% CI 0.94 to 81.81); moderate-certainty evidence. One study conducted in the Lao People's Democratic Republic shows that regulation of the distribution and sale of registered pharmaceutical products may improve composite pharmacy indicators (one trial, 115 pharmacies: improvements in four of six pharmacy indicators; low-certainty evidence). The outcome in three multifaceted intervention studies was the quality of pharmacy practice; including the ability to ask questions, give advice, and provide appropriate treatment. The trials applied regulation, training, and peer influence in sequence; and the study design does not permit separation of the effects of the different interventions. Two trials conducted among 136 pharmacies in Vietnam found that the multifaceted intervention may improve the quality of pharmacy practice; but the third study, involving 146 pharmacies in Vietnam and Thailand, found that the intervention may have little or no effects on the quality of pharmacy practice (low-certainty evidence). Only two studies (both conducted in Vietnam) reported cost data, with no rigorous assessment of the economic implications of implementing the interventions in resource-constrained settings. No study reported data on equity, mortality, morbidity, adverse effects, satisfaction, or attitudes. Authors' conclusions Training probably improves quality of care (i.e. adherence to recommended practice), regulation may improve quality of care, and we are uncertain about the effects of co-ordination on quality of private for-profit healthcare services in LMICs. The likelihood that further research will find the effect of training to be substantially different from the results of this review is moderate; implying that monitoring of the impact is likely to be needed if training is implemented. The low certainty of the evidence for regulation implies that the likelihood of further research finding the effect of regulation to be substantially different from the results of this review is high. Therefore, an impact evaluation is warranted if government regulation of private for-profit providers is implemented in LMICs. Rigorous evaluations of these interventions should also assess other outcomes such as impacts on equity, cost implications, mortality, morbidity, and adverse effects. Government regulation, training, or co-ordination of private for-profit health care in low- and middle-income countries What is the aim of this review? The aim of this Cochrane review was to evaluate the effect of government regulation, training, or co-ordination of private for-profit health care in low- and middle-income countries. We collected and analysed all relevant studies to answer this question and included six studies in the review. Why do governments regulate, train or co-ordinate private healthcare providers? In many low- and middle-income countries, the public sector is not able to provide high quality healthcare services to all citizens, and private healthcare providers therefore play a major role. However, there is concern that health care provided by the private sector is not always of high quality and that recommended practices and guidelines are not always followed. Governments therefore use different approaches to ensure that private for-profit healthcare services meet certain quality standards. This type of government guidance is referred to as 'public stewardship' and can for instance involve training and education for private for-profit healthcare providers; introduction of regulations where quality standards are set and enforced; and co-ordination between private for-profit and public sector healthcare providers, for instance, creating referral systems between the private for-profit and public sectors. What happens when governments regulate, train or co-ordinate private, for-profit health care providers? Training In two studies in Kenya and Indonesia, the Ministry of Health offered private drug sellers short training sessions on prescribing and dispensing drugs. These sellers were compared to drug sellers who were not offered training. The studies suggested that training probably improves the quality of healthcare services. Regulation In one study in the Lao People's Democratic Republic, the Ministry of Health supervised private pharmacy services in certain districts over a three-month period, applied sanctions when rules were broken, and offered information about areas needing improvement. These districts were compared to districts without this enhanced supervision. The study suggested that this enhanced regulation may make little or no difference to quality of care. Training and regulation In three studies in Vietnam and Thailand, private pharmacies in some districts received educational visits as well as visits from pharmacy inspectors to enforce regulations. These districts were compared to districts that did not receive any visits. The studies suggested that these types of visits may improve quality of care. Co-ordination The review did not find any eligible study that assessed the effects of co-ordination on quality of care. How up-to-date is this review? The review authors searched for studies that had been published up to June 2016. PMID:27510030

Barking, Havering and Redbridge University Hospitals NHS Trust Fellowships in Clinical Leadership Programme: An Evaluation.

PubMed

Miani, Celine; Marjanovic, Sonja; Jones, Molly Morgan; Marshall, Martin; Meikle, Samantha; Nolte, Ellen

2013-01-01

Leadership is seen to be central to improving the quality of healthcare and existing research suggests that absence of leadership is related to poor quality and safety performance. Leadership training might therefore provide an important means through which to promote quality improvement and, more widely, performance within the healthcare environment. This article presents an evaluation of the Fellowships in Clinical Leadership Programme, which combines leadership training and quality improvement initiatives with the placement of temporary external clinical champions in Barking, Havering and Redbridge University Hospitals NHS Trust. We assessed impacts of the Programme on individual and organisational change, alongside core enablers and barriers for Programme success. Analyses drew on the principles of a theory-of-change-led realist evaluation, using logic modelling to specify the underlying causal mechanisms of the Programme. Data collection involved a stakeholder workshop, online questionnaires of programme participants, senior managers and support staff (n=114), and follow-up in-depth semi-structured interviews with a subsample of survey participants (n=15). We observed that the Programme had notable impacts at individual and organisational levels. Examples of individual impact included enhanced communication and negotiation skills or increased confidence as a result of multi-modal leadership training. At the organisational level, participants reported indications of behaviour change among staff, with evidence of spill-over effects to non-participants towards a greater focus on patient-centred care. Our findings suggest that there is potential for combined leadership training and quality improvement programmes to contribute to strengthening a culture of care quality in healthcare organisations. Our study provides useful insights into strategies seeking to achieve sustainable improvement in NHS organisations.

Barking, Havering and Redbridge University Hospitals NHS Trust Fellowships in Clinical Leadership Programme

PubMed Central

Miani, Celine; Marjanovic, Sonja; Jones, Molly Morgan; Marshall, Martin; Meikle, Samantha; Nolte, Ellen

2013-01-01

Abstract Leadership is seen to be central to improving the quality of healthcare and existing research suggests that absence of leadership is related to poor quality and safety performance. Leadership training might therefore provide an important means through which to promote quality improvement and, more widely, performance within the healthcare environment. This article presents an evaluation of the Fellowships in Clinical Leadership Programme, which combines leadership training and quality improvement initiatives with the placement of temporary external clinical champions in Barking, Havering and Redbridge University Hospitals NHS Trust. We assessed impacts of the Programme on individual and organisational change, alongside core enablers and barriers for Programme success. Analyses drew on the principles of a theory-of-change-led realist evaluation, using logic modelling to specify the underlying causal mechanisms of the Programme. Data collection involved a stakeholder workshop, online questionnaires of programme participants, senior managers and support staff (n=114), and follow-up in-depth semi-structured interviews with a subsample of survey participants (n=15). We observed that the Programme had notable impacts at individual and organisational levels. Examples of individual impact included enhanced communication and negotiation skills or increased confidence as a result of multi-modal leadership training. At the organisational level, participants reported indications of behaviour change among staff, with evidence of spill-over effects to non-participants towards a greater focus on patient-centred care. Our findings suggest that there is potential for combined leadership training and quality improvement programmes to contribute to strengthening a culture of care quality in healthcare organisations. Our study provides useful insights into strategies seeking to achieve sustainable improvement in NHS organisations. PMID:28083304

77 FR 62602 - Privacy Act of 1974, as Amended; System of Records Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... Record; (12) Statistical Reports--retrievable by names: (a) Personnel Transcript Report, (b) Class... training processes, such as the collection of statistical information on training programs, development of... systems, creating and reviewing statistics to improve the quality of services provided, or conducting debt...

Systemic Change in Vocational Training Institutions in France.

ERIC Educational Resources Information Center

Moallem, Abbas; Moallem, Mahnaz

1998-01-01

The Specialized Vocational Training Institutions known as Institut Medico-Professionel (IMPro) in France are faced with increasing demands to provide quality services to adolescents with intellectual disabilities. This article describes the process of organizational changes in IMPro including the model, methods, tools, and techniques used in…

SPECIATE's VOC and PM Speciation Profiles and Their use to Prepare for Air quality Modeling (2017 EIC)

EPA Pesticide Factsheets

This training provides general concepts on chemical speciation, the SPECIATE database and browser, and how to use the Speciation Tool to create model ready speciation inputs for a photochemical air quality model.

Qualities of Single Electrode Stimulation as a Function of Rate and Place of Stimulation with a Cochlear Implant

PubMed Central

Landsberger, David M.; Vermeire, Katrien; Claes, Annes; Van Rompaey, Vincent; Van de Heyning, Paul

2015-01-01

Objectives Although it has been previously shown that changes in temporal coding produce changes in pitch in all cochlear regions, research has suggested that temporal coding might be best encoded in relatively apical locations. We hypothesized that although temporal coding may provide useable information at any cochlear location, low rates of stimulation might provide better sound quality in apical regions that are more likely to encode temporal information in the normal ear. In the present study, sound qualities of single electrode pulse trains were scaled to provide insight into the combined effects of cochlear location and stimulation rate on sound quality. Design Ten long term users of MED-EL cochlear implants with 31 mm electrode arrays (Standard or FLEXSOFT) were asked to scale the sound quality of single electrode pulse trains in terms of how “Clean”, “Noisy”, “High”, and “Annoying” they sounded. Pulse trains were presented on most electrodes between 1 and 12 representing the entire range of the long electrode array at stimulation rates of 100, 150, 200, 400, or 1500 pulses per second. Results While high rates of stimulation are scaled as having a “Clean” sound quality across the entire array, only the most apical electrodes (typically 1 through 3) were considered “Clean” at low rates. Low rates on electrodes 6 through 12 were not rated as “Clean” while the low rate quality of electrodes 4 and 5 were typically in between. Scaling of “Noisy” responses provided an approximately inverse pattern as “Clean” responses. “High” responses show the trade-off between rate and place of stimulation on pitch. Because “High” responses did not correlate with “Clean” responses, subjects were not rating sound quality based on pitch. Conclusions If explicit temporal coding is to be provided in a cochlear implant, it is likely to sound better when provided apically. Additionally, the finding that low rates sound clean only at apical places of stimulation is consistent with previous findings that a change in rate of stimulation corresponds to an equivalent change in perceived pitch at apical locations. Collectively, the data strongly suggests that temporal coding with a cochlear implant is optimally provided by electrodes placed well into the second cochlear turn. PMID:26583480

Medical School Hotline: Developing communication skills for leading family meetings.

PubMed

Inaba, Michiko; Bell, Christina; Tamura, Bruce; Kasuya, Richard; Masaki, Kamal

2011-06-01

Good clinician-family communication is essential for the provision of high-quality patient care. Families rate the communication skills of clinicians as critical clinical skills. However, there has been no structured training of fellow communication skills while leading family meetings in the University of Hawai'i Geriatric Medicine Fellowship Program. Effective training to develop communication skills with families will better prepare Geriatric Medicine fellows for this important task, and ultimately improve the quality of care they provide to these patients and patients' families.

Intensive gait training with rhythmic auditory stimulation in individuals with chronic hemiparetic stroke: a pilot randomized controlled study.

PubMed

Cha, Yuri; Kim, Young; Hwang, Sujin; Chung, Yijung

2014-01-01

Motor relearning protocols should involve task-oriented movement, focused attention, and repetition of desired movements. To investigate the effect of intensive gait training with rhythmic auditory stimulation on postural control and gait performance in individuals with chronic hemiparetic stroke. Twenty patients with chronic hemiparetic stroke participated in this study. Subjects in the Rhythmic auditory stimulation training group (10 subjects) underwent intensive gait training with rhythmic auditory stimulation for a period of 6 weeks (30 min/day, five days/week), while those in the control group (10 subjects) underwent intensive gait training for the same duration. Two clinical measures, Berg balance scale and stroke specific quality of life scale, and a 2-demensional gait analysis system, were used as outcome measure. To provide rhythmic auditory stimulation during gait training, the MIDI Cuebase musical instrument digital interface program and a KM Player version 3.3 was utilized for this study. Intensive gait training with rhythmic auditory stimulation resulted in significant improvement in scores on the Berg balance scale, gait velocity, cadence, stride length and double support period in affected side, and stroke specific quality of life scale compared with the control group after training. Findings of this study suggest that intensive gait training with rhythmic auditory stimulation improves balance and gait performance as well as quality of life, in individuals with chronic hemiparetic stroke.

Using quality experts from manufacturing to transform primary care.

PubMed

Steiner, Rose M; Walsworth, David T

2010-01-01

Improving Performance in Practice (IPIP) is an initiative convened by the American Board of Medical Specialties. It investigates the efficacy of coaches in helping primary-care practices improve the care of patients with diabetes and asthma. Most IPIP states use coaches who have a health care background, and are trained in quality and process improvement. Michigan uses quality experts from the manufacturing industry who are educated regarding the health care environment, which enables them to perform as quality-improvement coaches (QICs) in primary-care practices. In this case study, ninety-six quality experts were trained to coach primary-care practices, with 53 currently assigned to offices, and others assisting as needed. Practice teams and QICs identify gaps in care and office practices with the use of assorted quality-improvement tools. Reports are made monthly to describe clinical and process measures and methods used. Michigan has 33 practices engaged, involving 205 physicians and 40 midlevel providers. The teaming of quality experts from the manufacturing industry with primary-care office providers and staff resulted in office efficiency, improved care provided, and progress toward attainment of a patient-centered medical home (PCMH). Quality experts from manufacturing volunteered to coach for improvements in primary care. The efforts of QICs have been successful. Because the QICs are volunteers, sustainability of the Michigan Improving Performance in Practice program is a challenge.

Achieving Quality in the Navy Field Contracting System

DTIC Science & Technology

1986-12-01

they place on suppliers increase. Unless the supplier can satisfy the consumer , the consumer will go elsewhere for his/her needs. This reality caught...Quality products sell. Today’s consumers are willing to pay for quality so a company with a quality product is likely to control the market. Finally...the quality doctrine, but will provide a central point within the KFCS to address problems founc in improving quality. Training is another important

Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting.

PubMed

Frey, Rosemary; Gott, Merryn; Raphael, Deborah; O'Callaghan, Anne; Robinson, Jackie; Boyd, Michal; Laking, George; Manson, Leigh; Snow, Barry

2014-12-01

Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting. The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence. A purposive sample of clinical staff members (598) in a 710-bed hospital were surveyed regarding their experiences of palliative care delivery and their education needs. On average, the clinical staff rated the quality of care provided to people who die in the hospital as 'good' (x̄=4.17, SD=0.91). Respondents also reported that 19.3% of their time was spent caring for end-of-life patients. However, only 19% of the 598 respondents reported having received formal palliative care training. In contrast, 73.7% answered that they would like formal training. Perceived confidence in palliative care delivery was significantly greater for those clinical staff with formal palliative care training. Formal training in palliative care increases clinical staff perceptions of confidence, which evidence suggests impacts on the quality of palliative care provided to patients. The results of the study should be used to shape the design and delivery of palliative care education programmes within the acute hospital setting to successfully meet the needs of all clinical staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Managing data quality in an existing medical data warehouse using business intelligence technologies.

PubMed

Eaton, Scott; Ostrander, Michael; Santangelo, Jennifer; Kamal, Jyoti

2008-11-06

The Ohio State University Medical Center (OSUMC) Information Warehouse (IW) is a comprehensive data warehousing facility that provides providing data integration, management, mining, training, and development services to a diversity of customers across the clinical, education, and research sectors of the OSUMC. Providing accurate and complete data is a must for these purposes. In order to monitor the data quality of targeted data sets, an online scorecard has been developed to allow visualization of the critical measures of data quality in the Information Warehouse.

Partnering for Quality under the Workforce Investment Act: A Tool Kit for One-Stop System Building. Module 5: Building a Process for Continuous Improvement. Training Manual with Participant Workbook.

ERIC Educational Resources Information Center

Kogan, Deborah; Koller, Vinz; Kozumplik, Richalene; Lawrence, Mary Ann

This document is part of a five-module training package to help employment and training service providers comply with the Workforce Investment Act (WIA) of 1998 and develop a one-stop training and employment services system. It consists of the participant workbook, trainer manual, and activity worksheets for a module on building a process for…

Annual National Report of the Australian Vocational Education and Training System, 2001. Volume 1: National Overview; Volume 2: Commonwealth, State & Territory Reports.

ERIC Educational Resources Information Center

Australian National Training Authority, Brisbane.

This document contains the first two volumes of a three-volume annual national report on Australia's vocational education and training (VET) system. Volume 1, which constitutes approximately 30% of the document, details progress in achieving the following national priorities: (1) a quality national training system that provides value for money…

Partnering for Quality under the Workforce Investment Act: A Tool Kit for One-Stop System Building. Summary of Tools.

ERIC Educational Resources Information Center

Kogan, Deborah; Koller, Vinz; Kozumplik, Richalene; Lawrence, Mary Ann

This document presents 22 tools that were developed for use in a five-module training package to assist employment and training service providers comply with the Workforce Investment Act of 1998 and develop a one-stop training and employment services system. Each tool addresses a different aspect of the process of developing a one-stop delivery…

Partnerships for Quality project: closing the gap in care of children with ADHD.

PubMed

Lannon, Carole; Dolins, Judith; Lazorick, Suzanne; Crowe, Virginia Leigh Hamilton; Butts-Dion, Sue; Schoettker, Pamela J

2007-12-01

The Partnerships for Quality project was designed to close the gap between knowledge and care for children with attention deficit hyperactivity disorder by fostering a partnership between a major medical specialty society, a professional certifying body, a national family-based advocacy organization, and a child health improvement organization. Ten American Academy of Pediatrics chapters conducted training workshops for practicing pediatricians and their office teams. Assistance was provided in the form of feedback of data, ongoing communication via conference calls, and a listserve. Two national workshops were conducted to disseminate learnings and promote sustainability. Participation in the intervention resulted in greater involvement in quality improvement activities by practice teams and improved care outcomes. The training workshops facilitated collaboration among providers, parents, and the educational, mental health, and legal systems. The partnership structure used demonstrated what professional societies can do to support improvement at the local level and what component chapters need to do to support improvement at the practice level. The integration of quality improvement infrastructure and policy changes at the national and local levels suggest that the quality efforts are likely to be sustained, providing long-term improvement in care and outcomes for children and families.

Strengthening healthcare capacity through a responsive, country-specific, training standard: the KITSO AIDS training program's support of Botswana's national antiretroviral therapy rollout.

PubMed

Bussmann, Christine; Rotz, Philip; Ndwapi, Ndwapi; Baxter, Daniel; Bussmann, Hermann; Wester, C William; Ncube, Patricia; Avalos, Ava; Mine, Madisa; Mabe, Elang; Burns, Patricia; Cardiello, Peter; Makhema, Joseph; Marlink, Richard

2008-01-01

In parallel with the rollout of Botswana's national antiretroviral therapy (ART) program, the Botswana Ministry of Health established the KITSO AIDS Training Program by entering into long-term partnerships with the Botswana-Harvard AIDS Institute Partnership for HIV Research and Education and others to provide standardized, country-specific training in HIV/AIDS care. The KITSO training model has strengthened human capacity within Botswana's health sector and been indispensable to successful ART rollout. Through core and advanced training courses and clinical mentoring, different cadres of health care workers have been trained to provide high-quality HIV/AIDS care at all ART sites in the country. Continuous and standardized clinical education will be crucial to sustain the present level of care and successfully address future treatment challenges.

A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

PubMed

Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

2014-01-01

This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success.

Effects of a performance and quality improvement intervention on the work environment in HIV-related care: a quasi-experimental evaluation in Zambia.

PubMed

Bazant, Eva; Sarkar, Supriya; Banda, Joseph; Kanjipite, Webby; Reinhardt, Stephanie; Shasulwe, Hildah; Mulilo, Joyce Monica Chongo; Kim, Young Mi

2014-12-20

Human resource shortages and reforms in HIV-related care make it challenging for frontline health care providers in southern Africa to deliver high-quality services. At health facilities of the Zambian Defence Forces, a performance and quality improvement approach was implemented to improve HIV-related care and was evaluated in 2010/2011. Changes in providers' work environment and perceived quality of HIV-related care were assessed to complement data of provider performance. The intervention involved on-site training, supportive supervision, and action planning focusing on detailed service delivery standards. The quasi-experimental evaluation collected pre- and post-intervention data from eight intervention and comparison facilities matched on defence force branch and baseline client volume. Overall, 101 providers responded to a 24-item questionnaire on the work environment, covering topics of drugs, supplies, and equipment; training, feedback, and supervision; compensation; staffing; safety; fulfilment; and HIV services quality. In bivariate analysis and multivariate analyses, we assessed changes within each study group and between the two groups. In the bivariate analysis, the intervention group providers reported improvements in the work environment on adequacy of equipment, feeling safe from harm, confidence in clinical skills, and reduced isolation, while the comparison group reported worsening of the work environment on supplies, training, safety, and departmental morale.In the multivariate analysis, the intervention group's improvement and the comparison group's decline were significant on perceived adequacy of drugs, supplies, and equipment; constructive feedback received from supervisor and co-workers; and feeling safe from physical harm (all P <0.01, except P <0.04 for equipment). Further, the item "provider lacks confidence in some clinical skills" declined in the intervention group but increased in the comparison group (P = -0.005). In multivariate analysis, changes in perceived quality of HIV care did not differ between study groups. Provider perceptions were congruent with observations of preparing drugs, supplies, equipment, and in service delivery of prevention of mother-to-child transmission of HIV and antiretroviral therapy follow-up care. The performance and quality improvement intervention implemented at Zambian Defence Forces' health facilities was associated with improvements in providers' perceptions of work environment consistent with the intervention's focus on commodities, skills acquisition, and receipt of constructive feedback.

Essential Tension: Specialization with Broad and General Training in Psychology

ERIC Educational Resources Information Center

Roberts, Michael C.

2006-01-01

The practice fields of psychology develop through specialization in training and education. The recognized specialties play a major role in developing new opportunities for professional psychology and providing quality services for the public. The essential tension comes from the balance of innovation and tradition and, in professional psychology,…

Perceived Cultural Competence Levels in Undergraduate Athletic Training Students

ERIC Educational Resources Information Center

Volberding, Jennifer L.

2013-01-01

Context: As the patient population continues to diversify, it is essential that athletic training students (ATSs) are educated to provide culturally competent care. This high-quality health care within the context of a patient's race, ethnicity, language, religious beliefs, or behaviors is a foundation of professional practice. Objective:…

The Lincoln Training System: A Summary Report.

ERIC Educational Resources Information Center

Butman, Robert C.; Frick, Frederick C.

The current status of the Lincoln Training System (LTS) is reported. This document describes LTS as a computer supported microfiche system which: 1) provides random access to voice quality audio and to graphics; 2) supports student-controlled interactive processes; and 3) functions in a variety of environments. The report offers a detailed…

Nutrition Education and Training Program, 1985-86. Final Evaluation Report.

ERIC Educational Resources Information Center

Guerrero, Frank; Hunt, Daniel M.

The New York City Board of Education's Nutrition Education and Training Program was developed and implemented to improve the quality of nutrition education in elementary schools. The project's primary objectives were to: (1) provide elementary school teachers and food service personnel with enhanced knowledge of sound nutrition; (2) provide…

Professional Environment for Teacher Professional Development

ERIC Educational Resources Information Center

Zascerinska, Jelena

2010-01-01

Introduction. Teaching and training are at the heart of the knowledge society where the continuing professional development of teachers and trainers provides the cornerstone for the development of a high quality education and training systems. The Aim of the Study. To identify a design of professional environment for teacher professional…

Amount of kinematic feedback affects learning of speech motor skills.

PubMed

Ballard, Kirrie J; Smith, Heather D; Paramatmuni, Divija; McCabe, Patricia; Theodoros, Deborah G; Murdoch, Bruce E

2012-01-01

Knowledge of Performance (KP) feedback, such as biofeedback or kinematic feedback, is used to provide information on the nature and quality of movement responses for the purpose of guiding active learning or rehabilitation of motor skills. It has been proposed that KP feedback may interfere with long-term learning when provided throughout training. Here, twelve healthy English-speaking adults were trained to produce a trilled Russian [r] in words with KP kinematic feedback using electropalatography (EPG) and without KP (noKP). Five one-hour training sessions were provided over one week with testing pretraining and one day and one week posttraining. No group differences were found at pretraining or one day post training for production accuracy. A group by time interaction supported the hypothesis that providing kinematic feedback continually during skill acquisition interferes with retention.

[The future of intensive medicine].

PubMed

Palencia Herrejón, E; González Díaz, G; Mancebo Cortés, J

2011-05-01

Although Intensive Care Medicine is a young specialty compared with other medical disciplines, it currently plays a key role in the process of care for many patients. Experience has shown that professionals with specific training in Intensive Care Medicine are needed to provide high quality care to critically ill patients. In Europe, important steps have been taken towards the standardization of training programs of the different member states. However, it is now necessary to take one more step forward, that is, the creation of a primary specialty in Intensive Care Medicine. Care of the critically ill needs to be led by specialists who have received specific and complete training and who have the necessary professional competences to provide maximum quality care to their patients. The future of the specialty presents challenges that must be faced with determination, with the main objective of meeting the needs of the population. Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved.

Effects of training set selection on pain recognition via facial expressions

NASA Astrophysics Data System (ADS)

Shier, Warren A.; Yanushkevich, Svetlana N.

2016-07-01

This paper presents an approach to pain expression classification based on Gabor energy filters with Support Vector Machines (SVMs), followed by analyzing the effects of training set variations on the systems classification rate. This approach is tested on the UNBC-McMaster Shoulder Pain Archive, which consists of spontaneous pain images, hand labelled using the Prkachin and Solomon Pain Intensity scale. In this paper, the subjects pain intensity level has been quantized into three disjoint groups: no pain, weak pain and strong pain. The results of experiments show that Gabor energy filters with SVMs provide comparable or better results to previous filter- based pain recognition methods, with precision rates of 74%, 30% and 78% for no pain, weak pain and strong pain, respectively. The study of effects of intra-class skew, or changing the number of images per subject, show that both completely removing and over-representing poor quality subjects in the training set has little effect on the overall accuracy of the system. This result suggests that poor quality subjects could be removed from the training set to save offline training time and that SVM is robust not only to outliers in training data, but also to significant amounts of poor quality data mixed into the training sets.

International standards for programmes of training in intensive care medicine in Europe.

PubMed

2011-03-01

To develop internationally harmonised standards for programmes of training in intensive care medicine (ICM). Standards were developed by using consensus techniques. A nine-member nominal group of European intensive care experts developed a preliminary set of standards. These were revised and refined through a modified Delphi process involving 28 European national coordinators representing national training organisations using a combination of moderated discussion meetings, email, and a Web-based tool for determining the level of agreement with each proposed standard, and whether the standard could be achieved in the respondent's country. The nominal group developed an initial set of 52 possible standards which underwent four iterations to achieve maximal consensus. All national coordinators approved a final set of 29 standards in four domains: training centres, training programmes, selection of trainees, and trainers' profiles. Only three standards were considered immediately achievable by all countries, demonstrating a willingness to aspire to quality rather than merely setting a minimum level. Nine proposed standards which did not achieve full consensus were identified as potential candidates for future review. This preliminary set of clearly defined and agreed standards provides a transparent framework for assuring the quality of training programmes, and a foundation for international harmonisation and quality improvement of training in ICM.

An assessment of air quality impacts of fires associated with fire fighting operations.

PubMed

Leahey, D M; Hansen, M C; Schroeder, M B

1993-03-01

Fire fighters in Canada's navy must undergo regular training with fires from simulated helicopter crashes. Visible emissions from these fires often create health concerns in surrounding communities. This paper presents air quality implications of plume dispersion associated with "helicopter fires." Evaluations involved measuring plume rise, estimating emissions, dispersion modeling and ambient monitoring. Results of the evaluation provided ground-level concentration estimates of plume particulate matter, oxides of nitrogen, hydrogen fluoride, carbon monoxide, 22 metals, 15 PAH and 13 VOC. The study showed that the air quality impact of the fire fighting training is much lower than the relevant time-weighted averages established to protect workers' health. This paper will be of interest to people in environmental protection agencies because it demonstrates the effects of fire fighting operations that must frequently occur as part of training exercises.

Training Requirements and Curriculum Content for Primary Care Providers Delivering Preventive Oral Health Services to Children Enrolled in Medicaid.

PubMed

Sams, Lattice D; Rozier, R Gary; Quinonez, Rocio B

2016-07-01

Despite the emphasis on delivery of preventive oral health services in non-dental settings, limited information exists about state Medicaid policies and strategies to educate practicing physicians in the delivery of these services. This study aims to determine: (1) training requirements and policies for reimbursement of oral health services, (2) teaching delivery methods used to train physicians, and (3) curricula content available to providers among states that reimburse non-dental providers for oral health services. Using Web-based Internet searches as the primary data source, and a supplemental e-mail survey of all states offering in-person training, we assessed training requirements, methods of delivery for training, and curriculum content for states with Medicaid reimbursement to primary care providers delivering preventive oral health services. RESULTS of descriptive analyses are presented for information collected and updated in 2014. Forty-two states provide training sessions or resources to providers, 34 requiring provider training before reimbursement for oral health services. Web-based training is the most common CME delivery method. Only small differences in curricular content were reported by the 11 states that use in-person didactic sessions as the delivery method. Although we found that most states require training and curricular content is similar, training was most often delivered using Web-based courses without any additional delivery methods. Research is needed to evaluate the impact of a mixture of training methods and other quality improvement methods on increased adoption and implementation of preventive oral health services in medical practices.

A Pilot Project Demonstrating that Combat Medics Can Safely Administer Parenteral Medications in the Emergency Department.

PubMed

Schauer, Steven G; Cunningham, Cord W; Fisher, Andrew D; DeLorenzo, Robert A

2017-12-01

Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration. Project Design This was a quality assurance project that monitored training of combat medics to administer parenteral medications and to ensure patient safety. Combat medics were provided training that included direct supervision during medication administration. Once proficiency was demonstrated, combat medics would prepare the medications under direct supervision, followed by indirect supervision during administration. As part of the quality assurance and safety processes, combat medics were required to document all medication administrations, supervising provider, and unexpected adverse events. Additional quality assurance follow-up occurred via complete chart review by the project lead. Data During the project period, the combat medics administered the following medications: ketamine (n=13), morphine (n=8), ketorolac (n=7), fentanyl (n=5), ondansetron (n=4), and other (n=6). No adverse events or patient safety events were reported by the combat medics or discovered during the quality assurance process. In this limited case series, combat medics safely administered parenteral medications under indirect provider supervision. Future research is needed to further develop this training model for both the military and civilian setting. Schauer SG , Cunningham C W, Fisher AD , DeLorenzo RA . A pilot project demonstrating that combat medics can safely administer parenteral medications in the emergency department. Prehosp Disaster Med. 2017;32(6):679-681.

Communicating with patients who have advanced dementia: training nurse aide students.

PubMed

Beer, Laura E; Hutchinson, Susan R; Skala-Cordes, Kristine K

2012-01-01

The increase of dementia in older adults is changing how medical care is delivered. Recognizing symptoms of pain, managing behaviors, and providing quality of life for people who have advanced dementia requires a new skill set for caregivers. Researchers in this study targeted nurse aide students to test an educational module's effect on students' perceptions of dementia and their ability to care for patients with dementia. The results indicated the training was effective regarding nurse aides' understanding of residual cognitive abilities and need for meaningful contact among patients with advanced dementia; however, the training was not successful in terms of nurse aides' comfort level or perceived skills in working with this population of patients. The findings suggest a need to transform how caregivers are trained in communication techniques. Incorporating this training into nurse aide education has the potential to increase quality of life for people with dementia.

Decentralised training for medical students: Towards a South African consensus.

PubMed

De Villiers, Marietjie R; Blitz, Julia; Couper, Ian; Kent, Athol; Moodley, Kalavani; Talib, Zohray; Van Schalkwyk, Susan; Young, Taryn

2017-09-28

Health professions training institutions are challenged to produce greater numbers of graduates who are more relevantly trained to provide quality healthcare. Decentralised training offers opportunities to address these quantity, quality and relevance factors. We wanted to draw together existing expertise in decentralised training for the benefit of all health professionals to develop a model for decentralised training for health professions students. An expert panel workshop was held in October 2015 initiating a process to develop a model for decentralised training in South Africa. Presentations on the status quo in decentralised training at all nine medical schools in South Africa were made and 33 delegates engaged in discussing potential models for decentralised training. Five factors were found to be crucial for the success of decentralised training, namely the availability of information and communication technology, longitudinal continuous rotations, a focus on primary care, the alignment of medical schools' mission with decentralised training and responsiveness to student needs. The workshop concluded that training institutions should continue to work together towards formulating decentralised training models and that the involvement of all health professions should be ensured. A tripartite approach between the universities, the Department of Health and the relevant local communities is important in decentralised training. Lastly, curricula should place more emphasis on how students learn rather than how they are taught.

Team-training in healthcare: a narrative synthesis of the literature.

PubMed

Weaver, Sallie J; Dy, Sydney M; Rosen, Michael A

2014-05-01

Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings. A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes. Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice. Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes.

Training a Chest Compression of 6–7 cm Depth for High Quality Cardiopulmonary Resuscitation in Hospital Setting: A Randomised Controlled Trial

PubMed Central

Oh, Jaehoon; Cho, Youngsuk; Kang, Hyunggoo; Kim, Wonhee; Chee, Youngjoon; Song, Yeongtak; Kim, In Young; Lee, Juncheol

2016-01-01

Purpose During cardiopulmonary resuscitation (CPR), chest compression (CC) depth is influenced by the surface on which the patient is placed. We hypothesized that training healthcare providers to perform a CC depth of 6–7 cm (instead of 5–6 cm) on a manikin placed on a mattress during CPR in the hospital might improve their proper CC depth. Materials and Methods This prospective randomised controlled study involved 66 premedical students without CPR training. The control group was trained to use a CC depth of 5–6 cm (G 5–6), while the experimental group was taught to use a CC depth of 6–7 cm (G 6–7) with a manikin on the floor. All participants performed CCs for 2 min on a manikin that was placed on a bed 1 hour and then again 4 weeks after the training without a feedback. The parameters of CC quality (depth, rate, % of accurate depth) were assessed and compared between the 2 groups. Results Four students were excluded due to loss to follow-up and recording errors, and data of 62 were analysed. CC depth and % of accurate depth were significantly higher among students in the G 6–7 than G 5–6 both 1 hour and 4 weeks after the training (p<0.001), whereas CC rate was not different between two groups (p>0.05). Conclusion Training healthcare providers to perform a CC depth of 6–7 cm could improve quality CC depth when performing CCs on patients who are placed on a mattress during CPR in a hospital setting. PMID:26847307

Team-training in healthcare: a narrative synthesis of the literature

PubMed Central

Weaver, Sallie J; Dy, Sydney M; Rosen, Michael A

2014-01-01

Background Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings. Methods A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes. Results Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice. Conclusions Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes. PMID:24501181

[The training of medical and scientific manpower in the system of postgraduate medical education].

PubMed

Kabanova, S A; Lozhkevich, I Iu

2010-01-01

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.

Exploration of the methodological quality and clinical usefulness of a cross-sectional sample of published guidance about exercise training and physical activity for the secondary prevention of coronary heart disease.

PubMed

Abell, Bridget; Glasziou, Paul; Hoffmann, Tammy

2017-06-13

Clinicians are encouraged to use guidelines to assist in providing evidence-based secondary prevention to patients with coronary heart disease. However, the expanding number of publications providing guidance about exercise training may confuse cardiac rehabilitation clinicians. We therefore sought to explore the number, scope, publication characteristics, methodological quality, and clinical usefulness of published exercise-based cardiac rehabilitation guidance. We included publications recommending physical activity, exercise or cardiac rehabilitation for patients with coronary heart disease. These included systematically developed clinical practice guidelines, as well as other publications intended to support clinician decision making, such as position papers or consensus statements. Publications were obtained via electronic searches of preventive cardiology societies, guideline databases and PubMed, to November 2016. Publication characteristics were extracted, and two independent assessors evaluated quality using the 23-item Appraisal of Guidelines Research and Evaluation II (AGREE) tool. Fifty-four international publications from 1994 to 2016 were identified. Most were found on preventive cardiology association websites (n = 35; 65%) and were freely accessible (n = 50; 93%). Thirty (56%) publications contained only broad recommendations for physical activity and cardiac rehabilitation referral, while 24 (44%) contained the necessary detailed exercise training recommendations. Many were labelled as "guidelines", however publications with other titles (e.g. scientific statements) were common (n = 24; 44%). This latter group of publications contained a significantly greater proportion of detailed exercise training recommendations than clinical guidelines (p = 0.017). Wide variation in quality also existed, with 'applicability' the worst scoring AGREE II domain for clinical guidelines (mean score 53%) and 'rigour of development' rated lowest for other guidance types (mean score 33%). While a large number of guidance documents provide recommendations for exercise-based cardiac rehabilitation, most have limitations in either methodological quality or clinical usefulness. The lack of rigorously developed guidelines which also contain necessary detail about exercise training remains a substantial problem for clinicians.

Are We All Speaking the Same Language? Understanding "Quality" in the VET Sector. Occasional Paper

ERIC Educational Resources Information Center

Griffin, Tabatha

2017-01-01

Quality in vocational education and training (VET) is a perennial topic of interest, attracting much attention from participants, providers, funders, regulators and public commentators. Quality is as much subjectively in the "eye of the beholder" as it is objectively assessed through hard data, measures and surveys. This paper summarises…

Does dental undergraduate education and postgraduate training enable intention to provide inhalation sedation in primary dental care? A path analytical exploration.

PubMed

Yuan, S; J Carson, S; Rooksby, M; McKerrow, J; Lush, C; Humphris, G; Freeman, R

2017-08-01

To examine how quality standards of dental undergraduate education, postgraduate training and qualifications together with confidence and barriers could be utilised to predict intention to provide inhalation sedation. All 202 dentists working within primary dental care in NHS Highland were invited to participate. The measures in the questionnaire survey included demographic information, undergraduate education and postgraduate qualifications, current provision and access to sedation service, attitudes towards confidence, barriers and intention to provide inhalation sedation. A path analytical approach was employed to investigate the fit of collected data to the proposed mediational model. One hundred and nine dentists who completed the entire questionnaire participated (response rate of 54%). Seventy-six per cent of dentists reported receiving lectures in conscious sedation during their undergraduate education. Statistically significantly more Public Dental Service dentists compared with General Dental Service (GDS) dentists had postgraduate qualification and Continuing Professional Development training experience in conscious sedation. Only twenty-four per cent of the participants stated that they provided inhalation sedation to their patients. The findings indicated that PDS dentists had higher attitudinal scores towards inhalation sedation than GDS practitioners. The proposed model showed an excellent level of fit. A multigroup comparison test confirmed that the level of association between confidence in providing inhalation sedation and intention varied by group (GDS vs. PDS respondents). Public Dental Service respondents who showed extensive postgraduate training experience in inhalation sedation were more confident and likely to provide this service. The quality standards of dental undergraduate education, postgraduate qualifications and training together with improved confidence predicted primary care dentists' intention to provide inhalation sedation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effect of strength training on quality of prolonged basic cardiopulmonary resuscitation.

PubMed

Abelairas-Gómez, Cristian; Barcala-Furelos, Roberto; Szarpak, Łukasz; García-García, Óscar; Paz-Domínguez, Álvaro; López-García, Sergio; Rodríguez-Núñez, Antonio

2017-01-01

Providing high-quality chest compressions and rescue breaths are key elements in the effectiveness of cardio-pulmonary resuscitation. To investigate the effects of a strength training programme on the quality of prolonged basic cardiopulmonary resuscitation on a manikin. This was a quasi-experimental trial. Thirty-nine participants with prior basic life support knowledge were randomised to an experimental or control group. They then performed a test of 10 min of chest compressions and mouth-to-mouth ventilation on manikins equipped with a skill reporter tool (baseline or test 1). The experimental group participated in a four-week strength training programme focused on the muscles involved in chest compressions. Both groups were subsequently tested again (test 2). After training, the experimental group significantly increased the mean depth of compression (53.7 ± 2.3 mm vs. 49.9 ± 5.9 mm; p = 0.003) and the correct compression fraction (68.2 ± 21.0% vs. 46.4 ± 29.1%; p = 0.004). Trained subjects maintained chest compression quality over time better than the control group. The mean tidal volume delivered was higher in the experimental than in the control group (701.5 ± 187.0 mL vs. 584.8 ± 113.6 mL; p = 0.040) and above the current resuscitation guidelines. In test 2, the percentage of rescue breaths with excessive volume was higher in the experi-mental group than in the controls (31.5 ± 19.6% vs. 15.6 ± 13.0%; p = 0.007). A simple strength training programme has a significant impact on the quality of chest compressions and its maintenance over time. Additional training is needed to avoid over-ventilation of potential patients.

Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows.

PubMed

Kumar, Navin L; Perencevich, Molly L; Trier, Jerry S

2017-10-01

Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year. We queried participants about (1) the current models of inpatient training, (2) the content, objectives, and quality of the inpatient training experience, and (3) the frequency and quality of educational activities on the inpatient service. We analyzed five-point Likert items and rank assessments as continuous variables by an independent t test and compared proportions using the Chi-square test. Survey response rate was 48.4% (75/155) for PDs and a total of 194 fellows completed the survey, with both groups reporting the general GI consult team (>90%) as the primary model of inpatient training. PDs and fellows agreed on the ranking of all queried responsibilities of the inpatient fellow to develop during the inpatient service. However, fellows indicated that attendings spent less time teaching and provided less formal feedback than that perceived by PDs (p < 0.0001). PDs rated the overall quality of the inpatient training experience (p < 0.0001) and education on the wards (p = 0.0003) as better than overall ratings by fellows. Although GI fellows and PDs agree on the importance of specific fellow responsibilities on the inpatient service, fellows report experiencing less teaching and feedback from attendings than that perceived by PDs. Committing more time to education and assessment may improve fellows' perceptions of the inpatient training experience.

Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

PubMed Central

2010-01-01

Background To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. Methods The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. Results In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). Conclusions These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services. PMID:21062460

Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

PubMed

Qureshi, Asma M

2010-11-09

To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services.

Adaptive predictors based on probabilistic SVM for real time disruption mitigation on JET

NASA Astrophysics Data System (ADS)

Murari, A.; Lungaroni, M.; Peluso, E.; Gaudio, P.; Vega, J.; Dormido-Canto, S.; Baruzzo, M.; Gelfusa, M.; Contributors, JET

2018-05-01

Detecting disruptions with sufficient anticipation time is essential to undertake any form of remedial strategy, mitigation or avoidance. Traditional predictors based on machine learning techniques can be very performing, if properly optimised, but do not provide a natural estimate of the quality of their outputs and they typically age very quickly. In this paper a new set of tools, based on probabilistic extensions of support vector machines (SVM), are introduced and applied for the first time to JET data. The probabilistic output constitutes a natural qualification of the prediction quality and provides additional flexibility. An adaptive training strategy ‘from scratch’ has also been devised, which allows preserving the performance even when the experimental conditions change significantly. Large JET databases of disruptions, covering entire campaigns and thousands of discharges, have been analysed, both for the case of the graphite and the ITER Like Wall. Performance significantly better than any previous predictor using adaptive training has been achieved, satisfying even the requirements of the next generation of devices. The adaptive approach to the training has also provided unique information about the evolution of the operational space. The fact that the developed tools give the probability of disruption improves the interpretability of the results, provides an estimate of the predictor quality and gives new insights into the physics. Moreover, the probabilistic treatment permits to insert more easily these classifiers into general decision support and control systems.

Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

PubMed

Agha, Sohail; Gage, Anastasia; Balal, Asma

2007-05-01

With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to increased provider willingness to remain part of the franchise and to abide by the standards of quality set by the franchiser.

A novel method of assessing quality of postgraduate psychiatry training: experiences from a large training programme

PubMed Central

2013-01-01

Background Most assessments of the quality of postgraduate training are based on anonymised questionnaires of trainees. We report a comprehensive assessment of the quality of training at a large postgraduate psychiatry training institute using non-anonymised face-to-face interviews with trainees and their trainers. Methods Two consultant psychiatrists interviewed 99 trainees and 109 trainers. Scoring of interview responses was determined by using a pre-defined criteria. Additional comments were recorded as free text. Interviews covered 13 domains, including: Clinical, teaching, research and management opportunities, clinical environment, clinical supervision, adequacy of job description, absence of bullying and job satisfaction. Multiple interview domain scores were combined, generating a ‘Combined’ score for each post. Results The interview response rate was 97% for trainers 88% for trainees. There was a significant correlation between trainee and trainer scores for the same interview domains (Pearson’s r = 0.968, p< 0.001). Overall scores were significantly higher for specialist psychiatry posts as compared to general adult psychiatry posts (Two tailed t-test, p < 0.001, 95% CI: -0.398 to −0.132), and significantly higher for liaison psychiatry as compared to other specialist psychiatry posts (t-test: p = 0.038, 95% CI: -0.3901, -0.0118). Job satisfaction scores of year 1 to year 3 core trainees showed a significant increase with increasing seniority (Linear regression coefficient = 0.273, 95% CI: 0.033 to 0.513, ANOVA p= 0.026). Conclusions This in-depth examination of the quality of training on a large psychiatry training programme successfully elicited strengths and weakness of our programme. Such an interview scheme could be easily implemented in smaller schemes and may well provide important information to allow for targeted improvement of training. Additionally, trends in quality of training and job satisfaction amongst various psychiatric specialities were identified; specifically speciality posts and liaison posts in psychiatry were revealed to be the most popular with trainees. PMID:23768083

A novel method of assessing quality of postgraduate psychiatry training: experiences from a large training programme.

PubMed

Bizrah, Mukhtar; Iacoponi, Eduardo; Parker, Elizabeth; Rymer, Janice; Iversen, Amy; Wessely, Simon

2013-06-14

Most assessments of the quality of postgraduate training are based on anonymised questionnaires of trainees. We report a comprehensive assessment of the quality of training at a large postgraduate psychiatry training institute using non-anonymised face-to-face interviews with trainees and their trainers. Two consultant psychiatrists interviewed 99 trainees and 109 trainers. Scoring of interview responses was determined by using a pre-defined criteria. Additional comments were recorded as free text. Interviews covered 13 domains, including: Clinical, teaching, research and management opportunities, clinical environment, clinical supervision, adequacy of job description, absence of bullying and job satisfaction. Multiple interview domain scores were combined, generating a 'Combined' score for each post. The interview response rate was 97% for trainers 88% for trainees. There was a significant correlation between trainee and trainer scores for the same interview domains (Pearson's r = 0.968, p< 0.001). Overall scores were significantly higher for specialist psychiatry posts as compared to general adult psychiatry posts (Two tailed t-test, p < 0.001, 95% CI: -0.398 to -0.132), and significantly higher for liaison psychiatry as compared to other specialist psychiatry posts (t-test: p = 0.038, 95% CI: -0.3901, -0.0118). Job satisfaction scores of year 1 to year 3 core trainees showed a significant increase with increasing seniority (Linear regression coefficient = 0.273, 95% CI: 0.033 to 0.513, ANOVA p= 0.026). This in-depth examination of the quality of training on a large psychiatry training programme successfully elicited strengths and weakness of our programme. Such an interview scheme could be easily implemented in smaller schemes and may well provide important information to allow for targeted improvement of training. Additionally, trends in quality of training and job satisfaction amongst various psychiatric specialities were identified; specifically speciality posts and liaison posts in psychiatry were revealed to be the most popular with trainees.

Improving care quality and preventing maltreatment in institutional care - a feasibility study with caregivers.

PubMed

Hermenau, Katharin; Kaltenbach, Elisa; Mkinga, Getrude; Hecker, Tobias

2015-01-01

Institutionalized children in low-income countries often face maltreatment and inadequate caregiving. In addition to prior traumatization and other childhood adversities in the family of origin, abuse and neglect in institutional care are linked to various mental health problems. By providing a manualized training workshop for caregivers, we aimed at improving care quality and preventing maltreatment in institutional care. In Study 1, 29 participating caregivers rated feasibility and efficacy of the training immediately before, directly after, and 3 months following the training workshop. The results showed high demand, good feasibility, high motivation, and acceptance of caregivers. They reported improvements in caregiver-child relationships, as well as in the children's behavior. Study 2 assessed exposure to maltreatment and the mental health of 28 orphans living in one institution in which all caregivers had been trained. The children were interviewed 20 months before, 1 month before, and 3 months after the training. Children reported a decrease in physical maltreatment and assessments showed a decrease in mental health problems. Our approach seems feasible under challenging circumstances and provides first hints for its efficacy. These promising findings call for further studies testing the efficacy and sustainability of this maltreatment prevention approach.

Improving care quality and preventing maltreatment in institutional care – a feasibility study with caregivers

PubMed Central

Hermenau, Katharin; Kaltenbach, Elisa; Mkinga, Getrude; Hecker, Tobias

2015-01-01

Institutionalized children in low-income countries often face maltreatment and inadequate caregiving. In addition to prior traumatization and other childhood adversities in the family of origin, abuse and neglect in institutional care are linked to various mental health problems. By providing a manualized training workshop for caregivers, we aimed at improving care quality and preventing maltreatment in institutional care. In Study 1, 29 participating caregivers rated feasibility and efficacy of the training immediately before, directly after, and 3 months following the training workshop. The results showed high demand, good feasibility, high motivation, and acceptance of caregivers. They reported improvements in caregiver–child relationships, as well as in the children’s behavior. Study 2 assessed exposure to maltreatment and the mental health of 28 orphans living in one institution in which all caregivers had been trained. The children were interviewed 20 months before, 1 month before, and 3 months after the training. Children reported a decrease in physical maltreatment and assessments showed a decrease in mental health problems. Our approach seems feasible under challenging circumstances and provides first hints for its efficacy. These promising findings call for further studies testing the efficacy and sustainability of this maltreatment prevention approach. PMID:26236248

Programmatic assessment of a university-based implant training program using patient-reported outcomes.

PubMed

Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

2014-11-01

The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

Factors influencing healthcare service quality

PubMed Central

Mosadeghrad, Ali Mohammad

2014-01-01

Background: The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality. PMID:25114946

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

PubMed Central

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

2017-01-01

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

Race, Income, and Education: Associations with Patient and Family Ratings of End-of-Life Care and Communication Provided by Physicians-in-Training

PubMed Central

Engelberg, Ruth A.; Downey, Lois; Kross, Erin K.; Reinke, Lynn F.; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W.; Back, Anthony L.; Curtis, J. Randall

2014-01-01

Abstract Background: Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. Objective: To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. Methods: As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Results: Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Conclusions: Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families. PMID:24592958

Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training.

PubMed

Long, Ann C; Engelberg, Ruth A; Downey, Lois; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W; Back, Anthony L; Curtis, J Randall

2014-04-01

Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.

Neuromuscular electrical stimulation and inspiratory muscle training as potential adjunctive rehabilitation options for patients with heart failure.

PubMed

Arena, Ross; Pinkstaff, Sherry; Wheeler, Emma; Peberdy, Mary Ann; Guazzi, Marco; Myers, Jonathan

2010-01-01

Aerobic and resistance exercise training programs produce an abundance of physiologic and clinical benefits in patients with heart failure (HF). Improved maximal aerobic capacity, submaximal aerobic endurance, muscle force production, perceived quality of life, and skeletal muscle characteristics are among the more established outcomes resulting from these rehabilitation techniques. Moreover, both aerobic and resistance exercise training appear to portend a low risk to patients with HF when appropriate exercise prescription methods are followed. While the aforementioned training techniques will undoubtedly continue to be at the center of a well-formulated rehabilitation program, other adjunctive interventions, which are presently underutilized in clinical practice, may prove beneficial in patients with HF. Specifically, both neuromuscular electrical stimulation (NMES) and inspiratory muscle training (IMT) appear to significantly improve several physiologic, exercise, symptomatologic, and quality-of-life parameters. NMES targets skeletal muscle abnormalities, whereas IMT primarily targets the weakened respiratory musculature, both often encountered in patients with HF. A PubMed search using relevant key words identified 19 original investigations examining the impact of NMES (13 studies) and IMT (6 studies) training programs in patients with HF. The resultant review (1) provides a summary of the original research outcomes of both NMES and IMT in patients with HF; (2) addresses current research gaps, providing a direction for future investigations; and (3) provides clinical scenarios where NMES and IMT may prove to be beneficial during the rehabilitation of patients with HF.

Telemedicine spirometry training and quality assurance program in primary care centers of a public health system.

PubMed

Marina Malanda, Nuria; López de Santa María, Elena; Gutiérrez, Asunción; Bayón, Juan Carlos; Garcia, Larraitz; Gáldiz, Juan B

2014-04-01

Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (p<0.001). In the second phase, 7,200 spirometry tests were assessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; p<0.001). (1) The quality of spirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.

YoungStar in Milwaukee County: An Initial Progress Report as of July 2011

ERIC Educational Resources Information Center

Edie, Dave

2011-01-01

YoungStar is a program of the Department of Children and Families (DCF) created to improve the quality of child care for Wisconsin children. YoungStar is designed to: (1) Evaluate and rate the quality of care given by child care providers; (2) Help parents choose the best child care for their kids; (3) Support providers with tools and training to…

YoungStar in Wisconsin: An Initial Progress Report as of July 2011

ERIC Educational Resources Information Center

Edie, Dave

2011-01-01

YoungStar is a program of the Department of Children and Families (DCF) created to improve the quality of child care for Wisconsin children. YoungStar is designed to: (1) Evaluate and rate the quality of care given by child care providers; (2) Help parents choose the best child care for their kids; (3) Support providers with tools and training to…

Strengthening Healthcare Capacity Through a Responsive, Country-Specific, Training Standard: The KITSO AIDS Training Program’s Sup-port of Botswana’s National Antiretroviral Therapy Rollout

PubMed Central

Bussmann, Christine; Rotz, Philip; Ndwapi, Ndwapi; Baxter, Daniel; Bussmann, Hermann; Wester, C. William; Ncube, Patricia; Avalos, Ava; Mine, Madisa; Mabe, Elang; Burns, Patricia; Cardiello, Peter; Makhema, Joseph; Marlink, Richard

2008-01-01

In parallel with the rollout of Botswana’s national antiretroviral therapy (ART) program, the Botswana Ministry of Health established the KITSO AIDS Training Program by entering into long-term partnerships with the Botswana–Harvard AIDS Institute Partnership for HIV Research and Education and others to provide standardized, country-specific training in HIV/AIDS care. The KITSO training model has strengthened human capacity within Botswana’s health sector and been indispensable to successful ART rollout. Through core and advanced training courses and clinical mentoring, different cadres of health care workers have been trained to provide high-quality HIV/AIDS care at all ART sites in the country. Continuous and standardized clinical education will be crucial to sustain the present level of care and successfully address future treatment challenges. PMID:18923699

The motivation to learn: efficacy and relevance of the Oswestry postgraduate orthopaedic training programme.

PubMed Central

Morgan-Jones, R. L.; Wade, R.; Richardson, J. B.

1998-01-01

The efficacy and relevance of medical education has come under increased scrutiny in recent years. The shortening of basic surgical training and the introduction of 'seamless' higher surgical training has placed greater emphasis on the quality of education provided/facilitated by trainers. Additionally, study leave budgets are under increasing pressure from trainees wishing to attend courses or conferences, and regional postgraduate deans who wish to see a proportionally greater amount of training on an 'in-house' basis. Against this background we have reviewed the learning opportunities available on the Oswestry postgraduate programme to see if these opportunities provide adequate motivation to learn for the trainee. PMID:9771229

Protocol: Evaluating the impact of a nation-wide train-the-trainer educational initiative to enhance the quality of palliative care for children with cancer.

PubMed

Widger, Kimberley; Friedrichsdorf, Stefan; Wolfe, Joanne; Liben, Stephen; Pole, Jason D; Bouffet, Eric; Greenberg, Mark; Husain, Amna; Siden, Harold; Whitlock, James A; Rapoport, Adam

2016-01-27

There are identified gaps in the care provided to children with cancer based on the self-identified lack of education for health care professionals in pediatric palliative care and in the perceptions of bereaved parents who describe suboptimal care. In order to address these gaps, we will implement and evaluate a national roll-out of Education in Palliative and End-of-Life Care for Pediatrics (EPEC®-Pediatrics), using a 'Train-the-Trainer' model. In this study we are using a pre- post-test design and an integrated knowledge translation approach to assess the impact of the educational roll-out in four areas: 1) self-assessed knowledge of health professionals; 2) knowledge dissemination outcomes; 3) practice change outcomes; and 4) quality of palliative care. The quality of palliative care will be assessed using data from three sources: a) parent and child surveys about symptoms, quality of life and care provided; b) health record reviews of deceased patients; and c) bereaved parent surveys about end-of-life and bereavement care. After being trained in EPEC®-Pediatrics, 'Master Facilitators' will train 'Regional Teams' affiliated with 16 pediatric oncology programs in Canada. Each team will consist of three to five health professionals representing oncology, palliative care, and the community. Each team member will complete online modules and attend one of two face-to-face conferences, where they will receive training and materials to teach the EPEC®-Pediatrics curriculum to 'End-Users' in their region. Regional Teams will also choose a Tailored Implementation of Practice Standards (TIPS) Kit to guide implementation of a quality improvement project in their region; support will be provided via quarterly meetings with Co-Leads and via a listserv and webinars with other teams. Through this study we aim to raise the level of pediatric palliative care education amongst health care professionals in Canada. Our study will be a significant step forward in evaluation of the impact of EPEC®-Pediatrics both on dissemination outcomes and on care quality at a national level. Based on the anticipated success of our project we hope to expand the EPEC®-Pediatrics roll-out to health professionals who care for children with non-oncological life-threatening conditions.

There is a long way to go: a nationwide survey of professional training for mental health practitioners in China.

PubMed

Gao, Xiao; Jackson, Todd; Chen, Hong; Liu, Yanmei; Wang, Ruiqiang; Qian, Mingyi; Huang, Xiting

2010-04-01

This nationwide survey of professional training for mental health practitioners (i.e., psychiatrists, psychiatric nurses, clinical psychologists, and the counselors working in industry, prisons, and schools) investigated sociodemographic characteristics, training experiences, and training perceptions of mental health service providers in China. Participants included service providers recruited from hospitals, universities, high/middle schools, private mental health service organizations and counseling centers operated by government, prisons or corporations from 25 provinces and four cities directly under the Central Government in China. In order to obtain a broad and representative sample, stratified multi-stage sampling procedures were utilized. From a total of 2000 questionnaire packets distributed via regular mail, the final sample comprised of 1391 respondents (525 men, 866 women). About 70% of the sample had a bachelor's level education or lower degree, only 36.4% majored in psychology, and nearly 60% were employed part time. Fewer than half of participants were certified and nearly 40% reported no affiliation with any 'professional' association. Training and continuing education programs were reported to be primarily short term and theory-based with limited assessment and follow-up. A high proportion of respondents reported having received no supervision or opportunities for case conferences or consultations. With respect to perceptions of and satisfaction with training, many agreed that training had been very helpful to their work but quality of supervision and the capability of supervisors were common issues of concern. In light of these findings, three general recommendations were made to improve the quality of training among mental health service providers in China. First, increased input from professional organizations of various disciplines involving mental health service provision is needed to guide training and shape policy. Second, universities and colleges should have a more vital role in developing accredited professional training programs. Finally, on-the-job supervision and continuing education should be mandated within discipline-specific training programs. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Meeting the milestones. Strategies for including high-value care education in pulmonary and critical care fellowship training.

PubMed

Courtright, Katherine R; Weinberger, Steven E; Wagner, Jason

2015-04-01

Physician decision making is partially responsible for the roughly 30% of U.S. healthcare expenditures that are wasted annually on low-value care. In response to both the widespread public demand for higher-quality care and the cost crisis, payers are transitioning toward value-based payment models whereby physicians are rewarded for high-value, cost-conscious care. Furthermore, to target physicians in training to practice with cost awareness, the Accreditation Council for Graduate Medical Education has created both individual objective milestones and institutional requirements to incorporate quality improvement and cost awareness into fellowship training. Subsequently, some professional medical societies have initiated high-value care educational campaigns, but the overwhelming majority target either medical students or residents in training. Currently, there are few resources available to help guide subspecialty fellowship programs to successfully design durable high-value care curricula. The resource-intensive nature of pulmonary and critical care medicine offers unique opportunities for the specialty to lead in modeling and teaching high-value care. To ensure that fellows graduate with the capability to practice high-value care, we recommend that fellowship programs focus on four major educational domains. These include fostering a value-based culture, providing a robust didactic experience, engaging trainees in process improvement projects, and encouraging scholarship. In doing so, pulmonary and critical care educators can strive to train future physicians who are prepared to provide care that is both high quality and informed by cost awareness.

A randomized trial of cardiopulmonary resuscitation training for medical students: voice advisory mannequin compared to guidance provided by an instructor.

PubMed

Díez, Nieves; Rodríguez-Díez, María-Cristina; Nagore, David; Fernández, Secundino; Ferrer, Marta; Beunza, Juan-Jose

2013-08-01

Current European Resuscitation Guidelines 2010 recommend the use of prompt/feedback devices when training for cardiopulmonary resuscitation (CPR). We aimed to assess the quality of CPR training among second-year medical students with a voice advisory mannequin (VAM) compared to guidance provided by an instructor. Forty-three students received a theoretical reminder about CPR followed by a 2-minute pretest on CPR (compressions/ventilations cycle) with Resusci Anne SkillReporter (Laerdal Medical). They were then randomized into a control group (n = 22), trained by an instructor for 4 minutes per student, and an intervention group (n = 21) trained individually with VAM CPR mannequin for 4 minutes. After training, the students performed a 2-minute posttest, with the same method as the pretest. Participants in the intervention group (VAM) performed more correct hand position (73% vs. 37%; P = 0.014) and tended to display better compression rate (124 min vs. 135 min; P = 0.089). In a stratified analyses by sex we found that only among women trained with VAM was there a significant improvement in compression depth before and after training (36 mm vs. 46 mm, P = 0.018) and in the percentage of insufficient compressions before and after training (56% vs. 15%; P = 0.021). In comparison to the traditional training method involving an instructor, training medical students in CPR with VAM improves the quality of chest compressions in hand position and in compression rate applied to mannequins. Only among women was VAM shown to be superior in compression depth training. This technology reduces costs in 14% in our setup and might potentially release instructors' time for other activities.

The National Institute of Dental Research Clinical Dental Staff Fellowship.

ERIC Educational Resources Information Center

Baum, Bruce J.; And Others

1988-01-01

A program in one of the National Institutes of Health offers clinical training fellowships as a means of training potential dental school faculty by providing both unique clinical skills and high-quality research experience. The program was developed in response to a perceived need for change in academic dentistry. (MSE)

75 FR 61167 - Notice of Availability: Notice of Funding Availability (NOFA) for HUD's Fiscal Year (FY) 2010...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

...: Notice of Funding Availability (NOFA) for HUD's Fiscal Year (FY) 2010 Housing Counseling Training Program... requirements for HUD's Housing Counseling Training Program NOFA for FY2010. This year's Housing Counseling... improve and standardize the quality of counseling provided by housing counselors employed by...

The Impact of Organisational Change on the Nature and Extent of Training in Australian Enterprises

ERIC Educational Resources Information Center

Smith, Andrew; Oczkowski, Edward; Noble, Charles; Macklin, Robert

2004-01-01

This article reports on a study investigating the relationship between the introduction of new management practices and the training provided by Australian enterprises for their employees. The new management practices investigated include teamworking, total quality management, lean production, business process re-engineering and the learning…

Managing Better: Measuring Institutional Health and Effectiveness in Vocational Education and Training

ERIC Educational Resources Information Center

Maxwell, Graham; Noonan, Peter; Bahr, Mark; Hardy, Ian

2004-01-01

Vocational education and training (VET) policy is increasingly focused on the importance of quality in each VET institution's capacity to deliver effective programs. This report addresses institutional-level monitoring and evaluation of performance and provides a comprehensive model which institutes can use for this purpose. The model draws on…

Environmental Scan of Weight Bias Exposure in Primary Health Care Training Programs

ERIC Educational Resources Information Center

Russell-Mayhew, Shelly; Nutter, Sarah; Alberga, Angela; Jelinski, Susan; Ball, Geoff D. C.; Edwards, Alun; Oddie, Scott; Sharma, Arya M.; Pickering, Barbara; Forhan, Mary

2016-01-01

Negative attitudes and beliefs about individuals with obesity (also known as weight bias) have negative consequences for physical and mental health for individuals with obesity and impact the quality of care provided by health professionals. A preliminary environmental scan of college and university training programs was conducted consisting of 67…

Day Care Enrichment Resources: A Training Guide. Revised Edition.

ERIC Educational Resources Information Center

Louisiana State Dept. of Health and Human Resources, Baton Rouge. Div. of Evaluation and Services.

The guidelines offered for child care providers in this training manual are intended to insure quality care in day care centers that meet the on-going daily needs of children--nutrition, health, social, intellectual and physical development. The manual begins by individually addressing by age (infants and toddlers, two-year-olds, three- and…

Introducing Online Training in an Early Childhood Professional Development System: Lessons Learned in One State

ERIC Educational Resources Information Center

Stone-MacDonald, Angi; Douglass, Anne

2015-01-01

Online educational opportunities provide improved access to high quality professional development for the early education and care workforce. Online and technology mediated learning can create sustainable education and development opportunities for states when face-to-face training is financially prohibitive. This study examined one state's…

Addressing Cultural Variables in Parent Training Programs with Latino Families

ERIC Educational Resources Information Center

Barker, Chikira H.; Cook, Katrina L.; Borrego, Joaquin, Jr.

2010-01-01

There has recently been increased attention given to understanding how cultural variables may have an impact on the efficacy of treatments with Latino families seeking psychological services. Within parent training programs, understanding the extent to which culture can affect parenting practices is vital to providing quality care. The focus of…

A Cystems Approach to Training and Complexity

ERIC Educational Resources Information Center

Kennedy, Bob

2005-01-01

Purpose: This paper aims to explore the quality profession's fascination with various models to depict complex interactive systems. Building on these and the outcome of a four-year action research programme, it provides a model which has potential for use by other professions. It has been tailored here to suit training and learning systems.…

Provision and perceived quality of mental health services for older care home residents in England: a national survey.

PubMed

Stewart, Karen; Hargreaves, Claire; Jasper, Rowan; Challis, David; Tucker, Sue; Wilberforce, Mark

2018-02-01

This study examined the nature, extent and perceived quality of the support provided by community mental health teams for older people (CMHTsOP) to care home residents. A postal survey was sent to all CMHTsOP in England. Information was collected about teams' staffing and their involvement in case finding, assessment, medication reviews, care planning and training as well as team managers' rating of the perceived quality of the service they provided for care home residents. Data were analysed using chi-squared tests of association and ordinal regression. Responses were received from 225 (54%) CMHTsOP. Only 18 per cent of these teams contained staff with allocated time for care home work. Services for care home residents varied considerably between teams. Two-fifths of teams provided formal training to care home staff. Team managers were more likely to perceive the quality of their service to care homes as good if they had a systematic process in place for reviewing antipsychotic drugs or routine mental health reviews, including contact with a GP. The findings suggested that more evidence is needed on the best approach for supporting care home residents with mental health needs. Areas to consider are the potential benefits of training to care home staff and regular mental health reviews, utilising links between GPs and CMHTsOP. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Consulting a trained physician when considering a request for euthanasia: an evaluation of the process in flanders and the Netherlands.

PubMed

Van Wesemael, Yanna; Cohen, Joachim; Bilsen, Johan; Onwuteaka-Philipsen, Bregje D; Distelmans, Wim; Deliens, Luc

2010-12-01

In Belgium and the Netherlands, consultation of a second independent physician by the attending physician is mandatory in euthanasia cases. In both countries, specialized consultation services have been established to provide physicians trained for that purpose. This retrospective study describes and compares the quality of consultation of both services based on surveys of attending physicians and those providing the consultation (consultants). While Dutch consultants discussed certain subjects, for example, alternative curative or palliative treatment more often with the attending physician than Belgian consultants, both usually discussed those subjects considered necessary for a quality consultation and were independent from patient and attending physician. Over 90% of attending physicians in both countries evaluated the consultant's knowledge of palliative care, patient's disease, and judicial procedure, and their communication skills, as sufficient. Consultation with specialized consultation services seems to promote quality of euthanasia consultations.

Quality of dispatch-assisted cardiopulmonary resuscitation by lay rescuers following a standard protocol in Japan: an observational simulation study.

PubMed

Asai, Hideki; Fukushima, Hidetada; Bolstad, Francesco; Okuchi, Kazuo

2018-04-01

Bystander cardiopulmonary resuscitation (CPR) is essential for improving the outcomes of sudden cardiac arrest patients. It has been reported that dispatch-assisted CPR (DACPR) accounts for more than half of the incidence of CPR undertaken by bystanders. Its quality, however, can be suboptimal. We aimed to measure the quality of DACPR using a simulation study. We recruited laypersons at a shopping mall and measured the quality of CPR carried out in our simulation. Dispatchers provided instruction in accordance with the standard DACPR protocol in Japan. Twenty-three laypersons (13 with CPR training experience within the past 2 years and 10 with no training experience) participated in this study. The median chest compression rate and depth were 106/min and 33 mm, respectively. The median time interval from placing the 119 call to the start of chest compressions was 119 s. No significant difference was found between the groups with and without training experience. However, subjects with training experience more frequently placed their hands correctly on the manikin (84.6% versus 40.0%; P = 0.026). Twelve participants (52.2%, seven in trained and five in untrained group) interrupted chest compressions for 3-18 s, because dispatchers asked if the patient started breathing or moving. This current simulation study showed that the quality of DACPR carried out by lay rescuers can be less than optimal in terms of depth, hand placement, and minimization of pauses. Further studies are required to explore better DACPR instruction methods to help lay rescuers perform CPR with optimal quality.

Encouraging French medical students to choose a career in psychiatry: how and why?

PubMed

Andlauer, Olivier; Van Effenterre, Aude; Haffen, Emmanuel; Sechter, Daniel; Farooq, Kitty; Lydall, Gregory; Malik, Amit; Bhugra, Dinesh

2013-08-01

There is an increasing demand for psychiatrists in France. This paper reviews the reasons for French medical students choosing psychiatry and the rationale and mechanisms for encouraging them towards this medical speciality. The main factors associated with choosing psychiatry as a career are the quantity and quality of undergraduate training and placements in psychiatry, better attitudes towards psychiatry and more emphasis on a positive life/work balance. The quality of postgraduate training can also influence students' decisions. Medical students should be encouraged to choose psychiatry first to counterbalance the existing stigma towards mental illness within the society, but also towards psychiatry within the medical profession, and second because of the current decline in French medical demography. Ways to improve recruitment are a selection process that favours a large number of psychiatric trainees, and an increase in the quality and quantity of training. Providing medical students with relevant information about training in psychiatry, notably through a national trainees' association, will not only improve the quality of care by increasing recruitment in psychiatry, but also ensure that all future doctors are familiar with and develop positive attitudes towards mental health issues.

A feedback system in residency to evaluate CanMEDS roles and provide high-quality feedback: Exploring its application.

PubMed

Renting, Nienke; Gans, Rijk O B; Borleffs, Jan C C; Van Der Wal, Martha A; Jaarsma, A Debbie C; Cohen-Schotanus, Janke

2016-07-01

Residents benefit from regular, high quality feedback on all CanMEDS roles during their training. However, feedback mostly concerns Medical Expert, leaving the other roles behind. A feedback system was developed to guide supervisors in providing feedback on CanMEDS roles. We analyzed whether feedback was provided on the intended roles and explored differences in quality of written feedback. In the feedback system, CanMEDS roles were assigned to five authentic situations: Patient Encounter, Morning Report, On-call, CAT, and Oral Presentation. Quality of feedback was operationalized as specificity and inclusion of strengths and improvement points. Differences in specificity between roles were tested with Mann-Whitney U tests with a Bonferroni correction (α = 0.003). Supervisors (n = 126) provided residents (n = 120) with feedback (591 times). Feedback was provided on the intended roles, most frequently on Scholar (78%) and Communicator (71%); least on Manager (47%), and Collaborator (56%). Strengths (78%) were mentioned more frequently than improvement points (52%), which were lacking in 40% of the feedback on Manager, Professional, and Collaborator. Feedback on Scholar was more frequently (p = 0.000) and on Reflective Professional was less frequently (p = 0.003) specific. Assigning roles to authentic situations guides supervisors in providing feedback on different CanMEDS roles. We recommend additional supervisor training on how to observe and evaluate the roles.

Assessment of dietary intake using the healthy eating index during military training.

PubMed

Lutz, Laura J; Gaffney-Stomberg, Erin; Scisco, Jenna L; Cable, Sonya J; Karl, J Philip; Young, Andrew J; McClung, James P

2013-01-01

The objectives of this study were to use the healthy eating index (HEI) as a tool to characterize diet quality in Soldiers (n=135) during basic combat training (BCT), and to assess the effects of BCT on diet quality by comparing HEI scores before and after the training period. HEI scores were calculated from a 110-item semiquantitative food frequency questionnaire. Soldiers were then divided into tertiles (high, medium, and low) of diet quality based upon HEI scores at the start of BCT. No relationships between pre-BCT total HEI score and age, sex, racial background, or physical activity were observed. The odds of being a smoker were 4.75 times higher for those in the low HEI tertile and 3.03 times higher for those in the medium HEI tertile when compared to those in the high HEI tertile (95% CI, 1.67, 13.48 and 1.04, 8.82 respectively). Diet quality improved in the medium and low HEI tertiles over the course of BCT, as total HEI scores increased by 22% and 46% respectively (P<.05) with time in these groups. Although different at the start of BCT, HEI scores were similar between the medium and high HEI tertiles at the end of BCT. Study findings suggest that the BCT dining environment elicits positive changes in diet quality for Soldiers who enter military training with lower diet quality, and the HEI appears to be a useful tool to identify military personnel with lower diet quality at the start of training. This may provide the opportunity to target interventions such as diet counseling and education in an effort to improve Soldier health and performance.

Quality Management for Schools.

ERIC Educational Resources Information Center

Mulligan, Dorothy

1992-01-01

W. Edwards Deming introduced management principles that helped Japan become a world economic power. Virginia is attempting to adapt these techniques to education with a grant that provides training and support for school personnel in several school districts. Describes a quality management program at Christa McAuliffe Elementary School that has…

34 CFR 602.16 - Accreditation and preaccreditation standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regarding the quality of the education or training provided by the institutions or programs it accredits... education or correspondence education, the agency's standards must effectively address the quality of an... 34 Education 3 2010-07-01 2010-07-01 false Accreditation and preaccreditation standards. 602.16...

Protocol—the RAMESES II study: developing guidance and reporting standards for realist evaluation

PubMed Central

Greenhalgh, Trisha; Wong, Geoff; Jagosh, Justin; Greenhalgh, Joanne; Manzano, Ana; Westhorp, Gill; Pawson, Ray

2015-01-01

Introduction Realist evaluation is an increasingly popular methodology in health services research. For realist evaluations (RE) this project aims to: develop quality and reporting standards and training materials; build capacity for undertaking and critically evaluating them; produce resources and training materials for lay participants, and those seeking to involve them. Methods To achieve our aims, we will: (1) Establish management and governance infrastructure; (2) Recruit an interdisciplinary Delphi panel of 35 participants with diverse relevant experience of RE; (3) Summarise current literature and expert opinion on best practice in RE; (4) Run an online Delphi panel to generate and refine items for quality and reporting standards; (5) Capture ‘real world’ experiences and challenges of RE—for example, by providing ongoing support to realist evaluations, hosting the RAMESES JISCmail list on realist research, and feeding problems and insights from these into the deliberations of the Delphi panel; (6) Produce quality and reporting standards; (7) Collate examples of the learning and training needs of researchers, students, reviewers and lay members in relation to RE; (8) Develop, deliver and evaluate training materials for RE and deliver training workshops; and (9) Develop and evaluate information and resources for patients and other lay participants in RE (eg, draft template information sheets and model consent forms) and; (10) Disseminate training materials and other resources. Planned outputs: (1) Quality and reporting standards and training materials for RE. (2) Methodological support for RE. (3) Increase in capacity to support and evaluate RE. (4) Accessible, plain-English resources for patients and the public participating in RE. Discussion The realist evaluation is a relatively new approach to evaluation and its overall place in the is not yet fully established. As with all primary research approaches, guidance on quality assurance and uniform reporting is an important step towards improving quality and consistency. PMID:26238395

Training Quality: Before and after Winning the Deming Prize.

ERIC Educational Resources Information Center

Magennis, Jo P.

1995-01-01

Describes the Quality Improvement Program developed by Florida Power and Light's Nuclear Training organization that was awarded the Deming Application Prize for quality control. Training quality, team activities, training's role in business planning, customer involvement and evaluation, and continuous improvement of training are discussed. (LRW)

Improved protein model quality assessments by changing the target function.

PubMed

Uziela, Karolis; Menéndez Hurtado, David; Shu, Nanjiang; Wallner, Björn; Elofsson, Arne

2018-06-01

Protein modeling quality is an important part of protein structure prediction. We have for more than a decade developed a set of methods for this problem. We have used various types of description of the protein and different machine learning methodologies. However, common to all these methods has been the target function used for training. The target function in ProQ describes the local quality of a residue in a protein model. In all versions of ProQ the target function has been the S-score. However, other quality estimation functions also exist, which can be divided into superposition- and contact-based methods. The superposition-based methods, such as S-score, are based on a rigid body superposition of a protein model and the native structure, while the contact-based methods compare the local environment of each residue. Here, we examine the effects of retraining our latest predictor, ProQ3D, using identical inputs but different target functions. We find that the contact-based methods are easier to predict and that predictors trained on these measures provide some advantages when it comes to identifying the best model. One possible reason for this is that contact based methods are better at estimating the quality of multi-domain targets. However, training on the S-score gives the best correlation with the GDT_TS score, which is commonly used in CASP to score the global model quality. To take the advantage of both of these features we provide an updated version of ProQ3D that predicts local and global model quality estimates based on different quality estimates. © 2018 Wiley Periodicals, Inc.

A cluster randomised controlled trial of a staff-training intervention in residential units for people with long-term mental illness in Portugal: the PromQual trial.

PubMed

Cardoso, Graça; Papoila, Ana; Tomé, Gina; Killaspy, Helen; King, Michael; Caldas-de-Almeida, José Miguel

2017-11-01

This study aimed to assess the efficacy of a staff-training intervention to improve service users' engagement in activities and quality of care, by means of a cluster randomised controlled trial. All residential units with at least 12-h a day staff support (n = 23) were invited to participate. Quality of care was assessed with the Quality Indicator for Rehabilitative Care (QuIRC) filled online by the unit's manager. Half the units (n = 12) were randomly assigned to continue providing treatment as usual, and half (n = 11) received a staff-training intervention that focused on skills for engaging service users in activities, with trainers working alongside staff to embed this learning in the service. The primary outcome was service users' level of activity (measured with the Time Use Diary), reassessed at 4 and 8 months. Secondary outcomes were the quality of care provided (QuIRC), and service users' quality of life (Manchester Short Assessment of Quality of Life) reassessed at 8 months. Generalized linear mixed effect models were used to assess the difference in outcomes between units in the two trial arms. The trial was registered with Current Controlled Trials (Ref NCT02366117). Knowledge acquired by the staff during the initial workshops increased significantly (p ≤ 0.01). However, the intervention and comparison units did not differ significantly in primary and secondary outcomes at either follow-up. The intervention increased the level of knowledge of staff without leading to an improvement in service users' engagement in activities, quality of life, or quality of care in the units.

Measuring and improving the quality of mental health care: a global perspective

PubMed Central

Kilbourne, Amy M.; Beck, Kathryn; Spaeth‐Rublee, Brigitta; Ramanuj, Parashar; O'Brien, Robert W.; Tomoyasu, Naomi; Pincus, Harold Alan

2018-01-01

Mental disorders are common worldwide, yet the quality of care for these disorders has not increased to the same extent as that for physical conditions. In this paper, we present a framework for promoting quality measurement as a tool for improving quality of mental health care. We identify key barriers to this effort, including lack of standardized information technology‐based data sources, limited scientific evidence for mental health quality measures, lack of provider training and support, and cultural barriers to integrating mental health care within general health environments. We describe several innovations that are underway worldwide which can mitigate these barriers. Based on these experiences, we offer several recommendations for improving quality of mental health care. Health care payers and providers will need a portfolio of validated measures of patient‐centered outcomes across a spectrum of conditions. Common data elements will have to be developed and embedded within existing electronic health records and other information technology tools. Mental health outcomes will need to be assessed more routinely, and measurement‐based care should become part of the overall culture of the mental health care system. Health care systems will need a valid way to stratify quality measures, in order to address potential gaps among subpopulations and identify groups in most need of quality improvement. Much more attention should be devoted to workforce training in and capacity for quality improvement. The field of mental health quality improvement is a team sport, requiring coordination across different providers, involvement of consumer advocates, and leveraging of resources and incentives from health care payers and systems. PMID:29352529

Training the eye care team: principles and practice.

PubMed

Garg, Prashant; Reddy, Snigdha; Nelluri, Chaitanya

2014-01-01

One of the crucial factors to make high quality eye care services available, accessible and affordable to all is the availability of appropriately trained human resources. Providing health through a health care team is a better and cost effective alternative. The concept of the team approach is based on the principles of working together; task shifting; and ensuring continuity of care. Composition of a team varies based on the community needs, population characteristics and disease burden. But for it to be effective, a team must possess four attributes - availability, competency, productivity, and responsiveness. Therefore, training of all team members and training the team to work together as a unit are crucial components in the success of this concept. Some of the critical attributes include: Training across the health spectrum through quality and responsive curricula administered by motivated teachers; accreditation of programs or institutions by national or international bodies; certification and recertification of team members; and training in working together as a team through inter- and intra- disciplinary workshops both during training and as a part of the job activity.

Training the Eye Care Team: Principles and Practice

PubMed Central

Garg, Prashant; Reddy, Snigdha; Nelluri, Chaitanya

2014-01-01

One of the crucial factors to make high quality eye care services available, accessible and affordable to all is the availability of appropriately trained human resources. Providing health through a health care team is a better and cost effective alternative. The concept of the team approach is based on the principles of working together; task shifting; and ensuring continuity of care. Composition of a team varies based on the community needs, population characteristics and disease burden. But for it to be effective, a team must possess four attributes - availability, competency, productivity, and responsiveness. Therefore, training of all team members and training the team to work together as a unit are crucial components in the success of this concept. Some of the critical attributes include: Training across the health spectrum through quality and responsive curricula administered by motivated teachers; accreditation of programs or institutions by national or international bodies; certification and recertification of team members; and training in working together as a team through inter- and intra- disciplinary workshops both during training and as a part of the job activity. PMID:24791103

Evaluation of the breast cancer train the trainer program for nurses in Turkey.

PubMed

Karayurt, Ozgul; Gürsoy, Ayla Akkaş; Taşçi, Sultan; Gündoğdu, Fatma

2010-09-01

The Breast Cancer Train the Trainer (TTT) program was designed to increase breast cancer awareness, improve knowledge about breast cancer among nurses, and provide quality care for breast cancer patients by trained nurses. A total of three programs were held and 82 nurses from different regions of Turkey attended this training. The educational activities employed several teaching and learning strategies. After completion, we determined that the participating nurses' knowledge on breast cancer had increased significantly, and they were satisfied with the training received. The Breast Cancer TTT program is a unique educational endeavor for nurses in Turkey, and our results showed that the training achieved its goal. Trained nurses in Breast Cancer TTT programs can help educate women about the importance of breast health and the measures they need to take to protect themselves against breast cancer. At the same time, nurses can also increase and enhance the quality of life in patients with breast cancer. This is an example of a program that can easily be spread throughout the world as it was done from England and Australia to Turkey.

Institutional review board training for community practices: advice from the Agency for Health Care Research and Quality Practice-Based Research Network listserv.

PubMed

Dolor, Rowena J; Smith, Peter C; Neale, Anne Victoria

2008-01-01

Human subject protection training is required for all research personnel regardless of funding source. This article summarizes recommendations from a discussion about ethics training for community personnel from the practice-based research network (PBRN) listserv sponsored by the Agency for Health Care Research and Quality PBRN Resource Center. PBRN projects can involve community providers and their staff as subjects of the research project or as collaborators with recruitment and data collection. Distinguishing between usual care and research procedures is important for determining if training is required of community-based personnel. The use of research assistants or practice facilitators to collect research-related information is one way of limiting practice involvement to usual care procedures, thereby allowing PBRNs to limit training to dedicated research staff. Key methodologies for human subject protection training of community practice staff include on-site lectures, online modules, videotapes, and paper-based training. Ultimately, a discussion by the PBRN researcher with his or her governing Institutional Review Board is recommended for finding acceptable strategies within a PBRN.

Weaknesses in the Resident Language Training System of Defense Language Institute Affect the Quality of Trained Linguists. Report to the Secretary of the Army.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

This report is a summary of the review of the Defense Language Institute (DLI) that was made by the General Accounting Office (GAO) at the request of a member of Congress. The objectives of the study were to identify and analyze significant internal DLI problems that diminish the overall effectiveness of the language training provided there.…

Public library computer training for older adults to access high-quality Internet health information

PubMed Central

Xie, Bo; Bugg, Julie M.

2010-01-01

An innovative experiment to develop and evaluate a public library computer training program to teach older adults to access and use high-quality Internet health information involved a productive collaboration among public libraries, the National Institute on Aging and the National Library of Medicine of the National Institutes of Health (NIH), and a Library and Information Science (LIS) academic program at a state university. One hundred and thirty-one older adults aged 54–89 participated in the study between September 2007 and July 2008. Key findings include: a) participants had overwhelmingly positive perceptions of the training program; b) after learning about two NIH websites (http://nihseniorhealth.gov and http://medlineplus.gov) from the training, many participants started using these online resources to find high quality health and medical information and, further, to guide their decision-making regarding a health- or medically-related matter; and c) computer anxiety significantly decreased (p < .001) while computer interest and efficacy significantly increased (p = .001 and p < .001, respectively) from pre- to post-training, suggesting statistically significant improvements in computer attitudes between pre- and post-training. The findings have implications for public libraries, LIS academic programs, and other organizations interested in providing similar programs in their communities. PMID:20161649

Sleep, anxiety and electronic device use by athletes in the training and competition environments.

PubMed

Romyn, Georgia; Robey, Elisa; Dimmock, James A; Halson, Shona L; Peeling, Peter

2016-01-01

This study subjectively assessed sleep quality and quantity, state anxiety and electronic device use during a 7-day training week (TRAIN) and a 7-day competitive tournament (COMP). Eight state-level netball players used wrist-watch actigraphy to provide indirect sleep measures of bedtime, wake time, sleep duration, sleep onset latency, sleep efficiency, wake after sleep onset and fragmentation index. State anxiety was reported using the anxiety sub-scale in the Profile of Mood States-Adolescents. Before bed duration of electronic device use and the estimated time to sleep after finishing electronic device use was also recorded. Significant main effects showed that sleep efficiency (p = 0.03) was greater in COMP as compared to TRAIN. Furthermore, the bedtime and wake time were earlier (p = 0.01) during COMP. No further differences existed between conditions (p > 0.05). However, strong negative associations were seen between state anxiety and the sleep quality rating. Here, sleep efficiency was likely greater in COMP due to the homeostatic need for recovery sleep, resulting from the change in environment from training to competition. Furthermore, an increased anxiety before bed seems to influence sleep quality and should be considered in athletes portraying poor sleep habits.

Predicting Observer Training Satisfaction and Certification

ERIC Educational Resources Information Center

Bell, Courtney A.; Jones, Nathan D.; Lewis, Jennifer M.; Liu, Shuangshuang

2013-01-01

The last decade produced numerous studies that show that students learn more from high-quality teachers than they do from lower quality teachers. If instruction is to improve through the use of more rigorous teacher evaluation systems, the implementation of these systems must provide consistent and interpretable information about which aspects of…

YoungStar in Wisconsin: Analysis of Data as of July 2014. YoungStar Progress Report #5

ERIC Educational Resources Information Center

Wisconsin Council on Children and Families, 2014

2014-01-01

YoungStar is a program of the Department of Children and Families (DCF) designed to improve the quality of child care for Wisconsin children. YoungStar is designed to: (1) evaluate and rate the quality of care given by child care providers; (2) help parents choose the best child care for their kids; (3) support providers with tools and training to…

European otorhinolaryngology training programs: results of a European survey about training satisfaction, work environment and conditions in six countries.

PubMed

Oker, N; Alotaibi, Naif H; Reichelt, A C; Herman, P; Bernal-Sprekelsen, M; Albers, Andreas E

2017-11-01

ORL-students and residents have an ongoing debate about the "best" programme in Europe. Aim of this study was to comparatively assess differences among programmes in training, satisfaction, quality of life (QoL) of residents and recent otorhinolaryngologist (ORL) specialists in France, Germany, Spain, Italy, Austria, and Belgium. A self-administered anonymous questionnaire, structured in ten sections including general information, provided guidance, working environment, training structure, teaching of medical students, publication work, QoL, and satisfaction with training, were emailed to residents and recent ORL specialists. 476 returned questionnaires from 6 countries revealed that daily work hours were the highest in France and Belgium with 11 and 10.4 h on average, respectively. QoL, work conditions, and salary were best in Germany followed by Austria in terms of possibility of part-time contracts, better respect for post-duty day off, and compensation for overtime. Satisfaction with training including support and guidance of seniors was lowest in Italy, but, on the other hand, the publication work and support had a more important place than in other countries. In Belgium, there was some gap between the quality of teaching and feedback from seniors as well as apprenticeship. The highest satisfaction with training was in France and Spain followed by Austria. The study results provide guidance before choosing an ORL training programme in Europe. Country-specific strengths could be included into future harmonization efforts to improve all programmes, facilitate professional exchange and, finally, establish standards-of-care carried out by well-trained doctors also looking after a satisfying work-life balance.

Effect of Somatic Experiencing Resiliency-Based Trauma Treatment Training on Quality of Life and Psychological Health as Potential Markers of Resilience in Treating Professionals

PubMed Central

Winblad, Neal E.; Changaris, Michael; Stein, Phyllis K.

2018-01-01

Background: Individuals who treat trauma are at significant risk of vicarious traumatization and burnout. Somatic Experiencing® (SE®) is a resiliency-focused trauma treatment modality designed to address autonomic nervous system (ANS) dysregulation and its impacted physical health and mental health symptoms e.g., anxiety, depression, post-traumatic stress disorder, migraines, fibromyalgia, and chronic fatigue, etc. The SE® training supports the development of clinical skills to reduce physical health/mental health symptoms as well as increase clinician resilience. Individuals who display resilience often have increased experiences of well-being (quality of life) and decreased levels of self-reported psychological symptoms. Greater resilience could mitigate the risks to providers and the clients they treat. Materials and Methods: This within-groups, longitudinal study assessed students (N = 18) over the course of a 3-year SE® practitioner training. This training focuses on increased ANS, physical, and emotional regulation skills. The convenience of a web-based survey allowed for: measures of a general quality of life (WHOQOL-BREF), psychological symptoms, somatic, anxiety, and depressive symptoms (PHQ-SADS), as well as a measure of early life exposure to adversity (CDC/Kaiser Permanente ACE Score Calculator Questionnaire). The clinician survey was conducted yearly for 3 years. Future studies would do well to also include laboratory-based objective measures of ANS functioning. Results: ANOVA with repeated measures showed that there were significant reductions in anxiety symptoms (GAD7, p < 0.001) and somatization symptoms (PHQ15, p < 0.001). Health-related quality of life (a measure of physical well-being) and social quality of life (a measure of interpersonal well-being) both increased significantly (Health QoL p = 0.028; Social QoL p = 0.046). Conclusions: Results suggest that professionals attending the 3-year SE® training course experience a significant improvement in self-reported measures associated with resiliency including: quality of life (well-being) and psychological symptoms (anxiety and somatization). Our results support the importance of future research in a larger sample and support the exploration, cross-sectionally and prospectively, of the relationship of clinician resiliency and changes in clinician resiliency with SE® training and clinical outcomes. These data have implications for other professions at risk of exposure to vicarious trauma (VT) including nurses, medical providers, and paramedics. PMID:29503607

Importance and performance of managerial skills in the Australian aged care sector - a middle managers' perspective.

PubMed

Meissner, Ellen; Radford, Katrina

2015-09-01

This study examined the importance and performance of middle managers' skills to provide a starting point for a sector-wide leadership and management framework. There is an increasing consensus that the quality of management, leadership and performance of any organisation is directly linked to the capabilities of its middle managers and the preparation and on-going training they receive. A total of 199 middle managers from three aged care organisations in Australia participated in a questionnaire conducted during 2010-2011. This study found that middle managers perceived the need to develop their communication skills, self-awareness, change management, conflict resolution and leadership skills. Middle managers perceive a discrepancy between performance and importance of various managerial skills. This study demonstrated that provision of training needs to go beyond clinical skills development and further investigation into managers' needs is necessary, particularly considering the diversity of this critical group in organisations. Future training opportunities provided to middle managers need to address the 'softer' skills (e.g. communication) rather than 'technical' skills (e.g. clinical skills). The provision of training in these skills may improve their performance, which may also lead to increased job satisfaction, continuity in leadership and management and ultimately improvements in the quality of care provided. © 2014 John Wiley & Sons Ltd.

Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System.

PubMed

Lee, Ann Joo; Kraemer, Dale F; Smotherman, Carmen; Eid, Emely

2016-01-01

Inflammatory bowel disease (IBD) quality measures were established in an effort to standardize IBD health care. Despite effort to improve clinical performance, considerable variations in practice still exist. To further improve IBD health care, we propose incorporating an in-service educational session on IBD health maintenance to provide trainees with increasing awareness and knowledge on IBD management. Fifty electronic medical charts were randomly selected, and the level of quality documentation was assessed for 15 core IBD quality measures. Data were reported as the percentage of charts meeting audit criteria (compliance score). Fellows then attended an in-service educational session to review IBD quality measures and reinforce practice expectations. A second audit was then performed on an additional 50 patient charts to determine whether documentation practices improved after the educational session. We found a positive correlation between an in-service educational session and fellows' compliance with IBD health maintenance. Overall, the fellows' compliance score increased by 18% (before intervention, 65%; after intervention, 83%; P < 0.0001). The intervention was equally beneficial irrespective of training level. Although the magnitude of improvement was comparable, the mean compliance score was highest in year 2 at 81% (year 1: 72% [P = 0.019] and year 3: 70% [P = 0.002]). Fellows expressed a high degree of satisfaction with the educational intervention and emphasized the value in reviewing the conceptual bases for IBD health maintenance. Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.

Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities.

PubMed

Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah

2015-08-01

To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct similar projects. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

University strategy for doctoral training: the Ghent University Doctoral Schools.

PubMed

Bracke, N; Moens, L

2010-01-01

The Doctoral Schools at Ghent University have a three-fold mission: (1) to provide support to doctoral students during their doctoral research, (2) to foster a quality culture in (doctoral) research, (3) to promote the international and social stature and prestige of the doctorate vis-a-vis potential researchers and the potential labour market. The Doctoral Schools offer top-level specialized courses and transferable skills training to doctoral students as part of their doctoral training programme. They establish mechanisms of quality assurance in doctoral research. The Doctoral Schools initialize and support initiatives of internationalization. They also organize information sessions, promotional events and interaction with the labour market, and as such keep a finger on the pulse of external stakeholders.

A conceptual curriculum framework designed to ensure quality student health visitor training in practice.

PubMed

Hollinshead, Jayne; Stirling, Linda

2014-07-01

This paper describes the challenges faced by a trust in England following the introduction of the Health Visitor Implementation Plan. Two practice education facilitators designed a conceptual curriculum framework to ensure quality student health visitor education in practice. This curriculum complimented the excellent academic course already delivered by the University. A justification is provided for the design of the curriculum framework, including a rationale for the introduction of specific training sessions. Student and practice teacher feedback demonstrate the success of the introduction of this programme to ensure the development of student health visitors fit for practice. The conclusion places emphasis on the importance of continuous evaluation of the training programme to meet the needs of the students and the service.

Event-based image recognition applied in tennis training assistance

NASA Astrophysics Data System (ADS)

Wawrzyniak, Zbigniew M.; Kowalski, Adam

2016-09-01

This paper presents a concept of a real-time system for individual tennis training assistance. The system is supposed to provide user (player) with information on his strokes accuracy as well as other training quality parameters such as velocity and rotation of the ball during its flight. The method is based on image processing methods equipped with developed explorative analysis of the events and their description by parameters of the movement. There has been presented the concept for further deployment to create a complete system that could assist tennis player during individual training.

Effectiveness of community health worker training programmes for cardiovascular disease management in low-income and middle-income countries: a systematic review

PubMed Central

Putica, Barbara; Praveen, Deversetty; Abimbola, Seye; Joshi, Rohina

2017-01-01

Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs. Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers. Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention. Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs. PMID:29101131

Global Vision, Local Reality: Transforming Pre-Primary Teacher Training in Tanzania

ERIC Educational Resources Information Center

Wilinski, Bethany; Nguyen, Cuong Huy; Landgraf, Jessica M.

2016-01-01

Global attention to early childhood education (ECE) has led to an increased focus on ECE teacher training as a critical component of providing young children with access to high-quality ECE programs. In this paper, we ask how Tanzanian stakeholders at different levels of implementation experienced and responded to efforts to build capacity in…

The Relationship between the Training Function and ISO-9000 Registration.

ERIC Educational Resources Information Center

Maxwell, Randy C.; Jost, Karen L.

ISO 9000 is one of a series of international standards providing guidelines and governing quality of products and services. The ISO 9000 certification demonstrates the capability of a supplier to control the processes that determine the acceptability of the product or service being supplied. This paper focuses on the training aspects of ISO 9000…

Keeping America Working Project: Industry Training Inventory, 1986.

ERIC Educational Resources Information Center

Gollattscheck, James; And Others

A survey was conducted of selected two-year colleges to gain an in-depth knowledge about the business/industry training programs provided by these colleges and to quantify the efforts of two-year colleges to improve the quality of the work force and the efficiency of public and private enterprises. Study findings, based on responses from 54 of the…

Student Teams' Development over Time: Tracing the Relationship between the Quality of Communication and Teams' Performance

ERIC Educational Resources Information Center

Pöysä-Tarhonen, Johanna; Elen, Jan; Tarhonen, Pasi

2016-01-01

Current discussions in higher education and alumni training acknowledge the challenges training programs face in responding to the authentic needs of the labor market. In addition to academic knowledge, higher education institutions are expected to provide general twenty-first-century skills, such as problem-solving, critical thinking,…

Quality assurance and quality improvement in U.S. clinical molecular genetic laboratories.

PubMed

Chen, Bin; Richards, C Sue; Wilson, Jean Amos; Lyon, Elaine

2011-04-01

A robust quality-assurance program is essential for laboratories that perform molecular genetic testing to maintain high-quality testing and be able to address challenges associated with performance or delivery of testing services as the use of molecular genetic tests continues to expand in clinical and public health practice. This unit discusses quality-assurance and quality-improvement considerations that are critical for molecular genetic testing performed for heritable diseases and conditions. Specific discussion is provided on applying regulatory standards and best practices in establishing/verifying test performance, ensuring quality of the total testing process, monitoring and maintaining personnel competency, and continuing quality improvement. The unit provides a practical reference for laboratory professionals to use in recognizing and addressing essential quality-assurance issues in human molecular genetic testing. It should also provide useful information for genetics researchers, trainees, and fellows in human genetics training programs, as well as others who are interested in quality assurance and quality improvement for molecular genetic testing. 2011 by John Wiley & Sons, Inc.

An overview and evaluation of the oncology family caregiver project: improving quality of life and quality of care for oncology family caregivers.

PubMed

Ferrell, Betty; Hanson, Jo; Grant, Marcia

2013-07-01

With changes in health care, oncology family caregivers (FCs) provide the vast majority of patient care. Yet, FCs assume their role with little or no training and with limited resources within the cancer setting to support them. The purpose of this project is to develop and implement a curriculum to improve the quality of life and quality of care for FCs by strengthening cancer care settings in this area. A National Cancer Institute (NCI) R25 grant funded the development of an FC curriculum for professional healthcare providers. The curriculum, based on the City of Hope Quality-of-Life Model, is presented to professionals from cancer centers in national training courses. The project brings together the most current evidence-based knowledge and multiple resources to help improve FC support. Participants develop goals related to implementation and dissemination of the course content and resources in their home institution. Goal evaluation follows at 6, 12, and 18 months. To date, three courses have been presented to 154 teams (322 individuals) representing 39 states. Course evaluations were positive, and participants have initiated institutional FC support goals. Although the goals are diverse, the broad categories include support groups, staff/FC/community education, resource development, assessment tools, and institutional change. There is a critical need to improve support for cancer FCs. This FC training course for professionals is a first step in addressing this need. Copyright © 2012 John Wiley & Sons, Ltd.

Study on Quality Indicator System of Rhythmic Gymnasts in Analytic Hierarchy Process

NASA Astrophysics Data System (ADS)

Luo, Lin

2017-08-01

The rhythmic gymnastics (RG) is a sport item with the direct aim of winning as well as a good ornamental value. The scientific selection by the rhythmic gymnasts is necessary for the success, and also the beginning for the scientific training of the gymnasts in their special training stage. According to RG characteristics and the physical characteristics of the gymnasts, also in combination with the investigations & interviews to the coaches who have years of training experience in RG, the experts & scholars on RG study & teaching in universities, and by referring to relevant documents, this paper established the quality indicator system in analytic hierarchy process (AHP). We summarized and selected several indicators obviously influencing the RG training and divided them into the three types of factors: physical factors, flexibility & strength factors, and speed & dexterity factors, according to which 12 specific indicators, their weights and comprehensive evaluation coefficients. Based on these indicators, we established the quality indicator system of the gymnasts, and developed corresponding software system, providing scientific theoretical basis & practical application basis for the selection & evaluation of the gymnasts.

Addressing research capacity for health equity and the social determinants of health in three African countries: the INTREC programme.

PubMed

Hofman, Karen; Blomstedt, Yulia; Addei, Sheila; Kalage, Rose; Maredza, Mandy; Sankoh, Osman; Bangha, Martin; Kahn, Kathleen; Becher, Heiko; Haafkens, Joke; Kinsman, John

2013-04-03

The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) was established with this concern in mind. It aims to provide training for researchers from the INDEPTH network on associations between health inequities, the social determinants of health (SDH), and health outcomes, and on presenting their findings in a usable form to policy makers. As part of a baseline situation analysis for INTREC, this paper assesses the current status of SDH training in three of the African INTREC countries - Ghana, Tanzania, and South Africa - as well as the gaps, barriers, and opportunities for training. SDH-related courses from the three countries were identified through personal knowledge of the researchers, supplemented by snowballing and online searches. Interviews were also conducted with, among others, academics engaged in SDH and public health training in order to provide context and complementary material. Information regarding access to the Internet, as a possible INTREC teaching medium, was gathered in each country through online searches. SDH-relevant training is available, but 1) the number of places available for students is limited; 2) the training tends to be public-health-oriented rather than inclusive of the broader, multi-sectoral issues associated with SDH; and 3) insufficient funding places limitations on both students and on the training institutions themselves, thereby affecting participation and quality. We also identified rapidly expanding Internet connectivity in all three countries, which opens up opportunities for e-learning on SDH, though the current quality of the Internet services remains mixed. SDH training is currently in short supply, and there is a clear role for INTREC to contribute to the training of a critical mass of African researchers on the topic. This work will be accomplished most effectively by building on pre-existing networks, institutions, and methods.

The impact of emergency obstetric care training in Somaliland, Somalia.

PubMed

Ameh, Charles; Adegoke, Adetoro; Hofman, Jan; Ismail, Fouzia M; Ahmed, Fatuma M; van den Broek, Nynke

2012-06-01

To provide and evaluate in-service training in "Life Saving Skills - Emergency Obstetric and Newborn Care" in order to improve the availability of emergency obstetric care (EmOC) in Somaliland. In total, 222 healthcare providers (HCPs) were trained between January 2007 and December 2009. A before-after study was conducted using quantitative and qualitative methods to evaluate trainee reaction and change in knowledge, skills, and behavior, in addition to functionality of healthcare facilities, during and immediately after training, and at 3 and 6 months post-training. The HCPs reacted positively to the training, with a significant improvement in 50% of knowledge and 100% of skills modules assessed. The HCPs reported improved confidence in providing EmOC. Basic and comprehensive EmOC healthcare facilities provided 100% of expected signal functions-compared with 43% and 56%, respectively, at baseline-with trained midwives performing skills usually performed by medical doctors. Lack of drugs, supplies, medical equipment, and supportive policy were identified as barriers that could contribute to nonuse of new skills and knowledge acquired. The training impacted positively on the availability and quality of EmOC and resulted in "up-skilling" of midwives. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Evaluation of training programme uptake in an attempt to reduce obstetric anal sphincter injuries: the SUPPORT programme.

PubMed

Rahman, Nadia; Vinayakarao, Latha; Pathak, Sangeeta; Minden, Dawn; Melson, Louise; Vitue, Ella; Pradhan, A

2017-03-01

The objective was to assess the feedback from a quality improvement training programme to reduce obstetric anal sphincter injuries (OASIS). Training sessions were organised that included evidence-based information on OASIS risk factors and training on models to measure perineal body length (PBL), perform episiotomies with standard and 60° fixed angle scissors (EPISCISSORS-60®), and measure post-delivery episiotomy suture angles with protractor transparencies. Feedback forms using a Likert scale (1-4) were completed and analysed. The setting was an evidence-based quality improvement programme (Strategy for Using Practical aids for Prevention of OASIS, Recording episiotomies and clinician Training [SUPPORT]) at two National Health Service (NHS) Hospitals in the UK. The participants were midwives and doctors attending the SUPPORT training programme RESULTS: All of the participants (100 %) would recommend the training programme to a friend or colleague. 92 % felt that the training session improved their knowledge of the impact of PBL and perineal distension and their knowledge of the relationship between episiotomy angle and OASIS "a lot" or "somewhat". Based on this feedback, we recommend the addition of the knowledge content of the SUPPORT programme to other centres providing perineal assessment and repair courses.

Comparison of Different Forms of Exercise Training in Patients With Cardiac Disease: Where Does High-Intensity Interval Training Fit?

PubMed

Gayda, Mathieu; Ribeiro, Paula A B; Juneau, Martin; Nigam, Anil

2016-04-01

In this review, we discuss the most recent forms of exercise training available to patients with cardiac disease and their comparison or their combination (or both) during short- and long-term (phase II and III) cardiac rehabilitation programs. Exercise training modalities to be discussed include inspiratory muscle training (IMT), resistance training (RT), continuous aerobic exercise training (CAET), and high-intensity interval training (HIIT). Particular emphasis is placed on HIIT compared or combined (or both) with other forms such as CAET or RT. For example, IMT combined with CAET was shown to be superior to CAET alone for improving functional capacity, ventilatory function, and quality of life in patients with chronic heart failure. Similarly, RT combined with CAET was shown to optimize benefits with respect to functional capacity, muscle function, and quality of life. Furthermore, in recent years, HIIT has emerged as an alternative or complementary (or both) exercise modality to CAET, providing equivalent if not superior benefits to conventional continuous aerobic training with respect to aerobic fitness, cardiovascular function, quality of life, efficiency, safety, tolerance, and exercise adherence in both short- and long-term training studies. Finally, short-interval HIIT was shown to be useful in the initiation and improvement phases of cardiac rehabilitation, whereas moderate- or longer-interval (or both) HIIT protocols appear to be more appropriate for the improvement and maintenance phases because of their high physiological stimulus. We now propose progressive models of exercise training (phases II-III) for patients with cardiac disease, including a more appropriate application of HIIT based on the scientific literature in the context of a multimodal cardiac rehabilitation program. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

The effect of adding whole body vibration training to strengthening training in the treatment of knee osteoarthritis: A randomized clinical trial.

PubMed

Bokaeian, Hamid Reza; Bakhtiary, Amir Hoshang; Mirmohammadkhani, Majid; Moghimi, Jamile

2016-04-01

Strengthening training (ST) and whole body vibration training (WBV) alone may improve symptoms of osteoarthritis of the knee. In this study, we investigated the effect of adding WBV training to quadriceps and hamstring muscles strengthening training on functional activity, pain, quality of life and muscle strength in patients with knee osteoarthritis. 28 volunteers were randomly allocated to two groups; 1) quadriceps and hamstring muscles strengthening training (ST group, 13 patients) and 2) quadriceps and hamstring muscles strengthening training along with WBV training (ST + WBV group, 15 patients). The treatment protocol for both groups involved 3 sessions per week for 8 weeks. All measurements were performed before and after intervention. The measurements included: pain by means of a visual analogue scale (VAS), quality of life by means of the WOMAC scale, functional activity by the 2 min walking test (2MWT), time up & go test (TUGT) and 50-foot walking test (50FWT) and the muscle peak torque (MPT), total work (TW) and muscle power (MP) as muscle performance of quadriceps and hamstring muscles by an Isokinetic Biodex machine. After intervention, the comparison of mean changes between two groups showed improvement in the WBV + ST group in terms of 2MWT, MPT, TW and MP variables (P < 0.05). However, no significant difference was found between the experimental groups in term of pain, quality of life, TUGT and 50FWT. These results suggest that adding whole body vibration training to strengthening training may provide better treatment effects for patients with knee osteoarthritis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dementia-specific training for nursing home staff : A systematic literature review.

PubMed

Riesch, Julia; Meyer, Lucy; Lehr, Bosco; Severin, Thomas

2017-08-22

For people with dementia high-quality care is vital, since at present dementia cannot be cured. In nursing homes this care is provided by the staff, who therefore require dementia-specific training enabling them to improve the quality of life for people with dementia. This article compares existing dementia-specific training for nursing home staff with recommendations, based on the current state of research, by the Alzheimer's Association and the National Institute for Health and Care Excellence, and discusses the outcome of this training. A systematic review of the literature was conducted to identify studies addressing dementia-specific training. The electronic databases Embase, Medline, Cochrane, CINAHL, PsychINFO, PSYNDEX, and ScienceDirect were searched. The training topics most commonly considered were person-centered care, communicating with people affected by dementia, and information about dementia. The roles of different social and healthcare professionals, palliative care of people with dementia, and understanding family dynamics are least featured in the training. There are training concepts which focus not only on the transfer of knowledge but also on practical exercises. In general, the recommended topics were addressed in dementia-specific training concepts, but there is potential for optimization. Further research is needed to identify success criteria in dementia-specific training and identify the successful combination of theoretical knowledge and practical exercise.

Urban Waters Small Grants 101

EPA Pesticide Factsheets

General information on Urban Waters Small Grants is provided in this document. Grantees are listed by themes, including Environmental Justice, Water Quality, Job Training and Creation, and Green Infrastructure.

Teacher Training Programs: Activities Underway To Improve Teacher Training, but Information Collected To Assess Accountability Has Limitations. Testimony before the Subcommittee on 21st Century Competitiveness, Committee on Education and the Workforce, U.S. House of Representatives.

ERIC Educational Resources Information Center

Ashby, Cornelia M.

This testimony highlights two components of the 1998 amendments to the Higher Education Act (which were intended to enhance the quality of classroom teaching by improving training programs for prospective teachers and qualifications of current teachers). One component provides grants, and another, called the "accountability provisions," requires…

The transition from learner to provider/teacher: the learning needs of new orthopaedic consultants.

PubMed

McKinstry, Brian; Macnicol, Malcolm; Elliot, Katy; Macpherson, Stuart

2005-05-17

Given the relatively sudden change from learner to teacher-provider that new consultants experience and the likely clinical and managerial challenges this may pose, there is a relative dearth of research into the problems they may have in relation to their new roles, or how supported they feel by senior colleagues acting in a mentoring role. This research sought to determine new consultants views on the quality and relevance of their training, its relationship to their confidence in clinical and managerial skills and their views on mentorship by senior colleagues. Detailed postal questionnaire to new consultants using open and closed questions. Open questionnaire to established consultants to validate new consultant responses. Respondents felt their clinical training was good and were generally confident in most clinical skills although some perceived deficiencies in more complex procedures and specialist areas. Most lacked confidence in many managerial skills. These perceptions were verified by established consultants. Although no relationship was found between total training time or quality of training with confidence, extra training in specific sub-specialities improved confidence in these areas. While most established consultants thought that mentorship would be useful for new consultants, only 52% of them shared this view. Training and experience in management should be given greater emphasis. There may be a need for specific, targeted training in complex procedures for doctors who experience lack of confidence in these areas. Mentorship should be offered to new consultants and recognised in the job-plan of the new consultant contract.

Endoscopic training in gastroenterology fellowship: adherence to core curriculum guidelines.

PubMed

Jirapinyo, Pichamol; Imaeda, Avlin B; Thompson, Christopher C

2015-12-01

The Gastroenterology Core Curriculum and American Society of Gastrointestinal Endoscopy provide guidelines for endoscopic training. Program adherence to these recommendations is unclear. This study aims to assess endoscopic training experience during fellowship. Questionnaire study. The questionnaire was circulated to US fellowship programs, with the assistance of the American Gastroenterological Association. Graduating third-year fellows. Seventy-three fellows returned the questionnaire. Nearly all fellows met the required numbers for esophagoduodenoscopy (98%) and colonoscopy (100%), with fewer meeting requirements for PEG (73%) and non-variceal hemorrhage (75%). The majority of fellows did not meet minimum numbers for variceal banding (40%), esophageal dilation (43%), capsule endoscopy (42%). Fellows rated training in cognitive aspects of endoscopy as 3.86 [1 (inadequate), 5 (excellent)] and reported greatest emphasis on interpreting endoscopic findings and least on virtual colonography. Quality indicators of endoscopy received little emphasis (rating of 3.04; p = 0.00001), with adenoma detection rate being least emphasized. Fifty-six percent of fellows reported having routine endoscopy conferences. Half of the programs have endoscopic simulators, with 15% of fellows being required to use simulation. Following direct hands-on experience, fellows rated external endoscopy courses (64%) as the next most useful experience. Many fellows do not meet required numbers for several endoscopic procedures, and quality indicators receive little emphasis during training. Most programs do not provide simulation training or hold regular endoscopy conferences. Fellowship programs should perform internal audits and make feasible adjustments. Furthermore, it may be time for professional societies to revisit training guidelines.

First-aid training in school: amount, content and hindrances.

PubMed

Bakke, H K; Bakke, H K; Schwebs, R

2017-11-01

To increase knowledge and competence about first aid in the population, first-aid instruction is included in primary and secondary school curricula. This study aimed to establish how much time is spent on first-aid training, which first-aid measures are taught, and which factors prevent teachers from providing the quantity and quality of first-aid training that they wish to give. A questionnaire was distributed to teachers in physical education in primary and secondary schools and to teachers in vocational subjects in higher secondary schools. The teachers taught a median of two lessons in first aid per year. Cardiopulmonary resuscitation (CPR) was taught by 64% of teachers, free airway and recovery position by 69% and stopping severe bleeding by 51%. Recognising heart attack and stroke was taught by 25% and 23%, respectively. The main factors that the teachers perceived as limiting the amount and quality of first-aid training were insufficient learning objective specifications in the curriculum, too many other competence aims, lack of CPR mannequins and lack of training as first-aid instructors. Norwegian teachers provide an appreciable amount of first-aid training to their students. However, several potential life-saving measures are poorly covered. The curriculum needs to contain first aid but also should specify what first-aid measures to be taught. First-aid training of teachers should adequately prepare them to be first-aid instructors. © 2017 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Global Health and Primary Care: Increasing Burden of Chronic Diseases and Need for Integrated Training

PubMed Central

Truglio, Joseph; Graziano, Michelle; Vedanthan, Rajesh; Hahn, Sigrid; Rios, Carlos; Hendel-Paterson, Brett; Ripp, Jonathan

2015-01-01

Noncommunicable diseases, including cardiovascular disease, chronic respiratory disease, diabetes, cancer, and mental illness, are the leading causes of death and disability worldwide. These diseases are chronic and often mediated predominantly by social determinants of health. Currently there exists a global-health workforce crisis and a subsequent disparity in the distribution of providers able to manage chronic noncommunicable diseases. Clinical competency in global health and primary care could provide practitioners with the knowledge and skills needed to address the global rise of noncommunicable diseases through an emphasis on these social determinants. The past decade has seen substantial growth in the number and quality of US global-health and primary-care training programs, in both undergraduate and graduate medical education. Despite their overlapping competencies, these 2 complementary fields are most often presented as distinct disciplines. Furthermore, many global-health training programs suffer from a lack of a formalized curriculum. At present, there are only a few examples of well-integrated US global-health and primary-care training programs. We call for universal acceptance of global health as a core component of medical education and greater integration of global-health and primary-care training programs in order to improve the quality of each and increase a global workforce prepared to manage noncommunicable diseases and their social mediators. PMID:22786735

Mixed messages: residents' experiences learning cross-cultural care.

PubMed

Park, Elyse R; Betancourt, Joseph R; Kim, Minah K; Maina, Angela W; Blumenthal, David; Weissman, Joel S

2005-09-01

An Institute of Medicine report issued in 2002 cited cross-cultural training as a mechanism to address racial and ethnic disparities in health care, but little is known about residents' training and capabilities to provide quality care to diverse populations. This article explores a select group of residents' perceptions of their preparedness to deliver quality care to diverse populations. Seven focus groups and ten individual interviews were conducted with 68 residents in locations nationwide. Qualitative analysis of focus-group and individual interview transcripts was performed to assess residents' perceptions of (1) preparedness to deliver care to diverse patients; (2) educational climate; and (3) training experiences. Most residents in this study noted the importance of cross-cultural care yet reported little formal training in this area. Residents wanted more formal training yet expressed concern that culture-specific training could lead to stereotyping. Most residents had developed ad hoc, informal skills to care for diverse patients. Although residents perceived institutional endorsement, they sensed it was a low priority due to lack of time and resources. Residents in this study reported receiving mixed messages about cross-cultural care. They were told it is important, yet they received little formal training and did not have time to treat diverse patients in a culturally sensitive manner. As a result, many developed coping behaviors rather than skills based on formally taught best practices. Training environments need to increase training to enhance residents' preparedness to deliver high-quality cross-cultural care if the medical profession is to achieve the goals set by the Institute of Medicine.

Review and evaluation of online tobacco dependence treatment training programs for health care practitioners.

PubMed

Selby, Peter; Goncharenko, Karina; Barker, Megan; Fahim, Myra; Timothy, Valerie; Dragonetti, Rosa; Kemper, Katherine; Herie, Marilyn; Hays, J Taylor

2015-04-17

Training health care professionals is associated with increased capacity to deliver evidence-based smoking cessation interventions and increased quit rates among their patients. Online training programs hold promise to provide training but questions remain regarding the quality and usability of available programs. The aim was to assess the quality of English-language online courses in tobacco dependence treatment using a validated instrument. An environmental scan was conducted using the Google search engine to identify available online tobacco dependence treatment courses. The identified courses were then evaluated using the Peer Review Rubric for Online Learning, which was selected based on its ability to evaluate instructional design. It also has clear and concise criteria descriptions to ensure uniformity of evaluations by trained experts. A total of 39 courses were identified, of which 24 unique courses were assessed based on their accessibility and functionality during the period of evaluation. Overall, the course ratings indicated that 17 of 24 courses evaluated failed to meet minimal quality standards and none of the courses evaluated could be ranked as superior. However, many excelled in providing effective navigation, course rationale, and content. Many were weak in the use of instructional design elements, such as teaching effectiveness, learning strategies, instructor's role, and assessment and evaluation. Evaluation results and suggestions for improvement were shared with course administrators. Based on the courses evaluated in this review, course developers are encouraged to employ best practices in instructional design, such as cohesiveness of material, linearity of design, practice exercises, problem solving, and ongoing evaluation to improve existing courses and in the design of new online learning opportunities.

Just-in-Time Training: A Novel Approach to Quality Improvement Education.

PubMed

Knutson, Allison; Park, Nesha D; Smith, Denise; Tracy, Kelly; Reed, Danielle J W; Olsen, Steven L

2015-01-01

Just-in-time training (JITT) is accepted in medical education as a training method for newer concepts or seldom-performed procedures. Providing JITT to a large nursing staff may be an effective method to teach quality improvement (QI) initiatives. We sought to determine if JITT could increase knowledge of a specific nutrition QI initiative. Members of the nutrition QI team interviewed staff using the Frontline Contextual Inquiry to assess knowledge regarding the specific QI project. The inquiry was completed pre- and post-JITT. A JITT educational cart was created, which allowed trainers to bring the educational information to the bedside for a short, small group educational session. The results demonstrated a marked improvement in the knowledge of the frontline staff regarding our Vermont Oxford Network involvement and the specifics of the nutrition QI project. Just-in-time training can be a valuable and effective method to disseminate QI principles to a large audience of staff members.

A quality approach for conducting training needs assessments in the Ministry of Health, State of Bahrain.

PubMed

Benjamin, S; al-Darazi, F

2000-01-01

In health care organizations around the world, Training Needs Assessments (TNAs) have generally followed a professions-based approach. For example, the training needs of doctors, nurses, each allied health profession, and distinct support staff have been analyzed separately--individualized TNAs conducted for each speciality and functional area. Although a professions-based TNA model can provide useful information to human resource development (HRD) professionals, there are two major drawbacks: (1) it is possible that important training needs might be overlooked because of lack of information sharing among professions and (2) such an approach does not encourage an interdisciplinary, team orientation to service provision. This paper proposes an improved method of conceptualizing TNAs, using an approach that builds on the quality management literature (TQM, CQI, etc.) which stresses the importance of customer- and service-orientations to organizing and measuring organizational and individual performance.

Major challenges to scale up of visual inspection-based cervical cancer prevention programs: the experience of Guatemalan NGOs.

PubMed

Chary, Anita Nandkumar; Rohloff, Peter J

2014-08-01

Like many other low- and middle-income countries, Guatemala has adopted visual inspection with acetic acid (VIA) as a low-resource alternative to the Pap smear for cervical cancer screening. Nongovernmental organizations (NGOs) introduced VIA to Guatemala in 2004, and a growing number of NGOs, working both independently and in collaboration with the Guatemalan Ministry of Health, employ VIA in cervical cancer prevention programs today. While much research describes VIA efficacy and feasibility in Latin America, little is known about NGO involvement with VIA programming or experiences with VIA outside the context of clinical trials and pilot projects in the region. To explore challenges faced by NGOs implementing VIA programs in Guatemala, we conducted semi-structured interviews with 36 NGO staff members involved with 20 VIA programs as direct service providers, program administrators, and training course instructors. Additionally, we collected data through observation at 30 NGO-sponsored cervical cancer screening campaigns, 8 cervical cancer prevention conferences, and 1 week-long NGO-sponsored VIA training course. Frequently highlighted challenges included staff turnover, concerns over training quality, a need for opportunities for continued supervision, and problems with cryotherapy referrals when immediate treatment for VIA-positive women was unavailable. Reducing staff turnover, budgeting to train replacement providers, standardizing training curricula, and offering continued supervision are key strategies to improve VIA service quality and program sustainability. Alternative training methods, such as on-the-job mentoring and course prerequisites of online learning, could help increase training time available for clinical supervision. Efforts should be made to ensure that VIA testing is coupled with immediate cryotherapy, that providers trained in VIA are also trained in cryotherapy, and that cryotherapy supplies and equipment are maintained. Where this is not possible and only VIA screening is available, referral systems must be strengthened.

Major challenges to scale up of visual inspection-based cervical cancer prevention programs: the experience of Guatemalan NGOs

PubMed Central

Chary, Anita Nandkumar; Rohloff, Peter J

2014-01-01

ABSTRACT Background: Like many other low- and middle-income countries, Guatemala has adopted visual inspection with acetic acid (VIA) as a low-resource alternative to the Pap smear for cervical cancer screening. Nongovernmental organizations (NGOs) introduced VIA to Guatemala in 2004, and a growing number of NGOs, working both independently and in collaboration with the Guatemalan Ministry of Health, employ VIA in cervical cancer prevention programs today. While much research describes VIA efficacy and feasibility in Latin America, little is known about NGO involvement with VIA programming or experiences with VIA outside the context of clinical trials and pilot projects in the region. Methods: To explore challenges faced by NGOs implementing VIA programs in Guatemala, we conducted semi-structured interviews with 36 NGO staff members involved with 20 VIA programs as direct service providers, program administrators, and training course instructors. Additionally, we collected data through observation at 30 NGO-sponsored cervical cancer screening campaigns, 8 cervical cancer prevention conferences, and 1 week-long NGO-sponsored VIA training course. Results: Frequently highlighted challenges included staff turnover, concerns over training quality, a need for opportunities for continued supervision, and problems with cryotherapy referrals when immediate treatment for VIA-positive women was unavailable. Conclusions: Reducing staff turnover, budgeting to train replacement providers, standardizing training curricula, and offering continued supervision are key strategies to improve VIA service quality and program sustainability. Alternative training methods, such as on-the-job mentoring and course prerequisites of online learning, could help increase training time available for clinical supervision. Efforts should be made to ensure that VIA testing is coupled with immediate cryotherapy, that providers trained in VIA are also trained in cryotherapy, and that cryotherapy supplies and equipment are maintained. Where this is not possible and only VIA screening is available, referral systems must be strengthened. PMID:25276590

USGS QA Plan: Certification of digital airborne mapping products

USGS Publications Warehouse

Christopherson, J.

2007-01-01

To facilitate acceptance of new digital technologies in aerial imaging and mapping, the US Geological Survey (USGS) and its partners have launched a Quality Assurance (QA) Plan for Digital Aerial Imagery. This should provide a foundation for the quality of digital aerial imagery and products. It introduces broader considerations regarding processes employed by aerial flyers in collecting, processing and delivering data, and provides training and information for US producers and users alike.

LGBT Cultural Competence and Interventions to Help Oncology Nurses and Other Health Care Providers.

PubMed

Radix, Asa; Maingi, Shail

2018-02-01

To define and give an overview of the importance of lesbian, gay, bisexual, and transgender (LGBT) cultural competency and offer some initial steps on how to improve the quality of care provided by oncology nurses and other health care professionals. A review of the existing literature on cultural competency. LGBT patients experience cancer and several other diseases at higher rates than the rest of the population. The reasons for these health care disparities are complex and include minority stress, fear of discrimination, lower rates of insurance, and lack of access to quality, culturally competent care. Addressing the health care disparities experienced by LGBT individuals and families requires attention to the actual needs, language, and support networks used by patients in these communities. Training on how to provide quality care in a welcoming and non-judgmental way is available and can improve health equity. Health care professionals and institutions that acquire cultural competency training can improve the overall health of LGBT patients who currently experience significant health care disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

Policy and Barriers Related to Implementing Adult E-Learning in Taiwan

ERIC Educational Resources Information Center

Chung, Hsiu-Ying; Lee, Gwo-Guang; Liu, Shih-Hwa

2014-01-01

The work quality of public servants direct affects a country's administrative performance, and the Taiwan government has recently invested a considerable amount of funds in constructing e-government learning platforms and developing digital courses to provide all public servants with sufficient on-the-job training and enhance the quality of human…

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

PubMed

Whitelaw, C M; Nash, M C

2001-04-16

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

“Putting It All Together” to Improve Resuscitation Quality

PubMed Central

Sutton, Robert M.; Nadkarni, Vinay; Abella, Benjamin S.

2013-01-01

Cardiac arrest is a major public health problem affecting thousands of individuals each year in both the before hospital and in-hospital settings. However, although the scope of the problem is large, the quality of care provided during resuscitation attempts frequently does not meet quality of care standards, despite evidence-based cardiopulmonary resuscitation (CPR) guidelines, extensive provider training, and provider credentialing in resuscitation medicine. Although this fact may be disappointing, it should not be surprising. Resuscitation of the cardiac arrest victim is a highly complex task requiring coordination between various levels and disciplines of care providers during a stressful and relatively infrequent clinical situation. Moreover, it requires a targeted, high-quality response to improve clinical outcomes of patients. Therefore, solutions to improve care provided during resuscitation attempts must be multifaceted and targeted to the diverse number of care providers to be successful. PMID:22107978

Evidence-based training and mentorship combined with enhanced outcomes surveillance to address the leading causes of neonatal mortality at the district hospital level in Ghana.

PubMed

Brantuo, Mary N A; Cristofalo, Elizabeth; Meheš, Mira M; Ameh, Juliana; Brako, Nana Okai; Boahene, Frederick; Adjei, Stella B; Opoku, Ernest; Banda, Harriet; Wang, Yu T; Forgor, Abdulai A; Punguire, Damien; Brightson, Kennedy; Sottie, Cynthia; Owusu-Agyei, Seth; Williams, John E; Sulemana, Abubakari; Oduro, Abraham R; Gyampong, Margaret; Sarpong, Doris; Andrews, Edith; Gyansa-Lutterodt, Martha; Hodgson, Abraham; Bannerman, Cynthia; Abdullah, Fizan

2014-04-01

To evaluate the impact of a district hospital intervention focused on enhancing healthcare provider capacity to address leading causes of neonatal death: birth asphyxia, infection and prematurity. The neonatal quality improvement initiative was launched at two intervention referral district hospitals in Ghana. Local Health and Demographic Surveillance Systems were enlisted to enhance recording of neonatal and infant deaths in the community and at the facility. After baseline site assessments, a team of local paediatric experts conducted three clinical trainings on-site at each intervention hospital. Assessments were conducted to evaluate participant knowledge before and after participation in training modules. Monthly mentorship visits provided additional training to support the adoption of essential early neonatal care practices. In the first year of implementation, the initiative provided focused clinical training to 278 participants. A comparison of pre- and post-training test results demonstrates significant improvement in provider knowledge (73% vs. 89% correct, P < 0.001), with even greater improvement among trainees receiving recurrent refresher training (86% vs. 94% correct, P < 0.001). Participant feedback following training revealed enthusiasm about the programme and improved confidence. Locally led initiatives that invest directly in healthcare provider education and health systems strengthening represent a promising avenue for reducing neonatal morbidity and mortality. The NQI initiative demonstrates the positive impact of a district hospital intervention that combines on-site training, mentorship and enhanced demographic surveillance. © 2014 John Wiley & Sons Ltd.

High-intensity resistance training in multiple sclerosis - An exploratory study of effects on immune markers in blood and cerebrospinal fluid, and on mood, fatigue, health-related quality of life, muscle strength, walking and cognition.

PubMed

Kierkegaard, Marie; Lundberg, Ingrid E; Olsson, Tomas; Johansson, Sverker; Ygberg, Sofia; Opava, Christina; Holmqvist, Lotta Widén; Piehl, Fredrik

2016-03-15

High-intensity resistance training is unexplored in people with multiple sclerosis. To evaluate effects of high-intensity resistance training on immune markers and on measures of mood, fatigue, health-related quality of life, muscle strength, walking and cognition. Further, to describe participants' opinion and perceived changes of the training. Twenty patients with relapsing-remitting multiple sclerosis performed high-intensity resistance training at an intensity of 80% of one-repetition maximum, twice a week for 12 weeks. Blood and optional cerebrospinal fluid samples, and data on secondary outcome measures were collected before and after intervention. A study-specific questionnaire was used for capturing participants' opinion. Seventeen participants completed the study. Plasma cytokine levels of tumor necrosis factor were significantly decreased post-intervention (p=0.001). Exploratory cytokine analyses in cerebrospinal fluid (n=8) did not reveal major changes. Significant and clinically important improvements were found in fatigue (p=0.001) and health-related quality of life (p=0.004). Measures of mood (p=0.002), muscle strength (p ≤ 0.001), walking speed (p=0.013) and cognition (p=0.04) were also improved. A majority of participants evaluated the training as very good and perceived changes to the better. High-intensity resistance training in persons with relapsing remitting multiple sclerosis with low disability had positive effects on peripheral pro-inflammatory cytokine levels, led to clinically relevant improvements in measures of fatigue and health-related quality of life, and was well tolerated. These results provide a basis for a larger randomized trial. Copyright © 2016 Elsevier B.V. All rights reserved.

Addiction treatment staff perceptions of training as a facilitator or barrier to implementing evidence-based practices: a national qualitative research study.

PubMed

D'Ippolito, Melinda; Lundgren, Lena; Amodeo, Maryann; Beltrame, Clelia; Lim, Lynn; Chassler, Deborah

2015-01-01

This qualitative effort examines training-related facilitators and barriers to implementing evidence-based practices (EBPs) in 285 community-based addiction treatment organizations (CBOs) nationwide that were funded by the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA/CSAT) to implement EBPs. Using qualitative interviews, the authors explored staff (N = 514) descriptions of training as a facilitator or barrier to implementation. Training-related factors were described 663 times as facilitators (by 440 staff) and 233 times as barriers (by 170 staff). Responses were coded using content analysis. Specific characteristics of the training received, such as access to expert knowledge and quality, as well as ongoing training were described as central facilitating factors to EBP implementation. Key reasons training was perceived as a barrier included the amount of training; the training did not fit current staff and/or organizational needs; the training for some EBPs was perceived to be too demanding; and the difficulty accessing training. Since government funders of addiction treatments require that CBOs implement EBPs and they provide training resources, the quality, flexibility, and accessibility of the available training needs to be promoted throughout the addiction treatment network. Only 17% of CBOs reported that they used the SAMHSA-funded ATTC (Addiction Technology Transfer Center) training centers and 42% used SAMHSA technical assistance. Hence, federally funded resources for training were not always used.

Developing students' teaching through peer observation and feedback.

PubMed

Rees, Eliot L; Davies, Benjamin; Eastwood, Michael

2015-10-01

With the increasing popularity and scale of peer teaching, it is imperative to develop methods that ensure the quality of teaching provided by undergraduate students. We used an established faculty development and quality assurance process in a novel context: peer observation of teaching for undergraduate peer tutors. We have developed a form to record observations and aid the facilitation of feedback. In addition, experienced peer tutors have been trained to observe peer-taught sessions and provide tutors with verbal and written feedback. We have found peer observation of teaching to be a feasible and acceptable process for improving quality of teaching provided by undergraduate medical students. However, feedback regarding the quality of peer observer's feedback may help to develop students' abilities further.

Point-of-care ultrasonography by pediatric emergency physicians. Policy statement.

PubMed

Marin, Jennifer R; Lewiss, Resa E

2015-04-01

Point-of-care ultrasonography is increasingly being used to facilitate accurate and timely diagnoses and to guide procedures. It is important for pediatric emergency physicians caring for patients in the emergency department to receive adequate and continued point-of-care ultrasonography training for those indications used in their practice setting. Emergency departments should have credentialing and quality assurance programs. Pediatric emergency medicine fellowships should provide appropriate training to physician trainees. Hospitals should provide privileges to physicians who demonstrate competency in point-of-care ultrasonography. Ongoing research will provide the necessary measures to define the optimal training and competency assessment standards. Requirements for credentialing and hospital privileges will vary and will be specific to individual departments and hospitals. As more physicians are trained and more research is completed, there should be one national standard for credentialing and privileging in point-of-care ultrasonography for pediatric emergency physicians.

Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial.

PubMed

Yeh, Ting-Ting; Wu, Ching-Yi; Hsieh, Yu-Wei; Chang, Ku-Chou; Lee, Lin-Chien; Hung, Jen-Wen; Lin, Keh-Chung; Teng, Ching-Hung; Liao, Yi-Han

2017-08-31

Aerobic exercise and cognitive training have been effective in improving cognitive functions; however, whether the combination of these two can further enhance cognition and clinical outcomes in stroke survivors with cognitive decline remains unknown. This study aimed to determine the treatment effects of a sequential combination of aerobic exercise and cognitive training on cognitive function and clinical outcomes. Stroke survivors (n = 75) with cognitive decline will be recruited and randomly assigned to cognitive training, aerobic exercise, and sequential combination of aerobic exercise and cognitive training groups. All participants will receive training for 60 minutes per day, 3 days per week for 12 weeks. The aerobic exercise group will receive stationary bicycle training, the cognitive training group will receive cognitive-based training, and the sequential group will first receive 30 minutes of aerobic exercise, followed by 30 minutes of cognitive training. The outcome measures involve cognitive functions, physiological biomarkers, daily function and quality of life, physical functions, and social participation. Participants will be assessed before and immediately after the interventions, and 6 months after the interventions. Repeated measures of analysis of variance will be used to evaluate the changes in outcome measures at the three assessments. This trial aims to explore the benefits of innovative intervention approaches to improve the cognitive function, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline. The findings will provide evidence to advance post-stroke cognitive rehabilitation. ClinicalTrials.gov, NCT02550990 . Registered on 6 September 2015.

Determination of Minimum Training Sample Size for Microarray-Based Cancer Outcome Prediction–An Empirical Assessment

PubMed Central

Cheng, Ningtao; Wu, Leihong; Cheng, Yiyu

2013-01-01

The promise of microarray technology in providing prediction classifiers for cancer outcome estimation has been confirmed by a number of demonstrable successes. However, the reliability of prediction results relies heavily on the accuracy of statistical parameters involved in classifiers. It cannot be reliably estimated with only a small number of training samples. Therefore, it is of vital importance to determine the minimum number of training samples and to ensure the clinical value of microarrays in cancer outcome prediction. We evaluated the impact of training sample size on model performance extensively based on 3 large-scale cancer microarray datasets provided by the second phase of MicroArray Quality Control project (MAQC-II). An SSNR-based (scale of signal-to-noise ratio) protocol was proposed in this study for minimum training sample size determination. External validation results based on another 3 cancer datasets confirmed that the SSNR-based approach could not only determine the minimum number of training samples efficiently, but also provide a valuable strategy for estimating the underlying performance of classifiers in advance. Once translated into clinical routine applications, the SSNR-based protocol would provide great convenience in microarray-based cancer outcome prediction in improving classifier reliability. PMID:23861920

Assessing family planning service-delivery skills in Kenya.

PubMed

Valadez, J J; Transgrud, R; Mbugua, M; Smith, T

1997-06-01

This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.

Interprofessional immersion: Use of interprofessional education collaborative competencies in side-by-side training of family medicine, pharmacy, nursing, and counselling psychology trainees.

PubMed

Boland, Daubney Harper; Scott, Mary Alice; Kim, Helen; White, Traci; Adams, Eve

2016-11-01

While supported by the Affordable Care Act, in the United States, interprofessional training often takes place after healthcare providers graduate and are practicing in the field. This article describes the implementation and evaluation of an interprofessional training for graduate-level healthcare trainees. A group of interprofessional healthcare faculty provided a weeklong interprofessional immersion for doctoral-level healthcare trainees (n = 24) in Pharmacy, Counselling Psychology, Nursing, and Family Medicine residents. Healthcare faculty and staff from each profession worked side-by-side to provide integrated training utilising the Interprofessional Education Collaborative core competency domains. Trainees were placed into small teams with representatives from each profession; each team observed, learned, and practiced working within teams to provide quality patient care. Qualitative and quantitative data were collected to identify the effect of the training on trainees' self-reported team skills, as well as the extent to which the trainees learned and utilised the competencies. The results suggest that after completing the training, trainees felt more confident in their ability to work within an interprofessional team and more likely to utilise a team-based approach in the future.

Concept of Operations Evaluation for Using Remote-Guidance Ultrasound for Exploration Spaceflight.

PubMed

Hurst, Victor W; Peterson, Sean; Garcia, Kathleen; Ebert, Douglas; Ham, David; Amponsah, David; Dulchavsky, Scott

2015-12-01

Remote-guidance (RG) techniques aboard the International Space Station (ISS) have enabled astronauts to collect diagnostic-level ultrasound (US) images. Exploration-class missions will likely require nonformally trained sonographers to operate with greater autonomy given longer communication delays (> 6 s for missions beyond the Moon) and blackouts. Training requirements for autonomous collection of US images by non-US experts are being determined. Novice US operators were randomly assigned to one of three groups to collect standardized US images while drawing expertise from A) RG only, B) a computer training tool only, or C) both RG and a computer training tool. Images were assessed for quality and examination duration. All operators were given a 10-min standardized generic training session in US scanning. The imaging task included: 1) bone fracture assessment in a phantom and 2) Focused Assessment with Sonography in Trauma (FAST) examination in a healthy volunteer. A human factors questionnaire was also completed. Mean time for group B during FAST was shorter (20.4 vs. 22.7 min) than time for the other groups. Image quality scoring was lower than in groups A or C, but all groups produced images of acceptable diagnostic quality. RG produces US images of higher quality than those produced with only computer-based instruction. Extended communication delays in exploration missions will eliminate the option of real-time guidance, thus requiring autonomous operation. The computer program used appears effective and could be a model for future digital US expertise banks. Terrestrially, it also provides adequate self-training and mentoring mechanisms.

Economic evaluation of emergency obstetric care training: a systematic review.

PubMed

Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

2017-12-04

Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a need to scale-up and standardise processes that capture both cost and effectiveness of training and to agree on suitable economic evaluation models that allow for comparability across settings. PROSPERO_CRD42016041911 .

CGAT: a model for immersive personalized training in computational genomics

PubMed Central

Sims, David; Ponting, Chris P.

2016-01-01

How should the next generation of genomics scientists be trained while simultaneously pursuing high quality and diverse research? CGAT, the Computational Genomics Analysis and Training programme, was set up in 2010 by the UK Medical Research Council to complement its investment in next-generation sequencing capacity. CGAT was conceived around the twin goals of training future leaders in genome biology and medicine, and providing much needed capacity to UK science for analysing genome scale data sets. Here we outline the training programme employed by CGAT and describe how it dovetails with collaborative research projects to launch scientists on the road towards independent research careers in genomics. PMID:25981124

Training for older adults.

PubMed

Hautier, C; Bonnefoy, M

2007-07-01

Aging is associated with a reduction in physical fitness, with loss of muscular force and endurance. Physical activity has been demonstrated to provide substantial health benefits and to maintain functional independence and improve quality of life in older adults. Resistance training has a significant effect on muscle mass and force whereas endurance training increases oxygen transport and consumption capacities. This article presents training methods used in the literature and their associated effects in order to adapt training protocols to older populations. To maximise benefits from adoption of a program to which the patient can adhere for long time, it is important to tailor the exercise prescription to the individual.

Factors affecting quality of care in family planning clinics: a study from Iran.

PubMed

Shahidzadeh-Mahani, Ali; Omidvari, Sepideh; Baradaran, Hamid-Reza; Azin, Seyyed-Ali

2008-08-01

Despite good contraceptive coverage rates, recent studies in Iran have shown an alarmingly high incidence of unplanned pregnancy. To determine factors affecting quality of family planning services, a cross-sectional study was performed from June to August 2006 on women visiting urban Primary Health Care clinics in a provincial capital in western Iran. The primary focus of the study was on provider-client interaction. We used a slightly edited version of a UNICEF checklist and a convenient sampling method to assess quality of care in 396 visits to the family planning sections at 25 delivery points. Poor performance was observed notably in Counselling and Choice of method sections. In logistic regression analysis, the following factors were found to be associated with higher quality of care: provider experience [OR (odds ratio)=1.9, CI(0.95) (confidence interval)=1.2-3.0], low provider education (OR=6.7, CI(0.95)=4.0-10.8), smaller workload at the clinic (OR=3.7, CI(0.95)=2.0-6.7), and 'new client' status (OR=4.2, CI(0.95)=2.6-6.7). This study identified the issues of counselling and information exchange as the quality domains in serious need of improvement; these areas are expected to be the focus of future training programmes for care providers. Also, priority should be given to devising effective supervision mechanisms and on-the-job training of senior nursing and midwifery graduates to make them more competent in delivering basic family planning services.

Heavy Duty and Industrial Alternative Fuel Applications. Forklift and Material Handling. Alternative Fuels Training.

ERIC Educational Resources Information Center

Eckert, Doug; Casto, Lori

This training manual is designed to lay the foundation for trainers and technicians by showing the steps to achieve and maintain good indoor air quality through use of cleaner-burning forklifts and materials handlers. The first part of the manual consists of nine units that provide informational material and diagrams on these topics: comparison of…

Detailed Work Programme on the Follow-Up of the Objectives of Education and Training Systems in Europe.

ERIC Educational Resources Information Center

Commission of the European Communities, Brussels (Belgium).

This report describes policy cooperation in the Education and Training Area in the European Union (EU) in response to the Lisbon strategy and provides a comprehensive plan to respond to the challenges of the knowledge society, globalization, and the enlargement of the EU. It focuses on these three objectives: (1) improving the quality and…

Transforming the Public Provision of Training: Reorganisation or Privatisation? Long-Term Changes in Sweden and the Netherlands. CEDEFOP Discussion Dossier.

ERIC Educational Resources Information Center

Brandsma, Jittie; Noonan, Richard; Westphalen, Sven-Age

The public sector is becoming less concerned with who is providing a given service but more concerned about the quality, reliability, accessibility, and price of the service. In vocational education and training (VET), one consequence of this transformation is that the various public stakeholders involved with funding, purchasing, and providing…

[Physical activity diminishes aging-related decline of physical and cognitive performance].

PubMed

Apor, Péter; Babai, László

2014-05-25

Aging-related decline of muscle force, walking speed, locomotor coordination, aerobic capacity and endurance exert prognostic impact on life expectancy. Proper use of training may diminish the aging process and it may improve the quality of life of elderly persons. This paper provides a brief summary on the impact of training on aging-related decline of physical and cognitive functions.

Immersive virtual reality used as a platform for perioperative training for surgical residents.

PubMed

Witzke, D B; Hoskins, J D; Mastrangelo, M J; Witzke, W O; Chu, U B; Pande, S; Park, A E

2001-01-01

Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real-time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.

Intercultural Internet-Based Learning: Know Your Audience and What They Value

ERIC Educational Resources Information Center

Bentley, Joanne P. H.; Tinney, Mari Vawn; Chia, Bing Howe

2004-01-01

As the internet-based learning (IBL) market becomes increasingly global, understanding differing educational values and cultural expectations could provide an important competitive edge for providers (universities, publishing houses, and corporate training entities). How each of person determines "good" or "quality" instruction…

Task-shifting challenges for provision of skilled birth attendance: a qualitative exploration.

PubMed

Chandhiok, Nomita; Joglekar, Neelam; Shrotri, Aparna; Choudhury, Panna; Chaudhury, Nayanjeet; Singh, Shalini

2015-05-01

Shortage of skilled birth attendants (SBA) is one of the determinants of maternal mortality in India. To combat this shortage, innovative task-shifting strategies to engage providers of the Indian system of medicine (Ayurveda and Homeopathy), called AYUSH practitioners (AP), to provide SBA services is being implemented. Engagement of APs for SBA service provision was assessed in 3 states of India (Maharashtra, Rajasthan and Odisha) through 73 in-depth interviews (37 with APs and 36 with programme managers). The interviews explored the providers' SBA training experience, barriers for SBA service provision, workplace and community acceptance, and the perspective of programme managers on the competence and quality of SBA services provided. SBA training led to skill enhancement with adoption of appropriate maternal and newborn care practices. A dedicated trainer, more hands-on practice, and strengthening training on newborn care practices and management of complications emerged as the training needs. Conditional involvement in SBA-related work, a discriminatory attitude at the workplace and lack of legal/regulatory authorisation were identified as barriers to the inclusion of APs in SBA service provision. Quality skill enhancement measures, an enabling work environment, a systematic task-shifting process, role definition, supportive supervision and credentialing could be key for the integration of APs and their acceptance in the health system. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Quality of surgical care in hospitals providing internship training in Kenya: a cross sectional survey.

PubMed

Mwinga, Stephen; Kulohoma, Colette; Mwaniki, Paul; Idowu, Rachel; Masasabi, John; English, Mike

2015-02-01

To evaluate services in hospitals providing internship training to graduate doctors in Kenya. A survey of 22 internship training hospitals was conducted. Availability of key resources spanning infrastructure, personnel, equipment and drugs was assessed by observation. Outcomes and process of care for pre-specified priority conditions (head injury, chest injury, fractures, burns and acute abdomen) were evaluated by auditing case records. Each hospital had at least one consultant surgeon. Scheduled surgical outpatient clinics, major ward rounds and elective (half day) theatre lists were provided once per week in 91%, 55% and 9%, respectively. In all other hospitals, these were conducted twice weekly. Basic drugs were not always available (e.g. gentamicin, morphine and pethidine in 50%, injectable antistaphylococcal penicillins in 5% hospitals). Fewer than half of hospitals had all resources needed to provide oxygen. One hundred and forty-five of 956 cases evaluated underwent operations under general or spinal anaesthesia. We found operation notes for 99% and anaesthetic records for 72%. Pre-operatively measured vital signs were recorded in 80% of cases, and evidence of consent to operation was found in 78%. Blood loss was documented in only one case and sponge and instrument counts in 7%. Evaluation of surgical services would be improved by development and dissemination of clear standards of care. This survey suggests that internship hospitals may be poorly equipped and documented care suggests inadequacies in quality and training. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Improving Quality of Care for Seriously Ill Patients: Opportunities for Hospitalists.

PubMed

Fail, Robin E; Meier, Diane E

2018-03-01

As the shift to value-based payment accelerates, hospitals are under increasing pressure to deliver high-quality, efficient services. Palliative care approaches improve quality of life and family well-being, and in doing so, reduce resource utilization and costs. Hospitalists frequently provide palliative care interventions to their patients, including pain and symptom management and engaging in conversations with patients and families about the realities of their illness and treatment plans that align with their priorities. Hospitalists are ideally positioned to identify patients who could most benefit from palliative care approaches and often refer the most complex cases to specialty palliative care teams. Though hospitalists are frequently called upon to provide palliative care, most lack formal training in these skills, which have not typically been included in medical education. Additional training in communication, safe and effective symptom management, and other palliative care knowledge and skills are available in both in-person and online formats. © 2017 Society of Hospital Medicine.

[Analysis of interventions designed to improve clinical supervision of student nurses in Benin].

PubMed

Otti, André; Pirson, Magali; Piette, Danielle; Coppieters T Wallant, Yves

2017-12-05

The absence of an explicit and coherent conception of the articulation between theory and practice in the reform of nursing training in Benin has resulted in poor quality clinical supervision of student nurses. The objective of this article is to analyze two interventions designed to improve the quality of supervision. A student welcome booklet developed by means of a consultative and provocative participatory approach was tested with twelve student nurses versus a control group. Content analysis of the data collected by individual semi-directed interviews and during two focus groups demonstrated the value of this tool. Student nurses were also taught to use to training diaries inspired by the ?experiential learning? Training diaries were analysed using a grid based on the descriptive elements of the five types of Scheepers training diaries (2008). According to the student nurses, the welcome booklet provided them with structured information to be used as a reference during their training and a better understanding of their teachers, and allowed them to situate the resources of the training course with a lower level of stress. Fifty-eight per cent of the training diaries were are mosaics, reflecting the reflective practice and self-regulated learning of student nurses. This activity also promoted metacognitive dialogue with their supervisors. The student welcome booklet appeared to facilitate integration of student nurses into the clinical setting and promoted professional and organizational socialization. The training diary improved the quality of clinical learning by repeated reflective observation of student nurses and helped to maintain permanent communication with the supervisors.

Telehealth and eHealth in nurse practitioner training: current perspectives

PubMed Central

Rutledge, Carolyn M; Kott, Karen; Schweickert, Patty A; Poston, Rebecca; Fowler, Christianne; Haney, Tina S

2017-01-01

Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this article focuses on topics including 1) defining telehealth, 2) telehealth etiquette, 3) interprofessional collaboration, 4) regulations, 5) reimbursement, 6) security/Health Insurance Portability and Accountability Act (HIPAA), 7) ethical practice in telehealth, and 8) satisfaction of patients and providers. A multimodal approach based on a review of the literature is presented for providing the training: 1) didactics, 2) simulations including standardized patient encounters, 3) practice immersions, and 4) telehealth projects. Studies found that training using the multimodal approach allowed the students to develop comfort, knowledge, and skills needed to embrace the utilization of telehealth in health care. PMID:28721113

Pelvic Floor Muscle Training to Manage Overactive Bladder and Urinary Incontinence.

PubMed

Angelini, Kimberly

Overactive bladder (OAB) and urinary incontinence (UI) are common chronic conditions that can negatively affect women's quality of life. Pelvic floor muscle training is the first-line treatment. Two recent Cochrane Reviews examining pelvic floor muscle training for the treatment of UI and OAB are summarized here to provide women's health nurses with current recommendations for UI and OAB management. This column also identifies practice improvement education in the area of pelvic floor muscle training and treatment for OAB and UI. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Comparison of Cardiopulmonary Resuscitation Quality Between Standard Versus Telephone-Basic Life Support Training Program in Middle-Aged and Elderly Housewives: A Randomized Simulation Study.

PubMed

Kim, Tae Han; Lee, Yu Jin; Lee, Eui Jung; Ro, Young Sun; Lee, KyungWon; Lee, Hyeona; Jang, Dayea Beatrice; Song, Kyoung Jun; Shin, Sang Do; Myklebust, Helge; Birkenes, Tonje Søraas

2018-02-01

For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs. Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs. The T-BLS training program included concepts and current instruction protocols for telephone-assisted CPR, whereas the S-BLS training program provided training for BLS. After each training course, the participants simulated CPR and were assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality was measured and recorded using a mannequin simulator. The primary outcome was total no-flow time (>1.5 seconds without chest compression) during simulation. Among 24 participants, two (8.3%) who experienced mechanical failure of simulation mannequin and one (4.2%) who violated simulation protocols were excluded at initial simulation, and two (8.3%) refused follow-up after 6 months. The median (interquartile range) total no-flow time during initial simulation was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6 (122.5-184.0) seconds for the S-BLS training group (P < 0.01). Median cumulative interruption time and median number of interruption events during BLS at initial simulation and 6-month follow-up simulation were significantly shorter in the T-BLS than in the S-BLS group (1.0 vs. 9.5, P < 0.01, and 1.0 vs. 10.5, P = 0.02, respectively). Participants trained with the T-BLS training program showed shorter no-flow time and fewer interruptions during bystander CPR simulation assisted by a dispatcher.

What European gynaecologists need to master: Consensus on medical expertise outcomes of pan-European postgraduate training in obstetrics & gynaecology.

PubMed

van der Aa, Jessica E; Tancredi, Annalisa; Goverde, Angelique J; Velebil, Petr; Feyereisl, Jaroslav; Benedetto, Chiara; Teunissen, Pim W; Scheele, Fedde

2017-09-01

European harmonisation of training standards in postgraduate medical education in Obstetrics and Gynaecology is needed because of the increasing mobility of medical specialists. Harmonisation of training will provide quality assurance of training and promote high quality care throughout Europe. Pan-European training standards should describe medical expertise outcomes that are required from the European gynaecologist. This paper reports on consensus development on the medical expertise outcomes of pan-European training in Obstetrics and Gynaecology. A Delphi procedure was performed amongst European gynaecologists and trainees in Obstetrics & Gynaecology, to develop consensus on outcomes of training. The consensus procedure consisted of two questionnaire rounds, followed by a consensus meeting. To ensure reasonability and feasibility for implementation of the training standards in Europe, implications of the outcomes were considered in a working group thereafter. We invited 142 gynaecologists and trainees in Obstetrics & Gynaecology for participation representing a wide range of European countries. They were selected through the European Board & College of Obstetrics and Gynaecology and the European Network of Trainees in Obstetrics & Gynaecology. Sixty people participated in round 1 and 2 of the consensus procedure, 38 (63.3%) of whom were gynaecologists and 22 (36.7%) were trainees in Obstetrics & Gynaecology. Twenty-eight European countries were represented in this response. Round 3 of the consensus procedure was performed in a consensus meeting with six experts. Implications of the training outcomes were discussed in a working group meeting, to ensure reasonability and feasibility of the material for implementation in Europe. The entire consensus procedure resulted in a core content of training standards of 188 outcomes, categorised in ten topics. European consensus was developed regarding the medical expertise outcomes of pan-European training in Obstetrics and Gynaecology. The outcomes will be described in core trainings standards, aimed at harmonising training in Obstetrics and Gynaecology in Europe to promote high quality care. Copyright © 2017 Elsevier B.V. All rights reserved.

Improving the United States airline industry's capacity to provide safe and dignified services to travelers with disabilities: focus group findings.

PubMed

McCarthy, Michael J

2011-01-01

As a component of a training development project for intercity air travel providers, we investigated the capacity of the airline industry to meet the needs of travelers with disabilities by exploring: (1) the level of sensitivity among personnel to travelers' needs, (2) training currently provided, (3) areas in which additional training might be beneficial, and (4) organisational/systems-level commitment to dignified assistance to all travelers. Forty-four airline/vendor employees participated in nine focus groups in four US cities. Groups were audio recorded and transcribed. A grounded-theory approach was used to develop a coding system which was then applied to transcripts to identify themes. Factors influencing capacity grouped broadly into four areas: characteristics of the job/system, characteristics of current training, characteristics of providers themselves, and characteristics of travelers. At an interpersonal level, providers were empathetic and desired to provide dignified services. They lacked training and adequate equipment in some cases, however, and organisational commitment varied between companies. Traveler characteristics were also shown to impact service delivery. Results are promising but additional regulatory and organisational policies are needed to ensure quality services. Providers and consumers of intercity air travel services may benefit from the findings and recommendations of this study.

Geriatric Training Academy: innovative education for certified nurse aides and charge nurses.

PubMed

Cherry, Barbara; Marshall-Gray, Paula; Laurence, Ann; Green, Alexia; Valadez, Ana; Scott-Tilley, Donna; Merritt, Pearl

2007-03-01

Quality care for the rapidly growing number of older Americans is a major challenge facing the health care industry today. With the baby-boom generation "coming of age"--older age-the need for quality long-term care workers is on the rise. It is estimated that the number of persons needing assisted or alternative living arrangements will increase from 15 million in 2000 to 27 million in 2050 (U.S. Department of Health and Human Services [HHS], 2003). In response to the rising demand for quality long-term care workers, the Geriatric Education and Training Academy (the Academy) was created at Texas Tech University Health Sciences Center (TTUHSC) to provide advanced geriatric education and training for certified nurse aides (CNA), licensed vocational nurses (LVN) and registered nurses (RN) who work in long-term care facilities. This article describes how the Academy is addressing the need for the recruitment, education, and retention of long-term care workers for the expanding geriatric population in West Texas.

A curriculum for training quality scholars to improve the health and health care of veterans and the community at large.

PubMed

Splaine, Mark E; Aron, David C; Dittus, Robert S; Kiefe, Catarina I; Landefeld, C Seth; Rosenthal, Gary E; Weeks, William B; Batalden, Paul B

2002-01-01

In 1998, the Veterans Health Administration invested in the creation of the Veterans Administration National Quality Scholars Fellowship Program (VAQS) to train physicians in new ways to improve the quality of health care. We describe the curriculum for this program and the lessons learned from our experience to date. The VAQS Fellowship program has developed a core improvement curriculum to train postresidency physicians in the scholarship, research, and teaching of the improvement of health care. The curriculum covers seven domains of knowledge related to improvement: health care as a process; variation and measurement; customer/beneficiary knowledge; leading, following, and making changes in health care; collaboration; social context and accountability; and developing new, locally useful knowledge. We combine specific knowledge about the improvement of health care with the use of adult learning strategies, interactive video, and development of learner competencies. Our program provides insights for medical education to better prepare physicians to participate in and lead the improvement of health care.

Managing obesity in pharmacy: the Australian experience.

PubMed

Um, Irene S I; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

2010-12-01

To explore pharmacists' opinions about the provision of weight management services in community pharmacy and their attitudes towards the establishment of an accredited training course in weight management in pharmacy. Interviews were conducted with practising pharmacists on site in various community pharmacies in metropolitan Sydney, Australia. In-depth, semi-structured interviews with twenty practising pharmacists were conducted. Of the twenty interviewed pharmacists, sixteen were involved in the provision of one or more pharmacy based weight management programs in their pharmacies. Interviews were audio-recorded, transcribed and analysed using the grounded theory approach. The data were thematically analysed to identify facilitators and perceived barriers to the provision of high quality services, and pharmacists' willingness to undertake training and accreditation. Participants clearly perceived a role for pharmacy in weight management. Key facilitators to provision of service were accessibility and the perception of pharmacists as trustworthy healthcare professionals. The pharmacists proposed collaboration with other healthcare professionals in order to provide a service incorporating diet, exercise and behavioural therapy. A program that was not-product-centred, and supported by ethical marketing was favoured. Appropriate training and accreditation were considered essential to assuring the quality of such services. Barriers to the provision of high quality services identified were: remuneration, pharmacy infrastructure, client demand and the current marketing of product-centred programs. Australian pharmacists believe there is a role for pharmacy in weight management, provided training in accredited programs is made available. A holistic, evidence-based, multi-disciplinary service model has been identified as ideal.

Robot-assisted upper extremity rehabilitation for cervical spinal cord injuries: a systematic scoping review.

PubMed

Singh, Hardeep; Unger, Janelle; Zariffa, José; Pakosh, Maureen; Jaglal, Susan; Craven, B Catharine; Musselman, Kristin E

2018-01-15

Abstact Purpose: To provide an overview of the feasibility and outcomes of robotic-assisted upper extremity training for individuals with cervical spinal cord injury (SCI), and to identify gaps in current research and articulate future research directions. A systematic search was conducted using Medline, Embase, PsycINFO, CCTR, CDSR, CINAHL and PubMed on June 7, 2017. Search terms included 3 themes: (1) robotics; (2) SCI; (3) upper extremity. Studies using robots for upper extremity rehabilitation among individuals with cervical SCI were included. Identified articles were independently reviewed by two researchers and compared to pre-specified criteria. Disagreements regarding article inclusion were resolved through discussion. The modified Downs and Black checklist was used to assess article quality. Participant characteristics, study and intervention details, training outcomes, robot features, study limitations and recommendations for future studies were abstracted from included articles. Twelve articles (one randomized clinical trial, six case series, five case studies) met the inclusion criteria. Five robots were exoskeletons and three were end-effectors. Sample sizes ranged from 1 to 17 subjects. Articles had variable quality, with quality scores ranging from 8 to 20. Studies had a low internal validity primarily from lack of blinding or a control group. Individuals with mild-moderate impairments showed the greatest improvements on body structure/function and performance-level measures. This review is limited by the small number of articles, low-sample sizes and the diversity of devices and their associated training protocols, and outcome measures. Preliminary evidence suggests robot-assisted interventions are safe, feasible and can reduce active assistance provided by therapists. Implications for rehabilitation Robot-assisted upper extremity training for individuals with cervical spinal cord injury is safe, feasible and can reduce hands-on assistance provided by therapists. Future research in robotics rehabilitation with individuals with spinal cord injury is needed to determine the optimal device and training protocol as well as effectiveness.

Disability Diversity Training in the Workplace: Systematic Review and Future Directions.

PubMed

Phillips, Brian N; Deiches, Jon; Morrison, Blaise; Chan, Fong; Bezyak, Jill L

2016-09-01

Purpose Misinformation and negative attitudes toward disability contribute to lower employment rates among people with disabilities. Diversity training is an intervention intended to improve intergroup relations and reduce prejudice. We conducted a systematic review to determine the use and effectiveness of disability diversity training aimed at improving employment outcomes for employees with disabilities. Methods Five databases were searched for peer-reviewed studies of disability diversity training interventions provided within the workplace. Studies identified for inclusion were assessed for quality of methodology. Results Of the total of 1322 articles identified by the search, three studies met the criteria for inclusion. Two of the three articles focused specifically on training to improve outcomes related to workplace injuries among existing employees. The other study provided an initial test of a more general disability diversity training program. Conclusions There is currently a lack of empirically validated diversity training programs that focus specifically on disability. A number of disability diversity trainings and resources exist, but none have been well researched. Related literature on diversity training and disability awareness suggests the possibility for enhancing diversity training practices through training design, content, participant, and outcomes considerations. By integrating best practices in workplace diversity training with existing disability training resources, practitioners and researchers may be able to design effective disability diversity training programs.

Postural stability and quality of life after guided and self-training among older adults residing in an institutional setting.

PubMed

Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Moisio-Vilenius, Päivi; Mäkinen, Erja; Toppila, Esko; Pyykkö, Ilmari

2013-01-01

To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly's daily routine and making it more active and exhausting.

Medical Physics Challenges for the Implementation of Quality Assurance Programmes in Radiation Oncology.

PubMed

Meghzifene, A

2017-02-01

The importance of quality assurance in radiation therapy, as well as its positive consequences on patient treatment outcome, is well known to radiation therapy professionals. In low- and middle-income countries, the implementation of quality assurance in radiation therapy is especially challenging, due to a lack of staff training, a lack of national guidelines, a lack of quality assurance equipment and high patient daily throughput. According to the International Atomic Energy Agency (IAEA) Directory of Radiotherapy Centres, the proportion of linear accelerators compared with Co-60 machines has increased significantly in recent years in low- and middle-income countries. However, this increase in the proportion of relatively more demanding technology is not always accompanied with the necessary investment in staff training and quality assurance. The IAEA provides supports to low- and middle-income countries to develop and strengthen quality assurance programmes at institutional and national level. It also provides guidance, through its publications, on quality assurance and supports implementation of comprehensive clinical audits to identify gaps and makes recommendations for quality improvement in radiation therapy. The new AAPM TG100 report suggests a new approach to quality management in radiation therapy. If implemented, it will lead to improved cost-effectiveness of radiation therapy in all income settings. Low- and middle-income countries could greatly benefit from this new approach as it will help direct their scarce resources to areas where they can produce the optimum impact on patient care, without compromising patient safety. Copyright © 2016. Published by Elsevier Ltd.

Success in Outreach and Education Through a Partnership Approach Between Government and Grass Roots: The Yukon River Basin Water Quality Monitoring Program

NASA Astrophysics Data System (ADS)

Maracle, B. K.; Schuster, P. F.

2008-12-01

The U.S. Geological Survey (USGS) recently concluded a five-year water quality study (2001-2005) of the Yukon River and its major tributaries. One component of the study was to establish a water quality baseline providing a frame of reference to assess changes in the basin that may result from climate change. As the study neared its conclusion, the USGS began to foster a relationship with the Yukon River Inter-Tribal Watershed Council (YRITWC). The YRITWC was in the process of building a steward-based Yukon River water quality program. Both the USGS and the YRITWC recognized the importance of collaboration resulting in mutual benefits. Through the guidance, expertise, and training provided by the USGS, YRITWC developed and implemented a basin-wide water quality program. The YRITWC program began in March, 2006 utilizing USGS protocols, techniques, and in-kind services. To date, more than 300 samplings and field measurements at more than 25 locations throughout the basin (twice the size of California) have been completed by more than 50 trained volunteers. The Yukon River Basin baseline water quality database has been extended from 5 to 8 years due to the efforts of the YRITWC-USGS collaboration. Basic field measurements include field pH, specific conductance, dissolved oxygen, and water temperature. Samples taken for laboratory analyses include major ions, dissolved organic carbon, greenhouse gases, nutrients, and stable isotopes of hydrogen and oxygen, and selected trace elements. Field replicates and blanks were introduced into the program in 2007 for quality assurance. Building toward a long-term dataset is critical to understanding the effects of climate change on river basins. Thus, relaying the importance of long-term water-quality databases is a main focus of the training workshops. Consistencies in data populations between the USGS 5-year database and the YRITWC 3-year database indicate protocols and procedures made a successful transition. This reflects the success of the YRITWC- USGS sponsored water-quality training workshops for water technicians representing more than 18 Tribal Councils and First Nations throughout the Yukon River Basin. The collaborative approach to outreach and education will be described along with discussion of future opportunities using this model.

Will HEE and LETBs deliver the 'right nurse'?

PubMed

While, Alison

2012-03-01

The restructuring of the NHS in England will see the loss of strategic health authorities, with their workforce education remit being transferred to a completely new structure comprising Health Education England (HEE) and Local Education and Training Boards (LETBs). HEE will provide national oversight of strategic workforce planning and allocate the education and training budget, and will also be responsible for national schemes like junior doctor training. The LETBs will be populated by representatives of health-care providers and professionals, and will be the interface with HEE. They will be charged with ensuring high-quality outcomes from educational investment and meeting the needs of health-care delivery, patients and the public. The universities, colleges, employers and other local education providers will remain responsible for educating the health-care workforce.

Lean-Six Sigma: tools for rapid cycle cost reduction.

PubMed

Caldwell, Chip

2006-10-01

Organizational costs can be grouped as process cost, cost of quality, and cost of poor quality. Providers should train managers in the theory and application of Lean-Six Sigma, including the seven categories of waste and how to remove them. Healthcare financial executives should work with managers in eliminating waste to improve service and reduce costs.

PDQ: Planning and Development of Quality Services in the Schools, Instructional Guide, Student Manual and Reference Materials.

ERIC Educational Resources Information Center

Wright, Sandra Raymore

The instructional guide, student manual, and reference materials were developed by the PDQ Project, Planning and Development of Quality Services in the Schools, an effort by the American Speech-Language-Hearing Association to provide public school personnel working with communication disordered children with information and training related to…

A Critical Analysis of Management Indicators for the Director of Materiel Management, Sacramento ALC.

DTIC Science & Technology

1980-06-01

Dist. AVAIL, and/or SP A Re aw rade tostt.on Organizatin iL.cti *~ NO OSTAGI PtN*V FORn PffVA13 Ut.SIL $3- -. dil -- T I BUSINESS REPLY MAIL... Leadership Qualities Provide Quality Training Programs Establish Realistic Project and Task Priorities Minimize Not Mission Capable Supply (NMCS) 47 zz

Effects of Professional Development Training on Joint Attention Engagement in Low-Quality Childcare Centers

ERIC Educational Resources Information Center

Cain, David W.; Rudd, Loretta C.; Saxon, Terrill F.

2007-01-01

This study carries forward the exploration of joint attention engagement in children from 18 to 24 months of age enrolled in "low-quality" childcare centers. Childcare providers and children were videotaped to capture social interactions in the classroom including duration and bids for joint attention. One-half of 48 childcare providers…

A Journey of Surprises: Rivers Reveal Their Secrets to Idaho Students Researching Water Quality through Rigorous Scientific Inquiry.

ERIC Educational Resources Information Center

Boss, Suzie

2002-01-01

Idaho secondary students learn the scientific method through outdoor environmental projects related to water quality monitoring. A program trains teachers to design project-based learning and provides extensive followup support. Five-day summer workshops immerse teachers in the types of projects they will orchestrate with their own students.…

The primary care sports medicine fellowship: American Medical Society for Sports Medicine proposed standards of excellence.

PubMed

Asif, Irfan M; Stovak, Mark; Ray, Tracy; Weiss-Kelly, Amanda

2017-09-01

The American Medical Society for Sports Medicine recognises a need to provide direction and continually enhance the quality of sports medicine fellowship training programmes. This document was developed to be an educational resource for sports medicine physicians who teach in a 1-year primary care sports medicine fellowship training programme. It is meant to provide high standards and targets for fellowship training programmes that choose to re-assess their curriculum and seek to make improvements. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Survey of handwriting instruction practices of elementary teachers and educational programs: implications for occupational therapy.

PubMed

Donica, Denise K; Larson, Michelle H; Zinn, Abbey A

2012-01-01

ABSTRACT The purpose of this study was to investigate perceptions of elementary school teachers on training in handwriting instruction received during their education, as well as their current classroom practices. The quantity and quality of training in handwriting instruction provided by baccalaureate degree-granting teacher education programs in North Carolina was also examined. An online survey was administered to each population identified to inquire about handwriting instruction practices. Results from 505 teachers and 16 professors indicated that while handwriting instruction content is valued by both teachers and professors, varied levels of training were provided to the teachers. Implications for occupational therapy practice are discussed including strategies for school-based therapists.

Factors Affecting Medical Service Quality.

PubMed

Mosadeghrad, Ali Mohammad

2014-02-01

A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.

A Multifaceted Intervention to Improve Health Worker Adherence to Integrated Management of Childhood Illness Guidelines in Benin

PubMed Central

Onikpo, Faustin; Lama, Marcel; Osterholt, Dawn M.; Rowe, Samantha Y.; Deming, Michael S.

2009-01-01

Objectives. We evaluated an intervention to support health workers after training in Integrated Management of Childhood Illness (IMCI), a strategy that can improve outcomes for children in developing countries by encouraging workers' use of evidence-based guidelines for managing the leading causes of child mortality. Methods. We conducted a randomized trial in Benin. We administered a survey in 1999 to assess health care quality before IMCI training. Health workers then received training plus either study supports (job aids, nonfinancial incentives, and supervision of workers and supervisors) or usual supports. Follow-up surveys conducted in 2001 to 2004 assessed recommended treatment, recommended or adequate treatment, and an index of overall guideline adherence. Results. We analyzed 1244 consultations. Performance improved in both intervention and control groups, with no significant differences between groups. However, training proceeded slowly, and low-quality care from health workers without IMCI training diluted intervention effects. Per-protocol analyses revealed that workers with IMCI training plus study supports provided better care than did those with training plus usual supports (27.3 percentage-point difference for recommended treatment; P < .05), and both groups outperformed untrained workers. Conclusions. IMCI training was useful but insufficient. Relatively inexpensive supports can lead to additional improvements. PMID:19299681

A workforce in crisis: a case study to expand allied ophthalmic personnel.

PubMed

Astle, William; Simms, Craig; Anderson, Lynn

2016-08-01

To examine how the development of allied ophthalmic personnel training programs affects human resource capacity. Using a qualitative case study method conducted at a single Ontario institution, this article describes 6 years of establishing a 2-tiered allied ophthalmic personnel training program. The Kingston Ophthalmic Training Centre participated in the study with 8 leadership and program graduate interviews. To assess regional eye health workforce needs, a case study and iterative process used triangulations of the literature, case study, and qualitative interviews with stakeholders. This research was used to develop a model for establishing allied ophthalmic personnel training programs that would result in expanding human resource capacity. Current human resource capacity development and deployment is inadequate to provide the needed eye care services in Canada. A competency-based curriculum and accreditation model as the platform to develop formal academic training programs is essential. Access to quality eye care and patient services can be met by task-shifting from ophthalmologists to appropriately trained allied ophthalmic personnel. Establishing formal training programs is one important strategy to supplying a well-skilled, trained, and qualified ophthalmic workforce. This initiative meets the criteria required for quality, relevance, equity, and cost-effectiveness to meet the future demands for ophthalmic patient care. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Cervical cancer screening and treatment training course in El Salvador: experience and lessons learned.

PubMed

Masch, Rachel; Ditzian, Lauren R; April, Ayana K; Maza, Mauricio; Peralta, Ethel; Cremer, Miriam L

2011-09-01

Visual inspection with acetic acid (VIA) is a simple, low-cost alternative to traditional Pap smears that could greatly benefit the amount of screening and treatment available in low-resource areas, such as rural El Salvador. The objective of this study was to train Salvadoran health providers in VIA and cryotherapy using a week-long competency course. Health providers participated in the VIA training course, which consisted of 1 half-day of didactics, followed by 4 and 1 half days of clinical training. Pretests and posttests were administered. A 1-day didactic refresher course was administered to assess the quality of services being provided. Sixty-eight nurses and physicians completed the training course. Each trainee screened approximately 120 women and performed, on average, seven cryotherapy treatments. The average trainee improved his or her score by 15% on the theoretical test and 16.7% on the image test. At the completion of the 1-day refresher, average test scores were the highest among all the courses. The final assessment was based on 41 providers. The course proved a successful tool for training healthcare providers in methods of cervical cancer screening and treatment. The course is replicable in other low-resource settings in different countries. It also provided trainees with the opportunity to adapt their clinical skills in their realistic work setting.

The case of "Miss Jacobs": adolescent simulated patients and the quality of their role playing, feedback, and personal impact.

PubMed

Bokken, Lonneke; van Dalen, Jan; Rethans, Jan-Joost

2010-12-01

Adolescents as standardized patients are relatively new in medical education. Studies have mostly explored the impact of role playing on adolescents trained to perform standardized patient roles for assessment purposes. No studies were found with regard to the quality of adolescents' role playing. We evaluated the effects of performing a patient role on adolescents trained as simulated patients (SPs) for teaching purposes (in contrast to standardized patients) and evaluated the quality of adolescent SPs' role playing and feedback. Nine young women, aged 16 to 18 years, were trained to portray roles of adolescents asking their general practitioner for an oral contraceptive. Three adolescent men were trained to portray roles of some of the girls' boyfriends. Each role was developed in consultation with the individual adolescent and was largely based on her own personal experience. Students rated the quality of the adolescent SP's role playing and feedback after each SP encounter on a previously validated questionnaire (the Maastricht Assessment of Simulated Patients). Both the adolescent SPs and faculty teachers both completed questionnaires on their experiences. Three hundred forty-one students rated the quality of the SPs' role playing and feedback with a mean score of 7.5 of 10. The faculty teachers were also generally positive about the role playing and feedback. Nevertheless, there were some concerns about the quality of the feedback. Adolescent SPs reported no negative effects because of their performance. Generally, students and teachers were satisfied with the quality of the role playing and feedback provided by the adolescent SPs. The adolescent SPs experienced no negative effects related to their performance, which confirms earlier findings among adolescent standardized patients.

Tuberculosis management practices of private practitioners in Pune municipal corporation, India.

PubMed

Bharaswadkar, Sandeep; Kanchar, Avinash; Thakur, Narendra; Shah, Shubhangi; Patnaik, Brinda; Click, Eleanor S; Kumar, Ajay M V; Dewan, Puneet Kumar

2014-01-01

Private Practitioners (PP) are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of India's Revised National Tuberculosis Control Programme (RNTCP) to improve the quality of TB management through training of PP. We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra). We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC). We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals. Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249) of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249) of responses were consistent with ISTC treatment practices. However, 48% (120/249) PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249) PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices. In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts.

Tuberculosis Management Practices of Private Practitioners in Pune Municipal Corporation, India

PubMed Central

Bharaswadkar, Sandeep; Kanchar, Avinash; Thakur, Narendra; Shah, Shubhangi; Patnaik, Brinda; Click, Eleanor S.; Kumar, Ajay M. V.; Dewan, Puneet Kumar

2014-01-01

Background Private Practitioners (PP) are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of India’s Revised National Tuberculosis Control Programme (RNTCP) to improve the quality of TB management through training of PP. Methods We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra). We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC). We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals. Results Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249) of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249) of responses were consistent with ISTC treatment practices. However, 48% (120/249) PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249) PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices. Conclusion In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts. PMID:24897374

Integration of pharmacists into a patient-centered medical home.

PubMed

Scott, Mollie Ashe; Hitch, Bill; Ray, Lisa; Colvin, Gaye

2011-01-01

To define the joint principles of the patient-centered medical home (PCMH) and describe the integration of pharmacists into a PCMH. Family medicine residency training program in North Carolina from 2001 to 2011. Mountain Area Health Education Family Health Center is a family medicine residency training program that is part of the North Carolina Area Health Education Center system. The goal of the organization is to train and retain health care students and residents. The practice is recognized as a level III PCMH by the National Committee for Quality Assurance (NCQA) and seeks to provide quality, safe, patient-centered care according to the joint principles of PCMH. Pharmacists, nurses, nutritionists, care managers, Spanish translators, and behavioral medicine specialists work collaboratively with physicians to provide seamless, comprehensive care. The Department of Pharmacotherapy is embedded in the family medicine clinic. Three pharmacists and two pharmacy residents are involved in providing direct patient care services, ensuring access to community resources, assisting patients with transitions of care, providing interprofessional education, and participating in continuous quality improvement initiatives. The pharmacists serve as clinical pharmacist practitioners and provide medication therapy management services in a pharmacotherapy clinic, anticoagulation clinics, and an osteoporosis clinic and via an inpatient family medicine service. Multiple learners such as student pharmacists, pharmacy residents, and family medicine residents rotate through the various pharmacy clinics to learn about pharmacotherapeutic principles and the role of the pharmacist in PCMH. PCMH is a comprehensive, patient-centered, team-based approach to population management in the primary care setting. Pharmacists play a vital role in PCMH and make fundamental contributions to patient care across health care settings. Such innovations in the ambulatory care setting create a unique niche for pharmacists to use their skills.

Active Video Games as a Training Tool for Individuals With Chronic Respiratory Diseases: A SYSTEMATIC REVIEW.

PubMed

Butler, Stacey J; Lee, Annemarie L; Goldstein, Roger S; Brooks, Dina

2018-02-26

Exercise is an effective treatment for reducing symptom severity and improving quality of life for patients with chronic respiratory diseases. Active video games offer a new and enjoyable way to exercise and have gained popularity in a rehabilitation setting. However, it is unclear whether they achieve comparable physiological and clinical effects as traditional exercise training. A systematic literature search was performed to identify studies that included an active video game component as a form of exercise training and a comparator group in chronic respiratory disease. Two assessors independently reviewed study quality using the Cochrane risk of bias tool and extracted data for exercise capacity, quality of life, and preference of exercise model. Six studies were included in this review. Because of the heterogeneity of the populations, study designs, length of intervention, and outcome measures, meta-analysis could not be performed. Active video game training resulted in comparable training maximal heart rate and dyspnea levels to those achieved when exercising using a treadmill or cycle (n = 5). There was insufficient evidence (n = 3) to determine whether active video game training improved exercise capacity as measured by 6-min walk test or treadmill endurance walking. Although the quality of evidence was low, in a small number of studies active video games induced peak heart rates and dyspnea levels comparable with traditional exercise training. Larger and longer-term randomized controlled trials are needed to establish the impact of video game training for individuals with chronic respiratory diseases.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

[The Academy of Trauma Surgery (AUC). Service provider and management organization of the DGU].

PubMed

Sturm, J A; Hoffmann, R

2016-02-01

At the beginning of this century the German Trauma Society (DGU) became extensively active with an initiative on quality promotion, development of quality assurance and transparency regarding treatment of the severely injured. A white book on "Medical care of the severely injured" was published, focusing on the requirements on structural quality and especially procedural quality. The impact of the white book was immense and a trauma network with approved trauma centers, structured and graded for their individual trauma care performance, was developed. In order to monitor and document the required quality of care, a registry was needed. Furthermore, for cooperation within the trauma networks innovative methods for digital transfer of radiological images and patient documents became necessary. Finally, the auditing criteria for trauma centers had and still have to be completed with advanced medical education and training programs. In order to realize the implementation of such a broad spectrum of economically relevant and increasingly complex activities the Academy of Trauma Surgery (AUC) was established as a subsidiary of the DGU in 2004. The AUC currently has four divisions: 1) networks and health care structures, 2) registries and research management, 3) telemedicine, 4) medical education and training, all of which serve the goal of the initiative. The AUC is a full service provider and management organization in compliance with the statutes of the DGU. According to these statutes the business operations of the AUC also cover projects for numerous groups of patients, projects for the joint society the German Society for Orthopedics and Trauma (DGOU) as well as other medical institutions. This article describes the success stories of the trauma network (TraumaNetzwerk DGU®), the TraumaRegister DGU®, the telecooperation platform TKmed®, the new and fast-growing orthogeriatric center initiative (AltersTraumaZentrum DGU®) and the division of medical education and training, e.g. advanced trauma life support (ATLS®) and other training programs including the innovative interpersonal competence (IC) course.

Targeting anxiety to improve quality of life in patients with schizophrenia.

PubMed

Buonocore, M; Bosia, M; Bechi, M; Spangaro, M; Cavedoni, S; Cocchi, F; Bianchi, L; Guglielmino, C; Mastromatteo, A R; Cavallaro, R

2017-09-01

Several studies suggested that anxiety can significantly affect the outcome of schizophrenia. Despite this evidence, non-pharmacological interventions targeting anxiety are still heterogenous. This study aims to test the efficacy of a novel training specifically designed to target anxiety in patients with schizophrenia. Innovatively, this training, beyond psychoeducation and problem solving, also targets Theory of Mind, as it provides coping strategies. Twenty-seven outpatients with schizophrenia received a novel rehabilitative training targeting anxiety (Anxiety Management Group [AMG]) combined with a Computer-Assisted Cognitive Remediation (CACR), and twenty received CACR plus a control intervention (Control Newspaper discussion Group [CNG]). All patients were assessed at baseline and after treatment for quality of life, neurocognition and anxiety. After training, patients treated with AMG+CACR showed significantly greater improvements on anxiety. A significant increase in quality of life was observed only for AMG+CACR group. Moreover, the participants' appraisal showed a significant difference between treatment groups with higher ratings among patients who received the AMG+CACR. This study thus suggests feasibility and efficacy of the proposed intervention, that could be implemented in rehabilitative programs for patients with schizophrenia with potential benefits also on disease course and outcome. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The customer satisfaction towards the service quality of Tawang Alun Malang-Banyuwangi Train

NASA Astrophysics Data System (ADS)

Permatasari, D.

2017-06-01

Service sector which has quiet vital role in supporting people’s daily activities is transportation service. Transportation is one of the important and strategic developments in improving economy sector. One of the alternative ways to overcome people’s need of transportation is by providing trains. This research was conducted on the weekend that has objectives to analyze the work performance of Indonesian Railway Company towards the service quality that can determine the customers’ satisfaction of TawangAlun Malang-Banyuwangi train and to analyze the customers’ satisfaction itself towards the service quality of TawangAlun Malang-Banyuwangi train. This research used quantitative descriptive as the research method. There are two kinds of data that were used in this research; the first one is the primary data taken from questionnaire’s results and interview meanwhile the second one is the secondary data taken from literature and internet. The sample used in this research is nonprobability sampling using convenience sampling technique. Data analysis used in this research is Importance Performance Analysis (IPA) and Customer Satisfaction index (CSI). The results are the Indonesian Railway Company should make a new innovation to buy the ticket from the ticket machine and add more exhausts in every railway coach.

Iatrogenic Errors during Root Canal Instrumentation Performed by Dental Students

PubMed Central

Hendi, Seyedeh Sareh; Karkehabadi, Hamed; Eskandarloo, Amir

2018-01-01

Introduction: The present study was set to investigate the training quality and its association with the quality of root canal therapy performed by fifth year dentistry students. Methods and Materials: A total number of 432 records of endodontic treatment performed by fifth year dentistry students were qualified to be further investigated. Radiographs were assessed by two independent endodontists. Apical transportation, apical perforation, gouging, ledge formation, and the quality of temporary restoration were error types investigated in the present study. Results: the prevalence of apical transportation, ledge formation, and apical perforation errors were significantly higher in molars in comparison with other types of teeth. The most prevalent type of error was the apical transportation, which was significantly higher in mandibular teeth. There was no significant differences among teeth in terms of other types of errors. Conclusion: The quality of training provided for dentistry students should be improved and endodontic curriculum should be modified. PMID:29692848

Learning to rank for blind image quality assessment.

PubMed

Gao, Fei; Tao, Dacheng; Gao, Xinbo; Li, Xuelong

2015-10-01

Blind image quality assessment (BIQA) aims to predict perceptual image quality scores without access to reference images. State-of-the-art BIQA methods typically require subjects to score a large number of images to train a robust model. However, subjective quality scores are imprecise, biased, and inconsistent, and it is challenging to obtain a large-scale database, or to extend existing databases, because of the inconvenience of collecting images, training the subjects, conducting subjective experiments, and realigning human quality evaluations. To combat these limitations, this paper explores and exploits preference image pairs (PIPs) such as the quality of image Ia is better than that of image Ib for training a robust BIQA model. The preference label, representing the relative quality of two images, is generally precise and consistent, and is not sensitive to image content, distortion type, or subject identity; such PIPs can be generated at a very low cost. The proposed BIQA method is one of learning to rank. We first formulate the problem of learning the mapping from the image features to the preference label as one of classification. In particular, we investigate the utilization of a multiple kernel learning algorithm based on group lasso to provide a solution. A simple but effective strategy to estimate perceptual image quality scores is then presented. Experiments show that the proposed BIQA method is highly effective and achieves a performance comparable with that of state-of-the-art BIQA algorithms. Moreover, the proposed method can be easily extended to new distortion categories.

The OA System of College - - Design of the Teaching Quality Monitoring Subsystem

NASA Astrophysics Data System (ADS)

Wu, Hongjuan; Ying, Hong; Jiang, Youyi; Yan, Pei

According to the drawbacks of traditional teaching quality monitoring subsystems and based on the achievements of practical research in the teaching quality monitoring administration in College, this paper provides a design of overall structure of teaching quality monitoring subsystem, that is more suitable for colleges' management. This new system is endowed with the same features as .NET application programes: easy to extend, easy to maintain, flexible, convenient, and it let enterprises, students' parents and excellent graduates participate in teaching quality monitoring administration, have significant effect to ensure the quality of talent training in colleges.

The role of clinical nurse educators in organ procurement organizations.

PubMed

Swain, Sharon

2011-12-01

Clinical nurse educators are advanced practice nurses with preparation at the master's level or higher. Such nurses play an important role in organ procurement organizations. As leaders and members of the team, they provide structure and design to the training process. These educators oversee orientation of new employees, serve as mentors to preceptors, assess the learning needs of the organization, and provide ongoing training to veteran staff. Clinical nurse educators also contribute to continuous quality improvement for the organization and help to comply with regulatory standards.

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

PubMed

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

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

Evaluating training of screening, brief intervention, and referral to treatment (SBIRT) for substance use: Reliability of the MD3 SBIRT Coding Scale.

PubMed

DiClemente, Carlo C; Crouch, Taylor Berens; Norwood, Amber E Q; Delahanty, Janine; Welsh, Christopher

2015-03-01

Screening, brief intervention, and referral to treatment (SBIRT) has become an empirically supported and widely implemented approach in primary and specialty care for addressing substance misuse. Accordingly, training of providers in SBIRT has increased exponentially in recent years. However, the quality and fidelity of training programs and subsequent interventions are largely unknown because of the lack of SBIRT-specific evaluation tools. The purpose of this study was to create a coding scale to assess quality and fidelity of SBIRT interactions addressing alcohol, tobacco, illicit drugs, and prescription medication misuse. The scale was developed to evaluate performance in an SBIRT residency training program. Scale development was based on training protocol and competencies with consultation from Motivational Interviewing coding experts. Trained medical residents practiced SBIRT with standardized patients during 10- to 15-min videotaped interactions. This study included 25 tapes from the Family Medicine program coded by 3 unique coder pairs with varying levels of coding experience. Interrater reliability was assessed for overall scale components and individual items via intraclass correlation coefficients. Coder pair-specific reliability was also assessed. Interrater reliability was excellent overall for the scale components (>.85) and nearly all items. Reliability was higher for more experienced coders, though still adequate for the trained coder pair. Descriptive data demonstrated a broad range of adherence and skills. Subscale correlations supported concurrent and discriminant validity. Data provide evidence that the MD3 SBIRT Coding Scale is a psychometrically reliable coding system for evaluating SBIRT interactions and can be used to evaluate implementation skills for fidelity, training, assessment, and research. Recommendations for refinement and further testing of the measure are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

A condition metric for Eucalyptus woodland derived from expert evaluations.

PubMed

Sinclair, Steve J; Bruce, Matthew J; Griffioen, Peter; Dodd, Amanda; White, Matthew D

2018-02-01

The evaluation of ecosystem quality is important for land-management and land-use planning. Evaluation is unavoidably subjective, and robust metrics must be based on consensus and the structured use of observations. We devised a transparent and repeatable process for building and testing ecosystem metrics based on expert data. We gathered quantitative evaluation data on the quality of hypothetical grassy woodland sites from experts. We used these data to train a model (an ensemble of 30 bagged regression trees) capable of predicting the perceived quality of similar hypothetical woodlands based on a set of 13 site variables as inputs (e.g., cover of shrubs, richness of native forbs). These variables can be measured at any site and the model implemented in a spreadsheet as a metric of woodland quality. We also investigated the number of experts required to produce an opinion data set sufficient for the construction of a metric. The model produced evaluations similar to those provided by experts, as shown by assessing the model's quality scores of expert-evaluated test sites not used to train the model. We applied the metric to 13 woodland conservation reserves and asked managers of these sites to independently evaluate their quality. To assess metric performance, we compared the model's evaluation of site quality with the managers' evaluations through multidimensional scaling. The metric performed relatively well, plotting close to the center of the space defined by the evaluators. Given the method provides data-driven consensus and repeatability, which no single human evaluator can provide, we suggest it is a valuable tool for evaluating ecosystem quality in real-world contexts. We believe our approach is applicable to any ecosystem. © 2017 State of Victoria.

Innovative Strategies for Transforming Internal Medicine Residency Training in Resource-Limited Settings: The Mozambique Experience

PubMed Central

Mocumbi, Ana Olga; Carrilho, Carla; Aronoff-Spencer, Eliah; Funzamo, Carlos; Patel, Sam; Preziosi, Michael; Lederer, Philip; Tilghman, Winston; Benson, Constance A.; Badaró, Roberto; Nguenha, A.; Schooley, Robert T.; Noormahomed, Emília V

2014-01-01

With approximately four physicians per 100,000 inhabitants, Mozambique faces one of the most severe health care provider shortages in Sub-Saharan Africa. The lack of sufficient wel-trained medical school faculty is Mozambique’s major barrier to producing new physicians annually. A partnership between the Universidade Eduardo Mondlane and the University of California, San Diego, has addressed this challenge with support from the Medical Education Partnership Initiative. Following an initial needs assessment involving questionnaires and focus groups of residents, and working with key members from the Ministry of Health, the Medical Council, and Maputo Central Hospital, a set of interventions was designed. The hospital’s Internal Medicine Residency Program was chosen as the focus for the plan. Interventions included curriculum design, new teaching methodologies, investment in an informatics infrastructure for access to digital references, building capacity to support clinical research, and providing financial incentives to retain junior faculty. The number of candidates entering the Internal Medicine (IM) residency program has increased, and detailed monitoring and evaluation is measuring the impact of these changes on the quality of training. These changes are expected to improve the long-term quality of postgraduate training in general through dissemination to other departments. They also have the potential to facilitate equitable distribution of specialists nationwide by expanding postgraduate training to other hospitals and universities. PMID:25072585

Shoulder Dystocia: Quality, Safety, and Risk Management Considerations.

PubMed

Moni, Saila; Lee, Colleen; Goffman, Dena

2016-12-01

Shoulder dystocia is a term that evokes terror and fear among many physicians, midwives, and health care providers as they recollect at least 1 episode of shoulder dystocia in their careers. Shoulder dystocia can result in significant maternal and neonatal complications. Because shoulder dystocia is an urgent, unanticipated, and uncommon event with potentially catastrophic consequences, all practitioners and health care teams must be well-trained to manage this obstetric emergency. Preparation for shoulder dystocia in a systematic way, through standardization of process, practicing team-training and communication, along with technical skills, through simulation education and ongoing quality improvement initiatives will result in improved outcomes.

CGAT: a model for immersive personalized training in computational genomics.

PubMed

Sims, David; Ponting, Chris P; Heger, Andreas

2016-01-01

How should the next generation of genomics scientists be trained while simultaneously pursuing high quality and diverse research? CGAT, the Computational Genomics Analysis and Training programme, was set up in 2010 by the UK Medical Research Council to complement its investment in next-generation sequencing capacity. CGAT was conceived around the twin goals of training future leaders in genome biology and medicine, and providing much needed capacity to UK science for analysing genome scale data sets. Here we outline the training programme employed by CGAT and describe how it dovetails with collaborative research projects to launch scientists on the road towards independent research careers in genomics. © The Author 2015. Published by Oxford University Press.

Effectiveness of community health worker training programmes for cardiovascular disease management in low-income and middle-income countries: a systematic review.

PubMed

Abdel-All, Marwa; Putica, Barbara; Praveen, Deversetty; Abimbola, Seye; Joshi, Rohina

2017-11-03

Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs. A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project's Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers. The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before-after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention. The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Otorhinolaryngology residency in Spain: training satisfaction, working environment and conditions.

PubMed

Oker, N; Alotaibi, N H; Herman, P; Bernal-Sprekelsen, M; Albers, A E

2016-06-01

Europe-wide efforts are being initiated to define quality standards and harmonize Otolaryngology, Head and Neck Surgery (ORL-HNS)-specialty-training by creating an European board examination. However, differences within and between countries remain and are underinvestigated making comparisons and further improvement more difficult. The study aimed at assessing quality of training, satisfaction and quality of life of residents and recent ORL-HNS specialists in Spain and to trace similarities and differences to France and Germany administering anonymous online-questionnaire to ORL-HNS-residents and recent specialists. 146 questionnaires were returned with answers of 75.6 % of residents, a mean age of 30 years and a female to male ratio of 1.46:1. The global satisfaction of training was high as 76 % would choose the same ENT training again, 86 % confirmed that responsibilities which were given to them were adapted to their level of training and 97 % felt well considered in their department. Ninety-two confirmed that helpful seniors contributed to a good work environment (75 %) and to a good organization within the department (69 %). The respondents spent on average 8.8 h per day at the hospital and covered on average 4.8 night duties or week-end shifts per month with mostly no post-day off (86 %). Seventy-four percent participated regularly at complementary training sessions. Research work was supported and guided in 59 %. This study is the first one, to our best of knowledge, to assess the ORL-HNS-training in Spain and to trace parallelisms and differences to other European countries, such as France and Germany. The satisfaction of training and supervision was high in Spain, but there are still efforts to make concerning resident's quality of life. Compared to France and Germany, satisfaction with ORL-HNS-training and the support and guidance provided by seniors was similar. Work conditions were comparable to those in France. Motivation, teaching and scientific output was higher in Spain, despite the salary being the lowest.

Quality improvement training for core medical and general practice trainees: a pilot study of project participation, completion and journal publication.

PubMed

McNab, Duncan; McKay, John; Bowie, Paul

2015-11-01

Small-scale quality improvement projects are expected to make a significant contribution towards improving the quality of healthcare. Enabling doctors-in-training to design and lead quality improvement projects is important preparation for independent practice. Participation is mandatory in speciality training curricula. However, provision of training and ongoing support in quality improvement methods and practice is variable. We aimed to design and deliver a quality improvement training package to core medical and general practice specialty trainees and evaluate impact in terms of project participation, completion and publication in a healthcare journal. A quality improvement training package was developed and delivered to core medical trainees and general practice specialty trainees in the west of Scotland encompassing a 1-day workshop and mentoring during completion of a quality improvement project over 3 months. A mixed methods evaluation was undertaken and data collected via questionnaire surveys, knowledge assessment, and formative assessment of project proposals, completed quality improvement projects and publication success. Twenty-three participants attended the training day with 20 submitting a project proposal (87%). Ten completed quality improvement projects (43%), eight were judged as satisfactory (35%), and four were submitted and accepted for journal publication (17%). Knowledge and confidence in aspects of quality improvement improved during the pilot, while early feedback on project proposals was valued (85.7%). This small study reports modest success in training core medical trainees and general practice specialty trainees in quality improvement. Many gained knowledge of, confidence in and experience of quality improvement, while journal publication was shown to be possible. The development of educational resources to aid quality improvement project completion and mentoring support is necessary if expectations for quality improvement are to be realised. © The Author(s) 2015.

The role of point of care ultrasound in prehospital critical care: a systematic review.

PubMed

Bøtker, Morten Thingemann; Jacobsen, Lars; Rudolph, Søren Steemann; Knudsen, Lars

2018-06-26

In 2011, the role of Point of Care Ultrasound (POCUS) was defined as one of the top five research priorities in physician-provided prehospital critical care and future research topics were proposed; the feasibility of prehospital POCUS, changes in patient management induced by POCUS and education of providers. This systematic review aimed to assess these three topics by including studies examining all kinds of prehospital patients undergoing all kinds of prehospital POCUS examinations and studies examining any kind of POCUS education in prehospital critical care providers. By a systematic literature search in MEDLINE, EMBASE, and Cochrane databases, we identified and screened titles and abstracts of 3264 studies published from 2012 to 2017. Of these, 65 studies were read in full-text for assessment of eligibility and 27 studies were ultimately included and assessed for quality by SIGN-50 checklists. No studies compared patient outcome with and without prehospital POCUS. Four studies of acceptable quality demonstrated feasibility and changes in patient management in trauma. Two studies of acceptable quality demonstrated feasibility and changes in patient management in breathing difficulties. Four studies of acceptable quality demonstrated feasibility, outcome prediction and changes in patient management in cardiac arrest, but also that POCUS may prolong pauses in compressions. Two studies of acceptable quality demonstrated that short (few hours) teaching sessions are sufficient for obtaining simple interpretation skills, but not image acquisition skills. Three studies of acceptable quality demonstrated that longer one- or two-day courses including hands-on training are sufficient for learning simple, but not advanced, image acquisition skills. Three studies of acceptable quality demonstrated that systematic educational programs including supervised examinations are sufficient for learning advanced image acquisition skills in healthy volunteers, but that more than 50 clinical examinations are required for expertise in a clinical setting. Prehospital POCUS is feasible and changes patient management in trauma, breathing difficulties and cardiac arrest, but it is unknown if this improves outcome. Expertise in POCUS requires extensive training by a combination of theory, hands-on training and a substantial amount of clinical examinations - a large part of these needs to be supervised.

The art of customer service.

PubMed

Williams, Jeni

2007-10-01

Strategies for improving the consumer service skills of finance staff include: Hire employees who have a customer service background. Work with your human resources department to provide customer service training. Monitor new hires extensively. Offer front-end employees scripted language for situations they may face on the job. Measure the quality of customer service provided. Provide incentives for performance.

Integrating the Science of Team Training: Guidelines for Continuing Education

ERIC Educational Resources Information Center

Weaver, Sallie J.; Rosen, Michael A.; Salas, Eduardo; Baum, Karyn D.; King, Heidi B.

2010-01-01

The provision of high-quality, efficient care results from the coordinated, cooperative efforts of multiple technically competent health care providers working in concert over time, spanning disciplinary and professional boundaries. Accordingly, the role of medical education must include the development of providers who are both expert clinicians…

Vocational Education Tool and Equipment Inventory.

ERIC Educational Resources Information Center

Lewis, James P.; Burrows, Robert T.

This study was conducted to provide information on equipment needs, the extent of planning to upgrade equipment, and technological advancements necessary to continue providing quality training to entry-level students and incumbent workers. The results were based on a 98 percent return from 72 area vocational-technical school directors, 17…

Abolishment of 24-hour continuous medical call duty in quebec: a quality of life survey of general surgical residents following implementation of the new work-hour restrictions.

PubMed

Hamadani, Fadi T; Deckelbaum, Dan; Sauve, Alexandre; Khwaja, Kosar; Razek, Tarek; Fata, Paola

2013-01-01

The implementation of work hour restrictions across North America have resulted in decreased levels of self injury and medical errors for Residents. An arbitration ruling in Quebec has led to further curtailment of work hours beyond that proposed by the ACGME. This may threaten Resident quality of life and in turn decrease the educational quality of surgical residency training. We administered a quality of life questionnaire with an integrated education quality assessment tool to all General Surgery residents training at McGill 6 months after the work hour restrictions. Across several strata respondents reveal a decreased sense of educational quality and quality of life. The arbitration argued that work- hour restrictions would be necessary to improve quality of life for trainees and hence improve patient safety. Results from this study demonstrate the exact opposite in a large majority of respondents, who report a poorer quality of life and a self-reported inability on their part to provide continuous and safe patient care. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The medical education and its impact on public health. Perspectives and challenges.

PubMed

Pérez-Gómez, Héctor Raúl; Ramos-Zúñiga, Rodrigo

2012-01-01

This paper presents an analysis of the relevance of the formation of human resources trained in health sciences as an essential strategy for sustainability projects applied to health schemes. A solid linkage is required between training and application aspects through the transfer of knowledge in concrete actions. A series of actions aimed to improve the quality and coverage in health services has been proposed. However, the treatment given to education and training in human resources has not been in the same proportion. As a consequence, the formation of qualified human resources represents one of the fundamental axes to perform these actions in health fields. Training of human resources for health provided by educational institutions must not be separate from global decisions in health fields. Evidence shows that the higher density, quality and appropriate distribution of health workforce, the greater the impact on public health in an efficient manner. This rubric must be considered as a priority, achieving the training of professionals with leadership and with the ability of transforming their environment before the predictions about potential collapses in health systems are presented as an emerging challenge.

What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

PubMed

Costa, Anderson Adriano Leal Freitas da; Vasconcellos, Igor Martins; Pacheco, Rafael Leite; Bella, Zsuzsanna Ilona Katalin de Jármy Di; Riera, Rachel

2018-01-01

Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP). A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy). The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality) for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.

Home-based virtual reality balance training and conventional balance training in Parkinson's disease: A randomized controlled trial.

PubMed

Yang, Wen-Chieh; Wang, Hsing-Kuo; Wu, Ruey-Meei; Lo, Chien-Shun; Lin, Kwan-Hwa

2016-09-01

Virtual reality has the advantage to provide rich sensory feedbacks for training balance function. This study tested if the home-based virtual reality balance training is more effective than the conventional home balance training in improving balance, walking, and quality of life in patients with Parkinson's disease (PD). Twenty-three patients with idiopathic PD were recruited and underwent twelve 50-minute training sessions during the 6-week training period. The experimental group (n = 11) was trained with a custom-made virtual reality balance training system, and the control group (n = 12) was trained by a licensed physical therapist. Outcomes were measured at Week 0 (pretest), Week 6 (posttest), and Week 8 (follow-up). The primary outcome was the Berg Balance Scale. The secondary outcomes included the Dynamic Gait Index, timed Up-and-Go test, Parkinson's Disease Questionnaire, and the motor score of the Unified Parkinson's Disease Rating Scale. The experimental and control groups were comparable at pretest. After training, both groups performed better in the Berg Balance Scale, Dynamic Gait Index, timed Up-and-Go test, and Parkinson's Disease Questionnaire at posttest and follow-up than at pretest. However, no significant differences were found between these two groups at posttest and follow-up. This study did not find any difference between the effects of the home-based virtual reality balance training and conventional home balance training. The two training options were equally effective in improving balance, walking, and quality of life among community-dwelling patients with PD. Copyright © 2015. Published by Elsevier B.V.

Islam and family planning: changing perceptions of health care providers and medical faculty in Pakistan

PubMed Central

Mir, Ali Mohammad; Shaikh, Gul Rashida

2013-01-01

ABSTRACT A USAID-sponsored family planning project called “FALAH” (Family Advancement for Life and Health), implemented in 20 districts of Pakistan, aimed to lower unmet need for family planning by improving access to services. To enhance the quality of care offered by the public health system, the FALAH project trained 10,534 facility-based health care providers, managers, and medical college faculty members to offer client-centered family planning services, which included a module to explain the Islamic viewpoint on family planning developed through an iterative process involving religious scholars and public health experts. At the end of the FALAH project, we conducted a situation analysis of health facilities including interviews with providers to measure family planning knowledge of trained and untrained providers; interviewed faculty to obtain their feedback about the training module; and measured changes in women's contraceptive use through baseline and endline surveys. Trained providers had a better understanding of family planning concepts than untrained providers. In addition, discussions with trained providers indicated that the training module on Islam and family planning helped them to become advocates for family planning. Faculty indicated that the module enhanced their confidence about the topic of family planning and Islam, making it easier to introduce and discuss the issue with their students. Over the 3.5-year project period, which included several components in addition to the training activity, we found an overall increase of 9 percentage points in contraceptive prevalence in the project implementation districts—from 29% to 38%. The Islam and family planning module has now been included in the teaching program of major public-sector medical universities and the Regional Training Institutes of the Population Welfare Department. Other countries with sizeable Muslim populations and low contraceptive prevalence could benefit from this module. PMID:25276535

Cost-effectiveness of training rural providers to identify and treat patients at risk for fragility fractures.

PubMed

Nelson, S D; Nelson, R E; Cannon, G W; Lawrence, P; Battistone, M J; Grotzke, M; Rosenblum, Y; LaFleur, J

2014-12-01

This is a cost-effectiveness analysis of training rural providers to identify and treat osteoporosis. Results showed a slight cost savings, increase in life years, increase in treatment rates, and decrease in fracture incidence. However, the results were sensitive to small differences in effectiveness, being cost-effective in 70 % of simulations during probabilistic sensitivity analysis. We evaluated the cost-effectiveness of training rural providers to identify and treat veterans at risk for fragility fractures relative to referring these patients to an urban medical center for specialist care. The model evaluated the impact of training on patient life years, quality-adjusted life years (QALYs), treatment rates, fracture incidence, and costs from the perspective of the Department of Veterans Affairs. We constructed a Markov microsimulation model to compare costs and outcomes of a hypothetical cohort of veterans seen by rural providers. Parameter estimates were derived from previously published studies, and we conducted one-way and probabilistic sensitivity analyses on the parameter inputs. Base-case analysis showed that training resulted in no additional costs and an extra 0.083 life years (0.054 QALYs). Our model projected that as a result of training, more patients with osteoporosis would receive treatment (81.3 vs. 12.2 %), and all patients would have a lower incidence of fractures per 1,000 patient years (hip, 1.628 vs. 1.913; clinical vertebral, 0.566 vs. 1.037) when seen by a trained provider compared to an untrained provider. Results remained consistent in one-way sensitivity analysis and in probabilistic sensitivity analyses, training rural providers was cost-effective (less than $50,000/QALY) in 70 % of the simulations. Training rural providers to identify and treat veterans at risk for fragility fractures has a potential to be cost-effective, but the results are sensitive to small differences in effectiveness. It appears that provider education alone is not enough to make a significant difference in fragility fracture rates among veterans.

Delivery of nutrition services in health systems in sub-Saharan Africa: opportunities in Burkina Faso, Mozambique and Niger.

PubMed

Hampshire, Rachel D; Aguayo, Victor M; Harouna, Hamani; Roley, Julie A; Tarini, Ann; Baker, Shawn K

2004-12-01

In sub-Saharan Africa, underweight and micronutrient deficiencies account for an estimated 25% of the burden of disease. As the coverage of national health systems expands, increased opportunities exist to address the needs of children and women, the most vulnerable to these deficiencies, through high-quality nutrition services. To assess health providers' knowledge and practice with regard to essential nutrition services for women and children in Burkina Faso, Mozambique and Niger, in order to assist the development of a standard guide and tools to assess and monitor the quality of the nutrition services delivered through national health systems. The three surveys reveal the extent of missed opportunities to deliver nutrition services during routine prenatal, postnatal and child-care consultations for the prevention and treatment of highly prevalent nutritional deficiencies. A commitment to improving the quality of facility-based nutrition services is necessary to impact on the health outcomes of women and children 'covered' by national health systems. Rigorous assessment and monitoring of the quality of nutrition services should inform health programme and policy development. Building on the lessons learned in these three assessments, Helen Keller International has developed a standard Guide and Tools to assess the quality of the nutrition services delivered through national health systems. These tools can be adapted to assess ongoing nutrition services in health facilities, provide a framework for nutrition programming, inform the development of pre-service as well as in-service nutrition training curricula for providers, and evaluate the impact of nutrition training on providers' practices.

Introducing computer-assisted training sessions in the clinical skills lab at the Faculty of Medicine, Suez Canal University.

PubMed

Hosny, Somaya; Mishriky, Adel M; Youssef, Mirella

2008-01-01

The Faculty of Medicine, Suez Canal University clinical skills lab was established in 1981 as the first skills lab in Egypt to cope with innovation in medical education adopted since school inauguration in 1978. Students are trained using their peers or models. Training is done weekly, guided by checklists tested for validity and reliability and updated regularly. Students receive immediate feedback on their performance. Recently, the number of students has increased, leading to challenges in providing adequate supervision and training experiences. A project to design and implement a computer-assisted training (CAT) system seemed to be a plausible solution. To assess the quality of a newly developed CAT product, faculty and students' satisfaction with it, and its impact on the learning process. The project involved preparation of multimedia video-films with a web interface for links of different scientific materials. The project was implemented on second year students. A quality check was done to assess the product's scientific content, and technical quality using questionnaires filled by 84 faculty members (139 filled forms) and 175 students (924 filled forms). For assessment of impact, results of examinations after project implementation were compared with results of 2nd year students of previous 3 years. More faculty (96.3%) were satisfied with the product and considered its quality good to excellent, compared to 93.9% of students, p < 0.001. Most faculty (76.2%) have agreed on its suitability for self-learning, while most students considered the product would be suitable after modification. The percentage of students' failures was lower after project implementation, compared to previous 3 years, p < 0.05. CAT materials developed for training of second year students in skills lab proved to be of good scientific content and quality, and suitable for self-learning. Their use was associated with lower failure rates among students. A randomized trial is recommended to ascertain the effectiveness of its application.

Improving patient-centered communication: Results of a randomized controlled trial.

PubMed

Maatouk-Bürmann, Barbara; Ringel, Nadja; Spang, Jochen; Weiss, Carmen; Möltner, Andreas; Riemann, Urs; Langewitz, Wolf; Schultz, Jobst-Hendrik; Jünger, Jana

2016-01-01

Patient-centered communication is a key element for improving the quality of care in terms of therapeutic relationship, patient participation, and treatment process. Postgraduate trainings provide an essential way of promoting patient centeredness on the job where learning opportunities are often limited by time, patient volume, and economic pressure. In the present study, changes in patient centeredness during clinical routines of postgraduate physicians (internal medicine) after a three-day communication training were assessed. A randomized controlled trial was conducted in a primary care clinic. The intervention consisted of a communication training that aimed to enhance patient centeredness in postgraduate physicians. The training was based on a need assessment and the principles of deliberate practice. Workplace-based assessment of physicians' communication behavior was obtained using the Roter Interaction Analysis System. Three months after the intervention, trained physicians showed significantly increased patient centeredness (F=5.36, p=.04; d=0.42). The communication training significantly improved patient centeredness during routine clinical practice. Thus, this training provides a structured and theory-based concept to foster patient centeredness. The results support the implementation of communication trainings as a part of faculty development and medical specialization training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Quality of Life in the Navy, Findings From 1990 to 1992: The Navy-wide Personnel Survey. Volume 1: Research Report

DTIC Science & Technology

1994-10-01

surveys on quality - of - life issues connected with voluntary college-level education, first skills training, family support programs, child-care services...skills training, Leadership training, Living conditions, Navy exchanges, Quality of life , Recreation, Training, Voluntary education

Identifying current training provision and future training needs in allergy available for UK general practice trainees: national cross-sectional survey of General Practitioner Specialist Training programme directors.

PubMed

Ellis, Jayne; Rafi, Imran; Smith, Helen; Sheikh, Aziz

2013-03-01

There are ongoing concerns about the quality of care provision for allergy in primary care. To identify current training provision in allergy to GP trainees and to understand how this could be enhanced. A cross-sectional survey of GP Speciality Training (GPST) programme directors was undertaken. Programme directors of the 174 GPST schemes were sent an online questionnaire which was informed by the content of the Royal College of General Practitioners curriculum. Quantitative data were descriptively analysed and a thematic analysis was undertaken of free text responses. We obtained responses from 146 directors representing 106 training programmes. Responses indicated that two-thirds (62%, 95% CI 53.1 to 71.5) of programmes were providing at least some allergy training, with the remaining third stating that they either provided no training or were unsure. Overall, one-third (33%, 95% CI 22.7 to 42.2) of programme directors believed that all the relevant allergy-related curriculum requirements were being met. Where provided, this training was believed to be best for organ-specific allergic disorders but was thought to be poorer for systemic allergic disorders, particularly food allergy where 67% (95% CI 57.5 to 76.5) of respondents indicated that training was poor. There was considerable interest in increasing the allergy training provided, preferably through eLearning modules and problem-based learning materials supported by those with relevant specialist knowledge. This UK-wide survey has identified important gaps in the training of GP trainees in relation to allergy care. Addressing these gaps, particularly in the management of systemic allergic disorders, should help to improve delivery of primary care-based allergy care.

Teaching citizen science skills online: Implications for invasive species training programs

USGS Publications Warehouse

Newman, G.; Crall, A.; Laituri, M.; Graham, J.; Stohlgren, T.; Moore, J.C.; Kodrich, K.; Holfelder, K.A.

2010-01-01

Citizen science programs are emerging as an efficient way to increase data collection and help monitor invasive species. Effective invasive species monitoring requires rigid data quality assurances if expensive control efforts are to be guided by volunteer data. To achieve data quality, effective online training is needed to improve field skills and reach large numbers of remote sentinel volunteers critical to early detection and rapid response. The authors evaluated the effectiveness of online static and multimedia tutorials to teach citizen science volunteers (n = 54) how to identify invasive plants; establish monitoring plots; measure percent cover; and use Global Positioning System (GPS) units. Participants trained using static and multimedia tutorials provided less (p <.001) correct species identifications (63% and 67%) than did professionals (83%) across all species, but they did not differ (p =.125) between each other. However, their ability to identify conspicuous species was comparable to that of professionals. The variability in percent plant cover estimates between static (??10%) and multimedia (??13%) participants did not differ (p =.86 and.08, respectively) from those of professionals (??9%). Trained volunteers struggled with plot setup and GPS skills. Overall, the online approach used did not influence conferred field skills and abilities. Traditional or multimedia online training augmented with more rigorous, repeated, and hands-on, in-person training in specialized skills required for more difficult tasks will likely improve volunteer abilities, data quality, and overall program effectiveness. ?? Taylor & Francis Group, LLC.

Cracking the code for maintaining quality training in Olympic distance triathlon: lessons learnt from a squad of elite Scandinavian athletes

PubMed Central

Myburgh, Corrie; Hansen, Tobias; Holm Beck, Anders; Boyle, Eleanor

2017-01-01

Objective High-quality training is a key determinant of performance in the Olympic distance triathlon and is potentially influenced by a unique array of context-specific biopsychosocial factors. Our objective was to explore and describe these factors among squad members of a university-based, elite Olympic distance triathlete developmental programme. Method A qualitative investigation using a visual communication tool-assisted focus group and longitudinal semistructured individual interviews was conducted. Responses were solicited from the University of Southern Denmark’s elite triathlon team (n=8), and inductive coding from the focus group formed the basis of questions for the two rounds of individual interviews 11 months apart. All interviews were transcribed verbatim and then analysed thematically. Results Seventeen context-relevant factors were identified and 10 themes emerged, these being ‘the cold weather ritual’, ‘digestive system conditioning’, ‘the curse of the night owl’, ‘the strings attached to sponsorship’, ‘my coach—my rock’, ‘mood maintenance’, ‘the asynchronous training rhythm’, ‘psychological slavery’, ‘the legacy of the asphalt tattoo’ and ‘the tension of family and friends’. Conclusions By reflecting on their personal training vortex, elite triathletes were able to provide context-relevant insights into the maintenance of training quality over the course of a competitive season. Further research is required to elucidate whether and how biopsycholosocial factors can be modified to optimise the achievement of training goals. PMID:29071114

Impact of new duty-hour rules on residency training.

PubMed

Duran-Nelson, Alisa; Van Camp, Joan; Ling, Louis

2010-11-01

On the surface, changing the rules related to the number of hours residents work per day and per week sounds like a good idea. Theoretically, residents who work fewer hours would be less tired and provide better patient care. But even small changes in residency training programs have implications for the quality of the educational experience and the cost of training, as well as patient care. This article highlights the challenges that two Minnesota residency programs are facing as they adapt to the new rules around residents' work hours.

Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

PubMed

Thatte, Nandita; Choi, Yoonjoung

2015-04-01

Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be explored to better understand the relationship between HR management and FP service quality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Building community resilience through mental health infrastructure and training in post-Katrina New Orleans.

PubMed

Springgate, Benjamin F; Wennerstrom, Ashley; Meyers, Diana; Allen, Charles E; Vannoy, Steven D; Bentham, Wayne; Wells, Kenneth B

2011-01-01

To describe a disaster recovery model focused on developing mental health services and capacity-building within a disparities-focused, community-academic participatory partnership framework. Community-based participatory, partnered training and services delivery intervention in a post-disaster setting. Post-Katrina Greater New Orleans community. More than 400 community providers from more than 70 health and social services agencies participated in the trainings. Partnered development of a training and services delivery program involving physicians, therapists, community health workers, and other clinical and non-clinical personnel to improve access and quality of care for mental health services in a post-disaster setting. Services delivery (outreach, education, screening, referral, direct treatment); training delivery; satisfaction and feedback related to training; partnered development of training products. Clinical services in the form of outreach, education, screening, referral and treatment were provided in excess of 110,000 service units. More than 400 trainees participated in training, and provided feedback that led to evolution of training curricula and training products, to meet evolving community needs over time. Participant satisfaction with training generally scored very highly. This paper describes a participatory, health-focused model of community recovery that began with addressing emerging, unmet mental health needs using a disparities-conscious partnership framework as one of the principle mechanisms for intervention. Population mental health needs were addressed by investment in infrastructure and services capacity among small and medium sized non-profit organizations working in disaster-impacted, low resource settings.

Do Teachers Receive Proper In-Service Training to Implement Changing Policies: Perspective from the South African Case?

ERIC Educational Resources Information Center

du Plessis, Elize

2013-01-01

Worldwide there is a responsibility of governments to provide learners with quality education to face the challenges of change. Emanating from this challenge, the Department of Basic Education (DBE) in South Africa introduces in the last decade several curriculum changes which impacted on the delivery of quality education for all. This research…

Professional Development in Teacher Digital Competence and Improving School Quality from the Teachers' Perspective: A Case Study

ERIC Educational Resources Information Center

Cervera, Mercè Gisbert; Cantabrana, José L. Lázaro

2015-01-01

Professional development in ICT for teachers, in addition to being necessary given the dynamic nature of technology, also improves the institutional quality of schools. This work, based on action research, provides evidence that the school itself is capable of organising and designing a training plan as part of a broader process to improve quality…

The use of reflective diaries in end of life training programmes: a study exploring the impact of self-reflection on the participants in a volunteer training programme.

PubMed

Germain, Alison; Nolan, Kate; Doyle, Rita; Mason, Stephen; Gambles, Maureen; Chen, Hong; Smeding, Ruthmarijke; Ellershaw, John

2016-03-05

A training programme was developed and delivered to a cohort of volunteers who were preparing for a unique role to provide companionship to dying patients in the acute hospital setting. This comprehensive programme aimed to provide an opportunity for participants to fully understand the nature and responsibilities of the role, whilst also allowing sufficient time to assess the qualities and competencies of participants for their ongoing volunteering role. Participants completed reflective diaries throughout the training course to record their ongoing thoughts and feelings. The purpose of this paper is to present a phenomenological analysis of these entries to understand participants' experiences, perceptions and motivations. The wider study was structured into three phases. Phase 1 was the delivery of a 12 week, bespoke training programme; Phase 2 involved a 26 week pilot implementation of the Care of the Dying Volunteer Service and Phase 3 was the research evaluation of the training and implementation which would inform the further development of the training programme. Self-reflection is a common component of End of Life training programmes and volunteers in this study completed a reflective diary after participation in each of the training sessions. A thematic analysis was undertaken to explore and understand the participants' experience, perceptions and motivations in relation to their participation in the training. All 19 volunteers completed the reflective diaries. From a potential 228 diary entries over the 12 week training programme, 178 diary entries were submitted (78 %). The following key themes were identified: Dying Alone and the importance of being present, Personal loss and the reconstruction of meaning, Self-Awareness and Personal growth, Self-preservation and Coping strategies and group unity/cohesion. The participants in this study demonstrated that they were able to use the diaries as an appropriate medium for reflection. Their reflections were also instrumental in the ongoing revision and development of the training programme. Analysis of their entries illustrated that the diaries could provide the opportunity for a reappraisal of their world view and personal philosophy around death and dying. Further research is undoubtedly required, however this paper suggests that self-reflection in this way, supports preparation in honing the appropriate attitudes and qualities required to work in this role.

Quality assessment of a new surgical simulator for neuroendoscopic training.

PubMed

Filho, Francisco Vaz Guimarães; Coelho, Giselle; Cavalheiro, Sergio; Lyra, Marcos; Zymberg, Samuel T

2011-04-01

Ideal surgical training models should be entirely reliable, atoxic, easy to handle, and, if possible, low cost. All available models have their advantages and disadvantages. The choice of one or another will depend on the type of surgery to be performed. The authors created an anatomical model called the S.I.M.O.N.T. (Sinus Model Oto-Rhino Neuro Trainer) Neurosurgical Endotrainer, which can provide reliable neuroendoscopic training. The aim in the present study was to assess both the quality of the model and the development of surgical skills by trainees. The S.I.M.O.N.T. is built of a synthetic thermoretractable, thermosensible rubber called Neoderma, which, combined with different polymers, produces more than 30 different formulas. Quality assessment of the model was based on qualitative and quantitative data obtained from training sessions with 9 experienced and 13 inexperienced neurosurgeons. The techniques used for evaluation were face validation, retest and interrater reliability, and construct validation. The experts considered the S.I.M.O.N.T. capable of reproducing surgical situations as if they were real and presenting great similarity with the human brain. Surgical results of serial training showed that the model could be considered precise. Finally, development and improvement in surgical skills by the trainees were observed and considered relevant to further training. It was also observed that the probability of any single error was dramatically decreased after each training session, with a mean reduction of 41.65% (range 38.7%-45.6%). Neuroendoscopic training has some specific requirements. A unique set of instruments is required, as is a model that can resemble real-life situations. The S.I.M.O.N.T. is a new alternative model specially designed for this purpose. Validation techniques followed by precision assessments attested to the model's feasibility.

[Health-related strength and power training in seniors: Purpose and recommendations].

PubMed

Donath, Lars; Faude, Oliver; Bopp, Micha; Zahner, Lukas

2015-05-01

The proportion of older people in western societies rapidly increases. Aging-induced disease conditions accompanied with declines in cardiocirculatory and neuromuscular performance constitute a major individual and economic health burden. Besides decreasing vascular and cardiac function during the process of aging, a loss of skeletal muscle mass, muscle structure and function seem to mainly account for decreasing maximal strength, strength development and strength endurance. These findings adversely interfer with static and dynamic postural control and may lead to an increased risk of falling with impairments of autonomy and quality of life. Traditional strength training recommendations basing on health-related exercise prescriptions for elderly people have been proven to counteract or at least attenuate aging-induced declines of neuromuscular muscular function. Multimodal and combined strength and balance training deliver additional improvements of neuromuscular capacity. Recent evidence additionally underpin the need of trunk muscle training and claimed for regimes considering explosive and high-velocity strength training in seniors. High quality RCTs revealed notable strength training effects on mobility, autonomy, quality of life and the reduction of the risk of falling (up to 50%). Available evidence also indicates that various strength training regimes elicit preventive and therapeutic effects on osteoporosis, diabetes type 2 and other chronic diseases, with effect sizes comparable to medication intake. Thus, health care providers, health insurances, Employers' Liability Insurance Associations and politicians should promote infrastructural developments that enable feasible and cost-effective access to health-related fitness centers or other sport facilities (e. g. sport clubs). These environmental requirements should be embedded in multi-centric education programs and campaigns that might enable regularly conducted strength and endurance training perceived as beneficial and valuable from an individual health care perspective.

Training and certification for construction inspectors : final report.

DOT National Transportation Integrated Search

2016-11-01

Construction inspectors are an important asset to the success of a Department of Transportation; they provide quality control for state- and federally funded transportation infrastructure projects. A majority of departments of transportation in the U...

[Innovative instruction for assisting patients with arterial hypertension].

PubMed

Bontemps, S; Pechère-Bertschi, A

2015-09-09

The MOOC In The Heart of Hypertension is an innovative online training for students and health providers. Its aim is to strengthen skills for professionals caring people suffering from hypertension. A MOOC is a free online training aiming unlimited participation. It widely promotes a high quality education. Medical and paramedical training recently seized upon this powerful tool, for initial and continuing training. Indeed, MOOC responds to several pedagogic challenges, particularly through educational strategies focused on the learner's skills: mastery of pedagogy, retrieval practice and peer grading. This MOOC about hypertension aims at responding to the needs of caregivers to enhance their therapeutic support skills.

Providing Quality Education and Training for Rural Australians. SPERA National Conference Proceedings (17th, Wagga Wagga, New South Wales, Australia, July 8-11, 2001).

ERIC Educational Resources Information Center

Hemmings, Brian, Ed.; Boylan, Colin, Ed.

This proceedings of the 17th annual conference of the Society for the Provision of Education in Rural Australia (SPERA) contains 28 keynote addresses and conference papers. Major conference themes were vocational education and training (VET) in rural schools, small schools, flexible rural delivery systems, and the community as a resource and…

Supporting Military Families with Young Children throughout the Deployment Lifecycle

DTIC Science & Technology

2017-10-01

military service since the September 11th, 2001 terrorist attacks has placed tremendous demands on families. Approximately 43% of the Total Forces are...Parents program on the primary outcomes of interest including parental reflective capacity, parent-child relationship quality, and parenting stress...Hire and train SFSF2 staff at BU and UTHSCSA (for Ft. Hood site) 4a) Provide intensive training on home-based intervention (Strong Families

Training in laboratory management and the MBA/MD in laboratory medicine.

PubMed

Weiss, Ronald L

2007-06-01

The business of medicine requires more than just the knowledge and skills necessary to provide quality patient care. A growing number of opportunities are available for physicians to learn how to better manage the business side of their practices. Today's clinical laboratories, particularly those in health care organizations under pressure to efficiently use limited resources, benefit from having management and leadership specifically trained for these roles.

Process and implementation of participatory ergonomic interventions: a systematic review.

PubMed

van Eerd, Dwayne; Cole, Donald; Irvin, Emma; Mahood, Quenby; Keown, Kiera; Theberge, Nancy; Village, Judy; St Vincent, Marie; Cullen, Kim

2010-10-01

Participatory ergonomic (PE) interventions may vary in implementation. A systematic review was done to determine the evidence regarding context, barriers and facilitators to the implementation of participatory ergonomic interventions in workplaces. In total, 17 electronic databases were searched. Data on PE process and implementation were extracted from documents meeting content and quality criteria and synthesised. The search yielded 2151 references. Of these, 190 documents were relevant and 52 met content and quality criteria. Different ergonomic teams were described in the documents as were the type, duration and content of ergonomic training. PE interventions tended to focus on physical and work process changes and report positive impacts. Resources, programme support, ergonomic training, organisational training and communication were the most often noted facilitators or barriers. Successful PE interventions require the right people to be involved, appropriate ergonomic training and clear responsibilities. Addressing key facilitators and barriers such as programme support, resources, and communication is paramount. STATEMENT OF RELEVANCE: A recent systematic review has suggested that PE has some effect on reducing symptoms, lost days of work and claims. Systematic reviews of effectiveness provide practitioners with the desire to implement but do not provide clear information about how. This article reviews the literature on process and implementation of PE.

Structural barriers to South African volunteer home-based caregivers providing quality care: the need for a policy for caregivers not affiliated to primary healthcare clinics.

PubMed

Morton, David; Mayekiso, Thoko; Cunningham, Peter

2018-03-01

Community home-based care (CHBC) is a critical component of non-formal care in communities in Africa that have a high prevalence of HIV and tuberculosis (TB). Community carers consisting primarily of volunteers are critical role players in African healthcare systems and particularly in South Africa's strategy to fight HIV and AIDS. This paper explores the structural barriers volunteer caregivers need to overcome to provide quality CHBC. The researchers used two focus group discussions with key informants (each with four participants), and semi-structured interviews with six key informants to collect data relating to the meaning of quality CHBC. The data were coded using Tesch's data analysis technique. A major theme that emerged from the results was "Addressing structural challenges to improve the quality of CHBC". Subthemes underpinning this theme were: 1) lack of standardised training of volunteer caregivers; 2) the need for a scope of practice, parameters and legal boundaries; 3) lack of monitoring and evaluation (M&E) of CHBC; and 4) the importance of mentoring and supervision in CHBC. CHBC policy should address the need for standardised training programmes for caregivers, so that they are equipped with multiple skills. Furthermore CHBC policy must emphasise mentoring as well as M&E to encourage quality care. Finally, the policy should provide a clear scope of practice for caregivers to regulate their competencies and boundaries.

The expert-generalist: a contradiction whose time has come.

PubMed

Fins, Joseph J

2015-08-01

The author suggests the creation of expert-generalists to help provide the additional cost-effective access to care necessitated by increased insurance coverage under the Affordable Care Act. Expert-generalists, a concept drawn from an extant Canadian model, would be a cohort of primary care physicians who obtain additional training in a subspecialty area, which would widen their practice portfolio and bring enhanced infrastructure to primary care settings. Expanding the reach of primary care into the realm of more advanced subspecialty practice could be a way to enhance both access to and quality of care in a cost-effective fashion, in part because the educational framework for additional training already exists. Trainees could opt for an extra year of training after traditional residency or return to training after years in practice. Properly trained, an expert-generalist would benefit both the quality of the patient experience and the bottom line by expertly triaging patients to determine who will truly benefit from specialty consultations, decreasing specialists' engagement with cases that do not require their higher-tier care. The author considers the merits of this proposal, as well as potential objections and implementation challenges. It is suggested that this model be adopted incrementally, using demonstration projects that could assess the impact of an expert-generalist initiative on the physician workforce and on patients' access to quality primary and specialty care.

Developing Orthopaedic Trauma Capacity in Uganda: Considerations From the Uganda Sustainable Trauma Orthopaedic Program.

PubMed

OʼHara, Nathan N; OʼBrien, Peter J; Blachut, Piotr A

2015-10-01

Uganda, like many low-income countries, has a tremendous volume of orthopaedic trauma injuries. The Uganda Sustainable Trauma Orthopaedic Program (USTOP) is a partnership between the University of British Columbia and Makerere University that was initiated in 2007 to reduce the consequences of neglected orthopaedic trauma in Uganda. USTOP works with local collaborators to build orthopaedic trauma capacity through clinical training, skills workshops, system support, technology development, and research. USTOP has maintained a multidisciplinary approach to training, involving colleagues in anaesthesia, nursing, rehabilitation, and sterile reprocessing. Since the program's inception, the number of trained orthopaedic surgeons practicing in Uganda has more than doubled. Many of these newly trained surgeons provide clinical care in the previously underserved regional hospitals. The program has also worked with collaborators to develop several technologies aimed at reducing the cost of providing orthopaedic care without compromising quality. As orthopaedic trauma capacity in Uganda advances, USTOP strives to continually evolve and provide relevant support to colleagues in Uganda.

Extreme learning machines: a new approach for modeling dissolved oxygen (DO) concentration with and without water quality variables as predictors.

PubMed

Heddam, Salim; Kisi, Ozgur

2017-07-01

In this paper, several extreme learning machine (ELM) models, including standard extreme learning machine with sigmoid activation function (S-ELM), extreme learning machine with radial basis activation function (R-ELM), online sequential extreme learning machine (OS-ELM), and optimally pruned extreme learning machine (OP-ELM), are newly applied for predicting dissolved oxygen concentration with and without water quality variables as predictors. Firstly, using data from eight United States Geological Survey (USGS) stations located in different rivers basins, USA, the S-ELM, R-ELM, OS-ELM, and OP-ELM were compared against the measured dissolved oxygen (DO) using four water quality variables, water temperature, specific conductance, turbidity, and pH, as predictors. For each station, we used data measured at an hourly time step for a period of 4 years. The dataset was divided into a training set (70%) and a validation set (30%). We selected several combinations of the water quality variables as inputs for each ELM model and six different scenarios were compared. Secondly, an attempt was made to predict DO concentration without water quality variables. To achieve this goal, we used the year numbers, 2008, 2009, etc., month numbers from (1) to (12), day numbers from (1) to (31) and hour numbers from (00:00) to (24:00) as predictors. Thirdly, the best ELM models were trained using validation dataset and tested with the training dataset. The performances of the four ELM models were evaluated using four statistical indices: the coefficient of correlation (R), the Nash-Sutcliffe efficiency (NSE), the root mean squared error (RMSE), and the mean absolute error (MAE). Results obtained from the eight stations indicated that: (i) the best results were obtained by the S-ELM, R-ELM, OS-ELM, and OP-ELM models having four water quality variables as predictors; (ii) out of eight stations, the OP-ELM performed better than the other three ELM models at seven stations while the R-ELM performed the best at one station. The OS-ELM models performed the worst and provided the lowest accuracy; (iii) for predicting DO without water quality variables, the R-ELM performed the best at seven stations followed by the S-ELM in the second place and the OP-ELM performed the worst with low accuracy; (iv) for the final application where training ELM models with validation dataset and testing with training dataset, the OP-ELM provided the best accuracy using water quality variables and the R-ELM performed the best at all eight stations without water quality variables. Fourthly, and finally, we compared the results obtained from different ELM models with those obtained using multiple linear regression (MLR) and multilayer perceptron neural network (MLPNN). Results obtained using MLPNN and MLR models reveal that: (i) using water quality variables as predictors, the MLR performed the worst and provided the lowest accuracy in all stations; (ii) MLPNN was ranked in the second place at two stations, in the third place at four stations, and finally, in the fourth place at two stations, (iii) for predicting DO without water quality variables, MLPNN is ranked in the second place at five stations, and ranked in the third, fourth, and fifth places in the remaining three stations, while MLR was ranked in the last place with very low accuracy at all stations. Overall, the results suggest that the ELM is more effective than the MLPNN and MLR for modelling DO concentration in river ecosystems.

[Designing and implementation of a web-based quality monitoring system for plasma glucose measurement in multicenter population study].

PubMed

Liu, Yong; Wang, Limin; Pang, Richard; Mo, Nanxun; Hu, Yan; Deng, Qian; Hu, Zhaohui

2015-05-01

The aim of this paper is to describe the designing and implementation of a web-based plasma glucose measurement quality monitoring system to assess the analytical quality of plasma glucose measurements in multicenter population study and provide evidence for the future studies. In the chronic non-communicable disease and related factor surveillance in China, a web based quality monitoring system for plasma glucose measurement was established to conduct evaluation on plasma glucose monitoring quality and effectiveness in 302 surveillance centers, including quality control data entry, transmission and feedback. The majority of the surveillance centers met the quality requirements and passed the evaluation of reproducibility and precision of plasma glucose measurement, only a few centers required intensive training and re-assessment. In order to ensure the completeness and reliability of plasma glucose measurement in the surveillance centers, the establishment of web-based plasma glucose measurement quality control system can facilitate the identification of the qualified surveillance centers and evaluation of plasma glucose measurement quality in different regions. Communication and training are important in ensuring plasma glucose measurement quality. It is necessary to further improve this web-based plasma glucose measurement quality monitoring system in the future to reduce the method specific plasma glucose measurement bias.

Renewable energy water supply - Mexico program summary

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

Foster, R.

1997-12-01

This paper describes a program directed by the US Agency for International Development and Sandia National Laboratory which installed sustainable energy sources in the form of photovoltaic modules and wind energy systems in rural Mexico to pump water and provide solar distillation services. The paper describes the guidelines which appeared most responsible for success as: promote an integrated development program; install quality systems that develop confidence; instill local project ownership; train local industry and project developers; develop a local maintenance infrastructure; provide users training and operations guide; develop clear lines of responsibilities for system upkeep. The paper emphasizes the importancemore » of training. It also presents much collected data as to the characteristics and performance of the installed systems.« less

Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.

PubMed

Beach, Mary Catherine; Roter, Debra L; Saha, Somnath; Korthuis, P Todd; Eggly, Susan; Cohn, Jonathan; Sharp, Victoria; Moore, Richard D; Wilson, Ira B

2015-09-01

Medication adherence is essential in HIV care, yet provider communication about adherence is often suboptimal. We designed this study to improve patient-provider communication about HIV medication adherence. We randomized 26 providers at three HIV care sites to receive or not receive a one-hour communication skills training based on motivational interviewing principles applied to medication adherence. Prior to routine office visits, non-adherent patients of providers who received the training were coached to discuss adherence with their providers. Patients of providers who did not receive the training providers were not coached. We audio-recorded and coded patient-provider interactions using the roter interaction analysis system (RIAS). There was more dialogue about therapeutic regimen in visits with intervention patients and providers (167 vs 128, respectively, p=.004), with the majority of statements coming from providers. These visits also included more brainstorming solutions to nonadherence (41% vs. 22%, p=0.026). Intervention compared with control visit providers engaged in more positive talk (44 vs. 38 statements, p=0.039), emotional talk (26 vs. 18 statements, p<0.001), and probing of patient opinion (3 vs. 2 statements, p=0.009). A brief provider training combined with patient coaching sessions, improved provider communication behaviors and increased dialogue regarding medication adherence. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cell phone cardiopulmonary resuscitation: audio instructions when needed by lay rescuers: a randomized, controlled trial.

PubMed

Merchant, Raina M; Abella, Benjamin S; Abotsi, Edem J; Smith, Thomas M; Long, Judith A; Trudeau, Martha E; Leary, Marion; Groeneveld, Peter W; Becker, Lance B; Asch, David A

2010-06-01

Given the ubiquitous presence of cellular telephones, we seek to evaluate the extent to which prerecorded audio cardiopulmonary resuscitation (CPR) instructions delivered by a cell telephone will improve the quality of CPR provided by untrained and trained lay rescuers. We randomly assigned both previously CPR trained and untrained volunteers to perform CPR on a manikin for 3 minutes with or without audio assistance from a cell telephone programmed to provide CPR instructions. We measured CPR quality metrics-pauses (ie, no flow time), compression rate (minute), depth (millimeters), and hand placement (percentage correct)-across the 4 groups defined by being either CPR trained or untrained and receiving or not receiving cell telephone CPR instructions. There was no difference in CPR measures for participants who had or had not received previous CPR training. Participants using the cell telephone aid performed better compression rate (100/minute [95% confidence interval (CI) 97 to 103/minute] versus 44/minute [95% CI 38 to 50/minute]), compression depth (41 mm [95% CI 38 to 44 mm] versus 31 mm [95% CI 28 to 34 mm]), hand placement (97% [95% CI 94% to 100%] versus 75% [95% CI 68% to 83%] correct), and fewer pauses (74 seconds [95% CI 72 to 76 seconds] versus 89 seconds [95% CI 80 to 98 seconds]) compared with participants without the cell telephone aid. A simple audio program that can be made available for cell telephones increases the quality of bystander CPR in a manikin simulation. Copyright (c) 2009 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Franchising of health services in low-income countries.

PubMed

Montagu, Dominic

2002-06-01

Grouping existing providers under a franchised brand, supported by training, advertising and supplies, is a potentially important way of improving access to and assuring quality of some types of clinical medical services. While franchising has great potential to increase service delivery points and method acceptability, a number of challenges are inherent to the delivery model: controlling the quality of services provided by independent practitioners is difficult, positioning branded services to compete on either price or quality requires trade-offs between social goals and provider satisfaction, and understanding the motivations of clients may lead to organizational choices which do not maximize quality or minimize costs. This paper describes the structure and operation of existing franchises and presents a model of social franchise activities that will afford a context for analyzing choices in the design and implementation of health-related social franchises in developing countries.

Training needs of nurses and social workers in the end-of-life care for people with intellectual disabilities: a national survey.

PubMed

Bekkema, Nienke; de Veer, Anke J E; Albers, Gwenda; Hertogh, Cees M P M; Onwuteaka-Philipsen, Bregje D; Francke, Anneke L

2014-04-01

Nurses and social workers caring for people with intellectual disabilities are increasingly confronted with clients in need of end-of-life care. Previous studies, however, suggest that professionals in intellectual disability care services lack knowledge and experience concerning end-of-life care. Moreover, the proportion of nurses within the staff of intellectual disability services has declined in recent years, while the proportion of social workers has increased, which may have consequences for the quality of end-of-life care. To gain insight into the quality of end-of-life care, past vocational training, training needs and expert consultation opportunities of nurses and social workers working in intellectual disability care services. Survey questionnaire study conducted in the Netherlands. Intellectual disability care services. The study sample was recruited from an existing nationally representative research panel of care professionals. In 2011, all 181 nurses and social workers in the research panel who worked in intellectual disability care services were sent our survey questionnaire. Postal survey addressing education, views and needs regarding end-of-life care. The response was 71.8%. Respondents positively evaluated the quality of end-of-life care. However, most respondents felt inadequately trained in end-of-life care issues. Nurses had received more training in end-of-life care and had fewer training needs than social workers. Respondents wished for additional training, especially in supporting clients in dealing with the impending death and farewell process. Half of the respondents were unaware of the availability of external consultation facilities. This study shows that although nurses and social workers positively appraise the quality of end-of-life care for people with intellectual disabilities, the majority feel inadequately trained to provide good end-of-life care. As the number of people with intellectual disability in need of end-of-life care grows, organizations need to offer additional relevant training and must give information about the availability of external expert consultation for nurses and social workers. © 2013.

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

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

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

2014-11-01

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

Leadership training in health care action teams: a systematic review.

PubMed

Rosenman, Elizabeth D; Shandro, Jamie R; Ilgen, Jonathan S; Harper, Amy L; Fernandez, Rosemarie

2014-09-01

To identify and describe the design, implementation, and evidence of effectiveness of leadership training interventions for health care action (HCA) teams, defined as interdisciplinary teams whose members coordinate their actions in time-pressured, unstable situations. The authors conducted a systematic search of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012. They identified peer-reviewed English-language articles describing leadership training interventions targeting HCA teams, at all levels of training and across all health care professions. Reviewers, working in duplicate, abstracted training characteristics and outcome data. Methodological quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). Of the 52 included studies, 5 (10%) focused primarily on leadership training, whereas the remainder included leadership training as part of a larger teamwork curriculum. Few studies reported using a team leadership model (2; 4%) or a theoretical framework (9; 17%) to support their curricular design. Only 15 studies (29%) specified the leadership behaviors targeted by training. Forty-five studies (87%) reported an assessment component; of those, 31 (69%) provided objective outcome measures including assessment of knowledge or skills (21; 47%), behavior change (8; 18%), and patient- or system-level metrics (8; 18%). The mean MERSQI score was 11.4 (SD 2.9). Leadership training targeting HCA teams has become more prevalent. Determining best practices in leadership training is confounded by variability in leadership definitions, absence of supporting frameworks, and a paucity of robust assessments.

Functions of standard CPR training on performance qualities of medical volunteers for Mt. Taishan International Mounting Festival.

PubMed

Fanshan, Meng; Lin, Zhao; Wenqing, Liu; Chunlei, Lu; Yongqiang, Liu; Naiyi, Li

2013-01-01

Cardiopulmonary resuscitation (CPR) is a sudden emergency procedure that requires a rapid and efficient response, and personnel training in lifesaving procedures. Regular practice and training are necessary to improve resuscitation skills and reduce anxiety among the staff. As one of the most important skills mastered by medical volunteers serving for Mt. Taishan International Mounting Festival, we randomly selected some of them to evaluate the quality of CPR operation and compared the result with that of the untrained doctors and nurses. In order to evaluate the functions of repeating standard CPR training on performance qualities of medical volunteers for Mt. Taishan International Mounting Festival, their performance qualities of CPR were compared with those of the untrained medical workers working in emergency departments of hospitals in Taian. The CPR performance qualities of 52 medical volunteers (Standard Training Group), who had continually taken part in standard CPR technical training for six months, were tested at random and were compared with those of 68 medical workers (Compared Group) working in emergency departments of hospitals in Taian who hadn't attended CPR training within a year. The QCPR 3535 monitor (provided by Philips Company) was used to measure the standard degree of single simulated CPR performance, including the chest compression depth, frequency, released pressure between compressions and performance time of compression and ventilation, the results of which were recorded in the table and the number of practical compression per minute was calculated. The data were analyzed by x2 Test and t Test. The factors which would influence CPR performance, including gender, age, placement, hand skill, posture of compression and frequency of training, were classified and given parameters, and were put to Logistic repression analysis. The CPR performance qualities of volunteers were much higher than those of the compared group. The overall pass rates were respectively 86.4% and 31.9%; the pass rates of medical volunteers in terms of the chest compression depth, frequency, released pressure between compressions were higher than those of the compared group, which were 89.6%, 94.2%, 95.8% vs 50.3%, 53.0%, 83.1%, P<0.01; there were few differences in overall performance time, which were (118.4 ± 13.5s) vs (116.0 ± 10.4s), P>0.05; the duration time of ventilation in each performance section was much shorter than that in the compared group, which were (6.38 ± 1.2) vs (7.47 ± 1.7), P<0.01; there were few differences in the number of practical compression per minute, which were (78.2 ± 3.5) vs (78.8 ± 12.2), P>0.05); the time proportion of compression and ventilation was 2.6:1 vs 2.1:1. The Logistic repression analysis showed that CPR performance qualities were clearly related to hand skill, posture of compression and repeating standard training, which were respectively OR 13.12 and 95%CI (2.35~73.2); OR 30.89, 95%CI (3.62~263.5); OR 4.07,95%CI (1.16~14.2). The CPR performance qualities of volunteers who had had repeating standard training were much higher than those of untrained medical workers, which proved that standard training helped improve CPR performance qualities.

Continuous Evaluation in Ethics Education: A Case Study.

PubMed

McIntosh, Tristan; Higgs, Cory; Mumford, Michael; Connelly, Shane; DuBois, James

2018-04-01

A great need for systematic evaluation of ethics training programs exists. Those tasked with developing an ethics training program may be quick to dismiss the value of training evaluation in continuous process improvement. In the present effort, we use a case study approach to delineate how to leverage formative and summative evaluation measures to create a high-quality ethics education program. With regard to formative evaluation, information bearing on trainee reactions, qualitative data from the comments of trainees, in addition to empirical findings, can ensure that the training program operates smoothly. Regarding summative evaluation, measures examining trainee cognition, behavior, and organization-level results provide information about how much trainees have changed as a result of taking the ethics training. The implications of effective training program evaluation are discussed.

Standardized training in nurse model travel clinics.

PubMed

Sofarelli, Theresa A; Ricks, Jane H; Anand, Rahul; Hale, Devon C

2011-01-01

International travel plays a significant role in the emergence and redistribution of major human diseases. The importance of travel medicine clinics for preventing morbidity and mortality has been increasingly appreciated, although few studies have thus far examined the management and staff training strategies that result in successful travel-clinic operations. Here, we describe an example of travel-clinic operation and management coordinated through the University of Utah School of Medicine, Division of Infectious Diseases. This program, which involves eight separate clinics distributed statewide, functions both to provide patient consult and care services, as well as medical provider training and continuing medical education (CME). Initial training, the use of standardized forms and protocols, routine chart reviews and monthly continuing education meetings are the distinguishing attributes of this program. An Infectious Disease team consisting of one medical doctor (MD) and a physician assistant (PA) act as consultants to travel nurses who comprise the majority of clinic staff. Eight clinics distributed throughout the state of Utah serve approximately 6,000 travelers a year. Pre-travel medical services are provided by 11 nurses, including 10 registered nurses (RNs) and 1 licensed practical nurse (LPN). This trained nursing staff receives continuing travel medical education and participate in the training of new providers. All nurses have completed a full training program and 7 of the 11 (64%) of clinic nursing staff serve more than 10 patients a week. Quality assurance measures show that approximately 0.5% of charts reviewed contain a vaccine or prescription error which require patient notification for correction. Using an initial training program, standardized patient intake forms, vaccine and prescription protocols, preprinted prescriptions, and regular CME, highly trained nurses at travel clinics are able to provide standardized pre-travel care to international travelers originating from Utah. © 2010 International Society of Travel Medicine.

Applying Theories of Adult Learning in Developing Online Programs in Gerontology

ERIC Educational Resources Information Center

Carter, Christy S.; Solberg, Lauren B.; Solberg, Laurence M.

2017-01-01

The Department of Aging and Geriatric Research at the University of Florida College of Medicine has established online education programs to provide healthcare professionals with advanced training in the field of gerontology to establish proficiency in providing quality care to older individuals. A major barrier to creating our online education…

Selling Workplace ESL Instructional Programs. ERIC Digest.

ERIC Educational Resources Information Center

Burt, Miriam

Although basic skills and English language instruction are often viewed as real needs at the workplace, few companies provide this for their workers. Those that do are motivated by one or more of these factors: product quality improvement, commitment of top management to training and education, or the sales effort of an educational provider. Those…

Understanding VET Teachers' Challenges in Providing Quality Education to International Students

ERIC Educational Resources Information Center

Nakar, Sonal

2013-01-01

In the past fifteen years, increasing attention has been given to the role of Vocational Education and Training (VET) in attracting large numbers of international students and its contribution to the economic development of Australia. This trend has given rise to many challenges in vocational education, especially with regard to providing quality…

Lessons from the Training Programme for Women with Domestic Violence Experience

ERIC Educational Resources Information Center

Anczewska, Marta; Roszczynska-Michta, Joanna; Waszkiewicz, Justyna; Charzynska, Katarzyna; Czabala, Czeslaw

2013-01-01

It is well recognized that trauma of domestic violence has destructive impact on somatic and mental health--hence quality of life. In Poland today's assistance programs provide a quite wide range of services, including emergency shelter, crisis intervention, support groups and counselling services. While health care providers may be successful at…

School-Age NOTES, 1999.

ERIC Educational Resources Information Center

Scofield, Richard T., Ed.

1999-01-01

This document is comprised of the 12 monthly issues of a newsletter providing support and information for providers of child care for school-age children. The featured articles for each month are: (1) "Tips for New and Old for the New School Year" (September); (2) "Train Them and Retain Them: Keeping Quality Staff" (October); (3) "What Older Kids…

Management of Nursing Workplace Incivility in the Health Care Settings: A Systematic Review.

PubMed

Armstrong, Nancy

2018-05-01

Workplace incivility is a well-documented issue in nursing in the health care setting. It has the potential to cause emotional and physical distress in victims and potentially affects the quality of care provided. The purpose of this study was to critique and summarize the most recent, available evidence related to interventions in assisting nursing staff working in health care settings in managing incivility. This systematic review of literature yielded 10 studies meeting the criteria. The studies were mostly identified as lower quality research. Despite the lower quality of research, the collection of evidence suggests the use of a combination of educational training about workplace incivility, training about effective responses to uncivil workplace behaviors, and active learning activities to practice newly learned communication skills, in assisting nurses in improving their ability to manage incivility in the workplace.

20 CFR 670.525 - What residential support services must Job Corps center operators provide?

Code of Federal Regulations, 2011 CFR

2011-04-01

... the Secretary: (a) A quality living and learning environment that supports the overall training..., vending machines, disciplinary fines, and donations, and is run by an elected student government, with the...

20 CFR 670.525 - What residential support services must Job Corps center operators provide?

Code of Federal Regulations, 2010 CFR

2010-04-01

... the Secretary: (a) A quality living and learning environment that supports the overall training..., vending machines, disciplinary fines, and donations, and is run by an elected student government, with the...

The future of surgical training in the context of the 'Shape of Training' Review: Consensus recommendations by the Association of Surgeons in Training.

PubMed

Harries, Rhiannon L; Williams, Adam P; Ferguson, Henry J M; Mohan, Helen M; Beamish, Andrew J; Gokani, Vimal J

2016-11-01

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. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Preliminary experience of a PDCA-cycle and quality management based training curriculum for rat liver transplantation.

PubMed

Jin, Hao; Huang, Hai; Dong, Wei; Sun, Jian; Liu, Anding; Deng, Meihong; Dirsch, Olaf; Dahmen, Uta

2012-08-01

As repeatedly operating rat liver transplantation (LTx) until animals survive is inefficient in respect to time and use of living animals, we developed a new training concept. METHODS AND CONCEPTS: Training was divided into four phases: pretraining-phase, basic-microsurgical-training phase, advanced-microsurgical-training phases, and expert-microsurgical-training phase. Two "productivity-phases" were introduced right after the basic- and advanced-microsurgical-training phases, respectively, to allow the trainee to accumulate experience and to be scientifically productive before proceeding to a more complex procedure. PDCA cycles and quality criteria were employed to control the learning-process and the surgical quality. Predefined quality criteria included survival rate, intraoperative, postoperative, and histologic parameters. Three trainees participated in the LTx training and achieved their first survival record within 4-10 operations. All of them completely mastered the LTx in fewer procedures (31, 60 and 26 procedures) as reported elsewhere, and the more complex arterialized or partial LTx were mastered by trainee A and B in additional 9 and 13 procedures, respectively. Fast progress was possible due to a high number of training in the 2 Productivity-phases. The stepwise and PDCA-based training program increased the efficiency of LTx training, whereas the constant application and development of predefined quality criteria guaranteed the quality of microsurgery. Copyright © 2012 Elsevier Inc. All rights reserved.

Impact of a TeamSTEPPS Trauma Nurse Academy at a Level 1 Trauma Center.

PubMed

Peters, V Kristen; Harvey, Ellen M; Wright, Andi; Bath, Jennifer; Freeman, Dan; Collier, Bryan

2018-01-01

Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers. With the increased expectations of a well-orchestrated team and larger number of emergency nurses, our program created the Trauma Nurse Academy. This academy provides a core of experienced nurses with an advanced level of training while decreasing the variability of personnel in the trauma bay. Components of the academy include multidisciplinary didactic education, the Essentials of TeamSTEPPS, and interactive trauma bay learning, to include both equipment and drug use. Once completed, academy graduates participate in the orientation and training of General Surgery and Emergency Medicine residents' trauma bay experience and injury prevention activities. Internal and published data have demonstrated growing evidence linking trauma teamwork training to knowledge and self-confidence in clinical judgment to team performance, patient outcomes, and quality of care. Although trauma resuscitations are stressful, high risk, dynamic, and a prime environment for error, new methods of teamwork training and collaboration among trauma team members have become essential. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Using Predictive Evaluation to Design, Evaluate, and Improve Training for Polio Volunteers

PubMed Central

Traicoff, Denise A.; Basarab, Dave; Ehrhardt, Derek T.; Brown, Sandi; Celaya, Martin; Jarvis, Dennis; Howze, Elizabeth H.

2018-01-01

Background Predictive Evaluation (PE) uses a four-step process to predict results then designs and evaluates a training intervention accordingly. In 2012, the Sustainable Management Development Program (SMDP) at the Centers for Disease Control and Prevention used PE to train Stop Transmission of Polio (STOP) program volunteers. Methods Stakeholders defined specific beliefs and practices that volunteers should demonstrate. These predictions and adult learning practices were used to design a curriculum to train four cohorts. At the end of each workshop, volunteers completed a beliefs survey and wrote goals for intended actions. The goals were analyzed for acceptability based on four PE criteria. The percentage of acceptable goals and the beliefs survey results were used to define the quality of the workshop. A postassignment adoption evaluation was conducted for two cohorts, using an online survey and telephone or in-person structured interviews. The results were compared with the end of workshop findings. Results The percentage of acceptable goals across the four cohorts ranged from 49% to 85%. In the adoption evaluation of two cohorts, 88% and 94% of respondents reported achieving or making significant progress toward their goal. A comparison of beliefs survey responses across the four cohorts indicated consistencies in beliefs that aligned with stakeholders’ predictions. Conclusions Goal statements that participants write at the end of a workshop provide data to evaluate training quality. Beliefs surveys surface attitudes that could help or hinder workplace performance. The PE approach provides an innovative framework for health worker training and evaluation that emphasizes performance. PMID:29457126

Academic training of nursing professionals and its relevance to the workplace 1

PubMed Central

Ortega, Maria del Carmen Barbera; Cecagno, Diana; Llor, Ana Myriam Seva; de Siqueira, Hedi Crecencia Heckler; Montesinos, Maria José López; Soler, Loreto Maciá

2015-01-01

OBJECTIVE: to identify the training nursing professionals receive and its relevance to the workplace, as well as professional demand for continuous education. METHODOLOGY: this was a descriptive observational study using a questionnaire entitled "Training and Adaptation of the Nursing Professional to the Workplace" available at: http://enfermeriadocente.es for nursing professionals. RESULTS: 53.8% of nurses do not consider the training received to be relevant to the needs of the workplace and 94.2% reported that linking academic education to the workplace impacts on the quality of care provided. CONCLUSIONS: Nursing professionals think that continuous education needs to be adjusted to their jobs and careers. Education should be viewed as a continuum, which begins with training. PMID:26312632

The development of an assessment system for dental vocational training and general professional training: a Scottish approach.

PubMed

Prescott, L E; McKinlay, P; Rennie, J S

2001-01-13

The role of competencies in postgraduate dental education and training has been a major topic of interest in recent years. Concerns have been voiced from all sides of the profession about how the competence of trainees and the quality of training can be assured so that high standards of patient care can be maintained. A three year project which seeks to develop a competency-based assessment system for general professional training is underway which hopes to answer some of the concerns and provide an evidence-based system of assessment for the early postgraduate years. This paper looks at the reasoning behind the project, its aims, and the progress made to date.

Postural stability and quality of life after guided and self-training among older adults residing in an institutional setting

PubMed Central

Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Moisio-Vilenius, Päivi; Mäkinen, Erja; Toppila, Esko; Pyykkö, Ilmari

2013-01-01

Purpose To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. Patients and methods A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Results Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Conclusion Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly’s daily routine and making it more active and exhausting. PMID:24072969

Effects of task-oriented robot training on arm function, activity, and quality of life in chronic stroke patients: a randomized controlled trial.

PubMed

Timmermans, Annick A A; Lemmens, Ryanne J M; Monfrance, Maurice; Geers, Richard P J; Bakx, Wilbert; Smeets, Rob J E M; Seelen, Henk A M

2014-03-31

Over fifty percent of stroke patients experience chronic arm hand performance problems, compromising independence in daily life activities and quality of life. Task-oriented training may improve arm hand performance after stroke, whereby augmented therapy may lead to a better treatment outcome. Technology-supported training holds opportunities for increasing training intensity. However, the effects of robot-supported task-oriented training with real life objects in stroke patients are not known to date. The aim of the present study was to investigate the effectiveness and added value of the Haptic Master robot combined with task-oriented arm hand training in chronic stroke patients. In a single-blind randomized controlled trial, 22 chronic stroke patients were randomly allocated to receive either task-oriented robot-assisted arm-hand training (experimental group) or task-oriented non-robotic arm-hand training (control group). For training, the T-TOAT (Technology-supported Task-Oriented Arm Training) method was applied. Training was provided during 8 weeks, 4 times/week, 2 × 30 min/day. A significant improvement after training on the Action Research Arm Test (ARAT) was demonstrated in the experimental group (p = 0.008). Results were maintained until 6 months after cessation of the training. On the perceived performance measure (Motor Activity Log (MAL)), both, the experimental and control group improved significantly after training (control group p = 0.008; experimental group p = 0.013). The improvements on MAL in both groups were maintained until 6 months after cessation of the training. With regard to quality of life, only in the control group a significant improvement after training was found (EuroQol-5D p = 0.015, SF-36 physical p = 0.01). However, the improvement on SF-36 in the control group was not maintained (p = 0.012). No between-group differences could be demonstrated on any of the outcome measures. Arm hand performance improved in chronic stroke patients, after eight weeks of task oriented training. The use of a Haptic Master robot in support of task-oriented arm training did not show additional value over the video-instructed task-oriented exercises in highly functional stroke patients. Current Controlled Trials ISRCTN82787126.

Automated reference-free detection of motion artifacts in magnetic resonance images.

PubMed

Küstner, Thomas; Liebgott, Annika; Mauch, Lukas; Martirosian, Petros; Bamberg, Fabian; Nikolaou, Konstantin; Yang, Bin; Schick, Fritz; Gatidis, Sergios

2018-04-01

Our objectives were to provide an automated method for spatially resolved detection and quantification of motion artifacts in MR images of the head and abdomen as well as a quality control of the trained architecture. T1-weighted MR images of the head and the upper abdomen were acquired in 16 healthy volunteers under rest and under motion. Images were divided into overlapping patches of different sizes achieving spatial separation. Using these patches as input data, a convolutional neural network (CNN) was trained to derive probability maps for the presence of motion artifacts. A deep visualization offers a human-interpretable quality control of the trained CNN. Results were visually assessed on probability maps and as classification accuracy on a per-patch, per-slice and per-volunteer basis. On visual assessment, a clear difference of probability maps was observed between data sets with and without motion. The overall accuracy of motion detection on a per-patch/per-volunteer basis reached 97%/100% in the head and 75%/100% in the abdomen, respectively. Automated detection of motion artifacts in MRI is feasible with good accuracy in the head and abdomen. The proposed method provides quantification and localization of artifacts as well as a visualization of the learned content. It may be extended to other anatomic areas and used for quality assurance of MR images.

Institutional training programs for research personnel conducted by laboratory-animal veterinarians.

PubMed

Dyson, Melissa C; Rush, Howard G

2012-01-01

Research institutions are required by federal law and national standards to ensure that individuals involved in animal research are appropriately trained in techniques and procedures used on animals. Meeting these requirements necessitates the support of institutional authorities; policies for the documentation and enforcement of training; resources to support and provide training programs; and high-quality, effective educational material. Because of their expertise, laboratory-animal veterinarians play an essential role in the design, implementation, and provision of educational programs for faculty, staff, and students in biomedical research. At large research institutions, provision of a training program for animal care and use personnel can be challenging because of the animal-research enterprise's size and scope. At the University of Michigan (UM), approximately 3,500 individuals have direct contact with animals used in research. We describe a comprehensive educational program for animal care and use personnel designed and provided by laboratory-animal veterinarians at UM and discuss the challenges associated with its implementation.

A CNN based neurobiology inspired approach for retinal image quality assessment.

PubMed

Mahapatra, Dwarikanath; Roy, Pallab K; Sedai, Suman; Garnavi, Rahil

2016-08-01

Retinal image quality assessment (IQA) algorithms use different hand crafted features for training classifiers without considering the working of the human visual system (HVS) which plays an important role in IQA. We propose a convolutional neural network (CNN) based approach that determines image quality using the underlying principles behind the working of the HVS. CNNs provide a principled approach to feature learning and hence higher accuracy in decision making. Experimental results demonstrate the superior performance of our proposed algorithm over competing methods.

Internal Medicine Residents' Training in Substance Use Disorders: A Survey of the Quality of Instruction and Residents' Self-Perceived Preparedness to Diagnose and Treat Addiction

ERIC Educational Resources Information Center

Wakeman, Sarah E.; Baggett, Meridale V.; Pham-Kanter, Genevieve; Campbell, Eric G.

2013-01-01

Background: Resident physicians are the direct care providers for many patients with addiction. This study assesses residents' self-perceived preparedness to diagnose and treat addiction, measures residents' perceptions of the quality of addictions instruction, and evaluates basic knowledge of addictions. Methods: A survey was e-mailed to 184…

From Policy to Practice: The Challenges of Providing High Quality Physical Education and School Sport Faced by Head Teachers within Primary Schools

ERIC Educational Resources Information Center

Rainer, Paul; Cropley, Brendan; Jarvis, Stuart; Griffiths, Rob

2012-01-01

Background: Despite considerable investment in UK government initiatives (e.g., the Physical Education School Sport [PESS] plan) aimed at improving the delivery and quality of physical education (PE) in primary schools, many remaining problems have been highlighted (e.g., facilities; staff training). It is suggested that the head teacher (school…

Exploratory development and services for preparing and examining ultrathin polished sections of lunar rocks and particulates, part 1

NASA Technical Reports Server (NTRS)

Beauchamp, R. H.; Williford, J. F.; Gafford, E. L.

1972-01-01

Development of improved procedures is reported for three classes of lunar materials: dense rocks, breccias, and particulates. High quality ultrathin sections of these materials are obtained. Lists of equipment and supplies, procedures, photomicrographic documentation, and training are provided. Advantages of ultrathin polished sections for conventional and unconventional optical microscopy methods are described. Recommendations are provided for use of ultrathin sections in lunar rock studies, for further refinement of ultrathinning procedures, and for additional training efforts to establish a capability at the Manned Space Center. For Part 2, See N72-50754.

The legendary Smiths and their Paris hospital.

PubMed

Prewitt, Taylor; Smith, John C; Bell, J P

2015-01-01

The Paris Hospital in Paris, Arkansas, provided high quality care during its existence from 1910 to 1971, offering a prepaid health care plan from 1920 to 1971. Three generations of Smith doctors were its nucleus, subsidizing the annual losses of the hospital and providing care to all, regardless of ability to pay. The hospital was a community unto itself for the nurses who lived, trained, and worked there. A unique family in the history of medicine in Arkansas, the Smith physicians were well trained, altruistic, compassionate, and conscientious, exemplifying the traditional values of twentieth century medical practice.

Influence of pilates training on the quality of life of chronic stroke patients.

PubMed

Yun, Seok-Min; Park, Sang-Kyoon; Lim, Hee Sung

2017-10-01

[Purpose] This study was to observe the influence of Pilates training on the quality of life in chronic stoke patients. [Subjects and Methods] Forty chronic stroke patients participated in this study. They were divided into same number of experimental group (EG) and control group (CG). EG participated in a 60-min Pilates training program, twice a week for 12 weeks, while the CG did not participate in any exercise-related activities for the duration and participating in general occupational therapy without any exercise-related activities. Then the MMSE-K was performed before and after Pilates training to observe the influence of Pilates training on the quality of life in chronic stroke patients. [Results] Statistically significant improvement in the physical, social, and psychological domains was found in EG after the training. No statistically significant difference was found in all three quality of life domains for the CG. EG experienced a statistically significant improvement in all quality of life domains compared with that of CG. [Conclusion] Therefore, participation in Pilates training was found to effectively improve the quality of life in stroke patients. Pilates training involves low and intermediate intensity resistance and repetition that match the patient's physical ability and can be a remedial exercise program that can improve physical ability and influence quality of life.

Influence of pilates training on the quality of life of chronic stroke patients

PubMed Central

Yun, Seok-Min; Park, Sang-Kyoon; Lim, Hee Sung

2017-01-01

[Purpose] This study was to observe the influence of Pilates training on the quality of life in chronic stoke patients. [Subjects and Methods] Forty chronic stroke patients participated in this study. They were divided into same number of experimental group (EG) and control group (CG). EG participated in a 60-min Pilates training program, twice a week for 12 weeks, while the CG did not participate in any exercise-related activities for the duration and participating in general occupational therapy without any exercise-related activities. Then the MMSE-K was performed before and after Pilates training to observe the influence of Pilates training on the quality of life in chronic stroke patients. [Results] Statistically significant improvement in the physical, social, and psychological domains was found in EG after the training. No statistically significant difference was found in all three quality of life domains for the CG. EG experienced a statistically significant improvement in all quality of life domains compared with that of CG. [Conclusion] Therefore, participation in Pilates training was found to effectively improve the quality of life in stroke patients. Pilates training involves low and intermediate intensity resistance and repetition that match the patient’s physical ability and can be a remedial exercise program that can improve physical ability and influence quality of life. PMID:29184300

A study of deficiencies in teamwork skills among Jordan caregivers.

PubMed

Al-Araidah, Omar; Al Theeb, Nader; Bader, Mariam; Mandahawi, Nabeel

2018-05-14

Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members. Surveyed care providers included physicians, nursing and anesthesiologists operating in emergency departments, surgical operating rooms and intensive care units from various hospitals. Findings With a response rate of 78.8 percent, statistical analysis of collected data of opposing staff members revealed low levels of satisfaction (40.7-48 percent opposing), lack of awareness on the impact of teamwork on quality of care (15.6-22.1 percent opposing), low levels of involvement of top management (27.1-57.3 percent opposing), lack of training (52.5-69.8 percent opposing), lack of leadership skills (29.8-60 percent opposing), lack of communication (22.3-62.1 percent opposing), lack of employee involvement (37.6-50.8 percent opposing) and lack of collaboration among team members (28.6-50 percent opposing). Among the many, results illustrate the need for improving leadership skills of team leaders, improving communication and involving team members in decision making. Originality/value Several studies investigated relationships between teamwork skills and quality of care in many countries. To the authors' knowledge, no local study investigated the deficiencies of teamwork skills among Jordan caregivers and its impact on quality of care. The study provides the ground for management at Jordan hospitals and to healthcare academic departments to tailor training courses to improve teamwork skills of caregivers. Data of this study are collected from the society who is working in the field of healthcare. As the results of this are produced from a real data, it is expected that applying the recommendations will impact the society positively by enhancing the patients' satisfaction.

The effect of resistance training on clinical outcomes in heart failure: A systematic review and meta-analysis.

PubMed

Jewiss, D; Ostman, C; Smart, N A

2016-10-15

To quantify the change in effect sizes, for selected clinical outcome measures, in people with heart failure, from resistance exercise, either in isolation, or in combination with aerobic training. Most exercise training data in heart failure, relates to aerobic exercise, we sought to provide current evidence for the benefits of resistance training in this population. We conducted a MEDLINE search (1985 to May 1, 2016), for exercise based rehabilitation trials in heart failure, using search terms 'resistance training, combined training, left ventricular dysfunction, peak VO2, cardio-myopathy and systolic heart dysfunction'. The 27 included studies provided a total of 2321 participants, 1172 in an intervention and 1149 in either sedentary controls or aerobic exercise only groups, producing over 31,263 patient-hours of training. Mortality, hospitalization, resting blood pressure and Left ventricular fraction were all unchanged with resistance or combined aerobic and resistance training. Peak VO2 was improved in combined exercise vs. control MD of 1.43ml·kg(-1)·min(-1) (95% CI 0.63, 2.23, p=0.0004; and in resistance vs. control MD 3.99ml·kg(-1)·min(-1) (95% CI 1.47, 6.51, p=0.002). Quality of Life (MLwHFQ) was improved in combined vs. control MD -8.31 (95% CI -14.3, -2.33, p=0.006). Six-minute walk distance was improved combined exercise vs. control, MD 13.49m (95% CI 1.13, 25.84, p=0.03); and resistance vs. control MD 41.77m (95% CI 21.90, 61.64, p<0.0001): SMD 1.25 (95%CI 0.53, 1.98, p=0.0007). Resistance only or combined training improves peak VO2, quality of life and walking performance in heart failure patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Nephrology training curriculum and implications for optimal kidney care in the developing world.

PubMed

Okel, Julius; Okpechi, Ike G; Qarni, Bilal; Olanrewaju, Timothy; Courtney, Mark J; Luyckx, Valerie; Naicker, Sarala; Bello, Aminu K

An effective workforce is essential for delivery of high-quality chronic disease care. Low-income nations are challenged by a dearth and/or maldistribution of an essential workforce required for all chronic disease care including chronic kidney disease (CKD). Nephrology education and training in developed countries have grown at pace with the technological advancement in the practice of medicine in order to meet the standards required of kidney health professionals towards high-quality, patient-centered medical care. The standards designed by institutions and/or professional societies, such as Royal Colleges and Medical Councils in high-income nations with well-developed health systems and infrastructures, are often not easily translatable to issues critical to nephrology practice in low-income nations. Little or no guidance is provided on common nephrological issues of regional nature or pertaining to ethnic minorities and disadvantaged groups living in those countries. There is an emergent need for a training curriculum that meets the needs and peculiarities of the developing nations, and this needs to leverage on the existing and well-validated systems of training across the globe. We evaluated nephrology training programs across 25 upper-middle and high-income nations to identify best practices and opportunities for adoption in low-income nations. We reviewed training guidelines from major professional societies on content and process of training. There are similarities and differences in structure, content, and process of training programs across countries, and there are clearly adoptable concepts/frameworks for application in low-income nations. We provide recommendations and a strategic plan for the future focus of nephrology training in the developing world to align with current trends in technological advancement and development as well as the need for emphasis on prevention of CKD. The essential competencies (patient- and population--based) required of a nephrologist in a developing world setting are outlined with practical measures and an action plan for adoption.

A Fully Automated Drosophila Olfactory Classical Conditioning and Testing System for Behavioral Learning and Memory Assessment

PubMed Central

Jiang, Hui; Hanna, Eriny; Gatto, Cheryl L.; Page, Terry L.; Bhuva, Bharat; Broadie, Kendal

2016-01-01

Background Aversive olfactory classical conditioning has been the standard method to assess Drosophila learning and memory behavior for decades, yet training and testing are conducted manually under exceedingly labor-intensive conditions. To overcome this severe limitation, a fully automated, inexpensive system has been developed, which allows accurate and efficient Pavlovian associative learning/memory analyses for high-throughput pharmacological and genetic studies. New Method The automated system employs a linear actuator coupled to an odorant T-maze with airflow-mediated transfer of animals between training and testing stages. Odorant, airflow and electrical shock delivery are automatically administered and monitored during training trials. Control software allows operator-input variables to define parameters of Drosophila learning, short-term memory and long-term memory assays. Results The approach allows accurate learning/memory determinations with operational fail-safes. Automated learning indices (immediately post-training) and memory indices (after 24 hours) are comparable to traditional manual experiments, while minimizing experimenter involvement. Comparison with Existing Methods The automated system provides vast improvements over labor-intensive manual approaches with no experimenter involvement required during either training or testing phases. It provides quality control tracking of airflow rates, odorant delivery and electrical shock treatments, and an expanded platform for high-throughput studies of combinational drug tests and genetic screens. The design uses inexpensive hardware and software for a total cost of ~$500US, making it affordable to a wide range of investigators. Conclusions This study demonstrates the design, construction and testing of a fully automated Drosophila olfactory classical association apparatus to provide low-labor, high-fidelity, quality-monitored, high-throughput and inexpensive learning and memory behavioral assays. PMID:26703418

A fully automated Drosophila olfactory classical conditioning and testing system for behavioral learning and memory assessment.

PubMed

Jiang, Hui; Hanna, Eriny; Gatto, Cheryl L; Page, Terry L; Bhuva, Bharat; Broadie, Kendal

2016-03-01

Aversive olfactory classical conditioning has been the standard method to assess Drosophila learning and memory behavior for decades, yet training and testing are conducted manually under exceedingly labor-intensive conditions. To overcome this severe limitation, a fully automated, inexpensive system has been developed, which allows accurate and efficient Pavlovian associative learning/memory analyses for high-throughput pharmacological and genetic studies. The automated system employs a linear actuator coupled to an odorant T-maze with airflow-mediated transfer of animals between training and testing stages. Odorant, airflow and electrical shock delivery are automatically administered and monitored during training trials. Control software allows operator-input variables to define parameters of Drosophila learning, short-term memory and long-term memory assays. The approach allows accurate learning/memory determinations with operational fail-safes. Automated learning indices (immediately post-training) and memory indices (after 24h) are comparable to traditional manual experiments, while minimizing experimenter involvement. The automated system provides vast improvements over labor-intensive manual approaches with no experimenter involvement required during either training or testing phases. It provides quality control tracking of airflow rates, odorant delivery and electrical shock treatments, and an expanded platform for high-throughput studies of combinational drug tests and genetic screens. The design uses inexpensive hardware and software for a total cost of ∼$500US, making it affordable to a wide range of investigators. This study demonstrates the design, construction and testing of a fully automated Drosophila olfactory classical association apparatus to provide low-labor, high-fidelity, quality-monitored, high-throughput and inexpensive learning and memory behavioral assays. Copyright © 2015 Elsevier B.V. All rights reserved.

Planning and assessing a cross-training initiative with multi-skilled employees.

PubMed

Wermers, M A; Dagnillo, R; Glenn, R; Macfarlane, R; St Clair, V; Scott, D

1996-06-01

An improvement initiative begun by nurses at Parkview Episcopal Medical Center (Pueblo, Colo) to develop patient-focused care delivered by multiskilled workers followed a quality improvement methodology. Implementation of the new care delivery system on a model unit--2 South--provided the opportunity to plan, analyze data, and make changes as appropriate. Parkview's indoctrination of the teachings of W. Edwards Deming has helped leaders and staff realize the integral role of training in improvement activities. In his 14 points, Deming emphasizes the importance of employee education and of the employee having a clear understanding of his or her job. The time and money put into up-front education should help ensure the long-term success of this initiative. DEFINING THE CAREPARTNER: Three new multi-skilled positions were developed on 2 South--a Personal CarePartner, a Business CarePartner, and a Clinical CarePartner. By cross-training each of these roles to perform duties formerly done by centralized departments, 2 South was able to cut costs and time while ensuring quality care. TRAINING THE CAREPARTNER: An internally developed training program provided the new CarePartners with up-front education to prepare them to deliver patient-centered care. 2 South has experienced drops in patient falls and medication errors--areas that are often negatively affected when multi-skilled programs are instituted. Patient and physician surveys have shown increased satisfaction with care provided on the unit. The increased efficiency of the model unit has produced these outcomes while cutting costs substantially. The interdisciplinary team coordinating the improvement project learned many lessons in the process, including the importance of communication, education, and a sense of humor.

The Role of Leaders’ Working Alliance in Premarital Education

PubMed Central

Owen, Jesse J.; Rhoades, Galena K.; Stanley, Scott M.; Markman, Howard J.

2011-01-01

Premarital (and general relationship) education programs, as a prevention method, have been shown to have a positive effect on marital quality and can prevent divorce. However, it is unclear whether these positive effects are consistent across leaders who conduct premarital education programs. Examining the variability in relationship outcomes attributed to the leaders of premarital education programs, and the role of general therapeutic factors such as working alliance in explaining relationship outcomes, may help increase the effectiveness of these programs. Accordingly, this study examined 31 leaders who trained 118 couples (236 attendees) in a randomized clinical trial of PREP, a research-based and empirically supported premarital education program being compared to a treatment as usual track. The results demonstrated that couples’ relationship outcomes from pre to post training varied based on the leader who provided the premarital education training. Both training in PREP and aggregated leader working alliance quality (as rated by attendees) explained variability between leaders in change in attendees’ observed negative and positive communication. Leaders’ aggregated working alliance quality also explained change in relationship satisfaction. Additionally, attendees’ ratings of their leaders’ working alliance predicted change in their relationship satisfaction and confidence, and attendees had higher positive communication when they reported better working alliance with their leader. PMID:21355646

Construction, water-level, and water-quality data for multiple-well monitoring sites and test wells, Fort Irwin National Training Center, San Bernardino County, California, 2009-12

USGS Publications Warehouse

Kjos, Adam R.; Densmore, Jill N.; Nawikas, Joseph M.; Brown, Anthony A.

2014-01-01

Because of increasing water demands at the U.S. Army Fort Irwin National Training Center, the U.S. Geological Survey in cooperation with the U.S. Army carried out a study to evaluate the water quality and potential groundwater supply of undeveloped basins within the U.S. Army Fort Irwin National Training Center. In addition, work was performed in the three developed basins—Langford, Bicycle, and Irwin—proximal to or underlying cantonment to provide information in support of water-resources management and to supplement monitoring in these basins. Between 2009 and 2012, the U.S. Geological Survey installed 41 wells to expand collection of water-resource data within the U.S. Army Fort Irwin National Training Center. Thirty-four monitoring wells (2-inch diameter) were constructed at 14 single- or multiple-well monitoring sites and 7 test wells (8-inch diameter) were installed. The majority of the wells were installed in previously undeveloped or minimally developed basins (Cronise, Red Pass, the Central Corridor area, Superior, Goldstone, and Nelson Basins) proximal to cantonment (primary base housing and infrastructure). Data associated with well construction, water-level monitoring, and water-quality sampling are presented in this report.

A succinct rating scale for radiology report quality

PubMed Central

Yang, Chengwu; Ouyang, Tao; Peterson, Christine M; Sarwani, Nabeel I; Tappouni, Rafel; Bruno, Michael

2014-01-01

Context: Poorly written radiology reports are common among residents and are a significant challenge for radiology education. While training may improve report quality, a professionally developed reliable and valid scale to measure report quality does not exist. Objectives: To develop a measurement tool for report quality, the quality of report scale, with rigorous validation through empirical data. Methods: A research team of an experienced psychometrician and six senior radiologists conducted qualitative and quantitative studies. Five items were identified for the quality of report scale, each measuring a distinct aspect of report quality. Two dedicated training sessions were designed and implemented to help residents generate high-quality reports. In a blinded fashion, the quality of report scale was applied to 804 randomly selected reports issued before (n = 403) and after (n = 401) training. Full-scale psychometrical assessments were implemented onto the quality of report scale’s item- and scale-scores from the reports. The quality of report scale scores were correlated with report professionalism and attendings’ preference and were compared pre-/post-training. Results: The quality of report scale showed sound psychometrical properties, with high validity and reliability. Reports with higher quality of report scale score were more professional and preferable by attendings. Training improved the quality of report scale score, empirically validating the quality of report scale further. Conclusion: While succinct and practitioner friendly, the quality of report scale is a reliable and valid measure of radiology report quality and has the potential to be easily adapted to other fields such as pathology, where similar training would be beneficial. PMID:26770756

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

PubMed

Al-Bustani, Saif; Halvorson, Eric G

2016-06-01

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

Water-based exercise training for chronic obstructive pulmonary disease.

PubMed

McNamara, Renae J; McKeough, Zoe J; McKenzie, David K; Alison, Jennifer A

2013-12-18

Land-based exercise training improves exercise capacity and quality of life in people with chronic obstructive pulmonary disease (COPD). Water-based exercise training is an alternative mode of physical exercise training that may appeal to the older population attending pulmonary rehabilitation programmes, those who are unable to complete land-based exercise programmes and people with COPD with comorbid physical and medical conditions. To assess the effects of water-based exercise training in people with COPD. A search of the Cochrane Airways Group Specialised Register of trials, which is derived from systematic searches of bibliographic databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED and PsycINFO, was conducted (from inception to August 2013). Handsearching was done to identify further qualifying studies from reference lists of relevant studies. Review authors included randomised or quasi-randomised controlled trials in which water-based exercise training of at least four weeks' duration was compared with no exercise training or any other form of exercise training in people with COPD. Swimming was excluded. We used standard methodological procedures expected by The Cochrane Collaboration. Five studies were included with a total of 176 participants (71 people participated in water-based exercise training and 54 in land-based exercise training; 51 completed no exercise training). All studies compared supervised water-based exercise training versus land-based exercise training and/or no exercise training in people with COPD (with average forced expiratory volume in one second (FEV1) %predicted ranging from 39% to 62%). Sample sizes ranged from 11 to 53 participants. The exercise training programmes lasted from four to 12 weeks, and the mean age of participants ranged from 57 to 73 years. A moderate risk of bias was due to lack of reporting of randomisation, allocation and blinding procedures in some studies, as well as small sample sizes.Compared with no exercise, water-based exercise training improved the six-minute walk distance (mean difference (MD) 62 metres; 95% confidence interval (CI) 44 to 80 metres; three studies; 99 participants; moderate quality evidence), the incremental shuttle walk distance (MD 50 metres; 95% CI 20 to 80 metres; one study; 30 participants; high quality evidence) and the endurance shuttle walk distance (MD 371 metres; 95% CI 121 to 621 metres; one study; 30 participants; high quality evidence). Quality of life was also improved after water-based exercise training compared with no exercise (standardised mean difference (SMD) -0.97, 95% CI -0.37 to -1.57; two studies; 49 participants; low quality evidence). Compared with land-based exercise training, water-based exercise training did not significantly change the six-minute walk distance (MD 11 metres; 95% CI -11 to 33 metres; three studies; 62 participants; moderate quality evidence) or the incremental shuttle walk distance (MD 9 metres; 95% CI -15 to 34 metres; two studies; 59 participants; low quality evidence). However, the endurance shuttle walk distance improved following water-based exercise training compared with land-based exercise training (MD 313 metres; 95% CI 232 to 394 metres; two studies; 59 participants; moderate quality evidence). No significant differences were found between water-based exercise training and land-based exercise training for quality of life, as measured by the St George's Respiratory Questionnaire or by three of four domains of the Chronic Respiratory Disease Questionnaire (CRDQ); however, the fatigue domain of the CRDQ showed a statistically significant difference in favour of water-based exercise (MD -3.00; 95% CI -5.26 to -0.74; one study; 30 participants). Only one study reported long-term outcomes after water-based exercise training for quality of life and body composition, and no significant change was observed between baseline results and six-month follow-up results. One minor adverse event was reported for water-based exercise training (based on reporting from two studies; 20 participants). Impact of disease severity could not be examined because data were insufficient. There is limited quality evidence that water-based exercise training is safe and improves exercise capacity and quality of life in people with COPD immediately after training. There is limited quality evidence that water-based exercise training offers advantages over land-based exercise training in improving endurance exercise capacity, but we remain uncertain as to whether it leads to better quality of life. Little evidence exists examining the long-term effect of water-based exercise training.

Delivery of health surveillance for hand-arm vibration in the West Midlands.

PubMed

Kinoulty, Mary

2006-01-01

Concerns about provider competence and quality of hand-arm vibrations (HAVs) health surveillance programmes were identified by Health & Safety Executive (HSE) inspectors. To evaluate health surveillance programmes and compare them with published HSE guidance. To identify deficiencies and areas for improvement in the health surveillance programmes. A proforma was developed for the study and used on a sample of 10 local occupational health providers. All 10 organizations were aware of current HSE guidance for health surveillance for HAVs but only a minority (30%) were following it. Occupational health provider training, written procedures and health surveillance delivery were all identified as areas requiring improvement. The majority of organizations were not following HSE guidance. Occupational health providers undertaking health surveillance for HAV require specific training.

Does assist-as-needed upper limb robotic therapy promote participation in repetitive activity-based motor training in sub-acute stroke patients with severe paresis?

PubMed

Grosmaire, Anne-Gaëlle; Duret, Christophe

2017-01-01

Repetitive, active movement-based training promotes brain plasticity and motor recovery after stroke. Robotic therapy provides highly repetitive therapy that reduces motor impairment. However, the effect of assist-as-needed algorithms on patient participation and movement quality is not known. To analyze patient participation and motor performance during highly repetitive assist-as-needed upper limb robotic therapy in a retrospective study. Sixteen patients with sub-acute stroke carried out a 16-session upper limb robotic training program combined with usual care. The Fugl-Meyer Assessment (FMA) score was evaluated pre and post training. Robotic assistance parameters and Performance measures were compared within and across sessions. Robotic assistance did not change within-session and decreased between sessions during the training program. Motor performance did not decrease within-session and improved between sessions. Velocity-related assistance parameters improved more quickly than accuracy-related parameters. An assist-as-needed-based upper limb robotic training provided intense and repetitive rehabilitation and promoted patient participation and motor performance, facilitating motor recovery.

Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence.

PubMed

Bosch-Capblanch, Xavier; Marceau, Claudine

2014-12-01

To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which included additional support of equipment and supplies, seemed to improve selected quality of care outcomes. However, current evaluation and reporting practices need to be revised in a new research agenda to address the methodological challenges of iCCM evaluations.

Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

PubMed Central

Bosch–Capblanch, Xavier; Marceau, Claudine

2014-01-01

Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong components of training, supervision, which included additional support of equipment and supplies, seemed to improve selected quality of care outcomes. However, current evaluation and reporting practices need to be revised in a new research agenda to address the methodological challenges of iCCM evaluations. PMID:25520793

Quality of Documentation as a Surrogate Marker for Awareness and Training Effectiveness of PHTLS-Courses. Part of the Prospective Longitudinal Mixed-Methods EPPTC-Trial.

PubMed

Häske, David; Beckers, Stefan K; Hofmann, Marzellus; Lefering, Rolf; Gliwitzky, Bernhard; Wölfl, Christoph C; Grützner, Paul; Stöckle, Ulrich; Dieroff, Marc; Münzberg, Matthias

2017-01-01

Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness. This was a prospective pre-post intervention trial and was part of the mixed-method longitudinal EPPTC (Effect of Paramedic Training on Pre-Hospital Trauma Care) study, evaluating subjective and objective changes among participants and real patient care, as a result of PHTLS courses. The courses provide an overview of the SAMPLE approach for interrogation of anamnestic information, which is believed to be responsible for patient safety as relevant, among others, "Allergies," "Medication," and "Patient History" (AMP). The focus of the course is not the documentation. In total, 320 protocols were analyzed before and after the training. The PHTLS course led to a significant increase (p < 0.001) in the "AMP" information in the documentation. The subgroups analysis of "allergies" (+47.2%), "drugs" (+38.1%), and "medical history" (+27.8%) before and after the PHTLS course showed a significant increase in the information content. In summary, we showed that PHTLS training improves documentation quality, which we used as a surrogate endpoint for learning effectiveness and awareness. In this regard, we demonstrated that participants use certain parts of training in real life, thereby suggesting that the learning methods of PHTLS training are effective. These results, however, do not indicate whether patient care has changed.

[MODERN EDUCATIONAL TECHNOLOGY MASTERING PRACTICAL SKILLS OF GENERAL PRACTITIONERS].

PubMed

Kovalchuk, L I; Prokopchuk, Y V; Naydyonova, O V

2015-01-01

The article presents the experience of postgraduate training of general practitioners--family medicine. Identified current trends, forms and methods of pedagogical innovations that enhance the quality of learning and mastering the practical skills of primary professionals providing care.

Science Matters.

ERIC Educational Resources Information Center

Blanchard, Pam

2000-01-01

Describes Louisiana Sea Grant's most recent marine education program, the coastal Ecosystem Stewardship project. Its purpose is to provide students with background information on wetlands management issues; training in basic water quality monitoring methods, data collection, and manipulation; and opportunities to participate in a restoration…

Criteria for determining safe water conditions for underwater operations.

DOT National Transportation Integrated Search

1984-01-01

Virginia Department of Highways and Transportation employees trained in the use of SCUBA inspect certain of the Department's bridges and provide a degree of quality control for inspections done under contract. Safety standards to be followed in divin...

20 CFR 670.525 - What residential support services must Job Corps center operators provide?

Code of Federal Regulations, 2013 CFR

2013-04-01

... issued by the Secretary: (a) A quality living and learning environment that supports the overall training..., vending machines, disciplinary fines, and donations, and is run by an elected student government, with the...

20 CFR 670.525 - What residential support services must Job Corps center operators provide?

Code of Federal Regulations, 2012 CFR

2012-04-01

... issued by the Secretary: (a) A quality living and learning environment that supports the overall training..., vending machines, disciplinary fines, and donations, and is run by an elected student government, with the...

20 CFR 670.525 - What residential support services must Job Corps center operators provide?

Code of Federal Regulations, 2014 CFR

2014-04-01

... issued by the Secretary: (a) A quality living and learning environment that supports the overall training..., vending machines, disciplinary fines, and donations, and is run by an elected student government, with the...

Paediatric emergency and acute care in resource poor settings.

PubMed

Duke, Trevor; Cheema, Baljit

2016-02-01

Acute care of seriously ill children is a global public health issue, and there is much scope for improving quality of care in hospitals at all levels in many developing countries. We describe the current state of paediatric emergency and acute care in the least developed regions of low and middle income countries and identify gaps and requirements for improving quality. Approaches are needed which span the continuum of care: from triage and emergency treatment, the diagnostic process, identification of co-morbidities, treatment, monitoring and supportive care, discharge planning and follow-up. Improvements require support and training for health workers and quality processes. Effective training is that which is ongoing, combining good technical training in under-graduate courses and continuing professional development. Quality processes combine evidence-based guidelines, essential medicines, appropriate technology, appropriate financing of services, standards and assessment tools and training resources. While initial emergency treatment is based on common clinical syndromes, early differentiation is required for specific treatment, and this can usually be carried out clinically without expensive tests. While global strategies are important, it is what happens locally that makes a difference and is too often neglected. In rural areas in the poorest countries in the world, public doctors and nurses who provide emergency and acute care for children are revered by their communities and demonstrate daily that much can be carried out with little. © 2016 The Authors. Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Job/Task Analysis: Enhancing the Commercial Building Workforce Through the Development of Foundational Materials; Preprint

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

Studer, D.; Kemkar, S.

2012-09-01

For many commercial building operation job categories, industry consensus has not been reached on the knowledge, skills, and abilities that practitioners should possess. The goal of this guidance is to help streamline the minimum competencies taught or tested by organizations catering to building operations and maintenance personnel while providing a basis for developing and comparing new and existing training programs in the commercial building sector. The developed JTAs will help individuals identify opportunities to enhance their professional skills, enable industry to identify an appropriately skilled workforce, and allow training providers to ensure that they are providing the highest quality productmore » possible.« less

Effect of Auditory-Perceptual Training With Natural Voice Anchors on Vocal Quality Evaluation.

PubMed

Dos Santos, Priscila Campos Martins; Vieira, Maurílio Nunes; Sansão, João Pedro Hallack; Gama, Ana Cristina Côrtes

2018-01-10

To analyze the effects of auditory-perceptual training with anchor stimuli of natural voices on inter-rater agreement during the assessment of vocal quality. This is a quantitative nature study. An auditory-perceptual training site was developed consisting of Programming Interface A, an auditory training activity, and Programming Interface B, a control activity. Each interface had three stages: pre-training/pre-interval evaluation, training/interval, and post-training/post-interval evaluation. Two experienced evaluators classified 381 voices according to the GRBASI scale (G-grade, R-roughness, B-breathiness, A-asthenia, S-strain, I-instability). Voices were selected that received the same evaluation by both evaluators: 57 voices for evaluation and 56 for training were selected, with varying degrees of deviation across parameters. Fifteen inexperienced evaluators were then selected. In the pre-, post-training, pre-, and postinterval stages, evaluators listened to the voices and classified them via the GRBASI scale. In the stage interval evaluators read a text. In the stage training each parameter was trained separately. Evaluators analyzed the degrees of deviation of the GRBASI parameters based on anchor stimuli, and could only advance after correctly classifying the voices. To quantify inter-rater agreement and provide statistical analyses, the AC1 coefficient, confidence intervals, and percentage variation of agreement were employed. Except for the asthenia parameter, decreased agreement was observed in the control condition. Improved agreement was observed with auditory training, but this improvement did not achieve statistical significance. Training with natural voice anchors suggest an increased inter-rater agreement during perceptual voice analysis, potentially indicating that new internal references were established. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Response to Bodin and Grote regarding postdoctoral recruitment in clinical neuropsychology.

PubMed

Nelson, Aaron; Bilder, Robert M; O'Connor, Margaret; Brandt, Jason; Weintraub, Sandra; Bauer, Russell M

2016-07-01

Bodin and Grote convey their opinion that the field of clinical neuropsychology would be best served by a match system for recruitment into postdoctoral training. We critically review their arguments and offer an alternative point of view. Our view considers the current state of the match system in neuropsychology, incorporates comparisons with other disciplines that rely on a match system, and addresses the role of postdoctoral training and the specialization that takes shape at this level. We make recommendations aimed at promoting greater unity among postdoctoral training programs with the goal of focusing leadership efforts on advancing our shared mission of providing the highest quality training in clinical neuropsychology.

Integrating team training strategies into obstetrical emergency simulation training.

PubMed

Daniel, Linda T; Simpson, Ellen K

2009-01-01

Successful management of obstetrical emergencies such as shoulder dystocia requires the coordinated efforts of a multidisciplinary team of professionals. Simulation education provides an opportunity to learn and master simple as well as complex technical skills needed in emergent situations. Team training has been shown to improve the quality of communication among team members and consequently has an enormous impact on human performance. In the healthcare environment, especially obstetrics where the stakes are high, integrating team training into simulation education can advance efforts to create and sustain a culture of safety. With over 7,100 deliveries annually, our 1,100-bed, two-hospital regional healthcare system embarked on this journey to advance the culture of safety.

Applying lessons from commercial aviation safety and operations to resuscitation.

PubMed

Ornato, Joseph P; Peberdy, Mary Ann

2014-02-01

Both commercial aviation and resuscitation are complex activities in which team members must respond to unexpected emergencies in a consistent, high quality manner. Lives are at stake in both activities and the two disciplines have similar leadership structures, standard setting processes, training methods, and operational tools. Commercial aviation crews operate with remarkable consistency and safety, while resuscitation team performance and outcomes are highly variable. This commentary provides the perspective of two physician-pilots showing how commercial aviation training, operations, and safety principles can be adapted to resuscitation team training and performance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Emergency medical conference South Africa, October 1998--a report on proceedings and clinical visits.

PubMed

Hodgetts, T J

1999-06-01

The South Africans are keen to adopt the Major Incident Medical Management and Support course, developed in the UK. South Africa can provide an excellent training ground for military personnel in the triage, resuscitation and surgical management of the patient with penetrating trauma. Johannesburg General Hospital has a high quality training system under the direction of Dr Ken Boffard. The nearby Baragwaneth Hospital is the closest to military surgical practice one can probably get in a civilian setting. There is an unprecedented opportunity for clinical skills training, and a wealth of research opportunities.

Leadership in Surgery

PubMed Central

Maykel, Justin A.

2013-01-01

Many opportunities exist for surgeons to be leaders in healthcare. Leadership training should begin in medical school and continue throughout residency training and in clinical practice. Most leadership skills can be developed and refined through a variety of training programs. Formal programs that result in degrees can provide surgeons with special insight, experience, and skill sets. Leadership skills are used in everyday practice and are particularly valuable when shifting roles or taking on new positions, whether at your home institution or within national organizations. Ultimately, physician leaders are responsible for leading healthcare and will directly impact the quality of care delivered to our patients. PMID:24436687

Building and Maintaining Organizational Infrastructure to Attain Clinical Excellence.

PubMed

Lebak, Kelly; Lane, Jason; Taus, Richard; Kim, Hansol; Stecker, Michael S; Hall, Michael; Lane-Fall, Meghan B; Weiss, Mark S

2017-12-01

Active maintenance of highly functional teams is critical to ensuring safe, efficient patient care in the non-operating room anesthesia (NORA) suite. In addition to developing collaborative relationships and patient care protocols, individual and team training is needed. For anesthesiologists, this training must begin during residency. The training should be supplemented with continuing education in this field for providers who find themselves working in the NORA space. As NORA continues to grow, robust NORA-specific quality assurance and improvement programs will empower anesthesiologists with the tools they need to best care for these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

NASA Space Biology Research Associate Program for the 21st Century

NASA Technical Reports Server (NTRS)

Sonnenfeld, Gerald

2000-01-01

The Space Biology Research Associate Program for the 21st Century provided a unique opportunity to train individuals to conduct biological research in hypo- and hyper-gravity, and to conduct ground-based research. This grant was developed to maximize the potential for Space Biology as an emerging discipline and to train a cadre of space biologists. The field of gravitational and space biology is rapidly growing at the future of the field is reflected in the quality and education of its personnel. Our chief objective was to train and develop these scientists rapidly and in a cost effective model.

Training hospital managers for strategic planning and management: a prospective study.

PubMed

Terzic-Supic, Zorica; Bjegovic-Mikanovic, Vesna; Vukovic, Dejana; Santric-Milicevic, Milena; Marinkovic, Jelena; Vasic, Vladimir; Laaser, Ulrich

2015-02-26

Training is the systematic acquisition of skills, rules, concepts, or attitudes and is one of the most important components in any organization's strategy. There is increasing demand for formal and informal training programs especially for physicians in leadership positions. This study determined the learning outcomes after a specific training program for hospital management teams. The study was conducted during 2006 and 2007 at the Centre School of Public Health and Management, Faculty of Medicine, University of Belgrade and included 107 participants involved in the management in 20 Serbian general hospitals. The management teams were multidisciplinary, consisting of five members on average: the director of the general hospital, the deputy directors, the head nurse, and the chiefs of support services. The managers attended a training program, which comprised four modules addressing specific topics. Three reviewers independently evaluated the level of management skills at the beginning and 12 months after the training program. Principal component analysis and subsequent stepwise multiple linear regression analysis were performed to determine predictors of learning outcomes. The quality of the SWOT (strengths, weaknesses, opportunities and threats) analyses performed by the trainees improved with differences between 0.35 and 0.49 on a Likert scale (p < 0.001). Principal component analysis explained 81% of the variance affecting their quality of strategic planning. Following the training program, the external environment, strategic positioning, and quality of care were predictors of learning outcomes. The four regression models used showed that the training program had positive effects (p < 0.001) on the ability to formulate a Strategic Plan comprising the hospital mission, vision, strategic objectives, and action plan. This study provided evidence that training for strategic planning and management enhanced the strategic decision-making of hospital management teams, which is a requirement for hospitals in an increasingly competitive, complex and challenging context. For the first time, half of state general hospitals involved in team training have formulated the development of an official strategic plan. The positive effects of the formal training program justify additional investment in future education and training.

A comparison of how behavioral health organizations utilize training to prepare for health care reform.

PubMed

Stanhope, Victoria; Choy-Brown, Mimi; Barrenger, Stacey; Manuel, Jennifer; Mercado, Micaela; McKay, Mary; Marcus, Steven C

2017-02-14

Under the Affordable Care Act, States have obtained Medicaid waivers to overhaul their behavioral health service systems to improve quality and reduce costs. Critical to implementation of broad service delivery reforms has been the preparation of organizations responsible for service delivery. This study focused on one large-scale initiative to overhaul its service system with the goal of improving service quality and reducing costs. The study examined the participation of behavioral health organizations in technical assistance efforts and the extent to which organizational factors related to their participation. This study matched two datasets to examine the organizational characteristics and training participation for 196 behavioral health organizations. Organizational characteristics were drawn from the Substance Abuse and Mental Health Services Administration National Mental Health Services Survey (N-MHSS). Training variables were drawn from the Clinical Technical Assistance Center's master training database. Chi-square analyses and multivariate logistic regression models were used to examine the proportion of organizations that participated in training, the organizational characteristics (size, population served, service quality, infrastructure) that predicted participation in training, and for those who participated, the type (clinical or business) and intensity of training (webinar, learning collaborative, in-person) they received. Overall 142 (72. 4%) of the sample participated in training. Organizations who pursued training were more likely to be large in size (p = .02), serve children in addition to adults (p < .01), provide child evidence-based practices (p = .01), and use computerized scheduling (p = .01). Of those trained, 95% participated in webinars, 64% participated in learning collaboratives and 35% participated in in-person trainings. More organizations participated in business trainings than clinical (63.8 vs. 59.2%). Organizations serving children had higher odds of participating in both clinical training (OR = 5.91, p < .01) and business training (OR = 4.24, p < .01) than those that did not serve children. The majority of organizations participated in trainings indicating desire for technical assistance to prepare for health care reform. Larger organizations and organizations serving children were more likely to participate potentially indicating increased interest in preparation. Over half participated in business trainings highlighting interest in learning to improve efficiency. Further understanding is needed to support organizational readiness for health care reform initiatives among behavioral health organizations.

Effectiveness of a multi-level implementation strategy for ASD interventions: study protocol for two linked cluster randomized trials.

PubMed

Brookman-Frazee, Lauren; Stahmer, Aubyn C

2018-05-09

The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS modules individually and together on multiple implementation outcomes. Implementation outcomes including provider training completion, fidelity (coded by observers blind to group assignment) and child behavior change will be examined for 295 mental health providers, 295 teachers, and 590 children. This implementation intervention has the potential to increase quality of care for ASD in publicly funded settings by improving effectiveness of intervention implementation. The process and modules will be generalizable to multiple service systems, providers, and interventions, providing broad impact in community services. This study is registered with Clinicaltrials.gov ( NCT03380078 ). Registered 20 December 2017, retrospectively registered.

A comparison between stabilization exercises and pelvic floor muscle training in women with pelvic organ prolapse.

PubMed

Özengin, Nuriye; Ün Yıldırım, Necmiye; Duran, Bülent

2015-03-01

This study aimed to compare the effectiveness of stabilization exercises and pelvic floor muscle training in women with stage 1 and 2 pelvic organ prolapse. In a total 38 women with pelvic organ prolapse whose average age was 45.60 years, pelvic floor muscles were evaluated with electromyography, and prolapse with pelvic organ prolapse quantification system, and the quality of life with prolapse quality of life questionnaire. Afterwards, the subjects were divided into two groups; stabilization exercise group (n=19) and pelvic floor muscle training group (n=19). Stabilization exercise group were given training for 8 weeks, 3 times a week. Pelvic floor muscle training group were given eight-week home exercises. Each group was assessed before training and after eight weeks. An increase was found in the pelvic muscle activation response in the 2 groups (p≤0.05). There was no difference in EMG activity values between the groups (p>0.05). A difference was found in the values Aa, Ba and C in subjects of each group (p≤0.05), and the TVL, Ap, Bp and D values of subjects in pelvic floor muscle training group (p≤0.05) in the before and after pelvic organ prolapse quantification system assessment, however, no difference was found between the groups (p≤0.05). A positive difference was found in the effect of prolapse sub parameter in each of the two groups, and in general health perception sub parameter in subjects of stabilization exercise group (p<0.05) in the prolapse quality of life questionnaire. It was concluded that both training programs increased the pelvic floor muscle strength, provided a decline in prolapse stages. Stabilization exercise has increased general health perception unlike home training, thus, these exercises can be added to the treatment of women with prolapse.

A comparison between stabilization exercises and pelvic floor muscle training in women with pelvic organ prolapse

PubMed Central

Özengin, Nuriye; Ün Yıldırım, Necmiye; Duran, Bülent

2015-01-01

Objective: This study aimed to compare the effectiveness of stabilization exercises and pelvic floor muscle training in women with stage 1 and 2 pelvic organ prolapse. Materials and Methods: In a total 38 women with pelvic organ prolapse whose average age was 45.60 years, pelvic floor muscles were evaluated with electromyography, and prolapse with pelvic organ prolapse quantification system, and the quality of life with prolapse quality of life questionnaire. Afterwards, the subjects were divided into two groups; stabilization exercise group (n=19) and pelvic floor muscle training group (n=19). Stabilization exercise group were given training for 8 weeks, 3 times a week. Pelvic floor muscle training group were given eight-week home exercises. Each group was assessed before training and after eight weeks. Results: An increase was found in the pelvic muscle activation response in the 2 groups (p≤0.05). There was no difference in EMG activity values between the groups (p>0.05). A difference was found in the values Aa, Ba and C in subjects of each group (p≤0.05), and the TVL, Ap, Bp and D values of subjects in pelvic floor muscle training group (p≤0.05) in the before and after pelvic organ prolapse quantification system assessment, however, no difference was found between the groups (p≤0.05). A positive difference was found in the effect of prolapse sub parameter in each of the two groups, and in general health perception sub parameter in subjects of stabilization exercise group (p<0.05) in the prolapse quality of life questionnaire. Conclusions: It was concluded that both training programs increased the pelvic floor muscle strength, provided a decline in prolapse stages. Stabilization exercise has increased general health perception unlike home training, thus, these exercises can be added to the treatment of women with prolapse. PMID:28913034

Factors influencing intercultural doctor-patient communication: a realist review.

PubMed

Paternotte, Emma; van Dulmen, Sandra; van der Lee, Nadine; Scherpbier, Albert J J A; Scheele, Fedde

2015-04-01

Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This study aimed to provide an overview of the literature and to explore how ICC works. A systematic search was performed to find literature published before October 2012. The search terms used were cultural, communication, healthcare worker. A realist synthesis allowed us to use an explanatory focus to understand the interplay of communication. In total, 145 articles met the inclusion criteria. We found ICC challenges due to language, cultural and social differences, and doctors' assumptions. The mechanisms were described as factors influencing the process of ICC and divided into objectives, core skills and specific skills. The results were synthesized in a framework for the development of training. The quality of ICC is influenced by the context and by the mechanisms. These mechanisms translate into practical points for training, which seem to have similarities with patient-centered communication. Training for improving ICC can be developed as an extension of the existing training for patient-centered communication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Practice-based Learning and Improvement (PBLI) in Postgraduate Medical Training: Milestones, Instructional and Assessment strategies.

PubMed

Mahajan, Rajiv; Anshu, -; Gupta, Piyush; Singh, Tejinder

2017-04-15

Patient-safety and quality-improvement are high-priority issues. One of the ways by which this can be implemented is by training residents to gather and appraise scientific evidence, as well as to evaluate their own patient-care practices. This competency is called Practice-based Learning and Improvement (PBLI). Training in PBLI provides residents with skills and knowledge necessary to reflect on their own strengths and deficiencies, identify their own learning needs, and engage in learning for improvement. PBLI also involves teaching residents to access and integrate literature by using scientific evidence and practice experience to make better clinical decisions. Training in PBLI has been found to lead to better health outcomes. We recommend explicitly incorporating elements of PBLI training and assessment in the present residency training curriculum in India. Implementing PBLI training and assessment will also require capacity-building through targeted faculty development programs.

Family planning providers' perspectives on family planning service delivery in Ibadan and Kaduna, Nigeria: a qualitative study.

PubMed

Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna

2013-01-01

In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.

The effect of facilitator training on the development and practice of participants in an online induction program for teachers of science and mathematics

NASA Astrophysics Data System (ADS)

Taylor, Peggy Sue

Learning in computer-mediated conferencing systems requires frequent and open interaction in environments that foster sharing and examination of group knowledge and experiences. Written dialogue is the means by which this interaction takes place. This study examined the effects of a training program designed for facilitators in the e-Mentoring for Student Success (eMSS) program, which provides online induction for beginning science and mathematics teachers. The training was designed to improve the quality of dialogue among participants in the program. The intervention consisted of three components: (1) an online training institute prior to beginning of the program year, (2) placement of facilitators in positions within the discussion areas of the program, and (3) ongoing online support for practicing facilitators. Three examinations were conducted in this mixed-method study. First, preintervention program dialogue was quantitatively compared to post-intervention program dialogue through use of a program-specific rubric to code program discussions. Second, case studies were conducted to determine how the training affected the practices of seven program facilitators and which components of the training effected change or growth. Third, pre and post intervention surveys were administered to all participants of the training to obtain their perceptions of their development as a result of the intervention. Comparison of dialogue before and after the intervention indicated a significant improvement in dialogue quality in the discussion areas of the program. Case studies of facilitators' practices revealed areas of the training that impacted the skills and strategies that facilitators used in efforts to foster increased and improved dialogue. Survey results indicated that participants gained a better understanding of what constituted quality dialogue in terms of the eMSS program and how better to foster quality dialogue in an online environment. Components of the training found to be effective in helping facilitators to foster dialogue improvement were: (1) focus on program goals and vision, (2) focus on the nature of online communication, (3) practice with the analysis of actual program dialogue, (4) practice in composing effective online messages. Implications for online facilitators are discussed and recommendations are made for designing training for facilitators to work in computer-mediated conferences.

Evaluating ambulatory care training in Firoozgar hospital based on Iranian national standards of undergraduate medical education

PubMed Central

Sabzghabaei, Foroogh; Salajeghe, Mahla; Soltani Arabshahi, Seyed Kamran

2017-01-01

Background: In this study, ambulatory care training in Firoozgar hospital was evaluated based on Iranian national standards of undergraduate medical education related to ambulatory education using Baldrige Excellence Model. Moreover, some suggestions were offered to promote education quality in the current condition of ambulatory education in Firoozgar hospital and national standards using the gap analysis method. Methods: This descriptive analytic study was a kind of evaluation research performed using the standard check lists published by the office of undergraduate medical education council. Data were collected through surveying documents, interviewing, and observing the processes based on the Baldrige Excellence Model. After confirming the validity and reliability of the check lists, we evaluated the establishment level of the national standards of undergraduate medical education in the clinics of this hospital in the 4 following domains: educational program, evaluation, training and research resources, and faculty members. Data were analyzed according to the national standards of undergraduate medical education related to ambulatory education and the Baldrige table for scoring. Finally, the quality level of the current condition was determined as very appropriate, appropriate, medium, weak, and very weak. Results: In domains of educational program 62%, in evaluation 48%, in training and research resources 46%, in faculty members 68%, and in overall ratio, 56% of the standards were appropriate. Conclusion: The most successful domains were educational program and faculty members, but evaluation and training and research resources domains had a medium performance. Some domains and indicators were determined as weak and their quality needed to be improved, so it is suggested to provide the necessary facilities and improvements by attending to the quality level of the national standards of ambulatory education PMID:29951400

Total Quality Training: The Quality Culture and Quality Trainer.

ERIC Educational Resources Information Center

Thomas, Brian

This book examines the application of total quality management (TQM) principles to training and development. It contains 10 chapters on the following topics: the quality revolution (the nature of and rationale for quality); major barriers to achieving quality (supplier-led approaches, problems with customers, throughput orientation, variable…

Effects of brief training on use of automated external defibrillators by people without medical expertise.

PubMed

Mitchell, K Blake; Gugerty, Leo; Muth, Eric

2008-04-01

This study examined the effect of three types of brief training on the use of automatic external defibrillators (AEDs) by 43 lay users. Because AEDs were recently approved for home use, brief training for nonprofessional users needs investigation. During training, the exposure training group read an article about AEDs that provided no information on how to operate them; the low-training group inspected the AED and read the operating instructions in the paper-based manual but was not allowed to use the device; and the high-training group watched a training video and performed a mock resuscitation using the AED but no manikin. All participants returned 2 weeks later and performed a surprise simulated AED resuscitation on a manikin. Most participants in each training group met criteria of minimally acceptable performance during the simulated manikin resuscitation, as measured by time to first shock, pad placement accuracy, and safety check performance. All participants who committed errors were able to successfully recover from them to complete the resuscitation. Compared with exposure training, the low and high training had a beneficial effect on time to first shock and errors. Untrained users were able to adequately use this AED, demonstrating walk-up-and-use usability, but additional brief training improved user performance. This study demonstrated the importance of providing high-quality but brief training for home AED users. In conjunction with other findings, the current study helps demonstrate the need for well-designed training for consumer medical devices.

Quality and Quality Assurance in Vocational Education and Training in the Mediterranean Countries: Lessons from the European Approach

ERIC Educational Resources Information Center

Masson, Jean-Raymond; Baati, Mounir; Seyfried, Erwin

2010-01-01

This article reflects on the development of the European approach towards quality and quality assurance in vocational education and training (VET) and its relevance for VET reforms in the European Training Foundation (ETF) partner countries. The analysis is based on an ETF project conducted in 2007-2008 in the Mediterranean partner countries to…

Leadership, collaboration, and effective training principles and practices from a decade of training by a center for public health preparedness.

PubMed

Reid, William Michael; Brown, Lisa M; Landis, Danielle C

2014-01-01

To review a decade's experience of a Centers for Disease Control and Preparedness (CDC) funded Center for Public Health Preparedness (hereafter referred to as the Center) and to identify interventions that led to surmounting serious obstacles to achieving the Center's CDC-mandated goals and objectives. The Center's purpose was to train the public health workforce to protect the population from bioterrorism, infectious diseases, and emerging public health threats. This case study used the concepts of the judgment process as developed by Noel Tichy and Warren Bennis to describe the experiences and actions of the Center's leaders. Center staff used public health principles of collaboration, the use of relevant science, and professional training principles in developing and delivering training in epidemiology, behavioral health, crisis leadership, and other fields through distance learning and on-site methods. The study's primary focus was on training in Florida, although the program's reach was national and international. Preparedness training was provided to approximately 10,000 public health officials, primarily drawn from Florida. This is a descriptive study of the Center's activities. The interventions were the steps taken by Center leadership to accomplish the federal and state goals of the program, despite meeting major challenges. The outcome measures were degrees of success, as measured by federal and state officials and other indicators, in delivering high quality training that met CDC and state goals. The Center delivered trainings in fields determined to be needed in Florida and nationally. Participant and observer evaluations were strongly positive. Nationally published papers and presentations contributed to the training evidence base. The Florida Department of Health incorporated the trainings into Florida's mandatory training for Incident Command strike teams. The leaders of the Center and the Florida Department of Health developed a formal statement of principles to guide the training. These could be useful to other training organizations. The study illustrates the value of the Tichy and Bennis judgment process framework to describe actions of the Center leadership's successful effort to overcome system obstacles and provide high quality training to public health workers. The framework can be used by leaders in other organizations to increase their ability to make good judgments.

Psychiatric Residents' Views of Quality of Psychotherapy Training and Psychotherapy Competencies: A Multisite Survey

ERIC Educational Resources Information Center

Calabrese, Christina; Sciolla, Andres; Zisook, Sidney; Bitner, Robin; Tuttle, Jeffrey; Dunn, Laura B.

2010-01-01

Objective: Few studies of residents' attitudes toward psychotherapy training exist. The authors examined residents' perceptions of the quality of their training, support for training, their own competence levels, and associations between self-perceived competence and perceptions of the training environment. Methods: An anonymous, web-based…

Assessment of groundwater quality: a fusion of geochemical and geophysical information via Bayesian neural networks.

PubMed

Maiti, Saumen; Erram, V C; Gupta, Gautam; Tiwari, Ram Krishna; Kulkarni, U D; Sangpal, R R

2013-04-01

Deplorable quality of groundwater arising from saltwater intrusion, natural leaching and anthropogenic activities is one of the major concerns for the society. Assessment of groundwater quality is, therefore, a primary objective of scientific research. Here, we propose an artificial neural network-based method set in a Bayesian neural network (BNN) framework and employ it to assess groundwater quality. The approach is based on analyzing 36 water samples and inverting up to 85 Schlumberger vertical electrical sounding data. We constructed a priori model by suitably parameterizing geochemical and geophysical data collected from the western part of India. The posterior model (post-inversion) was estimated using the BNN learning procedure and global hybrid Monte Carlo/Markov Chain Monte Carlo optimization scheme. By suitable parameterization of geochemical and geophysical parameters, we simulated 1,500 training samples, out of which 50 % samples were used for training and remaining 50 % were used for validation and testing. We show that the trained model is able to classify validation and test samples with 85 % and 80 % accuracy respectively. Based on cross-correlation analysis and Gibb's diagram of geochemical attributes, the groundwater qualities of the study area were classified into following three categories: "Very good", "Good", and "Unsuitable". The BNN model-based results suggest that groundwater quality falls mostly in the range of "Good" to "Very good" except for some places near the Arabian Sea. The new modeling results powered by uncertainty and statistical analyses would provide useful constrain, which could be utilized in monitoring and assessment of the groundwater quality.

Home-Based Child Care Provider Education and Specialized Training: Associations with Caregiving Quality and Toddler Social-Emotional and Cognitive Outcomes

ERIC Educational Resources Information Center

Schaack, Diana D.; Le, Vi Nhuan; Messan Setodji, Claude

2017-01-01

Research Findings: Although there has been considerable research on the associations between the qualifications of teachers in center-based settings and preschool-age children's developmental outcomes, very little is known about the relationships between home provider qualifications and the developmental outcomes of toddlers who attend licensed…

Pathways for Academic Career and Employment (PACE) Program: Fiscal Year 2015 Report

ERIC Educational Resources Information Center

Iowa Department of Education, 2016

2016-01-01

The pathways for academic career and employment program (PACE) is established to provide funding to community colleges for the development of projects that will lead to gainful, quality, in-state employment for members of target populations by providing them with both effective academic and employment training to ensure gain. This is the second…

The attitudes of emergency department nurses towards patient safety.

PubMed

Durgun, Hanife; Kaya, Hülya

2017-11-23

This research was planned to identify the attitudes of emergency department nurses towards patient safety. The study was performed as descriptive. The universe of the research the universe comprised hospitals defined as 3rd level according to Turkish health care classification, which provides service to all health disciplines in Istanbul. The sample consisted of emergency department (ED) nurses who work in those hospitals. The data was collected by using tools such as the "Information Questionnaire" and the "Patient Safety Attitudes Scale". In this study, the attitudes of ED nurses towards patient safety were found to be average and was not related to age, gender, education level, nursing experience, ED experience, ED certification, patient safety training, nurse's self sufficiency perception of patient safety, hospital's quality certification or ED quality certification. The attitudes of nurses towards patient safety were compared by age, gender, marital status, education level, ED experience and there was no meaningful difference. However, a meaningful difference was found between the age groups and the "defining stress" sub-dimension of the Patient Safety Attitudes Scale. ED nurses' status of certification for emergency care, patient safety training, training of quality, hospitals' or ED's quality certification status had no significant statistical difference. Copyright © 2017 Elsevier Ltd. All rights reserved.

Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer

PubMed Central

Wiener, Lori; Weaver, Meaghann Shaw; Bell, Cynthia J; Sansom-Daly, Ursula M

2015-01-01

Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs). The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential phases of training. This article reviews unique epidemiologic, developmental, and psychosocial factors that make the provision of palliative care especially challenging in AYAs. A conceptual framework is provided for AYA palliative care education. Critical instructional strategies including experiential learning, group didactic opportunity, shared learning among care disciplines, bereaved family members as educators, and online learning are reviewed. Educational issues for provider training are addressed from the perspective of the trainer, trainee, and AYA. Goals and objectives for an AYA palliative care cancer rotation are presented. Guidance is also provided on ways to support an AYA's quality of life as end of life nears. PMID:25750863